1904. FORTY-NINTH ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE METROPOLITAN Borough of Islington. ALFRED EDWIN HARRIS MEDICAL OFFICER OF HEALTH. London: Vail & Co., Printers to the Council, 170, Farringdon Road, E C. 1905. MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November 1903, to November 1904). Mayor. ANDREW MITCHELL TORRANCE, D.L., J.P Aldermen. CUFFLIN, ROBERT S. EGGETT, H. GODDARD. SMALLWOOD, EDWARD. Councillors. 1. CADBURY-BROWN, H. 1. CLARKE, JOHN. 2. MACKIE, ALEXANDER 3. MAYO, JOHN A. 4 COLE, GEORGE 4. TRACY, EDWARD 5. PRICE, GEORGE E. 6. CROLE-REES, C. 7. CHEESLEY, HY. N. 7. PARKER. WM. B. 8. CALLENDER, H. W. 10. CROWTHER, R. W. 11. ANSELL, HENRY 11. SMYTH, JOHN W. Chairman Alderman SMALLWOOD. Vice Chairman Alderman EGGETT. OFFICERS OF THE Public Health Department. Medical Officer of Health. ALFRED EDWIN HARRIS, L.R C.S., L.R.C.P.Edin. Solicitor. ARTHUR MELLOR BRAMALL. Public Analyst. FRANK LITHERLAND TEED, D.Sc., F.I.C., F.C.S. Superintendent of Public Health Department and Chief Sanitary Inspector JAMES RICHARD LEGGATT. Inspector of Meat. HARGREAVES WILKINSON, Cert. Sanit. Inst. Inspector of Workshops and Bakehouses. GEORGE WEST. Inspectors of Houses let in Lodgings. JAMES JARVIS JORDAN. GEORGE JAMES BRIDEL, Cert. Sanit. Insp. Ex. Bd. Inspector appointed under the Sale of Food and Drugs Acts. WILLIAM WALTER WARD. Inspector of Workshops, &c., in which Females are employed. JESSY MACDONALD STEWART GRAY, Cert. Sanit. Inst. Inspectors of Nuisances and Sanitary Inspectors. District 1 WILLIAM COOK, Cert. Sanit. Inst. ,, 2 HARRY JAMES BICKNELL, Cert. Sanit. Inst. ,, 3 ALLEN BAGSHAW, Cert. Sanit. Inst. ,, 4 CHARLES THOMAS BACON, Cert. Sanit. Inst. ,, 5 WILLIAM HOLSGROVE FLOOD, Cert. Sanit. Inst. ,, 6 CHARLES EDWIN HORSMAN, Cert. Sanit. Inst. „ 7 EDWARD ISAAC FORTUNE, Cert. Sanit. Inst. ,, 8 JOHN METCALF, Cert. Sanit. Inst. ,, 9 WILLIAM IRVING, Cert. Sanit. Inst. ,, 10 HARRY JOHN JAMES WATSON, Cert. Sanit. Inst. ,, 11 TOM LEONARD BURRELL, Cert. Sanit. Inst. ,, 12 THOMAS WALLACE AGAR, Cert. Sanit. Inst. ,, 13 WILLIAM ROLFE. ,, 14 HARRY CALLOW, Cert. Sanit. Inst. Engineer in charge of Steam Disinfectors. JOSEPH TWIZELL. Caretaker of Shelter House. Mrs. TWIZELL. Mortuary Keeper. ARTHUR ROBINSON. Distributor of Disinfectants. JOHN REDDY. Disinfectors. JOHN WRIGHT and THOMAS DIXON. Clerical Staff. Chief Clerk GEORGE HAROLD KING. Second Clerk HENRY ANGEL Third Clerk GEORGE JAMES ELDRIDGE. Fourth Clerk EDWARD ALBERT ABBOTT. Fifth Clerk WALTER JOSEPH WOLFE. Sixth Clerk WILLIAM GEORGE BUNCH. Junior Clerk ARTHUR R. WITTRICK. EDWARD JOHN DURLEY. Messenger. iv INDEX. Page Adulteration of Food Ages at Death Annual Birth and Death rates, and Death-rates of Children 261 72 Appendicitis Area of Borough Areas and Densities of Metropolitan Boroughs 10 Artizans Dwellings 212 Bacteriological Diagnoses 157 Bakehouses 169 Barbers' Shops, Hygienic precautions 199 Baths and Washhouses 274 Births 18 Blowing Lamb and Veal 224 Brandy Adulteration, prosecutions 238 Cancer 75 Common Lodging House 211 Constitutional Diseases 75 Continued Fever 117 Cow Houses 226 Deaths 25 ,, from Classified Causes 35 „ at different age periods 28 ,, in the Quarters 28, 32-34 „ „ Sub-Districts 26, 31 „ Wards 27,32 „ „ Encircling Districts 66, 67 „ from Epidemic Diseases 41 Deaths registered from all causes during the Year 254 Deaths registered from all causes in each Quarter 257 Deaths since 1882, from specified Diseases 265 Deaths in Public Institutions 86 Death-rates of Metropolitan Boroughs 37 Diarrhoea 61 Diphtheria 56 ,, Fatality from 108 „ Notification of 106 Diphtheria and Croup 108 V. Page Disinfecting Station 162 Disinfection Work 161 District Inspection 186 Dust, removal of 206 Enteric Fever 59 „ Fatality from 112 „ Notification of 111 Epidemic Diseases 41 Erysipelas, Fatality from 114 „ Notification 113 Factories and Workshops 166 Fatality from Infectious Diseases 98, 135 Food, Adulteration of 233 Food Inspection 216 Hospital Isolation of Infectious Diseases 134 Houses Let in Lodgings 183 Ice Creams 232 Infantile Mortality 39 Infectious Diseases in Schools 129 Infectious Sickness in the several Wards from 1891-1904 267 Influenza 69 Inspection of Food 216 „ Kitchens of Restaurants 172 „ Slaughter Houses and Cow Houses 217 Local Government Board Returns 262, 263, 266 Margarine Act 236, 248 Marriages 14 Measles 49 Meat Inspection 216 Membranous Croup 106, 108 Milk Shops and Dairies 233 Mortality in Sub-Registration Districts 26 Mortuary and Coroner's Court 94 Notification of Infectious Diseases 96 „ „ ,, ,, in Registration Sub-Districts 97 „ „ ,, in the Sanitary Inspectors Districts 123 „ „ „ „ in the Wards 121, 122 „ „ ,, „ during the several Months 124 ,, ,, ,, ,, in the Encircling Districts 125, 126 „ ,, „ „ in Metropolitan Boroughs 127, 128 Notification of Pulmonary Consumption 324 „ „ Small Pox 98 Non-notifiable Infectious Diseases in Schools 130 Occupation of persons attacked with Infectious Disease 137 Offensive Trades 197 Overcrowding in Islington, Report on 277 Pauperism 208 Persons to an Acre 8 Phthisis 80 vi. Page Places where Food is prepared172 Population—Estimated in 1904 8 „ Sex and Age Distribution 11 „ in Sub-Districts 8 „ and Density of Wards 9 Population, Inhabited Houses, Marriages, Births, and Deaths 260 Preservatives in Food 250 Prosecutions, Summary of 249 Puerperal Fever 74 „ „ Notification of 115 „ ,, Fatality from 116 Pulmonary Consumption 80 Queensland Road Area 191 Relapsing Fever 117 Registered Lodging Houses 183 Respiratory Diseases 85 Sanitary Inspectors' Work 186 Scarlet Fever 54 „ Notification of 101 „ Fatality from 105 Seasonal Mortality 28 Septic Diseases 72 Shelter House 164 Slaughter Houses 217 Small Pox 49 „ Notification of 98 Streets where Infectious Disease occurred 143 Summary of Sanitary Work in fourteen Districts 202 Summary of Applications for Removal of Dust 207 Trades carried on in Houses where Infectious Disease has occurred 136 Tubercular Diseases 80 Typhus Fever 61, 113 Voluntary Notification of Consumption, Report on 324 Vaccination, State of 159 Venereal Diseases 85 Water Analysis 273 Water Certificates 200 Water Supply 252 Whooping Cough 58 Workshop Inspectors 166 REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1904. To the Right Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. Gentlemen, In presenting the 49th Annual Report on the Health and Sanitary condition of your Borough, I am glad to be able once more to congratulate you on its very healthy state, and its comparative freedom from epidemic diseases, so that it will compare most favourably in these respects with any community in the country with a similar population, notwithstanding the fact that none of them is so densely populated. It is a matter for regret that the birth-rate, with some slight fluctuations, has continued to decline steadily since 1875, and that in the year recently finished, it reached the lowest point hitherto chronicled. It is satisfactory to be able to report that the volume of work performed by your Sanitary Inspectors has been as full and as useful as in previous years, and that the workshops and places where men and women are employed continue to be improved. viii. I would desire to thank the Public Health Committee and particularly its Chairman, Alderman Smallwood, for the valuable assistance they have given, both to myself and the staff, in carrying on the work of the department, which at times is of a very arduous and thankless character, and to state that the knowledge that they generally approved our actions has been a great support to us in the discharge of our duties. Finally I would desire to thank Mr. J. R. Leggatt, the Superintendent and Chief Sanitary Inspector of the Public Health Department, and the Sanitary Inspectors, as well as Mr. G. H. King, the Chief Clerk, and the clerical staff, for the punctual and creditable manner in which they have performed their work. I am, Mr. Mayor, Aldermen and Gentlemen, Your obedient servant, Medical Officer of Health. Town Hall, Islington. June 1st. 1905. X. SUMMARY of Vital Statistics, 1904. Population Males 162,149 Females 178,895 Estimated increase on population, 1903 1,907 persons. Area 3,092 acres. Density 110 persons per acre. Marriages 2,948. Persons married 5,896. Persons married rate 17.29 per 1,000 inhabitants. Births Males 4,453 Females 4,437 Persons 8,890. Birth rate 26.06 per 1,000 inhabitants. Deaths from all causes Males 2,654 Females 2,582 Persons 5,234, Death rate „ ,, 15.35 per 1,000 inhabitants, Deaths from principal Epidemic Diseases Males 535 Females 71 606 persons. Death rate ,, „ ,, 1.78 per 1,000 inhabitants. Infantile Deaths under 1 year Males 646 Females 494 Total 1,140. Infantile mortality rate 128 per 1,000 births. Excess of Births over Deaths 3,654. Persons 341,044. PART I. POPULATION, AREAS AND DENSITIES OF THE SUB-REGISTRATION DISTRICTS, THE WARDS AND THE BOROUGH. 3 [1904 REPORT OF THE Medical Officer of Health FOR THE YEAR 1904. SUB-DISTRICTS, AREA, POPULATION AND DENSITY. Sub-Districts.—The Borough of Islington is for the purpose of the registration of births and deaths, divided into seven sub-registration districts, to each of which a registrar is appointed, so that fairly complete mortality returns are available for them. Originally, that is to say in 1837, when registration commenced, the parish consisted of only two such districts, but as time passed and it became more and more populous they were increased for the convenience of the public,* so that to-day they number seven as stated. Wards.—The Borough is also divided into eleven wards for the purpose of municipal representation in the Council, but the tabulation of the diseases and the deaths occurring in them has not been extended to the same degree as in the case of the sub-registration districts. Nevertheless particulars as to the notifiable infectious diseases, the gross number of deaths, and the deaths from the epidemic diseases have been extracted from the returns, and are dealt with in this report. Areas.—The Borough measures 3,092 statute acres, or nearly five square miles. These, which are the gross measurement, include 13.2 acres of water, b 2 * Vide Annual Report 1901, p. 7. 4 1904] consisting mainly of the Regent's Canal and New River, 158.5 acres covered by the Great Northern and North London Railways, 15.5 acres forming the Islington Cattle Market, and 37.5 acres laid out in parks and open spaces, of which Highbury Fields form 25 acres,† or a total of 224.7 acres, thus leaving the net area of the Borough at 2,867.3 acres. Sub-Registration Districts.—The size of the sub-districts vary considerably; thus Highbury comprises 798 acres, while Upper Holloway only consists of 290. The area of each sub-district has been measured as follows :— Highbury 798, South East Islington 545, Tufnell 417, Lower Holloway 413, Tollington 320, Barnsbury 309, and Upper Holloway 290 acres. Wards.—The Wards also are very unequal in size, as the following figures show:—Highbury 417 acres, Tufnell 417, Lower Holloway 413, Mildmay 337, Tollington 320, Upper Holloway 290, Canonbury 286, Thornhill 172, St. Peter 155, St. Mary 148, and Barnsbury 137 acres. Population.—The number of persons estimated to have been living in the Borough at the middle of the year was 341,044, of whom 162,149 were males and 178,895 were females, as compared with 339,137 persons of whom 161,246 were males, and 177,891 were females, in 1903. This population was distributed to the sub-registration districts in the following manner. Persons. Persons. Tufnell 33,225 Highbury 65,717 Upper Holloway 35,210 Barnsbury 54,186 Tollington 35,153 South-East Islington 75,964 Lower Holloway 41,589 Total 341,044 The Registrar General's estimated increase, if increase there were, of the population over the preceding year was only 1,907 persons, or slightly over one-half per cent., which is very different from that which used to obtain in previous years when the annual increase varied from 4 per cent to as high as 7 per cent. In this connection it will be of interest to note the population at the several censuses since 1801, and the actual and percentage increases from one enumeration to another. † Vide Annual Report 1898, p. 9. 5 [1904 Census Years. Enumerated Populations. Actual Decennial Increases. Percentage Increases. 1811 10,212 — — 1811 15,065 4,853 39.7 1821 22,417 7,352 40.5 1831 37,316 14,899 66.4 1841 55,776 18,460 49.4 1851 95,329 39,553 70.7 1861 155,341 60,012 63.1 1871 213,749 58,408 37.1 1881 282,865 69,116 32.3 1891 319,155 36,290 12.8 1901 334,991 15,836 10.5 These figures cover a period of one hundred years, and depict the steady growth of the population from census to census. That this growth could be maintained at the same rate of increase from period to period was of course impossible, but that it should have fallen off so greatly since 1881 is somewhat surprising. It is not that the houses in Islington are so fully occupied that they cannot hold any more people, for that this is not the case is proved by the fact that, at the present time, there are over 1,300 empty houses in the borough. These are, however, nearly all of the better class, houses of high rentals, and situated in neighbourhoods to which the clerk, the artisan, or the labourer do not resort. That so many houses of this class are empty is due to the increased facilities now given by railway companies and tramways to live in the country, to the desire to live in flats, and to the servant difficulty, which forces people to seek out non-basement houses, of which there are comparatively few in the borough. There is little doubt that if these empty houses had been built without basements, none or very few, would be empty to-day. Living underground, in however slight a degree, is repugnant to persons imbued with the teachings of modern sanitation, and consequently people, especially educated people, will not live in houses so built. These are not cheerful views for the owners of basement or semibasement houses in this borough, but the fact that they are correct will be endorsed by nearly every property agent in Islington, who will also declare that a non-basement house if in a good condition is snatched up the moment it is announced to be let. The continued increase of the population, slow though it be, is due entirely to the continued invasions of the Borough by the working classes, who 6 1904] occupy an ever increasing number of houses that were formerly occupied by members of one family, but are now let in tenements or lodgings. Let us see how far this is true. The censuses of 1891 and 1901 are fortunately available, and give the desired information. In 1891 one-roomed tenements numbered 12,856 „ 1901 „ , „ 12,955 Increase 99 In 1891 two-roomed tenements numbered 16,716 ,, 1901 ,, ,, 18,934 Increase 2,218 In 1891 three-roomed tenements numbered 11,806 „ 1901 ,, ,, ,, 14,379 Increase 2,573 In 1891 four-roomed tenements numbered 8,015 ,, 1901 ,, ,, ,, 9,533 Increase 1,518 Thus in the ten years there was an increase of 6,408 tenements, each containing from one to four rooms. These figures also indicate that 12,955 rooms were occupied in single tenements. 37,8658,, ,, two-roomed „ 43,137 „ „ three-roomed „ 38,132 „ „ four-roomed „ making a total of 132,092 rooms which were let out in tenements of the sizes mentioned. This was an increase of 18,326 rooms on the return of 1891, when the number so occupied was 123,766. 7 [1904 As to the number of persons living in these rooms, the census returns show that whereas 180,330 persons resided in them in 1891, 196,423 occupied them in 1901, being an increase of 16,093. These figures point to a very curious state of affairs, for they show that while the increase of the people living in the rooms had increased by only 16,093, the number of rooms themselves had increased by 18,326. This was mainly, if not entirely, due to the largely increased sanitary supervision that has been exercised in the borough since 1892, when the Public Health (London) Act came into force, and the consequent reluctance of the owners and agents of property of this class to let their rooms to persons with large families lest they should be proceeded against for overcrowding. This is well shown by the fact that the number of persons living in one-room tenements was reduced from 28,189 in 1891 to 25,988 in 1901, being a decrease of 2,201. The reduction in the average number of persons occupying each set of tenements has not been confined to the one-roomed tenements alone, for each class shows a decrease in the average number occupying them. Thus the average for two-room tenements fell from 3.63 persons in 1891 to 3.46 in 1901, or 4.3 per cent.; the average for three-room tenements from 4.21 to 4.0, or 5 per cent.; the average for four-room tenements from 5.21 to 4.95 or 5 per cent. Thus the reduction of lodgers per room has been general, and proves still further that overcrowding has not only been checked all round, but actually reduced, a fact on which the Council is to be heartily congratulated. In an appendix to this report a very important document is printed —("Report on Overcrowding")—which has been under the consideration of the Public Health Committee for some time. It is a careful analysis of the complete census returns for Islington, which had been placed by the London County Council at the disposal of the Medical Officer of Health, by whom it has been made. Density.—By the term "density" is meant the number of persons living on each acre of the borough. In Islington it is 110 persons as compared with 62.1 in the county of London, where only seven boroughs show a higher number, namely, Chelsea, 112.6, Holborn, 141.1, Finsbury, 168.0, Bethnal Green, 171.5, Stepney, 172.1, Shoreditch, 177.8, and Southwark, 183.8. Registration Sub-districts.—As might be expected these show considerable variation in their densities, ranging from 79 persons to an acre in Tufnell and 82 in Highbury, to 139 in Barnsbury and 139 in South-East Islington. In Lower Holloway there are 101 persons to the acre, in Tollington, 110, and in Upper Holloway 121. 8 1904] Wards.—The densities here also vary considerably, ranging from the lowest to the highest as follows:—Mildmay 74 persons per acre, Tufnell 79, Highbury 84, Lower Holloway 101, Tollington 110, Canonbury 111, St. Mary 117 Upper Holloway 121, Barnsbury 152, Thornhill 194, and St. Peter 211. When considering the death-rates of the various areas, it is well to have the preceding particulars respecting them in view, so as to appreciate the due significance of the figures. Table I. Showing the Areas, Densities, and Estimated Populations of the Sub-registration Districts at the middle of the year 1904. Sub-Districts. Area. Acres. Acres to a person. Persons to an Acre. Estimated Population Mid-year. 1904. Tufnell 417 0.0125 79 33,225 Upper Holloway 290 0.0082 121 35,210 Tollington 320 0.0091 110 35,153 Lower Holloway 413 0.0099 101 41,589 Highbury 798 0.0121 82 65,717 Barnsbury 309 0.0057 175 54,186 South-East Islington 545 0.0072 139 75,964 The Borough 3,092 0.0091 110 341,044 9 [1904 Table II. Showing the Areas, Densities and Estimated Populations of the Wards at the middle of the year 1904. WARDS. Area in Acres. Persons to an Acre, or Density of Population. Estimated Population Mid-year, 1904. No. 1—Tufnell 417 79 33,225 2—Upper Holloway 290 121 35,210 3—Tollington 320 110 35,153 4—Lower Holloway 413 101 41,589 5—Highbury 417 84 34,919 6—Mildmay 337 74 24,923 7—Thornhill 172 194 33,412 8—Barnsbury 137 152 20,774 9—St. Mary's 148 117 17,343 10—Canonbury 286 111 31,710 11—St. Peter's 155 211 32,786 The Borough 3,092 110 341,044 10 1904 Table III. Showing the Estimated Populations, Areas, Densities and Death-rates of London and of the several Metropolitan Boroughs in 1904, arranged in order of Density. Boroughs. Estimated Population, 1903. Area in Acres. (Density) Persons to each Acre Death Rates. All Causes. Zymotic Diseases. Cols. 1 2 3 4 5 London County 4,648,950 74,839 62.1 16.1 2.14 Woolwich 123,416 8,276 14.9 14.3 2.40 Lewisham 140,401 7,014 20.0 12.0 1.41 Greenwich 101,651 3,852 26.4 14.4 2.26 Wandsworth 257,448 9,129 28.2 13.4 1.73 City of London 23,482 671 35.0 16.7 0.60 Hampstead 86,663 2,265 38.3 10.2 0.66 Hammersmith 117,412 2,286 51.4 15.7 2.53 Camberwell 268,384 4,480 59.9 14.9 1.90 Stoke Newington 52,445 863 60.8 13.3 1.13 Hackney 226,266 3,288 68.8 14.9 2.13 City of Westminster 177,321 2,502 70.9 13.5 0.87 Deptford 113,509 1,562 72.7 16.1 2.46 Poplar 169,905 2,327 73.0 18.6 3.35 Lambeth 310,359 4,080 76.1 15.8 2.10 Kensington 179,236 2,291 78.2 14.3 1.45 Battersea 175,465 2,160 81.2 14.5 2.02 Bermondsey 129,397 1,500 86.2 20.0 3.52 St. Pancras 235,936 2,694 87.6 17.4 2.01 St. Marylebone 130,337 1,472 88.5 16.2 1.51 Fulham 152,482 1,703 89.5 15.4 2.49 Paddington 146,975 1,356 108.3 13.8 1.56 Islington 341,044 3,092 110.0 15.3 1.78 Chelsea 74,329 660 112.6 16.5 1.49 Holborn 57,161 405 141.1 18.5 1.80 Finsbury 98,958 589 168.0 21.3 2.57 Bethnal Green 130,207 759 171.5 19.3 2.95 Stepney 303,791 1,765 172.1 19.4 2.84 Shoreditch 117,033 658 177.8 20.4 3.20 Southwark 207,937 1,131 183.8 20.1 3.13 11 [1904 Table IV. Showing the Estimated Number of Persons living in Islington at the middle of 1904, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 18,552 18,110 36,662 5—15 31,451 31,540 62,991 15—25 32,008 35,869 67,877 25—35 29,320 32,802 62,122 35—45 21,127 23,293 44,420 45—55 14,775 16,935 31,710 55—65 9,280 11,300 20,580 65—75 4,208 6,245 10,453 75 and upwards 1,428 2,801 4,229 All ages 162,149 178,895 341,044 Table V. Showing the number of Persons in the several Districts mentioned living at Nine Groups of Ages in every thousand of their populations. DISTRICTS. —5 —15 —25 —35 —45 —55 —65 —75 75 and ards England and Wales 114 210 196 162 123 89 60 33 13 Urban Districts 114 207 201 168 124 88 57 30 11 Rural ,, 114 221 177 142 118 92 70 45 21 London 109 190 203 179 130 91 57 29 12 Islington 108 185 199 182 130 93 60 31 12 PART II. MARRIAGES, BIRTHS AND DEATHS. 1904] 14 MARRIAGES. The number of persons married in 1904 was 5,896 as compared with 6,106 in the preceding year, and with 5,985, the average for the ten years 1894-1903. The marriage rate was 17.29 per 1,000 inhabitants as against 18.00 in 1903 and with the decennial rate of 17.81. The rate now recorded is the lowest since 1895, when the proportion of persons married was only 15.97 per 1,000 of the population. The Registrar-General in his report for 1903 points out that the total population is not a satisfactory standard by which to measure the rate of marriage; and that a better standard is obtained by eliminating the married persons from the population, and by calculating the rates on the unmarried and widowed portion of the population aged 15 years and upwards, and so dealing with only that section of the people in which marriage takes place. This proposition is of course self-evident, for it is absurd to include infants and children in the basis of calculation, whose numbers vary considerably in various communities, and who, of course, are not eligible for marriage. It is unfortunate that the figures with respect to the borough are not easily ascertainable, and, therefore, it is impossible to show what the marriage rates would be if calculated on the basis suggested by him. It may, however, be interesting to show what occurs in England, and therefore a table calculated by the two methods has been extracted from the Registrar-General's Report for 1903, and is now printed. Calculated on total population at all ages, Calculated on the unmarried and widowed population, aged 15 years and upwards. Rate per 1000. Compared with rate in 1880-82 taken as 100. Rate per 1000. Compared with rate in 1880-82 taken as 100. 1880-82 15.2 100 57.5 100 1890-92 15.5 i02 49.8 97 1900-02 15.9 105 48.7 95 15 [1904 The Registrar-General remarks on these figures that "it will be seen that the two methods used for calculating the marriage-rate lead to very different conclusions, for while the proportion of marriages to total population at the successive census periods have shown a progressive increase, on the other hand, the proportions to the unmarried and widowed population, aged 15 years and upwards, have shown a progressive decrease. There can be no doubt that the changes in the marriage-rate are misrepresented by the former, but are shown with approximate accuracy by the latter method." Table VI. Showing the number of Persons Married and the Marriage Rates in the Borough in 1904. No. persons married. Persons married per 1,000 inhabitants. 1st quarter 946 11.10 2nd „ 1,608 18.86 3rd „ 1,768 20.73 4th „ 1,574 18.46 The year 5,896 17.29 16 1904] Table VII. Showing the Marriages and the Marriage Rates in the Borough during the preceding ten years. Years. No. persons married. Persons married per 1ooo, inhabitants. 1894 5.,388 16.23 1895 5,360 15.97 1896 5,938 17.58 1897 6,000 17.79 1898 6,410 19.°3 1899 6,508 19.35 1900 5,936 17.67 19O1 5,988 17.85 1902 6,2l6 18.o8 1903 6,106 18.00 Mean of 10 years 5,985 17,81 1904 5,896 17,29 Increase on mean 89 0,52 17 [1904 Table VIII. Showing the Marriages and Marriage Rates in Six Decennial Periods, 1841-1900. Periods Marriages. Persons married per 1,000 of the Population. 1841-50 6,109 16.03 1851-60 10,901 18.12 1861-70 16,194 17.55 1871-80 20,889 17.06 1881-90 23.324 15.55 1891-1900 28,947 17.44 1904 5,896 17.29 18 1904] BIRTHS. The births of 8,890 children, of whom 4,453 were males and 4,437 females, were registered. These are equal to an annual birth-rate of 26.06 per 1000, which is the lowest birth-rate recorded in the last twenty-eight years, and probably the lowest which has been known since 1843. An examination of the figures given on the next page will in this connection repay perusal. The following statement gives the birth-rate for the country as well as for some of the most populous places :— England and Wales 27.9 per thousand. 76 Great Towns 29.1 „ „ „ less London 29.5 „ 142 Smaller Towns 27.5 „ London 27.9 „ Birmingham 31.6 „ Liverpool 33.7 „ Manchester 31.3 „ Leeds 28.0 „ Sheffield 32.0 „ Bristol 26.7 „ St. Pancras 26.0 „ Stoke Newington 21.8 „ Hackney 27.3 „ Hornsey 19.9 „ Finsbury 3.4 „ Shoreditch 32.1 „ The Encircling Districts 27.5 „ Islington 2606 „ The Births and Birth-rates in the seven sub-districts were as follows:— Births. Birth-rates. Tufnell 799 24.05 Upper Holloway 1,066 30.28 Tollington 815 23.18 Lower Holloway 1,114 26.79 Highbury 1,423 21.65 Barnsbury 1,672 30.85 South East Islington 2,001 26.34 The Borough 8,890 26.06 19 [1904 Birth-rates of Islington from 1841 to 1904. Year. Year. Year. 1841 •25.58 1861 35.31 l88l 34.87 1842 25.28 1862 34.76 1882 34.79 1843 25.86 1803 36.51 1883 34.19 1844 27.18 1864 36.84 1884 33.54 1845 26.20 1865 37.9° 1885 32.45 1846 29.13 1866 38.02 1886 32.66 1847 2975 1867 38.97 1887 31.92 1848 30.76 1868 38.86 1888 31.10 1849 30.13 1869 37.24 1889 30.79 1850 32.96 1870 36.77 1890 29.16 Mean . 28.65 Mean 37.20 Mean 32.56 1851 31.46 1871 35.63 1891 30.68 1852 34.19 1872 36.36 1892 29.68 1853 34'81 1873 36.89 1893 29.83 1854 35.5° 1874 37.I6 1894 28.91 1855 35.37 1875 37.67 1895 29.81 1856 34.97 1876 37.26 1896 28.87 1857 34.89 1877 36.85 1897 29.33 1858 33.57 1878 36.28 1898 28.07 1859 35.13 1879 36.08 1899 28.71 1860 34.84 1880 35.86 1900 27.55 Mean 34.54 Mean 36.60 Mean 29.11 1901 27.62 1903 26.48 1902 26.80 1904 . . 2606. C 2 20 1904] The continued decline in the birth.rate was commented on in the Annual Report for 1902, and, therefore, there is little to say on this subject now. It is a matter, which is, however, causing considerable anxiety in the country, fcr the decrease is a national one. Indeed, in a Report of the Registrar.General he states that in the year with which it deals, 1903, the rate was the lowest on record. In that report it is stated that the total population is not the most satisfactory standard by which to measure the birth rate, because it does not take account of the age constitution of the population, and particularly the age constitution of the female population of conceptive age. For instance, the proportion of women aged 15.45 to the total population of England and Wales, which in 1871 and 1881 was 23.1 per cent., rose to 23.8 per cent. in 1891 and to 25.0 per cent. in 1901. If, therefore, the average fecundity of the female population at these ages had remained constant, the birth rate in proportion to total population would have increased during the past 30 years by nearly 2 per cent.; stated in another way, had the ratio of births to the female population of conceptive ages been identical in 1871 and in 1903, the births registered in the latter year would have amounted to upwards of one and a quarter millions, instead of the 984,271 actually recorded. Further from 1871 to 1903 the female population aged 15.45 contained a constantly decreasing proportion of married women, among whom the proportion of those at ages under 25 years has continuously decreased. In view of these facts, the Registrar General thinks that it is evident that a preferable method by which to measure the birth rate is to calculate the proportion of births per 1,000 women of conceptive age. He then shows by certain tables that the decrease in the birth-rate is not adequately shown. In his Annual Summary for 1904 he continues this argument, and there shows that if the ratio of births to the female population had been the same in 1871 and 1904, the births registered in London would have amounted to upwards of 166,000, instead of the 129,335 actually registered. If this method were applied to Islington, but taking 1881 as the oasis instead of 1871, the figures for which are not available, there would have been fully 12,021 births, instead of 8,890, the number actually registered, or an addition of 3,131 births. If, on the other hand, the birth rate that attained in 1880-2 were applied to the total population for 1904, there would have been 11,982 births, instead of 8,890 the actual number registered, or an addition of 2,092. 21 [1904 From these figures it can be discerned plainly that the method of calculating the birth rate on the total population does not give a true idea of the great falling off that has taken place in the number of children born annually. PERIOD. BIRTHS. Calculated on Total Population at all ages. Calculated on Female Population aged 15-45 Rate per 1,000. Compared with rate in 1880-2 taken at 100. Rate per 1,000. Compared with rate in 1880-2 taken as 100. 1880-2 35.13 100 133.1 100 1890-2 29.92 85 113.4 85 1900-2 27.59 79 102.3 77 1903 26.48 75 98.2 74 19°4 2606 74 967 73 It should be stated that a number of women living in this borough, are confined in public institutions outside its bounds, particularly in the City of London Lying-in Hospital, Finsbury, and that consequently the Islington birth rate suffers slightly. It is much to be regretted that some measures are not adopted to correct the birth rate similar to those that now obtain with respect to the death rate, Illegitimate Births.—These numbered 273, which was the largest number registered since 1899 when the return was 279. Since 1891, when compared with former years there has been a decrease in these births. From 1851 to 1860 the average was 135 per annum, in the next decade, 1861-70, it was 261, in the decade 1871-80, 342, and from 1881 to 1890 347, since which period the average number of illegitimate births has been 247. 22 1904] Table IX. Illegitimate Births registered in Islington during the years 1841-1904. Years. Births. Years. Births. Years, Births, Years. Births. Years Births. Years. Births. Years. Births. 1841 ♦ 1851 100 1861 184 1871 280 1881 380 1891 265 1901 228 1842 33 1852 100 1862 207 1872 346 1882 353 1892 298 1902 248 1843 * 1853 95 1863 224 1873 335 1883 370 1893 267 1903 242 1844 * 1854 125 1864 248 1874 344 1884 341 1894 290 1904 273 1845 43 1855 126 1865 291 1875 363 1885 327 1895 286 1846 53 1856 149 1866 272 1876 361 1886 331 1896 242 1847 64 1857 151 1867 306 1877 337 1887 350 1897 269 1848 85 1858 140 1868 317 1878 303 1888 345 1898 262 1849 74 1859 174 1869 284 1879 401 1889 350 189 279 1850 97 1860 175 1870 318 1880 359 1890 328 1900 261 1851 1861 1871 1881 1891 1901 6 yrs. 449 10 1335 to 2651 10 3429 10 3475 10 2719 10 991 1860 1870 1880 1890 1900 1904 The birtns in these years could not be ascertained. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1904, and in the four quarters of the year and of London and the Great Towns during the same period ; also the mean Borough Birthrates for the years 1894-1903. Birth Rates. Quarter. Males. Females. Total. Islington, 1904. Islington. 1894-03. London, 1904. 76 Great Towns, 1904. 1st 1,151 1,122 2,273 26.66 29.30 28 7 29 7 2nd 1,104 1,183 2,287 26.82 27.78 28.1 29 5 3rd 1,091 1,113 2,204 25 85 28.20 27.6 29 0 4th 1,107 1,019 2,126 24 93 28 33 27 2 28.1 The Year 1904 4,453 4,437 8,890 26 06 28.26 27.9 29.1 1903 4,653 4,330 8,983 26 .48 26 .06 28.5 29.7 Increase or decrease -200 + 107 -93 -0 42 -2 .20 -0 .6 -0.6 to co CD O Table XI. showing the Births of Males and Females in each quarter and for the year, 1904, in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Bamsbury. South-East Islington. The Borough. Males. Females. Total. Males. Females. Total Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Qr 117 93 210 147 142 289 103 116 219 137 150 287 164 164 328 221 202 423 262 255 517 1,151 1,122 2,273 2nd ,, 105 91 196 125 136 261 109 104 213 142 139 281 177 202 379 192 233 425 254 278 532 1,104 1,183 2,287 3rd ,, 109 120 229 130 124 254 103 85 188 124 134 258 188 185 373 199 209 408 238 256 494 1,091 1,113 2,204 4th ,, 89 75 164 135 127 262 101 94 195 155 133 288 169 174 343 229 187 416 229 229 458 1,107 1,019 2,126 Year 420 379 799 537 529 1,066 416 399 815 558 556 1,114 698 725 1,423 841 831 1,672 983 1,018 2,001 4,453 4,437 8,890 24 1904] Table XII. Showing the Birth-rates for each quarter and for the year 1904, of Islington, of London, and of the 76 Great Towns. Sub-Districts. 1 St Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Tufnell 25.28 23.59 27.57 19.74 24.05 Upper Holloway 32.82 29.64 28.85 29.76 30.28 Tollington 24.92 24.24 21.39 22.19 23.18 Lower Holloway 27.62 27.02 24.81 27.70 26.79 Highbury 19.96 23.06 22.70 20.88 21.65 Barnsbury 31.22 31.37 30.11 30.71 30.85 Islington, S. East 27.22 28.01 26.01 24.11 26.34 The Borough 26.66 26.82 25.85 24.93 26.06 London 28.7 28.1 27.6 27.2 27.9 76 Great Towns 29.7 29.5 29.0 28.1 29.1 Table XIII. Showing the Population, Births, and Birth-rates in Six Decennial Periods, 1841 to 1900, and in 1904. Periods. Mean Population in each Decade. Number of Births in each Period. Birth-rates. Average Yearly Number of Births, corrected on the basis of the population of 1904. 1 2 3 4 5 1841-50 72,767 20,850 28.65 9,774 1851-60 121,353 41,915 34.54 11,780 1861-70 181,529 67,520 37.20 12,684 1871-80 244,884 89,627 36.60 12,483 1881-90 299,857 97,647 32.56 11,105 1891-1900 331,868 96,607 29.11 9,928 1904 341,044 8,890 26.06 8,890 25 [1904 DEATHS. Once more the mortality returns for the borough are exceptionally good, so good, indeed, that only on one previous occasion have they been better, namely, in the preceding year, when the death-rate was only 14.2 per 1,000. Now the deaths number only 5,236, of which 2,654 were those of males, and 2,582 of females, and the death-rate was 15.35 per 1,000 of the population. So that the improvement in the death-rate may be understood the returns since registration was commenced in 1838 are reprinted from a report issued five years ago. In these it will be noticed that there has been a steady improvement since 1870, and that in each succeeding decade the death-rate has fallen progressively. In the ten years 1861-70 it was 24.64, in the next decade 1871-80 it averaged 20.40, in the succeeding decade 1881-90 it fell to 18.60, and in the decade 1891-1900 it was as low as 17.50 per 1,000 inhabitants, since which period it has averaged only 15.44 per 1,000. Thus there has been a steady decrease. The question naturally arises, to what is this due ? The causes are not far to seek : first, improved public sanitation ; second, an improvement in private sanitation—that is to say more orderly and more cleanly homes, &c. ; and third, the education of the people. These points might be argued at length, but the limits of such a report as this prevent their discussion. It is noticeable that during the fourteen years, which is to say since the Public Health London Act 1891 was enacted, and particularly since 1895, when its provisions were more stringently enforced, the death-rates have been exceedingly low. Indeed the death-rate during the last four years has almost been phenominal in a borough like Islington, containing as it does so many of the working classes. The borough is to be congratulated on its healthy state. The death-rates which follow have been calculated for each year on a careful estimate of the populations as revealed by the census returns which were obtained at the close of each successive decade. Years. Deaths. Death-rates. Years. Deaths. Death-rates. 1838 1,147 22.96 1844 1,294 19.94 1839 1,018 19.58 1845 1,258 17.96 1840 1,042 19.25 1846 1,383 18.72 1847 1,624 20.83 1838-40 3,207 20.55 1848 1.745 21.22 1849 1,891 21.80 1841 1,013 17.91 1850 1,609 17.58 1842 1,101 18.46 1843 1,115 17.72 1841-50 14,033 19.28 26 1904] Years. Deaths. Death-rates. Years. Deaths. Death-rates. 1851 2,082 21.59 1881 5,617 19.79 1852 2,086 20.60 1882 5,643 19.65 1853 2,395 22.52 1883 5,561 19.12 1854 2,800 25.07 1884 5,515 18.74 1855 2,680 22.85 1885 5,740 19.27 1856 2,677 21.74 1886 5,434 18.02 1857 3.586 20.00 1887 5,699 18.67 1858 2.777 20.44 1888 5,197 16.82 1859 2,898 20.32 1889 5,035 16.10 1860 3,028 21.21 1890 6,152 19.43 1851-60 26,009 21.43 1881-90 55,782 18.60 1861 3,123 19.94 1891 6,326 19.77 1862 3,496 21.62 1892 6,075 18.78 1863 4,340 26.00 1893 6,391 19.55 1864 4,594 26.65 1894 5,263 15.92 1865 4,617 25.94 1895 5,760 17.24 1866 5,154 28.06 1896 5,884 17.42 1867 4,509 24.55 1897 5,395 16.00 1868 4,886 24.95 1898 5,705 16.94 1869 4,937 24.42 1899 6,293 18.71 1870 5,078 24.33 I900 5,721 17.03 1861-70 44,734 24.64 1891-1900 58,813 17.50 1871 5,048 23.44 1901 5,361 15.98 1872 4,196 18.95 1902 1903 5,635 4,839 16.71 14.27 1873 4,156 18.25 1904 5,236 15.35 1874 4,816 20.57 1875 4,833 20.07 1901-04 21,071 I5.58 1876 4,969 20.07 ______ 1877 5,111 20.07 1878 5,376 20.53 1879 5,456 20.27 1880 5,716 20.65 1871-80 49,977 20.40 The Mortality in the Sub-Registration Districts.—The mortality rates ranged from 1179 per 1,000, caused by 775 deaths in Highbury, to 17.77, representing 963 deaths in Barnsbury. In the other sub-districts the 27 [1904 death-rates were as follows:—Tufnell, 17.18 (571 deaths), Tollington, 13.51 (475 deaths), Lower Holloway, 16.66 (693 deaths), South-East Islington, 16.27 (1,236 deaths), and Upper Holloway, 14.85 per 1,000 (523 deaths). Some of these death-rates are very low, especially that of Highbury, when it is recollected that they represent the mortality of communities which are as large as, or even larger than, many places which are tabulated by the Registrar-General among the large towns of England and Wales. The Borough Death rate contrasted with those of other places. —We have seen that the death-rate for the year contrasts favourably with previous death-rates; let us now see how it compares with those of other places. In the country generally, that is in all England and Wales, the death-rate was 16.23 per 1,000, a rate almost identical with Islington's. In the 76 Great Towns it was 17.24, in 142 Smaller Towns 15.6, and in Rural England 15.3. In the six great urban districts which are larger than this borough, the death-rates were as follows:—In Bristol, 15.62, in Birmingham, 19.88, in Liverpool, 22.59, in Manchester, 21.27, in Leeds, 18.02, and in Sheffield, 16.79 Per 1,000, which returns are higher than the local returns. In the County of London the death-rate was 161 per 1,000, and in the six boroughs which surround this borough the rates were as follows:—St. Pancras, 17.4, Stoke Newington, 13.3, Hackney, 14.9, Hornsey, 8.4, Finsbury, 21.3, and Shoreditch, 20.4 per 1,000 of their population. Notwithstanding the exceedingly low death-rates in Stoke Newington and Hornsey, the death rate of the Encircling Boroughs taken in the aggregate, was above the Islington rate, namely 16.4, per 1,000, as compared with the borough rate of 15.35. (Vide Table LII.) The Mortality in the Wards varied from 11.87 Per 1,000 (296 deaths), in Mildmay, and 11.88 (415 deaths) in Highbury, to 17.66 (579 deaths) in St. Peter's, and 17.92 (599 deaths) in Thornhill. In the other wards the death-rates were 17.18 (571 deaths) in Tufnell, 14.85 (523 deaths) in Upper Holloway, 13.51 (475 deaths) in Tollington, 16.66 (693 deaths) in Lower Holloway, 17.52 (364 deaths), in Barnsbury, 15.39 (267 deaths) in St. Mary's, and 14.31 (454 deaths) in Canonbury. In the second quarter of the year, Mildmay Ward exhibited the unusually low mortality-rate of 9.46 per 1,000, and in the third quarter 10.42. It is very satisfactory to note that in the two wards of Highbury and Mildmay containing an aggregate population of 59,842, the death-rate was only 11.88 per 1,000. 28 1904] Ages at Death.—In the annexed table (XV.) there is a full statement of the number of persons who died at twelve age periods. On examining this table the first and most notable feature that presents itself is that at each of the age periods under 55 years there was a decrease in the number of deaths. Thus, during the first year of life the number fell from an average of 1,351 to 1,140 being a decrease of 211; in the period 1 to 5 years the number decreased from the average of 754 to 603, a decrease of 151; in the period 5 to 15 the number fell from 203 to 165, or a decrease of 38; in the period 15 to 25 there was a decrease from 318 to 295, or 23; in the period 35 to 45 the diminution was from 449 to 439, a decrease of 10, and in the period 45 to 55, the number decreased from 531 to 521 being a fall of 10. At the remaining age periods there was an increased mortality, thus in the period 55 to 65, the number of deaths rose from 584 to 603, in the period 65 to 75 from 613 to 666, in the period 75 to 85 from 452 to 496, and in the period 85 to 95 from 104 to hi. In the period 95 and upwards there was a decrease of 3 deaths. These figures are even better than they have appeared, because no allowance has been made for the increase in the population. SEASONAL MORTALITY. The mortality in the quarters was variable, for although the deaths numbered as many as 1,436 in the first quarter, they decreased to 1,106 in the second, but increased to 1,284 in the third, and to 1,410 in the fourth. Table XIV. Showing the Deaths and Death-Rates of Islington in 1904, and in the four quarters of the year, of London and the Great Towns during the same period ; also the mean Borough Death-Rates for the years 1894-03. Quarter. Males. Females. Total. Islington, 1904. Death Rates. 76 Great Towns, 1904. Islington, 1894-03. London, 1904. First 681 755 1,436 16.84 19.60 17.8 18.7 Second 607 499 1,106 12.97 14.96 14.3 15.3 Third 655 629 1,284 15.06 15.14 15.8 17.5 Fourth 711 699 1,410 16.53 16.77 16.4 17.5 The Year 1904 2,654 2,582 5,236 15.35 16.62 16.1 17.2 1903 2,523 2,316 4,839 14.26 15.35 15.2 16.3 Increase or decrease + 131 + 266 + 397 + 1.09 -1.27 +0.9 +0.9 Table XV. Showing the Ages at Death during the Years 1894—1903 and in 1904. Years. AGES. 0—1 1—5 All under 5 yrs. 5—15 15—25 25—35 35—45 45—55 55—65 65—75 75—85 85—95 95 upwards All above 5yrs. Totals 1894 1,229 885 2,114 259 231 329 388 452 485 541 389 72 3 3,149 5,263 1895 1,416 803 2,219 220 231 333 461 507 561 616 500 104 8 3,541 5,76o 1896 1,490 1,008 2,498 277 228 290 465 564 493 59i 385 91 2 3,386 5,884 1897 1,338 679 2,017 207 230 297 474 496 546 585 449 91 3 3,378 5,395 1898 1,504 924 2,428 161 196 292 435 497 560 585 444 105 2 3,277 5,705 1899 I,548 767 2,315 212 248 349 486 610 700 712 540 115 6 3,978 6,293 1900 !,344 612 1,956 183 233 339 480 605 664 678 469 111 3 3,765 5,721 1901 1,290 638 1,928 176 210 315 444 511 631 592 451 98 5 3,433 5,36I 1902 1,219 687 1,906 198 222 339 470 571 664 656 468 141 — 3,729 5,635 1903 1,136 538 1,674 139 201 299 390 491 533 577 423 112 — 3,165 4,839 Mean. i,35i 754 2,105 203 223 318 449 531 584 613 452 104 3 3,480 5,585 1904 1,140 603 1,743 165 197 295 439 521 603 666 496 111 3,493 5,236 Increase or Decrease -211 -151 -362 -38 -26 -23 -10 -10 + 19 + 53 +44 +4 13 -349 80 1904] Table XVI. Showing the Estimated Population, together with the Deaths and Deathrates from All Causes, at Nine Age-periods of life among Males, Females, and Persons. Males. Females Persons. Ages. Population. Deaths. Death Rates. Population. Deaths. Death Rates. Population. Deaths. Death Rates. 0—5 18,552 967 52.12 18,110 776 42.84 36,662 1,743 47.54 5—15 31,451 84 2.67 31,540 81 2.57 62,991 165 2.62 15—25 32,008 84 2.62 35,869 113 3.15 67,877 197 2.90 25—35 29,320 151 5.15 32,802 144 4.39 62,122 295 4.75 35—45 21,127 226 10.70 23,293 213 9.14 44,420 439 9.88 45—55 14,775 278 18.81 16,935 243 14.35 31,710 521 16.43 55—65 9,280 313 33.73 11,300 290 25.66 20,580 603 29.30 65-75 4,208 324 77.00 6,245 342 54.77 10,453 666 63.71 75 and upwards 1,428 227 158.96 2,801 380 135.67 4,229 607 143.53 All ages 162,149 2,654 16.36 178,895 2,582 14.43 341,044 5,236 15.35 *The deaths of 649 persons who had come from other districts of London for treatment in the Public Institutions of Islington are excluded from these returns, while the deaths of 627 persons who had died outside the district are included. 81 [1904 Table XVII. Showing the Deaths and Death Rates from All Causes in the several Sub-Registration Districts. SUB-DISTRICTS. Males. Females Totals. Death Rates. Tufnell 307 264 571 17.18 Upper Holloway 247 276 523 14.85 Tollington 257 2l8 475 13.51 Lower Holloway 364 329 693 16.66 Highbury 372 403 775 11.79 Barnsbury 474 489 963 17.77 South-East Islington 633 603 1,236 16.27 The Borough 2,654 2,582 5,236 15.35 Previous year 1903 2,523 2,316 4,839 14.26 82 1904] Table XVIII. Showing the Deaths and Death-rates from All Causes in the Wards during the Four Quarters of 1904. Wards. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 156 18.78 111 13.36 144 17.33 160 19.26 571 17.18 Upper Holloway 142 16.12 128 i4.54 100 11.36 153 17.38 523 14.85 Tollington 124 14.11 115 13.08 105 11.95 131 14.90 475 13.51 Lower Holloway 167 16.07 125 12.02 205 19.71 196 18.85 693 16.66 Highbury 120 13.74 103 11.80 96 10.99 96 10.99 415 11.88 Mildmay 93 14.92 59 9.46 62 10.42 82 13.16 296 11.87 Thornhill 157 18.79 126 15.08 159 19.03 157 18.80 599 17.92 Barnsbury 103 19.83 78 15.01 79 15.21 104 20.02 364 17.52 St. Mary's 72 16.60 52 11.99 65 14.99 78 17.98 267 15.39 Canonbury 140 17.66 90 11.35 110 13.87 ii4 14.38 454 14.31 St. Peter's 162 19.76 119 14.51 159 19.40 139 16.95 579 17.66 The Borough 1,436 16.84 1,106 12.97 1,284 15.06 1,410 16.53 5,236 15.35 N.B.—The heavy figures show the healthiest Ward in the several periods to which they refer. 88 [1904 Table XIX. Showing the Deaths and Death Rates from All Causes for each Quarter since 1885. (The Lowest Death Rates are printed in heavy type.) QUARTERS. Years. First. Second. Third. Fourth. Year. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. 1885 1,551 20.83 1,445 19.40 1,392 18.68 1,352 18.15 5,740 19.27 1886 1,675 22.22 1,151 15.26 1,364 18.09 1,244 16.50 5,434 18.02 1887 1,474 19.32 1,365 17.89 1,450 19.00 1,410 18.48 5,699 18.67 1888 1,629 21.09 1,163 15.05 1,072 13.88 1,333 17.25 5,197 16.82 1889 1,440 18.42 1,186 15.17 1,101 14.07 1,308 16.73 5,035 16.10 1890 1,789 22.60 1,359 17.16 1,282 16.20 1,722 20.20 6,152 19.43 1891 1,698 21.22 1,725 21.56 1,299 16.23 1,604 20.05 6,326 19.77 1892 2,193 27.13 1,260 15.57 1,231 15.22 1,391 17.20 6,075 18.78 1893 1,597 19.53 1,485 18.16 1,558 19.06 1,751 21.41 6,391 19.55 1894 1,613 19.52 1,284 15.54 1,131 13.68 1,235 14.94 5,263 15.92 1895 1,936 23.18 1,210 14.48 1,292 15.47 1,322 15.83 5,760 17.24 1896 1,664 19.71 1,382 16.37 1,336 15.82 1,502 17.79 5,884 17.42 1897 1,421 16.85 1,081 12.82 1,335 15.83 1,558 18.48 5,395 16.00 1898 1,744 20.71 1,246 14.80 1,439 17.09 1,276 15.15 5,705 16.94 1899 1,681 19.99 1,281 15.23 1,572 18.70 1,759 20.92 6,293 18.71 1900 1,819 21.66 1,390 16.55 1,221 14.54 1,291 15.37 5,721 1703 1901 1,411 16.83 1,253 14.94 1,216 14.50 1,481 17.66 5,361 15.98 1902 1,796 21.30 1,220 14.47 1,149 13.62 1,470 16.19 5,635 16.71 1903 1,333 16.31 1,226 14.46 1,031 12.16 1,199 14.14 4,839 14.27 Corrected Mean 19 years 1,741 20.42 1,366 16.02 1,346 15.78 1,503 17.63 5,956 17.46 1904 1,436 16.84 1,106 12.97 1,284 15.06 1,410 16.53 5,236 15.35 Increase or Decrease .305 -3.58 -260 -3.05 -62 -0.72 -93 -1.10 -720 -2.11 10 84 1904] Table XX. Showing the Deaths and Death-rates from All Causes in the Four Quarters and in the Sub-districts, together with the Death-rates in the Borough during the same periods. Quarters. Tufnell. Upper Holloway, Tollington. Lower Holloway. Highbury. Barnsbury. South-east Islington. The Borough. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates First Quarter 156 18.78 142 16.12 124 14.11 167 16.07 231 14.05 260 19.19 356 18.74 1,436 16.84 Second Quarter 111 13.36 128 14.54 115 13.08 125 12.02 173 10.53 204 15.06 250 13.16 1,106 12.97 Third Quarter 144 17.33 100 11.36 105 11.95 205 19.71 181 11.01 238 17.56 311 16.37 1,284 15.06 Fourth Quarter 160 19.26 153 17.38 131 14.90 196 18.85 190 11.56 261 19.27 319 16.80 1,410 16.53 The Year 571 17.18 523 14.85 475 13.51 693 16.66 775 11.79 963 17.77 1,236 16.27 5,236 15.35 N.B.—The figures for the healthiest quarter of each district are printed in heavy type CO ©T (—4 cd O Table XXI. Showing the Deaths and Death-rates from eleven Classified Diseases in the Sub-Districts and in the Borough. Classified Diseases. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. The Borough. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths Death Rates. Deaths. Death Rates. Deaths. Death Rates. Miasmatic 38 1.14 38 1.08 37 1.05 62 1.49 48 0.73 88 1.62 88 1.16 399 1.17 Diarrhœal 17 0.51 19 0.54 25 0.71 53 1.27 28 0.42 63 1.16 55 0.72 260 0.76 Constitutional 119 3.58 129 3.66 105 2.99 152 3.65 166 2.53 179 3.30 266 3.50 1,116 3.27 Developmental 45 1.35 37 1.05 29 0.82 45 0.11 64 0.97 82 1.51 86 1.13 388 1.14 Nervous 36 1.08 51 1.45 36 1.02 36 0.87 61 0.93 61 1.12 70 0.92 351 1.03 Circulation 92 2 .77 69 1.96 74 2.10 80 1.92 89 1.35 123 2.27 147 1.93 674 1.98 Respiration 99 2.98 84 2.38 76 2.16 130 3.12 140 2.13 188 3.47 278 3.66 995 2.92 Digestive Organs 44 1.32 34 0.96 25 0.71 32 0.77 56 0.85 48 0.88 66 0.87 305 0.89 Urinary System 21 0.63 15 0.42 13 0.37 18 0.43 34 0.52 27 0.49 36 0.47 164 0.48 Violence 14 0.42 17 0.48 16 0.45 33 0.79 29 0.44 44 0.81 49 0.64 202 0.59 III defined 27 0.81 16 0.45 15 0.43 31 0.74 27 0.41 23 0.42 55 0.72 194 0.57 The heavy figures denote that these were the highest rates experienced in the several districts. 86 1904] Table XXII. Showing the Deaths (arranged in Classes) front All Causes, in the Four Quarters. Classified Causes of Death. Quarters. 1st. 2nd. 3rd. 4th. Year. I. Specific or Febrile Causes 133 139 342 134 748 1. Miasmatic Diseases 89 118 96 96 399 2. Diarrhœal ,, 14 6 230 10 260 3. Malarial ,, .. .. .. .. .. 4. Zoogenous ,, 1 .. 1 .. 2 5. Venereal ,, 4 7 6 3 20 6. Septic ,, 28 8 9 25 67 II. Parasitic Diseases .. .. .. .. .. III. Dietic 10 5 8 5 28 IV. Constitutional Diseases 294 264 260 298 1,116 V. Developmental 109 104 83 92 388 VI. Local 806 515 459 780 2,560 1. Diseases of Nervous System 97 87 80 87 351 2. „ Organs of Special Sense 3 1 4 3 11 3. ,, Circulatory System 191 149 149 185 674 4. „ Respiratory „ 365 163 103 364 995 5. ,, Digestive ,, 87 65 76 77 305 6. ,, Lymphatic „ 1 3 2 3 9 7. ,, Urinary „ 49 36 32 47 164 8. ,, Reproductive „ 8 8 10 7 33 9. ,, Bones and Joints 3 2 1 3 9 10. ,, Integumentary System 2 1 2 4 9 VII. Violence 53 38 63 48 202 1. Accident or Negligence 44 26 50 38 158 2. Homicide 1 2 1 4 3. Suicide 8 10 12 10 40 4. Execution . . . . . . . . . . VIII. Ill-defined Causes 31 41 69 53 194 All Causes 1,436 1,106 1,284 1,410 5,236 Note.—The heavy figures denote that the diseases to which they are applied were most fatal in the Quarter to which they referred. 87 [1904 Table XXIII. Showing the Recorded and Corrected Death Rates per 1,000 persons living in London and in the Metropolitan Boroughs, arranged in order of their Corrected Death Rates. Borough. Standard Death Rate * Factor for Correction for Sex and Age Distribution, † Crude or Recorded Death Rate 1901. Corrected Death Rate, 1904. Comparative Mortality Figure,§ 1904. England and Wales 18.194 1.0000 16.23 16.23 1,000 London 17.31 1.0511 16.63 17.48 1,077 Hampstead 16.13 1.1280 10.23 11.54 711 Lewisham 17.46 1.0420 12.01 12.51 771 Stoke Newington 17.43 1.0438 13.33 13.91 857 Wandsworth 17.25 1.0547 13.38 14.11 869 Greenwich 17.82 1.0210 14.35 14.05 903 Paddington 17.04 1.0677 13.76 14.69 905 City of Westminster 16.22 1.1217 13.55 15.20 937 Woolwich 17.02 1.0690 14.32 15.31 943 Kensington 16.88 1.0778 14.31 15.42 950 Camberwell 17.54 1.0373 14.92 15.48 954 Hackney 17.46 1.0420 14.92 15.55 958 Battersea 16.96 1.0728 14.52 15.58 960 Islington 17.51 1.0391 15.42 16.02 987 Fulham 17.39 1.0462 15.43 16.14 994 Lambeth 17.63 1.0320 15.78 16.28 1,003 Hammersmith 17.47 1.0414 15.71 16.36 1,008 Deptford 17.31 1.0511 16.10 16.92 1,043 Chelsea 17.56 1.0361 16.53 17.13 1,055 St. Marylebone 17.08 1.0652 16.23 17.29 1,065 St Pancras 17.40 1.0456 17.43 18.22 1,123 City of London 16.55 1.0993 16.65 18.30 1,128 Poplar 17.64 1.0314 18.58 19.16 1,181 Bethnal Green 18.01 1.0102 19.25 19.45 1,198 Holborn 16.90 1.0766 18.49 19.91 1,227 Stepney 17.41. 1.0450 19.40 20.27 1,249 Bermondsey 17.76 1.0244 20.01 20.50 1,263 Southwark 17.41 1.0450 20.10 21.00 1,294 Shoreditch 17.34 1.0493 20.37 21.37 1,317 Finsbury 17.57 1.0355 21.28 22.04 1,358 * The Standard Death Rate signifies the death rate at all ages calculated on the hypothesis that the rates at each of the twelve.age periods in each town were the same as in England and Wales during the ten years 1891-1901; the death rate at all ages in England and Wales during that period having been 18.19 per 1,000. † The Factor for Correction is the figure by which the Crude or Recorded Death Rate should be multiplied in order to correct for variations of sex and age distribution. ‡ The Corrected Death Rate is the Crude or Recorded Death Rate after correction has been made for variations of age and sex distribution, and may be obtained by multiplying the latter by the Factor for Correction. § The Comparative Mortality Figure represents the Corrected Death Rate in each Borough compared with the Recorded Death Rate at all ages in England and Wales in 1904 taken as 1,000. 38 1904] Table XXIV. Showing the Death-rates from All Causes in the several under-mentioned places during the Four Quarters and during the Year. Places. First Quarter. Second Quarter Third Quarter. Fourth Quarter, The Year 1904. England and Wales 18.2 14.8 15.7 16.3 16.2 76 Great Towns 18.7 15.3 17.5 17.5 17.2 142 other Large Towns 17.2 13.8 15.4 15.9 15.6 England and Wales less the 218 Towns 18.0 14.5 13.9 15.1 15.3 London (Registration) 17.8 14.3 15.8 16.4 16.1 Bristol 17.4 13.9 13.3 17.8 15.6 Birmingham 22.0 18.8 19.3 19.5 19.9 Liverpool 22.6 18.9 26.9 22.0 22.6 Manchester 22.6 20.0 20.9 21.7 21.3 Leeds 20.4 17.6 17.7 16.3 18.0 Sheffield 18.0 14.4 18.1 16.7 16.8 The Encircling Boroughs 17.5 14.1 16.7 17.3 16.4 St. Pancras 19.4 14.5 17.0 18.8 17.4 Stoke Newington 14-6 12.1 13.3 13.5 13.3 Hackney 16.0 12.6 15.5 15.5 14.9 Hornsey 8-3 8.8 7.6 8.4 8.4 Finsbury 21.5 19.0 22.5 22.2 21.3 Shoreditch 20.7 17.1 21.6 22.0 20.4 Islington 16.8 12.9 15.1 16.5 15.3 39 [1904 INFANTILE MORTALITY. The Infantile Mortality was particularly low during 1904, for not only were the deaths of infants under a year old below the average, but the rate itself was less than that experienced in the preceding nineteen years, with one exception, 1903, when it was only 1 per 1,000 births less. The number of infant deaths was 1,140 as compared with an average of 1,394, and was in the proportion of 128 per 1,000 infants born during the year, This rate was exceedingly gratifying, for it was lower than the general rate of the country at large, than that of any of the 33 Great Towns and of the 67 Smaller Towns, while it was almost identical with the rate of Rural England. Only 10 among the Great Towns showed so good a mortality return. In the County of London the Infantile Mortality rate was 146 per 1.000 births, which contrasts favourably with the populous provincial towns, and in eight of its boroughs even lower rates than that of Islington were registered. The collective rate of the boroughs encircling Islington was 146 per 1,000 children born, or 18 above the local rate. The cause of the low mortality was due to a great decrease in nearly every infantile malady, although there was an increase under the headings of Measles (13), Diarrhoea (65), Premature Births (5), and Gastritis (3). The various diseases are set out in Table XXV. The mortality since 1885 is set out in the following table :— Years. Deaths, under 1 year. Deaths per 1,000 Births. Years. Deaths under 1 year. Deaths per 1,000 Births. 1885 1,387 144 1896 1,490 150 1886 1,512 154 1897 1,338 136 1887 1,557 160 1898 1,504 159 1888 1,271 133 1899 1,548 160 1889 1,261 132 1900 1,344 145 1890 1,488 158 1901 1,290 139 1891 1,481 151 1902 1,219 132 1892 1,417 148 1903 1,136 126 1893 1,595 163 Average 1,394 145 1894 1,229 129 1895 1,416 143 1904 1,140 128 40 1904] The Infantile Mortality in the Sub-Registration Districts was as follows:— Deaths under one year. Births Deaths per 1,000 Births. Tufnell 113 799 141 Upper Holloway 98 1,066 92 Tollington 104 815 128 Lower Holloway 180 1,114 161 Highbury 140 1,423 98 Barnsbury 237 1,672 142 South-East Islington 268 2,001 134 The Borough 1,140 8,890 128 In England and Wales, in the seven principal great towns, and in the boroughs surrounding Islington, the infantile mortality rates were as follows:— England and Wales 146 per 1,000 births. Rural Districts 125 „ 76 Great Towns 160 „ 142 Smaller Towns 154 „ London 144 „ Birmingham 197 „ Liverpool 196 ,, Manchester 187 „ Leeds 175 „ Bristol 134 „ Sheffield 158 „ The Encircling Boroughs Hornsey 87 „ Stoke Newington 114 „ Hackney 142 „ Shoreditch 188 „ Finsbury 140 „ St. Pancras 150 „ The Encircling Boroughs 146 „ Islington 128 „ 41 1904 Table XXV. Showing the Chief Causes of Infantile Mortality in the year 1904, and in the ten preceding years, 1894-1903. Diseases. Years. +Increase or -Decrease on mean of 10 years. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902 1903. Mean 10 years. 1904. Measles 37 37 67 12 65 27 42 37 24 29 38 51 +13 Whooping Cough 72 34 103 58 67 66 68 38 76 63 64 30 -34 Diarrhoea 73 144 125 138 220 208 148 143 72 83 135 200 +65 Syphilis 14 11 6 17 12 7 17 10 11 10 12 11 -1 Tabes Mesenterica 45 56 64 55 48 30 25 26 25 20 39 20 -19 Phthisis 27 28 17 15 18 27 27 18 16 16 21 12 -9 Tubercular Meningitis 17 46 28 23 29 30 25 24 20 20 26 10 -16 Premature Births 148 151 169 174 191 187 176 169 194 174 173 178 +5 Other Developmental Diseases 48 37 40 39 30 21 36 48 33 49 38 43 +5 Erysipelas 2 3 5 2 ... 6 3 2 3 4 3 3 — Inflammation of Brain 19 14 21 27 25 16 19 23 16 18 20 10 -10 Convulsions 71 63 74 60 46 62 57 68 69 47 62 47 -15 Bronchitis 121 125 141 129 129 124 119 104 116 90 120 78 -42 Pneumonia 88 97 129 86 87 112 118 123 134 109 108 101 -7 Dentition 23 29 25 21 23 16 25 24 16 18 22 11 -11 Enteritis 40 54 62 65 105 159 67 70 43 46 71 20 -51 Gastritis 9 11 10 8 9 13 21 21 23 22 15 18 +3 Suffocation 56 43 51 39 48 45 43 39 51 35 45 27 -18 Debility 71 112 68 76 76 81 53 40 65 38 68 36 -32 Marasmus, Atrophy 161 195 174 180 168 204 168 148 127 145 167 141 -26 All other Diseases 87 126 111 114 108 107 87 115 85 100 104 93 -11 Totals 1229 1416 1490 1338 1504 1548 1344 1290 1219 1136 1351 1140 -211 DEATHS FROM THE SEVEN PRINCIPAL EPIDEMIC DISEASES. These include Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fevers (Typhus, Enteric and Continued), and Diarrhoea. These diseases caused 606 deaths, as compared with a corrected average of 817 in the preceding nineteen years, and they equalled a death-rate of 1.78 per 1,000 of the population, as against a mean rate for the years mentioned of 2.39, or a decrease of over 25 per cent. The 606 deaths represented 39 per cent. of the total mortality for the year. 42 1904 Table XXVI. Showing the Deaths from the principal Epidemic Diseases for the Nineteen years 1885-1903 and in 1904. Years. Deaths. Deathrates. Years. Deaths Deathrates. 1885 1,099 3.69 1896 1,038 3.07 1886 760 2.52 1897 638 1.89 1887 1,036 3.39 1898 933 2.77 1888 714 2.31 1899 781 2.32 1889 604 2.01 1900 660 1.96 1890 771 2.44 1901 628 1.87 1891 899 2.81 1902 608 1.80 1892 798 2.47 1903 471 1.39 1893 884 2.70 Corrected mean number of deaths—1885-1903 817 2.39 1894 808 2.44 1904 606 1 78 1895 650 1.94 Increase or Decrease -211 -0.61 Table XXVII. Showing the Corrected Mean Number of Deaths from the principal Epidemic Diseases, 1885-1903, and in 1904. Diseases. Corrected Average, Number of Deaths 1885-1903. 1904. Increase or Decrease. Small Pox 12 1 -11 Measles 192 181 -11 Scarlet Fever 50 35 -15 Diphtheria 132 28 -104 Whooping Cough 181 83 -98 Typhus Fever 1 .. -1 Enteric Fever 46 18 -28 Continued & Ill-defined Fevers 1 .. -1 Diarrhœa 202 260 +58 The Above Diseases 817 606 -211 43 1904 The following statement shows the position occupied by Islington in the country:— Epidemic death-rate. England and Wales 1.94 per 1,000 inhabitants. 76 Great Towns 2.49 „ „ 142 Smaller Towns 2.02 „ „ Rural Districts 1.28 „ „ The Encircling Boroughs St. Pancras 2.01 „ „ Stoke Newington 1.13 „ „ Hackney 2.13 „ „ Hornsey 0.89 „ „ Finsbury 2.57 „ „ Shoreditch 3.20 „ „ The Encircling Boroughs 2.11 „ „ London West London Distric 1.68 „ „ North „ „ 1.74 „ „ Central „ „ 2.06 ,, ,, East ,, ,, 3.03 „ „ South ,, „ 2.22 „ „ County of London 2.14 „ „ Islington 1.78 „ „ Epidemic death-rate. West Ham 3.43 per 1,000 inhabitants. Bristol 1.64 „ „ Birmingham 3.42 „ „ Nottingham 2.58 „ „ Liverpool 4.66 „ „ Manchester 3.09 „ „ Salford 4.37 „ „ Bradford 2.42 „ „ Leeds 2.56 „ „ Sheffield 2.20 „ „ Hull 3.52 „ „ Edinburgh 1.38 „ „ Glasgow 2.44 „ „ Dublin 2.36 „ „ Islington 1.78 „ „ 44 1904 The number of the deaths in, and the death-rate of, each sub-registration district were as follows:— Deaths. Epidemic Death-rate. Tufnell 48 1.44 Upper Holloway 53 1.50 Tollington 59 1.68 Lower Holloway 109 2.62 Highbury 67 1.02 Barnsbury 142 2.62 Islington, South East 128 1.68 606 1.73 The higher death-rates in Lower Holloway and Barnsbury were due to a heavier incidence of epidemic diarrhœa. (Vide Tables XXVIII. and XXIX.). Table XXVIII. Deaths from the principal Epidemic Diseases during the year 1904, inclusive of the Deaths of Borough Patients in Hospitals outside the Borough. SUBREGISTRATION DISTRICTS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhoea. TOTALS. Tufnell ... 19 1 4 5 ... 2 17 48 Upper Holloway ... 22 1 3 7 ... 1 19 53 Tollington ... 14 10 2 5 ... 3 25 59 Lower Holloway ... 35 2 3 16 ... ... 53 109 Highbury ... 19 4 3 11 ... 2 28 67 Barnsbury 1 42 6 9 18 ... 3 63 142 S. East Islington ... 30 11 4 21 ... 7 55 128 The Borough 1 181 35 28 83 ... 18 260 606 Preceding year, 1903 ... 120 24 43 152 ... *23 109 471 * Including 1 Continued Fever. 45 1904 Table XXIX. Death-rates from the principal Epidemic Diseases during the Year, 1904, inclusive of Borough Patients in Hospitals outside the Borough. REGISTRATION DISTRICTS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhœa. Total Death-Rates. Tufnell ... 0.57 0.03 0.12 0.15 ... 0.06 0.51 1.44 Upper Holloway ... 0.62 0.03 0.08 0.20 ... 0.03 0.54 1.50 Tollington ... 0.40 0.28 0.06 0.14 ... 0.09 0.71 1.68 Lower Holloway ... 0.84 0.05 0.07 0.39 ... ... 1.27 2.62 Highbury ... 0.29 0.06 0.04 0.17 ... 0.03 0.43 1.02 Barnsbury 0.02 0.78 0.11 0.17 0.33 ... 0.05 1.16 2.62 S. East Islington ... 0.40 0.14 0.05 0.28 ... 0.09 0.72 1.68 The Borough 0.02 0.53 0.10 0.08 0.24 ... 0.05 0.76 1.78 Preceding year, 1903 ... 0.35 0.07 0.13 0.45 ... 0.07 0.32 1.39 46 1904 Table XXX. Showing the Deaths and Death Rates from the Principal Epidemic Diseases in the Wards during the Several Quarters of 1904. WARDS. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates Deaths. Deathrates. Tufnell 7 0.84 5 0.60 29 3.49 7 0.84 48 1.44 Upper Holloway 9 1.02 19 2.16 16 1.82 9 1.02 53 1.50 Tollington 5 0.57 16 1.82 31 3.53 7 0.79 59 1.68 Lower Holloway 8 0.77 21 2.02 72 6.92 8 0.77 109 2.62 Highbury 6 0.68 11 1.26 21 2.40 3 0.34 41 1.17 Mildmay 4 0.64 1 0.16 8 1.28 4 0.64 17 0.68 Thornhill 18 2.15 20 2.39 51 6.10 10 1.20 99 2.96 Barnsbury 5 0.96 6 1.15 23 4.43 9 1.73 43 2.07 St. Mary's 2 0.46 1 0.23 13 3.00 1 0.23 17 0.98 Canonbury 9 1.13 7 0.88 26 3.28 6 0.76 48 1.51 St. Peter's 15 1.83 12 1.46 34 4.15 11 1.34 72 2.20 Totals 88 1.03 119 1.39 324 3.80 75 0.88 606 1.78 47 1904 Table XXXI. Showing the Deaths from the Principal Epidemic Diseases in the several Wards during the Year 1904. WARDS. Small Pox. Measles. Scarlet Fever. Diphtheria Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhoea. Total Epidemic Deaths. Tufnell ... 19 1 4 5 — 2 — 17 48 Upper Holloway ... 22 1 3 7 — 1 — 19 53 Tollington ... 14 10 2 5 — 3 — 25 59 Lower Holloway ... 35 2 3 16 — ... — 53 109 Highbury ... 16 1 2 5 — 1 — 16 41 Mildmay ... 3 ... 1 5 — 1 — 7 17 Thornhill 1 31 4 6 14 — 2 — 41 99 Barnsbury ... 11 2 3 4 — 1 — 22 43 St. Mary's ... 8 ... 2 2 — ... — 5 17 Canonbury ... 5 12 1 9 — 1 — 20 48 St. Peter's ... 17 2 1 11 — 6 — 35 72 Totals 1 181 35 28 83 — 18 — 260 606 48 1904 Table XXXII. Showing the Death-rates of the Wards from the Principal Epidemic Diseases during the Year 1904. WARDS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhoea. Death-rate from Epidemic Diseases. Tufnell ... 0.57 0.03 0.12 0.I5 — 0.06 — 0.51 1.44 Upper Holloway ... 0.62 0.03 0.08 0.20 — 0.03 — 0.54 1.50 Tollington ... 0.40 0.28 0.06 0.14 — 0.09 — 0.71 1.68 Lower Holloway ... 0.84 0.05 0.07 0.39 — ... — 1.27 2.62 Highbury ... 0.46 0.03 0.06 0.14 — 0.03 — 0.46 1.17 Mildmay ... 0.12 ... 0.04 0.20 — 0.04 — 0.28 0.68 Thornhill 0.03 0.93 0.12 0.18 0.42 — 0.06 — 1.22 2.96 Barnsbury ... 0.53 0.10 0.14 0.19 — 0.05 — 1.06 2.07 St. Mary's ... 0.46 ... 0.11 0.11 — ... — 0.30 0.98 Canonbury ... 0.16 0.38 0.03 0.28 — 0.03 — 0.63 1.51 St. Peter's ... 0.52 0.06 0.03 0.34 — 0.18 — 1.07 2.20 Total 0.02 0.53 0.10 0.08 0.24 — 0.05 — 0.76 1.78 49 1904 SMALL POX. There was only one death registered from Small Pox during the year, although 17 cases of the disease were notified. The deaths in previous years have been as follows:— Years. Deaths. Years. Deaths. 1885 125 1895 1 1886 3 1896 1 1887 — 1897 1 1888 — 1898 — 1889 — 1899 — 1890 — 1900 1 1891 — 1901 8 1892 3 1902 53 1893 2 1903 0 1894 3 1904 1 death. MEASLES. To Measles were ascribed 181 deaths, of which 19 were registered in Tufnell sub-district, 22 in Upper Holloway, 14 in Tollington, 35 in Lower Holloway, 19 in Highbury, 42 in Barnsbury, and 30 in Islington South East. The death-rate represented 0.53 per 1,000 of the population. Fifty-one of these deaths were recorded among children under a year old, 117 were between this age and five years, and 13 were children over five years. Twenty deaths occurred in the first quarter, 75 in the second, 56 in the third, and 30 in the fourth quarter. The return was 11 below the corrected average of the preceding nineteen years. No fewer than 170 out of 181 deaths, or 94 per centum, were certified as being contributed to by secondary causes. Of this large number 124 were due to Pneumonia and 24 to Bronchitis, thus indicating, to a very large extent, a want of careful nursing and management of the patients, a fact on which stress has been frequently laid in these reports. The mortality now reported is the highest that has occurred since 1898, when 325 deaths were recorded. The returns from this disease show that a very considerable number of lives are sacrificed by it annually, and which demonstrate that it is not E 50 1904 the harmless infection which the public deem it. The subsequent figures, which have appeared in last years' report are again given. They show the ravages of the disease in ten quinquennial periods. Quenquennial. Deaths. Annual Aver. No. of Deaths. Quinquennial. Deaths. Annual Aver. No. of Deaths. 1856-60 424 85 1861-65 457 91 1866-70 514 103 1871-75 633 127 1876-80 629 126 1881-85 898 179 1886-90 924 185 1891-95 856 171 1896-00 1024 205 1901-04 (4 years). 566 141 Table XXXIII. Shotting the Deaths from Measles in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. 3 12 4 19 Upper Holloway 4 15 1 2 22 Tollington 3 7 3 1 14 Lower Holloway 2 16 16 1 35 Highbury 1 9 5 4 19 Barnsbury 4 17 9 12 42 Islington, South East 6 8 10 6 30 The Borough 20 75 56 30 181 Table XXXIV. Showing the Death-rates from Measles of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. 0.36 1.44 0.48 0.57 Upper Holloway 0.45 1.70 0.11 0.23 0.62 Tollington 0.34 0.80 0.34 0.11 0.40 Lower Holloway 0.19 1.54 1.54 0.09 0.84 Highbury 0.06 0.55 0.30 0.24 0.29 Barnsbury 0.29 1.26 0.67 0.89 0.78 Islington, South East 0.32 0.42 0.53 0.32 0.40 The Borough 0.24 0.88 0.66 0.35 0.53 51 1904 Table XXXV. Showing the Deaths-Rates of the Encircling Boroughs from Measles in the Four Quarters of 1904. Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. St. Pancras 0.77 0.58 0.41 0.41 0.54 Stoke Newington .. 0.23 0.15 0.15 0.13 Hackney 0.21 0.57 027 0.30 0.34 Hornsey 0.19 0.69 .. .. 0.22 Finsbury 0.20 0.69 0.53 0.93 0.59 Shoreditch 0.58 0.75 0.65 0.79 0.69 The Above Districts 0.41 0.60 0.36 0.44 0.45 Islington 0.24 0.88 0.66 0.35 0.53 Table XXXVI. Showing the Secondary Causes of the Deaths from Measles. Secondary Diseases. Quarters. The Year 1904. 1 2 3 4 Males. Females. Totals. Pneumonia 19 51 31 23 71 53 124 Bronchitis 1 9 8 6 15 9 24 Whooping Cough .. 4 .. .. 3 1 4 Convulsions .. 2 2 .. 1 3 4 Marasmus .. .. 1 .. 1 .. 1 Meningitis .. 1 1 .. 1 1 2 Laryngitis .. 2 .. 1 3 .. 3 Tracheitis .. 1 .. .. .. 1 1 Rachitis .. 2 .. .. 1 1 2 Diarrhoea .. 1 1 .. 2 .. 2 Dentition .. 1 .. .. 1 .. 1 Toxcemia .. .. 1 .. 1 .. 1 Abscesses of Scalp .. .. 1 .. 1 .. 1 Total Secondary Diseases 20 74 46 30 101 69 170 Deaths where no secondary disease was entered .. 1 10 .. 5 6 11 Total Deaths 20 75 56 30 106 75 181 E 2 52 1904 Table XXXVII. Showing the Deaths from Measles during each Week of 1904. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Week. Deaths. Week. Deaths. Week Deaths. Week. Deaths. 1 .. 14 8 27 8 40 .. 2 .. 15 7 28 7 41 .. 3 3 16 9 29 7 42 3 4 1 17 1 30 8 43 1 5 .. 18 3 31 4 44 1 6 .. 19 5 32 4 45 1 7 .. 20 3 33 6 46 1 8 1 21 6 34 2 47 2 9 .. 22 7 35 6 48 1 10 2 23 8 36 .. 49 3 11 2 24 4 37 .. 50 7 12 5 25 11 38 .. 51 5 13 6 26 3 39 4 52 5 13 weeks 20 13 weeks 75 13 weeks 56 13 weeks 30 53 1904 Table XXXVIII. Showing the deaths from Measles in the Quarters, 1894-03 and 1904 Years. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. 1894 66 118 14 1 199 1895 7 36 50 42 135 1896 170 84 25 9 288 1897 15 2 8 72 97 1898 183 107 23 12 325 1899 45 53 26 31 155 1890 64 75 15 5 159 1901 7 17 27 100 151 1902 53 29 12 20 114 1903 35 64 17 4 120 Corrected average number of deaths 65 59 22 30 176 1904 20 75 56 30 181 Increase or Decrease -45 + 16 +34 — +5 54 1904 SCARLET FEVER. There were 35 deaths registered, or 11 more than in the preceding year but 15 less than the average of the nineteen years 1885-1903. The death-rate was equal to 0.10 per 1,000 inhabitants of the Borough. Although the number of deaths for the year shows a small increase on the preceding year, yet the general tendency of Scarlet Fever is to decrease. This is well seen in the following returns, which give for each quinquennial period since 1856 the average number of deaths, together with the lowest in any one year during the five years, as follows:— Quinquennial Period. Total No. of Deaths. Average No of Deaths. Smallest No. of deaths in any one year. Year in which the lowest No. was recorded. 1856-60 594 120 51 1857 1861-65 1,072 214 144 1865 1866-70 1,198 240 116 1866 1871-75 585 117 43 1873 1876-80 831 166 125 1876 1881-85 439 88 29 1885 1886-90 254 51 26 1886 1891-95 332 65 50 1891 1896-1900 201 40 24 1900 1901-04 (4 years). 129 32 24 1903 During the last seven years the diminution has been most marked; it is plainly shown by the following figures :— 1890 65 deaths 1898 26 deaths 1891 50 „ 1899 33 „ 1892 53 „ 1900 24 „ 1893 94 „ 1901 30 „ 1894 69 „ 1902 40 „ 1895 66 „ 1903 24 „ 1896 57 „ 1904 35 „ 1897 61 „ 55 1904 Table XXXIX. Showing the Deaths from Scarlet Fever in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 .. .. .. 1 Upper Holloway .. • • 1 1 Tollington 1 3 2 4 10 Lower Holloway .. .. 1 1 2 Highbury .. .. 2 2 4 Barnsbury 1 1 2 2 6 Islington, South East 2 6 3 .. 11 The Borough 5 10 10 10 35 Table XL. Showing the Death-rates from Scarlet Fever of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.12 .. .. .. 0.03 Upper Holloway .. .. .. 0.11 0.03 Tollington 0.11 0.34 0.23 0.46 0.28 Lower Holloway .. .. 0.09 0.09 0.05 Highbury .. .. 0.12 0.12 0.06 Barnsbury 0.07 0.07 0.15 0.15 0.11 Islington, South East 0.10 0.32 0.16 .. 0.14 The Borough 0.06 0.12 0.12 0.12 0.10 56 1904 DIPHTHERIA. The number of deaths registered in 1904 from this disease was only 28. To find so small a return, it is necessary to go back to 1880, when 27 deaths were recorded, that is to say, to a date when diphtheria was more a disease of the country than of the towns. The returns from this disease since 1861, set out in quinquennial periods, have been as follows:— Deaths. Annual Average. 1861-65 194 39 1866-70 137 27 1871-75 115 23 1876-80 165 33 1881-85 418 83 1886-90 311 62 1891-95 842 168 1896-00 678 135 1901-04 (4 years). 309 77 While the particulars for the last eleven years are seen below:— Years. Cases. Attack Rates. Deaths. Death Rates. Fatality Deaths per 100 Cases. 1894 867 2.62 218 0.66 25.1 1895 582 1.74 144 0.43 24.7 1896 1091 3.23 257 0.76 23.5 1897 729 2.17 131 0.39 18.0 1898 544 1.62 93 0.27 17.1 1899 705 2.10 128 0.38 18.2 1900 633 1.89 106 0.32 16.7 1901 911 2.72 134 0.40 14.7 1902 878 2.55 104 0.30 11.8 1903 455 1.34 43 0.13 9.4 Corrected Mean 750 2.20 138 0.40 18.4 1904 347 1.02 28 0.08 8.1 Decrease 403 1.18 110 0.32 10.3 Fiom this return it is seen that not only have the deaths become fewer but also that they have become fewer in proportion to the attacks of the disease that have occurred. Indeed, the proportion of deaths to actual cases has grown year by year less with an almost assured decrease. 57 1904 Table XLI. Showing the Deaths from Diphtheria in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3id Quarter. 4th Quarter. Whole Year. Tufnell 2 .. 1 1 1 Upper Holloway .. .. .. 3 3 Tollington .. 1 1 .. 2 Lower Holloway 1 1 1 .. 3 Highbury .. 1 .. 2 3 Barnsbury 5 .. 3 1 9 Islington, South East 2 1 .. 1 4 The Borough 10 4 6 8 28 Table XLII. Showing the Death-rates from Diphtheria of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.24 .. 0.12 0.12 0.12 Upper Holloway .. .. .. 0.34 0.08 Tollington .. 0.11 0.12 .. 0.06 Lower Holloway 0.10 0.10 0.09 .. 0.07 Highbury .. 0.06 .. 0.12 0.04 Barnsbury 0.37 .. 0.22 0.07 0.17 Islington, South East 0.10 0.05 .. 0.05 0.05 The Borough 0.12 0.04 0.07 0.09 0.08 58 1904 WHOOPING COUGH. There were 83 deaths which is the lowest number except one, of which there is a record. The present return was, also, nearly approached in 1901, when 85 deaths were registered. Since 1885 in Islington the returns have been as follows:— Years. Deaths. Years. Deaths. 1885 210 1895 81 1886 214 1896 234 1887 240 1897 130 1888 231 1898 168 1889 86 1899 160 1890 204 1900 142 1891 255 1901 85 1892 161 1902 152 1893 181 1903 152 1894 188 1904 83 Table XLIII. Showing the Deaths from Whooping Cough in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2 1 1 1 5 Upper Hollo way 4 2 . . 1 7 Tollington . . 2 3 . . 5 Lower Holloway 5 4 4 3 16 Highbury 8 1 1 1 11 Barnsbury 8 6 3 1 18 Islington, South East 9 3 6 3 21 The Borough 36 19 18 10 83 59 1904 Table XLIV. Showing the Death-rates from Whooping Cough of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.24 0.12 0.12 0.12 0.15 Upper Holloway 0.45 0.23 . . 0.11 0.20 Tollington . . 0.23 0.34 . . 0.14 Lower Holloway 0.48 0.38 0.39 0.29 0.39 Highbury 0.49 0.06 0.06 0.06 0.17 Barnsbury 0.59 0.44 0.22 0.07 0.33 Islington, South East 0.47 0.16 0.32 0.16 0.28 The Borough 0.42 0.22 0.21 0.12 0.24 ENTERIC FEVER. Only 18 deaths were returned, as compared with an annual average of 46 in the nineteen years 1885-1903. The return is the lowest hitherto recorded, the nearest approach being that of the preceding year (1903) when 22 deaths were entered. These returns are extremely satisfactory in view of the fact that the disease is peculiarly amenable to sanitation. The deaths occurred at the following age periods :— 0.5 1 or 0.03 per 1,000 living at this age. 5.15 2 „ 0.03 „ „ 15.25 4 „ 0.06 „ „ 25.35 7 „ 0.11 „ „ 35.45 3 „ 0.07 „ „ 45.55 1 „ 0.03 „ „ 55 and upwards — — 60 1904 Table XLV. Showing the Deaths from Enteric Fever in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter Whole Year. Tufnell . . . . 1 1 2 Upper Holloway 1 . . . . . . 1 Tollington . . 2 . . 1 3 Lower Holloway . . . . . . . . . . Highbury . . 1 1 . . 2 Barnsbury . . 1 1 1 . . Islington, South East 1 1 1 4 7 The Borough 2 5 4 7 18 Table XLVI. Showing the Death-rates from Enteric Fever of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell . . . . 0.12 0.12 0.06 Upper Holloway 0.11 . . . . . . 0.03 Tollington . . 0.23 . . 0.11 0.09 Lower Holloway . . . . . . . . . . Highbury . . 0.06 0.06 . . 0.03 Barnsbury . . 0.07 0.07 0.07 0.05 Islington, South East 0.05 0.05 0.05 0.21 0.09 The Borough 0.02 0.06 0.04 0.08 0.05 61 1904 TYPHUS FEVER. No death occurred, nor has there been one registered from this disease since 1898, when 1 was recorded. In twenty years only 9 deaths have been returned by the registrars in Islington. DIARRHŒA. The diarrhoea record for the year was not satisfactory when compared with previous returns, for 260 deaths were entered in the registers as against an average of 202 in the preceding nineteen years (1885-1903). These deaths represented a death rate of 0.76 per 1,000. The deaths in each quarter of the year were as follows:— Deaths. Death rate. 1st Quarter 14 = 0.l6 2nd „ 6 = 0.07 3rd „ 230 = 2.70 4th „ 10 = 0.12 Total 260 = 0.76 The third quarter was responsible for the increased number of deaths, for in this period the returns were higher than any that obtained since 1899, when 236 were returned. In the month of July 15 deaths were registered, in August, 134, and in September (5 weeks), 81, the mean temperatures for these months being respectively 66.8°, 62.5°, and 57°, while the mean temperature for the whole quarter was 62.1°,; and the ground temperatures at four feet deep were respectively 587°, 60.8°, and 57.4°., the mean ground temperature being 58.9°. Rain fell on thirty-two days in the same quarter, namely, on eight days in July, on nine days in August, and on fifteen days in September, while the total rainfall was 8.31 inches, of which 3.15 inches fell in July, 3.22 in August, and 1.94 in September. 62 1904 Table XLVII. Showing the Deaths from Diarrhœa in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2 1 14 . . 17 Upper Holloway . . 2 15 2 19 Tollington 1 1 22 1 25 Lower Holloway . . . . 50 3 53 Highbury 1 . . 27 . . 28 Barnsbury 4 1 56 2 63 Islington, South East 6 1 46 2 55 The Borough 14 6 230 10 260 Table XLVIII. Showing the Death-rates from Diarrhœa of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.24 0.12 1.69 . . 0.51 Upper Holloway . . 0.23 1.71 0.23 0.54 Tollington 0.11 0.11 2.50 0.11 0.71 Lower Holloway . . . . 4.81 0.29 1.27 Highbury 0.06 . . 1.64 . . 0.43 Barnsbury 0.29 0.07 4.13 0.15 1.16 Islington, South East 0.32 0.05 2.42 0.10 0.72 The Borough 0.16 0.07 2.70 0.12 0.76 63 1904 Table XLIX Showing the Deaths from Diarrhœal Diseases together with those classed under Enteritis and its sub-headings, arranged in quarterly periods, and at three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc Totals Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Under 1 year 8 5 13 2 10 12 181 17 198 9 6 15 200 38 238 1 to 5 years 3 1 4 3 2 5 40 1 41 1 2 3 47 6 53 Over 5 years 3 5 8 1 6 7 9 9 18 — 10 10 13 30 43 Totals 14 11 25 6 18 24 230 27 257 10 18 28 260 74 334 Note.—In this Table the deaths under Enteritis include only those which are not epidemic or zymotic. 64 1904 Table L. Showing the Diarrhœal Deaths including Epidemic Enteritis in the Third Quarter, 1904. 1904. Deaths Death-Rate. Meteorology. Week Ending. Tuf. U.H. Toll. L.H. H. B. S.E. Total. Tuf. U.H. Toll. L.H. H. B. S.E. Total. Mean temperature of air in degrees. Departure from mean temperature. Temperature of the earth 4 feet below surface. Rainfall in inches. 1 No. of days on which rain fell. July 9th .. .. 1 .. .. .. .. 1 .. .. 1.48 .. .. .. .. 0.15 64.2 +1.2 56.6 0.50 1 „ 16th 1 .. .. .. .. .. 2 3 1.57 .. .. .. .. .. 1.37 0.45 69.1 +5.3 57.8 0.11 1 „ 23rd 1 1 1 1 .. 1 .. 5 1.57 1.48 1.48 1.25 .. 0.96 .. 0.76 67.7 +4.2 59.8 0.36 1 „ 30th .. 2 .. .. 1 1 2 6 .. 2.96 .. .. 0.79 0.96 1.37 0.91 66.4 + 3.1 60.7 2.18 5 2 3 2 1 1 2 4 15 0.78 1.11 0.74 0.31 0.20 0.48 0.68 0.57 66.8 +3.4 58.7 3.15 8 August 6th 2 .. .. 4 3 6 6 21 3.14 .. .. 5.01 2.38 5.77 4.12 3.21 68.3 +5.9 60.9 1.35 1 „ 13th 1 3 3 12 4 9 5 37 1.57 4.44 4.45 15.05 3.17 8.66 3.43 5.65 62.8 -1.5 61.3 1.30 1 „ 20th 2 2 4 8 1 10 7 34 3.14 2.96 5.93 10.03 0.79 9.62 4.80 5.19 60.7 -2.3 61.1 0.31 3 „ 27th 1 2 4 9 7 10 9 42 1.57 2.96 5.93 11.29 5.55 9.62 6.18 6.42 58.3 -3.3 60.1 0.26 4 6 7 11 33 15 35 27 134 2.35 2.59 4.08 10.34 2.97 8.42 4.63 5.11 62.5 -0.3 60.8 3.22 9 Sept. 3rd 5 1 3 2 5 9 8 33 7.85 1.48 4.45 2.50 3.97 8.66 5.49 5.04 61.8 +1.0 59.2 0.97 4 „ 10th 1 3 3 5 .. 3 3 18 1.57 4.44 4.45 6.27 .. 2.88 2.06 2.75 58.5 -1.9 58.8 0.31 3 „ 17th .. .. 3 5 3 1 3 15 .. .. 4.45 6.27 2.38 0.96 2.06 2.29 57.3 -1.3 58.0 0.30 2 „ 24th .. 1 .. 2 1 3 .. 7 .. 1.48 .. 2.50 0.79 2.88 .. 1.07 54.6 -2.3 57.1 0.15 3 Oct. 1st .. .. .. 2 2 3 1 8 .. .. .. 2.50 1.58 2.88 0.68 1.22 52.9 -2.6 56.0 0.21 3 6 5 9 16 11 19 15 81 1.88 1.48 2.69 4.01 1.74 3.65 2.05 2.48 57.0 -1.4 57.4 1.94 15 3rd Quarter 14 15 22 50 27 56 46 230 1.68 1.70 2.50 4.81 1.64 4.13 2.47 2.70 62.1 -0.6 58.9 8.31 32 65 1904 Table LI. Showing the Mean Temperature of the Air and the Earth, and the Rainfall, for each week of the Third Quarter, 1904, together with those of the corresponding periods in 1903. and also the Deaths from Diarrhœa in the same periods. Weeks of Quarter. Mean Air Temperature. Earth Temperature at 3 feet. Rainfall in inches. Diarrhœal Deaths. 1903. 1904. Difference between 1903 and 1904. 1903. 1904. Difference between 1903 and 1904. 1903. 1904. 1903. 1904 Difference o o o o o o July 9 63.6 64.2 +0.6 60.58 59.43 -1.15 0.00 0.50 .. 1 +1 ,, 16 60.7 69.1 +8.4 61.64 61.52 -0.12 0.57 0.11 4 3 -1 ,, 23 60.5 67.7 +7.2 61.39 63.58 +2.19 3.18 0.36 1 5 +4 ,, 30 58.6 66.4 +7.8 61.07 64.23 +3.16 1.52 2.18 2 6 +4 July 60.8 66.8 +6.0 61.17 62.19 +1.02 5.27 3.15 7 15 +8 Aug. 6 61.2 68.3 +7.1 60.70 64.53 +3.83 0.35 1.35 1 21 +20 ,, 13 59.5 62.8 +3.3 60.87 64.62 +3.75 2.11 1.30 5 37 +32 „ 20 58.3 60.7 +2.4 60.49 63.26 +2.77 1.11 0.31 6 34 +28 .. 27 58.1 58.3 +0.2 59.83 61.58 +1.75 1.23 0.26 4 42 +38 Aug. 59.3 62.5 +3.2 60.47 63.49 +3.02 4.80 3.22 16 134 +118 Sept. 3 62.9 61.8 -1.1 60.69 61.37 +0.68 0.86 0.97 10 33 +23 ,, 10 53.7 58.5 +4.8 60.53 60.57 +0.04 0.55 0.31 8 18 +10 ,, 17 51.7 67.3 +5.6 57.98 59.29 +1.31 0.01 0.30 12 15 +3 ,, 24 59.3 54.6 -4.7 57.87 58.13 +0.26 0.22 0.15 5 7 +2 Oct. 1 59.3 52.9 -6.4 58.72 56.72 -2.00 0.61 0.21 7 8 +1 Sept. 57.4 57.0 -0.4 59.15 59.21 +0.06 2.25 1.94 42 81 +39 3rd Qr. 59.2 62.1 +2.9 60.27 61.63 +1.36 12.32 8.31 65 230 +165 In this table the heavy figures denote that the temperatures, rainfall or deaths, were higher in the year to which they refer than in that with which they are contrasted. They are printed in this manner in order that comparison may be more readily made. F 66 1904] Table LI I. Showing the Deaths occurring in Islington and in the several Encircling Boroughs from All Causes, from the principal Epidemic Diseases, and from Phthisis in the year 1904. THE ENCIRCLING BOROUGHS. Estimated Populations, 1904. Total Deaths from All Causes. Total Epidemic Deaths. Deaths from principal Epidemic Diseases. Deaths from Phthisis. Deaths of infants under 1 year of age. Deaths under 1 year to 1,000 Births. Small Pox. Meas es. Scarlet Fever. Diphthera. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fevers. Diarrhoea. 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 St. Pancras 235,936 4,102 474 - 127 27 38 82 — 17 — 183 443 920 150 Stoke Newington 52,445 697 59 — 7 3 8 12 — 3 — 26 90 130 114 Hackney 226,266 3,366 481 — 76 20 55 55 — 26 — 24 314 876 142 Hornsey 81,221 684 73 — 18 2 7 16 — 2 — 28 45 139 86 Finsbury 98,958 2,100 254 3 58 17 16 28 — 9 — 123 236 504 140 Shoreditch 117,033 2,378 374 2 81 13 18 63 - 8 - 189 254 702 187 The above Boroughs 811,859 13,327 1,715 5 367 82 142 256 — 65 — 798 1,382 3,271 146 Islington 341,044 5,236 606 1 181 35 28 83 — 18 — 260 533 1,140 128 67 [1904 Table LIII. Showing the Death Rates of Islington and of the several Encircling Boroughs froyn All Causes, from the principal Epidemic Diseases, and from Phthisis in the the year 1904. THE ENCIRCLING BOROUGHS. Estimated Populations, 1904. Total Deathrates from All Causes. Total Epidemic Death-rates. Death-rate from principal Epidemic Diseases. Death-rates from Phthisis. Deaths under 1 year to 1,000 Births. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fevers. Diarrhœa. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 St. Pancras 235,936 17.38 2.01 ... 0.54 0.11 0.16 0.35 ... 0,07 ... 0.78 1.88 150 Stoke Newington 52,445 13.29 1.12 ... 0.13 0.06 0.15 0.23 ... 0.06 ... 0.49 1.72 114 Hackney 226,266 14.87 2.13 ... 0.34 0.09 0.24 0.24 ... 0.12 ... 1.10 1.39 142 Hornsey 81,221 8.42 0.89 ... 0.22 0.02 0.09 0.20 ... 0.02 ... 0.34 0.55 86 Finsbury 98,958 21.22 2.57 0.03 0.59 0.17 0.16 0.28 ... 0.09 ... 1.24 2.38 140 Shoreditch 117,033 20.31 3.20 0.02 0.69 0.11 0.15 0.54 ... 0.07 ... 1.62 2.17 187 The above Boroughs. 811,859 16.41 2.11 0.01 0.45 0.10 0.18 0.31 ... 0.08 ... 0.98 1.70 146 Islington 341,044 15.35 1.78 0.02 0.53 0.10 0.08 0.24 ... 0.05 ... 0.76 1.78 128 f 2 68 1904] Table LIV. Showing the Death-rates from All Causes, from the principal Epidemic Diseases, together with the Infantile Mortality, in the Country, in the Populous Towns, in Towns whose Populations exceed 300,000 inhabitants, the Encircling Boroughs, and in Islington. All Causes. Principal Epimic Diseases! (Cols. 3-9). Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhoea. Deaths under 1 Year to 1,000 Births. Cols. 1. 2. 3. 4. 5. 6. 7 8. 9. 10. England and Wales 16.2 1.94 0.01 0.36 0.11 0.17 0.34 0.09 0.86 146 76 Great Towns 17.2 2.49 0.01 0.47 0.12 0.19 0.40 0.10 1.20 160 142 Smaller Towns 15.6 2.02 0.03 0.36 0. 13 0.16 0.35 0.10 0.89 154 England and Wales less the 218 Towns . 15.3 1.28 0.01 0.23 0.09 0.14 0.27 0.08 0.46 125 London 16.1 2.14 0.01 0.49 0.0 0.16 0.32 0.06 1.02 144 Bristol 15.6 1.64 0.00 0.03 0.11 0.30 0.34 0.08 0.51 134 Birmingham 19.9 3.42 • • 0.38 0.12 0.24 0.85 0.07 1.76 197 Liverpool 22.6 4.66 0.00 0.94 0.20 0.27 0.58 0.15 2.52 196 Manchester 21.3 3.09 0.02 0.76 0.15 0.17 0.50 0.12 1.37 187 Leeds 18.0 2.56 0.00 0.76 0.13 0.10 0.47 0.11 0.99 175 Sheffield 16.8 2.20 0.00 0.08 0.20 0.11 0.34 0.12 1.35 158 St. Pancras 17.4 2.01 .. 0.54 0.11 0.16 0.35 0.07 0.78 150 Stoke Newington 13.3 1.12 .. 0.13 0.06 0.15 0.23 0.06 0.49 114 Hackney 14.9 2.13 .. 0.34 0.09 0.24 0.24 0.12 1.10 142 Hornsey 8.4 0.89 .. 0.22 0.02 0.09 0.20 0.02 0.34 86 Finsbury 21.2 2.57 0.03 0.59 0.17 0.16 0.28 0.09 1.24 140 Shoreditch 20.3 3.20 0. 02 0.69 0.11 0.15 0.54 0.07 1.62 187 Encircling Boroughs 16.4 2.11 0.01 0.48 0.10 0.18 0.31 0.08 0.98 146 Islington 15.3 1.78 0.02 0.53 0.10 0.08 0.24 0.05 0.76 128 69 [1904 INFLUENZA. The return was one of the best in recent years, although that for 1903 was slightly better. Only 48 deaths were reported, or 34 below the corrected average for ten years. The decrease occurred in the first three quarters of the year, when 12, 5, and 2 deaths were respectively attributed to the disease, figures which are 39, 8, and 2 below the averages. In the fourth quarter, however, 29 deaths were notified, or 15 more than the average for that period of the year. The disease has not been extensively prevalent in Islington since the early part of 1900, when 122 deaths occurred. Indeed, it has been only in recent years, that is to say since 1891, that influenza has been fatally prevalent among us, for between 1856 and 1889 (inclusive) it only caused 48 deaths; in 1890, however, 38 deaths were attributed to it, since which period 1,355 persons have succumbed to its attacks. The death-rate for the year was only 0.14 per 1,000 inhabitants, as against a mean rate for ten years of 0.24. Of the 48 deaths, 4 occurred among children under five years, none between 5 and 15, and 44 between the ages of 25 and 85. As many as 19, or more than 39 per cent., occurred between 55 and 75 years of age. The disease was equally fatal to 23 males and to 25 females. In London it caused 709 deaths, equal to a death-rate of 0.15 per 1,000. 70 1004] Table LV. Showing the Deaths from Influenza in the Quarters of the Year 1904, together with those of the corresponding periods 1894-03. Years. Quarters. Totals. First. Second. Third. Fourth. 1894 31 3 4 13 51 1895 137 29 4 9 179 1896 13 5 6 9 33 1897 14 11 4 18 47 1898 41 13 4 7 65 1899 52 25 4 45 126 1900 122 17 3 7 149 1901 18 13 4 11 46 1902 45 15 5 18 83 1903 30 3 1 6 40 Corrected Average 51 13 4 14 82 1904 12 5 2 29 48 Increase or Decrease -39 -8 -2 + 15 -34 71 [1904 Table LVI. Showing the Secondary Causes of Death from Influenza in the Four Quarters of the Year 1904. Tufnell. U pper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. Totals for Year. Quarters. Quarters. Quarters. Quarters. Quarters. Quarters. Quarters. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. Bronchitis .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 3 .. 1 .. 2 10 Pneumonia 1 .. .. .. .. .. .. 2 .. .. .. .. 1 1 .. 2 1 .. .. 2 .. .. .. 3 0 .. 1 3 21 Pleurisy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 2 Nephritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Diabetes Mellitus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paraplegia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brain Paralysis .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Endocarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Senile Decay .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 Heart Disease, etc. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 9 1 .. 1 .. 1 .. .. .. 8 Sloughing Prostitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tubercular Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dentition .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Peripheral Neuritis .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 All Secondary Causes 1 .. •• 3 .. 1 •• 3 2 •• .. 1 2 1 •• 3 3 •• .. 6 1 .. 1 6 3 3 1 6 47 No Secondary Causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Totals 1 •• •• 3 •• 1 .. 3 2 •• .. 1 2 1 .. 3 3 .. •• 6 1 .. 1 6 3 3 1 7 48 72 1904] APPENDICITIS. The disease known by this name may be described as inflammation of the appendix ccecnm vermiformis, which is a long worm-shaped tube or process, the rudiment of the lengthened ctzcum* (a cul-de-sac almost two inches and a half long, situated at the commencement of the large intestine). The cause of the disease has not been too well defined; but it is more than probable that all attacks of true appendicitis are the result of the action of bacteria, while its severity depends upon the virulence of the microbe, as well as upon the power of resistance possessed by the patient. It may be ascribed frequently, to a faecal concretion, or to foreign bodies, such as fruit stones or other small particles which have gained access to the intestine. Special prominence has been given to the disease during the last few years owing to the illness of His Majesty the King. The disease is now more generally and more certainly diagnosed than formerly, and, therefore, mention is more frequently made of it. It was frequently confounded with peritonitis, and when death ensued it was usually registered under this heading. During the past three years more frequent entries have been made of it in the local registers, where it has been returned as the cause of 20 deaths in 1902 (12 males and 8 females), 8 in 1903 (3 males and 5 females), and 27 in 1904 (13 males and 14 females). SEPTIC DISEASES. Altogether 67 deaths, equal to a death-rate of o-ig per 1,000 of the population, were caused by diseases, the best known of which are Erysipelas, Pyaemia, Septica;mia, and by those included under the term Puerperal Fever. Twenty-five deaths from Septic Diseases were registered in the first quarter, 8 in the second, 9 in the third, and 25 in the fourth. Erysipelas.—Erysipelas was credited with 23 deaths, or ii more than the corrected average of the preceding ten years. It was fatal to 3 infants, the remaining 20 deaths occurring among p rsons whose ages ranged from 25 to 75 years. Of the deaths 18 were among males, and 5 among females. * Lat.: cacutn intestinum, blind intestine. 78 [1904 Table LVII. Deaths from Erysipelas in the Sub-Districts during the Year 1904. Deaths Death Rates. Tufnell 2 0.06 per 1,000 inhabitants. Upper Holloway 1 0.03 „ „ Tollington 4 0.11 „ „ Lower Holloway 5 0.12 „ „ H ighbury 3 0.04 „ „ Barnsbury 4 0.07 „ „ Islington, South-East 4 0.05 „ „ The Borough 23 0.06 „ „ Table LVIII. Deaths jrom Erysipelas during the Ten Years, 1894-1903. Deaths. Death Rates. 1894 15 0.04 per 1,000 inhabitants. 1895 l6 0.05 „ „ 1896 l6 0.05 ,, ,, 1897 11 0.03 „ „ 1898 8 0.02 ,, ,, 1899 16 0.04 „ „ 1900 17 0.05 „ „ 1901 15 0.04 „ „ 1902 13 0.04 „ „ 1903 9 0.02 „ „ Corrected Average 14 0.04 „ „ 1904 23 0.06 „ „ 1904] 74 PUERPERAL DISEASES. There were 14 deaths from the diseases which this heading embraces, namely, Puerperal Pyaemia, Septicaemia, Saprsemia, Septic Intoxication, and the indefinite appellation " Puerperal Fever." These deaths, all of which occurred between the ages of 20 and 45, were in the proportion of 1.57 per 1,000 births that occurred during the year. This proportion is considerably higher than the average for the ten years 1894-1903, during which it was 1.04 per 1,000 births. The records for the years mentioned were as follows:— Years. Deaths. Deaths per 1,000 births. 1894 8 0.84 1895 12 1.21 1896 11 1.11 1897 10 1.01 1898 7 0.74 1899 14 1.45 1900 6 0.65 1901 15 1.62 1902 12 1.30 I903 9 1.00 Average 10 1.04 1904 14 1.57 Table LIX. Showing the Deaths from Puerperal Fever in the Sub-Districts for each Quarter and the Year 1904. Bub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell .. .. .. 1 1 Upper Holloway 1 .. .. 1 2 Tollington 1 .. .. .. 1 Lower Holloway • • .. .. • • • • Highbury 1 .. .. .. 1 Barnsbury 2 .. .. 2 4 Islington, South East 1 2 2 .. 5 The Borough 6 2 2 4 14 75 [1904 Table LX. Showing the Deaths from Puerperal Fever per 1,000 Births in the Sub Districts for each Quarter and the Year 1904. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. 6.10 1.25 Upper Holloway 3.46 .. .. 3.82 1.88 Tollington 4.57 .. .. .. 1.23 Lower Holloway .. .. .. .. .. Highbury 3.05 •• .. .. 0.70 Barnsbury 4.73 .. .. 4.81 2.39 Islington, South East 1.93 376 4.05 .. 2.50 The Borough 2.64 0.87 0.97 1.88 1.57 CONSTITUTIONAL DISEASES. This group, which includes, among many others, such diseases as Rheumatic Fever, Rheumatism, Gout, Rickets, Cancer, Phthisis and the allied tubercular diseases, Purpura, Anaemia, and Diabetes caused 1,116 deaths, which were 40 above the uncorrected average for the preceding seven years. The total deaths numbered 1,116 as against an average of 1,076 in the preceding ten years, and the resulting death-rate was 3.27 per 1,000 inhabitants. These deaths were referred to the several periods of the year as follows :— 1st Quarter - 294 = 3.45 per 1,000 2nd „ - 264 = 3.10 „ 3rd ,, - 260 = 3.05 „ 4th ,, - 298 = 3.50 „ Total 1,116 = 3.27 „ Cancer or Malignant Disease.—To Cancer were ascribed 323 deaths, a return, which, although 27 less than that of the preceding year, is neverthe- 19041 76 less 27 above the corrected average of the preceding ten years, as may be seen in the following return :—0 Years. Deaths Deaths per 10,000 Pop. Years. Deaths. Deaths per 10,000 Pop. 1891 218 6.8 1900 303 9.9 1892 219 6.8 1901 289 8.6 1893 238 7.3 1902 326 9.5 1894 239 7.2 1903 350 10.3 1895 266 7.9 1896 291 8.5 Corrected Average 296 8.70 1897 304 9.0 1898 283 8.4 1899 270 8.0 1904 323 9.47 Out of the 323 deaths registered during the year 305, or 94 per cent., took place amongst people over thirty-five years of age. The deaths from the disease occur in the greatest number, as well as in the highest proportion to the persons living, at the age period 65-75, although the numbers dying between 35 to 45, 45 to 55, and 55 to 65 are also very considerable. This is well seen in the following return for the last five years. Ages. 1900. 1901. 1902. 1903. 1904. 0- 5 1 — 3 4 1 5-15 2 1 3 3 2 15-2532575 25-35 6 8 8 5 10 35-45 32 33 29 43 43 45-55 79 63 75 75 61 55-65 92 76 103 95 84 65-75 58 75 70 83 90 75-85 27 27 27 34 22 85 and upwards 3 4 3 1 5 303 289 326 350 323 The parts of the human frame attacked by the disease as shown by the medical certificates are numerous. Thus death was ascribed in 36 instances, (17 males and 19 females) to cancer of the liver; in 35 instances (27 males and 8 females) to cancer of the stomach ; in 20 instances (18 males and 2 females) to cancer of the oesophagus ; and in 54 instances (23 males and 31 females) to cancer of the various parts of the intestines or their coverings. Among women cancer of the uterus caused 43 deaths, and of the heart 30. The fullest particulars of the parts affected by the disease, together with the ages and sex of the persons who died are set out in a subsequent table (p. 78). 77 [1904 The distribution of the disease throughout the year, and in the subregistration districts, was as stated in the following table. Table LXI. Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the Year 1904. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough. 1st 10 7 11 10 15 9 11 73 2nd 7 10 11 12 11 10 19 80 3rd 11 11 8 10 13 18 19 90 4th 9 14 4 8 17 14 14 80 The Year 37 42 34 40 56 51 63 323 Table LXII. Deaths an ! Death-rates from Cancer at seven age periods. Males. Females. Persons. Ages. Deaths. Deaths per 10,000 living at the age. Deaths. Deaths per 10.000 living at the age. Deaths. Deaths per 10.000 living at the age. 0-25 3 0.37 5 0.58 8 0.48 25-35 6 2.05 4 1.22 10 1.61 35-45 12 5.68 31 13.30 43 9.68 45-55 30 20.30 31 18.30 61 19.23 55-65 39 42.02 45 39.82 84 40.81 65-75 43 102.18 47 75.27 90 86.10 75 & up. 14 98.04 13 46.41 27 63.85 All Ages 147 9.06 176 9.84 323 9.47 78 1904] Table LXIII. Mortality from Cancer during the Year 1904. ORGANS AFFECTED. Sex. Age at Death. Males. Females. Totals. 0—6 —16 — 26 —86 —46 —65 -66 -75 -75 upwards. Diseases of Nervous System M. .. .. .. .. .. .. .. .. .. .. .. .. F. .. .. .. .. .. .. .. .. .. .. •• Organs of Special Sense — Eye (Orbit) M .. .. .. .. .. .. 1 .. 1 .. 1 F. .. .. .. .... .. .. .. .. .. .. Nose M .. 1 .. .. .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Diseases of Heart, etc.— Endocarditis m. .. .. .. .. 1 .. .. .. .. 1 .. 5 F. .. .. 3 .. 1 .. .. .. .. .. 4 Respiratory System— Larynx m. .. .. .. .. .. .. 2 .. .. .. .. 3 F. .. .. .. .. .. .. 1 .. .. .. 1 Lung M. .. .. .. .. .. 1 .. .. .. 1 .. 4 F .. 1 1 .. 1 .. .. .. .. .. 3 Throat M. .. .. .. .. .. .. .. 1 .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Digestive System— Rectum M. .. .. .. .. 1 2 6 .. .. 9 .. 17 F. .. .. .. .. 1 1 3 3 .. .. 8 Pylorus M .. .. .. .. .. 2 .. 2 .. 4 .. 11 F. .. .. .. .. 1 .. 4 1 2 .. 7 Pancreas M. .. .. .. .. .. 2 .. 1 .. 3 .. 5 F. .. .. .. 1 .. .. .. .. 1 .. 2 Liver M. .. .. .. 2 1 .. 4 8 2 17 .. 36 F. .. .. .. 1 2 2 4 10 .. .. 19 Ventriculi M. .. .. .. .. .. 1 .. . . .. 1 .. 2 F .. .. .. .. .. .. 1 .. .. .. 1 Oesophagus M. .. .. .. .. 2 6 3 6 1 18 20 F. .. .. .. .. .. 1 .. 1 .. .. 2 Stomach M. .. .. .. 1 1 7 8 6 4 27 .. 35 F. .. .. .. 1 .. 1 1 4 1 .. 8 Spleen M. 1 .. .. .. .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Tongue M. .. .. .. .. 1 2 4 .. .. 7 .. 7 F .. .. .. .. .. .. .. .. .. .. .. Palate M .. .. .. .. .. .. .. .. 1 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Caecum .. .. .. .. .. .. 1 .. .. 1 .. 3 F. .. .. .. .. .. 1 .. .. .. .. 2 Gall Bladder M. .. .. .. .. 1 .. .. .. .. 1 .. 2 F. .. .. .. .. .. .. 1 .. .. .. 1 Abdomen M. .. .. .. .. 1 .. .. .. .. 4 .. 5 F. .. .. .. .. .. .. 1 .. .. .. 1 Omentum M. .. .. 1 .. .. .. .. .. .. 2 .. 7 k .. .. .. 1 .. .. 3 .. .. .. 5 Peritoneum M. .. .. .. .. .. .. 1 .. .. 1 .. 2 F. .. .. .. .. .. .. .. 1 .. .. 1 Colon M .. .. .. .. .. .. .. .. 2 2 .. 9 F. .. .. .. .. .. 1 3 3 .. .. 7 Jaw M. .. .. .. .. .. 1 .. 2 1 4 .. 5 F. .. .. .. .. .. .. .. .. 1 .. 1 Intestines (parts not specified) M .. .. .. .. .. .. 4 2 1 7 .. 16 F .. .. .. .. 2 1 2 2 2 .. 9 Duodenum M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. .. 1 .. .. 1 Tonsils M .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. 79 [1904 Table LXIII.—continued. ORGANS AFFECTED. Sex. Age at Death. Males. Femai es. Totals. 0-5 —15 —25 35 —45 - 65 —65 -75 -75 upwards. Digestive System—continued. Lips M. .. .. .. .. .. .. 1 1 .. 2 .. 3 F. .. .. .. .. .. .. .. .. 1 .. 1 Face M. .. .. .. .. .. .. .. 1 .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Lymphatic System — Parotid Glands M .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. .. 1 .. .. 1 Cervical Glands M .. .. .. .. .. .. .. .. 1 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Urinary System— Kidney M. .. .. .. .. 1 .. .. .. .. 1 .. 1 F .. .. .. .. .. .. .. .. .. .. .. Bladder M. .. .. .. 1 .. 1 4 3 .. 9 .. 11 F. .. .. .. .. 1 .. .. .. 1 .. 2 Prostate M. .. .. .. .. .. .. .. 1 .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Generative System— Breast M. .. .. .. .. .. .. .. .. .. .. .. 30 F. .. .. .. .. 4 10 6 9 1 .. 30 Uterus M. .. .. .. .. .. .. .. .. .. .. .. 43 F. .. .. .. .. 15 9 10 7 2 .. 43 Vagina M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. .. 1 .. .. 1 Ovary M. .. .. .. .. .. .. .. .. .. .. .. 4 F. .. .. .. .. 1 1 2 .. .. .. 4 Vulva M .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. 1 .. .. .. 1 Testicle M. .. .. .. 2 .. .. .. .. .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Penis M. .. .. .. .. .. 1 .. 1 1 3 .. 3 F. .. .. .. .. .. .. .. .. .. .. .. Pelvis M. .. .. .. .. .. .. .. .. .. .. .. 2 F. .. .. .. .. 1 .. 1 .. .. .. 2 Organs of Locomotion— • Neck M .. .. .. .. .. 1 1 1 .. 3 .. 6 F. .. .. .. .. 1 1 .. 1 .. .. 3 Spine M .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Bones and Joints— Tibia M. .. .. .. 1 .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Unspecified M. .. .. .. .. .. .. 1 2 .. 3 .. 8 F. .. .. .. .. 1 2 .. 2 .. .. 5 Total Males and Females for Year M. 1 1 1 6 11 30 40 43 14 147 .. .. F. .. 1 4 4 32 31 44 47 13 .. 176 .. Total Deaths 1 2 5 10 43 61 84 90 27 147 176 323 80 1904] Tubercular Diseases. - Tuberculosis of the Lungs or Phthisis, Tuberculosis of the Brain, Tuberculosis of the Larynx, Tuberculosis of the Abdomen or Tabes Mesenterica, and General Tuberculosis. Phthisis caused 533 deaths, 315 males and 218 females, of whom 501 were over fifteen years of age. 50 of thesedeaths occuired inTufnell Sub-district, 63 in Upper Holloway, 41 in Tollington, 73 in Lower Holloway, 72 in Highbury, 84 in Barnsbury, and 150 in South-East Islington. The deaths were equal to a death-rate of 1.56 per 1,000, as compared with a mean rate for the preceding ten years of 1.61. This rate is higher than the mean rate of England and Wales, which during the last ten years has been 1.29 per 1,000 of the population. The deaths from Phthisis were in the proporiion of 10.18 to every 100 deaths from all causes. It will be noticed that the deaths of males greatly exxeeded those of females, the death-rate among the former being 1.94 per 1,000 and among the latter 1.22 per 1,000. The mortality was greatest in the coldest months of the year, the first and fourth quarters, when 160 and 154 deaths were respectively registered. In the second quarter no deaths occurred, and in the third 109. Since 1891 the death-rate from this disease hdS varied from 1.45 in 19.3 to 1.79 in 1900, while the mean death-rate has been 1.6i per 1,000. In the succeeding statement it is seen that the greatest mortality occcnrred between 25 and 55 years of age. The particulars for each period of life were as follows :— Age periods. Deaths. Deaths per 1,000 at each age. Age periods. Deaths. Deaths per 1,000 at each age. 0- 5 32 0.87 55-65 36 1.75 5-15 19 0.30 65-75 20 1.91 15-25 80 1.18 75-85 2 0.47 25-35 35-45 115 120 1.85 2.70 Total 533 1.56 45-55 109 3.44 81 [1904 The particulars of the deaths during the last n years are set out below :— Deaths Phthisis. Death rates per 1,000 inhabitants. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. 1894 539 1.63 10.24 15.9 1895 568 1.70 9.86 17.2 1896 530 1.54 9.01 17.1 1897 520 1.54 9.64 16.0 1898 527 1.56 9.24 16.9 1899 583 1.73 9.26 18.7 1900 602 1.79 10.52 17.0 1901 545 1.62 10.16 15.9 1902 515 1.50 9.4 16.4 1903 492 1.45 10.16 14.2 Corrected mean 550 1.61 9.70 16.6 1904 533 1.56 1018 15.3 Table LXIV. Showing the Deaths from Phthisis in the Sub-Districts during the Four Quarters of the Year 1904. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Borough 1st 13 15 12 21 26 28 45 160 2nd 13 18 9 11 18 17 24 110 3rd 12 18 5 16 14 14 30 109 4th 12 12 15 25 14 25 51 154 The Year 50 63 41 73 72 84 150 533 82 1904] Tabes Mesenterica, commonly known as consumption of the bowels, caused 40 deaths, which represent a death-rate of 0.12 per 1,000, 20 of which were of persons under a year old, 16 between that age and five years, and 4 over five but under fifteen. Consequently it is seen that it is a disease of early life. The deaths among males numbered 22, and among females 18. Tubercular Meningitis or Hydrocephalus was registered as the cause of 74 deaths, of which 42 were males and 32 females, the resulting deathrate being 0.22 per 1,000. With the exception of 17 all were among children under five years of age. Tuberculosis of the Larynx caused 18 deaths, all of which with one exception occurred among persons between the ages of 20 and 45. General Tuberculosis sometimes called scrofula, was registered as the cause of 18 deaths. Here all the deaths, with 4 exceptions, occurred among children under 15 years old. Other Tubercular Diseases were responsible for 10 deaths, the ages of the deceased ranging from under a year to 55 years. 88 [1904 Table LXV. Showing the Deaths from the Tubercular Diseases during 1904. Diseases. Ages. Sex. Districts. Total Deaths. Death Rates. 0—1 1—5 Over 5 m. F. Tuf. U.h. Toll. l.h. h. b. S.E. 0—5 5-15 All Ages. Phthisis 12 20 501 315 2l8 50 63 41 73 72 84 150 533 0-87 0-30 1-56 Tabes Mesenterica 20 16 4 22 18 2 2 6 8 7 7 8 40 0.98 — 0.12 Tubercular Meningitis 10 47 17 42 32 10 6 11 9 7 17 14 74 1.56 0.17 0.22 Tuberculosis of the Larynx — — 7 5 2 i — — — 2 3 1 7 — — 0.02 General Tuberculosis 3 5 10 9 9 — — 3 6 2 4 3 18 0.22 0.09 0.05 Other Forms of Tuberculosis 1 2 7 5 5 i — 1 1 3 2 2 10 0.08 0.02 0.03 All Tubercular Diseases 46 90 546 398 284 64 71 62 97 93 117 178 682 3.71 0.58 2.00 G 2 84 1904] LXVI. Showing the Deaths from the several Constitutional Diseases during the Years 1894-03, also the Corrected Mean Number of Deaths for these Years, together with the Deaths in 1904. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. Averages 189403. 1904. Increase or Decrease Rheumatic Fever 14 9 17 20 22 26 16 9 17 16 17 13 - 4 Rheumatism 8 12 12 4 12 8 10 12 15 21 11 21 +10 Gout 7 9 15 9 7 4 7 7 11 6 8 11 + 3 Rickets 10 17 12 17 19 25 13 19 17 9 16 11 - 5 Cancer 239 266 291 304 283 270 303 289 326 350 292 323 + 31 Tabes Mesenterica 09 80 81 71 65 50 36 38 43 40 57 40 -17 Tubercular Meningitis 62 108 103 82 87 89 69 80 77 71 83 71 - 9 Phthisis 539 568 530 520 527 583 602 545 515 492 542 533 - 9 Other Tubercular and Scrofulous Diseases 3 7 16 16 7 7 3 14 37 29 14 35 + 21 Purpura 2 2 .. 2 1 4 2 2 2 1 2 1 - 1 Anaemia, Chlorosis, Leucocythaemia 13 10 9 12 11 11 12 9 7 8 10 14 + 4 Diabetes 23 16 19 13 18 20 28 33 28 26 22 35 + 13 Other Diseases .. 1 3 3 .. 3 3 5 2 1 2 5 + 3 Totals 989 1,105 1,108 1,073 1,059 1,100 1,104 1,062 1,097 1,070 1,076 1,116 + 40 85 [1904 RESPIRATORY DISEASES. These diseases, including among others, Acute and Chronic Bronchitis, Pneumonia, Pleurisy, Emphysema, and Asthma, caused 995 deaths, of which 365 were registered in the first quaiter, 163 in the second, 103 in the third, and 364 in the fourth; and resulted in a death-rate of 2.92 per 1,000 of the population. They formed 19 per cent, of the entire mortality during the year. Bronchitis—Acute.—This ailment was responsible for 160 deaths, 69 males and 91 females, of which 76 occurred among infants, in addition to 28 among very young children. Bronchitis—Chronic was credited with 374 deaths all of which with 23 exceptions occurred among people over 45 years of age. The deaths among males and females were nearly equal in number, as 178 of the former and 184 of the latter died. Pneumonia caused 392 deaths, of which 131 occurred in the first quarter, 80 in the second, 56 in the third, and 125 in the fourth. It was fatal to 216 males and to 176 females. There were 104 deaths among infants, and 112 among very young children, or altogether 216 among children under 5 years of age. Thus between this disease and pneumonia, the deaths of 180 infants undet a year old, and of 244 children between 1 and 5 years, or a total of 424 deaths were caused, of which it would be only a mild remark to state that many were sacrificed by the ignorance or carelessness of the maternal parents. There is a great leakage of life at these early ages, which can only be stopped by the instruction, and the education at school of the future mothers of the race. Girls from their earliest age possess the motherly instinct, and this instinct should be fostered and brightened in their school days, especially during the last year. VENEREAL DISEASES. These include Syphilis and Gonorrhoea, and from them there resulted 20 deaths, 15 being ascribed to the former, and 5 to the latter disease. As many as 12 of these deaths occurred among infants under a year old, while 2 children were between 1 and 5 years; 1 person was 25 years old, 1 was 45, and 4 were 55. Twelve of the persons who died were males, and 8 females. Six of the deaths occurred in Public Institutions within the borough. 86 1004] DEATHS IN PUBLIC INSTITUTIONS. The deaths of the people in the public institutions is a gauge to some extent, but by no means to the full, of the amount of medical relief that has been afforded during the year, and, therefore, particulars respecting them are of interest. During 1904, it was found that 30.1 per cent, of the total deaths of Islingtonians were registered from charitable institutions, and many of them from hospitals that were situated in distant parts of the Metropolis. Within the Borough.—There died during the year 1,619 persons in the Public Institutions of Islington, of whom 987 were residents, and 632 were non-residents, who had only come into it for the treatment of the diseases from which they ultimately died. Many of these last mentioned persons' deaths occurred in the Holborn Infirmary, situated in the Upper Holloway. Of Residents.—The major portion of the 987 residents died in the Islington Workhouse Infirmary. These numbered 719, in addition to which 112 died in the Workhouse and 1 in the Workhouse Schools. In the Great Northern Central Hospital 132 persons died, and in the Holborn Infirmary 3. In addition to these there was 1 death in the London Fever Hospital, 2 in the Memorial Cottage Hospital, 2 in the Bookbinders' Asylum, and 1 in the Aged Pilgrims' Asylum. Of Non-Residents.—Of the 632 deaths of non-residents, 433 died in the Holborn Union Infirmary, 94 in the Great Northern Central Hospital, 30 in the Islington Workhouse Infirmary, 4 in the London Fever Hospital, 11 in St. Pelagia's Creche, and 4 in Holloway Prison Infirmary. Without the Borough.—627 persons (347 males and 280 females) belonging to Islington died in institutions situated outside the borough. Of these 67 died in hospitals belonging to the Metropolitan Asylums Board, 78 in St. Bartholomew's Hospital, 51 in the Royal Free Hospital, 47 in the Children's Hospital, Great Ormond Street, 22 in the Metropolitan Hospital, 29 in University College Hospital, and the remainder in various other metropolitan institutions. Within and without the Borough.—Altogether, the deaths of 1,576 persons belonging to Islington, out of the 5,236 persons who died and were properly credited to the borough, or 30.1 per cent., occurred in Public Institutions situated either within or without the borough. (Vide Tables LXVIII. and LXIX.). 87 [1904 Accidental and Sudden Deaths without the Borough.—Thirty- one such deaths were registered as occurring in various London districts north of the Thames. (Vide Table LXX.). The foregoing figures contrast with those of the ten preceding years as shown in the next table, and are of interest. Table LXVII. Years Total Deaths in Local Institutions cols. 3 and 4). Inhabitants of Islington in Local Institutions. NonInhabitants of Islington in Local Institutions. Inhabitants in Islington Infirmary. Inhabitants of Islington in G N.C. Hospital. Inhabitants of Islington in Institutions outside the Borough. Total Deaths ' of Inhabitants in all Institutions (cols. 3 and 7). Proportion per 100 deaths from all causes (col.8). I 2 3 4 5 6 7 8 9 1894 1,000 630 370 470 94 542 1,172 22.2 1895 1,180 686 494 539 82 524 1,210 21.0 1896 1,299 779 520 584 109 658 1,437 24.4 1897 1,260 729 531 569 93 566 1,295 24.0 1898 1.365 820 545 656 95 517 1,337 23.4 1899 1,672 993 679 772 136 593 1,586 25.2 I9OO 1.564 990 574 779 124 553 1,543 26.9 I9OI 1,394 903 491 603 124 630 1,533 28.6 1902 1.53I 909 622 587 130 737 1,646 29.2 I903 1,467 912 555 654 122 627 1.539 31.8 Average 1.373 835 538 621 111 595 1,430 25.6 1904 1,619 987 632 719 132 589 1,576 30.1 88 1904] Table LXVIII. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated within the Borough distributed to their respective Sub-registration Districts. Also the Deaths of Non-Inhabitants in the same Institutions during the Year 1904. public institution. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. Total Inhabitants. Nonj Inhabitants. Islington Infirmary 154 67 72 qo 70 112 154 719 30 Islington Workhouses 7 15 9 12 l6 29 24 112 8 Workhouse Schools — — — 1 — — — 1 — Gt. Northern Hospital 18 34 22 14 27 8 9 132 94 Holborn Infirmary — 1 — — 1 — 1 3 433 Aged Pilgrims' Asylum — — — — — — 1 1 7 St. Pelagias' Creche — — — — — — — — 11 Aged Blind Home — — — — — — — — 7 Medical and Surgical Home — — — — — — — — — Children's Nursing Home — — — — — — — — — St. John's Nursing Institute — — — — — — — — — Kingsdown Orphanage — — — — — — — — — Alexandra Orphanage — — — — — — — — — Whittington College — 1 — — — — — 1 2 Tufnell Park Nursing Institution 1 — — — — — — 1 4 H.M. Prison, Holloway 2 — — — — — — 2 4 H.M. Prison, Pentonville — — — 3 — — — 3 10 Drovers'Almshouses — — — 2 — — — 2 — London Fever Hospital — — — — — 1 — 1 4 Memorial Cottage Hospital — — — — 1 — 1 2 4 Invalid Home, Aubert Park — — — — — — — 3 Invalid Home, Highbury Terrace — — — 1 — — — 1 2 Bookbinders' Asylum — — — — 1 1 — 2 3 Metropolitan Benefit Societies'Asylum — — — — 1 — — 1 2 Bricklayers' and Tilers' Almshouses — — — — 1 — — 1 Dyers' Almshouses — — — — — — — — 3 Pennefather Memorial Home — — — — — — — — — Clothworkers' Almshouses — — — — — — 2 2 1 Totals 182 118 103 123 118 151 192 987 *632 * There were also 17 deaths at places not mentioned in list. 89 [1904 Table LXIX. Showing the Deaths of Inhabitants of Islington in Public Institutions and in other places situated outside the Borough distributed to their respective Sub-Registration Districts during the Year 1904. Sub-Registration Districts. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Whole Year. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Tufnell 6 8 14 5 4 9 6 5 11 3 10 13 20 27 47 Upper Holloway 5 5 10 10 9 19 5 6 11 9 16 25 29 36 65 Tollington 5 5 10 8 4 12 4 6 10 7 7 14 24 22 46 Lower Holloway 5 11 16 8 5 13 18 7 25 11 6 17 42 29 71 Highbury 19 14 33 12 7 19 13 10 23 7 10 17 51 41 92 Barnsbury 28 13 41 18 7 25 24 17 41 18 16 34 88 53 141 South-East Islington 29 21 50 22 15 37 17 23 40 25 13 38 93 72 165 Borough 97 77 174 83 51 134 87 74 161 80 78 158 347 280 627 90 1904] Table LXX. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated without the Borough, during the Year 1904. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Middlesex Hospital 4 5 6 5 20 Friedenheim (Home of Peace), N.W. 3 2 5 1 11 North Western Fever Hospital 1 1 .. 1 3 University College Hospital 5 4 16 4 29 Eastern Fever Hospital 3 .. .. .. 3 Children's Hospital, Gt. Ormond Street 13 12 14 8 47 Banstead Asylum 2 .. 1 4 7 Manor Asylum (Epsom) 1 1 .. 1 3 Darenth Asylum 2 2 1 1 6 Hanwell Asylum 4 6 1 3 14 Convent Hospital .. .. .. .. .. St. Mary's Hospital .. .. 1 .. 1 Hospital of St. John and St. Elizabeth .. .. .. 1 1 Hospital for Women (Euston Road) 2 .. .. 2 2 Metropolitan Hospital 6 4 7 5 22 German Hospital 6 .. 3 1 10 St. Bartholomew's Hospital 20 17 21 20 78 Royal Chest Hospital 2 2 .. 2 6 King's College Hospital 2 5 .. .. 7 Guy's Hospital .. 3 4 .. 7 Colney Hatch Asylum 6 2 4 7 19 North Eastern Fever Hospital 11 12 14 18 55 Leavesden Asylum 2 3 1 1 7 St. Thomas's Hospital 2 1 .. .. 3 Cane Hill Asylum 3 2 2 4 11 Paddington Infirmary .. .. .. .. .. Royal Free Hospital 12 9 16 14 51 London Temperance Hospital 3 1 2 1 7 Cancer Hospital (Chelsea) 1 .. .. 1 2 London County Asylum (Dartford) 3 2 1 2 8 London Hospital 1 1 .. 4 6 St. Anne's House, Stoke Newington 1 2 .. 1 4 Maternity Home, Hackney .. .. .. .. .. Mildmay Hospital 2 .. .. .. 2 Grove Hall Asylum .. .. .. 2 2 Westminster Hospital 1 1 .. 2 5 Homcepathic Hospital, Gt. Ormond Street .. 1 .. 1 1 Clayburn Asylum 5 2 .. 3 10 Homerton Hospital.. .. .. .. .. .. Children's Hospital (Paddington Green) .. .. .. .. .. St. George's Hospital 2 .. 2 .. 4 North Eastern Hospital (Haggerston) .. .. .. .. .. Hackney Infirmary 2 .. .. .. 2 Middlesex Asylum .. .. .. .. .. Queen Charlotte Hospital .. .. 1 1 2 Ilford Asylum .. .. 2 .. 2 French Hospital .. .. .. .. .. Pancras Workhouse 1 .. .. .. 1 Invalid Asylum (Stoke Newington) .. .. .. .. .. St. Peter's Home .. 1 2 .. 3 Brompton Hospital 3 .. .. 1 4 West London Hospital .. .. .. .. .. City of London Lying-in Hospital 6 .. .. 1 9 Peckham House Asylum .. .. .. .. .. Poplar Hospital .. .. .. .. .. South Western Fever Hospital .. .. .. .. .. [1904 91 Table LXX.—continued. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Camberwell House Asylum .. .. .. .. .. Wine and Beer Sellers' Asylum. Nunhead .. .. .. .. .. Hospital Ship "Castalia" .. .. .. .. .. Hospital Ship "Atlas" .. .. .. .. .. Bethnal Green Infirmary .... .. .. .. .. City of London Asylum (Stone) .. .. .. .. .. Hoxton House Asylum 1 .. .. .. 1 Charing Cross Hospital 1 2 .. 2 5 Royal Hospital for Women and Children .. .. .. .. .. Home Hospital, 16, Fitzroy Square .. .. 1 .. 1 Hampstead Home Hospital .. .. 1 .. 1 School for Indigent Blind (Southwark) .. .. .. .. .. Hostel of God .. .. .. .. .. North West London Hospital 2 4 4 1 11 Bethlem House .. .. .. .. .. Poplar and Stepney Sick Asylum .. .. .. .. .. Northern Fever Hospital .. .. .. .. .. National Hospital 1 .. .. .. 1 Bethnal House Asylum 1 1 .. .. 2 St. Luke's House .. 1 2 .. 3 City Infirmary, Bow .... .. .. .. .. City of London Chest Hospital 1 .. .. .. 1 South Eastern Fever Hospital .. .. .. .. .. Butchers' Almshouses .. .. .. .. .. Central London Throat and Ear Hospital 1 .. .. .. 1 Gresham Almshouses, Brixton .. .. .. .. .. Italian Hospital l 1 .. 1 3 St. Mark's Hospital .. 1 .. .. 1 Holborn Workhouse, Hoxton 2 .. 3 2 7 Lewisham Infirmary .. .. .. .. .. St. Olave's Infirmary .. .. .. .. .. St. Giles' Infirmary .. .. .. .. .. Surgical Home, 24, Devonshire Street, Marylebone .. .. .. .. .. Shoreditch Infirmary .. 1 1 4 6 Samaritan Free Hospital .. .. .. 1 1 Horton Asylum (Epsom) 1 3 .. 8 12 Throat Hospital, Golden Square .. .. .. .. .. Chest Hospital, Chelsea .. .. .. .. .. Heart Hospital, Soho Square 1 .. .. .. 1 Hospital for Women, Soho 2 .. 1 .. 3 Gore Farm Hospital .. .. .. .. .. Royal Hospital for Incurables .. 1 .. .. 1 South Wharf Shelter .. .. .. .. .. Samaritan Free Hospital .. .. .. .. .. Chelsea Hospital for Women .. .. .. .. .. British Lying-in Hospital, Endell Street .. .. .. .. .. Royal London Ophthalmic Hospital .. .. .. .. .. Licensed Victuallers' Asylum .. .. .. 1 1 Childrens's Hospital, Shadwell .. .. .. .. .. North Eastern Children's Hospital 2 .. 1 .. 3 Metropolitan Ear and Throat Hospital .. .. .. .. .. Throat Hospital, Golden Square .. .. .. .. .. Hospital for Incurable Children, Maida Vale .. .. .. .. .. Tooting Bec Asylum .. .. 1 .. 1 City of London Asylum, Stone .. .. .. .. .. London County Asylum, Norwood .. .. 1 .. 1 H. M. Hospital, 19, Stepney Causeway .. 1 .. .. l St. Pancras Infirmary 2 3 2 .. 9 Surgical Home, 45, Devonshire Street, W. .. .. .. .. .. St. Elizabeth's Home, Mortimer Street, W. .. .. .. .. .. Mount Vernon Consumption Hospital .. 2 .. .. 2 St. George-in-the-East Infirmary .. .. .. .. .. Caterham Asylum .. 1 .. .. 1 1904] 92 Table LXX.—continued. Places where deaths occurred. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. West End Hospital 1 .. .. .. 1 Joyce Green Hospital 1 .. .. .. 1 Ravenswood Nursing Home, Highgate Road 1 .. .. .. 1 Strand Workhouse, Edmonton 1 .. .. .. 1 Home for Aged Jews, Hackney 1 .. .. .. 1 Ironmongers' Almshouses, Haggerston .. 1 .. .. 1 Wormwood Scrubbs Prison .. l .. .. 1 Clapham Maternity .. .. 1 .. 1 Roman Catholic Orphanage, Hackney Road .. .. 1 .... 1 St. Joseph's Home, Kensington .. .. 1 .. 1 Evelina Hospital .. .. 1 .. 1 Bermondsey Infirmary .. .. .. 1 1 St. Barnabas Home, 9, Lloyd Square, E.C. .. .. .. 1 1 St. Peter's Hospital, Covent Garden .. .. .. 1 1 St. Marylebone Infirmary .. .. .. 1 1 Accidental and other Deaths:— 167 130 150 149 596 In Cab in Gray's Inn Road, W.C. In Dalston Lane, N.E. 1 .. .. .. 1 At Dalston Junction 1 .. .. .. 1 At 20, Eagle Wharf Road, Hoxton 1 .. .. 1 2 At 10, Springfield, Upper Clapton 1 .. .. .. 1 At 27, Tottenham Court Road, W.C. 1 .. .. .. 1 In Kentish Town Road, N.W. 1 .. .. .. 1 At the "Nest," Springfield, Clapton 1 .. .. 1 2 At 3, Beaumont Street, W. .. 1 .. .. 1 In Regent's Canal, Hoxton .. l .. .. 1 In Lavatory, Liverpool Street Station .. 1 .. .. 1 At Police Station, Hunter Street, W. .. 1 .. .. 1 At 35, St. Philip Street, Haggerston .. .. 1 .. 1 In Gray's Inn Road, W.C. .. .. 1 .. 1 At 29, Lea Bridge Road, Hackney .. .. 1 1 2 Near Charing Cross Hospital .. .. 1 .. 1 In Central Street, St. Luke .. .. 1 .. 1 In River Thames .. .. 1 .. 1 At 18, Drummond Street, St. Pancras .. .. 4 .. 4 In No. 2 Pond, Highgate .. .. 1 .. 1 Electric Railway, Old Street Station .. .. .. l 1 At 21, Charing Cross Road, W.C. .. .. .. 1 1 In White Stone Pond, Hampstead .. .. .. 1 1 In Goswell Road, St. Luke .. .. .. 1 1 At 8, Macclesfield Street, FiEsbury .. .. .. 1 1 .. .. .. 1 1 Totals 174 134 161 158 627 93 [1904 Table LXXI. Showing the Deaths of Inhabitants and Non-Inhabitants in Public and Charitable Institutions situated within the Borough during the Four Quarters and in the Year, 1904. PUBLIC INSTITUTIONS. Inhabitants. Non-Inhabitants. Totals. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. Islington Infirmary 174 145 186 214 719 10 6 7 7 30 184 151 193 221 749 Islington Workhouses and Schools 34 24 20 35 113 .. 3 1 4 8 34 27 21 39 121 Great Northern Central Hospital 36 29 36 31 132 34 19 20 21 94 70 48 56 52 226 Holborn Inrfimary 1 .. 1 1 3 122 102 90 119 433 123 102 91 120 436 St. John's Nursing Institute .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tufnell Park Nursing Institution 1 .. .. .. 1 .. 4 .. .. 4 1 4 .. .. 5 London Fever Hospital .. .. .. .. 1 2 1 .. 1 4 2 2 .. 1 5 Aged Pilgrims' Asylum .. .. .. 1 1 3 1 2 1 7 3 1 2 2 8 St. Pelagia's Creche .. .. .. .. .. 2 3 1 5 11 2 3 1 5 11 Memorial Cottage Hospital .. .. .. 1 2 .. .. .. 4 4 1 .. .. 5 6 Nursing Home, Hungerford Road .. .. .. .. .. .. .. .. .. .. .. .. .. .. Aged Blind Home .. .. .. .. .. .. 1 .. 2 7 .. 1 .. 2 7 Medical and Surgical Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Invalid Home, Aubert Park .. .. .. .. .. .. 1 .. .. 3 .. 1 .. .. 3 H.M. Prison, Holloway .. .. 1 l 2 .. 3 1 .. 4 .. 3 2 1 6 H.M Prison, Pentonville .. .. 1 .. 3 .. 2 2 5 10 .. 3 3 5 13 Children's Nursing Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Kingsdown Orphanage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nursing Home, Turle Road .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whittington College .. .. .. l 1 .. .. .. 1 2 .. .. .. 2 3 Metropltn. Benefit Societies'Asylum .. .. .. l 1 .. 1 .. .. 2 .. 1 .. 1 3 Winifred House .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Alexandra Orphanage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drover's Almshouses .. 1 .. .. 2 .. .. .. .. .. .. 1 .. .. 2 Bookbinder's Asylum .. 1 .. .. 2 .. 1 .. 1 3 .. 2 .. 1 5 Invalid Home, Highbury Terrace .. 1 .. .. 1 .. 1 .. 1 2 .. 2 .. 1 3 Royal Caledonian Asylum .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dyers' Almshouses .. .. .. .. .. .. .. .. 3 3 .. .. .. 3 3 Highbury Truant School .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bricklayer's and Tiler's Almshouses .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 Clothworkers' Almshouses .. .. 1 1 2 .. .. 1 .. 1 .. .. 2 1 3 St. Andrew's Nursing Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 250 203 247 287 987 182 149 126 175 632 432 352 373 462 1619 1904] 94 INQUESTS AND MORTUARY. During the year 660 bodies were received into the Mortuary of which 3 were taken there because the deceased had suffered from infectious diseases. The return is the lowest since 1889 when 613 bodies were removed thither. The coroner found it necessary to hold 424 inquests as compared with 393 in 1903, and with an average of 433 in the ten years immediately preceding. Bodies received into Mortuary. Inquests. 1894 685 382 1895 742 412 1896 757 463 1897 708 443 1898 712 402 1899 807 467 1900 754 475 1901 693 431 1902 745 458 1903 681 393 Average 728 433 1904 660 424 The following table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1903 and 1904. 1903. No. of bodies received. Daily Average. No. of Inquests held. 1904. No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 166 1.8 110 1st Quarter 194 2.1 115 2nd „ 179 1.9 104 2nd „ 131 1.4 85 3rd „ 174 1.9 80 3rd „ 166 1.8 103 4th „ 162 1.7 99 4th „ 169 1.8 121 Total for Year 681 1.8 393 Total for Year 660 1.8 424 PART III. THE NOTIFICATION, ISOLATION, FATALITY, AND PREVENTION OF DISEASE. VACCINATION. INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS AND ON BUSINESS PREMISES, TOGETHER WITH THE OCCUPATIONS OF THE ATTACKED. 1904] 96 THE NOTIFICATION OF INFECTIOUS DISEASES. Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric (or Typhoid) Fever, Erysipelas, Puerperal Fever, Continued Fever, Relapsing Fever, Cholera. The return of 1,941 cases was very satisfactory, for it was 906 below the corrected average number notified in the preceding ten years; and also because it was particularly noticeable for a reduction in the attacks from all the notifiable infectious diseases, and it indicated one of the healthiest years since notification was commenced. The cases represent an attack-rate of 5.69 per 1,000 inhabitants, which is 2.65 per 1,000 below the mean rate of the years 1894-1903. This rate also compares favourably with that of the Encircling Boroughs, in which it averaged 6.90 per 1,000, and with the County of London, the rate of which was 6.08 per 1,000. Attack-Rates. St. Pancras 6.81 per 1,000 inhabitants. Stoke Newington 5.59 „ „ Hackney 8.48 „ „ Hornsey 6.55 „ „ Finsbury 6.55 „ „ Shoreditch 6.64 „ ,, The Encircling Boroughs 6.90 ,, „ County of London 6.08 „ „ Islington 5.69 „ ,, This return shows that, with the single exception of Stoke Newington, Islington was more free from the notifiable infectious diseases than any of the communities named in it. For the particulars respecting the various Metropolitan Boroughs reference should be made to Tables CIII. and CIV. (pp. 127, 128.) 97 [1904 The particulars for each year since 1891 are seen below:— Years. Cases. Attack-rates. 1891 2,059 = 6.43 per 1,000 inhabitants. 1892 3,318 10.26 „ „ 1893 4.853 14.84 ,, ,, 1894 3,121 = 9.44 ,, ,, 1895 2,841 = 8.50 „ „ 1896 3,822 = 11.32 ,, ,, 1897 2,906 = 8.62 ,, ,, 1898 2,418 = 7.18 ,, ,, 1899 2.943 = 8.75 ,, ,, 1900 2,276 = 6.78 ,, ,, 1901 2,852 = 8.50 ,, ,, 1902 3.164 = 9.20 ,, ,, 1903 1,707 = 5.03 ,, ,, 1904 1,941 = 5.69 ,, ,, The Sub-registration Districts.—The heaviest incidence of the infectious diseases was felt in Tollington, where it was at the rate of 8.82 per 1,000 of the population, while their lowest incidence occurred in the neighbouring Sub-district (Upper Holloway), where the rate was only 4.66. The particulars for each sub-district are as follows: Cases. Attack-rates. Tufnell 155 4.66 per 1,000 inhabitants. Upper Holloway 146 4.15 ,, ,, Tollington 310 8.82 ,, ,, Lower Holloway 2l8 5.24 ,, ,, Highbury 338 5.14 ,, ,, Barnsbury 399 7.36 ,, ,, Islington South East 375 4.94 ,, ,, Total 1,941 5.69 ,, ,, In the Wards the cases and attack-rates are as follows:— Cases. Attack-rates. Tufnell 155 4.66 per 1,000 inhabitants. Upper Holloway 146 4.15 ,, ,, Tollington 310 8.82 ,, ,, Lower Holloway 218 5.24 ,, ,, Highbury 184 5.27 ,, ,, Mildmay 133 5.33 ,, ,, Thornhill 266 7.96 ,, ,, H 1904] 98 Cases. Attack-rates. Barnsbury 133 6.40 per 1,000 inhabitants. St. Mary 79 4.55 „ „ Canonbury 177 5.58 „ „ St. Peter 140 4.27 „ „ In the Quarters—In the first quarter 330 cases were notified, in the second 436, in the third 567, and in the fourth 608. The attack rates for these periods being respectively 3.87, 5.11, 6.65 and 7.13 per 1,000 inhabitants. Hospital Isolation.—Out of 1,941 cases which were notified 1,467, or 75.6 per cent., were removed to hospital, of whom 82, or 5.5 per cent., died as against 7.8 per cent. of the cases retained at home for treatment. Fatality.—By this term is meant the percentage proportion which the deaths bear to the notified cases. During the year 1904 out of 1,942 cases that were notified 119 died, so that the fatality was 6.1 per cent. This is the lowest proportion hitherto recorded in Islington, and is slightly lower than that of the preceding year, which had been the record up to that time. The previous returns are given in the following statement:— Years. Cases. Deaths. Fatality. 1891 2,059 258 12.5 1892 3.318 291 8.7 1893 4.853 383 7.9 1894 3.121 339 10.8 1895 2,841 266 9.3 1896 3.822 390 10.2 1897 2,906 258 8.8 1898 2,418 173 7.1 1899 2,943 238 8.1 1900 2,276 202 8.8 1901 2,852 250 8.7 1902 3,167 268 8.4 1903 1,707 108 6.3 1904 1,941 119 6.1 Total 40,224 3,543 8.8 SMALL POX. Seventeen cases were notified, equal to an attack rate of 0 05 per 1,000 of the population, as compared with a corrected average of 52 cases and an attack Showing the rise and fall of SMALLPOX for each week in 1904, and the averages for the corresponding weeks in the Ten vears 1894-1903. 99 [1904 rate of 0.10, in the preceding ten years. These cases were reported in the first and second quarters of the year, 1 case occurring in January, 2 in February, 2 in March, 4 in April, 5 in May, and 3 in June, from which period to the end of the year none was known. The cases were confined in Islington to Barnsbury, where 12 were notified, to Islington South-East where there were 4, and to Lower Holloway where there was 1. Owing to a probable outbreak of the disease, the London County Council on March 29th, 1904, made an order under the provisions of the Public Health London Act, 1891. making Chicken Pox a notifiable disease in the County of London for four months commencing on April 7th. This Order was subsequently renewed for a further period of three months, terminating on November 7th. Altogether 812 cases were notified under it. In the County of London 491 cases of Small Pox were notified, equal to an attack rate of 0.11 per 1,000. Owing to the great vigilance exercised by the Metropolitan Medical Officers of Health, and the sanitary staffs under them, the disease did not make much headway. The outbreak was chiefly confined to the Eastern Boroughs, where 126 cases were notified in Bethnal Green, 90 in Stepney, and 42 in Poplar, or a total of 258, or more than half the cases, actually 52.5 per cent. A statement showing the returns for previous years is given in Table XCIII. Table LXXII. Showing the Sickness from Small Pox in the Sub Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. .. .. Upper Holloway .. .. .. .. .. Tollington .. .. .. .. .. Lower Holloway .. 1 .. .. 1 Highbury .. .. .. .. .. Barnsbury 4 8 .. .. 12 Islington, South East 1 3 .. .. 4 The Borough 5 12 .. .. 17 h 2 1904] 100 Table LXXIII. Showing the Attack Rates from Small Pox of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. and Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell •• •• •• •• •• Upper Holloway •• •• •• •• •• Tollington •• •• •• •• •• Lower Holloway •• 0.09 •• •• 0.02 Highbury •• •• •• •• •• Barnsbury 0.29 0.59 •• •• 0.22 Islington, South East 0.05 0.16 •• •• 0.05 The Borough 0.06 0.14 •• •• 0.05 Table LXXIV. Showing the Fatality from Small Pox. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell •• •• •• •• •• Upper Holloway •• •• •• •• •• Tollington •• •• •• •• •• Lower Holloway •• •• •• •• •• Highbury •• •• •• •• •• Barnsbury 25.0 •• •• •• 8.33 Islington, South East •• •• •• •• •• The Borough 20.0 •• •• •• 5.88 Showing the rise and fall of SCARLET FEVER for each week in 1904, and the averages for the corresponding weeks in the Ten years 1894-1903. 101 [1904 SCARLET FEVER. The number of cases of this disease which were notified was 1,146, or 297 below the corrected average of the preceding ten years. On only two previous occasions have the returns been so good as those now recorded, namely in 1900 when there were 1,074 cases, and in 1903 when there were 865. The attack rate was 3.36 per 1,000 of the population as compared with a decennial rate of 4.23 per 1,000. In the County of London 13,438 were notified, and the attack-rate was 2.89 per 1,000 inhabitants, or 0.45 per 1,000 less than in this Borough. In the Encircling Boroughs 2,729 cases were reported, resulting in an attack rate of 3.36 per 1,000 of the population, which is identical with the local rate. For the returns of the preceding ten years Table XCIII. (page 117) must be consulted. Hospital Isolation.—As many as 1,024 cases were removed to Hospital, or 89.4 per cent. of the known cases, which is the highest percentage hitherto recorded. Much has been said and written lately with respect to the isolation of Scarlet Fever in hospitals, and it has been stated by some observers that it has had no appreciable effect in the prevention of the disease. This is a startling statement, and one with which the writer cannot agree; and, indeed, it would require some very strong facts to convince him that the removal of over a thousand cases of infection, for the most part from tenement houses, occupied by numerous children, nearly all susceptible to the disease, has had no effect on the public weal of this borough. When we are considering this question we must recollect that coincident with the notification of the infectious diseases, which gave such an impetus to hospital isolation, came the very stringent application of the Education Act, in consequence of which children were whipped up to school by the attendance officers in a manner that, while it has filled the Schools, has not been to the best interest of the public health, and we should put to ourselves this query : What would have happened if there had been no isolation ? the answer, of course, can only be based on surmise. Schools have ever been a fruitful source of infection to scholars, more especially since large establishments, where sometimes between one and two thousand children are gathered together, have become general; and frequently cases of Scarlet Fever have been traced to scholars, who either had returned to school too early after home treatment, or who, through the ignorance of their parents, in slight cases had returned while in an infected state. 1904] 102 But there is also another light in which to look on this question, which is that isolation in hospital prevents an enormous dislocation of school work, as well as of business, especially of businesses where food stuffs or drinks are sold, and where clothing is made. It is a sine qua non in all school codes that children shall not attend school from houses in which there is a case of Scarlet Fever, and consequently whenever a case is notified to a Medical Officer of Health one of his first acts is to enquire the names of the schools attended by the children living on the premises, so that he may forward them to the school teacher. He has no option but to do this, for the London Public Health Act, sec. 55 (4), provides that the Medical Officer of Health shall within 12 hours after the receipt of a certificate send information to the head teacher of the school attended by the patient (if a child), or by any child who is an inmate of the same house as the patient. It is his implied duty also to inform the parents of the children that they are not to attend school until seven days have elapsed after the disinfection of the premises, for the London County Council Schools' Code provides that "it will be necessary for a further period (that is after disinfection) of seven days to elapse before the return of such children to school." Consequently, if the infected child were not removed to hospital every child in the house would be compelled to remain at home until the patient had completely recovered, and until a week after the premises had been disinfected, that is to say for a period varying from six weeks to three months—a state of affairs that would be intolerable. Again, if the patients were not removed to hospital, businesses where food and drink are sold would be ruined, apart from which disadvantage great danger would accrue to the public. Once it got noised abroad, and it would be difficult to keep it secret because of the visits of the Medical Officer of Health or the Sanitary Inspector, customers would cease to buy and would purchase their food or drink elsewhere, fearing lest they should contract the infection. It is of course quite possible that there may be very little risk to the public in those businesses in which the females of the household are not employed, because they do not serve in the shop or handle the goods; but there is a very real danger in those businesses where the mother and the daughters, but particularly the former, take an active part in selling the wares, because they are the persons who in nearly every instance nurse the patients. And even when they do not, and when the mothers profess that if their children are not removed to hospital they will not enter the rooms where the patients lie ill, can any thinking person believe for a 103 [1904 moment that such a contract will be kept? Of course not, because it is entirely contrary to the natural ties that bind humanity. No mother, unless a most unnatural one, could resist the maternal call if her sick child desired her presence, with the result that she would be at one moment in the sick room and at the next in the shop, duty alternating with business, which in these cases is not permissible. It must be either all duty or all business, which is a hopeless proposition under these circumstances. It is a serious matter for a case of scarlet fever to occur on premises where clothing is made, for the Factory and Workshop Act in its 109 section prohibits the making, cleaning, or repairing of wearing apparel in any dwelling house whilst an inmate is suffering from scarlet fever. In consequence of this enactment one or two things must be done when a case of this disease occurs, either the patient must be removed or the business must be stopped. To stop the business would mean utter ruin to many persons, especially to those poor women, so many of whom are widows, who are home-workers endeavouring to earn the merest pittance for the support of their family by making blouses, shirts, ties, and the thousand and one small articles that are worn by ladies. The question is not has the presence of scarlet fever been lessened by hospital isolation, but rather what would have happened in these modern days under the circumstances that have been detailed if there had been no isolation? The disease will more than probably never be stamped out, but it can be, and is, kept within due limits by isolation in hospital. But why this recent endeavour to belittle hospital isolation of this disease? It is because a certain number of what are known as "return cases" of scarlet fever have arisen among brothers and sisters soon after the patients' return to their homes. In Islington, as elsewhere, such cases have occurred, but they are more or less unavoidable. Only recently, for instance, a child who had been in hospital for about nine weeks returned home. She seemed quite well; skin in good condition; no discharge of mucous from the ears, nose or throat. She had been at home, however, for only four days when one from the nose commenced, with the resuit that in a few days her sister was attacked. More frequently, however, cases have arisen shortly after the arrival home of the patients from hospital, although they have been apparently entirely free of disease on their discharge. But surely it is no reason because these cases now and again occur that hospital isolation should not be practised, but that on the contrary the patients should be allowed to remain at home, for the most part, living in tenement 1904] 104 houses, confined (as they might be, but unfortunately are not) to a single room for weeks, with their fathers and mothers constantly with them, and with their brothers and sisters and their friends running in and out to them. Is this what should be allowed? It certainly could not be prevented—is such a state of affairs conducive to the best interests of the public health? is such a practice or isolation in hospital the more likely to prevent the spread of the disease? Common sense, despite all reasonings to the contrary, will dictate the answers at once and unambiguously. The question is not argued here as to whether treatment at home or in the hospital is the better for the patients, especially when their ordinary surroundings in populous places are considered, but the unhesitating opinion of the Medical Officer of Health, after nearly twelve years' actual hospital experience, and with six years' experience as a private practitioner, and altogether an active experience of twenty-nine years, is that the removal to hospital is best for the patient. Fatality.—Among 1,146 cases there occurred 35 deaths, or a fatality of 3.0 per cent., as compared with 3.2 in the thirteen years 1891-1903. Table LXXV. Showing the Sickness from Scarlet Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 20 11 25 16 72 Upper Holloway 11 15 22 28 76 Tollington 18 44 88 72 222 Lower Holloway 24 44 34 33 135 Highbury 21 43 56 83 203 Barnsbury 27 50 77 77 231 Islington, South East 38 77 56 36 207 The Borough 159 284 358 345 1,146 105 [1904 Table LXXVI. Showing the Attack Rates from Scarlet Fever of the SubDistricts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2.41 1.33 3.01 1.93 2.17 Upper Holloway 1.25 1.70 2.50 3.18 2.16 Tollington 2.05 5.01 10.01 8.19 6.32 Lower Holloway 2.31 4.23 3.27 3.17 3.25 Highbury 1.28 2.62 3.41 5.05 3.09 Barnsbury 2.00 3.69 5.69 5.68 4.26 Islington, South East 2.00 4.06 2.95 1.90 2.73 The Borough 1.86 3.33 4.20 4.05 3.36 Table LXXVI I. Showing the Fatality from Scarlet Fever. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 5.0 .. .. .. 1.3 Upper Holloway .. .. .. 3.6 1.3 Tollington 5.5 68 2.3 5.6 4.5 Lower Holloway .. .. 2.9 3.0 1.4 Highbury .. .. 3.6 2.4 1.9 Barnsbury 3.7 2.0 2.6 2.6 2.6 Islington, South East 5.3 7.8 5.4 .. 5.3 The Borough 3.1 3.5 2.8 2.9 3.0 1904] 106 DIPHTHERIA. In the report for 1903 it was recorded that this disease, which includes Membranous Croup, "showed a very large decrease in the number of cases reported," and now it is again possible to record a further decline. During 1904 only 347 cases were notified, as against 455 in the preceding year, and as compared with a corrected decennial average of 750. The present return is the lowest hitherto known, and it is, therefore, exceedingly satisfactory to be able to chronicle the event. The attack-rate was ro2 per 1,000 of the population, as against a rate of 2.21 in the ten years immediately preceding. In the County of London the attack-rate was 1.55 per 1,000 inhabitants, and in the Encircling Boroughs 1.74. Hospital Isolation.--260 out of the 347 known cases, or 74.9 per cent., were removed to hospital for isolation and treatment, of whom 18, or 6.9 per cent. died. Fatality.—There died 28 persons out of 347 attacked, so that the fatality was 8.1 per cent., as compared with an average fatality during thirteen years (1891-1903) of 19.4. There has been an enormous fall in the fatality from Diphtheria in the last fourteen years, and although the figures were given last year, they are again reproduced, for they are of very great interest. Year. Fatality. Year. Fatality. Year. Fatality. 1891 23.5 1896 23.5 1901 14.7 1892 23.0 1897 18.0 1902 11.8 1893 22.6 1898 17.1 1903 9.4 1894 25.1 1899 18.2 1904 8.1 1895 24.7 1900 16.7 Here it will be noted that there has been a steady decrease in the fatality from 1894 to the end of last year, which is very suggestive of the success of the antitoxin treatment of the disease. Showing the rise and fall of DIPHTHERIA for each week in 1904, and the averages for the corresponding weeks in the Ten years 1894-1903. 107 [1904 Table LXXVIII. Showing the Sickness from Diphtheria in the Sub-Districts for each Quarter and, for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 7 6 6 9 28 Upper Holloway 11 5 10 11 37 Tollington 8 14 11 12 45 Lower Holloway 13 7 9 8 37 Highbury 14 9 8 28 59 Barnsbury 26 17 21 15 79 Islington, South East 20 15 13 14 62 The Borough 99 73 78 97 347 Table LXXIX. Showing the Attack Rates from Diphtheria of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.84 0.72 0.72 1.08 0.84 Upper Holloway 1.25 0.57 1.14 1.25 1.05 Tollington 0.91 1.59 1.25 1.37 1.28 Lower Holloway 1.25 0.67 0.87 0.77 0.89 Highbury 0.85 0.55 0.49 1.71 0.89 Barnsbury 1.92 1.26 1.55 1.11 1.46 Islington, South East 1.05 0.79 0.69 0.74 0.82 The Borough 1.16 0.86 0.92 1.14 1.02 1904] 108 Table LXXX. Showing the Fatality from Diphtheria, including Membranous Croup. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 28 6 •• 16. 7 11.1 14.3 Upper Holloway •• •• •• 27.3 8.1 Tollington •• 7.1 9.1 •• 4.4 Lower Holloway 7.7 14.3 12.5 •• 8.1 Highbury •• 11.1 •• 7.1 5.1 Barnsbury 19.2 •• 14.3 6.6 11.4 Islington, South East 10.0 6.6 •• 7.1 6.4 The Borough 10.1 5.6 7.7 8.2 8.1 Table LXXXI. Showing the Cases and Deaths from Diphtheria together with the Fatality and the Departurs from the Mean Fatality during the ten years 1894-1903 ,and 1904. Year. Cases. Deaths. Fatality. Diphtheria. Membranous Croup. Total of Diphtheria and Membranous Croup. Diphtheria. Membranous Croup. Total of Diphtheria and Membranous Croup. Deaths to 100 cases of Diphtheria and Membranous Croup. Departure from Average Fatality of 10 years. 1894 843 24 867 208 10 218 25.1 + 3.5 1895 564 18 582 137 7 144 24.7 + 3.1 1896 1,067 24 1,091 247 10 257 23.5 + 1.9 1897 700 29 729 115 16 131 18.0 – 3.6 1898 531 13 544 90 3 93 17.1 – 4.5 1899 688 17 705 120 8 128 18.2 – 3.5 1900 624 9 633 100 6 106 16.7 – 4.9 1901 902 9 911 124 10 134 14.7 – 6.9 1902 871 7 878 101 3 104 11.8 – 8.8 1903 452 3 455 41 2 43 9.4 – 10.0 1894-03 7,242 153 7,395 1,283 75 1,358 18.4 – 3.4 1904 347 •• 347 27 1 28 8.1 – 10.3 109 [1904 Table LXXXII. Showing the Cases, Deaths and Fatality from Diphtheria at Home and in Hospital. Quarter. Cases Nursed at Home. Cases Nursed at Hospital Cases. 1 Deaths. 2 Percentage Fatality. 3 Cases. 4 Deaths. 5 Percentage Fatality. 6 1st 21 2 9.5 78 8 10.2 2nd 15 2 12.1 58 2 3.4 3rd 18 2 11.1 60 4 6.6 4th 33 4 12.1 64 4 6.2 Year 87 10 11.5 260 18 6.9 Note In comparing columns 3 and 6 it must not be forgotten that it is only the mildest cases which as a rule are retained at home. The worst cases are invariably hurried to hospital. 110 1904] Table LXXXIII. Showing the Fatality from Diphtheria* at each year of life up to 15 years of age, and at each decennial period after that age. Ages. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. The Year. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. 0— 1 1 1 100 2 1 50 1 ... ... 3 ... ... 7 3 43 1— 2 5 2 40 2 ... ... 6 ... 7 1 14 20 2 10 2— 3 15 2 13 3 1 33 15 1 6 8 1 12 41 5 12 3— 4 8 2 25 8 ... ... 6 1 16 8 ... ... 30 3 10 4— 5 12 ... 9 ... ... 5 1 20 10 ... ... 36 1 3 5— 6 12 2 17 5 ... ... 8 ... ... 12 2 17 37 4 11 6— 7 8 ... ... 4 ... 8 2 25 10 2 20 30 4 11 7- 8 2 ... ... 2 1 50 3 ... ... 5 ... ... 12 1 8 8— 9 3 ... ... 7 ... ... 5 1 20 9 ... ... 24 1 4 9—10 3 ... ... 1 1 100 2 ... ... 4 ... ... 10 1 10 10—11 4 1 25 4 ... ... 1 ... ... 3 ... 33 12 2 16 11—12 ... ... ... 4 ... ... 2 ... • • • 2 ... ... 8 ... ... 12—13 5 ... ... 3 ... ... ... ... ... 2 ... ... 10 ... ... 13—14 ... ... ... 2 ... ... ... ... ... 1 1 100 3 1 33 14—15 1 ... ... 2 ... ... 2 ... ... 1 ... ... 6 ... ... 15-25 10 ... ... 8 ... ... 6 ... ... 4 ... ... 28 ... ... 25-35 5 ... ... 3 ... ... 7 ... ... 6 ... ... 21 ... ... 35—45 4 ... ... 3 ... ... 1 ... ... ... ... ... 8 ... ... 45—55 ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 55—65 ... ... ... 1 ... ... ... ... ... 1 ... ... 2 ... ... 65 upwards 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Totals 99 10 10 73 4 5 78 6 7 97 8 8 347 28 8 * Inclusive of Membranous Croup. Showing the rise and fall of TYPHOID FEVER for each week in 1904, and the averages for the corresponding weeks in the Ten years 1894-1903. 111 [1904 ENTERIC FEVER. One hundred and twenty-six cases of enteric fever, equal to an attack rate of 0.37 Per 1,000 of the population, were notified, as against a decennial average of 247, and a rate of 0.72 per 1,000. The return was the smallest hitherto recorded. This is particularly gratifying as it followed one which had hitherto been the lowest record, namely 130 in 1903. Thirteen cases were notified in the first quarter, 19 in the second, 52 in the third, and 42 in the fourth. In the County of London the attack rate was 0.14 per 1,000, and in the Encircling Boroughs 0.55. Hospital Isolation. All the cases, except 18, were treated in hospital so that in all 85.7 per cent, were removed from their homes. Fatality.—Eighteen out of the 126 known cases died, so that the fatality was 14.3 per cent. Of the hospital cases only in per cent, died, compared with 33.3 per cent, that remained at home. Table LXXXIV. Showing the Cases of Enteric Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. Whole Year. Tufnell 1 4 4 4 13 Upper Holloway 1 •• 7 2 10 Tollington •• 4 5 1 10 Lower Holloway 1 1 8 6 16 Highbury 4 4 13 6 27 Barnsbury 4 5 11 6 26 Islington, South East 2 1 4 17 24 The Borough 13 19 52 42 126 1904] 112 Table LXXXV. Showing the Attack Rates from Enteric Fever of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.12 0.48 0.48 0.48 0.39 Upper Holloway 0.11 •• 0.79 0.23 0.28 Tollington •• 0.45 0.57 0.11 0.28 Lower Holloway 0.10 0.09 0.77 0.58 0.38 Highbury 0.24 0.24 0.79 0.37 0.41 Barnsbury 0.29 0.37 0.81 0.44 0.48 Islington, South East 0.11 0.05 0.21 0.89 0.32 The Borough 0.15 0.22 0.61 0.49 0.37 Table LXXXVI. Showing the Fatality from Enteric Fever. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell .. •• 25.0 25.0 15.4 Upper Holloway 100.0 •• • • 10.0 Tollington •• 50.0 .. 100.0 30.0 Lower Holloway •• • • •• • • •• Highbury •• 25.0 7.7 .. 7.4 Barnsbury ••• 20.0 9.1 16.6 11.5 Islington, South East 50.0 100.0 25.0 23.5 29.2 The Borough 15.4 26.3 7.7 16.7 14.3 Showing the rise and fall of ERYSIPELAS for each week in 1904, and the averages for the corresponding weeks in the Ten years 1894-1903. 118 [1904 TYPHUS FEVER. Only one case was known, and it was the first case recorded since 1902, when 2 cases occurred. The disease is seldom heard of in this borough, indeed, in the thirteen years 1891-1903, only 15 cases were recorded, about several of which there was some doubt as to their genuiness. Two cases were notified in 1891, 1 in 1893, 1 in 1894, 5 in 1895, 2 in 1898, 1 in 1900, and 2 in 1901. In the County of London only 3 cases were reported, namely I in Westminster, 1 in Stepney, and 1 in Islington. ERYSIPELAS. During the year 1904, 280 cases were notified, as compared with a corrected annual average during ten years of 325. The attack-rate represented 0.82 cases per 1,000 of the population, and was 0.13 beneath the mean decennial rate, as compared with 1.06 per 1,000 in the County of London, and with 1.11 in the Encircling Boroughs. Hospital Isolation.—Patients suffering from Erysipelas, unless the disease is of a grave type requiring surgical treatment, are seldom taken into hospital, so that, unlike the diseases previously discussed, only a small proportion, namely, 46 out of 280 cases, 16.4 per cent, were treated in hospital, and of these many were reported from local institutions, where they had gone for the surgical or medical treatment of other diseases. Fatality.—The fatality was at the rate of 8.2 per cent. among the total cases, but it was 23.9 per cent, among the hospital cases, and 5.1 per cent, amongst the home cases. Table LXXXVII. Showing the Sickness from Erysipelas in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 10 8 4 14 36 Upper Holloway • • 3 5 11 19 Tollington 4 5 7 14 30 Lower Holloway 7 3 5 14 29 Highbury 7 6 16 17 46 Barnsbury 3 13 12 17 45 Islington, South East 13 7 26 29 75 The Borough 44 45 75 116 280 1904] 114 Table LXXXVIII. Showing the Attack Rates from Erysipelas of the Sub-District; for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1.20 0.96 0.48 1.69 1.08 Upper Holloway •• 0.34 0.57 1.25 0.54 Tollington 0.45 0.57 0.80 1.59 0.85 Lower Holloway 0.67 0.30 0.48 1.35 0.70 Highbury 0.43 0.36 0.97 1.03 0.70 Barnsbury 0.22 0.96 0.89 1.26 0.83 Islington, South East 0.69 0.37 1.37 1.53 0.98 The Borough 0.52 0.53 0.88 1.36 0.82 Table LXXXIX. Showing the Fatality from Erysipelas. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. •2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell 10.0 .. 25.0 .. 5.5 Upper Holloway .. .. •• 9.1 5.3 Tollington .. 20.0 21.4 13.3 Lower Holloway 42.8 .. 20.0 7.1 17.2 Highbury .. 16.6 6.2 5.9 6.5 Barnsbury 33.3 • • 8.3 11.8 8.9 Islington, South East 7.7 .. •• 10.3 5.3 The Borough 13.6 4.4 5.3 9.5 8.2 115 [1904 PUERPERAL FEVER. The number of cases of Puerperal Fever notified was 24, or exactly the same number as the corrected average for the preceding ten years. It was, however, 5 more than that notified in the preceding year. These 25 cases represent 2.70 per 1,000 of the births registered during the year, as compared with an annual average of 2.49 per 1,000 which obtained during the ten years 1894-1903. In the County of London 273 cases were known and were in the proportion of 2' 11 to every 1,000 births, while in the Encircling Boroughs the proportion was 2.28 per 1,000. Hospital Isolations.—Out of the 25 cases 11, or 44 per cent., were treated in hospital. Fatality.—This was as usual very high, and it is a sad record that 56.0 per cent., slightly more than one in every two cases, died. Table XC. Showing the Sickness from Puerperal Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell .. 1 2 2 5 Upper Holloway 3 .. .. 1 4 Tollington 2 .. .. 1 3 Lower Holloway .. .. .. .. .. Highbury 2 .. .. 1 3 Barnsbury 2 1 .. 3 6 Islington, South East 1 1 1 .. 3 The Borough 10 3 3 8 24 1 2 1904] 116 Table XCI. Showing the Attack Rates from Puerperal Fever per 1,000 registered Births of the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. 5.10 8.73 12.20 6.26 Upper Holloway 10.39 •• .. 3.82 3.75 Tollington 9.13 •• .. 5.13 3.68 Lower Holloway •• •• .. .. .. Highbury 6.10 .. 2.92 2.11 Barnsbury 4.73 2.35 .. 7.21 3.59 Islington, South East 1.93 1.88 2.02 .. 1.50 The Borough 4.40 1.31 1.36 3.76 2.70 Table XCII. Showing the Fatality from Puerperal Fever. Deaths to 100 cases of Sickness. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell .. .. .. 50.0 20.0 Upper Holloway 33.3 .. .. 100.0 50.0 Tollington 50.0 .. .. •• 33.3 Lower Holloway •• .. .. .. •• Highbury 50.0 .. •• .. 33.3 Barnsbury 100.0 .. .. 66.6 66.6 Islington, South East 100.0 50.0 50.0 •• *100.0 The Borough 60.0 66.6 66.6 50.0 58.3 *N.B.—The Notification Certificates were not received in respect of two of these deaths. 117 [1904 CONTINUED FEVER. No cases were notified, which is a decrease of 4 on the corrected average of ten years. RELAPSING FEVER. Nil return. CHOLERA. Nil return. Table XCIII. Showing the number of Cases of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1894-03, and in 1904. DISEASES. YEARS. Corrected average number of cases. Increase or Decrease 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. 1891-03. 1904. Small Pox 90 25 50 3 3 2 50 276 9 52 17 —35 Scarlet Fever 1493 1692 2031 1577 1336 1494 1074 1286 1372 865 1443 1146 —297 Diphtheria 843 564 1067 700 531 688 624 92 871 452 735 347 —388 Membranous Croup 24 18 24 29 13 17 9 9 7 3 15 ... — 15 Enteric Fever 245 184 229 256 237 353 259 281 257 130 247 126 -121 Typhus Fever 1 5 ... ... 2 ... 1 2 ... ... 1 1 ... Erysipelas 395 320 385 312 279 350 285 285 357 227 325 280 —45 Puerperal Fever 23 22 30 27 19 33 16 34 19 19 24 24 ... Continued Fever 7 9 6 1 1 2 6 3 5 2 4 ... —4 Relapsing Fever ... 2 ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... 1 ... 3* ... ... ... ... 1 ... —1 Totals 3121 2841 3822 2906 2418 2943 2276 2852 3164 1707 2847 1941 —906 * English Cholera. 1904] 118 Table XCIV. Showing the Attack Rates arising from the several Notifiable Infectious Diseases which occurred during the Ten Years 1894-1903 and in 1904. DISEASES. YEARS. Mean Attack Kates. Attack Rate. Increase or Decrease. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. 1894-03. 1904. Small Pox 0.27 0.07 0.15 0.00 0.00 0.00 0.00 0.15 0.80 0.03 0.15 0.05 —0.10 Scarlet Fever 4.52 5.06 6.02 4.68 3.97 4.44 3.20 3.84 3.99 2.55 4.23 3.36 —0.87 Diphtheria 2.55 1.69 3.16 2.08 1.58 2.05 .186 2.69 2.53 1.33 2.16 1.02 —1.14 Membranous Croup 0.07 0.05 0.07 0.09 0.04 0.05 0.03 0.03 0.02 0.01 0.05 ... —0.05 Enteric Fever 0.74 0.55 0.68 0.76 0.70 1.05 0.77 0.84 0.75 0.38 0.72 0.37 —0.35 Typhus Fever 0.00 0.01 ... ... 0.00 ... 0.00 0.00 0.00 0.00 0.00 0.00 ... Erysipelas 1.20 0.96 1.14 0.93 0.83 1.04 0.85 0.85 0.14 0.67 0.95 0.82 —0.13 Puerperal Fever 2.42 2.23 3.02 2.74 2.86 3.42 1.73 3.67 2.06 2.11 2.49 2.70 +0.21 Continued Fever 0.02 0.03 0.01 0.00 0.00 0.00 0.02 0.00 0.01 0.00 0.01 ... — 0.01 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... 0.00 ... 0.00 ... ... ... ... ... ... ... Totals 9.44 8.50 11.32 8.62 7.18 8.75 6.78 8.50 9.20 5.03 8.34 5.69 —2.65 * These figures are calculated as per 1,000 Registered Births. 119 [1904 TABLE XCV. Shewing the number of Cases of Infectious Diseases notified in the Sub-Registration Districts during 1904. Sub-Registration District. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals. Attack-Rate per 1,000 of the Population. Tufnell ... 72 28 ... 13 1 36 5 ... ... ... 155 4.66 Upper Holloway ... 76 37 ... 10 ... 19 4 ... ... ... 146 4.15 Tollington ... 222 45 ... 10 ... 30 3 ... ... ... 310 8.82 Lower Holloway 1 135 37 ... 16 ... 29 ... ... ... ... 218 5.24 Highbury ... 203 59 ... 27 ... 46 3 ... ... ... 338 5.14 Barnsbury 12 231 79 ... 26 ... 45 6 ... ... ... 399 7.3 6 Islington South East 4 207 62 ... 24 ... 75 3 ... ... ... 375 4.94 The Borough 17 II46 347 ... 126 1 280 24 ... ... ... 1941 5.69 (All Duplicates have been deducted). 120 1904] TABLE XCVI. Showing the Attack rates from Infectious Diseases notified in the Sub-Registration Districts during 1904. Sub-Registration Districts. Small Pox. ! Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal* Fever. Continued Fever. Relapsing Fever. Cholera. Attack-Rate per 1.000 of the Population. Tufnell ... 2.17 0.84 ... 0.39 0.03 1.08 6.26 ... ... ... 4.66 Upper Holloway ... 2.16 1.05 ... 0.28 ... 0.54 3.75 ... ... ... 4.15 Tollington ... 6.32 1.28 ... 0.28 ... 0.85 3.68 ... ... 8.82 Lower Holloway 0.02 3.25 0.89 ... 0.38 ... 0.70 ... ... ... ... 5.24 Highbury ... 3.09 0.89 ... 0.41 ... 0.70 2.11 ... ... ... 5.14 Barnsbury 0.22 4.26 1.46 ... 0.48 ... 0.83 3.59 ... ... ... 7.36 Islington, South East 0.05 2.73 0.82 ... 0.32 ... 0.98 1.50 ... ... ... 4.94 The Borough 0.05 3.36 1.02 ... 0.37 0.00 0.82 2.70 ... ... ... 5.69 * Per 1,000 Registered Births. 121 [1904 TABLE XCVII. Showing the number of Cases of Infectious Disease notified in the Wards during the year 1904. (N.B.—Duplicate notifications have been deducted). WARDS. Estimated Population. 1904. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals. Cases Notified per 1,000 of Population. I 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Tufnell 33,225 ... 72 28 ... 13 1 36 5 ... ... ... 155 4.66 Upper Holloway 35,210 ... 76 37 ... 10 ... 19 4 ... ... ... 146 4.15 Tollington 35,153 ... 222 45 ... 10 ... 30 3 ... ... ... 310 8.82 Lower Holloway 41,589 1 135 37 ... 16 ... 29 ... ... ... ... 218 5.24 Highbury 34,919 ... 127 26 ... 6 ... 23 2 ... ... ... 184 5.27 Mildmay 24,923 ... 65 28 ... 20 ... 19 1 ... ... ... 133 5.33 Thornhill 33,412 12 147 49 ... 23 ... 30 5 ... ... ... 266 7.96 Barnsbury 20,774 ... 84 30 ... 3 ... 15 1 ... ... ... 133 6.40 St. Mary's 17,343 2 45 13 ... 2 ... 16 1 ... ... ... 79 4.55 Canonbury 31,710 2 103 25 ... 8 ... 38 1 ... ... ... 177 5.58 St. Peter's 32,786 ... 70 29 ... 15 ... 25 1 ... ... ... 140 4.27 Totals 341,044 17 1146 347 ... 126 1 280 24 ... ... ... 1941 5.69 1902 276 1372 871 7 257 ... 357 19 5 ... ... 3164 9.20 1903 9 865 452 3 130 ... 227 19 2 ... ... 1707 5.03 122 1904] Table XCVIII. Showing the Attack-Rates arising from the Infectious Diseases notified, in the Wards during the Year 1904. WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total AttackRates. Tufnell ... 2.17 0.84 ... 0.39 0.03 1.08 0.15 ... ... ... 4.66 Upper Holloway ... 2.l6 1.05 ... 0.28 ... 0.54 0.12 ... ... ... 4.15 Tollington ... 6.32 1.28 ... 0.28 ... 0.85 0.09 ... ... ... 8.82 Lower Holloway 0.02 3.25 0.89 ... 0.38 ... 0.70 ... ... ... ... 5.24 Highbury ... 3.64 0.75 ... 0.17 ... o.66 0.05 ... ... ... 5.27 Mildmay ... 2.6l 1.12 ... 0.80 ... 0.76 0.04 ... ... ... 5.33 Thornhill 0.36 4.40 1.47 ... 0.68 ... 0.90 0.15 ... ... ... 7.96 Barnsbury ... 4.04 1.44 ... 0.15 ... 0.72 0.05 ... ... ... 6.40 St. Mary's 0.11 2.60 0.75 ... 0.11 ... 0.92 0.06 ... ... ... 4.55 Canonbury 0.06 3.25 0.79 ... 0.25 ... 1.20 0.03 ... ... ... 5.58 St. Peter's ... 2.14 0.88 ... 0.46 ... 0.76 0.03 ... ... ... 4.27 Totals 0.05 3.36 1.02 ... 0.37 o.oo 0.82 0.07 ... ... ... 5.69 123 [1904 Table XCIX. Showing the Number of Cases of Infectious Diseases which were investigated by the several Sanitary Inspectors during the Year 1904. Sanitary Inspectors. Number of the Sanitary District. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Mr. Cook 1 ... 61 19 ... 9 1 25 3 ... ... ... 118 ,, Bicknell 2 ... 77 37 ... 11 ... 19 5 ... ... ... 149 ,, Bagshaw 3 ... 79 18 ... 3 ... 8 ... ... ... ... 108 ,, Bacon 4 ... 183 33 ... 10 ... 30 3 ... ... ... 259 „ Flood 5 ... 27 26 ... 5 ... 16 2 ... ... ... 76 „ Horsman 6 ... 97 16 ... 7 ... 21 ... ... ... ... 141 „ Fortune 7 ... 67 14 ... 3 ... 11 1 ... ... ... 96 „ Metcalf 8 ... 54 24 ... 15 ... 13 1 ... ... ... 107 „ Irving 9 12 138 41 ... 22 ... 22 4 ... ... ... 239 „ Watson 10 2 86 24 ... 10 ... 28 ... ... ... ... 150 „ Burrell 11 ... 58 24 ... 14 ... 28 1 ... ... ... 125 „ Agar 12 1 90 39 ... 11 ... 27 1 ... ... ... 169 „ Rolfe 13 ... 71 19 ... 2 ... 9 1 ... ... ... 102 „ Callow 14 2 58 13 ...... 4 ... 23 2 ... ... ... 102 Totals 17 1146 347 ... 126 1 280 24 ... ... ... 1,941 124 1904] Table C. Showing the Cases of Infectious Disease which were notified in the several Months during the Year 1904. N.B.—(Duplicate Notifications have been deducted.) Month. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total each month. January 1 64 40 ... 3 ... 18 5 ... ... ... 131 February 2 48 28 ... 4 ... 13 4 ... ... ... 99 March 2 47 31 ... 6 ... 13 1 ... ... ... 100 April 4 54 30 ... 7 ... 12 1 ... ... ... 108 May 5 97 15 ... 5 ... 20 ... ... ... ... 142 June 3 133 28 ... 7 ... 13 2 ... ... ... 186 July ... 123 14 ... 7 ... 18 ... ... ... ... 162 August ... 94 29 ... 15 ... 22 2 ... ... ... 162 September ... 141 35 ... 30 1 35 1 ... ... ... 243 October ... 136 26 ... 17 ... 54 3 ... ... ... 236 November ... 100 46 ... 16 ... 37 1 ... ... ... 200 December ... 109 25 ... 9 ... 25 4 ... ... ... 172 Total 17 1146 347 ... 126 1 280 24 ... ... ... 1,941 125 [1904 Table CI. Showing the Cases of Infectious Disease notified during the Year 1904 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1904. Small Pox. Scarlet Fever or Scarlatina. Diphtheria (including Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Cases. St. Pancras 235,936 7 848 349 136 ... 258 10 ... ... ... 1,608 Stoke Newington 52,445 8 154 61 14 ... 53 3 ... ... ... 293 Hackney 226,266 13 858 572 185 ... 266 23 3 ... ... 1,920 Hornsey 81,221 ... 196 101 16 ... 40 5 ... ... 358 Finsbury 98,958 15 330 145 46 ... 106 5 ... ... ... 647 Shoreditch 117,033 14 343 188 48 ... 177 5 2 ... ... 777 The Encircling Boroughs 811,859 57 2,729 1,416 445 ... 900 51 5 ... ... 5,603 Islington 341,044 17 1,146 347 126 1 280 24 ... ... ... 1,941 126 1904] Table CII. Showing the Attack Rates per 1,000 inhabitants arising front the Infectious Diseases notified during the Year 1904 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1904. Small Pox. Scarlet Fever or Scarlatina. Diphtheria (including Membranous) Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever.* Continued Fever. Relapsing Fever. Cholera. Total Attack-Rates. 1 2 3 4 5 6 7 8 9 10 11 12 13 St. Pancras 235,936 0.03 3.60 1.48 0.57 ... 1.09 0.04 ... ... ... 6.81 Stoke Newington 52,445 0.15 2.95 1.16 0.27 ... 1.01 0.05 ... ... ... 5.59 Hackney 226,266 0.06 3.79 2.53 0.82 ... 1.18 0.10 0.01 ... ... 8.49 Hornsey 8l,22I ... 2.41 1.25 0.20 ... 0.49 0.06 ... ... ... 4.41 Finsbury 98,958 0.15 3.34 1.47 0.46 ... 1.07 0.05 ... ... ... 6.54 Shoreditch 117,033 0.12 2.93 1.61 0.41 ... 1.51 0.04 0.02 ... ... 6.64 The Encircling Boroughs 811,859 0.07 3.36 1.74 0.55 ... 1.11 0.06 0.00 ... ... 6.90 Islington 341.044 0.05 3.36 1.02 0.37 0.00 0.82 0.07 ... ... ... 5.69 Increaseor Decrease ... - 0.02 ... — 0.72 — 0.18 ... — 0.29 +0.01 ... ... ... — 1.21 * Per 1,000 of the population 127 [1904 Table CIII. Showing the Cases of Infectious Disease notified in the several Metropolitan Boroughs during the year 1904. Cities and Boroughs. Estimated population in the middle of 1904. Notified Cases of Infectious Disease. Small Pox. Scarlet Fever. Diphtheria.* Typhus Fever Enteric Fever. Other continued j Fevers. Puerperal Fever. Erysipelas. Cholera. Total. LONDON 4.648,950 488 13,435 7,219 3 1,894 29 273 4,943 .. 28,284 West Districts. Paddington 146,975 4 363 143 .. 48 .. 10 117 .. 685 Kensington 179,236 3 265 187 .. 47 3 11 141 .. 657 Hammersmith 117,412 .. 284 204 .. 39 1 12 123 .. 663 Fulham 152,482 .. 295 300 .. 39 .. 8 130 .. 772 Chelsea 74,329 108 61 .. 13 .. 7 45 .. 234 City of Westminster 177,321 6 313 145 1 51 2 5 126 .. 649 North Districts. St. Marylebone 130,337 8 294 118 .. 50 .. 3 187 .. 660 Hampstead 86,663 1 169 57 .. 27 1 6 56 .. 317 St Pancras 235,936 7 848 349 .. 136 .. 10 258 .. 1,608 Islington 341.044 17 1,146 347 1 126 .. 24 280 .. 1,941 Stoke Newington 52,445 8 154 61 .. 14 .. 3 53 .. 293 Hackney 226,266 13 858 572 .. 185 3 23 266 .. 1,920 Central Districts. Holborn 57,161 6 98 46 .. 41 .. 7 76 .. 274 Finsbury 98,958 15 330 145 .. 46 .. 5 106 .. 647 City of London 23,482 2 32 40 .. 14 .. •• 21 .. 109 East Districts. Shoreditch 117 033 14 343 188 .. 48 2 5 177 .. 777 Bethnal Green 130,207 126 661 425 .. 58 4 12 224 .. 1,510 Stepney 303,791 89 1,261 821 1 198 .. 15 467 .. 2,852 Poplar 169,905 42 548 670 .. 93 1 15 204 .. 1,573 South Districts. Southwark 207,937 28 415 281 .. 92 .. 12 298 .. 1,126 Bermondsey 129,397 19 454 193 .. 73 1 5 186 .. 931 Lambeth 310,359 27 658 327 .. 100 4 16 248 .. 1,380 Battersea 175,465 7 385 227 .. 63 2 7 160 .. 851 Wandsworth 257,448 6 772 404 .. 71 3 14 270 .. 1,540 Camberwell 268,384 19 956 270 .. 78 1 13 328 .. 1,665 Deptford 113,509 11 405 195 .. 30 .. 10 151 .. 802 Greenwich 101,651 1 213 152 .. 49 .. 2 86 .. 503 Lewisham 140,401 .. 337 130 .. 29 .. 8 83 .. 587 Woolwich 123,416 8 469 161 .. 27 1 5 75 .. 746 Port of London .. 1 1 .. .. 9 .. .. 1 .. 12 * Including Membranous Croup. 1904] 128 Table CIV. Showing the Attack Rates of the Infectious Diseases notified in the several Metropolitan Cities and Boroughs during the year 1904. Cities and Boroughs. Estimated Population in the middle of 1904. Small Pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Total Attack Rate. County of London 4 648,950 0.11 2.89 1.55 0.00 0.41 0.00 0.06 1.06 .. 6.08 West Districts. Paddington 146,975 0.03 2.47 0.97 .. 0.33 .. 0.07 0.79 .. 4.66 Kensington 179,236 0.02 1.48 1.04 .. 0.26 0.02 0.06 0.79 .. 3.67 Hammersmith 117,412 .. 2.42 1.74 .. 0.33 0.00 0.10 1.05 .. 5.64 Fulham 152,482 .. 1.93 1.97 .. 0.26 .. 0.05 0.85 .. 5.06 Chelsea 74,329 .. 1.45 0.82 .. 0.18 .. 0.09 0.61 .. 3.15 City of Westminster 177,321 0.03 1.77 0.82 0.00 0.29 0.01 0.03 0.71 .. 3.66 North Districts. St. Marylebone 130,337 0.06 2.25 0.91 .. 0.38 .. 0.02 1.44 .. 5.06 Hampstead 86,663 0.01 1.95 0.66 .. 0.31 0.01 0.07 0.65 .. 3.66 St. Pancras 235,936 0.03 3.60 1.48 .. 0.57 .. 0.04 1.09 .. 6.81 Islington 341,044 0.05 3.36 1.02 0.00 0.37 .. 0.07 0.82 .. 5.69 Stoke Newington 52,445 0.15 2.95 1.16 .. 0.27 .. 0.05 1.01 .. 5.59 Hackney 226,266 0.06 3.79 2.53 .. 0.82 0.01 0.10 1.18 .. 8.49 Central Districts. Holborn 57,161 0.10 1.71 0.81 .. 0.72 .. 0.12 1.33 .. 4.79 Finsbury 98,958 0.15 3.34 1.47 .. 0.46 .. 0.05 1.07 .. 6.54 City of London 23,482 0.08 1.36 1.70 .. 0.60 .. .. 0.90 ..•• 4.64 East Districts Shoreditch 117,033 0.12 2.93 1.61 .. 0.41 0.02 0.04 1.51 .. 6.64 Bethnal Green 130,207 0.97 5.08 3.27 .. 0.44 0.03 0.09 1.72 .. 11.60 Stepney 303,791 0.30 4.15 2.70 0.00 0.65 .. 0.05 1.54 .. 9.39 Poplar 169,905 0.25 3.23 3.94 .. 0.55 .. 0.09 1.20 .. 9.26 South Districts. Southwark 207,937 0.13 2.00 1.35 .. 0.44 .. 0.06 1.43 .. 5.41 Bermondsey 129,397 0.15 3.51 1.49 .. 0.56 0.01 0.04 1.44 .. 7.20 Lambeth 310,359 0.09 2.12 1.05 .. 0.32 0.01 0.05 0.80 .. 4.44 Battersea 175,465 0.04 2.19 1.29 .. 0.36 0.01 0.04 0.92 .. 4.85 Wandsworth 257,448 0.02 3.00 1.57 .. 0.28 0.01 0.05 1.05 .. 5.98 Camberwell 268,384 0.07 3.56 1.01 .. 0.29 0.00 0.05 1.22 .. 6.20 Deptford 113,509 0.10 3.57 1.72 .. 0.26 .. 0.09 1.33 .. 7.07 Greenwich 101,651 0.01 2.10 1.50 .. 0.48 .. 0.02 0.84 .. 4.95 Lewisham 140,401 2.40 0.93 .. 0.21 .. 0.06 0.59 .. 4.19 Woolwich 123,416 0.06 3.80 1.31 .. 0.22 0.01 0.04 0.61 .. 6.05 Port of London 129 [1904 INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. Notifiable Diseases—It was found that 757 children, who suffered from one or other of the notifiable infectious diseases, were scholars attending the public elementary schools; and that 473 scholars, who, although themselves not ill, lived in houses in which one of these diseases was present, and who consequently were excluded from school until the patient had been either removed to a hospital or had recovered, and the premises had been disinfected. The proportion of cases amongst scholars attending these schools to the total number of cases that was notified was 39 per cent. The scholars who were attacked suffered from the following diseases:— Scarlet Fever 571 Diphtheria 138 Enteric Fever 29 Other notifiable diseases 20 Total 757 It will be seen from the following statement that these figures as a whole are an improvement on those of preceding years:— Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Diseases. Total scholars attacked. Proportion to every 100 cases notified. 1896 3 842 355 28 12 1,240 32.4 1897 — 753 267 38 12 1,070 36.8 1898 — 640 206 57 8 891 36.9 1899 — 725 290 61 11 1,087 36.9 1900 1 547 219 64 13 914 40.2 1901 — 669 438 72 32 1,211 42.5 1902 14 664 405 64 34 1,181 37.3 1903 — 507 216 35 16 774 45.3 1904 — 571 138 29 20 757 39.0 It is particularly satisfactory to notice in this statement that there has been a fairly general decrease in the return from nearly all the diseases, although it is true that there has been a slight increase in the Scarlet Fever cases in the schools; nevertheless since 1896 the general tendency has been downwards. It will be observed that in the last column the proportion between the number of scholars attacked and the total number of notified cases does not vary very much, 4 to 5 per cent., although in one of the eight years mentioned the per- k 1904] 180 centage was as low as 32.4, and in another (1903) as high as 45.3, while the average percentage has been 38.6, which is almost identical with the proportion that obtained in 1904. Cases amongst Scholars—757 cases occurred among scholars who were in attendance at the public elementary schools. Cases in Scholars' Homes. 473 cases were notified from the homes of scholars or in the houses in which they resided. Small Pox.—No case occurred among the scholars attending any of these schools. Scarlet Fever attacked 571 scholars as compared with an average of 668 that obtained in the preceding eight years. In only six schools was there an excessive number of cases, namely: Montem Street School (52 cases), Thornhill Road (50 cases), Gifford Street (36 cases), Ecclesbourne Road (31 cases), the Forster (25 cases), and Drayton Park (24 cases). The cases that arose in other schools varied from 17 to 0. It is a remarkable fact that no cases were discovered among the scholars of St. Paul's, St. Barnabas', St. Ann's, St. Bartholomew's, and St. Matthew's Schools, all of which are non-provided schools connected with the Church of England. If we had lived in the middle ages we would probably have attributed this circumstance to a miraculous dispensation of Providence. In addition to these cases 211 were discovered in the homes or houses of children in attendance at school. Diphtheria and Membranous Croup.—138 cases were known among scholars, of whom 17 were in attendance at Buckingham Street School, and 11 at Grafton Street School. The largest number of cases in any other school was 6. There were no cases known among the scholars of no less than thirteen non-provided or Church Schools, while there were on the other hand no cases in four L.C.C. Schools. 103 cases were referred to homes or houses from which scholars had been in attendance at school. Enteric Fever.—29 cases occurred among scholars in attendance at eighteen schools, and 59 in homes or houses from which they attended school. Non-notifiable Diseases.—Altogether 2,425 cases, which are not included among the diseases which are compulsorily notifiable under the London Public Health Act, came under observation, information about which was received from the head teachers of the various departments of the schools, 131 [1904 but mainly from the head teachers of the infant departments. The teachers make these notifications in compliance with their School Code, which requires them to inform the Medical Officer of Health of the Borough, in which the school is situated, of the absence of any scholar through Measles, Whooping Cough, Chicken Pox, and Mumps. Measles.—355 cases of Measles were notified by the teachers, of which 36 occurred at Montem Street, 34 at Buckingham Street, 32 at Holy Trinity, 24 at Forster, 22 at Station Road, and 12 at Ambler Road Schools. The number of schools invaded was 39. Chicken Pox.—182 cases were notified by teachers, in addition to those cases that were reported by medical practitioners under the order of the London County Council, to which reference has already been made. The principal schools invaded were St. Philip's 27 cases, Buckingham Street 19 cases, Newington Green 19 cases, Westbourne Road 15 cases, Rotherfield Street, 14 cases, and Gillespie Road 13 cases. Altogether 28 schools were invaded. Whooping Cough.—A very large number was reported, namely, 1293. The disease was particularly prevalent among the scholars of Yerbury Road School, whence 107 cases were notified. Other schools were also heavily affected, namely, Blackstock Road 69 cases, Buckingham Street 61, Cottenham Road 59, Gillespie Road 69, Gifford Street 57, Hungerford Road 56, Montem Street 48, Poole's Park 44, Rotherfield Street 67, Station Road 56, St. Philip's 61, Upper Hornsey Road 48, and Westbourne Road 54. As many as 46 schools were invaded. It is a remarkable fact that although so many cases of Whooping Cough were known yet the mortality was the lowest on record. Mumps and Other Diseases were notified in 595 instances. It is a pleasure to be able to record once more that the head teachers, particularly those of the infant schools, have continued to render valuable assistance in the preservation of the health of the public by their action in sending information to the Medical Officer of Health as to the presence of infectious diseases among their pupils or at their homes. This information has, however, in some instances been delayed until it was of little use. To be valuable it should be sent immediately. Unfortunately, some teachers have not sent the notification until, apparently, they have been frightened by the number of cases that kept cropping up, when they reported them in a batch. Nevertheless, the sincerest thanks of the Public Health Department is tendered to the teachers as a body for their assistance. k 2 132 1904] Table CV. Showing the cases of Notifiable Infectious Diseases occurring in Public Elementary Schools during the Year 1904. NAME OF SCHOOL. Scholars attacked. Non-Scholars attacked who lived in houses from which children attended the several Schools. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Feves. Total. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever, Other Fevers. Total. Yerbury Road, B.S. .. 6 2 2 .. 10 .. 2 3 1 5 11 St. John's, Holloway Road, C.S. .. 4 .. .. .. 4 .. .. .. .. .. .. St. Joseph's, R.C.S. .. 3 1 .. .. 4 .. 1 1 .. .. 2 Hargrave Park, B.S. .. 5 .. .. 2 11 .. 5 2 .. 3 10 Burleigh Road, B.S. .. 6 4 .. 1 11 .. 8 3 1 1 12 St. Mark's, Grove Road, C.S .. 5 .. .. .. 5 .. .. .. .. 2 2 St. Paul's, Blenheim Road .. .. .. .. 2 2 .. 1 .. .. .. 1 Cottenham Road, B.S. .. 11 5 .. .. 17 .. 4 2 1 3 10 Grafton Road, B.S. .. 12 11 .. .. 23 .. 3 .. 1 .. 4 Duncombe Road, B.S. .. 6 8 .. .. 14 .. 4 3 .. 2 9 Whittington, B.S. .. 8 5 .. .. 13 .. 1 .. .. .. 1 Montem Street, B.S. .. 52 2 .. .. 56 .. 13 4 1 3 21 St. Barnabas .. .. 1 .. .. 1 .. .. .. .. .. .. Forster, B.S. .. 25 2 .. .. 27 .. 5 .. 3 .. 8 St. Ann's .. .. .. .. .. .. .. 1 .. .. .. 1 Poole's Park, B.S. .. 16 1 .. 2 20 .. 9 1 2 5 17 Hornsey Road, B.S. .. 13 4 .. 1 21 .. 13 4 1 2 20 Hungerford Road, B.S. .. 1 2 .. 1 4 .. 2 1 1 .. 4 Brecknock, B.S. .. 4 .. .. .. 4 .. 3 6 .. 2 11 Pakeman Street, B.S. .. 10 6 .. .. 16 .. 3 1 2 2 8 St. James , C.S. .. 3 1 .. .. 4 .. 9. .. l .. .. Catholic School, Eden Grove, R.C.S. .. 2 .. .. .. 2 .. 5 .. 1 .. 6 Caledonian Road, B.S. .. 17 2 1 .. 20 .. 4 1 1 .. 6 Westbourne Road, B.S. .. 13 1 1 .. 15 .. 5 2 .. 2 9 Chapel-of-Ease, C.S. .. 11 .. .. .. 11 .. 4 1 1 .. 6 Blackstock Road, B.S. .. 9 3 1 .. 13 .. 5 3 .. 1 9 Gillespie Road, B.S. .. 7 3 .. .. 10 .. 2 .. .. .. 2 Drayton Park, W.M.S. .. 24 3 .. .. 27 .. 5 .. 3 .. 8 St. John's, Conewood Street, C.S. .. 6 .. .. .. 6 .. .. 1 .. .. 1 St. Jude's, C.S. .. 6 4 1 .. 11 .. .. 2 2 2 6 St. Mathias.. .. 9 2 2 .. 13 .. 6 2 1 3 12 Ambler Road, B.S. .. 4 1 .. .. 5 .. 1 .. 1 .. 2 York Road, B.S. .. 9 6 1 .. 16 .. 8 5 1 .. 14 Gifford Street, B.S. .. 36 2 3 .. 41 .. 7 3 2 .. 15 St. Thomas', C.S. .. 3 .. 1 .. 7 .. .. 7 .. 2 9 St. Clement s, C.S. .. 4 2 .. .. 6 .. 2 1 .. 1 4 Blundell Street, B.S. .. 10 5 1 .. 16 .. 3 3 5 .. 11 St. Paul's, Dorset Street, C.S. .. 2 2 1 .. 5 .. 2 1 2 4 9 Ecclesbourne Road, B.S. .. 31 2 .. .. 33 .. 10 5 1 4 20 Tottenham Road, B.S. .. 4 3 .. .. 7 .. 2 .. 1 1 4 Queen's Head Street, B.S. .. 8 1 1 .. 10 .. 6 .. .. 5 13 St. Bartholomew's.. .. .. .. .. .. .. .. .. .. .. .. .. Angler s Gardens, B.S. .. 9 2 .. 1 12 .. 2 .. 2 2 8 St. Philip's, B.S .. 3 .. .. 1 4 .. 6 .. 2 1 9 St. Matthew's, Rotherfield Street .. .. .. .. .. .. .. .. .. .. .. Shepperton Road, B.S. .. 12 2 .. 2 16 .. 4 1 2 2 9 Rotherfield Street, B.S. .. 4 1 .. .. 5 .. 1 4 4 5 14 Buckingham Street, B.S. .. 14 17 .. .. 31 .. 8 4 1 5 18 Winchester Street, B S. .. 8 .. .. .. 8 .. 2 .. .. 2 5 All Saint's, C.S. .. 4 .. .. .. 4 .. 2 1 .. 1 4 Vittoria Place, B.S. .. 9 1 .. .. 11 .. 2 3 1 3 9 Holy Trinity, C.S. .. 6 2 .. .. 8 .. .. .. 3 .. 3 Richard Street, B.S. .. 5 2 .. .. 7 .. .. 4 .. 5 9 Station Road, B.S. .. 11 4 2 .. 15 .. .. 2 .. 2 4 Thornhill Road, B.S. .. 50 5 .. 2 57 .. 10 4 1 .. 15 St. Matthew's, City Road, C.S. .. 3 .. .. .. 3 .. 2 2 .. .. 4 St. John's, Duncan Terrace, R.C S. .. 1 1 1 .. 2 .. 1 .. 1 1 3 Hanover Street, B.S. .. 9 3 .. 1 14 .. 8 1 4 6 19 Canonbury Road, B.S. .. 15 1 .. .. 16 .. 5 1 .. 3 9 St. Mary's, C.S. .. 3 .. .. .. 3 .. 1 4 .. 1 6 Total .. 571 138 29 20 757 3 211 103 59 97 473 133 [1904 Table CVI. Showing the Infectious Diseases notified during the year 1904 by the Teachers of Public Elementary Schools under the provisions of Regulation 148, sec. iv., of the London County Council School Code. School. Measles. Chicken Pox. Whooping Cough. Other Diseases. Totals. Ambler Road 12 3 7 2 24 Burleigh Road .. 1 .. 1 2 Brecknock Road 2 2 4 .. 8 Blackstock Road 2 .. 69 9 80 Blundell Street 4 1 25 4 34 Buckingham Street 34 19 61 5 119 Cottenham Road 9 4 59 8 80 Canonbury Road .. 1 2 5 8 Caledonian Road 2 5 28 12 47 Chapel of Ease 1 .. 21 3 25 Duncombe Road 11 5 29 12 57 Ecclesbourne Road 5 6 9 3 23 Forster Road 24 .. 11 3 38 Fortess Road .. .. 1 .. 1 Grafton Road 3 1 38 26 68 Gillespie Road 7 13 69 20 109 Gifford Street 12 9 57 103 181 Hargrave Park 2 .. 13 1 16 Hugh Middleton .. .. 1 .. 1 Hungerford Road 7 4 56 15 82 Holy Trinity 32 1 18 9 60 Hanover Street 4 .. 22 11 37 Montem Street 36 1 48 56 141 Napier Street .. .. 2 .. 2 Newington Green 6 19 10 6 41 Poole's Park 9 .. 44 38 91 Pakeman Street .. .. 4 2 6 Popham Road 11 4 10 12 37 Queen's Head Street .. 1 22 1 24 Risinghill Street .. 1 1 1 3 Rotherfield Street 1 14 67 44 126 Richard Street 1 6 15 3 25 Shepperton Road .. .. .. 1 1 Station Road 22 .. 56 12 90 St. Mark's, Grove Road 2 .. 3 3 8 St. Barnabas 2 .. 20 3 25 St. John's, Conewood Street .. 4 .. .. 4 St. Jude's 12 8 .. 20 St. Paul's, Dorset Street. 2 10 33 23 68 St. Bartholomew's .. .. .. 6 6 St. Philip's 13 27 61 9 110 St. Matthew's, City Road .. .. .. 5 5 St John's, Duncan Terrace .. .. 3 3 6 St. Mary's 1 .. .. 1 2 Tottenham Road 4 .. .. 12 16 Upper Hornsey Road 11 3 48 33 95 Vittoria Place 1 .. 20 .. 21 Whittington 2 .. 25 12 39 Wenlock Road .. .. 1 .. 1 Westbourne Road 5 15 54 21 95 Winchester Street 4 .. 29 4 37 Yerbury Road 19 .. 107 31 157 York Road 18 2 2 1 23 Total 355 182 1293 595 2425 184 19041 ISOLATION OF THE NOTIFIABLE INFECTIOUS DISEASES. Of the 1,942 cases that were notified, 1,467, or 75.5 per cent., were received into hospitals for isolation and treatment, as compared with 72.6 per cent. in the preceding year. The percentage of these cases has shown a progressive increase for several years, as it has risen from 48.4 per cent. in 1896 to 75.5 last year. 1896 48.4 per cent. 1897 55.7 „ 1898 58.4 „ 1899 64.6 „ 1900 68.2 „ 1901 69.6 per cent. 1902 71.9 „ 1903 72.6 „ 1904 75.5 „ The cases removed or treated in hospital included 17 of Small Pox, 1,024 of Scarlet Fever, 260 of Diphtheria, 108 of Enteric Fever, 1 of Typhus, 46 of Erysipelas, and 11 of Puerperal Fever. The Metropolitan Asylums Board Hospitals received the great majority of these cases, the particulars of which are set out in the following table. Table CVII. Showing the number of Cases of Infectious Disease removed from Islington to the Metropolitan Asylums Board's Hospitals for treatment and isolation during 1904. Metropolitan Asylums Board's Hospitals. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Diseases. Total Admissions. Total Deaths. Eastern .. 15 1 .. 1 3 20 3 North Eastern .. 833 143 60 .. 142 1,178 56 North Western .. 85 5 3 .. 6 99 2 Western .. 1 .. .. .. .. 1 .. South Western .. .. .. .. .. .. .. .. The Grove .. .. .. .. .. .. .. .. South Eastern .. .. .. .. .. .. .. .. Northern .. .. .. .. .. .. .. .. Small Pox 15 .. .. .. .. .. 15 1 Total s 15 934 149 63 1 151 1,313 62 135 [1904 Table CVIII. Summary of Infectious Sickness and of the Deaths arising therefrom, distinguishing the Cases treated at Home and in Hospitals; and showing the percentages of notified Cases removed to Hospitals, together with the Fatality among cases treated at Home and in Hospitals. Notified Cases Treated. Percentages of Notified Cases Treated. Deaths Occurring. Percentages of Deaths Occurring. In Hospitals. At Home. Total. In Hospital. At Home. In Hospital. At Home. Total. In Hospital. At Home. Total. Small Pox 17 .. 17 100.0 .. 1 .. 1 5.9 .. 5.9 Scarlet Fever 1,024 122 1,146 89.4 10.6 32 3 35 3.1 2.4 3.0 Diphtheria 260 87 347 74.9 25.1 18 10 28 6.9 11.5 8.1 Enteric (Typhoid Fever) 108 18 126 85.7 14.3 12 6 18 11.1 33.3 14.3 Typhus Fever 1 • • 1 100.0 .. .. .. .. .. .. .. Erysipelas 46 234 280 16.4 83.6 11 12 23 23.9 5.1 8.2 Puerperal Fever *11 14 25 44.0 56.0 8 6 14 7.3 4.3 56.0 Continued Fever .. •• •• •• .. •• .. .. .. .. .. Relapsing Fever .. •• .. .. .. .. .. .. .. .. .. Cholera .. •• .. .. .. .. .. .. .. .. .. Total *1,467 475 1,942 75.5 24.5 82 37 119 5.5 7.8 6.1 136 1904] INFECTIOUS DISEASES ON BUSINESS PREMISES. If the isolation of persons suffering from infectious diseases needed justification its uses would be supplied by a perusal of the table on page 138 which gives a list of the businesses carried on in houses where they occurred during the year 1904. The record therein given is no new one; it is similar to others that have now been given for ten years, and demonstrates how important it is that infected persons should be taken away for isolation lest they should infect the goods that were being made or on sale at the premises. In one instance a man, a Russian, suffering from Typhus Fever, was discovered in a confectioner's house. He was, of course, removed to hospital, but unfortunately he had been sleeping in a room where about twenty-pounds worth of sweetmeats of all descriptions were stored, which came under strong suspicion of being infected, and were, therefore, at once destroyed. It would not have been possible to have allowed such a person to remain at home, because of the possibility and probability of the disease being conveyed to the shop. The writer has seen some sad cases of sickness and death in the North of England from this disease, the germs of which were conveyed from the sick room by persons in attendance on the patient to persons assisting in the shops. It must, however, be said that at that time they were not aware of the nature of the illness. Such incidents prove the danger of allowing infectious diseases to remain on business premises. Trades carried on in the Invaded Premises—Altogether 186 cases occurred on business premises of which there were of Scarlet Fever ... ... ... ... 125 cases Diphtheria ... ... ... ... 29 „ Enteric Fever ... ... ... ... 6 „ Typhus Fever ... ... ... ... 1 „ Erysipelas ... ... ... ... 25 „ Scarlet Fever was discovered on premises in which the following businesses, among others, were conducted:—Butcher, Bootmaker, Baker, Beltmaker, Bibmaker, Confectioner, Dressmaker, Dairy, Draper, Dyer and Cleaner, Embroiderer, Furrier, General Dealer, Grocer, Greengrocer, Hairdresser, Ice Cream, Laundry, Mangling, Newsagent, Public House, Restaurant, Sweetshop, Tailors, Underclothing. 137 [1904 Diphtheria infected 29 premises wherein the undermentioned businesses were carried on:—Butcher, Bootmaker, Baker, Boarding House, Beer Bottler, Draper, Furrier, Fruiterer, Grocer, Greengrocer, Hairdresser, Laundry, Newsagent and Public House. Occupation of the Persons Attacked.—Particulars respecting 1,230 cases of infectious diseases were obtained, and naturally the great bulk of these were referred to the heading "School Children," of whom 871 were infect d. A full statement is given in Table CX., page 140. Small Pox attacked, among others, a builder, a glazier, a labourer, a porter, and a packer. Scarlet Fever, besides attacking the school children already mentioned, infected persons pursuing the following occupations:—Accountant, bag maker, butcher, bookbinder, clerks, carpet makers, chemists, dressmaker, errand boy, feather curler, hatter, jeweller, laundress, leather worker, messenger, mother's help and nurse. Enteric Fever was responsible for attacks on persons carrying on the following businesses or professions, among others:—Agent, architect, bag maker, bricklayer, baker, barman, clerk, coachman, caiman, chemist, charwoman, cabman, dressmaker, furrier, hairdresser, housekeeper, labourer, laundress, milkman, painter and pawnbroker. Erysipelas infected 168 persons engaged in various occupations. 138 1904] Table CIX. List of Trades and Businesses carried on in Houses wherein Infectious Diseases have occurred during 1904. trades and businesses. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Boxing Glove Maker ... 1 ... ... ... ... ... ... ... I Butcher ... 1 1 ... ... ... 1 ... ... 3 Builder ... 6 ... ... ... ... ... ... ... 6 Boot Maker ... 5 1 ... 1 ... ... ... ... 7 Baker ... 3 1 ... ... ... ... ... ... 4 Beerhouse ... 1 ... ... ... ... 1 ... ... 2 Belt Making ... 1 ... ... ... ... ... ... ... 1 Brush Manufacturing ... ... ... ... ... ... 1 ... ... 1 Bib Maker ... 1 ... ... ... ... ... ... ... 1 Boarding House ... ... 3 ... ... ... ... ... ... 3 Beer Bottler ... ... 1 ... ... ... ... ... ... 1 Confectioner ... 6 ... ... ... 1 1 ... ... 8 Carriage Builder ... 1 ... ... ... ... ... ... ... 1 Cnimney Sweep ... 1 ... ... ... ... ... ... ... 1 Cornchandlers ... 3 ... ... ... ... 3 ... ... 6 Chiffon Tacker ... 1 ... ... ... ... ... ... ... 1 Crochetting ... 1 ... ... ... ... ... ... ... 1 Cheesemonger ... ... ... ... ... ... 1 ... ... 1 Cycle Maker ... 1 ... ... ... ... ... ... ... 1 Dressmaking ... 4 ... ... 2 ... 1 ... ... 7 Dairy ... 5 ... ... ... ... ... ... ... 5 Draper ... 4 2 ... ... ... ... ... ... 6 Dentist ... ... ... ... ... ... 1 ... ... 1 Dyer and Cleaner ... 1 ... ... ... ... ... ... ... 1 Embroiderers ... 2 ... ... ... ... ... ... ... 2 Electrician ... 1 ... ... ... ... ...... ... ... 1 Furriers ... 2 1 ... ... ... 1 ... ... 4 Furniture Dealer ... 1 ... ... ... ... ... ... ... 1 Fire Station ... 1 ... ... ... ... ... ... ... 1 Fruiterer ... ... 1 ... ... ... ... ... ... 1 General Dealer ... 5 1 ... ... ... 3 ... ... 9 Grocer ... 3 4 ... ... ... 1 ... ... 8 Greengrocer ... 4 2 ... ... ... 3 ... ... 9 Glass Cutter ... 1 ... ... ... ... ... ... ... 1 Hairdressing ... 4 2 ... ... ... ... ... ... 6 Horsekeeper ... 1 ... ... ... ... ... ... ... 1 Hatter ... 1 ... ... ... ... ... ... ... 1 Hotel ... 1 ... ... ... ... ... ... ... 1 Infants' Millinery ... 1 ... ... ... ... ... ... ... 1 Ice Cream and Minerals ... 1 ... ... ... ... ... ... ... 1 Jeweller ... 1 ... ... ... ... ... ... ... 1 Ironmonger ... 3 ... ... ... ... ... ... ... 3 Lodging House ... ... ... ... ... ... 1 ... ... 1 139 [1904 Table CIX.—continued. trades and businesses. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Laundry ... 7 4 ... ... ... ... ... ... 11 Mangling ... 1 ... ... ... ... 2 ... ... 3 Machinist ... 1 ... ... ... ... ... ... ... 1 Needlework ... ... ... ... 1 ... ... ... ... 1 Nursing Home ... ... ... ... ... ... 1 ... ... 1 Newsagent ... 2 1 ... ... ... ... ... ... 3 Oilman ... 2 ... ... ... ... ... ... ... 2 Optician ... 1 ... ... ... ... ... ... ... 1 Photographer ... 1 ... ... ... ... ... ... ... 1 Public House ... 4 1 ... ... ... 1 ... ... 6 Picture Frame Maker ... 1 ... ... ... ... ... ... ... 1 Pianoforte Teaching ... ... 1 ... ... ... ... ... ... 1 Pianoforte Maker ... ... ... ... ... ... 1 ... ... 1 Restaurant ... 2 ... ... ... ... 1 ... ... 3 Sweet Manufacturer ... 4 ... ... ... ... ... ... ... 4 Saddler ... 1 ... ... ... ... ... ... ... 1 Sawyer ... 1 ... ... ... ... ... ... ... 1 School ... 1 ... ... ... ... ... ... ... 1 Second-hand Dealer ... 1 ... ... ... ... ... ... ... 1 Sweep ... 1 ... ... ... ... ... ... ... 1 Tobacconist ... 1 ... ... 1 ... ... ... ... 2 Tailor ... 9 ... ... 1 ... ... ... ... 10 Upholsterer ... 1 ... ... ... ... ... ... ... 1 Umbrella Maker ... 1 ... ... ... ... ... ... ... 1 Underclothing Making ... 2 ... ... ... ... ... ... ... 2 Wood Chopper ... ... 1 ... ... ... ... ... ... 1 Wardrobe Dealer ... ... 1 ... ... ... ... ... ... 1 Totals ... 125 29 6 1 25 ... ... 186 140 1904] OCCUPATIONS OF PERSONS ATTACKED WITH INFECTIOUS DISEASES. An interesting table (CX.) showing the occupations of 1,230 persons who were attacked with one or the other of the several notifiable diseases is given below. TABLE CX. Showing the Occupations of Patients suffering from the several Infectious Diseases during the year 1904. [ OCCUPATIONS. Small Pox. Scarlet Fever. Diphtheria Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Tout. Agent ... ... ... ... 2 ... ... ... ... 2 Apprentice ... 1 ... ... ... ... ... ... ... 1 Artificial Florist ... ... 1 ... ... ... ... ... ... 1 Architect ... ... ... ... 1 ... ... ... ... 1 Accountant ... 1 ... ... ... ... ... ... ... 1 Bookkeeper ... ... ... ... ... ... ... ... ... 1 Bag Maker ... 1 ... ... 1 ... ... ... ... 2 Butcher ... 2 ... ... ... ... ... ... ... 2 Bricklayer ... ... ... ... 3 ... ... ... ... 3 Baker ... ... ... ... 1 ... ... ... ... 2 Barman ... ... ... ... 1 ... ... ... ... 1 Barmaid ... ... 1 ... ... ... ... ... ... 1 Box Maker ... ... 1 ... 1 ... ... ... ... 2 Bookbinder ... 1 ... ... ... ... ... ... ... 2 Bootmaker ... ... ... ... 1 ... ... ... ... 1 Boarding House Keeper ... ... 1 ... ... ... ... ... ... 1 Brass Finisher ... ... 2 ... ... ... ... ... ... 2 Blouse Maker ... ... 1 ... 1 ... 2 ... ... 4 Brushmaker ... ... ... ... ... ... 2 ... ... 2 Bookfolder ... ... ... ... ... ... 3 ... ... 3 Bailiff ... ... ... ... ... ... 1 ... ... 1 Builder ... ... ... ... ... ... ... ... ... 1 Clerk ... 5 ... ... 3 ... 5 ... ... 13 Carpet Maker ... 1 ... ... ... ... ... ... ... 1 Coachman ... ... ... ... 1 ... ... ... ... 1 Carman ... ... 1 ... 2 ... 8 ... ... 11 Carpenter ... ... 1 ... ... ... 4 ... ... 5 Chemist ... 2 ... ... 1 ... ... ... ... 3 Costermonger ... ... ... ... ... ... 1 ... ... 1 Coal Porter ... ... ... ... 1 ... 1 ... ... 2 Christmas Card Maker ... ... ... ... 1 ... 1 ... ... 2 Charwoman ... ... 1 ... 1 ... 9 ... ... 11 Cabman ... ... ... ... 1 ... 1 ... ... 2 Cabinet Maker ... ... 1 ... ... ... ... ... ... 1 Cycle Maker ... ... ... ... ... ... 1 ... ... 1 Carriage Washer ... ... ... ... ... ... 2 ... ... 2 Cats'-meat Purveyor ... ... ... ... ... 1 ... ... 1 Coffee House Keeper 1 ... ... ... ... ... ... ... ... 1 Dustman ... ... ... ... ... ... 2 ... ... 2 Dentist ... ... ... ... ... ... 1 ... 1 141 1904 Table CX.—continued. occupations. Small Pox. Scarlet Fever. Diphtheria Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Dressmaker ... 2 1 ... 2 ... 1 ... ... 6 Embosser ... 1 ... ... ... ... ... ... ... 1 Engineer ... 1 ... ... ... ... 1 ... ... 2 Errand Boy ... 3 ... ... ... ... ... ... ... 3 Engraver ... ... ... ... ... ... 1 ... ... 1 Engine Driver ... ... ... ... ... ... 1 ... ... 1 Electrician ... 1 ... ... ... ... ... ... ... 1 Furriers ... ... 1 ... 1 ... 3 ... ... 5 Factory Hand ... 1 ... ... ... ... 1 ... ... 2 Feather Curler ... 1 ... ... ... ... ... ... ... 1 French Polisher ... ... ... ... ... ... 1 ... ... 1 Gardener ... ... ... ... ... ... 2 ... ... 2 Grocer ... ... ... ... ... ... 1 ... ... 1 Gilder ... ... ... ... ... ... 3 ... ... 3 Gold Beater ... ... ... ... ... ... 1 ... ... 1 Glazier 1 ... ... ... ... ... ... ... ... 1 Housewife 2 9 3 ... ... ... 28 24 ... 80 Horsekeeper ... ... ... ... ... ... 1 ... ... 1 Hatter ... 1 ... ... ... ... ... ... ... 1 Hairdresser ... ... 1 ... 1 ... ... ... ... 2 Housekeeper ... ... 1 ... 1 ... ... ... ... 2 Hawker ... ... ... ... ... 1 1 ... ... 2 Jeweller ... 1 ... ... ... ... ... ... ... 1 Jet Worker ... 1 ... ... ... ... ... ... ... 1 Jewel Case Maker ... ... 1 ... 1 ... ... ... ... 2 Joiner ... ... ... ... ... ... 1 ... ... 1 Labourer 1 ... 2 ... 2 ... 5 ... ... 10 Laundress ... 1 2 ... 1 ... 3 ... ... 7 Labeller ... 1 ... ... ... ... ... ... ... 1 Leather Worker ... 1 ... ... ... ... ... ... ... 1 Lace Worker ... ... ... ... 1 ... 1 ... ... 2 Law Writer ... ... ... ... ... ... 1 ... ... 1 Messenger ... 4 ... ... ... ... ... ... ... 4 Milliner ... ... 1 ... ... ... ... ... ... 1 Milkman ... ... ... ... 1 ... 2 ... ... 3 Mother' Help ... 2 ... ... ... ... ... ... ... 2 Machinist ... ... 3 ... 1 ... 3 ... ... 7 Manageress ... ... ... ... ... ... 1 ... ... 1 Mantle Maker ... ... ... ... ... ... 2 ... ... 2 Music Hall Artiste ... ... ... ... ... ... 1 ... ... 1 Nurse ... 2 1 ... ... ... 2 ... ... 5 Omnibus Driver ... ... ... ... ... ... 1 ... ... 1 Optician ... 1 ... ... ... ... ... ... ... 1 Porter 1 ... ... ... ... ... 2 ... ... 3 Photographer ... 1 ... ... ... ... ... ... ... 1 142 1904] Table C X.—continued. occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Polisher ... 1 ... ... ... ... ... ... ... 1 Policeman ... 1 ... ... ... ... 2 ... ... 3 Postman m ... ... ... ... 1 ... ... ... ... 1 Painter ... ... ... ... 1 ... 1 ... ... 2 Pattern Maker ... 1 ... ... ... ... ... ... ... 1 Pianoforte Maker ... ... ... ... ... ... 1 ... ... 1 Post Office Official 1 ... ... ... ... ... ... 1 Packer 1 ... 1 ... 1 ... 4 ... ... 7 Pawnbroker's Assistant ... 1 ... ... 1 ... ... ... ... 2 Pipe Case Maker ... ... ... ... 1 ... ... ... 1 Printer ... ... ... ... 2 ... 1 ... ... 3 Pattern Folder ... ... ... ... 1 ... ... ... ... 1 Pianoforte Teaching ... ... ... ... 1 ... ... ... ... 1 Railway Servant ... ... 1 ... ... ... ... ... ... 1 Railway Guard ... ... ... ... 1 ... ... ... ... 1 Scholar ... 676 155 ... 19 ... 21 ... ... 871 Servant ... 1 5 ... 1 ... 6 ... ... 13 Shop Assistant ... 2 4 ... 3 ... 1 ... ... 10 Shunter ... 1 ... ... ... ... ... ... 1 Shop Fitter ... ... 1 ... ... ... ... ... ... 1 Stove Fitter ... ... ... ... ... ... 1 ... ... 1 Stonemason ... ... ... ... ... ... 1 ... ... 1 Solicitor ... ... ... ... ... ... 1 ... ... 1 Stationer ... ... ... ... ... ... 1 ... 1 Super (Theatre) 1 ... ... ... ... ... ... ... ... 1 Surgeon ... 1 ... ... ... ... ... ... ... 1 Tin Worker ... ... ... ... ... ... 1 ... ... 1 Traveller ... ... ... ... ... ... 1 ... ... 1 Telegraph Messenger ... ... ... ... 1 ... ... ... ... 1 Table Maker ... ... ... ... 1 ... ... ... ... 1 Teacher ... ... 1 ... 1 ... 1 ... ... 3 Tea Packer ... 1 ... ... ... ... ... 1 Tram Driver ... ... 1 ... ... ... ... ... ... 1 Tailor ... ... 1 ... 1 ... 1 ... ... 3 Theatre Attendant ... 1 ... ... ... ... ... ... ... 1 Valet ... ...I ... ... ... ... ... ... 1 Van Boy ... ... 1 ... ... ... ... ... ... 1 Warehouseman ... ... ... ... ... ... 1 ... ... 1 Waitress ... 1 ... ... ... ... ... ... ... 1 Wire Mattress Maker ... 1 ... ... ... ... ... ... ... 1 Wood Turner ... ... ... ... 1 ... ... ... ... 1 Warehouse Boy ... ... ... ... 1 ... ... ... ... 1 Woodchopper ... ... ... ... 1 ... ... ... ... 1 Washerwoman ... ... ... ... ... ... 1 ... ... 1 Wood Merchant ... ... ... ... ... ... 1 ... ... 1 Totals 9 739 200 ... 89 1 168 24 ... 1230 143 [1904 Table CXI. Showing the Streets in which the several cases of Infectious Disease occurred during 1904. The large figures denote the number of cases and the small figures the number of infected houses. NAME of STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Aberdeen Road ... 11 11 ... ... ... ... ... ... 22 Alfred Street ... 43 22 ... ... ... ... ... ... 65 Andover Road ... 108 33 ... ... ... ... ... ... 1311 Albion. Grove ... 32 ... ... ... ... ... ... 32 Alsen Road ... 32 32 ... ... ... 22 ... ... 86 Archway Road ... 11 ... ... ... ... ... ... 11 Ash by Road ... 11 ... ... ... ... ... ... 11 Ashbrook Road ... 11 11 ... ... ... ... ... ... 22 Avenell Road ... 22 ... ... ... ... ... ... 22 Ashley House (Upper Park Street) ... ... 11 ... ... ... ... ... ... 11 Albion Street ... 54 ... ... ... ... ... ... 54 Aimesley Road ... 53 ... ... ... ... 11 ... 64 Alexandra Orphanage ... 2 ... ... ... ... ... ... 11 Anatola Road ... 11 ... ... ... 11 ... ... 22 Andover Grove ... 21 ... ... ... ... ... ... 21 Arlington Street ... ... ... ... ... 22 ... ... 22 Arthur Road ... 62 ... ... ... ... ... ... 62 Almorah Road ... 54 ... 11 ... 11 ... ... 76 Arundel Square ... 22 ... ... ... ... ... ... 22 Arlington Square ... 22 ... ... ... ... ... ... 22 Ashley Road ... 11 ... ... ... 22 ... ... 33 Arvon Road ... ... ... ... ... ... 11 ... 11 Ashburton Grove ... ... ... ... ... 11 ... ... 11 Ambler Road ... 11 ... ... ... ... ... ... 11 Albemarle Mansions ... 11 ... ... ... ... ... ... 11 Alexander Road ... 22 ... ... ... ... ... ... 22 Aubert Park ... 11 ... ... ... 11 ... ... 22 Almington Street ... 65 ... ... ... ... ... ... 65 Albany Cottages, Popham Street ... 22 ... ... ... ... ... ... 22 Ashmount Road ... ... ... ... ... 11 ... ... 11 Albert Place ... 11 11 ... ... ... ... ... ... 22 Athelstane Road ... ... ... ... ... 22 ... ... 22 Albany Place ... 11 ... ... ... ... ... ... 11 Arundel Street ... ... ... 11 ... ... ... ... 11 Alwyne Villas ... ... ... ... ... 11 ... ... 11 Arundel Grove ... ... ... ... 11 ... ... ... ... 11 144 1904] Table CXI .—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Archibald Road ... ... ... ... ... ... 11 ... ... 11 Annette Road ... ... ... ... ... ... 11 ... ... 11 Arundel Road ... 11 ... ... ... ... ... ... ... 11 Ardilaun Road ... ... 11 ... ... ... ... ... ... 11 Anson House, Essex Road ... 11 ... ... ... ... ... ... ... 11 Andover Row ... 11 ... ... ... ... ... ... ... 11 Astey's Row ... ... 11 ... ... ... 11 ... ... 22 Balmoral Grove ... 11 31 ... ... ... ... ... ... 42 Bemerton Street ... 54 44 ... 11 ... 22 22 ... 1412 Balls Pond Road ... 32 11 ... ... 32 ... ... 76 Baring Street ... 32 ... ... ... ... 22 ... ... 54 Beaconsfield Buildings ... 2819 44 ... 11 ... 3 s ... ... 3624 Bingfield Street ... 22 ... ... ... ... 11 ... ... 33 Benwell Road ... 108 ... ... ... ... 11 11 ... 1210 Bedford Terrace ... 21 11 ... ... ... ... ... ... 32 Burnard Place ... ... ... ... ... ... 11 ... ... 11 Bride Street ... 97 ... ... ... ... 11 ... ... 108 Blackstock Road ... 11 21 ... ... ... ... ... ... 32 Baldwin Terrace ... 43 ... ... ... ... ... ... ... 43 Balfour Road ... 11 ... ... ... ... ... ... ... 11 Bickerton Road ... 11 ... ... ... ... ... ... ... 11 Barbara Street ... 65 11 ... ... ... ... ... ... 75 Barnsbury Street ... 55 ... ... ... ... ... ... ... 55 Blenheim Road ... 22 ... ... 11 ... ... 1 ... 44 Britannia Row ... 11 11 ... ... ... ... ... ... 22 Barnsbury Road ... 22 22 ... 11 ... 38 ... ... 88 Bovav Street ... ... 11 ... ... ... ... ... ... 11 Beversbrook Road ... 11 ... ... ... ... ... ... ... 11 Brecknock Road ... ... 11 ... ... ... 11 ... ... 22 Battledean Road ... 22 ... ... ... ... ... ... ... 22 Bismarck Road ... ... 11 ... ... ... 1 ... ... 22 Brunswick Street ... ... ... ... ... ... 11 ... ... 11 Brooksby Street ... 21 ... ... ... ... ... ... ... 21 Barnsbury Grove ... ... ... ... ... ... 11 ... ... 11 Bryantwood Road ... 11 ... ... ... ... ... ... ... 11 Brewery Road ... 22 11 ... 21 ... ... ... ... 54 Barnsbury Terrace ... 22 ... ... ... ... ... ... ... 22 Boleyn Road ... 31 44 ... 55 ... ... ... ... 129 Bryan Street ... 11 11 ... 11 ... ... ... ... 32 Bimam Road ... 41 ... ... ... ... 11 ... ... 52 Brand Street ... 11 ... ... ... ... ... ... ... 11 Baxter Road ... 11 11 ... ... ... 11 ... ... 33 Brand Court ... 11 ... ... 11 ... ... ... ... 22 Bracey Street ... 86 ... ... ... ... 11 ... ... 96 145 [1904 Table CXI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Belper Street ... 41 ... ... ... ... ... ... ... 41 Bure House, Offord Road ... 11 ... ... ... ... ... ... ... 11 Buckingham Street ... 22 ... ... ... ... 11 ... ... 33 Blythwood Road ... ... ... ... 11 ... ... ... ... 11 Bryan Place ... ... ... ... ... ... 11 ... ... 11 Bampton House, Halton Road ... ... ... ... ... ... 11 ... ... 11 Bookbinders' Asylum ... ... ... ... 1 ... ... ... ... 11 Bratton Street ... ... ... ... 11 ... 11 ... ... 22 Brook Road ... ... ... ... ... ... 42 ... ... 42 Bishops' Grove ... ... ... ... 11 ... ... ... ... 11 Brandon Road ... ... ... ... 11 ... ... ... ... 11 Brunswick Road ... ... 11 ... 11 ... ... ... ... 22 Cromwell Road ... 42 11 ... ... ... 11 ... ... 65 Caledonian Road 11 11 74 ... ... ... 22 ... ... 2115 Cloudesley Road ... 31 ... ... ... ... 11 ... ... 42 Church Road ... 65 22 ... ... ... ... ... ... 87 Citizen Road ... ... 11 ... ... ... 11 ... ... 22 Cornelia Street ... 32 ... ... ... ... ... ... ... 32 Cheverton Road ... 22 ... ... ... ... ... 11 ... 33 Copenhagen Street 11 54 33 ... 43 ... 22 ... ... 1513 Conewood Street ... 11 22 ... ... ... ... ... ... 33 Canonbury Grove ... 11 ... ... ... ... ... ... ... 11 Canonbury Road ... 44 ... ... ... ... ... ... ... 44 Clayton Street ... ... ... ... 52 ... 11 ... ... 68 Cloudesley Place ... 22 11 ... ... ... ... ... ... 33 Crane Grove ... 11 11 ... ... ... ... ... ... 22 Clarence Street ... 22 ... ... 11 ... ... ... ... 33 Campbell Road ... 86 11 ... ... ... 22 11 ... 129 Corporation Street ... ... 41 ... 11 ... 11 ... ... 63 Corbyn Street ... 96 ... ... ... ... ... ... ... 96 Crowland Terrace ... ... 11 ... ... ... ... ... ... 11 Corinne Road ... 11 11 ... 11 ... ... ... ... 33 Clephane Road 11 11 ... ... ... ... ... ... ... 22 Cardale Street ... 21 11 ... ... ... 11 ... ... 43 Charles Street, Oxford Road ... 11 ... ... ... ... ... ... ... 11 Charteris Road ... 32 ... ... ... ... 11 ... ... 43 Cornwall Cottages, Eden Grove ... ... 11 ... ... ... ... ... ... 11 Carlsbad Street ... ... 11 ... ... ... ... ... ... 11 Charlesworth Street ... 11 22 ... ... ... ... ... ... 33 Coleman Street ... 11 ... ... ... ... ... ... ... 11 Cloudesley Square ... 22 11 ... ... ... ... ... ... 33 Crescent Avenue ... 11 ... ... ...... ... ... ... ... 11 Cumberland Street ... 11 ... ... 11 ... 11 ... ... 33 L 146 1904] Table CXI.— continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Cornwallis Road ... ... 11 ... ... ... 11 ... ... 22 Cottenham Road ... 22 11 ... 22 ... 11 ... ... 65 Canning Road ... 38 ... ... ... ... ... ... ... 33 City Garden Row ... 11 ... ... ... ... 33 ... ... 44 Carleton Road ... ... 11 ... ... ... ... ... ... 11 Charlotte Street ... 4s 11 ... 11 ... 22 11 ... 97 Church Street ... 11 ... ... ... ... ... ... 11 Courtney Road ... 31 ... ... ... ... ... ... 31 Charlotte Terrace ... 3l 11 ... ... ... ... ... 42 Cornwall Cottages, Popham Road ... 11 22 ... 11 ... ... ... 44 Cornwallis Road Workhouse ... ... ... ... ... 1 ... 1 Canal Terrace ... 21 ... ... ... ... ... ... 21 Cross Street ... 11 ... ... ... ... ... ... 11 Calabria Road ... 22 ... ... 11 ... 11 ... 44 Crayford Road ... ... ... ... ... ... 11 11 ... 22 Camden Road ... 38 11 ... 11 ... ... ... 55 Corinth Road ... 22 ... ... ... ... ... ... 22 Clarence Terrace, York Road ... ... 11 ... ... ... ... ... 11 College Street ... 51 11 ... ... ... ... ... 61 Canterbury Road ... 33 11 ... ... ... 21 ... 65 Crouch Hill ... ... ... ... ... ... 11 ... 11 Charlton Place ... ... 11 ... ... ... ... ... 11 Caledonia Crescent ... ... ... ... 11 ... 11 ... 22 Crossley Street ... 48 ... ... ... ... ... ... 43 Charlton Crescent ... ... ... ... ... ... 11 ... 11 Caledonia Street ... ... ... ... 22 ... ... ... 22 Colebrooke Row ... 11 11 ... ... ... ... ... 22 Coleridge Road ... ... 11 ... ... ... ... ... 11 Cressida Road ... 11 ... ... ... ... ... ... 11 Chalfont Road ... 11 ... ... ... ... 11 ... 22 Cottenham Terrace ... ... 11 ... ... ... ... ... 22 Canonbury Lane ... 11 ... ... ... ... ... ... 11 Cathcart Hill ... ... 11 ... ... ... ... ... 11 City Road ... 11 ... ... ... ... ... ... 11 Crescent Street ... ... ... ... 11 ... ... ... 11 Carlton Terrace, Halton Road ... 11 ... ... ... ... ... ... 11 Compton Road ... 11 ... ... ... ... ... ... 11 Canonbury Avenue ... 33 ... ... 11 ... 11 ... 55 Cardozo Road ... 11 ... ... ... ... ... ... i1 Compton Terrace ... ... ... ... ... ... 11 ... 11 Devonshire Street ... 22 ... ... ... ... ... ... 22 Durham Road ... 33 22 ... 11 ... 43 ... 109 Denmark Grove ... ... 22 ... ... ... ... ... 22 147 [1904 Table CXI.—continued. NAME of STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Duncan Terrace ... ... 22 ... ... ... 11 ... ... 33 Danbury Street ... 22 ... ... ... ... ... ... ... 22 Dunford Road ... 22 ... ... ... ... ... ... ... 22 Dorset Street ... 31 ... ... 11 ... 11 ... ... 5s Dorinda Street ... 11 ... ... ... ... ... ... ... 11 Davenant Road ... ... 11 ... ... ... ... ... ... 11 Dennis Street ... ... 11 ... ... ... 11 ... ... 22 Delhi Street ... 11 ... ... ... ... 11 ... ... 21 Duncan Street ... ... 11 ... ... ... ... ... ... 11 Dean Street ... 11 11 ... ... ... ... ... ... 22 Drayton Park ... 11 ... ... ... ... 11 ... ... 22 Despard Road ... 11 ... ... ... ... ... ... ... 11 Duncombe Road ... ... ... ... ... ... 11 ... ... 11 Dresden Road ... 33 ... ... ... ... ... ... ... 33 Denmark Terrace ... ... ... ... ... ... 11 ... ... 11 Devonshire Road ... 74 33 ... ... ... ... ... ... 106 Dartmouth Park Hill ... 22 ... ... ... ... ... ... ... 22 Dagmar House, Dagmar Terrace ... 11 ...... ... ... ... 11 ... ... 22 Denmark Street ... ... ... ... ... ... 11 ... ... 11 Dillon Place ... 22 ... ... ... ... ... ... ... 22 Edinboro' Cottages, Popham Street ... 22 ... ... ... ... ... ... ... 22 Elwood Street ... 66 22 ... ... ... ... ... ... 88 Eden Grove ... 3s 11 ... ... ... 22 ... ... 66 Edinburgh Place, Brewery Road ... 66 22 ... 11 ... ... ... ... 98 Edward Square 11 64 54 ... 22 ... ... ... ... 148 Elthorne Road ... 22 32 ... ... ... ... ... ... 54 Essex Road 21 87 ... ... 11 ... 22 ... ... 1311 Ellington Street ... ... 11 ... ... ... ... ... ... 11 Englefield Road ... ... ... ... ... ... 11 ... ... 11 Ella Road ... ... 11 ... ... ... ... ... ... 11 Elmore Street ... 76 11 ... ... ... 22 ... ... 109 Ecclesbourne Road ... 22 11 ... ... ... 22 ... ... 54 Elliott's Place ... 11 ... 22 ... ... ... ... 33 East Street ... 11 ... 11 ... 11 ... ... 33 Evershot Road ... 11 22 ... ... ... ... ... ... 33 Emily Place ... 11 ... ... ... ... ... ... ... 11 Ellenborough Road ... 22 ... ... ... ... ... ... ... 22 Elthorne Mansions ... 11 ... ... ... ... ... ... ... 11 Edwards Cottages, Canonbury Road ... ... ... ... ... ... ... 11 ... 11 11 Enkel Street ... ... ... ... 11 ... ... ... ... 21 L 2 148 1904] Table CXI.—continued. name OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Everleigh Street ... 22 ... ... ... ... ... ... ... 22 Elton Street ... ... ... ... ... 11 ... ... 11 Frederick Street ... 54 11 ... ... ... 11 ... ... 76 Fonthill Road ... 107 22 ... 22 ... ... ... ... 1410 Fowler Road ... ... 11 ... ... ... ... ... ... 11 Friends' Cottages, Canonbury Road ... 11 ... ... ... ... ... ... ... 11 Fro me Street ... 32 11 ... ... ... ... ... ... 42 Foxham Road ... ... ... ... ... ... ... 11 ... 11 Fairmead Road ... ... 11 ... 11 ... ... ... ... 22 Freeling Street ... 22 ... ... ... ... ... ... ... 22 Fairbridge Road ... 33 11 ... ... ... ... ... ... 44 Fullbrook Road ... 22 ... ... ... ... ... ... ... 22 Framfield Road ... 22 ... ... ... ... ... ... ... 22 Florence Street ... 43 ... ... ... ... ... ... ... 43 Fortnam Road ... ... 11 ... ... ... ... ... ... 11 Fulford House, Fairmead Road ... ... ... ... 22 ... ... ... ... 22 Graham Street ... 38 ... ... ... ... 22 ... ... 55 Goodinge Road ... 11 33 ... ... ... 11 ... ... 55 Gresley Road ... 11 11 ... ... ... ... ... ... 22 Gifford Street 21 98 22 ... ... ... 11 ... ... 1410 Gillespie Road ... 85 11 ... ... ... 11 ... ... 107 Gloucester Road ... 22 ... ... ... ... ... 11 ... 33 Grovedale Road ... 21 22 ... ... ... ... ... ... 43 Grove Road ... 44 11 ... ... ... ... ... ... 5s Grosvenor Road ... ... 54 ... 11 ... 11 ... ... 76 Giesbach Road ... ... 11 ... ... ... ... ... ... 11 Grosvenor Street ... 11 11 ... 11 ... 3s ... ... 66 Georges Road ... 53 11 ... ... ... 22 ... ... 86 Girdlestone Road ... 63 44 ... ... ... ... ... ... 106 Gatoombe Road ... 11 ... ... ... ... ... ... 11 Gerrard Street ... 11 ... ... ... ... ... ... ... 11 Gainsford Street ... 22 32 ... ... ... ... ... ... 54 Grove Street ... 11 ... ... ... ... ... ... ... 11 Grafton Road ... ... 11 ... ... ... ... ... ... 11 Great Northern Hospital ... 1 ... ... ... ... ... ... ... 1 Grenville Road ... 44 ... ... ... ... ... ... ... 44 Grace Street ... ... ... ... 11 ... ... ... ... 11 Goodwin Street ... 21 ... ... ... ... 11 ... ... 32 Garden Villas, Woodville Rd. ... ... 11 ... ... ... ... ... ... 11 Hides Street, Westbourne Rd. ... 11 ... ... ... ... ... ... ... 11 Highbury Grove ... ... 11 ... ... ... ... ... ... 11 Inddlestone Road ... 32 22 ... 11 ... ... ... ... 65 149 [1904 Table CXI.—continued. NAME of STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Half Moon Crescent ... 21 11 ... ... ... ... ... 32 Hazelville Mews, Hazelville Road ... 11 ... ... ... ... ... ... 11 Hope Street ... 11 ... ... ... 11 ... ... 22 Hargrave Road ... ... ... 11 ... ... ... ... 11 Hartham Road ... 11 ... ... ... ... ... ... ... 11 Hatley Road ... 11 22 ... ... ... ... ... ... 3' Hillmarton Road ... 11 ... ... ... ... ... ... 11 Hemingford Road 62 44 22 ... ... ... 21 ... ... 148 Horsell Road ... 22 11 ... ... ... ... ... ... 33 Highgate Hill ... 11 ... ... ... 11 11 ... ... 33 Hungerford Road ... 11 ... ... ... ... 11 ... ... 22 Hollingworth Street ... 74 ... ... ... ... ... ... ... 74 H.M. Prison, Hollow ay ... 2 ... ... ... 5 ... ... 7 Hornsey Road ... 109 54 ... 11 ... 11 ... ... 1715 Hampden Road ... 11 3s ... ... ... 22 ... ... 66 Hanley Road ... 97 ... ... ... ... ... ... ... 97 Halton Road ... 22 ... ... ... ... 11 ... ... 38 Hale Street ... ... ... 11 ... ... ... ... 11 Hawthorn Street ... 11 ... ... ... ... ... ... ... 11 Highbury New Park ... 11 38 ... ... ... ... ... ... 44 Highbury Place ... 11 ... ... ... ... ... ... ... 11 Holmwood Mansions, Anson Road ... 11 ... ... ... ... ... ... 11 Hilldrop Road ... 11 ... ... ... 11 ... ... 22 Highbury Park ... 11 ... ... ... ... ... ... 11 Harberton Road ... 11 ... ... ... ... 11 ... ... 22 Hanover Street ... 11 ... ... 11 ... ... ... ... 22 Halliford Street ... 22 ... ... ... ... ... ... 22 Holloway Road ... 38 ... ... ... ... 11 ... ... 44 Hornsey Street ... ... ... ... ... 11 ... ... 11 H.M. Prison, Pentonville ... ... ... ... 1 ... ... ... ... 2 Hilldrop Crescent ... 11 ... ... ... ... ... ... 11 Highburv Hill ... 11 ... ... ... ... 11 ... ... 22 Huntingdon Street ... 84 11 ... ... ... ... ... ... 95 Hazelville Road ... 22 ... ... ... ... ... ... ... 22 Highbury Grange ... 11 ... ... ... ... ... ... ... 11 Hercules Road ... 32 ... ... ... ... ... ... ... 32 Highbury Crescent West ... 11 11 ... ... ... ... ... ... 22 Hargrave Park ... 21 ... ... ... ... 11 ... ... 32 Hartnoll Cottages, Eden Grove ... 11 ... ... ... ... ... ... ... 11 High Street ... 11 ... ... ... ... ... ... ... 11 Holly Park ... 21 ... ... ... ... ... ... ... 71 150 1904] Table CXI.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Haverstock Street ... ... ... ... ... ... 11 ... ... 11 Hayman Street ... ... ... ... ... ... 11 ... ... 11 Hatechard Road ... ... ... ... ... ... 11 ... ... 11 Hertslet Road ... ... 21 ... ... ... ... ... ... 21 Hardinge Street ... 11 ... ... ... ... 11 ... ... 22 Hornsey Rise ... 11 ... ... ... ... ... ... ... 11 Hamilton Mews, Hamilton Road ... 11 ... ... ... ... ... ... ... 11 Halse Street ... 11 ... ... ... ... ... ... ... 11 Henry Place, Copenhagen St. ... ... ... ... ... ... 11 ... ... 11 Islington Infirmary ... 2 1 ... ... ... 12 ... ... 17 Isledon Road ... 11 22 ... ... ... ... ... ... 33 Islington Workhouse ... 3 ... ... ... ... 1 ... ... 4 Ingleby Road ... ... 33 ... ... ... ... ... ... 33 Islington Green ... ... ... ... ... ... 11 ... ... 11 Junction Road ... 4 ... ... ... ... 11 ... ... 54 Jackson Road ... 44 ... ... 11 ... ... ... ... 55 Kingsbury Road ... 11 11 ... 22 ... ... ... ... 44 Ringsdown Road ... 55 11 ... 21 ... 11 11 ... 109 King Henry Street ... 68 ... ... 72 ... ... ... ... 134 King Edward Street ... 11 ... ... ... ... 11 ... ... 22 Kiver Road ... 11 11 ... ... ... ... ... ... 22 King Henry's Walk ... ... ... ... ... ... 22 ... ... 22 Lyon Street ... 22 11 ... ... ... ... ... ... 33 Lidyard Road ... ... 11 ... ... ... ... ... ... 11 Lesly Street ... 55 11 ... 22 ... ... ... ... 87 Liverpool Buildings, Liverpool Road ... 11 44 ... ... ... ... ... ... 55 London Street ... 22 11 ... ... ... 11 ... ... 44 Lavina Grove ... 11 ... ... ... ... 21 ... ... 32 Liverpool Road ... 1410 44 ... .1 ... ... ... ... 1915 Langdon Road ... 32 ... ... ... ... 22 ... ... 54 Luard Street ... 22 11 ... ... ... ... ... ... 33 Leigh Road ... 11 ... ... ... ... ... ... ... 11 Lennox Road ... 44 22 ... 11 ... ... ... ... 77 London Fever Hospital ... 5 ... ... ... ... ... ... ... 5 Legard Road ... 11 ... ... ... ... ... ... ... 11 Lofting Road ... 54 11 ... ... ... ... 11 ... 76 Lonsdale Square ... 11 ... ... ... ... 11 ... ... 22 Loraine Road ... 32 ... ... ... ... 33 ... ... 65 Landseer Road ... 48 ... ... 31 ... ... ... ... 74 Lorne Buildings, Benwell Rd. ... 11 ... ... ... ... ... ... ... 11 Linton Street ... 11 ... ... ... ... 11 ... ... 22 Lampeter Street ... ... ... ... ... ... 21 ... ... 21 151 [1904 Table CXI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Little Cumming Street ... 21 ... ... ... ... ... ... ... 21 Leconfield Road ... ... ... ... ... ... 11 ... ... 11 Maygood Street ... 22 ... ... ... ... 11 ... ... 33 Mildmay Street ... 32 ... ... 11 ... ... ... ... 4 Moray Road ... 55 ... ... 11 ... ... 11 ... 77 Marriott Road ... 11 11 ... ... ... ... ... ... 22 Monnery Road ... 11 ... ... ... ... ... ... 11 Marquess Road ... 32 ... ... ... ... ... ... 32 Melgund Road ... 54 ... ... 11 ... ... ... ... 65 Mildmay Road ... 22 11 ... ... ... ... ... ... 33 Mitford Road ... 21 11 ... ... ... ... ... ... 32 Marlborough Road ... 22 22 ... 11 ... 11 ... ... 66 Matthias Road ... 22 ... ... ... ... 11 ... ... 33 Milton Grove ... 11 ... ... ... ... 11 ... ... 22 Moreland Street ... 11 ... ... ... ... ... ... ... 11 Marcellus Road ... ... ... ... ... ... 22 ... ... 22 Market Street ... 11 11 ... ... ... ... ... ... 22 Montpelier Road ... 11 ... ... ... ... ... ... ... 11 Mercers Road ... 22 ... ... ... ... ... ... ... 22 Mildmay Grove ... 22 ... ... ... ... ... ... ... 22 Morton Road ... ... 11 ... ... ... ... ... ... 11 Mayville Street ... 42 ... ... ... ... 11 ... ... 53 Matilda Street ... 22 11 ... ... ... ... ... ... 33 Muriel Street ... ... ... ... ... ... 11 ... ... 11 Middlesex Street ... 21 ... 11 ... 21 ... ... 53 Moon Street ... ... 11 ... ... ... ... ... ... 11 Mentone Road ... 11 ... ... ... ... ... ... ... 11 Milner Square ... 11 ... ... ... ... 11 ... ... 22 Medina Road ... 22 ... ... ... ... ... ... ... 22 Montem Street ... 31 ... ... ... ... ... ... ... 31 Mayton Street ... ... 22 ... ... ... ... ... ... 22 Malvern Terrace ... 11 ... ... ... ... ... ... ... 11 Mfranda Road ... 11 ... ... ... ... ... ... ... 11 Mulkern Road ... 21 ... ... ... ... .... ... ... 21 Mildmay Park ... ... 11 ... ... ... ... ... ... 11 Mildmay Cottage Hospital ... ... 11 ... ... ... ... ... ... 11 North Cottages, Canonbury Road ... ... ... ... ... ... ... 11 ... 11 Norfolk Road 11 64 22 ... ... ... 11 ... ... 108 North Road ... 11 ... ... ... ... ... ... ... 11 Newhall Street ... ... ... ... ... ... 11 ... ... 11 Northampton Grove ... ... 11 ... ... ... 11 ... ... 22 Newington Green Road ... 53 21 ... ... ... ... ... ... 74 New North Road ... 44 11 ... 21 ... 11 ... ... 87 152 1904] Table CXI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. North Street ... ... ... ... ... ... 22 ... ... 22 Noel Street ... 11 ... ... ... ... ... ... ... 11 North Avenue ... ... ... ... ... ... 11 ... ... 11 Northampton Street ... 11 ... ... ... ... 11 ... ... 22 Newington Green ... 22 ... ... ... ... 11 ... ... 38 Nelson Terrace ... 22 ... ... ... ... ... ... ... 22 Norfolk Street ... 42 ... ... ... ... ... ... ... 42 Nailour Street ... 11 ... ... ... ... ... ... ... 11 Netherland Place ... 31 ... ... ... ... ... ... ... 31 Oxford Road ... 55 11 ... ... ... 22 ... ... 88 Outram Street ... 44 11 ... 11 ... ... 11 ... 76 Offord Terrace ... ... 11 ... ... ... ... ... ... 11 Offord Road ... 76 22 ... ... ... ... ... ... 98 Urpingley Road ... 11 ...... ... 11 ... ... ... ... 22 Offord Street ... 21 22 ... ... ... ... ... ... 48 Ockenden Road ... 11 ... ... ... ... 22 ... ... 33 Oakley Road ... 33 ... ... ... ... 11 ... ... 44 Orleans Road ... 11 ... ... ... ... ... ... ... 11 Ormond Road ... ... 11 ... 11 ... ... ... ... 22 Oakley Crescent ... ... ... ... 11 ... ... ... ... 11 Pyrland Road ... 52 21 ... ... ... ... ... ... 7s Pleasant Place ... 11 ... ... ... ... ... ... ... 11 Plimsoll Road ... 22 ... ... ... ... 11 ... ... 33 Peabody Buildings ... ... 55 ... 32 ... 22 ... ... 109 Pembroke Street ... 66 22 ... 21 ... 11 ... ... 1110 Prebend Street ... ... 11 ... ... ... 33 ... ... 44 Poole's Park ... 64 11 ... 11 ... 11 ... ... 97 Packington Street ... 22 ... ... ... ... ... ... ... 22 Prospect Place, Barnsbury ... 22 11 ... ... ... ... ... ... 33 Pulteney Terrace ... 11 ... ... ... ... ... ... ... 11 Pulteney Street ... 53 ... ... ... ... ... ... ... Penn Road Villas ... ... 11 ... ... ... 11 ... ... 22 Palmerston Road ... 111 11 ... ... ... ... ... ... I24 Popham Road ... 11 ... 11 ... ... ... ... 32 Petherton Road ... 31 11 ... ... ... ... ... ... 42 Poet's Road ... 11 ... ... ... ... ... ... ... 11 Parkfield Street ... 22 ... ... 11 ... 21 ... ... 54 Popham Street ... ... 11 ... ... ... ... ... 11 Park Street ... ... 11 ... 11 ... ... ... 22 Pentonville Cottages, ket Street ... 11 ... ... ... ... ... ... 11 Paddington Street ... 22 ... ... ... ... ... ...... 22 Pentonville Road ... ... 11 ... ... ... ... ... 11 Pine Grove ... ... 21 ... ... ... ... ... 21 158 [1904 Table CXI.—continued. name OF street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever Continued Fever. Totals. Prah Road ... 11 ... ... ... ... 11 ... ... 22 Poynings Road ... 11 ... ... ... ... ... ... ... 11 Princes Mansions, Liverpool Road ... ... ... ... 11 ... ... ... ... 11 Payne Street ... ... ... ... ... ... 11 ... ... 11 Parkhursfc Road ... ... 11 ... ... ... ... ... ... 11 Pleasant Buildings, York Road ... ... ... ... 11 ... ... ... ... 11 Queen's Head Street ... 11 ... ... ... ... 11 ... ... 22 Queen's Cottages, Popham Street ... ... 11 ... ... ... ... ... ... 11 Queen Margaret's Grove ... 22 22 ... ... ... ... ... ... 44 Queensbury Street ... 11 22 ... ... ... ... ... ... 44 Queen's Arms Buildings, Cattle Market ... ... 11 ... ... ... 11 ... ... 22 Queensland Road ... 75 ... ... ... ... ... ... 75 Quinn Buildings, Popham St. ... 11 32 ... ... ... 11 ... ... 54 Queen's Square ... ... ... ... ... ... 22 ... ... 22 Quadrant Road ... ... ... ... ... ... 11 ... ... 11 Rotherfield Street ... ... 44 ... 11 ... 11 ... ... 66 Rheidol Terrace ... 11 ... ... ... ... ... ... ... 11 Roman Road ... 119 22 ... ... ... 22 ... ... 1518 Rosemary Street ... 33 22 ... ... ... 11 ... ... 66 Rocliffe Street ... 11 11 ... ... ... ... ... ... 22 Riversdale Road ... 21 ... ... ... ... 11 ... ... 32 Randalls Road ... 22 ... ... ... ... ... ... ... 22 Rupert Road ... ... ... ... 11 ... ... ... ... 11 Richmond Crescent ... 22 ... ... ... ... ... ... ... 22 Rock Street ... 11 11 ... ... ... ... ... ... 22 Regina Road ... 119 ... ... ... ... 11 ... ... 1210 Richard Street ... ... 11 ... ... ... ... ... ... 11 Railway Street ... 11 ... ... ... ... ... ... ... 11 Richmond Road ... 75 ... ... ... ... ... ... ... 75 Ronalds Road ... 43 ... ... ... ... 21 ... ... 64 Roseleigh Avenue ... 11 ... ... ... ... ... ... ... 11 Rhodes Street ... 54 ... ... ... ... ... ... ... 54 Roads Place ... 31 ... ... ... ... 11 ... ... 42 Rufford Street ... 11 ... ... ... ... ... ... ... 11 Run,ton Street ... 21 ... ... ... ... 11 ... ... 32 Ralph Street ... ... ... ... ... ... 11 ... ... 11 Roden Street ... 33 22 ... ... ... ... ... ... 58 Russell Road ... 11 ... ... ... ... ... ... ... 11 St. John's Villas ... ... 21 ... ... ... 11 ... ... 32 St. Peter's Street ... 11 ... ... ... ... 11 ... ... 22 154 1904] Table CXI.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Sparsholt Road ... 43 11 ... ... ... ... ... ... 54 St. John's Road ... 11 11 ... ... ... ... ... ... 22 Seven Sisters Road ... 22 ... ... 11 ... 11 ... ... 44 Spencer Road ... 53 ... ... ... ... ... ... ... 53 Spencer Street ... ... 11 ... ... ... 11 ... ... 22 Suffolk Place ... ... ... ... ... ... ... 11 ... 11 Shepperton Road ... ... 11 ... ... ... 54 ... ... 64 Sudeley Street ... 21 ... ... ... ... ... ... ... 21 Stanmore Street ... ... 11 ... ... ... ... ... ... 11 Sherringham Road ... 21 ... ... ... ... ... ... ... 21 Story Street ... ... 32 ... ... ... ... ... 11 ... 43 St. Thomas' Road ... 11 ... ... ... ... ... ... ... 11 Sonderberg Road ... 11 11 ... ... ... ... ... ... 21 St. Jude Street ... ... 11 ... ... ... 11 ... ... 22 St. George's Avenue ... 11 ... ... ... ... ... ... ... 11 St. James' Road ... 66 11 ... ... ... 33 ... ... 1010 Sherbourne Street ... 126 ... ... ... ... ... ... ... 126 Stavordale Road ... 22 ... ... ... ... ... ... ... 22 St. John Street ... 11 ... ... ... ... ... ... ... 11 Salisbury Road ... ... 11 ... ... ... 11 11 ... 38 St. Paul's Road ... 32 ... ... ... ... 22 ... ... 54 South Street ... 31 ... ... ... ... 22 ... ... 53 Stanley Road ... 11 ... ... ... ... ... ... ... 11 Sonning Street ... 33 ... ... ... ... ... ... ... 33 Southgate Road ... 22 22 ... ... ... 11 ... ... 55 Stroud Green Road ... 44 ... ... ... ... ... ... ... 44 Sotheby Road ... ... 11 ... ... ... ... ... ... 11 Stonefield Street ... 11 ... ... ... ... ... ... ... 11 Shaftesbury Road ... 22 ... ... ... ... ... ... ... 22 Scholefield Road ... ... 11 ... ... ... ... ... ... 11 Stock Orchard Crescent ... 11 ... ... ... ... ... ... ... 11 Shelbourne Road ... 22 ... ... ... ... ... ... ... 22 St. Clement's Street ... 11 11 ... ... ... 11 ... ... 33 Sebbon Street ... ... 11 ... ... ... 22 ... ... 33 Sun Row ... ... 11 ... ... ... ... ... ... 11 Stradbroke Road ... 11 ... ... ... ... ... ... ... 11 St. Thomas Street ... 21 ... ... ... ... ... ... ... 21 Sable Street ... ... ... ... ... ... 11 ... ... 11 Sussex Road ... 11 11 ... ... ... ... ... ... 22 St. Peter's Road ... 11 ... ... ... ... ... ... ... 11 St. Aloysius' Schools ... ... ... ... 11 ... ... ... ... 11 Studd Street ... 11 ... ... ... ... ... ... ... 11 Tiber Street ... 74 11 ... ... ... 11 ... ... 96 Twyford Street ... ... 33 ... ... ... ... ... ... 33 155 [1904 Table CXI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Tibbertcon Square ... ... ... ... 2 2 ... ... ... ... 22 Tufnell Park Road ... 22 22 ... 11 ... 11 ... ... 66 Tabley Road ... 42 ... ... ... ... 11 11 ... 64 Travers Road ... ... ... ... ... ... 11 ... ... 11 Tytherton Road ... 11 11 ... ... ... ... ... ... 22 Tollington Park ... 11 ... ... ... ... 22 ... ... 33 Tyndale Place ... 22 ... ... ... ... ... ... ... 22 Thorpedale Road ... 43 11 ... ... ... ... ... ... 51 Trinity Street ... 11 11 ... ... ... 11 ... ... 32 Thornhill Square ... ... ... ... ... ... 11 ... ... 11 Tollington Road ... ... 11 ... ... ... 11 ... ... 22 Thornhill Crescent ... 63 ... ... ... ... ... ... ... 63 Torrens Buildings, City Rd. ... 11 ... ... ... ... ...... 11 ... 22 Tavistock Mews ... 11 ... ... ... ... ... ... ... 11 Thornhill Road ... 43 ... ... ... ... ... ... ... 43 Trinder Road ... 11 ... ... ... ... ... ... ... 11 Tollington Place ... ... ... ... ... ... 11 ... ... 11 Thornhill Houses, Offord Road ... 33 ... ... ... ... ... ... ... 33 Tavistock Terrace ... 11 ... ... ... ... ... ... ... 11 Turle Road ... 11 ... ... ... ... ... ... ... 11 Thornhill Bridge Place ... 11 ... ... ... ... ... ... ... 11 Upper Park Street ... 21 22 ... ... ... ... ... ... 43 Upper Street ... 32 11 ... ... ... 11 ... ... 54 Vittoria Street ... 43 11 ... ... ... 11 ... ... 64 Vorley Road ... 54 ... ... ... ... ... ... ... 54 Victor Road ... 107 ... ... ... ... 11 ... ... 118 Vittoria Place ... ... 11 ... ... ... ... ... ... 11 Victoria Road ... 43 ... ... ... ... ... ... ... 43 Victoria Place, Queensland Road ... 31 ... ... ... ... ... ... ... 31 Warrender Road ... 54 ... ... ... ... ... ... ... 54 Wallace Road ... 11 11 ... ... ... ... ... ... 22 Windsor Street ... 56 ... ... ... ... ... ... ... 5s Witley Road ... 11 11 ... ... ... ... ... ... 2l Whitehall Park ... ... ... ... 11 ... ... ... ... 11 Whitehall Parade ... 11 ... ... ... ... ... ... ... 11 Westbourne Road ... 11 11 ... 11 ... ... ... ... 33 Woodville Road ... 42 ... ... ... ... 32 ... ... 74 Wall Street ... 22 ... ... 11 ... ... ... ... 32 Windsor Road ... 11 11 ... ... ... ... ... ... 22 Whitehall Mansions ... 11 ... ... ... ... ... ... ... 11 Wellington Road ... ... 21 ... ... ... 22 ... ... 43 Wedmore Street ... 11 11 ... ... ... ... ... ... 22 156 1904 Table CXI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever Erysipelas. Puerperal Fever. Continued Fever. Totals. Whistler Street ... 75 11 ... ... ... 11 ... ... 97 Warner Street ... 44 ... ... ... ... 11 ... ... 55 Wynford Road ... 64 21 ... ... ...... 11 ... ... 96 Wharfdale Road ... 42 ... ... ... ... ... ... ... 42 Winchester Street ... 11 ... ... ... ... ... ... ... 11 Wilton Street ... 11 ... ... ... ... ... ... ... 11 Workhouse Schools, Hornsey Road 45 6 ... ... ... 1 ... ... 52 William Street, Wynford Rd. ... 11 ... ... ... ... ... ... ... 11 White Horse Yard, Liverpool Road ... ... 11 ... ... ... ... ... ... 11 Woodville Grove ... 51 ... ... ... ... ... ... ... 51 Waterloo Terrace, Upper St. ... 11 ... ... ... ... ... ... ... 11 Wray Crescent ... 11 ... ... ... ... ... ... ... 11 Whewell Road ... ... ... ... ... ... 22 ... ... 22 Wolsey Road ... ... ... ... ... ... 11 ... ... 11 Witherington Road ... 22 ... ... ... ... 11 ... ... 33 Willow Bridge Road ... 11 ... ... ... ... ... ... ... 11 Wedmore Gardens ... 11 ... ... ... ... ... ... ... 11 Wells Terrace, Fonthill Road ... ... 11 ... ... ... ... ... ... 11 York Road ... 11 22 ... 11 ... 11 ... ... 56 Yerbury Road ... 11 ... ... 11 ... ... ... ... 22 157 1904 BACTERIOLOGICAL DIAGNOSIS OF DIPHTHERIA, ENTERIC FEVER, AND PHTHISIS. Since July, 1897, mucus and blood from patients living in the borough suspected to be suffering from Diphtheria and Enteric Fever have been examined gratuitously for Medical Practitioners, and since January 1898 the sputum from suspected phthisical patients has also been examined. During 1904, 274 specimens were submitted for examination which is a decrease of 11 on the preceding year. This may be accounted for by the continued decrease in the number of notifications. Of the specimens examined 86 were from suspected Diphtheria cases, 53 from suspected Enteric Fever cases, and 135 from suspected Phthisis cases. These examinations have proved a great boon to the medical profession, who have again and again expressed their appreciation of the work that has been done for them. Diphtheria.—In 28 instances, out of 86 specimens of mucus from the throats of patients examined, the bacillus of diphtheria was discovered whilst in 58 it was not found, so that 32.5 per cent. gave a positive diagnosis. Enteric Fever.—53 specimens of blood were examined, of which 14, or 26.4 per cent. resulted in a positive diagnosis of the disease, while 39 gave negative results. Phthisis.—139 specimens of sputum were forwarded for examination, of which 46 or 443 per cent. were discovered to contain the tubercle bacilli, while 59 gave negative results. In the annual report for 1899, p. 172, the method of examination was explained. The examinations were made as usual under an arrangement with the Lister Institute, who performed their work with the least possible delay. Since these diagnoses were started in 1898, 1861 specimens have been examined, namely 689 from cases of suspected Diphtheria, 550 from cases of suspected Enteric Fever, and 622 from cases of suspected Phthisis. Diseases. Total Examinations. Positive Results. Negative Results. Percentage of Positive Results. Diphtheria 689 275 414 39. 9 Enteric Fever 550 229 321 41.6 Phthisis 622 224 398 36.0 Totals 1861 728 1133 39.1 158 1904 Table CXII. Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Phthisis, 1898-1904. Periods. Diphtheria. Enteric Fever. Phthisis. Totals. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. 3rd Quarter 3 6 9 9 8 17 ... ... ... 26 4th „ 8 14 22 22 9 31 ... ... ... 53 1898 11 20 31 31 17 48 ... ... ... 79 1st Quarter 12 16 28 4 7 11 7 6 13 52 2nd ,, 10 7 17 1 9 10 16 19 35 62 3rd „ 10 14 24 6 19 25 4 9 13 62 4th ,, 15 13 28 14 16 30 9 9 18 76 1899 47 50 97 25 51 76 36 43 79 252 1st Quarter 10 14 24 8 8 16 14 17 31 71 2nd ,, 8 11 19 4 17 21 7 10 17 57 3rd ,, 14 14 28 4 14 18 8 8 16 62 4th „ 11 23 34 17 6 23 6 9 15 72 1900 43 62 105 33 45 78 35 44 79 262 1st Quarter 13 17 30 7 12 19 8 13 21 70 2nd ,, 14 18 32 7 12 19 7 12 19 70 3rd ,, 21 22 43 30 9 39 6 4 10 92 4th ,, 32 33 65 22 13 35 7 14 21 121 1901 80 90 170 66 46 112 28 43 71 353 1st Quarter 19 18 37 9 22 31 12 27 39 107 2nd ,, 15 17 32 6 9 15 9 16 25 72 3rd „ 15 15 30 14 19 33 7 19 26 89 4th „ 3 20 23 16 19 35 11 21 32 90 1902 52 70 122 45 69 114 39 83 122 358 1st Quarter 5 17 22 2 12 14 10 17 27 63 2nd ,, 1 15 16 0 12 12 10 29 39 67 3rd ,, 5 16 21 3 17 20 13 30 43 84 4th ,, 3 16 19 10 13 23 7 20 27 69 1903 14 64 78 15 54 69 40 96 136 283 1st Quarter 3 9 12 1 5 6 14 23 37 55 2nd ,, 4 13 17 1 8 9 8 21 29 55 3rd ,, 3 11 14 8 20 28 13 23 36 78 4th ,, 18 25 43 4 6 10 11 22 33 86 1904 28 58 86 14 39 53 46 89 135 274 Totals 275 414 689 229 321 550 224 398 622 1861 159 [1904 VACCINATION. The returns respecting vaccination deal with the year 1903, and are the latest complete returns available. They show an improvement upon those of the preceding year, which were in turn in advance of the returns of the year 1901. Of the 8,959 births, 6,673 were registered as successfully vaccinated, being 74.5 per cent.; and the number registered as having died unvaccinated was 7.39, or 8.2 per cent. of the whole. Of the remaining 1,627 children, 23, or 0.25 per cent. of the whole had been registered as insusceptible to vaccination; o as having contracted Small Pox prior to vaccination; 62, or 0.69 per cent. as having their vaccination postponed by medical certificate; and 103, or 1.1 per cent. respecting whom certificates of conscientious objection were received; leaving 1,359, or 15.1 Per cent., as "removed," "not to be traced," or otherwise unaccounted for. A better method of estimating the state of vaccination is by taking as the basis of the calculation the number of births, less those infants who have died unvaccinated. This leaves it for the year 1903 at 8,959 less 739 or 8,220. Of these 8,220 surviving children, 6,673, or 81.2 per cent., were successfully vaccinated; 0.27 per cent. were insusceptible to vaccination; 0.75 per cent. as under medical certificate of postponement; and 1.3 per cent. in respect of whom certificates of conscientious objection to vaccination had been obtained, leaving 16.5 per cent. as unaccounted for as regards vaccination. The number of exemption certificates granted to persons holding conscientious objections to vaccination, as we have seen, numbered 103, or 30 more than in the preceding year, but were less by 3 than the number granted in 1901, which was in turn less by 21 than the number granted in 1900. The exemptions do not appear to be of any great moment, being under 1½ per cent. in Islington. 160 1904 Years. Vaccinations per 100 births, less infants who died unvaccinated. Years. Vaccinations per 100 births, less infants who died unvaccinated. 1880 89.8 1892 85.5 1881 990.8 1893 85.0 1882 91.1 1894 84.0 1883 990.4 1895 70.9 1884 990.5 1896 73.9 1885 990.6 1897 73.3 1886 990.8 1898 64.9 1887 90.4 1899 66.4 1888 88.4 1900 679 1889 89.0 I901 75.8 1890 89.3 1902 80.0 1891 87.4 1903 8l.2 Table CXIII. Showing the State of Vaccination in Islington, 1880-1903, also in London and England and Wales, 1880-99. Years. No. of Births. Successfully Vaccinated. Insusceptible to Vaccination. Died Unvaccinated No. of exemption certificates. Postponed by medical certificate. #Remaining. Cases (cols. 6, 7, & 8), not finally vaccinated per 100 births.† Ditto in London. Ditto in Rest of England. 1 2 3 4 5 6 7 8 9 10 11 1880 9,931 8,123 26 885 Not granted for years previous to 1897. 118 779 9.0 7.0 4.5 1881 9,993 8,339 21 812 89 730 8.2 5.7 4.3 1882 10,000 9,360 22 819 155 644 8.0 6.6 4.5 1883 9,950 8,192 25 890 194 644 8.4 6.8 4.9 1884 9,892 8,121 47 924 191 601 8.0 6.8 5.3 1885 9,683 7,874 41 991 157 617 8.0 7.0 5.5 1886 9,844 7.914 39 1,091 148 622 7.8 7.8 6.1 1887 9,732 7,769 44 1,133 171 615 8.1 9.0 6.7 1888 9,620 7,522 39 1,112 219 728 9.8 10.3 8.2 1889 9,638 7,581 22 1,120 198 717 9.5 11.6 9.6 1890 9,239 7,250 19 1,117 122 731 9.2 13.9 10.9 1891 9,823 7,584 33 1 145 131 930 10.8 16.4 12.9 1892 9.626 7.221 28 1,182 127 1,048 12.2 18.4 14.3 1893 9,757 7,251 38 1 222 132 1.114 12.7 18.2 15.7 1894 9,574 7,151 39 1.067 101 1,216 13.7 20.6 19.0 1895 9,959 7,079 50 975 237 1,618 18.7 24.9 19.8 1896 9,752 6,575 46 854 223 2.054 23.4 26.4 22.3 1897 9,878 6,539 30 954 14 220 2,121 23.8 29.1 21.6 1898 9,478 5,422 44 1,068 103 251 2,590 31.1 33.0 21.5 1899 9,631 5,698 81 1,048 101 333 2,370 29.1 27.7 17.2 1900 9,316 5,777 30 812 127 298 2,272 28.9 25.8 13.9 1901 9,266 6,382 29 852 106 107 1,790 21.6 24.1 11.2 1902 9,055 6,593 39 818 73 98 1,434 17.7 Not Not 1903 8,959 6,673 23 739 103 62 1,359 1.0 1904 4,577 3,333 10 195 35 77 927 22.7 able able. (6 m'ths) * The figures in Column 8 are obtained by adding together the numbers given in Columns 3, 4, 5, 6 and 7 and deducting the total from the number in Column 2. † The figures in Column 9 are percentage statements, obtained by adding together the numbers given in Columns 6, 7 and 8 and applying them to the numbers in Column 2. 161 1904 DISINFECTION. Disinfection of Rooms.—2,195 rooms were disinfected after the occurrence of an infectious disease. The disinfectant used has again been formaldehyde either in its gaseous form or in solution (formalin), the latter being applied as a spray. Since its adoption it has not been found necessary to strip the paper from so many walls as formerly. It is very satisfactory to find that in no single instance has there been a case of infectious disease attributable to a failure in the disinfection. The Cleansing and Stripping of Rooms.—396 rooms were cleansed and their paper stripped from the walls. Although this return is 256 more than that for 1903, it is no less than 918 below that for 1902. Disinfection of Schools.—In consequence of the prevalence either of Measles or Chicken Pox, or both, class rooms in the undermentioned schools were disinfected:— 1st Quarter. Hungerford Road. Montem Street. Gifford Street. Upper Hornsey Road. Grafton Road. St. Philip's, Arlington Square. 2nd Quarter. Cottenham Road. St. Paul's (Dorset Street). Gillespie Road. Ecclesbourne Road. Chapel of Ease. St. John's (R.C.) Duncan Terrace. Wesleyan Schools (Drayton Park). 3rd Quarter. Station Road. Workhouse Schools. Montem Road. 4th Quarter. St. Philip's, Arlington Square. Alexandra Orphanage. Workhouse Schools. The Islington Workouse Schools were disinfected on 15 occasions owing to the presence of Scarlet Fever among the scholars. m 162 1904] Table CXIV. Showing the Disinfection of Rooms af'er Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1904. Sanitary Inspectors' Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1904. 1903 1st Q'rter 26 29 12 33 37 31 17 22 43 27 34 37 19 25 392 474 2nd do. 21 26 26 53 41 29 33 31 51 57 38 32 34 26 498 598 3rd do. 33 40 41 73 29 45 21 42 68 52 50 52 49 38 633 527 4th do. 33 56 55 76 28 48 36 33 73 33 64 63 39 35 672 422 Year 113 151 134 235 135 153 107 128 235 169 186 184 141 124 2195 2021 Table CXV. Showing the Cleansing and Stripping of Rooms after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1904. Sanitary Inspectors Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1904. 1903 1st Q'rter . . 2 6 1 11 16 .. .. 14 .. .. 11 .. 16 77 35 2nd do. .. .. 68 19 .. .. .. 12 54 18 .. 13 .. 14 198 30 3rd do. 8 .. 8 .. .. 20 .. .. .. 4 .. 11 .. .. 51 45 4th do. 6 1 17 .. .. 6 11 13 1 .. 6 3 .. 2 66 26 Year 14 3 99 20 11 42 11 25 69 22 6 38 .. 32 392 136 WORK DONE AT THE DISINFECTING STATION. There were 2 7,868 large articles disinfected in the steam chambers at Seven Sisters Road, compared with 23,748 that were treated in 1903. The present return brings up the total number of large articles disinfected to 261,924. No record has ever been kept of the enormous number of small articles, such as handkerchiefs, stockings, towels, etc., that are disinfected, as they are generally placed loosely in bags and disinfected together as one lot. If it had, the number of different articles would have run probably into millions. A list of the principal articles that have been sterilized is given in the following table. 163 1904 TABLE CXVI. Summary of the chief articles of Clothing, Bedding, &c., disinfected during the year 1904, and also in the preceding year 1903. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1904 1903. Beds 334 419 546 556 1,855 1,601 Blankets 536 595 780 947 2,858 6,277 Bolsters 229 249 399 414 1,291 1,099 Carpets 56 71 77 113 317 383 Chair Bed Cushions 62 80 89 84 315 383 Mattresses 196 200 307 320 1,023 889 Palliasses 258 283 420 479 1,440 1,269 Pillows 563 627 956 983 3,129 2,779 Quilts 301 287 437 484 1,509 1,255 Sheets 526 630 891 974 3,021 2,518 Other Articles 1,047 967 1,468 1,628 5,110 5,295 Totals 4,108 4,408 6,370 6,982 21,868 23,748 The disinfecting chambers have now been in continuous use for ten years, and during that period have required no attention beyond that which the engineer-in-charge has been able to give. They have been a great success; they have performed their work most efficiently and economically ; and are to-day in as good a state as when they were first erected. They reflect the very highest credit on their makers, Messrs. Goddard, Massey, and Warner, Nottingham. The following is a record of the work performed by the Steam Disinfectors during the past ten years:— 1895 17,240 articles. 1896 42,258 1897 28,302 1898 20,172 1899 25.378 1900 1901 27.050 1902 36,772 1903 23.748 1904 21,868 „ Total for ten years 261,924 M 2 164 1904 Disinfectants distributed and used.—The following statement gives the quantity of disinfectants distributed by the Sanitary Authority, and used in disinfecting and cleansing rooms:— How disposed of. Carbolic Powder. Carbolised Creosote. Clear Carbolic Acid. Formaldehyde. Tablets. Solution. To Householders.. Tons. 3 cwts. 5 Gallons. 770 Gallons. — cwts. — lbs. Gallons — Disinfection of Premises - — 6 2 16 50 SHELTER HOUSE. The Shelter House was occupied by only five persons during the year on account of Scarlet Fever in the homes. It was, however, used to give baths to three verminous persons, while it was also used to shelter six nurses while they underwent disinfection after Puerperal Fever. It need not be pointed out that it was not built for either the bathing of verminous persons or the disinfection of nurses, and that if it had happened that any serious disease, such as Small Pox, had occurred, it would have been impossible to carry out the obligations resting on the Council under the Verminous Persons Act, or with respect to the disinfection of midwives after attendance on cases of Puerperal Fever. It is most satisfactory, therefore, to know that the Council, fully recognising their responsibility, have decided to erect suitable buildings for each of these purposes. Table CXVII. Families accommodated in the Shelter House. Date of Admittance. Address. Number in Family. Cause. 1904: 2nd June 272, New North Road 3 Scarlet Fever. 4th July 11A, Norfolk Street 1 ,, 8th ,, 28, Petherton Road 1 ,, 2nd November Norris, Lodging House, Campbell Road 1 Verminous Person. 3rd December 173, Downham Road 1 ,, 21st „ 17, Pickering Street 1 ,, PART IV. SANITATION. ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901. INSPECTION OF WORKSHOPS, WORKPLACES, LAUNDRIES AND BAKEHOUSES. HOUSES LET IN LODGINGS. DISTRICT INSPECTIONS. STATE OF PAUPERISM. COMMON LODGING HOUSES. DUST REMOVAL. 166 1904] ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901. This Act requires, by its 132nd section, that "the Medical Officer of Health of every District Council shall in his Annual Report to them report specifically on the Administration of this Act in workshops and workplaces, and he shall send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State." In the report of 1903 (pp. 166-170) the duties of Borough Councils under it were fully detailed, and, therefore, there is no occasion to set them forth here. During 1904 the work of the Inspectors has been, as hitherto, of a most useful character, and has resulted in many additional improvements being effected in factories, workshops and workplaces. It is satisfactory once more to be able to report that, although there is some very slight overlapping of the work of His Majesty's Inspectors and those of the Council, that they have mutually assisted each other, and that there has been no friction, which cannot be equally asserted of the County Council Inspectors with respect to work of another character. The work done during the year will now be considered under the various headings that were adopted in the Report for 1903 in accordance with the spirit of the requirement of the Act. Inspections and Visits.—There are two inspectors employed by the Council, namely, Miss Gray, who visits all workshops and workplaces where women are employed, and Mr. West, who inspects all those where men are engaged. Where both sexes work together, then both inspectors look after the welfare of the workpeople. During the year 1904 they made 7,463 inspections and visits to the several workplaces, as compared with 7,846 visits paid in 1903, 8,040 in 1902, and with an average of 7,195 in the preceding eight years. Since 1896, when Islington first commenced to pay particular attention to the sanitary state of the factories and workshops within its boundaries, to the present time over sixty-five thousand inspections have been made, and naturally these have resulted in very great improvements being effected in the sanitary state of the workplaces. 167 [1904 1896 5,996 inspections and revisits. 1897 6,761 „ „ 1898 6,882 „ „ 1899 7,233 „ „ 1900 7,411 „ „ 1901 7,371 „ „ 1902 8,060 „ „ 1903 7,846 „ „ Average 7,195 „ „ 1904 7,463 „ „ These inspections included the examination, by Mr. West, of 265 bakehouses, 113 boot and shoe shops, 25 cycle shops, 28 furriers, 58 pianoforte works, 41 tailors' shops, 17 wheelwrights, 30 coachbuilding shops, in addition to many others which are set out in his report (p. 181). Miss Gray has inspected the premises of 280 dressmakers, 171 laundries, 82 milliners, 61 mantle makers, 63 blouse and skirt makers, 50 fur sewers, 49 tie makers, 41 tailors, 27 underclothiers, 18 artificial flower makers, 18 leather goods manufacturers, 16 jet and bead workers, besides many others which are duly set out in page 176. Altogether Mr. West made 4,732 inspections and visits, while Miss Gray made 3,216. Registers.—Each inspector keeps a separate register on the card system. On the Female Inspector's register there were at the end of the year 1,040 premises containing 1,781 workrooms, while on the Male Inspector's register there were 1,238 workplaces containing 1,738 workrooms. Thus at the end of the year there were 2,278 workshops on the register. Additions and Removal from the Register.—There were added to Miss Gray's register 159 workplaces, while 202 have been removed; and to Mr. West's register there were added 45 workshops, and 6 have been removed. The total workshops added to the register was, therefore, 104, while 208 have been removed, leaving the net number on the register as stated. Sanitation. There was a general improvement noticed in the sanitary conditions of the workshops, and there has been again in evidence a disposition on the part of the owners to assist the inspectors in their endeavour to provide wholesome surroundings for the workers. In the following table are set forth the particulars of some of the matters dealt with in 1904, and in the preceding eight years. 168 1904]  1896 1897 1898 1899 1900 1901 1902 1903 1904 Total Overcrowding 26 12 15 14 22 14 4 13 4 124 Ventilation 14 13 2 5 4 3 5 8 11 65 Dirty rooms 311 195 109 99 217 218 231 423 630 2.433 Drains 554 458 375 313 216 177 90 50 19 2,252 W.C.'s 420 325 341 355 411 375 154 161 165 2,707 Water supplies 79 41 35 20 19 13 83 54 18 362 Surface drains 79 109 87 51 78 81 2 53 40 580 Cleansing 412 375 393 424 437 387 558 441 609 4,036 Cleanliness.—The state of the workshops as regards cleanliness was somewhat similiar to that reported in the preceding year, as 422 workplaces were found by the Inspectors to be dirty, while in addition 5 were discovered and notified by H.M. Inspectors. Two hundred and twenty-seven of these nuisances were abated on attention being drawn to them, but in 200 instances it became necessary to serve notices. Effluvium Nuisances.—None came under notice. Want of Air Space: Overcrowding.—In only 4 instances was overcrowding discovered, and after the service of notices the nuisances were remedied. This is a very small number of offences compared with the number of workplaces in the borough. It is satisfactory to find that so much care is taken to provide the hands with the full amount of air-space that is required under the Acts. Want of Ventilation.—Only 7 premises were found to be insufficiently ventilated, and in these cases the Council's requirements were met after the service of notices. Want of Drainage of Floors.—The inefficient drainage of floors does not exist to any extent in Islington, where it is almost entirely confined to laundries. Four cases only came under notice, and the faults were duly remedied. Sanitary Accommodation.— In 11 instances it was found that the w.c. accommodation was either insufficient or absent, as compared with 30 in 1903. This decrease is explainable by the fact that for many years special attention has been given to the provision of sufficient w.c.'s to workshops. In 208 cases it was found that the sanitary accommodation was unsuitable or defective; while in 9 cases there was no separate provision for the sexes. 169 [1904 The Inspectors also discovered, in addition to the defective w.c. accommodation, the following sanitary defects. Female Inspector. Male Inspector. Total. Water cisterns dirty or defective 17 1 18 Dustbins wanting or defective 25 20 45 Drains defective 15 4 19 W.c.'s defective or dirty 67 65 132 Miscellaneous 74 227 301 198 317 515 Bakehouses.—There are altogether 222 bakehouses in Islington, of which 102 are built underground. There are in addition to this latter number 38 which are not in use, and consequently have not been licensed. The ovens, however, still remain, and they are, therefore, visited from time to time by the Inspector to see that they are not used. It would be well, that they should now be dismantled by the removal or blocking up of their ovens, for as long as they are allowed to remain it will be essential that the workshops' inspector should visit them. During the year 33 underground bakehouses, that had not been placed in a state to meet the requirements of the Council at the end of 1903, were licensed. There remains now only one bakehouse, which is unoccupied, in which the alterations have not been made. The owner, however, states that it is his intention to make them at some future time. Possibly, however, it may be never again used, as the required alterations are considerable. The state of the bakehouses generally is very good. They have recently been inspected by Mr. J. R. Leggatt, the Superintendent and Chief Inspector, who has presented a report on the subject, in which he states that—"There is a marked improvement in their general condition, and there is a desire on the part of the occupiers, especially of those underground bakehouses which have been certified, to keep them clean." He, however, noted in several instances that coal receptacles had not been provided, and that consequently coals had been deposited on the floors of the bakehouses. He also found in a few instances that clothes had been dried in them. The following is a list of the Unused Bakehouses the ovens of which have neither been removed nor bricked up:— UPPER HOLLOWAY DISTBICT. Underground 6, Highgate Hill, not used for years Empty ,, 88, Milton Grove ,, Shop not used ,, 6, Andover Eoad ,, Greengrocers , 167, Thorpedale Road ,, Premises empty 170 1904] LOWER HOLLOWAY DISTRICT. Underground 16, Sherringbam Road, not used for years Provision shop „ 25, Wellington Road „ B. H. used as a store ,, 92, ,, ,, Provision shop ,, 214, York Road, about 4 years Shop at present empty Above-ground 1, Hope Street ,, Private house HIGHBURY DISTRICT. Underground 182, Drayton Park, not used for years Now used as a Laundry ,, 25, Lowman Road, about 2 years Shop still used as bakers „ 98, Balls Pond Road, not used for years Premises now empty „ 2, Queen's Square, about 4 years Shop closed „ 77, Boleyn Road, not used for years Second hand furniture shop Above-ground 16, St. Jude Street „ Cat's meat shop BARNSBUBY DISTBICT. Underground 181, Copenhagen Street, not used for years Confectioners' shop ,, 269, Liverpool Boad ,, Second hand furniture shop ,, 279, ,, ,, Shop not used ,, 62, Barnsbury Street, about 3 years Cycle works ,, 86, Thornhill Road, not used for years Shoemakers' shop ,, 123, Offord Road „ General shop „ 205, Copenhagen Street „ Shoemaker's shop ,, 334, Caledonian Road „ Printer's store room SOUTH EAST DISTRICT. Underground 49, Dorset Street, not used for years Greengrocer's shop „ 26, Orchard Street ,, >> ,, 28, Baxter Road „ General shop ,, 285, Essex Road „ Watchmakers ,, 30, Canonbury Street ,, Oil shop „ 202, Essex Road ,, Post office and fancy shop ,, 82, Parfield Street ,, General shop „ 38, High Street „ Bakers and confectioner's sliop ,, 44, ,, ,, Tobacconist shop, etc. ,, 78, ,, ,, Premises empty ,, 3, St. Paul's Street ,, Grocers' shop ,, 76, ,, ,, General shop ,, 24, Church Street „ Motor works ,, 289, City Road ,, Shop fitter ,, 2, High Street „ Tailors ,, 29, Camden Street ,, Clothiers ,, 67, Essex Road ,, Baker's shop Above-ground 8, Islington Green, not used for 1 year Premises empty ,, 107, Upper Street, not used for years Confectioners ,, 58, Queensbury Street ,, General shop „ 822, Essex Road „ Baker's shop „ 298, New North Road Grocer's store 171 [1904 Homework.—The great bulk of the work done at home is that undertaken by women, who are employed largely by wholesale firms and large drapers in making clothing for men and women, but mostly for the latter as will be seen in the particulars given below. During the year 201 lists containing 1,756 names, of which 886 were those of persons living in other places, and whose addresses were, therefore, forwarded as required by the Factory and Workshop Act to the Medical Officers of Health of the districts in which they lived. On the other hand, the names and addresses of 875 persons employed by firms outside the borough were received. Thus there were 1,748 homeworkers to be dealt with in Islington. The lists are required to be presented on or before February 1st and August 1st, but the law has not been strictly obeyed, for it was necessary to communicate with numerous employers before some of them were sent in. The lists due February 1st numbered 101, and contained the names of 881 outworkers, of whom 441 lived in other boroughs, while those due on August 1st numbered 0100, and contained the names of 878 persons, of whom 445 lived outside Islington; 473 names were received from Medical Officers of Health from lists due February 1st, and 402 from those due August 1st. It may be stated that the respective lists contain practically the same names, so that in reality instead of there being 1,948 separate persons to deal with there were only something like 1,000. The outworkers were employed as set out in the following statement, which has been prepared by Miss Gray. LIST OF OUTWORKERS. Class of Homework. 1904. Number of Lists Received. Number of Addresses of Outworkers. Due Feb. 1st. Due Aug. 1st. Forwarded to Other Authorities. Received from Other Authorities. No. of Lists. No. of Outworkers. No. of Lists. No. of Outworkers Due Feb. 1st. Due Aug. 1st. Due Feb. 1st. Due Aug. 1st. Mantle and Costume making 8 88 11 144 19 28 62 58 Blouse and Underclothing making 12 314 11 270 195 177 175 115 Belt and Tie making 2 24 1 16 4 4 58 36 Millinery 9 146 7 129 91 72 44 39 Tailoring 57 234 50 244 129 132 40 41 Miscellaneous 13 75 14 75 3 32 94 113 Total 101 881 100 878 441 445 473 402 172 1904] Places where Food is Prepared.—Apart from Bakehouses there are 336 places, such as restaurant kitchens, where food is prepared. At the end of 1903, Miss Gray had not completed her inspection of these places. It was, therefore, continued during the year, and she reports that while some of them were in excellent condition, yet there was room for improvement in most of them, and she goes on to say that the defect she found most frequently was the accumulation of refuse on the premises, and she adds that an effort should be made to secure a daily removal of refuse from such places. There is no doubt that cleanliness is absolutely essential, and that the only way to obtain it is by frequent and systematic inspection, which is, unfortunately, impossible with the staff of inspectors whose duties are to administer the Factory and Workshop Acts in a large borough like Islington. An additional inspector is greatly required to thoroughly carry out the duties and responsibilities cast on the Council under its provisions. As these were fully set out in the Report for 1903 (pp. 167-171), it is not necessary to repeat them now. Laundries.—At the end of 1903, there were 193 on the register, to which 5 were added, and from which 27 were removed in 1904, so that at the end of the year there were 171, containing 439 rooms. These laundries were inspected 346 times. Generally speaking, they were found in a better condition than formerly, but, as the female inspector points out in her interesting report, "though many of the hand laundries are well kept and well arranged, others are carried on in such unsuitable premises, and are so badly managed, that the gradual absorbtion of the business by the large steam laundries is a matter for congratulation." Really what is required is that these hand laundries should be all licensed, work being permitted only in those that meet with the requirements that may from time to time be laid down by the sanitary authority. Miss Gray has mentioned some requirements which she thinks necessary, and her suggestions are valuable. Workshops Notified to H.M. Inspector.—130 Workshops were notified to H.M. Factory Inspector, wherein 472 "protected persons," of whom 9 were young males under the age of eighteen, but who had ceased to be children. The particulars as to the trades carried on in these workshops are set out in the following table. 178 [1904 Workshops Notified to H.M. Inspector in 1904. Number of Workshops. Protected Persons Employed. Trade. Females. Male Young Persons. Total. Dressmaking and Ladies Tailoring 32 71 .. 71 Blouse and Skirt making 28 181 .. 181 Underclothing making 10 25 .. 25 Mantle and Costume making 9 23 .. 23 Fur Sewing 8 27 .. 27 Tailoring 6 9 .. 10 Tie and Belt making 6 14 .. 14 Millinery 5 33 .. 33 Chiffon Tucking 3 9 .. 9 Laundries 3 21 .. 21 Leather Goods making 2 12 .. 12 Embroidering 2 6 .. 6 Jet and Bead Work 1 3 .. 3 Lantern Slide Painting 1 3 .. 3 French Polishing 1 14 .. 14 Ink making 1 3 .. 4 Wig making 1 3 .. 3 Swansdown Sewing 1 2 .. 2 Hat Shape making 1 2 .. 2 Feather Curling 1 4 .. 4 Toy making 1 4 .. 4 Pickling 1 2 .. 2 Pianoforte making 1 .. 2 2 Wood Chopping 1 .. 1 1 Bakehouse 1 .. 1 1 Printing Factory 1 .. 2 2 Tobacco Factory 1 1 .. 1 Harness making 1 .. 1 1 Totals 130 472 9 481 174 1904] SECRETARY OF STATE'S RETURN. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Inspections. Number of Written Notices. Prosecutions. Factories 290 40 1 (Including Factory Laundries) Workshops 5,183 262 • • (Including Workshop Laundries) Workplaces 1,030 82 • • Homeworkers' Premises 960 9 • • Total 7,463 393 1 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied Referred to H.M. Inspector. Nuisances under the Public Health Acts:—* Want of cleanliness 427 423 4 Want of ventilation 7 . 7 .. .. Overcrowding 4 4 .. .. Want of drainage of floors 4 4 .. .. Other nuisances 488 488 .. .. insufficient 11 11 .. .. †Sanitary Accommodation unsuitable or defective 208 208 .. .. not separate for sexes 9 9 .. 1 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) .. .. .. .. Breach of special sanitary requirements for bakehouses (SS. 97 to 100) .. .. .. .. Failure as regard lists of outworkers (S. 107) .. .. .. .. Giving out work to be done unwholesome (S. 108) .. .. .. .. in premises which are infected (S. 110) .. .. .. .. Allowing wearing apparel to be made in premises infected by scarlet fever or small pox (S. 109) .. .. .. .. Other offences .. .. .. .. Total 1,158 1,154 4 1 * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act as remediable under the Public Health Acts, † For districts not in London state here whether Section 22 of the Public Health Acts Amendment Act, 1890, has been adopted by the District Council; and if so, what standard of efficiency and suitability of sanitary accommodation for persons employed in factories and workshop! has been enforced. 175 [1904 3—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 130 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5) Notified by H.M. Inspector 10 Reports (of action taken) sent to H.M. Inspectors. 10 Other 2 Underground Bakehouses (S. 101):— In use during 1903 115 Certificates granted in 1903 69 in 1904 33 In use at the end of 1904 104 Homework :— Number of List of Outworkers* (S. 107) :— Lists. Outworkers. Lists received 201 1759 Addresses of outworkers forwarded to other Authorities 886 received from other Authorities 875 Homework in unwholesome or infected premises : — Wearing Apparel. Other. Notices prohibiting homework in unwholesome premises (S. 108) Cases of infectious disease notified in homeworkers' premises 12 Orders prohibiting homework in infected premises (S. 110) Workshops on the Register IS. 131) at the end of 1904 Important classes of workshops, such as workshop bakehouses, may be enumerated here. Workshops where men are employed 647 Workshops where women are employed 869 Laundries 171 Bakehouses 255 Restaurant Kitchens, &c. 336 Total number of workshops on Register 2278 * The Lists should be received twice in the year. The year's figures required in the Table are then obtained by adding together the two half-yearly totals. 1904] 176 Miss GRAY'S REPORT. The Town Hall, Islington. 1 st February, 1905. To A. E. Harris, Esq., Medical Officer of Health. Sir, I have the honour of presenting for your consideration a report of my work for the year 1904. During the year I inspected 1,751 premises, in which there were 2,365 workrooms, and I have made 1,465 calls and re-inspections. The premises which I inspected were :— Registered Workshops and Laundries .. .. 1,089 The Homes of Female Homeworkers .. .. .. 434 The Kitchens of Restaurants, &c. .. .. .. .. 131 Miscellaneous Premises .. .. .. .. 97 Registered Workshops.—At the end of the year there were on the " Register of workshops, workplaces and laundries where females are employed " 1,040 premises, containing 1,781 workrooms. This is a reduction of 43 workshops during the year, as 159 have been added to the register while 202 have been removed from it. The addresses of 130 workshops, which had not been visited by the Home Office Inspectors, or in which the abstract of the Factory and Workshop Act was not affixed, have been forwarded to H.M. Inspector for the district. The following table shows the trades carried on in the different workshops Nature of Business. Number of Workshops. Number of Workrooms. Dressmaking 280 350 Laundries 171 439 Millinery 82 183 Mantle making 61 99 Blouses and skirt making 63 107 Fur sewing 50 71 Tie making 49 76 Tailoring 41 54 Underclothing making 27 35 Table CXVIII. Giving a Summary of Miss Gray's Workshop Work during the Year 1904. Register. Inspections. Forms and Notices. Sanitary Defects Discovered. Improvements Effected. 1904 Quarter ending. Number of Workshops. Number of Laundries. Additions To. Removals From. Total. Number of Workrooms. Registered Workshops, &c. Homeworkers' Premises. Kitchens. Miscellaneous. Total. Calls and Re-inspections. Workrooms. Workshops Reported to H.M. Inspector. Homeworkers notified to Local Authorities. Workroom Cards. Intimation Notices Served. Statutory Notices Served. Workrooms Overcrowded. Workrooms insufficiently Ventilated. Workrooms in a Dirty Condition. Floors Defective or Undrained. Dustbins Wanting or Defective. Cisterns Dirty or Defective. Drains Defective. Drains Unventilated or Untrapped, &c. Sanitary Conveniences, Defective or Dirty. Insufficient Sanitary Accommodation, Miscellaneous. Total. Overcrowding Abated. Additional Means of Ventilation Provided. Rooms Whitewashed. Floors Repaired or Drained. Dustbins, Cisterns, Roofs, &c., Repaired. Sanitary Conveniences Repaired. Miscellaneous. Total. 2nd April 892 191 43 45 1,081 1,828 27.' 134 58 27 494 388 667 27 277 58 27 3 2 40 5 14 8 3 17 22 114 3 2 10 3 13 7 6 44 2nd July 897 184 59 63 1,077 1,826 311 89 6 24 430 427 570 50 48 101 16 1 1 39 2 2 3 3 5 19 2 9 86 1 1 39 •• 10 15 2 68 1st October 899 178 30 47 1,060 1,806 242 142 12 24 420 365 569 23 302 47 21 50 8 4 3 3 19 2 22 111 63 8 9 10 7 97 31st December 886 171 27 47 1,040 1,781 261 69 55 22 407 285 559 24 25 36 16 1 41 2 5 3 1 12 4 21 90 37 2 16 10 8 73 Total for Year.. 892 191 159 202 1,040 1,781 1,089 434 131 97 1,751 1,465 2,365 124 652 242 80 •• 4 4 170 17 25 17 7 8 67 8 74 401 4 3 149 13 48 42 23 282 177 [1904 Nature of Business. No. of Workshops. No. of Workrooms. Artificial flower making... 18 43 Leather goods making ... 18 32 Jet and bead work 16 25 Cardboard box making ... 8 25 Fancy goods making 7 13 Apron and pinafore making 7 8 Rag and waste paper sorting 7 19 Stationery and valentine making ... 6 9 Shirt making 6 9 Dressing-gown making ... 6 6 Feather curling 6 8 Embroidering 6 11 Boot upper and shoe making 5 6 Confectionery making ... 5 18 Trimming making 4 6 Hairwork and wig making 4 9 Firewood cutting 4 6 Pickle making 4 4 Seed and drug packing ... 4 4 Belt making .. 4 4 Chifion tucking 4 4 Baby linen making 4 4 Bassinette hood making 3 4 Workbox and cabinet making 3 3 French polishing 3 4 Photograph frame making o 3 Collar making 2 4 Curtain making 2 2 Paint brush making 2 3 Brace making 2 5 Tin box making 2 2 Waterproof making 2 3 Surgical appliance making 2 2 Boys' blouse making ... 2 3 Photograph slide making 2 2 Ink making 2 3 Lamp and candle shade making ... 1 1 Toy making 1 4 Blind making 1 Umbrella making 1 1 Jewel case making 1 1 Gold beaters' skin preparing 1 4 Gum sorting 1 1 Perfumery making 1 1 Pattern card making 1 1 Glass Painting 1 1 Balloon making 1 1 Surplice making 1 n 1904] 178 Nature of Business. No. of Workshops. No. of Workrooms Mattress making 2 Cork cutting 2 Funeral furnishing making 1 1 Boot polish making 1 Musical string making 3 Buttonhole making 1 2 Gaiter making 1 2 Artificial fly making ... 1 Naval cap making 1 3 Bath glove making 1 1 Japanning 1 1 Marquetry 1 Camera bellows making 1 2 Wax figure making 1 2 Christmas stocking making 1 1 Aerated water makers' sundries making 1 2 Bottle washing 1 2 Hassock making 1 2 Fan making 1 1 Meat pie making 1 Total 1,040 1781 179 [1904 tion being given. In the fur trade, homeworkers are as a rule only employed in the autumn months, and I have received their names and addresses on visiting the workshops during the season. The names and addresses of 652 female homeworkers on these lists have been forwarded to the Medical Officers of Health of the 38 districts in which they live. In the course of the year I have registered all female homeworkers, notified as living in Islington, on a "card" register. These cards record the names and addresses of workers and their employers, the dates of notification and inspection, and the conditions under which the work was being done. The number of names on this register at the end of the year was 803. The total number of homeworkers notified as living in Islington was 1,728; 875 of these were notified by the Medical Officers of Health for other districts, most of them from those of the City of London and the Boroughs of Finsbury and Hackney. The discrepancy between the number notified and the number registered is explained by the following facts:— (1) Many persons notified as homeworkers are employers of labour and their premises are registered on the "Workshop Register." (2) As the lists are sent in twice a year all homeworkers who are regularly employed are notified twice by the same employer. (3) A homeworker is frequently notified by two or more employers (one workshop occupier was notified 18 times in 1904). (4) A certain number of the addresses given are incorrect. The 434 homeworkers, whom I visited in the course of the year, were those who were notified for the first time or whose homes were not satisfactory when previously visited. As usual, they comprised all sorts of workers, the comparatively well-to-do and the very poor, the good manager and the shiftless. Most of the homes were satisfactory as regards cleanliness. I find that in some trades—such as millinery—the standard of the homes is high, in others—such as infants' shoe making and cheap mantle making—the conditions are not, as a rule, good, though much depends on the individual employers, some of whom are very careful as to the kind of person they employ, while others seem to consider that they have no responsibility in the matter. The introduction of the use of mechanical power to drive ordinary sewing machines, and the elaborate and expensive machines which are being more and more used in factories and large workshops, are likely to diminish the amount of homework. There is no doubt that this system is responsible to a certain extent for the excessively low prices paid for the making of wearing apparel, as it is impossible for the workers to unite to resist the lowering of the prices paid, but the system is a convenience to a number of women who are unable to go to work every day, and their homes—in Islington, at any rate—are not the "dens" which out-and-out objectors to the system represent them to be. Home work has been discovered to be carried on in twelve homes where there were cases of notifiable infectious disease, during the year. All goods likely to be infected have been disinfected before being returned to the warehouses. The diseases of which, it seems to me, the infection is most likely to be carried by home-work are the non-notifiable infectious diseases, such as measles and chicken-pox, about which many people seem to think there is no need to exercise any care. N 2 180 1904] I have experienced little difficulty in gaining admittance to the homes of workers, as they are now generally told by their employers that they are liable to be visited by an inspector, and an explanation of the evils that inspection is expected to check usually reconciles those who are inclined to resent it as an intrusion. Restaurant Kitchens.—During the year I have inspected 131 kitchens connected with dining-rooms, tea-shops, and restaurants. Some of them were in excellent order and very clean, but in most of them there was room for improvement. The defect that I found most frequently was the accumulation of refuse on the premises, and I again suggest that it is most desirable that an effort should be made to secure a daily removal of refuse from such places. I was struck by the numbers of flies in most of the kitchens in summer, and I find that cockroaches are a great trouble in many of them also. In some cases there is a great lack of larder accommodation, and the food is kept in passages, where it is liable to contamination from various sources. In order to keep the kitchens satisfactorily great care and good management are necessary. Miscellaneous Inspections.—I made during the year 97 miscellaneous inspections, They were chiefly of the sanitary arrangements in factories and steam laundries and of the four public conveniences for women in the Borough. I refer to the results of my inspections under the following headings:— Overcrowding.—Only four cases of overcrowding were discovered in registered workshops during the year. The overcrowding was abated in each case on notice being given to the employer. I have distributed 242 cards, stating the cubic capacity of workrooms measured and the number of persons who may be employed in each. Cleanliness.—I found 170 workrooms in a dirty condition. 149 of these had been cleansed and whitewashed under my supervision by the end of the year, the others were dealt with by the district inspectors. A large proportion of the dirty workrooms were in laundries. Ventilation.—In three workrooms, structurally insufficiently ventilated, additional ventilators were provided during the year. There is no doubt that more attention is paid now to the ventilation of workrooms than was the case ten vears ago, although there is still great room for improvement. The amendment is partly due to a greater sense of the need of fresh air on the part of the workers, and partly to the fact that gas jets are not now so often used as a means of heating as they used to be. This question of heating is a matter in which the inspectors of the local authority cannot directly interfere, as it is not a "sanitary provision" within the meaning of the Factory and Workshop Act, and it has therefore to be dealt with by H.M. Inspectors of Factories. Sanitary Defects.—In addition to the above-mentioned saniary defects, I have discovered in the course of my inspections, the existence of 223 nuisances, liable to be dealt with under the Public Health Act. Details of these are to be found in the table which accompanies this report. I have served 80 intimation notices, and I have personally supervised the abatement ct 156 of these nuisances. The remainder have been dealt with by the men inspectors. Complaints.—I have forwarded to H.M. Principal Lady Inspector of Factories complaints which have been made to me with regard to excessive and irregular hours of work and unreasonable deductions from wages. I am, Sir, Your obedient Servant, JESSY M. S. GRAY, Sanitary"Inspector of Workshops. Table CXIX. Summary of Inspector West's Work-shop Work during the year 1904. 1904 Quarter ending. Workshops on Register. Workrooms therein. Newly discovered workshops. Workrooms therein measured. Inspections. Total. Re-inspections and Calls. Total. Workshops. Notices. Nuisances. Improvements. Miscellaneous. Total of Improvements. Tailors. Shoemakers. Pianoforte Makers. Cycle Makers. Bakehouses. Restaurants, &c. Miscellaneous. Tailors. Shoemakers. Pianoforte Makers. Cycle Makers. Bakehouses. Restaurants, &c. Miscellaneous. Overcrowded. Insufficiently Ventilated. Dirty condition. Reported to H.M. Inspector. Removed from Register. Cards distributed. Intimations. Statutory Notices. Homeworkers reported to Local Authorities. Drains defective. W.C.'s defective. Cisterns dirty or uncovered. Dust bins defective or wanting. Miscellaneous. Water Closet. Dust bins provided. General Water. Ventilation and Cleansing. Constructed or provided. Pan and trap furnished Water supply provided. Cisterns provided. Cisterns repaired or cleansed. Water supply provided. Additional ventilation. Workrooms cleansed or limewhited. Yards, &c., repaired. Overcrowd.ng abated. 2nd April 1,207 1,675 12 21 114 45 17 14 133 99 192 614 14 31 14 18 56 274 407 77 3 10 68 1 90 1 15 •• 5 40 2 2 1 10 •• 1 •• 2 66 8 •• 50 142 2nd July 1,217 1,696 10 22 29 58 15 12 118 85 169 486 11 35 22 15 142 61 440 726 3 63 1 1 83 2 36 3 33 1 1 66 5 4 4 1 •• •• •• 2 17 3 •• 74 267 1st October 1,234 1,728 17 32 123 46 10 9 108 99 174 569 34 42 10 5 43 88 398 620 52 1 8 73 1 18 10 2 55 2 5 9 1 •• •• •• 4 113 3 •• 55 192 31st December 1,238 1,738 6 12 13 21 22 11 256 105 156 584 4 27 24 3 179 149 340 726 •• 65 2 2 4 76 2 9 •• 7 •• 12 66 4 6 4 16 •• •• •• •• 107 9 •• 60 206 Total for Year 1,238 1,738 45 87 279 170 64 46 615 388 691 2,253 63 135 70 23 382 354 1,452 2,479 •• 3 257 4 6 22 300 6 253 4 65 1 20 227 13 17 18 28 •• 1 •• 8 460 23 •• 239 807 181 [1904 INSPECTOR WEST'S REPORT. Town Hall, Upper Street, Islington, N. 4th February, 1905. To A. E. Harris, Esq., Medical Officer of Health. Sir, I have much pleasure in submitting my report to you for the year ending the 31st of December, 1904. During that time I have made 4,732 visits to various places of business, consisting of factories, workshops and workrooms in the Borough, having made 2,253 inspections and 2,479 re-inspections. The visits to the trades carried on in them were as follows:— 342 tailors, 305 shoemakers, 134 pianoforte makers, 69 cycle makers, 997 bakehouses, 742 restaurants, etc., and 2,143 miscellaneous places of business. These are as follows :— Trade. No. Trade. No. Artificial florist 1 Fish curing 6 Automatic machine maker 1 File cutting 1 Art metal worker 1 Gas stove maker 1 Bakers 265 Gut scraping 2 Bamboo workers 3 Gas fitters 1 Boot and shoe makers 113 Gold beating 1 Builders 6 Gold beaters' skin making 1 Brush makers 2 Harness makers 3 Bookbinder 1 Ironmongers 4 Beer bottlers 2 Instrument case maker 1 Birdcage maker 1 Invalid chair maker 1 Confectioners 11 Instrument makers 2 Coach builders 30 Ironfounder 1 Carpenters 13 Leather goods makers 2 Cabinet makers 31 Lath renders 2 Cycle makers 25 Laundry machine makers 4 Cork cutter 1 Lamp cleaner 1 Coopers 2 Leather case maker 1 Camera maker 1 Ladder makers 3 Cardboard box maker 1 Monumental mason 1 Card gilder 1 Marquetry inlaying 3 Compass makers 2 Mail-cart makers 6 Cribbage board maker 1 Mattress makers 2 Clock makers 2 Mount making 1 Dairy outfitters 2 Motor car making 2 Die sinkers 2 Map making 1 Dyers and cleaners 2 Marble mason 1 Dining-table makers 2 Nosebag maker 1 Enameller 1 Naturalist 1 Engineer 1 Organ builders 4 Egg sorter 1 Optician 1 Farriers 28 Pianoforte works 58 Fancy working 1 Picture frame makers 4 182 1904] Trade. No. Trade. No. Pianoforte string maker 1 Trunk makers 5 Patent food maker 1 Tea sifter 1 Pie makers 1 Tea merchant 1 Pipe mounter 1 Tin worker 1 Plumbers 1 Upholsterers 4 Provision dealer 1 Undertakers 3 Patent medicine makers 1 Ventilator making 1 Platers 2 Wheelwrights 17 Rag sorters 3 Woodchoppers 5 Scale makers 2 Thermometer makers 2 Saddlers 2 Musical string maker 1 Slate polisher 1 Writing-desk maker 1 Stonemasons 2 Wreath-case maker 1 Sundial maker 1 Waterproof maker 1 Smiths 2 Wood letter makers 1 Stick maker 2 Watchmakers 4 Shop fitters 3 Wire workers 1 Sign writers 2 Workbox making 1 Soap maker 1 Zinc workers 5 Skin dresser 1 Process engraver 1 Shirt maker 1 Hat makers 2 Tailors 41 Typefounder 1 Ticket writers 2 Total 817 Table maker 1 Register.—During the year, 45 workshops, containing 87 workrooms, have been measured and added to the Register, whilst 6 workshops, containing 12 workrooms, have been removed, thus making a total of 1,238 workshops, containing 1,738 workrooms. Sanitary Improvetments.—I have served 305 notices for the abatement of various nuisances. 460 workshops have been cleansed and limewhited. Thirteen w.c.'s have been provided at various factories and workshops, whilst 334 other improvements were carried out under my supervision. I have reported through you to H.M. Inspector of Factories, as required by Section 27 of the Public Health Act, 1891, the addresses of four workshops in the Borough where young people under the age of 18 years were employed. Outworkers.—In accordance with Section 107 of the Factories and Workshops Act, 1901, I have during the year sent through you to the Medical Officers of Health of the Metropolitan Boroughs, the names and addresses of 253 outworkers who reside in the various Boroughs of London, and who work for tradespeople in Islington. Bakehouses.—You will observe by the number of visits paid to the bakehouses during the year, and since the great improvements carried out in many of them, they will need as much attention as I can possibly give to keep them up to the standard in which they now are, as some are inclined to be rather slovenly in not thoroughly sweeping out under the troughs or finding receptacles for the coals; but I trust to overcome this difficulty and leave little or no cause for complaint in this respect; otherwise, for cleanliness of ceilings and walls in the whole of them, they have been very satisfactory. I am, Sir, Your obedient Servant, GEORGE WEST, Sanitary Inspector of Workshops. 188 [1904 HOUSES LET IN LODGINGS. There were 749 houses on the register at the end of the year, as against 655 in 1903, being an addition of 94. There were 2,065 separate inspections of these premises, and in addition 7,124 subsequent visits to them for the purpose of seeing that the work required by the inspectors was carried out, thus making a total of 9,189 visits. In the first quarter 2,294 visits were made, in the second 1,614, in the third 2,369, and in the fourth 2,914. The cause of the increased number of inspections and visits in the third and fourth quarters was that at the end of the second quarter Inspector Ward, who had up to that period divided his time between the inspection of houses let in lodgings and the taking of samples under the Sale of Food and Drugs Acts, was instructed to devote his whole time to the latter duty, and that Inspector Bridel was appointed an inspector of housei let in lodgings in the northern part of the borough. The early part of the year was remarkable for the judgment of the High Court in the appeal case of Nokes v. the Council, owing to which the by-law which deals with cleansing was declared to be bad, because it did not provide for a notice being given to the owner. As this judgment was delivered when the annual report for 1903 was going through the press, it was printed in extenso in it, as it was thought that the matter was of such importance that it should be brought under the notice of the Council as soon as possible. Since then a new set of by-laws has been framed, and will have, it is hoped, received the sanction of the Local Government Board nearly as soon as this report is presented. Improvements.—The inspections resulted in 2,259 separate improvements being effected. These included the following among many other items of a less important character. Drains constructed 8 „ repaired 219 184 1904] Traps fixed 52 W.C.'s—extra provided 18 „ amended 57 „ supplied with water 135 Dust bins provided 98 „ repaired or covered 6 Surface drains and yard pavements constructed or relaid 91 Water supply—cisterns provided 3 „ „ repaired and cleansed 167 „ provided 32 Houses—repaired 32 „ cleansed and limewashed 330 „ ventilated 16 Overcrowding abated 69 "Overcrowding.—In only 69 instances was overcrowding detected in these houses, and then it was generally found that the number of persons occupying the rooms was very little in excess of the limits allowed by the by-laws. * Vide p. 190. 185 [1904 HOUSES LET IN LODGINGS. Table CXX. Summary of Sanitary Work carried out by Inspectors Jordan, Ward and Bridel in Houses Let in Lodgings during the year 1904. 1 Inspector Jordan. Inspector Ward. lnspector Bridel. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. Year. 1st Quarter. 2nd Quarter. 3rd , Quarter 4th Quarter. Year. Lodging Houses on the Register 476 504 524 524 524 194 194 194 225 225 749 Number of Houses inspected 391 319 355 394 1,459 27 40 209 330 606 2,065 Re-inspections, Calls made, etc. 1,286 693 1,193 1,268 4,440 588 562 612 922 2,684 7,124 Total inspections, etc. 1,677 1,012 1.548 1,662 5,899 615 602 821 1,252 3,290 9,189 Improvements. Drains— Constructed 1 1 1 .. 3 .. .. 2 3 5 8 Improved or repaired 90 39 41 33 203 .. .. 9 7 16 219 Traps fixed 6 11 6 5 28 .. .. 4 20 24 52 Cesspools— Abolished .. .. .. .. .. .. .. .. .. .. .. Cleansed or disinfected .. .. .. .. .. .. .. .. .. .. .. Water Closets — 14 Pan, trap and water supply furnished 1 8 3 1 13 .. .. .. .. 22 43 Pan and trap only furnished 9 8 2 2 21 .. .. .. .. .. .. Water supply furnished 26 23 30 28 107 3 22 2 1 28 135 Extra closets provided 1 6 2 1 10 .. .. .. 8 8 18 Dust Bins- Provided 15 10 19 33 77 .. 1 20 .. 21 98 Repaired 1 .. 1 1 3 .. .. 3 .. 3 6 Surface Drains and Pavement of Yards Constructed 2 2 2 .. 6 .. .. 1 1 2 8 Relaid 13 24 9 26 72 .. .. .. 3 11 83 Domestic Water Supply— New cisterns provided 1 .. 1 1 3 .. .. .. .. .. 3 Cisterns repaired and cleansed 21 49 47 25 142 .. .. 12 13 25 32 Water supply provided 7 11 10 1 29 .. .. 2 1 3 32 Other Improvements— Houses generally repaired 4 4 .. 10 18 .. 4 4 6 14 32 etc., cleansed or limewashed 38 87 89 78 292 .. 4 15 19 38 330 ,, ventilated .. .. .. .. .. .. .. 2 14 16 16 Overcrowding abated 21 11 23 9 64 .. .. 2 3 5 69 Illegal use of underground rooms for sleeping discontinued 6 1 2 1 10 .. .. .. .. .. 10 Other Amendments and Nuisances abated 152 154 112 182 600 .. .. .. 112 313 913 Rooms Disinfected .. .. .. .. .. .. .. .. 3 3 3 Total Improvements 415 449 400 437 1,701 29 133 167 229 558 2,259 Total Premises Improved 258 236 236 221 951 18 62 94 177 351 1,302 * Inspector Ward was appointed Inspector of Food and Drugs in June last. 186 1904] DISTRICT INSPECTION. There are fourteen Inspectors engaged in the inspection of the fourteen sanitary districts into which the borough has been divided. In addition to this work, they make inquiries respecting infectious disease, obtaining particulars as to the schools which the patients, if children, attend, and also ascertaining the names of the schools at which any other children living in the house are instructed. It was pointed out last year that the amount of work falling on these inspectors was very heavy, and particulars of it will be found on page 203 of the Annual Report for 1903. Inspections and Visits.—During 1904, 7,133 houses were inspected, of which 1,903 were examined in the course of house-to-house inspections, and 5,230 as the result of complaints, or owing to the appearance of an infectious disease in them. These inspections entailed 53,163 subsequent visits, so that altogether 60,296 visits were paid to the 7,133 properties, or an average of visits to each premises. From this statement it may be easily divined that some houses required to be visited a very large number of times before the work required by Inspectors was completed. Indeed, there are a few owners and one or two agents, of property, and that of the worst type, who take a delight in thwarting, and putting obstacles in the way of the inspectors. Latterly, certain of these people never attempt to abate a nuisance on the receipt of an "intimation" from the sanitary inspectors, and consequently their "intimations" have become so much waste paper, with the result that many nuisances, though often of a pressing character, remain unabated for an undue period of time. The primary cause of this is that it is no offence to ignore an "intimation" from an inspector, and, therefore, certain owners and agents decline to abate the nuisances, being much more sympathetic towards their own pockets than to the health and comfort of their tenants. The practice of ignoring "intimations" first arose a few years ago when it was found that the cost of work done to a combined drain or sewer under an inspector's "intimation" could not be recovered, because it was held by the High Court that an "intimation" is not a notice of the sanitary authority—that is to say a statutory notice. Some authorities in London have refused to refund their costs to owners, because they practically say "it is an injustice that we, the sanitary authorities, should be called upon to repair or relay a combined drain, which only became a charge on us through a previous owner or owners of the properties having committed an illegal act in not submitting a plan for the approval of the then existing sanitary authorities, and now we will avail ourselves of the technicality that an "intimation" is not a notice from us to execute works, and we will not pay you 187 [1904 for the work you have done to the combined drain or sewer." The result has been that latterly an almost invariable delay has occurred where defective combined drains are concerned, and a frequent delay where other nuisances exist, especially if they appear on the same "intimation" with a defective drain. The evil is unfortunately spreading from one class of nuisances to all nuisances. No doubt it will continue to spread, for property owners look keenly after their rights, irrespective of the feelings and wishes of their tenants. It is much to be regretted that any sanitary authorities should have ever adopted the course indicated, for it has been the undoubted cause of raising in an acute form the question of the "intimation'' not being a notice. The Medical Officer of Health feels, and has always advised, that although an authority may not be legally compellable to pay for work done under the inspector's "intimations" yet that morally they are. Many owners of property even yet do not understand the difference between an "intimation" and a notice, but believe, and naturally so, that since the authority orders the inspector to make the inspections, and the Public Health Act decrees that he shall do so, and since the sanitary authority provide printed forms for the inspector and pay his postages where necessary, that an "intimation" is a notice from the sanitary authority, which it undoubtedly is de facto although not de jure. The law should be brought into line with common sense. The District Inspectors also visited the following places:— Ice Cream Shops or Factories 280 visits. Dairies and Milkshops 1,112 Stables and Yards 4,001 „ Manure Depots 122 „ Workshops—re drains 578 „ Certificates under Customs and Inland Revenue Act 101 „ Water Certificates for New Houses 792 „ Sale of Food and Drugs Acts 371 „ Registered Common Lodging Houses 9 „ Smoke Prevention 515 „ Notices Served.—There were 4,287 intimations served by the inspectors, of which 4,192 were delivered by themselves personally, and 95 forwarded 188 1904] by post. There were also 253 statutory notices served by order of the Public Health Committee, of which 72 were served personally and 181 by registered post. Anonymous Complaints.— It is matter for regret that as many as 416 anonymous complaints respecting nuisances have been received, many being without doubt prompted by malevolence to the owners or agents of properties, and some of them being altogether unjustified. For a considerable period it was the habit of the Public Health Department to examine carefully every communication of this character, and if on the face of it there appeared to be good ground for making an inspection, it was made. For instance, where the complaint stated that there was no water supply, that a drain was choked, that a w.c. was stopped or overflowing, or that there was water in the basement, immediate attention was given to the letter, but where it was merely stated that a drain was defective, which in nine cases out of ten could only be proved by testing, and in a similar class of complaints, the communication was placed on the file. Some very great hardships have had to be endured by some property owners, owing to these vindictive complaints, or complaints made with an object—as for the purpose of depreciating a property before its sale. The practice of ignoring these communications has had to be altered, because it has been found that sometimes when the local authority failed to attend to them similar anonymous complaints were made to the London County Council, who, finding the Borough Council had taken no notice of them themselves, instructed their inspectors to call at the premises, and then wrote to the Council or its Medical Officer, making complaint, when, of course, the matter was attended to, for it no longer came in an anonymous garb. So far as Islington is concerned there ought to be no hesitation on the part of its people to make their complaints openly, because every possible care is taken by the Public Health Department to prevent the names of the complainants becoming known. Frequently complaints are addressed, for the greater part in error, to the London County Council, and it is a matter of regret that they do not forward them, or copies of them, to the Council. For some reason they decline to do this, or even to divulge the name of the person who made the complaint Consequently such complaints are, so far as the Council of this borough 189 [1904 is concerned, anonymous. When it is recollected that the London County Council is not the sanitary authority, and that, as already stated, the majority of these complaints are made to them in error, it is, to speak mildly, not treating the Borough Council with that courtesy and consideration which it has every right to expect, as the authority duly appointed under the Public Health (London) Act, 1891, to receive complaints, to abate nuisances, and to prevent disease. Improvements effected —As a result of these inspections and the notices which were served, the following sanitary defects were abated:— Houses. Dirty 718 Damp 278 Out of Repair 346 Water Closets. Foul 627 Without water supply 203 With deficient water supply 225 Improperly constructed 735 Defective 473 Stopped 82 Improperly situated 48 Insufficient external ventilation 105 Insufficient in number 94 Soil Pipes. Defective 139 Unventilated 183 Improperly ventilated 178 190 1904] Yards. Improperly paved 640 Dirty 88 Undrained 45 Drains Foul 101 Defective 1,104 Choked or stopped 306 Unventilated 532 Cesspools. Abolished 47 Overcrowding. Abated 138 Underground Rooms. Abolished for sleeping 57 Other Nuisances 5,402 Total Nuisances 12,894 Cesspools.—It is not a little remarkable that notwithstanding the large number of cesspools that have been abolished in past years in the borough that they still continue to be discovered. During the year no less than 47 were abolished, while in 1903 43 were done away with. Thirteen were discovered in No. 13 (Inspector Rolfe's) district, which contains a large part of Upper Street, and the streets abutting on it, as well as some of the oldest houses in Islington. Overcrowding.—138 cases of overcrowding were discovered, which, together with the 69 discovered by the Inspectors of Houses let in lodgings make a total of 207 cases dealt with during the year. 191 [1904 Queensland Road Area.—In pursuance of the instructions of the Public Health Committee of the 22nd February, 1904, an inspection was made of the Queensland Road area, which comprises Queensland Road, Albert Place, Victoria Place, Emily Place and Queen's Square. The work was entrusted to Inspectors Bacon, Agar and Bridel, who carried it on continuously, as far as their other duties enabled them, until its completion. The area, which is a comparatively small one, contains altogether only 130 houses, viz., 76 in Queensland Road, 17 in Victoria Place, 18 in Albert Place, 7 in Emily Place, and 12 in Queen's Square. The result of the inspection, which is fully set out in the table attached to the Inspector's report, clearly demonstrates that there was very little legal overcrowding, by which is meant overcrowding as defined in the by-laws relating to "houses let in lodgings or occupied by members of more than one family." These specify that a room occupied as a sleeping room must provide 300 cubic feet air space for each person exceeding ten years of age and 150 for each person not exceeding that age. Also, that a room that is not used exclusively for a sleeping apartment must provide 400 cubic feet of air space for each person above ten years of age and 200 cubic feet for each person under that age. Altogether only 10 tenements were proved to be overcrowded, namely 6 in Queensland Road, 2 in Emily Place, and 2 in Queen's Square. The Medical Officer of Health is not surprised at the fact because it has long been his opinion that overcrowding does not exist in Islington to nearly the extent that it does in other districts where foreigners congregate. It must not be forgotten that for many years past steady and persistent efforts have been made by the sanitary staff to prevent it, and also to require w.c. accommodation for every twelve persons in every house (due regard being had to the number of mere infants), and the result has been that it is only the worst class of landlords who now permit "legal" overcrowding. It is not to be understood from these remarks that houses that are occupied to their full "legal" limits are desirable residences, for that is not so. Indeed such a state of affairs would greatly jeopardize the health of the community, and such premises should be kept under continuous observation, and, therefore, should be registered, whereby extreme crowding will be prevented. Out of the 130 houses in this area 98 are let in lodgings and 32 are occupied by only one family. In the several streets comprising this area the following houses were not on the register at the time of the inspection although they have since been added to it. 192 1904] Queensland Road. Street. No of House. No. of Families. No. of Adults. No. of Children. No. of Rooms. Total No. of Persons. 3 4 7 5 7 12 37 2 9 1 6 10 51 2 4 4 4 8 57 2 4 3 3 7 61 2 3 4 4 7 65 2 4 4 4 8 85 6 9 0 6 9 87 6 11 4 6 15 14 2 4 4 J 8 16 2 6 5 6 11 36 3 8 0 6 8 38 5 9 3 6 12 62 3 5 1 6 6 64 2 6 5 6 11 70 2 5 0 5 5 72 2 7 5 5 12 74 2 5 4 5 9 76 2 4 4 5 8 78 3 7 4 6 11 82 3 8 0 6 8 84 2 7 7 5 14 86 2 7 7 5 14 88 2 10 0 5 10 90 2 4 4 5 8 193 [1904 Queen's Square. Street. No. of House. No. of Families. No. of Adults. No. of Children. No. of Rooms. Total No. of Persons. 2 4 7 5 5 12 7 2 4 4 4 6 15 2 6 1 5 7 12 2 4 8 6 12 Albert Place. Street. No. of House. No. of Families. No. of Adults. No. of Children. No. of Rooms. Total No. of Persons. 14 2 4 5 4 9 Victoria Place. Street. No. of House. No. of Families. No. of Adults. No. of Children. No. of Rooms. Total No. of Persons. 4 3 5 I 4 6 5 2 4 0 4 4 6 2 3 2 4 5 16 2 7 2 4 9 0 194 1904] Public Health Department, Town Hall, Islington, October 31st, 1904. QUEENSLAND ROAD AREA. A. E. Harris, Esq., Medical Officer of Health. Dear Sir, The house-to-house inspection of the Queensland Road Area being now completed, we beg to submit to you our report thereon. The area comprises Queensland Road, Victoria Place, Albert Place, Emily Place, and Queen's Square. By reference to the attached list, you will observe that the inspections have been tabulated so as to simplify the report. In Queensland Road 76 houses have been inspected; 18 in Albert Place, 7 in Emily Place, 12 in Queen's Square, and 17 in Victoria Place. The hous's in these four streets are smaller than the majority in Queensland Road, consisting of four, five, and six rooms. Although in many cases the rooms are fully occupied, and in some contain the maximum number of occupants, yet we found comparatively little legal overcrowding, there being discovered 6 one-roomed tenements overcrowded in Queensland Road, 1 one-roomed tenement, and 1 four-roomed tenement in Queen's Square; 1 one-roomed tenement, and 1 two-roomed tenement in Emily Place. These have nearly all been abated. In some cases, although occupiers had ample room, the sleeping accommodation was badly arranged, so that full advantage of available space had not been taken, and better arrangements were promised when this was pointed out. As an instance of this, it was found that in one tenement of two rooms, one only was in occupation by the 3 adults comprising the family, the other not being used. In another instance, a four-roomed house was occupied by 7 adults (1 family) 4 of whom were sleeping in one room and three in another. Several of the houses were found to be in a bad state of repair, and many required cleansing. Some of the floors, windows, yards, etc., which should be cleansed by the tenants, were noticeably neglected. Some of the houses are let out as furnished rooms at rents varying from 6s. 6d. to 7s. 6d. per week per room. In Queensland Road 101 one-roomed tenements are thuja let, and 2 tworoomed tenements, and in Albert Place 8 one-roomed tenements are similarly let. The average number of occupants in Queensland Road is:— For one room, 2 adults and 1 child (actually 1.61 adults, 0.54 children). For two rooms, 2 adults and 3 children (actually 2.21 adults, 2.64 children). For three rooms, 3 adults and 2 children (actually 3.0 adults, 2.0 children). For four rooms, 4 adults and 3 children (actually 4.0 adults, 2.25 children). In Albert Place the average number per house (four rooms) is 4 adults and 4 children (4.77 adults and 2.44 children). 195 [1904 In Emily Place, per house of four rooms, 5 adults and 3 children (5.33 adults and 2.33 children). In Queen's Square (4, 5, and 6 rooms) 5 adults and 5 children (5 0 adults and 5.60children). In Victoria Place, per house of four rooms, 4 adults and 2 children (4.35 adults and 1.75 children). The rent of a one-room tenement (unfurnished) varies from 2s. 9d. to 4s. 6d. per week. The rent of a two-room tenement (unfurnished) averages 6s. weekly. The rent of a four-roomed house averages 9s. 6d. weekly. The rent of a six-roomed house averages 12s. to 14s. weekly. Seventy-nine Intimation Notices have been served, and one Statutory Notice, for various sanitary defects, and in many instances complied with. Other work is in progress, and there are still some notices to serve, as a result of the very recent inspections. A distinct improvement has been effected in many of the houses. We are, Sir, Yours obedientlv (Signed) C. T. BACON, T. W. AGAR, Sanitary Inspectors. GEO. J. BRIDEL. NAMES OF STREETS. Queensland Road. Victoria Place. Albert Place. Emily Place. Queen's Square Totals. Number of houses inspected 76 17 18 7 12 130 Number of houses occupied by one family 13 7 9 1 2 32 Number let in lodgings 63 10 9 6 10 98 Number of one-room tenements 161 13 18 8 11 211 Number of two-room tenements 45 5 3 5 3 61 Number of three-room tenements 12 6 4 2 8 32 Number of four-room tenements 14 .. .. .. 2 16 Number of furnished one-room tenements 101 .. 8 .. .. 109 Number of furnished two-room tenements 2 .. .. .. .. 2 Number of furnished three-room tenements Number of furnished four-room tenements Overcrowding, one-room tenements 6 .. .. 1 1 8 Overcrowding, two-room tenements .. .. .. 1 Overcrowding, four-roomed house .. .. .. .. 1 1 Dirty condition of premises 39 5 10 7 6 67 Dilapidated condition of premises 37 .. 9 7 4 57 Defective yard paving 17 .. 6 4 5 32 Defective drains 6 .. .. .. 2 8 Unventilated drains 24 .. .. .. 6 30 Defective w.c's. 17 .. .. 1 3 31 No water to w.c's. 6 1 .. 2 3 12 Dirty and uncovered cisterns 32 .. 8 4 7 51 Defective roofs 20 14 6 7 4 51 Defective dustbins 17 1 13 .. 5 30 Foul w.c's. 11 .. 3 2 5 21 Intimation notices served 47 .. 13 7 9 79 Statutory notices served 1 .. .. .. .. 1 196 1904] Underground Rooms.—57 underground rooms which had been illegally occupied were closed. It is satisfactory to note that the number of these rooms in occupation are very few, as they were very stringently dealt with some years ago. Houses closed.—No houses were closed as being unfit for human habitation. Nuisances from Sewers.—Very few complaints were received, and those that have been made generally related to street gullies that were untrapped. Whenever these have been discovered they have been reported to the Borough Engineer who has had the defects remedied. Serious cause for complaint has in the past few years arisen owing to the overflow of what is known as the Stroud Green Road Sewer, which has proved insufficient to carry off the rainfall and sewage of the district which it serves, due to the largely increased number of houses and area which have been drained into it, especially in Hornsey, part of which borough it also serves. The triangular dispute which arose between the London County Council, Islington, and Hornsey, has now been settled by arbitration before Lord James of Hereford, so that there is every prospect of the grave nuisance caused by the flooding of numerous houses being averted in the future by the building of a larger sewer. Manure Depots.—There is only one place in the borough where manure is sometimes stored, namely, at the Great Eastern Railway sidings at Ashburton Grove, where a large manure contractor deposits stable manure prior to sending it to farmers. As a rule great efforts are made by this firm to get it quickly away, but at times, especially during the hay and harvest seasons, owing to all the farm hands being engaged in harvesting operations, difficulty is met with, and then it becomes almost a necessity to deposit it for a short while. The alternative to doing this is to allow it to accumulate at the stables, which of course cannot be thought of. A remonstrance was addressed to the firm on one occasion, and after a slight delay the deposit was removed by rail. A large quantity of the dust and ashes from houses as well as of the street sweepings are also sent away by the Council by rail from a siding at this place, and it is satisfactory to note that the work was well done, little or no nuisance being reported. Of course a manure siding can never be kept altogether free from nuisance, nevertheless there are some people who complain because now and again a faint odour, which it is impossible to prevent, 197 [1904 becomes perceptible, especially in hot weather, for it must be recollected that dust-bin refuse contains, besides ashes, decaying vegetable and animal matters, some of which have been the accumulations of nearly a week. A nuisance of this character can never be entirely got rid of where there is only a weekly removal of refuse. This is one of the reasons why the Medical Officer of Health has advocated a more frequent removal of house dust. (Vide p. 219 Annual Report, 1903.) Complaints have been from time to time made by the Head Teacher of Yerbury Road L.C.C. School as to the effluvium caused at the Midland Railway sidings, Upper Holloway, whence a large quantity of refuse is sent away, but as the work at this place is always effected in a most cleanly and orderly manner, it is impossible to see what improvement can be made. This siding has been frequently visited by the Public Health Committee and systematically by the sanitary officials, but no nuisance that it was possible to deal with could be discovered Regent's Canal.—The Sanitary Inspectors kept this canal under constant observation, but as the water seemed in a better condition than usual no action on their part was necessary. No complaints reach the Public Health Department as to its condition. Offensive Trades.—These number only 7, and include 3 tripe dressers, 2 gut scrapers, 1 tallow melter, and 1 knacker. They were kept under constant observation by Inspector Wilkinson, who made 202 visits to them, and found that they were in a satisfactory state. The London County Council, as pointed out in last year's report, have decided to carry out extensive alterations at Messrs. Harrison & Barber's knackers' yard, York Road, but as yet they have not been effecied. It is understood that the necessary works will be undertaken as soon as other premises belonging to the same firm, but situated in other parts of London, have been dealt with. Smoke Nuisances.—During the year 515 observations were made of chimneys emitting black smoke, in addition to which the London County Council reported 37 premises, many of which had been already under the observation of the Sanitary Inspectors. The following is a list of the premises where smoke nuisances were observed:— The Great Northern and City Electric Railway, Finsbury Park Station. Engine House, Monsell Road Works. 198 1904] 9 and 11, Elthorne Road. 55 to 65, Wharfdale Road. 2, Elthorne Road. The Islington Infirmary, Highgate Hill. Mayfield Laundry, 93, Gillespie Road. The Calthorpe Box and Packing Case Co., 44, Wharfdale Road. Electric Tube Station, Bingfield Street. Slater's Ice Factory, North Road. 5, Oakley Crescent. Bellchambers Works, 71, Ronalds Road. Engine Works, Drayton Park Siding. Camden Steam Laundry, 260, York Road. Shoeing Forge, Rufford Street. London General Omnibus Coy., Works, North Road. 99 and 101, Fonthill Road. Keen's Forge, Morgan's Yard, Barnsbury Grove. King's Cross Laundry, 20 and 22, York Road. Brewis Bro.'s Repairing Shed, Rufford Street. 1601/2, Holloway Road. Tozer & Sons, Repairing Shed, Pleasant Grove. 370—374, Holloway Road, and 2—6, Tollington Road. 40 and 40A, Wharfdale Road. 120, Essex Road. Brush Factory, Eden Grove. Great Northern Railway Provender Stores, Wellington Road. Lead Works, Southgate Road. Lorimer's Factory, Britannia Row. The Self-Opening Tin Box Works, 34, York Road. 134, Holloway Road. Highbury Brewery, Holloway Road. Lead Works, Caledonian Road. 176, Elthorne Road. 258, Seven Sister's Road. 26, Blenheim Road. 60, Bingfield Street. G.N,R. Electric Lighting Station, Drayton Park. Islington Workhouse, St. John's Road. Great Northern Railway Milk Station, Finsbury Park. Mildmay Steam Laundry, Mildmay Grove. Holborn Infirmary, Archway Road. Whittington Schools, Highgate. 199 [1904 Public-House Sanitary Accommodation. One of the most crying evils in London is the want of adequate accommodation at Public-houses and Beer-houses. Complaints are frequently received from ratepayers that streets, particularly side streets, in the neighbourhood of these houses are used as urinals. That they are justified is without question. But it is a difficult matter to deal with, as there is no law in the Metropolis which enacts that taverns shall be provided with urinal and w.c. accommodation which can be easily approached from the bars. Several of the provincial boroughs have obtained special legislation which enables them to deal with this want, and, therefore, nuisances such as those experienced here are not so many. Some thirteen years ago, when your Medical Officer of Health served the County Borough of Sunderland in a similar capacity, he succeeded in prevailing on his authority to seek powers, which they ultimately obtained, from Parliament. The Public Health Committee are fully alive to the annoyance and nuisances that are caused in Islington, and have decided in future to ask the magistrates to refuse the licences to houses where they arise through the want of accommodation. It is a drastic, but very necessary, remedy. Barbers' Shops.—On February 8th a report was presented to the Public Health Committee by the Medical Officer of Health calling attention to the danger arising from insanitary fittings, such as untrapped lavatory basins, as well as to the skin diseases which might occur through the lack of cleanliness on the part of the hairdressers and barbers, particularly with respect to the articles and instruments used by them in their businesses, with the result that every barber's shop in the borough was inspected, and the sanitary defects made good, and that the following instructions, which were the first of their kind issued in London, and probably in England, were issued:— HYGIENIC PRECAUTIONS TO BE ADOPTED BY BARBERS TO PREVENT SKIN DISEASES. The Public Health Committee, being aware that the neglect of necessary hygienic precautions has been the cause of certain skin diseases, and especially of a parasitic disease known as ringworm, strongly recommend all Barbers to adopt the following means whereby these diseases may be prevented:— 1.—The saloon or barber's shop, together with all the furniture, to be at all times kept in a cleanly condition. 200 1904] 2.—The head-rest to be covered for each customer with a clean towel or cloth. 3.—Mugs, shaving brushes, and razors to be sterilized by immersion in boiling water after each separate use there of. 4.—A separate clean towel to be used for each person. 5.—Alum, or other astringent, to be used in powder form and applied on a towel. 6.—Powder-puffs, which are a fruitful cause of ringworm, not to be used. 7.—Sponges not to be used. 8.—Running hot and cold water to be provided in the saloon or barber's shop. 9.—The saloon or barber's shop not to be used as a dormitory. 10.—The Barber to cleanse his hands thoroughly immediately after serving each customer. If these precautions are adopted the Public Health Committee feel assured that many, if not all, of the skin diseases now contracted in barbers' shops, will be prevented. Water Certificates.—During the year 32 certificates were issued by the Council under sec. 48 of the Public Health Act. In each instance an examination of the premises was first made to ascertain if the following requirements of the Council had been complied with 1.—The water service pipe must be buried in the ground to a depth of two feet six inches. 2.—Where such service pipe passes through the open air or through cellars it must be amply protected from frost. 3.—A Draw Tap for dietetic purposes shall be fixed to the main supply pipe in a suitable position. 4.—The storage cistern shall be placed in an easily accessible position and shall be of sufficient capacity for the household requirements for at least twenty-four hours. 201 [1904 SYNOPSIS OF THE DISTRICT INSPECTORS' SANITARY WORK FROM 1891 to 1904 (14 years). Houses inspected and visited 779,603 Drains Constructed 16,256 „ Improved and repaired 12,868 „ Traps fixed 74,232 Water closets, pan, trap, etc., furnished 19,410 „ Pan and trap only, furnished 13,043 „ Water only, furnished 5,590 Soil Pipe, Defective, renewed or remedied 3,118 „ Insufficiently ventilated, fully ventilated 2,633 „ Unventilated, ventilation supplied 5,075 Dust Bins, Constructed 10,412 „ Repaired 3,394 Surface drainage, Constructed 10,162 „ Relaid I8,437 Water supply, New cisterns provided 4,044 „ Cisterns repaired and cleansed 8,504 „ New supply 4,506 Houses generally Repaired 5,314 „ Cleansed 10,187 „ Ventilated 12,377 Other Improvements 91,759 Total Improvements 331,321 19011 202 Table CXXI. Showing summary of Sanitary Work from Inspectors' reports for the Year 1904. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 10 11 I'' 13 14 House to House Inspections 127 17 45 79 17 344 296 93 30 160 45 16 2 73 1903 Number of Houses inspected 178 282 550 269 289 506 236 324 351 624 392 569 21 442 5230 Re inspections, Calls made, etc. 3622 3811 2905 2911 3500 3229 5072 4793 3740 4516 3963 3687 2261 5155 53163 Total Visits 3927 4109 3500 3258 3806 4079 5604 5210 4121 5300 4814 4417 2481 15670 60296 Visits to Ice Cream Factories 21 51 29 6 2 21 5 20 17 26 27 46 .. 9 280 Dairies and Milkshops 90 94 19 88 79 48 87 41 91 3t 201 174 8 55 1112 ,, Stables and Yards 48 148 7811 14! 567 567 62 39 91 204 19 370 670 278 4001 ,, Manure Depots l0 .. 102 2 .. .. 1 .. 3 .. 4 .. .. .. 122 ,, Workshops, with respect to drains .. 2 2 .. 4 1 .. 6 15 .. 545 2 1 578 ,, Under Customs and Inland Revenue Acts .. .. 46 .. .. .. 54 .. .. .. .. .. .. 1 101 ,, re Water Certificates 450 .. .. .. .. 300 25 .. .. .. .. .. .. 17 792 ,, Under Sale of Food and Drugs Acts 26 31 27 10 29 29 29 41 28 29 30 38 .. 24 371 Registered Lodging Houses 8 1 .. .. .. .. .. .. .. .. .. .. .. .. 9 Smoke observations 25 5 4 21 180 36 47 4 61 29 89 10 1 515 Dust Removals ordered .. .. 2 .. .. .. .. .. .. 2 1 .. .. .. 5 All Inspections, visits, etc 4605 4439 4520 3536 4663 5084 5915 5354 4361 5673 5126 5679 3171 6056 68182 Notices Served. Intimation — Personally 237 259 156 376 134 300 363 243 274 363 441 431 206 384 4192 By Post .. .. 4 4 .. 12 6 13 10 9 4 12 8 13 95 Statutory— Personally 5 5 3 2 1 3 12 2 25 2 1 6 2 3 72 By Post Improvements. 3 22 5 13 9 26 19 8 2 5 16 33 3 17 181 Drains— Constructed 78 48 77 39 46 202 177 127 89 66 34 69 33 116 1201 Improved or repaired 18 18 30 12 15 16 44 16 36 48 79 66 36 78 462 Traps fixed 367 228 392 202 240 329 766 496 424 319 146 355 198 325 4787 Cesspools— Abolished 15 .. 1 .. .. 3 .. 6 13 3 .. 5 1 .. 47 Cleansed or disinfected 1 .. 3 .. .. .. .. .. .. .. .. 5 4 .. 13 Water Closets— Pan, trap and water supply furnished 123 25 117 7 18 51 28 15 43 35 13 3!) 56 60 630 Pan and trap only furnished 21 61 89 45 50 37 216 154 101 86 47 158 1 118 1184 Water supply furnished 13 12 54 19 16 23 7 10 4 25 84 15 25 25 332 Dust Bins— Provided 59 49 52 55 48 64 58 45 51 40 76 114 38 86 835 Repaired 4 1 80 .. 6 5 5 .. 22 2 6 2 3 2 138 Surface Drains and Pavements of Yards— Constructed 1 18 5 26 3 17 148 93 16 81 38 103 26 30 605 Relaid 60 31 126 47 48 36 75 42 91 34 43 92 37 185 917 Domestic Water Supply- New Cisterns provided .. 2 13 .. 3 19 4 .. 2 2 2 14 28 5 94 Cisterns repaired and cleansed 38 17 61 33 17 61 14 2 9 54 31 191 39 43 610 Water Supply provided 85 13 32 33 9 8 5 17 12 30 8 35 18 7 312 Other Improvements- Houses generally repaired 4 5 6 51 15 66 9 3 30 11 126 158 25 42 551 ,, etc., cleansed or limewashed 45 6 107 58 12 73 18 5 33 23 83 114 48 67 692 ,, ventilated 31 33 1 9 10 . 56 8 48 3 77 86 49 111 Overcrowding abated 9 3 1 8 2 1 8 2 15 24 7 10 90 Illegal use of underground Rooms for sleeping discontinued 1 .. 25 .. .. 13 .. .. .. .. 16 2 .. .. 57 Other Improvements, or Nuisances abated 173 355 303 250 245 607 326 344 333 504 518 2357 746 660 7721 Rooms Disinfected 98 107 51 107 143 114 65 96 64 161 149 122 74 117 1468 Total Improvements 1204 996 1664 1020 936 1761 1977 1528 1389 1574 1517 4117 1529 1975 3187 Total Premises Improved 337 199 264 311 249 645 340 287 264 411 544 431 715 417 5414 203 [1904 Table CXXII. Giving a Summary of the Nuisances discovered by the District Sanitary Inspectors during the Four Quarters and for the Year 1904, for the abatement of which notices were served. NUISANCES. QUARTERS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. 1. The house or part of the house in a dirty condition 136 197 207 178 718 2. „ „ in a damp condition 91 55 70 62 278 3. in a dilapidated condition 57 88 121 80 346 4. The inlet of surface drain improperly trapped 64 69 85 41 259 5 The water-closet so foul as to be a nuisance 180 163 167 117 627 6. „ ,, without a water supply 44 56 56 47 203 7. ,, „ with a deficient supply of water 55 62 65 43 225 8. „ „ improperly constructed so as to be a nuisance 214 189 183 149 735 9. „ „ so defective as to be a nuisance 99 141 135 98 473 10. „ ,, stopped 25 24 15 18 82 11. „ „ placed in an improper position 9 5 16 18 48 12. Insufficient external ventilation to water-closets 19 26 33 27 105 13. Insufficient water-closet accommodation 16 27 14 37 94 14. The soil pipe defective 35 24 48 32 139 15. „ unventilated 51 54 46 32 183 16. ,, improperly ventilated 41 57 46 34 178 17. The yard in a condition injurious to health by reason of the want of proper paving 152 162 156 170 640 18. The yard dirty 20 22 19 27 88 19. „ undrained 8 11 14 12 45 20. A gully trap improperly placed within the house 58 93 77 79 307 21. The waste pipe of sink directly connected with the drain 37 45 46 28 156 22. „ „ improperly trapped 15 29 20 13 77 23. „ „ untrapped 96 112 137 131 476 24. „ of lavatory directly connected with the drain 14 4 10 3 31 25. „ „ improperly trapped 3 5 12 .. 20 26. „ „ untrapped 57 100 133 38 328 27. ,, of bath directly connected with the drain 2 6 6 3 17 28. „ „ improperly trapped 4 2 3 3 12 29. „ „ untrapped 22 39 21 30 112 30. The water cistern so foul as to be a nuisance 68 83 137 73 361 31. „ „ being without a close fitting cover .. 89 124 153 118 484 32. „ „ being placed in an improper position 42 42 58 64 206 33. „ „ defective 10 5 9 12 36 1904] 204 TABLE CXXII.—continued. NUISANCES. QUARTERS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. 34. An accumulation or deposit of refuse injurious to health, by reason of the want of a proper dustbin or ashpit 51 52 43 61 207 35. The dustbin or ashpit defective 133 141 164 219 657 36. „ ,, placed in an improper position 1 5 4 .. 10 37. The drain foul 12 22 57 10 101 38. „ defective 278 277 285 264 1,104 39. ,, choked or stopped 57 114 84 51 306 40. ,, unventilated 135 135 143 119 532 41. The rain-water pipe in direct communication with the drain 85 85 93 68 331 42 ,, ,, in direct communication with the soil-pipe 6 5 9 6 26 43. „ ,, defective 40 38 26 42 146 44. The water supply used for domestic purposes connected with the cistern which is used for flushing the W.C. 2 2 3 1 8 45. The house without a proper water supply 20 31 24 19 94 46. The roof defective 61 50 97 76 284 47. The guttering defective 48 38 49 46 181 48. The area improperly paved 31 23 21 15 90 49. ,, dirty 1 12 4 1 18 50. „ undrained 11 3 4 1 19 51. The paving of the washhouse defective 27 42 52 49 170 52. The back addition walls defective 1 .. 1 3 5 53. The want of a proper manure receptacle 2 .. 4 3 9 54. The bakehouse walls dirty .. .. .. .. .. 55. An animal kept in such a manner as to be a nuisance 13 18 12 31 74 56. The house or part of a house so overcrowded as to be injurious or dangerous to the health of the inmates 36 27 36 39 138 57. An underground room occupied as a dwelling contrary to the provisions of the Act 2 9 2 1 14 58. A tent, van, shed or similar structure used for human habitation which is in such a state as to be injurious or dangerous to the health of the inmates .. .. .. .. .. 59. The space below floor in the basement or ground floor being unventilated 33 13 34 21 101 60. The space below floor in the basement or ground floor being improperly or insufficiently ventilated 63 48 36 33 180 All Nuisances 2,982 3,311 3,605 2,996 12,894 205 [1904 Table CXXIII. Giving a Summary of the Sanitary Work performed by the District Inspectors in 1904. Inspections. QUARTERS. The Year. First. Second. Third. Fourth. House to House Inspections 569 511 423 400 1,903 Number of Houses Inspected 1,146 1,333 1,376 1,375 5,230 Re-inspections, Calls made, &c. 12,736 12,918 12,195 15,314 53,163 Total Visits 14,451 14,762 13,994 17,089 60,296 Visits to Ice Cream Factories 2 225 51 2 280 Do. Dairies and Milkshops 190 355 346 221 1,112 Do. Stables and Yards 902 1,273 944 882 4,001 Do. Manure Depots 57 22 38 5 122 Do. Workshops, with respect to Drains 169 138 83 188 578 Do. Under Customs and Inland Revenue Acts 62 38 1 .. 101 Do. re Water Certificates 10 75 146 561 792 Do. Under Sale of Food and Drugs Acts 179 184 8 .. 371 Do. Registered Lodging Houses 9 •• • • • • 9 Smoke Observations 113 135 173 94 515 Dust Removals Ordered 2 •• 1 2 5 All Inspections, Visits, &c. 16,146 17,207 15,785 19,044 68,182 1904] 206 Removal of Dust.—The ashes, refuse, and dust from houses was removed with system and regularity, and so far as a weekly removal can be considered satisfactory it was particularly worthy of approval. Indeed, the dusting department may be heartily congratulated on the manner in which they have executed the work devolving on them, (or during the twelve months only 116 applications were made to the Public Health Department to have the dustbins cleansed, which is at the rate of onequarter per cent, of the separate assessments. The following statement shows how great an improvement has been effected in the removal of dust since 1891:— Year. Applications to remove dust. Year. Applications to remove dust. 1891 10,138 1898 303 1892 9,964 1899 262 1893 4,986 1900 234 1894 4,506 1901 157 1895 4,596 1902 198 1896 4,245 1903 152 1897 312 1904 116 Dust Receptacle.—During the year 835 dust receptacles were provided, while 138 were repaired. At the present time a strong attempt is being made to compel owners of property to provide new dust bins in substitution for those that are out of repair. Some trouble, however, is being experienced with property owners because very many of them consider that they should be provided by the tenants, while others seem to think that the Council should supply them. 207 [1904 Table CXXIV. Summary of Applications for the Removal of Dust during the Year 1904. Ward. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Number of Assessments Christmas, 1904. Number of Applications to every 100 Assessments. 1 5 3 2 4 14 4,647 0.301 2 1 2 1 2 6 4,705 0.127 3 2 3 2 2 9 4,404 0.204 4 6 6 5 2 19 5,135 0.370 5 I 5 4 4 14 5,669 0.247 6 3 8 3 3 17 4,049 0.420 7 4 3 4 1 12 4,066 0.295 8 3 1 — 2 6 2,709 0.221 9 — 1 1 3 5 2,701 0.185 10 3 — 2 3 8 3,484 0.230 11 2 1 — 3 6 4,58l 0.131 Totals 30 33 24 29 116 46,150 0.251 1904] 208 THE STATE OF PAUPERISM. Although the close of the year was signalised by considerable distress in the borough, due to the want of work, the average number of poor persons relieved per week by the Board of Guardians, when compared with the preceding year, shows only a very small increase, namely, from 8,004 in 1903 to 8,086 in 1904. Compared with the weekly average of the previous eight years the increase was considerable, for it rose from 7,046 to 8,086, an increase of 1,040 per week. How great this increase is can be seen when we calculate what it means for the year. It is then found that the number of occasions on which relief was given rose from an annual average of 366,392 during eight years to 416,200 in 1904, an increase of 49,807. It can be easily understood that these figures contain relief to the same persons repeated over and over again—but they nevertheless show that poverty must have been acute to give rise to such an increase. It has been pointed out that the increase in the number relieved in 1903 was almost identical with that in the year under consideration. If, however, we go back to 1896, we find that the average number relieved per week was 6,436, or 1,650 fewer than that of 1904, and representing a difference in the total number of reliefs of 85,800. The increased figures are instructive, and must, no doubt, have been caused to a large extent by the depression of trade. The returns since 1896 have been as follows:— 1896 6,436 per week relieved. 1897 6,486 1898 6,635 1899 6,854 1900 6,956 1901 7.327 1902 7,668 1903 8,004 Average 7,046 1904 8,086 Increase 1,040 Outdoor Paupers.—The weekly average of outdoor paupers relieved numbered 4,464, of whom 3,069 were adults, and 1,395 children under 16 209 [1904 years old, as compared respectively with averages for eight years of 3,699, 2,382 and 1,317. Indoor Paupers.—Inclusive of children these averaged 3,622 per week, as against an eight years' average of 3.347, or an increase of 275. In 1896 the weekly average was 710 fewer than this return. Here, again, we are given a very significant indication as to the state of trade. Vagrants Relieved.—Even a still more significant item in these returns is the large increase in the number of vagrants relieved. From 1896 to 1903 tiiey averaged only 17 per week, while in 1904 this number rose to 65. In other words, whereas in the eight years the number of vagrants relieved per annum wa= 884, in 1904 it was 3,380, or an increase of 2,496. Children Boarded Out.-The number of children boarded out averaged 122 throughout the year, as compared with 119 in the preceding eight years. It is satisfactory to note that the Guardians have not relaxed in their dispensation of this description of »jlief. As there can be no doubt it is the best form in which to grant it to children, it is to be regretted that more children are not sent out. Table CXXV. Showing the State of Pauperism in the Borough during the years 1896-1904. Average number Relieved during each week. Years. 1 Indoor Paupers, Adults and Children. 2 Outdoor Paupers. Totals Outdoor. 5 Totals. All paupers relieved, cols. 2 & 5. 6 Vagrants Relieved. 7 Children Boarded out. 8 Deathrates. 9 Adults. 3 Children under 16. 4 1896 2,912 2,215 1,309 3,524 6,436 24 117 17.09 1897 2,951 2,250 1,285 3,535 6,486 25 108 15.80 1898 3,168 2,224 1,243 3,467 6,635 27 116 16.53 1899 3,351 2,237 1,266 3,503 6,854 16 131 18.04 1900 3,397 2,288 1,271 3,559 6,956 7 100 16.23 1901 3,522 2,444 1,361 3,805 7,327 12 130 15.98 1902 3,594 2,662 1,412 4,074 7,668 10 125 16.39 1903 3,879 2,739 1,386 4,125 8,004 17 127 14.26 Average 3,347 2,382 1,317 3,699 7,046 17 119 16.29 1904 3,622 3,069 1,395 4,464 8.086 65 122 15.35 P 1904] 210 Table CXXVI. Showing the State of Pauperism in the Borough during the year 1904. Quarters. 1 Average number Relieved during each week. Death rates. 9 Indoor Paupers, Adults and Children. 2 Outdoor Paupers. Totals. 5 Totals corresponding periods 1903. 6 Vagrants Relieved. 7 Children Boarded out. 8 Adults. 3 Children under 16. 4 1st Qr. 3,692 3,003 1,413 8,108 8,191 80 124 16.84 2nd „ 3,367 2,900 1,316 7,583 7,736 50 121 12.97 3rd „ 3,636 3,122 1,478 8,236 7,792 70 119 15.06 4th „ 3,794 3,253 1,374 8,421 8,297 80 126 16.53 The Year 3,622 3,069 1,395 8,086 8,004 65 122 15.35 211 [1904 COMMON LODGING HOUSES. The Common Lodging Houses are under the control of the London County Council, whose Inspectors visit them regularly. They are generally to be found in a satisfactory condition. They now number 47 houses, which are licensed to 16 persons. 39 are licensed for men, 8 for women, and 1 for married couples. Table CXXVII. Showing the Addresses of the Common Lodging-Houses in the Borough. (Under the Control of the London County Council). Situation of Premises. Authorized No. of Lodgers. Sex of Lodgers. M = Men. W = Women. MC = Married Couples. Date when Licensed. Name of Licensee. 36, Ball's Pond Road 25 M. 24th June, 1904 A. e. Hurworth. 18, 20 & 22, Barnsbury Street 91 M. „ Robert Crosher Maples. 47a, Campbell Road 71 M. 14th October, 1904 Wm. J no. Cragg. 35, Campbell Road 27 W. „ „ 37 & 39, Campbell Road 61 M. „ „ 10 & 12, Campbell Road 52 M. 21st July,"l904 Hugh Hersey. 180, Caledonian Road 51 M. 27th January, 1905 . Samuel Wm. Jefcoate. 55, Colebrooke Row 73 W. „ Dave Levy 155, Englefield Road 64 M. 14th October, 1904 Wm. Jno. Cragg. 1 & 3, Eden Grove 107 M. 27th January, 1905 Lewis Henry Levy. 87, Essex Road 52 M. ,, Jas. Shuttleworth, Jun. 89, Essex Road 35 M. ,, „ 8, Flower's Mews 72 M. „ Samuel Wm. Jefcoate. 102, 104 & 106, George's Road 51 W. 24th June, 1904 Robert Crosher Maples. 68, George's Road 38 W. „ ,, 1, Gordon Place, Highgate Hill 5 M. „ George Willis. 2, Grrdon Place 5 M. „ „ 3, Gordon Place 5 M. „ „ 4, Gordon Place 10 M. „ „ 5, Gordon Place 10 M. „ „ 6, Gordon Place 9 M. „ „ 7, Gordon Place 9 M. „ „ 12, Gordon Place Deputy „ „ 13, Gordon Place 9 M. „ „ 29, Halton Road 59 M. 14th October, 1904 Chas. Jas. Vincent Somerville. 29, Hornsey Road 88 M. 24th June, 1904 Sidney Allen. 8a, Hornsey Street 48 M. 14th October, 1904 Colin F. Campbell. 10, Milton Place 22 M. 27th January, 1905 Lewis Henry Levy. 24, North Road 17 W. 24th June, 1904 Louisa Pryce. 4 & 6, Queensland Road 34 M. „ Margaret Jones. 8 & 10, Queensland Road 16 M.C. ,, „ 23 & 25, Queensland Road 28 W. 14th October, 1904 .. ,, 160 & 162, St. James' Road 76 M. 24th June, 1904 Wm. John McGrath. 235a, Upper Stre 37 M. 30th September, 1897 Sarah B. Watts. 92 and 128, York Road .. 51 M. 24th June, 1904 Albert Bingham. P 2 1904] 212 ARTISANS DWELLINGS. There are 194 blocks of buildings, containing 3,239 separate dwellings in the Borough. They vary considerably in the class of persons occupying them, some being only labourers while others are well paid mechanics. A list of these buildings has been prepared, and is now presented for the first time. WARD. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Tufnell Wessex Buildings Wedmore Street 2 155 Lower Holloway Queen's Arms Buildings North Road 1 63 „ City Arms Buildings North Road 1 63 „ Camden Dwellings York Road 1 44 „ North London Cottages Market Road 8 „ Prince's Mansions Liverpool Road 2 24 „ Prince's Mansions Paradise Passage, Liverpool Road 1 10 „ St. James's Mansions St. James's Road 6 „ Pleasant Buildings York Road 3 27 „ Edinburgh Place Brewery Road 2 45 „ Aberdeen Place „ 2 35 „ Anchor Dwellings „ 2 15 Highbury Lome Buildings Benwell Road 4 26 „ Holloway House Hornsey Road 1 6 „ Highbury House ,, 1 6 „ Hatton House „ 1 6 „ Drayton House „ 1 6 „ Ingram House „ 1 6 „ 23, Hornsey Road „ 1 3 „ 25, Hornsey Road „ 1 3 „ 27, Hornsey Road „ 1 3 Thornhill Beaconsfield Buildings East Street 1 475 „ Clarence Terrace Rufford Street 1 53 „ Carlton House Stanmore Street 1 15 „ Pembroke House „ 1 15 Barnsbury Cloudesley Mansions Cloudesley Place 1 12 „ Stonefield Mansions Cloudesley Square 1 12 „ Oat lands House Upper Park Street 1 12 „ Ashley House „ 1 12 „ Halliford House „ 1 12 „ Thanet House „ 1 15 „ Thornhill Houses Thornhill Road 1 84 „ Arvon House Offord Road 1 10 „ Buckland House „ 1 10 „ Colne House „ 1 8 „ Bures House „ 1 8 St. Mary's Liverpool Buildings Liverpool Road 26 276 „ Essex House Essex Road 1 13 „ Anson House „ 1 8 „ Thatched House Buildings „ 1 8 „ Bampton House Pleasant Place 1 10 „ Catton House „ 1 10 „ Tiverton House „ 1 10 „ Dawlish House „ 1 10 „ Fowler House Halton Road 1 10 „ Arundel House „ 1 10 „ Brook field House „ 1 4 „ Worcester House Astey's Row 1 10 „ Lincoln House „ 1 10 218 [1904 ARTISANS DWELLINGS—continued. WARD. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. St. Mary's Carleton House Cross Street 1 6 „ Devonshire House „ 1 10 „ Dagmar House Dagmar Terrace 1 16 „ Tufnell House Pleasant Place 1 10 „ Nos. 9 to 23 (inclusive), Pleasant Place „ 14 42 „ Nos. 1, 2, 3, 4, 5, Carleton Terrace Halton Road 5 15 Canonbury Canonbury Avenue Canonbury Road 17 148 „ Ebenezer Buildings Rotherfield Street 5 36 St. Peter's Palmerston Buildings City Garden Row 3 72 „ Torren's Buildings Torren's Street 6 83 „ Myddleton Buildings High Street 5 80 „ Albany Cottages Popham Street 1 98 „ Cornwall Cottages „ 1 94 „ Edinburgh Cottages „ 1 86 „ Queen's Cottages „ 1 86 „ Quinn Buildings „ 13 240 „ Peabody Buildings Greenman Street 10 294 „ Dibden Street Buildings Dibden Street 4 32 „ Pickering Street Buildings Pickering Street 11 83 „ Nos. 10a 11a, 12a, 13a, Norfolk Street Norfolk Street 2 6 194 3,239 PART V. FOOD. INSPECTION OF FOOD AND THE PLACES WHERE FOOD IS PREPARED. THE ADULTERATION OF FOOD AND THE ADMINISTRATION OF THE ADULTERATION ACTS. WATER SUPPLY. 1904] 216 INSPECTION OF FOOD. This duty, which mainly devolves on the Inspector of Food, Mr. H. Wilkinson, was well carried out during the year, and resulted in the destruction of 5 tons, 8 cwts. 3 qrs. 17 lbs. of food stuffs. 1st Quarter. Tons Cwts. Qrs. lbs. Tons Cwts Qrs lbs. Diseased organs at Slaughter Houses 0 2 2 24 Ox livers unsound (imported) 1 1 2 12 Unsound meat from Shops 0 0 2 1 One Rabbit (unsound) 0 0 0 2 Unsound fruit 0 0 0 10 I 4 3 21 2ND Quarter. Diseased meat and organs at Slaughter Houses 0 3 3 1 Unsound meat from Shops and Stalls 0 2 2 5 Unsound fruit 2 6 1 22 2 12 3 0 3rd Quarter. Diseased organs at Slaughter Houses 0 0 2 27 Unsound meat at Shops and Stalls 0 1 1 14 Unsound fruit 0 0 0 12 Unsound bacon (Coster's Stall) 0 0 1 1 0 2 1 26 4th Quarter. Diseased organs at Slaughter Houses 0 0 3 12 Unsound meat from Shops and Stalls 0 0 1 19 Unsound fruit 0 0 0 15 380 unsound turkeys 1 7 0 16 8 unsound rabbits 0 0 0 20 I 8 2 26 Total for Year 5 8 3 17 In the preceding year 3 tons 5 cwts. 3 qrs. 4 lbs of unsound food was destroyed, so that there was an increase in the amount dealt with of 2 tons 3 cwts. o qrs. 13 lbs. 217 [1904 Animals Slaughtered.—From the returns procured by the inspector, its appears that, apart from the Cattle Market, at Caledonian Road, which is under the supervision of the Corporation of the City of London, 35,516 animals were slaughtered in Islington, of which 2,360 were oxen. 4 „ cows. 154 „ calves. 32,973 „ Sheep and lambs. 25 .. Pigs as compared with 40,895 animals killed in the preceding year. This decrease °f 5>379 was made up by the lesser slaughter of 85 oxen, 169 cows, 5,117 sheep and lambs, and 21 pigs. There were, however, 13 more calves killed. There can be no doubt that the falling off in the number of animals slaughtered in the borough has been due to the severe supervision to which the slaughter-houses are now subjected, which has resulted in a decrease in the killing of inferior animals and consequently an improvement in the character the meat supply. This is well evidenced in the case of the slaughter of old cows, of which there were only 4 killed during the year. At one time Islington was a favourite locality in which to slaughter them, and to dispose of their carcases but this is now a thing of the past, for which there can be no regret, because such animals are generally affected with tuberculosis. Slaughter Houses.—The number of slaughter-houses in the borough number 40, which is the same as in 1903. They were all visited by the Medical Officer of Health in September in view of the L.C.C. licensing sessions, and were found in a very satisfactory state. They were also visited 2,242 times by the Inspector. The Slaughter of Cattle. —The Inspectorvery properly draws attention in his report to the incompetence of a slaughterman to fell an animal with the poll-axe after three attempts, so that he felt compelled to take the instrument from the man's hands and give the coup de grace to the ox. This paragraph in his report naturally suggests the question as to whether the most humane methods of slaughtering are practised by butchers in this country. This was the subject of investigation made by a committee appointed by the Admiralty who were ordered to consider " the humane slaughtering of animals," and who 1904] 218 have recently presented a very valuable report, in which they make the following recommendations General Recommendations. 6. As a result of the foregoing inquiries and investigations, the Committee are of opinion that the methods of slaughtering existing in this country are capable of considerable improvement, and they have come to the following general conclusions :— (a) All animals without exception should be stunned, or otherwise rendered unconscious, before blood is drawn. This is actually the law in Denmark, many parts of Germany, and Switzerland, and, therefore, cannot be considered an impracticable condition. It has the great merit of comprehensiveness and simplicity, and if carried out, makes the subsequent operations of slaughter of comparative unimportance from the standpoint of humanity. The detailed methods proposed to carry out this primary condition in the case of the various animals will be referred to subsequently. (See paragraph io). (b) In the interests not only of humanity, but of sanitation, order, and ultimate economy, it is highly desirable that, where circumstances permit, private slaughter-houses should be replaced by public abattoirs, and that no killing should be permitted, except in the latter, under official supervision. Such a change as this could only be brought about gradually and by legislation, but it cannot be described as impracticable, in view of the fact that this system is prescribed by law in several continental countries, and is actually enforced in the City of Edinburgh. (c) There should be an efficient system of inspection and supervision of all slaughter-houses, whether public or private, by the local authority, and uniformity in methods of slaughter should be introduced and enforced as far as possible. (d) All slaughtermen, and others employed in or about slaughter houses, should be licensed by the local authority. The Committee have carefully considered the question as to whether the license should partake of the nature of a certificate of proficiency, 219 [1904 but they recommend that, for the present at any rate, it should be merely permissive (like the present license for motor drivers), having as its main value the power of withdrawal in case of cruelty, incompetence, or misconduct. Only a nominal fee should be charged for a license. The Committee have received a good deal of evidence to show that the institution of licenses would not only be desirable from a general standpoint, but would also be received with favour by the trade." * In paragraph 10 of their report they give details as to the manner in which the various food animals should be killed. It reads as follows :— Detailed Methods of Slaughter. io. As a result of their investigations, and proceeding on the preliminary assumption that all animals should be stunned, or otherwise rendered unconscious before being bled, the Committee are of opinion that the following methods are the most humane, expeditious, and practical and recommend that they should be prescribed by bye-laws or otherwise enforced. Cattle. (a) Each animal should be roped before being brought into the slaughter-chamber, which should be so arranged that the animal can be led in straight up to the slaughter-ring, without having to be turned round. The turning round of a restive or excited animal in order to get its head into the proper position for a right-handed blow, is not an easy matter, particularly if the floor is slippery, and, besides causing delay, is apt to lead to cruelty in the way of blows and tail twisting. The slaughter ring should be affixed to the wall, about two feet from the ground, in such a position as to admit of a right-handed blow from the slaughterman. The common arrangement of fixing the slaughter-ring in the middle of the floor is not recommended, as it facilitates undesirable movement in the case of restive * The Committee are glad to note that the class of men employed in slaughtering work, at any rate, in large establishments, has greatly improved in late years, and for the greater part they now appear to be both highly trained and well paid. 1904] 220 animals. The animal should be steadied by pressing his flank against the wall, and the head being secured to the ring at the same time, the possibility of movement is reduced to a minimum. This renders it more easy for the slaughterman to strike with accuracy. (6) The Committee have practically tested a large number of appliances, designed for felling and stunning animals previous to " pithing." Amongst these may be mentioned the " Bruneau and Baxter Masks," the " Greener Patent Killer," the " Blitz " instrument, and the " Wackett" punch, all of which instantly stun and fell the animal, and are recommended for use in the case of quiet cattle or injured horses, particularly if the services of a trained slaughterman are not available. In the case of wild or restive animals, however, the adjustment of these instruments is very difficult, and their use is not recommended. Without going into further details, it will be sufficient to say that, whilst the Bruneau mask* has much to commend it— especially with inexperienced slaughtermen and when time is of little object—the Committee are of opinion that the pollaxe when used by an expert, is, on the whole, the most satisfactory implement. In coming to this conclusion they must add that in the hands of a nervous or inexperienced man, the poll-axe becomes an uncertain weapon, and may be productive of much suffering. The Committee, therefore, recommend that no man should be permitted to use the poll-axe on a living animal until he has gone through a thorough course of training, firstly, upon a dummy animal., and secondly, upon dead bodies. Detailed recommendations upon this point are made in appendix " D." (c) Except in the case of very restive animals, which may have to be stunned by a first blow on the poll, followed by a second stroke to perforate the forehead, one blow with the poll-axe on the forehead should be tsufficient to fell the animal, and to cause instantaneous * This appliance is used by the Army Service Corps, and forms part of the butcher's equipment issued to the troops on active service. \ It is seldom that an expert or properly trained slaughterman needs to strike more than one blow with a poll-axe. In any case, however, the first blow, if strongly delivered, is almost certain to fell and stun the animal, even if a second blow should be necessary to make the hole for the pithing cane. 221 [1904 loss of sensibility. The animal should then at once be " pithed " by thrusting a cane through the hole in the forehead and up the vertebrae, thus breaking up the spinal cord and ensuring absolute death. The animal should then be bled, and directly the bleeding is finished the carcase should be passed on into the "dressing" room, as described in paragraph 8 (e). The slaughter space can then be flushed down ready for the next animal. Calves. Calves should be first stunned with a blow on the head with a club. A tackle can then be fastened to the hind legs and the animal run up and bled, either by cutting its throat or by cutting the head off. The usual practice in this country appears to be to run the animal up first and then to stun it, previous to bleeding. This order of procedure is not so humane, and appears to be unnecessary. Sheep. The Committee have very carefully investigated the various methods of killing sheep. The usual method in this country is to lay the sheep on a wooden " crutch," and then to thrust a knife through the neck below the ears, and with a second motion to insert the point, from within, between the joints of the vertebrae, thus severing the spinal cord. In the hands of an expert this method is fairly rapid, but somewhat uncertain, the time which elapses between the first thrust of the knife and complete loss of sensibility varying, according to Professor Starling's observations, from five to thirty seconds. In the hands of an inexpert operator, it may be some time before death supervenes, and there can be little doubt that this method must be very painful to the sheep as long as consciousness remains. At the best it is a somewhat difficult operation, and yet in practice is often entrusted to the younger and less experienced hand in the slaughter-house, the probable reason being that sheep are easy to handle, and do not struggle or give trouble when stuck. In Denmark, many parts of Germany, and Switzerland, the law requires that sheep shall 1904] 222 always be stunned previous to being stuck, and the Committee have satisfied themselves by practical experiment and observations that this can be done expeditiously and without difficulty. A small club with a heavy head* should be used and the sheep should be struck on the top of the head between the ears. This point is important, as it is almost impossible to stun a sheep by striking it on the forehead. The sheep are previously placed on the crutch, and directly they are stunned they are stuck with a knife and bled in the ordinary way. It was ascertained that complete loss of sensibility from the stunning alone lasted for at least twenty seconds, which allows more than ample time for the completion of the killing operation. It was also clearly demonstrated that the stunning caused no injury to the sheep's head, or to the " scrag of mutton " which could in any way depreciate their market value. Lambs. Lambs should also be stunned previous to bleeding, but a lighter club should be used. Pigs. The Committee ascertained that it is the usual practice in large establishments in England to stun pigs by a blow on the forehead, previous to sticking them, and there is no difficulty in carrying this out, as the pig's head is soft as compared with that of the sheep. The Committee are of opinion that the preliminary stunning should be enforced in all cases, the evidence tending to show that this operation is often limited to pigs which are so large or strong as to give trouble to the sticker, or to cases where, owing to the location of the slaughter-house, the squeals of the stuck pigs cause annoyance to the neighbourhood. The Committee feel that considerations of humanity are at least as important as those above mentioned. * The Copenhagen instrument, with which the Committee conducted successful experiments, has a wooden handle and a round iron head. The Swiss instrument is the one recommended for general use, as it requires less skill on the part of the operator and consequently is more certain in its effects. 223 [1904 Finally the Admiralty Committee recommend that the methods of slaughter could advantageously be further defined, and in the 14th paragraph of their report they make the following suggestions. Proposed Regulations. 14. In many towns bye-laws have been drawn up regulating the methods of slaughter in public abattoirs, and, as an example, extracts from the bye-laws drawn up by the London County Council and other local authorities are printed in Appendix H. The Committee are of opinion, however, that the clauses dealing with the methods of slaughter could with advantage be further defined, and they suggest the following clauses which they would like to see universally adopted and strictly enforced. (а) All animals, without exception, must be stunned, or otherwise rendered unconscious, before blood is drawn. (б) Animals awaiting slaughter must be so placed that they cannot see into the slaughter house, and the doors of the latter must be kept closed while slaughtering is going on. (c) The drainage of the slaughter-house must be so arranged that no blood or other refuse can flow out within sight or smell of animals awaiting slaughter, and no such refuse shall be deposited in proximity to the waiting pens. (d) If more animals than one are being slaughtered in one slaughterhouse at the same time, they must not be within view of each other. (e) None but licensed men shall be employed in or about the slaughter-houses. It is quite certain that no humane persons can object to these recommendations, and it is therefore to be hoped that every person interested in this subject will do his utmost to secure the adoption of the proposals of the Committee, as undoubtedly they would go a long way to prevent needless torture 1904] 224 to animals which are destined for human food, and above all to sheep, whose instant slaughter requires the greatest skill, so that it be accomplished quickly and without pain. That something is required to be done is certain when we find a man, who lias had many years' experience, admitting that, although he must have seen millions of animals slaughtered, he very often turned his head away rather than see animals killed. (Vide, Report Q. 56.) Blowing Lamb and Veal.—Inspector Wilkinson, in his report, has drawn attention to the " obnoxious practice" by butchers, as he very properly styles it, of blowing lamb and veal, who, he avers, sometimes have to remove a plug of tobacco in order to carry out the operation. The Inspector has informed the Medical Officer of Health that one man whom he knew in the employment of two butchers, and who did this work, has since died of consumption of the lungs. Comment is unnecessary! Recently some provincial local authorities have endeavoured to stop the practice in their districts, and in the Parliamentary Session of 1904, four sanitary authorities—Kettering, Acton, Leyton and Ilford—obtained powers to deal with it. The Kettering clause reads as follows:— "It shall not be lawful to blow or to inflate the carcase or any part of the carcase of any animal slaughtered within or brought into the district, and any person offending against this enactment, or exposing or depositing for sale within the district a carcase blown or inflated, or any part thereof, shall be liable to a penalty not exceeding twenty shillings." Is it not time that the Metropolis possessed similar protection ? It will be noticed that this clause prevents blowing even by mechanical means, and rightly so, for it must not be forgotten that the operation is effected in the polluted air of the slaughter-house, and that, therefore, it is this air which is driven into the meat. Apart from this, blowing even with the purest air tends to hasten decomposition of the meat by bringing it into contact with the deep tissues. From every point of view the practice is objectionable and should be discontinued, for its object is either to give an enticing appearance to the meat, nearly always veal and lamb, or to disguise its quality. 225 [1904 LICENSED SLAUGHTER-HOUSES. Registered No. Name of Licensee. Situation of Premises. ks. 501b Gayes, W. D. 4, Athelstane Mews 400 Cockerill, A. E. 34, Balls Pond Road To kill not more than three beasts a week and small cattle. 451 Clarke, jno. 259. Balls Pond Road 475 Sharman, W. C. 53, Barnstury Street To kill small cattle only and for purposes of own shop. 461 Hack, T. 40, Bingfield Street Small cattle. 401 Guyer, Aubrey 18, Brecknock Road Small cattle. 416 Webber, George 41, Caledonian Road 413 Cheatle, Wm. 174, Caledonian Road 477 Maynard, John 309, Caledonian Road 434 Luxton, J. Carter's Yard, 170, Essex Rd 423 Selman, W. G. (Between) 185-7, Church Road 453 Toop, W (Rear of) 1, Clayton Street 480 Clark,C 12. Cloudesley Road 474 Mobbs, Jas. Hy. 219, Copenhagen Street Small cattle. 486 Sparry, T. 62, Essex Road Cattle admitted only between 11 p.m. and 7 a.m , and not more than five large animals to be killed per week. 449 Austin,W.Hanks 410, Essex Road 425 Hammond, F. 6, George's Road 402 Wadsworth,A.B 32, High Street 499 Webber, W. 81, Highgate Hill 484 Stone, S. 234, Holloway Road 443 Wilde, F. 498, Holloway Road 432 Watson, Harriet 576, Holloway Road 442 Tuck, W. 152, Hornsey Road 418 Worboys' R. 410, Hornsey Road 501c Haggar, Geo. 12, Hazelville Road, Hornsey Road 485 Webber, Jno. 9, Junction Road, Upper Holloway 488 Buckingham, J. 393, Liverpool Road 420 Gregory, Arthur T. 81, Newington Green Road Small cattle only belonging to licensee. 470 Wright, C. 275, New North Road Small cattle 431 Watson, R. (Jr.) 317, New North Road 421 Folkard, H. L. 52, Packington Street Small cattle. 458 Newbury, G. J. 102, Roman Road 472 Eteen, R. E. 49, St. Peter Street Small cattle. 498 Stone, A. 194, Seven Sisters Road 429 Farmer, C. 280. Seven Sisters Road 467 Fothergill, H. . 79, Stroud Green Road Cattle received upon the premises only between 7 p.m. and 8 a.m., and killing limited to requirements of own shop. 407 Richardson, J. 149, Upper Street Small cattle. 482 Farrin, Thomas (E. side of) Wycombe Mews 419 Lidstone (Ltd) 398, York Road Pemberton, G. J 53, Southgate Road Small cattle only. Total 40 Slaughter-Houses. Q 1904] 226 COWHOUSES. There were at the end of the year only ten cowhouses on the register, the licenses of two having been allowed to lapse. Their general state was good, while the animals were kept in a much more cleanly state than used to be the case a few years ago. They were visited systematically by the Inspector, who made 139 inspections of the buildings and the cattle. One cowkeeper was summoned under the bye-laws for keeping his cows in an uncleanly state, but when the case came on for hearing the Council was met by the defence producing three servants of the London County Council, the Veterinary Surgeon, his Assistant, and a Sanitary Inspector, who all said that they had not noticed the alleged dirty state of the animals. This was not to be wondered at, when it is remembered that their business at the cowhouse was not to examine the sanitary state of the buildings or cows, but for other purposes. The Magistrate dismissed the summons, allowing five guineas costs against the Council, notwithstanding the fact that the Inspector of these places (Mr. Wilkinson), and the Medical Officer of Health, who went to the premises on several occasions for the purpose of examining the cows, and whose duty it was to examine them, swore that on the dates alleged in the summons, the cattle were in a very dirty state. It is a noteworthy fact that four weeks after the hearing of the summons it was possible to detect the marks on the cows where the dung had been caked owing to the new hair which was then growing over the parts not having attained its full length. The Magistrate, possibly, may not be to blame for his decision owing to the contradictory evidence, but assuredly a system of inspection which may at any time put the officials of two great bodies into antagonism is one that needs alteration, and in addition is significent of an unnecessary overlapping of duties, and a waste of public money. That a conflict of evidence should have arisen in such a case as this was particularly unfortunate, because the Public Health Committee were endeavouring to protect the milk supply of the people, which is so well known to require it; and because it will render it almost impossible for similar prosecutions to be again undertaken in Islington lest once more the Council should be mulct in heavy costs, through the County of London officials viewing matters through a different set of glasses. 229 [1904 and lambs, and 21 pigs, whilst there was an increase of 13 in the number of calves, or a total decrease of 5,379 animals. , The large decrease in the number of sheep slaughtered is mainly due to the fact that a certain wholesale dealer retired from business a few months ago, it having been his custom tc buy from 50 to 200 sheep weekly, which were slaughtered within the Borough, and the carcases sent to Smithfield Meat Market. Nearly all the animals slaughtered during the year were young and of good quality, there being only 4 cows killed, as against 173 in the previous year, and nearly 500 in the year 1902; this is accounted for by the fact that a certain butcher who found the standard of meat inspection too high in Islington has since the middle of the year 1903 had his cows killed elsewhere. It will be understood that disease (especially tuberculosis) is far less prevalent in oxen than in cows. It is, therefore, pleasing to report that the amount of diseased meat and organs found in slaughter-houses, which has shown a steady and constant diminution since the records of meat inspection have been systematically kept within the Borough, has been much less during the year under consideration than that of any previous year, and I have no hesitation in saying the quality of the meat slaughtered in the Islington Private Slaughterhouses at the present time will compare most favourably with that of any City or Borough throughout the Kingdom. There is, however, a common practice (more prevalent in London and other places where meat is dressed and prepared for the London Market, than in other cities and towns), which is most repulsive, and I think ought to be stopped by the insertion pf a clause to that effect in any proposed alteration or amendment of the Public Health Acts. I refer to the obnoxious practice of blowing lamb and veal by the aid of the human lungs, often a plug of tobacco having to be removed in order to accomplish the feat- It is only fair to state that in some instances specially constructed mechanical appliances are provided and used for the purpose, although one has often seen men or youths testing the capacity of their lungs whilst the inflator provided was available, and I have further had in some instances reasonable grounds for suspicion as to the soundness of the operator's lungs. Whilst there would appear to be no serious objection to mechanical inflation under proper conditions, there is nothing to be said in its favour, as at the most it is only a disguise imparted to the meat in order to deceive the eye, and which may sometimes almost hide its defects from a practical person. The only excuse for the practice as given to me is that the London public would not buy it if dressed in a plain or normal condition, but my retort is that if the London public actually saw how such meat was prepared, the butcher would soon require a much different excuse for the deception. Owing to the fact that there are now practically no cows slaughtered under my supervision cases of tuberculosis which have previously figured largely in these reports are becoming rare, and only one carcase was destroyed on that account during the year, that being an exceedingly well nourished calf, which was surrendered by the owner at great sacrifice. _- There were, however, 145 animals which required some special attention during the year 231 [1904 In about 50 instances during the year meat, fruit, or other food substances, have been found on tradesmen's premises which were more or less in an unsound condition by reason of decomposition, but these were mainly in small quantities, such as butchers' small pieces, known in the trade as "tibbs," and which in many instances are the trimmings from larger joints that have become somewhat stale and discoloured. Or with reference to fruit, parts of parcels thereof, which have begun to decompose and have not received the necessary attention with regard to proper sorting before being exposed for sale. Cautions are administered where negligence is evident, and a record of these kept for reference. Only 3 summonses under Sec. 47 of the Public Health (London) Act, 1891, have been taken out during the year, two of which were separate charges against one person at the same time; for, in the first place, exposing fcr sale certain pork which was unsound; and, secondly, for depositing for the purpose of sale a quantity of pork in the ice safe connected with the shop, which was also unsound. The magistrate fined the defendant £5 and £1 2s. costs on the first summons, and ,£3 and £1 costs on the second charge. The third summons was taken out against a butcher for exposing for sale unwholesome bacon, and Mr. Bros fined the defendant £b and 2s. costs. Two cowshed licenses have been allowed to lapse during the year, with the result that there are now only ten on the register ; to these 139 visits have been paid during the year, and, as a whole, they have been found to be fairly well conducted, in a few instances repeated complaints having to be made regarding the cleanliness of some of the cows, and in one instance, where repeated warnings had not availed, you paid personal visits and reported the matter to the Public Health Committee, who gave instructions for legal proceedings; and in answer to the summons the cowkeeper appeared at the North London Police Court before Mr. Cluer, who refused to admit any evidence of previous warnings, whilst the defence had subpoened three Inspectors of the London County Council, who did not admit in evidence the alleged uncleanly condition of the cows, and the Magistrate dismissed the summons with £5 5s. costs against the Council. There has, however, been considerable improvement since these proceedings, the floor of the stalls in this cowshed having been relaid, and greater care as to the constant grooming of the cows has been observed- In five instances some abnormal affection of the udder has been detected, and reported to the Medical Officer of the London County Council, resulting in the attention of the Veterinary Inspector of that Authority. The offensive trade establishments remain as heretofore—viz., 3 tripe dressers, 2 gutscrapers, 1 tallowmelter, and 1 knacker's yard; these have received a total of 202 visits during the year, and no serious cause for complaint has arisen concerning them. The tallow melting establishment has been acquired by Messrs. Johnson Bros., of Hull, who are ref lacing the whole of the old plant by an entirely new arrangement under the closed chamber system, by which it is intended that the whole of the obnoxious fumes generated in the process will be driven by fans through the fire bars of the boiler furnace. The knacker's yard, it is understood, will in the coming year be reconstructed on a similar principle to the above-named. 1904] 252 WATER SUPPLY. The water supply of Islington is that obtained by the New River Company from wells of which there are 14, in the chalk and green sand formations, and from water obtained from the River Lea, from which 22,500,000 gallons can be taken daily. This supply is drawn from the river near Ware in Hertfordshire, and conveyed by a branch cut into the artificial channel which is so well known under the name of the New River, and into which also flows the water from the various chalk wells. Large though this supply is yet, to enable it to meet the demands made on it, the New River Company are engaged on the construction of works with a view of obtaining a supply of water from the Thames. The supply to the borough is now entirely on a constant system, and is calculated to be at the rate of 31.15 gallons daily throughout the year per head of the population. The quality of the water was exceedingly good, and consequently no complaints were received with respect to it. The latest available return gives the following particulars respecting the New River Company. Houses supplied 179,026 Houses on constant system 177,596 Houses not on constant system 1,430 Percentage of houses in constant system 99.2 Population supplied 1,290,579 Average daily supply (gallons) 40,201,692 Daily supply—Domestic purposes (gals.) 32,161,354 „ „ —Other purposes (gals.) 8,040,338 Quantity of water supplied during the year (gals.) 14,673,617,525 Average daily supply per house (gals.) 225.84 „ „ „ head (gals.) 31.15 Average daily supply per house for domestic purposes only (gals). 180.66 Average daily supply per head (gals.) 24.92 Average number of persons supplied per house 7'25 APPENDIX I. VITAL AND SANITARY STATISTICS, 1904 together with Abstracts for Ten Years, 1894-03. 254 1904] Table A. Showing the Deaths from All Cause in Islington during the Year 1904. Deaths of Non-Residents in Hospitals excluded. Deaths of Residents in Public Institutions are distributed. Institutions within Borough DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.E. Small Pox (a) Vaccinated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) Unvaccinated. . . 1 . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . 1 . . . . . . 1 (c) No. Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Measles 51 117 12 1 . . . . . . . . . . . . . . . . . . 168 13 19 22 14 35 19 42 30 105 75 181 Scarlet Fever 1 25 9 . . . . . . . . . . . . . . . . . . . . 26 9 1 1 10 2 4 6 11 19 16 35 Typhus Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Epidemic Influenza 2 2 . . . . 2 1 2 7 7 6 11 7 1 4 44 4 4 3 6 9 8 14 23 25 48 4 Whooping Cough 30 48 5 . . . . . . . . . . . . . . . . . . . . 78 5 5 7 5 16 11 18 21 38 45 83 1 Diphtheria 2 12 11 3 . . . . . . . . . . . . . . . . . . 14 14 4 3 2 3 3 9 4 16 12 28 3 Enteric Fever . . 1 . . 2 . . 4 7 3 1 . . . . . . . . 1 17 2 1 3 . . 2 3 7 6 12 18 Asiatic Cholera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Diarrhœa, Dysentery 118 24 . . . . . . . . . . 1 1 3 4 2 1 142 12 l4 9 16 29 14 32 40 75 79 154 2 Epidemic Enteritis 82 23 1 . . . . . . . . . . . . . . . . . . . . 105 1 3 10 9 24 14 31 15 61 45 106 Other Allied Diseases 4 . . . . . . . . . . . . . . . . 1 . . . . . . 4 1 3 . . . . . . . . 1 1 2 3 5 Hydrophobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Glanders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tetanus 1 l . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . 1 . . 1 . . . . 1 1 2 Anthrax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cow Pox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Syphilis 11 2 . . . . . . . . . . . . .1 1 . . . . . . 13 2 2 1 2 3 2 3 2 7 8 15 Gonorrhœa 1 . . . . . . . . 1 . . . . . . 3 . . . . . . 1 4 1 . . . . . . 3 . . 1 5 . . 5 Phagedæna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Erysipelas 3 . . . . . . . . . . 1 2 3 7 5 2 . . 3 20 2 1 4 5 3 4 4 18 5 23 4 Puerperal Fever . . . . . . . . . . 3 9 2 . . . . . . . . . . . . 14 1 2 1 . . 1 4 5 . . 14 14 3 Pyæmia 2 2 . . 1 3 . . 1 2 . . 1 . . 1 . . 4 9 2 1 1 1 3 1 4 7 6 13 Infective Endocarditis . . . . . . . . 1 . . . . 1 1 . . . . . . . . . . 3 . . 1 . . . . 1 . . 1 1 2 3 3 Other Allied Diseases 3 2 . . . . . . . . 3 . . 1 1 3 1 . . 5 9 2 1 4 2 2 1 2 8 6 14 Malarial Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rheumatic Fever . . 1 1 1 1 1 1 5 1 . . 1 . . . . 1 12 1 2 1 4 1 1 3 7 6 13 Rheumatism of Heart . . . . . . . . . . . . . . . . . . 1 . . . . . . . . 1 . . . . . . . . . . . . 1 . . 1 1 5 Tuberculosis of Brain 10 47 11 . . 3 1 1 . . . . 1 . . . . . . 57 17 10 6 11 9 7 17 14 42 32 74 Tuberculosis of Larynx . . . . . . . . . . 2 1 2 1 . . 1 . . . . . . 7 1 . . . . . . 2 3 1 5 2 7 124 Phthisis 12 20 7 12 25 55 115 120 109 36 20 2 . . 32 501 50 63 41 73 72 84 150 315 218 533 5 Abdominal Tuberculosis 20 16 . . . . . . . . 1 . . 1 2 . . . . . . 36 4 2 2 6 8 7 7 8 22 18 40 General Tuberculosis 3 5 2 4 3 . . 1 . . . . . . . . . . . . 8 10 . . . . 3 6 2 4 3 9 9 18 4 Other forms Tuberculosis 1 2 . . 1 1 1 2 1 . . 1 . . . . . . 3 7 1 . . 1 1 3 2 2 5 5 10 Other Infective Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Thrush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Actinomycosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hydatid Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Scurvy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Diseases due to Altered Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Acute Alcoholism . . . . . . . . . . . . . . 3 1 . . . . . . . . . . 4 . . . . . . 1 1 2 . . 3 1 4 7 Chronic Alcoholism . . . . . . . . . . . . . . 5 9 2 2 . . . . . . 18 3 1 3 1 4 3 3 9 9 18 Chronic Industrial Poisonings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Chronic Poisonings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Osteo-arthntis . . . . . . . . . . . . 1 2 2 1 10 4 . . . . 20 4 2 . . 3 3 3 5 9 11 20 Gout . . . . . . . . . . . . . . . . 1 3 5 1 1 . . 11 2 . . 2 2 1 . . 4 9 2 11 85 Cancer . . 1 1 1 1 4 10 43 61 84 90 22 5 1 322 37 42 34 40 56 51 63 47 176 523 Diabetes Mellitus . . . . . . . . . . 3 2 3 5 11 9 1 1 . . 35 4 6 4 3 9 2 7 19 16 35 Purpura Hæmorrhagica . . 1 . . . . . . . . . . . . . . . . . . . . . . 1 . . 1 . . . . . . . . . . . . . . 1 1 Hæmophilia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anæmia . . 3 1 . . 1 1 1 4 . . 1 2 . . . . 3 11 2 4 2 1 2 2 1 6 8 14 Lymphadenoma . . 1 . . . . . . . . . . 1 . . 2 1 . . . . 1 4 2 1 . . 1 . . . . 1 3 2 5 4 Premature Birth 178 . . . . . . . . . . . . . . . . . . . . . . . . 178 . . 18 15 12 21 26 44 42 104 74 178 Injury at Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Debility at Birth 36 . . . . . . . . . . . . . . . . . . . . . . . . 36 . . 6 1 1 8 5 6 9 25 11 36 Atelectasis 15 . . . . . . . . . . . . . . . . . . . . . . . . 15 . . . . 1 3 2 3 3 3 5 10 15 Congenital Defects 28 . . . . . . . . . . . . . . . . . . . . . . . . 28 . . 4 4 3 1 3 8 5 18 10 28 Want of Breast Milk 6 . . . . . . . . . . . . . . . . . . . . . . . . 6 . . 1 . . 2 1 1 1 . . 3 3 6 Atrophy, Debility, Marasmus 141 15 . . . . . . . . . . . . 1 . . . . . . . . 156 1 21 15 13 23 22 17 46 84 73 57 • 2 Chicken Pox. 255 [1904 Table A - Continued Deaths in Institutions within Borough. DISEASES. AGES. Under 5 Over 5. DISTRICTS Males Females 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf V.H. Tull L.H. H. B, S.E. Dentition 11 9 . . . . . . . . . . . . . . . . . . . . . . 20 . . 3 . . 5 1 5 5 1 9 11 Rickets 4 7 . . . . . . . . . . . . . . . . . . . . . . 11 . . 2 1 . . 1 1 3 3 7 4 Old Age, Smile Decay . . . . . . . . . . . . . . . . . . 2 26 96 43 . . 167 23 17 11 21 32 27 36 '66 101 Convulsions 17 6 1 . . . . . . . . . . . . . . . . . . . . 53 1 7 5 4 6 5 14 13 34 20 Meningitis 10 17 4 1 2 1 . . 2 1 1 . . 1 . . 27 13 2 4 4 7 8 3 12 18 22 Encephalitis 1 . . 1 . . . . . . 1 . . . . 2 1 . . . . 1 6 1 . . . . . . 2 2 2 2 5 Apoplexy . . . . . . . . . . 1 . . 1 13 7 12 13 1 . . 48 7 5 5 3 11 7 10 21 27 Softening of Brain . . . . . . . . . . . . . . 1 3 2 6 7 1 . . 20 1 1 4 2 4 1 7 11 9 Hemiplegia . . 1 . . 1 . . 1 1 2 3 11 11 9 1 1 40 5 2 7 3 7 11 6 16 25 General Paralysis of the Insane . . . . . . . . . . 1 7 1 3 2 1 . . . . . . 21 2 8 . . 5 3 2 1 17 4 Other forms of Insanity . . . . . . . . . . . . 2 1 7 9 8 4 1 . . 32 3 10 5 5 4 2 3 16 16 Chorea . . . . . . 1 . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . 1 . . 1 Cerebral Tumour . . . . 2 . . . . . . . . 2 . . 1 . . . . . . . . 2 . . 2 . . . . 1 . . 2 2 3 Epilepsy . . . . 1 1 1 1 2 2 5 1 3 1 . . . . 18 2 3 1 2 3 3 4 11 7 Laryngismus Stridulus 2 . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . 1 . . . . . . . . 1 1 1 Locomotor Ataxy . . . . . . . . . . . . . . . . 1 2 . . . . . . . . 3 . . 1 . . . . 1 1 . . 2 1 Paraplegia . . . . . . 1 1 1 1 3 8 9 13 8 1 . . 48 5 9 4 2 10 12 6 25 22 Other forms, Brain Diseases . . . . 1 . . 1 . . . . 3 . . 4 2 . . . . . . 11 1 . . 2 1 2 3 2 4 7 Otitis 1 2 1 . . 3 . . 1 1 2 . . . . . . . . 3 8 . . 2 1 . . 3 4 1 4 7 Disease of Nose, Epistixis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Disease of Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pericarditis . . 1 1 1 . . . . . . . . . . . . . . . . . . 1 2 . . . . . . . . . . 3 . . 3 . . 1 Endocarditis . . 1 3 1 . . . . 1 . . . . 1 1 . . . . 1 7 . . . . 1 1 2 2 2 4 4 Hypertrophy of Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Angina Pectoris . . . . . . . . . . . . . . . . . . 1 1 1 . . . . 3 1 . . . . . . 1 . . 1 . . 3 4 Aneurism . . . . . . . . . . . . 2 4 2 8 1 1 . . . . 18 2 1 3 3 1 3 5 13 5 4 Senile Gangrene . . . . . . . . . . . . . . . . . . 1 4 2 1 . . 8 3 . . . . 1 . . 1 3 1 7 12 Embolism, Thrombosis 1 . . . . . . . . . . 2 1 3 5 7 4 2 1 27 4 2 . . 3 7 9 3 8 20 2 Phlebitis . . . . . . 1 . . . . 1 1 . . . . 1 1 . . . . 5 1 1 1 . . . . 1 1 2 3 Varicose Veins . . . . . . . . . . . . . . . . 1 . . . . . . . . . . 1 . . . . . . 1 . . . . . . . . 1 155 Other Diseases, Heart and Vessels 4 3 6 7 9 15 25 61 87 121 136 108 18 7 593 81 65 69 71 73 101 132 293 307 1 Laryngitis 1 6 . . . . . . . . . . . . 1 2 . . . . . . 7 4 1 . . 1 . . 2 6 1 5 6 Croup 2 1 . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . 2 . . 1 1 2 Other Diseases, Larynx and . . . . . . . . . . . . . . 1 . . . . . . . . . . . . l 1 . . . . . . . . . . . . . . 1 8 Acute Bronchitis 76 28 1 . . . . . . . . 4 6 5 20 18 2 104 56 17 17 11 28 16 83 44 69 91 88 Chronic Bronchitis 2 3 . . . . . . 1 5 12 36 80 116 100 19 5 369 32 25 24 39 58 75 121 107 217 8 Lobar Pneumonia 3 2 . . . . 1 1 4 5 4 5 3 1 . .. . 5 24 3 5 3 1 1 6 10 17 12 Lobular Pneumonia . . 1 . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . 1 . . . . . . . . 1 59 Pneumonia 101 109 8 1 5 3 10 23 27 33 26 15 1 210 152 39 36 35 60 48 58 86 178 186 4 Emphysema, Asthma . . . . . . . . . . . . 2 3 .5 4 3 .5 1 . . 19 2 . . 1 1 1 4 10 12 7 7 Pleurisy . . 2 2 . . . . 3 2 4 1 7 3 1 1 2 4 1 . . 1 8 9 3 9 17 Other Diseases, Respiratory System 2 . . . . . . 1 . . . . 1 . . 2 3 . . . . 2 7 . . . . 1 1 4 1 2 8 1 Diseases of Mouth and Annexa l 1 . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . 1 . . 1 . . 2 . . Diseases of Pharynx . . . . . . . . . . . . . . . . 1 1 . . . . . . . . 2 1 . . . . 1 . . . . . . 1 1 Diseases of Œsophagus . . . . . . . . . . . . . . . . . . . . 1 . . . . . . 1 . . . . 1 . . . . . . . . 1 . . Ulcer of Stomach and Duodenum . . . . . . . . 2 1 4 4 4 3 1 . . . . . . 19 4 2 2 4 1 2 4 7 12 Other Diseases of Stomach 18 2 . . . . . . . . 1 2 4 3 3 5 1 20 19 8 6 5 4 5 4 7 19 20 1 Enteritis 20 4 1 . . . . . . 1 1 1 . . 3 3 1 24 11 4 6 4 5 3 8 5 16 19 1 Appendicitis . . . . 2 5 3 2 8 2 1 3 1 . . . . . . 27 4 2 1 3 5 4 8 13 14 Obstruction of Intestine 8 2 5 . . . . . . 4 4 10 13 6 1 . . 10 41 4 5 4 6 16 4 12 22 29 Other Diseases of Intestine 3 . . . . . . . . . . . . 1 . . 1 . . . . . . 3 2 . . . . . . . . 3 1 1 5 . . 8 Cirrhosis of Liver . . . . . . . . . . . . 1 18 19 11 7 2 . . . . 58 10 4 2 2 13 10 17 25 33 Other Diseases of Liver 7 1 . . . . . . 1 2 3 2 8 4 3 1 8 24 5 6 1 2 3 8 7 16 16 Peritonitis . . . . 1 . . 1 1 1 . . . . . . . . . . 1 . . 5 . . 2 . . 2 . . . . 1 2 3 Other Diseases, Digestive System 5 1 . . . . 1 . . . . 1 . . 1 l 1 . . 4 5 1 1 . . 1 2 1 3 3 6 Diseases, Lymphatic System and Glands 1 1 . . . . . . 1 1 . . 2 1 2 . . . . 2 7 1 . . . . . . 1 2 5 3 6 Acute Nephritis 1 . . . . 2 . . . . . . 4 . . 5 2 1 . . 1 14 3 1 2 . . 3 5 1 16 5 1 Bright's Disease . . 1 . . 2 1 3 3 15 23 29 23 10 1 1 110 14 9 10 14 25 15 24 50 61 11 Calculus . . . . . . . . . . . . . . . . . . . . 2 . . . . . . 2 . . . . . . . . 1 1 . . 2 . . Diseases of Bladder and tate . . 1 . . . . . . 1 1 . . . . 2 8 10 1 1 23 4 4 1 2 4 1 8 19 5 2 Other Diseases, Urinary System . . . . . . . . . . 1 . . . . 3 2 4 2 . . . . 12 . . l . . 2 1 5 3 8 4 1 Diseases of Testis and Penis 1 . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . 1 . . . . . . . . . . 1 . . Diseases of Ovaries . . . . . . . . . . . . 1 1 2 1 . . 1 . . . . 6 2 . . 1 . . 2 . . 1 . . 6 1 Diseases of Uterus and Appendages . . . . . . . . . . . . 2 1 . . . . 3 . . . . . . 6 . . 2 . . . . . . 2 2 . . 6 Diseases of Vagina and External Genitals 1 . . 1 . . . . . . . . 1 . . . . . . . . . . 1 2 . . 1 . . . . . . 2 . . . . 1 Diseases of Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Abortion, Miscarriage . . . . . . . . . . . . 1 . . . . . . . . . . . . . . 1 . . . . . . . . 1 . . . . . . 1 1 Puerperal Mania . . . . . . . . . . . . 1 1 . . . . . . . . . . . . 2 . . . . . . . . . . . . 2 . . 2 Puerperal Convulsions . . . . . . . . . . . . 1 . . . . . . . . . . . . . . 1 . . . . . . . . . . 1 . . . . 1 Placenta Prævia, Flooding . . . . . . . . . . . . 5 2 . . . . . . . . . . . . 5 . . . . 1 1 . . 2 1 . . 5 256 1904] Table A.—Continued. Borough. DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.E. Institutions within Puerperal Thrombosis . . . . . . . . . . . . 1 . . . . . . . . . . . . . . 1 . . . . . . . . 1 . . . . . . 1 1 Other Diseases, Pregnancy and Childbirth 3 . . . . . . . . . . 3 1 . . . . . . . . . . 3 4 . . . . 1 1 1 1 3 3 4 7 Arthritis, Ostitis, Periostitis . . . . . . . . . . 2 1 1 . . . . . . . . . . . . 4 . . . . . . 2 1 . . 1 2 2 4 Other Diseases, Osseous System . . . . 1 1 . . . . . . 2 . . 1 . . . . . . . . 5 . . . . 1 2 1 1 . . 4 1 5 Ulcer, Bedsore . . 1 . . . . . . . . . . . . . . 1 3 . . . . 1 4 . . . . . . 1 . . 2 2 2 3 5 Eczema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pemphigus 1 . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . 1 . . . . . . . . . . 1 1 2 Other Diseases, Integumentary System 2 1 . . . . . . . . . . . . . . . . . . . . . . 3 . . 2 . . . . . . . . 1 . . 2 1 3 Accidents and Negligence In Mines and Quarries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 In Vehicular Traffic . . 1 4 1 2 . . . . 1 3 5 . . 4 . . 1 20 1 3 1 5 3 3 5 15 6 21 On Railways . . . . . . . . . . 1 . . 2 . . . . . . . . . . . . 3 1 . . 1 . . . . 1 . . 2 1 3 On Ships, Boats, etc. (not drowning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a In Building Operations . . . . . . . . . . 1 2 1 . . . . 3 . . . . . . 7 . . . . 1 2 . . 1 3 7 . . 7 By Machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . By Weapons and Implements . . . . . . . . . . . . . . . . . . . . . . 1 . . . . 1 . . . . . . 1 . . . . . . . . 1 1 4 Burns and Scalds 1 7 1 . . . . . . 3 . . . . . . . . 2 . . 8 6 1 1 2 3 5 1 1 5 9 14 Poisons, Poisonous Vapours . . . . . . . . . . . . 1 1 1 2 . . . . . . . . 5 . . . . . . . . 3 . . 2 3 2 5 1 Surgical Narcosis . . 3 . . . . . . . . 1 . . . . . . 1 . . . . 3 2 . . . . 1 1 . . 1 2 3 2 5 Effects of Electric Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Corrosions by Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drowning . . . . 1 . . . . . . 3 2 3 1 . . . . . . . . 10 1 2 . . . . . . 6 1 6 4 10 1 Suffocation, Overlaid in Bed 25 2 . . . . . . . . . . . . . . . . . . . . . . 27 . . 4 1 2 3 2 7 8 15 12 27 2 ,, Otherwise 2 . . 1 . . . . . . 2 . . . . 1 1 2 . . 2 7 . . . . 1 1 2 1 4 5 4 9 8 Falls not specified 6 3 2 . . . . . . 6 4 4 5 6 9 2 9 38 4 3 2 8 9 10 11 25 22 47 4 Weather Agencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Otherwise, not stated 4 . . 1 . . 1 . . 1 . . 1 . . . . . . 1 4 5 . . 1 2 4 . . 1 1 7 2 9 Homicide 3 . . . . . . . . . . . . . . . . . . 1 . . . . 3 1 . . . . 1 . . 1 1 1 2 2 4 Suicide. 2 By Poison . . . . . . . . . . . . 2 3 3 4 3 . . . . . . 15 1 2 1 1 1 4 5 10 5 15 By Asphyxia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 By Hanging and Strangulation . . . . . . . . . . . . . . 1 4 1 2 . . . . . . 8 1 . . . . 1 1 3 2 7 1 8 24 By Drowning . . . . . . . . . . . . . . . . 1 1 . . . . . . . . 2 . . 1 . . . . . . . . 1 1 1 2 By Shooting . . . . . . . . . . . . 1 . . 1 1 . . . . . . . . 3 . . 1 . . . . 1 1 . . 2 1 3 By Cut or Stab . . . . . . . . . . . . 2 4 1 . . . . . . . . . . 7 . . 1 . . . . . . 2 2 7 . . 7 4 By Precipitation from Elevated Places . . . . . . . . . . . . 1 . . 3 . . . . 1 . . . . 5 . . 1 . . 2 1 1 . . 5 . . 5 By Crushing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . By other and unspecified methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Execution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sudden Death, cause not tained . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 7 III-defined and unspecified causes . . . . . . . . . . . . . . . . . . . . 1 . . . . . . 1 . . . . 1 . . . . . . . . . . 1 1 1 Males 646 321 58 26 34 50 151 226 278 313 324 198 29 967 1687 307 247 257 364 372 174 633 . . . . 2654 5 Females 494 282 54 27 42 71 144 213 243 290 342 298 82 776 1806 264 276 218 329 403 189 603 . . . . 2582 3 TOTAL DEATHS 1140 603 112 53 76 121 295 439 521 603 666 496 111 1743 _ 3493 571 523 475 693 773 963 1236 2634 2582 5236 257 [1904 Table B. Showing the Deaths from All Causes registered during the Quarters of the Year 1904 at three periods of life. CAUSES OF DEATH. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total for Year. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. (a) Vaccinated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (b) Unvaccinated . . 1 . . 1 . . . . . . . . . . . . . . . . . . . . . . . . 1 (c) No Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Measles 1 14 5 20 22 49 4 75 25 32 1 56 6 22 3 30 181 Scarlet Fever . . 3 2 5 . . 7 3 10 1 6 3 10 . . 9 1 10 35 Typhus Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Epidemic Influenza . . . . 12 12 . . . . 5 5 . . . . 2 2 2 2 25 29 48 Whooping Cough 13 21 2 36 9 9 1 19 6 12 . . 18 2 6 2 10 83 Diphtheria 1 6 3 10 i 1 2 4 . . 3 3 6 . . 2 6 8 28 Enteric Fever . . 1 1 2 . . . . 6 5 . . . . 4 4 . . . . 7 7 18 Asiatic Cholera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Diarrhœa, Desentery 3 1 3 7 l 3 1 5 111 20 8 139 3 . . . . 3 154 Epidemic Enteritis 5 2 . . 7 1 . . . . 1 70 20 1 91 6 1 . . 7 106 Other Allied Diseases 3 . . . . 3 . . . . . . . . . . . . . . . . 1 . . 1 2 5 Hydrophobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Glanders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tetanus . . 1 . . 1 . . . . . . . . 1 . . . . 1 . . . . . . . . 2 Anthrax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cow Pox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Syphilis . . . . 1 1 4 1 . . 5 4 1 1 6 3 . . . . 3 15 Gonorrhœa 1 . . 2 3 . . . . 2 2 . . . . . . . . . . . . . . . . 5 Phagedæna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Erysipelas 1 . . 5 6 . . . . 2 2 1 . . 3 4 1 . . 10 11 23 Puerperal Fever . . . . 6 6 . . . . 2 2 . . . . 2 2 . . . . 4 4 14 Pyæmia . . . . 6 6 . . . . 1 2 . . . . . . . . 2 1 2 5 13 Infective Endocarditis . . . . 1 1 . . . . . . . . . . . . 1 1 . . . . 1 1 3 Other Allied Diseases, 1 1 4 6 . . . . 2 2 1 . . 1 2 1 1 2 4 14 Malarial Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Rheumatic Fever . . . . 2 2 . . . . 5 5 . . 1 1 2 . . . . 4 4 13 Rheumatism of Heart . . . . . . . . . . . . 1 1 . . . . . . . . . . . . . . . . 1 Tuberculosis of Brain 4 10 7 21 1 17 3 21 3 10 4 17 2 10 3 15 74 Tuberculosis of Larynx . . . . 1 1 . . . . 2 2 . . . . 2 2 . . . . 2 2 7 Phthisis 4 3 153 160 I 7 102 110 4 6 99 109 3 4 147 154 533 Abdominal Tuberculosis 1 3 . . 4 6 2 . . 8 10 8 3 21 3 3 1 7 40 General Tuberculosis 1 . . 3 4 1 3 3 7 . . . . . . . . 1 2 4 7 18 Other Forms Tuberculosis . . . . 1 1 . . 1 . . 1 . . . . 1 1 1 1 5 7 10 Other Infective Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Thrush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Actinomycosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hydatid Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Scurvy Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Diseases due to Altered Food . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acute Alcoholism . . . . 1 1 . . . . 1 1 . . . . . . . . . . . . 2 2 4 Chronic Alcoholism . . . . 5 5 . . . . 3 3 . . . . 7 7 . . . . 3 3 18 Chronic Industrial Poisonings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other Chronic Poisonings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Osteo-arthritis . . . . 3 3 . . . . 7 7 . . . . 5 5 . . . . 5 5 20 Gout . . . . 6 5 . . . . 2 2 . . . . 4 4 . . . . . . . . 11 Cancer . . . . 73 73 . . 1 79 80 90 90 . . . . 80 80 323 Diabetes Mellitus . . . . 11 11 . . . . 10 10 . . . . 2 2 . . . . 12 12 35 Purpura Hæmorrhagica . . . . . . . . . . . . . . . . . . 1 . . 1 . . . . . . . . 1 Haemophilia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anæmia . . 1 3 4 . . 2 4 6 . . . . 3 3 . . . . 1 1 14 Lymphadenoma . . 1 2 3 . . . . 1 1 . . . . . . . . . . . . 1 1 5 Premature Birth 44 . . . . 44 53 . . . . 53 38 . . . . 38 43 . . . . 73 178 Injury at Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Debility at Birth 7 . . . . 7 7 . . . . 7 12 . . . . 12 10 . . . . 10 36 Atelectasis 5 . . . . 5 3 . . . . 3 3 . . . . 3 4 . . . . 4 15 Congenital Defects 10 . . . . 10 5 . . . . 5 6 . . . . 6 7 . . . . 7 28 Want of Breast Milk 4 . . . . 4 1 . . . . 1 1 . . . . 1 . . . . . . . . 6 Atrophy, Debility, Marasmus 22 1 1 24 29 5 . . 34 52 5 . . 57 38 4 . . 42 157 * 2 Chicken Pox. s 258 1904] Table B.—Continued. CAUSES OF DEATH. 1st Quarter. 2nd Quarter 3rd Quarter. 4th Quarter Total for Year Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 15 Over 5 Total Dentition 7 5 . . 12 1 2 . . 3 1 1 . . 2 2 1 . . 3 20 Rickets 1 1 . . 2 1 2 . . 3 . . 3 . . 3 2 1 . . 3 11 Old Age, Senile Decay . . . . 50 50 . . . . 43 43 . . . . 36 36 . . . . 38 38 167 Convulsious 13 1 1 15 11 1 . . 12 9 3 . . 12 14 1 . . 15 54 Meningitis 4 6 2 12 1 3 6 10 5 5 2 12 . . 3 38 6 40 Encephalitis . . . . . . . . 1 . . 3 4 . . . . 2 2 . . . . 1 1 7 Apoplexy . . . . 15 15 . . . . 11 11 . . . . 9 9 . . . . 13 13 48 Softening of Brain . . . . 5 5 . . . . 3 3 . . . . 5 5 . . . . 7 7 20 Hemiplegia . . . . 12 12 . . 1 11 12 . . 9 9 . . . . 8 8 41 Genral Paralysis of Insane . . . . 6 6 . . . . 2 2 . . . . 2 2 . . . . 11 11 21 Other forms of Insanity . . . . 9 9 . . . . 8 8 . . . . 8 8 . . . . 7 7 32 Chorea . . . . 1 1 . . . . . . . . . . . . . . . . . . . . . . . . 1 Cerebral Tumour . . . . 2 2 . . . . 1 1 . . . . . . . . . . . . 2 2 5 Epilepsy . . . . 6 6 . . . . 4 4 . . . . 5 5 . . . . 3 3 18 Laryngismus Stridulus . . . . . . . . 1 . . . . 1 . . . . . . . . 1 . . . . 1 2 Locomotor Ataxy . . . . 1 1 . . . . 1 1 . . . . . . . . . . . . 1 1 3 Paraplegia . . . . 10 10 . . . . 14 14 . . . . 14 14 . . . . 10 10 48 Other forms, Brain Insenses . . . . 3 3 . . . . 4 4 . . . . 2 2 . . . . 2 2 11 Otitis . . . . 3 3 1 . . . . 1 . . 1 3 4 . . 1 2 3 11 Disease of Nose, Epistaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Disease of Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pericarditis . . . . l 1 . . 1 . . 1 . . . . 1 1 . . . . . . . . 3 Endocarditis . . . . 3 3 . . 1 2 3 . . . . 1 1 . . . . 1 1 8 Hypertrophy of Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Angina Pectoris . . . . l 1 . . . . 1 1 . . . . 1 1 . . . . . . . . 3 Aneurism . . . . 3 3 . . . . 5 5 . . . . 6 6 . . . . 4 4 18 Senile Gangrene . . . . l 1 . . 4 4 . . . . 1 1 . . . . 2 2 8 Embolism, Thrombosis . . . . 10 10 1 . . 1 2 . . . . 9 9 . . . . 7 7 28 Phlebitis . . . . l 1 . . . . 1 1 . . . . 1 1 . . . . 2 2 5 Varicosa Veins . . . . . . . . . . . . 1 1 . . . . . . . . . . . . . . . . 1 Other Diseases, Heart and Vessels 2 . . 169 171 2 1 128 131 . . 1 128 129 . . 1 168 169 600 Laryngitis . . 4 1 5 1 2 1 4 . . . . 2 2 . . . . . . . . 11 Croup . . . . . . . . 1 . . . . 1 . . . . . . . . 1 1 . . 2 3 Other Diseases, Larynx and Traches . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 Acute Bronchitis 17 11 26 54 12 6 3 21 5 1 4 10 42 10 23 75 160 Chronic Bronchitis . . . . 154 154 . . 1 51 52 . . 1 28 29 2 1 136 139 374 Lobar Pneumonia 2 1 6 9 . . . . 5 5 1 . . 6 7 . . 1 7 8 29 Lobular Pueumonia . . 1 . . 1 . . . . . . . . . . . . . . . . . . . . . . . . 1 Pneumonia 31 40 50 121 13 30 32 75 17 13 19 49 40 26 51 117 362 Emphysema, Asthma . . . . 7 7 . . . . 2 2 . . . . . . . . . . . . 10 10 19 Pleurisy . . 1 12 13 . . . . 3 3 . . 1 2 3 . . . . 7 5 26 Other Diseases, Respiratory System . . . . 1 1 . . . . . . . . 2 . . 1 3 . . . . 5 . . 9 Diseases of Mouth and Annexe . . . . . . . . . . . . . . . . . . . . . . . . 1 1 . . 1 2 Diseases of Pharynx . . . . . . . . . . . . . . . . . . . . 1 1 . . . . 1 1 2 Diseases of (Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . 1 7 1 Ulcer of Stomach and Duodenum . . . . 4 4 . . . . 4 4 . . . . 4 4 . . . . 7 7 19 Other Diseases of Stomach 2 . . 4 6 6 . . 3 9 8 1 5 14 2 1 7 10 39 Enteritis 3 1 1 5 4 2 3 9 9 . . 4 13 4 1 3 8 35 Appendicitis . . . . 5 5 . . . . 7 7 . . . . 7 7 . . . . 8 8 27 Other Diseases Digestive System 3 . . 12 15 2 . . 14 16 3 2 9 14 . . . . 6 6 51 Diseases Lymphatic System 2 . . . . 2 . . . . . . . . . . . . 1 1 1 . . 1 2 5 Cirrhosis of Liver . . . . 24 24 . . . . 11 11 . . . . 6 6 . . . . 17 17 58 Other Diseases of Liver . . . . 7 7 . . . . 2 4 3 . . 10 13 2 1 5 8 32 Peritonitis . . . . 1 1 . . . . . . . . . . . . 1 1 . . . . 3 3 5 Other Diseases Digestive System 2 1 3 6 . . . . 2 2 . . . . . . . . 1 . . . . 1 58 Diseases Lymphatic System & Glands . . . . 1 1 . . 1 2 3 1 . . 1 2 . . . . 3 3 32 Acute Nephritis 1 . . 3 4 . . . . 2 2 . . . . 4 4 . . . . 5 5 5 Bright's Disease . . . . 36 36 . . 1 24 25 . . . . 22 22 . . . . 28 28 111 Calculus . . . . . . . . . . . . . . . . . . 1 1 . . . . 1 1 2 Diseases of Bladder and Prostate . . . . 6 6 . . 1 7 8 . . . . 4 4 . . . . 6 6 24 Other Diseases Urinary System . . . . 3 3 . . . . 1 1 . . . . 1 1 . . . . 7 7 12 Diseases of Tests and Pents . . . . . . . . . . . . . . . . 1 . . . . 1 . . . . . . . . 1 Diseases of Ovaries . . . . 2 2 . . . . 1 1 . . . . 3 3 . . . . . . . . 6 Diseases of Uterus and Appendages . . . . . . . . . . . . 2 2 . . . . 1 1 . . . . 3 3 6 Dis. of Vagina and External Genitals 1 . . . . 1 . . . . . . . . . . . . 2 2 . . . . . . . . 3 Diseases of Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Abortion, Miscarriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 Puerperal Mania . . . . . . . . . . . . . . . . . . . . 2 2 . . . . . . . . 2 Puerperal Convulsions . . . . . . . . . . . . . . . . . . . . 1 1 . . . . . . . . 1 Placenta Prævia, Flooding . . . . 2 2 . . . . 2 2 . . . . . . . . . . . . 1 1 5 Puerperal Thrombosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 Other Dis., Pregnancy and Childbirth. 1 . . 2 3 1 . . 2 3 . . . . . . . . 1 . . . . 1 7 Arthritis. Ostitis. Periostitis . . . . 3 3 . . . . . . . . . . . . . . . . . . . . 1 1 4 Other Diseases, Osseous System . . . . . . . . . . . . 2 2 . . . . 1 1 . . . . 2 2 5 Ulcer, Bedsore . . . . . . . . . . 1 . . 1 . . . . . . . . . . . . 4 4 5 259 [1904 Table B.—Continued. CAUSES OF DEATH. 1st Quarter 2nd Quarter. 3rd Quarter. 4th Quarter. Total for Year Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Eczema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pemphigus 1 . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . 1 Other Diseases, Integumentary System 1 . . . . 1 . . . . . . 1 1 . . 2 . . . . . . . . 3 Accidents and Negligence. In Mines and Quarries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . In Vehicular Traffic . . . . 3 3 . . . . 4 4 . . 1 9 10 . . . . 1 21 On Railways . . . . 1 1 . . . . . . . . . . . . . . . . . . . . . . . . 3 On Ships, Boats, &c. (not drowning) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . In Building Operations . . . . 1 1 . . . . . . . . . . . . 6 6 . . . . . . . . 7 By Machinery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . By Weapons and Implements . . . . 1 1 . . . . . . . . . . . . . . . . . . . . . . . . . . Burns and Scalds . . . . 2 8 1 . . 1 2 . . . . 2 2 . . 1 1 2 14 Poisons, Poisonous, Shock . . . . 1 1 . . . . 1 1 . . . . . . . . . . . . 3 3 5 Surgical Narcosis . . . . 1 3 . . 1 . . 1 . . . . . . . . . . . . 1 1 5 Effects of Electric Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Corrosions by Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Drowning . . . . 1 1 . . . . 1 1 . . . . 6 6 . . . . 2 2 10 Suffocation, Overlaid in Bed 10 . . . . 10 5 1 . . 6 5 1 . . 6 5 . . . . 5 . . ,, Otherwise . . . . 1 . . . . . . . . 1 1 2 . . 5 1 . . Falls not specified 1 1 11 14 . . 1 8 9 3 . . 10 13 2 1 9 12 47 Weather Agencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Otherwise, not stated 1 . . . . 1 . . . . 1 2 1 2 6 1 1 9 Homicide 1 . . . . 1 2 . . . . 2 . . . . 1 1 . . . . . . . . 4 Suicide. By Poison . . . . 3 3 . . . . 1 1 . . . . 8 8 . . . . 3 3 15 By Asphyxia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . By Hanging and Strangulation . . . . 1 1 . . . . 3 3 . . . . 1 1 . . . . 3 3 8 By Drowning . . . . . . . . . . . . 1 1 . . . . . . . . . . . . 1 1 2 By Shooting . . . . 2 2 . . . . 1 1 . . . . . . . . . . . . . . . . 3 By Cut or Stab . . . . 2 2 . . . . 2 2 . . . . 1 1 . . . . 2 2 7 By Precipitation from Elevated Places . . . . . . . . . . . . 2 2 . . . . 2 2 . . . . 1 1 5 By Crushing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . By other and unspecified methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Execution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sudden Death, cause not ascertained . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ill-defined and unspecified causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 1 Males 127 69 485 681 134 101 372 607 234 87 334 655 151 64 496 711 2654 Females 111 83 561 753 81 68 350 499 190 74 365 629 112 57 530 699 2582 TOTAL DEATHS 238 132 1046 1436 213 169 722 1106 424 161 699 1284 263 121 1026 1410 5236 260 1904] Table C. Showing the Population, Inhabited Houses, Marriages, Births and Deaths for the year 1904, and 10 years preceding. gross numbers. Year. Estimated Population. No. of Inhabited Houses. Marriages. Registered Births. Number of Deaths. Deaths of Residents in Public Institutions. Total all ages. Under one year. Under five 1 2 3 4 5 6 7 8 9 1904 341044 39 920 2 948 8,890 5,236 1,140 1.743 1.576 1894 330,485 39,015 2,694 9,502 5,263 1,229 2,114 1,090 1895 334,058 39,440 2,680 9,879 5,760 1,416 2,219 1,245 1896 337,66b 39,860 2,969 9,921 5,884 1,490 2,498 1,434 1897 337,197 40,079 3,000 9,842 5,395 1,338 2,017 1,295 1898 336,727 42,672 3,205 9,453 5,705 1,504 2,428 1,327 1899 336,259 42.973 3,254 9,658 6,293 1,548 2,315 1,586 1900 335,892 42,959 2,968 9,254 5,721 1.344 1,956 1,542 1901 335,325 38,645 2.994 9,264 5,361 1,290 1,928 1,533 1902 337,268 39,766 3,108 9,214 5,635 1,219 1,906 1,646 1903 339,137 39,902 3,053 8,983 4.839 1,136 1,674 1,539 Average of 10 years. 336,001 40,531 2,992 9,497 5,585 1. 351 2,105 1,415 Notes.—1. Population of Census, 1901 = 334.991 = 159,290 Males 175,701 Females. 2. Average number of persons in each house at Census, 1901 = 8.6. 3. Area of Parish in acres = 3,091.5. 4. Average number of Persons living on each acre at Census, 1901 = 108 261 [1904 Table D. Showing the Annual Birth and Death-rates, Death-rates of Children, and Deaths in Public Institutions per 1,000 Total Deaths, for the year 1904, and 10 years preceding. Year. Birth-rates per 1,000 of the population. Deathrates per . 1,000 of the population. *Corrected Death-rates per 1,000 of the population Deaths of Children under 1 year per 1,000 of Registered Births. Deaths of Children under 1 year per 1,000 of Total Deaths Deaths of Children under 5 years per 1,000 of Total Deaths. Deaths of Residents in Public Institutions per 1,000 of Total Deaths 1 2 3 4 5 6 7 8 1904 26.06 15.35 15.93 128 218 333 301 1894 28.7 15.9 1.7 129 233 401 207 1895 29.6 17.2 18.6 143 245 385 216 1896 28.8 17.1 18..6 150 253 424 244 1897 29.22 16.0 17.1 136 248 374 240 1898 28.1 16.9 18.1 159 264 425 233 1899 28.7 18.0 20.0 160 246 368 252 1900 27.5 17.0 18.2 145 235 342 269 1901 27.6 15.9 16.5 139 241 360 286 1902 26.8 16.4 17.0 132 216 338 292 1903 26.5 14.3 14.8 126 235 346 318 Average of 10 years. 28.1 16.5 I7.6 142 242 376 256 # The Death Rates in column 4 are corrected for sex and age distribution for the purpose of contrasting them on an equal basis with those of England. 262 1904] LOCAL GOVERNMENT BOARD RETURN.—Table I. Table E. Metropolitan Borough of Islington. vital statistics of whole district during 1904 and previous years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of NonResidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District Under 1 Year of Age. At all Ages. Number. Rate.* Number. Rate per 1,000 Births registered. Number. Heath Rate.* Number. Death Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1894 330,485 9,502 28.7 1,229 129 5,091 15.4 1,090 370 542 5,263 15.9 1895 334,058 9,879 29.6 1,416 143 5,733 17.2 1,245 497 524 5,760 17.2 1896 337,666 9,921 28.8 1,490 150 5,749 16.7 1,434 523 658 5,884 17.1 1897 337,197 9,842 29.2 1,338 136 5,370 15.9 1,295 541 566 5,395 16.0 1898 336,727 9,453 28.1 1,504 159 5,746 17.1 1,327 558 517 5,705 16.9 1899 336,259 9,658 28.7 1,548 160 6,395 19.0 1,586 695 593 6,293 18.7 1900 335,892 9,254 27.5 1,344 145 5,767 17.2 1,542 599 553 5,721 17.0 1901 335,325 9,264 27.6 1,290 139 5,222 15.6 1,394 491 630 5,361 15.9 1902 337,268 9,214 26.8 1,219 132 5,530 16.1 1,541 632 737 5,635 16.4 1903 339,137 8,983 26.5 1,136 126 4,772 14.1 1,472 560 627 4,839 14.3 A verages for yrs. 18941903 336,001 9,497 28.1 1,351 142 5,537 16.4 1,393 547 595 5,585 16.5 1904 341,044 8,890 260 1,177 132 5,241 15.4 1,619 632 627 5,236 15.3 * Rates in Columns 4, 8 and 13 calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the tern "non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out 01 the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions" to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. Area of District in acres (exclusive of area covered by water) 3,085 Total population at all ages, 334,991 Number of inhabited houses, 38,645 Average number of persons per house, 8 6 At Census of 1901 LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Metropolitan Borough of Islington.—TABLE F. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1904 AND PREVIOUS YEARS. Names of Localities. 1.—Upper Holloway. 2.— South-West. 3.—Highbury. 4.—South-East. 5 — 6 — 7 — year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births registered. Deaths at all Ages Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a b. c. d. a. b. c. d. a. b. c. d. 1890 89,049 2,740 2,059 — 105,290 3,311 2,007 — 58,399 1,452 1,234 — 63,805 1,916 898 — 1891 90,622 2,751 2,170 — 105,644 3,456 2,065 — 59,452 1,639 937 — 64,273 1,956 1,148 — 1892 92,201 2,753 2,158 — 105,999 3,385 1,813 — 60,509 1,542 952 — 64,742 1,872 1,152 — 1893 93,801 2,768 1,702 409 106,359 3,386 2,303 647 61,581 1,601 1,008 219 65,217 1,994 1,378 320 1894 95,411 2,698 1,458 326 106,721 3,301 1,859 464 62,658 1,608 865 183 65,695 1,895 1,081 256 1895 97,041 2,779 1,564 400 107,088 3,475 2,023 527 63,750 1,621 939 211 66,179 2,004 1,234 278 1896 97,449 2.929 1,603 395 107,457 3,39o 2,099 561 66,146 1,709 997 246 66,614 1,893 1,185 288 1897 97,879 2,904 1,481 347 107,332 3,289 1,855 502 66,283 1,657 886 217 65,703 1,992 1,173 272 1898 98,308 2,793 1,530 414 106,984 3,244 2,050 576 66,417 1,578 931 214 65,ol8 1,838 1,194 300 1899 98,736 2,792 1,698 407 106,397 3,269 2,184 590 66,520 1,651 1,093 238 64,606 1,946 1,318 313 Averages of Years 1890 to 1899 195,047 2,790 1,742 385 106,527 3,350 2,025 552 63,171 1,605 984 218 65,185 1,930 1,176 289 Upper holloway. Lower holloway. Highbury. Barnsbury. South-east. 1900 99,071 2,699 1,635 375 41,618 1,170 738 181 62,092 1,551 932 186 55,445 1,782 1,004 265 77,666 2,052 1,412 337 1901 100,099 2,707 1,454 318 44,433 1,179 688 193 59.540 1,463 898 202 54,457 1,788 I.033 253 79,796 2,127 1,288 324 Tufnell. Upper holloway. Tollington. Lower holloway. Highbury. Barnsbury. South-east. 1902 32,458 745 491 93 34,442 1,131 605 117 34,385 849 527 122 41,486 1,122 714 175 64,519 1,488 945 169 54,368 1,757 1040 266 75,610 2,122 1,313 277 1903 32,838 740 440 83 34,822 1,108 535 138 34,765 850 437 105 41,537 1,126 618 159 65,112 1,460 796 178 54,278 1,648 899 210 75,785 2,051 1,114 263 1904 33,225 799 571 113 35,210 1,066 523 98 35,153 815 475 104 41,589 1,114 693 180 65,717 1,423 775 140 54,146 1,672 963 237 75,964 2,001 1.236 268 Notes.—(a) The separate localities adopted for this Table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes or registration sub-districts. Block 1 may, if desired, be used for the whole district; and blocks 2, 3, &c„ for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (4) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this Table, and those of non-residents registered in public institutions in th° district excluded. (See note on Table I. as to meaning of terms "resident" and "non-resident.") (c) Deaths of residents occurring in public institutions whether within or without the district are to be allotted to the respective localities, according to the addresses of the deceased (d) Care should be taken that the gross totals of the several columns in this Table respectively equal the corresponding totals for the whole districts in Tables I and IV • thus the totals of sub-columns a, b. and c should agree with the figures for the year in the columns 2, 3, and 12 respectively of Table I : the gross total of the sub-columns c should agree with the total of column 2 in Table IV , and the gross total of sub-columns d with the total of column 3 in Table IV. 263 [1904 LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Table G. Metropolitan Borough of Islington. CAUSES OF, AND AGES AT. DEATH DURING YEAR, 1904. Causes of Death Deaths in or belonging to whole District of Residents at subjoined Ages. Deaths in or belonging to Localities of Residents (at all Ages). Total Deaths in Public Institutions in the District, whether Residents or Non-residents. All ages. Under 1 yr. 1 and under 5. 5 and under 15. 15 and under 25 25 and under 65. 65 and upwards Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury Barnsbury. South-East Islington. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Small-pox 1 . . 1 . . . . . . . . . . . . . . . . . . 1 . . . . Measles l8l 51 117 13 . . . . . . 19 22 14 31 19 42 30 25 Scarlet Fever 35 1 25 9 . . . . . . 1 1 10 2 4 6 11 1 Whooping Cough 83 30 48 5 . . . . . . 5 7 5 l6 11 18 21 8 Diphtheria and Membranous Croup 28 2 12 14 . . . . . . 4 3 2 3 3 9 4 3 Croup 3 2 1 . . . . . . . . . . . . . . . . 2 . . 1 . . Fever Typhus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Enteric 18 . . 1 2 4 11 . . 2 1 3 . . 2 3 7 5 Other continued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Epidemic Influenza 48 2 2 . . 3 22 19 4 4 3 6 9 8 14 6 Cholera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Plague . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Diarrhœa 260 200 47 1 . . 5 7 17 19 25 53 28 63 55 9 Enteritis . . 20 . . 1 . . . . . . . . 6 4 5 3 8 5 7 Puerperal Fever 14 . . . . . . 3 11 . . 1 2 1 . . 1 4 5 6 Erysipelas 23 3 . . . . . . 13 7 2 1 4 5 3 4 4 11 Other Septic Diseases 30 5 4 1 4 11 5 4 3 5 3 6 2 7 10 Phthisis 533 12 20 19 80 380 22 50 63 41 73 72 84 150 288 Other Tubercular Diseases 149 34 70 18 11 15 1 . . 8 21 24 21 33 28 30 Cancer, Malignant Disease 323 . . 1 2 5 198 117 37 42 34 40 56 51 63 134 Bronchitis 534 78 31 1 1 148 275 49 42 35 65 74 104 165 183 Pneumonia 392 104 112 9 10 111 46 42 41 38 62 49 64 96 79 Pleurisy 26 . . 2 2 3 14 5 4 1 . . 1 8 9 3 8 Other Diseases of Respiratory Organs 40 3 6 . . 1 19 11 4 . . 3 2 7 11 13 11 Alcoholism Cirrhosis of Liver 80 . . . . . . . . 69 11 13 5 5 4 18 15 20 25 Venereal Diseases 20 12 2 . . 1 5 . . 3 1 2 3 5 3 3 9 Premature Birth 178 178 . . . . . . . . . . 18 15 12 21 26 44 42 6 Diseases and Accidents of Parturition 17 3 . . . . . . . . . . . . . . 2 2 3 4 6 2 Heart Diseases 674 5 5 20 24 331 289 92 69 74 80 89 123 147 221 Accidents 158 38 16 11 5 56 32 12 11 13 28 24 32 18 45 Suicides 40 . . . . . . . . 34 6 2 6 2 5 4 11 10 13 Homicide 4 3 . . . . . . . . . . . . . . 1 . . 1 1 1 . . All other causes 1309 354 76 37 42 387 413 168 150 116 155 227 206 287 474 All causes 5236 1140 603 165 197 1858 1273 571 523 475 693 775 963 1236 1619 264 1004] Table H. Showing the Births, Deaths, Infantile Mortality, the Deaths from the Principal Zymotic Diseases, and from Influenza Cancer. Phthisis, and Puerperal Fever occurring in the Year 1904, and during the Years 1894-1903- Year. Births. Birth-rates. Deaths. Death-rates. Deaths of Infants under 1 year of age. Deaths under 1 year to 1 000 Births. Deaths from the Principal Zymotic Diseases. Total Zymotic Death rates Influenza. Cancer Phthisis. Puerperal Fever Totals. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and undefined Fevers. Diarrhœal Diseases. Deaths. Death-rates Deaths. Death-rates Deaths. Death rates. Deaths Deaths in 1,000 births 1894 9,502 28.7 5,263 15.9 1,229 129 808 3 199 69 218 188 . . 36 . . 95 2.44 51 0.15 239 0.72 539 1.63 8 0.84 1895 9.879 29.6 5,760 17.2 1,416 143 650 1 135 66 144 81 1 30 3 189 1.94 179 0.53 266 0.79 566 1.70 12 1.21 1896 9,921 28.8 5,884 17.1 1,490 150 1038 1 285 57 257 234 . . 46 2 153 3.07 33 0.09 291 0.85 530 1.54 11 1.11 1897 9.842 29.2 5,395 16.0 1,338 136 638 1 97 61 131 130 . . 44 . . 174 1.89 47 0.14 304 0.90 520 1.54 10 1.01 1898 9.453 28.1 5,705 16.9 1,504 159 933 . . 325 26 93 168 1 36 1 283 2.77 65 0.19 283 0.84 527 1.56 7 0.74 1899 9,658 28.7 6,293 18.7 1,548 160 781 . . 155 33 128 160 . . 47 . . 258 2.32 126 0.37 270 0.80 583 1.73 14 1.45 1900 9.254 27.5 5,721 17.0 1,344 145 660 1 159 24 106 142 . . 46 2 180 1.96 49 0.44 303 0.90 602 1.79 6 0.65 1901 9,264 27.6 5,361 15.9 1,290 139 628 8 151 30 134 85 . . 47 1 172 1.87 46 0.14 289 0.86 545 1.62 15 1.62 1902 9.214 26.8 5,635 16.4 1,219 132 608 53 114 40 104 152 . . 45 1 99 1.80 83 0.24 336 0.95 515 1.50 12 1.30 1903 8,983 26 5 4,839 14.2 1,136 126 471 . . 120 24 43 152 . . 22 1 109 1.39 40 0.12 350 1.03 492 1.45 9 1.00 Corrected average. 9,639 28.3 5,670 16.6 1.371 142 732 7 177 44 138 151 . . 41 1 173 2.15 83 0.24 296 0.87 550 1.61 10 1.04 1904 8,890 26.0 5.236 15.3 1,140 128 606 1 181 35 28 83 . . 18 . . 260 1.78 48 0.14 323 0.95 533 1.56 14 1.57 Departure from average. -749 -23 -434 -1.3 -231 -14 -126 -6 +4 -9 -110 -68 . . -23 -1 + 87 -0.37 -35 -0.10 +27 —0.08 — 17 —0.05 +4 +0.53 265 Table I. Showing the deaths since 1882 from the several diseases specified, under and above five years of age, and the total number of deaths, with death-rate per 1,000. Year. Population in the middle of the year. Ages Deaths from the principal diseases of a Zymotic nature. Deaths from Tubercular Diseases. Deaths from Diseases of the Organs. Deaths from Diarrhœa. Deaths from Diseases of the Digestive Organs. Deaths from Violence. Total Deaths Death Rate per 1000. Total Total Total Total Total Total † 1882 287,191 under 5 years 580 739 236 753 530 1,146 137 149 53 248 65 126 5,464 18.3 above 5 „ 159 517 616 12 195 61 † 1883 290,711 under 5 „ 385 536 269 836 522 1,088 149 162 45 227 53 104 5,140 17.6 above 5 ,, 151 567 566 13 181 51 † 1884 294,267 under 5 ,, 302 683 313 835 463 978 247 266 43 274 71 129 5,229 17.7 above 5 „ 181 522 313 19 231 58 † 1885 297,867 under 5 „ 592 749 217 706 330 1,197 172 191 36 268 53 104 5,740 19.3 above 5 „ 157 489 667 19 232 47 † 1886 301,512 under 5 ,, 313 396 202 772 493 1,201 291 307 49 231 57 127 5,434 18.0 above 5 „ 83 480 706 l6 182 70 † 1887 305,112 under 5 ,. 593 687 252 725 494 1,169 275 291 69 246 64 122 5,699 18.7 above 5 „ 94 473 677 16 177 58 † 1888 308,936 under 5 ,, 411 313 218 671 442 1,040 131 146 62 253 54 115 3,197 16.8 above 5 „ 194 453 598 15 191 64 † 1889 312,713 under 5 „ 326 425 104 702 395 970 157 170 67 250 60 120 5,035 16.1 above 5 ,, 99 508 575 13 183 60 † 1890 316,543 under 5 ,, 416 496 260 785 569 1,406 134 169 82 250 73 166 6,152 19.4 above 5 „ 80 525 837 15 168 83 † 1891 319,991 under 5 „ 486 587 207 717 624 1,476 131 146 82 263 65 133 6,326 19.8 above 5 „ 101 510 852 15 181 68 † 1893 323,451 under 5 „ 378 481 198 677 509 1,301 143 156 88 270 71 139 6,975 18.8 above 5 „ 13 479 792 13 182 68 1893 326,958 under 5 „ 466 634 224 758 452 1,131 223 237 136 379 84 206 6,394 19.5 above 5 ,, 168 534 176 861 14 243 122 1894 330,485 under 5 „ 347 703 673 420 973 84 93 131 330 78 173 5,263 15.9 above 5 „ 156 497 553 9 199 95 1895 334,058 under 5 „ 341 450 240 763 461 1,131 172 188 168 389 76 191 5,760 17.2 above 5 „ 109 523 218 170 16 221 115 1896 337,666 uuder 5 „ 693 675 730 494 141 153 158 380 80 206 5,884 17.1 above 5 „ 182 512 503 997 12 222 126 1897 337,197 under 5 „ 328 448 178 689 439 975 161 174 151 380 69 186 5,395 16.0 above 5 „ 120 511 556 13 220 117 1898 136,727 under 5 „ 557 647 179 686 426 1,013 266 283 208 409 68 174 5,705 16.9 above 5 „ 90 172 507 587 17 201 106 1899 336,259 under 5 „ 397 515 174 729 420 1,272 241 258 266 487 85 229 6,293 18.7 above 5 „ 118 555 852 17 221 144 1900 313,892 under 5 „ 375 480 135 710 411 1,132 164 180 160 387 58 195 5,721 17.0 above 5 „ 105 575 721 16 218 137 1901 333,323 under 5 „ 347 455 143 677 381 986 158 172 152 423 70 180 5,362 15.9 above 5 „ 108 534 605 14 242 110 1902 337,268 under 5 „ 367 508 154 672 435 1,242 94 99 144 366 85 240 5,635 16.4 above 5 „ 141 518 807 5 222 155 1903 339,137 under 5 „ 308 362 132 532 341 874 102 199 136 298 62 190 4,839 14.2 above 5 „ 54 300 533 7 162 128 1904 341,044 under 5 „ 288 348 136 682 339 905 247 460 91 395 57 202 5,236 15.3 above 5 „ 58 546 656 13 214 145 * This includes Small-pox, Measels, Scarlatina, Typhoid Fever, Diptheria and Whooping Cough. † The deaths in these years do not include those of ??? occurring in outlying institutions. LOCAL GOVERNMENT BOARD RETURN.—Table III. Table J. Cases of Infectious Disease coming to the knowledge of the Medical Officer of Health during the year 1904. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 Under 1. 1 to 5. 5 to 15 15 to 25. 25 to 65. 65 and upwards. Tufnell. Upper holloway Tollington. Lower Holloway Hig-bury. Barnsbury. South-East Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Small-pox 17 . . 2 1 5 9 . . . . . . . . 1 . . 12 4 . . . . . . 1 . . 12 4 Cholera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Diphtheria 347 7 125 155 27 32 1 28 37 45 37 59 79 62 16 26 38 26 33 68 53 Membranous Croup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Erysipelas 280 7 9 22 38 185 19 36 19 30 29 46 45 75 11 2 5 7 6 1 14 Scarlet Fever 1146 14 324 696 76 35 1 72 76 222 135 203 231 207 58 69 205 121 165 225 181 Typhus Fever 1 . . . . . . 1 . . . . 1 . . . . . . . . . . . . 1 . . . . . . . . . . . . Enteric Fever 126 . . 12 33 36 45 . . 13 10 10 16 27 26 24 11 6 7 15 24 23 22 Relapsing Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Continued Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Puerperal Fever 24 . . . . . . 10 14 . . 5 4 3 . . 3 6 3 2 1 . . . . . . 5 1 Plague . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Totals 1941 28 472 907 193 320 21 155 146 310 218 338 399 375 99 104 255 170 228 334 275 266 267 [1904 Table K. Showing the Cases of Small Pox that occurred in the several Wards from 1891 to 1904. Year. Tufnell. * Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's Totals. 1891 . . . . . . 1 . . . . . . . . . . . . . . 1 1892 . . 12 . . 12 . . 7 . . . . 9 1 1 42 1893 . . 41 . . 28 6 3 14 6 6 5 9 118 1894 17 8 2 5 2 3 10 . . 15 2 26 90 1895 1 6 3 1 1 1 2 4 1 . . 5 25 1896 8 3 25 1 6 5 1 1 . . . . . . 50 1897 1 1 . . . . . . . . . . . . . . 1 . . 3 1898 . . . . . . . . . . . . . . . . . . . . . . . . 1899 . . . . 2 . . . . . . . . . . . . . . 1 3 1900 . . 1 . . 1 . . 1 . . . . . . . . . . 2 1901 3 . . . . 11 4 1 13 6 4 4 4 50 1902 9 34 28 32 17 13 25 33 7 16 62 276 1903 3 1 . . 2 . . . . . . . . . . 1 2 9 1904 . . . . . . 1 . . . . 12 . . 2 2 . . 17 * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards. † The figures for 1891-2 are inclusive of Highbury. Table L. Showing the Cases 0f Scarlet Fever that occurred in the several Wards from 1891 to 1904. Year. Tufnell. *Upper Holloway. Tollington. Lower Holloway. Highbury. †Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St.Peter's. Totals. 1891 ... 229 ... 108 ... 99 55 59 27 46 105 728 1892 ... 435 ... 225 ... 313 148 100 94 194 200 1709 1893 ... 790 ... 368 ... 633 355 209 136 201 187 2880 1894 176 235 114 196 152 67 165 116 91 90 91 1493 1895 142 166 220 214 168 117 182 89 108 112 174 1692 1896 181 244 191 169 230 127 150 149 104 191 295 2031 1897 144 153 193 187 137 126 !55 91 76 113 202 1577 1898 159 151 152 182 151 102 114 38 58 107 122 1336 1899 100 172 183 178 176 n8 117 102 79 98 171 1494 1900 78 85 102 138 152 90 85 66 51 107 120 1074 1901 97 109 129 172 178 83 137 86 61 93 141 1286 1902 140 147 160 187 121 88 187 67 45 94 136 1372 1903 76 78 113 129 130 70 88 42 28 36 75 865 1904 72 76 222 135 127 65 147 84 45 103 70 1146 * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards. † The figures for 1801-2-3 are inclusive of Highbury. 268 1904] Table M. Shewing the Cases of Diphtheria that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Toliington Lower Holloway. Highbury Mildmay Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 . . 305 . . 43 . . 112 37 44 44 54 73 712 1092 . . 299 . . 43 . . 95 49 43 54 37 75 695 1893 . . 283 . . 57 . . 140 94 46 55 62 117 855 1894 86 91 177 131 93 40 81 37 45 25 97 843 1895 64 77 50 67 80 21 46 28 21 34 76 564 1896 129 177 84 89 87 46 200 95 29 49 82 1067 1897 71 77 118 66 43 60 81 43 30 52 59 700 1898 44 52 50 36 41 64 54 30 26 92 42 531 1899 148 99 88 56 62 28 28 29 39 52 59 688 1900 61 64 46 62 49 74 47 43 55 38 85 624 1901 83 69 61 104 87 55 96 67 61 60 159 902 1902 128 100 62 165 106 38 73 31 29 55 84 871 1903 43 45 47 120 37 17 34 17 21 36 35 452 1904 28 37 45 37 26 28 49 30 13 25 29 347 Table N. Showing the Cases of Membranous Croup that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Toliington, Lower Holloway. Highbury. Mildmay. Thornhill, Barnsbury. St. Mary's. Canonbury. St. Peter's, Totals. 1891 . . 20 . . 2 . . 5 . . 1 1 2 10 44 1892 . . 10 . . 3 . . 10 3 1 . . 8 6 43 1893 . . 10 . . 5 . . 3 3 3 1 . . 5 30 1894 2 2 . . 5 . . 2 6 1 . . 5 1 24 1895 1 3 . . 3 3 1 1 . . 1 1 4 18 1896 3 3 . . 4 4 1 3 1 1 1 3 24 1897 2 4 2 5 . . . . 1 . . . . 3 3 29 1898 2 4 . . 1 1 . . 4 . . 1 . . . . 13 1899 2 1 1 2 1 1 3 2 1 . . 3 17 1900 2 . . . . 1 1 . . 1 2 . . 1 1 9 1901 1 . . 1 1 . . 2 1 2 . . 1 .. 9 1902 . . 1 . . 3 1 . . 1 1 . . . . . . 7 1903 . . . . . . 1 . . . . 1 . . . . . . 1 3 1904 . . . . . . . . . . . . . . . . . . . . . . . . 269 [1904 Table O. Showing the Cases of Typhoid Fever that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 61 .. 25 .. 33 31 15 8 5 11 189 1892 .. 78 .. 19 .. 49 25 16 7 12 13 219 1893 .. 88 .. 19 .. 56 17 17 9 24 21 251 1894 24 23 18 32 25 23 19 21 9 21 30 245 1895 21 16 12 25 26 22 10 9 9 14 20 184 1896 17 22 19 35 30 15 40 10 9 12 20 229 1897 25 25 43 34 25 27 20 18 10 11 18 256 1898 22 34 24 30 26 21 18 16 10 15 21 237 1899 39 40 94 24 49 !7 31 17 '5 16 11 353 1900 14 37 42 25 23 27 34 15 9 13 20 259 1901 32 42 19 39 22 28 15 14 14 27 29 281 1902 29 22 18 32 23 12 37 25 11 20 28 257 1903 9 13 14 11 13 13 21 7 4 13 12 130 1904 13 10 10 16 6 20 23 3 2 8 15 126 Table P. Showing Cases of Typhus Fever that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Hollowav. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 •• •• •• •• •• •• •• 1 •• •• 1 2 1892 •• •• •• •• •• •• •• •• •• •• •• •• 1893 •• 1 •• •• •• •• •• •• •• •• •• 1 1894 •• •• •• 1 •• •• •• •• •• •• •• 1 1895 3 •• •• •• •• •• •• 2 •• •• •• 5 1896 •• •• •• •• •• •• •• •• •• •• •• •• 1897 •• •• •• •• •• •• •• •• •• •• •• •• 1898 •• •• 1 •• •• •• •• •• •• 1 •• 2 1899 •• •• •• •• •• •• •• •• •• •• •• •• 1900 •• •• •• •• 1 •• •• •• •• •• •• 1 1901 •• •• •• •• •• •• 1 1 •• •• •• 2 1902 •• •• •• •• •• •• •• •• •• •• •• •• 1903 •• •• •• •• •• •• •• •• •• •• •• •• 1904 1 •• •• •• •• •• •• •• •• •• •• 1 270 1904] Table Q. Showing the Cases of Erysipelas that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury St. Mary's. Canonbury. St Peter's. Totals. 1891 .. 139 .. 23 .. 42 30 28 13 23 45 343 1892 .. 194 .. 46 .. 80 35 39 44 39 73 550 1893 .. 244 .. 70 .. 75 63 51 49 41 79 672 1894 34 85 23 59 29 19 43 19 20 26 38 395 1895 29 62 ?3 38 36 24 26 21 16 12 33 319 1896 54 65 20 51 35 30 22 29 18 22 39 385 1897 24 66 21 38 25 26 19 15 16 19 43 312 1898 23 60 20 31 22 16 !5 17 13 22 40 279 1899 15 70 36 47 25 12 39 23 22 19 12 350 1900 31 45 25 30 24 13 29 16 15 20 37 285 1901 24 52 30 16 18 14 37 10 15 25 44 285 1902 33 47 34 41 30 18 33 19 13 51 38 357 1903 23 28 22 25 16 10 25 10 12 31 25 227 1904 36 19 30 29 23 19 30 15 16 38 25 280 Table R. Showing the Cases of Puerperal Fever that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 10 .. 9 .. 7 2 1 1 .. 3 33 1892 .. 28 .. 5 .. 7 5 2 2 .. 2 51 1893 3 5 4 7 5 3 3 3 2 .. 3 38 1894 1 3 6 4 3 2 2 I I .. 23 1895 1 2 I a 6 2 3 I I 3 22 1896 3 2 3 5 2 1 5 2 I 3 3 30 1897 5 6 2 4 3 1 4 I 1 27 1898 .. .. 2 2 .. 3 2 I 4 3 19 1899 1 7 4 9 1 1 4 3 .. 1 2 33 1900 4 2 1 3 3 .. .. 2 .. 1 16 1901 2 3 4 5 5 .. 3 4 .. 3 3 34 1902 2 1 2 1 4 .. 5 .. .. 3 1 19 1903 3 4 1 4 4 1 .. 1 .. .. 1 19 1904 5 4 3 •• 2 1 5 1 1 1 1 24 271 [1904 Table S. Showing the Cases of Continued Fever that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's Canonbury. St. Peter's. Totals. 1891 .. 1 .. 2 .. .. 3 .. .. .. .. 6 1892 .. 2 .. .. .. 3 .. .. .. 1 .. 6 1893 .. .. .. .. 1 .. 1 .. .. 1 2 7 1894 .. .. 2 1 3 .. .. .. .. 1 .. 7 1895 .. 4 1 .. 1 3 .. .. .. .. .. 9 1896 .. 2 .. .. .. 1 1 .. .. .. .. 6 1897 .. .. .. .. .. .. .. .. .. .. 1 1 1898 .. .. .. .. .. .. .. .. .. 1 .. 1 1899 .. .. .. .. .. .. 1 .. .. .. 1 2 1900 .. .. .. 3 .. .. .. .. .. 1 .. 6 1901 .. .. .. 1 .. .. 1 .. .. .. 1 3 1902 .. .. .. .. .. .. 5 .. .. .. .. 5 1903 1 .. .. .. .. .. .. .. .. 1 .. 2 1904 .. .. .. .. .. .. .. .. .. .. .. .. Table T. Showing the Cases of Relapsing Fever that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 1 .. .. .. .. .. .. .. .. .. 1 1892 .. .. .. .. .. .. .. .. .. .. .. .. 1893 .. .. .. .. .. .. .. .. .. .. .. .. 1894 .. .. .. .. .. .. .. .. .. .. .. .. 1895 .. .. .. 1 .. .. .. .. 1 .. .. 2 1896 .. .. .. .. .. .. .. .. .. .. .. .. 1897 .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. .. 1901 .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 1904 .. .. .. .. .. .. .. .. .. .. .. .. 272 1904] Table U. Showing the Cases of Cholera that occurred in the several Wards from 1891 to 1904. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals 1891 . . . . . . . . . . . . . . . . . . . . . . . . 1892 . . . . . . . . . . . . . . . . . . . . 3 3 1893 . . . . . . . . . . . . 1 . . . . . . . . 1 1894 . . . . . . . . 1895 . . . . . . . . . . . . . . . . . . . . . . . . 1896 . . . . . . . . . . . . . . . . . . . . . . . . 1897 . . . . . . . . . . . . 1 . . . . . . . . 1 1898 . . . . . . . . . . . . . . . . . . . . . . . . 1899 . . 2 1 . . . . . . . . . . . . . . . . 3 1900 . . . . . . . . . . . . . . . . . . . . . . . . 1901 . . . . . . . . . . . . . . . . . . . . . . . . 1902 . . . . . . . . . . . . . . . . . . . . . . . . 1903 . . . . . . . . . . . . . . . . . . . . . . 1904 . . . . . . . . . . . . . . . . . . . . . . . . *Asiatic Cholera. 278 [1904 Table V. Showing the Analyses (made monthly) of the New River Company's Water Supply recorded during the Year. Analyses of Samples taken from the Works of the Company. 1904. Total Solid Matter. Chlorine. Equal to Chloride of Sodium. Nitrogen as Nitrates. Nitrogen as Ammonia. Oxygen required to oxidise Organic Matter. Degree of Hardness. Degree after boiling¼ of an hour. Organic Carbon. Organic Nitrogen. January 26.00 1.296 2.124 0.323 0.000 0.026 18.22 4.59 . . . . February 24.00 1.296 2.124 0.229 ,, 0.064 16.52 4.80 . . . . March 23.90 1.296 2.124 0.261 ,, 0.016 17.37 3.99 . . . . April 21.00 1.296 2.124 0.219 ,, 0.012 15.47 3.19 . . . . May 20.60 1.368 2.242 0.208 ,, 0.008 15.89 3.59 . . . . June 19.40 1.368 2.242 0.156 ,, 0.016 14.84 3.40 . . . . July 22.00 1.440 2.360 0.198 ,, 0.015 14.63 3.00 . . . . August 21.50 1.368 2.242 0.167 ,, 0.022 14.84 3.00 . . . . September 22.00 1.296 2.124 0.208 ,, 0.012 16.10 3.10 . . . . October 22.90 1.296 2.124 0.229 ,, 0.008 15.89 3.19 . . . . November 21.20 1.368 2.242 0.208 ,, 0.003 15.89 3.19 . . . . December 23.50 1.368 2.242 0.219 ,, 0.003 16.73 4.10 . . . . Average 22.33 1.338 2.193 0.219 0.000 0.017 16.03 3.59 . . . . Analyses of Samples taken from the Mains of the Company. 1904. Total Solid Matter. Chlorine. Equal to Chloride of Sodium. Nitrogen as Nitrates. Nitrogen as Ammonia. Oxygen required to oxidise Organic Matter. Degree of Hardness. Degree after boiling ¼ of an hour. Organic Carbon. Organic Nitrogen. January . . 1.332 2.183 0.286 0.000 1.00l8 17.79 . . 0.092 0.012 February . . 1.350 2.212 0.247 ,, 0.044 17.37 . . 0.135 0.017 March . . 1.368 2.242 0.271 ,, 0.027 17.72 . . 0.087 0.010 April . . 1.320 2.163 0.226 ,, 0.013 15.75 . . 0.060 0.008 May . . 1.350 2.212 0.216 ,, 0.010 15.57 . . 0.059 0.007 June . . 1.404 2.301 0.169 ,, 0.016 15.52 . . 0.051 0.006 July . . 1.464 2.399 0.194 ,, 0.012 14.49 . . 0.032 0.006 August . . 1.350 2.212 0.195 ,, 0.016 15.15 . . 0.055 0.006 September . . 1.350 2.212 0.200 ,, 0.008 15.21 . . 0.037 0.005 October . . 1.350 2.212 0.221 ,, 0.010 15.68 . . 0.032 0.005 November . . 1.368 2.242 0.212 ,, 0.006 16.52 . . 0.026 0.004 December . . 1.386 2.271 0.237 ,, 0.009 17.15 . . 0.049 0.005 Average . . 1.366 2.238 0.222 0.000 0.016 16.16 . . 0.059 0.008 T 274 1904] Table W. BATHS AND WASHHOUSES. Table showing the Number of Persons using the Swimming Baths, Private Baths, and the Washhouses during 1904. Swimming Baths. Bathers. Caledonian Road Hornsey Road Essex Road. Total. Public. 1st class Males 13,180 49,903 15,965 79,048 Females 146 11,246 1,825 13,217 2nd class Males 28,917 40,594 24,912 94,423 Females 1,968 4,722 3,129 9,819 Schools. 1st class Boys 919 12,076 2,494 15,489 Girls 2,443 14 2,457 2nd class Boys Girls 38,689 20,990 34,232 12,259 37,647 11,955 110,568 45,204 Totals 104,809 167,475 97,941 370,225 Private (Slipper Baths.) 1st class Males 18, 60 33-886 16,928 68,874 Females 1,409 4,097 2,364 7,870 2nd class Male 55,296 54,852 53,147 163,295 Females 16,571 19,935 2 ,977 57,483 Totals 91,336 112,770 93,416 297,522 Washhouses. Washers 32,019 24,997 56,859 "3,875 Total Persons using the Establishments. Total persons using each establishment in 1904 228,164 305,242 248,216 781,622 275 1904 LONDON COUNTY COUNCIL RETURN. PROCEEDINGS DURING 1904. PREMISES. Number of Places— Number of inspections, 1904. Number of Notices. 1904. Number of Prosecutions 1904. On Register at end of 1903. Added in 1904. Removed in 1904. On Register at end of 1904. Milk premises 674 30 ... 704 1112 98 5 Cowsheds 12 None 2 10 139 ... 1 Slaughter-houses 40 ,, ... 40 2242 ... ... Other offensive trade premises 7 ,, ... 7 202 ... 1 Ice cream premises 183 51 ... 234 280 75 ... Registered houses let in lodgings 655 93 1 749 9189 1(a)* 51 (a)*... (b)†455 (b)†... * (a) For overcrowding. †(b) For other conditions. Overcrowding, 1904. Number of dwelling rooms overcrowded 159 Number remedied 159 Number of prosecutions — Underground rooms - Illegal occupation dealt with during year 67 Number of rooms closed Insanitary houses— Number closed under the Public Health (London) Act, 1891 — Number closed under the Housing of the Working Classes Act - Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 14 276 1904 Revenue Acts— Number of houses for which applications were received during year 31 Number of tenements comprised therein 290 Number of tenements for which certificates were (a) granted 176 (b) refused 114 (c) deferred — Number of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. 2 (b) For prevention of nuisance arising from offensive matter ning out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. — if) As to cesspools and privies, removal and disposal of refuse, etc. (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. (t) With respect to sufficiency of water supply to water closets — (;') With respect to drainage, etc. (Metropolis Management Act, section 202) 1 (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) 3 Mortuaries— Total number of bodies removed 660 Total number of infectious bodies removed 3 APPENDIX II. REPORT ON OVERCROWDING IN ISLINGTON BY The Medical Officer of Health. The Metropolitan Borough of Islington. R EPORT ON OVERCROWDING BY THE MEDICAL OFFICER OF HEALTH (Printed by order of the Public Health Committee, March 21st, 1904). LONDON: Vail & Co., Printers to the Council, 170, Farringdon Roap, E.C. OVERCROWDING IN ISLINGTON. To the Chairman and Members of the Public Health Committee. Gentlemen,— In 1894 I presented a report, whicli was included in my Annual Report for 1893, showing the conditions which prevailed at that time in Islington with respect to overcrowding. That report was based on the returns respecting population, houses and tenements which were contained in the 1891 Census of London, published towards the close of 1893. Again in March, 1902, I presented another report based on the Census of 1901, which showed how far the overcrowded conditions had been improved. It is necessary to consider much of that information now, and I have therefore incorporated a large portion of it in the present report. Since then, through the courtesy of the Statistical Officer of the London County Council, particulars relating to the Enumeration Areas into which the Borough had been divided for the purposes of the Census have been placed at my disposal, so that it is possible to point more definitely to those parts of the Borough which are most overcrowded. But first it is essential that we should start with a fixed idea as to what is meant by the term "overcrowding." In 1894, I pointed out that it was not always the mere allowance of cubic feet, per individual occupying a room, which taken alone should be the determining quantity, but that consideration should be given to several other important factors, such as:— (a) The occupation of the room both as a sleeping and a living room. (b) The outward surroundings or situation of the house or room. (c) The work or employment carried on in the house or room; and (d) The ventilation, light, and sanitary circumstances generally of the house. These are without doubt factors to be carefully considered in dealing with a case of overcrowding; but as it is not possible to lay them down in any 4 by-laws, a ready general rule has been adopted in the Local Government Board Model By-laws, as well as in the by-laws of nearly all sanitary authorities, which requires 300 cubic feet for each adult dwelling in rooms occupied solely as sleeping rooms, and 400 cubic feet for each adult dwelling in rooms which are used as living and sleeping apartments, and half these amounts for each child under ten years of age. These limits vary somewhat in different districts, although they have been generally adopted in London. In discussing the census returns, however, it is not possible to judge the overcrowding on these lines, because the necessary data are not given in them; and, consequently, I am forced to fall back on the definition of "overcrowding" which Dr. Ogle gave in the "General Report" on the Census of 1891, but which is, in my opinion, too stringent for legal purposes, although for the purpose of considering the general question it might be applicable. It ran as follows:— "It is plain the number of rooms and occupants is not in itself an absolutely sure guide, because rooms differ largely from each other in size. Still we may be tolerably certain that the rooms in tenements with less than five rooms will not, in any but exceptional cases, be of large size, and that ordinary tenements which have more than two occupants per room, bedrooms and sitting rooms included, may be safely considered as overcrowded." At the census of 1901 it was ascertained that there were 38,645 inhabited houses in the borough, and that they contained 79,129 tenements. This was an increase of 770 houses and of 6,477 tenements on the returns for 1891. The number of persons living in each house, it was also ascertained, numbered 8.6 as against 8.4 ten years previously. From these figures it might be fairly assumed, even if there had been no special return with respect to tenements, that more houses were now let out in tenements than had been the case in 1891. This is, in fact, the case. Indeed, at the present time there is no metropolitan borough which contains so many tenements as Islington. The borough that approaches nearest to it in this respect is Lambeth, wherein there are 70,887 tenements, of which, however, only 44,495 contain less than five rooms, as against 55,801 in this borough. A comparison between the number of one to four-room tenements in Islington, as enumerated at the last census, and at that of 1891 shows that one-room tenements have increased by 99, two-room tenements by 2,218 5 three-room tenements by 2,573, and four-room tenements by 1,518; thus making a total increase of 6,408 tenements with four rooms and under:— 1-room tenements 2 „ „ 3 ,, ,, 4 „ Totals 1891. 12,856 16,716 11,806 8,015 49,393 1901. 12,955 18,934 14,379 9,533 55,801 Increase. 99 2,218 2,573 1,518 6,408 Although tenements of four rooms and under have increased in number, yet the number of those that had been overcrowded have decreased. Thus the one-room tenements only showed an increase in the number of those tenements which held only one or two persons, and which, therefore, were not overcrowded; while those that contained four and more persons decreased; the general result being that overcrowded one-room tenements decreased by 743. This was practically the case also with the two-room tenements, which showed a decrease of 300 in the number of overcrowded tenements; with the three-room tenements which showed a decrease of 90 overcrowded tenements; and with the four-room tenements which showed a decrease of 105 overcrowded tenements. Altogether this wa^ an exceedingly satisfactory return, which can be better understood by a study of Tables I., II., III., and IV. When the numbers dwelling in these tenements are examined, it is found that there were on an average 2.0 persons living in each one-room tenement, as against 2.19 in 1891; 3.46 persons in each two-room tenement, as against 3.63 in 1891; 4.01 in each three-room tenement, as against 4.21 in 1891; and 4.96 in each four-room tenement, as against 5.21 in 1891, all of which averages are below the standard of the Registrar-General, and, therefore, it is plain that taken all round these tenements are not overcrowded. Nevertheless a study of the census returns shows that there is still a large amount of overcrowding, although it has been considerably reduced since the preceding census, notwithstanding the fact that the population has increased by 15,836 persons. In 1891,4,057 one-room tenements were overcrowded; whereas in 1901, there were 3,314, or a decrease of 743. 6 In 1891, 4,755 two-room tenements were overcrowded; whereas in 1901, there were 4,455, or a decrease of 300. In 1891, 1,752 three-room tenements were overcrowded; whereas in 1901, there were 1,662, or a decrease of 90. In 1891, 743 four-room tenements were overcrowded; whereas in 1901, there were 638, or a decrease of 105. In 1891,15,150 persons were overcrowded in one-room tenements, whereas in 1901, there were 11,772, or a decrease of 3,378 persons. In 1891, 28,524 persons were overcrowded in two-roomed tenements, whereas in 1901, there were 26,056, or a decrease of 2,468. In 1891, 13,742 persons were overcrowded in three-room tenements, whereas in 1901, there were 12,914, or a decrease of 828. In 1891, 7,188 persons were overcrowded in four-room tenements, whereas in 1901, there were 6,206, or a decrease of 982. Altogether in 1891, there were 64,604 persons living in all "overcrowded" tenements containing less than five rooms, while in 1901, there were still 56,948 persons, or 17-0 per cent of the population, so living, or a decrease of 7,656. These important facts are tabulated in the following statement:— Overcrowded Tenements. Overcrowded Persons. 1891 1901 Decrease. 1891 1901 Decrease. 1 room tenements 4,057 3,314 743 15,150 11,772 3,378 2 „ ,, 4,755 4,455 300 28,524 26,056 2,468 3 ,, ,, 1,752 1,662 90 13,742 12,914 828 4 ,, ,, 743 638 105 7,188 6,206 982 11,307 10,069 1,238 64,604 56,948 7,656 The "overcrowding" that these figures represent is based on the definition of that word as laid down by the Registrar-General, the meaning of which I have already explained. I do not for a moment think it is a practical basis to work upon, however desirable it may be, in Islington or elsewhere. While I am of opinion that not more than two persons should under any circumstances be allowed to dwell in a one-room tenement, wherein you must recollect that food is prepared and cooked, clothes washed, and other domestic duties undertaken, and also wherein people live as well as sleep; I am also of 7 opinion that a two-room tenement does not necessarily hold its full complement with four people, or a three-room tenement with six people, or a four-room tenement with eight people. Indeed it would not be possible to enforce such a restriction, either by legal means or moral suasion. The houses in Islington are, as a rule, larger than those to be found in the majority of the districts in London. Indeed, it is a rare circumstance that a room contains less than 1,000 cubic feet, especially in the older houses, which were formerly occupied by families of good position in life, but are now let out as tenement dwellings. A room of this size, on the basis of the Local Government Board's Model By-laws, would accommodate three adults for sleeping purposes alone, or two adults, and two children, or six children under 10 years old, for two children count as one adult. Consequently some greater allowance than that defined by the Registrar-General must be made when dealing with overcrowding as a practical question. If this be granted, then, if two persons be allowed to a one-room tenement, five persons to a two-room tenement, seven to a threeroom tenement, and nine to a four-room tenement, and these figures are low, it is found that whereas in 1891, 44,187 persons were overcrowded, there were still in 1901, 36,771. Nevertheless, 7,41(5 persons were living in comfort in the latter year ivlio previously had been living in discomfort. Thus there has been a reduction of 16.8 per cent. in the overcrowded residents, but there remain, however, 11*0 per cent, of the population living in overcroivded tenements. This statement is based on the following figures:— Overcrowded Persons. 1891. 1901. Decrease. 1 room tenements 15,150 11,772 3,378 2 ,, ,, 17,849 15,041 2,808 3 ,, ,, 7,708 6,803 905 4,, ,, 3,480 3,155 325 44,187 36,771 7,416 I think the reduction in the overcrowding is eminently satisfactory, especially recollecting the great demand that there is at all times in Islington for the tenements, and the consequent temptation to property owners to let 8 them, at enhanced rents, to those persons, who, unfortunately, are saddled with large families. The decrease in the overcrowding is rendered all the more remarkable from the fact that, compared with 1891, there are now 16,093 more persons living in tenements of less than five rooms than in 1901. The actual figures are: 1891180,330 1901 196,423 Increase 16,093 These figures are referred to the several tenements in the following manner:— Persons. Increase or decrease. 1891 1901 1 room tenements 28,189 25,988 - 2,201 2 ,, „ 60,639 65,508 + 4,869 3 ,, ,, 49,762 57,671 + 7,909 4 ,, ,, 41,740 47,256 + 5,516 180,330 196,423 +16,093 The persistent efforts of your Public Health Department during the last nine years to prevent overcrowding have been well rewarded, as shown by the above figures. They have been continuous, and have been successful, not so much by serving notices to abate overcrowding as by calling on the landlords to provide additional water-closet accommodation where the number of persons living in a house exceeded twelve. The trouble, inconvenience and cost of making this provision have had far more effect, both in reducing and preventing overcrowding, especially in the smaller class of houses, than any notices to reduce it could have had. So long as the cost and inconvenience fell on the tenant alone, some owners did not trouble very much how their houses were occupied, but when their pockets were touched, a reduction in the number of occupiers followed almost as a matter of course. Up to this poiDt the overcrowding of the Borough as a whole has only been considered. It now, however, becomes essential to consider it more in detail; and in order to do this it has been necessary to go through innumerable returns, to make many calculations, and to examine maps and records which are in the possession of the London County Council. 9 In considering how it would be possible to make a minute inquiry into the question of how the people are housed, I came to the conclusion that the best, and indeed, the only accurate method would be to take the sub-registration districts as the starting point, that is to say those districts over each of which there is a registrar of births and deaths, whose boundaries and populations are well defined, and about which positive information was obtained at the last census. These sub-districts are five in number and are known as (1) Upper Holloway; (2) Lower Holloway; (3) Barnsbury; (4) Islington South East; and (5) Highbury. I do not intend to enter into every particular respecting these sub-districts, but only such as are of immediate concern, and should be known so far as they relate to the subject under consideration. Their sizes are very unequal, varying from l,0243/5 acres, which is the area of Upper Holloway (this sub-district has since been divided into three sub-districts) to 3103/10 acres, the area of Barnsbury. Lower Holloway covers 4122/5 acres, Islington South-East 545 acres, and Highbury 79911/5 acres. Their populations are also very unequal, fur whereas there are 99,895 people living in Upper Holloway, there are only 41,424 living in Lower Holloway, while in Barnsbury there are 54,478, in Highbury 63,797, and in Islington South East 75,397. As these two factors, area and population, vary so much, it follows that the densities of their populations also differ materially. Thus in Barnsbury there are 176 persons living on each acre, while in Highbury there are only 80. In Islington South-East there are 138 persons to each acre, in Lower Holloway 100 and in Upper Holloway 98. The number of inhabited houses, and the average number of persons occupying them, naturally also differ materially, for in Upper Holloway there are 12,149 houses containing on an average 8.2 persons; in Lower Holloway 4,118 houses with 10T persons per house; in Barnsbury, 5,558 houses with 9.8 persons per house; in Islington South-East, 8,034 houses with 9.4 persons per house; and in Highbury, 8,786 houses, with 7.3 persons per house; while the number of houses in the borough is 38,645, with an average of 8.7 persons per house. From these figures we learn that the houses in Lower Holloway contain more people on the average than the houses in any of the other 10 districts; after which comes Barnsbury, then Islington Sonth-East, next Upper Holloway, and lastly Highbury. Lower Holloway 10.1 persons per house. Barnsbury 9.8 „ „ Islington South-East 9.4 „ „ Upper Holloway 8.2 „ „ Highbury 7.3 The Borough 8'67 „ ,, When these figures are contrasted with figures I have calculated from the census of 1891, I find that there has been a slight increase in the average of the number of persons living in the houses in four out of the five sub-districts. This increase amounted to 0.2 person in Upper Holloway, 0.11 in Lower Holloway, 0.77 in Islington South-East, and 0.22 in Highbury. There was, however, a decrease of 0.13 person per house in Barnsbury. The increase of 0.77 (nearly 1) per house in Islington South-East is accounted for by the fact that the number of inhabited houses in that district showed a decrease of 544 (of which the houses in the demolished Norfolk Square area numbered 45) compared with 1891. On the other hand there has been an increase of 809 houses in Upper Holloway, and of 442 in Highbury. The number of houses in Lower Holloway and Barnsbury remained practically the same although there has been really a decrease of 1 in the former, and of 5 in the latter district. On a survey of the whole borough it is evident that the housing accommodation did not keep pace with the increase in the population, small though the increase was, when compared with preceding decades: for in 1891 each house contained on an average 8.42 persons, who increased to 8.67 in 1901, or 0.25 person per house. That is to say, that every 4 houses contained 1 more person. The number of houses only increased by 761, as compared with an increase of 3,738 between 1881 and 1891. It may be pointed out that in each succeeding census since 1811, the number of persons per house has gradually increased, as may be seen in the following return:— Year. 1811 1821 1831 1841 1851 Houses. 2,399 3,495 5,797 8,508 13,528 Persons to a house. 6.3 6.4 6.4 6.5 7.0 Year. 1861 1871 1881 1891 1901 Houses. 20,704 27,079 34,046 37,884 38,645 Persons to a house. 7.5 7.9 8.3 8.4 8.7 11 These figures demonstrate that the increase in the number of houses has never kept pace with the increase of the population, the result being that overcrowded conditions have prevailed to a greater or less extent in various parts of the borough. Now with respect to the number of separate families living in the borough, I find that in 1891 there were 72,652 families distributed among 37,875 houses, which give an average of 1'91 (nearly 2) families per house, and that they had increased in 1901 to 79,129 families, living in 38,645 houses, or an average of 2.04 families per house. Thus there was an increase of 0.13 family per house. This is not a very large increment, but when it is recollected that there are many thousands of houses occupied by single families, it represents much more than it appears to do by a mere recital of the fact, for the increase occurs only in tenement houses. This is more apparent when the different sub-districts are examined separately. It is not, however, possible to contrast the figures calculated from the last census returns with figures based on the 1891 census, because the latter unfortunately did not give the necessary information for the sub-districts. I have, however, made calculations on the figures obtained in the census of 1901, and I find that— In Upper Holloway, 22,357 families live in 12,149 houses, or 1.84 families per house. In Lower Holloway, 9,243 families live in 4,118 houses, or 2.24 families per house. In Barnsbury, 13,781 families live in 5,558 houses, or 2.48 families per house. In Islington, South East, 18,847 families live in 8,034 houses, or 2.34 families per house. In Highbury, 14,901 families live in 8,786 houses, or 1.70 families per house. It is, therefore, found that the houses in Lower Holloway, in Barnsbury, and Islington South East, contain more families per house than the average which obtained throughout the Borough, and that those in Upper Holloway and Highbury contain fewer families. These facts do not, however, enable me to come closely in touch with the small areas of the Borough containing comparatively few people, that is to 12 say, from 1,000 to 1,500, and with houses that are overcrowded, although they do direct attention to particular districts which might be all the better for closer examination. In seeking for suitable areas for my investigations I was driven to adopt the enumeration districts that were defined when the census was last taken, for about them alone could particulars be obtained; although I am bound to state that they do not altogether meet my requirements, for many of them are ill-defined, badly planned and of extraordinary contours. An examination of the map which I have laid before you will fully bear out this statement. Nevertheless I have been able to extract from the returns concerning these areas particularo which are of the greatest importance, and were most useful in the preparation of this report. For the purposes of the census the borough was divided into 271 Enumeration Areas, each of which contained, on an average, 1,235 persons. The averages varied, however, in the several registration sub-districts. Upper Holloway was divided into 66 areas, each with an average population of 1,513; Lower Holloway into 36 areas, each with an average population of 1,150; Barnsbury into 54 areas, each with an average population of 1,008; Islington South East into 70 areas, each with an average population of 1,077; and Highbury into 45 areas, each with an average population of 1,417. From the returns relating to each area, I have abstracted the number of tenements containing less than five rooms, together with the number of persons residing in them. I have also after a long—though fortunately not difficult—process ascertained the number of these tenements that are "overcrowded," by which term I am to be understood to mean overcrowded according to the dictum of the Registrar-General; and from the figures thus obtained I have calculated the percentage number of tenements that are overcrowded, as well as the percentage number of persons living under overcrowded conditions; and lastly I have abstracted the ages of these persons at four periods of life. It is much to be regretted, however, that the ages of children between 5 and 10 were not available, as they are very material factors in deciding the question of overcrowding, because every two children under that age only count as one person, a circumstance which seems to have been either entirely forgotten or else ignored by the Registrar-General. The result of this omission is that I have been compelled to use his method, and to make my calculations as if the persons were all adults. It may be stated, however, that a fairly accurate estimate of the number of children under ten years of 13 age may be obtained by halving the number of persons between 5 and 15 years of age and adding the result to the number of children under 5 years. This method is based on the fact that 51 per cent, of the children living in the borough above five years, but under fifteen, are between the ages of five and ten years; and, therefore, it is a fair inference that a similar proportion exists throughout the various areas, with possibly slight variations. Now I have ascertained that 18 per cent. of the tenements of the borough containing less than five rooms are overcrowded, and I have consequently made this figure the basis for classifying the degree of overcrowding which obtains in each of the 271 enumeration areas which are set out in Table VI., and I have used it in this way. Those areas in which the overcrowded tenements are more than 25 per cent, below the average of the overcrowding of the borough as a whole (18 per cent.) I have called Class I.; those which are less than '25 per cent, below the average of the borough I have called Class II.; those which are less than 25 per cent. above the average oi the borough I have called Class III.; while those which are more than 25 per cent, above the average of the borough I have called Class IV. Let me illustrate this by an example. In Table 6, column 6, it is stated that 26.34 per cent. of the tenements under five rooms are overcrowded, then the calculation is 18.0: 26.34: :100 :146.3. Consequently the crowded tenements are 46.3 per cent. above the average, and therefore, the area would be included in Class IV. From an analysis of the figures in column 6 of Table 7 I find that in Upper Holloway 32 areas come under Class I., 2 under Class II., 8 under Class III., and 15 under Class IV. In Lower Holloway 5 areas come under Class I., 4 under Class 11., 4 under Class III., and 19 under Class IV. In Barnsbury 20 areas come under Class I., 7 under Class II., 10 under Class III., and 17 under Class IV. In Highbury 25 areas come under Class I., 5 under Class II., 2 under Class III., and 2 under Class IV. In Islington South East 29 areas come under Class I., 14 under Class II., 9 under Class III., and 16 under Class IV. 14 - Classes— IV. III. II. I. Upper Holloway Lower Holloway Barnsbury Highbury Islington South-East The Borough 32 5 20 25 29 111 2 4 7 5 14 32 8 4 10 2 9 83 15 19 17 2 16 69 In the Borough as a whole 111 areas come under Class I., 32 under Class II., 33 under Class III., and 69 under Class IV. It is interesting to note that while the least crowded areas are the most numerous, the most crowded follow next in order. The Enumeration Areas referred to in the separate classifications are as follows:— Upper Holloway. Class I.—Areas 5, 9, 10, 11, 12, 13, 14, 16, 18, 19, 23, 24, 25, 26, 29, 32, 33, 34. 39, 42, 43, 44, 45, 46, 47, 48, 49, 51, 56, 57, 59, 60. Total 32. Class II.—Areas 4, 31. Total 2. Class III.—Areas 3, 6, 7, 27, 30, 50, 64, 65. Total 8. Class IV.—Areas 1, 2, 8, 17, 35, 36, 52, 53, 54, 55, 58, 61, 62, 63 and 66. Total 15. The greatest overcrowding (Class IV.) occurs in that part of the district which is bounded by Seven Sisters lioad on the south, Moray Road and Birnam Road on the north, and Stroud Green Road on the east. In this area are contained enumeration districts numbered 53, 54, 55, 61, 62, 63, 64. 15 Lower Holloway. Class I.—Areas 20, 22, 29, 32, 35. Total 5. Class II.—Areas 13, 28, 34, 36. Total 4. Class III.—Areas 19, 21, 23, 30. Total 4. Class IV.—Areas 5, 6, 7, 8, 9, 10, 11, 12, 14, 15, 16, 17, 18, 24, 25, 26, 27, 31, 33. Total 19. The greatest overcrowding (Class IV.) occurs in that part of the district which is bounded by the Great Northern Railway on the north, the North London Railway on the south, Liverpool Road on the east, and Roman Road and small part of Caledonian Road on the west. In this area are contained enumeration districts 15, 16, 17, 18, 24, 25, 26, 27, 31, and 33. There is another smaller area, also overcrowded, which is bounded on the north by Market Street, on the south by Frederick Street and the North London Railway, on the east by Caledonian Road, and on the west by York Road. In this area are contained enumeration districts 8, 9, 10, 11, and 12. There is also a very small area situated and bounded by the backs of the houses in Hungerford Road on the north, by the backs of the houses in Hartham Koad on the east, by North Road on the south, and by York Road on ihe west. In this area are contained enumeration districts Nos. 5, 6, and 7. Baknsbury. Class I.—Areas 2, 3, 4, 5, 7, 8, 9, 10, 11, 15, 16, 17, 19, 23, 24, 25, 26, 27, 28, 32. Total 20. Class II.—Areas 12, 18, 37, 38, 39, 43, 50. Total 7. Class III.—Areas 1, 6, 13, 40, 41, 42, 46, 47, 48, 52. Total 10. Class IV.—Areas 14, 20, 21, 22, 29, 30, 31, 33, 34, 35, 36, 44, 45, 49, 51, 53, 54. Total 17. The greatest overcrowding (Class IV.) occurs in that part of the district which is bounded by the North London Railway on the north, by Bingfield Street on the south, by Caledonian Road on the east, and by York Road on the west. In this area are contained enumeration districts numbered 29, 30, 31, 33, 34, 35, and 36. That portion of the district bounded on the north by Copenhagen Street, on the south by the borough boundary, on the east by Cloudesley Road, and on the west by York Road is also overcrowded. The enumeration districts are numbered 20, 21, 22, 44, 45, 49, 51, and 54. 16 Highbury. Class I.—Areas 5, 6, 7, 10, 12, 13, 15, 16, 17, 18, 19, 20, 21, 22, 25, 26, 27, 29, 33, 35, 36, 40, 41, 42, 44. Total 25. Class II.—Areas 14, 23, 24, 37, 43. Total 5. Class III.—Areas 8 and 9. Total 2. Class IV.—Areas 32 and 34. Total 2. The greatest overcrowding (Class IY.) is confined to two districts only, Nos. 32 and 34, the centres of which are Brand Street in one area, and Queensland Road in the other. Islington South-East. . Class I.—Areas 6, 7, 8, 9, 10, 11, 19, 20, 21, 22, 24, 26, 30, 31, 36, 37, 38, 45, 48, 50, 51, 54, 55, 57, 61, 62, 63, 64, 67 Total 29. Class II.—Areas 4, 12, 13, 25, 27, 29, 32, 42, 52, 53, 58, 65, 66, 69. Total 14. Class III.—Areas 3, 5, 28, 34, 39, 40, 46, 59, 60. Total 9. Class IY.—Areas 2, 14, 15, 16, 17, 18, 23, 33, 35, 41, 43, 44, 47, 56, 68, 70. Total 16. The greatest overcrowding (Class IV.) occurs in that part of the district which is bounded on the north by Essex Road, on the south by Linton Street, on the east by New North Road, and on the west by Packington Street. In this area are contained enumeration districts Nos. 14, 15, 16, 17, 18, 35, and 41. In pursuing my investigations further, I found that— In Upper Ilollotvay.—723 one-room tenements are over-crowded. That is to say, each tenement contains on an average more than 2 persons. That 986 two-room tenements are over-crowded. That is to say, that each tenement contains on an average more than 4 persons. 17 That 390 three-room tenements are overcrowded. That is to say, that each tenement contains on an average more than 6 persons. And That 151 four-room tenements are overcrowded. That is to say, that each tenement contains on an average more than 8 persons. In Lower Holloway.—That 436 one-room tenements are similarly overcrowded. That 825 two-room „ „ „ That 354 three-room „ „ „ That 119 four-room „ „ „ In Bamsbury.—That 939 one-room tenements are similarly overcrowded. That 1,216 two-room „ „ „ That 299 three-room „ „ „ That 104 four-room „ ,, „ In Islington South—That 850 cne-room tenements are similarly East. crowded. That 1086 two-room „ „ „ That 483 three-room „ „ „ That 174 four-room „ „ „ In Highbury.—That 333 one-room tenements are similarly overcrowded. That 361 two-room „ „ „ That 149 three-room „ „ „ That 95 four-room „ „ „ With respect to the number of persons living in these overcrowded tenements in the various sub-districts I find that In Upper Holloway.—2,591 persons resided in overcrowded 1-room tenements. 5,662 „ „ „ 2-room „ 3,023 „ „ 3-room „ 1,466 „ „ „ 4-room Total 12,742 „ „ „ 1 to 4-room „ 18 In Lower Holloivay.—1,576 persons resided in overcrowded 1-room tenements. 4,779 „ „ „ 2-room „ 2,778 „ „ „ 3-room „ 1,165 „ „ „ 4-room „ Total 10,298 „ „ „ 1 to 4-room „ In Barnsbury.—3,341 persons resided in overcrowded 1-room tenements. 7,141 „ „ „ 2-room „ 3,311 „ „ ,, 3-room „ 1,009 „ „ „ 4-room „ Total 14,802 ,, „ „ 1 to 4-room „ In Islington South—2,966 persons resided in o\ercrowded 1-room tenements. East. 6,360 ,, „ „ 2-room „ 3,700 „ „ „ 3-room „ 1,650 „ „ „ 4-room „ Total 14,676 „ „ „ 1 to 4-room „ Highbury.—1,213 persons resided in overcrowded 1-room tenements. 2,063 „ „ „ 2-room „ 1,137 „ „ „ 3-room „ 936 „ „ „ 4-room „ Total 5,349 „ „ 1 to 4-room ,, In Table VI. I have tabulated the actual number of overcrowded tenements, distinguishing the number of rooms as well as the number of persons living in them. This Table, which exhibits the extraordinary variations that occur in the several areas with respect to the character of the tenements, is worthy of careful study, for in some it is seen that one-room tenements are the most numerous, in others that two-room tenements are most numerous, and so on. Indeed, it is a good index also of the circumstances of the inhabitants, for the poorer they are the fewer rooms they occupy. 19 I have now laid before you the fullest particulars that it is possible to obtain respecting the borough unless, indeed, such as could only be ascertained by a house to house investigation, and, in a great borough like Islington, at a considerable expense and by the employment of a special staff of Inspectors. I think, however, that with the information which is now in your hands you will be enabled to come down on the overcrowded spots of the borough. It, however, rather exaggerates the prevailing conditions owing to the Kegistrar-General's definition of "overcrowding;" but bearing this in mind you will be able to distinguish between it and legal overcrowding—that is, from overcrowding to abate which you would obtain an Abatement Order in a Court of Summary Jurisdiction. I do not, however, suggest that you should take no action on this account. Far from it, because I think, firstly, it would be extremely unwise to allow overcrowding to go on until its abatement could only be obtained by legal force; and, secondly, that the great health interests of the public are best served by the prevention of evils, rather than by their abatement when they have arisen. It is folly to wait to close the stable door until the steed has been stolen. I have not made any suggestions in this report as to the means of abating the overcrowding, because I have inferred from your discussions that your object in desiring a report from me was to obtain particulars, such as I have now given you, with a view to your consideration of the question of Housing Overcrowded Persons. I am, Gentlemen, Your obedient Servant, Medical Officer of Health. Town Hail, Upper Street, N. 21 st March, 1904. APPENDIX. TABLE I. Showing the number of One-room Tenements, the number of Persons occupying them in 1891 and 1901, together with the increase or decrease in 1901 when compared with 1891. ONE-ROOM TENEMENTS. No. of Persons each Tenement. Number of Tenements. Increase or Decrease 1901. Number of Persons, in Occupation. Increase or Decrease 1901. 1891. 1901. 1891. 1901. 1 person 4,559 5,062 + 503 4,559 5,062 + 503 2 persons 4,240 4,577 + 337 8,480 9,154 + 647 3 ,, 2,137 2,014 -123 6,411 6,042 - 369 4 ,, 1,194 925 -269 4,776 3,700 - 1,076 5 ,, 497 273 -224 2,485 1,365 - 1,120 6 ,, 159 74 - 85 954 444 - 510 7,, 51 22 - 29 357 154 - 203 8 ,, 10 6 - 4 80 48 - 32 9 ,, 4 1 - 3 30 9 - 27 10 ,, 4 1 - 3 40 10 - 30 11 ,, 1 - 1 11 — 11 12 ,, — — — — - — Totals 12,856 12,955 + 99 28,189 25.988 - 2,201 TABLE II. Showing the number of Two room Tenements, the number of Persons occupying them in 1891 and in 1901, together with the increase or decrease in 1901 when compared with 1891. TWO-ROOM TENEMENTS. No. of Persons each Tenement Number of Tenements. Increase or Decrease 1901. Number of Persons in Occupation. Increase or Decrease 1901. 1891. 1901. 1891. 1901. 1 persons 1,293 1,204 -89 1,293 1,204 - 89 2 persons 4,097 5,084 + 987 8,194 10,168 + 1,974 3 ,, 3,656 4,684 + 1,028 10,968 14,052 + 3,084 4 ,, 2,915 3,507 + 592 11,660 14,028 + 2,368 5 ,, 2,135 2,203 + 68 10,675 11,015 + 340 6 ,, 1 304 1 253 -51 7,824 7,518 - 306 7 ,, 753 624 -129 5,271 4,368 - 903 8 ,, 379 258 - 121 3,032 2,064 - 968 9 ,, 133 87 -46 1,197 783 - 414 10 ,, 39 23 -16 390 230 - 160 11 ,, 9 6 -3 99 66 - 33 12 ,, 3 1 -2 36 12 - 24 Totals 16,716 18.934 + 2,218 60,639 65,508 + 4,869 21 TABLE III. Showing the number of Three-room Tenements, the number of Persons occupying them in 1891 and in 1901, together with the increase or decrease in 1901 when compared with 1891. THREE ROOM TENEMENTS. No of Persons each Tenement Number of Tenements. Increase or Decrease 1901. Number of Persons in Occupation. Increase or Decrease 1901. 1891. 1901. 1891. 1901. 1 person 392 430 + 38 392 430 + 38 2 persons 2,339 2,982 + 643 4,678 5,964 + 1,286 3 ,, 2,406 3,375 + 969 7,218 10,125 + 2,907 4 ,, 2,035 2,730 + 695 8,140 10,920 + 2,780 5 ,, 1,700 1,882 + 182 8.500 9.410 + 910 6 ,, 1,182 1,318 + 136 7,092 7,908 + 816 7 ,, 862 873 + 11 6,034 6,111 + 77 8 ,, 491 461 - 30 3,928 3,638 - 240 9 ,, 266 205 - 61 2,394 1,845 - 549 10 ,, 87 92 + 5 870 920 + 50 11 ,, 36 22 - 14 396 242 - 154 12 ,, 10 9 -1 120 108 - 12 Totals 11,806 14,379 + 2.573 49,762 57,671 + 7,909 TABLE IV. Showing the number of Four-room Tenements, the number of Persons accupying them in 1891 and in 1901, together with the increase or decrease in 1901 when compared with 1891. FOUR-ROOM TENEMENTS. No. of Persons each Tenement. Number of Tenements. Increase or Decrease, 1901. Number of Persons in Occupation. Increase or Decrease, 1901. 1891. 1901. 1891. 1901. 1 person 100 117 + 17 100 117 + 17 2 persons 831 975 + 144 1,662 1,950 + 288 3 ,, 1,152 1,577 + 425 3,456 4 731 + 1,275 4 ,, 1,301 1.766 + 465 5,204 7,064 + 1,860 5 ,, 1,285 1,665 + 380 6.425 8,325 + 1,900 6 ,, 1 118 1 306 + 188 6,708 7,836 + 1,128 7 ,, 883 885 + 2 6,181 6,195 + 14 8 ,, 602 601 + 2 4,816 4,832 + 16 9 ,, 412 339 - 73 3,708 3,051 - 657 10 ,, 20-5 176 - 29 2,050 1,760 - 290 11 ,, 82 81 -1 902 891 - 11 12 „ 44 42 -2 528 504 - 24 Totals 8,015 9,533 + 1,518 41,740 47,256 +5,516 22 TABLE V. Showing the number of Persons per centum of the Population in Family Groups containing from one to twelve persons living in One-room to Four-room Tenements. Number of Persons occupying each Tenement. One-Roomed Tenements. Two-Roomed Tenements. Three Roomed Tenements. Four-Roomed Tenements. 1891. 1901. 1891. 1901. 1891. 1901. 1891. 1901. 1 person 1.43 1.51 0.41 0.36 0.12 0.13 0.03 0 03 2 persons 2.66 2 73 2.57 3.04 1.46 1.78 0.52 0 58 3 " 2.01 1.80 3 43 4.20 2.26 3.02 1.08 1.41 4 " 1.50 1.10 3.65 4.19 2.55 3.26 1 63 2.11 5 " 0.78 0.41 3 35 3.29 2.35 2.81 2.01 2.48 6 " 0.30 0.13 2.45 2.24 2.22 2.36 2.10 2.34 7 " 0 12 0 05 1.65 1.30 1.89 1.82 1.93 1 85 8 " 0.02 0 01 0 95 0 62 1.23 1.10 1 50 1. 44 9 " 0 01 0 00 0.38 0.23 0.75 0.55 1 16 0 91 10 " 0.01 0 00 0.12 0 07 0 27 0.27 064 0 52 11 0.00 — 0.03 0 02 0 12 0 07 0.,28 0. 27 12 — — 0 01 0 000 003 0 03 0.16 0.15 8 83 7 76 19 00 19.55 15 28 17 21 12-98 14 10 In this Table 0.000 means that the numbers were not sufficient to read 0.01 (that is, the one hundredth of one) per cent. 23 TABLE VI. Showing the Number of Tenements of Less than Five Rooms and the Number of Persons living in them. The Overcrowded Tene ments, the Persons Overcrowded, and the Percentage Proportion of Overcrowded Tenements and Persons Overcrowded, together with the Ages of such persons. Sub-District— UPPER HOLLOWAY. Enumeration Districts. All tenements of less than 5 rooms and persons enumerated therein OVERCROWDING. Overcrowded tenements of, and persons in, less than 5 rooms. Percentage of Tenements. Percentage of Persons. Ages. Under 5 years. 5 to 15- 15 to 65- 65 and Upwards. Tenements. Persons Tenements. Persons. i 205 812 54 3°5 2634 37 56 54 102 149 2 249 1068 73 440 29 31 41-20 91 146 197 6 3 343 1218 7' 392 20 70 3218 83 121 182 6 4 210 772 32 185 15 23 23 96 46 50 86 3 5 182 590 11 63 6. 04 10. 67 10 22 31 6 297 1053 54 302 18 18 2868 59 109 134 7 191 646 42 214 21 99 33 13 39 76 99 8 302 1146 79 452 26'16 39 44 101 143 202 6 9 104 285 4 24 3 84 842 3 8 13 io 203 625 8 5° 394 800 11 18 21 ii 145 383 1 3 069 078 1 2 12 295 964 28 173 949 17 94 45 55 73 13 368 1278 37 212 1005 16 58 47 65 95 55 14 170 458 8 35 4 70 7. 64 5 12 18 15 No Info rmation 16 176 513 4 19 227 3 .70 8 2 9 .. 17 372 1657 135 802 36 29 48-40 146 286 367 3 18 169 579 22 141 13. 01 24.35 34 38 67 2 19 138 462 6 47 4.35 101.7 8 18 21 20 io 243 Nil Nil Nil Nil .. 21 171 443 Nil Nil Nil Nil .. .. 22 No Information 23 163 436 1 7 0.61 1.60 1 4 2 ... 24 196 592 5 32 2'55 5 4 6 12 M 25 268 872 22 107 821 12.27 17 27 61 2 26 129 321 4 32 3.10 9.97 7 14 11 .. 27 128 434 26 155 20.31 35.71 35 53 67 .. 28 No Information 29 396 1357 50 298 12.62 21.96 65 106 125 2 30 233 907 44 284 18.88 3.73 65 92 126 1 31 290 1172 60 364 2069 31 5 82 124 •57 1 32 322 1164 39 220 12.11 18 90 5i 77 88 4 33 173 580 11 70 6.36 12.07 13 26 3° 1 34 72 243 2 12 278 4.94 3 5 4 .. 35 48o 1990 147 859 30.06 43.16 177 286 392 4 36 223 831 55 319 2466 38.38 65 101 148 5 37 No Information 38 No Information 39 118 335 1 7 0.85 209 1 2 4 .. 40 No Information 41 No Information 24 TABLE VI.—continued. Sab-District—Upper Holloway — continued. Enumeration Districts. All tenements of less than 5 rooms and persons enumerated therein. OVERCROWDING. Overcrowded tenements of, and persons in, less than 5 rooms. Percentage of Tenements Percentage of Pursons Ages. U nder 5 years. 5 to 15 15 to 65- 65 and Upwards. Tenements Persons Tenements. Persons. 42 140 405 4 23 2.86 568 4 8 11 .. 43 121 33° 2 12 1 65 3 63 i 7 4 44 221 761 13 75 5.88 985 17 21 36 1 45 39t 1592 45 283 11-51 1777 62 105 114 2 46 85 274 3 19 3 69 693 4 8 7 47 127 408 16 63 12 60 I5-44 14 9 40 48 '44 439 4 24 278 546 10 14 49 275 869 27 128 9.82 14.72 31 34 61 2 5° 210 793 38 212 18 09 2673 37 76 94 5 5i 292 936 14 79 4 .79 8.44 13 25 41 52 236 1036 61 369 25-84 35 61 66 116 185 2 53 188 927 74 451 3936 4865 88 163 200 54 284 1169 89 477 31.33 40.80 104 148 223 2 55 185 688 43 250 23.24 36.33 57 89 104 .. 56 272 896 22 130 8.08 14.51 32 41 57 .. 57 324 i°43 33 155 10. 18 14.86 43 36 72 4 58 250 938 69 366 27.60 39.02 65 123 173 5 59 300 976 39 197 13 00 20 18 4° 54 101 2 60 337 1073 39 223 11.57 20.78 40 80 101 2 61 148 561 35 210 23-64 37 43 37 72 IOI 62 487 1867 235 1187 • 48.25 63.57 200 397 580 10 63 253 1081 61 378 2.ii 34 97 96 127 154 i 64 249 874 46 222 18-47 25 40 55 57 108 2 65 248 972 48 264 19 35 27 16 58 7i 133 2 66 181 777 54 320 29 83 4I-I9 65 96 155 4 Sub-District—LOWER HOLLOWAY. 1 No Info rmation 2 No Info rmation 3 No Infc rmation 4 No Info rmation 5 3" 1440 95 596 3054 4138 120 218 257 i 6 272 1289 108 694 3971 5383 130 267 294 3 7 215 938 69 446 32 09 47 55 69 168 207 2 8 220 95° 59 385 2681 40 52 56 137 187 5 9 281 1476 112 773 3986 52 36 134 286 349 4 10 125 636 44 3°4 35 20 47-80 45 125 132 2 11 261 1135 84 539 32 18 47 49 114 176 247 2 12 268 1001 67 349 2500 34-86 86 99 162 2 13 255 887 42 237 1647 26 71 63 70 104 14 172 592 39 214 2267 36 15 44 58 no 2 15 187 735 48 291 25 66 39 59 53 92 144 2 16 180 890 68 432 3777 48 53 86 150 '95 1 17 176 812 65 394 36 93 4852 64 142 185 3 18 221 808 5° 295 22'62 3651 69 88 138 19 136 502 28 158 20-58 3148 34 52 69 3 25 TABLE VI.—continued. Sub-District—Lower Holloway--continued. Enumeration Districts. J All tenements of less than 5 rooms and persons enumerated therein. OVERCROWDING. Overcrowded tenements of, and persons in, less than 5 rooms. Percentage of Tenements. Percentage of Persons. Ages. Under 5 years. 5 to 15 15 to 65 65 and Upwards. Tenements. Persons. _ a Tenements. | Persons. 20 169 575 19 105 11.24 18.26 25 37 42 1 21 117 353 23 88 1965 2492 16 20 49 3 22 141 426 12 58 851 1361 12 16 30 .. 23 244 872 48 262 19 67 3005 47 86 128 1 24 270 1056 66 384 24 44 3636 77 121 181 5 25 170 640 43 237 25.29 37 03 63 65 107 2 26 311 1334 148 847 47'59 63 49 155 306 383 3 27 172 708 51 298 29 65 42 08 55 93 147 3 28 334 1184 55 308 16.46 26. 01 63 102 143 29 239 959 3° 182 2'55 1898 39 54 89 30 266 930 51 262 19-17 2817 59 72 128 31 184 777 64 351 3478 4517 90 101 157 32 3°9 1017 36 176 ii 65 17 3° 47 49 79 1 33 184 698 43 239 23 36 3424 46 75 118 34 160 573 19 102 11.87 17.80 24 31 46 1 35 275 972 37 212 13 45 2i-8i 55 67 90 36 85 336 13 80 1529 23 80 16 24 39 1 Sub-District—HIGHBURY. 1 No Information 2 No Info rmation 3 No Info rmation 4 No Info rmation 5 277 93° 33 190 n-gi 20 42 46 52 91 1 6 254 854 22 112 8 66 13 11 24 32 55 1 7 194 537 6 29 3 09 5'4° 9 7 13 8 313 1187 58 327 1853 27 55 66 no 150 1 9 "5 788 46 262 21 39 3324 57 81 122 2 10 239 857 27 158 11-29 1843 3' 46 81 11 No Info rmation 12 279 i°35 34 195 1218 1885 32 70 90 3 13 256 778 21 104 820 1336 20 o7 55 2 14 236 880 39 241 1652 27 38 52 85 102 2 15 206 766 19 in 922 1449 26 33 51 1 16 241 825 14 83 5'8i 1006 14 24 44 1 17 182 54i 6 30 329 554 6 6 18 18 220 672 5 27 2.27 4.01 7 10 10 19 225 685 7 37 3 5'4° 7 11 19 20 202 663 24 131 ii-88 1976 28 48 53 2 21 122 393 14 72 11'47 1832 16 25 29 2 22 230 664 8 39 348 587 7 10 22 23 279 914 40 222 1433 2428 63 69 89 1 24 158 563 24 129 15-19 2291 35 29 64 1 25 233 597 8 40 3 43 670 11 9 19 1 26 119 373 8 47 672 1260 8 15 24 .. 27 233 753 14 78 601 i°'35 20 26 32 .. 28 No Info rmation TABLE VI.—continued. Sub-District—Highbury—continued. Enumeration Districts. All tenements of less than 5 rooms and persons enumerated therein. OVERCROWDING. Overcrowded tenements of. and persons in, less than 5 rooms. Percentage of Tenements. Percentage of Persons. Ages. Under 5 years. 5 to 15 15 to 65. 65 and Upwards. Tenements. Persons Tenements. Persons 29 102 267 2 14 1.96 5.24 4 5 5 . . 30 No Information 3i No Information 32 222 1141 104 679 46.84 59 .51 119 255 299 6 33 330 1022 29 172 8.78 16.83 36 53 80 3 34 322 1366 139 770 43.16 56.36 141 281 344 4 35 199 565 4 18 2.01 3.18 3 7 8 .. 36 259 767 11 70 4.24 9.12 13 25 32 .. 37 232 873 32 179 13.79 20.50 44 55 80 .. 38 262 692 Nil 39 67 161 Nil 40 166 607 20 110 12.04 18.12 26 38 46 .. 41 285 924 24 133 8.42 14.39 32 47 53 1 42 283 768 31 149 10.95 19.40 29 42 76 2 43 292 1099 47 289 16.09 26.30 61 107 119 2 44 179 561 18 102 10.05 18.18 19 33 50 .. 45 No Information Sub-District—BARNSBURY. 1 233 769 49 256 21.03 33.29 52 79 122 3 2 194 55i 23 100 11.86 18.15 24 25 50 1 3 258 748 20 93 7.75 12.43 18 22 52 1 4 150 444 13 61 8.66 13.74 13 21 27 .. 5 140 419 13 69 9.28 16.47 17 19 31 2 6 212 720 39 211 18.39 29.30 49 63 97 2 7 170 543 13 67 764 12 34 11 25 30 1 8 163 507 17 76 10.43 14.99 13 18 43 2 9 142 412 6 34 4.22 8.25 8 10 16 .. 10 166 547 4 22 2.41 4.02 8 4 10 .. 11 162 440 2 10 1 23 227 4 1 5 .. 12 188 569 29 138 15.43 24.25 28 36 73 1 13 239 779 51 246 2134 31.58 50 59 134 3 14 241 854 63 324 26.14 37.94 74 93 154 3 15 235 681 26 126 11.06 18.50 32 29 64 1 16 211 696 25 134 11.85 19.25 41 38 55 .. 17 151 459 13 64 8. 60 13. 94 16 16 30 2 18 203 662 34 168 1675 25.37 36 54 77 1 19 229 719 15 86 6.55 11.96 21 25 40 .. 20 269 876 70 342 26.03 39. 04 95 80 164 3 21 288 925 72 352 25.00 38.05 78 83 188 3 22 229 981 92 537 40.18 54.74 104 166 264 3 23 164 578 18 97 10.97 16.78 26 24 45 2 24 188 560 22 101 11.70 18.03 32 18 49 2 25 222 691 17 81 7.'65 11.72 19 19 42 1 26 234 698 14 70 5.98 10.03 13 15 42 .. 27 111 287 4 19 3.63 6.62 3 3 13 .. 28 118 328 4 26 3.39 7 .92 8 4 14 .. 27 TABLE VI.—continued. Sub-District—Barnsbury—continued. Enumeration Districts. All tenements of less than 5 rooms and persons enumerated therein. Overcrowded tenements of, and persons in, less than 5 rooms. OVERCROWDING. Percentage of Tenements. Percentage of Persons. Ages Under 5 years 5 to 15 15 to 65 65 and Ufwards. Tenements. Persons. Tenements. Persons. 29 218 896 90 499 41.29 55.68 102 157 238 2 30 225 922 102 562 45.33 60.95 106 195 258 3 31 305 1210 114 609 37.37 50.33 121 185 302 1 32 219 689 26 138 11.87 20.03 26 43 67 2 33 280 1266 108 660 38. 57 52.14 148 209 296 7 34 376 1592 167 933 44 42 58-60 197 285 445 6 35 423 2198 270 1753 63.82 79.76 368 645 732 8 36 122 503 74 357 60.66 70.96 60 106 188 3 37 227 731 37 160 16.30 21.88 48 28 84 .. 38 268 891 41 178 1530 19.97 49 29 99 1 39 240 583 34 174 14.17 29.85 41 47 84 2 40 187 694 41 213 21.93 30.69 50 59 104 .. 41 126 505 24 124 19.05 24.56 34 23 67 .. 42 165 638 36 197 21.82 30.87 40 53 102 2 43 153 568 27 161 1764 28 35 40 49 72 •14 263 1009 85 446 32.32 44.2I 111 115 216 4 45 206 704 49 253 23.79 35.94 57 79 113 4 46 239 866 53 290 22.l8 33.49 57 91 141 1 47 258 860 55 26l 21 32 3035 55 66 138 2 48 206 703 39 183 18.93 26.03 45 46 92 .. 49 232 863 59 312 25.43 36.15 59 87 165 1 50 206 602 37 177 17 97 29 40 42 43 90 2 51 165 599 53 281 32.12 46.91 63 74 143 1 52 280 894 60 297 21.43 33.22 77 78 140 2 53 132 513 39 248 29.54 48.34 45 86 114 3 54 227 921 70 426 30.84 46.25 59 136 226 5 Sub-District—SOUTH-EAST ISLINGTON. 1 No Information 2 108 499 3° 190 27.77 38.08 39 58 93 .. 3 235 811 45 244 19.14 30.09 56 74 113 i 4 162 585 27 155 1666 2649 32 46 77 .. 5 206 736 43 221 2087 3003 52 65 ioi 3 6 210 566 5 31 238 547 5 11 15 .. 7 150 458 5 28 3'33 611 7 8 13 .. 8 189 598 16 76 846 1270 17 20 36 3 9 312 966 19 88 609 911 24 18 44 2 10 234 634 8 35 342 552 9 7 19 .. 11 188 529 10 48 532 907 8 12 26 2 12 223 756 3i 178 13 90 2354 41 50 84 3 13 265 887 44 239 1660 2694 61 61 117 .. 14 151 634 53 321 35io 50 62 64 96 158 3 15 233 914 71 395 3047 43 21 82 124 188 1 16 2S9 1451 145 884 50.17 60.92 139 326 415 4 17 226 1151 155 957 68 60 8314 200 37° 387 .. 18 362 2257 209 1555 5773 68.90 223 603 722 7 19 267 746 26 125 974 16 .75 28 37 58 2 28 TABLE VI.—continued. Sub-District—South-East Islington—continued. Enumeration Districts j All tenements of less than 5 rooms and persons enumerated therein. Overcrowded tenements of, and persons in, less than 5 rooms. OVERCROWDING. Percentage of Tenements. Percentage of Persons. Ages. Tenements. Persons. I Tenements. Persons. Under 5 years 5 to '5- 15 to 65- 65 and Upwards 20 191 522 21 104 10 99 19.92 20 24 58 2 21 67 225 3 15 448 6.66 2 5 7 1 22 180 616 23 124 1277 20.13 33 33 57 1 23 148 5i9 44 233 29 72 44.90 42 80 111 .. 24 131 426 16 97 12-21 22.77 15 28 54 .. 25 167 485 24 in 1437 22.88 25 26 60 .. 26 145 428 13 55 8.96 12.85 11 16 28 .. 27 220 784 34 195 15.45 24.87 40 72 83 .. 28 286 917 56 272 1958 29.66 50 78 143 1 29 289 929 40 208 13 84 2239 46 83 98 1 3° 241 771 19 99 788 12.84 16 24 I4 2 31 221 670 27 117 1221 17.46 28 28 6l 2 32 208 648 29 148 r3 94 22.84 23 42 82 1 33 235 888 73 407 3106 45 .83 59 139 206 3 34 214 717 39 227 1822 31.66 53 56 il6 2 35 286 810 20 114 699 14.07 20 39 55 36 300 896 31 141 i°'33 15.72 33 34 72 2 37 255 786 23 133 9 02 16.92 26 44 61 2 38 174 535 14 62 804 11.58 16 13 31 2 39 166 585 33 180 19.88 30.76 36 39 105 40 232 797 46 232 1983 83 29.11 54 61 116 1 4' 295 1201 9i 5io 3085 42. 47 95 164 250 1 42 223 729 32 180 I4'35 24.69 36 58 84 2 43 397 1487 115 659 28 96 44 32 "4 216 322 7 44 285 983 63 326 2442 3316 82 93 149 2 45 209 639 19 83 9 09 1299 23 14 46 46 238 786 47 243 1975 30 92 50 67 124 2 47 98 418 26 162 26 53 3875 35 52 75 48 177 699 20 146 11 30 2088 23 60 60 3 49 No Info rmation 50 149 440 14 7i 939 16-13 20 20 3i 51 129 330 8 45 620 13 63 8 15 21 1 52 292 1013 45 258 15-41 25 47 49 73 136 53 225 763 37 208 16-45 2726 32 76 99 1 54 !34 367 8 45 5-97 1226 12 '3 20 •• 55 292 922 35 180 11-98 19 52 36 45 99 56 190 760 55 322 28-95 4236 58 94 169 1 57 132 452 13 77 9-84 1704 15 21 4i 58 241 767 33 173 13-69 2255 50 40 81 59 264 855 59 283 2235 33 10 64 61 157 1 60 91 37i 17 . ioi 18-68 2722 16 32 52 1 61 282 877 25 120 8-86 1368 23 26 67 62 68 235 6 34 8-82 1447 7 11 16 63 268 ^93 27 116 1007 16-73 20 33 63 64 289 795 16 79 5 53 9 93 19 22 38 65 105 425 17 130 1619 3058 20 51 59 66 80 264 11 70 T3'75 2652 7 23 38 67 251 997 29 160 "'55 16 05 34 53 72 1 68 289 1105 66 384 2284 3475 109 130 144 1 69 190 522 27 103 14-21 1973 22 20 61 70 217 895 58 364 2673 4067 57 133 174 29 TABLE VII. Showing the Number of Overcrowded One Room, Two Room, Three Room and Four Room Tenements, and the Number of Persons Living in them. Sub-District—UPPER HOLLOWAY. OVERCROWDED. District No. Tenements. Total. Persons living in Total. 1 room. 2 rooms. 3 rooms 4 rooms, 1 room. 2 rooms. 3 rooms 4 rooms. i 14 26 12 2 54 49 146 91 19 305 2 23 34 8 8 73 9' 207 64 78 440 3 22 36 9 4 7i 77 2 J7 72 36 392 4 12 10 4 6 32 43 55 3i 56 185 5 2 7 2 11 6 37 .. 20 63 6 15 31 8 54 5° 184 68 ,... 3<" 7 17 20 4 1 42 59 115 3i 9 214 8 17 47 15 .. 79 59 277 116 .. 452 9 .. 3 1 4 15 9 24 io 1 3 3 1 8 3 16 22 9 50 ii 1 1 3 3 12 8 10 5 5 28 30 56 37 5° 173 13 11 12 11 3 37 35 66 84 27 212 14 4 3 1 8 12 16 7 35 15 Nil Nil 16 2 i 1 .. 4 6 5 8 .. 19 7 34 65 32 4 135 122 381 260 39 802 18 4 9 5 4 22 •3 52 39 37 141 19 1 3 2 6 4 23 20 47 20 Nil Nil 21 Nil Nil 22 Nil Nil 23 .. .. 1 .. 1 .. .. 7 .. 7 24 1 2 2 5 3 10 .. 19 32 25 8 12 1 1 22 24 67 7 9 107 26 .. .. 3 1 4 .. .. 22 10 32 27 8 14 1 3 26 33 86 7 29 155 28 Nil Nil 29 13 22 11 5° 48 128 86 36 298 3° 10 15 12 7 44 35 88 92 69 281 31 16 25 11 8 60 56 141 87 80 364 32 10 17 9 3 39 30 94 67 29 220 33 1 6 3 1 11 3 35 23 9 70 34 .. 1 1 .. 2 .. 5 7 .. 12 35 43 69 22 13 147 158 409 162 130 859 36 18 21 11 5 55 63 121 82 53 319 37 3* Nil Nil Nil Nil 39 .. .. 1 .. 1 .. .. 7 .. 7 40 Nil Nil 41 Nil Nil 42 2 1 1 4 7 7 9 23 43 1 1 2 4 26 8 12 44 5 5 1 2 13 21 7 21 75 45 7 16 17 5 45 23 85 128 47 283 46 1 1 1 3 3 7 9 19 30 TABLE VII.—continued. Sub-District—Upper Holloway—continued. District No. OVERCROWDED. Tenements. Persons living in Total. 1 room. 2 rooms. 3 rooms. 4 rooms. Total. 1 room. 2 rooms. 3 rooms. 4 rooms. 47 .. 16 .. .. 16 .. 63 .. .. 63 48 1 1 2 .. 4 3 5 l6 .. 24 49 11 13 2 1 27 34 71 14 9 128 50 6 26 3 3 38 18 144 21 29 212 51 5 4 4 1 14 16 20 34 9 79 52 18 20 16 7 61 59 111 129 70 369 53 24 25 17 8 74 86 141 143 81 451 54 31 43 11 4 89 111 246 83 37 477 55 9 23 10 1 43 32 132 75 11 250 56 4 11 7 .. 22 13 62 55 .. 130 57 16 14 3 .. 33 55 77 23 .. 155 58 28 33 7 1 69 112 195 50 9 366 59 17 15 4 3 39 57 83 29 28 197 60 11 19 8 1 39 35 116 63 9 223 61 10 15 8 2 35 39 84 68 19 210 62 39 72 20 4 235 543 444 157 43 1187 63 ii 33 11 6 61 36 196 86 60 378 64 19 21 4 2 46 59 116 29 18 222 65 14 21 ii 2 48 46 "5 83 20 264 66 17 18 14 5 54 64 104 106 46 320 Totals 723 986 390 151 2250 2591 5662 3023 1466 12742 Sub-District—LOWER HOLLOWAY. 1 Nil Nil 2 Nil Nil 3 Nil Nil 4 Nil Nil 5 12 50 23 10 95 41 279 184 92 596 6 11 71 20 6 108 45 431 160 58 694 7 6 42 19 2 69 19 255 153 19 446 8 8 27 14 10 59 26 158 106 95 385 9 15 33 58 6 112 58 185 470 60 773 10 5 19 13 7 44 16 119 102 67 304 11 19 46 10 9 84 77 284 84 94 539 12 20 38 5 4 67 64 205 38 42 349 13 12 20 6 4 42 41 112 46 38 237 14 9 24 5 1 39 29 133 43 9 214 15 15 20 7 6 48 61 115 54 61 291 16 17 23 19 9 68 63 141 140 88 432 l7 27 21 12 5 65 105 141 97 51 394 18 16 20 9 5 50 58 120 68 49 295 19 12 9 4 3 28 45 53 30 30 158 20 4 13 2 .. 19 13 78 14 • • l05 21 2 20 1 .. 23 7 73 8 • • 88 22 6 5 1 .. 12 21 29 8 .. 58 23 16 25 5 2 48 56 139 44 23 262 24 18 25 17 6 66 57 139 132 56 384 31 TABLE VII.—continued. Sub-District—Lower Holloway—continued. OVERCROWDED, District No. Tenements. Persons living in Total. 1 room. 2 rooms. 3 rooms 4 rooms Total. 1 room. 2 rooms. 3 rooms. 4 rooms. 25 16 18 6 3 43 62 103 43 29 237 26 44 86 15 3 148 168 526 122 31 847 27 11 30 8 2 51 38 176 65 19 298 28 17 22 14 2 55 58 122 110 18 308 29 6 10 11 3 30 18 56 80 28 182 30 20 23 6 2 51 70 128 45 19 262 31 22 28 11 3 64 77 156 87 31 351 32 19 10 7 .. 36 63 60 53 .. 176 33 15 17 9 2 43 53 97 71 18 239 34 6 8 5 .. 19 22 43 37 .. 102 35 10 14 11 2 37 37 78 77 20 212 36 2 8 1 2 13 8 45 7 20 80 Totals 438 825 354 119 1736 1576 4779 2778 1165 10298 Sub-District—HIGH BU RY. i Nil Nil 2 Nil Nil 3 Nil Nil 4 Nil Nil 5 9 15 6 3 33 30 87 43 30 190 6 11 6 3 2 22 38 33 23 18 112 7 3 2 1 6 10 10 .. 9 29 8 27 15 9 7 58 100 84 70 73 327 9 17 13 9 7 46 56 73 66 67 262 10 11 6 2 8 27 38 31 14 75 158 11 Nil Nil 12 9 14 8 3 34 30 79 58 28 195 13 9 8 2 2 21 30 41 15 18 104 14 8 19 5 7 39 30 105 35 7i 241 15 8 3 5 3 19 27 20 37 27 in 16 2 8 4 .. 14 6 45 32 .. 83 17 3 2 1 .... 6 11 11 8 .. 30 18 1 2 2 .. 5 3 10 14 .. 27 j9 3 2 1 1 7 9 11 7 10 37 20 7 10 5 2 24 21 53 39 18 131 21 4 6 4 .. 14 13 31 28 .. 72 22 3 3 2 .. 8 9 '5 15 .. 39 23 10 23 6 1 40 36 129 48 9 222 24 9 12 2 1 24 36 70 14 9 129 25 3 3 2 .. 8 10 16 14 • • 40 26 2 4 1 1 8 7 24 7 9 47 27 4 6 3 1 14 13 33 22 10 78 28 Nil Nil 20 .. 1 .. 1 2 .. 5 .. 9 14 30 Nil Nil 31 Nil Nil 32 38 37 14 15 104 i73 227 118 161 679 32 TABLE VII.—continued. Sub-District—H ighbury —continued. OVERCROWDED. District No. Tenements. Total. Persons living in Total. 1 room. 2 rooms. 3 rooms. 4 rooms 1 room. 2 rooms 3 rooms. 4 rooms. 33 9 9 7 4 29 32 49 53 38 172 34 63 49 18 9 139 240 297 143 90 770 35 1 3 .. .. 4 3 15 .. .. 18 36 3 4 4 .. 11 13 23 34 .. 70 37 13 ii 5 3 32 44 66 40 29 179 38 Nil Nil 39 Nil Nil 40 7 9 2 2 20 23 50 !5 22 110 41 8 8 4 4 24 25 43 29 36 133 42 19 8 2 2 31 68 47 15 19 149 43 4 31 9 3 47 14 178 67 30 289 44 5 9 2 2 18 15 52 14 21 102 45 Nil Nil Totals 333 361 149 95 938 1213 2063 1137 936 5349 Sub-District—BARNSBURY. 1 20 26 3 .. 49 71 162 23 .. 256 2 13 8 2 .. 23 42 44 14 .. 100 3 10 7 3 .. 20 31 37 25 .. 93 4 6 6 1 .. 13 23 30 8 .. 61 5 5 4 2 2 13 16 20 15 18 69 6 15 12 10 2 39 48 67 77 19 211 7 2 9 2 .. 13 6 46 15 .. 67 8 10 4 3 .. 17 32 21 23 .. 76 9 2 2 1 1 6 6 12 7 9 34 10 1 2 1 4 3 10 .. 9 22 11 .. 2 .. .. 2 .. 10 .. .. 10 12 15 12 2 .. 29 51 70 17 .. 138 13 28 18 3 2 51 101 104 21 20 246 14 28 25 9 1 63 101 147 66 10 324 15 12 12 2 .. 26 40 71 15 .. 126 16 10 9 4 2 25 32 54 30 18 134 17 3 9 1 .. 13 9 48 7 .. 64 18 15 11 7 1 34 50 58 51 9 168 19 4 7 3 1 15 13 41 23 9 86 20 34 26 8 2 70 116 139 68 19 342 21 34 31 5 2 72 117 175 40 20 352 22 36 32 16 8 92 141 190 125 81 537 23 5 11 1 1 18 22 59 7 9 97 24 11 7 3 1 22 35 36 21 9 101 25 6 9 2 .. 17 18 47 16 .. 81 26 7 3 4 .. 14 25 15 30 .. 70 27 1 3 .. .. 4 4 15 .. .. 19 28 2 1 1 .. 4 10 6 10 .. 26 29 32 46 9 3 90 125 278 68 28 499 30 33 48 18 3 102 123 272 135 32 562 31 44 52 11 7 114 159 299 81 70 609 33 TABLE VII.—continued. Sub-District—Barnsbury—continued. OVERCROWDED. District No. Tenements. Total. Persons living in Total. 1 room. 2 rooms. 3 rooms. 4 rooms. 1 room. 2 rooms. 3 rooms 4 rooms. 32 10 12 4 .. 26 33 74 31 . . 138 33 21 66 17 4 108 80 403 136 41 660 34 64 77 17 9 167 235 470 141 87 933 35 50 208 10 2 270 239 1405 88 21 1753 36 .. 68 5 1 74 .. 307 40 10 357 37 21 15 .. 1 37 71 80 .. 9 160 38 23 15 1 2 41 72 78 8 20 178 39 15 13 4 2 34 48 75 31 20 174 40 14 21 4 2 41 46 120 28 19 213 41 15 3 2 4 24 54 16 14 40 124 42 13 14 6 3 36 47 75 46 29 197 43 9 7 8 3 27 29 40 65 27 161 44 35 39 10 1 85 123 235 77 11 446 45 22 15 9 3 49 72 85 69 27 253 46 21 21 6 5 53 75 124 45 46 290 47 25 22 7 1 55 80 119 53 9 261 48 20 13 5 1 39 64 71 39 9 183 49 24 24 6 5 59 80 136 45 51 312 50 17 18 1 1 37 59 102 7 9 177 51 19 25 6 3 53 62 141 48 30 281 52 29 23 7 1 60 99 135 53 10 297 53 6 24 5 4 39 23 149 37 39 248 54 22 20 22 6 70 80 118 172 56 426 Totals. 939 1216 299 104 2558 3341 7141 2311 1009 13802 Sub-District—SOUTH-EAST ISLINGTON. i Nil Nil 2 9 11 4 6 30 29 60 34 67 190 3 18 15 8 4 45 62 77 67 38 244 4 10 9 4 4 27 34 5i 31 39 155 5 14 21 8 .. 43 46 119 56 • • 221 6 1 1 3 .. 5 3 5 23 .. 31 7 2 1 1 1 5 7 5 7 9 28 8 8 5 3 .. 16 25 28 23 .. 76 9 11 4 2 2 19 34 20 16 18 88 10 6 .. 1 1 8 19 .. 7 9 35 11 5 4 1 .. 10 18 22 8 .. 48 12 12 11 5 3 31 45 65 40 28 178 j3 17 18 6 3 44 57 105 49 28 239 14 14 30 8 1 53 55 189 66 11 321 15 28 28 8 7 7i 98 160 69 68 395 16 32 70 33 10 145 115 417 255 97 884 17 25 118 11 1 155 102 754 92 9 957 18 1 83 103 22 209 4 512 827 212 1555 19 13 9 3 1 26 45 48 22 10 125 20 9 10 2 .. 21 33 57 14 .. 104 21 .. 3 •• •• 3 .. 15 •• .. 15 34 TABLE VII.—continued. Sub-District—South-East Islington—continued. OVERCROWDED. District No. Tenements. Total. Persons living in. . 1 room. 2 rooms. 3 rooms. 4 rooms. 1 room. 2 rooms. 3 rooms. 4 rooms. 22 4 14 5 .. 23 12 75 37 .. 124 23 28 14 2 .. 44 130 88 15 .. 233 24 5 5 1 5 16 16 25 9 47 97 25 10 12 2 .. 24 33 64 14 .. 111 26 10 2 1 .. 13 34 12 9 .. 55 27 7 22 5 .. 34 27 130 38 .. 195 28 26 25 4 1 56 87 146 30 9 272 29 19 11 6 4 40 62 60 45 41 208 30 6 10 1 2 19 19 55 7 18 99 31 15 9 3 .. 27 49 46 22 .. 117 32 13 12 1 3 29 41 71 7 29 148 33 28 32 10 3 73 102 203 73 29 407 34 11 23 3 2 39 40 140 23 24 227 35 6 9 4 1 20 23 50 31 10 114 36 14 15 2 .. 31 45 82 14 .. I41 37 8 6 5 4 23 26 31 38 38 133 38 8 4 1 1 14 26 20 7 9 62 39 15 8 3 7 33 46 43 22 69 180 40 24 12 5 5 46 80 67 38 47 232 41 42 23 19 7 91 155 140 !50 65 510 42 14 10 5 3 32 47 61 39 33 180 43 42 29 39 5 115 141 160 309 49 659 44 25 30 5 3 63 85 173 39 29 326 45 9 8 2 .. 19 27 42 14 .. 83 46 23 11 10 3 47 79 64 71 29 243 47 6 10 8 2 26 19 61 62 20 162 48 • • 6 10 4 20 .. 35 73 38 [46 49 Nil Nil 50 3 10 1 .. 14 11 52 8 .. 71 51 2 3 2 1 8 6 16 15 8 45 52 13 23 6 3 45 44 135 49 30 258 53 11 20 5 1 37 38 120 41 9 208 54 1 6 1 .. 8 3 35 7 .. 45 55 19 7 6 3 35 64 42 47 27 180 56 12 34 6 3 55 44 204 44 30 322 57 3 7 2 1 13 12 39 17 9 77 58 16 13 .. 4 33 56 77 .. 40 173 59 32 23 1 3 59 "5 132 7 29 283 60 5 6 5 1 17 15 33 43 10 ioi 61 14 10 .. i 25 50 61 .. 9 120 62 2 1 2 i 6 6 5 14 9 34 63 16 9 2 .. 27 53 48 15 .. 116 64 5 7 4 .. 16 16 35 28 .. 79 65 •• 7 2 8 17 41 14 75 130 66 .. 6 5 • • 11 .. 33 37 .. 70 67 1 .. 26 2 29 3 .. 138 19 160 68 3 46 17 .. 66 10 247 127 .. 384 69 22 3 2 27 72 17 14 .. 103 70 18 21 12 7 58 66 135 93 70 364 Totals.. 850 1086 483 170 2589 2966 6360 3700 1650 14676 35 TABLE VIII. Showing the Number of One Room, Two Room, Three Room and Four Room Tenements, the Number Overcrowded, and the Percentage of Tenements Overcrowded. Enumeration District. All Tenements. Overcrowded. Percentage Overcrowded. Rooms. Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 3 4 i 57 78 51 19 14 26 12 2 24.56 33.33 23.52 10.52 2 53 9i 57 48 23 34 8 8 43.40 37.36 14.03 16.66 3 88 134 80 41 22 36 9 4 25.00 26.86 11.25 9. 75 4 33 59 63 55 12 10 4 6 36.36 16.94 6.34 10.91 5 22 45 63 52 2 7 .. 2 9.09 15.55 .. 3.84 6 50 99 100 48 15 31 8 .. 30.00 31.31 8.00 7 57 64 38 32 17 20 4 1 29.82 31.25 10.52 3.12 / 8 67 121 70 44 l7 47 15 .. 25.37 38.84 21.42 .. 9 10 28 38 28 .. 3 .. 1 .. 10.71 • • 3.57 10 14 23 109 57 1 3 3 1 7.14 13.04 2.75 1.75 i 1 23 33 56 33 1 .. .. .. 4.35 .. .. .. 12 49 93 108 45 8 10 5 5 1632 10.75 4.63 11.11 13 58 93 143 74 11 12 11 3 18.96 12.90 7. 69 4.05 14 43 42 49 36 4 3 1 .. 930 7.14 2.04 .. 15 .. .. .. .. .. .. .. .. .. .. .. .. 16 9 20 97 50 2 1 1 .. 22.22 5.00 1.03 .. 17 84 155 93 40 34 65 32 4 40.47 4.93 344 10.00 18 30 48 55 36 4 9 5 4 13. 33 I8.75 9.09 11.11 19 6 12 79 41 1 .. 3 2 16. 66 •• 3.79 4.87 20 8 22 53 20 .. .. .. .. .. .. .. .. 21 16 33 76 46 .. .. .. .. .. .. .. .. 22 .. .. .. .. .. .. .. .. .. .. • • 23 7 21 77 58 .. .. 1 .. .. .. 1.30 • • 24 17 28 107 44 1 2 .. 2 5.88 7.14 1.03 4.54 25 57 64 97 5° 8 12 1 1 14.03 18.75 4.84 17.64 26 15 3° 62 22 60 .. 3 1 19.51 30..43 41..84 4.16 4 27 4T 46 24 I7 8 14 1 3 J 28 • • l666 22*00 7.23 6*06 29 78 100 152 66 13 22 11 4 / J T 0 ■ 0 5? 30 60 54 62 57 io 15 12 7 i6 00 27.77 19.35 12.28 31 54 78 94 64 l6 25 11 8 29.63 32.05 10.58 3.41 32 66 83 85 88 I0 J7 9 3 I5' J5 O. -»-» j 4x 33 12 55 75 3i i 6 3 1 0 33 i0*90 8*33 4 'oo 3'03 3'22 34 1 12 33 26 • • 1 1 j j c* * 35 126 182 no 7i 43 69 22 13 34.13 3791 20 OO 10*30 36 57 68 58 40 18 21 11 5 3158 3088 1896 12*50 37 38 • • * * 39 7 26 48 37 1 • • • * z 00 40 •• •• 4i • • • • • • 1 .. .. 9.52 2 .63 .. 2.70 42 21 38 44 37 2 1 • • 1 9 * "j 1.85 43 J4 21 54 32 1 1 • • 7.14 .. 1.85 .. 44 17 57 72 75 5 5 1 2 29.41 8.77 I.39 2.66 36 TABLE VIII.—continued. Sub-District—Upper Holloway—continued. Enumeration District. All Tenements. Overcrowded. Percentage Overcrowded. Rooms. Rooms. . 1 2 3 4 1 2 3 4 1 2 3 4 45 41 100 152 98 7 16 17 5 17.07 l6'00 1118 5io 46 12 21 23 29 1 1 1 833 435 3 44 47 5 28 65 29 ... 16 571I4 48 10 44 46 44 1 1 2 .. 10.00 2.27 4.35 49 46 110 72 47 11 13 2 1 23.91 11.81 27.8 2.12 50 21 91 54 44 6 26 3 3 28.57 28.57 5.55 6 .81 51 46 76 86 84 5 4 4 1 10.87 5.26 4.65 1.19 52 49 48 80 59 18 20 16 7 3673 41-.7 2000 ii-86 53 41 58 45 44 24 25 17 8 5853 4310 37 78 1818 54 7i 114 52 47 31 43 ii 4 4366 3772 21.15 851 55 41 66 54 24 9 23 10 1 2195 3484 1851 4'I7 56 32 123 79 38 4 11 7 .. 12.50 894 8.86 .. 57 55 123 86 60 16 14 3 2908 11.38 3.49. .. 58 72 97 46 35 28 33 7 1 3889 3402 15 21 2'86 59 77 108 67 48 17 15 4 3 2207 i3-88 597 6 25 60 86 n7 80 54 ii 19 8 1 12 79 1623 1000 1'85 61 30 55 39 24 10 15 8 2 33 33 27-27 20 51 833 62 280 126 52 29 139 72 20 4 49-64 57*5 3846 1379 63 41 109 56 47 11 33 11 6 2682 30 27 r9 64 1276 64 62 97 39 5i 19 21 4 2 3064 2165 1025 3 92 65 41 88 76 43 14 21 ii 2 3415 2386 r4'47 465 66 47 56 41 37 17 18 T4 5 3617 3214 34'I5 i3'5i Sub-District—LOWER HOLLOWAY. i 2 .. 3 4 5 33 oo 138 T 86 54 12 5° 23 10 36-36 36 23 2674 1852 0 20 i4o 69 29 11 7i 20 6 3928 4863 28 99 2079 7 0 21 no 69 15 6 42 19 2 2857 3818 2753 13 34 0 20 _ Q 103 48 41 8 27 14 10 28-57 2622 2916 24 39 9 2o 79 131 43 15 33 58 6 53'57 41 77 44-27 1395 10 12 t a 49 32 32 5 19 13 7 41-66 3877 4062 2187 11 46 132 46 37 19 46 10 9 4130 34 85 21-74 2432 12 oo 129 44 35 20 38 5 4 3333 2946 1136 11 43 *3 51 I23 41 28 40 12 20 6 4 23'53 1626 1464 10 00 *4 36 9i 63 17 9 24 5 1 25 00 2637 1786 588 J5 16 55 40 29 15 20 7 6 27-27 3174 I7'5° 2069 34 42 52 52 17 23 19 9 50 00 5476 3653 17'3I *7 18 SO 56 38 26 27 21 12 5 4821 37 50 3158 1923 73 07 50 31 16 20 9 5 2192 2985 1800 1613 19 20 42 30 39 65 24 31 12 9 4 3 2857 23-08 1667 9 67 40 34 4 13 2 I3'34 2000 500 21 20 42 28 27 2 20 1 1000 4762 3'57 22 33 41 41 26 6 5 1 1818 1219 2'43 23 67 89 47 41 16 25 5 2 2388 28.09 10.64 4.87 37 TABLE VIII.—continued. Sub-District — Lower Holloway—continued. c o rt o S'S £ 7) w All Tenements. Overcrowded. Percentage Overcrowded. Rooms. [Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 3 4 24 64 86 79 41 18 25 17 6 2812 29-07 2152 1463 25 49 59 29 33 16 18 6 3 3265 3051 20 69 909 26 103 134 48 26 44 86 15 3 4272 64-18 3I25 "■54 27 32 71 49 20 11 3° 8 2 3438 4225 i6'33 100 28 68 124 116 26 J7 22 14 2 25-00 17 75 i207 770 29 27 52 93 67 6 10 11 3 2222 1923 H'83 4'47 30 76 97 64 29 20 23 6 2 26-31 2371 937 6 89 31 32 54 7i 60 123 38 88 32 27 22 19 28 10 11 7 3 40-54 2676 4662 813 28-95 795 9'37 33 35 77 41 31 15 17 9 2 42 85 22 07 21-91 645 34 37 55 38 3° 6 8 5 l6'22 '454 1316 35 52 112 68 43 10 14 11 2 1923 1250 1618 4'65 36 7 24 43 11 2 8 1 2 28 57 33 33 232 1818 Sub-District—HIGHBURY. 1 .. 2 3 • • 4 5 69 93 54 61 9 15 6 3 1304 1612 iiii 492 6 59 77 59 59 11 6 3 2 1864 7 79 508 339 7 34 65 60 35 3 2 .. 1 882 3 °7 2-86 8 73 77 85 78 27 15 9 7 36'97 1947 1058 897 9 56 50 64 45 17 13 9 7 3° 35 26 00 14-06 I5'55 10 37 55 52 95 11 6 2 8 29 73 1090 384 842 11 12 54 79 92 54 9 J4 8 3 1666 1772 869 5 55 13 46 62 97 5i 9 8 2 2 1956 12 90 2 06 392 14 5° 78 47 61 8 19 5 7 1600 24 35 io 63 1147 15 3° 52 72 52 8 3 5 3 2666 577 694 5 77 16 18 86 86 51 2 8 4 iiii 9 3° 465 17 18 54 70 40 3 2 1 16-66 3 7° i 43 18 22 57 95 46 1 2 2 4'54 351 210 19 29 68 79 49 3 2 1 1 I0'34 2 94 126 2 04 20 32 67 71 32 7 10 5 2 2187 14 92 704 625 21 23 47 33 19 4 6 4 1739 1276 i2'i2 22 25 57 99 49 3 3 2 1200 526 202 23 7i 108 5° 5° 10 23 6 1 141 2130 12 oo 200 24 22 62 35 39 9 12 2 1 40-91 19 35 5 71 2 56 25 57 73 49 54 3 3 2 526 4'11 408 26 16 27 5° 26 2 4 1 1 1250 1481 200 384 27 32 5i 90 60 4 6 3 1 1250 1176 333 166 28 29 14 31 30 27 1 1 3'22 37° 3° 31 39 TABLE VIII.—continued. Sub-District—Barnsbury—continued. a o CS O ®'S 6.2 w All Tenements. Overcrowded. Percentage Overcrowded. Rooms. Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 8 4 33 47 138 74 21 21 66 17 4 4467 4782 2297 1905 34 136 148 53 39 64 77 17 9 4705 52 °3 ft A ' O ft 3207 23-07 35 107 280 22 *4 50 208 10 2 4672 74 2a ft O • A O 45'45 O O • ft T 14*28 36 9 82 21 10 68 5 1 02 93 z j o i 37 59 104 33 31 21 *5 1 35'59 x4'42 O * T ft 3 22 38 66 119 36 47 23 15 1 2 34'84 I2"6o 2 70 ft * ah 4'25 /i ■ 87 39 60 89 50 41 15 13 4 2 25-00 14*60 o oo 4 °7 4° 49 73 31 34 21 4 2 28-57 28 76 1290 5-88 41 31 38 20 37 15 3 2 4 4838 7-89 iooo 1081 42 41 65 32 27 x3 *4 6 3 3170 2153 1875 ii-n /i ^ 31 g 7 8 3 2368 15 55 2580 7-69 43 44 3° 117 J A 48 j? 23 35 39 10 1 46-66 3333 2083 4'35 T'T* / D 76 / 34 21 22 15 9 3 2894 2000 2647 1428 45 46 /u 80 /J 93 JT 3° 36 21 21 6 5 26-25 2258 2000 1388 87 7J ioi 3Q 31 25 22 7 1 28-73 2178 17 94 3 22 47 48 °7 76 60 jy 37 J 1 33 20 13 5 1 2631 21-66 I3'51 3 03 j n 81 77 31 24 24 6 5 29-63 3i"i7 13 95 1612 49 89 / / 80 22 15 17 18 1 1 19-10 2250 4'54 6 66 j 51 71 53 13 28 19 25 6 3 2676 47'i7 4615 1071 K2. 107 iog 32 32 29 23 7 1 2710 2110 2187 3 12 53 1 w/ 4° 54 15 23 6 24 5 4 1500 44'44 33'33 I7'39 54 65 80 53 29 22 20 22 6 33'84 25-00 4I'5° 2069 Sub-District—SOUTH-EAST ISLINGTON. 1 . . 1 22 *6 19 31 9 ii 4 *6 4091 30^6 21 05 19 36 3 62 89 49 35 18 15 8 4 2903 I685 16*33 nil 4 49 38 39 36 10 9 4 4 22 45 23 *68 1026 nil 5 61 75 39 31 14 21 8 2295 2001 2052 6 36 62 73 39 1 i 3 2-77 I*6i 4' 10 7 16 41 52 5' 2 i 1 1 1250 2 33 1*92 1 96 8 44 57 56 32 8 5 3 18 02 877 534 9 54 117 91 5° 11 4 2 2 2037 3" 219 400 10 38 70 96 3° 6 1 1 1579 1 09 3 33 11 52 59 51 26 5 4 1 961 6*78 1 96 12 58 90 42 33 12 11 5 3 2069 12*22 11*91 909 13 78 89 56 42 17 18 6 3 2179 20*22 10*71 7'i4 x4 48 55 29 '9 14 3° 8 1 29-16 5454 27-58 526 15 77 73 40 43 28 28 8 7 36 35 38-35 200 1628 16 65 100 81 43 32 70 33 10 49'23 70 00 4074 23 26 17 53 '58 13 2 25 118 11 1 47'i7 74-64 8461 5000 18 2 "7 88 189 54 1 83 i°3 22 5°'°° 70-92 54-5° 4074 19 95 53 3i 13 9 3 1 1368 10-23 5-66 322 20 69 63 46 13 9 10 2 1304 1587 4'34 21 9 24 15 19 3 12-5 22 32 69 55 24 4 14 5 125 20*29 909 23 59 61 15 13 28 14 2 4746 2295 13 33 4° TABLE VIII.—continued. Sub-District—South-East Islington—continued. Enumeration District. All Tenements. Overcrowded. Percentage Overcrowded. Rooms. Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 3 4 24 39 49 24 19 5 5 1 5 1282 1021 416 2631 25 62 71 24 10 10 12 2 16 13 16 go 833 26 43 51 34 Z7 10 2 1 2320 3'92 2'94 27 41 ioi 48 30 7 22 5 1708 2178 1041 28 100 no 40 36 26 25 4 1 26 00 2272 1000 2 77 29 90 121 48 30 19 11 6 4 2111 9 09 12-50 13 33 3° 45 9i 67 38 6 10 1 2 13 33 10 99 1 49 526 31 77 62 46 36 r5 9 3 I931 I4'5I 652 32 78 72 35 23 13 12 1 3 1668 16-66 285 13 04 33 89 82 44 20 28 32 10 3 3i'46 38 97 2273 15 0° 34 74 75 36 29 11 23 3 2 i486 3067 833 6 89 35 78 102 66 40 6 9 4 1 769 882 606 2 50 36 78 136 46 40 14 15 2 r7 95 11 03 10 64 37 64 100 47 44 8 6 5 4 125 600 1064 9 09 38 49 58 30 37 8 4 1 1 16 33 6 89 3'33 270 39 56 43 33 34 !5 8 3 7 26 78 18 61 9 09 2059 40 82 82 29 39 24 12 5 5 29-27 1464 1724 1282 41 112 72 67 44 42 23 19 7 3751 3i'94 38 35 1591 42 72 64 44 43 14 10 5 3 19 45 15 63 1136 697 43 J44 97 "5 41 42 29 39 5 29 17 2990 33 9i 1219 44 78 93 45 42 25 3° 5 3 32-05 3225 ii io 714 45 53 68 52 36 9 8 2 16 98 "77 384 46 79 78 46 35 23 11 10 3 29-12 14-10 21*17 8'57 47 19 29 27 23 6 10 8 2 3158 34 48 29*63 869 48 3 63 84 27 6 10 4 .. 9 52 11 90 14-82 49 50 35 62 35 17 3 10 1 8 57 1613 285 51 39 54 26 10 2 3 2 1 512 555 7-69 1000 52 74 100 67 5i r3 23 6 3 i7'57 23-00 8-95 5'88 53 68 69 58 3° 11 20 5 1 1618 2898 862 333 54 36 39 32 27 1 6 1 277 1538 3 12 55 86 98 72 36 19 7 6 3 22 09 714 833 8 33 56 41 90 37 22 12 34 6 3 29-27 37 78 1622 1364 57 23 43 47 19 3 7 2 1 1304 1628 425 526 58 83 67 55 36 16 13 4 19-28 19-40 11-13 59 i°3 108 34 19 32 23 i 3 3io7 2130 2'94 1579 60 13 29 28 21 5 6 5 1 3844 20 6g 1786 476 61 58 97 78 49 14 10 1 2413 10 31 2 04 62 ir 16 34 7 2 1 2 1 18 18 6 25 5'88 1427 63 93 102 48 25 16 9 2 17*21 882 4-16 64 76 no 70 33 5 7 4 657 636 5 71 65 14 25 14 52 7 2 8 2801 14-29 15 39 66 15 33 18 6 5 1796 27 78 67 1 125 125 1 26 2 10000 2080 160 68 40 164 83 2 3 46 17 750 2805 20-48 69 84 58 23 25 22 3 2 2618 517 8 69 70 39 76 52 50 18 21 12 7 46'15 2763 23-08 1400 4i TABLE IX. Showing the Number of Persons living in One-Room, Two Room, Three Room, and Four-Room Tenements, the Number of Persons Overcrowded, and the Percentage of Persons Overcrowded. Sub-District—UPPER HOLLOWAY. a o u .5 Total Persons Enumerated in. Persons Overcrowded and Living im. Percentage of Persons Overcrowded. 0) u s a go Rooms. Rooms. Rooms. a] 1 • 3 4 1 2 3 4 1 2 3 4 I 116 3°5 276 "5 49 146 91 19 42-24 47-87 32-97 1652 2 142 381 260 285 91 207 64 78 64*08 54 33 2461 27'37 3 178 476 348 216 77 207 72 36 4326 4348 20 69 1666 4 74 186 241 271 43 55 31 56 5810 29 '57 1286 20 66 5 29 127 205 229 6 37 20 20*69 2913 873 6 97 37i 382 203 5° 184 68 5X'54 49'59 1780 7 "5 232 147 z52 59 JI5 31 9 51 3° 4956 21-09 5'92 8 129 496 326 195 59 277 116 45'74 55 '84 35'57 9 11 69 96 109 15 9 21 - 74 825 IO 19 54 325 227 3 16 22 9 1579 XT' 29*62 67-68 3 96 II 28 63 159 r33 3 10*71 . . 12 88 291 365 220 30 56 37 5° 34 °9 19*24 10-13 22*72 13 100 300 531 347 35 66 84 27 35 00 22 OO 1582 778 r4 59 I07 145 147 12 16 7 20*34 I4'95 4827 15 16 13 48 274 178 *6 5 *8 46i5 10*41 2 92 17 205 662 541 249 122 381 260 39 59*50 57'55 48 06 15 66 18 46 162 198 173 *3 52 39 37 28*26 3210 19-70 2138 19 14 33 252 '63 4 23 20 28*57 9-12 12*27 20 11 41 129 62 21 18 69 196 160 22 23 8 42 194 192 7 360 24 22 74 3°9 187 3 10 J9 J3 63 I3'5I IOl6 25 95 206 35° 221 24 67 7 9 25*26 32'52 2 00 407 26 21 52 175 73 22 10 1257 I37O 27 75 168 92 99 33 86 7 29 44*00 51*19 760 2 92 28 29 138 346 576 297 48 128 86 36 3478 36-99 1243 I2I2 30 105 194 277 33i 35 88 92 69 33 33 45 36 3321 20*84 31 "3 290 4O6 363 56 *4X 87 80 49 56 4861 2143 2204 32 IOI 280 355 428 3° 94 67 29 29*70 33'57 18-87 677 33 17 165 261 >37 3 35 23 9 I7'^5 2I2I 881 657 34 1 32 108 102 5 7 .. I5'62 648 35 276 740 546 428 158 4°9 162 I3° 5724 55 26 29 66 30-37 36 119 262 250 200 63 121 82 53 5294 46-17 3280 26-50 37 .. 38 #. 39 *8 51 '41 >35 7 496 [[ 40 41 42 32 87 i4i 145 7 7 9 2187 804 620 43 22 42 159 107 4 8 1818 5 °3 44 38 161 234 328 21 26 7 21 55 26 1615 2'99 640 42 43 TABLE IX.—continued. Sub-District—Lower Holloway—continued. Enumeration District. Total Persons Enumerated in. Persons Overcrowded and Living in. Percfntage of Persons O vt rcrowded. Rooms. Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 0 3 4 25 hi 218 130 181 62 i°3 43 29 55'85 47'24 33 °8 1602 26 265 669 251 149 168 526 122 31 63'39 7861 4860 20 80 27 72 294 231 in 38 176 65 19 52'77 59'87 2813 17-12 28 !3° 408 494 152 58 122 no 18 4462 29'90 2227 11-84 29 48 183 418 3io 18 56 80 28 37'50 30*60 19-14 9°3 3° '56 332 279 163 70 128 45 19 44-88 38'55 1612 11-65 31 129 258 200 190 77 156 87 31 597° 60-46 43'5° 16 31 32 141 398 35' 127 63 60 53 44 68 I5'°7 15'10 33 83 248 200 167 53 97 7i 18 63-86 39 12 35'5° 1° 77 34 69 185 163 r56 22 43 37 3188 2324 22-70 35 104 361 283 224 37 78 77 20 3558 2161 2721 892 36 17 92 162 65 8 45 7 20 4707 48 90 4'32 3077 Sub-District—HIGHBURY. 3 4 5 112 308 210 300 30 87 43 3° 26 79 2825 20'47 io'oo 6 109 224 209 312 38 33 23 18 34-86 1473 11 00 577 7 47 l6l 177 152 10 10 9 2128 621 5'92 8 161 255 372 399 100 84 70 73 6211 32 94 18-82 1829 9 "5 J74 261 238 56 73 66 67 48-69 4J'95 25-28 28-15 10 77 156 T73 45i 38 3i J4 75 49'35 1987 809 1663 11 12 91 261 395 288 3° 79 58 28 32 96 3027 1468 972 13 74 176 308 220 30 41 15 18 4°'54 2329 4870 818 14 90 258 196 336 3° !°5 35 71 33'33 4070 1786 21-13 15 57 *55 293 261 27 20 37 27 47'37 I2*90 12-62 1034 16 27 246 299 253 6 45 32 22-22 l8*29 1070 17 29 143 211 158 ii 11 8 37'93 7-69 3 79 18 33 152 299 188 3 10 909 658 4-68 19 42 172 238 233 9 11 7 10 2143 6-39 294 429 20 55 204 249 155 21 53 39 18 3818 2598 1566 1161 21 36 142 130 85 13 31 28 36-11 2183 21 '54 22 37 141 302 184 9 15 15 2432 1063 496 23 122 358 186 248 36 129 48 9 2951 36 04 2581 362 24 56 189 122 196 36 70 14 9 64*27 37*04. 11 *47 25 75 164 172 186 10 16 r4 I3'33 j / 1 9'75 TV 8-14 4'59 26 25 83 160 105 7 24 7 9 2800 2891 4'37 8-57 27 51 151 3°5 246 13 33 22 10 2548 21-85 7'2I 4* 06 28 29 16 70 83 98 5 9 7'i4 918 3° • 31 32 213 284 192 452 173 227 118 161 8122 79'93 6i-44 35*62 33 107 241 352 322 32 49 53 38 2991 2033 1506 n*8o 44 TABLE IX.- continued. Sub-District—Highbury—continued. Enumeration District. Total Persons Enumerated in. Persons Overcrowded and Living in. Percentage of Persons Overcrowded. Rooms. Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 3 4 34 387 429 223 327 240 297 !43 90 6201 6923 64-11 2752 35 48 130 236 151 3 15 6 25 " 53 36 57 229 293 188 13 23 34 2280 ioo4 1160 37 hi 243 214 3°5 44 66 40 29 39 65 2716 18 69 951 38 34 89 381 188 39 1 8 75 77 . , . . 40 53 138 150 266 23 50 15 22 43'4° 3623 10 00 827 41 95 313 290 226 25 43 29 36 26 31 1374 10 00 i5'93 42 207 251 90 220 68 47 15 19 3285 1872 1666 863 43 71 334 4r5 279 M 178 67 3° 1972 53 28 1614 1075 44 52 169 188 152 15 52 H 21 2885 3077 744 1381 45 •• •• •• •• Sub-District—B ARN SBU RY. 1 184 370 87 128 7i 162 23 .. 3858 43 78 26 43 2 136 196 146 73 42 44 14 30-88 2244 959 .. 3 114 237 240 157 31 37 25 2719 1561 IO*4l 4 78 137 "5 114 23 3° 8 2948 2189 6 95 5 83 112 140 84 16 20 J5 18 19 27 17 85 10-71 2142 6 116 204 275 125 48 67 77 19 4I-37 32-84 2800 1520 7 45 178 204 116 6 46 15 1333 2584 735 8 80 122 195 no 32 21 23 40 OO 17-21 11 79 891 9 32 106 173 ioi 6 12 7 9 18 75 11 32 404 10 40 79 143 285 3 10 9 75° 12 65 315 11 41 136 145 118 10 .. 735 .. 12 128 249 120 72 5i 70 r7 3984 2811 1416 13 198 296 151 134 ioi 104 21 20 5100 3513 13 90 1492 r4 200 299 179 176 ioi 147 66 10 50-50 49-16 3687 568 15 138 253 150 140 40 71 15 2898 2806 1000 16 112 255 149 180 32 54 3° 18 2857 21-17 2013 '7 64 178 72 145 9 48 7 1406 26 96 972 18 117 273 151 121 5° 58 51 9 4273 2124 3377 743 19 64 311 180 164 13 41 23 9 20 31 1318 1277 548 20 242 354 143 137 116 139 68 19 4793 39 26 4755 13-86 21 217 43i 145 132 117 175 40 20 53 92 4060 2758 I5-I5 22 208 306 249 218 141 190 125 81 6779 6210 5019 3715 23 65 r93 176 144 22 59 7 9 33 84 3° 56 397 625 24 81 181 182 116 35 36 21 9 43 21 1989 "•53 776 25 71 258 196 166 18 47 16 .. 2535 18-21 8 16 26 84 145 298 171 25 15 3° 2976 1034 1006 27 17 100 "5 55 4 15 2352 1500 28 54 74 138 62 10 6 10 1851 811 7-24 29 199 428 156 "3 125 278 68 28 6281 6495 43-58 24 77 30 215 369 229 109 123 272 135 32 57'2i 7371 58-95 29 35 31 247 498 236 229 159 299 81 70 6437 60'04 34 31 30 57 32 81 310 173 125 33 74 31 40-74 2387 1791 33 119 618 4°3 126 80 4°3 136 41 6722 6522 3374 32 54 34 357 696 275 264 235 470 141 87 65 83 6753 5128 32 95 46 TABLE IX.—continued. Sub-District —South-East Islington—continued. Enumeration District. total persons enumerated in. persons overcrowded and living in. percentage ©f persons oyercrowded. Rooms. Rooms. Rooms. 1 2 3 4 1 2 3 4 1 2 3 4 27 71 352 211 150 27 !3° 38 38.03 36 .92 1801 28 205 371 156 185 87 146 30 9 42.44 39 .35 19-23 486 29 170 368 218 173 62 60 45 41 36.47 16.30 20-64 2370 30 77 263 240 191 19 55 7 18 24.67 20.91 291 9 42 31 136 90 181 163 49 46 22 3603 51 .11 12.15 .. 32 133 248 '34 i33 41 7i 7 29 30.82 28.63 5.22 21 80 33 203 348 207 130 102 203 73 29 50.24 58.32 35.27 22.31 34 43 281 151 142 40 140 23 24 2797 49'82 15.23 16.90 35 126 280 231 173 23 50 31 10 1825 1785 13.42 578 36 142 4°5 165 184 45 82 14 31 69 20-24 8.48 37 107 267 183 229 26 3i 38 38 2430 11.61 20.76 i6.59 38 86 163 111 175 26 20 7 9 3023 12.27 6.0 5.i4 39 104 135 138 208 46 43 22 69 4423 3185 15.94 33.17 40 181 260 >32 224 80 67 38 47 4420 2577 28.79 2098 41 259 294 373 275 155 140 150 65 59 85 4762 40.20 23 64 42 129 204 178 218 47 61 39 33 36-43 2991 30.46 15 13 43 300 358 612 217 141 160 3°9 49 47-00 4470 50.48 2258 44 161 37° 210 242 85 173 39 29 52.80 4675 18.57 11.98 45 96 203 189 151 27 42 t4 2812 20.69 7.40 46 167 246 192 181 79 64 71 29 47 30 2602 36.98 16.02 47 38 112 138 130 19 61 62 20 50 00 54 47 44.92 15 38 48 3 180 369 147 35 73 38 1945 19.78 2585 49 .. .. .. .. .. .. .. .. .. .. .. .. 5° 56 188 119 77 11 52 8 1964 2766 6.72 51 56 144 87 43 6 16 15 8 10.71 nil 17.24 i860 52 131 346 281 255 44 135 49 30 33 59 39 .01 17.44 1176 53 119 259 234 151 38 120 41 9 31'93 46.33 17.52 5 96 54 49 119 89 110 3 35 7 612 29.41 7.86 55 156 279 308 179 64 42 47 27 4io3 15. 05 1526 1508 56 88 375 166 131 44 204 44 30 50 00 54 .40 2650 22-90 57 40 134 183 95 12 39 17 9 3000 29. 10 928 947 58 150 227 203 187 56 77 .. 40 3734 33.93 •• 21.39 59 233 375 139 108 115 132 7 29 49 35 3520 5 03 26.85 60 30 101 128 112 15 33 43 10 50 00 3267 33 58 8 93 61 117 284 252 224 50 61 .. 9 42-73 21-47 4.02 62 20 47 128 40 6 5 14 9 30 00 10-63 1093 22.50 63 157 267 150 119 53 48 15 .. 33 75 17-97 1000 .. 64 118 290 252 135 16 35 28 .. 13 55 1206 ii.ii 28.10 65 18 88 52 267 .. 41 14 75 .. 46 60 26 .92 66 19 108 76 61 .. 33 37 .. .. 30.55 40.68 .... 67 3 416 578 3 .. 138 19 10000 33. 17 3 29 68 64 599 428 14 10 247 127 15 62 41-24 29.67 • • 59 158 166 93 105 72 17 14 45 57 1024 15.05 .. 70 102 293 226 274 66 135 93 70 6470 4608 4!.i5 25.54 APPENDIX III. REPORT on the Voluntary Notification of Pulmonary Consumption by The Medical Officer of Health. BOROUGH OF ISLINGTON A FURTHER REPORT ON The Voluntary notification OF PULMONARY TUBERCULOSIS OR CONSUMPTION. [Ordered by the Public Health Committee to be printed.) BY THE MEDICAL OFFICER OF HEALTH. VAIL & CO., Printers, 170, Farringdon Road, E.C. Chart showing the mortality from Phthisis and certain Zymotic Diseases for twelve years 1893-1903, to every 100 deaths from All Causes. CHART, SHOWING DEATHS FROM PHTHISIS TO EVERY 100 DEATHS FROM ALL CAUSES. At Eight Group of Ages, and at all Ages. Phthisicorum cadavera fugi adolescens, fugio etiavi senex. —Morgagni. The Voluntary Notification of Pulmonary Tuberculosis or Consumption. To the Chairman and Members of the Public Health Committee. Gentlemen. RETROSPECTIVE. It is now nearly two years ago since I presented a report on this subject to your predecessors, which after careful and anxious consideration they adopted; and about which on December 22, 1902, they reported to the Council as follows :— " We have had under consideration a very important and exhaustive report from the Medical Officer of Health on the voluntary notification of pulmonary tuberculosis or consumption, a copy of which we have directed to be forwarded to each member of the Council. Having regard to the now known infectious nature of phthisis, and to the sympathetic and encouraging replies which have been received by the Medical Officer of Health in response to a letter addressed to the members of the medical profession in the borough asking whether they would be prepared to notify this disease, we are of opinion that every means tending to prevent the spread of this scourge should be adopted. We, therefore, recommend that the voluntary notification of pulmonary tuberculosis or consumption be adopted in this borough, and that it be referred to us to make the necessary arrangements for carrying this resolution into effect." This recommendation led to a long discussion with the result that the proposal was rejected on a division by 22 votes to 14. In the course of the debate it was alleged inter alia by various speakers :— 1. That voluntary notification of phthisis is useless. 2. That it is a question that is not ripe enough for local bodies to deal with, 2 3. That the proper course instead of blindly following in the wake of other boroughs was to wait and see the result of notification in them. 4. That notification was no service whatever unless followed by remedial measures. 5. That it was absurd to disinfect the rooms in which people suffering from phthisis had been living. 6. That it was no value whatever except to take the ratepayers' money and place it in the hands of medical men. 7. That it would cause friction between the Medical Officer of Health and the medical men in the borough. 8. That there were doubts as to whether this disease was caused by a bacillus. 9. That it had not been proved that the disease was infectious. 10. That the working classes would resent the intrusion of the Council's officials. Now in the face of the facts and figures that I gave in my report, many of these contentions could not for a moment be sustained, and, indeed, were based on no solid foundation of fact, and would not have been alleged if it had been carefully studied. I do not propose to discuss them now for I am convinced that any person who carefully reads this further report, will come to an opposite conclusion to that which the majority of the late Council came to, and who adopted a resolution, which I feel would never have been arrived at, if they had not been more or less swayed by two members of the medical profession, who I am bound to assert gave utterance to opinions which were entirely their own and which were not held by the great majority—fully four-fifths—of their professional brethren practising in Islington. Indeed, I would not be far wrong in asserting that, with an additional exception, the members of the medical profession agreed with the Committee that the voluntary notification of pulmonary tuberculosis was necessary, and that they were willing to notify the disease. At all events this was the opinion of Dr. John Gray Glover, J.P., so well-known in connection with all public movements having as their object the welfare of this borough, who wrote a letter to Alderman Cufflin, the former Chairman of your Committee, soon after the proposal was rejected by the Council. It is valuable as showing what so well-known a citizen thinks on this subject, and also as a reflection of the general opinion held by the medical profession, of which he may rightly be said to be the doyen in Islington. 3 25, Highbury Place, N. February, 27, 1903. Dear Mr. Cufflin, May I express to you as Chairman of the Sanitary Committee of the Town Council, my regret that the recent proposal of the Sanitary Committee to arrange a system for the voluntary notification of phthisis was not accepted by the Council. The report of the Medical Officer of Health on the subject was most earnest and convincing, and was in accordance with the prevailing views of the medical profession, and the latest teachings of medical science. The pitifulness of the action of the Borough Council was much impressed on my mind at the time by the fact that I was witnessing daily the lingering death of a fine young man in his prime from consumption, leaving a widow and child. Both he and his wife willingly consented to notification. Surely in these days of enlightened State Medicine it is not too much to expect of a municipality that it shall do all in its power to save the unaffected and to reduce the number of cases of a disease so costly and difficult to cure. A system of voluntary notification would at a small cost powerfully contribute to this end. The widows and orphans made by consumption are a fruitful source of pauperism. Notification would be a wise measure financially as well as a very benevolent one. There can be little doubt that the great majority of my medical neighbours would approve of voluntary notification It would tend to diminish their income by diminishing the number of cases of tubercular disease. But this consideration has never hindered medical men as a body from advocating measures for the prevention of disease. Believe me, dear Mr. Cufflin, Yours very truly, (,Signed) J. G. GLOVER. Alderman Cufflin, Chairman of the Sanitary Committee, Borough of Islington. 4 CHRONOLOGICAL. A few facts arranged chronologically respecting this disease (which I may point out has been recognised from very early ages, for it may surprise many to learn that it is not a modern disease, but one that was well recognised and written about more than two thousand years ago) will be valuable as showing that its treatment and prevention have always been an object of great concern. B.C. 436-338. Isocrates, one of the ten great Athenian orators, a teacher of Xenophon and other great Greeks, in a speech on behalf of a client who claimed to inherit his father's estate on the ground that he had nursed him while suffering from phthisis contrary to the advice of his friends, who said that nearly every person, who nursed this disease, died of it themselves. B.C. 400. Hippocrates, the father of medicine, seems to have been well acquainted with it, for he describes an acute attack of phthisis. " Consumption," he wrote in his Epidemica (Lib. I, 2). " which then (i.e., the beginning of spring, through the summer and towards the winter) prevailed, and the only one (i.e., disease) which proved fatal to many persons. Most of them were affected by these diseases in the following manner. Fevers Accompanied by rigors of the continued type, acute, having no complete intermissions, but of the form of the semi-tertians, being milder the one day, and the next having an excitation, and increasing in violence, constant sweats, but not diffused over the whole body; extremities very cold, and warmed with difficulty, bowels disordered, with bilious, scanty, unmixed, thin, pungent and frequent dejections. The urine was thin, colourless, unconcocted, or thick with deficient sediment, not settling favourably, but casting down a crude and unseasonable sediment. Sputa small, dense, concocted, but brought up rarely, and with difficulty, and in those who encountered the most violent symptoms there was no concoction at all, but they continued throughout spitting crude matters. Their fauces, in most of them, were painful from first to last, having redness with inflammation ; defluxions, thin, small, and acrid; they were soon wasted and became worse, having no appetite for any kind of food throughout; no thirst, most persons delirious when near death. So much concerning the phthisical affections." Again, in another part of the same work (Lib. III, 14), he wrote with respect to the predispositions to phthisis thus:—" The form of the body peculiarly subject to phthisical complaints was the smooth, the whitish, that resembling the lentil, the reddish, the blue-eyed, the leucophlegmatic, and that with the scapula; having the appearance of wings." 5 In another of his works (Aphorismi, V. 9), this most careful observer wrote. " Phthisis most commonly occurs between the ages of eighteen and thirty-five and again he remarks {lib. cit. V., 11) " In persons affected with phthisis, if the sputa which they cough up has a heavy smell when poured upon coals, and if the hairs of the head fall off, the case will prove fatal." This curious test it may be remarked was approved by Galen, and most commentators down to Heurnius in the 17th century. He further wrote (lib. cit. V., 12), that " phthisical persons, the hair of whose head fall off, die if diarrhoea sets in," and that (lib. cit. V. 13) " in persons who cough up frothy blood, the discharges of it comes from the lungs," that (lib. cit. V., 14) "diarrhoea attacking a person affected with phthisis is a mortal symptom." It is a noticeable fact that Hippocrates, great observer as he undoubtedly was, omits to notice that phthisis was communicable, an omission, which, as has been shown, was made up for by his contemporary Isocrates. A.D. 100. Artseus, a Greek Physician of Cappadocia, so fully described the disease, that even to this day, no fuller description of it can well be given. A.D. 130-200. Galen, the Greek medical writer and philosopher, considered phthisis an infectious disease, and declared that it was dangerous to live with persons suffering from the disease. A.D. 1614-1672. Frangois de la Boe (Sylvius) first described nodules which by their purulent disintegration form cavities in the lungs ; and he also recognised the analogy between them and the glandular lesions in scrofulous persons. A.D. 1638. Lazarus Riverius in his " Practice of Physik " points out in a remarkable passage that the chief external cause is contagion, and that the disease is so infections, that women are infected by their husbands, husbands by their wives, and that their children die of the disease, and not only by heredity, " but from the company of him who was first affected."* Also that it is not safe for a brother or sister to enter into the chamber for the miasmata or infective vapours, which come from the lungs and infect the whole air of the chamber so that they beget the same disease in others. A.D. 1666-1723. Antonio Valsalva, an Italian, pointed out that consumption of the lungs was infectious. * Compare this with the Manchester experience of Dr. Niven, p. 29. 6 A.D. 1689. An English Physician, Morton, in his " Phthisisologia" recognised that tubercles were the pathological evidence of the disease of the lungs, which is always characterized at some period of its evolution by their presence. A.D. 1750. The magistrates at Nancy caused the effects of a woman who had died from phthisis to be burned in the market place. A.D. 1754. Morgagni* (Giovanni Battista), an Italian anatomist, taught, that phthisis was infectious, and through his teaching the Sanitary Magistrates of Florence requested the Medical College of that city to define the articles that would be most likely to be infected by a phthisical patient, and the means whereby they could be purified. Antonio Cocchi, in evidence that reads as if it were only given yesterday, pointed out to them :— (1) The curative effect of large and well cleaned rooms, exposed to the sun. (2) The necessity of open windows. (3) The ill effects of stuffy rooms with closed doors and windows. (4) The necessity for the phthisical to spit into glass or porcelain vessels, which should be cleaned frequently. (5) The necessity that floors and walls should be cleansed and whitened in all small rooms, but that it is sufficient to whitewash up to the height of a man in large rooms. A.D. 1757 The Sanitary Magistrates of Florence issued an edict on the subject of phthisis. A.D. 1760. A special hospital was erected at Olivuzza for the isolation of patients, suffering from phthisis, who had been under treatment in other hospitals, so that they might not infect the sick in the other beds. A.D. 1782. An edict was issued at Naples ordering : During illness. (a) The isolation of consumptives. (b) The disinfection of their rooms, furniture, books, etc. * It was he who said " Phthisicorum cadavera fugi adolescens, fugio etiamsenex." " As a young man Igshunned the dead bodies of the phthisical, as an old man I still shun them." 7 After death. (c) The cleansing of the rooms. (d) The renewal of the wainscoting and ceiling. (e) The scrubbing and cleansing of the doors and windows. (/) The introduction of fresh plants so that the infected atmosphere might not be communicated to persons who lived near. The edict also ordered the Governors and Directors (1) to burn the clothing etc., ot persons infected with the disease, and (2) to provide new clothes in cases of poverty. The decree provided penalties (1) Three years at the galleys or prison according to the condition of the person, and three years imprisonment and 300 ducats fine for opposing the officials making their inventories, etc (2) Physicians who did not reveal the nature of the illness to pay a fine of 300 ducats for the first offence, and for the second ten years' banishment. It also enacted on the relatives that (1) those who buy an infected robe shall have three years at the galleys, and (2) those who sell shall pay three times the value of the robe as a fine, (3) those who refuse to send the patient to a hospital, or remove him without the knowledge of the Officer of Health, shall have three months' imprisonment if of low birth, or pay a fine, 300 ducats if noble. A.D. 1785-94. Stark and Baillie first described miliary tubercle, i.e., the minute grey early tubercle. A.D. 1792. Portal found that tubercles disintegrate and leave cavities in the lungs. 1819 Laennec (1781-1826) first showed by his careful anatomical observations of the lungs that growths to which the name "tubercles " were applied, formed almost the sole cause of consumption, and he, therefore, restricted the term " phthisis " to the disease produced by tubercles in the lungs. It was his immortal discovery of auscultation by means of the stethescope that enables physicians to-day to examine the lungs of living men, and to determine their lesions. Andral, a French physician, confirmed these observations, and even went so far as to say that under certain conditions emenations become a source of true contagion. A.D. 1803. Vetter, a German, compared the matter resulting from the disentegrations of tubercles to cheese, whence the name " caseous " afterwards applied to tubercular matter. 8 In the same year Chateaubriand, writing to Fontanes, announcing the death of Madame de Beaumont, complains that he is in great difficulty, because he had hoped to obtain 2,000 crowns by the sale of his carriages, but " by a law of the time of the Goths, phthisis is declared in Rome a contagious disease," and as Madame de Beaumont rode in his carriages nobody was willing to buy them. 1830. Schonlein first used the term " tuberculosis." A.D. 1839. Georges Sand, travelling in Spain and its islands with Chopin, then suffering from the disease to which he succumbed ten years later, had just settled down in Majorca. " At the end of a month," she writes, " poor Chopin, who had a cough since we left Paris, became worse, we sent for a doctor—two doctors—three doctors—each more stupid than the other, who started to spread the news in the island that the sick man was a consumptive in the last stage. As a result there was great alarm. Phthisis is rare in these climates, and is looked upon as contagious. We were regarded as plague infected, and furthermore as heathens as we did not go to Mass. The owner of the little house which we had rented turned us out brutally, and wished to bring an action against us to limewash his house, which he said we had infected." At Barcelona iust as they were leaving the inn, the landlord demanded that they should pay for the bed on the pretext that it was infected, and that the police regulations required that it should be burnt. A.D. 1843. Klencke afforded the first experimental proof that phthisis was communicable by injecting tubercular matter into the jugular vein of a rabbit, and finding tuberculosis twenty-six weeks later in its liver and lungs. A.D. 1857. Pasteur in his researches into the process of fermentation showed that it is a correlative of life, being the work of microscopic living organisms; and it was his investigations which led to Lister's researches in antiseptic surgery, which in turn led up to Koch's great discovery at a later period. A.D. 1865. Villemin, Professor at Val-de-Grace, demonstrated by a series of unexceptionable experiments on rabbits, guinea pigs, and dogs, that tuberculosis can be transmitted from man to animals :—for instance that if a small portion of tubercular matter, such as expectoration from a consumptive, is introduced under the skin into the peritoneal cavity, and into the trachea of an animal, tuberculosis will be found on killing it a few weeks later in the lungs or other organs. 9 A.D. 1868. Chauveau, in France, introduced tuberculosis in bovines by causing them to eat tubercular matter mixed with their food. A.D. 1877. Pasteur definitely established the specific pathogenic influence of certain minute organisms, thread like bodies like rods or sticks which, in 1850, Bayer and Davaine had discovered in the blood of animals suffering from anthrax. A.D. 1880. Tappeiner made animals tuberculous by causing them to breathe air containing tuberculous expectoration in the form of dust. A.D. 1881. Robert Koch, of Berlin, discovered, isolated, and cultivated the bacillus of tuberculosis. After this year, clinical researches were undertaken in all countries. In England by Watson-Cheyne, Dreschfeld, and C. T.Williams; in France by Chantemesse, Duguet, Gosselin, Hericourt, and Warlomont; In Italy by Celli, Cavagnis, Guarnieri, and Yitolini; in Germany by Baumgarten, Biedert, Langerhans, Veraguth, and many others, with the result that Koch's observations were entirely verified, and that his bacillus was acknowledged as the specific cause of the disease. WHAT IS TUBERCULOSIS ? Generally the word tuberculosis is associated in the popular mind with phthisis, or consumption of the lungs, which is its most fatal form. There are, however, other forms which are known under the names Tubercular Meningitis {i.e. of the membranes of the brain), Tubercular Peritonitis, Tabes Mesenterica, Lupus {i.e., Tubercle in the skin), Tubercle of various organs, General Tuberculosis, and Scrofula, which are the headings under which the disease is classified in the death returns of the Registrar-General. Sometimes the disease, especially when in the joints and bones causes suppurations in various places, and occasions surgical operations " almost as various in their nature as their locality." It is a disease not only of man but also of animals. It is met with more frequently, however, in those animals which are domesticated or confined, such as cows, pigs, rabbits, monkeys, fowls, pigeons, ducks and turkeys. The cause of the disease is a bacillus, " Koch's bacillus," as it is called after its brilliant discoverer. There can be no tubercular disease without its presence; and, therefore, if we stamp out the bacillus we preserve life. A recent writer observes "from our point of view, tuberculosis is a disease 10 From the point of view of the bacillus it is a natural life process. The bacillus has a plan of life laid down for it, providing as usual for the maintenance of the individual, and the propagation of its kind. Clearly, it is necessary that we should understand this plan before we can hope to disconcert it." THE LIFE OF THE BACILLUS. There is now a concensus of opinion that the bacillus is not inherited, although it may pass from a tubercular patient into the foetus, and be born with it, but this is so rare that it is really a matter of the smallest moment, and " for all practical purposes, the hygienic administrator is bound to regard every case of tuberculosis as caused by infection which has taken place so to speak in the open—within the sphere of his control." We are therefore driven to inquire how it gets into the body. The experiments of Villemin, Chauveau, and Tappeiner have demonstrated that the bacillus may enter it through an injury to the skin, through the alimentary canal, or through the respiratory passages and organs, whence it may be conveyed to the internal tissues of the body by the blood vessels or the lymphatic vessels. When the bacillus enters the blood it multiplies with great rapidity, and a generalized form of the disease quickly results, but when it propagates in the lymphatic system, which is its most frequent habit, its progress is much slower, and consequently the tissues are not so quickly affected. The bacilli multiply at first without causing noticeable lesions, but after a time they penetrate the fixed cells of the tissues, and give rise in them to a nutrative and formative irritation, whether they be cells of the connective tissue, of the blood vessels, or of the lungs, which cause their (the cells) multiplication. This multiplication of cells in turn leads to the formation of small nodules, really tubercular follicles, which are full of baccilli, and these follicles by their agglomeration form granulations and miliary tubercles, which may in turn by their coalescence become large tubercles, the size of a nut or an egg, such as may be found at times in the lungs, in the brain, and in other organs. Tubercular products such as these undergo a caseous (cheesey) degeneration, caused by the necrosing toxins secreted by the microbe, which begins at the centre, while at the same time the lesions are spreading at the circumference. And thus tubercular matter, which is at first grey and hard, then yellow and pliable, becomes a puriform thick yellowish paste which seeks discharge outside. Sometimes instead of forming clusters the tubercular follicles spread out in a sheet, and infiltrate the tissues, which, thickening, "assume an appearance similar to that of bacon. These infiltrations pay a considerable part in pulmonary consumption and in tubercular disease of the bones and joints, and follow a course similar to that 11 of the tubercular granulations ; they become caseous, disintegrate, and assume a greyish and yellowish colour, and when the transformation is complete no cellular arrangement is recognisable. It is in this manner that Koch's baccilli thrive and perform their deadly work, and thereby annually and prematurely carry off many thousands of human beings, and it is these baccilli that man has set himself the task of stamping out. The bacilli themselves are fungoid vegetable growths and are small rodlike bodies in shape and appearance resembling small very slender sticks, varying in length from 80 to 300 millionths of an inch, and 12 millionths in thickness. They are straight or curved, sometimes considerably so, and may be seen under the microscope, at a magnitude of 600 diameters, singly, in pairs, or collected in groups. They can be easily obtained by straining sputum or tubercular matter with methylin blue, when some hours later, on washing off the superfluous colouring matter, the bacilli appear, as described, in the field of the microscope. ACCESS OF THE BACILLUS TO MAN. The heredity of the disease has now been proved to be of such rare occurrence that it may practically be set aside as a matter of little or no moment; and so also, as of no great sanitary importance, may those cases which arise from scratches or other abrasions or ruptures of the skin remain unnoticed. There is, however, one great gateway through which the bacillus enters the body, namely the mouth, into and through which it is conveyed either by the air or by food, thus easily gaining access to the throat, the lungs, or the digestive tract. Now as every bacillus must have sprung from a predecessor, so also must it have had its breeding place in an animal, and must have passed out from that animal. Consequently we are brought to these conclusions that the disease in man must have been caused either by bacilli contained in (a) discharges or excretions from man or infected animals; (b) the milk of infected animals; or (c) the flesh of infected animals. With respect to the first of these conclusions it is a well established fact that bacilli are almost invariably present in the dust of rooms which have been occupied by phthisical patients, who cough, bring up mucus, spit on the floor, or are otherwise careless in destroying their sputum, which on drying becomes pulverized, floats about as dust, and at once becomes a very real danger to other persons. Now in reference to this subject Dr. Gordon in a report to the Local Government Board, says as the outcome of varied and repeated 12 experiments that it has been well substantiated that not only in the act of coughing and sneezing, but also in loud speaking, fine droplets of mucus are sprayed from the mouth into the air, that thev float in the air, and that they may be wafted by air currents, such as obtain in ordinary rooms, to a distance that at first sight appears to be almost incredible. Thus it has been shown that by reading aloud for half-an-hour Bacillus prodigiosus may be disseminated from the mouth to a distance of 24 feet in front, and may also be obtained in the air behind the speaker. In another experiment by sneezing 12 times, giving a few short coughs, and speaking a few words, the same bacillus was shown to penetrate to a distance of 40 feet in front (Kceniger). The length of time these droplets remain suspended in the air is uncertain ; thus Von Weismayr states that they fall to the ground within half-an-hour; Kceniger within 1| hours; while Fliigge believes they may not disappear from the air of the room for 4-6 hours. Now this subject is of serious moment when considered in the light of phthisis, for there is no reason to suppose, if the Bacillus prodigiosus spreads to such a distance, that Koch's bacillus would not spread to an equal distance under similar circumstances and would become a source of infection. We know that animals have succumbed to anthrax after exposure for 10-15 minutes to an atmosphere impregnated with anthrax spores (Buchner in Annales d' l'Institut Pasteur, January 1888) and also that inhalation experiments with dried tubercular sputum, carried out by various observers have had positive results; and Koch showed that tubercular bacilli in pure culture could produce similar results when inhaled by animals. Other experimenters, Moller, Fliigge, and Heyman, have shown that when they exposed guinea pigs close to the mouth of coughing phthisical patients, a proportion of the animals developed tuberculosis. In this connection it may be recollected that Klein showed that tuberculosis was contracted by guinea pigs that were kept in a ventilating shaft at the Brompton Hospital. We have seen how the Italians and the Spanish in years long gone by recognised the infective power of the disease although they did not, as we do, know its real cause. They were not aware, as we are, that the cough-sprayed minute droplets which are discharged by the patient become the very finest form of tubercular matter, and may become potent factors in spreading the disease. Nevertheless, they adopted preventive measures, which are models to us to-day, with all our accumulated knowledge, and which are too much ignored or neglected by many sanitary authorities, who, instead of being apathetic, should be energetic in preventing this frightful scourge of phthisis, which is so eminently a preventable disease. 13 It is not merely the duty of sanitary authorities to endeavour to prevent what is known as the Zymotic Diseases, Scarlet Fever, Measles, Diphtheria, Smallpox. Enteric Fever, Typhus, Plague and the like, but it is their duty also to endeavour to check and control all diseases which are controllable by preventive or sanitary measures. The Government clearly recognise this, and the Local Government Board have everywhere allowed the payment of fees to medical men for notifying tubercular phthisis. THE MONEY LOSS THROUGH CONSUMPTION. It is not possible to gauge with any degree of accuracy the amount of money annually lost through illness from Consumption, but when it is recollected that it is most prevalent at the period of life when man possesses his greatest physical and mental power, and is, therefore, more easily able to earn his maximum wages, it must indeed be very great. In Islington we have seen that 9½ per cent. of all the deaths are caused through Phthisis, while 30T per cent, of all persons dying occurred between the ages of 15 to 25 ; 35'5 per cent, between 25 to 35; 28.5 per cent. between 35 to 45; and 17T per cent. between 45 and 55 (vide chart). Last year in the Workhouse Infirmary of this borough 125 out of 654 deaths, or 19.1 per cent. were due to Consumption, most of them in adult life, so that locally the monetary loss must be considerable. Dr. Herman Biggs, Health Officer, of New York, has calculated that the annual loss through the disease in the United States amounts to £66,000,000, arriving at this conclusion by estimating the value of each life at the average age at which deaths from Phthisis occur at £300. This gives a total value to the lives lost annually (150,000) of £45,000,000. To this must be added the loss arising from incapacity for work during illness, lasting on an average nine months, and the loss of service at one dollar a day, with food, nursing, medicines, attendance, etc., at one and a-half dollars a day, which result in a further loss of £21,000,000. For the City of New York the loss is £4,600,000 per annum. On the basis of Dt. Bigg's estimate, the annual loss in London would amount to £3,300,000, and in Islington to £240,000. It is a reasonable proceeding to estimate a man's life at £300, for it represents the cost of his rearing, his education, his training to a trade, business or profession, all of 14 which were given to him to enable him in turn to rear, educate and train the succeeding generation. When he has failed to do this through premature death, he has failed in his alloted part in the scheme of life, and, therefore, all the money spent on him has not been merely lost but also wasted. In other words, the human machine like any other machine is a failure if it breaks down at the time it is most required, and the money spent on it is so much money thrown away. a working man's question. The Friendly Societies of this country, which may be truthfully said to represent the most thrifty of the artizans, are fully alive to the great financial losses which are inflicted on them annually by the loss of life through the disease, and are fully intent to do their utmost to prevent its spread amongst their members; and so far from resenting the intrusion of Public Health Officials among their members to teach and instruct them how they might prevent the disease, would hail their visits with delight. At Manchester in 1902, a Conference, at which the representatives of 27 Friendly Societies, representing 3,620,488 members, paying nearly 2½ millions of money for sickness, and over half a million for funerals annually, assembled and appointed a sub-committee to attend the Congress then about to be held in London with reference to the cure and prevention of tuberculosis, and also resolved that "The Committee of the Conference appoint a Sub-Committee to deal with the question in the interests of the members of our Societies." The result of these decisions was that the Sub-Committee attended the Congress, and afterwards visited Germany with a view of seeing what was being done there in preventing Consumption, while the Committee brought up a report to the National Conference of Friendly Societies held at Sheffield in 1903, at which it was resolved "that the reports of the Societies be considered at the Special Meeting of the Conference to be held in the autumn, with a view to determine the best way of co-operating with the National Association for the Prevention of Consumption." Thus we see that the Friendly Societies as a whole are seriously considering this great question. The Ancient Order of Foresters on their own behalf are also moving, and last year (1903) a return was presented to their High Court at Sheffield, the importance of which may be judged by the fact that it dealt with three and three-quarters million vears of lives, of which 2,271,822 were those of benefit members, and 1,028,337 of wives and widows of members. The return related to the deaths that occurred in the United Kingdom in the five years 1897-1901 and are very remarkable, 15 Benefit Members. Deaths from All Causes. Deaths from Consumption. Percentage of deaths from Consumption to total deaths. England 31,498 4,478 14.21 Ireland - 48 11 22.91 Isle of Man 54 8 14.81 Scotland ... 2,369 646 27.26 Wales 1,217 177 14.54 United Kingdom 35,186 5,320 15.11 Wives and Widows of Members. Deaths from All Causes. Deaths from Consumption. Percentage of deaths from Consumption to total deaths. England 10,290 1,281 12.44 Ireland - 32 9 28.12 Isle of Man 34 6 17.64 Scotland 1,279 239 18.68 Wales 653 91 13.93 United Kingdom 12,288 1,626 13.25 In his comments on these returns the Reporter remarks that " it will be seen that the total deaths from Consumption returned in the United Kingdom in the five years 1897-1901, is 5,320 amongst benefit members, and 1,626 amongst wives and widows of members, in a total of 6,946 lives claimed by one form of disease alone, the percentage of deaths from Consumption to the deaths from all causes being 15.11 in the case of the benefit members, and 13.25 in the case of the wives and widows." It would be extremely interesting to quote this document in full, but as it is necessary to curtail, it must suffice to quote one further paragraph. 16 " In inviting the Ancient Order of Foresters to be represented at the British Congress on Tuberculosis, held in London, 1901, the Secretary of the latter body stated:—'I would point out to you that the prevention of consumption, and the care of those who are afflicted with the disease, is emphatically a workman's question.' There can be no doubt of the truth of this statement. How far the working classes, however, are more subject to consumption than the more favoured classes is a question that does not at present admit of any definite answer. The Registrar General in a report for the four years 1896.99 shows that the mortality from all ages in the four years stated in England and Wales, was equal to a rate of 1,521 per million living among males, and to a rate of 1,141 per million among females. Practically, he says, the incidence of Phthisis is upon the ages from 15 to 75 years of age, very old people and very young people being comparatively exempt. " Calculated upon the basis of the particulars supplied by branches of our Order in England and Wales, our death.rates from consumption would be equivalent to 1,885 per million amongst males and 1,529 per million amongst females." The result of the visit of the Friendly Societies sub.committee or deputation to Germany has had a very considerable effect in opening the eyes of the working classes connected with them to the importance of preventing and curing consumption, and the reports of the members of that deputation to their several Societies are full of the deepest interest. In one of these, Mr. A. Chapman, late Parliamentary Agent to the Ancient Order of Foresters, quotes from a return of the Imperial Board of Insurance (Prussia) "of the whole population in Prussia, the mortality from consumption was in 1886, 31 per 10,000, in 1901, 19 per 10,000," commenting on which he exclaims " truly a splendid outcome of the combat so far ! That means that in Prussia alone nearly 300,000 less died of consumption in the 15 years than would have been the case had the rate continued as in 1886. What a vindication of the methods adopted; and what a pledge of the victory so confidently predicted by the medical profession, that if the fight is maintained and all do their duty, consumption will be as much a thing of the past in 50 years as is leprosy at the present time ! " Mr. F. Litchfield (a local resident) of the National Deposit Friendly Society, speaking quite recently at a conference convened by the Derby Medical Society stated that the Friendly Societies could reduce their sick pay by 30 per cent. if only they gave the subject of consumption the attention it deserved, 17 Mr. A. Chapman in a paper in the "Foresters' Miscellany" for this month (October) gives the result of an inquiry in the South London District on the money loss through consumption, and it is so valuable that I cannot refrain from quoting from it. He takes as the basis of his argument the returns of the " Princess Royal" Court, in which during the past ten years 18 members had died, 5 from consumption and 13 from other causes. In these cases sick pay had been given as follows :— Average per Total. member. Days. Amount. Days Amount. To five consumptives 987 £105 197 £21 To 13 who died from other causes 882 91 63 7 These figures show that on an average the sick pay of consumptive members costs three times, or £14, more than the average sick pay to members dying from all other causes. He then goes on to state the experience of the South London District as to the financial aspect of the loss of life. He says :—" Along with the question of money cost of consumptive sickness is intimately associated the financial aspect of the loss of life occasioned by consumption. The discussions that have arisen have led me to ascertain definitely what has been the experience of the South London District in this respect. Starting with the year 1880, I find that in the 2½ years, 1880, June 1904, the deaths occurring in the district have been as follows:—425 members died from consumption whose average age was 40 years (nearly). 2,294 members died from all causes (including consumption), average age 52 years 4 months. Eliminating the 425 members dying from consumption, 1869 members died from other causes, and their average age was 55 years 1 month. " Look at these figures, they put it beyond dispute that in the South London District the lives of 425 consumptive members have been cut short by at least 15 years. What does that mean financially ? Les us see ! Consumptive members died in 24½ years 425 Multiply by £14 the excess cost of sick pay as experience of " Princess Royal"14 Total excess of sick pay to 425 consumptive members . £5,950 18 " Thus the Courts have had to pay out of their sick funds an excess of £5,950 in hard cash caused by consumption, and this sum at 4 per cent. (the percentage realized by the S.L.D. Courts in the 24 years is over 4 per cent.) means a loss of no less than £9,526. But that is not all. The District Funeral Fund has suffered also. We have seen that the 425 consumptive members died 15 years before their time. That means that the District Funeral Fund has received in each case an average of 15 years' less contributions than would have been paid but for consumption. How does that work out ? Taking the contribution at its lowest of 4s. per year, that means an actual loss of contributions to the Funeral Fund of £1,275, or at \\ per cent, (the district interest has nearly reached 5 per cent. in the 25 years) the total loss is £1,766. The total money loss to Courts and District works out as follows: — Loss to Court Sick Funds £9,526 Loss to District Funeral Fund 1,766 Total £11,292 " Now, if the loss has been anything approaching these figures, it will be evident what a serious question this becomes. It should be noted that I have not taken account of the loss of contributions to the Sick Funds, because if the members had lived the fifteen years they would have been eligible tosick pay, which would have absorbed the contributions payable. It will be seen that cannot apply to the Funeral Fund contributions. " Well then, the broad fact remains that (on the above named assumptions) during the past 24½ years the Courts and District of the S.L.D. have suffered in their Funds to the extent of £10,000 or £11,000, and what applies to us applies to all other Courts and Districts and Friendly Societies. What an aggregate loss must the total represent, and how evident it is that from a mere money point of view almost any sum of money spent will be cheaply spent in ' stopping the leak.' " Mr. E. W. Brabrook, C.B., F.S.A., Chief Registrar of Friendly Societies, has pointed out to the British Congress on Tuberculosis that it is probable that the care which the Friendly Societies exercise in the admission of such persons only as members who are healthy and, so far as can be ascertained by medical examination, free from predisposition to the disorder, tends to render the proportion of deaths among their members less than that among the general population, and he gives some interesting figures on the point. In 1900, out of 441 deaths among the members and wives of members of the Operative Bricklayers' Society who died, 59,or 13 per cent. died from phthisis 13 Out of 512 members of the United Society of Boiler Makers and Iron Ship Builders, 60, and out of 311 wives of members 39, or about 12 per cent. in both cases died of phthisis. Out of 265 members of the Amalgamated Society of Railway Servants who died, 26, or 10 per cent. died of phthisis. Out of 1,146 members of the Amalgamated Society of Engineers, 113, or 10 per cent. and out of 527 wives of members, 66, or 12 per cent., died of phthisis and tuberculosis. He also shows that the average ages of those who died from phthisis were for males 37 3/4 years, and for females 37¼ years in the Amalgamated Engineers Society, while the average ages from all causes of death in the same Society were for males 52 and for females 47. So that in this Union the deaths from phthisis are premature to the extent of from 10.15 years. In the Operative Bricklayers' Union the average ages of those dying from all causes was 46, and from phthisis 39½ years. In the Boiler Makers Society members deaths from all causes were 47, from phthisis 38½ wives of members from all causes 43, from phthisis 35½ Among Railway Servants from all causes 44½, from phthisis 36½. Thus we see that the question of the prevention of tuberculosis is of the very utmost importance to Friendly Societies, and to Sick Benefit Societies generally, and, therefore, to working men. A POOR LAW QUESTION. But outside of these Societies there is a huge mass of humanity who have no Society to look to, labourers, persons in casual employment, widows, orphans, and especially single women, or married women deserted by their husbands, who earn a precarious livelihood, and whose ultimate fate is to flee to the workhouses and their infirmaries when disease overtakes them. The prevention of phthisis is, therefore, a great question for those engaged in Poor Law Administration, as well as for Sanitary Authorities. And here let me state that something of this has dawned on the Islington Guardians, for they are now through their Relieving Officers notifying cases of the disease which come under their notice. All of them had, however, previously been removed to hospital or had died. The figures as to the ages at death among the Friendly Societies given by Mr. Brabrook, show that even among a tolerably select class of lives the average ages at death from phthisis range from 35½ to 39½, and it occurs, therefore, at a time when the parents have young families around them. Consequently, when we come to the lower grades of working men, who live under ill conditions both as to housing, food and clothing, we must necessarily find that the workers die at even a lesser age, leaving their families to be provided for to a very large extent by the rates. The fact is that Consumption causes more pauperism than any other disease, and, therefore, if it can be stamped 20 out, as it assuredly can in course of time, it ought for the cost of keeping so many persons, clothing and feeding them, to say nothing of the cost of nursing, medical attendance and hospitals, or to mention the education of the children, must be enormous. I am sorry I can not adduce figures as to the probable saving there would be to the public purse as I cannot at present find them, although I believe there are some statistics on the subject. Nevertheless, the facts I have given all point to this contention. In Ireland the Local Government Board are very alive to the necessity of preventing and curing consumption, and in 1901 issued a circular to each County Borough Council, Urban and Rural District Councils, Medical Officer of Workhouse and Dispensary Medical Officer, urging that people should be educated as to the best means of guarding against this disease, and that the Local Authorities should endeavour to enlist the sympathy and support of the Clergy of all denominations, School Managers and Teachers, and in fact every person whose duties brought them intimately in contact with the people; and the Board also urged that when provision had not already been made, consumption should be treated in Workhouse Hospitals apart from cases of other disorders. The result has been that in 72 out of 159 Unions in Ireland, provision has been made in their Infirmaries for the separate treatment and accommodation of cases of consumption, while in 11 others partial provision (for one sex only) has been made; so that altogether 83 Unions have been stimulated into action. This circular was re.issued in October, 1903, from which it may be inferred that the Irish Government consider the prevention and cure of consumption of the utmost importance. In England and Wales the Board of Guardians have not been quite so active, perhaps they require stimulating by the Local Government Board. Nevertheless, a movement among them has begun, for according to a very recent inquiry made by Dr. Lionel A. Weatherby, of Bath, it was found that out of the 695 Boards (a) 7 had erected buildings for the treatment of Consumption ; (6) 28 had allocated and adapted special Wards in their infirmaries for their consumptive patients ; (c) 44 had separate accommodation, but as far as could be gathered, no means of carrying out the special open air treatment; (d) 16, by shelters or tents in the grounds of their Workhouses, treat a few consumptive cases ; (e) 24 subscribe to a sanatorium for a bed, or send their cases at a weekly charge to a sanatorium. Altogether 119 Boards of Guardians are more or less alive to their responsibilities, but it is after all only a very small proportion of the 695 Boards in England and Wales. In Germany, where working men and masters are all compelled under the law to subscribe to the Workmen's Insurance, it has been found " that it costs loss to pay for the cure of men, than to pay their pensions and bury 21 them." Let us hope that the time is not far distant when it will be accepted as an axiom in England, that the cost of preventing and stamping out phthisis is less than that of burying its victims, and supporting their families. ACTION BY SANITARY AUTHORITIES. In my previous report on this subject a list of forty.five sanitary authorities in England and Wales which had adopted voluntary notification were given. Since then many others have come into line, so that the following 91 authorities are now engaged in doing their duty with respect to phthisis. BOROUGHS. Accrington Derby Northampton Appleby Eccles Newport (Mon) Bath Exeter Plymouth Birkenhead Eastbourne Reading Bristol Huddersfield Sheffield (compulsory) Bolton Hove Sunderland Bootle Jarrow.on.Tyne Stockport Bury Kendal St. Helens (Lanes.) Bradford Leicester Southport Cardiff Leigh Warrington Chester Liverpool York Croydon Manchester URBAN DISTRICT COUNCILS. Llanley Birkdale Waterloo.with.Seaforth Borough of Hyde Leavensholme Garstang Knutsford Little Hulton Biddulph Middlewich Little Leven Burgess Hill Winsford Moss Side Cuckfield Seven Oaks Nuck Woolton Ambleside Ashby Walds Newton.in.Makerfield Windermere Market Harborough Stretford Kirby Lonsdale Wigston Yottington Balby Acton Ulverston Wheatley Chiswick RURAL DISTRICT COUNCILS. Bucklow Malton Cherbury Norton Garstang Westmorland Billesden Drayton South Westmorland Market Bosworth 22 LONDON AUTHORITIES. The City Greenwich Lambeth Westminster Hammersmith Southwark Chelsea Hampstead Stoke Newington Finsbury Holborn Wandsworth Fulham Kensington Woolwich This list does not pretend to be by any means complete ; nor is it, because great difficulty has been experienced in obtaining particulars from those counties which do not possess a Medical Officer of Health. It is, however, very suggestive of the widespread interest that is taken in the question throughout the land, for it contains places whose populations approximate a half.millon people, and others whose numbers must be reckoned almost by hundreds. During the last Session of Parliament a great step forward has been made because for the first time it has recognised that the time has come when statutory powers might be given to enforce the notification of phthisis. This power was given to Sheffield, who foremost in this good work has prepared hospital accommodation for its treatment. The "Police and Sanitary Committee" in their report to the House of Commons on their work during the Session make the following observation :— " In the Sheffield Corporation Bill, the Committee have granted a clause providing for the compulsory notification of phthisis, which has not been hitherto allowed. They had evidence before them that a voluntary system of notification had been in operation for some time, and that the Corporation had the means and intentions of dealing with all cases that might be brought to their notice. One of the medical advisers of the Local Government Board was called as a witness by the Committee, and gave evidence in favour of the clause, which your Committee allowed for a period of seven years, considering that the experience thus gained would be of more than local value." From this report we see that not only is the Local Government Board in favour of notification but that Parliament has become alive to the necessity for adopting more stringent measures to prevent the spread of the disease. It is not difficult to foresee that other communities will before long be given similar powers, although, as usual, it is more than likely that London will have to lag behind the cities and boroughs of the country. The course that is now being adopted by Parliament is much similar to that formerly followed with respect to the notification of the infectious diseases, for then as now powers were first given to individual sanitary authorities, which were followed later by an enabling act, and finally by a compulsory act. 23 It should be stated that several authorities throughout the country are, in addition to Voluntary Notification, promoting the erection of Sanatoria for the treatment of Consumption either (1) by building these places themselves, or (2) by subsidising institutions which have been built or are in the course of erection. Thus in Bradford a Sanatorium for the treatment of 42 consumptive patients, and estimated to cost £10,000, is approaching completion. In Brighton, the Sanitary Authority maintain seven patients at the cost of the rates. Bristol has contributed £1,000 towards the cost of a Sanatorium for the Counties of Gloucester, Somerset and Wiltshire; and also pays £260 annually towards its maintenance, on condition that four beds are placed at the disposal of the City Council. The County Borough of Leeds subscribe £400 a year to a voluntary hospital. In Liverpool the Poor Law Guardians have erected a hospital; and there, also, a sanatorium has been erected by voluntary subscriptions in connection with the Consumptive Hospitals. In Sheffield the Council have passed a resolution that a sum of £'6,000 per annum be provided out of the rates in support of a Sanatorium which has been built. In Sunderland the Town Council subscribe £150 per annum for the use of two beds in the Sanatorium at Stanhope; and in Manchester Mr. W. J. Crossley, J.P., has made a splendid gift of a new Sanatorium for Consumptives. Counties are also taking action, for in Cheshire, Cornwall, Devonshire, Durham, Wiltshire, Somersetshire, Gloucestershire, Worcestershire, Yorkshire, (East and West Ridings), Westmoreland and Nottingham, Sanatoria have been, are about to be erected, or are in the course of erection. STATISTICAL. It will be well now to consider the extent of the mortality which is caused annually by this disease, so that you may form some idea of it. (Vide Tables attached to this report). Out of a total of 68,322 deaths from All Causes in Islington in the twelve years 1892—1903, Consumption was the cause of 6,485, or 9.5 per cent. Of these deaths 3,857 were of males, and 2,628 of females. The death rate averaged 1.61 per 1,000 inhabitants. It caused 1,663 more deaths than the combined deaths from Small Pox, Measles, Scarlet Fever, Diphtheria, and Enteric Fever, to prevent which the strongest sanitary measures are adopted. The deaths, too, from Consumption occurred at the most valuable period of life, for in the twelve years 1892—1903, 831 were registered between 15 and 25 years of age, 1,401 between 25 and 35, 1,554 between 35 and 45, 1,116 between 45 and 55, and 575 between 55 and 65; whereas nearly all the deaths from the Zymotic Diseases are registered at the early ages of life. '24 Table A. Showing the Deaths from the Principal Zymotic Diseases and from Pulmonary Consumption during twelve years, 1892—1903 in Islington. Ybars. DEATHS. DEATH RATES Deaths from Consumption to every ioo Deaths from All Causes. All Causes. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and Undefined Fever. Diarrhceal Diseases. Total Zymotic Deaths. Pulmonary Consumption. All Causes. Zymotic Diseases. Pulmonary Consumption. 1892 6,075 3 179 53 150 161 ... 41 ... 189 776 504 18.8 2.40 l.56 8.3 1893 6,391 2 119 94 189 181 1 48 2 237 873 560 19.5 2.67 1.71 8.7 1894 5,263 3 199 69 208 188 ... 36 ... 95 798 539 15.9 2.41 1.63 10.2 1895 5,760 1 135 66 137 81 1 30 3 189 643 568 17.2 1.92 1.70 9.8 1896 5,884 1 288 57 247 234 ... 46 2 153 1,028 530 17.4 3.04 1.57 9.0 1897 5,395 1 97 61 115 130 ... 44 ... 174 622 520 16.0 1.84 1.54 9.6 1898 5,705 ... 325 26 90 168 1 36 1 283 930 527 16.9 2.76 1.56 9.2 1899 6,293 ... 155 33 120 160 ... 47 ... 258 773 583 18.7 2.30 1.73 9.2 1900 5,721 1 159 24 106 142 ... 46 2 180 660 602 17.0 1.96 1.79 10.5 1901 5,361 8 151 30 134 85 ... 47 1 172 628 545 15.9 1.87 1.62 10.2 1902 5,635 53 114 40 104 152 ... 45 1 99 608 515 16.4 1.77 1.50 9.1 1903 4,839 ... 120 24 43 152 ... 22 1 109 471 492 14.2 1.39 1.45 10.2 Total, 12 yrs. 68,322 73 2,041 577 1,643 1,834 3 488 13 2,138 8,810 6,485 17.0 2.19 1.61 9 5 Average per annum. 5,693 6 170 48 137 153 41 1 178 734 540 17.0 2.19 1.61 9.5 25 Table B. Showing the Ages at uhich the Deaths from Pulmonary Consumption occurred. Years. Ages. Under 15 Over 15 Males. Females. Totals. Under 1 1-5 5-15 15-25 25-35 35-45 45-55 55-65 65 upwards 1892 25 21 20 25 103 113 76 87 34 66 438 294 210 504 1893 28 27 20 83 130 125 84 42 21 75 485 313 247 560 1894 27 37 19 77 122 123 78 37 19 83 456 312 227 539 1895 28 35 22 71 131 145 74 41 21 85 483 316 252 568 1896 17 32 16 65 93 145 93 53 16 65 465 303 227 530 1897 15 24 20 71 90 154 97 37 12 59 461 329 191 520 1898 18 24 18 70 110 126 87 53 21 60 467 322 205 527 1899 27 28 13 85 127 136 105 42 20 68 515 359 224 583 1900 27 20 21 79 134 126 123 55 17 68 534 385 217 602 1901 18 26 13 68 130 134 108 36 12 57 488 325 220 545 1902 16 18 15 71 121 121 96 42 15 49 166 308 207 515 1903 16 13 13 66 110 106 95 50 23 42 450 291 201 492 Total, 12 years 262 305 210 831 1,401 1,554 1,116 575 231 777 5,708 3,857 2,628 6,485 Average per annum 22 25 18 69 117 129 93 48 19 65 475 321 219 540 26 The death-rate from Phthisis in Islington during the last twelve years has remained practically stationary, as the following figures prove :— Rate per Rate per per 1,000 1,000 1,000 Years. population. Years. population. Years. population. 1892 . 1.56 . 1896 1.57 1900 1.79 1893 . 1.71 . 1897 1.54 1901 1.62 1894 . 1.63 . 1898 1.56 1902 1.50 1895 . 1.70 . 1899 1.73 1903 1.45 Mean rate 1892 to 1903—1.61 per 1,000. During the last thirty years, but especially during the last ten years, there has, however, been a gradual decrease in the number of these deaths, which are still enormously excessive, throughout England and Wales, as is shown in the following statement:— Deaths all ages per million of the population. Deaths under 5 years per million living at this age. 1851.60 2,579 1,329 1861.70 2,467 990 1871.86 2,209 783 1881.85 1,927 584 1886.90 1,781 521 1891.95 1.634 467 1896.1900 1,521 403 27 help and instruction can be given, and especially where the disinfection, which is so urgently necessary when consumptives die or change their residences, has to be effected." Notification is the key of the crusade against the disease. It will not, however, be necessary to notify all cases of Consumption, but only those which have arrived at that stage in which the sputum is tuberculous—i.e., contains the bacilli of Consumption—or those that, owing to the condition of their households, are sources of danger to others living with them. Disinfection will be necessary in all cases where consumptives die, or when they leave their residences, lest the infection should be contracted either by those who continue to live in the house or who might possibly succeed in the occupancy of the premises. In this respect let me say that I have had a search made in the mortality returns of the last eight years as to the number of houses in which one or more deaths from this disease have occurred, and I find that Phthisis resulting in death happened in 3,428 houses, and that in as many as one hundred and eighty four of these 2 deaths occurred at shorter or longer intervals; and that in eight, 3 deaths occurred. I also find that in two Common Lodging Houses 2 deaths occurred at intervals, in four 4 deaths, in one 5 deaths, in one G deaths, in one 8 deaths, in one 9 deaths, and in one 16 deaths. How far the infection has been passed on from the primary cases in these houses it is impossible to say ; but knowing, as we now do know, that dried expectoration, especially when it becomes pulverized, in which the germs of the disease retain their vitality so long, is the most fruitful agency in the propagation of the disease, it is not too much to assume that very many of these deaths were directly traceable to it. If this be so, then it at once becomes manifest that it is the duty of every Sanitary Authority to adopt measures that will tend to prevent the recurrence of the disease in the same house. In Manchester in the last four years the following cases were voluntarily notified by the Poor.law Medical Officers, from other Institutions, and by private practitioners: — Year. Poor.law cases. Institutions. Private practitioners. Total. 1900 587 446 540 1573 1901 625 373 341 1339 1902 667 305 303 1275 1903 556 550 251 1357 28 The materials accumulated in the course of investigation proved that the administrative measures do avert the subsequent occurrence of phthisical cases in a house infected with tuberculosis. Dr. Niven, the Medical Officer of Health of that City, declares that although "only about one.third of all the cases are known and dealt with, yet that these cases occur in such homes as render them peculiarly dangerous, and the operations are, therefore, doing a maximum of good." The investigations in Manchester have also clearly demonstrated that additional attention is required in public houses and other places where spitting is practised, among which may be instanced 'buses, trains, trams, places of amusement, etc. The inquiries, too, elicited the fact that in numerous cases the probable source of the infection was a consumptive relative. These relatives were of all degrees of kinship as is shown in the table on opposite page. No information was available for 56 of these cases, while double sources of infection were noticed in 89 instances. Would it be too much to suppose that many of these attacks would never have occurred if the patients had been careful in their habits; had adopted the simple precaution of destroying their sputum, or at least of rendering it innocuous before it dried, pulverized, and mixed with the household dust ? As bearing on this subject, I notice in "a paper on " The Prevention of Consumption," issued by the Board of Health of Maine, U.S., this phrase: — " Investigation has proved that the careless consumptive patient is a focus of infection, and a danger to all persons who come in much proximity to him." It is because of this carelessness, so often caused through ignorance, that he requires instruction. Dr. Cornet, Dr. Coates and others have shown the danger of spitting in workshops, railway carriages, waiting rooms, tram cars, theatres, music hallsclubs and public houses. 29 STATEMENT SHOWING THE SOURCE OF INFECTION OF PERSONS ATTACKED WITH PHTHISIS IN MANCHESTER.* Source of Infection. Likely source Less likely Possible. Father 44 29 9 Mother 34 22 11 Son 4 1 — Daughter 5 1 — Brother 42 17 4 Sister . 33 19 4 Husband 13 11 1 Wife 21 10 1 Uncle 4 4 2 Aunt . 2 — — Niece . 4 1 — Nephew 1 — 1 Cousin 6 1 — Grandfather . — 2 1 Grandmother — — 1 Stepfather . 2 — — Stepmother 1 1 — Stepbrother 1 — — Parents 1 1 — Father-in-law . — 1 — Mother-in-law 4 — 1 Brother-in-law 8 4 1 Sister-in-law . 5 2 — Son.in-law . 1 — — Niece's Husband — — 1 Lodger .... 4 6 3 Fellow Lodger 6 4 1 Neighbour . 14 10 17 Companion . . 36 18 4 Workfellow . 48 67 22 Work place 4 9 4 Work . 28 15 12 Houses, including Public Houses 86 89 18 Daughter of Tenant . 1 — — Housekeeper . 1 — — Mistress . — 1 — Employer 1 3 — Servant 2 1 — Landlady's Child . 3 — — Landlady or Landlady's Husband 9 1 — Nursing a Consumptive 2 1 — Being Nursed by Consumptive 1 — — Milk — — 6 Soldiers infected in South Africa 12 2 — Fiance or Fiancee 1 — — Others 2 3 1 Totals 497 357 125 *This statement was given in two tables in the report for 1903 of the Medical Officer of Health of Manchester, and has been condensed for the purposes of this report. 30 In the United States circulars giving information as to the infectious character of the disease are issued by the State Board of Health of the following 2.3 States:—California, Colorado, Connecticut, Deleware, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, Ohio, Rhode Island, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Wisconsin. In New York City 80,000 of these circulars are distributed among the tenemented houses yearly, but in most cities they are sent only to those families in which there is Phthisis. In New York the Sanitary Code requires (1) that all cases of pulmonary tuberculosis shall be reported; (2) that an inspector shall be sent to the house to instruct the family, and leave circulars; while subsequent visits are also made to see that the precautions are carried out; (3) that when a patient removes or dies an order is issued to the owner of the house to cleanse or disinfect it. The goods are also sometimes disinfected with steam. In the same city, too, section 194 of the Sanitary Code of the Board of Health makes it an offence to spit on the floors of public buildings, railroad cars and of ferryboats, and upon stations, platforms or stairs of elevated railroads ; and enacts that the officers in charge or control of these shall keep permanently posted a sufficient number of notices forbidding spitting, and also that it shall be their duty to call the attention of all violators of the ordinance to the notices. That this law is not a dead letter is proved by the fact that a millionaire was fined for this offence, and on repeating it was sent to prison for twenty.four hours. In Canada and Australia there have been enactments against spitting, and even in England the cities of Liverpool and Manchester, and the County of Glamorgan are enabled to inflict penalties for this offence; and last year London obtained similar powers. Such laws are very just and most requisite, for as Professor Brouardel, the distinguished representative of the French Government to the British Conference on Tuberculosis, says: "The danger is in the sputum, which contains thousands of consumptive germs. To expectorate on the street is a disgusting and dangerous habit. When this habit has quite disappeared tuberculosis will disappear rapidly. The Conference felt so strongly on this subject that in its very first Resolution it declared that " indiscriminate spitting should be suppressed." 31 In New York the Board of Education will not appoint an applicant as teacher unless he produces a certificate that he is free from tuberculosis. In Pennsylvania there is a law forbidding the employment by bakers of persons having consumption; and in Yonkers it is a misdemeanour for bakers or marketmen to pursue their occupation if they suffer from this disease. So potent a factor is tuberculous dust, all derived from sputum, in the propagation of Phthisis, that Dr. Bigg, of the New York Board of Health, a body which has grappled with this disease as no other body in any other country has hitherto done, has found that adjoining houses tend to become infected with tuberculosis in so marked a manner as to strongly suggest that one house becomes infected from another. The cause apparently being that the infected dust from one house when swept out gains an entrance to its neighbour, and is liable to infect persons living in it. In this connection let me state that I have discovered that in Islington, during the last five years, deaths from Consumption have occurred in 105 pairs of houses next to each other, that is, in 210 houses ; that it has occurred in 7 sets of three houses next to each other, that is, in 21 houses; and that it has occurred in 2 sets of five houses next to each other, that is, in 10 houses. The objects attainable by notification are these :— 1.—It will afford an opportunity of instructing the patients and the householders, especially those living in tenement dwellings and lodging houses, both orally and by printed matter, as to the precautions that are essential to prevent the spread of the disease, and as to the destruction of the sputum as it is discharged. 2.—It will afford an opportunity of carrying out such measures of disinfection as are necessary to destroy infective matter both in the house itself and in the bedding and personal clothing of the patient. 3.— It will afford an opportunity of inspecting the infected house and of discovering whether the rooms are overcrowded or dirty or insufficiently ventilated. 32 4.—It will afford an opportunity of maintaining some observation over consumptive patients, so as to ensure that they continue to take precautionary measures. 5.—It will afford an opportunity of inquiring into the possible source of the infection. 6.—It will enable information to be gleaned as to the conditions under which the patient worked, which is a most important matter, because ill.ventilated workshops have been most fruitful sources of this disease. And it will enable special attention to be drawn to the habit of spitting, which is so common in these places. 7.—It will afford an opportunity of obtaining information as to the part different occupations or trades play in the distribution of the disease. These are all important objects, and I have not the least doubt that the information gained through enquiries will tend to the decrease in the number of deaths from Phthisis. During the last thirty years, but especially during the last ten years, there has been a gradual decrease in these deaths throughout England and Wales, as has been shown on page 26. This decrease in the mortality has been due mainly to :— 1.—Improved drainage. 2.—The abatement of overcrowding. 3.—The improvement that has taken place in the conditions under which the labouiing classes live. 4.—Better and more wholesome food. This is well demonstrated in the case of young children, among whom the mortality is only one.third of what it was forty years ago, while at all ages it is only three.fifths of what it was. These sanitary measures were mainly directed against other diseases than Phthisis, and on them the effect was very marked. 33 The measure now advocated, which, as I have shown you, has been largely adopted throughout the country, will have an intimate and direct bearing on the prevention of this disease, and should, therefore, lead to very great results. In New York, the death rate from Phthisis has decreased more than 30 per cent. since 1885, and the Medical Officer (Dr. Biggs) anticipates that with compulsory notification, and with a complete and efficient scheme for dealing with Pulmonary Tuberculosis, there will be a further decrease of one.third, which means the saving of 3,000 lives annually. This question of the prevention of Tuberculosis has been associated with some of my early sanitary efforts. Indeed, I publicly advocated its compulsory notification more than twelve years ago. I was, however, before my time, for on that occasion not a single Medical Officer of Health supported my views. it was then said, and perhaps rightly, that the medical profession of this country were not prepared to notify the disease. But there is now a rapid change coming over them, and it is very possible that in course of time, perhaps in a very short time, they will agree to the form of notification which I then advocated, just as they have agreed to the notification of the so.called preventable zymotic diseases. I am glad to know that in this borough there are many medical men who hold a strong opinion that the time has arrived when this disease should be made compulsorily notifiable. This, I regret, cannot be done now, although I have little doubt that the time is not far distant when here, as elsewhere, this method of notification will prevail. Meanwhile, however, we should have it in its voluntary form, and endeavour to obtain public Sanatoria for London. I can, however, foresee that the time is approaching when practically all the London Borough Councils will have adopted the principle of voluntary notification, and that then the London County Council may be persuaded to obtain from Parliament the necessary statutory powers to compel its notification. Meanwhile, in my opinion, it is your duty to do what you can to prevent this disease, which, unlike the notifiable diseases that mainly attack children, is so fatal to persons in the prime of life. This matter is now in your hands once more to deal with as you deem right. I have, however, little doubt that you will come to the determination to invite the co.operation of the medical profession, as recommended by the 34 British Conference on Tuberculosis in 1901, in their third resolution, in endeavouring to check the spread of this disease, which systematically destroys more people than any other with which civilized communities have to grapple. " 'Tis a consummation devoutly to be wished." I am, Your obedient Servant, A. E. HARRIS, Medical Officer of Health. Town Hall, Upper Street, Islington. 1st October, 1904. 35 RESOLUTIONS Passed by the British Conference on Tuberculosis, 1901. RESOLUTION No. 1. Tuberculous sputum is the main agent for the conveyance of the virus of Tuberculosis from man to man ; indiscriminate spitting should therefore be suppressed. RESOLUTION No. 2. It is the opinion of this Congress that all public hospitals and dispensaries should present every out.patient suffering from Phthisis with a leaflet containing instructions with regard to the prevention of Consumption, and should supply and insist on the proper use of a pocket spittoon. RESOLUTION No. 3. That the Voluntary Notification of cases of Phthisis attended with tuberculous expectoration, and the increased preventive action which it has rendered practicable, have been attended by a promising measure of success, and that the extension of notification should be encouraged in all districts in which efficient sanitary administration renders it practicable to adopt the consequential measures. RESOLUTION No. 4. That the provision of Sanatoria is an indispensable part of the measures necessary for the diminution of Tuberculosis. RESOLUTION No. 5. That in the opinion of this Congress, in the light of the work that has been presented at its sittings, Medical Officers of Health should continue to use all the powers at their disposal, and relax no effort to prevent the spread of Tuberculosis by milk and meat. 36 Rules, Regulations, and Legislation against Spitting, IN VARIOUS COUNTRIES. ENGLAND. CITY AND COUNTY OF LONDON.—By.law against spitting in public places. LIVERPOOL.—By.law against spitting in tramcars or on tramway stations, or in premises connected therewith. MANCHESTER.—By.law against spitting in Corporation tramcars. GLASGOW.—By.law against spitting in Corporation tramcars. GLAMORGANSHIRE.—Obtained first by.law against spitting on the floor, side or wall of any public carriage, public hall, public waiting room or place of public entertainment. All other English By.laws are similar to it. This By.law reads as follows : "GLAMORGAN COUNTY COUNCIL—By.law for the good rule and govern" ment of the County, made by the Glamorgan County Council, on the 19th day of June. " 1902, and duly published and submitted to the Secretary of State, and not disallowed " within the time fixed by law. " A person shall not spit on the floor, side or wall of any public carriage, or of any " public hall, public waiting room, or place of public entertainment, whether admission " thereto be obtained upon payment or not. " Any person offending against this By.law shall be liable to a fine not exceeding £5. " This By.law is in force throughout the County of Glamorgan, except within the " limits of any Municipal Borough." UNITED STATES. NEW YORK.— Forbidden under a penalty of 500 dollars, or a year's imprisonment, or both, in tramcars and omnibuses. BOSTON.—Forbidden in railroad carriages, on railway stations, in car, public building, hall, church, theatre, market, or any sidewalk immediately connected with public places. AUGUSTA.— Prohibition of spitting strictly enforced. ATLANTA.—Prohibition of spitting strictly enforced. CHARLESTOWN.—Prohibition of spitting strictly enforced. PITTSBURG.—Law prohibits spitting. BUFFALO.—Law prohibits spitting. 37 ST. LOUIS.—Has under consideration a law to prohibit spitting. WASHINGTON.—Has under consideration a law to prohibit spitting. In Baltimore, Brooklyn, Cambridge, Colorado Springs, Columbus, Cleveland, Cincinatti, Camden, Denver, Dayton, Fitchburg, Fall River, Hartford, Indianapolis, Jersey City, Kansas City, Louisville, Lowell, Lynn, Minneapolis, New Orleans, Omaha, Peoria (III.), Rochester, Springfield (O.), Salem, San Francisco, Scranton, Seattle, Trenton, Waltham, and Worcester, regulation against spitting are in force but have not yet been incorporated into statute law. CANADA. TORONTO.—Forbidden in public places. OTTAWA.—Forbidden in public places. HALIFAX.—Forbidden in public places. NOVA SCOTIA.—Forbidden in public places. NEW SOUTH WALES. Power is given to Councils under the Municipalities' Act to make by.laws for the prevention of persons expectorating on any footway. GERMANY. The law of 1898 prohibits the practice of spitting in railway carriages and on platforms. AUSTRIA. The Railway Minister orders Notices to be placed in all railway carriages forbidding the practice. BELGIUM. Spitting on the ground is prohibited. DENMARK. Forbidden in public conveyances, railway carriages, tramcars, etc. FRANCE. Forbidden in public places, and public buildings; and the most stringept precautions are ordained in the public schools by the Minister of Instruction. HUNGARY. Forbidden in public places.