ISL 16 1909. FIFTY-FOURTH 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. 1910. 2 MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1908, to November, 1909). Mayor. Alderman GEORGE SAMUEL ELLIOTT, J.P. A1dermen. H. GODDARD EGGETT, J P HENRY MILLS, J.P. ALFRED MYERS. EDWARD SMALLWOOD, J.P. Councillors. Ward. 1. REUBEN LOOMES. 2. JAMES WM COWLING. 3. GEORGE GUTTRIDGE. 4. WM. EDWIN MANCHESTER 5. THOS. LUKE HARWOOD 6. GEORGE AUBER. 6. CHAS. CROLE REES. Ward. 7. HENRY MARK KINGSTON. 8. SAMUEL ISAAC COLL1NGWOOD. 9. WM. THORESBY COOKSEY. 9. WM. JOHN MEKRINGTON 10. ARTHUR L WILLIAMS. 11 WALTER E. MARKHAM Chairman Councillor JAMES WM. COWLING. Vice-Chairman Alderman H GODDARD EGGETT, J.P. 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 Inspectcr. JAMES RICHARD LEGGATT. Inspector of Meat. HARGREAVES WILKINSON, Cert. Sanit. Inst. Inspector of Workshops and Bakehouses. GEORGE WEST. Inspectors of Workshops &-c., in which Females arc employed. JOSEPHINE JANE BROWN, B.A., Cert. Sanit. Insp. Ex. Bd. ANNIE CATHERINE YOUNG, Cert. Sanit. Insp. Ex. Bd. Inspectors of Houses let in Lodgings. WILLIAM WALTER WARD. THOMAS HENRY HANCOCK, Cert. Sanit. Insp. Ex. Bd. Inspector appointed under the Sale of Food and Drugs Acts. TOM LEONARD BURRELL, 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 GEORGE JAMES BRIDEL. Cert. Sanit. Insp. Ex. Bd. „ 12 THOMAS WALLACE AGAR, Cert. Sanit. Inst. 13 JAMES JARVIS JORDAN. 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 Seventh Clerk ARTHUR R. WITTRICK. Junior Clerk CLEMENT MARSTONE WHEBLE. Messenger. ALEXANDER SANSON * Died 28th September, 1909. iv. INDEX. Page Adulteration of Food 271-303 Ages at Death 23 Alcoholism 106 Analyst's quarterly reports 297-303 Annual Birth and Death rates, and Death-rates of Children 313 Appendicitis 89 Area of Borough 5 Areas and Densities of Metropolitan Boroughs 9 Artizans and other Dwellings 9 Bacteriological Diagnoses 188 Bakehouses 207, 226 Baths and Washhouses 327 Births 15 „ in Decennial periods from 1841 315 Births, notification of 19 Butcher's Shops and Shops where food is sold 267 Butter and Margarine 289 Cancer 93 Cattle, Warranty with 259 Common Lodging Houses 251 Constitutional Diseases 93, 104 Continued Fever 80, 139 Cow Houses 264 Deaths 22 „ from Classified Causes 35, 36 „ at different age periods 23 ,, in the Quarters 25, 29, 33, 34 ,, „ Sub-Districts 24 „ Wards 25 „ „ Encircling Boroughs 84, 85 „ from Epidemic Diseases 58-86 Deaths registered from all causes during the Year 306 Deaths registered from all causes in each Quarter 309 Deaths in Decennial periods from 1841 317 Deaths in Public Institutions 107 Death-rates of Metropolitan Boroughs 37 Density of Borough 6 Diabetes Mellitus 103 Diarrhoea 80 Diphtheria 76 „ Fatality from 127, 131, 132 „ Notification of 128 Diphtheria and Croup 131 Disinfectants distributed and used 198 Disinfecting Station 197 Disinfection Work 195 V. Page District Inspection240 Dust, removal of 238 Enteric Fever 79 „ Notification of 133 „ Fatality from 133, 134 Epidemic Diseases 58-86 ,, Cerebro-Spinal Meningitis 151 Erysipelas, Notification 135 „ Fatality from 90, 136 Factories and Workshops 204 Fatality from Infectious Diseases 119 Food, Adulteration of 271-303 Food Inspection 255 Health Visitors 49 Hospital Isolation of Infectious Diseases 166, 168 Houses Let in Lodgings 233 Ice Creams 271 Illegitimate Births 18 ,, ,, in Decennial periods from 1841 316 Infantile Mortality 39-57 „ „ in Decennial periods from 1841 318 Infectious Diseases on Business Premises 168 Infectious Diseases in Streets 173 Infectious Diseases in Schools 160 ,, ,, (Non-notifiable) in Schools 163 Infectious Sickness in the several Wards from 1891-1909 320-325 „ „ in Quinquennial periods from 1891 319 Influenza 86 Inspection of Food 255 „ Kitchens of Restaurants 212, 227 „ Slaughter Houses and Cow Houses 262-264 Inquests 114 Isolation of Infectious Diseases 166 Local Government Board Returns 328-331 London County Council Return of Sanitary Work 332-333 Margarine Act 289-296 Marriages 12 Measles 66 Meat Inspection 255 Midwives attending Disinfecting Station 202 Milk Shops and Dairies 270 Mortality in Sub-Registration Districts 24 Mortuary and Coroner's Court 114 Notification of Infectious Diseases 116, 139, 140 „ „ „ in Registration Sub-Districts 117,141,142 „ „ „ in the Sanitary Inspectors' Districts 145 „ „ „ in the Wards 118, 143, 145 „ „ „ during the several Months 146 „ „ „in the Encircling Districts 147, 148 „ „ „ in Metropolitan Boroughs 149, 150 „ ,, Phthisis 151 ,, ,, Births Act 19 Non-notifiable Infectious Diseases in Schools 163 * VI. Page Occupation of persons attacked with Infectious Disease 170 Offensive Trades 270 Offices where women are employed 232 Outworkers' Premises 212, 230 Pauperism 249 Persons to an Acre 7 Persons living at different Ages 8 Phthisis 99 ,, Notification of 151 „ Voluntary Notification of 157 Places where Food is prepared 212,227 Population—Estimated in 1909 4 „ Sex and Age Distribution 3 „ in Sub-Districts 8 „ and Density of Wards 7 Population, Inhabited Houses, Marriages, Births, and Deaths 7 Prosecutions, Summary of 304 Puerperal Septic Diseases 91 Puerperal Fever 91 „ „ Notification of 137 „ „ Fatality from 138 Pulmonary Consumption 99,151,157 Registered Lodging Houses 233 Respiratory Diseases 104 Restaurant Kitchens 212, 227 Sanitary Inspectors' Work 240 Scarlet Fever 75 „ Notification of 122 „ Fatality from 123 School Children cleansed and bathed 200 Seasonal Mortality 25 Septic Diseases 90 Shelter House 200 Slaughter Houses 262 Small Pox 66 „ Notification of 120 Smoke Nuisances 242 Street Markets 258 Streets where Infectious Disease occurred 173 Summary of Sanitary Work in fourteen Districts 244 Summary of Applications for Removal of Dust 248 Trades carried on in Houses where Infectious Disease has occurred 168 Tubercular Diseases 98-102 Typhus Fever 80, 135 Unsound Food 257 Unsound Fish 258 Vaccination 189 Venereal Diseases 107 Verminous Persons 201 Water Certificates 241 Water Supply 304 „ to Tenement Houses 239 Whooping Cough 77 Workshops and Factories, Inspection of 204 Work of Public Health Department, Summary of 326 REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1909. To the Worshipful the Mayor, Aldermen and Councillors of the Borough of Islington. Gentlemen, Once more it affords me great pleasure, in presenting the fifty-fourth annual report on the health and sanitary condition of your Borough which deals with the year 1909, to be able to congratulate you on its continued good state of health. This condition is all the more satisfactory when one recollects that it is Islington's greatest asset, a fact which should always be remembered when matters affecting public health work are under consideration. At the present time the prevention of deaths among very young infants is engaging the attention of nearly every sanitary authority in the kingdom, and, therefore, I would ask you to pay particular attention to that portion of the report which deals with this matter, for it is of the utmost importance that the causes of these deaths should be understood, for then the necessity of appointing health visitors to instruct mothers as to the rearing of their children will become very apparent. I take this opportunity of expressing my sincere thanks to the clerical and inspectorial staffs of the department over which I have control for their assistance ungrudgingly afforded, and in this connection would specially name Mr. James R. Leggatt, the Superintendent and Chief Sanitary Inspector, and Mr. G. H. King, the Chief Clerk. I am, Your faithful servant, Medical Officer of Health. Town Hall, Islington, lst July, 1910 viii. SUMMARY of Vital Statistics, 1909. Population (Estimated) Males 166,974 Persons 351,202 Females 184,228 Estimated increase on population, 1908 2,111 persons. Area 3,092 acres. Density 113 persons per acre. Marriages 2,769 Persons married 5.538 Persons married rate 15.77 per 1,000 inhabitants. Births Males 4,238 J Persons 8,198 Females 3,960 Birth rate 23.34 per 1,000 inhabitants. Deaths from All Causes Males 2,487 Persons 4,918. Females 2,431 Death rate „ „ 14.00 per 1,000 inhabitants Deaths from principal Epidemic Diseases Males 195 418 persons. Females 223 Death rate 1.19 per 1,000 inhabitants. Infantile Deaths under 1 year Males 466 Total 841. Females 375 Infantile mortality rate 103 per 1,000 births. Excess of Births over Deaths 3,280. PART I. THE POPULATIONS, AREAS AND DENSITIES OF THE SUB-REGISTRATION DISTRICTS, THE WARDS AND THE BOROUGH. B 3 [1909 REPORT OF THE Medical Officer of Health FOR THE YEAR 1909. POPULATIONS, AREAS AND DENSITIES OF THE REGISTRATION DISTRICTS AND WARDS, AND OF THE BOROUGH. Population of the Borough.—The size of population of a town is the most important factor in the calculation of the health statistics of any community, for if the estimate of its size be incorrect, it follows that all the computations made upon it are in error, which of course will vary according to the extent of the miscalculation. Nearly nine years have elapsed since the last numbering of the people of the United Kingdom took place; and therefore, there is a possibility, indeed almost a certainty, in some places, that their estimated populations are incorrect. Last year it was indicated that the estimated population of this Borough was probably overstated, because the Registrar General had " relied on the number of the inhabitants increasing since 1901 in the same geometrical ratio as in the decade 1891-1900." It was also pointed out, when the censal periods were examined, that for a long while, which is to say since 1851, the percentage rates of increase of the population of Islington had been declining, so that it was hardly to be expected that the rate of increase between 1901 and 1908 had been maintained. These remarks are even more applicable now that another twelve months have elapsed. In the figures given below it will be perceived that, whereas the increase between 1841 and 1851 represented a percentum increase of 70.7, between 1891 and 1901 it was only 4.9. It is probable that even this small increase has not been maintained, and, therefore that the population has been somewhat over-estimated. Fortunately, the error can only be very small, and, as was pointed out in the last Annual Report, assuming that the increase of population is not as much as that with which the Borough is credited, it will affect the birth, death, and marriage rates to only a very small extent. B 2 1909] 4 The cure for this uncertainty is a quinquennial census, which is so necessary in London, where certain money grants are based on population. Census Years. Enumerated Populations. Actual Decennial Increases. Percentage Increases. 1801 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 4.9 The estimated population of the Borough at the middle of the year was 351,202, of which number 160,974 are males and 184,228 females. Thus for every 100 males there are 110 females. Ages of the Population.—It is supposed that in every 1,000 of the population, 108 persons are under 5 years of age 185 „ between 5 and 15 199 „ „ 15 and 25 182 „ „ 25 and 35 130 „ „ 35 and 45 93 „ „ 45 and 55 GO „ „ 55 and 65 31 „ „ 65 and 75 12 „ „ 75 and upwards. This was the age distribution of the population at the census, and on this basis it is calculated that the number of persons living in the Borough at these several age periods is as follows:— 0—5 37,770 44—55 32,652 5—15 64,875 55—65 21,187 15—25 69,894 65—75 10,763 25—35 63,962 75 and upds 4,357 35—45 45,742 Total 351,202 5 [1909 Area.—The area of the Borough is 3,092 acres, nearly all of which, with the exception of 291 acres, devoted to parks or similar open spaces, railway lines, canals or markets, is built upon. The areas of these places are as follows:— Water (Canals, Reservoirs, and New River Aqueducts) 17.1 acres. Railways 196.6 Markets 14.9 Parks and Open Spaces 62.8 Total unavailable space 291.4 Water, which is mainly the Regents Canal, covers in Tufnell 74 acres, in Thornhill 5T acres, in Canonbury 2.2 acres, in St. Mary's 0.9 acres, and in St. Peter's 1.6 acres. Railways in Tufnell occupy 20.84 acres, in Upper Holloway 7.3 acres, in Tollington 21.9 acres, in Lower Holloway 33 0 acres, in Thornhill 17.5 acres, in Barnsbury 4.5 acres, in Highbury 71.4 acres, in Mildmay 4.7 acres, in Canonbury 10.5 acres, and in St. Mary's 5.3 acres. Markets use up 14.9 acres in Lower Holloway, where the City of London Cattle Market is situated. Parks or Open Spaces are in possession of 6.2 acres in Tufnell of 110 acres in Lower Holloway, of 4.7 acres in Thornhill, of 22.4 acres in Highbury, of 10.0 acres in Mildmay, of 1.3 acres in Canonbury, of 5.3 acres in St. Mary's, and of 1.9 acres in St. Peter's. Areas of the Sub-Distriots.—The actual area of each of the sub-districts in acres is as follows:—Tufnell 417, Upper Holloway 290, Tollington 320, Lower Holloway 413, Highbury 798, Barnsbury 309, South-East Islington 545. Thus it is seen that large portions of these areas are not available for living on, and consequently the acreage of such unavailable spaces should be deducted from the gross area before the actual density of the population (i.e., the number of persons living on each acre) can be arrived at. The following figures give this information:— 1909] 6 Sub-Districts. Area in Acres. Area occupied by Parks, Open Spaces, Water, &c. Net Area. Tufnell 417 34.1 382.9 Upper Holloway 290 7.3 282.7 Tollington 320 21.9 298.1 Lower Holloway 413 58.9 354.1 Highbury 798 108.5 689.5 Barnsbury 309 31.8 277.2 South-East Islington 545 28.9 516.1 The Borough 3.092 291.4 2,800.6 Density of Population —Here we see that the net area of the Borough, on which the people actually live, is 2,800 acres. The number of persons living on each acre, or the density of the population, is therefore 125 on the net acreage, and 113 on the gross. These figures are very high, and, indeed, the crowding of 113 persons on each acre is 74.9 per cent. more than that which prevails in the County of London, for which the figure is 64.6. Compared with some of the Metropolitan Boroughs, our density of population is very excessive. Thus in Woolwich, Lewisham, and Greenwich it ranges from 16.1 persons per acre to 28.8; in Wandsworth, Hampstead, and Hammersmith, from 32.6 to 55.0; in Stoke Newington, Camberwell, and Westminster, from 631 to 67.5; in Hackney, Poplar, Deptford, Lambeth, from 72.2 to 79.4; in Kensington, Bermondsey, St. Marylebone, Battersea and St. Pancras, from 80.2 to 88.1; in Fulham, Paddington, Islington and Chelsea, from 103.5 to 114.0; in Holborn it is 132.8, and finally in Finsbury, Bethnal Green, Shoreditch, Stepney and Southwark it ranges from 161.8 to 186.6. A study of Table V. will discover the effect of these figures on the deathrates, which are given in Column 4; where it will be noticed that practically as the density increases, so also does the death-rate, although, of course, not quite evenly. It could not be otherwise, for just as crowded homes are invariably more unhealthy than those that are not, so also it is with communities or towns. This truth is well recognised, and consequently we find movements on foot to build cities in which the houses will be surrounded by ample air space, which is utilized at once for health purposes and gardening, and these places are called garden cities. There is little doubt that they will prove themselves to be, from a health point of view, desirable places to reside in. 7 [1909 Table I Showing the Areas, Densities, and Estimated Populations of the Sub-registration Districts at the middle of the year 1909. Sub-Districts. Area in Acres. Acres to a person. Persons to an Acre. Estimated Population Mid-year 1909. Tufnell 417 0.0118 84 35,292 Upper Holloway 290 0.0077 128 37,276 Tollington 320 0.0086 116 37,217 Lower Holloway 413 0.0098 101 41,865 Highbury 798 0.0116 86 68,941 Barnsbury 309 0.0057 174 53,695 South-East Islington 545 0.0071 141 76,916 The Borough 3,092 0.0088 113 351,202 Table II. Showing the Areas, Densities and Estimated Populations of the Wards at the middle of the year 1909. WARDS. Area in Acres. Persons to an Acre, or Density of Population. Estimated Population Mid-year, 1909. No. 1—Tufnell 417 84 35,292 2—Upper Holloway 290 128 37,276 3—Tollington 320 116 37,217 4—Lower Holloway 413 101 41,865 5—Highbury 417 84 35,294 6—Mildmay 337 75 25,303 7—Thornhill 172 195 33,533 8—Barnsbury 137 147 20,162 9—St. Mary's 148 119 17,582 10—Canonbury 286 121 34,535 11—St. Peter's 155 214 33,143 The Borough 3,092 113 351,202 1909] 8 Table III. Showing the Estimated Number of Persons living in Islington at the middle of 1909, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 19,102 18,668 37,770 5—15 32,385 32,490 64,875 15—25 32,961 36,933 69,894 25—35 30,194 33,768 63,962 35—45 21,755 23,987 45.742 45—55 15,217 17,435 32,652 55—65 9,555 11,632 21,187 65—75 4,334 6,429 10,763 75 and upwards 1,471 2,886 4.357 All ages 166,974 184,228 351,202 Table IV. Showing the number of Persons in the several Places mentioned living at Nine Groups of Ages in every thousand of their populations, according to the census 1901. DISTRICTS. —5 —15 —25 —35 —45 —55 —65 —75 75 and upwards 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 9 [1909 Table V. Showing the Estimated Populations, Areas, Densities and Death-rates of London and of the several Metropolitan Boroughs in 1909, arranged in order of Density. Boroughs. Estimated Population, 1909. Area in Acres. (Density) Persons to each Acre. Crude Death Rates. All Causes. Epidemic Diseases. Cols. 1 2 3 4 5 County of London 4,833,938 74,839 64.6 14.0 1.31 Woolwich 133,374 8,277 16.1 11.9 1.02 Lewisham 160,749 7,014 22.9 10.3 0.58 City of London 18,193 673 27.0 20.3 0.72 Greenwich 111,014 3,852 28.8 12.2 1.03 Wandsworth 297,646 9,130 32.6 11.9 0.96 Hampstead 94,185 2,265 41.6 8.9 0.52 Hammersmith 125,704 2,286 55.0 14.3 1.67 Stoke Newington .. 54,423 863 63.1 11.8 0.63 Camberwell 283,022 4,480 63.2 13.4 1.08 City of Westminster 168,883 2,503 67.5 13.1 0.63 Hackney 237,601 3,289 72.2 12.6 0.93 Poplar 171,965 2,328 73.8 16.3 2.37 Deptford 118,583 1,563 75.9 13.6 1.51 Lambeth 324,188 4,080 79.4 14.1 1.19 Kensington 183,683 2,291 80.2 13.3 1.00 Bermondsey 127,569 1,500 85.0 18.8 2.74 St. Marylebone .. 126,027 1,473 85.6 14.6 0.83 Battersea 186,036 2,160 86.1 13.0 1.29 St. Pancras 237,422 2,694 88.1 14.8 0.97 Fulham .. 176,406 1,703 103.5 12.0 1.57 Paddington 151,955 1,356 112.0 12.9 0.91 Islington 351,202 3,092 113 6 14-0 1.19 Chelsea 75,249 660 114 0 14 4 1.00 Holborn 53,802 405 132 8 15-6 0.85 Finsbury 95,289 589 161 8 19-2 2.36 Bethnal Green 131,316 759 173 0 16-8 1.99 Shoreditch 114,802 658 174 4 19 0 2.87 Stepney 312,525 1,766 177 0 15 3 1.68 Southwark 211,125 1,181 186.6 168 1.67 PART II. MARRIAGES, BIRTHS AND DEATHS. 1909] Vl MARRIAGES. Only 5,53S persons, or 15.77 per 1000 of the population, were married during the year, which is 24 less than in the preceding year. This decrease can, however, be accounted for by the fact that there were 53 weeks in the statistical year 1908. Nevertheless the number is 4G5 less than the average of the ten years 1899-1908. Ever since 1899 there has been annually a gradual decrease in the marriages, so that the difference between those registered in that year and in 1909 is 970, while the marriage rate has fallen from 19.35 per 1000 of the population to 15.77. No doubt there is a cause for this. At one time it used to be said that the price of wheat influenced the number of marriages, and attention was regularly drawn to it by the Registrar-General, who tabulated the prices per quarter. Now, however, no one pretends that this is so, and, indeed, in the introductory letter to the Registrar-General in his report for 1908, Dr. T. H. C. Stevenson says that "In previous reports it has been pointed out that although it was possible many years ago to trace some correspondence between the fluctuations of the marriage rate and the fluctuations in the price of wheat, in more recent years the figures show no such parallelism. It will be seen, however, that in recent years the fluctuations of the marriage-rate show some correspondence with the fluctuations of exports and of employment. In other words, the alternating periods of commercial prosperity and depression have some effect on the increase and decrease in the proportion of marriages. For example, the rise in the marriage-rate in the years 1906 and 1907 correspond to a rise in the value of exports and in the amount of employment while the considerable fall that took place in the marriage-rate in the year 1908 correspond to a reduction in exports and a high proportion of unemployed." There is no doubt that employment has a great effect on the marriagerate, for reasons which are too apparent to need discussion, and no doubt scarcity of work has had some effect in Islington, as elsewhere. It must not be forgotten, and it cannot be denied, that not only is marriage now delayed, particularly by the middle and upper middle classes, to a later period in life than formerly, but that the young men of the present day of these classes are selfishly postponing marriage, so that they themselves may live in a more luxurious manner; that they may have more amusements; and that they may spend more money on holidays. If they attempted to save money, so that later on they might marry more comfortably, much might be forgiven them, but, unfortunately, it is very doubtful if this is the case. They seek pleasure 18 [1909 more ardently than their fathers and grandfathers, and they think less of making homes of their own. They like the pleasure of ladies' society, but they forego its natural corollary, marriage. No doubt nearly all of them say to themselves they will get married some day, when their business is larger, when their salaries are higher, or when they have had their "fling." Unfortunately, however, as they grow older, the idea of marriage looms before them less brightly, its attractions seem less vivid, and the idea of children is repellent, so that many who put off the wedding feast until a more convenient season never enjoy it at all, and remain bachelors unto the end. There is no reason to think that females are equally inclined. The reasonable outlook for every woman is marriage, and as in the economy of life, nature intended that every male and female should be mated, it is natural that it should be so. It is the male who has cried off, and who, while he does not fail to extract all the innocent amusement he can out of her, meanly delays, or declines altogether, the mating in marriage. It is for this reason that many seriously-minded persons think that such men should be taxed, for they neither pay their just dues to the state nor to the municipalities in taxes or rates, in rents, or in the hundred and one other directions which paterfamilias understands. A tax on bachelors is, therefore, not such an unreasonable or probably remote matter as might be supposed. In any case, such a tax would not be so unpleasant as the punishment under the law of Lycurgus, which to an extent disfranchised those who continued bachelors, for they were excluded from the sight of certain processions of young men and maids intended to promote marriage, and in winter time the officers compelled them to march naked round the market-place, singing certain songs to their own disgrace, that they justly suffered this punishment for disobeying the laws. Moreover, they were denied that respect and deference which young men usually pay to their seniors. Indeed, this was carried to such an extent by the younger men that on the approach of Dercyllidas, an eminent commander, one of them instead of rising retained his seat, remarking "No child of yours will make room for me." Nor did he suffer any rebuke for so saying, for in those days it was looked upon as a dishonourable thing not to be married. The Registrar General, in his report for 1908 gives a table which shows that, in the five years 1886-1890, in every 1000 bachelors who married, 424 were between 21 and 25 years of age, whereas in 1908 the number was only 379; that in the former period between the ages of 30 and 35 there were 96 in every 1000, while in 1908 the number had increased to 130; also that in the age period 40-45 in 1886-90 there were 33, while the number had risen risen to 44 in 1908. 14 1909] TABLE VI. Showing the number of Persons Married and the Marriage Rates in the Borough in 1909. No. persons married. Persons married per 1,000 inhabitants. 1st quarter 862 9.81 2nd „ 1,408 16.03 3rd „ 1.744 19.86 4th „ 1,524 I7.35 The year 5,538 15.77 The record of marriages in Islington since 1841, given in decades and as abstracted and collected from the Registrar-General's annual reports is as follows:— Table VII. Showing the Marriages and Marriage Rates in Six Decennial Periods, 1841-1900, and in 1901 1909. Periods. Marriages. Persons married per 1,000 of the Population 1841-50 6,109 16.81 1851-60 10,901 17.96 1861-70 16,194 17.84 1871-80 20,889 17.06 1881-90 23,322 15.55 1891-1900 28,947 17.44 1901-09 (9 years) 29,718 17.32 1909 5,538 15.77 15 1909] Table VIII. Showing the Marriages and the Marriage Rates in the Borough during 1909 and in the preceding ten years. Years. No. persons married. Persons married per 1000, inhabitants. 1899 6,508 19.35 1900 5,936 17.67 1901 5,988 17.85 1902 6,2l6 18.08 1903 6,106 18.00 1904 5,896 17.29 1905 5,968 17.40 1906 5,928 17.18 1907 5,924 17.07 1908 5,562 15.63 Average of 10 years 6,003 17.60 1909 5,538 15.77 Decrease on mean 465 1.83 BIRTHS. The births registered during the year were 8,198 in number, of which 7,948 were legitimate, and 250 illegitimate. As regards sex, 4,238 were males and 3,900 females, so that the males were in the proportion of 107 to every 100 females. These births gave a birth-rate of 23.34 per 1000 of the population, which is the lowest hitherto recorded in Islington, and, indeed, 16 1909] is as much as 1.0 per 1000 less than the birth-rate of 1908, which in turn was 0.23 below that of 1907. Ten years ago (1899), the birth-rate was 28.71 per 1000; twenty years ago (1889) 30.79; thirty years ago (1879) 36.08; and forty years ago (1869) 37.24. Thus in forty years it has declined 37.33 per cent., or more than one-third. The decrease is due, apart from the variations in the marriage-rate, to other causes (discussed in a previous report), which are at work throughout England and, indeed, nearly all civilised communities. It is of interest to study the results in these countries as shown by the following figures. Birth-rates. Birth-rates. 1881 1908 United Kingdom 32.5 26.3 England & Wales 33.9 26.5 Scotland 33.7 27.2 Ireland 24.5 23.3 New Sth. Wales 37.9 26.8 Victoria 31.2 24.6 Queensland 37.2 26.7 So. Australia 38.6 24.7 Wn. Australia 33.9 28.9 Tasmania 33.4 30.8 New Zealand 37.9 27.4 Ontario (Canada) 22.1 23.31 Denmark 32.2 28.3 Norway 30.6 26.2 Sweden 29.1 25.7 Russia 47.8 48.12 1881 1908 Finland 35.0 31.33 German Empire 37.0 32.33 Prussia 37.0 32.8 Austria 37.5 33.83 Hungary 42.9 36.3 Roumania 41.5 40.8 Bulgaria 33.5 43.63 Servia 45.7 36.8 Netherlands 35.0 29.7 Belgium 31.8 25.33 France 24.9 20.2 Switzerland 29.8 26.83 Spain 37.1 33.2 Italy 38.0 33.4 Japan 25.6 33.03 Chili 46.2 39.3 1 (1906) 2(1903) 3 (1907) Thus it is seen that the Anglo-Saxon race as well as the Gaul and Teuton have reduced their birth-rates in these late years, and that the white man is not reproducing his species as in the past. In the case of that new civilizing race that has so recently burst forth in the vigour of its manhood this is not so. On the contrary, the birth-rate of Japan increased from the low rate of 25.6 per 1000 to 33.0 per 1000. It remains to be seen, however, whether this will continue, or prove to be only the increase which usually occurs in nations after a great war. 17 [1909 A better method of calculating the birth-rate is to base it on the number of women in the population at a marriageable age. In doing so it is found that in Islington the average birth-rate per 1000 women living between the ages of 15 and 45 was 114.2 per 1000 in the five years 1889-93, and 102.7 per 1000 in the five years 1899-1903, whereas in 1909 it was only 86.58. Births. 1889-93 48,076 = 114.21 births per 1,000 women aged 15-45 (5 years) 1899-03 46,373 = 102.72 „ (5 years) 1909 8,198 = 86.58 „ These figures show that since 1893 the fertility of women at the childbearing age has decreased 24.2 per cent. If the birth-rates be calculated on the number of married women, and the illegitimate births be excluded, the following results are obtained— Legitimate Births. 1889-93 46,568 = 237.7 births per 1,000 married women (5 years) 1899-03 45,115 = 211.8 „ (5 years) 1909 7,948 = 177.8 „ These figures show that since 1893 the fecundity of every 1000 married women has decreased by 59.9 births, or in other words, the birth-rate is now 25.2 per cent. lower than it was then. Such a diminution does not occur without a cause, or causes, but as these have been discussed in the report for 1908, they will not be considered now. There is one point, however, with respect to the curtailment of families, which is of great importance in view of the fact which modern investigators in the field of eugenics have discovered, and it is this, that the eldest-born are, as a rule, inferior in natural gifts to the younger-born, in a small but significant degree. So says Sir Francis Galton. Again, Dr. David Heron asserts that the first-born in a family is more likely to be insane, tuberculous, or criminal than the others, and that, therefore, it follows that the tendency to diminish the size of families increases the average number of such individuals in the community. Another great authority, Professor Karl Pearson, not long since, in a lecture delivered at University College, declared that if his observations were correct, and he believed them to be so, then the mental and physical condition of the first and second-born members of a family is differentiated from that of C 18 1909] the later members. They are of a more nervous and less stable constitution. He finds that the neurotic, the insane, the tuberculous and the albinistic are more frequent among the elder-born, and then he goes on to point out that Dr. Goring's results for criminality show the same law, the result of which is remarkable, for it proves that if you reduce the size of the family, you will tend to decrease the relative proportion of the mentally and physically sound in the community. This conclusion will not be upset if, as he suspects, the extraordinarily able man, the genius, is also among the early-born, for this man will not be lost if there is a larger family, although the sounder members will be if you curtail it. These grave statements, made by these distinguished men after the most patient and careful enquiry, are deserving of the most thoughtful consideration of persons who have not only the welfare of the state, but of our race, at heart, Illegitimate Births.—These numbered 250, or 10 more than the average of the preceding eight years, and 19 more than in 1908. They are in the proportion of 5 0 per 1000 unmarried women at the child-bearing age. The number of these births now noted is less than the average that obtained in previous years (Table G in the Appendix), wherein it may be seen that from 1851 to 1860 it was 133 per annum; from 1861-70 265; from 1871-80 342; from 1881-90 347; from 1891 to 1900 271; and from 1901 to 1908 192. The present tendency, therefore, is for these births, in common with the legitimate births, to decrease. There can be little doubt that the actual number of illegitimate births is more than that which is gleaned from the registers, because it is a well-known fact that many men and women among the labouring classes live together for years, indeed for life, who have never been married, but who pass among their friends and neighbours as married people, and who, when registering the births of their children, so describe themselves. That people are not always truthful with the registrars of births has been clearly proved by the notifications made under the Notification of Births Act, for in 1909 in no less than 92 instances the incorrect address of the mother was given to them, although the correct one had been notified to the Medical Officer of Health. If then this was done when there was very little to be gained by doing so, how much more likely is it to occur when there is a shameful disclosure to be made. The fact is that it is only when the truth cannot be concealed that it is declared. 19 [1909 Notification of Births.— Under the Notification of Births Act, 1907, it is required that all births shall be notified to the Medical Officer of Health within forty-eight hours, and accordingly during the year, 6,983 such notifications were made. Medical practitioners notified 988 of these, midwives 2,312, and parents and other persons 3,683. The birth registers, however, disclosed that there were 1,194 births of which no notification had been sent, and, therefore, enquiries were made, with the result that it was found that the actual confinements had been attended in 998 instances by medical men, in 56 instances by midwives, and in 48 by persons other than midwives, while in 92 the people were not known at the addresses given to the registrars, or had moved away. It is satisfactory to note that there is a gradual improvement in the number notified by medical practitioners, whose defaulters the Public Health Committee are unwilling to prosecute, in the hope that in time they will fulfil the obligations imposed on them by the Act of Parliament. Table IX. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1909, and in the four quarters of the year, and of the County of London and the Great Towns during the same period, also in the year 1908; together with the mean Borough Birth-rates for the years 1899-1908. Quarter. Males. Females. Total. Birth Rates. Islington, 1909. Islington. 1899-08. London, 1909. 76 Great Towns, 1909. 1st 1,115 1,079 2,194 24.99 27.31 25.3 26.7 2nd 1,054 978 2,032 23.14 26.41 24.9 26.6 3rd 1,046 936 1,982 22.57 26.11 23.9 25.3 4th 1,023 967 1,990 22.66 25.60 23.4 24.4 The Year 1909 4,238 3,960 8,198 23.34 26.36 24.2 25.7 1908 4,447 4,218 8,665 24 35 23.34 25.2 27.0 Increase or decrease -209 -258 -467 -1.01 -3.02 -0.8 -1.3 20 1909] Table X. Showing the Births of Males and Females in each quarter and for the year, 1909, in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. The Borough Males. Females. Total. Males. Females. Tota'. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Qr. 89 82 171 143 148 291 91 96 187 157 141 298 175 173 348 210 218 428 250 221 471 1,115 1,079 2,194 2nd ,, 91 104 195 127 144 271 76 89 165 126 114 240 169 159 328 203 159 362 262 209 471 1,054 978 2,032 3rd „ 105 88 193 115 99 214 90 97 187 138 139 277 158 144 302 165 182 347 275 187 462 1,046 936 1,982 4th ,, 115 85 200 110 107 217 83 83 166 141 128 269 170 153 323 177 179 356 227 232 459 1,023 967 1,990 Year 400 359 759 495 498 993 340 365 705 562 522 1,084 672 629 1,301 755 738 1,493 1,014 849 1,863 4,238 3,960 8,198 21 11909 Table XI. Showing the Birth-rates for each quarter and for the year 1909, of Islington, of the County of London, and of the 76 Great Towns. Sub-Districts. 1St Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Tufnell 19.38 22.10 21.87 22.67 ' 21.50 Upper Holloway 31.22 29.08 22.96 23.28 26.63 Tollington 20.10 17.73 20.10 17.84 18.94 Lower Holloway 28.47 22.93 26.46 25.70 25.89 Highbury 20.18 19.03 17.52 18.74 18.87 Barnsbury 31.87 26.96 25.84 26.51 27.80 Islington, S. East 24.49 24.49 24.02 23.87 24.22 The Borough 24.99 23.14 22.57 22.66 23.34 London 25.3 24.9 23.9 23.4 24.2 76 Great Towns 26.7 26.6 25.3 24.4 25.7 22 1909] DEATHS. The Death Registers showed that 4,918 persons, of whom 2,487 were males, and 2,431 females, died in 1909. These deaths produced the low mortality rate of 14.0 per 1000 inhabitants of the borough. Although the rate is not so low as that of the preceding year, namely 13.15 per 1000 (which was an extraordinarily low one, and one which was due, in no small extent, to climatic influences), yet it is highly satisfactory, as it is, with that exception, the lowest hitherto recorded in Islington. For many years this borough has enjoyed a series of low death-rates, averaging 15.34 per 1000 per annum from 1901 to 1905 and since then rates of 14.64, 14.63, 13.15 and 14.00 The evenness of the rates has been remarkable. Indeed, this is a marked feature of this great borough. Thus, from 1886-90, its death-rate averaged 17.81 per 1000; from 1891 to 1895 17.81, from 1896 to 1900 17.22, and from 1901 to 1905 15.34, while from 1905 to 1909 it has averaged 14.15 per 1000. There is little doubt, however, that the later death-rates will have to be somewhat revised, though probably to only a very small extent, when the census of 1911 has been taken, for it is surmised that the population of the borough has not latterly increased quite so rapidly as during the last intercensal period; and it is on the rate of increase then experienced that statisticians base their estimates of the populations from year to year. The continued diminution in the deaths of infants has also had an appreciable effect on the general death-rate, for they were no less than 394 below the average of the preceding ten years, a decrease which is equal to a rate of 1.12 per 1000 of the population. And this decrease was due, without any doubt whatever, to the very favourable climatic conditions which prevailed during the year, especially during the summer months, when these deaths, instead of being higher, as they usually are, were lower than in either the spring, autumn, or winter quarter. Apart, however, from the diseases which are specially amenable to climatic conditions, it is satisfactory to find that the death-rates from nearly all the classified causes of disease were below the averages of the ten years 1899-1908. These will be alluded to in a later part of the report. Comparison with the mortality in other places.—When compared with the mortality of the country, the death-rate is also satisfactory, for it is found that, while the mortality rate in Islington was 14 0 per 1000, that of England and Wales was 14-5. As there is, however, a considerable difference in the 23 [1909 distribution of the ages and sexes in the two populations, which of course affects the death-rate, a correction must be made before an accurate comparison can be arrived at, and then it is found that the death-rate in the borough becomes 14.5, so that the local mortality-rate is exactly the same as that of the country. This is satisfactory, particularly when it is recol'.ected that the crowded conditions which occur in Islington do not occur in the country as a whole. In the 76 Great Towns, the corrected death-rate was 15.5 per 1000, or 1.0 more than that of the Borough, and in the 143 Smaller Towns it was 14.5, while in the rural districts it was 13.7 per 1000. When we come nearer home, it is found that the corrected rate for the County of London was 14.7 per 1000, or 0.2 higher than the corrected rate for Islington. In the surrounding boroughs the several corrected death-rates were: Stoke Newington 11.77 per 1000, Hackney 13.14, Shoreditch 19.90; Finsbury 19*93; St. Pancras 15.50, and Hornsey 9.48. Among the Greatest Towns, which, by the size of their populations, are more properly comparable with Islington, Bristol alone shows a lower mortality, and there the corrected death-rate was 13.06 while in Birmingham it was 16.59, in Liverpool 20.38, in Manchester 19.98, in Leeds 15.33, and in Sheffield 16.24 per 1000 of their populations. The Ages at Death.— Compared with the preceding ten years, there was a decrease in the number of registered deaths at the several age periods (specified in Table XVIII.) up to 35-45 years, after which, with the exception of the age period 55-65, there was an increase. The decrease was very marked in the first year of life, when the number of deaths (841) was 331 below the decennial average. In very juvenile lives (0-5) there was the substantial decrease of 368, of which only 37 occurred between 1 and 5 years of age. Between 5 and 15 years of age there were 140 deaths, or a decrease of 25; between 15 and 25, 144 deaths, or a decrease of 50; between 25 and 35, 271 deaths, or a decrease of 38; between 35 and 45, 415 deaths, or a decrease of 12, and between 55 and 05, 000 deaths, or a decrease of 25. On the other hand, between the ages of 45 and 55 there were 539 deaths, or an increase of 6; between 65 and 75 692 deaths, or an increase of 37; between 75 and 85 544 deaths, or an increase of 73, and above 85 years of age 172, or an increase of 42. The one feature that stands out prominently in these figures is the considerable increase in the number of deaths at the later periods of life, amounting in all to 152, among people who had passed their sixty-fifth year. A reference to 24 1909] the returns respecting influenza on p. 87, and to cancer on p. 94, will partly explain the cause of the increases, for the former was responsible for an increase of 6 deaths, and the latter to 23. In his annual letter to the Registrar-General, which is published in his last annual report, Dr. T. H. Stevenson noticed in the English mortality that not only was the death-rate at all ages the lowest on record, but at each group of ages up to 65 years, and in each sex this was also the case; but above the 55-65 period the mortality had increased from an average of 86.2 per 1000 of the population at this age to 87.9. This increase was more marked in the urban populations, for there the increase was from 90.95 per 1000 to 94.08 per 1000. On the other hand, in the rural counties the increase was 82.8 per 1000 to 83.72. In Islington the death-rate among the people of this age was 84.52 in 1908, and 93.11 in 1909, from which figures it may be noticed that the local mortality rate approximates that of the English mortality, and is not so good as the rural counties, which of course one would naturally anticipate. The death-rate, then, among old people is increasing everywhere, and Islington is no exception to the rule. The Mortality in the Sub-Districts.—Just as it is impossible to contrast accurately the death-rate of one town with that of another without making corrections for the difference in the age and sex distribution of their inhabitants, so also it is impossible to contrast the death-rates of the several districts of the same borough. Thus in Islington, the Highbury sub-district and the lower Holloway or Barnsbury sub-district are inhabited bypeople who are different in their position in the world, in their habits, their occupations, their housing, and, judging by their birth-rates, in their age incidence. To say, therefore, that the death-rate is so much in one, and so much less in another does not enable us to say whether the one rate is a high death-rate or the other a low one. Unfortunately, the age and sex incidence is not known, and therefore it is impossible to make a correction for them. It only remains, therefore, to contrast the present returns for each district with those of previous years, so as to ascertain if the mortality is increasing or decreasing in them. Tufnell.—In Tufnell sub-district there were 440 deaths, equal to an annual death-rate of 12.46 per 1000 inhabitants, as compared with an average of 475 deaths in the preceding seven years. The death-rate, although slightly higher than that of 1908 (11.96), is, however, lower than any of the rates preceding that year. Upper Holloway—The number of deaths registered was 558, or 15 above the average of the preceding seven years. The death-rate of 14.97 per 1000, \ 25 [1909 however, owing to the increased population of the district, shows that the mortality was slightly below the average of the years 1902-08. Compared with the previous year, there was an increase of 29 deaths from Measles, of 11 from Phthisis, of 7 from Premature Birth, and of 10 from acute Bronchitis, which more than counterbalanced the decreased mortality from other causes. Tollington.— In this sub-district 430 deaths were known, which were equal to a death-rate of 11.55 per 1000 inhabitants. The returns, although showing an increase of 34 deaths on the preceding year, are nevertheless 22 below the average of the seven years 1902-08. Lower Holloway.— Here also the return is below the average, the number of deaths registered being 617, as against an average of 658, or a decrease of 41. The death-rate was 14.73 per 1000 of the population. Highbury.—In Highbury sub-district the 793 registered deaths were 30 below the average of the years 1902-1908, while the death-rate of 11.50 per 1000 was the lowest hitherto recorded in this healthy residential district. Barnsbury.—In this sub-district the deaths, 872 in number, exhibited the substantial decrease of 71 on the average of the preceding seven years, and indeed was a smaller number than any registered in any previous year. The death-rate was equal to 16.23 per 1000 of its population. South-East Islington.—There were 1,208 deaths registered, as compared with an average of 1,173 in the preceding seven years, while the resulting death-rate was 15.70 wes 1000, as against a mean death-rate of 15.32. The increased mortality was due chiefly to Measles, which caused 68 deaths, as against 13 in 1908, Whooping Cough 32, as compared with 15, and Chronic Bronchitis 101, as contrasted with 125. Mortality in the Wards.—The number of deaths in the several wards is set out in Table XV., which gives not only particulars as to the deaths and death-rates for the four quarterly periods, but also for the year. SEASONAL MORTALITY. The mortality in the spring, summer, autumn and winter quarters has already been given in the quarterly reports of the Medical Officer of Health, and reference should be made to them for full particulars. First Quarter.—The deaths numbered 1,676, or 104 more than the corrected average (1,572) of the ten years (1899-1908), and were equal to an annual death-rate of 19.09 per 1000, as compared with a mean decennial rate 26 1909] for this quarter of the year of 17.90 per 1000. Thus, the new year did not open very salubriously, nor did it give any indication of the more healthy conditions which prevailed later on. The highest mortality occurred in the third week of March, and the lowest in the third week of January, at which periods the death-rates were respectively 25.24 and 11.13 per 1000 annually. In the County of London in the same quarter, the death-rate was 19.0, and in the Encircling Boroughs 19.1 per 1000 inhabitants. In St. Pancras it was 20.5; in Stoke Newington 16.4; in Hackney 16.7; in Hornsey 10.2; in Finsbury 26.0; and in Shoreditch 25.4. Second Quarter.— In this quarter there was a decided improvement in the mortality returns, for the deaths only numbered 1,136, or 104 less than the corrected average (1,240) of the ten years (1899-1908), and were equal to the low annual death-rate of 12.93 per 1000, as compared with a mean decennial rate for this quarter of the year of 14.12 per 1000. The mortality, in proportion to population, was with two exceptions the lowest hitherto experienced in the borough in the second quarters of the years 1886-1908. The highest mortality occurred in the first and second weeks of April, and the lowest in the last week of June, at which periods the death-rates were respectively 17.37, 17.37 and 9.20 per 1000 annually. Third Quarter.—In this quarter the deaths numbered 903, or 295 less than the corrected average (1,198) of the ten years (1899-1908), and were equal to the low annual death-rate of 10.28 per 1000, as compared with a mean decennial rate of 13.64 per 1000. The mortality, in proportion to population, was lower than any experienced in the borough in the third quarters of the years 1886-1908. The highest mortality occurred in the second week of September, and the lowest in the first week of September, at which periods the death-rates were respectively 13.06 and 7.27 per 1,000 annually. The excellent health of the borough at this time was in great part due to the low infantile mortality, for it was found that there were only 180 deaths among infants under a year old, or 177 below the average (357) of the preceding ten years at this period of the year. These deaths represented an infantile mortality rate of 90 per 1000 infants born, as compared with 153 per 1000 in the third quarters of the ten years 1899-1908. In the third quarter of 1908 the rate was 95 per 1000 births. The infantile mortality rate was the lowest hitherto recorded for any corresponding period, with one exception, viz.: that of 79 per 1000 in 1907. In the County of London the infantile mortality rate was also low, being only 109 per 1000 births, while in the Encircling Boroughs it was 110. In these the respective infant mortality rates were as follows:—St. Pancras 106, Stoke Newington 97, Hackney 105, Hornsey 50, Finsbury 89, and Shoreditch 179. 27 [1909 Fourth Quarter.— The healthy condition of the Borough in the second and third quarters was maintained in the fourth, for in it the deaths only numbered 1,203, which is 230 less than the corrected average (1,433 )of the ten years (1899-1908). These deaths were equal to the low annual death-rate of 13.70 per 1000, as compared with a mean decennial rate for the fourth quarters of 16.32 per 1000. The mortality, in proportion to population, was lower than any experienced in the borough in any fourth quarter of the years 1886-1908. The highest mortality occurred in the first week of December, and the lowest in the third week of October, at which periods the death-rates were respectively 15.89 and 10.24 per 1000 annually. Table XIII. Showing the Estimated Populations, 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. DeathRates. Population. Deaths. DeathRates. Population. Deaths. DeathRates. 0–5 19,102 741 38.79 18,668 660 35.35 37,770 1,401 37.09 5–15 32,385 71 21.9 32,490 69 2.12 64,875 140 2.16 15–25 32,961 75 2.27 36,933 69 1.87 69,894 144 2.06 25–35 30,194 148 4.90 33,768 123 3.64 63,962 271 4.23 35–45 21,755 229 10.52 23,987 186 7.75 45,742 415 9.07 45–55 15,217 293 19.25 17,435 246 14.11 32,652 539 16.51 55–65 9,555 314 32.86 11,632 286 24.59 21,187 600 28.32 65–75 4,334 335 77.30 6,429 357 55.53 10,763 692 64.29 75 and upwards 1,471 281 191.03 2,886 435 150.73 4,357 716 164.33 All ages 166,974 2,487 14.89 184,228 2,431 13.19 351,202 4,918 14.00 The deaths of 634 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 770 residents who had died outside the district are included. 28 1909] Table XIV. Showing the Deaths and Death-Rates from All Causes in the several Sub-Registration Districts. sub-DISTRICTS. Males. Females. Totals. Death Rates. Tufnell 214 226 440 12.46 Upper Holloway 289 269 558 14.97 Tollington 219 211 430 11.55 Lower Holloway 317 300 617 14.73 Highbury 389 404 793 11.50 Barnsbury 459 413 872 16.23 South-East Islington 600 608 1,208 15.70 The Borough 2,487 2,431 4,918 14.00 Previous year 1908 2,348 2,331 4,679 13.15 29 [1909 Table XV. Showing the Deaths and Death-rates from All Causes in the Wards during the Four Quarters of 1909. Wards First Quartet. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 141 15.98 112 13.69 85 9.63 102 11.56 440 12.46 Upper Holloway 177 18.99 146 15.66 108 11.59 127 13.62 558 14.97 Tollington 154 16.55 104 11.17 73 7.84 99 10.64 430 11.55 Lower Holloway 211 20.16 131 12.51 122 11.65 153 14.62 617 14.73 Highbury l66 18.81 87 9.86 76 8.61 114 12.92 443 12.55 Mildmay 101 15.96 77 12.17 46 7.27 64 10.11 288 11.38 Thornhill 164 19.56 116 13.83 96 11.45 144 17.17 520 15.57 Barnsbury 131 25.99 73 14.48 56 11.11 92 18.25 352 17.46 St. Mary's 80 18.19 61 13.87 48 10.92 69 15.69 258 14.67 Canonbury 163 18.87 105 12.16 100 11.58 100 11.58 468 13.55 St. Peter's 188 22.68 124 14.96 93 11.22 139 16.77 544 16.41 The Borough 1,6 6 19.09 1,136 12.93 903 10.28 1,203 13.70 4,918 14.00 N.B.— The heavy figures show the healthiest Ward in the several periods to which they refer. 30 1909] TABLE XVI. Showing the deaths and death rates together with the mean Mortality in the Sub-Districts for the Seven Years, 1902-8 and during the Year, 1909. DEATHS. DEATH-RATES. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Average 1902-8. 1909. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Average 1902-8. 1909 ???nell 491 440 571 483 432 482 425 475 440 14.84 13.40 17.18 14.36 12.70 13.99 11.96 14.12 12.46 ??? Holloway 605 535 523 550 542 559 485 543 558 17.23 15.36 14.85 15.44 15.05 15.34 12.91 15.24 14.97 ??? lington 527 437 475 428 425 480 396 453 430 15.03 12.57 13.51 12.04 11.82 13.20 10.56 12.73 11.55 ??? Holloway 714 618 693 644 721 644 571 658 617 16.88 14.87 16.66 15.46 17.30 15.42 13.40 15.80 14.73 ??? hbury 945 796 775 837 779 816 816 823 793 14.37 12.22 11.79 12.6l 11.630 12.07 11.72 12.40 11.50 ???shury 1,040 899 963 897 967 949 885 943 872 18.77 16.56 17.77 16.58 17.90 17.60 16.14 17.43 16.23 ???ngton,S. East 1,313 1,114 1,236 1,116 1,184 1,149 1,101 1,173 1,208 17.03 14.70 16.27 14.65 15.51 15.01 14.08 15.40 15.70 Borough 5,635 4,839 5,236 4,955 5,050 5,079 4,679 5,068 4,918 16.39 14.26 15.35 14.44 14.64 14.63 13.51 14.77 14.00 31 [1900 Table XVII Showing the Deaths and Death Rates of Islington in 1909, and in the four quarters of the year, of London and the Great Towns during the same periods; in the year 1908; also the mean Borough Death-Rates for the years 1899-08. Quarter. Males Females. Total. Death Rates. Islington, 1909. Islington, 1899-08. London, 1909 76 Great Towns, 1909. First 827 849 1,676 19.09 17.90 19.0 18-7 Second 608 528 1,136 12.93 14.12 12.8 13 9 Third 451 452 903 10.28 13.64 10.8 118 Fourth 601 602 1,203 13.70 16.32 13.5 14-3 The Year 1909 2,487 2,431 4,918 14.00 15.50 14.0 14.7 1908 2,348 2,331 4,679 13.15 14.00 13.8 14.9 Increase or decease + 39 + 100 + 239 + 0 85 + 1.50 + 0 2 -0 2 82 [1909 Table XVIII. Showing the Ages at Death during the Years 1899—1908 and in 1909. 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 upwards All above 5 yrs. Totals. 1899 1,548 767 2,315 212 248 349 486 610 700 712 540 121 3,978 6,293 1900 1,344 612 1,956 183 233 339 480 605 664 678 469 114 3,765 5,721 1901 1,290 638 1,928 176 210 315 444 511 631 592 451 103 3,433 5,361 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 1904 1,140 603 1,743 165 197 295 439 521 603 666 496 111 3,493 5,236 1905 1,074 565 1,639 116 188 318 380 527 590 648 396 153 3,316 4,955 1906 1,083 589 1,672 141 167 273 377 528 611 654 490 137 3,378 5,050 1907 996 545 1,541 162 167 310 398 492 659 730 463 157 3,538 5,079 1908 894 426 1,320 161 170 257 408 471 597 637 510 148 3,359 4,679 Mean. 1,172 597 1,769 165 200 309 427 533 625 655 471 130 3,515 5,284 1909 841 560 1,401 140 144 271 415 539 600 692 544 172 3,517 4,918 Increase or Decrease –331 –37 –368 –25 –56 –38 –12 +6 –25 + 37 +73 42 + 2 –366 33 D Table XIX. Showing the Deaths and Death-rates from All Causes in the Four Quarters and in the Sub-districts, together with the Death-rates of 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 141 15.98 177 18.99 154 16.55 211 20.16 289 16.76 295 21.97 409 21.26 1,676 1909 Second Quarter 112 12.69 146 15.66 104 11.17 131 12.51 178 10.32 189 14.08 276 14.35 1,136 12.93 Third Quarter 85 9.63 108 11.59 73 7.84 122 11 .65 129 7.48 152 11.32 234 12.17 903 10.28 Fourth Quarter 102 11.56 127 13.62 99 10.64 153 14.62 197 11.43 236 17.58 289 15.03 1,203 13.70 The Year 440 12.46 558 14.97 430 11.55 617 14.73 793 11.50 872 16.23 1,208 15.70 4,918 14.00 N.B.—The heavy figures show which was the healthiest sub-district in the quarters to which they refer. [1909 84 1909 Table XX. Showing the Deaths and Death-Rates from All Causes for each Quarter since 1888. (The Lowest Death Rates are printed in heavy type.) Years. QUARTERS. First. Second. Third. Fourth. Year. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. 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 21.42 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 16.52 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 17.03 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 16.39 1903 1,383 16.31 1,226 14.46 1,031 12.16 1,199 14 14 4,839 14.27 1904 1,436 16.84 1,106 12.97 1,284 15.06 1,410 16.53 5,236 15 35 1905 1,316 15.35 1,178 13.73 1,076 12.55 1,385 16.15 4,955 14.44 1906 1,391 16.12 1,151 13.34 1,163 13.48 1.345 15.59 5,050 14.64 1907 1,640 18.90 1,224 14.11 939 10.82 1,276 14.70 5,079 14.63 1903 1.387 15.89 1010 11.57 984 14..27 1,298 13.81 4.679 13.15 Corrected Mean 21 years 1,706 19.43 1.326 15.11 1,291 14.70 1,503 17.11 5,826 16.74 1909 1,676 19.09 1,136 12.93 903 10.28 1,203 13.70 4,918 14.00 Increase or Decrease -30 -0.34 -190 -2.18 -388 -4.42 -300 -3 .41 -908 -2.74 35 D 2 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 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. Miasmatic 27 0.76 53 1.42 32 0.86 65 1.55 67 0.97 51 0.95 131 1.70 426 1.21 Diarrhœal 7 0.19 4 0.11 1 0.02 12 0.29 12 0.17 16 0.29 15 0.19 67 0.19 Constitutional 104 2.95 126 3.38 100 2.69 127 3.03 144 2.09 186 3.46 245 3.18 1,032 2.94 Developmental 38 1.08 56 1.50 40 1.07 44 1.05 58 0.84 84 1.56 91 1.18 411 1.17 Nervous 31 0.88 49 1.31 35 0.94 28 0.67 49 0.71 53 0.99 52 0.67 297 0.84 Circulation 53 1.50 81 2.17 50 1.34 69 1.65 122 1.77 114 2.12 172 2.24 661 1.88 Respiration 94 2.66 104 2.79 95 2.55 145 3.46 191 2.77 182 3.39 276 3.59 1,087 3.09 Digestive Organs 37 1.05 20 0.54 16 0.43 35 0.84 51 0.74 51 0.95 72 0.93 282 0.80 Urinary System 9 0.25 22 0.59 16 0.43 22 0.52 30 0.43 31 0.58 44 0.57 174 0.49 Violence 11 0.31 15 0.40 17 0.46 30 0.72 27 0.39 38 0.71 55 0.71 193 0.55 Ill-defined 16 0.45 13 0.35 14 0.37 23 0.55 16 0.23 26 0.48 34 0.44 142 0.40 The heavy figures denote that these death-rates were the highest experienced in the several districts during the year from the diseases mentioned. [1909 36 1909] Table XXII. Showing the Deaths (arranged, in Classes) from All Causes, in the Four Quarters. Classified Causes of Death. Quarters. Year. 1st. 2nd. 3rd. 4th. I. Specific or Febrile Causes 208 187 80 73 548 1. Miasmatic Diseases 183 167 28 48 426 2. Diarrhceal ,, 8 6 41 12 67 3. Malarial ,, .. .. .. .. .. 4. Zoogenous ,, .. .. .. .. .. 5. Venereal ,, 2 2 6 5 15 6. Septic „ 15 12 5 8 40 II. Parasitic Diseases .. .. .. 1 1 III. Dietic 5 9 7 6 27 IV. Constitutional Diseases 279 232 239 282 1,032 V. Developmental 138 93 79 101 411 VI. Local 957 523 418 666 2,564 1. Diseases of Nervous System 94 71 68 64 297 2. ,, Organs of Special Sense .. 3 3 4 10 3. ,, Circulatory System 216 152 132 161 661 4. ,, Respiratory „ 519 185 103 280 1,087 5. Digestive ,, 67 60 69 86 282 6. „ Lymphatic „ 6 5 3 3 17 7. Urinary „ 49 35 32 58 174 8. ., Reproductive „ 2 7 6 5 20 9. ,, Bones and Joints 4 3 1 3 11 10. ,, Integumentary System .. 2 1 2 5 VII Violence 57 50 34 52 193 1. Accident or Negligence 42 39 26 40 147 2 Homicide 1 .. 1 2 4 3. Suicide 14 11 7 10 42 4. Execution .. .. .. .. .. VIII. Ill-defined Causes 32 42 46 22 142 All Causes 1,676 1,136 903 1,203 4,918 Note—The heavy figures denote that the diseases to which they are applied were most fatal in the Quarter to which they refer. 37 [1909 Table XXIII. Showing the Recorded and Corrected Death Rates per 1,000 persons living in the County of London and in the Metropolitan Boroughs, arranged in their order of Corrected Death-Rates. Borough. Standard Death Rate * Factor for Correction for Sex and Age Distribution, † Crude or Recorded Death Rate 1909. Corrected Death Rate, † 1909. Comparative Mortality Figure,§ 1909. England and Wales 18194 1 0000 14 49 14-49 1,000 London 17.31 1.0511 14.03 14.75 1018 Hampstead 16.13 1.1280 8.93 10.07 695 Lewisham 17.46 1.0420 10.33 10.76 743 Stoke Newington 17.43 1.0438 11.28 11.77 812 Greenwich 17.82 1.0210 12.19 12.45 859 Wandsworth 17.25 1.0547 11.87 12.52 864 Fulham 17.39 1.0462 12.01 12.56 867 Woolwich 17.02 1.0690 11.93 12.75 880 Hackney 17.46 1.0420 12.61 13.14 907 Paddington 17.04 1.0677 12.91 13.78 951 Camberwell 17.54 1.0373 13.38 13.88 958 Battersea 16.96 1.0728 13.02 13.97 964 Deptford 17.31 1.0511 13.62 14.32 988 Kensington 16.88 1.0778 13.32 14.36 991 Lambeth 17.63 1.0320 14.06 14.51 1,001 Islington 17.51 1.0391 14.00 14.58 1006 City of Westminster 16.22 1.1217 13.13 14.73 1,017 Hammersmith 17.47 1.0414 14 29 14.88 1,027 Chelsea 17.56 1.0361 14.45 14.97 1,033 St Pancras 17.40 1.0456 14.82 15.50 1,070 St. Marylebone 17.08 1.0652 14.61 15.36 1,074 Stepney 17.41 1.0450 15.27 15.96 1,101 Poplar 17.64 1.0314 16.25 16.76 1,157 Holborn 16.90 1.0766 15.58 16.77 1,157 Bethnal Green 18.01 1.0102 16.81 16.98 1,172 Southwark 17.41 1.0450 16.76 17.51 1,208 Bermondsey 17.76 1.0244 18.77 19 23 1,327 Finsbury 17.57 1.0355 19 25 19.93 1,375 Shoreditch 17.34 1.0493 19.02 19.96 1,378 City of London 16.55 1.0993 20.28 22.29 1,538 * 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 Factors for Correction is the figure by which the Crude or Recorded Death Rates should be multiplied in order to correct for variations of sex and age distribution, and to make them comparable with the Death Rates of England and Wales and with each other. ‡ 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 1909 taken as 1,000. 38 1909] 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 1909. England and Wales 18.2 14.0 11.6 14.1 14.5 76 Great Towns 18.7 13.9 11.8 14.3 14.7 143 Smaller Towns 17.1 13.3 11.3 13.8 13.9 England and Wales less) the 219 Towns 18.1 14.5 11.6 14.1 14.5 County of London 19.0 12.8 10.8 13.5 14.0 Bristol 15.5 12.4 10.6 12.4 12.7 Birmingham 21.0 14.2 12.2 14.2 15.4 Liverpool 23.2 18.0 16.3 18.6 19.0 Manchester 22.2 17.9 14.4 17.2 17.9 Leeds 17.4 13.3 11.9 13.7 14.1 Sheffield 20.0 14.8 12.8 12.7 15.1 The Encircling Boroughs 19.1 14.6 11.1 13.6 14.2 St. Pancras 20.5 13.3 11.4 14.2 14.8 Stoke Newington 16.4 9.4 9.1 10.2 11.3 Hackney 16.7 11.6 9.6 12.6 12.6 Hornsey 10.2 8.1 5.8 9.2 8.4 Finsbury 26.0 18.4 14.7 17.9 19.2 Shoreditch 25.4 17.5 16.0 17.1 19.0 Islington 19.1 12.9 10.3 13.7 14.0 89 [1909 INFANTILE MORTALITY. The most gratifying feature of the returns during the years 1907 and 1908 was the marked reduction in the infantile mortality, a reduction which was also happily a feature in those of 1909, although, unhappily, it is still much greater than it should be, if only that care and attention were bestowed on infants, before and after birth, that their future well-being demands. During the year 841 deaths occurred among infants during their first year of life, and these were equal to a mortality rate of 103 in each 1000 born. This proportion is exactly the same as that of 1908, but 14 in every 1000 less than the rate for 1907, which was again 8 in every 1000 births less than the rate of 1906. Nevertheless, when the returns are scrutinized, it is found that there was not cause for equal satisfaction in all the districts of the Borough, for in at least two of them there was an increased death-rate when the mortality is compared with that of the preceding year. These districts were Tufnell, in which the proportion of deaths per 1000 births rose from 81 to 107, and South-East Islington, in which it rose from 99 to 117. There was also a very slight increase in the mortality-rate in Upper Holloway, from 74 to 77. These increases notwithstanding, it is good to note that there is a decreased mortality in all the sub-districts when comparison is made with the averages of the seven preceding years. The local infantile mortality rate compares satisfactorily with the rate for the whole country, in which it was 109, with that of the 70 Great Towns, in which it was 118, and with that of the 143 Smaller Towns, in which it was 111 per 1000 births. It was also less than the rate experienced in the County of London, which was 107; while in all the largest towns except. Bristol, there was a higher mortality. In Birmingham the rate was 1.34, in Liverpool 144, in Manchester 134, in Leeds 122, and in Sheffield 118. In the metropolitan boroughs which border on Islington, with the exception of Stoke Newington and Hackney, in which the rates were respectively 82 and 98 per 1000 births, the mortality was above that of this Borough, namely, 140 in Shoreditch, 108 in Finsbury, and 109 in St. Pancras, while in the neighbouring Borough of Hornsey it was as low as 61. England and Wales 109 per 1,000 births Rural Districts 98 „ „ 76 Great Towns 118 ,, „ 143 Smaller Towns 111 „ „ 40 1909] London 108 per 1,000 births Birmingham 134 „ ,, Liverpool 144 „ „ Manchester 134 „ „ Leeds 122 „ ,, Bristol 100 „ „ Sheffield 118 „ „ The Encircling Boroughs. Hornsey 61 per I,ooobirths Stoke Newington 80 „ ,, Hackney 102 „ ,, Shoreditch 140 „ „ Finsbury 131 „ „ St. Pancras 102 „ „ Islington 103 „ „ The deaths among infants and the infantile mortality rates in each district during 1909 were as follows:— Deaths per 1,000 Births. Sub-Districts. Deaths. 1909. 1908. Tufnell 81 107 81 Upper Holloway 77 77 74 Tollington 68 96 117 Lower Holloway 110 101 125 Highbury 121 93 101 Barnsbury 166 111 119 South-East Islington 218 117 99 The Borough 841 103 103 TABLE XXV. Showing the Deaths among Infants per 1,000 Births during the year 1909 and also the mean mortality rates for the years 1902 8. Sub-Districts. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Mean 1902 8. 1909. Decrease. Tufnell 123 112 141 127 122 127 81 119 107 12 Upper Holloway 103 138 92 101 105 88 74 98 77 21 Tollington 144 105 128 117 127 132 117 127 96 31 Lower Holloway 156 159 161 151 155 148 125 149 101 48 Highbury 114 178 98 117 95 107 101 108 93 15 Barnsbury 151 210 142 124 138 123 119 132 111 21 South East Islington 130 263 134 121 129 104 99 121 117 4 The Borough 132 126 128 123 125 117 103 122 103 19 41 [1909 These figures show that the Infantile Mortality in this Borough, if not so good as in some places, was yet below that of the majority of the great towns which contain a larger population than Islington, and was also below at least three of the Boroughs which surround it. Islington, however, has its own dark spots. These are Tufnell, Lower Holloway, Barnsbury, and South-East Islington, where the infant mortality rates were respectively 107, 101, 111 and 117. Although it must be stated that these rates were below the average of the past seven years, they cannot be said to be good. In Table XXV. just given, it will be seen that during the seven years prior to 1909, the infant mortality in lufnell sub-district was 119 per 1,000 births; in Tollington 127; in Lower Holloway 149 ; in Barnsbury 132, and in South-East Islington 121. In these days such rates, however satisfactory they may have been ten years ago, are not to be lightly looked over, for they indicate a considerable wastage of infant life, which we know now might be greatly reduced, and which we in Islington have as yet done hardly anything to prevent. In Table XXVI, which has been prepared to show the mortality from the several causes, it will be noted that the deaths from premature birth and congenital defects were equal last year to a rate of 21 per 1000 of the births; that bronchitis and pneumonia are accountable for 18 per 1000; atrophy and marasmus for nearly 15 per 1000, and diarrhoeal diseases for nearly 11 per 1000, and this, too, in an exceptionally favourable year for these diseases. TABLE XXVI. Showing the Mortality per 1,000 Births among Infants under one year of age w the three years 1901-03; and in 1909. Causes of Death. Mean rate of 3 years 1901-2-3 per 1,000 Births. 1909. Premature Birth and Congenital Defects 24.25 21.08 Bronchitis and Pneumonia 25.67 18.05 Atrophy and Marasmus 20.54 14.91 Diarrhoeal Diseases (all forms) 19.01 10.65 Convulsions 6.66 1.57 Whooping Cough 6.44 4.04 Measles 3.27 3.47 Phthisis 1.85 0.11 Other forms of Tuberculosis 5.68 5.05 Diphtheria 0.43 0.11 Total of above 113.79 79.05 All other causes 18.91 15.26 Total 132.70 94.30 42 1909] With respect to premature births and congenital defects, it may be said that they frequently denote some neglect by the mother in the pre-natal life of the child, and medical investigation has traced much of it to her ignorance and to the want of care of her own health when bearing a child. Indeed, it is not too much to say that many of the deaths from the diseases that have just been mentioned are attributable to woeful ignorance on the part of mothers. It would seem, therefore, that the time has arrived when communities must be plainly asked whether they are to allow the children to be killed through ignorance, or are to kill ignorance, and so save the children. This is the dilemma with which all communities who are not adopting special measures to save infant life, both before and after birth, are now faced. There has been, no doubt, a very great awakening in this country with respect to infantile mortality, brought about in a great measure by a serious reduction in the birth-rate, and it is more and more felt that once a child has been begotten, care should be taken that its life shall not be wasted. Since 1899 the previous high rates of mortality have been checked, and, indeed, up to the present year there has been a steady fall, which most observers attribute to the quickening of the public conscience during recent years. Not only has this been so in England, but among our own community, and indeed also among some of the Continental nations, especially Prussia, Denmark and Norway. In France it has been even more noticeable still, chiefly because it was here that the recent development of measures to prevent infantile mortality was commenced. These measures were specially devoted to the encouragement of natural feeding and the improvement of artificial methods. The result has been that whereas the French mortality was formerly considerably above that of the English, it has of recent years been almost as low as that of this country. Inasmuch as modern methods have most certainly shown that a decrease in the infant mortality rate by the organised teaching of mothers and those who have charge of children can be attained, it seems to make it more incumbent than ever that redoubled care of the infants should be adopted in every community. It is among the poor especially that the mortality is greatest, but it is also among the poor that the birth-rate has not diminished; and because the parents are poor and cannot always provide medical and other means to save their children, it becomes the duty of the community to do their best to save these lives. This responsibility is more and more felt as years go by, and everywhere throughout England movements may be observed, either philanthropic or official, whose objects are to teach mothers how they should bring up their children. On the continent, as well as in the United States, this is also the case. Indeed, according to Sir John 43 1909 Gorst, the City of Cologne is provided, as are most German cities, with paid official visitors of the poor, men and women of education and position, who are under a legal obligation to render service in this way to the municipality, and every poor woman on giving birth to a child is visited by one of these officials, almost invariably a woman. If the circumstances of the mother are such that she is compelled to go out to work to earn her living, a report is made to the municipality and a daily grant is made to her out of the municipal funds, on condition that she stays at home and nurses her infant. The Official Visitor sees that the condition is fulfilled. Here then is a recognition by the State of the infant's right to its mother's milk and of the State's own obligation to see that the right is fulfilled. In this country the fate of an illegitimate child is generally a very sad one, so that the mortality among them is double that of legitimate children, which proves at once that there is a terrible wastage of life among these children. There can be no doubt that they are born just as viable as many of the legitimate infants, but owing to neglect after birth, they soon fade away. That their lives can be preserved is proved by the experience of the city of Leipsig, where every illegitimate* child becomes on birth a ward of the municipality; its condition is inspected by public officials from time to time, and it may only be put out to nurse to persons publicly authorised; it must be produced monthly at the municipal offices for medical inspection, and the result is that the deathrate of illegitimate infants in that town is half that of legitimate infants. This fact is only mentioned to show that a very large number of infant lives can be saved if proper measures are adopted to that end. When one considers the enormous wastage of life in the first week of their existence—and last year in Islington it amounted to more than 18½ per cent, of the total deaths under 1 year—one cannot but be struck with the necessity that exists for establishing some institution at which mothers bearing children might seek advice. Among the 156 deaths at this age, no less than 27 were from congenital defects, and 25 from immaturity, indicating as strongly as possible that something must have been very seriously wrong in the ante-natal condition of the mothers These deaths also were greatest in number during the succeeding tiiree weeks, so that at the end of the fourth week premature birth was responsible for 118 deaths, congenital defects for 29, and immaturity for 46. At the end of the year it was found that in addition to these deaths, bronchitis and pneumonia had also levied a heavy toll, while diarrhoea had added a very large number. Then it may be taken, as Dr. Newman, in his splendid address on Child mortality in relation to the health of the State well points out, 44 1909] maturity and immaturity are the chief causes of infantile mortality, and arise in the main from the poor physique or ill health or ill nutrition of the mother. (2) That bronchitis and pneumonia are due in a large degree to exposure both to cold and inattention, for people do not sufficiently realize the fact of the fall of temperature on a newborn child when it issues forth from an environment of body temperature to a cold world, nor of the innumerable subsequent occasions of exposure to unequal temperatures through which the child passes both in health and such sickness as measles. (3) Atrophy and diarrhoea are obviously due to the disturbance of the alimentary system owing to wrong and insufficient feeding. Here then are three primary things, the physique of the mother, including both ante-natal and post-natal disability, infant mismanagement and exposure arising partly from ignorance and partly from neglect and unsatisfactory feeding. There can be no doubt about these things lying at the root of the problem of infantile mortality. And whilst to them must be added a variety of incidental circumstances such as accidents, inattention, teething, etc., the main proportion of mortality would appear to be due to withholding from the child a reasonable inheritance of warmth, food and rest. The fatal results to the nation of malnutrition in infancy are far-reaching, and can hardly be exaggerated." There is an old argument which is always used when a discussion on infantile mortality arises and it is that the fittest will survive. Unfortunately this is not supported by evidence, for it is too true that the opposite very frequently happens and that the weaklings do not always die off. There is hardly a medical man who does not know of many cases in which the delicate ones have survived while strong children in the same family have been taken away. The fact is that when a child is very delicate at its birth it naturally receives more attention than the child who is strong and healthy, who is too often fed and exposed to climatic changes in a manner a mother would not adopt with a delicate child who sometimes grows up to be a lifelong burden to himself, and oftentimes on society. We see this especially in such a disease as rickets, which is the direct result of insufficient and improper food, that is of food necessary for the growing bones. This disease essentially arises from ignorance as to how the child should be fed. It is not caused by heredity and it does not arise from a bacillus. As a rule it is not a fatal disease, but it is impossible to look around our schools or to note the children in our streets without seeing large numbers of them who are ricketty. To dissipate the ignorance of mothers well meaning persons have suggested that children, especially girls, should be 45 [1909 taught something of the care of children in our public elementary schools, but the system of teaching in them is such as to never make it possible to drill into the heads of the children a knowledge which they will retain for the 6 or 8 or 10 years which must elapse after leaving school to the time of their marriage. Besides there is the danger of making these very young children too precocious at 13 or 14 years of age. In any case an education of this description like the other education that is imparted to scholars in the public elementary schools would be of the veriest surface type and would never be of any use to the future mothers of children, and, therefore, it becomes necessary to teach mothers themselves something about the duties and demands of maternity, and the right way to clothe and feed their infants, and especially how to feed them in those terribly fatal hot summer months when diarrhoeal diseases are so rife. It may be said that of late years the infant mortality has been greatly checked, and that consequently no special effort is needed. No doubt there has been a slight check, which can be best understood by its past history in the Borough, and which may be studied in Table I. in the Appendix. Here it may be noticed that from 1871 to 1900 the infant mortality rate remained at a very high figure, averaging in the ten years 1871 to 1880, 147 per thousand births, from 1881 to 1890, 144, and from 1891 to 1900, 148. It was, therefore, during thirty years practically stationary, varying very slightly according as the mortality in the third quarter of the year was high or low. This influence may be seen in the following figures which relate to the quinquennial periods since 1886 to the present time. Annual Rate per 1,000 births. Third Quarter's Rate per 1,000 births. 1886-90 147 195 1891-95 145 173 1896-00 150 208 1901-05 130 154 1906-09 112 108 (4 years.) In every instance it is seen here that when there was a decrease in the mortality rate in the third quarter, which is usually much higher than the annual rate, although there are occasional exceptions, there was also a decrease in the annual rate, and this was especially marked during the last three years, when the mortality rates of the third quarters were respectively 79, 95 and 90 per 1,000 births, so that the annual rate was in every instance higher than that of the usually unhealthy third quarter. The chief factor in this unhealthiness is the mortality from the diarrhasal diseases, which are usually so prevalent at that time of the year. 46 1909] Now, these diarrheal diseases are largely influenced by earth temperature and rainfall, for it is noticed that when the earth temperature is low and the rainfall high the diarrhad diseases are few, and vice versa. This effect may be seen in the following statement, which has been prepared by grouping together the years in which the mortality rates in the third quarters most closely approximated each other. It may be added that after this statement had been prepared by the Medical Officer of Health he grouped together the mortality figures for London for the years which he had grouped for Islington, with the result that a similar effect was obtained, and he therefore added them to the table. Average Deaths under I year to 1,000 Births. Observations at Greenwich. London. Islington. Temperature of Earth at 3ft. 2 in. Rainfall in inches. No. of Days on which Rain fell. 118 961 59.7 7.9 43 163 1482 6O.2 7.5 44 170 1693 61.3 6.0 35 216 1914 61.8 6.3 37 230 23 45 62.9 4.7 32 In the first group the four years 1903, 1907, 1908 and 1909 are combined. In the second group the four years 1888, 1894, 1902 and 1905 are combined In the third group the eight years 1889 1890, 1891, 1892 1895, 1900, 1901 and 1906 are combined. In the fourth group the four years 1885, 1896, 1897 and 1904 are combined; and in the fifth group the five years 1886, 1887, 1893, 1898 and 1899 are combined. There can be no doubt, therefore, that given a moderate temperature, with occasional cooling showers, it is almost certain that a low infantile mortality will result. These facts are particularly interesting in Islington, for it was Dr. Edward Ballard, its first Medical Officer of Health, who first pointed this out; and it is a pleasant memory for the present holder of that office to recollect that in Sunderland he worked with him for many months at intervals on this question, when he was making his classic enquiry into the causes of summer diarrhoea on behalf of the Local Government Board. 47 [1909 It is a fortunate circumstance, however, that man is able to do something and is doing something in many places to combat these adverse atmospheric influences, for by providing teachers for mothers they are shown how they may so prepare their infants' food and so protect it and keep it safe from them that it may become a source of health and not a danger to those who partake of it. Man is pre-eminently the animal who can adapt himself to atmospheric and terrestrial influences; and he does this either by altering his clothing or his food to suit the climate, or if necessary both. And this preparation of food is one of the main things necessary to be done to preserve the lives of children, who, in addition to the protection of their food, should themselves have protection against their deadly foes : cold, damp and draughts, as well as the closeness, the stuffiness and the foul air of the rooms in which they live and which can be easily got rid of by the open window. They have learned to understand the benefit of pure air better in New York than in London, for there in the summer time, when the infants suffer from the intensely hot air of urban dwellings, they with their mothers are moved, mainly through voluntary effort, but with official co-operation, to open camps, and seaside and floating hospitals, which institutions are also of great service in teaching mothers the proper way to bring up children. And there, too, according to a paper read by Mr. Robert Simon before the French Academy of Medicine, the milk supply intended for infants is safeguarded by the issue of a certificate under the supervision of the municipal laboratories, but it is only issued from day to day and requires compliance with the following conditions:— 1. It must come from cows that have been tested with tuberculin. 2. It must not contain more than 30,000 bacteria per cubic centimetre. 3. It must be sent out in sealed bottles kept in ice. 4. It must be sold at the latest 36 hours after milking. 5. The bottles must be filled and sealed at the farm and not in New York. We sadly require some such safeguards in London. In that City also specially trained nurses make frequent visits to families in which there are very young infants, and they keep regular observation on pregnant women of the working classes. And the result of these visits has been that whereas the mortality was 17.1 per cent, among the infants born of poor parents that were not brought under the notice of the visiting nurses until the day after birth, it was only 4.7 per cent, when the mothers had received attention from 48 1909] the nurses for the period of a month or more previous to the termination of their pregnancy. But the story is exactly similar wherever a real attempt has been made to save infant lives, and consequently the small and successful beginnings that have been made, not merely in isolated English cities, but in every civilized country, is certain to become so great a movement that no community can afford to sit still and do nothing, for to do so would be to greatly neglect their duty. This remark does not apply to local authorities only, but to the public themselves, as well as to religious and philanthropic bodies, who must do all they can to assist in putting an end to the shameful waste of human life that is taking place among those infants who, lacking instinct like beasts, are entirely dependant on what their mothers do for them. 'And the mother," as Dr. Saleeby puts it, "is also human, and shares the human loss of instinct. She has only the maternal instinct in its essence. That could not be permitted to lapse by natural selection, since humanity could never have been evolved at all if women did not love Dabies. But of all the details she is bereft. She has, instead, an immeasurably greater thing, intelligence; but whilst intelligence can learn everything, it has everything to learn. Instinct can learn nothing, but is perfect from the first within its impassable limits. It is this lapse of instinctive aptitude that constitutes the cardinal difficulty against which we are assembled. The mother cat not merely has a far less helpless young creature to succour, but she has a far superior inherent or instinctive equipment. She knows the best food for her kitten, she does not give it ' the same food as we had ourselves,' but her own breast invariably. None of us can teach her anything as to washing her kitten, or keeping it warm. She can even play with it and so educate it, in so far as it need education. There are mothers in all classes of the community who should be ashamed to look a tabby cat in the face," and, therefore, women, being dependent on their intelligence, are often absolutely ignorant, because it has not been awakened by education, and therefore, must be taught, so that they may bring up their children in health and strength and not predestine them either to a premature grave or a life of ill health. It may be pleaded that this will tend to remove parental responsibility, but surely if parents destroy their children through ignorance, the State ought to step in and prevent them. This is no new doctrine, for in ancient Sparta Lycurgus, the great lawgiver, who has already been alluded to in another direction held the opinion that children were not so much the property of their parents as of the commonwealth, and therefore exerted himself to see that they were born of healthy parents and were properly reared. 49 [1909 Some local authorities have felt a responsibility in this direction and they have provided not only Health Visitors, who from time to time call on mothers and instruct them how to rear their children, but also have provided means whereby they can obtain a pure supply of milk. It is not proposed to advocate milk depots here, because the Medical Officer of Health is of opinion that a pure milk supply can be more cheaply provided by commercial firms under the inspection and certification of sanitary authorities than by the sanitary authorities themselves. Nevertheless, where these milk depots have been availed of by the people, there has been a very great reduction in the mortality among the infants using the milk from them. In a recent report of Dr. J. Priestly on the Infants' Milk Depot in Lambeth, he says, "taking the whole of the children fed upon the milk and the total number of deaths amongst them whilst so fed, the mortality rate is 69.5 per 1,000 as compared with quinquennial rates of 134 per 1,000 for the whole of the Borough, and 187 and 272 per 1,000 for Marsh and Bishop's Wards respectively. To be statistically correct, only those infants and children should be included who have been fed upon the milk for continuous consecutive periods. Thus taking those fed upon the milk for definite consecutive periods of 20 weeks and over the mortality rate is reduced to 22.7 per 1,000 and if we take those infants and children who have been fed upon the milk for four weeks or over, the mortality rate is 51.2 per 1,000. In short, the longer an infant or child is fed upon depot milk, the better its apparent chance of living. The saving of life has of course been accompanied by a corresponding saving of illness amongst the infants and children fed upon the milk whilst so fed." And this point cannot be too strongly insisted on, because it must be recollected that for every death there are at the very least 10 cases of sickness, and you cannot have sickness and death without a very large expense to the parents or to the Poor Law Guardians, which means the ratepayers or such other authority as renders public aid free of charge. But in order to get people to understand the benefits that will arise from a pure milk supply and from good nursing, it is necessary to have Health Visitors who would instruct the people, for without them it is universally acceded that nothing can be done. Here in Islington we issue a pamphlet of advice to mothers, which is sent to each one as soon as a birth is notified, but it is doubtful if it has much effect. Among those matters with which it deals is feeding and it strongly recommends that if infants are not fed on the breast they should be fed from a boat bottle, that is from a bottle without a tube. Let us see how far this instruction has been carried out. e 50 1909] In making inquiries respecting the deaths from Diarrhoea during the last three years, it was found that in 41 instances in 1907, 18 had used a bottle with a tube. In 1908, the first year in which these instructions were issued, it was found that in 63 cases of death 29 infants used similar bottles; and in 1909, out of 33 deaths, 18 had been fed from them. These figures show that in 1907, when no cards of instructions were sent out, 43.9 per cent, of the infants had been fed from a tube bottle; in 1908, the first year the cards were distributed, the figures rose to 46 per cent, and in 1909 they further increased to 54.5 per cent. This is a melancholy fact, and seems to indicate that instructions without visits are of very little use. This inquiry respecting these diarrhoeal deaths has also brought out the significant fact that whereas only 13 children had been breast fed, 124 had been fed artificially. Thus 72 had been given cows' milk only, 19 condensed milk only, 7 artificial foods only, 12 had cows' milk in addition to the breast, 2 had condensed milk therewith, 4 had artificial food with the breast and 6 had mixed foods. It would be interesting to know why these 124 children had been brought up artificially, because the inquiry showed that in 94 instances the health of the mother was good, and in 19 moderate, but not sufficiently bad to prevent her nursing her child, while in 22 instances it was bad. It could not be because they were employed at work, for it was found that 96 had no occupation, and 38 had either part or whole time occupation outside their own homes. It is not too much to suppose that if Health Visitors had conversed with these women, many of them would have brought up their children as nature intended they should, for their intelligence would have been awakened and their ignorance dispelled. As this matter is of so much consequence, the full particulars of the enquiries for each of these years are given on pages 52 and 53. It must be apparent to everyone who studies these figures that if breast feeding were universal, there would be very little summer diarrhoea, and, therefore, an enormous reduction in the infantile mortality that occurs in the hot season of the year from this disease alone. This country has been fortunate beyond all expectation during the last few years in having cool summers with ample rainfall, but it is not to be supposed that such a state of affairs will long continue. It is, therefore, all the more necessary that Islington should follow the example of all the great 51 [1909 munities throughout the kingdom and appoint Health Visitors*, who are now a fully recognised part of the preventive machinery of public health work. The duty of the Medical Officer of Health is very clear with respect to these important adjuncts of public health administration, and, therefore, he can have no hesitation in tendering advice to appoint such visitors, although he may know that such advice is not altogether acceptable to many of the members of the authority whose adviser he is. Nevertheless, it is his bounden duty to give it, and, therefore he cannot shirk his duty. He has already set out that advice very fully in a report dated October 7th, 1907, the first recommendation of which was accepted, namely, the adoption of the Notification of Births Act, 1907, but the second and third recommendations, the appointment of three Health Visitors, and the encouragement of voluntary associations to assist the Health Visitors, were not accepted. The necessity for such appointments has now passed out of the experimental stage, for unless it is asserted, and who would dare say so ? that the Councils of the great municipal boroughs are faddists and sentimentalists, their wisdom cannot be doubted. Indeed, the great towns have always led the way in every great movement intended to ameliorate the conditions under which the people live, while the Metropolis has invariably lagged behind. *In a leaflet published by the National League for Physical Education and Improvement, the result of 173 replies from Medical Officers of Health throughout the couDtry show that there are 90 places with 174 health visitors paid entirely out of the rates, 9 with 22 health visitors, including 11 in Salford, partly paid from the rates, and 20 with 70 rate paid women sanitary inspectors, whose duties include the work of health visiting. 54 report Voluntary Organisations co-operate with health departments or working independently with 33 paid workers, including nurses and a large number of honorary helpers. In some places, notably Cambridge, health visiting by a paid staff is thoroughly organised by a voluntary organisation which entirely relieves the health department of this work. In Manchester the Corporation has taken over all the 14 paid visitors formerly employed by the Ladies' Health Society. ^ In Miss Helen M. Blagg's " Statistical Analysis of Infantile Mortality and its causes in the United Kingdom," a return is given which shows that 27 out of the 32 greatest towns of England and Wales possess Health Visitors. E 2 52 1909] TABLE XXVII. Particulars of Investigations into Deaths of Infants from Diarrhœa during the three years 1907-9. Ages of Infants in three monthly periods. Total under twelve months. Total for 3 years. 0—3. 3—6. 6—9. 9—12. 1907 1908 1909. 1907. 1908. 1909 1907. 1908 1909. 1907 1908'1909 1907 1908 1909. 1907.9. Food of Infants. Breast milk only 3 3 .. 1 2 1 .. .. .. 1 1 1 5 6 2 13 Cows' milk only 4 9 3 6 14 5 7 11 6 6 .. 1 23 34 15 72 Condensed milk only .. 2 1 2 1 4 1 3 2 1 .. 2 4 6 9 19 Artificial foods only.. .. .. 1 .. .. .. .. 3 .. 3 .. .. 3 3 1 7 Breast and cows' milk 1 3 .. 2 1 .. .. 2 1 2 .. .. 5 6 1 12 ,, condensed milk .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 2 ,, artificial foods .. .. .. .. 1 .. .. 1 1 .. .. 1 .. 2 2 4 Mixed foods .. .. .. 1 1 .. .. .. 1 .. 3 .. 1 4 1 6 Not stated .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 8 18 5 12 20 10 8 21 12 13 4 6 41 63 33 137 State of Mother's Health. Good health 3 16 4 7 11 5 8 13 9 10 3 5 28 43 23 94 Moderate 3 1 1 2 4 1 .. 4 2 .. 1 .. 5 10 4 19 Bad 2 1 .. 3 5 4 .. 3 .. 3 .. 1 8 9 5 22 Not stated .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 8 18 5 12 20 10 8 21 12 13 4 6 41 63 33 137 Mothers State as to Occupation. No occupation 6 15 4 6 16 7 7 15 6 5 .. 5 24 50 22 96 Occupied 2 3 1 6 4 3 1 5 5 7 4 1 16 12 10 38 Unknown .. .. .. .. .. .. .. 1 1 1 .. .. 1 1 1 3 8 18 5 12 20 10 8 21 12 13 4 6 41 63 33 137 Method used to cleanse Feeding Apparatus. Scalding water 2 2 .. 6 3 3 1 5 .. 5 .. 1 14 10 7 31 Hot 1 4 .. .. 1 3 1 3 1 • • .. 1 .. 8 5 15 Hot water and soda 1 3 2 2 9 2 3 6 .. •• .. 2 6 18 8 32 Cold water .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 Brush and hot water .. 3 2 3 4 1 3 4 6 .. 1 12 11 8 31 Otherwise 1 .. 1 .. 1 .. .. .. 1 1 .. .. 2 1 2 5 Not stated (including 3 at breast) 3 6 .. 1 2 1 .. 2 1 1 4 1 5 14 3 22 8 18 5 12 20 10 8 21 12 13 4 6 41 63 33 137 Description of Feeding Apparatus. Breast 3 3 .. 1 2 1 .. .. .. 1 1 1 5 6 2 13 Bottle with tube 2 7 2 5 9 5 3 13 7 8 .. 4 18 29 18 65 Bottle (boat shape) without tube 2 7 2 6 8 4 5 6 .. 3 .. 1 16 21 10 47 Spoon 1 1 1 .. .. .. .. 1 .. 1 2 .. 2 4 1 7 Otherwise .. .. .. .. 1 .. .. .. 1 .. 1 .. .. 2 1 3 Not stated .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 8 18 5 12 20 10 8 21 12 13 4 6 41 63 33 137 No. of Rooms occupied by Family. 1 room .. 3 .. .. 5 1 .. 2 4 .. 1 2 .. 11 7 18 2 rooms .. 6 2 .. 8 6 .. 8 5 .. 1 2 .. 23 15 38 3 ,, .. 7 2 .. 3 1 .. 5 2 .. .. 2 .. 15 7 22 4 „ .. .. .. .. .. .. .. 2 .. .. 1 .. .. 3 .. 3 5 ,, or more .. 2 1 .. 1 2 .. 1 .. .. .. .. .. 4 3 7 Not stated .. .. .. .. 3 .. .. 2 .. .. 1 .. .. 6 .. 6 Unknown .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 .. 18 5 .. 20 10 .. 21 12 .. 4 6 •• 63 33 96 State of Rooms as to Cleanliness. Clean 8 13 5 12 15 8 8 16 6 12 2 3 40 46 22 108 Dirty .. 4 .. .. 3 1 .. 3 3 1 2 2 1 12 6 19 Unwholesome .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 2 Not stated .. 1 .. .. 1 1 .. 1 2 .. .. .. .. 3 3 6 Unknown .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 1 2 8 18 5 12 20 10 8 21 12 13 4 6 41 63 33 137 Prevalence of Flies. Numerous .. 2 .. .. 3 4 .. 5 1 .. .. 1 .. 10 6 16 Moderate .. .. .. .. .. 1 .. 4 1 .. .. .. .. 4 2 6 Few .. 2 3 .. 6 3 .. 3 5 .. .. 2 .. 11 13 24 None noted .. 14 2 .. 11 2 .. 9 5 •• 4 3 .. 38 12 50 .. 18 5 .. 20 10 .. 21 12 .. 4 6 .. 63 33 96 53 [1909 XXVIII. Summary of Investigations into Deaths of Infants from Diarrhœa during the three years 1907-9. Ages of Infants in three monthly periods. Total under twelve months. 0-3. 3-6. 6—9. 9-12. Food of Infants. Breast milk only 6 4 .. 3 13 Cows' milk only 16 25 24 7 72 Condensed milk only 3 7 6 3 19 Artificial foods only 1 .. 3 3 7 Breast and cows' milk 4 3 3 2 12 condensed milk 1 .. .. 1 .. ,, artificial foods .. 1 2 1 4 Mixed foods .. 2 1 3 6 Not stated •• .. 2 •• 2 31 42 41 23 137 State of Mother's Health. Good health 23 23 30 18 94 Moderate 5 7 6 1 19 Bad 3 12 3 4 22 Not stated .. .. 2 .. 2 31 42 41 23 137 Mother's state as to occupation, No occupation 25 29 28 14 96 Occupied at work 6 13 11 8 38 Unknown •• •• 2 1 3 31 42 41 23 137 Method used to cleanse Feeding Apparatus. Scalding water 4 12 9 6 31 Hot ,, 5 4 5 1 15 Hot water and soda 6 13 11 2 32 Cold water .. .. 1 .. 1 Brush and hot water 5 8 11 7 31 Otherwise 2 1 1 1 5 Not stated (including 3 at breast) 9 4 3 6 22 31 42 41 23 137 Description of Feeding Apparatus. Breast 6 4 .. 3 13 Bottle with tube 11 19 23 12 65 Bottle (boat shape) without tube 11 18 14 4 47 Spoon 3 .. 1 3 7 Otherwise .. 1 1 1 3 Not stated .. .. 2 .. 2 31 42 41 23 137 No. of Rooms Occupied by the Family. 1 room 3 6 6 3 18 2 rooms 8 14 13 3 38 3 ,, 9 4 7 2 22 4 ,, .. .. 2 1 3 5 ,, or more 3 3 1 .. 7 Not stated .. 3 2 1 6 Unknown .. .. 2 .. .. 23 30 33 10 96 State of Rooms as to Cleanliness. Clean 26 35 30 17 108 Dirty 4 4 6 5 19 Unwholesome .. 1 .. 1 2 Not stated 1 2 3 .. 6 Unknown .. .. 2 •• 2 31 42 41 23 137 Prevalence of Flies. Numerous 2 7 6 1 16 Moderate 1 3 .. 6 Few 5 9 8 2 24 None noted 16 13 14 7 50 23 30 33 10 96 54 h-» o o o TABLE XXIX. Showing the Ages at Death of Children under one year of age and the Deaths at the several periods per 1,000 Births during years 1905-1909. Ages at Death. Deaths. Deaths per 1,000 Births. 1905. 1906. 1907. 1908. 1909. Total 5 years. 1905. 1906. 1907. 1908. 1909. Total 5 yers. Under 1 week 185 182 187 186 156 896 21.13 21.01 21.91 21.46 19.02 20.93 1—2 weeks 61 42 58 52 52 265 6.96 4.85 6.80 6.00 6.34 6.19 2—3 „ 54 49 51 33 26 213 6.17 5.66 5.98 3.81 3.17 4.97 3—4 36 35 34 39 35 179 4.11 4.04 3.98 4.60 4.27 4.18 Total under a month 336 308 330 310 269 1,553 38.37 35.56 38.67 35.77 32.80 36.27 1—2 months 124 120 105 97 83 529 14.16 13.85 12.30 11.20 19.12 12.36 2—3 „ 91 108 84 83 64 430 10.39 12.47 9.84 9.58 7.80 10.04 Total 1—3 months 215 228 189 180 147 959 24.55 26.32 22.14 20 .78 17. 92 22.40 Total under 3 months 551 536 519 490 416 2,512 62.92 61.88 60.81 56.55 50.72 58.67 3-4 months 88 96 63 48 44 339 10.05 11.08 7.38 5.54 5. 37 7.92 4-5 „ 65 67 58 55 58 303 7.42 7.74 6.80 6.35 7.07 7.08 5—6 „ 43 67 48 48 46 252 4.91 7.74 5.63 5.54 5.61 5.88 Total 3—6 months 196 230 169 151 148 894 22.38 26.56 19.81 17.43 18 .05 20.88 6—7 months 62 56 55 37 55 265 7.08 6.47 6.44 4.27 6.71 6.19 7—8 „ 48 55 44 43 34 224 5.48 6.35 5.16 4.96 4 .15 5.23 8-9 „ 54 51 68 46 55 274 6.17 5.89 7.97 5.31 6.71 6.40 Total 6—9 months 164 162 167 126 144 763 18.73 18.71 19.57 14.54 17.57 17.82 9—10 months 55 51 45 39 45 235 6.28 5.89 5.27 4.50 5.49 5.49 10—11 52 54 51 39 40 236 5.94 6.24 5.98 4.50 4.88 5.51 11-12 „ 56 50 45 49 48 248 6.39 5.77 5.27 5.66 5.85 5.79 Total 9—12 months 163 155 141 127 133 719 18.61 17.90 16.52 14.76 16.22 16.79 Total under 1 year 1,074 1,083 996 894 841 4,888 122.64 125.05 116.71 103.28 102.56 114.16 55 [1909 Table XXX. Showing the Deaths of Infants under a year old, the Infantile Mortality Rate in each Quarter and, in each Year, since 1885. Years. QUARTERS. ANNUAL Deaths & Mortality First. Second. Third. Fourth. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1 000 Births. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births. 1885 322 121 299 128 460 195 306 123 1,387 144 1886 370 144 268 111 577 237 302 126 1,517 154 1887 288 117 323 132 580 239 366 153 1,557 160 1888 326 132 270 115 359 152 316 132 1,271 133 1889 421 164 162 94 376 164 302 130 1,261 132 1890 356 144 326 142 422 177 384 170 1,488 158 1886-90 1,761 141 1,349 113 2,314 195 1,670 142 7,094 147 1891 338 129 349 144 397 165 397 169 1,481 151 1892 425 171 295 122 384 164 313 136 1 417 148 1893 403 161 393 156 508 212 391 166 1,595 163 1894 313 125 267 113 363 154 286 123 1,229 129 1895 353 134 315 128 427 172 321 138 1,416 143 1891-95 1,832 144 1,619 133 2,079 173 1,708 139 7,138 145 1896 373 151 318 130 449 196 350 128 1,490 150 1897 296 115 216 90 446 183 380 156 1 338 136 1898 362 151 282 122 561 227 299 132 1,504 159 1899 308 123 256 105 622 256 362 157 1,548 160 1900 326 132 291 127 419 175 308 147 1,314 145 1896-00 1,665 134 1,363 115 2,497 208 1,699 143 7,224 150 1901 304 124 255 113 397 172 334 147 1290 139 1902 311 131 236 109 316 136 356 150 1,219 132 1903 329 145 243 107 262 118 302 136 1,136 126 1904 238 104 215 94 424 192 263 124 1,140 128 1905 226 101 250 109 318 152 280 131 1,074 123 1901-05 1,408 121 1,199 107 1,717 154 1,535 138 5,859 130 1906 271 120 203 90 344 164 265 129 1,083 125 1907 319 145 221 102 166 79 290 140 996 117 1908 247 111 171 80 204 95 272 124 894 103 1909 233 106 221 109 180 90 207 104 841 103 Note:—The lowest infantile mortality rates in the periods of the year to which they refer are printed in heavy type. 56 1909] In England and Wales, in the seven greatest towns, and in the boroughs surrounding Islington, the infantile mortality rates were as follows:— England and Wales 109 per 1,000 births Rural Districts 98 ,, 76 Great Towns 118 „ 143 Smaller Towns 111 ,, London 108 „ Birmingham 134 ,, Liverpool 144 ,, Manchester 134 ,, Leeds 122 „ Bristol 100 „ Sheffield 118 „ The Encircling Boroughs. Hornsey 61 „ Stoke Newington 80 „ Hackney 102 „ Shoreditch 140 „ Finsbury 131 ,, St. Pancras 102 „ The Encircling Boroughs 107 „ Islington 103 57 [1909 Table XXXI. Showing the Chief Causes of Infantile Mortality in the twelve years, 1896-1908, and in 1909. Cause of Death. Years. Mean 18 years. 1909 Difference. 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 i. Common Infections Diseases. Small-pox .. 1 .. .. .. 1 4 .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. . . .. .. .. .. .. .. .. .. .. .. .. •• Measles 67 12 65 27 42 37 24 29 51 27 36 27 24 36 31 — 5 Scarlet Fever 2 1 2 .. 2 2 1 1 1 .. 1 .. 3 1 1 .. Diphtheria (including Membranous Croup 10 6 6 3 5 7 1 4 2 2 3 1 4 1 1 - 3 Whooping Cough 103 58 67 66 68 38 76 63 30 51 30 53 29 56 36 — 20 ii. Diarrhœal Diseases. Diarrhœa, all forms 125 138 220 208 148 143 72 83 200 149 171 73 80 140 46 - 94 Enteritis, Muco-enteritis, Gastro-enteritis 62 65 105 159 67 70 43 46 20 53 92 49 52 60 26 - 34 Gastritis, Gastrointestinal Catarrah 10 8 9 13 21 21 23 22 18 15 14 9 7 15 23 + 8 iii. Wasting Diseases. Premature Birth 169 174 191 187 176 169 194 174 178 163 144 164 167 173 136 - 37 Congenital Defects 40 39 30 21 36 48 33 47 43 48 59 47 51 42 52 + 10 Injury at Birth .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. •• Want of Breast-milk, Starvation 7 3 2 2 1 5 2 7 6 4 5 8 4 4 4 •• Atrophy, Debility, Marasmus 242 256 244 285 221 188 192 183 177 138 134 137 138 195 133 - 62 iv. Tuberculous Diseases. Tuberculous Meningitis 28 23 29 30 25 24 20 20 10 19 20 17 13 21 18 — 3 Tuberculous Peritonitis Tabes Mesenterica 64 55 48 30 25 26 25 20 20 24 17 17 14 38 20 - 18 Other Tuberculous Diseases 22 20 20 27 28 19 23 30 16 12 12 23 13 20 8 - 12 Erysipelas 5 2 .. 6 3 2 3 4 3 1 3 3 4 3 4 + 1 v. Other Causes. Syphilis 6 17 12 7 17 10 11 10 11 13 9 5 13 11 10 - 1 Rickets 5 6 4 8 2 5 3 1 4 3 5 .. 2 4 1 — 3 Meningitis (not Tuberculous) 21 27 25 16 19 23 16 18 10 19 18 10 13 18 11 - 7 Convulsions 74 60 46 62 57 68 69 47 47 38 24 16 15 48 14 - 34 Bronchitis 141 129 129 124 119 104 116 90 78 77 82 83 39 101 55 - 46 Laryngitis 5 4 5 2 4 5 2 4 1 3 .. 1 .. 3 1 — 2 Pneumonia 129 86 87 112 118 123 134 109 101 107 103 153 106 113 106 — 7 Suffocation, overlying 51 39 48 45 43 39 46 15 25 14 22 23 23 33 27 — 6 Other Causes 102 109 110 108 97 113 86 108 88 94 79 77 80 96 77 — 19 1,490 1,338 1,504 1,548 1,344 1,290 1,219 1,136 1,140 1,074 1,083 996 894 1,235 841 - 394 58 1909] MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES. Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fevers (that is to say Typhus, Enteric and Continued) and Diarrheal Diseases. Deaths.—For the fourth year in succession it is possible to congratulate the Council on the low mortality from the principal epidemic diseases, as the deaths, 418 in number, although some (50 more than the return for the preceding year, are nevertheless 349 below the average, corrected for the increase of population, of the preceding 24 years. This is very satisfactory, especially when it is seen that with the exception of measles each disease showed a decrease on that average. The 418 deaths are, with the exception of ihe return for 1908, the smallest number that has been recorded in Islington during a quarter of a century, which denotes that the efforts that have been made to prevent them have not been without effect, especially when such a highly preventable disease as Enteric Fever has fallen from an average of 42 in these years to 12 in 1909, and tnat diarrhœal diseases have decreased by 135, although it must not be forgotten that these diseases are amenable to weather conditions. Death-rate.—The death-rate resulting from the epidemic diseases was 119 per 1,000 inhabitants, as compared with 1.01 in the preceding year, 124 in 1907, 1.63 in 1906, and 1.54 in 1905. Only twice in the 15 years preceding 1900 was it below 2.0 per 1,000, while on several occasions it was between 3.0 and 3.69 per 1,000. The mortality of the County of London during the year was 1.31 per 1,000, while in the encircling boroughs it was 1.29, several of which presented very low death-rates, especially St. Pancras, Stoke Newington, Hackney and Hornsey. Sub-Districts.—The epidemic death-rate varied considerably in the several sub-districts, ranging from 0.67 in Tollington to 1.71 in South-east Islington, where owing to an excess of Measles, it was higher than in any other part of the Borough. In Lower Holloway, too, for the same reason the rate was as high as 1.64. Full particulars for each sub-district are given on pages 61 and 62. 59 [1909 Table XXXII. Showing the Deaths from the principal Epidemic Diseases for the Twenty-three years 1885-1908 and in 1909. Years. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and Undefined Fevers. Diarrhœal Diseases. Totals. Death-Rate. 1885 129 294 36 167 210 3 63 — 197 1099 3.69 1886 3 63 26 72 214 2 60 — 320 760 2.52 1887 — 335 59 46 240 2 45 — 309 1036 3.39 1888 — 147 64 50 231 1 59 — 162 714 2.31 1889 — 177 40 62 86 — 61 — 178 604 2.01 1890 — 202 65 81 204 — 39 — 180 771 2.44 1891 — 224 50 178 255 1 32 — 159 899 2.81 1892 3 179 53 170 161 — 41 1 189 797 2.47 1893 2 119 94 200 181 1 48 2 237 884 2.70 1894 3 199 69 218 188 — 36 — 95 808 2.44 1895 1 135 66 144 81 1 30 3 189 650 1.94 1896 1 288 57 257 234 — 46 2 153 1038 3.07 1897 1 97 61 131 130 — 44 — 174 638 1.89 1898 — 325 26 93 168 1 36 1 233 933 2.77 1899 — 155 33 128 160 — 47 — 258 781 2.32 1900 1 159 24 106 142 — 46 2 180 660 1.96 1901 8 151 30 134 85 — 47 1 172 623 1.87 1902 53 114 40 104 152 — 45 1 99 608 1.80 1903 — 120 24 43 152 — 22 1 109 471 1.39 1904 1 181 35 28 83 — 18 — 260 606 1.78 1905 1 123 37 34 111 — 17 — 206 529 1.54 1906 — 187 37 32 74 — 19 — 213 562 1.63 1907 — 130 24 42 120 — 13 — 103 432 1 24 1908 — 78 30 60 55 — 18 — 117 358 1.01 1909 — 197 25 31 86 — 12 — 67 418 1.19 * From this date Membranous Croup was included. 60 1909] Table XXXIII. Showing the Corrected Mean Number of Deaths from the principal Epidemic Diseases, 1885-1908, and in 1909. Diseases. Corrected Average Number of Deaths 1885-1908. 1909 Increase or Decrease. Small Pox 9 .. - 9 Measles 186 197 + 11 Scarlet Fever 48 25 - 23 Diphtheria 114 31 - 83 Whooping Cough 165 86 - 79 Typhus Fever .. .. Enteric Fever 42 12 - 30 Continued & Ill-defined Fevers 1 .. - 1 Diarrhoea 202 67 - 135 The above Diseases 767 418 - 349 The following statement contrasts the position of Islington in respect to the Epidemic Diseases with that of the country and of the neighbouring metropolitan boroughs:— Epidemic death-rates per 1,000 inhabitants Epidemic death-rates. per 1,000 inhabitants. England and Wales 1.12 The Encircling Boroughs 1.29 76 Great Towns 1.42 County of London » West London Districts 1.11 143 Smaller Towns 1.08 North „ „ 0.96 Rural Districts o.8o Central „ „ 1.69 The Encircling Boroughs St. Pancras 0.9 7 East ,, ,, 2.08 Stoke Newington 0.63 South „ „ 1.25 Hackney 0.93 County of London 1.31 Hornsey 0.46 Islington 1.19 Finsbury 2.36 Epidemic death-rates per 1,000 inhabitants. Shoreditch 2.87 Epidemic death-rates per 1,000 inhabitants. West Ham 2.24 Salford 2.45 Bristol 0.87 Bradford 0.68 Birmingham 2.03 Leeds 0.8o Nottingham 1.67 Sheffield 178 Liverpool 2.11 Hull 1.38 Manchester 1.81 Islington 1.19 61 [1909 The number of the deaths in, and the epidemic death-rate of, each subregistration district were as follows:— Deaths. Epidemic Death rates Tufnell 26 0.73 Upper Holloway 43 1.15 Tollington 25 0.6 7 Lower Holloway 69 1.64 Highbury 61 0.88 Barnsbury 62 1.15 Islington, South-East 132 1.71 418 1.19 Table XXXIV. Deaths from each of the principal Epidemic Diseases during the year 1909, 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) Diarrhœa. TOTALS. Tufnell ... 13 1 3 2 ... ... 7 26 Upper Holloway ... 29 3 2 4 ... 1 4 43 Tollington ... 8 2 4 10 ... ... 1 25 Lower Holloway ... 37 3 5 11 ... 1 12 69 Highbury ... 25 5 4 11 ... 4 12 6l Barnsbury ... 17 6 5 16 ... 2 16 62 S. East Islington ... 68 5 8 32 ... 4 15 132 The Borough ... 197 25 31 86 ... 12 67 418 Preceding year, 1908 ... 78 30 60 55 ... 18 117 358 62 1909] Table XXXV. Death-rates arising from each of the principal Epidemic Diseases during the Year 1909„ inclusive of the Deaths 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 ... 0.37 0.03 0.08 o.o6 ... ... 0.19 0.73 Upper Holloway ... 0.77 0.08 0.05 0.11 ... 0.03 O.11 1.15 Tollington ... 0.21 0.05 0.11 0.27 ... ... 0.03 0.67 Lower Holloway ... 0.88 0.07 0.12 0.26 ... 0.02 0.29 1.64 Highbury ... 0.36 0.07 0.06 o.16 ... o.o6 0.17 0.88 Barnsbury ... 0.31 0.11 0.09 0.30 ... 0.04 0.30 1.15 S. East Islington ... 0.88 0.06 0.10 0.42 ... 0.05 0.20 1.71 The Borough ... 0.56 0.07 0-.09 0.25 ... 0.03 0.19 1.19 Preceding year, 1908 ... 0.22 0.08 0.17 o.16 ... 0.05 o.33 1.01 63 [1909 Table XXXVI. Showing the Deaths and Death-rates pom the Principal Epidemic Diseases in the Wards during the Four Quarters of 1909. WARDS. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 8 0.90 11 1.25 3 0.34 4 0.45 26 0.73 Upper Holloway 15 1.61 20 2.15 4 0.43 4 0.43 43 1.15 Tollington 5 0.54 10 1.07 3 0.32 7 0.75 25 0.67 Lower Holloway 24 2.29 23 2.20 18 1.72 4 0.38 69 1.65 Highbury 17 1.93 10 1.13 5 0.57 6 0.68 38 1.08 Mildmay 7 1.11 8 1.26 2 0.31 3 0.47 20 0.79 Thornhill 12 1.43 8 0.95 11 1.31 7 0.83 38 1.13 Barnsbury 7 1.39 8 1.59 4 0.79 5 0.99 24 1.19 St. Mary's 8 1.81 6 1.36 — — — — 14 0.79 Canonbury 18 2.08 19 2.20 9 1.04 2 0.23 48 1.39 St. Peter's 3 2 3.86 29 3.50 6 0.72 6 0.72 73 2.20 Totals 153 1.74 152 1.73 65 0.74 48 0.54 418 1.19 64 1909] Table XXXVII. Showing the Deaths from each of the Principal Epidemic Diseases in the several Wards during the Year 1909. WARDS. Small Pox. Measles. Scarlet Fever. Diphtheria Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhœa. Total Epidemic Deaths. Tufnell ... 13 1 3 2 — — — 7 26 Upper Holloway ... 29 3 2 4 — 1 — 4 43 Tollington ... 8 2 4 10 — — — 1 25 Lower Holloway ... 37 3 5 11 — 1 — 12 69 Highbury ... 18 3 1 5 — 2 — 9 38 Mildmay ... 4 2 3 6 — 2 — 3 20 Thornhill ... 7 1 2 12 — 2 — 14 38 Barnsbury ... 10 5 3 4 — — — 2 24 St. Mary's ... 8 1 1 2 — 2 — — 14 Canonbury ... 27 1 1 10 — 1 — 8 48 St. Peters ... 36 3 6 20 — 1 — 7 73 Totals ... 197 25 31 86 — 12 — 67 418 65 [1909 Table XXXVI [I. Showing the Death-rates of the Wards from each of the Principal Epidemic Diseases during the Year 1909. WARDS. Small Pox. Measles, Scarlet Fever Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhœa. Death-rate from Epidemic Diseases. Tufnell — 0.37 0.03 o.o8 0.06 — — — 0.19 0.73 Upper Holloway — 0.77 o.o8 0.05 0.11 — 0.03 — o.11 1.15 Tollington — 0.21 0.05 0.11 0.27 — — — 0.03 0.67 Lower Holloway — 0.88 0.07 0.12 0.26 — 0.02 — 0.29 1.64 Highbury — 0.51 0.08 0.03 0.14 — 0.06 — 0.26 1.o8 Mildmay — 0.16 o.o8 0.12 0.23 — o.o8 — 0.12 0.79 Thornhill — 0.19 0.03 o.o6 0.34 — o.o6 — 0.39 1.07 Barnsbury — 0.49 0.25 0.15 0.20 — — — 0.l0 1.19 St. Mary's — 0.45 o.o6 0.06 0.11 — 0.11 — — 0.79 Canonbury — 0.78 0.03 0.03 0.29 — 0.03 — 0.23 1.39 St. Peter's — 1.09 0.09 0.18 o.6o — 0.03 — 0.21 2.20 Total — 0.56 0.07 0.09 0.25 — 0.03 — 0.19 1.19 66 [1909 SMALL POX. No death from Small Pox was registered during the year. MEASLES. One hundred and ninety-seven deaths from measles were registered, as compared with a corrected average of 186 per annum during the preceding 24 years, and an average of 143, or an increase of 54, as compared with the average of the preceding 10 years. The return was the highest that has obtained since 1898, when 325 deaths were registered, and, with the exception of that of 1887, was the highest that has been known in the Borough since 1851. The epidemic began in the fourth quarter of 1908, and was continued into the first quarter of 1909, when 89 deaths were registered, and only came to a close towards the end of the second quarter, when 94 occurred. In the succeeding third and fourth quarters there was a large decrease for only 10 and 4 deaths were respectively registered. As usual, the deaths from this disease were complicated with other ailments, especially with pneumonia, which was certified as a secondary cause in 159 instances, while bronchitis was certified in 21. Thus in 180 out of 197 deaths, inflammatory diseases of the lungs were contributory to the fatal results. It has been pointed out many times in these reports that it invariably happens that measles is complicated with these affections, and that there can be no doubt that they arise among the poor in nine cases out of ten through want of care, ignorance, or good nursing. In Table V. in the appendix it will be seen that no less than 31 deaths occurred among infants between 3 and 12 months old and that 21 of these deaths took place between their 9th and 12th month. Of the remaining deaths, 156 befell between the ages of 1 and 5 years, and 10 between the ages of 5 and 10 years. Measles seems to have been very prevalent in the neighbouring boroughs of Finsbury, Shoreditch and St. Pancras, and, as in Islington, its incidence was greatest in the first and second quarters, and, as was also the case in Islington, the epidemic seems to have started in the fourth quarter of the preceding year, for a reference to Table XLI. shows that the death-rate for the first three months of the year was 1.27 in St. Pancras, 1.57 in Shoreditch, 101 in Islington, and 0.93 in Finsbury. In St. Pancras, however, it commenced to decline during the second quarter, while in Finsbury, Shoreditch and Islington it increased; indeed the increase in Shoreditch was very marked, the death-rate having risen from 1.57 to 2.41 per 1,000. These returns indicate that in the north of London measles was very rife for a considerable portion of the year and that 67 [1909 the neighbouring boroughs were equally attacked with Islington. It should be stated that 929 cases of the disease were notified by the teachers of the public elementary schools in the first quarter, and 664 in the second quarter, and that they then fell to 41 in the third quarter and 33 in the fourth, making a total of 1,667 cases notified during the year. During the whole course of the disease a close watch was kept on each of the schools, and children who had the disease in their homes and who had not themselves previously suffered from it were excluded. The following statement shows the number of children excluded from the various schools on account of measles in their homes. The letters I. B. G.J. M. respectively indicate infants, boys, girls, junior, and mixed departments. Name of School. Dept. 1st Qr. '2nd Qr. 3rd Qr. 4th Qr. Total in Dept. Total for School. Ambler Road 1. 30 5 ... 4 39 B. 6 2 ... ... 8 48 G. 1 ... ... ... l Blundell Street 1. 24 10 4 ... 38 B. 4 1 ... ... 5 52 G. 7 2 ... ... 9 Blackstock Road 1. ... 3 ... ... 3 7 B. ... 4 ... ... 4 7 Buckingham Street 1 2 1 1 ... 4 4 Burghley Road 1. 37 9 2 ... 48 B. ... 5 5 55 G. ... 2 ... ... 2 55 Caledonian Road 1. 21 4 3 1 29 29 Canonbury Road 1. 22 39 ... ... 61 61 Cottenham Road I. 8 35 3 ... 46 G. 1 6 3 ... 10 56 Drayton Park I. 10 1 ... ... 11 G. 1 ... ... ... 1 12 Duncombe Road I. 22 7 1 1 311 J. B 2 5 2 ... 9 44 J B 4 ... ... ... 4 Ecclesbourne Road I. 20 2 ... ... 22 B. 2 1 ... ... 31 27 G. 2 ... ... ... 2 Eden Grove 1. 3 ... ... ... 3 G. 7 ... ... ... 7 10 F 2 68 1909] Name of School, Dept. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Total in Dept. Total for School. Forster I. 54 15 ... ... 69 69 Gifford Street I. 4 4 ... 2 10 G. 2 ... ... ... 2 12 Gillespie Road I. 25 3 ... 6 34 B. 2 ... ... ... 2 39 G. 3 ... ... ... 3 Grafton Road I. 3 25 1 ... 29 B. 1 2 ... ... 3 39 G. ... 7 ... ... 7 Hanover Street I. 10 19 3 1 33 G. 1 1 3 ... 5 Hargrave Park I. 1 31 4 ... 36 G. ... 2 ... ... 2 Harvist Road I. 2 11 2 ... 15 G. ... 3 ... ... 3 18 Holy Trinity I. 1 ... ... ... 1 1 Hungerford Road I. 4 23 3 ... 30 B. 2 ... 1 ... 3 33 Montem Street I. 10 10 1 ... 21 21 Newington Green I. 1 2 2 ... 5 6 G. 1 ... ... ... 1 6 Pakeman Street I. 2 25 5 ... 32 jm. ... 4 ... ... 4 36 Poole's Park I. 6 27 ... ... 33 B. ... 3 1 ... 4 40 G. ... 2 1 ... 3 Queen's Head Street I. 8 18 1 ... 27 B. ... 1 ... ... 1 29 G. ... 1 ... ... 1 Richard Street I. 13 2 1 ... 16 G. 1 ... ... ... 1 17 Rotherfield Street I. 50 14 ... ... 64 64 St. Clement's I. ... 3 ... ... 3 3 St James'. ... 1 ... ... 1 1 St. John's, Holloway I. 5 ... ... ... 5 G. 5 ... ... ... 5 10 ,, Conewood Street I. 7 ... ... ... 7 7 St. Jude's I. ... ... 2 ... 2 2 St. Mark's I ... 2 ... ... 2 G ... 3 ... 1 4 9 69 [1909 Name of School. Dept. list Qr. '2nd Qr. 3rd Qr. 4th Qr. Total in Dept. Total for Schools. St. Mary's. Fowler Road I. 1 1 ... ... 2 2 St. Mary Magdalene I. 4 4 ... ... 8 8 St. Matthew's I. 10 4 ... ... 14 14 St. Philips I. ... 8 ... ...8 B. ... 2 ... ... 2 10 Shepperton Road I. 7 10 ... ... 17 B. 1 ... ... 1 20 G. 2 ... ... ... 2 St. Thomas' I. 1 1 ... ... 2 B. ... 1 ... ... 1 4 G. ... 1 ... ... 1 Station Road I. 3 4 8 ... 15 B. ... 1 ... ... 1 17 G. 1 ... ... ... 1 Thornhill Road G. ... 1 ... ... 1 1 Upper Hornsey Road I. 4 41 5 ... 50 B. ... 4 ... ... 4 57 G. 1 2 ... ... 3 Vittoria Place I. 2 1 1 ... 4 4 Westbourne Road I. 52 5 ... 1 58 B. 4 ... ... ... 4 62 Whittington I. 5 7 ... 1 13 13 Winchester Street I. 1 ... ... ... 1 1 Yerbury Road I. 50 23 ... 2 75 75 York Road I. 1 2 ... ... 3 3 St. John's, Duncan Place I. ... 2 ... ... 2 2 St. Joseph's I. ... 8 ... ... 8 8 610 541 64 20 1,235 1,235 SUMMARY. Department. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Total. Infants 546 471 53 19 1,089 Boys 24 32 4 ... 60 Girls 40 34 7 1 82 Junior Mixed ... 4 ... ... 4 610 541 61 20 1,235 70 1909] It is noteworthy that there was little or no measles in the Borough after the annual summer vacation, from which it might be inferred that the annual closure of the schools had put a stop to the epidemic. The returns, however, show that prior to the holidays the disease had practically worn itself out, so that instead of 10, 12 or more deaths being registered in a week, only 1 or none had been known, which proves that in this instance at all events, the school closure had had nothing to do with the cessation of the epidemic. Full tables are given to show the deaths and death rates in the several quarters for the sub-districts and for the neighbouring boroughs as are also tables showing the secondary causes of death, the progress of the disease from week to week and its past records in the several quarters of the ten years 1899-1908. Table XXXIX. Showing 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 10 .. .. 13 Upper Holloway 9 17 1 2 29 Tollington 2 4 1 1 8 Lower Holloway 19 15 3 .. 37 Highbury 15 9 .. 1 25 Barnsbury 12 3 2 .. 17 Islington, South East 29 36 3 .. 68 The Borough 89 94 10 4 197 Table XL. 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 0.34 1.13 .. .. 0.37 Upper Holloway 0.96 1.82 0.11 0.21 0.77 Tollington 0.21 0.43 0.11 0.11 0.21 Lower Holloway 1.81 1.43 0.29 .. 0.88 Highbury 0.87 0.52 .. 0.06 0.36 Barnsbury 0.89 0.22 0.15 .. 0.31 Islington, South East 1.51 1.87 0.16 .. 0.88 The Borough 1.01 1.07 0.11 0.05 0.56 71 [1909 Table XLI. Showing the Death-Rates of the Encircling Boroughs from Measles in the Four Quarters of 1909. Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. St. Pancras 1.27 0.39 0.10 0.02 0.44 Stoke Newington 0.37 0.29 0.07 .. 0.18 Hackney 0.52 0.20 0.02 0.22 0.24 Hornsey .. 0.08 .. 0.42 0.13 Finsbury 0.93 1.94 0.55 0.17 0.89 Shoreditch 1.57 2.41 0.38 0.17 1.13 The above Districts 0.85 0.75 0.15 0.16 0.48 Islington 1.01 1.07 0.11 0.05 0.56 Table XLII. Showing the Secondary Causes of the Deaths from Measles. Secondary Diseases. Quarters. The Year 1909. 1 2 3 4 Males. Females. Totals. Pneumonia 72 75 9 3 83 76 159 Bronchitis 12 9 .. .. 9 12 21 Empyema .. .. .. 1 .. 1 1 Enteritis 1 2 .. .. 2 1 3 Heart Disease .. 1 .. .. 1 .. 1 Whooping Cough 1 1 .. .. .. 2 2 Meningitis 1 1 .. .. .. 2 2 Laryngitis .. 1 .. .. .. 1 1 Œdema of Glottis 1 .. .. .. .. 1 1 Gastric Catarrh .. 1 .. .. .. 1 1 Stomatitis .. 2 .. .. 1 1 2 Tubercular Meningitis .. .. 1 .. 1 .. 1 Total Secondary Diseases 88 93 10 4 97 98 195 Deaths where no secondary disease was entered 1 1 .. .. 1 1 2 Total Deaths 89 94 10 4 98 99 197 72 1909] Table XLIII. Showing the Deaths from Measles during each Week of 1909 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Week. Deaths. Week. Deaths. Week. Deaths. Week. Deaths. 1 7 14 18 27 3 40 .. 2 2 15 18 28 1 41 1 3 4 16 8 29 1 42 .. 4 3 17 7 30 .. 43 1 5 3 18 4 31 1 44 .. 6 2 19 5 32 1 45 .. 7 5 20 4 33 2 46 .. 8 9 21 9 34 .. 47 1 9 8 22 3 35 .. 48 1 10 11 23 5 36 1 49 .. 11 13 24 5 37 .. 0 .. 12 10 25 6 38 .. 1 .. 13 12 26 2 39 .. 52 .. 13 weeks 89 13 weeks 94 13 weeks 10 13 weeks 4 Table XLIV. Showing the deaths from Measles in the Quarters, 1899 08 and 1909. Years. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. 1899 45 53 26 31 155 1900 64 75 15 5 159 1901 7 17 27 100 151 1902 53 29 12 20 114 1903 35 64 17 4 120 1904 20 75 56 30 181 1905 26 17 20 60 123 1906 93 75 11 8 187 1907 4 56 44 26 130 1908 19 12 7 40 78 Corrected average number of deaths 38 48 24 33 143 1909. 89 94 10 4 197 Increase or Decrease +51 +46 -14 -29 +54 73 [1909 SCARLET FEVER. Scarlet Fever caused 25 deaths, which, when the increase of population is taken into consideration, is possibly the lowest return for the Borough since 1885. Indeed the returns, as far back as 1856, show no such record. When the death registers are examined it is found that this disease, even without any correction being made for the large increase of population, averaged in the years 1856-1860,119; 1861-65, 214; 1866-70, 240; 1871-75,117; 1876-80,106; 1886-90, 51; 1891-95, 67; 1896-90,40; 1901-05, 33; and 1906-9,29. Thus from 1871, quinquennium after quinquennium, with the exception of 1891-95, has exhibited a lessened mortality from it. Indeed, it is somewhat marvellous to find that from the quinquennium 1866-70 to Ihe last four years, 1906 to 1909, the deaths have fallen from an annual average of 240 to 29, in other words by 88 per cent. And what is happening in Islington is happening everywhere throughout London and the country, so that one is driven to the conclusion, and, indeed, it is generally acknowledged, that the severity of this infection is not nearly so great as it was in former years. It is unfortunately not possible to obtain a return of the cases of the disease that occurred in the earlier years as was possible with the deaths. Nevertheless it is interesting to note that while from the quinquennium 1891-95 to the 4 years 1906-1909, the annual average number of deaths from Scarlet Fever fell by 56 per cent., the notified cases of the diseases fell by only 2.1*8 per cent., thus showing that the virulence of the disease as we know it during this short period has decreased. The question naturally arises to one's mind, is not the disease now of the same very mild a type that it was when Sydenham, one of the greatest medical observers of past days, said of it "hoc morbi nomen (vix enim altius assurgit)" thus speaking of it with a contempt vvhich he does not appear to have felt for Measles or Small Pox ? The history of Scarlet Fever, however, shows that from 1800-1804 it ravaged Ireland and was very fatal, while from 1804-1831 the physicians who had found it so terrible a disease from 1800 to 1804 saw scarcely any fatality, so mild had it been. In 1831 however an epidemic of malignant Scarlet Fever broke out in Dublin and its neighbourhood; in 1834 it had covered Ireland with mourning even more extensively than some years later was caused by Typhus Fever or even than that which had been produced two years previously by the outbreak of Asiatic Cholera. Trousseau, the distinguished Professor in the Faculty of Medicine of Paris says in one of his lectures on Clinical Medicine that at the commencement of his studies his illustrious master Bretonneau taught his class that Scarlet Fever, which he 74 1909] formerly heard spoken of as a very dangerous malady, was then a very mild affection and he told them that from 1799-1822 he did not recollect having seen a fatal case, although he had long practised in the country before he became first physician to the hospital of Tours. The numerous cases which he met with both at his hospital and in private practice seemed at that time to have satisfied him that Scarlet Fever was the mildest of all the infections. But in 1824 an epidemic broke out in Tours, with the result that before it had finished, Bretonneau, who had formerly looked upon Scarlet Fever as a slight malady, now consider it as equally mortal with Plague, Typhus Fever, and Cholera. Thus during a quarter of a century this disease, which appeared as an epidemic without showing any severity, all at once became changed in its character, and cruelly smote all whom it touched. Very severe epidemics of Measles and Small Pox do without doubt sometimes occur, but as epidemics they do not show such extremes of mildness and severity as Scarlet Fever. It is a disease which apparently is more influenced than Measles or Small Pox by a dominating epidemic constitution, and hence it arises that an epidemic of Scarlet Fever is sometimes very mild and at other times very severe. The Medical Officer of Health is old enough to recollect a very serious epidemic of this disease in Ireland about 1856 or 1857 when he with his sister and his brother were attacked with it in a very grave form and which, indeed, was fatal to his brother, and later on (in Gloucester in 1874) he had an opportunity of seeing four cases which were of a type as severe as any he has seen, or, indeed, read of, and all of which proved fatal. The neck in each case became the seat of an inflammation so severe that presently it passed into such a gangrenous condition that the cervical muscles were laid bare, as if they had been most carefully dissected, exposing the throbbing blood vessels. Such cases as these are very rare, and indeed Trousseau with all his experience seems to have seen only one such case, for he writes as follows:—" I recollect "a lad of 14 years of age in whom the gangrenous condition was so extensive "that the muscles of the neck were dissected as occurs in diffuse phlegmonous "inflammations, showing the carotids pulsating at the bottom of a horrible "wound. The patient recovered, but a hideous deformity remained as a "consequence of the gangrenous destruction of the tissue. A similar case is "described by Graves." It is fortunate, then, that Scarlet Fever of this severe type does not now prevail, but looking at its past history who shall say that at any time there may not be a recurrence of it in its severest form. 75 [1 909 Table XLV. Showing tiie Deaths from Scarlet Fever in the Sub-Distvicts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. 1 1 Upper Holloway 1 2 .. .. 3 Tollington .. .. .. 1 2 Lower Holloway 1 .. 1 1 3 Highbury 1 2 .. 2 5 Barnsbury I 1 1 3 6 Islington, South East 4 .. .. 1 5 The Borough 8 6 2 9 25 Table XLVI. 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 .. .. .. 0.11 0.03 Upper Holloway 0.11 0.22 •• 0.08 Tollington .. 0.11 •• 0.11 0.05 Lower Holloway 0.10 .. 0.09 0 .09 0.07 Highbury 0.06 0.11 .. 0.11 0. 07 Barnsbury 0.07 0.07 0.07 0 .22 0.11 Islington, South East 0.21 •• •• 0 .05 0.06 The Borough 0.09 0.07 0.02 0.10 0.07 76 1909] DIPHTHERIA. It is very satisfactory to find that only 31 deaths occurred during the year from this disease. This number is 80 less than the corrected annual average of the years 1885-1908 and is also 29 less than the return of the preceding year, The deaths were in the proportion of 0.09 per 1,000 of the population, as compared with a decennial rate of 0.21. The rate is below that of the County of London, in which it was 0.13. TI.e decrease in the deaths from so serious a disease must be a matter of congratulation, for it is not so long ago, in a smaller population, that instead of being numbered by tens, they were numbered by hundreds. Thus in 1891 there were 178 deaths; in 1893, 200, in 1894, 218 and in 1896, 257, while so recently as 1901 they numbered 134, and in 1902, 104. Table XLVII. Showing the Deaths from Diphtheria in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 .. 1 1 3 Upper Holloway 1 •• • • 1 2 Tollington 2 1 1 4 Lower Holloway 2 • • 2 1 5 Highbury 1 1 .. 2 4 Barnsbury 2 2 .. 1 5 Islington, South East 5 1 •• 2 8 The Borough 12 6 4 9 31 77 [1909 Table XLVIII. 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 0.11 .. 0.11 0.11 0.08 Upper Holloway 0.11 .. • • 0.11 0.05 Tollington .. 0.21 0.11 0.11 0.11 Lower Holloway 0.19 .. 0 19 0.09 0.12 Highbury 0.06 0.06 .. 0.11 0.06 Barnsbury 0.15 0.15 •• 0.07 0. 09 Islington, South East 0.26 0.05 .. 0.10 0.10 The Borough 0.14 0. 07 005 0.10 0.09 WHOOPING COUGH. There were 86 deaths attributed to Whooping Cough (35 males and 51 females) or 79 less than the corrected average of the preceding'24 years, although there were 31 more than the number registered in 1908. The deaths were by no means excessive, for with the exception of the years 1899, 1895, 1901, 1904, 1906 and 1908, they always ran into hundreds, the largest number being 255 in 1891. The resulting death-rate was 0.41 per 1,000 of the population, as contrasted with 0.26 in the County of London. In Islington the disease was most fatal in Barnsbury and South East Islington, in which 16 and 32 deaths were respectively registered. Ages at Death.—It is noteworthy that all the deaths, with the exception of two, occurred among children under five years of age. Thirty-six were in the first year of life and 48 were between one and five years. 78 19091] Table XLIX. Shoiving 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 1 1 .. .. 2 Upper Holloway 2 1 .. 1 4 Tollington 2 3 1 4 10 Lower Holloway 2 5 2 2 11 Highbury 5 5 •• 1 11 Barnsbury 2 9 1 4 16 Islington, South East 17 12 1 2 32 The Borough 31 36 5 14 86 Table L. 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 0.11 0.11 .. .. 0.06 Upper Holloway 0.21 0. 11 .. 0.11 0.11 Tollington 0.21 0.32 0.11 0.42 0.27 Lower Holloway 0.19 0.48 0.19 0.19 0.26 Highbury 0.29 0.29 .. 0.06 0.16 Barnsbury 0.15 0.67 0.07 0.30 0.30 Islington, South East 0.88 0.62 0.05 0.10 0.42 The Borough 0.35 0.41 0.06 0.16 0.25 79 [1909 ENTERIC FEVER. To this disease were attributed 12 deaths, as compared with a corrected average of 42 in the years 1885-1908, and with 18 in the preceding year. This return is the lowest recorded since 1885. If the table (XXXII.) showing the deaths from the principal epidemic diseases during the last 24 years be consulted, it will be seen that there has been a steady, if not always regular, decrease in the deaths since the first mentioned date. Thus if the 25 years be divided into quinquennial periods it is found that in i he first period the deaths averaged 57; in the second 39; in the third 40; in the fourth 35, and in the last 16. Table LI. 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 .. .. .. .. .. Upper Holloway 1 •• •• .. 1 Tollington •• •• .. .. Lower Holloway .. •• 1 .. 1 Highbury 2 1 1 .. 4 Barnsbury 1 1 .. .. 2 Islington, South East 1 2 1 .. 4 The Borough 5 4 3 .. 12 80 1909] Table LII. 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 .. .. .. . . .. U pper Holloway 0 .11 •• •• 0.03 Tollington .. .. •• .. .. Lower Holloway •• .. 0.09 .. 0.02 Highbury 0.11 0.06 0.06 .. 0.06 Barnsbury 0.07 0.07 •• .. 0.04 Islington, South East 0.05 0.10 0.05 .. 0.05 The Borough 0.06 0.04 0.03 .. 0.03 TYPHUS FEVER. No death was recorded during the year. CONTINUED AND ILL DEFINED FEVERS. Nil return. DIARRHCEAL DISEASES. The most satisfactory of all the returns has been undoubtedly that from diarrhcea, as only 67 deaths were ascribed to it, as contrasted with a corrected average of'20.2 in the preceding 24 years. There was thus a decrease of 135 deaths. The return is the lowest recorded from 1885 to the present time, and although that for 1908 was alow one, yet the return for the year under discussion is 50 below it. The causes of this decrease must be ascribed in a large measure to the diminution in the deaths during the third quarter, when there were only 41 registered, as compared with a corrected average of 134 This large decrease must be attributed mainly to the small number of deaths among infants in their first year of life, to which reference has been made under the heading of Infant Mortality. The deaths in ach quarter were respectively 8, 6, 41 .and 12. 81 Table LIII. Showing the Deaths from Diarrhoea in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 3 .. 2 2 7 Upper Holloway 1 .. 3 4 Tollington 1 .. .. • • 1 Lower Holloway .. 3 9 .. 12 Highbury 1 2 6 3 12 Barnsbury 1 •• 11 4 10 Islington, South East 1 1 10 3 15 The Borough 8 6 41 12 67 Table LIV. Showing the Death-rates from Diarrhcea of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.34 .. 0.23 0.23 0.19 Upper Holloway 0.11 .. 0.32 .. 0.11 Tollington 0.11 .. •• .. 0.03 Lower Holloway .. 0.29 1.86 .. 0.29 Highbury 0.06 0.11 0.35 0.17 0.17 Barnsbury 0.07 .. 0.82 0.30 0.30 Islington, South East * 0.05 0.05 0.52 0.16 0.20 The Borough 0.09 0.07 0.47 0.14 0.19 82 1909] Table LV. Showin;7 tie Deaths from Diarrhoeal Diseases together with those classed under Enteritis and its sub-headini/s, arratii/ed in quarterly periods, and at three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals Diarrhoea Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Under year 3 6 9 3 9 12 31 14 45 9 20 29 46 49 95 1 to 5 years l 4 5 1 3 4 10 5 15 2 2 12 14 26 Over 5 years 4 4 8 2 9 11 ... 9 9 3 8 11 9 33 39 Totals 8 14 2 2 6 21 27 41 28 69 12 30 42 67 93 160 Note.—In this Table the deaths under Enteritis include only those which are not epidemic or zymotic 83 [1909 g 2 TABLE LV1. Showing the Diarrhoeal Deaths including Epidemic Enteritis in the Third Quarter, 1909. 1909 Deaths. Death-Rate. Meteorology. l euiperature of the s>r. Temp, of the e irth. Rainfall. 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 of 65 years Temperature of the earth 3 feet below surface. Rainfall in inches. No. of days on which rain fell. July 10th ... ... ... ... ... ... ... ... .. .. .. ... ... ... ... ... 58.5 3.8 57.20 0.99 7 ,, 17th.. .. .. .. .. .. .. .. .. .. .. ... ... 60.0 3. 2 57 .59 0.71 4 ,, 24th .. ... .. 1 .. .. .. 1 .. .. 1.24 ... ... 0.14 61.9 1.2 59.39 0.15 2 ,, 31st .. .. .. 1 .. .. .. 1 .. .. 1.24 •• ... ... 0.14 59.9 2. 5 59.49 1.31 6 .. .. .. 2 .. .. ... 2 .. •• 0.62 •• ... ... 0.07 60.1 2 .7 58 .42 3.16 19 August 7th 1 .. .. .. .. .. ... 1 1.47 .. ... ... ... 0.14 60.8 1.4 59.68 0.26 2 ,, 14th .. .. .. 1 .. .. .. 1 .. .. 1.24 .. ... ... 0.14 66.9 4.5 61.25 0.00 .. ,, 21st .. .. ... .. 1 1 1 3 .. .. ... 0.75 0 97 0.67 0.44 63.3 1.4 62.79 0.82 5 ,, 28th 1 .. .. 1 .. 2 2 6 1.47 .. 1.24 ... 194 1 .35 0.89 58.1 2. 7 61.48 0.70 5 2 .. .. 2 1 3 3 11 0.73 .. 0 .62 0.19 073 0.50 0.40 62.3 0. 5 61.30 1.78 12 Sept. 4th .. 1 ... .. 1 .. .. 2 .. 1-39 .. ... 0.75 ... 0.29 54.5 5.4 60 19 0.30 4 ,, 11th.. .. .. .. 4 .. 1 5 .. .. 4.98 ... ... 0 .67 0 .74 54.5 4. 3 58.70 0.32 6 ,, 18th.. .. .. .. .. 2 4 2 8 .. .. ... 1.51 3.88 1.35 1.18 55.3 2. 2 57.87 0.58 3 ,, 25th.. .. .. .. .. 2 3 .. 7 .. .. ... 1.51 2 .91 1.35 1.03 56.3 0. 5 57.60 0.57 3 Oct. 2nd.. .. 2 .. 1 .. 1 2 6 .. 2-79 .. 1.24 ... 0.97 1.35 0.89 53.1 1.5 57.11 0.72 4 .. .. 3 .. 5 5 8 7 28 .. 0 83 .. 1.24 0.75 1.55 0.94 0.83 54.7 2. 6 58.29 2.49 20 3rd Quarter 2 3 •• 9 6 11 10 41 0.23 0 32 .. 0.86 0.35 0.82 0.52 0.46 59.0 1.6 59.34 7.43 51 84 [1909 Table LVII. Shotting the Deaths occurring in Islington and in t!u several Encircling Boroughs frum All Causes, from the principal Epidemic Diseases, and from Phthisis in the year 1909. THE ENCIRCLING BOROUGHS. Estimated Populations, 1909. 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. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fevers. Diarrhoea, j I 1 3 4 5 6 7 8 9 IO 11 12 13 14 15 16 St. Pancras 237,422 3,510 230 — 105 17 27 30 — 6 45 382 570 102 Stoke Newington 54.423 612 34 — 10 3 2 14 — 1 — 4 45 82 80 Hackney 237,601 2,988 220 — 57 10 19 51 — 6 — 77 289 550 102 Hornsey 95,628 793 44 — 12 2 10 12 — — — 8 43 89 6l Finsbury 95.289 1,8279 224 — 85 11 14 51 — 3 — 60 211 367 131 Shoreditch 114,802 2,178 328 - 130 9 22 72 — 6 — 89 200 510 140 The above Boroughs. 835,165 11,910 1,080 — 399 52 94 230 — 22 — 283 1,170 2,168 107 Islington 351,202 4,918 418 — 197 25 31 86 — 12 — 67 424 841 103 85 [1909 Table LVIII. Showing the Death Rates of Islington and of the several Encircling Boroughs from All Causes, from the principal Epidemic Diseases, and from Phthisis in the year 1909. THE ENCIRCLING BOROUGHS. Estimated Populations, 1909. Total Deathrates from All Causes. Total Epidemic Death-rates. Death-rates 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 Diarrhoea. 1 2 3 4 5 6 7 8 9 IO II 12 13 *4 15 St. Pancras 237,422 14.8 0.97 ... 0.44 0.07 0.11 0.13 ... 0.03 ... 0.19 1.61 102 Stoke Newington 54,423 11.3 0.63 ... 0.18 o.o6 0.04 0.26 ... 0.02 ... o.o7 0.83 80 Hackney 237,601 12.6 0.93 ... 0.24 0.04 0.04 0.22 ... 0.03 ... 0.32 1.22 102 Hornsey 95,628 8.4 0.46 ... 0.13 0.02 0.10 0.13 ... ... ... 0.08 0.45 61 Finsbury 95,289 19.2 2.36 ... 0.89 0.12 0.15 0.54 ... 0.03 ... 0.63 2.22 131 Shoreditch 114,802 19.0 2.87 ... 1.14 0.08 0.19 0.63 ... 0.05 ... 0.78 175 140 The above Boroughs 835,165 14.2 1.29 ... 0.48 0.06 0.11 0.27 ... 0.03 ... 0.34 1.40 107 Islington 351,202 14.00 1.19 ... 0.56 0.07 0.09 0.25 ... 0.03 ... 0.19 1.21 103 86 1909] Table LIX. Showing the Death-rates from All Causes, from the principal Epidemic Diseases, together with the Infantile Mortality, in the Country, in the Pofutons Towns, in Towns whose Populations exceed 300,000 inhabitants, in the Encircling Boroughs, and in Islington. All Causes. Principal Epidemic 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 14.5 112 0 00 0. 35 0.09 0.14 0. 20 0 06 0 28 109 76 Great Towns 14.7 1 42 0 00 0. 48 0.11 0 .15 0. 24 0 06 038 118 143 Smaller Towns 13.9 108 .. 0. 33 0. 09 0.16 0 .17 0 06 0 27 111 England and Wales 1ess the 219 Towns . 14.5 0. 80 0.00 0.21 0.06 0 .14 0. 16 006 0 17 98 London 14.-0 1.31 0.00 0.48 0.08 0 .13 0.26 0 .03 0. 33 108 Bristol 12. 7 0.87 0.02 0.24 0.03 0.14 0.14 0.03 0 .27 100 Birmingham 15.4 2.03 .. 0.93 0.19 0 .16 0.26 0.04 0 .45 134 Liverpool 19. 0 2.11 .. 0.61 0.28 0.15 0.30 0.07 0.70 144 Manchester 17.9 1.81 .. 0.62 0.26 0.17 0.19 0.14 0.43 134 Leeds 14.1 0.80 .. 0.16 0. 02 0 .13 0.17 0.09 0.23 122 Sheffield 15.1 1.78 .. 0.88 0. 09 0 .08 0 .11 0 .07 0.55 118 St. Pancras 14.8 0.97 .. 0.44 0.07 0.12 0 .13 0. 02 0.19 102 Stoke Newington 11.3 0. 63 .. 0.18 0.06 0 .04 0 .26 0.02 0.07 80 Hackney 12.6 0. 93 .. 0.24 0.04 0 .08 0 .22 0. 03 0.32 102 Hornsey 8.4 0.46 .. 0.13 0.02 0 .10 0.13 ... 0.08 61 Finsbury 19.2 2. 36 .. 0. 89 0.12 0 .15 0 .54 0. 03 0.63 131 Shoreditch 19. 0 2.87 .. 1.14 0.08 0.19 0.63 0.05 0.78 140 Encircling Boroughs 14 .2 1. 29 .. 0.48 0.06 0 .11 0..27 0. 03 0.34 107 Islington 14.0 1.19 .. 0.56 0.07 0.09 0.25 0. 03 0.19 103 INFLUENZA. Influenza was the registered cause of 70 deaths during the year, as contrasted with 81 in the preceding year, and an average of 76 in the 11 years 1898-1908. The returns show that 36 deaths occurred in the first quarter, 19 in the second, 4 in the third, and 11 in the fourth, and that the largest number '20) of them occurred between 65 and 75 years of age, thus showing that the disease is particularly fatal to old people. 87 [1909 The following statement giving the incidence of the disease at the several ages of life from 1898 to 1909 is reprinted from the report of last year, to which has been added the return for 1909 and the average for the years 1898-1908. Ages. 898 . 1899. 1900. 1901. 1902. 1903. 1901 1905. 1916 . 1907. 190S. Average. i8g8-t9oS. 1903 o- 5 8 6 3 4 4 3 4 4 4 5 3 4 1 5-10 2 2 3 1 — 1 — 1 1 1 — 1 1 10-15 -—- — — — — 1 — — — I5-25 4 4 9 — 3 2 3 — 4 3 5 4 2 25-35 4 12 7 2 7 3 2 3 5 10 3 5 4 35-45 5 17 16 5 13 5 7 5 4 19 8 9 8 45-55 9 15 18 5 14 9 7 7 10 5 14 10 10 55-65 15 28 28 12 6 8 6 9 13 6 16 14 9 65-75 11 24 36 12 17 6 11 12 16 12 14 16 20 75-85 6 14 25 5 15 3 7 12 8 12 14 11 11 85 and upwards 1 4 4 — 4 — 1 1 2 1 4 2 4 65 126 149 46 83 40 48 54 67 75 81 76 70 In 33 instances, or in nearly half the mortality, pneumonia was ascribed as the secondary cause of death, bronchitis in 16, and heart diseases in 10. The several secondary causes are set out in Table LXI. Table LX. Showing the Deaths from Influenza in the Quarters of the Year 1909, together with the corrected averages of the correspcnding periods 1899-1908. Years. Quarters. Totals. First. Second. Third. Fourth. 1899 52 25 4 45 126 1900 122 17 3 7 143 1901 18 13 4 11 46 1902 45 15 5 18 83 1903 30 3 1 6 40 1904 12 5 2 29 48 1905 26 16 3 9 54 1906 13 21 7 26 67 1907 48 12 4 11 75 1908 52 20 3 6 81 Corrected Averages 43 15 3 18 79 1909 36 19 4 11 70 Increase or Decrease -7 + 4 + 1 -7 -9 88 1909] Table LXI. Showing the Secondary Causes of Death jrom Influenza in the Four Quarters of the Year 1909. Tufnell. Upper 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. 4tb. 1st. 2nd. 3rd 4th 1st. 2nd. 3rd. 4th Pleurisy 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. 4 Pneumonia .. .. .. 1 7 1 .. 1 3 1 .. . . 1 .. .. 1 3 2 .. .. 1 .. .. .. 3 4 2 2 33 Bronchitis .. 1 .. .. 1 1 .. .. 2 .. .. .. 2 1 .. .. 1 3 .. .. 2 .. .. .. 2 .. .. 16 Heart Disease, etc. 2 .. .. .. 1 1 .. .. 1 .. .. .. 1 .. .. .. 1 .. .. 3 .. .. .. .. .. .. .. .. 10 Cerebral Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. l Paralysis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. l Liver Diseases .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Rheumatism .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. l All Secondary Causes 3 2 1 1 9 4 .. 1 6 1 .. •• 4 1 •• 1 6 7 •• 4 3 .. .. .. 5 4 2 2 67 No Secondary Causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 3 Totals 3 2 1 1 9 4 •• 1 6 1 .. .. 4 1 •• 2 6 7 .. 4 3 .. 1 .. 5 4 2 3 70 89 [1909 APPENDICITIS. Appendicitis was registered as causing 25 deaths, which is the same number as was registered in 1908. In the preceding 7 years the deaths were respectively 20, 32, 27, 29, 20, 19 and 25, which together with the 25 now registered make 197 deaths. No period of life seems to have been free from attacks, for even among children under 5 years of age 2 deaths occurred, while between 5 and 10 there were 7. Indeed, the returns of the 8 years 1902-1909 fully bears out this statement. This may be seen in the following statements, which are again presented, as they are of very great interest. Deaths. Deaths. 1902 20 1903 32 1904 27 1905 29 1906 20 1907 19 1908 25 1909 25 The subsequent tabular statement has been prepared to show the ages at hich people died from the disease. ages. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1909. totals. O- 5 — 1 — 1 — 1 2 2 7 5-10 2 4 2 4 3 — 7 7 29 10-15 7 3 5 1 2 7 1 2 28 15-20 1 4 3 6 3 3 3 3 26 20-25 1 7 2 3 1 2 3 1 20 25-35 3 5 8 3 2 2 2 1 26 35-45 2 3 2 4 5 - 4 4 24 45-55 3 2 1 4 1 i 0 1 15 55-65 — 1 3 2 2 3 1 2 14 65-75 1 2 1 1 1 — — 2 18 75-85 — — — — — — — — — 85 and upwards - - - - - - - - - 20 32 27 29 20 19 25 25 197 90 1909] 4 per cent, of these deaths occurred at the age period o- 5 15 „ „ „ „ 5-10 14 „ „ „ „ 10-15 13 „ „ „ „ 15-20 10 „ „ „ „ 20-25 13 „ „ „ „ 25-35 12 „ „ „ „ 35-45 8 „ „ „ „ 45-55 7 „ „ „ „ 55-65 4 „ „ „ „ 65-75 100 All apes SEPTIC DISEASES. In this class are included Erysipelas, Pyaemia, Septicaemia and so-called Puerperal Fever, which together caused 40 deaths, as compared with 44 in the preceding year. Erysipelas.—To this disease were ascribed 12 deaths, as compared with an average of 14 in the preceding 12 years. Four of them were infants under a year old, while 7 were adults aged from 20 to 45 years. Five deaths occurred in public institutions. 1097 11 i8g8 8 1899 16 1900 17 1901 15 1902 13 1903 9 1904 23 1905 12 1906 16 1907 13 1908 14 1909 12 Table LXII. Deaths from Erysipelas in the Sub Districts during the Year 1909. Deaths. Death Rates. Tufnell — per 1,000 inhabitants. Upper Holloway 4 0.11 „ „ Tollington 2 0.05 „ „ Lower Holloway 2 0.05 „ „ Highbury 1 0.01 „ „ Barnsbury 2 0.04 „ „ Islington, South-East 1 0.01 „ „ The Borough 12 0.03 „ „ 91 [1909 Puerperal Septic Diseases-- These diseases of women are the result of infection after childbirth, and include Puerperal Pya;mia, Septicaemia, Sapraemia, Septic Intoxication and the so-cilled Puerperal Fever. The deaths from thein during 1909 were 7 in number, as compared with 4 in the preceding year, and a corrected average of 10 during the 10 years 1899-1908. They were in the proportion of 0'85 per 1,000 births. These diseases are very grave, being usually fatal to those whom they attack, as will be readily seen when it is stated that there were only 14 cases known in the 12 months, so that the fatality was 50 per centThe deaths are very often the result of gross carelessness on the part of the mothers themselves, because they do not trouble to prepare clean bedding for their lying-in. This is not always due to actual dirty habits, but to the fact that they do not wish to soil their bedding, not knowing in their ignorance that at the time of lying-in cleanliness is of the first importance. The following is a statement of the deaths for the last decennial period: — Years Deaths. Deaths per 1,000 births. 1899 14 1.45 1900 6 0.65 19oi 15 1.62 i902 12 1.30 1903 9 1.00 1904 14 1.57 1905 6 0.68 1906 11 1.27 1907 8 0.94 1908 4 0.46 Corrected average 10 1.08 1909 7 0.85 92 1909] Table LXIII. Showing the Deaths from Puerperal Fever in the Sub Districts for each Quarter and the Year 1909. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell .. 1 .. .. 1 Upper Holloway .. .. .. .. .. Tollington .. 1 .. .. 1 Lower Holloway .. .. .. .. Highbury 2 .. .. .. 2 Barnsbury 1 .. .. .. 1 Islington, South East 2 .. .. .. 2 The Borough 5 2 .. .. 7 TABLE LXIV. Showing the Deaths from Puerperal Fever per 1,000 Births in the Sub Districts for each Quarter and the Year 1909. [###Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. 5.12 .. .. 1.32 Upper Holloway .. .. .. .. .. Tollington .. 6.06 .. .. 1.42 Lower Holloway •• .. .. .. •• Highbury 5.75 .. .. .. 1.54 Barnsbury 2.34 •• .. .. 0.67 Islington, South East 4.24 •• .. .. 1.07 The Borough 2.28 0.98 .. .. 0.85 93 [1909 CONSTITUTIONAL DISEASES. In this group of diseases are included those of a tuberculous character as well as rheumatic fever, rheumatism, rickets, diabetes, gout, anaemia and one or two others. Combined they caused 1,032 deaths, which is an increase of 69 on the average of the preceding 10 years, after correction had been made for the increase in the population, and they were equal to a rate of 2 94 per 1,000 as against 323 per 1,000 in the decennium 1899-1908. The deaths from each disease for these years, together with those for 1909, are set out in Table LXXII. Cancer and malignant Diseases.—These diseases, next to those of a tuberculous character, are undoubtedly the most important of the constitutional diseases, and more especially so because they attack persons in the prime of life. In 1909 they caused 353 deaths, which is an increase of 44 on the corrected average of the 18 years 1891-1908, and were equal to a death-rate of 10.05 per 10,000 of the population, as contrasted with 8.8 in the years just mentioned. The present rate is, however, practically the same as that experienced during the preceding three years. It is to be regretted that since 1891 there has been a gradual but very steady rise in the death-rate from these diseases, for an examination of the figures given below shows that whereas in 1891 it was 6.8 per 1,000, in 1895 it was 7.9 ; in 1899, 8.0 ; in 1905, 9.5, and in 1909, 10.5 per 1,000, with varying rates in the intermediate periods. Years Deaths Deaths per 10,000 Pop. Years Deaths Deaths per 10,000 Pop. 1891 218 6.8 1892 219 6.8 1893 238 7.3 1894 239 7.2 1895 266 7.9 1896 291 8.5 1897 304 9.0 1898 283 8.4 1899 270 8.0 1900 303 9.0 1901 289 8.6 1902 320 95 1903 350 10.3 1904 323 9.5 1905 328 9-5 1906 363 10.5 I9°7 348 10.0 1908 367 10.3 Corrected – – Average 309 8.8 1909 353 10.05 From 1891 to 1895 the deaths averaged 234 per annum; from 1896 to 1900,290; from 1901 to 1905, 323; and from 1906 to 1909 (4 years), 358, These figures show how enormous has been the increase in the mortality, which humanity is at present powerless to prevent. Ages at Death.—The ages of the persons who died from cancer and malignant diseases are fully set out in the statement given below, which shows that now, as in previous years, their heaviest incidence occurred at the ages above 25 years, and particularly in the period 55-75. Ages. 1899. 1900. 1901. 1902. 1903, 1904. 1905, 1906. 1907. 1908. Average. 1899-1908 1909. 0-5 — 1 — 341 2 1 1 1 1 — 5-15 I 2 I 3 3 2 I 3 3 2 2 3 15-25 2 3 2 5 7 5 3 3 3 8 4 3 25-35 8 6 8 8 5 10 11 7 6 6 8 10 35-45 19 32 33 29 43 43 22 35 39 41 34 27 45-55 63 79 63 75 75 61 74 90 64 63 71 79 55-65 85 92 76 103 95 84 95 110 95 112 95 96 65-75 72 58 75 70 83 90 92 74 12 93 81 94 75-85 18 27 27 27 34 22 25 38 27 39 28 34 85 & up- wards 2 3 4 3 1 5 3 2 8 2 3 7 270 303 289 326 350 323 328 363 348 367 327 353 The diseases as usual proved more fatal to females than males, the deathrate being 8.74 per 10,000 for the latter and 11.23 for the former. In Table LXVI. the death-rates at the several ages are given, and it is remarkable that whereas between the ages of 35 and 45 years the death-rate among males was 3.22 and among females 8.34 per 10,000 living at that age, in the next period (45-55) the death-rate is practically the same among males and females, being 24.31 per 10,000 for males and 24.09 for females. At the next period however (55-65), the death-rate among females rose to 46.42 per 10,000 as against 43.95 amongst males. When the figures for the succceding age period (65-75) are examined, the mortality is found to be greatest among males, and to reach the very high rate of 103.84 per 10,000, as against 76.22 among females. Among persons 75 and upwards, the rate was 54.38 per 10,000 among males and 114.35 among females. These rates are so high that it is no wonder that many scientists are making every effort to discover some remedy for these terrible diseases, and it is to be hoped that their work, which enjoyed the support and encouragement of His late Majesty, King Edward VII. and other great personages throughout the world, will meet, as it surely will some day, with success. It would be sad, indeed, if no method of prevention or cure were found for ailments which are increasing steadily among our people. In the Report of the Medical Officer of Health for 1908 information was given as to the progress of Cancer Research, and it is therefore not proposed ta say anything further on the subject now. Particulars of the several parts of the human system attacked with these diseases are set forth in Table LXVII., and therein it will be noticed that among women there were no less than 53 deaths from cancerous diseases of the uterus and 35 from those of the breast, the majority of which did not occur until the child-bearing age of life had been passed, for out of 88 deaths from these two causes, only 15 occurred during that period. 95 [1909 Table LXV. Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the Year 1909. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islineton, South-East The Borough. 1st 9 8 9 12 17 15 13 83 2nd 15 11 13 9 12 13 9 82 3rd 9 11 9 12 12 16 21 90 4th 11 6 12 14 14 20 21 98 The Year 44 36 43 47 55 64 64 353 Table LXVI. Deaths and 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 0.35 3 0.34 6 0.35 25-35 4 1.32 6 1.78 10 1.56 35-45 7 3.22 20 8.34 27 5.90 45-55 37 24.31 42 24.09 79 24.19 55-65 42 43.95 54 46.42 96 45.31 65-75 45 103.84 49 76.22 94 87.34 75 & up- 8 54.38 33 114.35 41 94.12 All Ages 146 8.74 207 11.23 353 10.05 96 19091 Table LXVII. Mortality from Cancer or Malignant Disease during the Year 1909. Age at Death. ■X) U ORGANS AFFECTED. Sex. in < 0-5 -15 -25 —85 —45 — 55 — 65 -75 -75 upward "P. w uH h Diseases of Nervous System m. F. Brain.. 1 I Organs of Special Sense — Nose 1 1 m. F. Diseases of Heast, etc — m. F. ] 1 Endocarditis 1 1 1 1 .. 2 I • Respiratory System— Larynx i i m F. i 4 .. 5 1 5 | Epiglottis m. F 1 1 l Lung .. i i m. F. i 2 2 i 5 1 ' 6 ) Digestive System— Rectum M F. 2 s 3 2 1 4 3 4 2 8 in |« Pylorus m. F. i 1 2 •• 1 1 4 2 1 • 6 Pancreas m F 1 1 •• i i | 2 Liver M F. 2 2 3 7 2 5 1 6 8 20 [28 Ventriculi M F 1 2 1 3 1 1 ^ (Esophagus M. F 2 1 4 5 9 22 1 (23 Stomach M. F. •• 1 2 2 8 4 6 \ 5 10 23 20 !- Peritoneum M. 1 i •• 1 1 '■ 2 1 k Gall Bladder M. F. 1 •• i I 1 Abdomen M. F 1 1 1 ? 1 3 Colon £ 1 3 1 4 5 .6 io jio Jaw .. M. F. 1 1 2 •• 1 3 1 4 Intestines (parts not sftcifitii) \1. F 1 1 1 1 3 4 8 1 12 Cheek M. F 1 1 2 !' 2 Tongue M F. 2 6 4 14 14 i Caecum m. F. 1 1 1 1 2 J- 3 1 Spleen m. F 1 i I i Fauces .. 1 m. 1 • • l 1 i ) F. 97 [1909 Table LXVII.—continued. Age at Death. V) u £ ORGANS AFFECTED. Sex. —6 —15 —25 -35 —45 -65 —65 —75 -76 upwards. ■J < s < S w b o H Pharynx M. 1 1 1 1 K. Mouth M. 2 .. 2 1 2 F Tonsils .. .. 1 M 1 2 3 b F. Lymphatic System— Groin M. F. Lymphatic Glands M. 1 ,. 1 I I F. f 1 Mediastinal Glands M. .. 1 1 .. t 4 F. 1 1 • • • • 1 3 1 Mesentery M. 1 i 1 F. 1 1 Urinary System— Kidney .. .. J M 1 1 • • •• 2 .. [ 8 1 1 F. 1 . . . . 1 I M 3 1 3 1 8 .. > 11 F. 3 2 .. 1 .. 6 1 U M. 1 3 1 5 1 f. Generative System— Breast F. 1 4 7 11 7 5 35 35 Uterus F. 3 7 13 18 8 4 53 53 Ovary F. 1 .. .. 1 2 2 Vulva F. 1 1 1 Testis .. M. 1 1 .. 1 Organs of Locomotion— ( M •?, 1 3 ) , Neck .. J F. M 1 1 1 } 4 1 . Arm F. 1 f 1 Thigh M. F. 1 1 ' Bones and Joints— Spine.. M. F. 1 1 •• 1 1 }■ Thorax M. F. 1 •• •• i ' Ribs M. , F. 1 1 1 Sternum M. I 1 F. 1 1 1 Shoulder Joint M. F. 1 1 f 1 Cervical Vertebrae M. F. 1 i ) Scapula .. M. F. 1 ,, ,, 1 ) 1 Hip Joint .. .. | M. F. 1 1 1 1 Integumentary System— M V Fa.ce .. .. 1 ,. 1 , F, f 1 Head .. .. M. F. 1 1 1' Unspecified .. M. F. • • •' 1 2 1 1 1 •• * 3 } 6 Total Males and Females for j M 2 1 4 7 37 42 45 8 146 Year ( F. •• 1 2 7 20 42 53 49 33 207 *• Total Deaths .. •• 3 3 11 27 79 95 94 41 146 207 353 h 98 1909] Tubercular Diseases.—Tuberculosis of the Lungs or Phthisis, Tuberculosis of the Brain or Tubercular Meningitis, Tuberculosis of the Larynx, Tuberculosis of the Abdomen or Tabes Mesenterica, and General Tuberculosis. Tubercular diseases caused 582 deaths, which were equal to a death-rate of 1.65 per 1,000 of the population. Of these deaths 128 occurred among children under 5 years old and represented a death-rate of 3.39 per 1,000 living at this age. Phthisis or Tuberculosis of the Lungs.—This disease, commonly called consumption, was credited with 424 deaths, a decrease of 8 on the return of the preceding years, and of 12 on the return for 1907. It is, however, above that of the year 1906, but 105 below the corrected average of the preceding 15 years, the particulars respecting which are set out in the statement given below. Phthisis. Years. Deaths 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 17.4 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 9.14 16.4 1903 492 1.45 10.16 14.3 1904 533 1.56 10.18 15.3 1905 438 1.28 8.84 14.4 1906 411 1.19 8.14 14.6 1907 436 1.26 8.58 14.6 1908 432 1.21 9.23 13.1 Corrected average 529 1.51 9.48 15.9 1909 424 1.21 8.62 14.0 99 [1909 It is satisfactory to note that there has been a decrease in the number of deaths from phthisis, especially during the last five years, for it is found that whereas from 1894 to 1898 2,684 persons died, and that from 1899 to 1903 2,737 died, there were only 2,250 from 1904 to 1908. Thus there was a decrease of no less than 487 deaths in the quinquennium 1904-1908, compared with that of 1899-1903. In London there has been an uninterrupted decrease in the mortality rate since 1881. Per 1,000 Per 1,000 1881-85 2.22 1906 1.44 1886-90 1.97 1907 1.40 1891-95 1.85 1908 1.32 1896-1900 1.75 1909 1.31 1901-1905 1.57 Similar decreases are to be noted throughout the United Kingdom—in England, Ireland and Scotland. Thus in Edinburgh the death-rate fell from 2T2 in 1881-85 to TOG in 1909, or 50 per cent.; in Glasgow, from 3T1 to 1.35; in Dublin, from 3.87 to 2.76 ; and in Belfast, from 3.82 to 2.10. These are highly gratifying figures, for they show that the great efforts that people are making everywhere to grapple with phthisis are proving successful. The following return gives the deaths and deaths per thousand persons living at each age:— Age periods. Deaths. Deaths per 1,000 persons living at each age. Age periods. Deaths. Deaths per 1,000 persons living at each age. 0-5 12 0.32 55-65 50 2.36 5-15 10 0.16 65-75 19 1.76 15-25 45 0.64 75-85 5 1.15 25-35 96 1.50 35-45 108 2.36 Total 424 1.21 45-55 79 2.42 These figures speak for themselves, and show very conclusively that the greatest mortality occurs at those periods of life which are most valuable, not only to the family but to the State, and silently demand that no effort should be spared to prevent the spread of the disease. H 2 100 1909] Table LXVIII. Showing the Deaths from Phthisis in the Sub-Districts during the Four Quarters of the Year 1909. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Borough 1st 13 18 10 8 18 22 30 119 2nd 9 13 7 10 15 13 19 86 3rd 6 15 9 11 12 14 26 93 4th 11 10 6 21 12 32 34 126 The Year 39 56 32 50 57 81 109 424 Tabes Mesenterica, a disease due to the same bacillus as phthisis, and popularly called "consumption of the bowels," was the cause of 41 deaths, of which 31 occurred among children under 5 years old. They were equal to a death-rate of 1.2 per 10,000 of the inhabitants, but of 8'2 per 10,000 of the children under 5 years old. Tubercular Meningitis and Hydrocephalus were the registered cause of 72 deaths of which 18 occurred among infants under 12 months old, and 42 among children aged 1 to 5 years, making a total of 60 deaths among children under 5 years old, equal to a death-rate of 15.9 per 10,000 living at that age. These deaths represented nearly half the mortality from tubercular diseases among children who had not passed their fifth year of life. Tuberculosis of the Larynx.— Five deaths were ascribed to this ailment, 4 of which were of males and 1 of a female. It is noteworthy that in the return for 1908 there were 3 males and 1 female. All the deaths occurred among persons over 5 years old. General Tuberculosis and Scrofula. Of the 25 deaths, 21 occurred among children under 5 years old and 4 among persons over that age. Ten of the deceased were males and 15 females. The death-rate among young children under 5 years of age was equal to 5.6 per 10,000 living at that age. Other Forms of Tuberculosis. Fifteen deaths were registered from these causes, of which 4 were under 5 years old. 101 [1909 Table LX1X. Showing the Deaths from the Tubercular Diseases during 1909. Diseases. Ages. Sex. Districts. Totals Deaths. Death Rates per 1000 Population 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 1 11 412 255 169 39 56 32 50 57 81 109 424 0.32 0.16 1..21 Tabes Mesenterica 20 11 10 24 17 2 1 6 6 4 7 15 41 0.82 0.09 0.12 Tubercular Meningitis 18 42 12 32 40 5 11 6 8 9 5 28 72 1.59 0.11 0.20 Tuberculosis of the Larynx — — 5 4 I — I — — — 1 3 5 — — 0.01 General Tuberculosis 6 15 4 10 15 I 2 1 2 5 9 5 25 0.56 0.01 0.07 Other Forms of Tuberculosis 1 3 11 10 5 3 2 2 4 2 2 — 15 0.10 0.03 0.04 All Tubercular Diseases 46 82 454 335 247 50 73 47 70 77 105 160 582 3.39 0.40 1.65 102 1909] Table LXX. Mortality from Tuberculosis of the Lung (including Phthisis) and other Forms of Tuberculosis. Years. Number of Deaths. Death Rates. Tuberculosis of Lung (including Phthisis.) Other forms of Tuberculosis. Tuberculosis of Lung (including Phthisis). Other forms of Tuberculosis. Males (all ages). Females (all ages). Males (all ages). Females (all ages). Children (under 5). Males (all ages). Females (all ages). Males (all ages). Females (all ages). Children 1 (under 5). 1899 359 224 76 70 119 2.26 1.26 0.48 0.39 2.89 19OO 385 217 57 51 88 2.42 1.22 0.36 0.29 2.12 19O1 325 220 82 50 99 2.04 1.25 0.51 0.28 2.74 1902 308 207 84 73 120 1.92 1.17 0.52 0.41 3.31 1903 291 201 80 60 103 1.80 1.13 0.49 0.34 2.82 1904 315 218 83 66 104 1.94 1.22 0.51 0.37 2.84 1905 243 195 74 68 107 1.49 1.08 0.45 0.38 2.90 1906 252 159 88 79 112 1.54 0.88 0.54 0.44 3.02 1907 260 176 83 89 110 1.58 0.97 0.45 0.49 2.95 1908 248 184 96 76 109 1.53 0.99 0.59 0.41 2.85 Average 298 200 80 68 107 1.85 1.12 0.49 0.38 2.84 1909 255 169 80 78 116 1.53 0 .92 0.48 0.42 3.07 103 [1909 DIABETES MELLITUS. This disease shows the considerable increase of 15 deaths, as compared with the preceding year, and of 11 as compared with the average of the preceding 10 years, the deaths numbering 36, as compared with 21 in 1908, and with an average of 25 in the years 1899-1908. 22 of these deaths occurred among males, and 14 among females, while its greatest incidence (18 deaths) occurred amongst persons from 45 to (i5 years of age. The return is higher than any in the previous years. Table LXXI. Showing the Deaths from Diabetes Mellitus at ten age periods during the year 1899-1908, and in 1909. Ages at Death. Years. Total 10 years. 1909 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 o—5 — — — — — — — — — — — — 5—15 — — — 1 1 — — — 1 — — — 15—25 — 2 2 — 1 3 1 1 1 — 1 4 25-35 1 1 3 2 2 2 3 3 1 1 2 2 35-45 1 2 1 7 2 3 2 3 1 2 2 1 45-55 2 7 5 4 2 5 4 3 2 4 4 10 55-65 — 7 10 9 8 11 6 7 7 7 7 8 65-75 1 7 8 2 7 9 11 14 5 5 7 5 75—85 — 2 3 3 3 1 1 1 2 1 2 3 85 upwards — — 1 — — 1 — — 1 1 — 3 All Ages 5 28 33 28 26 35 28 32 21 21 25 36 Males 3 11 20 12 11 19 15 13 11 10 12 22 Females 2 17 13 16 15 16 13 19 10 11 13 14 104 1909] TABLE LXXII. Showing the Deaths from the several Constitutional Diseases during the Years 1899-1908, alse the Corrected Mean Number of Deaths for these Years, together with the Deaths in 1909. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Corrected Means 18991908. 1909. Increase or Decrease Rheumatic Fever 26 16 9 17 16 13 18 15 11 9 16 10 - 6 Rheumatism 8 10 12 15 21 21 11 19 13 14 14 28 + 14 Gout 4 7 7 11 6 11 7 6 13 7 8 4 - 4 Rickets 25 13 19 17 9 11 11 11 5 5 13 3 -10 Cancer 270 303 289 326 350 323 328 363 348 367 337 353 + 16 Tabes Mesenterica.. 50 36 38 43 40 40 39 35 26 45 40 41 + 1 Tubercular Meningitis 89 69 80 77 71 74 63 80 74 63 76 72 - 4 Phthisis 583 602 545 515 492 533 438 411 436 432 515 424 -91 Other Tubercular and Scrofulous Diseases 7 3 14 37 29 35 40 52 72 64 36 45 + 9 Purpura 4 2 2 2 1 1 2 1 3 3 2 • • - 2 Anaemia, Chlorosis, Leucocythæmia. 11 12 9 7 8 14 15 16 15 14 12 13 + 1 Diabetes 20 28 33 28 26 35 28 32 21 21 28 36 + 8 Other Diseases 3 3 5 2 1 5 7 1 4 4 4 3 - 1 Totals 1,100 1,104 1,062 1,097 1,070 1,116 1,007 1,042 1,041 1,048 1,101 1,032 -69 DISEASES OF THE RESPIRATORY SYSTEM. The chief diseases included under this heading are Acute Bronchitis, Chronic Bronchitis, Pneumonia, Broncho-Pneumonia, Pleurisy and Asthma, which collectively caused 1,049 deaths, and formed 21.3 per cent. of the total deaths from all causes registered during the year. Thus it is seen that diseases of the respiratory system form one of the most important groups which come under the purview of the Medical Officer of Health, especially as they are a very considerable item in the mortality among infants, among whom, in the year under consideration, they were the certified primary cause of 166 deaths, while in very many cases they were ascribed as secondary causes. Altogether 192 deaths from the respiratory diseases occurred in the public institutions within the Borough. 105 [1909 Acute Bronchitis.— To Acute Bronchitis were ascribed 182 deaths, of which 76 were those of males, and 106 of females. These deaths show an increase of 50 as compared with the return of 1908. 53 of them occurred among children in their first year of life, and 19 between that age and five years. There were thus 72 deaths among children who had not reached their fifth year. Ten of the total deaths occurred in public institutions. Chronic Bronchitis was responsible for 352 deaths, of which 153 occurred among males, and 199 among females. Only 4 of these deaths were among children under 5 years old, while 32 were those of persons between 45 and 55 ; 84 between 55 and 65; 97 between 65 and 75; 91 between 75 and 85, and 28 above this age. As many as 88 deaths occurred in public institutions, chiefly in the Workhouse Infirmaries. Pneumonia was credited with 476 deaths, of which 279 were those of males and 197 of females, while 106 were of infants under 12 months old, and 207 (including those under 1 year old) had not attained to their fifth year. 75 deaths occurred in public institutions. Compared with the preceding year, there was an increase of 50 deaths, which were mainly attributable to the epidemic of measles that was rife for a considerable portion of the year. Pleurisy.— This disease caused 29 deaths, of which 6 were under 5 years old, and 8 occurred in public institutions. Asthma and Emphysema.—These distressing complaints were responsible for 22 deaths, of which 1 only was among children under 5 years old. Other Diseases of the Respiratory System were registered as causing 17 deaths, which were the same in number as in 1908. The particulars of the deaths of infants from these diseases are always of special interest. The returns are as follows:— Acute Bronchitis. Pneumonia. Total 1st quarter - 15 43 58 2nd „ 11 23 34 3rd „ 7 13 20 4th „ 22 27 49 55 106 161 1909] 106 ALCOHOLISM. 18 deaths were registered under this heading, of which 12 occurred among males and 6 among females. The return shows that the male deaths increased by 4 and that the female deaths increased by 3. Since 1901,217 deaths, 96 being males and 121 females, have been registered in Islington from this cause, thus showing that alcoholism is playing a not unimportant part in the mortality returns. Everyone who deals with mortality statistics very well understands that the registered deaths by no means represent the actual number caused by the excessive use of alcohol. In the Report for 1908 this fact was pointed out, and, therefore, it will not be discussed further here. It may, however, be mentioned that while acute alcoholic poisoning, acute alcoholic mania, delirium tremens, chronic alcoholic neuritis, and alcoholic paralysis are generally ascribed in the death returns to alcoholism, yet there are many other diseases to which alcohol is the attributing cause, which are not so included, and which comprise such diseases of the throat as catarrhal sore throat; of the stomach, such as gastric catarrh, chronic dyspepsia and dilatation of the stomach; of the liver, such as congestion, cirrhosis and fatty liver; of the kidneys, such as Chronic Bright's Disease; of faulty metabolism, such as gout; of altered tissue change, such as glycosuria and obesity; of functional disorders of the generative system, such as sterility and incapability of mothers to suckle their infants at the breast; of the heart, such as dilatation and fatty heart; of the blood vessels, such as degeneration; of fibroid changes in the vessels of the lungs, such as increased susceptibility to inflammatory and infectious diseases, viz., inflammation of the lungs, consumption, bronchial catarrh, etc.; of the eyes, such as susceptibility to inflammatory diseases; and of the nervous system, such as the inflammation and degeneration of the nerve structures, epilepsy, melancholia, dementia, imbecility, hysteria, idiocy, and sunstroke; of infectious diseases, such as erysipelas, blood poisoning of various types, tubercle, syphilis, diphtheria and cholera; and of industrial diseases, such as lead poisoning. It would be interesting to discuss the actual effect of alcohol on these several diseases, but this is not the place for it. Suffice it to say that excess of alcohol is a very potent factor in many diseases, although no return of the fact is made to the registrar of deaths; but it may be taken for granted that such excess is a secondary, if not a primary cause of death in innumerable cases. 107 [1909 The number of deaths during each year since 1901 is as follows:— Acute. Chronic. Total. Males. Females. 1901 27 27 7 20 1902 9 29 38 20 18 1903 3 23 26 13 13 1904 4 18 22 12 10 1905 4 21 25 9 16 1906 3 13 16 5 11 1907 4 24 28 10 18 1908 3 14 17 8 9 1909 4 14 l8 12 6 217 96 121 VENEREAL DISEASES. These diseases, which include Syphilis and Gonorrhoea, caused 15 deaths, which is a decrease of 5 on the preceding year. 10 of these were of infants under 12 months old, while 10 were of males and 5 of females. Of the 5 adults, one was between 25 and 35, 3 between 45 and 55, and 1 between 55 and 65 years of age. These diseases, like those arising from alcoholism, are never credited with their full tale, but are very frequently, for family and other reasons, disguised under secondary headings. Under 1 year. 1 — 5 years. Adults. Total. 1901 10 1 6 17 1902 11 - 10 21 1903 10 1 8 19 1904 12 2 6 20 1905 13 - 5 18 1906 9 1 6 16 1907 5- 11 16 1908 13 1 6 20 190910 - 5 15 Totals 93 6 63 162 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—1,672 persons died in the Public Institutions located in Islington, of whom only 1,055 belonged to this borough, the remaining 617 having come here for treatment or relief. Among the latter were 418 persons who died in the Holborn Infirmary, and 103 in the Great Northern Central Hospital, 13 in the Islington Infirmary, 12 in the London Fever Hospital, and 11 in St. Pelagia's Creche. 1909] 108 Of the 1,055 deaths of inhabitants, 755 occurred in the Islington Infirmary, 156 in the Islington Workhouses, and 113 in the Great Northern Central Hospital. The proportion which the 1,055 deaths bore to the borough mortality was 30.6 per cent. Without the Borough.—770 deaths of persons belonging to Islington were registered as occurring in Public Institutions in districts of London outside the Borough. They included, among others, 46 in the North-Eastern Fever Hospital, 70 in the Children's Hospital, Great Ormond Street, 91 in St. Bartholomew's Hospital, 38 in the Colney Hatch Asylum, 42 in the Royal Free Hospital, 41 in University College Hospital, and 28 in Claybury Asylum. These 770 deaths represented 15'6 per cent. of all the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians in Public Institutions numbered 1,790, and were equal to 36'4 per cent. of the total deaths registered during the year. Fatal accidents or sudden deaths outside the Borough.— Thirty-five inhabitants died from accidental deaths, or suddenly, in places outside Islington. Table LXXIII. Showing the Deaths of Inhabitants in Local Institutions and Institutions outside the Borough, also the Deaths of Non-Inhabitants m Local Institutions during the years 1899-1908 and in 1909. 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). 1 2 3 4 5 6 7 8 9 1899 1,672 993 679 772 136 593 1,586 25.2 1900 1,564 990 574 779 124 553 1,543 26.9 1901 1,394 903 491 603 124 630 1,533 28.6 1902 1,531 909 622 587 130 737 1,646 29.2 1903 1,467 912 555 654 122 627 1,539 31.8 1904 1,619 987 632 719 132 589 1,576 30.1 1905 1,526 962 564 680 126 619 1,581 31.9 1906 1,574 955 619 717 106 648 1,603 31.5 1907 1,675 1,082 593 760 130 656 1.738 34.2 1908 1,565 1,015 550 750 120 684 1,699 36.3 Average 1,559 971 588 702 125 633 1,604 32.6 1909 1,672 1,055 617 755 113 735 1,790 36.4 109 [l909 Table LXXIV. 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 1909. PUBLIC INSTITUTION. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. Total Inhabitants. NonInhabitants. Islington Infirmary 58 1l6 86 97 99 134 165 755 13 Islington Workhouses 17 20 18 27 20 25 29 156 3 Workhouse Schools — — — — — — — — — Gt. Northern Hospital 17 19 18 24 20 7 8 113 103 Holborn Infirmary 1 — — — 21 — 2 4 418 Aged Pilgrims' Asylum 1 — — — — — — 1 8 St. Pelagia's Creche — — — — — — — — 11 Aged Blind Home — — — 1 — — — 1 6 Medical and Surgical Home — — — — — — — — — Children's Nursing Home — — — — — — — — — St. John's Nursing Institute — — — — — — — — — Kingsdown Orphanage — — — — — — — — — Shoreditch Workhouse — — — — — — — — 2 Whittington College — — — — — — — — 3 Tufnell Park Nursing Institution — — — — — 1 — 1 — St. Andrew's Nursing Home — — — — 1 — — 1 1 H.M. Prison, Holloway 1 — — — — — — 1 7 H.M. Prison, Pentonville — — 1 — — — — 1 8 Drovers' Almshouses — — ——— — — — — — — London Fever Hospital — — 1 — 1 — — 2 12 Memorial Cottage Hospital — — — — 8 — 4 12 8 Invalid Home, Aubert Park — — — — — — — — — Invalid Home, Highbury Terrace — — — — — — — — 3 Bookbinders' Asylum — — — — — — 1 1 1 Metropolitan Benefit Societies' Asylum — — — — — — — — 4 Bricklayers' and Tilers' Almshouses — — — — — — — — 2 Dyers' Almshouses — — — — — — — — 1 Pennefather Memorial Home — — — — — — — — — Clothworkers' Almshouses — — — — — — 2 2 — Alexandra Nursing Home, Turle Road 1 — 2 1 — — — 4 1 Highbury Nursing Home — — — — — — — — 2 Totals 96 155 126 150 150 167 211 1,055 617 •There were also 16 deaths at places not mentioned in this list. 1909] 110 Table LXXV. 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 1909. 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 9 7 16 8 6 14 5 6 11 6 10 16 28 29 57 Upper Holloway 20 17 37 17 12 29 12 4 16 12 8 20 61 41 102 Tollington 8 7 15 7 9 16 2 6 8 6 3 9 23 25 48 Lower Holloway 13 13 26 7 9 16 11 11 22 11 10 21 42 43 85 Highbury 18 24 42 12 9 21 13 11 24 14 11 25 57 55 112 Barnsbury 26 14 40 32 19 51 20 11 31 28 23 51 106 67 173 South-East Islington 40 23 63 25 14 39 15 21 36 32 23 55 112 81 193 Borough 134 105 239 108 78 186 78 70 148 109 88 197 429 341 770 111 [1909 Table LXXVI. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated without the Borough, during the Year 1909. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Middlesex Hospital 6 6 5 9 26 Friedenheim (Home of Peace), N.W. 2 1 2 5 10 North Western Fever Hospital 11 3 2 .. 16 University College Hospital 12 9 4 16 41 Eastern Fever Hospital .. 1 .. .. 1 Children's Hospital, Gt. Ormond Street 13 19 22 16 70 Banstead Asylum 1 1 2 2 6 Manor Asylum (Epsom) 1 1 1 1 4 Darenth Asylum 4 1 .. .. 5 Hanwell Asylum 5 4 5 2 16 New Hospital for Women (Euston Road) 1 3 .. .. 4 Metropolitan Hospital 11 5 .. 3 19 German Hospital 3 3 .. 3 9 St. Bartholomew's Hospital 25 19 17 30 91 Royal Chest Hospital 4 3 .. 4 11 King's College Hospital 3 1 .. .. 4 Guy's Hospital .. 4 2 1 7 Colney Hatch Asylum 13 10 5 10 38 North Eastern Fever Hospital 11 12 8 15 46 8 Leavesden Asylum 3 1 2 2 St. Thomas's Hospital .. 1 .. .. 1 Cane Hill Asylum 1 .. 1 .. 2 Royal Free Hospital 11 19 7 5 42 London Temperance Hospital 4 3 2 6 15 Cancer Hospital (Chelsea) .. 2 1 .. 3 London County Asylum (Dartford) 1 3 3 1 8 London Hospital 4 4 4 1 13 St. Anne's House, Stoke Newington 1 .. 1 .. 2 Mildmay Hospital 1 1 .. 3 5 Homoepathic Hospital, Gt. Ormond Street 1 .. 1 3 5 Claybury Asylum 10 7 5 6 28 Children's Hospital (Paddington Green) .. 1 .. .. 1 St. George's Hospital .. .. .. .. .. Hackney Infirmary 2 .. .. 1 3 St. Pancras Infirmary 6 1 3 5 15 St. Pancras Workhouse .. .. 1 1 2 City of London Lying-in Hospital 2 .. 2 2 6 Marylebone Infirmary .. .. 1 .. l Wesminster Hospital .. .. 1 .. 1 Hospital of St. John and St. Elizabeth .. .. .. .. .. St. Mary's Hospital 1 .. 2 .. 3 Tooting Bec Asylum 3 1 l 3 8 Charing Cross Hospital 1 1 1 .. 3 Evelina Hospital .. .. .. 1 1 National Hospital, Queen's Square, W,C. 1 .. 1 1 3 Bethnal House Asylum .. .. .. .. .. St. Luke's House, Pembridge Square, S.W. .. 1 3 l 9 St. Barnabas Home, 9, Lloyd Street, W.C. .. .. .. 1 .. Chest Hospital Bethnal Green 1 1 .. .. 2 Holborn Workhouse, Hoxton 1 3 1 1 6 Caterham Asylum .. 1 .. 1 2 Hostel of God 1 1 1 .. 3 Shoreditch Infirmary 6 .. 2 .. 8 Horton Asylum 1 1 .. 4 6 French Hospital .. .. .. 2 2 Invalid Asylum, Stoke Newington .. .. 1 .. 1 Camberwell House Asylum 1 .. .. .. 1 Heart Hospital, Soho Square 1 .. .. .. 1 St. Peter's Hospital 1 1 .. .. 2 Long Grove Asylum 4 3 3 3 13 Belmont Workhouse 3 .. 1 1 5 East London Hospital 1 .. 2 1 3 Queen's Hospital, Bethnal Green 2 2 .. 3 7 Lock Hospital .. .. 2 .. 3 Home of Compassion, Paddington 1 .. .. .. 1 Eastern Hospital .. 1 .. .. 1 Royal Hospital, Waterloo Road 2 .. .. 2 4 Mount Vernon Hospital 1 .. .. .. 1 Home Hospital, 10, Fitzroy Square .. 1 .. .. 1 Hampstead Home Hospital 1 .. .. .. 1 112 1909] Table LXXVI—continued. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Central London Throat and Ear Hospital 1 .. 1 1 3 Italian Hospital .. 2 1 .. 3 Royal Hospital for Incurables .. .. 1 .. 1 Belgrave Hospital 1 .. .. .. 1 Maternity Home, Hackney 1 .. .. 1 2 St. Peter's Home 1 .. .. .. 1 Brompton Hospital .. .. 2 .. 2 Hoxton House Asylum 1 .. .. .. 1 North-West London Hospital .. .. 1 .. 1 Northern Fever Hospital .. .. .. 1 1 St. Mark's Hospital .. 1 .. .. 1 British Lying-in Hospital, Endell Street 1 .. .. 1 2 Lambeth Infirmary 1 .. .. .. 1 Home of Good Shepherd, Shoreditch 1 .. .. .. 1 Central London Sick Asylum Hendon 2 .. .. .. 2 St. Joseph's Hospice, Hackney 1 .. .. .. 1 Camberwell Workhouse 1 .. .. 1 Children's Infirmary, Carshalton 4 5 2 1 12 Goldsmith's Asylum, Hackney 1 .. .. .. 1 Kensington Infirmary 1 .. .. .. 1 Alexandra Hospital, Queen's Square, W.C .. 1 .. . . 1 Sick Asylum, Hendon .. 1 .. .. 1 Tailors' Benevolent Institution, St. Pancras .. 1 .. . . 1 Poplar Workhouse .. .. .. 1 1 Mile End Infirmary .. .. .. 1 1 St. Saviour's Hospital .. .. .. 1 1 Whitechapel Infirmary .. .. .. 1 1 City of London Workhouse, Hackney .. .. .. 1 1 Strand Union Workhouse, Edmonton .. .. .. 1 1 St. Marylebone Workhouse .. .. .. 1 1 229 178 139 189 735 Accidental and other Deaths :— In De Beauvoir Square, Hackney 1 .. .. .. 1 At Vale of Health Road, Hampstead 1 .. * * .. 1 At 5, Southgate Grove, Hackney 1 .. .. .. 1 At 47, Streatham Hill 1 .. .. .. 1 At 3, Hampstead Hill Gardens, N.W. 1 .. .. .. 1 In Vale of Health Pond, Hampstead 1 .. .. .. 1 At 5, Galen Place, Bury Street, W.C. 1 .. .. .. 1 In garden of 8. Upper Avenue Road, Hampstead 1 .. .. .. 1 At 9, Ferncliff Road, Hackney 1 .. .. .. 1 At 8a, Dean Street, Soho, W. 1 .. .. .. 1 At 4, Upper Wimpole Street, W. .. 1 .. .. 1 At 38, Hows Street, Shoreditch .. 1 .. .. 1 In River Thames off Albert Bridge, Battersea .. 1 .. .. 1 On an ambulance near Westminster Hospital .. 1 .. .. 1 At Mildmay Radical Club, Newington Green .. 1 .. .. 1 In River Lea near Craven Walk, Hackney .. 1 .. .. 1 At 173, Drummond Street, Hackney .. 1 .. .. 1 In canal between York Rd. and Wharf Rd., N.W. .. 1 .. .. 1 At Kennet Wharf, Upper Thames Street, E.C. .. .. .. 1 .. 1 In Kentish Town Road .. .. 1 .. 1 In No. 1 pond, Parliament Hill .. .. 1 .. 1 At 7, The Terrace, St. Pancras .. .. 1 .. 1 In bathing pond, No. 2, Parliament Hill .. .. 1 .. 1 At 90, Mortimer Road, Hackney .. .. 1 .. 1 In Regent's Canal, Pancras Bridge .. .. 1 .. 1 At London Fields, Hackney .. .. 1 .. 1 In Green Lanes, Stoke Newington .. .. 1 .. 1 At 53, Beaumont Street, W. .. .. .. 1 1 At 21, Beaumont Street, W. .. .. .. 1 1 At 13, Bulstrode Street, St. Marylebone .. .. .. 1 1 In Regent's Canal, near Park Road Bridge, St. Marylebone .. .. .. 1 1 In Rosebery Avenue, E C. .. .. .. 1 1 At 77, Manor Road, Stoke Newington .. .. .. 1 1 At 22, Somerford Grove, West Hackney .. .. .. 1 1 At Patterson's Hotel, Charterhouse Hotel .. .. .. 1 1 Total Deaths 239 186 148 197 770 1 Table LXXVII. 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 1909. 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. I Year. Islington Infirmary 262 170 142 181 755 8 1 1 3 13 170 171 143 184 768 Islington Workhouses and Schools 47 40 40 29 156 2 1 .. .. 3 49 41 40 29 159 Great Northern Central Hospital 35 33 15 30 113 30 27 23 23 103 65 60 38 53 216 Holborn Infirmary .. 1 .. 3 4 124 106 95 93 418 124 107 95 96 422 St. John's Nursing Institute .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tufnell Park Nursing Institute .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 1 London Fever Hospital .. 1 .. 1 2 3 7 .. 2 12 3 8 .. 3 14 Aged Pilgrims' Asylum .. l .. .. 1 2 .. 2 4 8 2 1 2 4 9 St. Pelagia's Creche. .. .. .. .. .. 9 1 1 11 9 1 1 .. 11 Memorial Cottage Hospital 5 1 .. 6 12 3 4 1 .. 8 8 5 1 6 20 Alexandra Nursing Home, Turle Road .. .. .. 4 4 .. .. .. 1 1 .. .. .. 5 5 Aged Blind Home .. 1 .. .. .. 1 2 2 1 1 6 3 2 1 1 7 Medical and Surgical Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Invalid Home, Aubert Park .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. H.M. Prison, Holloway 1 1 4 1 1 1 7 5 1 1 1 8 H.M. Prison, Pentonville .. 1 .. .. 1 2 3 2 1 8 2 4 9 1 9 Children's Nursing Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Kingsdown Orphanage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nursing Home, Turle Road .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whittington College .. .. .. .. .. 1 1 1 3 1 1 1 .. 3 Metropltn. Benefit Societies' Asylum .. .. .. .. .. .. 1 1 2 4 .. 1 1 2 4 Shoreditch Workhouse .. .. .. .. .. .. .. .. 2 2 .. 1 1 2 2 Drover's Almshouses .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 Bookbinder's Asylum .. .. .. .. 1 1 .. .. 1 1 .. .. .. 2 2 Invalid Home, Highbury Terrace .. .. .. .. .. .. .. 2 x 3 .. .. 2 1 3 Dyers' Almshouses .. .. .. .. .. .. 1 .. .. 1 .. 1 .. .. 1 Highbury Nursing Home .. .. .. .. .. .. 2 .. .. 2 .. 2 .. .. 2 Bricklayer's and Tiler's Almshouses .. .. .. .. .. 2 .. .. 2 2 .. .. .. 2 Clothworkers' Almhouses 1 1 .. .. 2 .. .. .. .. .. 1 1 .. .. 2 St. Andrew's Nursing Home .. .. .. 1 1 .. .. .. 1 1 .. .. .. 2 2 Totals 352 249 197 257 1055 192 158 131 136 617 544 407 328 393 1672 118 [1909 1909] 114 INQUESTS AND MORTUARY. During the year 592 bodies were received into the Mortuary, as compared with an average of 681 in the preceding 10 years. This is, with one exception, viz., 563 in 1908, the smallest number recorded in these years. The daily average number of bodies received into the mortuary was 1.6, as compared with 1.5 in 1908. In 407 cases inquests were held, as contrasted with an average of 434 in the years 1899-1908. Bodies received into Mortuary sts. 1899 807 469 1900 754 475 1901 693 431 1902 745 458 1903 681 393 1904 660 424 1905 625 419 1906 642 433 1907 644 441 1908 563 396 Average 681 434 1909 592 407 The following table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1908 and 1909. 1908. No. of bodies received. Daily Average. No. of Inquests held. 1909. No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 166 19 121 1st Quarter 193 2.1 136 2nd „ 111 12 80 2nd „ 128 1.4 82 3rd „ 140 15 92 3rd „ 129 1.4 78 4th ,, 146 16 103 4th „ 151 1.6 111 Total for Year 563 15 396 Total for Year 601 1.6 407 During the year the mortuary keeper's cottage, which had become damp and unfit for occupation, was pulled down, and a new one built on its site. The cottage, which had previously been rented, was purchased together with the site, and the new building was erected by the Council. PART III. THE NOTIFICATION, ISOLATION, FATALITY, AND PREVENTION OF INFECTIOUS DISEASES. INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS AND ON BUSINESS PREMISES, TOGETHER WITH THE OCCUPATIONS OF THE PERSONS ATTACKED. 12 1909] 116 THE NOTIFICATION OF INFECTIOUS DISEASES. Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric or Typhoid Fever, Erysipelas, Continued Fever, Relapsing Fever, and Cholera. These infectious diseases are notifiable under the 55th section of the Public Health (London) Act, 1891, and are usually known as the principal epidemic diseases. Altogether 2,049 cases were notified and are 366 below the corrected average of the preceding 10 years. They are also 240 less than the number notified in 1908. In proportion to the population, the cases represented 5.83 attacks per 1000, as contrasted with a mean rate of 6.87 during the years 1899-1908. In the table given below it will be observed that of late years there has been a gradual reduction in the number of cases notified annually. This is best discerned if they are split up into quinquennial periods. Thus from 1891 to 1895 there were 10,190 notifications, from 1896 to 1900, 14,367, from 1901 to 1905 11,592, while from 1906 to 1909 (4 years), there were 8,676. Consequently it is seen that in the first period the cases averaged 3,238 per annum, in the second 2,873, in the third, 2,318, and in the last four years 2,169. It is satisfactory to note that, compared with the preceding 10 years, there has been a decrease in each of the infectious diseases except Scarlet Fever, the increase from which is, however, so insignificant as to be a negligible quantity. It is only 2. The following return gives the number of cases, together with the attack rates, in each year since 1891, when these diseases became compulsorily notifiable. Years. Cases. Attack-rates per 1,000 inhabitants. Years. Cases. Attack-rates per 1,000 inhabitants. 1891 2,059 6.43 1901 2,852 8.50 1892 3.318 10.26 1902 3,164 9.20 1893 4.853 14.84 1903 1,707 5.03 1894 3.121 9.44 1904 1.941 5.69 1895 2,839 8.50 1905 1,928 5.62 1896 3.824 11.32 1906 2.275 6.59 1897 2,906 8.62 1907 2,063 5.94 1898 2,418 7.18 1908 2,289 6.43 1899 2,943 8.75 1891-1908 48,776 8.05 1900 2,276 6.78 1909 2,049 5 83 117 [1909 When compared with the neighbouring districts, the attack-rate of the borough is not unsatisfactory, for in St. Pancras it was 5.53, Finsbury 5.85, in Hackney 5.87, and in Shoreditch 6.40. As might have been expected, the rate was lower in the residential boroughs of Hornsey and Stoke Newington, where it was respectively 4.33 and 3.31 per 1000 inhabitants. Cases. Attack-Rates. St. Pancras 1,312 5.53 Stoke Newington 180 3.31 Hackney 1,395 5.7 Hornsey 413 4.33 Finsbury 558 5.85 Shoreditch 735 6.40 Encircling Boroughs 4,593 5.50 County of London 29,503 6.10 Islington 2,049 583 Sub-Registration Districts.—The greatest incidence of the cases of infectious diseases occurred in Lower Holloway, where in proportion to population the 297 cases were equal to a rate of 7 09 per 1000. This district was followed by Tufnell, where the attack rate was 0.71 per 1000, arising from 237 cases; Upper Holloway showed an almost similar rate, 6-68 per 1000, which represented 249 cases; Barnsbury came then, with a rate of 6 17 for 331 cases; Highbury followed with a rate of 5.60 per 1000 for 386 cases, and next succeeded Tollington, with a rate of 5.0 per 1000 for 186 cases. Lastly came South-east Islington, which had the lowest rate, 4.72 per 1000 for 363 cases. Cases. Attack-ratcs. Tufnell 237 6.71 Upper Holloway 249 6.68 Tollington 186 5.00 Lower Holloway 297 7.09 Highbury 386 5.60 Barnsbury 331 6.17 Islington South East 363 4.72 Total 2,049 5.83 1909] 118 Wards.—The following is a statement as to the cases and the attackrates in the several wards. Cases. Attack Rates. Tufnell 237 6.71 per 1,000 inhabitants. Upper Holloway 249 6.68 ,, ,, Tollington 186 5.00 ,, ,, Lower Holloway 297 7.09 ,, ,, Highbury 217 6.15 ,, ,, Mildmay 145 573 ,, ,, Thornhill 161 4.80 ,, ,, Barnsbury 170 8.43 ,, ,, St. Mary 91 5.18 ,, ,, Canonbury 140 4.05 ,, ,, St. Peter 156 4.71 ,, ,, 2,049 5.83 ,, ,, In the Quarters.—In the first quarter there were 548 cases notified, which produced an annual attack rate of 6.24 per 1000 inhabitants. The return was 41 above the corrected average for the first quarters of the preceding 10 years, the increase being chiefly due to scarlet fever. The rate was, however, below that of the County of London (6.42 per 1000), but slightly above the rate of the Encircling Boroughs, 6.02. In the second quarter, altogether 482 cases were notified, which produced an annual attack rate of 5.49 per 1000 inhabitants. These cases compare with a corrected average of 50.3 in the second quarters of the preceding 10 years. In London the attack rate was 5.98 per 1000, while in the Encircling Boroughs it was 5.11. In the third quarter 502 cases were notified, which yielded an attack rate of 6.40 per 1000 of the inhabitants. They were 83 below the corrected average (045) of the third quarters of the preceding 10 years. In the County of London the rate was 6.21 per 1000, and in the Encircling Boroughs 6.56. In the fourth quarter, 457 notifications were received, which represented an annual attack rate of 5.20 per 1000 of the population. These cases were 300 below the corrected average (757) which obtained in the fourth quarter of the preceding 10 years. The cause of sc large a decrease was chiefly due to the fact that Scarlet Fever exhibited 121 cases less than it usually does at this period of the year, whilst Diphtheria showed a decrease of 71, Enteric Fever of 56, and Erysipelas of 46. Indeed, all the diseases were less than is usual at this quarter. In London the attack rate was 5.83, and in the Encircling Boroughs 5.35 per 1000 of the inhabitants. 119 [1909 FATALITY FROM THE NOTIFIABLE INFECTIOUS DISEASES. By fatality is meant the percentage proportion of deaths to the cases notified. During the year the mortality amounted altogether to only 87, which is the smallest number of deaths among these diseases recorded since their notification became compulsory. As there were 2,049 cases, the fatality was at the rate of 4.2 per cent., which is the lowest of which there is any record. It will be noticed in the following figures that there has been a steady diminution in the fatality since 1896. Years. Cases. Deaths. Fatality. 1891 2,059 258 12.5 1892 3,318 291 87 1893 4,853 383 7.9 1894 3,121 339 10.8 1895 2,839 266 9.3 1896 3,824 390 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 3,164 268 8.4 1903 1,707 108 6.3 1904 1,941 119 6.1 1905 1,928 107 5.5 1906 2.275 115 5.0 1907 2,063 100 4.8 1908 2,289 126 5.5 1909 2,049 87 4.2 Total 50,825 4,078 8-o This decrease will be better seen when these figures are split up into quinquennial periods. Years. Cases. Deaths. Fatality. 1891—1895 16,190 1,537 9.5 1896—1900 14,367 1,261 8.8 1901- 1905 11,592 852 7.3 1906—1909 (4 years) 8,676 428 4.9 Thus we see that the fatality has fallen from 8.8 to 4.9, or no less than 44 3 per cent., during the last four years when compared with 1896-1900. The diseases among which these reductions have occurred will be shown under their separate headings. Hospital Isolation.—Out of the 2,049 cases, 1,705, or 83 2 per cent., were treated in hospital, while 344, or 16.8 per cent, remained at home. The percentage of cases isolated in hospital is the largest that has hitherto obtained in the borough. 1909] 120 SMALL POX. Three cases of Small Pox were notified during the last weeks of the year. The first was W— F—, male, age 7 years, unvaccinated, living at 29 Victor Road, who on December 13th was taken to Great Ormond Street Hospital with an eruption on the thigh. On the 14th the patient was worse, and on the 15th, as the rash was spreading rapidly a doctor was called in to see him at home, and he in turn, on the 18th, called in another medical practitioner in consultation, when they decided that the case was one of Small Pox. Investigation of the case revealed the fact that the disease had been contracted from a man named W— C—, 29 years, vaccinated in infancy, living in the same house, on whose back the Medical Officer of Health on making an examination, found some pustules which had not thoroughly healed. He, therefore, had him removed to hospital, whither the other patient had previously been taken. Another case, E— F—, female, 28 years, vaccinated in infancy, living also at 29, Victor Road, took ill on the 30th December, and was removed to hospital the same day. A fourth case, which properly does not come within this year's record, was detected by the Medical Officer of Health, who, after a consultation with Dr. Wanklyn, the Medical Officer appointed for special purposes by the London County Council, had the case removed to hospital. The history of these cases is of interest. It appears that W— C— was a member of a troupe called the Gordon Highlanders Troupe, which had been travelling on the Continent. When at Warsaw during November, a clown belonging to a troupe named the Flataleni Brothers, who dressed in the room next to that occupied by W— C— at the "Cirkus Ciniselli," was taken ill, died in the course of a few days, and was buried on November 15th, the disease being stated to be "Black Pox." On the same day, the Gordon Highlander Troupe left Warsaw for Danzig, where on the 26th W— C—, feeling ill, consulted a doctor, who, although he did not diagnose small pox, offered him hospital accommodation. W— C—, however, asked him if he could travel to England, and was informed that if he kept himself well wrapped up he might do so without danger. He therefore, started the same day for home via the Hook of Holland and Harwich, and arrived in England on the 28th, when he consulted a doctor, who, on the 30th certified that he was suffering from Chicken Pox. Thus this case was not diagnosed as the more serious disease, and unfortunately, the above-mentioned persons were infected. Unhappily, the infection did not end in Islington, for during his convalescence W— C— was visited by a person living in Tottenham, who contracted the disease from him This man's child, 9 months old, unvaccinated, 121 [1909 contracted the disease from her father, while a woman, 35 years old, was also infected, from whom another woman, 38 years old, contracted the disease. All these patients lived in one house. Another case, that of a man living at Friern Barnet, visited the first mentioned of the Tottenham cases, and was taken ill on December 31st and removed to hospital. The result of these attacks was that in Islington, in Tottenham, and in Friern Barnet it became necessary to keep a considerable number of persons, who had been in contact with those who were stricken with the disease under observation until its incubation period had expired. The several authorities in whose districts these cases occurred are to be congratulated that the infection was in each instance so speedily nipped in the bud. This small outbreak offers a good illustration of how small pox may be spread from one part of Europe to another. In this case, had it not been for the continual cross-examination W— C— underwent before his removal to hospital, during his detention there, and following his discharge therefrom, the origin of these cases would have remained a mystery. One of the contacts, who very much resented the pressure that was put on him to prevent his going to work procured employment in a very healthy rural district in Kent, whither he proposed to go, and had not the Medical Officer of Health threatened to write to the Medical Officer of Health there, he would have gone, with the result that to a certainty he would have conveyed the disease to that place, for he himself was attacked some days later. Indeed, were it not that the Medical Officer of Health promised to allow him £1 per week to support himself and his wife and child, for he had no means, he would have gone away in defiance of the advice that had been given him. There is no doubt that that Rural District escaped a visitation of small pox owing to the means adopted in Islington. There is another interesting fact connected with this outbreak, and it is this: that W— C—'s children, being vaccinated, escaped small pox. The circumstances under which the youngest had been vaccinated are noteworthy, and are as follows:—When the time arrived for the vaccination of the child, the father applied to Mr. Fordham, at the North London Police Court, for an exemption certificate, but the Magistrate, feeling that he had not put forward a serious conscientious objection against vaccination, postponed his application for a fortnight. By that time W— C—, the father, had obtained employment, and preferred to do without the certificate rather than lose half a day's work; consequently the child was vaccinated. Now, it is a remarkable circumstance that the only unvaccinated child (W—F—) in the house was attacked, although, so far as could be ascertained, there had been no contact with W— C—. There can be little doubt in anyone's mind that, considering that W— C— was 1909] 122 for a considerable period (November 28th to December 20th) living at home, with small pox fully developed in him, he would have infected his infant child if it had not been vaccinated. SCARLET FEVER. There were 1,285 cases known in the borough, as compared with 1,409 in the preceding year, and with a decennial corrected average of 1,283, so that it may be said that a normal state as regards this disease existed here. These cases were equal to an annual attack-rate of 3.66 per 1000 inhabitants, as contrasted with a decennial rate of 3.65. In September of the preceding year (1908), Scarlet Fever became very rife, and remained prevalent until the end of the year, for during that month 173 cases were notified, in October 107, in November 94, and in December 87. In January they increased to 111, in February they were 108, in March 93, in April only 86, rising, however, in May to 105, and in June to 128. In July they were 96, in August 97, increasing in September to 173, then dropping to 107 in October, to 95 in November, and to 87 in December. Thus the last three months of the year showed a great decrease when compared with the corresponding periods of 1908. At one time, especially in the early part of the year, the Medical Officer of Health feared that the borough was about to be afflicted with a serious epidemic, but happily this was not to be. A study of the chart of this disease will show more clearly that his fears were not unfounded, for therein it will be perceived that the disease curve was for the most part above the average curve (green on the chart) of the preceding ten years until the end of September, after which its fall was very considerable, and the curve remained below the decennial curve until the end of the year. When the returns of the several quarters are examined it appears that in the first quarter there were 312 cases, or an excess of 61 on the decennial average; in the second quarter 319, or an excess of 48; in the third 366, or an excess of 15. In the fourth, however, there were 288, or a decrease of 128. In the Sub-registration Districts.—The incidence of the disease was nearly equally distributed in these districts, although in Lower Holloway there was a decided excess, the attack rate being 4.92 per 1000 of the population, as compared with the rest of the borough. This rate may be partially explained by the probability that there is a larger population of juveniles in this district than in the others. It is not possible to dogmatise about it, as this is only a surmise, and not an ascertained fact. The Council possess no figures as to the ages of the population in the sub-districts, as they might have done if the taking of the census were in their hands, as it ought to be. Showing the rise and fall of SCARLET FEVER for each week in 1909, and the averages for the corresponding weeks in the Ten years 1899-1908. RED LINE8 = Weekly Notifications. GREEN LINE8 = Ten years' average. 123 [1909 Scarlet Fever. Number of cases occurring in one house. No. of cases. 1 case in one house. 2 cases in one house. 3 cases in one house. 4 cases in one house. 5 cases in one house. 6 cases in one douse. No. of houses infected in 1909. No. of houses infected. 844 134 28 8 3 3 1,020 No. of cases occurring in Public Institutions. Cases. Public Institutions Infected St. John's Road Workhouse 2 London Fever Hospital 2 Islington Workhouse Schools 20 24 Hospital Isolation.—Of the 1,285 notified cases, as many as 1,199 were removed to hospital for isolation and treatment, leaving only 80 at home. Thus 93.3 per cent. were isolated, which is a truly large proportion. In 1908 the percentage was 90.4, and in 1907 it reached the astounding figure of 94.4 per cent. Such percentages as these naturally suggest the query, could none of the cases be treated at home ? There is very little doubt that they could. Londoners, however, seem to have a dread of this disease, and with few exceptions, readily send their children to hospitals, where they are well treated at the expense of the ratepayers in general, while the parents are saved the cost, which is no small one, as well as the great inconvenience of having the patient nursed at home. Fatality.—The fatality was exceedingly small, as there were only 25 deaths among the 1,285 cases, or 1.9 per cent. Only on two previous occasions has this low rate been reached, namely in the years 1898 and 1907. During the 10 years 1891-1900 the percentage was 3.3, while in the eight years 1901-8 it has been 2.6. This fatality is very different to that which obtained 50 years ago, when the disease, as noted in another part of the report, was of a much more serious type. 1909] 124 Not very long since the Medical Officer of Health was very much shocked to hear that a medical practitioner, who, however, does not live in Islington, had deliberately allowed one of his children to contract the disease from another of his children who was then ill with the disease in a mild form. Such a proceeding is one which is not altogether unknown among lay people, who sometimes desire to have all their children "over" the Scarlet Fever, especially if the first case be of a mild type. This is a very dangerous proceeding if the children be very young, for the younger the child when attacked, the greater the danger of death. In a table (LXXVIII.) which has been prepared showing the deaths in age periods from 1893 to 1909, it is found that in children under one year of age there were 242 cases and 25 deaths, or 10.3 per cent.; in children between 1 and 2 years old there were 772 cases and 84 deaths, or 10.9 per cent.; in children from 2 to 3 years old there were 1,396 cases and 115 deaths, or 8.2 per cent.; in children from 3 to 4 years old there were 1,842 cases and 119 deaths, or 6.5 per cent.; whilst amongst children from 4 to 5 years old there were 2,256 cases and 106 deaths, or 4.7 per cent. Altogether there were 6,873 cases under 5 years, of which 449, or 6.5 per cent. died. These are average figures, but in the table it will be noted that the percentages are often very much higher. It will be noticed that as the age of the children increased, the fatality among them decreased, until, instead of being over 10 per cent. among those between 4 and 5 years old, as it was among infants under 12 months old, it was only 4.7 per cent. When, however, the periods over five years are examined, it is found that of 17,867 cases who had reached that age, there were only 263 deaths, or 1.47 per cent., while of all cases in these years, numbering 24,740, there were 712 deaths, or 2.88 per cent. The moral of this is that, instead of being anxious to get children "over" the disease as quickly as possible, every effort should be made to postpone it or to ward it off altogether. It is not merely that the fatality is greater when the child is young-, but there is always the danger in any attack of the disease of sequelae of a most unpleasant character, especially of those which involve the kidneys, and which may prove a lifelong trouble to the patient, if they should not result in death at an early period. Table LXXVIII. Showing Cases, Deaths and Fatality of Scarlet Fever in age periods 0—5 and over 5 years. Fatality means percentage of Deaths to Cases. Ages. 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 Totals 0-1 Cases 38 18 15 19 18 15 13 16 13 11 7 13 20 11 6 9 14 242 Deaths 4 2 3 2 1 2 — 2 2 — 1 1 — 1 — 3 1 25 Fatality 10.5 11.1 20.0 10.5 5.6 13.3 — 12.5 15.4 — 14.3 7.7 — 9.1 — 33.3 7.1 10.3 1-2 Cases 98 60 56 55 57 51 39 36 43 51 31 47 31 32 38 47 30 772 Deaths 14 9 5 5 7 4 1 3 4 7 1 6 5 2 2 5 4 84 Fatality 14.3 15.0 9.0 9.1 12.3 7.8 2.6 8.3 9.3 13.7 3.2 12.8 16.1 6.2 5.3 10.6 13.3 10.9 2-3 Cases 125 83 98 132 102 79 102 64 75 95 54 62 88 94 61 82 82 1,396 Deaths 14 13 12 12 5 3 7 4 4 6 4 5 6 10 4 3 3 115 Fatality 11.2 15.6 12.2 9.1 4.9 3.8 6.9 6.2 5.3 6.3 7.4 8.1 6.8 10.6 6.6 3.7 3.7 8.2 3-4 Cases 165 110 126 150 155 102 124 78 105 110 71 108 105 137 107 89 102 1,842 Deaths 14 10 11 8 9 7 6 2 5 7 5 6 11 8 4 2 4 119 Fatality 8.5 9.1 8.7 5.3 5.8 6.9 4.8 2.6 4.8 6.4 7.0 5.5 1.5 5.8 3.7 2.2 3.9 6.5 4-5 Cases 229 156 178 183 162 137 152 103 104 161 78 106 125 129 128 125 137 2,256 Deaths 10 14 8 6 12 2 5 4 3 8 2 8 6 2 4 4 8 106 Fatality 4.4 9.0 4.5 3.3 7.4 1.5 3.3 3.9 2.9 4.7 7.6 7.6 4.8 1.6 3.1 3.2 5.8 4.7 Total under 5 Years. Cases 655 427 473 539 494 384 430 297 340 428 241 336 369 403 340 252 365 6,873 Deaths 56 48 39 33 34 18 19 15 18 28 13 26 28 23 14 17 20 449 Fatality 8.6 11.2 8.2 6.1 6.9 4.5 4.4 5.1 5.3 6.5 5.4 7.7 7.6 5.7 4.1 4.8 5.5 6.5 Over 5 Years. Cases 2,225 1,066 1,219 1,492 1,083 952 1,064 777 946 944 624 810 829 983 876 1,057 920 17,867 Deaths 38 21 27 24 27 8 14 9 12 12 11 9 9 14 10 13 5 263 Fatality 1.7 1.9 2.2 1.6 2.5 0.1 1.3 1.2 1.3 1.3 1.8 1.1 1.1 1.4 1.1 1.2 0.5 1.5 Totals Cases 2,880 1,493 1,692 2,031 1,577 1,336 1,494 1,074 1,286 1,372 865 1,146 1,198 1,386 1,216 1,409 1,285 24,740 Deaths 94 69 66 57 61 26 33 24 30 40 24 35 37 37 24 30 25 712 Fatality 3.3 4.6 3.9 2.8 3 8 1.9 2.2 2.2 2.3 2. 9 2. 7 3.0 3.1 2.7 1.9 2.1 1.9 2.9 125 [1909 1909] 126 Table LXXIX. 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. Tufuell 47 60 27 21 155 Upper Holloway 33 42 42 32 149 Tollington 43 27 37 19 126 Lower Holloway 37 43 75 51 206 Highbury 66 54 67 72 259 Barnsbury 39 43 59 50 191 Islington, South East 47 50 59 43 199 The Borough 312 319 366 288 1,285 Table LXXX. Showing the Attack-Rates of 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 5.33 6.80 3.06 2.38 4.39 Upper Holloway 3.54 4.51 4.51 3.44 4.00 Tollington 4.62 2.90 3.98 2.04 3.39 Lower Holloway 3.54 4.11 7.17 4.87 4.92 Highbury 3.83 3.13 3.89 4.18 3.76 Barnsbury 2.91 3.20 4.39 3.73 3.56 Islington, South East 2.45 2.60 3.07 2.24 2..59 The Borough 3.55 3.63 4.17 3.28 3.66 127 [1909 Table LXXXI. 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 2.1 .. .. 4.7 1.3 Upper Holloway 3.0 4.7 .. .. 2.0 Tollington .. 3.7 .. 5.3 1.6 Lower Holloway .. .. 1.3 2.0 1.0 Highbury 1.5 3.7 .. 2.8 1.9 Barnsbury 2.5 2.3 1.7 6.0 3.1 Islington, South East 8.5 .. .. 2.3 2.5 The Borough 2.5 1.9 0.5 3.1 1.9 DIPHTHERIA. There were 4.30 cases of Diphtheria, inclusive of membranous croup, notified, which, it is gratifying to find, were with two exceptions, the smallest number known in one year since 1891, when the disease became compulsorily notifiable. These exceptions occurred in 1904 and 1905, when 347 and 351 cases were respectively notified. The present return is 160 below the corrected average of the years 18991908, and 68 below the return of 1908. The cases represent an attack-rate of 1.22 per 1000 of the population, as against a mean decennial rate of 1.68. In the County of London the attack rate was 1.39 per 1000 inhabitants, and in the several Encircling Boroughs it was as follows:—In St. Pancras 1.35 per 1000, Stoke Newington 0.52 per 1000, Hackney 1.11 per 1000, Finsbury 1.76 per 1000, Shoreditch 1.62 per 1000, and in Hornsey 1.56 per 1000. It will thus be seen that, on the whole, Islington did not compare unfavourably with them. 1909] 128 Diphtheria. Number of cases occurring in one house. No. of cases. 1 case in one house. 2 cases in one house. 3 cases in one house. 4 cases in one house. 5 cases in one house. 6 cases in one house. No. of houses infected in 1909. No. of houses infected. 343 25 7 2 — — 377 No. of cases occurring in Public Institutions. Cases. Public Institutions Infected St. John's Road Workhouse 1 London Fever Hospital 2 3 Hospital Isolation.—388 out of 430 notified cases, or 90.2 per cent., were removed to hospital for isolation and treatment, while only 42, or 9.8 per cent., were kept at home. Of the number treated in hospital, 284 were sent to hospitals belonging to the Metropolitan Asylums Board, 186 of which went to the North-Eastern Hospital, 88 to the North-Western Hospital, and 10 to the Eastern Hospital. Fatality.—Out of the 430 cases notified, 31, or 7.2 per cent., died, which is a very small number in comparison with that which used to occur in former days, before the introduction of the anti-toxin treatment. It should always be pointed out that, in order to get the full effect of this method of treatment, it should be begun at the earliest possible moment, for every day's delay means a lesser degree of potency. Thus in 1908 it was found in the Metropolitan Asylums Board's Hospitals that the percentage of mortality among cases that were treated on the first day was 3 0, on the 2nd 6.5, on the 3rd 10-6, on the 4th 12 9, and on the 5th and later days 14 8 per cent. Such figures as these require no comment. Showing the rise and fall of DIPHTHERIA for each week in 1909, and the averages for the corresponding weeks in the Ten years 1899-1908. RED LINES=Weekly Notifications. GREEN LINE3 = Ten years' average. 129 [1909 The following statement gives the fatality from the disease during the last 19 years. Years. Cases. Deaths. Fatality. 1891 - 756 - 178 - 23.5 1892 - 738 - 170 - 23.0 1893 - 885 - 200 - 22.6 1894 - 867 - 2l8 - 25.1 1895 - 582 - I44 - 24.7 1896 • 1091 - 257 - 23.5 1897 - 729 - 131 - 18.0 1898 544 - 93 - 17.1 1899 - 705 - T28 - 18.2 1900 - 633 - 106 - 16.7 1901 - 911 - 134 - 14.7 1902 - 878 - 104 - 11.8 1903 - 455 - 43 - 9.4 1904 - 347 - 28 - 8.1 1905 - 351 - 34 - 9.7 1906 - 439 - 32 - 7.3 1907 - 481 - 42 - 3.7 1908 - 530 - 60 - 11.3 1909 - 430 - 31 - 7.2 Table LXXXII. 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 19 8 19 7 53 Upper Holloway 13 15 20 17 65 Tollington 6 5 9 9 29 Lower Holloway 14 12 14 9 49 Highbury 16 16 10 19 61 Barnsbury 36 16 11 18 81 Islington, South East 34 18 18 22 92 The Borough 138 90 101 101 430 *(Inclusive of Membranous Croup.) 130 1909] Table LXXXIII. Showing the Attack-Rates of Diphtheria (inclusive of Membranous Croup) 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 .15 0.91 2.15 0.79 1.50 Upper Holloway 1. 40 1.61 2.14 1.82 1.74 Tollington 0.64 0.54 0.97 0.97 0.73 Lower Holloway 1.34 1.15 1.34 0.86 1.17 Highbury 0.93 0.93 0.58 110 0.88 Barnsbury 2.68 1.19 0.82 1.34 1.51 Islington, South East 1.77 0.94 0.94 1.15 1.20 The Borough 1.57 1.03 1.15 1.15 1.22 Table LXXXIV. Showing the Fatality from Diphtheria, including Membranous Croup. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2ml Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 5.3 .. 5.3 14.3 5.6 Upper Holloway 7.7 .. .. 5.9 3.1 Tollington .. 40.0 11.1 11.1 13.8 Lower Holloway 14.3 .. 14.3 11.1 10.2 Highbury 6.2 6.2 .. 10.5 6.5 Barnsbury 5.5 12.5 .. 5.5 6.2 Islington, South East 14.7 5.5 .. 9.1 8.7 The Borough 8.7 6.0 4.0 8.9 7.2 131 [1909 Table LXXXV. Showing the Cases and Deaths from Diphtheria and Membranous Croup, together with the Fatality and the Departure from the Mean Fatality during the ten years 1899-1908, and 1909. 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.* 1899 688 17 705 120 8 128 18.2 - .35 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 1904 347 .. 347 27 1 28 8.1 - 10.3 1905 351 .. 351 33 1 34 9.7 - 7.3 1906 437 2 439 30 2 32 7.3 - 8.6 1907 480 1 481 41 1 42 8.7 - 5.2 1908 522 8 530 59 1 60 11.3 - 1.6 1899-08 5,674 56 5,730 676 35 711 12.4 — 1909 425 5 430 30 1 31 7.2 - 5.2 * The last column shows the departure from the average fatality of the ten years preceding the year indicated. Table LXXXVI. 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 II 3 27.3 127 9 7.1 2nd II 3 27.3 79 3 3.8 3rd 13 1 8.0 88 3 3.4 4th 7 0 — 94 9 9.6 Year 42 7 16.6 388 24 6.1 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. K 2 132 1909J Table LXXXVII. 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 Casts. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Case?. 0—2 7 1 14 3 ... ... 1 ... ... 2 ... ... 13 1 8 1— 2 11 3 27 6 3 50 2 ... ... 8 1 12 27 7 26 2— 3 17 3 18 13 2 15 5 1 20 5 1 20 40 7 17 3— 4 16 2 12 13 ... 12 .. ... 8 3 37 49 5 10 4— 5 16 1 6 9 ... ... l6 ... ... 10 3 30 51 4 8 5—6 15 ... ... 8 ... ... 8 1 12 16 ... ... 47 1 2 6— 7 8 ... ... 5 ... ... 8 ... ... 6 1 16 27 1 4 7— 8 8 1 12 2 ... 10 1 10 6 ... ... 26 2 8 8— 9 7 1 4 5 ... ... 10 ... ... 6 ... ... 28 1 3 9—10 1 ... ... 2 ... ... 4 ... ... 8 ... ... 15 ... ... 10—11 3 ... ... 4 ... ... 4 1 25 3 ... ... 14 1 7 11 —12 1 ... ... 4 ... ... 1 ... ... 2 ... 8 ... ... 12—13 1 ... ... 1 ... ... 4 ... ... 4 ... ... 10 ... ... 13—14 1 ... ... 3 ... ... 1 ... ... 4 ... ... 9 ... ... 14—13 5 ... ... ... ... ... 1 ... ... 2 ... ... 8 ... ... 15—25 15 ... ... 6 ... ... 6 ... ... 8 ... ... 35 ... ... 25—35 2 ... ... 4 ... ... 5 ... ... 1 ... ... 12 ... ... 35—45 3 ... ... 2 1 50 2 ... ... 1 ... ... 8 1 12 45—55 1 ... .. ... ... ... 1 ... ... 1 ... ... 3 ... ... 55—65 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 65 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 138 12 9 90 6 7 IOI 4 4 IOI 9 9 43° 31 7 * Inclusive of Membranous Croup. Showing the rise and fall of ENTERIC FEVER for each week in 1909, and the averages for the corresponding weeks in the Ten years 1899-1908. RED LINES Weekly Notifications. GREEN LINES = Ten years' average. 133 [1909 Enteric Fever.—To Enteric Fever were ascribed 95 cases, or exactly 50 per cent. less than the corrected average of the preceding 10 years. This is an extraordinary decrease. An examination of the returns, however, shows that there has been a steady fall in the numbers since 1899, when 353 were notified. In comparing the returns in quinquennial periods, it is found that in the quinquennium 1891-1895 there were 1,088 cases reported, while in 1890-1900 l,344 were known. During the next quinquennium, 1901-1905, they fell to 894, and duriing the last four years the decline was continued, as in this period 433 cases only were notified. The summer and autumn weather conditions for several years past were as favourable to this disease as they were to diarrhceal diseases, and no doubt account for the considerable falling off that has occurred latterly. The attack rate was 0.27 per 1000 of the population, as against a decennial rate of 0.54. In the County of London it was as low as 0.22, which is considerably below that of 217 provincial towns tabulated in the Registrar General's return, in which it was 0 37. Hospital Isolation.—7'2 out of the 95 notified cases of the disease, or 75.8 per cent., unJerwent treatment in hospital. This is eminently a disease where good nursing tends to recovery, which is shown by the fact that whereas only 9.7 per cent. of the cases died in hospital, 21.7 of those treated at home succumbed. Fatality.—It was found that 12 deaths occurred among the notified cases or 12.6 per cent., as compared with 18.5 per cent. in 1907, 12.7 in 1900, and 17.9 in 1905. Table LXXXVIII. 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 2 1 4 Upper Holloway 7 1 4 1 13 Tollington 1 .. .. 1 2 Lower Holloway 1 2 9 2 14 Highbury 7 4 4 2 17 Barnsbury 12 6 4 1 23 Islington, South East 5 9 5 3 22 The Borough 33 23 28 11 95 134 1909] Table LXXXIX. Showing the Attack-Rates 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 .. 0.11 0.23 0.11 0.11 Upper Holloway 0.75 0.10 0.43 0.11 0.35 Tollington 0.11 .. .. 0.11 0.05 Lower Holloway 0.10 0.19 0.86 0.19 0.33 Highbury 0.41 0.23 0.23 0.12 0.25 Barnsbury 0.89 0.45 0.30 0.07 0.43 Islington, South East 0.26 0.47 0.26 0.16 0.29 The Borough 0.38 0.26 0.32 0.13 0.27 Table XC. Showing the Fatality from Enteric Fever. (Deaths to ico cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter Whole Year Tufnell .. .. .. .. .. Upper Holloway 14.3 .. •• .. 7.7 Tollington .. .. •• •• .. Lower Holloway .. .. 11.1 .. 7.1 Highbury 28.6 25.0 25.0 •• 23.5 Barnsbury 8.3 16.6 •• .. 8.7 Islington, South East 20.0 22.2 20.0 .. 18.2 The Borough 15.1 17.4 10.7 .. 12.6 Showing the rise and fall of ERYSIPELAS for each week in 1909, and the averages for the corresponding weeks in the Ten years 1899-1908. RED LINES = Weekly Notifications. GREEN LINE8 = Ten years' average. 135 [1909 TYPHUS FEVER. One case was notified, but careful examination in hospital proved that the diagnosis was incorrect. Since 1901 only 5 cases have been notified, but the diagnoses of these were not always correct. In the County of London 7 cases altogether were notified. ERYSIPELAS. 221 cases were notified, or 67 less than the corrected average of 288 which obtained from 1899-1908. The return is the smallest known since notification became compulsory. These cases are equal to an attack rate of 0.63 per 1000, as against a mean decennial rate of 0.82 per 1000, and a County of London rate of 0.87 per 1000. Hospital Isolation.—Many of these cases were notified from Public Institutions, and none was removed by the Metropolitan Asylums Board to hospitals. Altogether only 38 cases were known in the hospitals, or 17.2 per cent., as against 183, or 82.8 per cent., treated at home. Fatality.—Only 12 deaths were registered, and they were equal to a fatality of 5-4 per 1000. Table XCI. Showing the Sickness from Erysipelas in the Sub-Districts for each Quarter and for the Year. Sub. Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 1th Quarter. Whole Year. T ufnell 6 2 8 7 2 3 Upper Holloway 5 8 3 6 22 Tollington 7 4 6 6 23 Lower Holloway 5 5 11 5 26 Highbury 11 15 9 11 46 Barnsbury 16 4 11 4 35 Islington, South East 10 8 16 12 46 The Borough 60 46 64 51 221 136 1909J Table XCII. Showing the Attack-Rates of 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 0.68 0.23 0.91 0.79 0.65 Upper Holloway 0.54 0.86 0.32 0.64 0.59 Tollington 0.75 0.43 0.64 0.64 0.62 Lower Holloway 0.48 0.48 1.05 0.48 0.62 Highbury 0.64 0.87 0.52 0.64 0.67 Barnsbury 1.19 0.30 0.82 0.30 0.65 Islington, South East 0.52 0.41 0.83 0.62 0.60 The Borough 0.68 0.52 0.73 0.58 0.63 Table XC11I. Showing the Fatality from Erysipelas. (Deaths to ioo cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. Whole Year. Tufnell .. .. .. .. .. Upper Holloway .. 25.0 33.3 16.6 18.2 Tollington 14.3 25.0 .. .. 8.7 Lower Holloway .. 20.0 .. 20.0 7.7 Highbury .. 6.6 .. .. 2.2 Barnsbury 12 .5 .. .. .. 5.7 Islington, South East .. .. .. 8.3 2.2 The Borough 5.0 10.9 1.5 5.9 5.4 137 [1909 PUERPERAL FEVER. It is pleasing to note that the return (14 cases) was a decrease of 10 on the corrected average of the preceding 10 years, and, indeed, it is the lowest recorded since the notification of Puerperal Fever became compulsory. There is no happier feature of the returns than the decrease from this disease, for it is one which only occurs at a time that should be the very happiest in a household, viz., at the birth of a child. These 10 cases represented an attack rate of 1.71 per 1000 of the births registered in the borough during the year. Fatality.—It is a notable fact that of the 4 cases that were treated in hospital, 4 died, or 100 per cent., while of those who were treated at home, 3 died, or 30 per cent. The total fatality was 50 per cent. Table XCIV. 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 Tulnell •• 1 1 •• 2 Upper Holloway •• •• •• •• •• Tollington •• 2 1 •• 3 Lower Holloway •• 1 •• 1 2 Highbury 2 •• 1 •• 3 Barnsbury 1 •• •• •• 1 Islington, South East 2 •• •• 1 3 The Borough 5 4 3 2 14 138 1909] Table XCV. Showing the Attack-Rates of Puerperal Fever per i,oco registered Births in the Sub-Districts for each Quarter and Jor the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell •• 5.13 5.18 •• 2.64 Upper Holloway •• •• •• •• •• Tollington •• 12.12 5.35 •• 4.25 Lower Holloway •• 4.17 •• 3.72 1.84 Highbury 5.75 •• 3.31 •• 2.31 Barnsbury 2.34 •• •• •• 0.67 Islington, South East 4.25 •• •• 2.18 1.61 The Borough 2.28 1.97 1.51 1.00 1.71 Table XCVI. Showing the Fatality from Puerperal Fever. Deaths to ioo cases of Sickness. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. 100.0 •• .. 50.0 Upper Holloway •• •• •• •• •• Tollington •• 50.0 •• •• 33.3 Lower Holloway •• •• •• •• •• Highbury 100.0 •• •• •• 66.6 Barnsbury 100.0 •• •• •• 100.0 Islington, South East 100.0 •• •• •• 66.6 The Borough 100.0 50.0 •• •• 50.0 139 [1909 CONTINUED FEVER. No case was notified. As a general rule it is notified as Enteric Fever. Formerly, when there was a doubtful case, medical men notified it as Continued Fever, but now bacteriological examinations and blood tests enable them to arrive at a more correct diagnosis. Table XCVII. Showing; the number of Cases of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1899-1908 and in 1909. Diseases. YEARS. Corrected average number of cases. — Increase or Decrease. 1893. 1900. 1901 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1899 1908. 1909 Small Pox 3 2 50 276 9 17 3+ 1 ... ... 37 3 —34 Scarlet Fever 1494 1074 1286 1372 865 1146 1198 1386 1216 1409 1283 1285 +2 Diphtheria 688 624 902 871 452 347 351 437 480 552 584 425 — Membranous Croup 17 9 9 7 3 ... ... 2 1 8 6 5 — 1 Enteric Fever 353 259 281 257 130 126 100 149 92 97 190 95 —95 Typhus Fever ... 1 2 ... ... 1 ... 1 ... ... 1 1 ... Erysipelas 350 285 285 357 227 280 252 274 252 235 288 221 —67 Puerperal Fever 33 16 34 19 19 24 24 24 21 17 24 14 —10 Continued Fever 2 6 3 5 2 ... ... 1 1 1 2 ... —2 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera 3* ... ... ... ... ... ... ... ... ... ... ... ... Totals 2943 2276 2852 3164 1707 1941 1928 2275 2063 2289 2415 2049 —366 *English Cholera. † Case returned after a few days not Small Pox. 140 1909 Table XCVIII. Showing the Attack-Rat as of the several Notifiable Infectious Diseases during the Ten Years 1899-1908 and in 1909. DISEASES. years. Mean Attack Hates. Attack Rate. Increase or Decrease 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1908. 1899-1908. 1909. Small Pox 0.00 0.00 0.15 0.80 0.03 0.05 0.01 0.00 0.00 0.00 0.11 0.04 —0.10 Scarlet Fever 4.44 3.20 3.84 3.99 2.55 3.36 3.49 4.02 3.50 3.96 3.65 3.66 +0.01 Diphtheria 2.05 1.86 2.69 2.53 1.33 1.02 1.02 1.27 1.39 1.47 1.66 1.21 —0.45 Membranous Croup 0.05 0.03 0.03 0.02 0.01 ... ... 0.00 0.00 0.02 0.02 001 —0.01 Enteric Fever 1.05 0.77 0.84 0.75 0.38 0.37 0.29 0.43 0.26 0. 27 0.5 0.27 —0.27 Typhus Fever ... 0.00 0.00 0.00 0.00 0.00 ... 0.00 ... ... ... 0.00 ... Erysipelas 1.04 0.85 0.85 1.04 0.67 0.82 0.74 0.80 0.73 0.66 0.82 0.63 —0.19 *Puerperal Fever 3.42 1.73 3.67 2.06 2.11 2.70 2.74 2.79 2.46 1.96 2.59 1.71 —0.88 Continued Fever 0.00 0.02 0 00 0.01 0.00 ... ... 0.00 ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera o oo ... ... ... ... ... ... ... ... ... ... ... ... Totals 8.75 6.78 8.50 9.20 5.03 5.69 5.62 6.59 5.94 6.43 6.87 5.83 —1.04 * These figures are calculated as per 1,000 Registered Births. 141 [1909 TABLE XCIX. Showing the number of Cases of Infectious Diseases notified in the Sub-Registration Districts during 1909. 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 ... 155 52 1 4 ... 23 2 ... ... ... 237 6.71 Upper Holloway ... 149 63 2 13 ... 22 ... ... ... 249 6.68 Tollington 3 126 28 1 2 ... 23 3 ... ... ... 186 5.00 Lower Holloway ... 206 49 ... 14 ... 26 2 ... ... ... 297 7.09 Highbury ... 259 61 ... 17 ... 46 3 ... ... 386 5.60 Barnsbury ... 191 80 I 23 ... 35 1 ... ... ... 331 6.17 Islington South East ... 199 92 ... 22 1 ... 3 ... ... ... 363 4.72 The Borough 3 1285 425 5 95 1 221 14 ... ... ... 2049 5.83 (All Duplicates have been deducted). 142 [1909 TABLE C. Showing the Attack-rates of Infectious Diseases notified in the Sub-Registration Districts during 1909. 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 ... 4.39 1.47 0.03 0.11 ... 0.65 2.64 ... ... ... 6.71 Upper Holloway ... 4.00 1.69 0.05 0.35 ... 0.59 ... ... ... ... 6.68 Tollington 0.08 3.39 0.75 0.03 0.05 ... 0.62 4.25 ... ... ... 5.00 Lower Holloway ... 4.92 1.17 ... 0.33 ... 0.62 1.84 ... ... ... 7.09 Highbury ... 3.76 0.88 ... 0.25 ... 0.67 2.31 ... ... ... 5.60 Barnsbury ... 3.56 1.49 0.02 0.43 0.01 0.65 0.67 ... ... ... 6.17 Islington, South East ... 2.59 1.20 ... 0.29 ... 0.60 1.61 ... ... ... 4.72 The Borough 0.01 3.66 1.21 0.01 0.27 0.00 0.63 1.71 ... ... ... 5.83 * Per 1,000 Registered Bir ths. 143 [1909 TABLE CI. Showing the number of Cases of Infectious Disease notified in the Wards during the year 1909. (N.B.—Duplicate notifications have been deducted). WARDS. Estimated Population. 1909. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (T yphoid) 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 n 12 13 14 15 Tufnell 35,292 ... 155 52 1 4 ... 23 2 ... ... ... 237 6.71 Upper Holloway 37,276 ... 149 63 2 13 ... 22 ... ... ... ... 249 6.68 Tollington 37,217 3 126 28 1 2 ... 23 3 ... ... ... 186 5.00 Lower Holloway 41,865 ... 206 49 ... 14 ... 26 2 ... ... ... 297 7.09 Hiehbury 35,294 ... 149 34 ... 10 ... 22 2 ... ... ... 217 6.15 Mildmay 25,303 ... 94 24 ... 7 ... 19 1 ... ... ... 145 5.73 Thornhill 33,533 ... 81 46 ... 16 ... 17 1 ... ... ... 161 4.80 Barnsbury 20,162 ... 110 34 1 7 ... 18 ... ... ... ... 170 8.43 St. Mary's 17,582 ... 51 18 ... 6 1 14 1 ... ... ... 91 5.18 Canonbury 34,535 ... 84 27 ... 14 ... 14 1 ... ... ... 140 4.05 St. Peter's 33,143 ... 80 50 ... 2 ... 23 1 ... ... ... 156 4.71 Totals 351,202 3 1285 425 5 95 1 221 14 ... ... ... 2049 5.83 1907 ... 1216 480 1 92 ... 252 ... ... ... ... 2063 5.94 1908 ... 1409 522 8 97 ... 235 17 1 ... ... 2289 6.43 144 1909] Table CII. Showing the Attack-Rates of the Notifiable Infectious Diseases notified in the Wards during the Year 1909. 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 ... 4.39 1.47 0.03 0.11 ... 0.65 0.06 .. ... ... 6.71 Upper Holloway ... 4.00 1.69 0.05 0.35 ... 0.59 ... ... ... ... 6.68 Tollington 0.08 3.39 0.75 0.03 0.05 ... 0.62 0.08 ... ... ... 5.00 Lower Holloway ... 4.92 1.17 ... 0.33 ... 0.62 0.05 ... ... ... 7.09 Highbury ... 4.22 1.96 ... 0.28 ... 0.62 0.06 ... ... ... 6.15 Mildmay ... 3.72 0.95 ... 0.28 ... 0.75 0.03 ... ... ... 5.73 Thornhill ... 2.42 1.37 ... 0.48 ... 0.51 0.02 ... ... ... 4.80 Barnsbury ... 5.45 1.69 0.05 0.35 ... 0.89 ... ... ... ... 8.43 St. Mary.s ... 2.90 1.02 ... 0.34 0.06 0.80 0.06 ... ... ... 5.I8 Canonbury ... 2.43 0.78 ... 0.41 ... 0.41 0.03 ... ... ... 4.05 St. Peter.s ... 2.42 1.51 ... 0.06 ... 0.69 0.03 ... ... ... 4.71 Totals 0.01 3.66 1.21 0.01 0.27 0.00 0.63 0.04 ... ... ... 5.83 *Per 1,000 of the Population. 145 Table CIII. Showing the Number of Cases of Infectious Diseases which were investigated by the District Sanitary Inspectors during the Year 1909. 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. Cerebro Spinal Fever. Total. Mr. Cook 1 ... 137 37 1 3 ... 19 2 ... ... 2 201 „ Bicknell 2 ... 154 63 2 14 ... 25 ... ... ... ... 258 „ Bagshaw 3 ... 54 19 ... 2 ... 6 1 ... ... 1 83 ,, Bacon 4 ... 104 14 1 4 ... 21 3 ... ... ... 150 „ Flood 5 ... 80 27 ... 6 ... 11 ... ... ... ... 124 „ Horsman 6 ... "5 30 ... 7 ... 10 ... ... ... 1 163 „ Fortune 7 ... 103 23 ... 3 ... l6 1 ... ... ... 146 „ Metcalf 8 ... 74 18 ... 5 ... 14 1 ... ... ... 112 „ Irving 9 ... 94 38 ... 10 ... 15 2 ... ... ... 159 „ Watson 10 ... 88 27 ... 11 ... 13 1 ... ... 1 141 „ Bridel 11 ... 54 38 ... 4 ... l6 ... ... ... 1 113 ,, Agar 12 ... 99 41 ... 15 ... 25 ... ... ... 3 184 „ Jordan 13 ... 65 20 ... 5 1 17 1 ... ... 2 111 „ Callow 14 ... 64 30 ... 6 ... 13 2 ... ... ... 115 Totals 3 1,285 425 5 95 1 221 14 ... ... 11 2,060 1909 146 1909 Table CIV. Showing the Cases of Infectious Disease which were notified in the several Months during the Year 1909. 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 ... 111 51 ... 11 ... 23 1 ... ... ... 197 February ... 108 33 1 7 ... 12 1 ... ... ... 162 March 93 52 1 15 ... 25 3 ... ... ... 189 April 86 24 ... 9 ... 18 1 ... ... ... 138 May 105 33 1 8 ... 13 2 ... ... ... 162 June 128 32 ... 6 ... 15 1 ... ... ... 182 July 96 32 ... 8 ... 10 1 ... ... ... 147 August 97 21 ... 8 ... 15 1 ... ... ... 142 September 173 47 1 12 ... 39 1 ... ... ... 273 October 107 29 ... 2 1 20 ... ... ... 159 November 94 33 1 4 ... 13 ... ... ... ... 147 December 3 87 38 ... 5 ... 16 2 ... ... ... 151 Total 3 1,285 425 5 95 1 221 14 ... ... ... 2,049 147 1909 Table CV Showing the Cases of Infectious Disease notified during the Year 1909 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1909. 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 237,422 I 771 320 50 ... 155 15 ... ... ... 1,312 Stoke Newington 54,423 ... 110 28 11 ... 27 4 ... ... ... 180 Hackney 237,601 I 784 264 59 ... 271 15 1 ... 1,395 Hornsey 95,628 ... 223 149 4 ... 36 1 ... ... ... 413 Finsbury 95,289 ... 240 167 13 I 132 5 ... ... ... 558 Shoreditch 114,802 ... 340 186 51 ... 144 14 ... ... ... 735 The Encircling Boroughs 835,165 2 2,468 1,114 188 1 765 54 1 ... ... 4,593 Islington 351,202 3 1,283 430 95 1 221 14 ... ... ... 2,049 L 2 148 1909 Table CVI. Showing the Attack-Rates per 1,000 inhabitants of the Infectious Diseases notified during the Year 1909 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1909. Small Pox. Scarlet Fever or Scarlatina. Diptheria (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 237,422 0.00 3.26 1.35 0.21 ... 0.65 0.06 ... ... ... 5.53 Stoke Newington 54.423 ... 2.03 0.52 0.20 ... 0.50 0.07 ... ... ... 3.32 Hackney 237,601 0.00 3.31 1.11 0.25 ... 1.14 0.06 0.00 ... ... 5.87 Hornsey 95.628 ... 2.34 1.56 0.04 ... 0.38 0.01 ... ... ... 4.33 Finsbury 95,289 ... 2.53 1.76 0.14 0.01 1.39 0.05 ... ... ... 5.88 Shoreditch 114,802 ... 2.97 1.62 0.45 ... 1.26 0.12 ... ... 6.42 The Encircling) Borough 835,165 0.00 2.96 1.33 0.23 0.00 0.92 0.06 0.00 ... ... 5.50 Islington 351,202 0 01 366 1.22 0.27 0.00 0.63 0.04 ... ... ... 5.83 Increase or Decrease ... +0.01 +070 -0.11 +0.04 ... -0.29 -0.02 ... ... ... 0.33 * Per 1,000 of the population. 149 1909 Table CVII. Showing the Cases of Infectious Disease notified in the several Metropolitan Cities and Boroughs during the year 1909. Cities and Boroughs. Estimated population in the middle of 1909. Notified Casks of Infectious Disease. Small Pox. Scarlet Fever. Diphtheria.* Typhus Fever. Enteric Fever. Other continued Fevers. Puerperal Fever. Erysipelas. Cerebro-spinal meningitis. Total. LONDON 4,833,938 21 17,254 6,679 7 1,043 20 287 4,192 111 29,614 West Districts. Paddington 151,955 . . 630 184 . . 29 . . 3 106 4 956 Kensington 183,683 . . 420 177 . . 48 . . 7 135 4 791 Hammersmith 125,704 . . 389 192 . . 16 . . 14 76 1 688 Fulham 176,406 . . 511 322 . . 41 1 34 115 3 1,027 Chelsea 75,249 . . 307 98 . . 12 2 1 40 . . 460 City of Westminster 168,883 1 590 225 . . 25 . . 5 102 3 951 North Districts. St. Marylebone 126,027 . . 458 113 . . 21 . . 3 134 6 735 Hampstead 94,186 . . 259 47 . . 16 . . 5 30 4 361 St. Pancras 237,422 l 771 320 . . 50 . . 15 155 6 1,318 Islington 351,202 3 1,285 430 1 95 . . 14 221 11 2,060 Stoke Newington 54,423 . . 110 28 . . 11 . . 4 27 . . 180 Hackney 237,601 1 784 264 . . 59 1 15 271 6 1,401 Central Districts. Holborn 53,802 1 97 47 . . 16 1 3 41 . . 206 Finsbury 95,289 . . 240 167 1 13 . . 5 132 3 561 City of London 18,193 1 38 19 . . 4 . . 1 10 . . 73 East Districts. Shoreditch 114,802 . . 340 186 . . 51 . . 14 144 2 737 Bethnal Green 131,316 l 566 184 . . 33 l 7 164 5 961 Stepney 312,525 8 1,038 583 2 71 l 13 487 4 2,207 Poplar 171,965 . . 731 213 . . 54 . . 13 177 8 1,196 South Districts. Southwark 211,125 2 590 256 . . 35 l 6 224 5 1,119 Bermondsey 127,569 . . 459 197 3 30 . . 7 142 4 842 Lambeth 324,188 . . 1,171 378 . . 50 l 16 191 14 1,821 Battersea 186,036 . . 733 288 . . 54 . . 14 156 4 1,249 Wandsworth 297,640 . . 997 371 . . 66 . . 26 193 4 1,659 Camberwell 283,022 1 1,022 374 . . 47 . . 14 234 4 1,696 Deptford 118,583 . . 374 195 . . 33 5 7 181 2 797 Greenwich 111,014 . . 390 163 . . 30 2 8 95 4 692 Lewisham 160,749 1 927 388 . . 18 1 4 105 . . 1 444 Woolwich 133,374 . . 1,027 267 . . 12 . . 9 101 . . 1,416 Port of London . . . . . . 1 . . 4 1 . . 4 . . 10 *Including Membranous Croup. 1909 150 Table CVIII. Showing the Attack-Rates of the Infectious Diseases notified, in the several Metropolitan Cities and Boroughs during the year 1909. Cities and Boroughs. Small Pox. Scarlet Fever. Diphtheria. * Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cerebro-Spinal Meningitis. Total Attack-Rate. London 0.00 3.58 1.39 0.00 0.22 0.00 0.06 0.87 . . 6.12 West Districts. Paddington . . 4.16 1.21 . . 0.19 . . 0.02 0.70 . . 6.28 Kensington . . 2.29 0.97 . . 0.26 . . 0.04 0.74 . . 4.30 Hammersmith . . 3.10 1.53 . . 0.13 . . 0.11 0.61 . . 5.48 Fulham . . 2.91 1.83 . . 0.23 0.01 0.19 0.65 . . 5.82 Chelsea . . 4.09 1.31 . . 0.16 0.03 0.01 0.53 . . 6.13 City of Westminster 0.01 3.50 1.34 . . 0.15 . . 0.03 0.61 . . 5.64 North Districts. St. Marylebone . . 3.64 0.90 . . 0.17 . . 0.02 1.07 . . 5.80 Hampstead . . 2.76 0.50 . . 0.17 . . 0.05 0.32 . . 3.80 St. Pancras 0.00 3.26 1.35 . . 0.21 . . 0.06 0.65 . . 5.53 Islington 0.01 3.66 1.22 0.00 0.27 . . 0.04 0.63 . . 5.83 Stoke Newington . . 2.03 0.52 . . 0.20 . . 0.07 0.50 . . 3.32 Hackney 0.00 3.31 1.11 . . 0.25 0.00 0.06 1.14 . . 5.87 Central District, Holborn 0.02 1.81 0.88 . . 0.30 0.02 0.06 0.76 . . 3.85 Finsbury . . 2.53 1.76 0.01 0.14 . . 0.05 1.39 . . 5.88 City of London 0.06 2.09 1.05 . . 0.22 . . 0.06 0.55 . . 4.03 East Districts Shoreditch . . 2.97 1.62 . . 0.45 . . 0.12 1.26 . . 6.42 Bethnal Green 0.01 4.32 1.40 . . 0.25 0.01 0.05 1.25 . . 7.29 Stepney 0.03 3.33 1.87 0.01 0.23 0.00 0.04 1.56 . . 7.07 Poplar . . 4.26 1.24 . . 0.31 . . 0.08 1.03 . . 6.92 South Districts. Southwark 0 01 2.80 1.22 . . 0.17 0.00 0.03 1.06 . . 5.29 Bermondsey 3.61 1.55 0.02 0.24 . . 0.06 1.12 . . 6.60 Lambeth 3.62 1.17 . . 0.15 0.00 0.05 0.59 . . 5.58 Battersea 3.95 1.55 . . 0.29 . . 0.08 0.84 . . 6.71 Wandsworth 3.36 1.25 . . 0.22 0.01 0.09 0.65 . . 5.58 Cambtrwell 0 00 3.62 1.33 . . 0.17 . . 0.05 0.83 . . 6.00 Deptford .. 3.16 1.65 . . 0.28 0.04 0.06 1.53 . . 6.72 Greenwich 3.52 1.47 . . 0.27 0.02 0.07 0.86 . . 6.21 Lewisham 0 01 5.87 2.42 . . 0.11 0.01 0.02 0.66 . . 9.01 Woolwich . . 7.72 2.01 . . 0.09 . . 0.07 0.76 . . 1065 Port of London . . . . ? . . ? ? . . ? . . ? * Including Membranous Croup. 151 1909 EPIDEMIC CEREBRO SPINAL MENINGITIS. In March, 1907, this disease was, under an Order of the London County Council, made notifiable in London, because just prior to that time considerable epidemics had occurred in Ireland and Scotland, while cases had also cropped up throughout England and in London itself. During last year 10 cases were notified, of which 2 occurred in the first quarter, 3 in the second, 2 in the third, and 3 in the fourth. These figures do not differ very much from those of the preceding years, for in 1907 11 cases were notified, and in 1908 7 cases were known. The particulars are seen in the following statement:— 1907. 1908. 1909. Total Cases. Total Deaths 1907-09. 1st quarter — 2 2 4 2 2nd 3 2 3 8 1 3rd 5 — 2 7 1 4th 3 3 3 9 8 11 7 10 28 12 Fatality.—During the year two deaths were registered, and the fatality was therefore 20 per cent. of the cases. Since the disease became notifiable, 12 deaths have been registered among 28 cases, and, therefore, the fatality in Islington has so far been 42.8 per cent., which shows what a serious ailment this is. NOTIFICATION OF PHTHISIS. On December 18th, 1908, a very important Order was issued by the Local Government Board, making it compulsory on certain Poor Law servants to notify the cases of pulmonary phthisis which came under their observation. This Order was made in pursuance of Section 130 of the Public Health Act 1875, as amended and extended by the Public Health (London) Act 1891 and the Public Health Act 1896, to provide for the notification of cases of pulmonary phthisis occurring among the inmates of Poor Law Institutions, or among persons under the care of Poor Law District Medical Officers. It directs that— (a) The Medical Officer of a Poor Law Institution shall, after recognition of the symptoms of pulmonary tuberculosis notify the case to the Medical Officer of Health of the district in which the person resided immediately before he became an inmate. 1909 152 (b) The District Medical Officer shall make a similar notification to the Medical Officer of Health in the case of any poor person who is suffering from pulmonary tuberculosis. (c) The Superintendent Officer of Poor Law Institutions shall post to the Medical Officer of Health a notification of the actual or intended destination and address of any person leaving the institution, who has previously been notified as suffering from pulmonary phthisis. (d) The Relieving Officers shall notify any change of address (other than bv admission to a Poor Law Institution) of a poor person who has been previously notified to the Medical Officer of Health by a District Officer. These several notifications must be made to the Medical Officer of Health within 48 hours, and on printed forms as set out in the Schedule of the Order, and they are to be paid for by the Local Authority as follows:— (a) To the Medical Officer of a Poor Law Institution and to the Medical Officer of a district, Is. for every notification, but, if two or more notifications with respect to the same case are made to the same Medical Officer of Health, the remuneration will be at the rate of Gd. for each notification after the first. (b) To the Superintending Officer of a Poor Law Institution, 3d. for every notification. The notification forms are supplied by the Poor Law Authority. The Order gives power to take such measures as are authorised in the case of an infectious disease, namely the destruction and disinfection of infected articles, such as the cleansing of the rooms or premises, but the Medical Officer of Health or his Council are not authorised to enforce directly or indirectly any enactment which renders the poor person or a person in charge of the poor person liable to a penalty or to any restriction, prohibition, or disability affecting himself or his employment, occupation, means of livelihood or residence on the ground of his suffering from pulmonary phthisis. The Order makes it legal for the Council to provide, publish, and distribute placards, handbills, leaflets, and information and instructions respecting the disease, and the precautions to be taken against the spread of infection from it. In compliance with this Order, the following notifications were received during the year:— 153 1909 Form A. (From Medical Officers of Poor law Institutions) 659 Form B. (From the Medical Officer of a District) 221 Form C. (From the Superintending Officer of an Institution) 699 Form D. (From the Relieving Officer of a District) 3 Total 1,582 The fees in respect to the above certificates amounted to £49 16s. The certificates as they were received were entered in a book specially ruled and indexed, and each Medical Officer of an Institution, District Medical Officer and Superintending Officer was duly credited in it with the amount due for each certificate, and at the end of each quarter the accounts forwarded by the several notifying officers were checked by it. The several Poor Law Officers notifying these cases are obliged by the Order to forward the counterfoils of their certificates, so that there is a complete check on their accounts. The great object of the notification of these cases of tuberculosis is, of course, to prevent the spread of the disease by enabling the Sanitary Authority to give advice to the patients on the subject, to provide them with the necessary means and instructions towards that end, and also to disinfect houses, rooms and clothing that have become infected. In a report on the Voluntary Notification of Phthisis presented to the Council in 1904, the Medical Officer of Health pointed out that following results will be obtained by notification:— (1) That it will afford an opportunity of instructing the patients and the householders, especially those living in tenement dwelling 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) That 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) That it will afford an opportunity of inspecting the infected house and of discovering whether the rooms are overcrowded or dirty or insufficiently ventilated. 1909 154 (4) That it will afford an opportunity of maintaining some observation over consumptive patients, so as to ensure that they continue to take precautionary measures. (5) That it will afford an opportunity of inquiring into the possible source of the infection. (6) That 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) That it will afford an opportunity of obtaining information as to the part different occupations or trades play in the distributoin of the disease. In reporting on this compulsory notification to the Public Health Committee on January 25th, 1909, the Medical Officer of Health said:— "Naturally, the very first requirement by the Sanitary Authority would be the employment of a trained official, or a Health Visitor, whose duty it would be to point out to these poor people the danger they may be to their families and the public if they do not adopt preventive methods, and to instruct them as to the best methods to be adopted, and then to visit them periodically to see that these instructions have been carried out. The good tidings will also be borne to these afflicted people that the disease is not necessarily a fatal one, but that by the adoption of a proper mode of living, cleanliness, and the proper means for ventilating their rooms, they may prolong their lives, if indeed, they do not save them. "Secondly, the Sanitary Authority will be enabled to place in the hands of these poor people printed instructions as to what they are to do, or if they should be children, then into the hands of their parents and guardians. But I must confess that I do not anticipate much good to accrue by these methods unless they are followed up by visits from a qualified person to explain them and to see that they are carried out. "My views on this matter, which are those of every Medical Officer of Health, are, I think, already understood by this Committee, so that I do not 155 1909 propose to press them further than I have done already, beyond saying that the necessity of trained Health Visitors in this Borough is greatly accentuated by the Order of the Local Government Board with respect to pulmonary tuberculosis. It is not generally appreciated I am afraid that the deaths from phthisis, a preventable disease, form more than one-tenth of the total mortality in Islington. Thus from 1892 1907 inclusive, the number of deaths was 88,642 from all causes, and from phthisis 8,303, which represent 161 deaths in every 1,000 of the population. This mortality is indeed very great, but its saddest feature is that the greater part of it (about five-sixths) occurs during the principal working period of life, namely, from 15 to 55 years of age. Therefore, the importance of the work that may be done cannot be easily exaggerated, for it is, indeed, one of the greatest on which a sanitary authority can be engaged — the prevention of disease and death among the workers of the realm. "It is now seventeen years since I pleaded in public at Portsmouth on their behalf for the notification of phthisis at a meeting of Medical Officers of Health, at which I am glad to recollect your Chairman (Councillor Cowling), was present, and I, therefore, rejoice to think that at length, after the lapse of so much time, something is about to be done throughout the Kingdom. That good will follow the issue of this Order I have no doubt, if the sanitary authorities will do their duty, as for the most part I think I am right in anticipating, they will; but if they do nothing beyond issuing instructions without following them by visits and enquiries, then the Order will, I fear, be barren of good results." The Medical Officer of Health has seen no reason since that report was written to alter his views on this subject. On the contrary, the additional experience has strongly confirmed them. Of the total number of notifications received (1,582) during the year under the Order, 540, or 34.1 per cent, were merely notices of transfer of patients from one institution to another. Thus from Holborn Workhouse, Shepherdess Walk, which is situated outside the borough, 371 cases were transferred to Hclborn Infirmary, situated within this borough, and 169 cases were transferred from the Islington Workhouse to the Islington Infirmary, both within this borough. It will thus be seen that a large percentage of the notifications was of very little utility from a public health point of view. 1909 156 The following are the particulars as to the persons from whom the certificates were received:— Islington Infirmary Medical Officer 324 Islington Workhouse Medical Officer 216 District Medical Officers 284 Islington Relieving Officers 10 Holborn Infirmary Medical Officer 14 Superintending Officer of Institutions (within the borough) 287 Do. do. (without the borough) 382 Holborn Union Workhouse Medical Officer 33 Islington Workhouse Schools 1 St. Pancras Infirmary Medical Officer 5 Other sources. Principally outside institutions 26 1,582 The remarkable fact about these certificates is that many of them relate to the same individual, thus 1 individual was notified 17 times. 1 „ „ 15 ,, 1 „ „ 12 ,, 1 „ „ 11 „ 2 individuals „ 10 „ 2 „ „ 9 „ 2 „ „ 8 ,, 6 „ „ 7 „ 7 „ „ 6 ,, 20 „ „ 5 „ 45 „ „ 4 „ 72 „ „ 3 „ 202 „ „ twice, and 489 „ „ once. Islington cases 574 Total certificates received 1582 Total cases 808 The circumstances under which T M was notified to the Medical Officer of Health are interesting and are therefore given. They afford a good illustration of how these tuberculous people move about from place to place, from 157 1909 the Workhouse to the Infirmary and from the Infirmary to a common lodging house, only in a few weeks to again return to the Workhouse or Infirmary. Date of Notification. By whom Notified. Circumstances of Notification. Notification Fees Incurred. 1909. January 22 Workhouse Master Transfer from City Road Workhouse to Holborn Infirmary 3d. February 25 Medical Officer of Workhouse Entered Islington Workhouse from 8, Flowers Mews (common lodging-house) 1s. Ditto Workhouse Master Transfer from Islington Workhouse to Islington Infirmary 3d. April 13 Medical Officer of Workhouse Entered Islington Workhouse from 8, Flowers Mews (common lodging-house) 6d. Ditto Workhouse Master Transfer from Islington Workhouse to Islington Infirmary 3d. May 7 Medical Officer of Workhouse Entered Islington Workhouse from 8, Flowe's Mews (common lodging-house) 6d. June 8 Workhouse Master Transfer from City Road Workhouse to Holborn Workhouse 3d. June 23 Do. do. Do. do. do. 3d. July 29 Do. do. Transfer from Islington Workhouse to Islington Infirmary 3d. August 6 Medical Officer of Workhouse Entered Islington Workhouse from 8, Flowers Mews (common lodging-house) 6d. August 13 Medical Officer of Infirmary Entered Islington Infirmary from 8. Flowers Mews (common lodging-house) 1s. September 15 Workhouse Master Transfer from City Road Workhouse to Holborn Workhouse 3d. October 7 Do. do. Do. do. do. 3d. November 27 Medical Officer of Workhouse Entered Islington Workhouse from 8, Flowers Mews (common lodging-house) 6d. Noveml er 29 Medical Officer of Infirmary Entered Islington Infirmary from 1, Eden Grove (common lodging-house) 6d. Ditto Workhouse Master Transfer from Islington Workhouœ to Islington Infirmary 3d. December 24 Medical Officer of Infirmary Transfer from Islington Infirmary to 1, Eden Grove (commn) lodging-house) 3d. Voluntary Notification of Phthisis-—In addition to the cases notified under the Order of the Local Government Board, 32 cases arising in the private practice of medical practitioners, and 28 in their practice in 1909 158 section with public institutions, such as the City Road Chest Hospital and Brompton Hospital, were received. In addition, information with respect to 4 cases came from relieving officers, making a total of 64 voluntary notifications. Years. Medical Practitioners Relieving Officers. Totals. Private Practice. Public Practice. 1905 68 13 42 123 1906 30 34 62 126 1907 40 28 69 137 1908 27 32 50 129 1909 32 28 4 64 Five years 197 135 227 559 Disinfection of Premises.—In consequence of the notification order, there was a considerable increase in the number of premises that were disinfected, for whereas in 1908 the number of houses so treated was 201, in 1909 it rose to 514, while the number of rooms increased from 361 to 672. The following are the particulars:— Houses. Rooms. 1st quarter 152 191 2nd „ 120 146 3rd „ 99 124 4th „ 143 211 Total 514 672 These figures contrast with those of the preceding four years, as follows:— Houses. Rooms. 1905 283 380 1906 258 369 1907 296 411 1908 281 361 1009 514 672 159 [1909 Prevention of Phthisis.—A very strong feeling has possessed the public of late years that everything possible should be done to prevent the spread of this disease and to save the lives of those who have been attacked; and consequently public authorities and some private institutions have made considerable, and not unsuccessful, efforts in these directions. But possibly one of the best means hitherto adopted has been the establishment of Tuberculosis Dispensaries, such as were founded in Edinburgh and Paddington, at which persons in the very earliest stages of the disease are encouraged to seek advice, and where they receive instructions of great educational value as to how they should behave in their relationship with the public, with their relatives, and with others living in their own homes. It is believed that the knowledge thus disseminated has proved of great educational value, and that there is a possibility—nay, a probability—that many persons, who would otherwise be removed to sanatoria, are now able to adopt curative measures in their own homes. After all, if the public would oply recollect that fresh air and the open-air life diminish tuberculosis, while dampness and darkness increase it, many people, who now die, would live; and also that caution in intercourse with consumptives should be exercised, although it is doubtful if most people follow this course of action, at all events in England. It has already been noted that there has been a continual decrease in the number of deaths during the last 10 years. It is very difficult to say that this has been due to educational propaganda, but that it is rather to be ascribed to methods of sanitation, e.g., the reduction of overcrowding; increased cleanliness of houses—their better drainage and sewerage, which have led to a dryer subsoil; and the improvement in the general sanitation of the borough. All these have caused a decrease in the death-rate from 1.70 per 1000 in 1893, to 1.21 in 1909, or nearly 30 per cent. There is one point to which allusion should be made, which is that the improved sewage and drainage of the towns throughout England has undoubtedly resulted, as first pointed out by the late Sir George Buchanan, in a diminished death-rate by removing the dampness of the soil, which was due to the pipes acting as vehicles for the carriage of the underground or subsoil water, for in those early days it must be remembered that drains and sewers were not jointed with cement as they are now, and so, the pipes not being tightly jointed, very frequently not jointed at all, allowed an ingress to the sub soil water, and thus the land, under and about the houses, was 1909 160 drained and dried. In recent years it has very frequently happened in houses which have been redrained with pipes whose joints have been made with cement, that although previously perfectly dry, they have exhibited signs of dampness, and indeed, have had water under their floors or in their basements, so that it has become necessary to lay special pipes to drain it away. This is a danger that is now always looked for, so that people may be advised as to the steps they should take to prevent so great an evil. INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. Not the least important work carried out by the Public Health Department is inquiry into the cases of infectious diseases, whether notifiable or not, that occur among the scholars in the public elementary schools. The returns show that 938 scholars were attacked with one or other of the notifiable infectious diseases, and that such attacks were in the proportion of 45.8 per cent. of all the cases notified. In the preceding year 1,058 cases were notified among scholars, in 1907 836, in 1906 998, and in 1905 832, while the average of the last 10 years was 964, which represent 31.1 per cent. of all cases notified in that period. Investigation showed that 737 scholars were attacked with Scarlet Fever, as compared with a decennial average of 652 ; 184 with Diphtheria, as against an average of 253; 16 with Enteric Fever as against an average of 42; and 1 case with other diseases, as against an average of 15. From this statement it is seen that, with the exception of Scarlet Fever, the number of school children attacked from the various diseases was below the decennial average although the percentage proportion to all cases rose from a decennial average of 41.1 per cent. to 45.8. The 737 cases of Scarlet Fever among scholars represented 57.4 per cent. of all cases of Scarlet Fever notified, and the 184 cases of Diphtheria among scholars 42 8 per cent. of all the cases of that disease notified; while the 16 cases of Enteric Fever among school children represented 16.8 per cent. of the known cases of it. The following return has been prepared to show the number of scholars atacked with each disease during the preceding 10 years. 161 1909 Table CIX. Showing the Scholars attacked by the Notifiable Infectious Diseases in the Public Elementary Schools. Year. By Small Pox. By Scarlet Fever. By Diphtheria. By Enteric Fever. By Other Diseases. Total Scholars attacked. Proportion to every 100 cases notified. 1899 . . 725 290 61 11 1087 36.9 1900 1 542 283 67 13 906 39.8 1901 . . 669 438 72 32 1211 42.5 1902 14 664 405 64 34 1181 37.3 1903 . . 507 216 35 16 774 45.3 1904 . . 571 138 28 20 757 39.0 1905 . . 640 138 31 23 832 43.2 1906 . . 785 177 33 3 998 43.9 1907 . . 608 216 11 1 836 40.5 1908 . . 809 230 19 . . 1058 46.2 Ten years Average 2 652 253 42 15 964 41.1 1909 . . 737 184 16 1 938 45.8 162 Table CX. Showing the cases of Notifiable Infectious Diseases occurring in Public Elementary Schools during the Year 1909. NAME OF SCHOOL. Scholars attacked. Scholars excluded from School who lived in houses in which infected children resided. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Fevers. Total. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Fevers. Total. Yerbury Road . . 36 6 . . . . 42 . . 134 43 2 . . 179 St. John's, Holloway Road . . 30 6 . . . . 36 . . 42 9 . . . . 51 St. Joseph's, Highgate Hill . . 1 2 . . . . 3 . . 3 4 . . . . 7 Hargrave Park . . 15 3 . . . . 18 . . 89 11 4 . . 104 Burghley Road . . 14 6 . . . . 20 . . 41 18 3 . . 62 St. Mark's, Grove Road . . 6 6 1 . . 13 . . 26 12 . . . . 38 Cottenham Road . . 18 6 . . . . 24 . . 81 24 . . . . 105 Grafton Road . . 32 4 1 . . 37 . . 75 10 2 . . 87 Duncombe Road . . 24 14 . . . . 38 . . 77 63 . . . . 140 Whittington, Highgate Hill . . 6 1 . . . . 7 . . 23 11 2 . . 36 Montem Street . . 33 12 1 . . 46 . . 72 23 . . . . 95 St. Barnabas, Hornsey Road . . 6 3 1 . . 10 . . 15 4 1 . . 20 Forster, Hornsey Road . . 15 3 . . . . 18 . . 63 14 1 . . 78 Poole's Park . . 7 2 . . . . 9 3 44 5 . . . . 52 Hornsey Road (Upper) . . 30 5 . . . . 35 . . 77 21 7 . . 107 Hungerford Road . . 33 5 2 . . 40 . . 72 37 7 . . 116 Brecknock, York Road . . 7 1 1 . . 9 . . 38 9 11 . . 58 Pakeman Street . . 17 1 . . . . 18 3 44 5 . . . . 52 St. James', George's Road . . 7 2 . . . . 9 . . 36 5 . . . . 41 Catholic School, Eden Grove . . 5 1 . . . . 6 . . 13 3 . . . . 16 Caledonian Road . . 23 7 . . . . 30 . . 87 27 1 . . 115 Westbourne Road . . 18 4 . . . . 22 . . 93 22 2 . . 117 St. Mary Magdalene, Liverpool Road . . 14 . . . . . . 14 . . 32 17 3 . . 52 Blackstock Road . . 8 . . . . . . 8 . . 40 3 . . . . 43 Gillespie Road . . 29 2 . . . . 31 . . 59 3 1 . . 63 Drayton Park (Wesleyan) . . 11 . . . . . . 11 . . 32 . . . . 32 St. John's, Conewood Street . . 17 3 . . . . 20 . . 25 4 . . . . 29 St. lude's, King Henry's Walk . . 12 2 . . . . 14 . . 35 4 1 . . 10 Newington Greea . . 10 1 . . . . 11 . . 29 4 5 . . 38 Ambler Road . . 10 2 . . . . 12 . . 22 14 2 . . 38 York Road . . 13 4 . . . . 17 . . 58 14 1 . . 73 Gifford Street . . 7 1 1 . . 9 . . 25 10 3 . . 38 St. Thomas, Everilda Street . . 3 3 . . . . 6 . . 11 7 . . . . 18 St. Clement's. Cumberland Street . . 9 . . 1 . . 10 . . 24 6 3 . . 33 Blundell Street . . 7 3 3 . . 13 . . 22 24 18 . . 64 St. Paul's, Dorset Street . . 9 2 . . . . 11 . . 30 6 2 . . 38 Ecclesbourne Road . . 23 4 1 . . 28 . . 63 23 5 . . 91 Tottenham Road . . 3 2 . . . . 5 . . 7 9 . . . . 16 Queen's Head Street . . 16 5 . . . . 21 . . 40 13 . . . . 53 Popham Road (Angler's Gardens) . . 9 4 . . . . 13 . . 28 17 . . . . 45 St. Philip's, Arlington Square . . 5 . . . . . . 5 . . 9 2 . . . . 11 Shepperton Road . . 2 4 1 . . 7 . . 9 12 6 . . 27 Rotherfield Street . . 6 3 . . . . 9 . . 29 28 . . . . 57 St. Bartholomew, Shepperton Road . . 2 . . . . . . 2 . . 21 2 . . . . 23 Buckingham Street . . 11 9 . . . . 20 . . 36 21 . . . . 57 Winchester Street . . 1 1 . . . . 2 . . 11 24 3 . . 38 All Saints', Muriel Street . . 3 4 1 . . 8 . . 6 7 1 . . 14 Vittoria Place . . 16 2 . . . . 18 . . 73 20 . . . . 93 Holy Trinity, Cloudesley Street . . 7 1 . . . . 8 . . 22 3 . . . . 25 Richard Street . . 26 2 . . 1 29 . . 76 19 7 . . 102 Station Road . . 14 1 . . . . 15 . . 45 3 . . . . 48 Thornhill Road . . 21 5 . . . . 26 . . 72 24 6 . . 102 Barnsbury Park . . 4 . . . . . . 4 . . 20 4 . . . . 24 St. Matthew's, City Road . . 5 2 . . . . 7 . . 4 7 . . . . 11 St. John's, Duncan Terrace . . 3 4 . . . . 8 . . 23 13 3 . . 39 Hanover Street . . 8 5 . . . . 13 . . 25 27 . . . . 52 CaDonbury Road . . 6 1 . . . . 7 . . 17 9 . . . . 26 St. Mary's, Cross Street . . 4 2 . . . . 6 . . 15 8 3 . . 26 German School, St. Peter Street . . . . . . . . . . . . . . . . . . . . . . . . Total .. . . 737 184 16 1 938 6 2340 793 116 . . 3255 1909 163 1909 NON-NOTIFIABLE INFECTIOUS DISEASES. The number of cases of infectious diseases which are not notifiable under the Public Health (London) Act, 1891, notified by the teachers of the public elementary schools was 4,605, as compared with 4,359 in 1908, 5,829 in 1907, and 829 in 1899, since which year the notifications by teachers have steadily advanced especially since 1905, as shown below:— 1899 829 1904 2,425 1900 3,066 1905 3,397 1901 3.395 1906 4,135 1902 2,307 1907 5,829 1903 2,298 1908 4,359 1909 4,605 The increase in recent years has been due to the more vigorous administration at the Education Department of the London County Council. The principal diseases which the teachers report are Measles, Chicken Pox, and Whooping Cough, although others, such as Mumps, and cases of skin diseases of a contagious character, are also notified, as well as children in a verminous condition. The number of cases of Measles which came under observation was 1,607, as compared with 1,095 in the preceding year and with 2,005 in 1907. The returns show that the greatest number of cases occurred in Duncombe Road Schools, where there were 91 cases, which was followed in turn by Burghley Road Schools (73 cases), Montem Street Schools (67 cases), Blundell Street Schools (61 cases), Hungerford Road Schools (56 cases), and other schools in varying numbers, the least of which was in York Road Schools, whence only 1 case was notified. Only 491 cases of Chicken Pox were notified, as compared with 624 in 1908, and 981 in 1907. M 2 1909 164 The largest number of cases of Chicken Pox occurred at Duncombe Road Schools, 53 cases having been notified, which was followed by Montem Street Schools with 34 cases, Hanover Street Schools with 30 cases, Whittington Schools, with 23 cases, and Upper Hornsey Road Schools with 22 cases. Whooping Cough showed a considerable increase, 708 cases having been notified, as against 385, while the number in 1907 was 831. The largest number of cases notified from any one school was 41 from Ambler Road School, which was followed by 35 from Queen's Head Street, and 32 from Blundell Street. Other diseases, including Mumps, were notified in 1,739 instances, as compared with 2,255 in 1908, and 1,952 in 1907. Special efforts have been made in the case of Measles and Whooping Cough, to prevent the spread of these diseases, and leaflets containing instructions as to the precautions necessary to be taken were left at the houses of the patients. The work of dealing with these diseases, which have such an injurious effect on school attendance, has grown heavier and heavier each year, and takes up an increasingly large proportion of the time of the Inspectorial staff. 165 [1909 Table CXI. Showing the Infectious Diseases notified during the yeav 1909 by the Teachers of Public Elementary Schools under the provisions of Regulation 148, sec. iv., of the London County Council Schools Code. School. Measles. Chicken Pox. Whooping Cough. Other Diseases. Totals. All Saints' .. .. .. .. .. Ambler Road 48 5 41 27 121 Burghley Road 73 8 3 22 106 Blackstock Road 21 6 6 13 46 Barnsbury Park 2 .. .. 2 4 Blundell Street 61 4 32 99 196 Buckingham Street .. 8 15 49 72 Cottenham Road 70 2 13 36 121 Canonbury Road 62 20 17 36 135 Catholic School, Eden Grove 37 .. .. 4 41 Caledonian Road 34 12 10 28 84 Chapel of Ease 28 7 12 33 80 Duncombe Road 93 53 18 97 261 Drayton Park 55 .. 6 15 76 Ecclesbourne Road 47 3 1 41 92 Forster, Hornsey Road 55 2 17 35 109 Grafton Road 46 2 4 48 100 Gillespie Road 92 1 25 76 194 Gifford Street 2 21 7 64 94 Hargrave Park 27 1 39 47 114 Hungerford Road 56 4 35 40 135 Holy Trinity 3 .. 1 3 7 Hanover Street 26 30 22 37 115 Montem Street 67 34 23 76 200 Newington Green Poole's Park 3 1 .. 12 16 37 17 10 54 118 Pakeman Street 25 10 1 25 61 Popham Road .. .. .. .. .. Queen's Head Street 41 38 35 68 182 Risinghill Street .. .. .. .. .. Rotherfield Street 35 21 3 41 100 Richard Street 24 4 6 70 104 Shepperton Road 21 7 12 24 64 Station Road 18 13 11 47 89 St.John's.Holloway Road St. Joseph's 29 .. 1 28 58 15 2 .. .. 17 St. Mark's, Grove Road 16 .. .. 6 22 St. Paul's, Blenheim Road .. .. .. .. .. St. Barnabas 60 2 1 8 71 St. Ann's .. .. .. .. .. St. James St. John's, Conewood 4 20 13 20 57 Street 36 .. 6 13 55 St. Jude's 4 13 .. 21 38 St. Thomas' 14 1 3 19 37 St. Clement's 11 .. 2 5 18 St. Paul's, Dorset Street .. .. .. .. .. St. Bartholomew's .. .. .. .. .. St. Philip's 28 16 29 18 9i St. Matthew's, field Street .. .. .. .. .. St. Matthew's, City Road 4 5 11 37 60 St. John's, Duncan Terrace 22 .. 1 3 26 St. Mary's 12 1 13 14 40 Tottenham Road 19 16 14 12 61 Thornhill Road 5 .. 1 18 24 Upper Hornsey Road 47 22 6 43 118 Vittoria Place 7 5 7 28 47 Whittington 8 23 24 10 65 Westbourne Road 73 9 46 52 180 Winchester Street 8 4 2 14 Yerbury Road 43 1 70 93 207 York Road 1 13 28 20 62 Total 1,667 491 708 1,739 4,605 166 1909] ISOLATION OF INFECTIOUS DISEASES. As many as 1,705 cases out of the 2,049 that were notified under the Public Health (London) Act, 1891, were isolated in hospital, representing 83.2 per cent, of all the notified cases. This percentage is the largest which has been recorded in Islington, as may be judged by the following figures:— 1896 48.4 per cent. 1897 55.7 „ 1898 58.4 „ 1899 6.6 „ 1900 68.2 „ 1901 69.6 „ 1902 71.9 „ 1903 72.6 per cent. 1904 75.5 „ 1905 76.1 „ 1906 77.1 „ 1907 80.0 „ 1908 80.4 „ 1909 83.2 „ The Metropolitan Asylums Board naturally isolated the largest number ol these cases, and out of 1,705 cases removed from their homes, 1,577 were taken to their hospitals. Scarlet Fever.—1,199 cases out of 1,285, or 93.3 per cent., were isolated and treated in hospitals, and of these, 1,099, or 91.6 per cent., were removed to one or other of the Hospitals of the Metropolitan Asylums Board. Diphtheria.—388 cases, or 90.2 per cent, of the 430 cases notified, were isolated in hospital, and of these, 284 were treated in the Metropolitan Asylums Board's Hospitals. Only 42, or 9.8 per cent., remained at home. Enteric Fever.—Of the 95 cases that were notified, 72, or 75.8 per cent, were removed to hospital, while 23, or 24.2 per cent., remained at home. Erysipelas.—221 cases were known, ot which 38, or 17.2 per cent., were treated in hospitals. Nearly all these occurred in the institutions in which they were treated. Puerperal Fever.—4 cases out of 14 that occurred were treated in hospital, or 28.6 per cent., while 10, or 71.4 per cent., were treated at home. 167 [1909 Table CXII. 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 during the year 1909. Notified Cases Treated. Percentages of Notified Cases Treated. Deaths Occurring. Percentages of Deaths Occurring. In Hospital. At Home. Total. In Hospital. At Home. In Hospital. At Home. Total. In Hospital. At Home. Total. Small Pox 3 .. 3 100.0 .. .. .. .. .. .. .. Scarlet Fever 1,119 86 1,285 93.3 6.7 24 1 25 2.0 1.1 1.9 Diphtheria 388 42 430 90.2 9.8 24 7 31 6.2 16.6 7.2 Enteric (Typhoid Fever) 72 23 95 75.8 24.2 7 5 12 9.7 21.7 12.6 Typhus Fever 1 .. 1 100.0 .. .. .. .. .. .. .. Erysipelas 38 183 221 17.2 82.8 6 6 12 15.8 3.3 5.4 Puerperal Fever 4 10 14 28.6 71.4 4 3 7 100.0 30.0 50.0 Continued Fever .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. Total. 1,705 344 2,049 83.2 16.8 65 22 87 38 6.4 4.2 168 1909] Table CXIU. Showing the Gases of Infectious Disease removed to the Metropolitan Asylums Board's Hospitals fur treatment and isolation during 1909. Metropolitan Asylums Board's Hospitals. Small Pox. Scarlet Fever. Diphtheria. Enteiic Fever. Typhus Fever. Other Diseases. Total Admissions. Total Deaths. Eastern .. 46 10 2 .. 12 70 2 North Eastern .. 1,022 186 20 .. 135 1,363 44 North Western .. 29 88 2 .. 20 139 16 Western .. .. .. .. .. .. .. .. South Western .. .. .. .. .. .. .. .. The Grove .. 1 .. .. .. .. .. 1 .. Brook Hospital .. 1 .. .. .. .. 1 .. South Eastern .. .. .. .. .. .. .. .. Convalescent Hospital .. .. .. .. .. .. .. 1 Small Pox 3 .. .. .. .. .. 3 .. Totals 3 1,099 284 24 .. 167 1,577 63 INFECTIOUS DISEASES IN BUSINESS PREMISES. A strict account was kept of the trades and businesses carried on in premises where the notifiable infectious diseases occurred. The result of the inquiries is interesting, as it shows that 136 cases of Scarlet Fever were found on premises where one of the trades or businesses set out in Table CXI V. was carried on, and that no less than 15 of them were known in dressmakers' establishments. In 60 business places cases of Diphtheria occurred, the largest number being in houses where general dealers traded. Only 9 cases of Enteric Fever were known in such places, and 36 cases of Erysipelas. The good that is likely to accrue by the notification of these diseases is well seen in the case of Scarlet Fever or Enteric Fever occurring on premises where clothes are made or food is prepared. It is not too much to say that in Islington many cases of these diseases must have been prevented from time to time by the speedy removal of the patients to hospital. This point has been previously noted by the Medical Officer, who has also frequently pointed out in his preceding annual reports that if notification of the infectious diseases require justification it can be found by their perusal. 1(59 (1909 Table CX1V. List of Trades and Businesses curried on in Houses wherein Infection Diseases have occurred during 1909. trades and businesses. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Artificial Florists ... ... 1 ... ... ... ... ... ... 1 Bakers ... 2 2 ... ... ... ... ... ... 4 Bootmakers ... 3 2 ... ... ... 1 ... ... 6 Boarding House ... 5 ... ... ... ... 1 ... ... 6 Builder ... 1 ... ... ... ... 1 ... ... 5 Beerhouse ... 2 ... ... ... ... ... ... ... 2 Butchers ... 3 ... ... ... ... ... ... ... 3 Bottle Making ... 1 ... ... ... ... ... ... 1 Brushmaking ... 1 ... ... ... ... ... ... ... 1 Builders' Merchants ... ... ... ... ... ... 1 ... ... 1 Common Lodging House ... ... 1 ... 1 ... 2 ... ... 4 Clothiers ... 2 ... ... ... ... ... ... ... 2 Clockmaking ... ... ... ... ... ... 1 ... ... 1 Cornchandlers ... ... 1 ... ... ... ... ... ... 1 Carriers ... ... 1 ... ... ... ... ... ... 1 Coffee House ... 1 ... ... 1 ... ... ... ... 2 Chair Caning ... ... ... ... ... ... 1 ... ... 1 Confectioners ... ... ... ... ... ... 2 ... ... 6 Chemists ... 1 ... ... ... ... ... ... ... 1 Costumiers ... ... ... ... 1 ... ... ... ... 1 Cycle Repairing ... ... ... ... ... ... ... ... ... 3 Cats Meat ... ... ... ... ... ... 2 ... ... 2 Children's Costumiers ... 1 ... ... ... ... ... ... ... 1 Coal Merchants ... ... 1 ... ... ... ... ... ... 1 Dentist ... 1 1 ... ... ... ... ... ... 2 Dairy ... 1 ... ... ... ... ... ... ... 1 Dressmaking ... 15 2 ... ... ... 1 ... ... 18 Dancing ... ... ... ... ... ... 1 ... ... 1 Drapers ... 4 ... ... ... ... 1 ... ... 5 Egg Merchant ... 1 ... ... ... ... ... ... ... 1 Enamelled Iron Shop ... 1 ... ... ... ... ... ... ... 1 Embroidery ... 1 ... ... ... ... ... ... ... 1 Fire Station ... 1 1 ... ... ... ... ... ... 2 Fruiterers ... 2 ... ... ... ... ... ... ... 2 Furriers ... 3 1 ... ... ... ... ... ... 4 Furniture Dealers ... 2 ... ... ... ... 1 ... ... 3 Fishmongers ... 1 1 ... ... ... ... ... ... 2 Fried Fish Shop ... 1 ... ... ... ...1 ... ... ... 2 Fancy Leather Works ... ... ... ... ... ... 1 ... ... 1 Furniture Removers ... ... 1 ... ... ... ... ... ... 1 Funeral Furnishers ... 1 1 ... ... ... ... ... ... 2 General Dealers ... 3 5 ... ... ... 3 ... ... 13 Grocers ... 6 1 ... ... ... 1 ... ... 8 Greengrocers ... 1 1 ... ... ... 1 ... ... 3 Gas Fitters ... 1 ... ... ... ... ... ... ... 1 170 1909] Table CXIV.—continued. trades and businesses. Small Pox. Scarlet Fever or i Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Hatters ... 1 1 ... ... ... ... ... ... 2 Hairdressers ... 5 ... ... ... ... ... ... ... 5 Hosiers ... 3 1 ... ... ... ... ... ... 4 Haberdashers ... ... 2 ... ... ... ... ... ... 2 Laundry ... 5 2 ... ... ... 1 ... ... 8 Laundry Receiving Office ... ... 1 ... ... ... ... ... ... 1 Ladies Underclothing ... 2 1 ... ... ... 1 ... ... 4 Mangling ... 2 ... ... ... ... ... ... ... 2 Milk Shop ... 3 ... ... ... ... ... ... ... 3 Millinery ... 1 1 ... ... ... ... ... ... 2 Marine Store Dealers ... 1 ... ... ... ... ... ... ... 1 Mantle Makers ... 1 2 ... ... ... ... ... ... 3 Net Making ... 1 ... ... ... ... ... ... ... 1 Newsagents ... 2 4 ... 1 ... 1 ... ... 8 Nursing Home ... ... ... ... ... ... 1 ... ... 1 Oil and Color Merchants ... 2 ... ... ... ... 1 ... ... 3 Public House ... 4 ... ... ... ... ... ... ... 6 Provisions ... 1 1 ... ... ... ... ... ... 2 Printers ... ... 1 ... ... ... 2 ... ... 3 Purse Making ... ... 1 ... ... ... ... ... ... 1 Refreshment Rooms ... 2 ... ... ... ... 1 ... ... 3 School ... 1 3 ... ... ... 1 ... ... 6 Stable ... 2 ... ... ... ... ... ... ... 2 SweetstufF Shop ... 4 1 ... ... ... ... ... ... 5 Stewed Eel Shop ... 1 ... ... ... ... ... ... ... 1 Surgery ... 3 2 ... ... ... ... ... ... 5 Scale Makers ... 2 ... ... ... ... ... ... ... 2 Surgical Instrument Makers ... ... ... ... ... ... 1 ... ... 1 Skin Dressing ... ... 1 ... ... ... ... ... ... 1 Stamp Making ... 1 ... ... ... ... ... ... ... 1 Tailor ... 5 ... ... ... ... 3 ... ... 8 Tobacconist ... 2 1 ... ... ... ... ... ... 3 Tie Making ... ... 1 ... ... ... ... ... ... 1 Umbrella Makers ... ... ... ... 1 ... ... ... ... 1 Upholstery ... ... 1 ... ... ... ... ... ... 1 Wardrobe Dealers ... 2 ... ... ... ... ... ... ... 2 Washing ... 2 ... ... ... ... ... ... 2 Wood Chopping ... ... 1 ... ... ... 1 ... ... 2 Whalebone Cutting ... ... 1 ... ... ... ... ... ... 1 Totals ... 136 60 ... 9 ... 36 ... ... 241 OCCUPATIONS OF PATIENTS. The occupations of the different patients attacked by the notifiable diseases was ascertained in every case, and where the disease occurred among people who were engaged on work that might convey the infection, communications were addressed to their employers, so that in many instances it was discontinued. 171 [1909 Table CXV. Showing the Occupations of Patients suffering from the several notifiable Infectious Diseases during the year 1909. Occupations. Small Pox. Scarlet Fever. Diphtheria. Merab. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Cerebro-Spinal Fever. Total. Asphalte Worker ... ... ... ... ... ... 1 ... ... ... 1 Apprentice ... 1 ... ... 1 ... ... ... ... ... 2 Artist ... ... ... ... 1 ... ... ... ... ... 1 Artificial Flower Maker ... ... 1 ... ... ... 2 ... ... ... 3 Analyst's Assistant ... ... ... ... ... ... 1 ... ... ... 1 Barman ... 1 1 ... ... ... 1 ... ... ... 3 Blouse Presser ... 1 ... ... ... ... ... ... ... ... 1 Bricklayer ... 1 ... ... ... ... ... ... ... ... 1 Brass Finisher ... 1 ... ... ... ... ... ... ... ... 1 Bottler ... 1 ... ... ... ... ... ... ... ... 1 Baby Clothing ... ... ... ... 1 ... ... ... ... ... 1 Bus Conductor ... ... ... ... ... ... 1 ... ... ... 1 Blousemaker ... 2 ... ... ... ... ... ... ... ... 2 Bottlewasher ... ... ... ... ... ... 2 ... ... ... 2 Bookbinder ... ... ... ... 1 ... 1 ... ... ... 2 Bootmaker ... ... ... ... ... ... 1 ... ... ... 1 Billiard Table Maker ... ... ... ... ... ... 1 ... ... ... 1 Clerk ... 10 4 ... 7 ... 7 ... ... ... 28 Carpenter ... ... ... ... 1 ... 2 ... ... ... 3 Charwoman ... ... 1 ... ... ... 7 ... ... ... 8 Compositor ... 1 ... ... ... ... 2 ... ... ... 3 Canvasser ... 1 ... ... ... ... ... ... ... ... 1 Cabinet Maker ... ... 1 ... ... ... ... ... ... ... 1 Carpet Maker ... 1 ... ... ... ... ... ... ... ... 1 Clock Maker ... 1 ... ... ... ... ... ... ... ... 1 Coachmaker ... ... ... ... 1 ... 1 ... ... ... 2 Coffeehouse keeper ... ... ... ... 1 ... ... ... ... ... 1 Cutter ... ... ... ... 1 ... ... ... ... ... 1 Coachman ... ... ... ... 1 ... ... ... ... ... 1 Costume Maker ... ... ... ... 1 ... ... ... ... ... 1 Costermonger ... ... ... ... ... ... 1 ... ... ... 1 Carman ... 2 ... ... 3 ... ... ... ... ... 7 Catsmeat Vendor ... ... ... ... ... ... 1 ... ... ... 1 Cab Driver ... ... ... ... ... ... ... ... ... ... 2 Dressmaker ... 4 ... ... ... ... ... ... ... ... 4 Electrician ... ... ... ... ... ... 1 ... ... ... 1 Errand Girl ... ... ... ... 1 ... ... ... ... ... 1 Enamel Worker ... ... 1 ... ... ... ... ... ... ... 1 Errand Boy ... 2 1 ... ... ... ... ... ... ... 3 Engineer ... 1 ... ... ... ... 1 ... ... ... 2 Embroidress ... 1 ... ... ... ... 1 ... ... ... 2 Factory Hand ... 1 ... ... ... ... 1 ... ... ... 2 Fish Salesman ... ... ... ... 1 ... 1 ... ... ... 2 Florist ... 1 ... ... 1 ... ... ... ... ... 2 French Polisher ... 3 ... ... ... ... 1 ... ... ... 4 Fruiterer ... ... 1 ... ... ... ... ... ... ... 1 Greengrocer ... ... ... ... ... ... 1 ... ... ... 1 Gardener ... ... ... ... ... ... 1 ... ... ... 1 Gas Fitter ... 1 ... ... 1 ... ... ... ... ... 2 172 1909] Table CXV. — continued. Occupations. Small Pox. Scarlet Fever. j Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Cerebro-Spina Fever. Total. House Agent ... ... ... ... ... ... 1 ... ... ... 1 Hawker ... ... ... ... ... ... I ... ... ... 1 Hairdresser ... 1 ... ... ... ... ... ... ... ... 1 Horsekeeper ... ... 1 ... ... ... 1 ... ... ... Housewife ... 11 6 ... 8 ... 22 ... ... ... 61 Insurance Agent ... ... ... ... ... ... i ... ... ... 1 Jewel-Case Maker ... ... 1 ... ... ... ... ... ... ... 1 Jewellery Polisher ... 1 ... ... ... ... ... ... ... ... 1 Laundress ... 1 ... ... ... ... 2 ... ... ... 3 Leather Worker ... ... 1 ... ... ... ... ... ... ... 1 Lithographer ... ... ... ... 1 ... ... ... ... ... 1 Labourer ... 2 1 ... 1 ... 5 ... ... ... 9 Messenger ... 3 ... ... ... ... 1 ... ... ... 4 Manager ... ... ... ... 2 ... 2 ... ... ... 4 Milk Carrier ... ... ... ... ... ... 1 ... ... ... 1 Machinist ... 2 ... ... ... ... ... ... ... ... 2 Milliner ... 1 ... ... ... ... ... ... ... ... 1 Musical Instrument Maker ... ... ... ... ... ... I ... ... ... 1 Medical Practitioner ... 1 ... ... ... ... ... ... ... ... 1 Newsagent ... ... ... ... 1 ... I ... ... ... 2 Newspaper Boy ... I ... ... ... ... ... ... ... ... 1 Nurse ... 2 ... ... 6 ... 3 ... ... ... 11 Needlewoman ... ... ... ... ... ... 1 ... ... ... I Office Boy ... I ... ... ... ... ... ... ... ... I Porter ... I 1 ... 2 ... 6 ... ... ... 10 Postman ... I ... ... ... ... 2 ... ... ... 3 Packer ... I ... ... 2 ... ... ... ... ... 3 Printer ... I 4 ... ... ... ... ... ... ... 5 Plate Layer ... I ... ... ... ... ... ... ... ... 1 Pastrycook ... I ... ... ... ... ... ... ... ... 1 Paper Sorter ... I ... ... ... ... ... ... ... ... 1 Purss Maker ... ... ... ... I ... I ... ... ... 2 Paper Hanger ... ... ... ... ... ... I ... ... ... I Potman ... ... ... ... ... ... 1 ... ... ... I Paste Maker ... ... ... ... ... ... I ... ... ... I Railway Servant ... ... 2 ... 3 ... 4 ... ... ... 9 Restaurant Keeper ... ... ... ... ... ... 1 ... ... ... 1 Scholar ... 811 197 ... 21 ... 11 ... ... ... 1040 Sorter ... ... ... ... I ... ... ... ... ... 1 Servant ... 4 5 ... I ... 4 ... ... ... 14 Shop Assistant ... 6 1 ... I ... 4 ... ... ... 12 Straw Plaiter ... 1 ... ... ... ... ... ... ... ... 1 Stationer ... ... ... ... ... ... 1 ... ... ... 1 Shoe Maker ... 1 ... ... ... ... ... ... ... ... 1 Surgical Instrument Maker ... 1 ... ... ... ... ... ... ... ... 1 Shirt Maker ... 1 ... ... I ... ... ... ... ... 2 Shop Boy ... 2 ... ... I ... ... ... ... ... 3 Street Vendor ... I ... ... ... ... ... ... ... ... 1 Salesman ... I ... ... ... ... ... ... ... ... 1 Scalemaker ... I ... ... ... ... ... ... ... ... 1 Sawyer ... ... 1 ... ... ... ... ... ... ... 1 173 11909 Table CXV.—continued. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Cerebro-Spinal Fever. Total. Sweet Maker ... ... ... ... I ... ... ... ... ... I Sweep ... ... ... ... ... ... I ... ... ... 1 Tin Smith ... ... ... ... I ... I ... ... ... 2 Teacher ... 2 I ... ... ... ... ... ... ... 5 Tailoress ... I I ... ... ... I ... ... ... 3 Telegraph Boy ... I ... ... ... ... ... ... ... ... 1 Tennis Bat Maker ... ... ... ... ... ... I ... ... ... 1 Traveller ... I ... ... ... ... ... ... ... ... 1 Upholsterer ... ... I ... ... ... I ... ... ... 2 Veneer Cutter ... ... ... ... ... ... I ... ... ... 1 Van Boy ... I ... ... ... ... ... ... ... ... 1 Warehouseman ... 1 I ... ... ... 2 ... ... ... 4 Washerwoman ... ... ... ... ... ... I ... ... ... 1 Waitress ... ... I ... ... ... I ... ... ... 2 Walking Stick Maker ... 1 ... ... ... ... ... ... ... ... 1 Wood Chopper ... I ... ... ... ... ... ... ... ... 1 Watchmaker ... ... ... ... 2 ... ... ... ... ... 2 Wheelwright ... ... ... ... I ... 2 ... ... ... 3 Wood Turner ... ... ... ... ... ... I ... ... ... 1 Total ... 911 237 ... 82 ... 139 14 ... ... 1383 INFECTIOUS DISEASES IN STREETS. A table showing the infectious diseases in the various streets of the borough together with the number of houses is given as usual. Its study is not without considerable interest to those who are desirous of ascertaining the streets that are most infected. Last year special attention was drawn to the condition of Campbell Road, about whose state so much had appeared in the press, when it was noted that there were only seven cases of infectious diseases in its houses, viz: —3 Scarlet Fever, 3 Diphtheria and 1 Erysipelas, and that these occurred in seven different houses. It is now possible to state that only 5 cases occurred in that road in 1909, and that these also occurred in different houses. Again, in Queensland Road, which next to Campbell Road is the worst road in Islington, only 5 cases ot infectious diseases were known and these occurred in four houses. From this statement it is very apparent that nothing has been left undone on the part of the sanitary authority to prevent an infectious disease when it has broken out in these roads spreading to other'people living in the same houses. The table speaks for itself, and is also a fair guide, although not always a correct one, as to the "return" cases of infectious disease known in the borough, for frequently where more than one case has arisen in the same house it has been due to infection by the patient either prior to his removal to hospital or subsequent to his return home. In the latter case, people are often inclined to blame the hospital authorities, who, the Medical Officer of Health is aware, make every effort to prevent any case leaving hospital while there is a possibility of infection being conveyed to it. These occasional cases are the only penalties which the public have to bear in return for the very great benefit that is received by the isolation of persons suffering from infectious diseases. 174 1909] Table CXVI. Showing the Streets in which the several cases of Infectious Disease occurred during 1909. The large figure denotes the number of cases and the small figure 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.| Almington Street ... 11 I1 ... ... ... ... ... ... 22 Annette Road ... 11 ... ... ... ... ... ... ... 11 Archway Road ... 44 ... ... ... ... ... ... ... 44 Anatola Road ... ... ... 11 ... ... 32 ... ... 43 Aberdeen Road ... 11 11 ... ... ... ... ... ... 22 Ashburton Grove ... 43 11 ... ... ... ... ... ... 54 Anson Road ... ... 11 ... ... ... ... ... ... 11 Alsen Road ... 65 11 ... ... ... 22 ... ... 97 Alwyne Villas, Canonbury ... 11 ... ... ... ... ... ... ... 11 Ashmount Road ... 31 ... ... ... ... ... ... ... 31 Avenell Road ... 66 11 ... ... ... ... ... ... 7' Alexander Road ... 22 11 ... 11 ... ... ... ... 44 Albion Grove ... 55 ... ... ... ... ... ... ... 5s Aubert Paik ... 22 11 ... ... ... ... ... ... 3s Annesley Road ... 32 ... ... ... ... ... ... ... 32 Andover Road ... 116 22 ... ... ... ... ... 11 All Saints Street ... ... 11 ... ... ... ... ... ... 11 Ambler Road ... 41 11 ... ... ... ... ... ... 52 Andover Grove ... 11 ... ... ... ... ... ... ... 11 Ancona Road ... 11 ... ... ... ... ... ... ... 11 Arundel Mews, Arundel Square ... 11 ... ... ... ... ... ... ... 11 Arthur Road ... ... 11 ... 11 ... ... ... ... 22 Albany Place ... 22 ... ... ... ... ... ... ... 22 Alwyne Square ... ... ... ... 11 ... ... ... ... 11 Arlington Square ... 1l ...... ... ... ... ... ... ... 11 Ashley Road ... ... 11 ... ... ... ... ... ... 11 Adelaide Square ... ... 11 ... ... ... ... ... ... 11 Ashhurton Yard, Ashburton ... ... ... ... ... ... Grove ... 42 ... ... ... ... ... ... ... 42 Albert Street ... 32 11 ... ... ... ... ... ... 42 Arthur Mews, Caledonian Road ... 21 ... ... ... ... ... ... ... 21 Albion Street ... I1 11 ... ... ... ... ... ... 22 Alma Road ... ... ... ... ... ... 11 ... ... 11 Astey"s Row ... 11 ... ... ... ... ... ... ... I1 Albany Cottages, Popham ... ... ... ... Street ... 11 11 ... ... ... ... ... ... 22 Andover Street ... ... ... ... ... ... 11 ... ... I1 175 [1909 Table CXVI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. i Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Albemarle Mansions, Hollo- way Road ... ... 11 ... ... ... ... ... ... 11 Almorah Road ... ... ... ... 11 ... ... ... ... 11 Almeida Street ... 11 ... ... ... ... ... ... ... 11 Bemerton Street ... 22 55 ... 11 ... 44 ... ... 1212 Blundell Street ... 32 ... ... ... ... 22 11 ... 65 Barbara Street ... 22 ... ... 11 ... 11 ... ... 44 Birnam Road ... 11 i1 ... ... ... ... ... ... 22 Britannia Row ... ... 22 ... ... ... 22 ... ... 4s Balls Pond Place ... 11 ... ... ... ... ... ... ... 11 Barnsbury Road ... 129 ... 11 11 ... 11 11 ... i612 Bedford Terrace ... ... ... ... ... ... 11 ... ... 11 Blenheim Road ... 3s 11 ... ... ... ... ... ... 44 Barnsbury Park ... ... ... ... 11 ... ... ... ... 11 Balls Pond Road ... 21 11 ... ... ... 11 ... ... 4s Beresford Terrace ... ... ... ... ... ... 11 ... ... 11 Biekerton Road ... 33 ...... ... ... ... ... ... ... 33 Brooksby Street ... 11 22 ... ... ... 11 ... ... 44 Belle Isle Cottages, York ... ... ... ... ... ... Road ... ... ... ... ... ... 11 ... ... 11 Blackstock Road ... 22 44 ... ... ... 11 ... ... 7' Balfour Road ... 11 ... ... ... ... ... ... ... 11 Brewery Road ... 3s 11 ... 31 ... 11 ... ... 88 Brecknock Road ... 38 11 ... ... ... ... ... ... 44 Box worth Grove ... i1 ... ... ... ... ... ... ... i1 Baling Street ... 22 ... ... ... ... ... ... ... 22 Bride Street ... 87 ... ... ... ... 11 ... ... 98 Bryan Street ... i1 11 ... 11 ... ... ... ... 3s Barnsbury Grove ... 22 ... ... ... ... ... ... ... 22 Barnsbury Street ... 38 11 ... 11 ... 11 ... ... 66 Boothby Road ... l1 21 ... ... ... ... ... ... 32 Benwell Road ... 3s ... ... ... ... ... ... ... 38 Beaconsfield Buildings, York Road ... ii6 11 ... ... ... 11 ... ... 137 Brunswick Road ... i1 21 ... ... ... ... ... ... 32 Baring Street ... 22 ... ... ... ... ... ... ... 22 Boleyn Road ... I1 22 ... ... ... ... ... ... 33 Bryant wood Road ... 32 ... ... ... ... 11 ... ... 43 Baxter Road ... 22 ... ... ... ... 11 ... ... 3s Belitha Villas ... I1 11 ... ... ... ... ... ... 21 Barford Street ... I1 ... ... ... ... ... ... ... 11 Balmoral Grove ... 5s ... ... ... ... 11 ... ... 64 Bovay Street ... i1 ... ... ... ... ... ... ... 11 Beresford Road ... 38 ... ... ... ... ... ... ... 38 1909] 176 Table cxvi.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Beversbrook Road ... 3s ... ... ... ... ... ... ... 3s Brand Street ... 11 ... ... ... ... ... ... ... 11 Bingfield Street ... ... 11 ... ... ... 11 ... 22 Burns Buildings, Caledonian Road ... ... 11 ... ... ... ... ... ... 11 Bardolph Road ... 11 11 ... ... ... ... ... ... 22 Baalbec Road ... 11 ... ... ... ... 11 ... ... 22 Bracey Street ... 76 ... ... ... ... ... ... ... 76 Bampton House, Pleasant Place ... 11 ... ... ... ... ... ... ... 11 Bismarck Road ... ... 11 ... ... ... ... ... ... 11 Bishops Grove ... ... ... ... ... ... 11 ... ... 11 Bruce Buildings, Caledonian Road ... 31 ... ... ... ... ... ... ... 31 Burnard Place ... 11 ... ... ... ... ... ... ... 11 Canonbury Avenue ... 32 ... ... ... ... ... ... ... 32 Canterbury Terrace ... 32 ... ... ... ... ... ... ... 32 Cburcli Road ... 32 ... ... 11 ... 22 ... ... 65 Cumberland Street ... 32 83 ... 11 ... ... ... ... 126 Clarence Street ... 22 11 ... ... ... ... . . ... ... 32 CbattertoD Road ... 54 32 ... ... ... I1 ... ... 96 Caledonian Road ... 88 43 ... ... ... ... ... ... 1211 Copenhagen Street ... 1411 22 11 ... ... ... ... 1714 Crayford Road ... 22 2a ... ... ... 11 ... ... 55 Courtney Road ... .... ... ... ... ... ... ... ... 11 Cromwell Road ... 118 3s ... ... ... ... ... ... 1411 Canal Terrace ... 11 22 ... ... ... ... ... ... 3s Charteris Road ... 22 ... ... ... ... 21 ... ... 4s Crossley Terrace ... 11 ... ... ... ... ... ... ... 11 Canonbury Paik, South ... ... ... ... 11 ... ... ... ... 11 Cloudesley Road ... 44 38 ... 11 ... 48 ... ... 1211 Corbyn Street ... 22 73 ... ... ... 11 ... ... 106 Corinth Road ... 11 11 ... ... ... 11 ... ... 38 Corinne Road ... 11 .... ... ... ... ... 11 Cornwall Cottages, Popham Street ... 11 ... ... ... ... ... ... 11 Cheverton Road ... ... ... ... ... ... 11 ... ... 11 Carlton House, Stanmore ... ... ... ... ... Street ... 11 11 ... ... ... ... ... ... 22 Crouch Hill ... 23 ... ... ... ... ... ... ... 22 Colebrooke Row ... 8t 11 ... ... ... 23 ... ... 118 Crinan Street ... ... 31 ... ... ... ... ... ... 31 Carlton Terrace, Halton Road ... 11 ... ... ... ... ... ... 11 Clarence Terrace, York Road ... ... 11 ... ... ... ... ... ... 11 Cleveland Road ... 64 ... ... ... ... ... ... ... 64 177 [1909 Table CXVII.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Cathcart Hill ... 11 ... ... ... ... 11 ... ... 22 Clayton Street ... 11 ... ... ... ... ... ... ... 11 Camden Street ... 22 ... ... ... ... ... ... ... 22 Carlsbad Street ... 11 31 ... ... ... 11 ... ... 54 Clephane Road ... 11 ... ... ... ... ... ... ... 11 Charlotte Street ... 32 11 ... ... ... ... ... ... 4s Carville Street ... ... ... ... ... ... 11 ... ... l1 City Arms Buildings, North Eoad ... 22 ... ... ... ... ... ... ... 22 Cloudesley Place ... 11 11 ... 11 ... ... ... ... 32 Cressida Road ... ... ... ... ... ... 11 ... ... 11 Caledonian Crescent ... 11 22 ... ... ... 11 ... ... 44 Cornwai.lis Eoad Workhouse ... ... ... ... ... ... 41 ... ... 41 Camden Road ... 11 11 ... ... ... ... ... ... 2l Crown Mansions, Liverpool Road ... 22 ... ... ... ... ... ... ... 22 Corporation Street ... 7s 21 ... ... ... ... ... ... 91 Carmarthen Street ... ... ... ... 11 ... ... ... ... 11 Church Lane ... 11 11 ... ... ... ... ... ... 22 Carlton House, Cross Street ... ... ... ... 22 ... ... ... ... 22 Cornwallis Road ... 55 22 ... ... ... ... ... ... 77 Campbell Road ... 33 11 ... ... ... 22 ... ... 66 Cottenham Road ... 44 22 ... ... ... ... ... ... 66 Charlotte Terrace ... 11 ... ... ... ... 11 ... ... 22 Canning Road ... 36 i1 ... ... ... ... ... ... 44 Calabria Road ... 33 ... ... 11 ... ... ... ... 44 Crowland Terrace ... ... i1 ... ... ... ... ... ... 11 Church Street ... 52 ... ... ... ... ... ... ... 52 Cross Street ... 22 i1 ... ... ... ... ... ... 32 Canonbury Lane ... 21 i1 ... ... ... ... ... ... 31 Camden Dwellinss, York Road ... 11 ... ... ... ... 11 ... ... 22 Citizen Road ... i1 ... ... i1 ... ... ... ... 22 Canonbury Road ... 22 i1 ... ... ... ... ... ... 33 Clialfont Road ... 2 2 ... ... ... ... 11 ... ... 33 City Garden Row ... ... 22 ... ... ... ... ... ... 22 Coombe Street ... ... ... ... ... ... 11 ... ... 11 Canonbury Square ... ... 11 ... 11 ... ... ... ... 23 Crescent Avenue, Caledonian Road ... 11 ... ... ... ... ... ... ... 11 Coleridge Road ... ... 32 ... ... ... ... ... ... 32 Calverley Grove ... 22 31 ... ... ... ... ... ... 52 Crane Grove. ... ... ... ... ... ... ... ... ... 11 Crossley Street ... ... ... ... ... ... 11 ... ... 11 Church Grove ... i1 ... ... ... ... ... ... ... 11 N 178 1909] Table CXVII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. 1 Diphtheria. Mem"D. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Cruden Street ... ... ... ... ... ... 11 ... ... 11 Conewood Street ... 11 ... ... ... ... ... ... ... 11 Cloudesley Street ... ... ... ... ... ... 11 ... ... 11 City Road ... 11 ... ... ... ... ... ... ... 11 Charleswortli Street ... 11 ... ... ... ... ... ... ... 11 Coleman Street ... 11 ... ... ... ... ... ... ... 11 Cutlers Terrace, Balls Pond Road ... ... 11 ... ... ... ... ... ... 11 Clifton Terrace, Fontliill Road ... ... ... ... ... ... 11 ... ... 11 Canterbury Place ... ... ... ... ... ... 11 ... ... 11 Devonshire Road ... 55 44 ... ... ... ... ... ... 98 Dagmar House, Dagniar Terrace ... ... 21 ... ... ... ... 11 ... 32 Downham Road ... 22 i1 ... ... ... ... 33 Duncan Terrace ... 22 ... 11 ... 22 ... ... 55 Davenant Road ... 22 22 ... 2 2 ... i1 ... ... 77 Denmark Grove ... 86 11 ... ... ... ... ... ... 96 Dartmouth Park Hill ... ... 22 ... ... ... ... ... ... 22 Denmark Road ... 22 11 ... ... ... ... ... ... 38 Delhi Street ... 75 22 ... ... ... ... ... ... 98 Dagmar Terrace ... 11 ... ... ... ... ... ... ... 11 Dalmeny Road ... 22 ... ... ... ... ... ... ... 22 Durham Road ... 94 ... ... ... ... 22 ... ... 116 Dorset 8treet ... 11 11 ... 11 ... ... 11 ... 44 Dorinda Street ... 5s ... ... ... ... 11 ... ... 64 Drayton Park ... 3s 11 ... ... ... ... ... ... 44 Drayton Hodse, Hornsey Road ... ... 31 ... ... ... ... ... ... 3l Dibden Street ... 22 ... ... ... ... ... ... ... 22 Devonshire Street ... 3s ... ... ... ... ... ... ... 3s Dalmeny Avenue ... 11 ... ... ... ... 11 ... ... 21 Dresden Road ... 31 11 ... ... ... ... ... ... 41 Duncombe Road ... 21 ... ... ... ... ... ... ... 21 Despard Road ... ... ... ... 11 ... ... ... ... I1 Dennis Street ... ... 22 ... ... ... ... ... ... 22 Dame Street ... 11 ... ... ... ... ... ... ... 11 Eden Grove ... 76 22 ... ... ... ... ... ... 97 Edward Square ... 22 11 ... 71 ... i1 ... ... 111 Englefield Road ... 11 11 21 ... ... ... ... 43 Elthorne Road ... 39 ... 11 ... ... i1 ... ... 56 Elton Street ... 22 ... 11 ... ... ... ... ... 32 Evershot Road ... ... i1 ... ... ... i1 ... ... 22 Essex Road ... 107 11 ... ... ... 3s ... ... I41 Elwood Street ... 97 ... ... ... ... 11 ... ... 1011 Emily Place ... 21 ... ... ... ... ... ... ... 21 179 [1909 Table CXVII.—continued. NAME OF STREET. i | Small Pox. [ Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Edwards Cottages, Hydes Place ... ... ... ... 11 ... ... ... ... 11 Elfort Road ... 21 ... ... ... ... ... ... ... 21 Ellington Street ... 11 ... ... ... ... 22 ... ... 3s Elphinstone Street ... 32 11 ... ... ... ... ... ... 4s Edinboro' Cottages, Popham ... ... ... ... ... ... ... ... ... r Street ... 56 31 ... ... ... ... ... ... 85 Ecclesbourne Road ... 32 ... ... ... ... ... ... ... 32 Everleigh Street ... 42 ... ... ... ... ... ... ... 42 Elmore Street ... 21 22 ... 11 ... ... ... ... 54 Ellenborough Road ... 11 ... ... ... ... ... ... ... 11 Ebenezer Buildings, Rotlierfield Street ... ... 11 ... ... ... ... ... ... 11 Ebury Street ... ... 11 ... ... ... ... ... ... 11 East Street ... 11 ... ... ... ... ... ... ... 11 Enkel Street ... 11 ... ... ... ... 11 ... ... 22 Fife Terrace ... ... ... ... 11 ... ... ... ... 11 Francis Terrace ... ... ... ... ... ... 11 ... ... 11 Freegrove Road ... 3s 11 ... 11 ... ... ... ... 55 Fair bridge Road ... 87 21 ... ... ... 22 ... ... 1210 Fonthill Road ... 6s 11 ... ... ... ... ... ... 74 Francis Street ... 51 31 ... ... ... ... ... ... 82 Freeling Street ... 11 ... ... ... ... ... ... ... 11 Foxham Road ... 11 i1 ... ... ... ... ... ... 22 Ferntower Road ... 11 ... ... ... ... 11 ... ... 22 Fortnam Road ... 11 ... ... ... ... 11 ... ... 22 Fort Cottages, Myrtle Street ... ... ... ... ... ... 11 ... ... 11 Fowler Road ... 11 ... ... ... ... ... ... ... 11 Florence Street ... 22 ... ... ... ... 21 ... ... 44 Fairmead Road ... 11 11 ... ... ... ... ... ... 22 Frederick Street ... 11 ... ... ... ... 11 ... ... 22 Flowers Mews, Archway Road ... ... ... ... 11 ... ... ... ... 11 Fakeuham Street ... 11 ... ... ... ... ... ... ... 11 Framfield Villas, Framfield Road ... 11 ... ... ... ... ... ... ... 11 Furlong Road ... 11 ... ... ... ... ... ... ... 11 Grenville Road ... 11 ... ... ... ... ... ... ... 11' Grafton Road ... 58 22 ... ... ... ... ... ... 178 Grosvenor Road ... 87 ... ... ... ... ... ... ... / 87 Gloucester Road ... 11 ... ... 11 ... 11 ... ... 38 Grove Road ... 75 5s ... ... ... ... ... ... 128 Gifford Street ... I1 i1 ... ... ... ... ... ... 22 Goodinge Road ... i68 32 ... 22 ... 11 ... ... 2213 Gillespie Road ... 1311 ... ... 11 ... 44 ... ... 1816 Gerrard Street ... ... ... ... ... ... ... i1 ... 11 n 2 180 1909] Table CXVII.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Great Northern Hospital, Hollo way Road ... ... 1 ... 5 ... ... ... ... 6l Gainford Street ... 11 ... ... ... ... ... ... ... 11 Grovedale Road ... 5s ... ... ... ... ... ... ... 53 Grove Street ... 11 ... ... ... ... ... ... ... 11 George's Road ... 54 22 ... ... ... 11 ... ... 87 Gladstone Street ... ... ... ... ... ... 11 ... ... 11 Grosvenor Street ... ... 22 ... ... ... ... ... ... 22 George Street ... 11 ... ... ... ... ... ... ... 11 Gordon Street ... ... ... ... ... ... 11 ... ... 11 Gresley Road ... 11 ... ... ... ... ... ... ... 11 Grantbridge Street ... 11 ... ... ... ... ... ... ... 11 Hazellville Road ... 33 11 ... ... ... ... ... ... 4s Hope Street, Eden Grove ... 11 11 ... ... ... ... ... ... 22 Hornsey Road ... 1418 38 ... 11 ... 2'1 ... ... 2216 Hugo Road ... 33 ... ... ... ... ... ... ... 3s Havelock Street ... 65 11 ... ... ... ... ... ... 76 Highbury Quadrant ... ... 21 ... ... ... ... ... ... 65 Hargrave Park ... 66 11 ... 11 ... 32 ... ... 119 Huddleston Road ... 33 82 ... ... ... ... ... ... 118 Hemingford Road ... 22 22 ... ... ... 21 ... ... 65 Half Moon Crescent ... 33 ... ... ... ... ... ... ... 3s Hornsey Street ... 33 ... ... ... ... ... ... ... 33 Highbury Hill ... 85 i1 ... ... ... ... ... ... 96 Hercules Place ... 22 ... ... ... ... ... ... ... 22 Halton Road ... 11 38 ... ... ... ... ... ... 44 Hanover Street ... 11 22 ... ... ... ... ... ... 33 Highbury New Park ... 22 11 ... ... ... ... ... ... 33 Hargrave Road ... 58 ... ... ... ... ... ... ... 58 Hampden Road ... 97 ... ... ... ... ... 22 ... 119 Hamilton Road ... 11 ... ... ... ... 11 ... ... 22 Hollingworth Street ... 117 ... ... 11 ... ... ... ... 128 Huntingdon Street ... 43 ... ... 11 ... ... ... ... 84 Holloway Road ... 1310 43 ... ... ... ... ... ... 1712 Hardinge Street ... 11 ... ... ... ... ... ... ... 11 Highbury Place ... 11 ... ... ... ... ... ... ... 11 Hanley Road ... 38 ... ... ... ... ... ... ... 33 Hargbave Mansions, Holloway ... ... ... ... ... ... ... ... ... Road ... 11 ... ... ... ... ... ... ... 11 Harberton Road ... ... ... ... ... ... 22 ... ... 22 Horsell Road ... ... ... ... ... ... 11 ... ... 11 Hornsey Lane ... 11 11 ... 11 ... ... ... ... 33 Higliwood Road ... 21 ... ... ... ... ... ... ... 21 Highgate Hill ... i1 ... ... ...... ... ... ... ... 11 181 ri909 Table CXVII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diptheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Halse Street ... 11 ... ... ... ... ... ... ... 11 Hillmarton Road ... 32 ... ... ... ... ... ... ... 32 Hazelville Mews, Elthorne Road ... 11 ... ... ... ... ... ... ... 11 Highbury Park ... ... 11 ... ... ... 11 ... ... 22 Halliford Street ... 55 11 ... ... ... ... ... ... 6s Harvist Road ... 11 ... ... ... ... ... ... ... 11 Highbury Terrace ... ... ... ... ... ... 11 ... ... 11 Hornsey Rise ... i1 11 ... ... ... ... ... ... 22 Hungerford Road ... 22 ... ... ... ... 11 ... ... 3s Hartham Road ... 32 11 ... ... ... 11 ... ... 5s Hatley Road ... 11 ... ... ... ... 11 ... ... 24 Hope Cottages, Georges Road ... 11 ... ... ... ... ... ... ... 11 High Street ... ... ... ... ... ... 11 ... ... 11 Highbury Grange ... 11 ... ... ... ... ... ... ... 11 H.M.P Pentonville ... 11 ... ... 11 ... ... ... ... 21 Hercules Road ... ... ... ... ... ... 11 ... ... 11 Herrick Eoad ... ... 11 ... ... ... ... ... ... 11 Halton House, Horusey Road ... ... 11 ... ... ... ... ... ... 11 Hilton Road ... 11 ... ... ... ... ... ... ... 11 Henry Place ... ... 11 ... ... ... ... ... ... 11 Hilldrop Crescent ... ... ... ... 11 ... ... ... ... 11 Hatchard Road ... 11 ... ... ... ... ... ... ... 11 Hertslet Road ... 11 ... ... ... ... ... ... ... 11 Islington Infirmary, Highgate Hill ... 1 ... ... ... ... 4 ... ... 51 Ingram House, Hornsey Road ... ... ... ... ... ... i1 ... ... 11 Islington Workhouse Schools ... 20 ... ... ... ... ... ... ... 201 Isledon Road ... 64 ... ... ... ... ... ... ... 6' Ingleby Road ... 4s ... ... ... ... ... ... ... 4s Islington Green ... ... ... ... ... ... 11 ... ... 11 Jackson Road ... 11 ... ... ... ... ... ... ... 11 J unction Road ... 3s 22 ... 11 ... ... ... ... 68 Kingsdown Road ... 86 44 ... ... ... ... ... 1310 King Henry's Walk ... 53 ... ... ... ... ... ... ... 5s Kiver Road ... 21 ... ... ... ... ... ... ... 21 Kelvin Road ... 11 ... ... ... ... 11 ... ... 22 Kingsbury Road ... 32 ... ... ... ... ... ... ... 32 King Edward Street ... 22 11 ... ... ... ... ... ... 3, Knox Buildings, CaledoniaL Road ... 21 ... ... ... ... ... ... ... 32 Kelross Road ... ... ... ... ... ... 11 ... ... 11 Kinlock Street ... 11 ... ... ... ... ... ... ... 1 Liverpool Road ... 1917 33 ... 11 ... 11 11 ... 2 521 Lonsdale Square ... ... ... ... ... ... 11 ... ... 11 182 1909] Table CXVII.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. London Feveh Hospital ... 2 2 ... ... ... ... ... ... 41 Liverpool Buildings, Liverpool Boad ... ... 2a ... ... ... 11 ... ... 64 Lampeter Street ... 11 11 ... ... ... ... ... ... 22 Liberia Boad ... ... ... ... ... ... 11 ... ... 11 Lofting Boad ... 33 22 ... 11 ... ... ... ... 65 Little Cross Street ... 11 11 ... ... ... ... ... ... 21 Landseer Boad ... 107 11 ... ... ... ... ... ... 118 Lavina Grove ... ... 11 ... ... ... ... ... ... 11 Loraine Mansions, Holloway Boad ... 22 ... ... ... ... ... ... ... 22 Lady Margaret Boad ... 22 11 ... ... ... ... ... ... 33 Lowman Boad ... 22 11 ... ... ... ... ... ... 38 Lesly Street ... 41 11 ... ... ... ... ... ... 51 Lyon Street ... 11 ... 11 ... ... ... ... 22 Linton Street ... 11 11 ... ... ... ... ... ... 2a Lambton Boad ... 11 ... ... ... ... ... ... ... 11 Luard Street ... 32 ... ... ... ... ... ... ... 32 Legard Boad ... 21 ... ... ... ... ... 11 ... 32 Lorne Buildings, Ben well Boad ... 21 ... ... ... ... 11 ... ... 3a Langdon Boad ... 41 11 ... ... ... 3s ... ... 87 Lennox Boad ... 11 ... ... ... ... ... ... ... 11 Lincoln House, Astey's Bow ... 11 ... ... ... ... ... ... ... 11 Lambert Street ... 21 ... ... ... ... ... ... ... 21 Loraine Cottages, Annette Boad ... 2l ... ... ... ... ... ... ... 21 Leconfield Boad ... 11 ... ... ... ... ... ... ... 11 Mulkern Road ... 33 29 ... ... ... ... ... ... 54 Medina Boad ... 32 11 ... ... ... ... ... ... 43 Marriott Boad ... 21 3s ... ... ... ... ... ... 53 Mildmay Boad ... ... 11 ... 11 44 ... ... 66 Muriel Street ... 11 ... ... ... ... ... ... ... 11 Marquess Boad ... 11 ... ... ... ... ... ... ... 11 Mercers Road ... 65 ... ... ... ... ... ... ... 6' Market Street ... 11 ... ... ... ... ... ... ... 11 Moon Street ... ... ... ... ... ... 11 ... ... 11 Maygood Street ... 22 11 ... ... ... 11 ... ... 44 Miranda Boad ... 22 4s 11 ... ... ... ... ... 76 Mildmay Park ... 38 ... ... 11 ... ... ... ... 4' Magdala Boad ... 42 ... ... ... ... ... ... ... 42 Milner Square ... 11 ... ... ... ... 38 ... ... 4' May ton Street ... 32 ... ... 21 ... ... ... ... 5s Mildmay Street ... 22 11 ... ... ... ... ... ... 3s Matthias Boad .... 38 21 ... ... ... ... ... ... 54 183 [1909 Table CXVII.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. 1 Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Matilda Street ... 22 ... ... ... ... ... ... ... 22 Mitford Road ... ... 11 ... 11 ... 11 ... ... 3s Milton Grove ... 22 ... ... ... ... ... ... ... 22 Monnery Road ... 11 ... ... ... ... ... ... ... 11 Marlborough Road ... 44 38 11 ... ... 11 ... ... 99 Malvern Terrace ... ... 11 ... ... ... ... ... ... 11 Monte Cliristo Parade ... 21 ... ... ... ... ... ... ... 21 Memorial Cottage Hospital, Mildmay Park ... ... ... ... ... ... 11 ... ... 11 Mildmay Grove ... 4 11 ... ... ... ... ... ... 58 Mayville Street ... ... 11 ... ... 11 ... ... 2s Morton Road ... ... ... ... 11 ... ... ... ... 11 Monsell Road ... 33 ... ... ... ... ... ... 33 Moray Road ... ... 11 ... ... ... 11 ... ... 22 Moreland Street ... 11 ... ... ... ... ... ... ... 11 Myrtle Street ... 11 ... ... ... ... ... ... ... 11 Myddleton Buildings High Street ... ... 11 ... ... ... ... ... ... 11 Mountgrove Road ... 11 ... ... ... ... ... ... ... 11 Mildmay Avenue ... 11 ... ... ... ... ... ... ... 11 Marcellus Road ... ... 11 ... ... ... ... ... ... 2a Milgund Road ... 11 ... ... ... ... ... ... ... 11 Mildmay Orphanage, Newingtou Green ... 21 ... ... ... ... ... ... ... 21 Newington Green Road ... 3 ... ... ... ... 22 ... ... 54 Nailour Street ... 11 11 ... ... ... ... ... ... 44 Norfolk Road ... 44 31 ... ... ... ... ... ... 75 New North Road ... 11 11 ... 11 ... ... ... ... 38 Nilson Terrace ... 31 ... ... ... ... ... ... ... 31 Newingtou Green ... ... 11 ... ... ... ... ... ... 11 Norfolk Street ... 11 22 ... ... ... ... ... ... 3s Newliall Street ... 3s ... ... ... ... 11 ... ... 44 Northampton Grove ... 11 ... ... ... ... ... ... ... 11 Nicholay Road ... 45 ... ... ... ... ... ... ... 48 North Road ... 35 ... ... ... ... ... ... ... 38 Northdown Street ... 32 ... ... ... ... ... ... ... 32 Northampton Street ... ... 11 ... ... ... 11 ... ... 11 North Avenue ... ... ... ... ... ... ... ... ... 11 OSord Street ... ... ... ... 11 ... ... ... ... 11 Offord Road ... 97 32 ... ... ... 22 ... ... 4n Ockendon Road ... 54 11 ... ... ... ... ... ... 6fi Oxford Road ... 33 11 ... ... ... ... ... ... 44 Osnaburgh Cottages, Brand ... ... ... ... ... ... ... ... ... Street ... ... ... ... 11 ... ... ... 11 184 1909] Table CXVII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. I Enteric Fever. i Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Orchard Street 11 ... ... ... 11 Oufcram Street 38 11 ... ... 44 (Jrpinglev Road 11 11 11 ... 11 ... 48 Oakley Road 11 ... ... ... 11 Ormonde lload 11 ... ... ... 11 Pemberton Terrace 32 ... ... 32 Prospect Place ... 22 ... ... 22 Poole's Park 43 11 ... 11 ... 65 Peabody Buildings, Grceniiiau ... ... ... Street 11 3 ... ... 43 Plimsoll Road 6s 11 74 Parkfield Street 22 ... 11 33 ... 66 Prospect Cottagts, Prospect ... ... ... Place ... 11 ... 11 Poet's Eoad 11 ... 11 Prebend Street ... ... 22 ... ... ... 11 ... ... 38 Palmerston Buildings, City ... ... ... ... ... ... ... ... ... ... Garden Row ... 41 22 ... ... ... ... ... ... 66 Palmerstone Road ... 22 ... ... ... ... 11 ... ... 32 Pyrland Boad ... 11 ... ... 11 ... 11 ... ... 33 Pembroke Street ... ... 22 ... ... ... ... ... ... 22 Pemberton Gardens ... 54 ... ... ... ... ... ... ...... 54 Park Street ... 11 ... ... ... ... 11 ... ... 22 Petherton Road ... 64 21 ... ... ... ... ... ... 95 Prospect Row ... 38 22 ... ... ... ... ... ... 54 Pickering Street ... ... 11 ... ... ... ... ... ... 11 Pakeman Street ... ... ... ... ... ... 111 ... ... 11 Poynings Road ... 38 ... ... ... ... ... ... ... 33 Pleasant Place ... ... 11 ... ... ... ... ... ... 11 Packington Street ... 55 32 ... ... ... 11 ... ... 97 Providence Place ... 11 ... ... ... ... ... ... ... 11 Parolles Road ... 11 ... ... ... ... ... ... ... 11 Pulteney Street ... 11 ... ... ... ... 11 ... ... 22 Payne Street ... 2 2 22 ... ... ... ... ... ... 43 Queensbury Street ... ... 11 ... ... ... 33 ... ... 44 Quinn Buildings, Popliam St. ... 3s 66 ... ... ... 11 ... ... 1010 Queensland Road ... 38 21 ... ... ... ... ... ... 54 Queen's Arms Buildings, North ... ... ... ... ... ... ... ... ... ... Road ... 11 ... ... ... ... ... ... ... 11 Queen's Place, Rotherfield ... ... ... ... ... ... ... ... ... ... Street ... ... ... ... 11 ... ... ... ... 11 Queen Margaret's Grove ... 31 ... ... ... ... ... ... ... 31 Queen's Cottages, Popham ... ... ... ... ... ... ... ... ... ... Street ... 11 11 ... ... ... ... ... ... 2s 185 [1909 Table CXVII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Rhodes Street ... 55 56 ... ... ... ... ... ... 1010 Riversdale Road ... 65 11 ... ... ... ... ... ... 76 Rupert Road ... 65 44 ... ... ... 11 ... ... 1110 Rotherfield Street ... 22 22 ... ... ... ... ... ... 44 Ralph Street ... 21 11 ... ... ... ... ... ... 32 Richmond Road ... 66 11 ... ... ... ... ... ... 77 Roman Road ... 127 44 ... ... ... ... ... ... 169 Regina Road ... 44 ... ... ... ... 11 11 ... 66 Rocliffe Street ... 11 ... ... ... ... ... ... ... 11 Roden Street ... 44 ... ... ... ... ... ... ... 44 Rosemary Street ... 11 11 ... ... ... 11 ... ... 32 Railway Street ... ... ... ... ... ... 11 ... ... 11 Rayner's Place, Rothfield Street ... ... 11 ... ... ... ... ... ... 11 Remington Street ... ... 38 ... ... ... ... ... ... 33 Rufford Street ... 21 ... ... ... ... ... ... ... 21 Rheidol Terrace ... 11 11 ... ... ... ... ... ... 21 Ringcroft Street ... 22 ... ... ... ... ... ... ... 21 Roads Place ... 11 ... ... ... ... ... ... ... 11 Richmond Crescent ... 11 ... ... ... ... ... ... ... 11 Ronald's Road ... 22 ... ... ... ... ... ... ... 22 Richard Street ... 21 ... ... ... ... ... ... ... 21 River Street ... ... 11 ... ... ... ... ... ... 11 Rydon Street ... 11 .... ... ... ... ... ... ... 11 Stanmore Street ... 11 2a ... ... ... ... 11 ... 44 St. Thomas' Road ... 74 11 ... ... ... 22 ... ... 107 Sparsholt Road ... 32 ... ... ... ... ... ... ... 32 Shaftesbury Road ... 11 22 ... ... ... ... ... ... 38 Shepperton Road ... 42 38 ... ... ... ... ... ... 75 Story Street ... .. 11 ... ... ... ... ... ... 11 St. Paul's Place ... ... ... ... ... ... 11 ... ... 11 Sonning Street ... 33 11 ... ... ... ... ... ... 44 St. John's Road ... 54 74 ... ... ... ... ... ... 128 Sussex Road ... 43 22 ... ... ... ... ... ... 65 St. John's Road Workhouse ... 2 1 ... ... ... 2 ... ... 51 St. Paul Street ... 22 11 ... ... ... ... ... ... 3s Shelburne Road ... 11 ... ... ... ... ... ... ... 11 Seven Sisters' Road ... 65 11 ... ... ... ... ... ... 76 St. Jude Street ... 35 ... ... ... ... 22 ... ... 55 Salisbury Road ... 22 ... ... ... ... ... ... ... 22 St. Peter Street ... 22 ... ... ... ... i1 ... ... 38 Stroud Green Road ... 11 ... ... ... ... ... ... ... 11 St. John's Street ... ... 11 ... ... ... ... ... ... 11 Stonenest Street ... ... ... ... ... ... 11 ... ... 11 St. John's Park ... 33 22 ... ... ... ... ... ... 54 186 1909] Table CXVII.—continued. NAME of STREET. ; Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals.   Soutbgate Road ... 38 11 ... 11 ... ... ... ... 54 Scholefield Road ... 22 ... ... ... ... ... ... ... 22 St. John's Villas ... 22 ... ... ... ... ... ... ... 22 Sudeley Street ... 11 11 ... ... ... ... ... ... 22 Stonefield Street ... 63 ... ... ... ... ... ... ... 63 Stanley Road ... 43 111 ... ... ... 11 ... ... 65 Surr Street ... 22 ... ... ... ... ... ... ... 22 St. James Road ... 52 22 ... ... ... 22 ... ... 96 St. Clement's Street ... 11 11 ... ... ... ... ... ... 22 Sun Row ... 11 ... ... ... ... ... ... ... 11 Sebbon StreeT ... 11 ... ... ... ... ... ... ... 11 Sotheby Road ... 32 ...... ... ... ... ... ... ... 32 Stock Orchard Street ... ... 11 ... ... ... ... ... ... 11 South Street ... 11 ... ... ... ... 22 ... ... 38 St. Paul's Road ... 38 ... ... ... ... ... ... ... 38 St. James Street ... 11 ... ... ... ... ... ... ... 11 St. George's Avenuet ... 11 "38 ... ... ... ... ... ... 44 Stonefield Mansions, Cloudesley Street ... ... 11 ... ... ... ... ... ... 11 Sutterton Street ... 11 ... ... 11 ... 22 ... ... 43 Sheen Grove ... 22 ...... ... ... ... ... ... ... 22 Thornhill Road ... ... ... ... 11 ... 11 ... ... 22 Thornhill Bridge Place ... 11 ... ... ... ... ... ... ... 11 Tytherton Road ... 22 11 ... ... ... ... ... ... 38 Tufnell Park Road ... 96 11 ... ... ... ... ... ... 107 Thornhill Houses, Barnsbun Park ... 22 ... ... ... ... ... ... ... 22 Tibberton Square ... 11 ... ... ... ... ... ... ... 11 Tollington Road Torrens Buildings, City Road ... ... ... ... ... ... 11 ... ... 11 ... 42 11 ... ... ... 11 ... ... 61 Thorpedale Road ... 66 ... ... 11 ... ... ... ... 77 Trinity Street ... 38 ... ... ... ... ... ... ... 38 Turle Road ... 11 ... ... ... ... ... ... ... 11 Tavistock Terrace ... 22 ... ... 11 ... 11 ... ... 44 Thornhill Square The Mews, Tufnell Park Road ... ... 11 ... ... ... ... ... ... 11 ... 11 ... ... ... ... ... ... ... 11 Tabley Road ... ... 21 ... ... ... ... ... ... 21 Tiber Street ... ... ... ... ... ... 11 ... ... 11 Tollington Park ... 11 ... ... ... ... 11 ... ... 22 Tyndale Terrace ... 11 ... ... ... ... ... ... 11 Union Square ... 11 ... ... ... ... ... ... ... 11 Upper Park Street ... 11 11 ... ... ... ... ... ... 22 Upper Street ... 11 ... ... 11 ... 11 ... ... 38 Union Street ... 11 ... ... ... ... ... ... ... 11 187 [1909 Table CXVII.—continued. NAME OF street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever Erysipelas Puerperal Fever. Continued Fever. Totals Vorley Road ... 32 ... ... ... ... 32 ... ... 64 Vittoria Street ... 48 ... ... ... ... l1 ... ... 54 Victoria Road ... 48 ... ... ... ... ... ... ... 43 Victor Road ... 21 11 ... ... ... ... l1 ... 74 Vittoria Place ... ... 11 ... ... ... ... ... ... l1 Westbourne Road ... 58 l1 ... l1 ... l1 ... ... 85 Wharfdale Road ... ... l1 ... l1 ... 21 ... ... 43 Warner Street ... 33 ... ... ... ... ... ... ... 33 Wray Crescent ... 52 ... ... l1 ... ... ... ... 63 Wessex Buildings, Wedmore Street ... 66 54 ... ... ... l1 ... ... 1211 Wynford Road ... l1 38 ... 22 ... 22 ... ... 88 Winchester Street ... 41 l1 ... ... ... l1 ... ... 68 Wolsey Road ... ... ... ... ... ... ... l1 ... l1 Windsor Street ... 22 22 ... ... ... l1 ... ... 55 Wallace Road ... l1 ... ... ... ... ... ... ... l1 Wolsey Grove ... ... 11 ... ... ... ... ... ... l1 Wall Street ... 58 ... ... ... ... l1 ... ... 64 Wyatt Road ... 32 ... ... ... ... ... ... ... 32 Windermere Road ... l1 ... ... ... ... l1 ... ... 22 Wedmore Street ... 22 ... ... ... ... ... ... ... 22 Whitehall Park ... l1 l1 ... ... ... ... ... ... 22 William Street ... ... ... ... l1 ... l1 ... ... 22 Wedmore Gardens ... 22 2 2 ... ... ... ... ... ... 48 Williamson Street ... 22 ... ... ... ... ... ... ... 22 Waterloo House, Upper Street ... l1 ... ... ... ... ... ... ... l1 Whistler Street ... l1 21 ... ... ... ... ... ... 32 Wellington Road ... 33 22 ... ... ... ... ... ... 55 Windsor Road ... l1 ... ... ... ... l1 ... ... 22 Witley Road ... 22 ... ... ... ... ... ... ... 22 Wallace Buildings, Caledonian Road ... l1 ... ... ... ... ... ... ... l1 West View, Higligate Hill ... ... ... ... ... ... l1 ... ... l1 Wells Yard, Holloway Road ... l1 ... ... ... ... ... ... ... l1 Warrender Road ... l1 ... ... ... ... ... ... ... l1 Woodville Road ... ... ... ... ... ... l1 ... ... l1 Warlter'sMews, Parkhurst Road ... 31 ... ... ... ... ... ... ... 31 Witherington Road ... 21 ... ... ... ... ... ... ... 21 York Road ... 65 ... ... ... ... 33 ... ... 97 Yebury Road ... 48 22 ... ... ... ... ... ... 66 188 1909] BACTERIOLOGICAL EXAMINATIONS. During the year 577 specimens were examined for the medical profession practising in Islington (to enable them to diagnose with certainty suspicious cases of Diphtheria, Enteric Fever, and Phthisis) as compared with 545 in the preceding year, and 471 in 1907. Diphtheria.—300 specimens were examined, as contrasted with 281 in 1908 and 223 in 1907. This is the largest number hitherto forwarded for examination. In 64 instances the Lister Institute returned certificates showing positive results, and in 236 giving negative results. Enteric Fever.—Specimens of blood were examined in 55 instances, of which number 20 gave positive results, and 35 negative. Phthisis.—The sputum of 222 patients was examined, and the reports showed that 60 persons were suffering from the disease, and that 162 were not. All these examinations were made by the Lister Institute, who during the last eleven and a half years have examined 4,251 specimens for the Borough Council, namely:—1,807 Diphtheria, 835 Enteric Fever, and 1,609 Phthisis, and enabling the medical profession of Islington to diagnose diseases in 1,583 instances, or in 37.2 per cent. of the doubtful cases which they had under treatment. The following Tables show the results of the examinations that have been made:— Diseases. Total Examinations. Positive Results. Negative Results. Percentage of Positive Results. Diphtheria 1,807 649 1,158 35.9 Enteric Fever 835 369 466 442 Phthisis 1,609 565 1,044 35.1 Total 4,251 1,583 2,668 37.2 189 [1909 Table CXVIII. Showing the result of the Bacteriological Examinations made for tin Diagnosis of Diphtheria, Enteric Fever and Phthisis, 18981909. Periods. Diphtheria. Enteric Fevre. Phthisis. Totals. Positive Results. Negative Results. Total Examined. , Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. 1898 (6 months) 11 20 31 31 17 48 .. .. .. 79 1899 47 50 97 25 51 76 36 43 79 252 1900 43 62 105 33 45 78 35 44 79 262 1901 80 90 170 66 46 112 28 43 71 353 1902 52 70 122 45 69 114 39 83 122 358 1903 14 64 78 15 54 69 40 96 136 283 1904 28 58 86 14 39 53 46 89 135 274 1905 61 86 147 34 22 56 87 131 218 421 1906 68 99 167 27 29 56 57 96 153 376 1907 88 135 223 25 34 59 68 121 189 471 1908 93 188 281 34 25 59 69 136 205 545 1909 64 236 300 20 35 55 60 162 222 577 Totals (for 11½ years) 649 1158 1807 369 466 835 565 1044 1609 4251 VACCINATION. The returns dealing with vaccination relate to the year 1908, as it is impossible for the vaccination officers, owing to removals and postponements of vaccination, to collect the statistics within at least nine months of the close of the year. From the returns for 1908, it appears that out of 8,317 children who were born, 5,595 were successfully vaccinated; 31 were insusceptible to vaccination; 595 died unvaccinated; 588 were excused vaccination on production of exemption certificates, and 89 were postponed by medical certificate, leaving 1,419 not finally accounted for. These 1,419 cases, together with the exemptions and the cases postponed by medical certificates, numbering in all 2,096, represented 25.2 per cent. of the births, which is 3 per cent. more than the return of the preceding year. 190 1909] The returns show also that out of 8,317 births, 595 died before the infants could be vaccinated, thus leaving 7,222 that were liable to the operation, and as 5,595 of these were vaccinated, the percentage of vaccinations to those liable was 72.4, which is 4.5 per cent. less than in the preceding year. The figures since 1882 are very instructive, for they show that from that year to the present time there has been a very gradual but steady diminution in the vaccinations per 100 births, less the infants who died unvaccinated; in 1882 the percentage was 911; in 1908 it was only 72.4. Years. Vaccinations per 100 births, less infants who died unvaccinated. Years. Vaccinations per 100 births, less infants who died unvaccinated. 1880 89.8 1895 70.9 1881 90.8 1896 73.9 1882 91.1 1897 73.3 1883 90.4 1898 64.9 1884 90.5 1899 66.4 1885 90.6 1900 67.9 1886 90.8 1901 75.8 1887 90.4 1902 80.0 1888 88.4 1903 8l.2 1889 89.0 1904 82.3 1890 89.3 1905 80.5 1891 87.4 1906 79.9 1892 85.5 1907 76.9 1893 85.0 1908 72.4 1894 84.0 If one might judge by the manner in which the exemption certificates increase, even this low figure will diminish. Exemption Certificates—Since 1897, the first year in which exemption certificates were granted to conscientious objectors, they have risen from 14 to 588 in 1908. This matter is of so much importance that the particulars for each year are herewith set out. 1897 14 1903 103 1898 103 1904 89 1899 101 1905 110 1900 127 1906 123 1901 106 1907 259 1902 73 1908 588 This large increase in 1908 was to a certainty due to the Vaccination Act passed on the 28th August, 1907, in which it was enacted by section 1 as follows:— (1) "No parent or other person shall be liable to any penalty, under section 29 or section 31 of the Vaccination Act of 1867, if within four months from the birth of the child he makes a statutory declaration that he conscientiously believes that vaccination would be prejudicial to the health of the child, and within seven days thereafter delivers or sends by post the declaration to the vaccination officer of the district. 191 [1909 (2) "A statutory declaration made for the purposes of this section shall be exempt from stamp duty. (3) "A statutory declaration for the purposes of this section shall be made in the form set out in the schedule to this Act, or in a form to the like effect." The Act also provides a form of declaration which is to be made before a Commissioner of Oaths or other statutory officer authorised to receive a statutory declaration. The declaration is as follows:— SCHEDULE. "I, A.B., of in the parish of in the county "of being the parent (or person having the custody) of a child "named C.D., who was born on the day of 19 do "hereby solemnly and sincerely declare that I conscientiously believe that "vaccination would be prejudicial to the health of the child, and I make "this solemn declaration, conscientiously believing the same to be true, and "by virtue of the provisions of the Statutory Declarations Act, 1835. "Dated this day of 19, Signed—A.B. "Declared before me, at on the day of E.F. "a Commissioner for Oaths (or Justice of the Peace, or other officer authorised to receive a statutory declaration)." Thus we see that the road is made more smooth for the conscientious objectors to render it possible for their children to contract Small Pox. It is fervently to be hoped that the folly of the Government may not be rewarded in time with a serious outbreak of Small Pox. We had an illustration recently in Islington of the potency of vaccination, for in the small outbreak of Small Pox at the beginning of the year, it was a notable fact that the only child who contracted the disease was one who had not been vaccinated, although several other children were equally exposed to the infection. There is no use in labouring this matter. An anti.vaccinator is like every other "anti-", unamenable to reason, and nothing will alter his views except an affliction such as that described in the report of the Medical Officer of Health for last year. 192 1909] The last published statistics relating to England and Wales refer to 1907, and they show that only 70.9 per cent. of the children born during that year were vaccinated, as compared with 61 0 per cent. in 1898, and an average of 67.7 per cent. in the years 1893-1897; while those relating to the Metropolis show that in 1907 the vaccinations represented 65.9 per cent. of the births, as compared with 68 1 per cent. in 1906, and 70.7 in 1905, and an average of 65.4 in in the years 1893—97. Curiously enough, these returns (1907) are slightly better than those of the years 1893.1897, both for England and Wales and the Metropolis, and, therefore, it is a little unfortunate that an alteration in the law should have been made at such a time. Table CXIX. Showing the State of Vaccination in Islington, 1880-1909, also in London and England and Wales, 1880-1907. 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 9,860 22 819 155 644 8.0 6.6 4.5 1883 9,950 8,192 25 890 194 644 8.4 6.5 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 34.4 26.6 1899 9,631 5,698 81 1,048 101 333 2,370 29.1 28.7 20.8 1900 9,816 5,777 30 812 127 298 2,272 28.9 26.8 19.9 1901 9,966 6,382 29 852 106 107 1,790 21.6 25.2 17.3 1902 0,055 6,593 39 818 73 98 1,434 17.7 22.1 15.2 1903 8,959 6,673 23 739 103 62 1,359 17.0 21.7 14.7 1904 8,956 6,774 26 729 89 50 1,288 15.9 20.2 14.5 1905 8,603 6,360 28 709 110 66 1,330 17.5 20.1 14.8 1906 8,534 6,260 22 696 123 100 1,333 18.2 22.7 16.8 1907 8,372 5,976 15 609 259 65 1,448 21.2 25.8 20.3 1908 8,317 5,595 31 595 588 89 1,419 25.2 Not available. Not available. 1909 (6 ra'ths) 4,107 2,701 17 251 350 59 729 17.7 * 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. 193 [1909 Table CXX. Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the year 1908. REGISTRATION SUB-DISTRICTS. Number of Births registered in 1908. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Exemption Certificates received. Died Unvaccinated. Postponement by Medical Certificate. Removed to other Districts. Removed to places Unknown. Number of Children remaining Unvaccinated, or not accounted for in Report Book Total Number of Certificates of Primary Vaccination at All Ages received during year 1909. 1 2 3 4 5 6 7 8 9 10 11 Tufnell 800 519 5 ... 72 61 8 29 87 19 2,931 Upper Holloway 997 672 5 ... 63 65 11 13 156 12 Tollington 711 508 3 ... 51 53 6 9 68 13 Highbury 1,362 918 5 ... 141 92 14 15 145 32 Lower Holloway 1,021 702 2 ... 46 86 21 9 139 16 3,340 Barnsbury 1,552 1,126 4 ... 87 109 9 12 193 12 Islington, South East ... 1,874 1,150 7 ... 128 129 20 17 335 88 The Borough 8,317 5,595 31 ... 588 595 89 104 1,123 192 6,271 194 1909] Table CXXI. Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the period, January to June, 1909. REGISTRATION SUB-DISTRICT. Number of Births registered from 1st January to 30th June, 1909. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Exemption Certificates received. Died Unvaccinated. Postponement by Medical Certificate. Removed to other districts. Removed to places unknown. Number of children remaining unvaccinated or not accounted for in Report Book. Number of Exemption Certificates received during the year 1909 1 2 3 4 5 6 7 8 9 10 11 Tufnell 364 236 2 ... 39 24 11 7 32 13 427 Upper Holloway 549 378 3 ... 35 35 8 5 71 14 Tollington 345 236 2 ... 33 22 4 5 30 13 Highbury 663 431 2 ... 92 34 8 16 55 25 Lower Holloway 533 381 1 ... 31 29 9 6 54 22 362 Barnsbury 757 511 1 ... 38 48 4 10 106 39 Islington, South East 896 528 6 ... 82 59 15 7 133 66 The Borough 4,107 2,701 17 ... 350 251 59 56 481 192 789 195 [1909 DISINFECTION. The year under consideration was no exception to preceding years in the large amount of disinfection work that was carried out in the borough. It includes the spraying and stripping of rooms in houses and the classrooms of schools, as well as the disinfection of infected clothing, bedding, furniture and verminous articles, whether household furniture or personal clothing. Disinfection of Rooms.—There were '2,334 rooms disinfected after infectious diseases, or for other causes, as compared with 2,533 in the preceding year. The disinfectant used was in nearly every instance formaldehyde in vapour or solution, although in some instances where vermin had to be destroyed, sulphur dioxide was employed. The Cleansing and Stripping of Rooms —As many as 947 rooms, as contrasted with 818 in 1908, were cleansed, sprayed or stripped. 1908 1909 ist Quarter 184 209 2nd 179 234 3rd 162 175 4th 293 329 Disinfection of Schools —Class rooms in 17 public elementary schools, including the Guardians' Schools, Hornsey Road, were disinfected after Measles, Whooping Cough, Scarlet Fever or Diphtheria. The following statement shows the class rooms disinfected. 1st Quarter. Guardians' Schools, Hornsey Road (Boys' Dormitories), (Scarlet Fever). Vittoria Street L.C.C. Schools (Measles). Yerbury Road L.C.C. School, Infants (Scarlet Fever). 2nd Quarter Guardians' School (Scarlet Fever). Yerbury Road L.C.C. School (Scarlet Fever). St. Philip's School, Arlington Square (Measles). Upper Hornsey Road L.C.C. School (Scarlet Fever and Measles). 3rd Quarter Gillespie Road L.C.C. School (Scarlet Fevet). St. Jude's School (Scarlet Fever). O 2 196 1909] 4th Quarter Montem Street L.C.C. Schools (Whooping Cough). LTpper Hornsey Road L.C.C. School (Scarlet Fever). St. John's School (Diphtheria). Hanover Street L.C.C. School (Whooping Cough). St. Jude's School (Scarlet Fever). Highbury Vale School (Scarlet Fever). Mildmay Orphanage (Scarlet Fever). Wesleyan School, Drayton Park (Scarlet Fever). Table CXXII. Showing the Disinfection of Rooms by Formaldehyde Gas after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1909. Sanitary Inspectors' Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1909. 1908 1st Q'rter 63 50 25 33 34 29 46 33 50 33 42 75 32 44 589 579 2nd do. 76 63 12 51 39 45 27 35 28 35 65 43 32 38 594 479 3rd do. 47 72 31 49 51 55 35 25 40 39 40 52 32 40 608 630 4th do. 50 63 22 44 26 48 48 35 39 41 31 46 23 27 543 845 Year 236 248 90 177 150 177 156 128 157 148 178 221 119 149 2334 2533 Table CXXIII. Showing the Cleansing Spraying or Stripping of Rooms after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1909. Sanitary Inspectors Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1909. 1908 1st Q'rter 15 8 7 30 7 11 14 11 16 19 24 23 13 11 209 184 2nd do. 10 13 17 31 17 12 8 6 18 12 19 33 24 14 234 179 3rd do. 12 26 7 19 15 14 8 16 7 9 10 19 7 6 175 162 4th do. 42 18 16 32 37 11 29 38 23 10 17 28 7 21 329 293 Year 79 65 47 112 76 48 59 71 64 50 70 103 51 52 947 818 197 [1909 Disinfecting Station.—The work done at the Disinfecting Station was heavier than at any period since the erection of the steam disinfectors, for no less than 08,860 articles, which does not include handkerchiefs, stockings, or other small articles usually made up into bundles, underwent the process of disinfection. Of this large number, 37,273 had been exposed to an infectious disease. Particulars are given in the following table:— TABLE CXXIV. Summary of the chief articles of Clothing, Bedding, &c., disinfected during the year 1909, and also in the preceding year 1908. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1909 1908. Beds 776 715 728 640 2,859 2,797 Blankets - 1,320 1,194 1,088 1,208 4,810 4,5°5 Bolsters 687 631 715 683 2,716 2,337 Carpets 150 l8l 152 150 633 601 Chair Bed Cushions 122 8l 113 67 383 337 Mattresses 386 371 521 447 1,725 1,590 Palliasses - 341 369 449 299 1,458 1,515 Pillows 1,507 1,382 1,385 1,303 5,577 5,276 Quilts 781 690 716 670 2,857 2,782 Sheets 1,429 1,313 1.134 1,000 4,876 5.069 Other Articles 2,327 2,341 2,630 2,081 9,379 9,207 Totals 9,826 9,268 9,631 8,548 37,273 36,016 With respect to the other articles, 31,587 in number, it may be stated that they consisted of the cast-off clothing of soldiers and sailors, and included tunics, overcoats, and other garments, all of which were intended for exportation to various countries, and with respect to which the Medical Officer of Health issued certificates as to their having been satisfactorily disinfected. This work has only been undertaken by the Council for the last two years in order to meet the requirements of a large firm in Islington who export these articles, and who are required to produce a certificate from the Medical Officer of Health as to their satisfactory disinfection. Such certificates could not be given unless the clothing had been disinfected by the Council. A charge is, of course, made for the work, a minimum fee of £l, which is paid for any number of articles under 1,000, having been fixed; while for 1,000 articles '25s. is charged, and above that number in proportion to the rate last mentioned. 198 1909] The following statement gives a description of the clothing that was disinfected and the number of articles. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Soldiers' Tunics 6oo ... ... 800 1,400 ,, Overcoats - 2,208 ... ... 4,722 6,930 „ Jackets ... ... ... 794 794 Other Articles 1.130 10,491 6,365 4,477 22,463 3.938 10,491 6,365 10,793 31,587 The following is a record of the work performed by the Steam Disinfectors during the past fifteen years:— 1895 - 17,240 articles 1896 42,258 ,, 1897 28,302 ,, 1898 20,172 ,, 1899 25,378 „ 1900 19136 ,, 1901 27,050 ,, 1902 36,772 ,, 1903 23,748 ,, 1904 21,868 „ 1905 25,463 ,, 1906 28,629 ,, 1907 30,083 ,, 1908 62,455 ,, 1909 68,860 ,, Total for fifteen years 477,414 ,, Disinfectants distributed and used.—The total cost of these disinfectants was £38 12s., an infinitesimal sum as compared with the size of the borough or with the amounts paid in years gone by. If we look into the past records of Islington, it will be found that in 1892 59 tons of carbolic powder, 3,840 gallons of crude carbolic acid, and 80 gallons of clear carbolic acid were distributed among and used by the public, the cost being £533. In 1893, 62 tons of carbolic powder, 7,201 gallons of crude carbolic acid, and 115 gallons of clear acid were distributed and used by the public. 199 [1909 In 1895 45 tons of powder, 7,535 gallons of disinfecting fluid, and 95 gallons of clear carbolic acid were used by the department and distributed among the public, at a cost of £1,343. In 1896 the Medical Officer of Health formed a very definite opinion that nearly all the disinfectants distributed to the public were used in their house drains, sinks, w.c.'s, etc., in a wasteful manner, and were of little or no use in the prevention of infection, because they were used unscientifically and ignorantly. The fact is that disinfectants can only be used to an advantage for these purposes by skilled persons, and even then it is very uncertain that they are of any real utility except in the cloaking of unpleasant smells. The Medical Officer of Health therefore took the responsibility of ordering that no more disinfectants should be distributed to the public unless there was some special reason for doing so. The result was that only 10 tons of carbolic powder, 1,208 gallons of carbolised creosote, and 80 gallons of clear acid, the cost of which was £151, were distributed, and even the bulk of it was used under the supervision of the Inspectors and in the disinfection of premises in which infectious diseases had occurred. The most satisfactory part of this curtailment is that the borough does not appear to have suffered in any way by his action, while the Council saves something like £1,300 per annum. Very recently a correspondence appeared in a paper devoted to public health questions, on the use of disinfectants, from which it would appear that several Medical Officers of Health and others engaged in public health work are now beginning to find out what Islington discovered 14 years ago, that disinfectants as used by householders are of very little value in public health administration, which is demonstrated by the fact that Islington has not suffered in any way, for, as everyone knows, its death-rate, both from all causes and from the zymotic diseases, has largely decreased. 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. Disinfecting Fluid. Formaldehyde. Powder. Solution. Tons. cwts. Gallons. cwt. qr. lb. Gallons. To Householders 4 0 780 — — Disinfection of Premises — — 2 0 0 28 Cost = £38 12s. Od. 200 1909] SHELTER HOUSE. I he Shelter House was used for various purposes during the year, among which were the following:— 1st. To house persons whose homes were undergoing disinfection. 2nd. To cleanse verminous persons in its slipper baths under the provisions of the Verminous Persons Act. 3rd. To bathe verminous school children. 4th. To bathe and cleanse midwives after attendance on cases of Puerperal Fever. Only four families, consisting altogether of 6 persons, used the Shelter House while their homes were being disinfected. As many as 1,205 children attending the London County Council Schools were bathed and cleansed and their clothing disinfected. Many of the children attended more than once, and are included in the return given below. Thirty-one persons were cleansed under the Verminous Persons Act, 1897. Of this number, three were women. Five midwives were disinfected after attendance on cases of Puerperal Fever. Persons using Shelter House pending the disinfection of their homes. Date of Admittance. Address. Number in Family. Cause. 1909. 1 8th Jan. 24, Mulkern Road 1 Scarlet Fever. 9th „ „ „ 1 „ 8th May 77, Offord Road 1 „ 1st Sept, 12, Andover Road 3 „ 1 201 [1909 Verminous persons cleansed at the Shelter House under the " Cleansing of Persons Act, 1897." Date of Admittance. Address. Number of Persons Cause. 1909. 18th Jan. 10, Campbell Road 3 Verminous. 27th „ 72, Winchester Street 1 Do. 10th Feb. 12, Gordon Place 1 Do. nth „ Lodging House, Hornsey Road 1 Do. 17th „ Lodging House, Barnsbury Street Do. 19th „ Do. do. 1 Do. l9th „ Lodging House, Hornsey Road 1 Do. 26th May 8, Malvern Terrace 1 Do. 1st June 26, Loraine Road 1 Do. 4th „ 206, Caledonian Road 1 Do. 4th „ 26, Loraine Road 1 Do. 14th „ 10, Campbell Road 1 Do 17th „ 20. Barnsbury Street 1 Do. 20th July Lodging House, Hornsey Road 1 Do. 20th „ 160, Caledonian Road 1 Do. 20th „ 20, Barnsbury Street 1 Do. 16th Aug. 4, Queensland Road 1 Do. 25th „ 160, Caledonian Road Do. 8th Sept. 10, Campbell Road 1 Do. 23rd „ 87, Essex Road Do. 4th Oct. Albert House, Essex Road 1 Do. 20th „ Unknown 1 Do. 30th „ Unknown 1 Do. 12th Nov. 12, Gordon Place 1 Do. 18th „ 87, Essex Road Do. 1st Dec. 8, Flowers Mews Do. 1st „ Unknown 1 Do. 15th „ Lodging House, Barnsbury Street 1 Do. 31 202 1909] School Children Cleansed and Bathed—During the year 1,205 children attending the London County Schools were bathed and cleansed by the woman attendant, and had their clothes disinfected. Midwives attending Disinfecting Station for the purpose of disinfection after cases of Puerperal Fever. Date of Admittance. Name Address. 1909 15th March Nurse F. 85, Mildmay Grove 28th April Nurse W. 227, Essex Road 10th August Mrs. B. - 52, Nicholay Road 4th October Mrs. W. 7, Witley Road 8t!i December Nurse B. 175, Balls Pond Road 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. 204 1909] FACTORY AND WORKSHOP ADMINISTRATION. Under section 133 of the Factory and Workshop Act, 1901, it is required of the Medical Officer of Health of every district Council to report specifically in his Annual Report on the administration of the Act in workshops and workplaces, and to send a copy of his report, or such part of it as deals with this subject, to the Secretary of State. But, apart from this consideration, it is of great importance to the community that they should know in what manner workshops, which include laundries, bakehouses, restaurant kitchens, and outworkers' premises, are conducted, because of the effect these premises would have on the public health if they were not kept in a sanitary condition. The work of this part of the Public Health Department is, therefore, of no less importance than any other which it undertakes. Inspectors.—1 male and 2 female Inspectors are engaged in executing the work entailed on the Council under this Act. The duty of the male Inspector is to inspect factories, workshops, and workplaces where men are employed; while that of one of the Female Inspectors is to visit factories and workshops, including laundries and workplaces where women are employed; and that of the second Female Inspector is to inspect the homes of outworkers, the kitchens of restaurants and of all places where food is prepared. Inspections and Visits.—There were 11,470 inspections and visits made to the various premises, as compared with 11,505 in the preceding year, and with 10,727 in 1907 and 6,908 in 1900. To factories, which include factory laundries, were paid 447 visits, as compared with 434 in the preceding year; to workshops, which include workshop laundries, 1,820 visits were made, as against 2,008; to workplaces other than outworkers' premises, 311, as against 248; to kitchens and restaurants 822, as against 800; to outworkers' premises, 1,328, as against 995, while miscellaneous re-inspections and calls amounted to 0,748, as against 6,508. The slight decrease was due to the ill health which compelled the male Inspector's absence from duty for some time. Notices served.—780 intimations and 4 statutory notices were served on the owners of premises or proprietors of businesses, relating to 1,750 sanitary defects, of which 1,595 had been remedied at the close of the year. In addition to these notices, 66 relating to 119 sanitary defects were served at the homes of outworkers. These notices compare with 642 in the preceding year. 205 [1909 Registers.—There are 4,370 workshops on the register, as contrasted with 4,257 in 1908, and they include 544 workplaces where men are employed, 857 workplaces where women are employed, 128 laundries, 253 bakehouses, 738 kitchens of restaurants and eating houses or places where food is prepared, and 1,850 outworkers' premises, which show an increase of 19 on the figures for the corresponding period in 1908. The following table, giving the figures for the year, as well as those of 1908, has been prepared as in the preceding year. It shows the changes which have occurred in the registers in that time. Workshops and Workplaces. 1908. 1909. Workshops on Register. Workrooms on Register. Number added during Year. Number removed during Year. Total number of Workshops on Register. Number of Workrooms on Register. Workshops where Men are employed 533 832 93 82 544 804 Workshops where Women are employed 821 1,615 210 174 857 1,598 Laundries 132 20 24 128 Bakehouses 255 265 2 4 253 263 Restaurant Kitchens 685 939 68 15 738 1,018 Outworkers' Premises 1,831 1,831 19 – 1,850 2,035 Total 4,257 5,482 412 299 4,370 5,718 Sanitation.—The sanitary defects discovered numbered 1,750, of which 425 referred to want of cleanliness, 29 to insufficient ventilation, 9 to overcrowding, 99 to insufficient surface drainage or want of it, and 474 to other nuisances. Dustbins were wanting in 37 cases; in 34 the W.C. accommodation was not sufficient; in 418 it was foul; in 185 it was unsuitable or defective; and in 40 separate accommodation had not been provided for the sexes. At the close of the year 1,595 of these defects had been remedied. There were also 119 defects discovered in homeworkers' premises. In the subsequent table is shown the number of nuisances dealt with since 1890, where it is seen that 14,673 nuisances have been abated. These figures, however, by no means represent the volume of work that has been accomplished, for thousands of minor nuisances are not covered by the list. 1909] 206 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 Total Overcrowding 26 12 15 14 22 14 4 13 4 13 30 9 8 9 '93 Ventilation 14 13 2 5 4 3 5 8 11 4 8 31 12 29 149 Dirty Premises 311 195 109 99 217 718 231 423 630 412 448 970 719 425 5 407 Drains 554 458 375 313 216 177 90 50 19 15 4 19 261 61 2,612 W.C.'s 420 325 341 355 411 375 154 161 165 151 190 620 573 677 4 918 Water supplies 79 41 35 20 19 13 83 54 18 38 17 23 45 40 525 Surface drains 79 109 87 51 78 81 2 53 40 34 39 45 72 99 869 Cleanliness.—425 premises were found in an uncleanly state, and 444 were put into proper order. These figures exceed the defects found, but this is explained by the fact that they include the premises about which notices had been served in 1908, but which had not been cleansed at its close. The numbers of the preceding years have been 970, 448, 412, and 719. Effluvium Nuisances.—None was found. Ventilation.—Insufficient ventilation was discovered in 29 instances, of which 25 had been remedied at the close of the year. Overcrowding.—9 instances of overcrowding came under the observation of the Inspectors, and these were forthwith abated. In the preceding years the numbers were 13 in 1905, 30 in 1906, 9 in 1907, and 8 in 1908. It will thus be seen that overcrowding in the workshops in Islington is not of a serious character. Want of Drainage of Floors—In 99 instances the floors of workshops chiefly laundries, were found to be insufficiently drained, and consequently a notice was served in each instance, of which 80 had been complied with at the close of the year. Sanitary Accommodation.—Special attention was given again to the provision of this class of accommodation in workplaces, particularly to that provided for the sexes, and resulted in separate accommodation being provided in 40 instances. 207 [1909 Nuisances arising from insufficient accommodation were abated in 34 cases, while 418 foul W.C. pans were cleansed, and 185 that were unsuitable or defective were remedied. Bakehouses -- No instance was known of the illegal occupaton of underground bakehouses, nor indeed were there any other offences known against the Act with regard to them. Their general condition in the early part of the year, and only then, was not so good as that in the preceding year, but this Was owing to the fact that Inspector West, who has charge of them, was ill for a considerable time. The Chief Inspector, Mr. J. R. Leggatt, however, made his usual annual inspection, and his observations thereon are contained in his report, which is herewith submitted. Town Hall, Upper Street, Islington, N. 29th May, 1909. To the Medical Officer of Health. Dear Sir, I beg to report that I have now completed my annual inspection of the bakehouses above and below ground in the borough, which number 255. In consequence of the protracted illness of Inspector West, whose duty it is to inspect the bakehouses systematically, I found that they were not quite in such a satisfactory state as in former years. It would, therefore, appear that unless they are regularly inspected the tendency is on the part of those responsible to neglect to attend to the smaller details which are so necessary to the promotion of cleanliness, &c. This will be more readily understood when I state that there were 124 letters written calling attention to the floors and ceilings being out of repair, sweepings from the floors being found under the troughs, clothes being aired or dried in the bakehouse (but not so frequently as in former years), and to the necessity of the walls and ceilings of the bakehouses and flour stores or lofts being cleansed. I have given to each of the District Inspectors a list of the requirements, and they are seeing to the work being carried out, and I am glad to say that the greater portion has been done and the remainder will soon be completed. I am, Yours faithfully, JAMES R. LEGGATT, Superintendent and Chief Sanitary Inspector. 208 1909 LIST OF BAKEHOUSES. Upper Holloway District. Bakehouses above ground. 16, Brecknock Road 19, Archway Road 29, Highgate Hill 75, Elthorne Road 44, Cheverton Road 634, Holloway Road 103, Ekhorne Road (Factory) 12, Hercules Road 57, Elthorne Road 60, Grove Road 582, Holloway Road 29, Cottenham Road 90, Grove Road 110, Marlborough Road 62, Cottenham Road 103, Fairbridge Road 127, Marlborough Road 484, Hornsey Road 166, Fairbridge Road 346, Hornsey Road 163, Seven Sisters Road 67, Durham Road 104, Andover Road 88, Andover Road 25, Lennox Road 49, Campbell Road 47, Palmerston Road 81, Fonthill Road 114, Fonthill Road 125, Hanley Road 144, Tollington Park 51, Stroud Green Road 131, Stroud Green Road 5, Tollington Park (Factory) 626, Holloway Road 420, Hornsey Road 81, Junction Road 669, Holloway Road 24, Hampden Road 58, Hazellville Road Certified Underground Bakehouses. 54, Archway Road 26, Blenheim Road 33, Bedford Terrace 144, Elthorne Road 10, Campdale Road 487, Hornsey Road 87, Hazellville Road 27, Hornsey Rise 676, Holloway Road 264, Hornsey Road 575, Holloway Road 167, Junction Road 239, Junction Road 7, Junction Road 104, Junction Road 32, Milton Grove 57, Marlborough Road 212, Tufnell Park Road 1, Stapleton Hall Road 59, Junction Road 84, Yerbury Road 31, Salisbury Road 47, Landseer Road 3, Card well Terrace 84, Ashbrook Road 209 11909 Bakehouses not in use. 5, Andover Road (Underground) Crisp & Co., Seven Sisters Road (above ground) 102, Highgate Hill (Above ground) 33, Milton Grove (Underground) 23, Girdlestone Road (Underground) 599, Holloway Road (underground) 53, Poole's Park (Above ground) Lower Holloway District. Bakehouses above ground. 69, Holloway Road 254, York Road 251, Holloway Road 85, Holloway Road 463, Liverpool Road 261, Holloway Road 72, Rhodes Street 106, St. James' Road 421a, Caledonian Road V.V. Bakery, Brewery Road (Factory) Kemp's Bakery, Brewery Road (Factory) 16, Westbourne Road (Factory) 1 a, St. James' Road Certified Underground Bakehouses. 5, Crossley Terrace 37, Charlesworth Street 118, Roman Road 480, Caledonian Road 78, Goodinge Road 376, York Road 415, Caledonian Road 70, George's Road 132, St. James' Road 32, St. James' Road (Factory) 107, Roman Road 1, Frederick Street Bakehouses not in use. 46, Roman Road (Underground) 25, Cornelia Street (Above ground) 16, Sherringham Road „ 92, Wellington Road (Underground) 25, Wellington Road ,, 214, York Road ,, Highbury District. Bakehouses above ground. 112a, Drayton Park (Factory) 123, Newington Green Road 232, Holloway Road 132, Holloway Road 56, Hornsey Road 154, Hornsey Road 100, Hornsey Road 48, Seven Sisters Road 370, Holloway Road (Factory) 10, Blackstock Road 190, Seven Sisters Road 225, Blackstock Road 258, Seven Sisters Road 226, St. Paul's Road 3, Highbury Park 53, Boleyn Road 210, Seven Sisters Road 17, Annette Road (Factory) P 210 1909] Certified Underground Bakehouses. 64, Drayton Park 146, Blackstock Road 246, Hornsey Road 98, Gillespie Road 128, Blackstock Road 77, Newington Green Road 156, Blackstock Road 57, King Henry's Walk 42, Newington Green Road Salvation Army Bakery, Hawthorne Street (Factory) 52, Balls Pond Road 132, Holloway Road 13, Highbury Place 66, Blackstock Road 1 Mildmay Park Bakehouses not in use. 182, Drayton Park (Underground) 2, Queen's Square (Underground) 25, Lowman Road ,, 77, Boleyn Road „ 98, Balls Pond Road „ 202, Blackstock Road (Above ground) Barnsbury District. Bakehouses above ground. 112, Copenhagen Street 129, Barnsbury Road 5g, Caledonian Road 36, Caledonian Road 199, Caledonian Road 170, Caledonian Road 32, Bingfield Street (Factory) 275, Caledonian Road 185, Copenhagen Street 12, Bemerton Street 44, Outram Street 213, Copenhagen Street 57, Copenhagen Street 40, Cloudesley Road Certified Underground Bakehouses. 44, Bingfield Street 96, Caledonian Road 21, Barnsbury Road 72, Bemerton Street 60, Bingfield Street 68, Barnsbury Road 370, Caledonian Road 100, Bemerton Street 299, Caledonian Road 76, Caledonian Road 27, Dennis Street 159, Caledonian Road 26, Half Moon Crescent 179, Hemingford Road 1 and 3, Richmond Road 44, Northdown Street 6, Wharfdale Road 52, Stanmore Street 12, Randall's Road 62, Winchester Street Bakehouses not in use. 29, Offord Road (Underground) 205, Copenhagen Street (Underground 120, York Road „ 279, Liverpool Road ,, 181, Copenhagen Street (Underground) 86, Thornhill Road „ 269, Liverpool Road „ 334, Caledonian Road „ 123, Offord Road „ 29, Hemingford Road „ 19, Brooksby Street (Above ground) 21, Caledonian Road „ 62, Barnsbury Street (Underground) 211 [1909 South-East District. Bakehouses above ground. 76, Baxter Road 229, Balls Pond Road 361, New North Road 226, Essex Road 38, Coleman Street 313, New North Road 50, Popham Road 20, Popham Road 40, Cross Street 172, Essex Road 69, St. Peter Street 126, Packington Street 8, Danbury Street 52, City Garden Row 5, Charlton Place (Factory) 230, Upper Street 137, Upper Street 84, St. Peter Street Certified Underground Bakehouses. 24, Alfred Street 257, Balls Pond Road 14, Charlton Crescent 350, Essex Road 398, Essex Road 114, Essex Road 68, Essex Road 102, Essex Road 6, High Street 262, Liverpool Road 126, Liverpool Road 16, Rheidol Terrace 33, Park Street 1, Shepperton Road 32, Shepperton Road Oxford House, Sherborne Street 51, Southgate Road 102, Upper Street 1, Theberton Street West 57, Essex Road 55, Clephane Road 50, Arlington Street 121, Packington Street 14, Upper Street 192, New North Road 263, New North Road 1, Cross Street Bakehouses not in use. 28, Baxter Road (Underground) 51, Windsor Street (Above ground) 30, Canonbury Street ,, 76, St. Paul's Street (Underground) 202, Essex Road ,, 24, Church Street ,, 32, Parkfield Street „ 289, City Road ,, 38, High Street „ 2, High Street ,, 44, High Street ,, 29, Camden Street ,, 3, St. Paul's Street „ 67, Essex Road ,, 322, Essex Road (Above ground) 107, Upper Street (Above ground) 9, Islington Green „ 298, New North Road „ 129, Upper Street „ P 2 212 1909] Outworkers' Premises.—There were 1,850 outworkers' premises on the register, containing 2,035 workrooms, as contrasted with 1,831 in the preceding year, and 1,989 in 1907. There has, therefore, been a slight increase in the number of outworkers when compared with those of 1908, but they are below those of 1907. Particulars as to the outworkers' premises are fully set out in Table 3 (page 215) of the returns required by the Secretary of State. Restaurant kitchens and places where food is prepared.—The total number now on the register is 738 kitchens, with 1,108 rooms. During the year 15 were closed, while 68, with 88 workrooms, were added to the register. In the preceding year there were 685 such places, with 939 rooms. This work has proved most useful, and has engaged the very closest attention of one of the Inspectors (Mrs. Young), whose report is well worthy of careful study, and from which it appears that out of a total of 532 places where food is prepared that were examined during the year, 395 were found to be satisfactory, and 137 unsatisfactory. In 125 instances where special attention was given to the utensils, it was found that in 52 instances they were satisfactory, and in 73 unsatisfactory. These figures show how important it is that the places where food consumed by the public is prepared should be most carefully inspected. Fuller particulars are given in Mrs. Young's report. Workshops notified to H.M. Inspector—Under the provisions of section 133 of the Factory and Workshop Act, the Medical Officer of Health, as soon as he becomes aware that any woman, young child, or person is employed in a workshop, shall forthwith send notice to the Inspector of Factories. During the year 203 such instances were notified in accordance with this section. 213 [1909 Workplaces notified to Home Office, 1909. Trade. Number of Workshops. Protected Persons Employed, Females. Male Young Persons. Total. Dress Making 44 85 – 85 Blouse Making 23 48 — 48 Laundry 13 32 — 32 Millinery 13 34 — 34 Mantle Making 8 13 — 13 Tailoring 10 28 3 31 Tie Making 7 11 — 11 Skirt Making 5 17 — 17 Underclothing Making 4 8 — 8 Embroidery 4 8 — 8 Ticket Writing 3 3 3 6 Waistcoat Making 3 3 — 3 Fur Work 3 3 2 5 Hair Work 2 5 5 Artificial Flower Making 2 2 — 2 Apron Making 2 11 — 11 Infant's Millinery 2 1 — 1 Fancy Work 2 2 – 2 Box Making 2 2 — 2 Buttonhole Making 2 2 — 2 Sign Writing 2 2 — 2 Photographic Work 2 2 2 4 Mangling 2 2 — 2 Printing 2 — 4 4 Shoe Making 3 — 2 2 Wire Work 2 — 2 2 Pianoforte Making 2 — 4 4 Cabinet Making 2 2 2 Engineering 2 — 2 2 Bookbinding 1 1 — 1 Perambulator Hoods 1 1 1 Lace Work 1 1 Baby Comforter Fitting 1 — 1 Leather Work 1 4 Boot Upper Making 1 1 — 1 Wardrobe Alterations 1 1 Dyeing and Cleaning 1 — 2 Camisole Making 1 1 — 1 Fancy Shade Making 1 1 — 1 Outfitting 1 34 — 84 Needlework 1 1 — 1 Pyjama Making 1 7 — 7 Cigarette Making 1 1 — 1 Dressing Gown Making 1 — 3 Hosiery 1 1 — 1 Baby Linen i 3 — 3 Waterproofing 1 3 — J Fish Cleaning 1 — 1 1 Gelatine Work 1 – 1 1 Sausage Making 1 — 1 1 Gold Paint Making 1 — 2 2 Flour Weighing 1 — 2 2 Wheelwright 1 — 1 1 Pea Packing 1 — 4 4 Celluloid Case Making 1 — 2 2 Tin Work 1 — 2 2 Brush Making 1 — 1 1 Clock Making 1 — 1 1 Photographic Mount Making 1 — 1 1 Total 203 391 45 436 To elucidate this list it may be said that in many cases the addresses of workshops have been notified to the Home Office before any workpeople were actually found at work. Thus the number of employees given in the list does not fully represent the number of protected persons affected by the notification. 214 1909] SECRETARY OF STATE'S RETURNS on the administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES, AND HOMEWORK. 1.—INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of (1) Inspections. Written Notices. cutions. (2) (3) (4) Factories (Including Factory Laundries) 447 91 1 Workshops (Including Workshop Laundries) 1,820 302 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 1,133 324 1 Miscellaneous Re-inspections 6,748 _ — Total 10,148 717 2 2 -DEFECTS FOUND IN FACTORIES. WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) [ Nuisances under the Public Health Acts:—' Want of cleanliness 425 444 Nil Nil Want of ventilation 29 25 ,, ,, Overcrowding 9 9 ,, ,, Want of drainage of floors 99 86 ,, ,, Other nusiances 511 430 ,, ,, Sanitary Accommodation insufficient 34 31 ,, ,, unsuitable or defective 603 549 ,, ,, not separate for sexes 40 21 ,, ,, Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) Nil Nil ,, ,, Breach of Special sanitary requirements for bake houses (ss 97 to 100) ,, ,, ,, ,, Other offences .. (Excluding offences relating to outwork which are included in Part 3 of this report) ,, ,, ,, ,, Total 1,750 1,595 Nil Nil * Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. 215 [1909 3.—HOME WORK. NATURE OF WORK.* Outworkers' Lists, Section 107 Inspections of Outworkers' Premises. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises (Secs. 109, 110). Lists received from Employers Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served under Public Health Act, 1891. Prosecutions. Instances. Orders made (S. 110). cutions (Sections 109, 110). Sending twice in the year. Sending once in the year. Received from other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists, † Outworkers, f Lists. Outworkers. Contractors Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— (1) making, &c 580 520 3,348 18 .. 64 2,641 1,166 236 .. .. 1,033 107 53 .. 26 .. .. (2) cleaning and washing 4 4 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Artificial Flowers 8 .. 86 1 .. 6 136 22 2 .. .. 60 8 2 .. 2 .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and Upholstery 4 .. 13 2 .. 2 .. .. 1 .. .. 4 .. .. .. .. .. .. Fur pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, &c .. .. .. 2 .. 2 8 .. .. .. .. 1 .. .. .. .. .. .. Carding, &c., of buttons, &-c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper Bags and Boxes 18 .. 182 .. .. .. 108 16 4 Nil Nil 70 22 11 Nil 2 Nil Nil Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brush making 2 .. 57 .. .. .. 60 .. .. .. .. 28 .. .. .. .. .. .. Racquet and Tennis Balls.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed Toys .. .. .. .. .. .. 7 .. .. .. .. 5 .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Electro Plate .. .. .. .. .. .. 6 .. .. .. .. 3 .. .. .. .. .. .. Cables and Chains .. .. .. .. .. .. 8 .. .. .. .. 3 .. .. .. .. .. .. Anchors and Grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cart Gear .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, Latches and Keys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 616 524 3,688 23 .. 74 2,974 1,204 243 .. .. 1,207 137‡ 66 .. 30 .. .. 216 19091 4—REGISTERED WORKSHOPS. Workshops on the Registers (s. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop bakehouses may be enumerated here. ' Workshops where men are employed 544 Workshops where women are employed 857 Laundries 128 Restaurant kitchens 738 , Bakehouses 253 Total Number of Workshops on Registers 2,520 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 205 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5). Notified by H.M. Inspector 3 Reports (of action taken) sent to H.M. Inspector. 1 Other Nil. Underground Bakehouses (s. 101):— Certificates granted during the year Nil. In use at the end of the year 99 217 [1909 INSPECTOR WEST'S REPORT. Town Hall, Upper Street, Islington, N. 4th April. 1910 To the Medical Officer of Health. Sir,—I have pleasuie in heiewith submitting my repoit to you for the year ending the 1st January, 1910, during such time I have made 4,292 visits to the various places of business (factories, workshops and workplaces) on the register. I have made 1,846 inspections and 2,440 re-inspections. The visits to the various trade premises were as follows:— follows:—250 factories, 987 workshops, 198 work places, 290 bakehouses, 121 outworkers' premises, and 2,446 miscellaneous. No. of workshops. No of workshops Artificial florists 2 Fire escapc maker 1 Automatic machine maker 1 Fish dleaner 1 Bakehouses 253 File cutter 1 Builders, &c. 9 Fish curer 1 Blacksmiths 6 French polisher 1 Basket maker 1 Fur skin dyer 1 Blind makers 2 Fancy goods maker 2 Brush makers 6 Flour merchant 1 Bamboo cane workers 4 Gun makers 2 Balloon maker, &c. 1 Glazier, &c. 1 Brawn maker 1 Glove maker 1 Boot polish makers 3 Gold paint maker 1 Brace maker 1 Gilder (card edge) 1 Bust maker 1 Glass engraver 1 Confectioners 7 Glass worker 1 Cycle makers 14 Harness makers 9 Cabinet makers 35 Hat shapes makers 4 Coppersmith 1 Hair work 1 Camera bellows maker 1 Japanners 1 Cardboard box makers 6 Leather goods 9 Cap makers 2 Ladder makers, &c. 2 Clay pipe maker 1 Lath render 1 Cork cutter 1 Limelight works 1 Cattle food maker 1 Lamp makers 2 Coopers 2 Laundries 2 Cloth shrinkers 1 Marquetrie workers 2 Corset maker 1 Marking ink maker 1 Carpenters 3 Mineral water sundries 1 Coach painters 2 Marble masons 3 Dairy can maker 1 Metal workers 2 Dentist 1 Musical instrument maker 1 Engineers 9 Motor works 11 Exhibition stall fitter 1 Musical string makers , &c. 2 Embroiderers 1 Mantle makers 3 Farriers 30 Naturalist 1 Furriers 49 Optician 1 Fancy brooch maker 1 Organ builder 1 Feather dressers 3 Pianoforte makers 39 1909] 218 Number of Workshops. Number of Workshops. Provision dealers 2 Surgical appliance makers 3 Plaster block maker 1 Stationer 1 Pickle works 1 Seat makers (Patent) 1 Plumbers 3 Trunk maker 8 Picture frame makers 8 Tailors 67 Perambulator maker 1 Tarpaulin makers, etc. 1 Photographers 5 Tinsmiths 2 Picture post card maker 1 Turkish delight maker 1 Paper sorter 1 Ticket writers 6 Pea packer 1 Tea sifters 2 Rag sorters 7 Toy makers 4 Rubber workers 4 Undertakers 2 Scale makers 2 Umbreila maker 1 Shoemakers 140 Umbrella and stick handle makers 3 Sun-dial maker 1 Upholsterers 12 Sealing wax maker 1 Wheelwrights 39 Saddle tree maker 1 Wood choppers 7 Scientific instrument makers 5 Watchmakers, etc. 9 Stove makers 2 Wire workers 3 Soap makers 1 Wood letter maker 1 Stick mounter 1 Wreath case maker 1 Scene painter 1 Wax figure maker 1 Sign writers 3 — Shop fitter 1 Total 951 Sanitary improvements.—During the year I have served 281 notices for the abatement of nuisances, 228 workshops have been cleansed and lime-whited, 30 w.c.'s have been provided (23 for males and 7 for females) at various workshops, whilst 523 other improvements were carried out under my supervision. Also 48 workroom cards were distributed showing the cubic capacity and the number of employees allowed to work in each workroom. 40 water supplies were also provided. Bakehouses.—Subsequent to Mr. Leggatt's inspection and report on these places in May last, owing to my ill health, I have made 290 inspections of bakehouses, besides a number of other calls, and am very pleased to find the marked improvement in respect to their cleanliness which is kept up, and in some instances by paying casual visits, and this I find must be done to keep them in proper order. At the close of the year there were 202 bakehouses in use and 51 empty or not in use. I have also reported through you to H.M. Inspector of Factories, as required by Section 27 of the Public Health Act, 1891, the addresses of 39 workshops where young persons under the age of 18 years were emplloyed, and where the abstract of the Factory Act was not affixed. Register.—During the year, 106 workshops have been added to the Register, whilst 109 have been removed so that at the present time there are 951 workshops containing 1,399 workrooms and 54 outworkers' premises now on the register. I am, Sir, Your obedient servant, GEORGE WEST, Sanitary Inspector of Workshops, etc. 219 [1909 Miss BROWN'S REPORT. Town Hall, Islington, To the Medical Officer of Health, February 10th, 1910 Sir, I beg to submit to you a report of the work done by me during 1909 in connection with workplaces in Islington where women are employed. During the year I have made 1,088 inspections of premises and 2,303 calls and The inspections and re-inspections are as follows:— Inspections of Factories (including steam laundries) 197 Inspections of Workshops (including hand laundries) 833 Inspections of Workplaces 58 Miscellaneous re-inspections and calls 2,303 Total 3,391 Register of Factories.—There were on the register at the end of the year 185 factories as contrasted with 179 at the end of last year The following is a list of the Factories and Steam-Laundries on the register. Industry Number. Industry. Number. Laundry. 48 Capsule making 1 Printing 17 Brewery 1 Box making 12 Washing-powder making 1 Costume making 7 Beer bottling 1 Book binding 7 Publishing 1 Confectionery making 6 Wood cutting 1 Cigar making 6 Outdoor games making 1 Chemists' sundries making 4 Pill making 1 Dyeing and cleaning 5 Bootpolish making 1 Engineering 3 Table stationery making 1 Fur sewing 2 Curtain making 1 Bakery 2 Surgical leather work 1 Mattress Making 2 Dental requisites making 1 Millinery 2 Gelatine work 1 Cabinet making 2 Wicker work 1 Brushmaking 2 Leather work 1 Corset making 2 Slate work 1 Blind making 2 White lead works 1 Aerated water making 2 Surgical appliances making 1 Outfitting 2 Marquetrie 1 Mangling 2 Button making 1 Blouse making 2 Frame making 1 Toy making 2 Sack making 1 Meat preserving 2 Sauce making 1 Piano string making 1 Bottle making 1 Glass letter making 1 Pattern card making 1 Lock and key making 1 Shoe accessories making 1 Toothbrush making 1 Photographic mount making 1 Collar and Cuff makin 1 Arc lamp making 1 Syphon making 1 Stationery making 1 Apron making 1 Musical roll making 1 Skirt making 1 Vinegar making 1 Mirror making 1 Boot upper making 1 Total 185 220 1909] The register does not show much change since last year. There is a slight increase in the number, partly due, as before, to the installation of machinery in workshops. This change is not altogether welcomed by some of the employees because, though there is a saving of energy and labour, there is also a considerable nerve strain involved in keeping up the output which is expected from expensive machinery. The employees appear to think that the saving of physical exertion is dearly bought considering the exhaustion produced by the extra pressure to increase production. In the case of factories, for the most part, the occupier is also the owner, and, consequently, the industry is not being continually shifted from one house to another, as in the case of some workshop industries where the occupier appears to be constantly on the move, in this way escaping attention for some months between each removal. Once power has been installed at considerable expense there is not the same likelihood of a removal, so that the factory register remains much the same. Some of the factories on the list do not use power but are classed as Factories under Schedule VI. of the Factory Act, which defines certain industries as factories, whether they use power or not. Some of the factories mentioned are of considerable size, employing over 200 workers, whilst others are more of the nature of a domistic industry. The system of classification of Factories under the Act is rather confusing to the uninitiated, as it would appear there that any premises where power is used and where only members of the same family are employed is classed as a Factory, and inspected as such by H.M. Inspector; whereas any premises where certain work (such as bookbinding) coming under Schedule VI. of the Factory Act, whether power is used or not and where only members of the same family are employed, is classed as a Domestic Factory, to be inspected as a workshop by officers of the Local Authority. One of the factories in the list appears to be at the same time both factory and worshop. On certain days, when the rooms are not being used for laundry purposes, they are used, without power, for millinery and blouse making. This appears quite a distinct business, although it is carried on by the same occupier in the same room for the sake of economy. Although the visits paid to factories during the year were primarily with the object of ensuring that the conveniences provided for women were kept in proper order, any sanitary defects noticed, such as defective cisterns, floors, etc., have also been dealt with. It is sometimes a little difficult to determine in the case of workplaces which are under dual inspection where one official leaves off and the other begins as regards dealing with the various matters which require attention. As noticed last year the conveniences in factories are kept in a more satisfactory manner than formerly, and at present, taking them as a whole, they are in a very fair condition. A considerable number of the defects found were due to carelessness on the part of the employees, who often show a great disregard for the property of their employers. Their careless treatment of fittings, etc., results in broken basins and fastenings, choked drains and other evils. Naturally under these circumstances the efforts of the owners to keep things in proper order become relaxed, and one can scarcely blame them. In this matter, as in other matters, the influence of the forewoman is very noticeable, and sometimes, as the result of a new regime, the whole tone of a factory appears to alter and there is a transformation in manners, behaviour and cleanliness. As previously mentioned, factory owners, as a rule, welcome any visits as an assistance in keeping up to the mark those told off to supervise certain duties. Workshops and Laundries.—The register of workshops shows a small increase. At the end of the year there were 857 Workshops and 128 Laundries on the register. There were added during the year 210 workshops and 20 laundries, while 174 workshops and 24 laundries have been removed. The work places left on the register comprise 1,598 rooms. 221 [1909 The following is a list of the trades carried on in the various workshops. Nature of business. Number of Workshops. Number of Workrooms Dressmaking 275 363 Laundries 128 352 Millinery 82 137 Fur sewing 53 74 Tie making 44 47 Mantle making 40 59 Blouse making 41 75 Tailoring 37 47 Skirt making 16 22 Underclothing making 15 19 Waistcoat making 13 15 Artificial flower making 12 31 Leather goods making 12 31 Rag sorting 11 18 Box making 8 15 Feather dressing 7 10 Shirt making 7 9 Embroidery 7 10 Fancy goods making 6 10 Corset making 5 5 Photographic work 6 10 Cap making 4 8 Confectionery making 4 9 Apron making 4 5 Water Proofing 4 4 Costume alterations 4 4 Needlework 4 4 Trunk making 3 4 Dressing gown making 3 3 Perambulator hood making 3 5 Hair work 3 7 Paper sorting 3 4 Baby linen making 3 4 Underskirt making 3 4 Frilling making 3 5 Boot and shoe work 3 6 Umbrella making 3 3 Ink making 2 2 Buttonhole making 2 2 Drug packing 3 6 Children's frock making 2 2 Frame making 2 3 222 1909] Nature of business. Number of Workshops. Number of Workrooms. Firewood cutting 2 2 Lace work 3 3 Camisole making 2 3 Boot polish making 2 2 Postcard painting 2 4 Jet and sequin work 2 2 Glass painting 1 1 Dolls' hair curling 1 6 Collar and cuff making 1 1 Jet work 1 2 Stamp sorting 1 2 Trimming making 1 1 Wig making 2 3 Upholstery 1 1 Fancy glass work 1 1 Pickling 1 1 Brush making 1 1 Braces making 1 3 Pinafore making 1 1 Dressmakers' stand making 1 1 Doll dressing 1 1 Cabinet making 1 1 Bath glove making 1 1 Bonnet shape making 1 1 Artists' brush making 1 2 Bed couch making 1 1 Fancy ornament making 1 1 Dyeing and cleaning 1 1 Bottle washing 1 2 Valentine making 1 1 Japanning 1 1 Surgical instrument maker 1 1 Glass work 1 1 Back support making 1 1 Camera bellows making 1 1 Upholstery 1 2 Perfumery 1 1 Cushion making 1 1 Needlecase making 1 1 Pyjamas making 1 1 Metal sorting 1 1 Pelisse making 1 1 Balloon making 1 2 Swandown sewing 1 1 Cork cutting 1 1 223 [1909 Nature of business. Number of Workshops. Number of Workrooms. Tent making 1 1 Almanac making 1 4 Fancy shade making 1 1 Trousers' making 1 1 Toy making 1 1 Hat shape making 1 2 Chiffon tucking 1 1 Blind making 1 1 Limelight making 1 1 Ticket fastening 1 3 Surgical furniture making 1 1 Surgical appliances making 1 4 Stationery manufacturing 1 3 Chemists' sundries manufacturing 2 4 Kitchen jacket making 1 1 Purse making 1 1 Wax figure making 1 3 Funeral furnishing 1 1 Fancy cabinet making 1 1 Juvenile suit making 1 3 Jewell case making 1 1 Chimney-cleansing Imp making 1 1 Hassock making 1 2 Surplice making 1 2 Wreath case making 1 2 Juvenile outfitting 1 5 Evening cloak making 1 1 Fur muft making 1 1 Hosiery 1 1 Musical string making 1 2 Sausage skin making 1 2 Electrical engineering 1 1 Bathing dress making 1 1 Gold beaters skin preparing 1 4 Scientific instrument making 1 1 Glass etching 1 1 Decorative glass work 1 1 Piano key covering 1 1 Candle shade making 1 1 Mineral waters making 1 1 Making of sundries for mineral waters 1 1 Total 985 1,498 224 1909] Some of the workshops enumerated are really very little more than domestic workshops employing in the busy time one or two persons. As will be noticed from the list, dressmaking is numerically the most important. This classification includes wholesale dressmaking, private or "bespoke" dressmaking being somewhat, in Islington at least, a decaying industry. Some of the industries which were prominent some years ago have lately shown signs of falling off, such as blouse and artificial flower making—though possibly this is only a temporary change—whilst other industries such as fur-pointing and fur toque making have come to the front. There appears a tendency in workshop occupiers not to be content with one line of business only, but to fill in idle or slack times with other kinds of work, sometimes quite distinct in character. Thus, for example, in the case of one workshop, fur work, millinery, and belt making are all being done, the work fitted in so that the workers are kept going all the year. This aptitude for running fresh enterprises applies particularly to wholesale workers, and in the case of private dressmaking appears almost entirely absent as there is not perhaps the same opportunity of coming in contact with the demand for various articles that those workshop occupiers have who work for the City or West end, and are consequently more in touch with conditions there. One workshop was found during the year which was quite unsuitable for use as a workplace Rag sorting was being done in a basement room practically without light or air, which was approached through a trap door in the floor of the shop overhead, this door being mostly kept closed. Employment was forbidden here and the premises have been kept under observation since then to prevent any further employment under these conditions. This is, of course, exceptional, as workshops in Islington, speaking generally, are very respectable. The majority of laundries on the register now are under the Factory Act, few still remaining as domestic industries. Under the new regulations regarding laundries, which came into force at the beginning of 1908, all laundries employing one person have been brought under the Factory Act. This has necessitated the paving and draining of washhouse floors and the regulation of the number of persons employed according to cubic capacity. Another important provision which has affected very much the condition of laundries is that of separating the store from the ironing-room or table in such a way as to save the women from excessive heat. This is a very necessary provision and is being enforced by H.M. Inspector as being a matter of temperature which is not dealt with directly by the Local Authority. Some of the hand laundries have installed machinery and become factories, but this change is not by any means becoming universal. Many people object to steam laundries on account of the alleged wear and tear of the garments, and will only patronize those laundries where power is not used. This fact tends to keep hand laundry work from dying out. As a matter of fact much of the work sent to hand laundries is sent out again to steam laundries, this being a cheaper arrangement than employing workers and one that gives less trouble. The larger laundries might almost be considered as Outworkers or Contractors for the smaller, but the matter has not been gone into from this standpoint as all are under inspection anyhow. One matter in connection with laundries to which my attention has been called more than once is that the public washhouses are used by people for the purpose of gain. Women do not only their own washing there but perhaps take the linen of four or five neighbours and spend entire days there washing. In this way they manage to do a certain amount of laundry work without having to conform to the requirements of the Factory Act. The occupiers of laundries in poor neighbourhoods where this practice is likely to occur are inclined to find fault with the system as interfering with their legitimate profits. They say that sometimes a woman may do the washing for a whole street in the public washhouses taking employees in with her to assist, but this statement is possibly exaggerated. 225 [1909 Workplaces.—Fifty-four workplaces have been inspected and registered during the year. These are the receiving offices of laundries where the linen is received and given out again. These offices are not under the Factory Act at all, although a certain amouut of work is done similar to that done in laundries, such as packing and sorting, also marking, both in needlework and ink. They are really shops and come under the Shop Hours Act as regards the hours for thj persons employed there. These receiving offices appear to be of two classes, those run by steam laundries for the purpose of collecting work from various districts and those run by private occupiers who take in the work and get it done anywhere or anyhow. As regards the latter class there is always the possibility of the work being done on the premises if the giving out does not prove sufficiently satisfactory or lucrative. It is therefore desirable that these places should be inspected regularly to ascertain if work is actually done there, as it is not an unusual thing for a receiving office to become a laundry or vice versa. The number of defects found on the premises has quite justified the amount of attention given to them. Workplaces Notified to Home Office —The names and addresses of 203 workplaces where the Abstract of the Factory Act was not affixed, or which had not already been visited by H.M. Inspector have been forwarded to the Home Office. This is a larger number than last year in spite of the fact that trade is still dull. The particulars of the workplaces notified will be found in the accompanying tabular statement, which also includes those notified by Inspector West. The table of workplaces notified includes also any factories found unvisited or without the necessary papers. Although workshop occupiers are liable to a penalty for employing hands for a longer period than one month without notifying to the Home Office, they still continue to break the law with impunity, possibly due to the fact that prosecutions in this part of London have not been frequent. A good number of the workshops mentioned in table have been notified before any employees were engaged, so that the number of employees eventually affected by the notification is considerably larger than would appear from the table. Cleanliness—During the year 83 instances of workrooms found in a dirty condition either in whole or part have been dealt with. Of these 72 had been cleansed under my supervision before the end of the year. A few of these refer to the dirty state of the floors, but most refer to dirty walls and ceilings. A change for the better has been noticed in the cleanliness of workshop walls and ceilings during the year, many having been found cleansed at the time of inspection. The occupiers now know that cleansing must be done periodically, so they prefer to do it voluntarily in a quiet time, rather than be compelled to do it when work is busy. Overcrowding.—Overcrowding was found in 8 workrooms during the year. The number of employees was reduced in each case on notice being given. Most of the workrooms inspected had not nearly the full complement of workers allowed, as trade has, if anything, been more unsatisfactory han before. Some workrooms were certainly being run at a loss, one coming under notice where there were two employees entirely without work waiting patiently at their benches in the hope that an order might come in. They had then been waiting for days. Ventilation, etc.— Six instances of insufficient means of ventilation have been noticed and of these three had been remedied before the end of the year. There has been, as usual, an insufficient use of the means of ventilation. Some of the workrooms are not ventilated even during meal times, as the employees have meals in the rooms, and of course continue to exclude the fresh air. It almost appears desirable that meals in workrooms should be forbidden with a view to more efficient ventilation during the absence of the workers. Some of the larger workshops have mess-rooms specially given up to the workers, but this is by no means universal—in fact it is practically impossible in the case of a small industry. In four cases during the year the air was found vitiated by flueless gas R 1909] 226 stoves. All were provided with flues when the matter was pointed out. Iu one small workroom with one worker the girl complained of head-aches. As she was shut up all day working near the stove with the window closed, this was scarcely to be wondered at. She confessed to feeling better after the change was made. The matter of temperature is really not a sanitary provision within the meaning of the Act, unless the purity of the air be interferred with when it can be dealt with by the Local Authority. Sanitary Accommodation.—During the year 3 instances of insufficient accommodation, 185 of closets in a dirty condition, 45 of closets unsuitable or defective, and 13 instances of accommodation not separate for sex»s were found. Of these 171 have been cleansed and 41 repaired under my supervision. The other instances with accompanying defects in the same premises have been dealt with by Inspector West. Miscellaneous Defects.—Other defects, such as defective floors, ceilings, cisterns, dustbins, etc., were found to the number of 121. Of these 9(5 had been remedied before the end of the year. Any defects found on inspected premises, which concerned more especially the residential portion of the house, have been referred to the District Inspectors, and have been dealt with by them, together with any instances of defective or unventilated drainage. Workroom Cards.—During the year 359 workroom cards have been distributed specifying the cubic contents of each room, and stating the number of employees allowed during ordinary working hours and during overtime. A small percentage of the workrooms on register are used as bedrooms, consequently, according to the Order of the Home Secretary, which relates to workrooms used as sleeping apartments, the allowance of cubic capacity for each worker during the day is 400 cubic feet instead of 250, as ordinarily required. This fact has been duly entered upon all cards supplied to such workrooms. There does not appear to be any information given under the Act as to the amount of cubic space required during overtime worked in such workrooms. Fortunately overtime does not appear to be worked here in any of the workrooms used as bedrooms, so this matter has not come up for decision. Notices.—During the year 147 intimation notices have been served ; 31 in connection with factories, 104 in connection with workshops, and 12 in connection with workplaces and 1 statutory notice. As before, most of the defects found have been remedied after a verbal notice has been given, so that a written notice has not been necessary. Complaints from Home Office.—Three complaints from defects have been received from the Home Office. Of these one had been remedied before the end of the year, and this fact was duly notified. Matters referred to other authorities.—One matter, viz., employment in a house which was dilapidated and dangerous was referred to the London County Council and dealt with by them. Two other matters, viz., an apparently insufficiently guarded hoist in a workshop, and the taking of meals under what appeared to be unwholesome conditions, have been referred to the Home Office, together with any instances which came under notice of illegal overtime. I remain, Sir, Your obedient servant, JOSEPHINE J. BROWN, (Sanitary Inspector of Workshops.) 227 [1909 MRS. YOUNG'S REPORT. Town Hall, Upper Street, N. 31s/ March, 1910. To the Medical Officer of Health. Sir,—Herewith I ibeg to submit to you a report of the work done during the year 1910, in reference to restaurant kitchens and outworkers' premises. During that period 3,793 inspections and calls have been made as follows:— Inspections of Restaurant Kitchens, etc. 532 Inspections of Homeworkers' Premises 1,207 Inspections of Offices employing women 55 Re-inspections and calls 1,999 3,793 355 intimation notices were served to cover 567 sanitary defects; 11 statutory and 36 intimation Courtesy notices were forwarded. 243 letters to employers failing to send lists of outworked employed. 370 cards to outworkers' containing instructions in case of infectious disease occurring on premises where work is done; and 141 workshop cards specifying the cubic space of the workroom. Restaurant Kitchens.—At the beginning of the year there were 68-5 kitchens, with 939 workrooms registered; during the period under report 15 of these premises were closed, and 68 kitchens, with 88 workrooms added to the register. The total number now registered is therefore 738 kitchens, with 1,018 workrooms. The following is a brief summary of the general conditions (satisfactory or otherwise) found on inspection. Satisfactory. Unsatisfactory. Total. Restaurants 49 16 65 Do., attached to Public Houses 31 8 42 Coffee and Dining Rooms 120 45 165 Tea Rooms 29 8 37 Fried Fish shops 64 21 85 Ham and Beef, Tripe, etc. 27 12 39 Stewed Eels; Eel Pies 6 4 10 Oyster bars 2 0 2 Provision shops, selling cooked meats 64 23 87 395 137 532 R 2 228 1909] Satisfactory Unsatisfactory. Conditions of Utensils used 52 73 Conditions of Food storage 393 137 567 sanitary defects were found and 485 remedied, as follows:— Nuisances under the Public Health Acts:— Found. Remedied. Want of cleanliness 187 204 „ ventilation 14 9 Overcrowding 1 1 Want of drainage, and (defective) floors 51 44 Other nuisances 222 187 Sanitary accommodation insufficient 1 1 unsuitable or defective 59 15 . not separate for sexes 20 14 Offences under the London County Council General Powers Act 12 10 567 485 The nuisances found on the outworkers' premises are included in the above schedule, 119 in number, and caused principally by want of cleanliness in walls and floors. The fallowing tables show ithe comparative general conditions relative to the basement, ground floor, and upper storey kitchens, when inspected in the years 1907, 1908, anrl 1909. 1907— T otal. Satisfactory. Unsatisfactory. Basement 88 41 47 (or about 50 per cent ) Ground floor 431 288 143 ( ,, 30 ,, ) Upper storeys 74 63 11 ( ,, 15 „ ) 1908— Basement 134 80 54 ( ,, 40 ,, ) Ground floor 438 339 99 ( ,, 23 ,, ) Upper storeys 79 73 6( „ 7 „ ) 1909— Basement 109 69 40 ( ,, 37 ,, ) Ground floor 355 300 55 ( „ 16 ,, ) Upper storeys 66 65 1 (,, 2 ,, ) In this table it is noticeable that, while the ground floor and upper storey kitchens show constant improvement, the basement kitchens still have a very high percentage of "unsatisfactory" registrations, remaining about 40 per cent. And there does not appear to be any possibility of reducing this number while the structural conditions are unaltered. Nor should the 60 per cent, registered as satisfactory be considered in any way ideal; but owing to the fact that in some cases through ventilation can be obtained from open yards at the rear and large areas in front, and that extreme cleanliness is enforced by the 229 [1909 owners, they have been registered as satisfactory; but it must be remembered that the pavement ventilation invariably admits as much dirt and road detritis as fresh air, so that a greater amount of labour is required to obtain the necessary cleanliness, while it is doubtful in the disease geims in the dust-laden atmosphere are always destroyed in the processes of cooking. There are twelve offences scheduled under the London County Council's General Powers Act, 1908. In Section 8 of this Act it is laid down that— (a) No w.c. or earth closet, etc., etc., shall be within a room, shop, or part of a building where food is prepared, or stored for sale, or shall communicate therewith except through the open air. (A) No ashpit (dustbin) or similar convenience shall be within a room, shop, etc., etc. (c) No drain or pipe for carrying off fcecal or sewage matter shall have any inlet or opening within such room, shop, or other part of a building. Following your instructions, wherever any contravention of the Act was found, an intimation notice was duly served. No great difficulty was experienced in carrying out the first and second of the above sections, but the third has proved to be impracticable, if taken literally. The meaning of the Section is Obscure. Is "an opening to a drain" intended to include floor gullies, properly trapped, and designed to carry off the surface water from such places as fish washing and cutting rooms, brine pickling rooms, or cement floors in cookhouses that are cleansed at least once or twice daily by broom and hose? As an instance:—The business of brine pickling requires hundreds of gallons of water, and the tanks are usually emptied by removing a plug at the base, and allowing the water to flow away down the floor gully. The question has arisen as to how these tanks are to be emptied when situated in a basement kitchen from which all gullies have been r.emoved? It must be remembered that few basement cookhouses have any open space at the front or rear, every available inch of ground having been used for the business. The only alternative appears to be that the water must be carried up to a sink on the upper floors, or to the street, which is, of course, utterly impracticable. And whereas, under existing conditions, the floor is cleansed with broom and hose at least once or twice daily, without a gully, the labour required would be doubled, with the probable result that the cleansing would be less frequent. Therefore, the occupiers and owners of basement cookhouses protested against carrying out this section, for the reason that it would cause a general disorganization of the trade processes in some instances, with a probable diminution of the cleanliness of the premises in others. Briefly : it is theoretically good, but practically unworkable. To carry out its provisions would mean the abolition of basement cookhouse?, which, desirable as it is, might be better done by a time limit of occupation for those in use at present, and a prohibitory clause in reference to the opening of any other basement premises for the preparation of food. Upon this being made apparent, your instructions were that for the present this section should remain in abeyance, and no further notices for the abolition of basement gullies have been issued. 1909] 230 The difficult problem of refuse disposal has been brought forward in the period under report, especially in reference to these kitchens. Messrs. Lyons, Ltd., of Pentouville Road, were keeping light refuse bins in a basement kitchen (used for the preparation of food), awaiting the weekly clearance of the Borough Council. A decided nuisance was the inevitable result, and notice to abolish it was served on the occupiers. They refused to do this, and a summons was accordingly served upon them under the Public Health Act, 1891. The defence submitted was that they had already obtained judgment as to the nature of the refuse accumulated; that it was of the nature of house refuse; that under certain sections of the Public Health Acts the Council were bound to remove house refuse when necessary; aad therefore it was the duty of the Council to remove this refuse. The magistrate thereupon gave judgment for the defendants, and ruled that the Borough Council should clear their refuse daily from the premises in ques.tion. If, therefore, the refuse thus accumulated on Messrs. Lyon's premises is held to be of the nature of house refuse, it follows that all kitchen refuse is of the same nature, and a systematic bi-weekly clearance from all places where food is prepared (which my last report advocated) is a necessary compliance with the existing law. In a previous report I referred to Sec. 8 of the London County Council General Powers Act, 1908, where it is laid down that "due cleanliness shall be observed by persons engaged in such places" (viz., places where food is prepared). Further observation has confirmed the necessity of compelling employers to provide lavatory accommodation for the kitchen and restaurant workers. There are only about 10 per cent, of these places that have any such accommodation, in the remaining 90 per cent, the kitchen sink is used for the personal ablutions of the workers, and when plugged, is the actual wash-bowl for cups, saucers, plates, etc. ; which is, of course, equivalent to allowing the washing of utensils in the wash-basins of the employees. Beside this, combs and brushes are found in close proximity to pastry boards and sausage machines; in one instance a man employed in the kitchen was using a table cloth from the restaurant as a body towel at the time of the inspector's call, and, in another, a hair brush in use was wetted, at intervals, in a pan of peeled potatoes. True, the potatoes were to be boiled before being eaten, but altogether it seems desirable that a regulation forbidding the use of the kitchen as a lavatory for the employees should be rigorously enforced. It would be conducive to the personal comfort of the workers, and to the high standard of cleanliness so necessary in the preparation of food. Outworkers' Premises.—The total number of names and addresses received during the year is as follows :— From employers in Islington 2,180 „ ,, in the Boroughs, per the Medical Officer of Health 2,974 5,154 281 [1909 These figures represent the total number of the two half-yearly returns, viz., those made in February and August, in compliance with Sec. 107 Factories and Workshops Act, 1901. The number of Outworkers residing in the Borough at the end of the year 1909 was 1,850, an increase of 19 over the corresponding period for 1908, but the number of outworkers notified by the employers in the borough is less. There is also an increase of 176 in the total number notified, which in 1908 was 4,978. Thirty cases of infectious disease occurred on premises where work is done. In all these disinfection was duly carried out, and the patient removed to hospital where necessary under the supervision of the District Inspector. It should be noted that in some instances the illness did not occur in the rooms actually occupied by the outworker, but in another part of the house, due precaution in reference to the work and workers, however, being obligatory under the Act. The number of persons engaged in the trades scheduled are shown below.— Making, repairing, etc. of wearing apparel 4,642 Artificial flower making 185 Furniture and upholstery 8 Paper bags and boxes 199 Brush making 89 Stuffed toys 7 Electro plate 6 Umbrellas 10 Chain making 8 5,154 I have mentioned in my previous reports that the general conditions under which homework is carried on in Islington are fairly satisfactory; and out of 1,207 inspections made during the year, only 6 per cent, of the premises inspected were unsatisfactory because of unwholesome, viz., dirty or crowded conditions. 119 statutory defects were found, and 66 notices served to remedy thean; they are detailed in the schedule of nuisances found and remedied, shown previously in this report. Unfortunately, the rates of wages paid for homework are not equally satisfactory, and many of the workers, especially the single women, have a hard struggle to maintain the appearance of respectability, which is often kept up at the cost of bitter privation. The Trades Board Act, 1909, should bring about a better condition of affairs for the homeworkers, but before closing my report on this branch of the work done, it appears necessary to add a word as to the work of the Homeworkers' Aid Association, which has been one of the prime factors in the establishment of the Trades Boards, and has also been of incalculable benefit to the homeworkers themselves individually. A scheme attached to the Association gives a week's holiday, or at least a day in the country, to the members; and whenever a case of dire necessity has been reported to the Secretary by your Inspector, pecuniary assistance has always been forthcoming. 282 1909] It is pathetic to realize how much a day in the green fields means to a woman who has worked for ten, or in soane cases even twenty years without a holiday. One of the workers who had thus benefitted remarked: "It gives me something to think about all the winter." The main object of the Association at present, however, is to get the homeworkers to organize, and for this purpose a meeting of some of the representatives of the Board of Trade and the boxmakers was held recently at Bethnal Green, as without cohesion on the part of the workers, it is difficult to realize how the provisions of the Bill will be helpful to those persons for whose benefit it is principally intended. Therefore I have ventured to bring to your notice in this report an item that, though perhaps not absolutely connected with the work of the Inspector, has had so great an influence on this particular class of workers that no report on their conditions, etc., in the Borough would be complete without it. Offices where women are employed.—According to your instructions, inspection has been made of 55 offices employing women clerks. The results showed that the conditions were far from satisfactory. 27 of the premises had no separate sanitary accommodation for the women clerks employed; or, the approach to the w.c.'s was on a public staircase, or in a room where men were constantly employed, and without any sort of screen. In one instance there was no w.c. accommodation of any sort provided for the clerks; in another, application for the key had to be made to the manager, while in one establishment the pan was fixed in a store-room, without any partition round it, from which goods were continually taken and replaced by the warehousemen. Two of the offices inspected were overcrowded and badly ventilated, and it appeared from the results of the comparatively few inspections made that women clerks frequently work under conditions that would not be tolerated in any factory or workshop. The chief difficulty in remedying these conditions arises from the fact that it is doubtful whether an office would be legally held to be a " workshop," under the Act, and therefore the clauses that provide for the well-being and comfort of the factory operatives leave the women who work in a higher grade of the labour market unprotected. It is very desirable that some definite decision should be given by the Courts as to the precise meaning of the word " workshop" before mentioned, so that, if it is not intended to include offices and similar places where work is carried on for purposes of gain (i.e., workplaces), an amending Act might be passed that would compel all employers of labour (whether clerical i.r manual) to provide decent and adequate accommodation for the comfort and well-being of their employees. I remain, Sir, Yours obediently, (Mrs..) A. CATHERINE YOUNG, Inspector of Workshops. 233 [1909 INSPECTION OF HOUSES LET IN LODGINGS. The inspection of these houses was effected during the year under the very greatest disadvantage, because, since the appeal in "Arlidge v. Islington Borough Council," when the by-law relating to cleansing was declared to be unreasonable, inasmuch as it required a landlord of a lodging house to cause the work of cleansing to be done, although he might not be able to do this without committing a trespass, everything that was effected had to be accomplished with out the assistance of by-laws. Nevertheless, the total number of calls and inspections made numbered 10,555, while the total sanitary improvements completed were 2,735, and the premises improved 1,333. These, however, did not represent 1,333 separate houses, for improvements were effected at the same houses several times during the year owing to fresh nuisances being discovered in them. In the early part of the year, a correspondence took place between the Guardians and the Public Health Committee with reference to alleged overcrowding in Campbell Road, where nearly all the houses come within the purview of the by-laws. Owing to statements made at a meeting of the Board of Guardians, the question attracted considerable notice in the Press, and the Medical Officer of Health, at the request of his Public Health Committee, reported fully on the matter. They, in turn, ordered his report to be submitted to the Council. Campbell Road is a turning out of Seven Sisters Road, a little before the railway bridge which spans this thoroughfare before Finsbury Park Station is reached. It lies between Fonthill Road and Palmerston Road, and terminates in Lennox Road, which lies to the north of and parallel to, Seven Sisters Road. From outward appearances, one might reasonably judge it to be of a respectable character, for the houses are well built and of good external appearance, and in no wise dilapidated and slumlike. They were erected, so far as information can be gleaned, for the large numbers of workmen and labourers who were employed in building the Great Northern Railway in this neighbourhood. Later on, some of these houses became common lodging houses, and in turn were followed by houses let in furnished lodgings. These to-day continue to be so let, and are for the most part of a low type, and very poorly furnished. Thus it is seen that the common lodging houses became an injury to a neighbourhood by attracting undesirable people around them. This fact is 1909] 234 also borne out by what occurred at Queensland Road, where the presence of common lodging houses has also had a deleterious effect. Furnished lodgings of this low class are the outcome of an endeavour to escape the stringent inspection to which the common lodging houses are subject, especially as regards night inspection and the separation of the sexes and of children. They, however, are differentiated from them by the fact that there is no "common room," and that meals are taken in privacy in the rooms that are rented. Some people, therefore, prefer them to the common lodging house because of their escape from supervision by the London County Council Inspectors. The residents in these furnished lodgings are altogether unlike those which usually reside in tenements that are let unfurnished, in which as a rule are to be found hard-working labourers, skilled artizans, clerks, and women who earn their livelihood either as assistants in business places or as homeworkers. Campbell Road has been ever a source of grave anxiety to the Medical Officer of Health, who has frequently inspected all the houses in it, and has taken his Public Health Committee on at least two occasions through them, while he has caused an almost endless inspection to be made by the Inspector of Houses Let in Lodgings for the district in which it is situated. In the report which the Medical Officer of Health presented to the Council, he contrasted the state of Campbell Road in 189(5 with its present condition, and showed that then nearly every room in it was overcrowded, its sanitary accommodation altogether insufficient, and the houses themselves infrequently and irregularly cleansed; whereas in recent years they had been cleansed annually, sometimes two or three times in the year, while as regards sanitary accommodation, there was nothing to complain of, and very little overcrowding. Indeed, he pointed out that one of the houses about which a Poor Law Officer had complained had been cleansed no less than three times in 12 months. He also indicated that in the former period the tenants, who were so often in the landlord's debt, always sided with him and always hindered the efforts of the Inspectors to ameliorate the conditions under which they lived, and that uncleanliness used to be general, and vermin to be found everywhere. He showed that in the inspection of Campbell Road made on the 19th and 20th April, only G rooms out of 521 let in lodgings contained more people than their cubic capacity allowed, and that some of these cases were trivial. Again, with respect to W.C. accommodation, he pointed out that in the furnished and 235 [1909 unfurnished lodging houses there were 130 W.C.'s for 1,273 persons, or 1 W.C. for every 9½ persons, and that in each of 51 houses there were 2 W.C.'s, and in each of 28 houses 1 W.C., while in only 3 instances was deficient accommodation discovered, and even here this was doubtful when the ages of the children living in the house were taken into consideration. He further pointed out that uncleanliness was not so prevalent among the tenants now as formerly, and in proof of this stated that all the five inspectors who were taken from their districts for the purpose of specially inspecting the houses in the road, on account of the statements of certain Guardians, expressed their astonishment at finding them so cleanly, and that some of them stated that the rooms of some of the tenants were as clean as any room need be. The Medical Officer of Health also said that this was really the case, for a few of the people in the road were there only through misfortune, while others had not become so degraded as to have lost the desire of having clean rooms. He could vouch for this himself, for on nearly every occasion on which he had visited tjie road, he had found women scrubbing out their rooms. Nevertheless, vermin were still to be found, and at that period of the year, after having lain dormant during the winter, they usually began to make their appearance. It was no surprise, therefore, to detect them, in some cases in insignificant, but in no case serious, numbers, in 37 rooms. This was a marvellous improvement on the state of affairs in 1890, when there was hardly a room which was not badly infested. He pointed out that all these conditions had only been brought about by hard and persistent work, and were due to the pains-taking efforts of the Inspectors. But, while Campbell Road was so mucn better than it was in 1896, it was very far from perfection, particularly in those furnished houses to which he had alluded. In them were found, with a few exception, the conditions at their worst, for they were occupied by the lowest class of tenants, and the furniture was as bad as it could be. But the difficulty was how to deal with them! There was insufficient power under the by-laws, and if under the Public Health (London) Act, 1891, anything was destroyed, it must be replaced or compensation made to the owners for its destruction, a course of procedure which, though it might please the landlords, would be a decided loss to the Borough. Of the 100 houses in the road, 6 are common lodging houses, 45 are furnished lodging houses, 34 are houses let in unfurnished lodgings, 13 are private houses, 1 is a beer house with an on-license, and 1 a beer house with an off-license, and one house is unoccupied. 1909] 236 The 79 houses let in furnished and unfurnished lodgings contain 521 occupied and 31 unoccupied rooms, and contain occupied tenements as follows:— Tenements of 1 room 356 Tenements of 2 rooms 54 T enements of 3 rooms 12 Tenements of 4 rooms 4 Tenements of 5 rooms 1 The persons, exclusive of those in the common lodging houses, living in these rooms number 1,273, of whom 787 are adults and 48G children under twelve years of age. The common lodging houses provide beds for 211 persons, 184 males and 27 females, and are under the control of the London County Council. Notwithstanding the numbers and social status of the persons occupying the houses, the cases of the notifiable infectious diseases have not been excessive. 1900. 1907. 1908. 1909. Scarlet Fever 1 1 3 3 Diphtheria 2 4 3 1 Enteric Fever — — — — Erysipelas 1 2 1 2 Totals 4 7 7 6 Cases per 1,000 of the population in Campbell Road 3.01 5.3 5.3 4.7 In the Borough 6.6 5.9 6.4 5.8 Here it is seen that in proportion to its population Campbell Road bears a favourable comparison in respect to the principal infectious diseases with the whole borough. The inspection of the road has been constant, so that from November, 1906, to March, 1909, there were 4,113 visits paid to the houses for the discovery of nuisance, and 259 intimation and 21 statutory notices served. 158 annual cleansing notices were issued in 1907 and 1908, and 79 such notices would 237 [1909 have been sent out in March but for the result of the appeal in Arlidge v. Islington Borough Council, already alluded to. Letters have, however, been written to the owners, requesting them to carry out the annual cleansing as usual, and they were all duly attended to. It may be stated, as was pointed out in the report, that fully half the time of one Inspector is spent in this road, the meaning of which may be better appreciated when it is understood that if all the houses in the borough, which numbered 38,045 at the last census, received the same attention as the 79 houses let in furnished and unfurnished lodgings in Campbell Road, 230 inspectors would be required to perform the work. In his report to the Council, the Medical Officer of Health pointed out that some very strong powers were required to effectively control these so-called furnished lodging houses, and it seemed to him that the only way in which such control could be exercised was to be obtained by legislation which would enable the London County Council to make by-laws similar to those relating to common lodging houses, so that— (1) They should be licensed every year. (2) The bedding and furniture should be always kept in a cleanly state. (3) The dilapidations of all kinds should be promptly made good, and the houses generally kept in good condition. (4) They should be under the supervision of the Common Lodging House Inspectors of the London County Council. The Medical Officer of Health has conferred with a few of the Metropolitan Medical Officers of Health on this subject, and they have arrived at similar conclusions. Since the report was issued to the Council, the Medical Officer of Health has had an opportunityof placing his view before the Public Health Committee of the London County Council. Since that date a new Committee has been elected, and he has not been able, so far, to ascertain the views that are now held at Spring Gardens. A special inspection was also made of Queensland Road, in which 27 houses, containing 109 rooms, are let out as furnished lodgings, and in these 1909] 238 346 persons live, of whom 252 are adults and 94 are children. It was found also that for the accommodation of these people 41 W.C.s had been provided, so that there was 1 W.C. for every 8½ persons. It will thus be seen that, so far as sanitary accommodation is concerned, these people are amply provided for. The furnished lodgings in this road are much the same as in Campbell Road, being neither better nor worse, while the class of people occupying them is similar. There are also some three or four furnished houses in Albert Place, off Queensland Road, of a similar class, while latterly houses of this description have been springing up in George's Road. The work of the Inspectors is shown in the following statements:— Nuisances Abated.—Altogether 2,753 nuisances were abated, and in abating them the following work became necessary:— Drains constructed 6 „ repaired 4 „ traps supplied to 86 W.C.'s., extra provided 7 „ amended 25 „ water supply provided 214 Dustbins provided 99 „ repaired 1 Surface drains of yard constructed or relaid 27 Water supply.—Cisterns (new) provided 2 „ Cisterns, repairs and cleansed 60 Water supply provided 130 Rooms cleansed and limewashed 667 Walls and passages repaired, cleansed or limewashed 59 Floor space ventilated 9 Floors repaired 56 Overcrowding abated 79 Verminous rooms disinfected, &c. 8 Roofs repaired 75 Other improvements or nuisances abated 1,131 239 [1909 HOUSES LET IN LODGINGS, Table CXXV. Summary of Sanitary Work carried out under Inspectors Ward and Hancock in Houses Let in Lodgings during the year 1909, Inspector Ward. Inspector Hancock. Totals. 1st Quarter 2nd Quarter. 3rd Quarter. 4th Quarter. Year. 1st Quarter. 2nd Quarter. 8rd Quarter. 4th Quarter. Year. Number of Houses inspected 132 101 112 119 464 270 335 187 251 1,043 1,507 Re-inspections, Calls made, etc 932 1,015 883 819 3,649 1,520 1,161 1,319 1,399 5,399 9,048 Total inspections and calls 1,064 1,116 995 938 4,113 1,790 1,496 1,506 1,650 6,442 10,555 Notices Served. Intimation (Personally 45 39 38 21 143 178 99 70 71 418 561 | By Post .. 221 33 62 416 4 44 91 69 208 624 Statutory (Personally .. .. .. .. .. 13 11 1 23 48 48 { By Post 3 •• .. 2 5 23 17 6 9 55 60 Improvements. Drains— Constructed .. .. .. .. .. .. 2 .. 1 3 3 Re-constructed 1 .. .. .. 1 .. 1 1 2 3 Repaired .. .. .. 2 2 .. .. .. 2 2 4 Ventilated 1 .. .. .. 1 .. .. .. 1 .. 2 Gully and other Traps fixed 1 .. 1 2 4 42 24 6 10 82 86 Urinals— Water supplied—cleansed .. .. .. .. .. .. .. .. .. .. .. Cesspools— Abolished .. .. .. .. .. .. .. .. .. .. .. Water Closets— W.C. erected with pan, trap and water supply 1 .. .. 3 4 1 1 .. .. .. 7 Pan and trap only provided 2 3 4 2 11 3 2 4 5 14 25 Water supply provided 23 32 46 31 132 15 16 23 28 82 214 Ventilated .. .. .. .. .. .. .. .. .. .. .. Position altered .. .. .. .. .. .. .. .. .. .. .. Dust Bins— Provided 15 8 6 11 40 15 7 20 17 59 99 Repaired 1 .. .. .. 1 .. .. .. .. .. 1 Areas— Constructed .. .. .. .. .. .. .. .. .. .. .. Y ards— Paved .. .. 1 5 6 .. .. .. 1 1 7 Re paved 4 2 5 4 15 .. 3 .. 2 5 20 Sinks— Provided .. .. .. .. .. .. .. .. 2 2 2 Domestic Water Supply— Cisterns provided .. .. .. .. .. 1 .. .. 1 2 2 Cisterns repaired and cleansed 2 5 8 9 24 .. 15 12 9 36 60 Water supply provided to dwelling house 2 3 1 .. 6 .. .. .. .. .. 6 Water supply provided for tenement house 9 .. .. .. 9 60 23 7 25 115 124 Other Improvements— Rooms cleansed or limewashed 13 139 230 39 421 6 164 57 19 246 667 Walls and passages repaired, cleansed and whitewashed 4 20 26 9 59 .. .. .. .. .. 59 Floor space ventilated .. .. 3 .. 3 5 .. 1 .. 6 9 Floors repaired 1 2 31 12 46 9 .. .. 1 10 56 Roofs repaired 7 11 25 20 63 .. .. .. 12 12 75 Overcrowding abated .. 5 13 12 30 .. 14 15 20 49 79 Illegal use of underground rooms for sleeping discontinued .. .. .. .. .. 1 .. .. 3 4 4 Other Improvements or Nuisances abated 87 113 130 113 443 185 125 221 157 688 1,131 Rooms Disinfected •• 4 .. .. 4 .. .. 4 .. 4 8 Total Improvements 174 347 530 274 1,325 343 397 371 317 1,428 2,753 Total Premises Improved 84 137 128 125 474 192 296 215 156 859 1,333 1909] 240 DISTRICT INSPECTION. The work of the District Inspectors was particularly heavy, owing to the large number of cases of Measles reported by the London County Council School Teachers, which had to be inquired into, with the result that the house to house inspection suffered somewhat. 5,093 houses were inspected, which entailed 52,481 visits. The total inspections, visits and calls were 05,801, the particulars of which are set out in Table CXXVI., and show the sanitary work done by the Inspectors, as abstracted from their reports. It may be stated here that the discrepancy between 80,371 total inspections and calls that were made in 1908 and the 05,801 made in 1909 is chiefly due to the manner in which the returns are now abstracted. Thus, each Inspector is credited with only 1 visit for his inspections of shops, stalls, and markets on Saturday evenings, whereas formerly if a stall or shop was only glanced at, it counted as an inspection, and consequently some Inspectors would have only 10 or 20 inspections to their credit, others would have four or five times that number. Again, where formerly in the case of visits to stable yards the Inspector counted 1 visit to each stable in that yard, and thus had 12 visits to his credit, supposing there were 12 stables in It, now the visit to these places is counted as 1, as they are within the curtilage of a single premises, although let to separate tenants. The object of these alterations was, if possible, to arrive at some fair comparison between the work of each Inspector. Even now this is impossible, because in no two districts are the houses alike, and it cannot be pretended that to inspect a house which is occupied by a single family requires the same amount of time as one let in tenements. Nevertheless, the comparisons are fairer now than formerly. The alterations were worked out by the Chief Inspector and Mr. Ansjel. House to House Inspection.—783 houses were visited in this manner, as compared with 1,202 in the preceding year. There is no work in which the Inspectors are engaged in which they have met with more difficulties than in these inspections, because very frequently the people resent the visit, particularly if they should own the house, and only admit the inspector with the very greatest reluctance, lest they should be called on to execute sanitary repairs. It is to be regretted that the great epidemic of Measles and also the increase in cases of Scarlet Fever interfered very materially with this work, while the continued absence of Inspector Bacon, through illness, to which he subsequently succumbed, materially interfered with the work of two of the Inspectors. 241 [1909 Synopsis of the Inspectors Work.—The following statement gives a brief synopsis of the district inspectors' work:— House to house inspections 783 Other inspections of dwelling houses 5.093 Re-inspections and calls made 52,481 Visits of inquiry re notifiable infectious diseases 2,049 „ school cases of ,, 4.605 Butchers' shops, stalls, etc. (Saturday nights) 326 Ice cream shops and factories 167 Dairies and milkshops 2,231 Stables and yards 2,865 Manure depots 98 Certificates under the Customs and Inland Revenue Acts 103 Water certificates for newly erected houses or Hats 32 Visits re samples of foods and drugs, under the Sale of Food and Drugs Acts 36 Smoke observations 480 Notices Served.—There were 3,842 intimation notices served by the inspectors with respect to nuisances, of which 2,803 were delivered personally and 1,039 by post. In 476 instances it became necessary, as the intimations had not been attended to, to report to the Public Health Committee, who ordered statutory notices to be served, of which 129 were delivered personally and 347 by registered letter post. Improvements Effected.—The subjoined list of the principal nuisances abated speaks for itself as to the character and utility of the work that has been carried out. It contrasts favourably with the record of previous years:— Houses. Dirty 722 Damp 196 Out of repair 236 242 1909] Water Closets. Foul 415 Without water supply 202 With deficient water supply 206 Improperly constructed 309 Defective 343 Stopped 112 Improperly situated 19 Insufficient external ventilation 46 Insufficient in number 90 Soil Pipes. Defective 109 Unventilated 89 Improperly ventilated 96 Yards. Improperly paved 440 Dirty 84 Undrained 20 Drains. Foul 34 Defective 583 Choked or stopped 248 Unventilated 156 Cesspools. Abolished 5 Overcrowding. Abated 69 Underground Rooms. Abolished for sleeping 12 Other Nuisances 3,895 Total Nuisances 8,736 Notices served for Smoke Nuisances during 1909. The Jandas Arc Lamp & Electric Co., Ltd., Hartharn Works, Hart- ham Road. Mayfield Laundry Co., 93, Gillespie Road. Highbury Brewery, Holloway Road. Green's Factory, Dagmar Terrace. King's Cross Laundry, 20 and 22, York Road. 18, New Wharf Road. Great Northern Laundry, Fonthill Road. 5 and 6, Bovay Street. 243 [1909 190a, Holloway Road. 160a, Holloway Road. 246, Hornsey Road. Great Northern Railway Generating Station, Drayton Park. 166-170, Holloway Road. Santer's Brewery, Hillmarton Road. 71, Ronalds Road. 38, Holloway Road. 114, Dunoombe Road. 69, Holloway Road. 263, New North Road. N.B.—Only one prosecution—£1 4s. costs (nuisance abated). SYNOPSIS OF THE DISTRICT INSPECTORS' SANITARY WORK FROM 1891 to 1909 (19 years). Houses inspected and visited 1,121,515 Drains Constructed - 20,659 „ Improved and repaired 15,781 „ Traps fixed 95,324 Water closets, pan, trap, etc., furnished 21,534 „ Pan and trap only, furnished 18,624 „ Water only, furnished 8,078 Soil pipe, defective, renewed or remedied 3,880 „ Insufficiently ventilated, fully ventilated 3,371 „ Unventilated, ventilation supplied - 5,798 Dust Bins, Constructed 16,229 „ Repaired 3,912 Surface drainage, Constructed 11,919 „ Relaid 23,507 Water supply, new cisterns provided 4,302 ,, Cisterns repaired and cleansed 11,395 „ New supply 6,795 Houses generally Repaired 8,261 „Cleansed 16,086 „ Ventilated 13,322 Other Improvements 131,871 Total Improvements 440,648 S 2 244 1909] Table CXXVI. Showing summary of Sanitary Work from Inspectors' reports fo/the Year 1909. districts. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 59 21 23 25 7 71 107 69 '0 62 155 38 23 53 783 Other premises inspected 370 399 294 171 261 435 388 334 398 453 377 519 309 385 5093 Re-inspections, Calls made, etc. 4053 3983 3326 1522 3418 3057 4545 4276 3430 3825 4276 4286 3617 4867 52481 Ice Cream Factories inspected 10 6 10 12 3 11 38 18 13 12 7 23 4 167 Dairies and Milkshops „ 171 98 172 66 136 79 237 192 190 90 372 165 103 160 2231 Stables ,, 125 32 4t. 12 187 200 91 11 15 10 80 11 210 70 1100 Yards ,, 53 94 385 231 127 166 166 30 146 117 44 88 45 73 1765 Manure Depots ,, 89 1 7 1 98 Vacant land, Passages and Court inspected 2 .1 40 13 3 25 2 2 27 30 2 12 8 167 Urinals attached to P.H.'s inspectei 11 53 77 118 170 50 31 56 16 170 184 7 26 30 9i)9 Premises (re Certificate Customs and Inland Revenue Acts) inspected .. 27 22 10 7 33 2 2 103 Premises (re Water Certificates) inspected .. 1 18 6 6 1 .. 32 Visits re Sale of Food and Drugs Acts- 9 9 9 9 36 Smoke observations 4 7 4 17 85 7 38 2 33 58 61 156 8 480 Shops, Stalls and Markets (Saturdaj evening) 25 28 22 7 26 25 25 29 23 27 23 24 17 25 326 Total Inspections and calls 4981 4723 4400 2228 4420 4133 5674 5055 4350 4858 5620 5338 4396 5685 65861 Notices Served. Intimation—Personally 194 107 109 113 108 76 230 134 159 169 246 205 132 260 2242 By Post 4 39 7 13 13 4 91 17 1 8 102 2 114 415 Statutory—Personally 1 4 1 8 10 4 6 10 19 5 13 81 By Post 22 8 4 1 ii 2 14 11 10 59 36 64 16 29 287 Improvements. Drains- Constructed 1 3 5 4 3 4 5 3 11 5 44 Re-constructed 44 51 34 i4 44 24 76 69 35 38 26 45 39 44 583 Repaired 40 8 32 12 19 21 14 10 34 41 34 25 30 33 353 Ventilated 43 47 20 6 41 22 6b 46 27 29 17 55 30 31 477 Gully and other traps fixed 283 287 101 44 270 93 442 345 166 184 95 220 219 284 3033 Urinals—Water supplied, cleansed .. 3 2 4 2 6 6 2 23 2 10 6 66 Cesspools—Abolished .. 5 5 Water Closets— W.c. erected with pan, trap and water supply 12 6 1 2 3 12 6 2 5 2 3 16 5 8 85 Pan and trap only provided 76 100 62 23 75 33 117 108 92 72 67 48 85 69 1027 Water supply provided 22 63 18 17 44 10 18 21 5b 53 62 44 35 68 533 Ventilated 4 2 4 4 .. 1 0 2 2 7 4 1 2 8 46 Position altered 1 2 2 1 1 1 2 1 1 2 3 .. .. 1 18 Dust Bins—Provided 111 39 63 42 44 12 126 85 42 66 104 76 63 125 998 Repaired 4 2 .. .. 7 .. 2 .. 4 2 4 .. .. 6 31 Areas—constructed .. 1 .. .. .. 1 2 1 .. 1 2 4 2 2 16 Yards—Paved 7 26 8 14 21 12 24 19 15 12 26 9 193 Re paved 76 74 36 27 66 25 140 71 46 34 60 78 100 10a 938 Sinks—provided 8 17 2 3 7 6 9 11 58 26 13 74 19 51 304 Domestic Water Supply— Cisterns provided 2 2 .. .. .. .. .. .. 1 1 .. 2 1 3 12 Cisterns repaired and cleansed .. 28 30 16 9 27 8 13 10 25 40 55 35 15 46 357 Water Supply provided to dwelling house 31 11 13 5 10 3 1 17 13 36 23 16 9 26 214 Water supply provided for tenement house 20 11 5 2 8 4 2 43 40 50 92 28 57 362 Other Improvements- Rooms cleanstd and limewashed 43 44 104 28 75 71 106 20 303 74 161 229 105 237 1600 Walls and passages repaired, cleansed and whitewashed . 7 12 4 7 9 8 11 6 44 19 64 59 34 67 351 Floor space ventilated .. 8 5 1 3 14 5 22 5 3 17 25 5 7 120 Floors repaired 14 6 11 5 8 10 18 10 16 17 27 59 24 37 264 Roofs repaired 23 19 18 7 15 8 31 22 13 32 75 40 26 48 377 Overcrowding abated .. .. 2 2 3 6 1 3 13 6 19 5 9 69 Illegal use of underground Rooms for sleeping discontinued .. .. .. .. .. .. .. .. .. .. 9 1 1 1 12 Other Improvements, or Nuisances abated 107 10(1 72 29 45 69 79 74 113 158 237 183 93 255 1614 Rooms Disinfected 255 240 132 51 208 79 145 120 169 172 176 278 106 150 2281 Total Improvements 1262 1184 789 351 1033 557 1468 1095 1352 1193 1435 1749 1117 1798 16383 Total Premises Improved 514 407 366 171 329 198 482 332 508 519 621 578 379 539 5943 245 [1909 Table CXXVII. Giving a Summary of the Nuisances discovered by the District Sanitary Inspectors during the Four Quarters and for the Year 1909, 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 147 240 185 150 722 2. „ ,, in a damp condition .. 52 40 43 61 196 3. „ in a dilapidated condition 48 79 54 55 236 4. The inlet of surface drain improperly trapped 39 25 42 38 144 5. The water-closet so foul as to be a nuisance 138 91 95 91 415 6. ,, ,, without a water supply 84 54 30 34 202 7 ,, „ with a deficient supply of water 54 52 52 48 206 8. ,, ,, improperly constructed so as to be a nuisance 112 94 53 50 309 9. „ ,, so defective as to be a nuisance 94 77 119 53 343 10. ,, stopped .. 37 28 19 28 112 11. ,, ,, placed in an improper position 9 1 4 5 19 12. Insufficient external ventilation 10 water-closets 16 4 18 8 46 13. Insufficient water-closet accommodation 20 31 20 19 90 14. The soil pipe defective 31 23 30 25 109 15. „ unventilated 38 13 15 23 69 16. ,, improperly ventilated 38 26 15 17 96 17. The yard in a condition injurious to health by reason of the want of proper paving 129 89 104 118 440 18. The yard dirty 32 16 17 19 84 19. „ undrained 7 2 4 7 20 20. A gully trap improperly placed within the bouse 39 28 41 22 130 21. The waste pipe of sink directly connected with the drain 26 15 14 18 73 22. ,, ,, improperly trapped 10 7 11 13 41 23. ,, ,, untrapped 156 99 106 106 467 24. „ of lavatory directly connected with the drain 3 .. 1 2 6 25. „ improperly trapped .. 2 1 .. 3 26. „ „ untrapped 28 15 21 20 84 27. „ of bath directly connected with the drain 4 2 2 4 12 28. ,, improperly trapped 2 3 1 .. 6 29. „ .. untrapped .. 32 27 22 31 112 30. The water cistern so foul as to be a nuisance 58 69 78 64 269 31. „ „ being without a close fitting cover 73 95 95 68 331 32. ,, ,, being placed in an improper position 32 25 28 18 103 33. „ ,, defective 11 6 4 5 26 216 1909] TABLE CXXVII.—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 50 88 82 68 288 35. The dustbin or ashpit defective 143 263 188 155 749 36. ,, ,, placed in an improper position .. 2 2 5 9 37. The drain foul 14 8 7 5 34 38. ,, defective 210 125 93 155 583 39 „ choked or stopped 72 64 58 54 248 40. ,, unventilated 51 44 29 32 156 41. The rain-water pipe in direct communication with the drain 54 29 20 44 147 42 ,, ,, in direct communication with the soil-pipe 3 1 1 2 7 43. ,, ,, defective 51 40 34 57 182 44. The water supply used for domestic purposes connected with the cistern which is used for flushing the W.C. 1 .. 1 .. 2 45. The house without a proper water supply 89 118 101 119 427 46. The roof defective 64 102 59 75 300 47. The guttering defective 32 48 26 42 148 48. The area improperly paved 7 6 4 11 28 49. ,, dirty 3 6 3 3 15 50. „ undrained 1 7 1 2 11 51. The paving of the washhouse defective 24 23 19 15 81 52. The back addition walls defective .. .. .. .. .. 53. The want of a proper manure receptacle 4 3 6 4 17 54. The bakehouse walls dirty .. .. .. .. .. 55. An animal kept in such a manner as to be a nuisance 13 11 14 19 57 56. The house or part of a house so overcrowded as to be injurious or dangerous to the health of the inmates 29 47 22 27 125 57. An underground room occupied as a dwelling contrary to the provisions of the Act 6 16 1 5 28 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 .. 1 .. .. 1 59. The space below floor in the basement or ground floor being unventilated 7 4 3 4 18 60. The space below floor in the basement or ground floor being improperly or insufficiently ventilated 28 21 15 20 84 All Nuisances 2,555 2,455 2,133 2,143 9,286 247 [1909 Table CXXVIII. Giving a Summary of the Sanitary Work performed by the District Inspectors in 1909. Inspections. QUARTERS. The Year. First. Second. Third. Fourth. House to House Inspections 217 240 156 170 783 Number of Houses Inspected 1,261 1,460 1,241 1,131 5,093 Re-inspections, Calls made, &c. 14,921 14,302 10,572 12,686 52,481 Total Visits 16,399 16,002 11,969 13,987 58,357 Visits to Ice Cream Factories 2 110 54 1 167 Do. Dairies and Milkshops 545 551 577 558 2,231 Do. Stables and Yards 823 824 606 612 2,865 Do. Manure Depots 31 26 18 23 98 Do. Vacant Land Passages and Courts 56 37 32 42 167 Do. Urinals attached to P.H.'s 294 259 224 222 999 Do. Under Customs and Inland Revenue Acts 87 9 7 .. 103 Do. re Water Certificates 2 8 11 11 32 Do. under the Sale of Food and Drugs Acts .. .. 36 .. 36 Do. Shops and Stalls on Saturday Nights 84 85 83 74 326 Smoke Observations 136 129 132 83 480 All Inspections, Visits, &c. 18,459 18,040 13,749 15,613 65,861 REMOVAL OF DUST. The following statement is of interest, as showing the improvement that has been effected in the removal of dust since 1891:— Applications to Remove Dust. Applications to Remove Dust. 1891 10,138 I9OO 234 1892 9,964 19OI 157 1893 4,986 1902 198 1894 4.506 1903 152 1895 4.596 1904 Il6 1896 4.245 1905 89 1897 312 1906 58 1898 303 1907 55 1899 262 1908 64 1909 67 Dust Receptacles Provided.—During the year 1,097 dust receptacles were provided, while 32 were repaired. 248 1909] Table CXXIX. Summary of Applications for the Removal of Dust during the Year 1909- Ward. ist Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Number of Assessments Michaelmas, 1909. Number of Applications to every 100 Assessments. 1 — 3 3 — 6 4,900 0.122 2 — — 2 1 3 4.735 0.063 3 2 — 3 1 6 4.518 0.133 4 1 1 3 * 6 5,486 0 .109 5 3 3 — 4 10 5,739 0.174 6 9 4 2 1 16 4,108 0.389 7 — 2 — — 2 4,042 0.049 8 1 3 1 — 5 2,732 0.183 9 1 1 1 1 4 2,659 0.150 10 — 2 1 3 6 3,544 0.169 11 1 1 — 1 3 4,623 0.065 Totals 18 20 16 13 67 47,086 0.142 249 [1909 STATE OF PAUPERISM IN THE BOROUGH The state of pauperism in Islington shows no improvement as regards the number of persons in receipt of relief. For the last 10 or 12 years there has been a steady increase in the number of persons receiving parish relief either within or without the Workhouse. Thus, in 1898 persons in receipt of relief averaged 6,635, whereas in 1909 they amounted to 10,476 on a weekly average. In 1908 the number was 10,349, 9,599 in 1907, and 9,069 in 1906. The present return is the second in which the weekly average has reached five figures. It shows that 127 more persons were in receipt of weekly relief than in 1908, which itself was 750 per week in excess of the return of 1907. Such figures prove conclusively that work has been scarce in London. The average number of paupers relieved in each year since 1899 has been as follows:— 1899 6,854 Per week relieved. 1900 6,956 „ 1901 7.327 „ 1902 7,668 „ 1903 8,004 „ 1904 8,086 ,, 1905 9.224 „ 1906 9,069 „ 1907 9.599 „ 1908 10,349 „ Average 8,313 „ 1909 10,476 „ Indoor Paupers.—The average number relieved each week was 4,864, or 306 in excess of the average which obtained in the preceding year, and as contrasted with a weekly average of 3,867 in the decennium 1899-1908. Outdoor Paupers.—On an average 5,612 were relieved in each week, as compared with 5,791 in 1908, with 5,338 in 1907, and with a decennial weekly average of 4,447. Of these paupers, the average number of adults was 3,649, and of children under 16 years of age 1,963. There has, therefore, been an increase in the average number of indoor cases of relief, and a decrease in outdoor. The policy apparently, is to drive people into the workhouse instead of affording outdoor relief. It is certain to be efficacious in reducing the total amount of relief granted, but it is doubtful if it is the right course to pursue, for there are many poor people who would sooner starve than enter the workhouse, especially as it too often entails the breaking up of their families and homes. 250 1909] Vagrants.—No vagrants were relieved, as the wards were closed in January, 1909. Children Boarded out.—On a weekly average, these numbered 107, as compared with 125 in the preceding year. They are also 18 less than the decennial weekly average of the years 1899-1908. Table CXXX. Showing the State of Pauperism in the Borough during the years 1899-1908 and 1909. Average number Relieved during each week. Years. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals Outdoor. Totals. All paupers relieved, cols. 2 & 5. Vagrants Relieved. Children Boarded out. Deathrates. Adults. Children under 16. 1 2 3 4 5 6 7 8 9 1899 3,351 2,237 1,266 3,503 6,854 16 131 1871 1900 3,397 2,288 1,271 3,559 6,956 7 100 1703 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 16.71 1903 3,879 2,739 1,386 4,125 8,004 17 127 14.27 1904 3,622 3,069 1,395 4,464 8,086 65 122 15.35 1905 4,295 3,302 1,627 4,929 9,224 58 126 14.44 1906 4,189 3,335 1,545 4,880 9,069 12 134 14.64 1907 4,261 3,556 1,782 5,338 9,599 75 135 14.63 1908 4,558 3,752 2,039 5,791 10,349 13 125 13.15 Average 3,867 2,939 1,508 4,447 8,314 29 125 15.50 1909 4.864 3,649 1,963 5,612 10,476 Wards closed January 1909. 107 14.00 Table CXXXI. Showing the State of Pauperism in the Borough during tke year 1909 Average number Relieved during each week. Quarters. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals. Totals corresponding periods 1908 Vagrants Relieved. Children Boarded out. Death rate Adults. Children under 16. 1 2 3 4 5 6 7 8 1st Qr. 4,957 3,818 2,071 10,346 10,364 Wards clossd in January, 1909. 120 19 09 2nd ,, 4,793 3,512 1,848 10,153 9,724 112 12 93 3rd 4,718 3,498 1,873 10,089 9,905 98 10 28 4 th ,, 4,988 3,769 2,063 10,820 11,403 97 13-70 TheYear 4,864 3,649 1,963 10,476 10,349 — 107 1400 251 [1909 COMMON LODGING HOUSES. These places are controlled by the London County Council under by-laws which gives that body powers of inspection both by day and night. They are licensed annually, and therefore their keepers or owners are more amenable to control, and obey the by-laws more carefully than do the owners of any other class of lodgings. They number 49 in Islington, of which 38 are licenssd for men, 9 for women, and 2 for married couples. Table CXXXII. Showing the Addresses of the Common Lodging-Houses in the Borough. (Under the Control of the London County Council). Situation of Premises. Author. ized No. of Lodgers. Sex of Lodgers. M = Men. W = Women. MC ^ Married Couples. Name of Licensee. 36, Ball's Pond Road 28 M. Alfred Edward Hurworth. 14, 16, Barnsbury Street 51 M. Ellen Maples. 18, 20 & 22, Barnsbury Street 91 M. „ 47a, Campbell Road 71 M. Wm. Jno. Cragg. 35, Campbell Road 27 W. „ 37 & 39, Campbell Road 61 M. „ 10 & 12, Campbell Road 52 M. Hugh Hersey. 180, Caledonian Road 51 M. Mrs. Finetta Jefcoate. 55, Colebrooke Row 71 W. Dave Levy 13 & 14, Duncan Terrace 60 W. B. Jaffa. 155, Englefield Road 64 M. Wm. Jno. Cragg. 1 & 3, Eden Grove 107 M. Lewis Henry Levy. 87, Essex Road.. 52 M. Jas. Shuttleworth, Jun. 89, Essex Road.. 35 M. „ 8, Flower's Mews 72 M. Mrs. Finetta Jefcoate. 102, 104 & 106, George's Road 51 W. Robert Wm. Maples. 68, George's Road 38 W. Ellen Maples. 1, Gordon Place, Highgate Hill 5 M. George Willis. 2, Gordon 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. „ 13, Gordon Place 9 M. „ 87, Highgate Hill 16 M. „ 29, Halton Road, and la, Allen Street 59 M. Chas. Jas. Vincent Somerville. 29, Hornsey Road 88 M. Sidney Allen. 8a, Hornsey Street 48 M, Colin F. Campbell. 10, Milton Place 22 M. Lewis Henry Levy 4 & 6, Queensland Road 34 M. Margaret Jones. 8 & 10, Queensland Road 18 M.C. „ 23 & 25, Queensland Road 28 W. „ 160 & 162, St. James' Road 76 M. Wm. John McGrath, 235a, Upper Street 37 M. Hugh Hersey. 92, York Road 29 M. Hugh Hersey. 252 1909] ARTISANS AND OTHER DWELLINGS. There are 404 blocks of dwellings, containing 4,630 separate flats or tenements, in the Borough. These vary considerably in the class of persons occupying them, some of whom are only labourers while others are clerks, well paid mechanics, and middle class people. A list of these buildings has been prepared, as usual and is now presented. WARD. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Tufnell Wessex Buildings .. Wedmore Street 3 225 „ *Lincoln House Dartmouth Park Hill 1 6 „ *Suffolk House „ „ 1 6 „ *Durham House „ „ 1 3 „ *Carlisle House „ „ 1 6 „ *No. 46 and 48, Dartmouth Park Hill „ „ 2 12 „ *Nos. 8, 9, 10, 11 and 12, Wyndham Mansions .. Wyndham Crescent 1 30 „ *Nos. 17, 18. 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 and 29, Cathcart Hill Junction Road 1 78 „ *Roydon Mansions „ 1 3 „ *Manor Mansions .. Holloway Road 2 10 „ *Hargrave Mansions Hargrave Road 10 60 „ *St. John's Park Mansions Pemberton Gardens 8 64 „ *Nos. 18 and 21, Pemberton Gardens Holloway Road 2 5 „ *Fulford Mansions.. Fairmead Road 2 14 „ *10, St. John's Park Holloway Road 1 3 „ *47, Hargrave Park Junction Road 1 3 „ *Nos. 49 to 67, Hargrave Park „ „ 10 30 Upper Hollo way *Albermarle Mansions Holloway Road 3 24 .. Whitehall Mansions Archway Road 1 30 „ Elthorne House Elthorne Road 1 6 „ *Elthorne Mansions „ „ 1 12 *Nos. 34, 36, 38, 40, and 42, Dresden Road Dresden Road 5 15 „ *Nos. 27, 29, and 31, Cheverton Road Cheverton Road 3 9 „ Nos. 221 to 259, Hornsey Road Hornsey Road 38 114 „ Nos. 209 to 283, Hornsey Road „ „ 8 16 „ *473, Hornsey Road „ „ 1 3 Tollington Nos. 83 and 85, Alsen Road „ „ 2 8 „ *Turle Mansions Wray Crescent 1 11 „ *St. Mark's Mansions Tollington Park 4 16 „ *Tollington Park, Nos. 14, 16,20,22,24,26,28 and 30 „ „ 8 16 „ *Albert Mansions .. Crouch Hill 1 12 „ *Brambledown Mansions.. „ 1 12 „ *Hanley House Hanley Road 1 9 „ *Grenville Road, Nos. 28, 30, 32, 34, 36 and 38 .. Hornsey Road 6 12 Lower Holloway Queen's Arms Buildings .. North Road 1 63 „ City Arms Buildings North Road 1 63 * These flat tenements are occupied by people other than the working classes. 253 [1909 ARTISANS AND OTHER DWELLINGS—continued. WARD. Name of Dwellings Where situated. No. of Blocks. No. of separate Dwellings. Lower Holloway Camden Dwellings York Road 1 44 „ North London Cottages .. Market Road 1 8 „ *Crown Mansions .. Liverpool Road 2 24 „ Crown Mansions Paradise Passage, Liverpool Road 1 10 „ St. James's Mansions St. James's Road .. 1 6 .. Pleasant Buildings York Road 3 27 „ Edinburgh Place Brewery Road 2 45 „ Aberdeen Place Brewery Road 2 35 .. Anchor Dwellings .. „ 2 15 „ *Nos. 24, 34 & 33, Arundel „ Square O fford Road 3 12 „ *Loraine Mansions.. Widdenham Road 38 160 „ * Morgan Mansions Holloway Road 8 64 „ L.C.C. Dwellings Caledonian Road Burns 1 30 Scott 1 30 Wallace 1 70 Knox 1 66 Bruce 1 76 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 „ 23, Hornsey Road „ 1 3 „ 27. Hornsey Road „ 1 3 „ *York House Highbury Crescent 1 24 „ *Thane Mansions Thane Villas 1 10 „ *Walton House Thane Villas 1 10 „ *Wilmington House Highbury Crescent 1 8 „ *Nos. 1 and 2, Fieldway Houses Fieldway Crescent 2 16 „ *17, Highbury Crescent „ „ 1 8 „ *Nos. 1 to 16, Aberdeen Court Aberdeen Park 2 16 „ *Nos. 1 to 6 Durham House Fieldway Crescent 1 6 „ * ,. 1 to 6 Westmoreland House „ „ 1 6 „ *Nos. 1 to 6 Highbury Gardens Highbury Crescent 1 6 „ *15, Highbury Crescent „ „ 1 4 „ *16, „ „ 1 4 „ *55, Highbury Park Highbury Park 1 10 „ *Nos. 1 to 3, Hamilton Road „ „ 1 3 „ 60 Holloway Road Holloway Road 1 3 Thornhill Beaconsfield Buildings East Street 3 475 „ Clarence Terrace Rufford Street 1 53 „ Carlton House Stanmore Street 1 15 „ Pembroke House „ 1 15 Barnsbury Cloudesley Mansions Cloudesley Place 1 12 „ Stonefiekl Mansions Cloudesley Square 1 12 „ Oatlands House Upper Park Street 1 12 „ Ashley House „ 1 12 „ Halliford House „ 1 12 „ Thanet House „ 2 15 * These flat tenements are occupied by people other than the working classes. 254 1909] ARTISANS AND OTHER DWELLINGS—continued. ward. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Barnsbury Thornhill Houses Thornhill Road 5 84 „ Arvon House Offord Road 1 10 „ Buckland House .. „ 1 10 „ 33a & 33b, Thornhill Road Thornhill Road 1 2 „ Colne House Offord Road 1 8 „ Bures House ■„ 1 8 „ Liverpool Buildings Liverpool Road 26 276 „ 371, Liverpool Road „ 1 4 „ 1 and 2, Heathcote House Barnsbury Square.. 1 2 St. Mary's Albert Mansions Liverpool Road 1 8 „ 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 „ Brcokfield House „ 1 4 „ Worcester House Astey's Row 1 10 „ Lincoln House Astey's Row 1 10 „ 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 Essex Road 14 42 „ Nos. 1, 2, 3, 4, 5, Carleton Terrace .. Halton Road 5 15 „ No. 7, Astey's Row Essex Road 1 4 „ Nos. 1,2,3. Clarence Houses „ 1 4 York House „ 1 4 Canonbury Canonbury Avenue Canonbury Road 17 148 „ Ebenezer Buildings Rotherfield Street 5 36 „ *1 to 6, Wallace Gardens Wallace Road 3 6 „ *7 to 15 Wallace Gardens „ „ 5 9 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 Essex Road 2 6 „ Nos. 16, 17 to 30, Norfolk Street „ „ 15 30 „ Nos. 141 to 147, Shepperton Road New North Road 4 12 430 4,694 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. 255 [1909 INSPECTION OF FOOD. This part of the work of the Public Health Department was satisfactorily performed. It is everywhere looked upon as a most important duty, and especially so with respect to the inspection of food animals, whether immediately after slaughter or when the carcases have been cut up and placed for sale as joints. In 1906, owing to the revelations at Chicago, there was considerable anxiety exhibited by the public as to the sufficiency of the inspection adopted in our towns, but now that the scare has subsided nothing is heard. There is no doubt that it did an enormous amount of good, and led many English authorities to examine their defences against diseases caused by the consumption of unsound food, while in the United States a special Federal Act was passed, the Pure Food Law, and elaborate regulations were issued by their Government to insure that the public should get sound meat, whether canned or not, and to put an end to methods of handling and packing foodproducts that were not only uncleanly but also dangerous to health. It was shown that the establishments and slaughter houses were dirty; that a traffic existed in questionable meats; and that tuberculosis existed among the workers in a proportion far in excess of their numbers. That state of things has been remedied, and as a recent American writer, Dr. Albert Leffingwell, says in his book, " American Meat," " Taken all in all, " it would appear that the principal meat-packing establishments of Chicago " are now conducted with as strict attention to the demands of cleanliness as " circumstances permit, or as the most fastidious critic could require. What " the casual visitor may not remember is the fact that the real value of each " and every food-product depends not merely upon the nicety with which the " processes of manufacture are carried on, but above everything upon the quality " of the meat comprising them. It is probable that on this point the visitor will " learn nothing from observation in the packing-house, no matter how frequent " his visits, or how keen his sight." The writer then proceeds to show how the regulations are evaded or construed in favour of the great packers, and one rises from the perusal of the book, which is written in an exaggerated style that greatly discounts its reliability, with a feeling that although the methods of preparing and packing meats may have been improved, the meat itself is no better, and that an undue proportion of the pork dispatched to England is trichinous. He complains strongly that there is no microscopical examination made of the pork intended either for home consumption or export to England, and that " more singular than 256 1909] " American indifference is the attitude of unconcern manifested by Great " Britain. Of American pork products, she buys far more than all the rest of " the world purchases ; in 1904, for example, the United Kingdom took more " than 80 per cent. of the exports of American bacon and hams, and more than " 60 per cent. of all exported fresh and salted pork. Suppose that the English " Government, following the example of Germany, had made the importation " of American pork products dependent upon this microscopic examination for "trichina, is it likely that the United States would have refused it, no matter " what the cost ? Is England indifferent to the health of her people? " It would be folly to expect the United States to show greater solicitude for " the health of the English working man than his own Government manifests. " But no one can doubt that the microscopic examination of every pound of " pork-products going to England would have been granted for the sake of the " continued trade if the English Government had seen fit to ask for it." (The italics are Dr. Liffingwell's). He then gives extracts from the reports of the Chief of the Bureau of Animal Industry for the several years, 1902-1906, and also tabulates figures for 1900-1906 as follows :— FEDERAL INSPECTIONS OF PORK, 1900-1906. Total number of hogs slaughtered under Government inspection171,152,281 Number of these examined for trichina 4,102,330 Number of carcases found with trichina-like bodies of disintegrating trichinae 54,507 Number of carcases containing living parasites 54,237 Per cent. of carcases examined found infested by trichinae (half of which were alive) 2.65 From these figures he deduces the facts that one carcase in 38 examined presented evidence of being or having been infected by trichinae. He next urged that, as there were 203,000,000 hogs slaughtered under Government inspection during 1900-1907, and that as trichina was as common among all animals as among those whose carcases were examined, it followed " that, during this period of eight years, over five million carcases of hogs, or about a thousand million pounds of pork, infested with trichinae, at least half of which at the time of slaughter were potent for mischief, were turned into the meat supply of an unsuspecting world." 257 [1900 It appears, according to the report of Dr. Melvin, of Bureau of Animal Industry, from which Dr. Leffingwell quotes, that " The German Government has not accepted the American certificate as having any sanitary value, and has re-inspected, at the expense of the shipper, all pork received there from the United States. Nevertheless, it has appeared to be desirable to continue the microscopic inspection in this country in order to reduce the percentage of trichinae found on re-inspection in other countries. This is an important measure for maintaining the reputation of our meats, and one this country cannot afford to neglect." Strange to relate, a year later the American Department of Agriculture decided to abandon altogether the examination for trichinae, and, therefore, it is all the more necessary for us to look on American pork with suspicion. These statements, coming from an American with a large experience of the packing and meat trades of his country, should cause the consumers of pork to be careful as to what they buy and eat. The matter is doubtless receiving the attention of the Port Authorities who administer the regulations as to food imports, and, of course, can hardly have been overlooked by the Food Department of the Local Government Board, who possess considerable powers under the Regulations made under the Public Health (Regulations as to Food) Act, 1907. These Regulations have been framed with the object of securing that articles of food which are unsound, unwholesome, or unfit for human consumption, and which as part of the cargo of a ship are brought to this country, either as a place of destination or as a place of deposit for transmission to a place of destination elsewhere in the United Kingdom, shall be dealt with at the port of discharge. This procedure is necessary for the prevention of danger to the public health from the consumption of unsound or unwholesome food. The Regulations began to take effect on the 1st October, 1908, and are enforced in the districts of the various Port Sanitary Authorities. Unsound Food.—During the year 2 tons, 4 cwt. 3 qrs. 18 lbs. of unsound food were surrendered or seized, as compared with 5 tons, 7 cwt., 1 qr., 22 lbs. in 1908, and 2 tons, 1 cwt., 0 qrs. 9 lbs. in 1907, and with 2 tons, 1 cwt. 1 qr. 2 lbs. in 1906. In 1908 the increased amount was due to the seizure of over 2 tons of tinned foods which were found in a canning works. Only 11 seizures of unsound food were made under the Public Health (London) Act, 1891, and after inquiry into the facts, the Public Health Committee ordered legal 258 1909] ceedings to be taken in 9 instances, which resulted in the defendants being fined £40 16s. Gd. and costs. In the other casts there was no evidence that the traders had the unsound food knowingly on their premises, and, indeed, it was they themselves in some instances who had called the Inspector's attention to it. Inspection of Shops, Street Markets, Stalls, etc.—These were regularly inspected as well during each day as on Saturday nights, as were also fruit shops, sausage factories, and other places where food is sold or prepared for sale. Altogether 11,093 visits were recorded by Inspector Wilkinson, which are in addition to those of the district inspectors 7 of whom inspected the various shops and stalls on Saturday nights, while every Sunday morning throughout the year one Inspector keeps them under observation. Unsound Fish.—The costers continue to bring fish to the Town Hall for examination when on opening the trunks or boxes they have found the contents to be unsound. The Fishmongers' Company a short time since requested that all cases of this kind should be reported to them, which has been done. In every instance the fish has been detained until it was possible to remove it to the Manure Depot or Disinfecting Station for destruction in the destructor. The food destroyed during the year was as follows:— ist Quarter. cwts. qrs. lbs. Diseased meat and organs from slaughterhouses 3 3 14 Unsound fish surrendered - i o 4 Unsound vegetables, &c., surrendered — — i Diseased meat from shops, etc. i 2 13 Unsound meat and rabbits from shops — 2 24 Total 7 i 0 2nd Quarter. cwts. qrs. lbs. Diseased meat and organs from slaughterhouses 11 i 16 Diseased meat and organs from shops- — i 5 Unsound meat from shops, etc. - — i ii Unsound fish from shops and stalls - 3 o 26 Unsound fruits and vegetables from shops and stalls 2 i 20 Total 17 2 22 259 [1909 3rd Quarter. cwts. qrs. lbs. Diseased meat and organs from slaughterhouses 3 T I Diseased meat from other premises - — 3 20 Meat unsound by decomposition from shops (seized) - - 21 Unsound fish from shops and stalls 1 2 13 Unsound fruit (seized) ..... — 2 14 Unsound fruit (surrendered) .... — I 25 Total 7 O 10 4th Quarter. cwts. qrs. lbs Diseased and unsound meat and organs from slaughterhouses - 2 2 7 Unsound meat and rabbits from shops, etc. — - 21 Unsound fruit from shops and stalls 8 3 4 Unsound fish from shops 1 1 7 Unsound hens eggs - — 3 Total 12 3 14 Warranty with Cattle—This subject was dealt with in the report for 1908, as, although a trade matter, it was of interest to public health authorities, inasmuch as when a man stands to lose the price of an animal which costs between £18 and £30, according to its weight, and when he is to receive no compensation for its destruction he may be greatly tempted to sell the meat surreptitiously. Indeed, he sometimes does so. After that report was issued, the Medical Officer of Health, on the 24th May, 1909, reported as follows to the Public Health Committee:— To the Chairman and Members of the Public Health Committee. Indemnity for Butchers for Cattle seized as being diseased and unfit for human food. Gentlemen,—You will recollect that over two years ago I condemned the caucase of a bullock owned by Mr. Newbury at his slaughterhonse in Roman Road as being unfit for human food because it was tuberculous. In life this animal had showed no signs of disease, and was apparently a healthy sound beast. When it was slaughtered, however, it was found to have been suffering from generalized tuberculosis, so that I was compelled to have its carcase destroyed. t 2 260 1909] In consequence of this, Mr. Newbury, with the support of the Incorporated Society of the Meat Trades, brought an action against the farmer who had sold the animal, for the recovery of the price paid for it, but failed to get a decision in his favour in the High Court. In giving his judgment, the Lord Chief Justice said, as well as I recollect that butchers and others could protect themselves by methods of insurance. Be that as it may, I have now to report that the Incorporated Society of the London Meat Trades announce that an amicable arrangement has been arrived at by the cattle salesmen, the bankers, and the society, by which butchers purchasing oxen or heifers at the Islington Cattle Market will be indemnified against loss in the event of the seizure of the carcase or any portion of it to the full extent of the purchase price under the following conditions:— 1. In the event of an animal or animals being wholly condemned by or through the action of any Sanitary Authority as unfit for human food on account of being diseased, Hill & Sons shall pay to the purchaser the full purchase price (as shown by Hill & Sons' books), less any amount realised by the purchaser for the sale of the hide, waste tat, or such other offal as may be saleable, of the said animal or animals, provided that the animal or animals has or have been slaughtered immediately or within ten days from and including the date of purchase, beyond which period this indemnity will in no case be extended, and provided also that the purchaser shall give immediate notice to Hill & Sons that the carcase or any part thereof is condemned, together with certificate from the condemning authority, also a statement as to colour, sex, markings, etc., and parts and quantities to be surrendered, and of whom purchased. 2. In case of only a portion of a carcase being condemned, Hill & Sons will pay the purchaser the full value of such portion, such value being ascertained from current prices in the London Meat Market at the date of condemnation. 3. Hill & Sons may demand, if they deem necessary, the certificate of identification, to be verified by or on behalf of the purchaser by a statutory declaration, and the vendor shall also render any assistance required by Hill & Sons in connection therewith. 4. On any animal being found to be diseased, the hide shall not be wholly detached from the carcase until the animal has been inspected and the certificate signed as mentioned above. 261 [1909 5. No animal sold for less than £12 will be covered by this indemnity, and Hill & Sons reserve the right to refuse to accept any animal which may be considered an undue risk. 6. The purchaser must on the date of sale give to Hill & Sons full description of animals for which an indemnity is required, with all identification marks. 7. Compensation will be paid only to the ORIGINAL PURCHASER, as recorded by Hill & Sons. 8. The premium (to be paid by salesmen) to be ls. per head on bullocks or heifers. 9. If any dispute shall arise in the settlement of any claim under this scheme, the matter shall be referred to arbitration. Mr. William Reid has consented to act as Arbitrator for the Wholesale Trade, and Mr. John Lindsey for the Retail Trade. The result of this arrangement will undoubtedly be that butchers will be most anxious to give information respecting diseased cattle that come into their hands, and that in consequence the sale of diseased meat will become less. It is only to be regretted that similar arrangements have not been come to throughout the country. In this connection, it is interesting to note that on the 19th instant, an ox owned by Mr. Watson, 576, Holloway Road, was discovered to be affected with tuberculosis in a generalized form, although, prior to slaughtering, no trace of disease could be found. At the moment of Mr. Wilkinson's arrival at the Shop, Mr. Watson's servant was just about to start on his bicycle to find the Inspector, to get the carcase examined. As a result of the examination it was surrendered and taken to the disinfecting station to be cremated, the hide being alone retained by the butcher. This is the second time during the last 12 months that a whole carcase of beef has been surrendered by Mr. Watson, who on the first occasion lost its value, but this time I am happy to think he will be fully recompensed. I am. Your faithful servant, A. E. HARRIS, Medical Officer of Health Town Hall, Islington, 24th May, 1909. 262 1909] The Medical Officer of Health regrets to learn that, after a short trial, the system of compensation outlined in this report has been brought to an end through misunderstandings or disagreements between the buyers and sellers, and, therefore, the position of affairs has now reverted to the unsatisfactory state they were in previous to the arrangement being entered into. Slaughterhouses.—The number of slaughterhouses on the register is 34, which is the same number as in 1908, but 3 less than in 1907. The names of the licensees, the situation of the premises and the conditions attached to the licence are set out on page 263 of this report. J ust prior to the holding of the London County Council Licensing Sessions in October they were visited by the Medical Officer of Health, who found them in a clean and satisfactory state. Of course, they could never pretend to afford the same facilities for slaughtering cattle as public abattoirs, which for many reasons are to be preferred. As usual, the Food Inspector obtained returns from the butchers, from which it appears 38,350 animals, consisting of 1,763 oxen, 6 cows, 100 calves, 36,479 sheep, and 2 goats, were slaughtered, or 7,843 animals more than in 1908. This increase is due chiefly to the increased number of sheep that were killed, which were 8,003 in excess of the number (28,476) slaughtered the previous year. It appears from Inspector Wilkinson's report that a wholesale mutton butcher who formerly slaughtered at the Cattle Market has removed his slaughtering to a large slaughterhouse situated in Roman Road. Appended is a return showing the number and description of animals killed in the borough during the last six years. Animals killed. 1904. 1905. 1906. 1907. 1908. 1909 Oxen 2,360 2,195 2,172 2,146 1,941 1,763 Cows 4 17 — 4 — 6 Calves 154 12 7 143 142 86 100 Sheep 32,973 30,686 30,668 24,380 28,476 36,479 Pigs 25 48 11 2 4 — Goats — - - - - 2 35,516 33,073 32,994 26,674 30,507 38,350 263 [1909 From the Inspector's reports, it appears that he paid 1,8G3 vsits to the slaughterhouses, which he considers were conducted in a satisfactory manner. LICENSED SLAUGHTER-HOUSES. Registered No. Name of Licensee. Situation of Premises. Condition of Licence. 119 Gayes, W. J. D. 4, Athelstane Mews 120 Cockerill, A. E. 34, Balls Pond Road To kill small cattle only and not more than three beasts a week. 121 Clarke, Jno. 259, Balls Pond Road 122 Wood, Edward 53, Barnsbury Street To kill small cattle only and for purposes of own shop. 124 Hack, Thomas 40, Bingfield Street Small cattle only. 125 Guyer, Aubrey 18, Brecknock Road Small cattle only. 126 Webber, George 41, Caledonian Road 129 Luxton, John Carter's Yard, 170, Essex Rd. 130 Philip, Alfred (Between) 185-7, Church Road 132 Toop, William (Rear of) 1, Clayton Street 134 Mobbs, Jas. Hy 219, Copenhagen Street Small cattle only. 135 Sparrey, Thomas 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. 131 Austin,W.Hanks 410, Essex Road 136 Hammond, F 6, George's Road 137 Jenkins, Charles 12, Hazelville Road, Hornsey Road 138 Wadsworth,A.B. 32, High Street 139 Webber, Wm 81, Highgate Hill 140 Stone, Sidney 234, Holloway Road 141 Wilde, Fredk. 498, Holloway Road 142 Watson, Harriet 576, Holloway Road 143 Tuck, Wallace 152, Hornsey Road 144 Worboys, Richd. 410, Hornsey Road 145 Webber, Jno. 9, Junction Road, Upper Holloway 146 Buckingham, J 393, Liverpool Road 147 Gregory, Arthur T. 81, Newington Green Road Small cattle only. 151 Newbury, Louisa 102, Roman Road 152 Eteen, R. E. 49, St. Peter Street Small cattle only. 154 Stone, A. 194, Seven Sisters Road 155 Farmer, Chas. J. 280, Seven Sisters Road 157 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. 158 Richardson, J. 149, Upper Street Small cattle only. 159 Luxton, John (E. side of) Wycombe Mews 160 Lidstone (Ltd ) 398, York Road 156 Farley, E. J. 53, Southgate Road Small cattle only. Tot al 34 Slaughter-Houses. 264 1909] Cowhouses.—The cowhouses are 7 in number, which is the same as in the preceding two years. In 1892 they numbered 31, but year by year they have grown fewer, until in 1907 they were only 7, at which figure they have remained since. It, however, appears that there are but 5 in use at present, for no cows were kept in two of them during the year. Just prior, however, to the annual visit of the Medical Officer of Health, the licensee of one of them, who had allowed his cowhouse to be used as a storeroom for lumber, was cautioned that his licence would be opposed unless he conformed with the Dairies, Cowsheds and Milkshops Regulations, and consequently the premises were put in order. Nevertheless, they are still unused. The number of cows kept in the 7 sheds, which are licensed for 172 animals, averaged only 41, which is nine less than in the preceding year. The cowsheds were regularly inspected by the Inspector, who made 68 visits to them. They were also thoroughly examined prior to the Licensing Sessions by the Medical Officer of Health, who found them in a satisfactory state and far better than the majority of the cowhouses he has from time to time seen in rural districts. The cows were well groomed, and, therefore, clean, while the sheds themselves were free from manure and in a cleanly state. Years. Cowhouses. Years. Cowhouses. I092 31 I90I 13 1893 31 1902 13 1894 25 1903 13 1895 19 1904 10 1896 19 1905 9 1897 19 1906 9 1898 15 1907 7 1899 14 1908 7 1900 13 *909 7 List of Licensed Cowhousfs in the Borough of Islington. Registered No. Name of Licensee. Situation of Premises. No. of Cows licensed to hold. 107 Williams, Joseph 108, Elmore Street Shed No. 1=28 108 Jones, Elizabeth 3, Frome Street 18 111 White, George 24, Hercules Place, Holloway 12 112 Wright, Henry 11, Matilda 15 113 Edwards, James 1, Northampton Street 19 114 Jones, Edward 88, Roman Road 16 115 Arnold, George 233, Seven Sisters Road 64 Total 7 Cow-Houses. 265 [1909 INSPECTOR WILKINSON'S REPORT. Public Health Department, Town Hall, Upper Street, N. April 25th, 1910. To the Medical Officer of Health. Dear Sir,—I have pleasure in submitting the following report in connection with my duties concerned in the inspection of various premises where food-stuffs are deposited for sale or preparation, and the fitness or otherwise for human food of the various foods thus coming under observation, for the year 1909. Slaughterhouses.—The number of licensed slaughterhouses remains the same as in the previous year, viz., 34, and during a total of 1,863 visits they were in general found to be satisfactorily kept and conducted. The number of animals slaughtered was as follows, viz.: — Oxen Cows Calves Sheep and Lambs Goats Pigs Total 1,763 6 100 36,479 2 Nil 38,350 That of the previous year being as under, viz.:— Oxen Cows Calves Sheep and Lambs Goats Pigs Total 1,941 Nil 86 28,476 Nil 4 30,507 it will thus be seen that there were 172 less bovines killed, 14 more calves, 8,003 more sheep and lambs, 2 more goats and 4 less pigs, or a total of 7,843 animals more than in the previous year. This shows a continued annual reduction in the number of oxen slaughtered, which is due to varying causes, no doubt principally to the fact that English killed beef can usually be bought at the Smithfield Market at a lower price than that purchased alive and slaughtered on their own licensed premises, and consequently when prices are generally somewhat high and competition very keen, traders are driven by stress of circumstances to buy dead meat, although they are well aware that meat slaughtered as near as practicable to their own Bhop not only presents a much cleaner and better appearance, but will actually resist decomposition for days longer than the former, owing to the fact that dead meat, or meat specially killed for the wholesale market, generally is subjected to much handling and trucking about (very often with far too little care from a sanitary standpoint) before rigor mortis is allowed to run its proper course. Then again, within the past two years circumstances have arisen which have caused a considerable number of oxen to be killed in the slaughterhouses at the Metropolitan Cattle Market, for a butcher within the Borough who had previously had slaughtering accommodation in the Roman Road slaughterhouse. The numbers of other animals slaughtered as compared with recent previous years show little change, excepting that of sheep and lambs, which have further increased during the year by 8,003. This is mainly due to a wholesale firm of mutton butchers having, since the close of the year 1908, conducted their slaughtering at the Roman Road slaughterhouse, which was previously carried on at the Cattle Market. The quality of the animals slaughtered generally has been of the best, and the number diseased comparatively small. Only one ox was found to be suffering from generalised tuberculosis, and this was a very well nourished carcase, and had cost Fortunately, the butcher had received a warranty as to soundness at the time of purchase, the seller covering the risk by insurance with his bankers, who had to pay out the actual loss to the butcher. I much regret to find that this system of warranty and insurance has not made the progress I had hoped it would, owing to strong opposition on the part of feeders and dealers and the want of uniform and universal meat inspection, whereby the risk would be equally distributed amongst all traders, whereas at present the risk is unfairly divided between them, owing to the fact that in some instances a sharp look-out is kept over all animals slaughtered, whilst on the other hand, in very many instances there is practically no inspection at all. 266 1909] It will thus be seen that the butcher who need only consult his own private opinion as to whether the carcase of an animal is fit for human consumption or not, has a decided advantage over his rival in the live market, who has to toe the line with all his purchases. Consequently, when the cattle salesman refuses to warrant his cattle, the former butcher is not persistent in his demand for it, and is thus in a position to buy the very animals his rival refuses to buy without the warranty, and very probably at a less price owing to accepting all risks. There were also found four other animals affected with tuberculosis, but only in a localised form, and after careful examination in each case, and the rejection of certain parts and organs fully described in Table "A" of this report, the carcases were passed as fit for human consumption. Other abnormal affections of carcases or individual organs will also be found in detail in the same table. TABLE A. No. of Cases Description of Animals. Extent of Disease or Affection. Nature of Affection. How disposed of. 1 Ox Generalised Tuberculosis Carcase and organs destroyed 1 do Left sternum and viscera do. Affected parts and organs destroyed 1 do Liver, lungs and mesentery do. do. do. 3 Oxen Lungs (slight) do. Affected organs destroyed 1 Cow Lungs, liver, tripe and trimmings do. Affected parts and organs destroyed 2 Calves Carcase and organs No separate existence Carcase and organs destroyed 1 Ox Tongue Actinomycosis Affected organ destroyed 3 Sheep Carcase and organs Moribund Carcase and organs destroyed 1 Lamb Hind quarters Abscess Parts affected destroyed 1 Ox Stomach and spleen Inflammatory processes Organs destroyed 1 do Lungs and pleural membranes do. do. Parts and organs destroyed 1 Sheep Liver, lungs and trimmings Abscess do. do. 2 do. Lungs do. do. do. 31 Oxen Liver Parasitic (Dis. Hep.) do. do. 9 do. do Abscess do. do. 1 do. do Angiomatosis do. do. 48 Sheep do Various parasites do. do. 6 do. Lungs do. do. do. do. 4 do. Liver and lungs do. do. do. do. 267 [1909 Shops, Stalls, &-e., Inspection of.—This includes the inspection of butchers' shops, fish shops, fruit shops, sausage factories, and other premises where foodstuffs are sold or prepared for sale, as well as stalls, barrows, &c., from which perishable foods are sold. The approximate number of established traders within the Borough is as follows, viz.:— Butchers, provision dealers, etc, 247; fishmongers and fish fryers, 103; fruiterers and gieengrocers, 215; 9 premises where foodstuffs are deposited for preparation of sale (sausage factories, etc.), where no retail business is transacted, and also some 6 meat, etc., stalls, the same number of fish stalls and barrows, and about 30 greengrocer and fruiterer's stalls and barrows, but the number of itinerant traders fluctuates considerably, according to different seasons of the year and other varying conditions. To these a total of 11,093 visits have been recorded during the year, in addition to those of my colleagues the District Inspectors, who are each engaged fortnightly on Saturday evenings, and one on each Sunday morning throughout the year, on market inspections, but of which I have no proper record. The quality of the foods and their condition of soundness generally has been on the whole very satisfactory. Only 11 seizures were made under the Unsound Food Clauses of the Public Health (London) Act, 1891, and in 9 of these the Public Health Committee ordered legal proceedings to be taken, which resulted in a total of .£40 16s. 6d. fines and costs. In the previous year 12 summonses were taken out under the same Clause, resulting in a total of £'A7 18s. 6d. fines and costs. The particulars of each seizure, with the ultimate decision thereon, will be found in the second table "B" of this report, where also will be found particulars of the various surrenders of unsound foods. By a perusal of this table it will be seen that again the bulk of the unsound foods dealt with was due to decomposition or some circumstances of which the respective traders could have had no knowledge when the food originally came into their possession. In other words, there is no evidence forthcoming of traders within the Borough dealing in foodstuffs of doubtful repute, which is some proof of the effectiveness of constant special supervision thereof, and this is supported by the fact that the number of cases in which the attention of your inspector is solicited where doubt exists as to the soundness, appears to be still on the increase amongst all classes of traders. The amount of unsound foods actually dealt with during the year falls considerably short of that of the previous year, but a comparison will show that the principal difference related to a very considerable quantity of unsound tinned goods which were destroyed in the former year from premises which have been unoccupied during the year now under consideration. The total amount of foodstuffs destroyed was as under, viz.:— Tons. cwts qrs. lbs. Unsound Food as per Table "A" 1 1 0 10 Table " B '' 1 3 3 8 Tons 2 4 3 18 268 1909] TABLE B. Description of Food. Nature of Unsoundness. Conditions under which it was found. How disposed of. Weight in lbs. Observations. Beef and Mutton Decomposition Exposed for sale Burned at Council's destructor 17 Seized. Legal proceedings taken, resulting in a fine of £6 and 12/6 costs. Beef, Veal, etc Do On Pork Butcher's back premises Do. do. do. 21 Do. do. fine of £3 and £2 2s. costs. Tomatoes Do Exposed for sale Do do. do. 22 (a) Do. do. fine of £6 and £2 2s. costs. Fish (Codling) Do Do. do Do. do. do. 91 (6) Do. do. Defendant ordered to pay £2 2s. costs. Apples Do Do. do Do. do. do. 70 Seized. do. Defendant fined £2 and £1 1s. costs. 5, pieces of Beef and Lamb Do Deposited for sale Do. do. do. 21 Do. do. Defendant fined £8 and £2 2s. costs. Pears Do Exposed for sale Do. do. do. 18 Do. do Defendant fined 9s. and £1 1s. costs. Do Do Do. do. Do. do. do. 11 Do. do. Defendant to pay £2 2s. 3 Foreign Rabbits Do Do. do Do. do. do. 6 (c) Do. do. Defendant fined £1 and £1 3s. costs. Lamb Cutlets (foreign) Do Do. do Do. do. do. 2 Seized and reported to P.H. Committee. No further action taken. Various Meat substances Diseased or unsound Examined by request Do. do. do. 190 Comprising 7 lots of meat, surrendered owing to disease, decomposition or bruises. (a) Chief Inspector Leggatt. (b) Inspector Burrell. (c) Inspector Bridel. 269 [1909 TABLE B.—continued. Description of Food. Nature of Unsoundness. Conditions under which it was found. How disposed of. Weight in lbs. Observations. Various fish Decomposition Examined by request Burned at Council's destructor 714 Comprising 10 lots of fish, surrendered owing to decomposition. Vegetables and Fruit Do Do. do. Do. do. 1259 Comprising 9 lots of vegetables or fruit surrendered owing to decomposition. Oxen Livers Parasitic (Dis. Hep.) Do. do. Do. do. 192 Comprising 3 lots of livers (oxen) surrendered owing to disease. Do Abscess (Multiple) Do. do. Do. do. 30 Comprising 2 oxen livers surrendered on account of disease. Hens' Eggs Decomposition Do. do. Do. do. 3 25 hens' eggs, said to have been sent up from the country. Unsound. 2 tins of Sardines .. Do Do. do Do. do. 1 Seized owing to being slightly blown, after receiving complaint of poisoning. Particulars reported, but no legal action deemed advisable. 270 1909] Cowsheds.—The number of cowsheds still licensed in the Borough is 7, although no cows were kept in two of those during the whole of the year, one of which was allowed to become unfit for the keeping of cows, owing to neglect of the regulations and the place being used as a storeroom for lumber and rubbish; but at the time of your annual visit prior to the renewal of licenses, you caused the licensee to be notified that opposition to the renewal of his license would be lodged unless steps were at once taken to conform with the regulations, consequently, the premises were speedily put in order, although they still continue to be in disuse. There has been a further decline in the number of cows kept, for whilst there is licensed accommodation for 172 cows, the average number kept appears to have been slightly over 41, according to observations made during a total of 68 visits. Generally speaking, they are well conducted, and only in one instance was disease of the udder noted, in which case the attention of the Public Health Department of the London County Council was immediately directed thereto, and referred to their Veterinary Inspector. Offensive Trade Establishments, Comprising 9 Tripe Dressers, 2 Gut Scrapers, and the Knacker's Yard, have received a total of 87 visits, and have been conducted satisfactorily. The tallow-melting usually carried on at Pleasant Grove, York Road, was discontinued throughout the year, excepting that during the last quarter of the year some clearing up operations were conducted (in which some re-melting of certain tallow left on the premises by the late occupiers took place), by the owner or his agents. During the year the business at the knacker's yard was transferred to a new set of premises on the closed chamber principle, with entrance from Pleasant Grove. Yours obediently, H. WILKINSON;, Meat Inspector, &c. Milkshops and Dairies.—There were on the register at the end of the year 587 milkshops, to which 2,231 visits were paid by the district inspectors' in addition to which they were all inspected by the Chief Sanitary Inspector, Mr. J. R. Leggatt, during the last three months of the year, who, in a report to the Medical Officer of Health, drew special attention to the fact that in no less than 182 milkshops paraffin oil is sold. He specially referred to this article, because he was of opinion that of the many commodities which are sold where milk is purveyed, it is the most objectionable, and of all others most certainly tends to contaminate milk. He also called particular attention to the fact that the utensils in use were found in a much more satisfactory state than in former years, and that the milk in the counter pans was protected from contamination by flies and dust. This shows a very great advance on the state of affairs discovered in previous years, and is due mainly to the advice given by the Chief Inspector to the milk purveyors during his visits of inspection. It is also satisfactory to note that he reports that the cleansing of milk cans with steam or scalding water is now so well observed that little or no anxiety need be felt in this direction. 271 [1909 How different this is to the state of affairs that existed only a short time since, when hardly any of these people scalded their cans, although most used warm water. Bakehouses These have been dealt with in part 4 of this report, in connection with the administration of the Factories and Workshops, which the Medical Officer of Health has to report on specifically. Kitchens of Restaurants and Eating Houses.—These also have been dealt with in part 4 of this report. Places where Ice Creams are made.—There are 230 places where these articles of popular consumption are made in the borough, to which 167 visits were paid by the district inspectors, who have found them generally in a fair state. They are generally owned by Italians, some of whom cannot speak English, or very little, but as the provisions of the London County Council (General Powers) Act, 1902, relating to such places have been translated into their language, they understand the requirements of the law. THE ADULTERATION OF FOODS AND DRUGS. The work of the detection of adulterated foods and drugs was continued during the year with unabated vigour, such work having always been carried out in Islington with considerable energy and efficacy. During the years 1891-1908, some 15,449 samples were purchased under the Acts, of which number 1,692 were adulterated, or 11.0 per cent. It is, however, difficult to compare the results from year to year, for so much depends on the particular articles purchased, some being much more frequently adulterated than others. Samples Analysed in 1909.—The percentage amount of adulteration detected in 1909 and that which was discovered in the preceding 18 years is very similar, as in 1909, out of 1,201 samples, 141 were discovered to be adulterated, or 11.7 per cent. as against 11.0 per cent. in the former period. Informal Sampling. These figures are not, however, altogether comparable, for a very considerable amount of informal sampling was undertaken last year, 471 foods having been obtained and examined by the inspector, of which number 187 were genuine, while 109 were sold with printed or verbal declarations, and 75, or 15.9 per cent., were adulterated or sold in contraven tion to the Acts of Parliament. Of these 75, 45 official samples were subsequently purchased and submitted to the Public Analyst in the usual manner, of which he reported against 39. It may be noticed that there is a discrepancy between the number of informal adulterated samples and those of them purchased for submission to the Public Analyst. Thia is explained by the fact 272 1909] that in several instances it was necessary for the agent to become a regular customer at the shop before it was possible to secure an official sample with any certainty to send to the Public Analyst. As the Inspector points out in his report, the samples thus purchased found to be adulterated were included in the total, together with several milk samples which, while being very slightly below the standard, were not low enough for prosecution. With respect to these official samples, it may be stated that the prosecut ons arising directly from them numbered 39, and that the amount of fines and costs recovered was £100 15s. 6d. Informal sampling in the borough has only been undertaken during the last two years, with results that have been most satisfactory. The samples examined in this way in 1909, were Butter, 155; Demerara Sugar, 111; Coffee, 107; and Milk, 98. Of the Butter, 24 were found to be adulterated; of the Demerara Sugar, 35; of the Coffee. 17; and of the Milk, 12. With respect to Demerara Sugar, it may be pointed out that in 58 instances the purchaser was informed just before the sale was effected that the article was yellow crystals or that it was not Demerara Sugar, and in the case of the Coffees, declarations were made in 38 instances either verbally or by notice on the package. Table CXXXIII. Showing the Number of Samples of Foods and Drugs Analysed, with the Result of the Analyses for the Year 1909 and the preceding Eighteen Years. Years. No. of Samples Examined. Genuine. Adulterated. Per cent. Adulterated. 1891 368 345 23 6.2 1892 367 302 65 17.7 1893 378 327 51 13.5 1894 390 342 48 12.3 1895 772 673 99 12.8 1896 755 661 94 12.4 1897 863 765 98 11.3 1898 875 784 91 10.5 1899 899 820 79 8.8 1900 885 774 111 12.5 1901 942 800 142 15.1 1902 932 796 136 14.6 1903 1,016 898 118 11.6 1904 1,204 1,101 103 8.5 1905 1,200 1,101 99 8.2 1906 1,190 1,079 111 9.3 1907 1,213 1,131 82 6.7 1908 1,200 1,058 142 11.8 Totals 15,449 13,757 1,692 10.95 1909 1,201 1,060 141 11.7 273 [1909 The following statement gives the results of the analyses made by the Public Analyst during the several quarters of the year, respecting which his reports have been already published — Examined. Genuine. Adulterated. Per cent. 1st Quarter 300 258 42 I4.0 2nd ,, 300 263 37 12.3 3rd 300 268 32 10.7 4th 301 271 30 10.0 The Year 1,201 1,060 141 11.7 Milk, Butter, and Oleaginous Foods. 914 samples were obtained under the Adulteration Acts and submitted to the Public Analyst, who declared 80, or 8.7 per cent., to be adulterated, as against 9.5 per cent. in 1908. 6.5 in 1907, 10.2 in 1906, and 7.2 in 1905. The following is a list of the samples purchased. Samples. Adulterated. Percentage Adulterated in 1909. Percentage Adulterated in 1908. Percentage Adulterated in 1907. Milk 603 41 6.8 8.6 6.6 Milk (Separated) 2 1 500 ... 33.3 Milk (Dried) 1 ... ... ... ... Milk (Condensed) 3 ... ... ... ... Cream 5 ... ... ... ... Butter 200 25 12.5 9.5 6.2 Margarine 40 12 30.0 35.7 13.3 Cheese 40 ... ... ... ... Lard 20 1 5.0 ... ... 914 80 8.7 9.5 6.5 Milk.—605 samples of milk were analysed, of which 42, or 6.9 per cent., were found to be adulterated, as compared with 604 samples examined and 52 adulterated, or 8.6 percent., in 1908, the average percentage of adulteration for u 274 1909] the preceding 17 years being 10.5. There has thus been an appreciable decrease in the milk adulteration as shown by the returns of the Public Analyst. In considering these figures it must not be forgotten that the Inspector obtained 98 informal samples, of which 12 were adulterated, and that immediately afterwards official samples were taken of the same milks and submitted to the Public Analyst. Thus it appears that 703 samples were examined, of which 42 were adulterated, or a percentage of 5.9 per cent., which is the most satisfactory record hitherto established in Islington. The samples submitted to the Public Analyst were taken both at the railway stations on the arrival of the milk trains from the country, from street vendors, and from shops. They were also obtained on Sundays and weekdays, with the following results:— Sunday Milks. 159 samples were purchased, of which 14, or 8.8 per cent., were found to be adulterated. This is a slight decrease on the percentage of last year, when out of 160 samples, 15, or 9.4 per cent., were sophisticated. The return of this year is also remarkable from the fact that for the first time for some years the percentage of adulteration has been above that of the samples purchased on weekdays, in which the amount of adulteration was very low. Weekday Milks. Of 326 samples submitted to the Public Analyst, 22, or 6.7 per cent., were adulterated, as compared with 10.8 per cent. in 1908. There has thus been a very large decrease among the ordinary weekday vendors of milk adulteration. There can be no doubt that the proceedings against the North Eastern Dairy Company, which obtained wide publicity, have had a very considerable deterrent effect upon the milk vendors of the borough. Farmers' Milks. 120 samples of milk were procured at the railway stations from churns in the course of delivery, and of these, 6, or 5.0 per cent., were found to be adulterated. This is a large increase on the usual adulteration of farmers' milks, which is very low as a rule, and is to be accounted for by the fact that several of these 120 samples were examined on application being made by the consignees. Nevertheless, as will be seen later on, the percentage of fat shown was above the percentage of the milks sold on Sundays and weekdays. The following is a summary of these several samplings:— On Sundays 159, of which 14, or 8.8 per cent., were adulterated. On Weekdays 326, of which 22, or 67 per cent., were adulterated. At Railway Stations 120, of which 6, or 5.0 per cent., were adulterated. 275 [1909 The subsequent statement gives a summary of the quarterly returns of the samples analysed by the Public Analyst:— Samples Examined. Adulterated. Per cent. Adulterated. 1st Quarter 150 15 10.0 2nd „ 151 11 7.3 3rd ,, 158 9 5.7 4th ,, 146 7 4.8 605 42 6.9 The following is a record of the adulteration of milk in Islington since 1892:— MILK ADULTERATION. Samples Analysed. Genuine. Adulterated. Per cent. Adulterated. 1892 171 139 32 18.7 1893 213 173 40 18.7 1894 206 169 37 17.9 1895 413 343 70 16.9 1896 468 418 50 10.6 1897 513 464 49 9.5 I998 543 492 51 9.4 1899 532 477 55 10.3 1900 541 485 56 10.3 1901 632 556 76 12.0 1902 586 528 58 9.9 1903 508 458 50 9.8 1904 600 553 47 7.8 1905 594 549 45 7.6 1906 634 560 74 11.8 1907 597 557 40 6.7 1908 604 552 52 8.6 Totals 8,355 7,473 882 10.5 1909 605 563 42 6.9 u 2 276 1909] The Quality of Milk.—The quality of the milk sold in Islington has, as usual, been good, whether it be judged by that of the samples purchased on weekdays or on Sundays, or procured at the railway stations. Of course, as usual, the farmers' milks gave the largest average percentage of fat, which was 3.86, as compared with 3.67 per cent. in the case of both Sunday and weekday milks. In the case of these two milks the average for the previous 11 years has been 3.64 and 3.62 per cent. respectively, so that their fats as compared with farmers' milk, show a decrease of nearly 5 per cent. The consumption of milk is without doubt increasing, as it is not only more largely partaken of as a beverage in warm weather in the shape of soda and milk, but also in substitution for stimulants at meals, and, therefore, it is all the more necessary that its quality should be of the best. According to Professor J. P. Sheldon, the people of this country consume on an average 15 gallons per head per annum, those of Denmark, 40 gallons, Saxony, 46 gallons; United States, 25 gallons; and in London the Medical Officer of Health computes it to be 10½ gallons, for the annual consumption there is about 50,000,000 gallons. It it curious to note that 50 years ago the suburban and city dairies supplied London with all its milk, whereas now it is practically obtained from all parts of the Kingdom. When the non-fatty solids of the milk are examined it is found that the largest percentage occurs among the milks sold on weekdays, when the percentage was 8.85, as compared with 8.66 for Sunday milks and 8.74 for farmers' milks. It would be unwise to draw any positive conclusions from these figures as to sophistication, although a suggestion that the milk sold on weekdays has been treated with separated milk might not be unfounded, otherwise how is it to be understood that the percentage of these non-fatty solids in these milks is 8.85, whereas in the farmers' milks it is only 8.74. These figures, as well as those contained in Table CXXIX., which gives the analyses of the milks examined in Islington during the last twelve years, once more show that the average of the fatty content of the milks is much above the official standard of 3 per cent. laid down by the Board of Agriculture and Fisheries. A great deal has been said from time to time by people interested in the purveying of milk and by some dairy farmers that the official standard is too high, and they also allege that not only do individual cows, but at times a whole herd, give a lesser percentage than the standard ; and in support of their contention they seriously adduce as an example that the cows entered for milk trials at the great dairy shows very often fall short of it. Lately the fact 277 [1909 has been put forward that, at the Royal Show in 1909, of 32 shorthorns, 9 gave milk which was below the standard, and 2 barely reached it; also that at the Dairy Show in the same year it was reported that 19 animals yielded less than 3 per cent. of fat, while in 1907 the number of cows showing a similar deficiency was 27. In considering these figures it must not be forgotten that these animals had been sent to compete for prizes at these shows because they were very good milkers, both as regards quantity and quality, otherwise they would not have been there. It is reasonable, therefore, to assume that the deficiency in their fat was due to the very exceptional surroundings in which they found themselves; for it is well known that change of surroundings affect the cow and afterwards her milk. Indeed, the Secretary of the North Somerset Agricultural Society in a lecture to farmers related that experiments carried out at Wedmore for the study of herds under ordinary conditions showed that the yield of milk evidently depended on the nervous system, and that it was noticed that anything that interfered with the general comfort of the cows interfered with their nervous system, and consequently with the milk. Hence it may be reasonably assumed that the deficiency of fat in the milk of these show cattle has been due to their unusual surroundings, which affected their nervous systems. In any case it must be recollected that although an individual cow may give milk below the standard, due either to a permanent or passing cause, yet according to a recent report of the Lancashire County Council, while individual cows give milk below the standard, the standard for the herd was never below it. As bearing upon this point, the recent issue of a paper devoted to the interests of the milk trade, in commenting on the milk and butter tests at the Royal Show at Liverpool, may be quoted:— "Looking through the detailed results of the milking contests one cannot "fail to note that quite a large number of cows did not reach the standard. "There were no fewer than two Dexters, one Jersey (a breed which is known "to give the richest milk), two Red Polls, one South Devon, five Shorthorns, "and two Lincoln Red Shorthorns, which failed to reach the qualifying 3 per "cent. of butter fat. While the individual may prove a delinquent in the "matter of quality of milk there would be no trouble in this way when the "milk is mixed. The yield of single cows in never sold separately, and taking the "average of a herd, it is not at any time likely to fall below the required points in "fat.'' 278 1909] Many dairy farmers are very negligent in the management of their "businesses, and, indeed, if other businesses were carried on in the same slipshod manner, tradesmen would come to utter grief. It has been frequently urged that they should systematically examine the quality and quantity of the milk coming from their cows, that is to say, they should regularly weigh and analyse the milk from each cow so that they might see if they were getting a full return for the money they were spending on her feed . This is done in Germany, where in recent years, as some time ago in Denmark, the system of milk control has been established. The object of these German societies, which at the end of 1908 numbered 207, representing 3005 members, owning 88,296 cows, is to enable the farmer by a system of milk testing, combined with the keeping of careful records, to gauge the yield of each cow in his herd so that he may eliminate those which appear unprofitable. For this purpose it is usual to employ a young man to visit the farms at regular intervals to weigh and record the milk yield, and to ascertain its fat content. When the animals are stall fed, a record is kept of the amount of food used, and a scale is adopted for adjusting the quantity of food to the milk yield. In this manner records are obtained which are found to be of the greatest assistance in improving the breed of the cattle, which is so important if good milk is to be obtained. If this were done in this country, there would very soon be a great improvement in the quality of the milk, while at the same time we would hear little complaint as to the so-called high standard of the Board of Agriculture and Fisheries. "The Dairy World," no mean authority on milk questions, in the leading article in a recent issue, commenting on the ignorance displayed by a farmer of 31 years standing, who asked if anyone could tell him of a ready means of analysis which would ensure perfectly reliable tests, said, "We repeat "that the risk of conflict with the authorities can be considerably minimised by "close attention to details, by systematically testing the milk of the animals and "eliminating those of abnormal tendencies (the italics are the writers) and by a "little judgment being exercised in the filling of the churns so that one does " not get an undue proportion of the strippings, while another goes short." It is to be hoped that this advice will be taken to heart, especially as the results of the exhaustive enquiries made by Armstrong College, Newcastle-onTyne, last year, proved the wisdom of mixing the milk of all the cows in the herd before it leaves the farms, for the milk of the individual cow, whatever her capabilities of yielding a high percentage of butter fat might be, is likely to vary within wide limits. These inquiries, according to the report issued by that institution, point out that no matter how careful a farmer may be in the 279 [1909 selection of his cows and in management, he will be liable to what the report calls" unjust prosecution" if he sells the milk from one or a few cows separately, while the evidence that he may escape conflict with the authorities by mixing the milk of the whole herd is equally convincing. This proceeding comes as near as possible to ensure absolute safety. Thus it will be seen that farmers, if they are careful in their business, can supply milk of a very high standard. There can be no doubt that the mixing of milks at the farm is very necessary. Some time ago a consignment of three churns of milk to a public institution in Islington showed that two of them had a percentage of fat very much above the standard, while in the third the fat was very much below it, but the average amount of fat in the three churns was good. Now if only one sample of milk had been taken, and that from the churn containing the poor milk, it might have appeared that the milk was of an inferior quality, but as three samples were taken, and the average of the three worked out above the standard, the vendor escaped punishment. Or again if the three churns had been consigned to different persons, and the one that was deficient had been officially sampled, he would have been summoned and rightly fined. The human animal, like a cow, does not always give good quality milk, and therefore, when a doctor is consulted as to the state of the health of the infant, he inquires into the health of the mother and the quality of her milk, and if he finds that it is not good, even though the quantity may be more than ample, he stops the supply. But does a farmer, if he finds a cow's milk is not of good quality, stop the sale of the supply, so much of which goes to feed infants? It is to be feared that he does not; nor does he get rid of the cow so long as the quantity is all right. He is content to assume that everything that comes from the udder of a cow is milk, whereas it is nothing of the kind, but only a serous fluid when it does not contain a minimum amount of fat, which the Board of Agriculture practically say is 3 per cent. The sooner farmers understand this fact the better it will be for themselves and for the public, but particularly the public, who should not be required to pay a high price for a fluid which is not milk, even though it may be mixed with the genuine article to conceal its inferiority. The results of the analyses during the year were as follow:— Obtained. No, of Samples Analysed, Average Percentage of Fat. Average Percentage of Solids, not Fat. Average Percentage of Total Solids. On Sundays 159 3.67 8.66 12.33 On Weekdays 326 3.67 8.85 12.52 At Railway Stations 120 3.86 8.74 12.60 Official Standard ... 3.00 8.50 11.50 280 1909] Fastening Churns.—The Medical Officer of Health has for many years insisted that farmers were very unwise in not fastening their churns when sending their milk to the purveyors in the large towns. This view is held by all persons deeply interested in the milk trade, and recently he notes that Mr. J. G. Perrett, in addressing a meeting of the Gillingham Branch of the Somerset, Wiltshire and Dorset Farmers' Association, said "He would like to see the risk of farmers end on delivery at the station, "and then the Company take the ordinary carrier's risk. Failing that, the "farmers' liability should stop at the breaking of the seals of the churns. "All churns should be sealed, for it was not the quantity of the milk that "was extracted, but what was placed in the churns to make up. If farmers "would persist in sending their churns unsealed, they do so at their own "risk." Although arrangements have been made for many years by the Railway Companies to carry milk in sealed or locked churns, it is not uncommon to find both the farmers and the retail vendors of milk asserting in Courts of Justice that these Companies will not carry milk in them. Such ignorance of the railway regulations in matters that vitally concern their businesses is woeful. One cannot help thinking that the call the King made to the nation at large is particularly applicable to its farmers: " Wake up " It is indeed time they did so. The Standardization of Milk. By this expression is meant the reduction of milk of good quality to the minimum standard laid down for pure milk by the Board of Agriculture and Fisheries by the addition of separated milk. The operation is a simple one, for all that is required to be known is the amount of fat in the whole milk, so that any man of moderate knowledge and skill can easily determine the quantity of separated milk which should be added. There is a very simple method, well known to the trade in the United States, of making a calculation, but it is not proposed to give it here lest by chance it should fall into the hands of any milk purveyors in England who are not already aware of it, and so tempt them, owing to the ease with which it may be applied, to sophisticate their milk. There is no form of adulteration so difficult of determination, although persons accustomed to study the analyses of milks can make a shrewd guess as to those which have been standardized. Indeed, it was the examination of the analytical figures of many milks purchased from the North Eastern Dairy Company that led the Medical Officer of Health to think that they were standardizing their milks, and caused him to make private inquiries as to their purchase of separated milk. And it was on 281 [1909 account of the information thus received that the Solicitor in that case was instructed to cross-examine the defendants as to their use of that article. This Company were not the only purveyors of milk in North London who practise this method of adulteration, for a few purveyors, some doing a large trade, are known to purchase quantities of separated milk but are not known to sell it. What becomes of it? Such a question would hardly pay in a guessing competition, for the answers would undoubtedly be all in one direction, so that everyone would be eligible for the prize. In consequence of the facts elicited during the above-mentioned prosecution, the Medical Officer of Health submitted a report, which is given below, to his Public Health Committee. Since it was written, he has had a longer time to consider the matters therein discussed, and such consideration has made him more confirmed than ever in the opinions he has expressed in it; and he, therefore, earnestly asks that the Local Goverment Board and the Board of Agriculture and Fisheries shall seriously consider his suggestions, especially with respect to separated milk. He has at the time of writing before him a list of five prosecutions against another Companv which formerly traded in North London, and which is now happily defunct, in four of which the summonses were dismissed on the production of warranties. In one of the cases 40 per cent. of fat had been abstracted ; in another 8 per cent.; and in a third 20 per cent.; while one was for the addition of 8 per cent. of added water. From the information which the Medical Officer of Health has since obtained, he has not the least doubt that in every one of these cases separated milk had been added to the pure milk. At all events the vendors used to purchase the article and were not known to sell it. Such adulterations as these are barefaced robberies, and the people who commit them should be tried for obtaining money under false pretences, instead of being prosecuted under the Sale of Food and Drugs Act. Until some very strong measures are adopted, this nefarious trade will be continued. It is full time that the public should be protected by the adoption of means which will make it impossible for purveyors of milk to secretly convey separated milk into their premises, and also render it impossible for them to mix that article with pure milk at the railway stations without instant discovery being probable. In order to make certain of this, all churns or other vessels containing separated milk should be branded in some very distinctive manner; and persons who deal in it should be registered. Furthermore, the Government should make a very careful inquiry as to what becomes of all the separated milk which is a by-product of the various creameries throughout the country. 282 1909] To the Chairman and Members of the Public Health Committee. The Prosecution of the North-Eastern Dairy Company, and its Lessons. Gentlemen,—The defendant company were charged with selling milk which contained 6 per cent. of added water, and in defence pleaded warranty. In the end the magistrate inflicted a fine of £l00 and allowed 20 guineas costs. This prosecution has thrown no inconsiderable light on the practices of some members of the milk purveying trade in London, and probably also of the country. In the first place it proves incontestably that warranties are pleaded, as I have long said they were, to cover the misdeeds of the purveyors. In the second place it conclusively proves that it is not an uncommon practice for milk purveyors to add separated milk to their milks. And in the third place it affords strong support to the argument that the official minimum standard for milk is too low. 1. The defendants in this case had been suspected of adding separated milk to their whole milk, and it was because of this suspicion that I instructed your solicitor in Court to cross-examine the witnesses on the point. Of course, the suggestion that it was done was denied, but you know that on the second day's hearing it was admitted. Indeed, one of the witnesses treated this addition in a most off-handed manner, saying it was quite a common practice in the trade, and conveyed the impression that it was not looked on by them as an adulteration—as if he would say, "everyone did it! why shouldn't we? "Well, if one might judge by the analogy of other foods, they would have only to do it long enough without detection Jor the practice to have become a" custom of the trade," and then it would have been a valid defence! But I must not pursue this argument lest I shall be drawn into a by no means brief discussion. The defence set up by the company and supported by witnesses was warranty, on which they held they could legitimately rely, although separated milk had been added, because the charge against them was for the adulteration of their milk with water, which they entirely denied. This was, of course, only an excuse to get out of an untenable position for they knew, or ought to have known, being in the trade so long, that a 288 [1909 warranty is of no avail if the milk be altered in any way, or if any thing, even anatto, which is a colouring matter, be added to it. I think you ought to understand that it was only because of the low official standard that they escaped a charge of fat abstraction, for the analysis of the milk showed that it contained only 2.78 per cent. of fat (equal to 2.95 per cent. before the water was added) a deficiency which is practically accounted for by the addition of the 6 per cent. of water. It suggested, however, to anyone with the knowledge of the analysis of milk that fat had been abstracted, either by the addition of separated milk, or by its direct separation or skimming. It also suggested to some extent that the sophistication had been practised by the firm, because they, as experts, would have recognised the milk on its arrival from the farms as poor milk if it had only contained the minimum amount (3 per cent.) of fat; and they would in all probability—nay, to a certainty—have communicated with the inspector or myself, as so many traders do, when they are getting poor milk, and requested that samples of the farmer's milk should be procured for examination on arrival at Finsbury Park Railway Station. They would not have been satisfied with 3 per cent. of fat, when the average percentage contained in the milk arriving at Finsbury Park Station, based on the analyses of 1,174 milks, is 3.9, and when the average of 200,000 milks received by the Aylesbury Dairy Co. is exactly the same figure. This knowledge operated strongly on my mind and induced me to request the solicitor to cross examine the witnesses as to the use of separated milk; and no doubt similar knowledge with respect to milks in general tempt milk purveyors to sin. The standard is too low, and so long as it remains at 3 per cent. so long will it place temptation in the way of milk purveyors. And as they were tempted to add separated milk, so, too, were they tempted to plead "warranty." They may, perhaps, never have thought of the serious consequences the success of their plea would have had for the farmer, who in this instance happens to be a woman, struggling for existence, or if they did, and it is more than likely, they looked upon a successful prosecution against her as a remote contingency. It is true that if you decided on a prosecution against her for giving a false warranty, the witnesses who had stated that they had sold the milk as they received it would have been called on to give evidence to that effect, which would have placed them in a very terrible position, for it would be the alternative of telling the truth, or of committing perjury. The railway officials would have been called, and they naturally would have denied doing anything to the milk. Finally, the widow would have been called, and of course she would have said that she sent it away as it came from her cows : and the result would most probably have been a 1909] 284 missal of the charge; for amidst such general denials it would be most difficult for the magistrate to arrive at a conclusion. With this probability to face, I feel certain that your solicitor would not advise a prosecution, and I certainly would not. I am a strong believer in the honesty of the English farmer. He is type of all that is best in the manhood of the country. Simple-minded to a large degree when contrasted with the dwellers in our great towns; but slow to move or to be taught. Were this not so, dairy farming in England would not be in its present backward state, nor would they have allowed the warranty clause in the Sale of Food and Drugs Acts to have remained on the statutes. It is, however, now doomed, and the North Eastern Dairy Company's defence has given to the President of the Local Government Board his fullest justification for the introduction of clause 7, which proposes to abolish warranties, into his Milk and Dairies Bill. 2. The second lesson this case teaches is that the churns in which separated milk is conveyed into the milk depots should be marked with some distinguishing mark, so that the Inspectors may be able to at once recognise them on their arrival at the railway stations. I am of opinion that the best way to effect this is to paint the head of every milk churn on its outside surface with a bright colour. I do not think a brass plate or similar device with the words "separated milk" on it is sufficient, because it would be almost impossible to "spot" such a churn among the hundreds of churns that are packed on the milk platforms of the railway station after the arrival of the milk trains; and they would, therefore, often escape notice, whereas a churn with coloured head would be at once perceived. In this way the milk purveyors who use separated milk would soon be discovered, and consequently their milk would be closely watched, and frequently analysed. The trial also brought to light that there are several milk purveyors receiving separated milk in names other than their own; and yet these purveyors are not known to be dealers in it. Certainly they do not sell it in the streets as separated milk. Indeed, there can be no doubt that it is mixed with whole milk and is sold as " milk with all its cream," to use a dairy phrase, to the public. Under these circumstances I do not think that the proposal to mark the churns is too drastic. Indeed, it is not drastic enough, and, therefore, I would suggest that all dealers in separated milk should be specially registered for its sale, and thai it should be sold f rom vessels specially marked and labelled. 285 [1909 Recollect that milk is a universal food, and the chief food of our young children, and, therefore, everything that is possible should be done to protect it from adulteration. The Americans have found out how necessary it is to protect milk from admixture with separated milk, and, therefore, it was with no surprise that I discovered on consulting their State Laws that no less than 16 of the principal States, many of them containing cities ranging from a million and a half down to thirty thousand inhabitants, have made laws which compel the sale of separated milk in vessels, such as churns, cans, and bottles, plainly labelled. Under these circumstances there ought to be no difficulty in getting such a law passed, or a regulation made under the Public Health (Regulations as to Food) Act, 1907, in England. There is certainly sufficient warrant for such action. Lastly, I think that the persons dealing in separated milk should be compelled to keep registers showing the method of its disposal, much in the same way that wholesale dealers in margarine are compelled to keep books, and that these books should be open to official inspection. It is an unfortunate thing that it should be necessary to make these suggestions, but the undoubted very general adulteration of milk with separated milk, a by-product in the manufacture of butter, confirmed as the fact has been by the recent prosecution, has forced me to make them. 3. I do not propose to pursue the argument with respect to the official standard of milk. My views on the subject are well known to you and are to be found in many of my reports, and in nearly all my annual reports. I will, therefore, content myself with saying that this trial proved that eight quarts of separated milk could be added to a churn of milk and still escape a prosecution for the abstraction of fat. The standard is too low, and so long as it remains at 3.0 per cent., so long will it be a temptation to milk purveyors to add separated milk to the whole milk. The regulation is an immoral regulation, and should be altered. I am, Your faithful servant, A. E. HARRIS, Medical Officer of Health. Town Hall, Islington, N., 21st June, 1909. 1909] 286 Table CXXXIV. Showing the analyses of 6,949 milks examined in Islington during the twelve years 1898-1909, and distinguishing those purchased on Sundays, on Weekdays, and procured at the Railway Stations while in transit from the Farmer to the London Milk Purveyor. Years. Sunday Milks. Week-day Milks. Railway Milks (Farmers). No. of Samples. Per cent. of non-fatty solids. Per cent. of fat. No. of samples. Per cent. of non-fatty solids. Per cent. of fat. No. of samples. Per cent. of non-fatty solids. Per cent. of fat. 1898 193 8.50 3.50 230 8.56 3.69 120 8.84 404 1899 181 8.49 3.50 231 8.53 3.58 120 8.82 4.23 1900 196 8.64 3.62 224 8.55 3.53 121 8.5 3.93 1901 196 8.56 3 64 295 8.60 3.49 141 8.77 3.69 1902 192 8.59 3.60 274 8.64 3.51 90 8.76 3.85 1903 167 8.42 3.86 218 8.47 3.74 120 8.66 3.90 1904 164 8.52 3.78 317 8.48 3.74 120 8.62 3.97 1905 161 8.55 3.68 323 8.51 3.72 112 8.66 3.87 1906 195 8.49 3.58 332 8.52 3.59 110 8.75 3.69 1907 150 8.64 3 63 327 8 65 3.76 120 8.77 3'96 1908 160 8.58 3.69 324 8.58 3.52 120 8.73 3.88 Total Eleven Years 1,955 8.59 364 3,095 8.55 3.62 1,294 8.74 3.91 1909 159 8.66 3.67 326 8.85 3.62 120 8.74 3.86 287 [1909 From these analyses the following averages for the years 1898-1909 have been deduced:— Solids not fat. Fat Total solids. 2,114 Sunday Milks 8.55 3.65 I2.20 3,421 Week-day Milk 8.58 3.63 12.21 1,414 Farmers' Milk 8.74 3.91 12.65 Total Milks 8.62 3.73 12.35 Table CXXXV. Giving the particulars of the Milk taken during each quarter of 1909 on Sundays, on Week-days, and at the Railway Stations. 1909. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Quarters. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. 1st Quarter 40 80 30 150 33 75 27 135 7 5 3 15 17.5 6.2 10.0 10.0 2nd ,, 40 81 30 151 37 75 28 140 3 6 2 11 7.5 7.4 6.6 7.3 3rd „ 39 89 30 158 36 84 29 149 3 5 1 9 7.7 5.6 3.3 5.7 4th ,, 40 76 30 146 39 70 30 139 1 6 •• 7 2.5 7.9 •• 4.8 The Year 159 326 120 605 145 304 114 563 14 22 6 42 8.8 6.7 5.0 6.9 1909] 288 Table CXXXVI. Showing the Samples of Milk Analysed, the number found adulterated, with the percentage of Samples adulterated for the past twelve years. Year. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Sundays Week-days. Ry. Stations. All Milks. Sundays. Week-days. Ry. Stations. All Milks. Sundays. Weekdays. Ry. Stations. All Milks. Sundays. Week-days. Ry. Stations. All Milks. 1898 193 230 120 543 165 207 120 492 28 23 .. 51 15.0 10.0 .. 9.4 1899 181 231 120 532 154 204 119 477 27 27 1 55 14.9 11.2 0.8 10.3 1900 196 224 121 541 170 194 121 485 26 30 .. 56 13.3 13.4 .. 10.3 1901 196 295 141 632 172 247 137 556 24 48 4 76 12.3 16.3 2.8 12.0 1902 192 274 90 556 172 238 88 498 20 36 2 58 10.4 13.1 2.2 10.4 1903 167 218 120 505 147 190 118 455 20 28 2 50 11.9 12.8 1.7 9.9 1904 164 317 120 601 158 276 120 554 6 41 .. 47 3.6 12.9 .. 7.8 1905 161 323 112 596 151 294 106 551 10 29 6 45 6.2 9.0 5.3 7.5 1906 195 332 110 637 173 281 108 562 22 51 2 75 11.3 15.4 1.8 11.8 1907 150 327 120 597 137 300 120 557 13 27 .. 40 8.7 8.2 .. 6.7 1908 160 324 120 604 145 289 118 552 15 35 2 52 9.4 10.8 1.6 8.6 1909 159 326 120 605 145 304 114 563 14 22 6 42 8.8 6.7 5.0 6.9 Totals 2,114 3.421 1,414 6,949 1,889 3,024 1,389 6,302 225 397 25 647 10.6 11.6 1.7 9.3 289 [1909 BUTTER AND MARGARINE. Butter.—200 samples were purchased and analysed by the Public Analyst, of which 25, or 12.5 per cent., were declared to be adulterated. In 1908 the percentage was 9.5, and in 1907, 6.2. This increase is due to the fact that the inspector took 155 informal samples, of which he found 24 to be margarine, and which subsequently he had purchased officially and submitted to the Public Analyst, so that the actual amount of adulteration was 10.1 per cent. Whatever way one looks at these figures, it is extremely unsatisfactory to find so much adulteration of one of the prime foods. Nevertheless the inspector is deserving of credit for the detection of it. It is not an easy process, for the dealers who fraudulently substitute margarine for the genuine article are the most cunning of all tradesmen, and are mainly of a nationality which one does not desire to brand with dishonesty, and which may be described as neither English, Irish nor Scotch. Knowing that they are carrying on a nefarious trade, they are very wary; and, when a strange customer appears, very frequently send someone into the street to see if he can spy the inspector anywhere near. Hence it is absolutely essential to get an agent to make purchases for some time at their shops before the official samples are taken. Even then success is not always met with, because it happens not infrequently that the genuine article is given, although margarine has been substituted on several previous purchases. This seems to prove that even with known customers they occasionally give pure butter for a change. Sometimes it occurs that the agent is served by a new counter hand, who invariably sells the genuine article, and who continues to do so until he or she, for there are many women employed in the trade, knows the customer. No instance has come to light during the year of sales by the men who, driving their traps, called at houses professing to sell the finest dairy butter. One or two of these gentlemen have been fined heavily in the country; and, indeed, one was sent to prison for obtaining money under false pretences, which is after all the best thing to do with this class of itinerant rogue, who, because of his wanderings, is so difficult to serve with a summons. In Islington there is at least one summons unserved for an offence committed a few years ago. GROCERIES. There were submitted to the Public Analyst 180 samples of foods included under tnis heading, of which 51, or 28.3 per cent., were adulterated, as against 20.8 per cent. in the preceding year, and an average of 13.3 per cent. in the preceding eighteen years. V 1909] '290 Demerara Sugar.—Nineteen samples were submitted to the Public Analyst, of which 18 were returned as adulterated. The high percentage (94.7) is due to the fact that all the shops at which they were purchased had been first informally sampled by the inspector, together with 92 others which had sold the West Indian article or had made a declaration at the time of sale, which was the course practised by no less than 58 vendors. Coffee.—At one time this article was sold very much adulterated with chicory, whereas now it is more frequently sold pure or with a printed declaration that it is a mixture of coffee and chicory. Consequently it is no surprise to find that the inspector informally sampled 107 shops, at which 52 of the coffees were genuine, 38 were sold with a declaration, and only 17 without a declaration. He subsequently purchased these 17 samples officially, together with 2 others, and 18 of them, or 94.7 per cent., were afterwards reported by the Public Analyst as adulterated. Malt Vinegar.—In consequence of a report issued by the Food Department of the Local Government Board, pointing out that artificial vinegars were on sale, the simplest of which consists of acetic acid diluted with water and coloured with caramel to give it the colour of malt vinegar, a product obtained by brewing, 20 samples were submitted to the Public Analyst, of which 15, or 75.0 per cent., were declared to be adulterated, thus showing that the sale of dilute acetic acid is by no means uncommon. The trade in vinegar is not confined to grocers, for it is found that many vegetable dealers also sell it, as do some fishmongers, among both of whom the sale of the adulterated article is most rife. The best grocers usually sell their vinegars in the original bottles of the manufacturers, whereas the people mentioned, and the smaller dealers, sell it "loose," that is, draw it from a cask or jar and fill it into the customers' own bottles or jugs. Latterly manufacturers are putting up dilute acetic acid in bottles labelled "Finest Wood Vinegar," which of course is no offence. Golden Syrup.—This food, which is purchased largely by poor people for their children to eat with bread in lieu of butter, was purchased for analysis in 21 instances, and in 3 cases was returned as adulterated with glucose. Recently an attempt has been made by unscrupulous manufacturers to evade the Adulteration Acts by selling an article to grocers called "amber syrup" which has been found to consist of golden syrup mixed with glucose in very varying proportions or of glucose solely, tinted with a colouring matter to 291 [1909 resemble golden syrup. The article bears a very small label with the words "amber syrup" on the tin. As there is no standard for it, its composition may vary at the will of the manufacturers. It should be sold as a mixture of golden syrup and glucose, with the percentages declared on a label, or as glucose. To call it "amber syrup," especially in the latter case, should not be permissible. The poor do not often differentiate between words, and the term "amber" and "golden" denoting as they do very similar colours, naturally mean to them that the articles to which they are applied are the same. The particulars of the several samples analysed, are as follows:— No. of Samples. No. Adulterated. Percentage Adulterated. Percentage Adulterated in 1908. Coffee 18 10 55.5 59.2 Cocoa 21 1 4.8 6.6 Demerara Sugar 19 18 94.7 33.3 Pepper (White) 7 — — — Mustard 14 — — — Golden Syrup 21 3 14 3 — Honey 5 — — — Olive Oil 7 2 28.6 41.6 Rice 7 — — — Malt Vinegar 20 15 75.0 28.6 Yeast 4 — — — Dripping 7 — — — Tea 5 — — — Dried Milk 1 — — — Condensed Milk 3 — — — Preserved Spinach 1 — — 100.0 Preserved Peas 2 — — 50.0 Preserved French Beans 2 1 50.0 — Ground Ginger 7 1 143 — Chicken and Ham Paste 2 — — — Linseed Meal 7 — — — 180 51 28 3 20.8 V 2 1909] 292 Alcoholic Drinks.—33 samples were submitted to the Public Analyst, of which 3, or 9T per cent., were sold under strength. The Spirits were only examined for strength, but the Mild Ale about which a complaint had been made was examined for harmful ingredients. No. of No. Percentage Samples. Adulterated. Adulterated Whiskey (Scotch) 8 — — Whiskey (Irish) 8 2 25.0 Rum 8 — — Gin 8 1 12.5 . Mild Ale 1 — — Total 33 3 9.1 Drugs.—78 drugs were purchased for analysis, of which 7, or 8.9 percent., were reported against by the Public Analyst. It is very satisfactory to find that none of the 14 prescriptions were compounded incorrectly. The following is a return of the drugs examined:— Samples. Number adulterated. Percentage adulterated. Oil of Eucalyptus 7 — — Comp. Liquorice Powder 7 — — Comp. Syrup of Hypophosphites 1 1 100.0 Blaud's Pills 7 1 14.3 Cream of Tartar 7 — — Pil. Aloes et Ferri 7 — — Glycerine 7 1 14.3 Prescriptions 14 — — Lime Water 14 3 21.4 Fluid Magnesia 7 1 14.3 78 7 8.9 293 [1909 INSPECTOR BURRELL'S REPORT. Public Health Department, Town Hall, Islington, N. 12th February, 1910. To the Medical Officer of Health Dear Sir, In accordance with your instructions I have pleasure in submitting for your consideration the following report and summary of the sample testing work for the year ended December 31st, 1909. As in the preceding year, this work has proved of the highest value in the detection of cases of systematic fraud, but so many have been the calls upon my time in consequence of the great increase in the number of prosecutions, that I have found it necessary, rather than the work should remain in abeyance, to carry out the testing of the major portion of the samples after office hours. A total of 471 samples were tested and examined, of which number 287 were genuine, 96 were sold with a printed or verbal declaration, while 88 or 18 7 per cent. of the whole were adulterated. Of the latter, 45 duplicate samples were purchased and submitted to the Public Analyst in the usual manner, when he reported against 39 for prosecution. It will be observed that there is a considerable discrepancy between the number of preliminary adulterated samples and those purchased for submission to the Public Analyst, but the explanation lies in the fact that it was necessary in several instances for the agent to become a regular customer at the shop suspected before it was possible to secure an official sample that would expose the fraud in practice. The preliminary samples thus purchased and found to be adulterated were included in the total, together with several milk samples which, while being below the standard, were not low enough for prosecution. The prosecutions arisiag directly from the preliminary testing work numbered 39 ; the amount of fines and costs with reference to same totalling £100 15s. 6d. Totals for the Several Samples Purchased during the Year. Articles Purchased. Number. Genuine. Declared. Adulterated. Percentage Adulterated. Butter 155 131 — 24 15.5 Demerara Sugar 111 18 58 35 31.5 Coffee 107 52 38 17 15.9 Milk 98 86 — 12 12.2 471 287 96 88 18.7 Note.—With the adulterated milk samples are included those samples which, while being below the standard, were not low enough for prosecution. 1909] 294 Since the inauguration of the purchase of preliminary samples, now two years ago, there has been a very marked alteration in the method of selling the several articles under examination. It is now the common practice where the genuine article is not tendered to proffer the substitute in a package bearing a declaration which in most cases protects the seller from prosecutipn. This fact makes it increasingly difficult to procure suitable samples for examination, and during the year necessitated nearly 1,000 visits to shops for the sample testing work alone. I am, Sir, Your obedient servant, (Signed) TOM L. BURRELL, Inspector. It would be unfair of the Medical Officer of Health to conclude this section of his report without a recognition of the excellent work performed by Inspector Burrell under the Sale of Food and Drugs Acts. The Public Health Committee are fully cognisant of his ability and of the wholehearted manner in which he has thrown himself into his duties. His zeal may be better seen by the fact that of the 1,202 samples which were submitted to the Public Analyst, 1,178, or 98.8 per cent., were obtained from individual vendors, so that there was very little duplicate sampling. In addition to the official samples, he obtained and examined for quality 471 informal samples, so that altogether 1,671 samples were obtained by him. No other inspector has approached this figure, and it is doubtful if any inspector in the country has done better work. Mr. Burrell is particularly adapted by his attainments for an inspector under these Acts, as he is an excellent microscopist and has a good knowledge of the simpler methods employed for qualitatively examining many of the commoner foods. As a result of his efforts, it is pleasing to think that the Council obtained in fines and costs £434 11s. 6d. during the year, which is the largest sum hitherto obtained in a similar period. The nearest approach to this sum was obtained in 1901 when the fines and costs amounted to £429 10s. Od. 295 co © SO Table. CXXXVII. Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1909. Description. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Genuine. Adulterated. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Milk 148 151 158 146 603 134 140 149 139 562 14 11 9 7 41 Milk (Separated) 2 .. .. .. 2 1 .. .. .. 1 1 .. .. .. 1 Cream .. .. .. 5 5 .. .. .. 5 5 .. .. .. .. .. Butter 50 50 50 50 200 45 44 44 42 175 5 .. 6 8 23 Cheese 10 10 10 10 40 10 10 10 10 40 .. .. .. .. .. Dripping .. .. .. 7 7 .. .. .. 7 7 .. .. .. .. .. Lard 5 5 5 5 20 5 5 4 5 19 .. .. 1 .. 1 Coffee 7 7 .. 4 18 1 6 .. 1 8 6 1 .. 3 10 Cocoa 7 7 7 .. 21 6 7 7 .. 20 1 .. .. .. 1 Golden Syrup .. 7 7 7 21 .. 5 6 7 18 .. .. .. .. 3 Honey .. .. .. 5 5 .. .. .. 5 5 .. .. .. .. .. White Pepper 7 .. .. .. 7 7 .. .. .. 7 .. .. .. .. .. Mustard 7 .. 7 .. 14 7 .. 7 .. 14 .. .. .. .. .. Ground Ginger .. .. .. 7 7 .. .. .. 6 6 .. .. .. 1 1 Preserved Peas 2 .. .. .. 2 2 .. .. .. 2 .. .. .. .. .. Preserved Spinach 1 .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. Demerara Sugar 8 7 .. 4 19 1 .. .. .. 1 7 .. .. 4 18 French Beans 2 .. .. .. 2 1 .. .. .. 1 1 .. .. .. 1 Tea .. 5 • • .. 5 .. 5 .. .. 5 .. .. .. .. .. Rice .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Dried Milk .. .. 1 .. 1 .. .. 1 .. 1 .. .. .. .. .. Condensed Milk .. .. 3 .. 3 .. .. 3 .. 3 .. .. .. .. .. Chicken & Ham Paste .. .. .. 2 2 .. .. .. 2 2 .. .. .. .. .. Linseed Meal 7 .. .. .. 7 7 .. .. .. 7 .. .. .. .. .. Vinegar (Malt) 5 5 5 5 20 2 1 .. 2 5 3 4 5 3 18 Olive Oil .. .. 7 .. 7 .. .. 5 .. 5 .. .. 2 .. 2 Yeast .. .. .. 4 4 .. .. .. 4 4 .. .. .. .. .. Irish Whiskey 2 2 2 2 8 1 2 2 1 6 1 .. .. 1 2 1909] 29K Table CXXXVII.—continued. Description. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Genuine. Adulterated 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Scotch Whiskey 2 2 2 2 8 2 2 2 2 8 .. .. .. .. .. Rum 2 2 2 2 8 2 2 2 2 8 .. .. .. .. .. Gin 2 2 2 2 8 2 1 2 2 7 .. 1 .. .. 1 Mild Ale .. .. .. 1 1 .. .. .. 1 1 .. .. .. .. .. Lime Water .. 7 7 .. 14 .. 6 5 .. 11 .. 1 2 .. 3 Oil of Eucalyptus .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Blaud's Pills .. 7 .. .. 7 .. 6 .. .. 6 .. 1 .. .. 1 Comp. Liquorice Powder .. .. 7 .. 7 .. .. 7 .. 7 .. .. .. .. .. Comp. Syrup of Hypophosphites .. .. 1 .. 1 .. .. .. .. .. .. .. 1 .. 1 Pil. Aloes et Ferri .. .. .. 7 7 .. .. .. 7 7 .. .. .. .. .. Glycerine .. .. .. 7 7 .. .. .. 6 6 .. .. .. 1 1 Fluid Magnesia 7 .. .. .. 7 6 .. .. .. 6 1 .. .. .. 1 Prescriptions 7 .. 7 .. 14 7 .. 7 .. 14 .. .. .. .. .. Cream of Tartar .. .. .. 7 7 .. .. .. 7 7 .. .. .. .. .. 290 290 290 291 1,161 250 256 263 263 1,032 40 34 27 28 129 MARGARINE ACT Margarine 10 10 10 10 40 8 7 5 i 8 28 2 3 5 2 12 297 [1909 Abstract from the Public Analyst's Returns, together with the proceedings taken during the Quarters of the Year 1909 ADULTERATED SAMPLES.—First Quarter, 1909. Sample Numbered Article submitted for Analysis. By whom submitted for Analysis. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if adulterated, what were the nature and extent of the Adulteration Action taken on Public Analyst's Report. Result of Proceedings. 1065 T.L.B. Milk Inspector 8 per cent. of added water §No proceedings 1068 T.L.B. Separated Milk do. 6 per cent. of added water Summons. Fined 7/6 and 12/6 costs, or 7 days. 1073 T.L.B. Milk do. 5 per cent. of added water Cautioned. 1080 T.L.B. do. do. 20 per cent. of original fat abstracted Summons. £4 and 12/6 costs, or 1 month. 1117 T.L.B. do. do. 4 per cent. of added water Cautioned. 1118 T.L.B. Butter do. 90 per cent. of Margarine Summons ,, £5 and 12/6 costs. 1135 T.L.B. Milk do. 10 per cent. of added water ,, ,, 30/- and 12/6 costs. 1136 T.L.B. Butter do. 100 per cent. of Margarine ,, ,, £2 and 12/6 costs. 1142 T.L.B. Milk do. 7 per cent. of added water , , ,, £5 and £2 2s. costs, or 21 days, 1150 T.L.B. do. do. 4 per cent. of added water Caut oned. 1152 T.L.B. do. do. 9 per cent. of added water Summons. ,, £1 and 12/6 costs. Distress in 8 days. 1173 T.L.B. Demerara Sugar do. Dyed Sugar other than Demerara ,, Fined £2 and 12/6 costs, or 1 month. 1174 T.L.B. do. do. Refined Sugar not Demerara Cautioned. 1175 T.L B. do. do. Dyed Sugar other than Demerara Summons. Fined £2 and 12/6 costs. 1176 T.L.B. do. do. Dyed Sugar other than Demerara ,, ,, £2 and 12/6 costs. 1177 T.L.B. do. do. Dyed Sugar other than Demerara ,, ,, £2 and £1 3s. costs. 1186 T.L.B. Fluid Magnesia do. 22 per cent. of Magnesia deficient Cautioned. 1188 T.L.B. Coffee do. 74 per cent. of Chicory Summons. ,, £2 and £1 3s. costs. 1198 T.L.B. Irish Whiskey do. 26 5 degrees under proof Cautioned. 1203 T.L.B. Margarine do. 100 per cent. of Margarine No proceedings. 1207 T L B. Milk do. 4 per cent. of added water Cautioned. 1208 T.L.B. do. do. 8 per cent. of added water Summons. ,, £1 10s. and 12/6 costs. 1219 T.L.B. Coffee do. 76 per cent. of Chicory ,, ,, £2 10s. and £1 3s. costs. 1221 T.L.B. do. do. 50 per cent. of Chicory ,, ,, £i and 12/6 costs. 1222 T L B. do. do. 50 per cent. of Chicory ,, ,, £1 and 12/6 costs. 1231 T.L.B. Margarine do. 100 per cent. of Margarine Cautioned by letter re wrapper. § Summons not issued, the Defendant's Company having successfully prosecuted their servant for adulteration. He was fined £2 and 2s. costs. 1909] 298 ADULTERATED SAMPLES.—First Quarter, 1909—(continued). Sample Numbered Article submitted for Analysis. By whom submitted for Analysis. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if adulterated, what were the nature and extent of the Adulteration. Action taken on Public Analyst's Report. Result of Proceedings. 1244 T L B. Butter Inspector 50 per cent. of Margarine Summons Fined £15 and £5 costs. 1279 T.L.B. Coffee ,, 70 per cent. of Chicory Summons withdrawn 1283 T.L.B. Butter ,, 95 per cent. of Margarine Summons. ,, £3 and 12/6 costs. 1286 T.L.B. Beans ,, 2.2 grains of Crystallised Sulphate of Cautioned. Copper per pound 1288 T.L.B. Coffee ,, 73 per cent. of Chicory Summons. Ordered to pay 12/6 costs 1295 T L B. Milk ,, 10 per cent. of added water .. ,, Fined £1 and 12/6 costs 1302 T.L.B. Cocoa ,, 33 per cent. of added sugar and ,, ,, £3 and 12/6 costs. 20 per cent. of added starch 1319 T L B. Malt Vinegar ,, Vinegar other than Malt ,, Ordered to pay 12/6 costs. 1321 T.L.B. ,, ,, ,, Vinegar other than Malt ,, ,, to pay 12/6 costs. 1323 T.L.B. ,, ,, ,, Vinegar other than Malt ,, Fined £2 and 12/6 costs or 14 days 1326 T.L.B. Butter ,, 100 per cent. of Margarine ,, „ £1 and 12/6 costs. 1336 T.L.B. Milk ,, 13 per cent. of original fat abstracted ,, ,, £1 and 12/6 costs. 1345 T.L.B. ,, ,, 4 per cent. of added water and 16 per ,, ,, £1 and 12/6 costs. cent. of original fat extracted 1351 T.L.B. ,, ,, 2 per cent. of added water and 4 per Cautioned. cent. of original fat abstracted 1359 T.L.B. Demerara Sugar ,, Dyed Sugar other than Demerara Summons. ,, £2 and 12/6 costs. 1360 T.L B. ,, ,, ,, Dyed Sugar other than Demerara ,, ,, £2 and 12/6 costs. Total number of samples analysed during the Quarter, 300. to CO CO O CO ADULTERATED SAMPLES.—Second Quarter, 1909. Sample Numbered Article submitted for Analysis. By whom submitted for Analysis. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken on Public Analyst's Report. Result of Proceedings. 1383 T.L.B. Milk Inspector 6 per cent. of added water Summons Fined £100 and £21 costs. 1414 T.L.B. do. do. 8 per cent. of added water do. do. £5 and £2 4s. costs,or 1 month 1418 T.L.B. do. do. 7 per cent. of added water do. do. £5 and £2 4s. 6d. costs 1224 T.L.B. Butter do. 95 per cent. of Margarine do. do. £5 and 12/6 costs. 1454 T.L.B. Milk do. 9 per cent. of added water do. do. £1 and 12/6 costs. 1462 T.L.B. do. do. 6 per cent. of added water do. do. £5 or 1 month. 1463 T.L.B. do. do. 4 per cent. of added water Cautioned 1466 T.L.B. do. do. 4 per cent. of added water do. 1466 T.L.B. do. do. 4 per cent. of added water do. 1494 T.L.B. Coffee do. 44 per cent. of Chicory Summons Fined £1 and 12/6 costs. 149 ) T.L B. Butter. do. 100 per cent. of Margarine do. do. £5 do. 1496 T.L.B. do. do. 100 per cent. of Margarine do. do. £5 do. 1497 T.L.B. do. do. 100 per cent. of Margarine do. do £5 do. 1519 T.L.B. Margarine do. 100 per cent. of Margarine Cautioned 1638 T.L.B. Demerara Sugar do. Dyed Sugar other than Demerara Summons Fined £1 and 12/6 costs. 1532 T.L.B. Lime Water do 92 per cent. of Lime deficient do. do. £4 do. or 1 month. 1537 T L B, Butter do. 100 per cent. of Margarine do. do. £8 or 2 months in default of 1639 T.L.B. do. do. 100 per cent. of Margarine do. do. £10 and 12/6 costs. [distress 1542 T L B. Demerara Sugar do. Dyed Sugar other than Demerara do. Dismissed, £1 costs against Council. 1543 T.L.B. do. do. Dyed Sugar other than Demerara do. Dismissed. 1549 T.L.B. Blaud's Pills do. Double strength in iron but pill half size No proceedings. 1561 T.L.B. Demerara Sugar do. Dyed Sugar other than Demerara Summons Fined £1 and 12/6 costs. 1562 T.L.B. do. do. Dyed Sugar other than Demerara do. Ordered to pay 12/6 costs. 1564 T.L.B. Milk do. 12 per cent. of original fat abstracted do. Fined £5 and 12/6 costs. 1566 T.L.B. do. do. 17 per cent. of original fat abstracted do. do. £10 and £2 12s. 6d. costs. 1574 T.L.B. do. do. 13 per cent. of original fat abstracted do. Dismissed on Warranty. 1909] 300 ADULTERATED SAMPLES (Second Quarter, 1909)—continued. Sample Numbered Article submitted for Analysis. By whom submitted for Analysis. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken on Public Analyst's Report. Result of Proceedings. 1584 T.L.B. Gin Inspector 53 9 degrees under Proof Summons. Fined £20 and 12/6 costs. 1598 T.L.B. Margarine do. 100 per cent. Margarine Cautioned. 1599 T.L.B. do. do. 100 per cent. Margarine Summons. Ordered to pay 12/6 costs. 1622 T.L.B. Malt Vinegar do. Vinegar other than Malt do. Dismissed. 1623 T.L.B. do. . do. Vinegar other than Malt do. Ordered to pay 12/6 costs. 1624 T.L.B. do. do. Vinegar other than Malt do. Fined £2 and 12/6 costs. 1625 T.L.B. do. do. Vinegar other than Malt do. do. do. 1629 T.L.B. Golden Syrup do. 75 per cent. of Glucose Syrup do. Dismissed without costs. 1630 T.L.B. do. do. 64 per cent. of Glucose Syrup do. Fined £1 and 12/6 costs. 1653 T.L.B. Demerara Sugar do. Dyed Sugar other than Demerara do. Ordered to pay 12/6 costs. 1654 T.L.B. do. do. Dyed Sugar other than Demerara do. do. do. Total number of Samples analysed during the Quarter, 300. 301 [1909 ADULTERATED SAMPLES (Third Quarter, 1909). Sample Numbered. Article submitted for Analysis. By whom submitted for Analysis. Result of Analysis. Shewing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken on Public Analyst's Report. Result of Proceedings. 1661 TLB. Compound Syrup of Hypophosphites Inspector Iron deficient No proceedings* 1662 T.L.B. Milk ,, 9 per cent. of original fat abstracted Summons Ordered to pay 12s. 6d. costs. 1668 T.L.B. ,, ,, 17 ,, ,, ,, .. do. 12s. 6d. do. 1695 T.L.B. ,, ,, 17 ,, ,, ,, .. do. 12s. 6d. do. 1724 T.L.B. ,, ,, 3 ,, ,, ,, Cautioned 1740 T.L.B. Butter ,, 65 per cent. of Margarine Summons Fined £5 or one month. 18 T.L B „ ,, 50 „,, .. „ £5 25 T.L.B. ,, ,, 35 „,, .. ,, £4 1a T L.B. Milk ,, 9 per cent. of added water .. Fined £2 and 12s. 6d. costs. 3a T.L.B. ,, ,, 6 per cent. of original fat abstracted .. ,, £1 „ 12s. 6d. ,, 30 T.L.B. Butter ,, 70 per cent. of Margarine .. Withdrawn on the defendant paying 12s. 6d. costs. 35 T.L.B. ,, ,, 100 ,, „ .. Fined £2 and 12s. 6d. costs, or 14 days. 39 T.L.B Margarine ,, 100 ,, ,, .. Fined 10s. and £1 3s. Od. costs. 40 T.L.B. ,, ,, 100 „ „ Cautioned 42 T.L.B. ,, ,, 100 „ ,, .. 44 T.L.B. ,, ,, 100 „ ,, Summons Ordered to pay 12s. 6d. costs. 47 T L B. ,, ,, 100,, ,, .. ,, ,, 12s. 6d. „ 68 T.L.B. Olive Oil ,, 100 per cent. of Arachis Oil .. Fined £1 and 12s. 6d. costs. 70 T L.B. ,, ,, ,, ,, ,, .. ,, 5s. ,, 12s. 6d. „ 105 T.L.B. Malt Vinegar ,, Vinegar other than Malt .. „ £1 ,, 12s. 6d. 106 T.L.B. ,, ,, ,, ,, ,, ,, .. Dismissed. 107 T.L.B. ,, ,, ,, ,, ,, ,, .. Fined £1 and 12s. 6d costs. 108 T L B. ,, ,, ,, ,, ,, ,, .. ,, £1 ,, 12s. 6d. ,, 109 T.L.B. ,, ,, ,, ,, ,, ,, .. ,, 10s. ,, 12s. 6d. ,, or 7 days. *Not sufficient quantity to ensure a proper analysis. 1909] 302 ADULTERATED SAMPLES (Third Quarter, 1909)—continued. Sample numbered. Article submitted for Analysis. By whom submitted for Analysis. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken on Public Analyst's Report. Result of Proceedings. 112 T.L.B. Separated Milk Inspector Not separated milk but milk containing 6 per cent. of added water and having 33 per cent. of its original fat abstracted No proceedings* 118 T.L.B. Lime Water ,, 21 per cent. of the Lime deficient Cautioned 119 T.L.B. ,, ,, ,, 15 „ ,, ,, ,, 135 T.L.B. Milk ,, 15 per cent. of added water Summons Fined £1 and 12s. 6d. costs. 136 T.L.B. Butter ,, 100 per cent. of margarine ,, Ordered to pay 12s. 6d. costs. 147 T.L.B. Milk ,, 17 per cent. of added water ,, Fined £2 and 12s. 6d. costs. 164 T.L.B. Lard ,, 60 per cent. of Cottonseed Oil ,, ,, 10s. ,, 12s. 6d. ,, 173 T.L.B. Golden Syrup ,, 70 per cent. of Glucose Syrup ,, „ 10s. ,, 12s. 6d. „ Total number of Samples analysed during the Quarter, 300. * No summons issued on advice of Solicitor, as the Vendor stated that the milk was not for sale. 303 [1909 ADULTERATED SAMPLES (Fourth Quarter. 1909). Sample Numbered Article submitted for Analysis. By whom submitted for Analyses. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken on Public Analyst's Report. Result of Proceedings. 184 T.L.B. Milk‡ Inspector 8 per cent. of original fat abstracted Summons Fined 10/- and 12/6 costs. 185 T.L.B. „ ‡ „ 82 „ ,, ,, and 8 per cent. of added water present „ „ 10/- and 12/6 costs, or 7 days. 203 T.L.B. „ ‡ „ 4 per cent. of added water Cautioned. 204 T.L.B. Butter „ 100 per cent. of Margarine Summons Fined £5 and 12/6 costs. 12 T.L.B. Milk‡ „ 21 per cent. of added water and 11 per cent. of original fat abstracted „ Ordered to pay 12/6 costs. 220 T.L.B. „ ‡ „ 4 per cent. of added water Cautioned. 240 T.L.B. Butter „ 100 per cent. of added Margarine Summons Fined £1 and 12/6 costs. 259 T.L.B. „ „ 95 „ „ „ „ „ £3 and 12/6 costs. 200 T.L.B. „ „ 42 „ „ „ „ „ £5 and 12/6 costs. 261 T.L.B. Milk ‡ „ 7 „ of added water „ Ordered to pay 12/6 costs 273 T.L.B. Butter „ 95 „ of Margarine „ Fined £2 and 12/6 costs. 306 T.L.B Demerara Sugar „ Dyed Sugar other than Demerara „ „ £1 and £1 3s. costs. 307 T.L.B. „ „ „ „ „ „ „ 10/- and 12/6 costs. 308 T.L.B. „ „ „ „ „ „ Ordered to pay 12/6 costs. 318 T.L.B. Glycerine „ 62.9 per cent. of Invert Sugar and 37.1 per cent. of water „ „ 12/6 costs. 328 T.L.B. Ground Ginger „ 20 per cent. of added Rice „ Fined £1 and 12/6 costs, 336 T.L.B. Coffee „ 46 per cent. of Chicory „ „ £1 and 12/6 costs. 337 T.L.B. Demerara Sugar „ Dyed Sugar other than Demerara „ Dismissed. 349 T.L.B. Irish Whiskey „ 28.6 degree under proof „ „ 353 T.L.B. Margarine „ 100 per cent. of Margarine Cautioned. 356 T.L.B. „ „ „ „ „ „ 377 T.L.B. Malt Vinegar „ Vinegar other than Malt „ 379 T.L.B. „ ,, „ „ „ „ Summons Fined £1 and £1 3s. costs. 380 T.L.B. „ ,, „ „ „ „ „ „ £1 and £1 3s. costs. 382 T.L.B. Milk ‡ „ 7 per cent. of added water „ „ 7/6 and 12/6 costs. 392 T.L.B. Coffee „ 70 per cent. of Chicory „ „ £3 and 12/6 costs. 394 T.L.B. „ „ 35 „ ,, „ „ £4 and 12/6 costs. 400 T.L.B. Butter „ 90 per cent. of Margarine „ „ £1 and £1 2s. 6d. costs. 429 T.L.B. „ „ 100„ „ „ „ £2 and 12s. 6d. costs or 1 month 430 T.L.B. „ „ 100„ „ „ Fined 10/- and 12/6 costs. Total Number of Samples analysed during the Quarter, 301. ‡Boric Acid and Formalin absent. 304 1909] Table CXXXVIII. SUMMARY OF PROSECUTIONS.—During year 1909. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties Received. £ s. d. "Public Health (London) Act, 1891" 32 29 1 2 91 15 0 "Sale of Food and Drugs Acts, 1875-99" 110 101 6 3 427 13 6 "Margarine Act, 1887" 7 7 ... ... 6 18 0 "Dairies, Cowsheds and Milkshops Order, 1885" ... ... ... ... ... ... ... "Metropolis Local Management Act" ... ... ... ... ... ... ... "London County Council General Powers Acts" 1 1 ... ... 1 7 0 Total 150 138 7 5 527 13 6 WATER SUPPLY. The following are the particulars as to the water supply of the district receiving water from the New River, as abstracted from the last return of the Metropolitan Water Board They are a continuation of those which have been given for some years past:— 1907-8 1908-9. Houses Supplied 212,592 214,737 Houses on constant system 212,524 214,669 Houses not on constant system 58 68 Percentage of houses on constant system 99.9 99.9 Population supplied 1,393,668 1,405,126 Average daily supply (gallons) 42,509,789 43,333,418 Quantity of water supplied during the year (gals.) 15,558,582,823 15,816,697,652 Average daily supply per house (gals.) 200.66 202.58 „ „ „ head (gals.) 30.50 30.84 Average number of persons supplied per house 6.58 6.57 Capacity of subsidence reservoirs 468,100,000 468,100,000 No. of days supply 395 10.80 APPENDIX. VITAL AND SANITARY STATISTICS, 1909. together with the PRESCRIBED RETURNS OF THE LOCAL GOVERNMENT BOARD AND Abstracts for Previous Years. W 306 1909] Table A. Showing the Deaths from All Causes in Islington during the Year 1909. Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. •» Deaths in 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. 21 Small pox (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 31 156 10 .. .. .. .. .. .. .. .. .. .. 187 10 13 29 8 37 25 17 68 98 99 197 1 Scarlet Fever 1 19 3 1 .. .. 1 .. .. .. .. .. .. 20 5 1 3 2 3 5 6 5 10 15 25 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Epidemic Influenza 1 .. 1 .. 1 1 4 8 10 9 20 11 4 1 69 7 14 7 7 17 4 14 30 40 70 8 Whooping Cough 36 48 2 .. .. .. .. .. .. .. .. .. .. 84 9 9 4 10 11 11 16 32 35 51 86 2 Diphtheria 1 23 5 1 .. .. .. 1 .. .. .. .. .. 24 7 3 2 4 5 4 5 8 11 20 31 3 Enteric Fever .. 1 .. 1 .. .. 5 .. 2 2 1 .. .. 1 11 .. 1 .. 1 4 2 4 7 5 12 9 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa, Dysentery 36 12 .. .. .. .. 1 .. 3 1 1 1 .. 48 7 7 4 .. 9 8 15 12 26 29 55 1 Epidemic Enteritis 10 .. 1 .. .. .. .. 1 .. .. .. .. .. 10 2 .. .. 1 3 4 1 3 8 4 12 Other Allied Diseases *2 2 *1 .. .. .. .. .. .. .. .. .. .. 4 1 1 .. 1 1 1 1 .. 1 4 5 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 10 .. .. .. .. .. 1 .. 1 .. .. .. .. 10 2 1 .. .. 2 5 4 .. 7 5 12 1 Gonorrhœa .. .. .. .. .. .. .. .. 2 1 .. .. .. .. 3 .. .. .. 1 1 1 .. 3 .. 3 5 Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 4 .. .. .. .. .. .. 3 .. 2 3 .. .. 4 8 .. 4 2 2 1 2 1 8 4 12 1 Puerperal Fever .. .. .. .. .. 1 3 3 .. .. .. .. .. .. 7 1 .. 1 .. 2 1 2 .. 7 7 1 Pyæmia .. 1 .. .. .. .. .. .. .. 2 1 .. .. 1 3 1 .. .. .. 1 1 1 4 .. 4 3 Infective Endocarditis .. .. .. 2 2 .. .. 1 .. .. .. .. .. .. 5 .. 1 .. .. .. 3 1 5 .. 5 Other Allied Diseases 2 1 .. .. .. .. 2 2 2 1 1 1 .. 3 9 2 1 .. 3 1 4 2 8 4 12 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Rheumatic Fever .. .. 2 2 1 1 2 .. 2 .. .. .. .. .. 10 1 2 .. 3 1 1 2 5 5 10 Rheumatism of Heart .. .. .. 1 1 .. .. .. .. 2 .. .. .. .. 4 .. 2 .. 1 .. .. 1 1 3 4 10 Tuberculosis of brain 18 42 5 2 1 .. 2 1 1 .. .. .. .. 60 12 5 11 6 8 9 5 28 32 40 72 1 Tuberculosis of Larynx .. .. .. .. .. 1 1 2 .. 1 .. .. .. .. 5 .. 1 .. .. .. 1 3 4 1 5 128 Phthisis 1 11 6 4 7 38 96 108 79 50 19 5 .. 12 412 39 56 32 50 57 81 109 255 169 424 8 Abdominal Tuberculosis 20 11 4 2 .. 1 1 2 .. .. .. .. .. 31 10 2 1 6 6, 4 7 15 24 17 41 1 General Tuberculosis 6 15 .. 1 .. 1 .. .. 1 1 .. .. .. 21 4 1 2 1 2 5 9 5 10 15 25 5 Other forms Tuberculosis 1 3 1 1 1 .. 1 4 2 .. 1 .. .. 4 11 3 2 2 4 2 2 .. 10 5 15 Other Infective Diseases .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 1 Thrush 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. 1 Actinomycosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food 1 1 .. .. .. .. 1 1 .. .. .. .. .. 2 2 .. .. 1 .. .. 3 .. .. 4 4 Acute Alcoholism .. .. .. .. .. .. .. 3 1 .. .. .. .. .. 4 1 .. .. 2 .. 1 .. 3 1 4 1 Chronic Alcoholism .. .. .. .. .. .. 2 4 5 2 1 .. .. .. 14 .. 1 .. .. 1 6 6 9 5 14 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. .. .. 1 1 89 Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo-arthritis 1 .. .. .. .. .. .. .. 3 3 9 8 .. 1 23 5 3 1 3 4 4 4 5 19 24 Gout .. .. .. .. .. .. .. 1 .. .. 2 1 .. .. 4 .. .. .. .. 1 2 1 3 1 4 cancer .. .. 2 1 1 2 10 27 79 96 94 34 7 .. 353 44 36 43 47 55 64 64 146 207 353 1 Diabetes Mellitus .. .. .. .. 4 .. 2 1 10 8 5 3 3 .. 36 4 7 6 2 3 5 9 22 14 36 Purpura Hæmorrhagica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia .. .. 2 .. 1 .. .. 5 .. 1 4 .. .. .. 13 .. 1 1 1 2 5 3 7 6 13 Lymphadenoma .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 .. .. 1 .. 1 .. .. 2 .. 2 Premature Birth 136 1 .. .. .. .. .. .. .. .. .. .. .. 137 .. 10 20 8 12 15 32 40 77 60 137 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Debility at Birth 22 .. .. .. .. .. .. .. .. .. .. .. .. 22 .. 3 1 2 5 4 4 3 11 11 22 Atelectasis 19 .. .. .. .. .. .. .. .. .. .. .. .. 19 .. .. 1 .. 3 4 6 5 11 8 19 Congenital Defects 33 1 1 .. .. .. .. .. .. .. .. .. .. 34 1 4 4 4 2 6 7 8 18 17 35 Want of Breast Milk 4 .. .. .. .. .. .. .. .. .. .. .. .. 4 .. 3 .. .. 1 .. .. .. 4 .. 4 Atrophy, Debility, Marasmus 111 9 .. .. .. .. .. .. .. .. .. .. .. 120 .. 13 12 12 18 12 22 31 73 47 120 *Post-Basic Meningitis. 307 [1909 Table A.—Continued. Deaths in 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. Dentition 6 3 .. .. .. .. .. .. .. .. .. .. .. 9 .. 1 2 .. .. 2 3 1 4 5 9 1 Rickets 1 2 .. .. .. .. .. .. .. .. .. .. .. 3 .. .. 2 .. .. .. .. 1 2 1 3 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. 2 30 118 70 .. 220 24 31 28 27 33 39 38 89 131 320 Convulsions 14 5 .. .. .. .. .. .. .. .. 1 .. .. 19 1 2 5 2 1 4 •• 6 12 8 20 Meningitis 11 11 2 2 .. .. 2 .. 1 .. .. .... .. 22 7 4 1 4 3 2 9 6 12 16 29 Encephalitis 2 .. .. .. .. .. 1 .. .. .. .. .. .. 2 1 .. .. 1 .. .. 1 1 .. 3 3 Apoplexy .. .. .. .. .. .. .. 4 10 7 11 12 3 .. 47 7 6 7 2 10 4 11 19 28 47 Softening of Brain .. .. .. .. .. .. .. .. 3 4 4 2 2 .. 15 .. 4 1 2 3 4 1 7 8 15 Hemiplegia .. .. .. .. .. .. .. .. 1 3 11 5 .. .. 20 1 7 1 .. 4 3 4 13 7 20 General Paralysis of the Insane .. .. .. .. .. 1 7 10 7 3 1 .. .. .. 29 5 7 2 5 1 6 3 24 5 29 Other forms of Insanity .. .. .. .. .. .. 1 2 4 5 3 7 3 .. 25 3 6 2 4 4 3 3 6 19 25 Chorea .. .. .. 1 1 .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. 2 .. .. 2 2 Cerebral Tumour .. 1 .. .. 1 1 3 2 .. 2 .. .. .. 1 9 1 1 3 1 2 1 1 4 6 10 Epilepsy 1 .. 2 1 2 .. 2 3 1 3 2 .. .. 1 16 5 4 .. 2 2 4 .. 10 7 17 Laryngismus Stridulus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 l Locomotor Ataxy .. .. .. .. .. .. .. 2 1 6 2 1 .. .. 12 1 3 2 1 2 1 2 9 3 12 Paraplegia 1 3 1 .. 1 .. 2 5 7 4 17 10 1 4 48 1 5 7 5 11 11 12 32 20 52 Other forms, brain Diseases .. 1 1 .. .. .. 1 2 7 .. .. 2 1 1 14 1 .. 2 2 4 4 2 6 9 15 Otitis .. 1 .. 1 1 1 3 .. 1 .. .. 1 .. 1 8 .. 3 1 1 3 1 .. 5 4 9 Disease of Nose, Epistaxis .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 1 Disease of Fye .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Pericarditis .. .. 1 1 .. .. .. .. i l .. .. .. .. 4 1 .. .. .. 1 .. 2 2 2 4 2 Endocarditis 1 .. .. 2 2 .. 1 1 .. 2 1 1 .. 1 10 1 3 1 1 1 1 3 4 7 11 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 1 Angina Pectoris .. .. .. .. .. .. 1 .. .. 2 1 1 .. .. 5 .. .. 2 2 1 .. .. 2 3 5 1 Aneurism .. .. .. .. .. .. .. 4 4 3 5 .. 1 .. 17 3 3 .. 2 3 2 4 12 5 17 17 Senile Gangrene .. .. .. .. .. .. .. .. .. 3 7 13 5 .. 28 2 4 .. 2 3 8 9 19 9 28 5 Embolism, Thrombosis 1 2 .. .. 1 .. .. .. 4 8 5 6 .. 3 24 3 1 1 3 9 5 5 8 19 27 Phlebitis .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 Varicose Veins .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 114 Other Diseases, Heart and Vessels 4 2 6 12 15 12 26 51 79 101 159 86 13 6 550 43 70 46 59 104 97 147 176 290 566 2 Laryngitis 1 6 .. .. .. .. .. .. 1 1 .. .. .. 7 2 1 2 .. 2 1 3 .. 6 3 9 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Larynx and Traches .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 10 Acute Bronchitis 53 19 1 .. .. .. 1 2 10 23 32 31 10 72 110 21 29 16 24 29 23 40 76 106 182 88 Chronic Bronchitis 2 2 .. .. 1 .. 2 13 32 84 97 91 28 4 348 27 26 31 36 65 66 101 153 199 352 13 Lobar Pneumonia 3 2 .. .. 1 3 7 14 7 8 5 3 1 5 49 3 6 5 9 10 13 8 34 20 54 18 Lobular Pneumonia 68 60 3 1 .. 2 1 .. 6 16 9 13 4 128 55 16 11 16 27 31 38 44 92 91 183 44 Pneumonia 35 39 4 2 2 5 20 24 30 28 27 19 4 74 165 21 23 22 35 43 31 64 153 86 239 7 Emphysema, Asthma 1 .. .. .. .. .. 2 2 3 9 2 3 .. 1 21 4 2 1 1 4 2 8 14 8 22 8 Pleurisy 3 3 1 .. .. 1 3 7 6 3 1 .. 1 6 23 1 3 3 7 5 3 7 23 6 29 4 Other Diseases, Respiratory System 1 .. .. .. .. .. 1 8 2 3 2 .. .. 1 16 .. 2 1 4 3 3 4 7 10 17 Diseases of Mouth and Annexa .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Diseases of Pharynx 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. .. .. 1 .. 1 1 2 Diseases of Œsophagus .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. 1 Ulcer of Stomach and Duodenum .. .. .. .. .. .. 3 4 5 6 7 .. .. .. 25 1 2 1 3 7 4 7 15 10 25 14 Other Diseases of Stomach 23 3 .. .. .. .. 1 3 1 2 4 2 .. 26 13 6 6 2 5 10 5 5 20 19 39 11 Enteritis 26 11 .. .. 1 .. 2 3 .. 4 4 3 .. 37 17 7 .. 3 13 8 11 12 27 27 54 Appendicitis .. 2 7 2 3 1 1 4 1 2 2 .. .. 2 23 2 2 1 2 7 6 5 18 7 25 Obstruction of Intestine 6 4 .. .. .. .. 3 3 9 6 6 7 .. 10 34 5 6 5 5 6 3 14 19 25 44 Other Diseases of Intestine 1 .. .. .. .. .. .. .. 1 1 .. 1 .. 1 3 2 .. .. .. .. .. 2 3 1 4 5 Cirrhosis of Liver .. .. .. .. .. .. 2 10 12 7 9 1 .. .. 41 5 2 1 4 7 12 10 15 26 41 Other Diseases of Liver 2 .. .. .. .. 1 .. 1 1 5 1 1 1 2 11 1 .. 1 2 2 3 4 5 8 13 Peritonitis 1 1 2 .. .. .. 2 .. .. .. 2 .. .. 2 6 2 .. .. .. 2 1 3 3 5 8 Other Diseases, Digestive System 9 1 .. .. .. .. 1 1 2 .. 2 .. .. 10 6 4 .. 1 1 .. 2 8 8 8 16 Diseases, Lymphatic System and Glands 3 1 1 .. .. .. 1 2 5 2 1 1 .. 4 13 1 1 4 3 3 2 3 6 11 17 1 Acute Nephritis 1 .. .. .. 1 .. 5 4 2 1 4 .. 1 1 18 3 .. 1 2 3 3 7 7 12 19 1 Bright's Disease .. .. 1 3 1 .. 5 15 28 27 27 6 1 .. 114 3 15 11 15 21 20 29 61 53 114 Calculus .. .. .. .. .. 1 .. .. 1 2 1 .. .. .. 5 1 2 .. 1 .. .. 1 1 4 5 Diseases of Bladder and Prostate .. .. .. .. .. .. .. 1 2 2 3 11 3 .. 22 2 5 3 1 4 5 2 21 1 22 Other Diseases, Urinary System .. .. .. .. .. .. .. 3 3 2 2 3 1 .. 14 .. .. 1 3 2 3 5 7 7 14 Diseases of .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. 2 .. 1 1 .. 1 2 .. .. .. 7 .. 1 1 .. 1 3 1 .. 7 7 Diseases of Uterus and Appendages .. .. .. .. .. .. 1 1 1 1 .. .. .. .. 4 1 1 .. .. 1 1 .. .. 4 4 Diseases of Vagina and External .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 2 Abortion, Miscarriage .. .. .. .. .. 2 .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Puerperal Convulsions .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 2 2 Placenta Prævia, Flooding .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. .. 1 .. 1 .. .. .. w 2 808 1909] Table A.—Continued. Deaths in 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. Puerperal Thrombosis .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 Other Diseases, Pregnancy and .. .. .. .. .. .. 2 1 .. .. .. .. .. .. 3 .. .. 1 .. 1 .. 1 .. 3 3 Arthritis, Ostitis, Periostitis .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 • • .. .. .. 1 1 Other Diseases, Osseous System .. 1 1 3 .. 1 .. .. .. 2 1 1 .. .. 9 .. .. 1 2 2 4 1 6 4 10 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Eczema 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 1 1 .. .. .. .. .. 1 1 2 Pemphigus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Othet Diseases, Integumentary System 1 .. .. .. .. .. .. .. .. .. 1 .. .. 1 1 .. .. .. .. 1 1 .. .. 2 2 8 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. 2 2 1 3 .. 3 3 4 2 3 4 1 2 26 1 3 5 3 5 3 8 15 13 28 On Railways .. .. .. .. .. .. 1 1 1 .. .. .. .. .. 3 .. .. 1 2 .. .. .. 3 .. 3 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Building Operations .. .. .. .. .. 1 .. .. 1 1 .. .. .. .. 3 1 .. .. .. 1 1 .. 3 .. 3 By Machinery .. .. .. .. .. .. .. .. 2 .. .. .. .. .. 2 .. .. .. .. 1 1 .. 2 .. 2 1 By Weapons and Implements .. 1 .. .. .. .. .. .. 2 .. .. 1 .. 1 3 .. .. .. 2 1 .. 1 4 .. 4 9 Bure and Scalds 5 9 .. .. .. 1 1 .. 1 .. 1 2 .. 14 9 2 2 1 1 4 3 10 11 12 23 2 Poisons, Poisonous Vapours .. 1 1 1 .. .. 1 3 1 1 .. .. .. 1 8 .. 1 1 1 .. 4 2 3 6 9 Surgica, Narcosis .. 1 .. .. .. 1 1 1 .. 1 .. .. .. 1 4 1 .. .. 1 1 .. 2 2 3 5 Effects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. 2 .. .. .. .. 1 1 .. .. .. .. .. 4 .. .. 2 .. •• 1 1 4 .. 4 1 Suffocation, Overlaid in bed 27 .. .. .. .. .. .. .. .. .. .. .. .. 27 .. .. .. 3 7 3 7 7 17 10 27 ,, Otherwise 7 .. .. .. .. .. .. .. .. .. .. .. .. 7 .. .. 2 1 1 .. 2 1 5 2 7 8 Falls not specified 1 2 1 1 .. .. 1 .. 2 .. 8 9 3 3 25 .. 3 1 5 5 7 7 9 19 28 Weather Agencies .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise, not stated 3 .. .. .. .. .. .. .. 1 .. .. .. .. 3 1 .. .. .. 1 .. .. 3 2 2 4 Homicide 3 .. .. .. .. .. .. 1 .. .. .. .. .. 3 1 .. .. .. .. 1 .. 3 .. 4 4 Suicide. 1 By Poison .. .. .. .. .. 2 5 2 2 3 .. .. .. .. 14 2 1 .. 1 1 3 6 5 9 14 By Asphyxia .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. .. 1 .. .. 1 .. 1 1 2 By Hanging and Strangulation .. .. .. .. .. .. 1 2 2 .. .. .. .. .. 5 1 .. 1 1 .. 1 1 4 1 5 By Drowning .. .. .. .. .. .. .. 2 3 2 .. .. .. .. 7 1 1 .. 1 .. 1 3 7 .. 7 By Shooting .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 1 .. .. .. .. 1 .. 2 .. 2 By Cut or Stab .. .. .. .. .. 1 1 1 2 .. 1 .. .. .. 6 .. 2 .. 1 3 .. .. 5 1 6 3 By Precipitation from Elevated Places .. .. .. .. .. .. 1 .. 2 .. 1 .. .. .. 4 1 .. .. 2 .. 1 .. 4 .. 4 By Crushing .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. 2 .. .. .. .. 1 1 .. 1 1 2 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Males 466 275 42 29 30 45 148 229 293 314 335 226 55 741 1746 214 289 219 317 389 459 600 .. .. 2487 Females 375 285 45 24 29 40 123 186 246 286 357 318 117 660 1771 226 269 211 300 404 413 608 .. .. 2431 708 TOTAL DEATHS 841 560 87 53 59 85 271 415 539 600 692 544 172 1401 3517 440 558 430 617 793 872 1208 2487 2431 4918 309 [1909 Table B. Showing the Deaths from All Causes registered during the Quarters of the Year 1909 at three periods of life. DISEASES. 1st Quarter. Total. 2nd Quarter. Total. 3rd Quarter. Total. 4th Quarter. Total. Total for Year Under 1 l to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5. Under 1 1 to 5 Over 5 Small Pox— (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 9 75 5 89 22 67 5 94 .. 10 .. 10 .. 4 .. 4 197 Scarlet Fever .. 8 .. 8 .. 3 3 6 .. 2 .. 2 1 6 2 9 25 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. .. 36 36 .. .. 19 19 1 .. 3 4 .. .. 11 11 70 Whooping Cough 13 18 .. 31 16 19 1 36 .. 5 .. 5 7 6 1 14 86 Diphtheria 1 9 2 12 .. 5 1 6 .. 1 3 4 .. 8 1 9 31 Enteric Fever .. .. 5 5 .. 1 3 4 .. .. 3 3 .. .. .. .. 12 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa, Dysentery 2 1 3 6 3 1 2 6 22 10 .. 32 9 .. 2 11 55 Epidemic Enteritis 1 .. 1 2 .. .. .. .. 9 .. .. 9 .. .. 1 1 12 Other Allied Diseases .. l 1 2 1 l .. 2 .. .. .. .. *1 .. .. 1 5 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 2 .. .. 2 2 .. .. 2 3 .. 1 4 3 .. 1 4 12 Gonorrhœa .. .. .. .. .. .. .. .. .. .. 2 2 .. .. 1 1 3 Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 1 .. 2 3 2 .. 3 5 .. .. 1 1 1 .. 2 3 12 Puerperal Fever .. .. 5 5 .. .. 2 2 .. .. .. .. .. .. .. .. 7 Pyæmia .. 1 1 2 .. .. .. .. .. .. 1 1 .. .. 1 1 4 Infective Endocarditis .. .. 2 2 .. .. 2 2 .. .. .. .. .. .. 1 1 5 Other Allied Diseases 1 .. 2 3 .. .. 3 3 1 1 1 3 .. .. 3 3 12 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. 3 3 .. .. 2 2 .. .. 1 1 .. .. 4 4 10 Rheumatism of Heart .. .. 3 3 .. .. 1 1 .. .. .. .. .. .. .. .. 4 Tuberculosis of Brain 5 16 2 23 5 9 5 19 1 12 3 16 7 5 2 14 72 Tuberculosis of Larynx .. .. 1 1 .. .. 2 2 .. .. 2 2 .. .. .. .. 5 Phthisis .. 6 113 119 1 2 83 8b .. 2 91 93 .. 1 125 126 424 Abdominal Tuberculosis 9 5 3 17 4 2 3 9 2 2 2 6 5 2 2 9 41 General tuberculosis 1 4 2 7 3 5 .. 8 1 4 2 7 1 2 .. 3 25 other Forms Tuberculosis .. 1 1 2 .. .. 1 1 .. 2 5 7 1 .. 4 5 15 Other Infective Diseases .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 1 Thrush .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 1 Actinomycosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. 1 1 1 3 .. .. 1 1 .. .. .. .. 4 Acute Alcoholism .. .. 2 2 .. .. 1 1 .. .. 1 1 .. .. .. .. 4 Chronic Alcoholism .. .. 3 3 .. .. 3 3 .. .. 3 3 .. .. 5 5 14 Chromic Industrial Poisonings .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Other Chromic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo-arthritis .. .. 3 3 .. .. 10 10 .. .. 3 3 1 .. 7 8 24 Gout .. .. 2 2 .. .. 1 1 .. .. 1 1 .. .. .. .. 4 Cancer .. .. 83 83 .. .. 82 82 .. .. 90 90 .. .. 98 98 353 Diabetes Mellitus .. .. 10 10 .. .. 7 7 .. .. 9 9 .. .. 10 10 36 Purpura Hæmorrhagica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia .. .. 5 5 .. .. 3 3 .. .. 1 1 .. .. 4 4 13 Lymphadenoma .. .. .. .. .. .. 1 1 .. .. 1 1 .. .. .. .. 2 Premature Birth 42 1 .. 43 32 .. .. 32 30 .. .. 30 32 .. .. 32 137 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Debility at Birth 8 .. .. 8 5 .. .. 5 7 .. .. 7 2 .. .. 2 22 Atelectasis 9 .. .. 9 2 .. .. 2 1 .. .. 1 7 .. .. 7 19 Congenital Defects 9 .. .. 9 8 1 .. 9 6 .. .. 6 10 .. 1 11 35 Want of Breast Milk .. .. .. .. 1 .. .. 1 2 .. .. 2 1 .. .. 1 4 Atrophy, Debility, Marasmus 20 4 .. 24 3b 2 .. 37 37 2 .. 39 19 1 .. 20 20 *Post Basic Meningitis. 310 19091 Table B.—Continued. DISEASES. 1st Quarter. Total. 2nd Quarter. Total. 3rd Quarter. Total. 4th Quarter Total for Year Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Total. Dentition 2 2 .. 4 2 .. .. 2 1 .. .. 1 1 1 .. 2 9 Rickets .. 1 .. 1 .. .. .. .. 1 .. .. 1 .. 1 .. 1 3 Old Age, Senile Decay .. .. 77 77 .. .. 50 50 .. .. 42 42 .. .. 51 51 220 Convulsions 5 2 .. 7 3 2 v 5 5 v 1 6 1 1 .. 2 20 Meningitis 1 2 2 5 4 5 1 10 3 4 1 8 3 .. 3 6 29 Encephalitis .. .. .. .. 2 .. .. 2 .. .. 1 1 .. .. .. .. 3 Apoplexy .. .. 17 17 .. .. 8 8 .. .. 10 10 .. .. 12 12 47 Softening of Brain .. .. 6 6 .. .. 3 3 .. .. 5 5 .. .. 1 1 15 Hemiplegia .. .. 9 9 .. .. 1 1 .. .. 7 7 .. .. 3 3 20 General Paralysis of Insane .. .. 10 10 .. .. 4 4 .. .. 6 6 .. .. 9 9 29 Other forms of Insanity .. .. 6 6 .. .. 11 11 .. .. 2 2 .. .. 6 6 25 Chorea .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 2 Cerebral Tumour .. .. 4 4 .. .. .. .. .. 1 3 4 .. .. 2 2 10 Epilepsy .. .. 7 7 .. .. 3 3 .. .. 3 3 1 .. 3 4 17 Laryngismus Stridulus .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 1 Locomotor Ataxy .. .. 4 4 .. .. 4 4 .. .. 2 2 .. .. 2 9 12 Paraplegia 1 .. 15 16 .. 2 15 17 .. .. 10 10 .. 1 8 9 52 Other forms, Brain Diseases .. 1 2 3 .. .. 2 2 .. .. 4 4 .. .. 6 6 15 Otitis .. .. .. .. .. 1 2 3 .. .. 3 3 .. .. 3 3 9 Disease of Nose, Epistaxis .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Diseases of Eye .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pericarditis .. .. .. .. .. .. .. .. .. .. 2 2 .. .. 2 2 4 Endocarditis .. .. .. .. .. .. 3 3 .. .. 4 4 1 .. 3 4 11 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Angina Pectoris .. .. 2 2 .. .. .. .. .. .. 1 1 .. .. 2 2 5 Aneurism .. .. 9 9 .. .. 5 5 .. .. 3 3 .. .. .. .. 17 Senile Gangrene .. .. 7 7 .. .. 10 10 .. .. 6 6 .. .. 5 5 28 Embolism, Thrombosis .. 1 5 6 1 1 4 6 .. .. 5 5 .. .. 10 10 27 Phlebitis .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Varicose Veins .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Other Diseases, Heart ami Vessels 1 1 190 192 2 .. 125 127 .. .. 109 109 1 1 136 138 566 Laryngitis .. 4 l 5 .. 2 .. 2 .. .. .. .. 1 .. 1 2 9 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Larynx and. Trachea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Bronchitis 15 6 60 81 11 3 14 28 7 2 4 13 20 8 32 60 182 Chronic Bronchitis .. 1 188 189 .. 1 40 41 .. .. 26 26 2 .. 94 96 352 Lobar Pneumonia .. 1 17 18 2 1 12 15 1 .. 5 6 .. .. 15 15 54 Lobular Pneumonia 32 30 30 92 12 13 5 30 8 .. 8 16 16 17 12 45 183 Pneumonia 11 19 76 106 9 5 41 55 4 9 18 31 11 6 30 47 239 Emphysema, Asthma .. .. 13 13 .. .. 2 2 .. .. 1 1 1 .. 5 6 22 Pleurisy .. .. 11 11 .. 1 4 5 2 1 4 7 1 1 4 6 29 Other Diseases, Respiratory System 1 .. 3 4 .. .. 7 7 .. .. 3 3 .. .. 3 3 17 Diseases of Mouth and Annexa .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Diseases of pharynx 1 .. .. 1 1 .. .. 1 .. .. .. .. .. .. .. .. 2 Diseases of Œsophagus .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Ulcer of Stomach and Duodenum .. .. 10 10 .. .. 3 3 .. .. 2 2 .. .. 10 10 25 Other Diseases of Stomach 1 1 1 3 3 .. 5 8 10 2 4 l6 9 .. 3 12 39 Enteritis 5 3 3 11 6 3 4 13 4 3 5 12 11 2 5 18 54 Appendicitis .. 1 7 8 .. 1 2 3 .. .. 9 9 .. .. 5 5 25 Obstruction of Intestine 3 .. 5 8 1 1 7 9 1 1 9 11 1 2 13 16 44 Other Diseases of Intestine .. .. 1 1 .. .. 2 2 .. .. .. .. 1 .. .. 1 4 Cirrhosis of Liver .. .. 14 14 .. .. 7 7 .. .. 11 11 .. .. 9 9 41 Other Diseases of Liver 2 .. 1 3 .. .. 5 5 .. .. 3 3 .. .. 2 2 13 Peritonitis .. .. 1 1 .. .. .. .. .. 1 .. 1 1 .. 5 6 8 Other Diseases, Digestive System 2 .. 1 3 3 1 2 6 2 .. .. 2 2 .. 3 5 16 Diseases, Lymphatic System & Glands 2 .. 4 6 .. .. 5 5 1 .. 2 3 .. 1 2 3 17 Acute Nephritis .. .. 7 7 1 .. 5 6 .. .. 3 3 .. .. 3 3 19 Bright's Disease .. .. 31 31 .. .. 18 18 .. .. 25 25 .. .. 40 40 114 Calculus . .. .. .. .. .. .. 2 2 .. .. 1 1 .. .. 2 2 5 Diseases of Bladder and Prostate .. .. 8 8 .. .. 5 5 .. .. 2 2 .. .. 7 7 22 Other Diseases, Urinary System .. .. 3 3 .. .. 4 4 .. .. 1 1 .. .. 6 6 14 Diseases of Testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. .. .. 3 3 .. .. 2 2 .. .. 2 2 7 Diseases of Uterus and Appendages .. .. 1 1 .. .. .. .. .. .. 3 3 .. .. .. .. 4 Dis. of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 2 Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Placenta Prævia, Flooding .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. .. .. 2 Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Other Dis., Pregnancy and Childbirth. .. .. .. .. .. .. 1 1 .. .. 1 1 .. .. 1 1 3 Arthritis, Ostitis, Periostitis .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Other Diseases. Osseous System .. .. 4 4 .. 1 2 3 .. .. .. .. .. .. 3 3 10 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 811 [1909 Table B.—Continued DISEASES. 1st Quarter Total. 2nd Quarter. Total. 3rd Quarter. Total. 4th Quarter Total. Total. Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Eczema .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 2 2 Pemphigus .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 Other Diseases, Integumentary System .. .. .. .. 1 .. .. 1 .. .. 1 1 .. .. .. .. 2 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. .. 1 1 .. .. 5 5 .. 2 12 14 .. .. 8 8 28 On Railways .. .. .. .. .. .. 2 2 .. .. .. .. .. .. 1 1 3 On Ships, Boats, &c. (not drowning) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Building Operations .. .. 1 1 .. .. .. .. .. .. .. .. .. .. 2 2 3 By machinery .. .. 2 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 By weapons and Implements .. .. 1 1 .. 1 .. 1 .. .. .. .. .. .. 2 2 4 Burns and Scalds 1 5 4 10 2 .. 3 5 .. .. 1 1 2 4 1 7 23 Poisons, Poisonous Vapours .. .. 3 3 .. .. 2 2 .. .. 1 1 .. 1 2 3 9 Surgical Narcosis .. .1 1 2 .. .. 2 2 .. .. .. .. .. .. 1 1 5 Effects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. .. .. .. .. 3 3 .. .. .. .. .. .. 1 1 4 Suffocation, Overlaid in Bed 9 .. .. 9 6 .. .. 6 4 .. .. 4 8 .. .. 8 27 ,, Otherwise 2 .. .. 2 3 .. .. 3 2 .. .. 2 .. .. .. .. 7 falls not specified .. 1 8 9 1 .. 8 9 .. 1 2 3 .. .. 7 7 28 Weather Agencies .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise, not stated 2 .. .. 2 1 .. .. 1 .. .. 1 1 .. .. .. .. 4 Homicide 1 .. .. 1 .. .. .. .. 1 .. .. 1 1 .. 1 2 4 Suicide. By Poison .. .. 4 4 .. .. 3 3 .. .. 2 2 .. .. 5 5 14 By Asphyxia .. .. 1 1 .. .. .. .. .. .. .. .. .. .. 1 1 2 By Hanging and Strangulation .. .. 1 1 .. .. 2 2 .. .. 1 1 .. .. 1 1 5 By Drowning .. .. 3 3 .. .. 1 1 .. .. 3 3 .. .. .. .. 7 By Shooting .. .. 1 1 .. .. .. .. .. .. .. .. .. .. 1 1 2 By Cut or Stab .. .. 1 1 .. .. 2 2 .. .. 1 1 .. •• 2 2 6 By Precipitation from Elevated Places .. .. 3 3 .. .. 1 1 .. .. .. .. .. .. .. .. 4 By Crushing .. .. .. .. .. .. 2 2 .. .. .. .. .. .. .. .. 2 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Males 120 117 590 827 131 84 393 608 101 39 311 451 114 38 452 601 2487 Females 113 116 620 849 90 80 358 528 79 42 331 452 93 47 462 602 2431 TOTAL DEATHS 233 233 1210 1676 221 164 781 1136 180 81 642 903 207 82 914 1203 4918 312 1909] Table C. Showing the Population, Inhabited Houses, Marriages, Births and Deaths for the year 1909, 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 1909 351202 39,982 2,769 8,198 4,918 841 1,401 1,788 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 1904 341,044 39,920 2,948 8,890 5,236 1,140 1,743 1,576 1905 342,994 39,910 2,984 8,756 4,955 1,074 1,639 1,581 1906 344,987 39,884 2,964 8,659 5,050 1,083 1,672 1,603 1907 347,017 39,900 2,962 8,531 5,079 996 1,541 1,738 1908 349,091 39,926 2,781 8,665 4,679 894 1,320 1,699 Average of 10 years. 340,901 40,378 3,002 8,987 5,284 1,172 1,769 1,604 159,290 Males Notes.—1. Population of Census, 1901 = 334,991 = 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 = 108 318 [1909 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 1909, 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 1909 23.34 14.00 14.54 103 171 285 363 1899 28.7 18.7 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 1904 26.1 15.3 15.9 128 218 333 301 1905 25.5 14.4 15.0 123 217 331 319 1906 25.1 14.6 15.2 125 214 331 317 1907 24.6 14.6 15.2 117 196 303 342 1908 24.3 13.1 13.7 103 191 282 363 Average of 10 years. 26.3 15.5 16.1 130 221 333 306 *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. 314 1909] Table E. Showing the Births, Deaths, Infantile Mortality, the Deaths from the Principal Epidemic Diseases, and, from Influenza Cancer, Phthisis, and Puerperal Fever occurring in the Year 1909, antf during the Ten Years preceding. 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 Epidemic Diseases. Total Epidemic Death-rates. Influenza. Cancer. Phthisis. Puerperal Fever Totals. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and undefined Fevers. Dlarrhœal Diseases. Deaths. Death-rates. Deaths. Death-rates. Deaths. Death-rates. Deaths. Deaths per 1,000 births. 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 1.96 149 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 0.24 326 0.95 515 1.50 12 1.30 1903 8,983 26.5 4,839 14.3 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 1904 8,890 26.1 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 1905 8,756 25.5 4,955 14.4 1,074 123 529 1 123 37 34 111 .. 17 .. 206 1.54 54 0.l6 328 0.95 438 1.28 6 0.68 1906 8,659 25.1 5,050 14.6 1,083 125 562 •• 187 37 32 74 .. 19 .. 213 163 67 0.19 363 1. 05 411 1.19 11 1.27 1907 8,531 24.6 5,079 14.6 996 117 432 .. 130 24 42 120 .. 13 .. 103 1.24 75 0.22 348 1.00 436 1.26 8 0.94 1908 8,665 24.3 4,679 13.1 894 103 358 .. 78 30 60 55 .. 18 .. 117 1.01 81 0.23 367 1.03 432 1.21 4 0.46 Corrected average. 9,259 26.36 5,445 15.50 1,207 130 580 6 144 32 73 118 •• 30 .. 177 1.65 79 0.23 337 0.96 514 1.46 10 1.08 1909 8,198 23.34 4,918 14.00 841 103 418 .. 197 25 31 86 .. 12 .. 67 1.19 70 0.19 353 1.00 424 1.21 7 0.85 Departure from Average. —1061 -3.02 -527 -1.50 -366 -27 -162 -6 + 53 -7 -42 -32 .. -18 •• -110 — 0.46 -9 — 0.04 +16 + 0.04 -90 -0.25 -3 -0.23 315 [1909 TABLE F. Showing the Births and Birth Rates of Islington from 1841 to 1909. Years. Births. Birth Rates. Years. Births. Birth Rates. Years. Births. Birth Rates. Years. Births. Birth Rates. 1841 1446 25.58 1861 5530 35.31 1881 9894 34.87 1901 9264 27.62 1842* 1508 25.28 1862 5619 34.76 1882 9991 34.79 1902* 9214 26.80 1843 1627 25.86 1863 6094 36.51 1883 9940 34.19 1903 8983 26.48 1844 1804 27.18 1864 6349 36.84 1884* 9872 33.54 1904 8890 26.06 1845 1838 26.20 1865 6743 37.90 1885 9667 32.45 1905 8756 25.52 1846 2152 29.13 1866* 6983 38.02 1886 9849 32.66 1906 8659 25.10 1847 2318 29.75 1867 7391 38.97 1887 9740 31.92 1907 8531 24.58 1848* 2529 30.76 1868 7608 38.86 1888 9609 31.10 1908* 8665 24.35 1849 2613 30.13 1869 7529 37.24 1889 9628 30.79 1909 8198 23.34 1850 3015 32.96 1870 7674 36.77 1890* 9230 29.16 1841.50 20850 28.65 1861-70 67520 37.20 1881.90 97420 32.49 1901-09 79160 25.63 1851 3033 31.46 1871 7671 35.73 1891 9797 30.61 1852 3462 34.19 1872* 8048 36.36 1892 9743 30.12 1853 3701 34.81 1873 8398 36.89 1893 9749 29.81 1854* 3964 35.50 1874 8697 37.16 1894 9678 29.28 1855 4148 35.37 1875 9068 37.67 1895 10183 30.48 1856 4306 34.97 1876 9225 37.26 1896* 9921 29.38 1857 4512 34.89 1877 9380 36.85 1897 9842 29.19 1858 4560 33.57 1878* 9498 36.28 1898 9453 28.07 1859 5011 35.13 1879 9714 36.08 1899 9658 28.71 1860* 5218 34.84 1880 9928 35.86 1900 9254 27.55 1851-60 11915 34.54 1871-80 89627 36.60 1891-1900 97278 29.31 *These years contained 53 weeks. 316 1909] Table G. Showing the Illegitimate Births in Islington from 1841 to 1909. 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 1905 227 1846 53 1856 149 1866 272 1876 361 1886 331 1896 242 1906 244 1847 64 1857 151 1867 306 1877 337 1887 350 1897 269 1907 230 1848 85 1858 140 1868 317 1878 303 1888 345 1898 262 1908 231 1849 74 1859 174 1869 284 1879 401 1889 350 1899 279 1909 250 1850 97 1860 175 1870 318 1880 359 1890 328 1900 261 7 yrs. 449 1851 to 1860 1335 1861 to 1870 2651 1871 to 1880 3429 1881 to 1890 3475 1891 to 1900 2719 1901 to 1909 2173 * The births in these years could not be ascertained 317 [1909 TABLE H. Showing the Deaths and Death Rates of Islington from 1841 to 1909. Years. Deaths. Death Rates. Years. Deaths. Death Rates. Years. Deaths Death Rates. Years. Deaths. Death Rates. 1841 1013 17.91 1861 3123 19.94 1881 5617 19.79 1901 5361 15.98 1842 1101 18.46 1862 3496 21.62 1882 5643 19.65 1902 5635 16.39 1843 1115 17.72 1863 4340 26.00 1883 5561 19.12 1903 4839 14.27 1844 1294 19.49 1864 4594 26.65 1884 5515 18.74 1904 5236 15.35 1845 1258 17.96 1865 4617 25.94 1885 5740 19.27 1905 4955 14.44 1846 1383 18.72 1866 5154 28.06 1886 5434 18.02 1906 5050 14.64 1847 1624 20.83 1867 4509 24.55 1887 5699 18.67 1907 5079 14.63 1848 1745 21.22 1868 4886 24.95 1888 5197 16.82 1908 4679 13.15 1849 1891 21.80 1869 4937 24.42 1889 5035 16.10 1909 4918 14.00 1850 1609 17.58 1870 5078 24.33 1890 6152 19.43 1841-50 14033 19.28 1861-70 44734 24.64 1881-90 55782 18.60 1901-09 45752 14.81 1851 2082 21.59 1871 5048 23.44 1891 6326 19.77 1852 2086 20.60 1872 4196 18.95 1892 6075 18.78 1853 2395 22.52 1873 4156 18.25 1893 6391 19.55 1854 2800 25.07 1874 4816 20.57 1894 5263 15.92 1855 2680 22.85 1875 4833 20.07 1895 5760 17.24 1856 2677 21.74 1876 4969 20.07 1896 5884 17.42 1857 2586 20.00 1877 5111 20.07 1897 5395 16.00 1858 2777 20.44 1878 5376 20.53 1898 5705 16.94 1859 2898 20.32 1879 5456 20.27 1899 6293 18.71 1860 3028 21.21 1880 5716 20.65 1900 5721 17.03 1851-60 26009 21.43 1871-80 49977 20.40 1891-1900 58813 17.72 318 1909] TABLE I. Showing the Infantile Mortality Returns of Islington from 1841 to 1909. Years Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. 1841 190 131 1861 748 135 1881 1,400 140 1901 1,290 139 1842* 224 149 1862 725 130 1882 1,403 140 1902* 1,219 132 1843 - - 1863 906 147 1883 1,312 133 1903 1,136 126 1844 - - 1864 969 153 1884* 1,506 150 1904 1,140 128 1845 267 164 1865 1,088 161 1885 1,387 144 1905 1,074 123 1846 330 153 1866* 1,170 169 1886 1,510 154 1906 1,083 125 1847 348 150 1867 1,119 152 1887 1,.549 159 1907 996 117 1848* 386 152 1868 1,266 164 1888 1,262 132 1908* 894 I03 1849 441 168 1869 1,234 165 1889 1,242 130 1909 841 103 1850 360 119 1870 1,135 149 1890* 1,484 158 1841-50 (8 years) 2,546 146 1861-70 10,360 153 1881-90 14,055 144 1901-09 9,673 122 1851 457 151 1871 1,179 154 1891 1,481 152 1852 457 132 1872* 1,200 150 1892 1,417 145 1853 571 154 1873 1,172 139 1893 1,595 164 1854* 604 152 1874 1,278 147 1894 1,229 127 1855 605 146 1875 1,306 145 1895 1,416 139 1856 612 142 1876 1,397 152 1896* 1,490 150 1857 642 140 1877 1,302 140 1897 1,338 136 1858 648 142 1878* 1,453 154 1898 1,504 159 1859 665 133 1879 1,340 135 1899 1,548 160 1860* 747 144 1880 1,517 154 1900 1,344 145 1851-60 6,008 143 1871-80 13,144 147 1891-00 14,362 148 *These years contained 53 weeks. 319 [1909 Table J. Showing the Cases of Infectious Diseases in Islington in Quinquennial Periods, 1891-05 and in 1906-09 Year Smallpox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. | Relapsing Fever. Cholera. Total Notifications. Attack rates per 1,000 Population. 1891 1 728 756 189 2 343 33 6 1 .. 2059 6.43 1892 42 1709 738 219 .. 553 52 6 .. 3 3318 10. 26 1893 118 2880 885 251 1 672 58 7 .. 1 4853 14.84 1894 90 1493 867 245 1 395 23 7 .. .. 3121 9.44 1895 25 1692 582 184 5 320 22 9 .. .. 2839 8.50 1891-5 276 8502 3828 1088 9 2280 167 35 1 4 16,190 9.90 1896 50 2031 1091 229 .. 385 30 6 2 .. 3824 11.32 1897 3 1577 729 256 .. 312 27 1 .. 1 2906 8.62 1898 .. 1336 544 237 2 279 19 1 .. .. 2418 7.18 1899 3 1494 705 353 .. 350 33 2 .. 3 2943 8.75 1900 2 1074 633 259 1 285 16 6 .. .. 2276 6.78 1896-00 58 7512 3702 1334 3 1611 125 16 2 4 14,367 8.53 1901 50 1286 911 281 2 285 34 3 .. .. 2852 8.50 1902 276 1372 878 257 .. 357 19 5 .. .. 3164 9.20 1903 9 865 45.5 130 .. 227 19 2 .. .. 1707 5.03 1904 17 1146 347 126 1 280 24 .. .. .. 1941 5.69 1905 3 1198 351 100 .. 252 24 .. .. .. 1928 5.62 1901-05 355 5867 2942 894 3 1401 120 10 .. .. 11,592 6.83 1906 1 1386 439 149 1 274 24 1 .. .. 2275 6.59 1907 .. 1216 481 92 .. 252 21 1 .. .. 2063 5.94 1908 .. 1409 530 97 .. 235 17 1 .. .. 2289 6.43 1909 3 1285 430 95 1 221 14 .. .. .. 2049 5.83 320 1909] Table K. Showing the Cases of Small Pox that occurred in the several Wards from 1891 to 1909. 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 .. .. .. .. .. 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 1905 .. .. .. .. .. .. 2 .. .. .. 1 3 1906 .. .. .. .. .. 1 .. .. .. .. .. 1 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. 3 .. .. •• .. .. .. .. .. 3 *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 of Scarlet Fever that occurred in the several Wards from 1891 to 1909. 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 144 153 193 187 137 126 155 91 76 113 202 1577 1898 159 151 152 182 151 102 114 38 58 107 122 1336 1899 100 172 183 178 176 118 117 102 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 1905 100 r42 112 130 114 42 96 71 97 119 175 1198 1906 139 135 67 204 133 68 121 70 97 155 197 1386 1907 120 78 91 164 125 112 110 92 49 105 170 1216 1908 158 162 167 204 119 79 135 94 78 88 125 14090 1909 155 149 126 206 149 94 81 110 51 84 80 1285 *The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards. †The figures for 1891-2-3 are inclusive of Highbury. 321 [1909 Table M. Showing the Cases of Diphtheria that occurred in the several Wards from 1891 to 1909. Year. Tufnell. Upper Holloway. Tollington Lower Holloway. Highbury. Mild may. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals 1891 .. 305 .. 43 .. 112 37 44 44 54 73 712 1892 .. 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 1905 38 41 40 23 45 42 34 18 10 38 22 351 1906 25 56 49 60 50 22 47 28 27 35 38 437 1907 35 65 41 55 39 30 64 30 39 35 47 480 1908 45 76 52 79 45 26 49 24 19 60 47 522 1909 52 63 28 49 34 24 46 34 18 27 50 425 Table N. Showing the Cases of Membranous Croup that occurred in the severa Wards from 1891 to 1909. Year. Tufnell. Upper Holloway. Tollington. 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 2 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 3 29 1898 2 4 .. 1 1 .. 4 .. 1 .. .. 13 1899 2 1 1 2 1 1 3 2 .. 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 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. • • 1906 .. 1 .. .. .. .. 1 .. .. .. .. 2 1907 .. .. .. .. .. .. .. .. 1 .. .. 1 1908 .. 2 .. 3 1 .. 1 .. .. .. 1 8 1909 1 2 1 .. .. .. .. 1 .. .. .. 5 322 1909] Table o. Shoving the Cases of Typhoid Fever that occurred in the several Wards from 1891 to 1909. 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 17 31 17 15 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 !4 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 1905 3 12 9 13 9 14 7 10 4 5 14 100 1906 7 22 27 18 16 2 14 16 2 2 23 149 1907 9 10 10 10 15 6 11 2 6 6 7 92 1908 2 10 3_ 31 9_ 2 10 6 8 11 5 97 1909 4 13 2 14 10 7 16 7 6 14 2 95 Table P. Showing Cases of Typhus Fever occurred in the several Wards from 1891 to 1909. 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 .. I 1 1901 .. .. .. .. .. .. 1 1 .. .. .. 2 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 1904 1 .. .. .. .. .. .. .. .. .. .. 1 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. 1 .. .. .. .. .. .. 1 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. .. .. .. .. .. .. 1 .. .. 1 323 [1909 Table Q Showing the Cases of Erysipelas that occurred in the several Wards from 1891 to 1909. 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 23 38 36 24 26 21 16 12 33 320 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 15 17 13 22 40 279 1899 15 70 36 47 25 12 39 23 22 19 42 350 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 1905 26 18 22 36 25 16 29 17 19 16 28 252 1906 20 29 14 27 28 23 41 26 13 16 40 274 1907 26 20 21 35 17 18 33 22 13 18 29 252 1908 24 22 25 28 18 18 26 21 13 14 24 235 1909 23 22 23 26 22 19 17 18 14 14 23 221 Table R. Showing the Cases of Puerperal Fever that occurred in the several Wards from 1891 to 1909. 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 1 1 .. .. 23 1895 1 2 1 2 6 2 3 1 1 3 .. 22 1896 3 2 3 5 2 1 5 2 1 3 3 30 1897 5 6 2 4 3 1 4 .. 1 1 .. 27 1898 .. .. 2 2 .. 2 3 2 1 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 2 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 1905 1 1 3 9 2 1 3 .. .. 2 2 24 1906 2 1 3 4 3 1 5 2 1 1 1 24 1907 3 5 .. 5 .. 2 1 1 2 1 1 21 1908 2 .. 1 5 2 1 1 2 1 .. 2 17 1909 2 .. 3 2 2 1 1 .. 1 1 1 14 x 2 324 1909] Table S. Showing the Cases of Continued Fever that occurred in the several Wards from 1891 to 1909. 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 1 2 7 1894 .. .. 2 1 3 .. .. .. .. 1 .. 7 1895 .. 4 1 .. 1 3 .. .. .. .. .. 9 1896 .. 2 .. .. .. 1 1 1 .. .. .. 6 1897 .. .. .. .. .. .. .. .. .. .. 1 1 1898 .. .. .. .. .. .. .. .. .. 1 .. 1 1899 .. .. .. .. .. .. l .. .. .. 1 2 1900 .. .. .. 3 .. 2 .. .. .. 1 .. 6 1901 .. .. .. 1 .. .. l .. .. .. 1 3 1902 .. .. .. .. .. .. 5 .. .. .. .. 5 1903 .. .. .. .. .. .. .. .. .. .. .. 2 1904 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. 1 .. .. .. .. 1 1907 .. .. .. .. .. 1 .. .. .. .. .. 1 1908 .. 1 .. .. .. .. .. .. .. .. .. 1 1909 .. .. .. .. .. .. .. .. .. .. .. .. Table T. Showing the Cases of Relapsing Fever thai occurred in the several Wards from 1891 to 1909. 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 .. .. .. .. .. .. .. .. .. .. .. .. 1896 .. .. .. 1 .. .. .. .. 1 .. .. 2 1897 .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. .. 1901 .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 1904 .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. .. .. .. .. .. .. 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. .. .. .. .. .. .. .. .. .. .. 325 [1909 Table U. Showing the Cases of Cholera that occurred in the several Wards from 1891 to 1909. 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 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. .. .. .. .. .. .. 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. .. .. .. .. .. .. .. .. .. .. *Asiatic Cholera. 326 1909] TABLE V. Showing some of the Work of the Public Health Department. Years. Number of cases of Notifiable Infectious Diseases, inclusive of Phthisis. Number of cases of Non-notifiable Diseases notified by the Public Elementary Schools. Number of Infectious Diseases notified to School Teachers. Number of acknowledgments of Infectious Diseases to Medical Men, &c. Number of Letters received. Number of Letters written. Number of letters sent to County Council Schools after disinfection of Pupils homes. Number of Visits made by Sanitary Inspectors to houses. Number of Visits made to Workshops and Factories. Visits made by Food Inspector. Number of Houses wherein Nuisances were abated. Number of Houses wherein Drainage Work has been carried out. Number of Disinfections. Number of Intimation Notices served. Number of Statutory Notices served. 1891 2059 .. .. 2059 .. 1330 .. 45059 17 .. 3382 177 1487 .. .. 1892 3478 .. .. 3478 .. 1617 .. 58786 57 .. 5001 293 2624 .. .. 1893 5187 .. .. 5187 2140 2050 .. 51861 34 .. .. 888 4197 .. .. 1894 3338 .. .. 3338 7444 2931 .. 75969 124 .. .. 1129 3202 6412 .. 1895 3086 .. .. 3086 8409 3756 151 72382 40 .. 6309 1672 3039 6231 .. 1896 4149 .. .. 4149 8218 4600 147 67801 5996 .. 7077 1690 4540 4862 232 1897 3133 .. .. 3133 9062 4722 324 69098 6761 .. 6674 1728 3859 5586 573 1898 2571 .. .. 2571 8344 4039 978 70540 6882 .. 6011 1683 3391 5878 608 1899 3164 829 .. 3164 7160 3562 1650 64551 7233 4501 5505 1341 4051 4544 471 1900 2442 3066 .. 2442 6084 3311 1517 60936 7411 6086 5673 1095 3515 4432 316 1901 3054 3395 .. 3054 6486 3718 1690 58407 7371 -* 4461 843 3304 3955 328 1902 3447 2307 .. 3447 6872 5247 2092 63701 8060 4000 5827 1426 4464 4363 275 1903 2215 2298 .. 2215 6131 4409 1255 72140 7846 4889 6756 1711 2157 5153 372 1904 2068 2425 .. 2068 5738 3565 1319 68182 7463 4690 5411 1201 2587 5464 451 1905 2189 3397 .. 2189 5829 3518 1497 76418 7914 4955 7061 1132 2945 5157 630 1906 2550 4135 .. 2550 5911 3438 1774 83168 698O 6968 6004 1043 3220 5847 669 1907 2335 5829 .. 2335 6131 3358 1648 81628 10727 9938 6038 1259 3162 5624 518 1908 2483 4359 1943 2483 6318 4469 1914 86371 11565 13148 6332 1346 3351 5757 789 1909 3228 4605 1924 3228 5880 4197 1852 76416 11476 11093 7276 990 3281 5304 709 * Meat Inspector left Borough service for an appointment under City Corporation, and the appointment was vacant some time. 327 1909] Table W. BATHS AND WASHHOUSES. Table showing the Number of Persons using the Swimming Baths, Private Baths, and the Washhouses during 1909. Swimming Baths. Bathers. Caledonian Road. Hornsey Road. Essex Road. Total. Public. 1st class Males 10,894 38,263 13,448 62,605 Females 1,011 14,485 2,060 17,556 2nd class Males 20,738 23,890 19,273 63,901 Females 2,051 5,632 3,517 11,200 Schools. 1st class Boys 4 5,506 204 5,714 Girls ... 3,351 ... 3,351 2nd class Boys 43,037 45,813 56,649 145,499 Girls 24,183 21,821 22,069 68,073 Totals 101,918 158,761 117,220 377,899 Private (Slipper Baths.) 1st class Males 14,824 29,174 16,723 60,721 Females 1,155 4,233 2,168 7,556 2nd class Males 47,308 45,519 50,891 143,718 Females 14,310 19,613 21,413 55,336 Totals 77,597 98,539 91,195 267,331 Washhouses. Washers 32,790 28,041 43,091 103,922 Total Persos using the Establishments. Total admissions at each establishment in 1909 212,305 285,341 251,506 749,152 328 [1909 LOCAL GOVERNMENT BOARD RETURN.—Table I. Metropolitan Borough of Islington. VITAL STATISTICS OF WHOLE DISTRICT DURING 1909 AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths inPublic 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.C00 Births registered. Number. Death Rate.* Number. Death Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1904 341,044 8,890 26.1 1,177 132 5,241 15.4 1,619 632 627 5,236 15.3 1905 342,994 8,756 25.5 1,032 118 4,902 14.3 1,528 566 619 4,955 14.4 1906 344,987 8,659 25.1 1,045 120 5,000 14.5 1,589 634 684 5,050 14.6 1907 347,017 8,531 24.6 943 110 4,987 14.4 1,675 593 685 5,079 14.6 1908 349,901 8,665 24.3 827 95 4,530 12.7 1,566 568 717 4,679 13.1 Averages for yrs. 1899i908. 340,901 8,987 26.3 1,156 128 5,234 15.3 1,551 597 647 5,284 15.5 i909 351,202 8,198 23.3 805 93 4,732 13.6 1.673 634 770 4,918 14.0 * 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 term " 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 of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions" 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 Total population at all ages, 334,991 area covered by 3,085 Number of inhabited houses, 38,645 At Census of 1901 water) Average number of persons per house, 8.6 LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Metropolitan Borough of Islington. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1909 AND PREVIOUS YEARS. Names of Localities. Upper Holloway. Lower Holloway. Highbory. Barnsbury. South-East. 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. i. a. b. c. d. a. b. c. d. a. b. c. d. a b. e. d. a. b. c. d. a. b. c. d. 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 41,433 1,179 688 193 59,540 1,463 898 202 54,457 1,788 1,033 253 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 1905 33,622 758 483 96 35,607 1,067 550 108 35,549 809 428 95 41,642 1,118 644 169 66,336 1,303 837 153 54,091 1,706 897 212 76,147 1,995 1,116 241 1906 34,028 746 432 91 36,012 1,061 542 111 35,954 747 425 95 41,696 1,118 721 173 66,968 1,348 779 128 53,995 1,679 967 232 76,334 1,960 1,184 253 1907 34,441 745 482 95 36,425 1,023 559 90 36,367 755 480 100 41,751 1,094 644 162 67,612 1,278 816 137 53,897 1,709 949 211 76,524 1,927 1,149 201 1908 34,863 816 425 66 36,847 1,027 485 76 36,788 728 396 85 41,807 1,067 571 134 68,271 1,416 816 143 53,797 1,625 885 193 76,718 1,986 1,101 197 Averages 1902-8 33,639 764 475 91 35,623 1069 543 105 35,566 778 452 101 41,644 1,108 658 165 66,362 1,388 823 150 54,082 1,685 943 223 76,155 2,006 1,173 243 1909 35,292 759 440 81 37,276 993 558 77 37,217 705 430 68 41,865 1,084 617 110 68,941 1,301 793 121 53,695 1,493 872 166 76,916 1,863 1,208 218 Notes.—(a) The separate localities adopted for this Table are registration sub-districts. (b) Deaths of residents occurring in public institutions beyond the district are included in sub-columns c of this Table, and those of non-residents registered in public institutions in the district excluded. (c) Deaths of residents occurring in public institutions whether within or without the district are allotted to the respective localities, accoiding to the addresses of the deceased. (d) Care is 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 ot columns a, b, and c 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 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. 329 [1909 LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Cases of Infectious Disease coming to the knowledge of the Medical Officer of Health during the year 1909. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At Ages—Years. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 8 At all Ages. Under 1. 1 to 5. 5 to 15. 15 to 25. | 25 to 65. 65 and upwards. Tufnell. Upper Followay Tollington. Lower Holloway Highbury. Barnsbury. South-East Tufnell. Upper Holloway. Tollington. Lower Holloway Highbury. Barnsbury. South-East Total cases removed to Hospital. Small-pox 3 •• •• 1 •• 2 •• •• •• 3 •• •• •• •• •• •• 3 •• •• •• •• 3 Cholera •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Diphtheria (including Membranous Croup) 430 11 167 195 34 23 •• 53 65 29 49 61 81 92 39 58 28 46 50 76 91 388 Erysipelas 221 10 8 14 23 135 31 23 22 23 26 46 35 46 8 6 2 5 1 7 9 38 Scarlet Fever 1285 14 351 791 81 48 •• 155 149 126 206 259 191 199 136 143 122 194 227 185 192 1.199 Typhus Fever 1 •• •• 1 •• •• •• •• •• •• •• •• •• 1 •• •• •• •• •• •• 1 1 Enteric Fever 95 •• 6 23 24 41 1 4 13 2 14 17 23 22 •• 7 1 14 13 21 16 72 Relapsing Fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Continued Fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Puerperal Fever 14 •• •• •• 5 9 •• 2 •• 3 2 3 1 3 •• •• 1 •• ••i •• 2 4 Plague •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Totals 2049 35 532 1025 167 258 32 237 249 186 297 386 331 363 183 214 157 259 292 289 311 1,705 330 1909] local government board return—tABLE iv, Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING YEAR, 1909. Causes of Death Deaths of Residents at subjoined Ages, whether occurring in or beyond the District. Deaths of Residents (at all Ages) belonging to Localities whether occurring in or beyond the District. 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 Tcllington. Lower Holloway. Highbury. Barnsbury. South-East Islington. 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 Small-pox •• •• •• •• •• •• •• •• •• •• •• •• Measles 197 31 156 10 •• •• •• 13 29 8 37 25 17 68 54 Scarlet Fever 25 1 19 4 •• 1 •• 1 3 2 3 5 6 5 8 Whooping Cough 86 36 48 2 •• •• •• 2 4 10 11 11 16 32 26 Diphtheria and Membranous Croup 31 1 23 6 •• 1 •• 3 2 4 5 4 5 8 2 cCroup •• •• •• •• •• •• •• •• •• •• •• •• •• Fever Typhus •• •• •• •• •• •• •• •• •• •• •• •• •• Enteric 12 •• 1 1 •• 9 1 •• 1 •• 1 4 2 4 5 Other ued •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Epidemic Influenza 70 1 •• 1 2 31 35 7 14 7 7 17 4 14 12 Cholera •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Plague •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Diarrhœa 67 46 12 1 •• 6 2 7 4 1 12 12 16 15 13 Enteritis 54 26 11 •• 1 9 7 7 •• 3 13 0 11 12 15 Gastritis 39 23 3 •• •• 7 6 6 6 2 5 10 5 5 21 Puerperal Fever 7 •• •• •• 1 6 •• 1 •• 1 • • 2 1 2 2 Erysipelas 12 4 •• •• •• 5 3 •• 4 2 2 1 2 1 7 Phthisis (Pulmonary Tuberculosis) 424 1 11 10 45 333 24 39 56 32 50 57 81 109 268 Other Tuberculous Diseases 158 45 71 16 5 20 1 11 17 15 20 20 24 51 31 Cancer, Malignant Disease 353 •• •• 3 3 212 135 44 36 43 47 55 64 64 148 Bronchitis 534 55 21 1 1 167 289 48 55 47 60 94 89 141 174 Pneumonia 476 106 101 10 13 161 85 40 40 43 71 84 82 116 105 Pleurisy 29 3 3 1 1 19 2 1 3 3 7 5 3 7 12 Other Diseases of Respiratory Organs 48 3 6 •• •• 32 7 5 6 2 7 8 8 12 27 Alcoholism Cirrhosis of Liver 59 •• •• •• •• 48 11 6 3 1 6 8 19 16 13 Venereal Diseases 15 10 •• •• •• 5 •• 1 •• •• 3 6 5 •• 5 Premature Birth 137 136 1 •• •• •• •• 10 20 8 12 15 32 40 3 Diseases and Accidents of Parturition 20 •• •• •• 4 14 2 2 3 3 •• 4 5 3 10 Heart Diseases 661 6 4 22 30 294 305 53 81 5o 69 122 114 172 159 Accidents 147 43 16 9 6 41 32 5 11 15 24 21 29 42 47 Suicides 42 •• •• •• 3 36 3 6 4 2 6 5 9 10 15 Homicides 4 3 •• •• •• 1 •• •• •• •• •• 1 •• 3 •• All other causes 1211 261 53 43 29 367 458 122 156 126 139 189 223 256 491 All causes 4918 841 560 140 144 1825 1408 440 558 430 617 793 872 1208 1673 331 [1909 LOCAL GOVERNMENT BOARD RETURN.—TABLE V. Metropolitan Borough of Islington. INFANTILE MORTALITY DURING THE YEAR 1909. Deaths from stated Causes m Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7 8 Months 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes Certified 156 52 26 35 269 83 64 44 58 46 55 34 55 45 40 48 841 Uncertified •• •• •• •• •• •• •• •• •• •• •• Common Infectious Diseases. Small-pox •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Chicken-pox •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Measles •• •• •• •• •• •• •• 1 1 1 3 1 3 8 6 7 31 Scarlet Fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• 1 Diphtheria (including Membranous Croup) •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• 1 Whooping Cough •• •• 1 •• 1 3 •• 2 2 5 4 3 5 5 3 3 36 Diarrhœl Diseases. Wasting Diseases. Diarrhœa all forms •• •• •• •• •• 2 3 6 10 2 7 5 3 1 5 2 46 Enteritis, Muco-enteritis, Gastroenteritis •• 1 1 1 3 4 4 2 4 1 2 •• 1 2 •• 3 26 Gastritis, Gastro-intestinal Catarrh •• 3 2 •• 5 2 2 2 2 3 3 •• 1 2 1 •• 23 Premature Birth 86 18 7 7 118 10 1 •• 1 2 1 2 1 •• •• •• 136 Congenital Defects 27 8 2 2 39 5 1 2 2 1 •• 1 •• 1 •• •• 52 Injury at Birth •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Want of Breast-milk, Starvation •• •• •• •• •• 2 2 •• •• •• •• •• •• •• •• •• 4 Atrophy, Debility, Marasmus 25 10 5 6 46 25 16 10 17 1 4 7 2 3 2 •• 133 Tuberculous Meningitis •• •• •• •• •• 3 •• 1 3 2 2 1 •• 5 2 1 18 Tuberculous Diseases. Tuberculous Peritonitis: Tabes Mesenterica •• •• •• •• •• 1 2 3 3 2 3 •• 4 •• 1 1 20 Other causes. Other Tuberculous Diseases •• •• •• 1 1 •• •• •• •• 1 1 •• 2 2 1 •• 8 Erysipelas •• •• •• •• •• •• 1 •• 1 1 •• •• 1 •• •• •• 4 Syphilis •• 2 1 1 4 3 1 •• 1 1 •• •• •• •• •• •• 10 Rickets •• •• •• •• •• •• •• •• •• 1 •• •• •• •• •• •• 1 Meningitis (not Tuberculous) •• •• •• •• •• •• •• •• •• 1 2 3 2 3 •• •• 11 Convulsions 4 1 1 1 7 2 1 •• •• •• 1 •• •• •• •• 3 14 Bronchitis •• •• 1 3 4 7 5 2 1 8 4 2 10 3 5 4 55 Laryngitis •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• •• 1 Pneumonia 1 4 3 4 12 5 11 6 3 9 11 7 11 5 11 15 106 Suffocation, overlying 2 •• 1 4 7 4 9 3 3 •• •• •• 1 •• •• •• 27 Other Causes 11 5 1 5 22 5 5 4 4 4 7 2 7 6 2 9 77 Totals 156 52 26 35 269 83 64 44 58 46 55 34 55 45 40 48 841 Births in the year{legitimate .. 7,948} Deaths in the year of {legitimate infants .. 744 Population. {illegitimate .. 250 {illegitimate infants .. 67 Estimated to middle of 1908. Deaths from all Causes at all Ages .. 4,918 351,202. 332 1909] LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1909. PREMISES. Number of Places— Number of inspections, 1909. Number of Notices. 1909. Number of Prosecutions 1909. On Register at end of 1908. Added in 1909. Removed in 1909. On Register at end of 1909. Milk premises 573 38 24 587 2231 355 Nil Cowsheds 7 ... ... 7 ... ... „ Slaughter-houses Other offensive trade 34 ... ... 34 ... ... „ premises 7 ... ... 7 ... ... „ Ice cream premises 230 ... ... 230 167 22 „ Registered houses let in lodgings ‡ ... ... ... 10555 (a)* 79 (a)* Nil (6)† 1214 (b)† 3 * (a) For overcrowding. †(b) For other conditions. ‡ No Register now kept under new By-Laws. Total number of intimation notices served for all purposes 5304 Overcrowding, 1909. Number of dwelling rooms overcrowded 148 Number remedied 148 Number of prosecutions — Underground rooms— Illegal occupation dealt with during year 1 Number of rooms closed 16 Number of prosecutions 1 Insanitary houses— Number closed under the Public Health (London) Act, 1891 - Number closed under the Housing of the Working Classes Act - Number of premises cleansed under Sec. 20 of the L.C.C. (General Powers) Act, 1904 124 333 [190 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 40 Revenue Acts— Number of houses for which applications were received during year 8 Number of tenements comprised therein 78 Number of tenements for which certificates were (a) granted 31 (b) refused 47 (c) deferred nil Number of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive matter running 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. 2 (f) As to cesspools and privies, removal and disposal of refuse, etc. 1 (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. 2 (i) With respect to sufficiency of water supply to water closets — (j) 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) 1 Number of prosecutions under L.C.C. General Powers Act, 1907— (/) With respect to Water Supply to Tenement Houses 4 Mortuaries— Total number of bodies removed 592 Total number of infectious bodies removed 1