614 (06) AC 4361 W ISL 18 1916. SIXTY-FIR ST 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. 1917. 1916. SIXTY-FIRST 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. 1917. ii MEMBERS OF THE PUBLIC HEALTH COMMITTEE (November, 1915, to November, 1916.) Mayor. Alderman GEORGE SAMUEL ELLIOTT, J.P. Aldermen. WILLIAM ELLIOTT ROBERT STEPHENS CUFFLIN* Councillors. Ward 1. ROBERT JAMES GANN 1. REUBEN LOOMES 2. THOMAS B. MADGETT 3. HAROLD E. BUTCHER 3. WILLIAM J. SMITH 4. ROSA ESSEX 4. WALTER C. BYERS 4 GEORGE STRAPP Ward 5. THOS. LUKE HARWOOD 6. WM. MASON BRADBEAR 7. JAMES GRIFFITHS 7. GEORGE A. BRETT 8. MATILDA SOUTHGATE 10. HENRY MILLS, J.P 11. GEORGE DOLAN Chairman Councillor THOMAS LUKE HARWOOD Vice-Chairman Councillor WM. J. SMITH *Died 13th March 1916. iii. INDEX. Page Adulteration of Food 66 Ages at Death 9 Analyst's quarterly reports 71 Appendicitis 29 Area of Borough 2 Bacteriological Examinations 52 Bakehouses 57 Births 3 „ Illegitimate 6 „ notification of 6 „ Stillborn 6 Bronchitis 35 Butchers' Shops and Shops where food is sold 65 Butchers' open window stalls 65 Butter and Margarine 69, 70 Cancer 31 Cleansing of Verminous School Children 56 Constitutional Diseases 31 Cow Houses 65 Deaths 7, 78-80 „ from Classified Causes 10 ,, at different age periods 9 ., in the Quarters 8 „ „ Sub-Districts 8 „ „ Wards 9 „ from Epidemic Diseases 25-27 Deaths registered from all causes during the Year 78-80 Deaths in Public Institutions 24 Density of Borough 2 Diarrhœal Diseases 26-27 Diphtheria 26, 38 „ Notification of 38 Disinfectants distributed and used 56 Disinfecting Station 54, 55 Disinfection Work 47, 54 District Inspectors' Work 61 Dust, removal of 64 Enteric Fever, deaths from 26 „ Notification of 38 Epidemic Diseases 25, 38 ,, Cerebro-spinal Meningitis 44 iv. Page Erysipelas 29 „ Notification of 39 Factories and Workshops 57-61 Fatality from Infectious Diseases 42, 43 Food, Adulteration of 66 Food Inspection 65 Home Work 60 Hospital Isolation of Infectious Diseases 42 Illegitimate Births 6 Infant Mortality 11-24 Infant Welfare Work 17 Infectious Diseases in Schools 51 „ „ (Non-notifiable) in Schools 52 Influenza 28 Inspection of Food 65 „ Kitchens of Restaurants 57 „ Slaughter Houses and Cow Houses 65 Inquests 37 Isolation of Infectious Diseases 42, 43 Local Government Board Returns 81. 82 London County Council Return of Sanitary Work 83, 84 Margarine Act 70 Marriages 2 Measles 26 „ Notification of 52 Meat Inspection 65 Midwives attending Disinfecting Station 56 Milk and Cream Regulations 1912 68 Miikshops, Registration of 66 Milk Adulteration 67, 68 Milkshopsand Dairies 66 Mortality in Sub-Registration Districts 8 Mortuary and Coroner's Court 37 Notification of Infectious Diseases 38-43 „ „ ,, „ in Registration Sub Districts 41 „ „ „ „ in the Wards 41 „ „ Tuberculosis 45 ,, ,, Births Act 6 Non-notifiable Infectious Diseases in Schools 52 Offensive Trades 65 Ophthalmia Neonatorum 45 Outworkers' Premises 57 Pauperism 64 Persons to an Acre 2 Phthisis 33, 45 „ Notification of 45 Places where Food is prepared 65 Pneumonia 35 V. Page Population—Estimated in 1916 1 „ in Sub-Districts 2 Prosecutions, Summary of 77 Puerperal Septic Diseases 29 Puerperal Fever 30 „ „ Notification of 39 Polio-myelitis Acute 44 Pulmonary Tuberculosis 33, 45 Respiratory Diseases 35 Restaurant Kitchens 57 Samples analysed in 1915 66-76 Sanitary Inspectors' Work 61, 63 Scarlet Fever 26 „ Notification of 38 Septic Diseases 29 Shelter House 56 Slaughter Houses 65 Small Pox 26 „ Notification of 38 Smoke Nuisances 62 Summary of Sanitary Work in fourteen Districts 61 „ ,, Applications for Removal of Dust 64 Tubercular Diseases 33, 45 Tuberculosis Dispensary 48 Tuberculosis, Pulmonary, Notification of 45 Typhus Fever 39 Unsound Food 65 Unsound Fish 65 Vaccination 53 Venereal Diseases 36 Verminous Persons 56 ,, Children, Cleansing of 56 Verminous Premises 62 Voluntary Infant Welfare Centres 18 Whooping Cough 26 Workshops and Factories, Inspection of 57-61 vi. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1916. To the Worshipful the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. Dear Mr. Mayor, Aldermen and Councillors, In presenting my Annual Report I have to regret its late appearance, due to printing difficulties, which, I understand, were unavoidable. The amount of work by the staff shown in the report is not so great as usual, but this is due to the fact that five of the inspectors are away at the War, besides one death vacancy. Arrears of work are accumulating, and therefore it will become necessary to replace them by the appointment of temporary inspectors, as so many other boroughs have been compelled to do in similar circumstances. The chief feature in the Report is that which deals with the growing interest which is now taken, not only by the public itself, but by the Council, in Child Welfare. That is well proved not only by the appointment of Health Visitors but by the subscriptions given to the three Welfare Centres by the Council. These incidents bear strong testimony to the fact, which has afforded me the greatest pleasure, that the Council have at length fallen into line with all the great Sanitary Authorities of the Kingdom. Attention to Child Welfare means the saving of children's lives in large numbers and is more important now than at any previous time in British history. Indeed the nation at last fully realises it, and the mothers—even the poorest—are taking deeper interest in the welfare of their babies than they have previously done. vii. So that the Council may understand what is being effected in Islington, I have devoted several pages (17-24) of the Report to Infant Welfare Work, where there is given an account of the North, South and West Islington Infant Welfare and Maternity Centres. They are all doing very good and beneficent work, and are worthy of all the pecuniary and other assistance which can be given them. The ladies who are conducting them so zealously are giving their time and labour, and even money, freely, in carrying on a work which rightly and properly devolves on the Sanitary Authority itself, and which many Sanitary Authorities are now undertaking as part of the health administration of their boroughs. Indeed, if any of these local institutions should fail for want of sufficient pecuniary support, it is quite possible, nay, it is almost certain, that the Local Government Board would call on the Council to continue the work. East Islington does not possess a Centre, but I am glad to know that an effort is now being made by some ladies interested in work of this character to establish a Welfare Centre there, where one is very much needed. In issuing this Report I cannot refrain from expressing my very great regret, and, indeed, that of the entire Staff of the Public Health Department, at the loss we have sustained by the death of Alderman Robert Stephens Cufflin, who for fourteen years presided over the Public Health Committee, was a member of it for twenty-five years, and under whose guidance the Public Health Department grew and prospered, until it became a real power for good in the Borough. He was ever its friend and kindly critic, for while he was never blind to its deficiencies, he was always most anxious to enlarge its sphere of usefulness to the public, although he never advocated new departures without first studying the proposals from their pecuniary, legal, and health aspects. He was, therefore, a successful administrator because of these qualities, and also because he never allowed politics, strong Conservative though he was, or expediency to take the place of right or justice. Consequently, when the reports of the Public Health Committee came to be considered in the Council he was listened to attentively, while his arguments carried great weight and generally conviction. Islington was indeed fortunate in possessing such a guide in 1892, when the Public Health (London) Act, 1891, came into force, and afterwards when its provisions and the by-laws made under it were first enforced, and it suffered an equally great misfortune when he died, the blow being all the heavier because he was in the hey-day of his intellectual powers, which were considerable, while his bodily strength seemed to indicate that he had years of life before him. At the outbreak of the war he undertook most heartily many of the duties which viii. fell to the lot of Islington's public men, so that he was engrossed in public work night and day, under the strain of which he broke down, developing double pneumonia, from which he died, after a very brief illness, on 13th March, 1916, most deeply regretted and respected by everyone who had been privileged to know him, and by none more than by the young men and boys of St. Mary's Church and Schools, among whom he was as a boy among boys, encouraging them in their games, whether football, hockey or cricket, as he believed fully in the old tag, mens sana in carpore sano, which to-day is the cry of all our leading educationists. His life was one long round of activities; he was always doing something for poor suffering humanity, not publicly or ostentatiously, but quietly and unobtrusively, not letting his left hand know what his right hand was doing, Indeed, I, who knew him so well, have only recently learned of many of his good works. These showed that under a rather austere presence beat a very generous and kindly heart. To the last he lived a full life most of which was spent in doing good. I am, Your faithful servant, September 15th, 1917. Medical Officer of Health. 1 [1916 REPORT OF THE Medical Officer of Health FOR THE YEAR 1916. Population.—The Registrar-General has given two estimates of the population of the Borough for the year 1916. One is inclusive of the men who have joined the Army, and the other only of those persons, men and women, who remained at home. On the former statistic the birth rate has been calculated, and on the latter, the death rate. They are as follows:— Population (inclusive of military) 336,589 „ (non-inclusive of military) 309,359 The larger figure is the total population, based on the assumption that the ratio between the total and the civilian population is the same in the borough as in England and Wales as a whole. With a view to approximation to the population amongst which the births have occurred, the total population of England and Wales for this purpose has been calculated by adding to the estimate for 1914, the natural increase up to the middle of the year 1916. Probably neither estimate is correct, for it is inconceivable that the population, which at the census numbered 327,403 and was on the downward grade, should since the war began have begun to increase. The figures, in the opinion of the Medical Officer of Health, are unreliable in both cases, but the more reliable are those which do not include the military. He thinks this unreliability is clearly indicated by the fact that whereas in 1911, the year in which the census was taken, and, therefore, the year when calculations could be made on an almost exact population, the marriages numbered 2,843, and the persons married rate, commonly called the marriage rate, was 17.37, yet in 1916, although the number of persons married was 8 per cent, more, the marriage rate was increased by only 5 per cent. Clearly then, there must be an error in the figures on which the rates have been calculated. Hence after the war, or whenever the next census is taken, they must be carefully reviewed and corrected. 2 1916] Showing the Areas, Densities, and Estimated Populations of the Sub-registration Districts at the middle of the year 1914. Sub-Districts. Area in Acres Estimated Acres to a person, 1914. Estimated Persons to an Acre, 1914. Estimated Population Mid-year 1914. Population at Census 1911. Increase or Decrease on Census. Tufnell 411 0.0121 83 33,920 33,526 +394 Upper Holloway 299 0.0079 127 37,930 37,116 +814 Tollington 315 0.0107 94 29,768 30,609 -841 Lower Holloway 414 0.0107 94 38,837 39,362 -525 Highbury 754 0.0132 76 57,269 62,004 -4,735 Barnsbury 310 0.0059 170 52,648 53,011 -363 South-East Islington 589 0.0078 128 75,124 71,775 +3,349 The Borough 3,092 0.0095 105 325,496 327,403 -1,907 MARRIAGES. Marriages, 3,080; Marriage Rate, 18.30.—The number of persons married was 6,160, as contrasted with 8,504 in the preceding year, which is a decrease of 2,444. The marriage rate was 18.30 per thousand inhabitants, as compared with 26.12 in 1915. The following statement shows the figures for the previous ten years 1906-15, and in 1916. Years. Marriages. Marriage Rate. 1906 2,964 I7.91 1907 2,962 17.94 1908 2,781 16.56 1909 2,769 16.84 1910 2,870 17.50 1911 2,843 17.37 1912 3,091 18.94 1913 2,984 17.98 1914 3,188 19.59 1915 4,252 26.12 1916 3,080 18.30 3 [1916 Showing the number of Persons Married and the Marriage Rates in each quarter of 1916 and in 1915. Quarters. No. persons married. Persons married per 1,000 inhabitants. 1916. 1915. 1916. 1915. First 1,564 1,208 18.58 14.84 Second 1,700 2,298 20.20 28.23 Third 1,390 2,482 16.52 30.50 Fourth 1,506 2,516 17.90 30.91 The Year 6,160 8,504 18.30 26.12 BIRTHS. There were 7,262 births registered, of which 3,821 were boys and 3,441 girls. All these children, although borne by mothers living in Islington, were not, however, born in the Borough, for 251 occurred in the Lying-in Hospital, Finsbury; and 183, which were afterwards notified to the Medical Officer of Health by the Registrar-General, occurred in various other places. The annual birthrate was equal to 2T57 of the population as compared with a mean birth-rate of 25.29 in the preceding ten years. 4 1916] Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1916, 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 1915; together with the mean Borough Birth-rates for the years 1906-1915. Quarter. Males. Females. Total. Birth Rates. Islington, 1916. Islington 1906-15. London, 1916 96 Great Towns, 1916 First 895 851 1,746 20.75 26.18 23.1 24.4 Second 1,010 899 1,909 22.69 25.38 25.4 24.7 Third 910 822 1,732 20.58 24.63 22.9 23.2 Fourth 890 802 1,692 20.11 24.12 22.1 21.5 The Year 1916 3,705 3,374 7,079* 21.03 25.29 23.0 23.0 1915 3,852 3,685 7,537 23.15 21.03 22.6 22.8 Increase or decrease -147 -311 -458 -2.12 -4.26 +0.4 +0.2 * In addition to these 7,079 births the Registrar-General transferred 183 to Islington The total births are therefore 7,262 = 21.57 per 1,000 inhabitants. 5 9161] Showing the Births of Males and Females in each quarter and for the year, 1916, and in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington South-East. The Borough Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Qr. 106 86 192 95 89 184 88 87 175 122 121 243 114 114 228 163 167 330 207 187 394 895 851 1,746 2nd ,, 85 83 168 120 95 215 99 72 171 113 101 214 151 137 288 179 169 348 263 242 505 1,010 899 1,909 3rd „ 97 77 174 89 110 199 90 61 151 126 113 239 130 127 257 169 133 302 209 201 410 910 822 1,732 4th „ 90 74 164 100 82 182 63 64 127 108 97 205 131 133 264 176 151 327 222 201 423 890 802 1,692 Year 378 320 698 404 376 780 340 284 624 469 432 901 526 511 1,037 687 620 1,307 901 831 1,732 3,705 3374 7,079* * Vide note to Table on p. 4. 6 1916] Illegitimate Births. Illegitimate Births, 289—The number of illegitimate births shows an increase of 18 as contrasted with 1915, and is below that registered in 1914; it is equal to a rate of 3.98 per cent. of the total births. The number of births and the percentage of illegitimate births per 100 registered births during each of the preceding years have been as follows:- Years. No. of Illegitimate Births. Total Births. Illegitimate Births per 100 Registered Births. 1913 297 8,359 3.55 1914 304 8,177 372 1915 271 7,537 3.59 1916 289 7,262 3.98 These figures do not indicate that there has been any increase in illegitimacy since the war began—rather the contrary—and entirely disposes of the "war babies" scare. Notification of Births Act, 1907.—6,319 notifications were received and represent 87 per cent. of the total number of births registered. These are a decrease of 164 on the return for 1915. The following table gives the number of births notified under this Act by medical practitioners, certified midwives, and other persons in the several sub-registration districts. Sub-Registration District. Doctors. Certified Midwives. Parents and Other Persons. Total. Still born. Alive. Still born. Alive. Still born. Alive. Still born. Alive. Tufnell 4 76 13 303 4 266 21 645 Upper Holloway 5 69 13 397 2 211 20 677 Tollington 2 27 8 299 5 186 15 512 Lower Holloway 6 115 20 428 10 247 36 790 Highbury 7 218 11 291 11 410 29 919 Barnsbury 1 30 12 519 18 565 31 1,114 South-East 2 159 24 781 9 535 35 1,475 Borough 27 694 101 3,018 59 2,420 187 6,132 Total for year 721 3,119 2,479 6,319 CHART Showing Death-rafe for each Year 1841-1916 (75 Years) 7 [1916 In the preceding years the figures were as follows:— Births. Notifications. Failures to notify. Per cent. notified. Per cent. of Failures to notify 1908 (From July 16th) 3,967 3,211 756 80.9 19.1 1909 8,198 6,983 1,215 85.2 14.8 1910 8,201 7,407 794 90.3 9.7 1911 8,113 7,232 881 89.1 10.9 1912 8,211 7,238 973 88.1 11.9 1913 8,359 7,245 1,114 86.7 13.3 1914 8,177 7,121 1,056 87.1 12.9 1915 7,537 6,483 1,054 86.o 14.0 1916 7,262 6,319 943 87.0 13.0 DEATHS. These numbered 4.751, or 177 less than the average of the ten years 1906-15 (4.928); and were equal to a death-rate of 15.35 per 1,000 of the civil population, as compared with a mean decennial rate of 15.08. The death-rate is 10 above that of London, in which it was 14.3 per 1,000, and 0.9 above that of the great towns, wherein it was 14.4. The highest mortality occurred in the first quarter of the year when the deaths numbered 1,357, and were equal to an annual death-rate of 17.55 per 1,000 of the civil population, while the lowest was recorded in the third quarter, viz., 869 deaths, representing a death-rate of 11.23 per 1,000 annually. 8 1916] Showing the Deaths and Death Rates of Islington in 1916, and in the four quarters of the year, and of the County of London and the Great Towns during the same period, the mean Borough Death-Rates for the years 1906-15, and the deaths and death-rates in the year 1915. Quarter. Males. Females. Total. Death Rates. Islington, 1916 Islington, 1906-15. London, 1916. 96 Great Towns, 1916. First 681 676 1,357 17.55 18.04 16.0 16.5 Second 612 592 1,204 15.57 13.80 13.8 14.3 Third 470 399 869 11.23 12.61 11.1 11.4 Fourth 634 687 1,321 17.08 15.89 16.2 15.6 The Year 1916 2 397 2,354 4,751 15.35 15.08 14.3 14.4 1915 2,842 2,681 5,523 17.46 15.35 16.1 15.6 Increase or Decrease -445 -327 -772 -2.11 +0.27 -1.8 -1.2 Locally the Deaths from All Causes in the Sub-registration Districts were as follows:— Sub-Districts. Quarters. The Year. 1 2 3 4 Tufnell 147 106 75 108 436 Upper Holloway 169 137 107 155 568 Tollington 141 94 81 I20 436 Lower Holloway 160 153 112 176 601 Highbury 201 179 136 2l6 732 Barnsbury 234 240 158 239 871 Islington (South-East) 305 295 200 307 1,107 The Borough 1,357 1,204 869 1,321 4,751 9 [191G In the Wards the Death Returns were as follows :— WarJs. Quarters. The Year. 1 2 3 4 Tufnell 147 106 75 108 436 Upper Holloway 169 137 107 155 568 Tollington 141 94 81 120 436 Lower Holloway 160 153 112 176 601 Highbury 121 107 88 137 453 Mildmay 80 72 48 79 279 Thornhill 142 154 90 136 522 Barnsbury 92 86 68 103 349 St. Mary's 62 64 59 57 242 Canonbury 140 100 81 128 449 St. Peter's 103 131 60 122 416 The Borough 1,357 1,204 869 1,321 4,751 Ages at Death.—The following statement gives the ages at which persons died in the borough, and contrasts them with the returns for the preceding ten years. These deaths include two female centenarians, each of whom died at the advanced age of 101 years during the first and second quarters of the year respectively. Ages. Number of Mean Deaths Increase or Deaths. (to years), decrease on 1906-15. mean. o—i year - - 634 - 889 - - 255 x—5 years 399 - - 504 - - 105 5—15 „ - 168 - - 161 + 7 15—25 - 172 - - 167 - - + 5 25—35 » 243 ■ - 263 - 20 35—45 » 324 - * 39° - ~ 66 45—55 » - 535 - - 527 - - + 8 55—65 „ - 650 - - 629 - - + 21 65—75 .. 805 - - 716 - - -t- 89 75—85 .. - 642 - - 527 - - + 115 85 upwards - 179 - - 155 - - +24 4,75i 4.928 - 177 1916] 10 This return shows a considerable decrease in the early years of life, for, compared with the average record of the preceding ten years, the number under 5 years was 360 less, of which 255 occurred among infants under twelve months old, and 105 among children aged one to four years (inclusive). The number of deaths among infants is the lowest registered for many years, as the Table on page 13 fully proves. Causes of Death (Classified).—The following table shows the deaths arranged in classes from All Causes during the ten years 1906-15, and in 1916. Classified Causes of Death. Years. Mean 10 years. 1916 Difference. 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1. Specific or Febrile Causes 699 590 508 548 539 722 397 448 572 616 564 380 -184 1. Miasmatic Diseases 420 416 326 426 403 330 300 284 299 450 366 268 -98 2. Diarrhœal 213 103 117 67 76 326 36 99 174 94 130 56 -74 3. Malarial ... 1 ... ... 1 ... 1 ... 1 ... ... ... ... 4. Zoogenous 5 2 1 ... 1 ... ... 4 2 ... 2 3 +l 5. Venereal 16 16 20 15 15 13 17 19 21 23 17 15 -2 6. Septic 45 52 44 40 43 52 43 42 75 49 49 38 -11 II. Parasitic Diseases ... ... 4 1 1 2 ... 1 ... ... l 1 ... III. Dietic 22 40 26 27 11 18 19 17 11 36 23 3 -20 IV. Constitutional Diseases 1042 1041 1048 1032 989 957 1023 1032 1056 1131 1035 1095 +60 V. Developmental 401 420 398 411 382 429 396 468 515 554 437 522 +85 VI. Local 2524 2662 2379 2564 2303 2401 2500 2718 2488 2839 2537 2457 -80 1. Diseases of Nervous System 343 322 270 297 282 277 260 376 363 418 321 339 +18 2 ,, Organs of Special Sense 9 10 11 10 7 16 4 20 14 17 12 12 ... 3. ,, Circulatory System 696 697 619 661 645 642 754 733 660 721 683 669 -14 4. ,, Respiratory 914 1136 927 1087 870 858 980 958 896 1141 977 1006 +29 5. „ Digestive „ 347 298 311 282 280 342 290 362 304 319 313 233 -80 6. ,, Lymphatic „ 5 12 11 17 9 10 6 10 15 9 10 16 +6 7. ,, Urinary ,, 157 131 180 174 177 220 166 213 193 181 179 149 -30 8. ,, Reproductive ,, 32 33 30 20 17 12 25 26 18 18 23 24 +1 9. ,, Bones and Joints 14 11 12 11 19 12 10 6 10 8 11 9 -2 10. ,, Integumentary System 7 12 8 5 6 5 5 14 15 7 8 ... -8 VII. Violence 215 181 169 193 194 213 227 195 201 222 201 182 -19 1. Accident or Negligence 168 133 124 147 138 167 177 157 165 182 156 155 -11 2. Homicide 6 5 7 4 6 4 5 3 3 3 5 4 - 1 3. Suicide 41 43 38 42 48 42 45 34 33 37 40 23 -17 4. Execution ... ... ... ... 2 ... ... 1 ... ... ... ... ... VIII. Ill-defined Causes 147 145 147 142 104 124 120 149 98 125 130 111 -19 All Causes 5050 5079 4679 4918 4523 4866 4682 5028 4938 5523 1928 4751 -177 11 [1910 INFANTILE MORTALITY. Infant Deaths, 634; Mortality Rate, 87.—There were 634 deaths among infants under twelve months old during the year, or 255 below the decennial average (889), and they represented an infant mortality rate of 87 per 1,000 infants born. This rate is 20 per 1,000 below the mean annual record of the preceding ten years, and with one exception (86 per 1,000 in 1912) is the lowest rate hitherto recorded. The gradual decrease in recent years in the infant mortality of the country is the subject of a leading article in its issue of Whit Monday of the "Daily Telegraph," in which it states that, "during the last fifteen years, during which attention has been paid to maternal and infant welfare, the mortality amongst infants has decreased by nearly one-third, and mortality amongst women from circumstances connected with childbirth by rather more than one-fourth. We are therefore encouraged to make more strenuous efforts, and supplied with adequate reasons for hope. We see what the evil is; we have already discovered some means of combating it, and we know also that there has been an immense decrease in the avoidable maternal suffering. It need scarcely be added that the unprecedented circumstances of the war have given an additional stimulus to the supreme importance of the subject. The value of population has never been so appreciated as it is to-day. If we had been more careful for the last fifty years to prevent the unheeded waste of infant life we should now have had at least half-a-million more men available for the defence of the country." This last sentence may express the military point of view, which, though a practical one, is, nevertheless, a very poor reason in a Christian country. It would have been far better if the case had been based on the view which Charles Dickens, who loved children and hated to see them suffer, would have no doubt taken, that is the humanitarian one. He would have pointed out that many thousands of infants, not only in London but throughout our country, come into the world half developed, tortured with preventable pain and shorn of their natural capacity for health and enjoyment. He would, as he has done, reminded us of that delightful paper on "Dream Children" written by Charles Lamb, once a citizen of Islington, and then he would have conjured up before us, as he has before others, the dream children we love, the dearer dream children we have lost, the children we might have had, the children we certainly have been; and he would have told us how each of these dream children should hold in its pleading hand one of the little children now lying in some charitable Institution, or perishing in some mean home, and each of these dream children should say to us, "O help this supplicant in my 12 1916] name; O help it for my sake." But he never would have said to us, "O save the children because they will be necessary to fight our battles in the next generation." Such a motive would be unworthy of so great, so noble a cause, and is one of which so generous and so humanitarian—so Christian—a nation as ours should be ashamed. Rather let it be that which caused the Founder of our Religion to "touch" the infants who were brought to Him and whom His disciples would have driven away. Just now, when the prevention of infant mortality occupies so much public attention, it would be as well to analyse at least briefly the ages at which infants die in the first year of life. This has been done in the Table which immediately follows, wherein it is found that in the ten years 1907-1916, 1,710, or slightly more than one-fifth of all the infants born, die during the first week of life. Now most of these die from pre-natal causes, very many of which are entirely preventable, and it is, therefore, for this reason that efforts are made, and will be more strenuously made to get into touch with the mothers, especially young mothers, in the early periods of their pregnancies. In the same period 470 died in the first to second week of life, 358 in the second to third week, and 312 in the third to fourth week, making together 2,850, or just one-third of the deaths of infants in the first four weeks of their existence, which is an unpardonable waste of life, as it is due largely to, for the most part, preventable ante-natal causes. During the next two months 1,603 deaths are recorded, making in all 4,453, out of 8,444, deaths, or 52.7 per cent. of all the deaths in the first year of infant life, which shows how necessary it is to reach the mother before birth and the infants as soon as they are born, so that they may receive the assistance of a sympathetic, an advising, and a healing hand. During the second three months (3—6) the number of deaths falls to 1,561; in the third three months (6—9) it is 1,241, while in the fourth period (9—12) it is 1,189. 13 [1916 Infantile Mortality during each of the Ten Years 1907-16. Deaths at various Ages under One Year of Age. Years. Under 1 week. Weeks. Total under 4 weeks. Months. Total Deaths uuder 1 year. 1-2 2-3 3-4 4 weeks and under 3 months. 3-6 6-9 9-12 1907 187 58 51 34 330 189 169 167 141 996 1908 186 52' 33 39 310 180 151 126 127 894 1909 156 52 26 35 269 147 148 144 133 841 1910 163 45 41 29 278 131 144 106 118 777 1911 170 52 34 37 293 207 201 171 168 1040 1912 190 41 25 24 280 133 121 81 95 710 1913 195 49 47 29 320 187 178 111 102 898 1914 179 40 39 33 291 159 181 118 100 849 1915 155 49 35 31 270 142 152 125 116 805 1916 129 32 27 21 209 128 116 92 89 634 Totals 1710 470 358 312 2850 1603 1561 1241 1189 8444 The mortality in the registration sub-districts ranged from (57 per 1,000 births in Upper Holloway to 107 in Lower Holloway. 1916] 14 Showing the Deaths among Infants per 1,000 Births during the year 1916, and also the mortality rates for the years 1906-15. Sub-Districts. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915- Mean 1906-15. 1916. Increase or decrease on mean. Tufnell 122 127 81 107 78 85 6l 108 93 65 93 84 -9 Upper Hollo- way 105 88 74 77 88 115 85 119 86 118 95 67 -28 Tollington 127 132 117 96 88 131 88 104 92 135 111 93 -18 Lower Hollo- way 155 148 125 101 108 162 94 121 134 118 126 107 -19 Highbury 95 107 101 93 / 82 104 80 89 93 109 95 74 —21 Barnsbury 138 123 119 111 111 162 98 128 119 107 121 103 -18 Islington South East 129 104 99 117 94 128 94 98 105 108 107 91 —16 The Borough 125 117 103 103 95 128 86 107 104 107 107 87 —20 15 [1916 In London the infant mortality rate was 89 per 1,000 births, while in the six boroughs encircling Islington it was 91 per 1,000. The rate for England and Wales was 91 per 1,000 births. The following Table shows the diseases that proved most fatal in the first year of child life, together with the mortality rates per 1,000 births. Showing the Mortality per 1,000 Births among Infants under one year of age in the three years 1901-03; in the ten years 1906-15; and in 1916 from certain specified causes. Causes of Death Mean rate of 3 years 1901-2-3 per 1,000 Births. 1916. Mean rate 10 years 1906-15 per 1,000 Births. Premature Birth and Congenital Defects 24.25 17.08 22.62 Bronchitis and Pneumonia 25.67 19.70 19.60 Atrophy and Marasmus 20.54 13.77 14.76 Diarrhæal Diseases (all forms) 19.01 4.27 19.71 Convulsions 6.66 2.34 2.06 Whooping Cough 6.44 4.27 4.35 Measles 3.27 2.34 3.04 Phthisis 1.85 0.41 0.36 Other forms of Tuberculosis 5.68 1.93 3.63 Diphtheria 0.43 0.41 0.24 Total of above 113.80 66.52 90.37 All other causes 18.91 20.80 17.18 Total 132.71 87.32 107.55 1916] 16 Showing the Chief Causes of Infantile Mortality in the sixteen years, 1900-1915 and in 1916. Cause of Death Years. Mean 16 years. 1916 Difference. 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 i. Common Infectious Diseases. Small-pox .. 1 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. 1 .. 2 .. . . .. .. Measles 42 37 24 29 51 27 36 27 24 31 21 28 29 16 14 26 29 17 -12 Scarlet Fever 2 2 1 1 1 .. 1 .. 3 1 .. .. .. 2 2 1 1 .. -1 Diphtheria (including Membranous Croup 5 7 1 4 2 2 3 1 4 1 1 2 6 4 2 2 3 3 .. Whooping Cough 68 38 76 63 30 51 30 53 29 36 61 31 17 22 43 34 43 31 - 12 ii. Dia rhæal Diseases. Diarrhæa, all forms 148 143 72 83 200 149 171 73 80 46 33 229 23 68 131 58 107 31 - 76 Enteritis, Muco-enteritis, Gastro-enteritis 67 70 43 46 20 53 92 49 52 26 38 73 49 99 54 66 56 54 —2 Gastritis, Gastrointestinal Catarrh 21 21 23 22 18 15 14 9 7 23 15 9 8 14 13 13 15 8 -7 iii. Wasting Diseases. Premature Birth 176 169 194 174 178 163 144 164 167 136 121 149 128 139 143 130 155 91 -64 Congenital Defects 36 48 33 47 43 48 59 47 51 52 46 35 34 40 47 37 44 33 -11 Injury at Birth .. .. .. 1 .. .. .. .. .. .. 1 4 3 2 4 4 1 5 +4 Want of Breast-milk, Starvation 1 5 2 7 6 4 5 8 4 4 .. 14 5 6 3 24 6 1 -5 Atrophy, Debility, Marasmus 221 188 192 183 177 138 134 137 138 133 94 117 114 144 93 117 145 100 -45 iv. Tuberculous Diseases. Tuberculous Meningitis 25 24 20 20 10 19 20 17 13 18 24 19 15 9 9 8 17 10 -7 Tuberculous Peritonitis Tabes Mesenterica 25 26 25 20 20 24 17 17 14 20 14 11 8 7 10 6 17 3 -14 Other Tuberculous Diseases 28 19 23 30 16 12 12 23 13 8 8 16 5 5 8 6 14 4 -10 v. Other Causes. Erysipelas 3 2 3 4 3 1 3 3 4 4 3 .. .. 1 4 2 2 1 —1 Syphilis 17 10 11 10 11 13 9 5 13 10 8 4 8 12 17 13 11 8 -3 Rickets 2 5 3 1 4 3 5 .. 2 1 .. 6 1 2 .. 1 2 4 +2 Meningitis (not Tuberculous) 19 23 16 18 10 19 18 10 13 11 14 10 5 8 10 17 14 11 -3 Convulsions 57 68 69 47 47 38 24 16 15 14 22 17 17 18 13 13 31 17 -14 Bronchitis 119 104 116 90 78 77 82 83 39 55 50 51 41 59 43 46 71 41 -30 Laryngitis 4 5 2 4 1 3 .. 1 .. 1 .. 1 1 .. .. 1 1 1 .. Pneumonia 118 123 134 109 101 107 103 153 106 106 110 101 97 109 85 106 111 102 - 9 Suffocation, overlying 43 39 46 15 25 14 22 23 23 27 26 21 23 32 19 22 26 4 -22 Other Causes 97 113 86 108 88 94 79 77 80 77 64 91 73 80 80 52 84 54 -30 1,344 1,290 1,219 1,136 1,140 1,074 1,083 996 894 841 777 1,040 710 898 849 805 1,006 634 -372 17 [1916 INFANT WELFARE WORK. On the 8th June, 1916, the Council appointed two Health Visitors who subsequently commenced their work in August last. The duties primarily undertaken by them was in connection with the investigation of the cases of Measles notified under the General Order of the Local Government Board, and of notified cases of Ophthalmia Neonatorum (Purulent disease of the Eyes); also in making inquiries respecting deaths of infants from Diarrhæa. Enquiries have also been made in many cases of Births notified to the Medical Officer of Health, with satisfactory results; while periodical attendances at the Voluntary Welfare Centres in the borough have enabled them to keep in touch with the Infant Care work that is now very efficiently performed by these useful agencies. The appended statement gives a summary of the work of the Health Visitors from 8th August to 30th December, 1916. Miss KEYS. Miss HUGHESDON. Investigations Calls. Investigations. Calls. Measles (notifications) 247 272 89 99 Ophthalmia Neonatorum (notifications) 22 25 8 21 Diarrhoea (infant deaths) 15 20 6 11 Chicken Pox (notification) ... ... 1 1 Births (notified) 26 38 171 339 Do. (not notified) 167 51 86 57 Complaints (re Welfare of Infants) 5 5 1 2 Other investigations 3 3 2 4 Visits to Welfare Centres 11 12 Do. to Schools 3 4 Totals 485 428 364 550 Measles discovered by Health Visitor 34 4 Do. (deaths from) visited 4 nil. Close Contacts. Other Contacts. Close Contacts. Other Contacts. Measles Contacts 246 198 55 74 1916] 18 Voluntary Infant Welfare Centres.—The work performed by these very necessary institutions in the borough has now been recognised by the Council, who have made a grant of £200 each to the North, South and West Islington Infant Welfare Centres. The reports received from the three Centres in the borough are appended:— NORTH ISLINGTON MATERNITY CENTRE AND SCHOOL FOR MOTHERS. 8 and 9, Manor Gardens, N. The North Islington Maternity Centre has during the year published its second annual report, which covers a period of 18 months ending at 31st March, 1916, and contains a wonderful record of good work done in the promotion of public health. The effects of its work are already prominently shown in the improved statistics of infant mortality in North Islington, and the work is advancing by leaps and bounds. The Health Department have assisted and encouraged the work of the Centre in every way in their power, and the Council have quite recently voted a grant of £200 in aid of this voluntary enterprise and in recognition of the good work it is doing. The scope of the work includes ante-natal consultations and infant consultations held on five days in the week at which expectant and nursing mothers get advice, given by Doctors, Nurses and voluntary helpers, which cannot fail to assist in the babies being reared as healthy members of the community. Home visiting, health talks, lessons in the preparation of simple, wholesome foods and in the making of suitable clothes for the babies and endless other branches of work calculated to bind the mothers to the Centre and promote good feeling between them, the staff and the large body of voluntary helpers who are devoting much self-sacrificing time and effort for their advantage, are carried out. A few statistics taken from the Report for the year ending 31st March, 1916, will give some small idea of the extent and value of the work. The staff consists of 3 doctors, one superintendent, 4 nurses and a secretary. A fifth nurse has been engaged lately for half-time, and an extra house taken, as the rooms available were inadequate for the increased number of attendances. One ante-natal consultation is held every week, and a careful record is kept which is attached to the child's case-paper when it comes to the Centre. The attendances for the year up to March 31st, 1916, were 303, and those up to December 31st, 1916, were 453. 19 [1916 Seven post-natal consultations are held every week, at which the babies are weighed and the mothers consult the doctors about their babies. A careful record is kept of their condition. For the year ending March 31st, 1916, the attendances were 5,340, and for the year ending December 31st, 1916, they were 7,883. Every child is examined thoroughly as near its birthday as possible, and a special record is kept of these examinations. The ante-natal and birthday records and any other information that might be useful at the L.C.C. school medical inspection is recorded on a special card, which is forwarded to the L.C.C. school medical officer when the child is of school age. Short talks are given on consultation days on subjects that affect the health of the mother and the child. A sewing class is held once a week. Individual instruction in sewing and knitting is given on every consultation day whenever required. The mothers have been visited in their homes by four professional visitors and 21 voluntary visitors. The object of the visiting is to establish a feeling of friendship between the home and the Centre, to see that the doctor's orders are carried out, and to help with individual difficulties. Each professional visitor is responsible for a certain district, and visits ante-natal and post-natal cases that have been notified at the Town Hall. The number of visits paid for the year ending March 31st, 1916, was 3,060, and for the year ending December 31st, 1916, 7,634. The number of voluntary visits paid for the year ending March 31st, 1916, was 710, and for the year ending December 31st, 1916, was 1,312. A number of children who need attention for minor ailments or advice or massage attend at the Centre in the mornings. For the year ending December 31st, 1916, these "morning calls" numbered 1,185. Four women have been employed as "home helps." These women look after the home and children when the mother is laid aside. The mothers pay as much as the Home Helps Committee consider reasonable, taking into account all the mother's circumstances. A Home Helps Club has also been formed, and over 100 mothers have become members and pay in a small amount each week to secure a home help when necessary. The Centre is a branch of the Women's Country Holiday Fund, and 23 women went to Herne Bay from the Centre during the summer. The North London Midwives' Association has its meetings at 9, Manor Gardens. A course of lectures to midwives has been given at the Centre under the auspices of the L.C.C. from October to February. A Dental Clinic for L.C.C. elementary school children was started in October, 1916, in a part of the building, and is proving very successful. The number of children on the books on March 31st, 1916, was 1,042, and on December 31st, 1916, the number was 1,873. The number of children under one year attending the Centre at March 31st, 1916, was 571 during the year ending at that date, and the deaths 24, making an infant mortality rate per 1,000 attendances of 42.03, 1916] 20 Analysis of the Infant Mortality in the Three Sub-Registration Districts of Tufnell, Upper Holloway, and Tolling ton, showing the Difference in the Mortality amongst the Infants in attendance at the North Islington Maternity Centre and School for Mothers and amongst those who did not attend (April 1915 to March 1916). Sub-Registration Districts. Total Births and Deaths of Infants under a year old. The Three SubRegistration Districts. Infants under 1 year old not in attendance at the Maternity Centre. Infants under 1 year old in attendance at the Maternity Centre. Per Cent. Excess in the Mortality among Infants not in Attendance. Births. Deaths. Mortality per 1,000 Infants. Infants. Deaths. Mortality per 1,000 Infants. Infants. Deaths. Mortality per 1,000 Infants. Tufnell 682 54 83 474 49 103 208 5 24 329 Upper Holloway 780 75 96 609 65 107 171 10 58 84 Tollington 655 83 127 527 77 146 128 6 47 211 Total 2,117 212 100 1,610 191 119 507 21 41 190 21 [1916 THE SOUTH ISLINGTON MOTHERS' AND BABIES' WELFARE CENTRE. 9, Tyndale Place, Upper Street, Islington. Report for the year 1916. The Centre opened in September, 1915, so that 1916 was the first full year's work, and it is one of rapid growth and extended activities. Ante-natal Work.—Until the end of June the Ante-natal Consultations were held at the same time as the Infant Consultations, but it has been found much better to have them at a different time. This work which is under the Four Boroughs Maternity Scheme has made steady progress, and the midwives and Hospitals send an ever-increasing number of patients to the CentreFortnightly sewing classes and health talks for young mothers expecting a first baby have recently been started and a scheme has just been instituted for the hire of maternity bags containing simple requisites for the mothers. Thirty-two consultations were held during the year, at which there were 66 attendances, of which 30 were during the last quarter of the year; 93 home visits were paid. Post-natal Consultations for Mothers.—In December, fortnightly consultations were instituted for mothers with babies under two years old, as experience showed that many mothers needed advice for troubles which arose after the birth of a child and which prevented the mothers from regaining their strength and often caused serious trouble at subsequent confinements. Infant Welfare Work.—110 weighings and consultations have been held during the year; there were 3,348 weighings of children under 5 years old; 2,012 consultations; 30 was the average number weighed in an afternoon; 18 was the average attendance at the consultations; 121 children were on the books on 1st January, 1916; 640 children were on the books on 31st December, 1916; 430 children under 1 year of age attended the Centre during 1916; 20 children under 1 year old attending the Centre died during 1916, of which 6 children had only been to the Centre once. At the end of January the numbers attending the one weekly consultation were so large that it became necessary to hold a second consultation each week, and by September a third weekly consultation had to be instituted. At the same time it was found necessary to increase the Staff by the appointment of an Assistant Superintendent, and even so it has not been possible to visit all new-born babies notified to the Centre by the Public Health Department of the Borough Council. Many mothers bring their babies up to the Centre as a result of receiving a leaflet about the Centre from the Town Hall. 1916] 22 The staff has paid 1,473 home visits during the year; 324 were notification of births visits, 410 were first visits. 235 Mothers have brought their babies to the Superintendent for dressings, advice, or test feeds. On each Consultation afternoon one of the staff gives a few minutes' health talk on some simple principle of hygiene, and longer lectures and demonstrations are given during the sewing classes. The dispensary of simple drugs ordered by the doctor has proved an effective means of combating the tendency of the mothers to dose their children with a mixture of patent medicines. A distinct improvement has been made in the clothing of the children by means of the sewing classes and of the model garments exhibited at the Centre. 44 Children were sent to hospitals for minor operations 20 ditto ditto medical treatment WEST ISLINGTON INFANT WELFARE CENTRE, 44, Richmond Road, Islington, N. Interim Report. The West Islington Infant Welfare Centre, of which H.R.H. the Princess Beatrice is President, was opened in May, 1916, to provide medical advice and simple treatment for mothers and children in the western part of the Borough of Islington. This district was defined in consultation with the Committees of the North and South Islington Centres, which were already at work. A house was taken at 44, Richmond Road, Caledonian Road, and, in addition to the Medical Officer, a dispenser, resident Superintendent, and resident housekeeper were appointed. The object of the Centre is mainly preventative; the patients cannot afford to consult a private practitioner for minor ailments, yet these, if neglected, may entail far-reaching effects. The patients include—(1) expectant mothers, (2) nursing mothers, (3) infants under one year old, (4) children between one and five years old. Under present conditions, nearly all belong to the families of men on active service, and many have suffered a serious diminution of income owing to the war. This circumstance, together with high prices, has very adversely affected the health of both mothers and children, and immediate steps are needed to prevent permanent physical deterioration. After a series of preliminary visits had been paid by the Superintendent, the first weekly consultation was held on July 4, 1916. By the end of September the number of patients was so large that it became impracticable to deal with them at one consultation a week, and a second was instituted. 23 [1916 Attendances at Consultations. Month. Number of Consultations. New Patients. Total Attendances July 4 60 91 August 5 74 153 September 4 47 170 October 8 43 240 November 9 50 347 December 7 27 235 Totals 37 301 1,236 Attendances between Consultations. (For dressings, weighing, and minor advice.) First Quarter 71 Second Quarter 127 Visits to Homes. Preliminary 3,188 First Quarter 459 Second Quarter 238 It is satisfactory to note that among the babies 183 were breast-fed as compared with fifty bottle-fed and six cases of mixed feeding. As far as their circumstances allow, the patients contribute towards the cost of drugs and dressings. Cases unsuitable for treatment at the Centre are referred to hospitals or to private practitioners. The Committee are indebted to the Great Northern, Royal Free, and Great Ormond Street Hospitals for their friendly consideration in this respect, and for their help in informing the medical officer of cases of malnutrition in the district. Among others, the following cases have been treated:— Disorders of Nutrition. Rickets 58 Dyspepsia 38 Constipation 33 Debility 27 Marasmus (Wasting) 23 Diarrhæa 22 Vomiting 21 Debility due to lactation 11 Disorders of the Respiratory Organs. Bronchitis 36 Adenoids 6 Affections of the Skin 31 Defective Teeth 12 1916] 24 The cases of rickets are of a severe type and entail much deformity; they occur among bottle-fed babies and those who have been breast-fed for more than twelve months. The Committee have been fortunate in obtaining the voluntary services of Miss Dodd, an experienced masseuse, whose treatment has been of great benefit to these children. The cases of wasting require constant attention, which is often impossible under existing home conditions; the hospitals within easy reach of the district are few; they have been extensively devoted to military needs, and cannot take any but urgent cases; it has therefore been deemed advisable to hasten the opening of a small ward for these cases, and the first resident patient, aged six months, was received on November 22, 1916. The Committee will welcome contributions towards the endowment or maintenance of cots, which may be named by the donor. The national character of Infant Welfare Work needs no emphasis; it contributes to the well-being of the children of our soldiers. In the West Islington Centre voluntary helpers are urgently needed; they will be able to gain valuable experience among the mothers and children. No less urgent is the need of money. Inquiries and subscriptions should be addressed to Blanche, Lady Dodsworth, Hon. Secretary, West Islington Infant Welfare Centre 44, Richmond Road, Islington, N.l. DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—2,148 persons died in the Public Institutions located in Islington, of whom only 1,460 belonged to this borough, the remaining 688 having come here for treatment or relief. Among the latter were 501 persons who died in the Holborn Infirmary and 74 who died in the Great Northern Central Hospital. Of the 1,460 deaths of inhabitants, 1,027 occurred in the Islington Infirmary, 291 in the Islington Workhouses, and 100 in the Great Northern Central Hospital. The proportion which the 1,460 deaths in these public institutions bore to the borough mortality was 30.7 per cent. Without the Borough.—775 deaths of persons belonging to Islington were registered as occurring in Public Institutions in districts of London outside the borough. They included, among others, 35 in the Northwestern Fever Hospital, 52 in the Children's Hospital, Great Ormond Street, 101 in St. Bartholomew's Hospital, 50 in the Colney Hatch Asylum, 49 in the Royal Free Hospital, 39 in the University College Hospital, 35 in the North-Eastern Fever Hospital, 30 in the Middlesex Hospital, and 28 in the Claybury Asylum. 25 [1916 These 775 deaths represented 16.3 per cent. of all the deaths registered in the quarter. Within and Without the Borough.—The deaths of Islingtonians numbered 2,235, and were equal to 47.0 per cent. of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— Sixty inhabitants died from accidental deaths, or suddenly, in places outside Islington. Showing the Deaths of Inhabitants in Looal Institutions and in Institutions outside the Borough, also the Deaths of Non Inhabitants in Local Institutions during the ten years 1906-1915 and in 1916. 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 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 I20 684 1,699 36.3 1909 1,672 1,055 617 755 113 735 1,790 36.4 1910 1,683 1,120 563 839 97 681 1,801 39.8 1911 1,804 1,181 623 817 13 760 1,941 39.9 1912 1,693 1,184 509 840 127 760 1,944 41.5 1913 1,938 1,361 577 980 115 844 2,205 43.8 1914 2,034 1,407 627 1,053 100 875 2,282 46.2 1915 2,288 1,606 682 1,193 98 872 2,478 44.9 Average 1,793 1,197 596 871 112 775 2,235 39.4 1916 2,148 1,460 688 1,027 100 775 2,235 47.0 Transferable Deaths.—During the year 55 deaths that had occurred in outlying Institutions and other places outside the Borough were transferred by the Registrar-General to Islington. Deaths from the principal Epidemic Diseases—The deaths of 268 persons were ascribed to these diseases, and they were equal to an annual death-rate of 0.87 per 1,000 of the civil population, as contrasted with a decennial average of 430 deaths and a death-rate of 1.32. It is the lowest epidemic death-rate hitherto recorded in the Borough. 1916] 26 Locally the deaths in the Sub-Registration Districts and Wards were as follows:— Showing the Deaths from each of the Principal Epidemic Diseases in the several Wards and Sub- Registration Districts during the Year 1916. SUB-REGISTRATION DISTRICTS. WARDS. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhæa. Totals. Deaths. Deaths. Deaths. Deaths. Deaths. Deaths. Deaths. Deaths. Tufnell Tufnell 1 ... 1 3 10 3 8 26 Upper Holloway Upper Holloway 1 ... ... ... 4 5 6 16 Tollington Tollington 1 ... 2 4 3 6 3 19 Lower Holloway Lower Holloway 1 ... 14 1 9 5 5 35 Highbury Highbury 1 ... 4 1 1 1 6 14 Mildmay 2 ... ... ... 3 2 4 11 Barnsbury Thornhill ... ... 30 3 9 6 12 60 Barnsbury ... ... 9 ... 3 1 4 17 Islington South East St. Mary's ... ... 3 ... 5 4 2 14 Canonbury 1 ... 3 3 5 8 3 23 St. Peter's 1 ... 14 3 8 4 3 33 The Borough 9 ... 80 18 60 45 56 268 Total Death Rates 0.03 ... 0.26 0.06 0.19 0.15 0.18 0.87 27 [1916 In London the 268 deaths from these epidemic diseases represented a death-rate of 0.93 per 1,000 of the civil population, while in the Encircling Boroughs it was 0.94 per 1,000. Showing the Deaths from Diarrhæal Diseases together with those classed under Enteritis and its sub-headings, arranged in quarterly periods, and at three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. The Year. Diarrhæa. Enteritis, etc. Totals. Diarrhæa. Enteritis, etc. Totals. Diarrhæa Enteritis, etc. Totals. Diarrhæa. Enteritis, etc. Totals. Diarrhæa. Enteritis, etc. Totals. Under 1 year 2 5 1 7 4 17 21 13 15 28 12 25 37 31 62 93 1 to 5 years 1 1 2 1 4 5 6 2 8 1 5 6 9 12 21 Over 5 years 7 6 13 5 4 9 2 5 7 2 4 6 16 19 35 Totals 10 12 22 10 25 35 21 22 43 15 34 49 56 93 149 Note—In this Table the deaths under Enteritis include only those which are not epidemic or zymotic 1916] 28 INFLUENZA. During the year Influenza caused 36 deaths, which is a decrease of 19 on the average of the preceding ten years and 35 on the return for the year 1915. The annual death-rate was equal to 0.12 per 1,000 of the civil population as compared with a mean decennial rate of 0.16 per 1,000. Showing the Deaths from Influenza in the Quarters of the Year 1916, together with the corrected averages of the corresponding periods 1906-1915. Years. Quarters. Totals First. Second. Third. Fourth. 1906 13 21 7 26 67 1907 48 12 4 11 75 1908 52 20 3 6 81 1909 36 19 4 11 70 1910 21 6 2 7 36 1911 18 9 1 9 37 1912 14 4 2 8 28 1913 25 18 5 10 58 1914 17 5 3 5 30 1915 52 11 3 5 71 Averages 30 12 3 10 55 1916 9 7 2 18 36 Increase or Decrease -21 -5 -1 + 8 -19 29 [1910 APPENDICITIS. This disease caused 15 deaths, which is 4 below the number recorded in 1915, and 6 below the average (21) in the preceding decennium. The ages at which people died from the disease is shown in the following statement:— Ages. 1906. 1907. 1908. 1909. 1910. 1911. 1912 1913. 1914. 1915. Average 1906-15. 1916. 0- 5 - 1 2 2 3 — 1 2 — 2 1 1 5-10 3 - 7 7 2 3 1 5 2 4 4 1 10-15 2 7 1 2 3 2 — — 4 3 2 3 15-20 3 3 3 3 4 4 — 5 2 — 3 1 20-25 1 2 3 1 5 2 4 2 1 1 2 1 25-35 2 2 2 1 1 4 1 2 2 2 2 1 35-45 5 — 4 4 2 3 1 2 1 1 2 3 45-55 1 1 2 1 5 — 4 3 3 3 2 — 55-65 2 3 1 2 — 3 1 — 4 3 2 2 65-75 1 — — 2 2 1 — 2 — — 1 1 75-85 — — — — — 2 — 1 — — — 1 85 and upwards - - - - - - - - - - - - Totals 20 19 25 25 27 24 13 24 19 19 21 15 SEPTIC DISEASES. These include Erysipelas, Pyæmia, Septicaemia and Puerperal Septic Infections, which, taken together, caused 38 deaths; these are 11 below the return for 1915, and 37 below that of 1914, while they were 11 below the average mortality of the ten years 1906-15. Erysipelas.—Six deaths were ascribed to it, which is 5 below the number recorded in 1915, and 6 less than the ten years average for 1906-15. Puerperal Septic Diseases.-—These diseases, which refer to Puerperal Pyaemia, Septicaemia, Septic Intoxication and Puerperal Fever, caused 9 deaths, and was 1 above the number registered in 1915, and 2 more than the average of the preceding ten years. 1916] 30 In the first quarter 3 deaths were registered, in the second 3, in the third 1, and in the fourth 2. The death-rate per 1,000 births was 1.24. The returns for the last eleven years are given below:— Years. Deaths. Deaths per 1,000 births. Cases. Deaths, per 1,000 cases. 1906 11 1.27 24 45.8 1907 8 0.94 21 38.1 1908 4 0.46 17 23.5 1909 7 0.85 14 50.0 1910 8 0.97 20 40.0 1911 7 0.87 14 50.0 1912 2 0.24 16 12.5 1913 7 0.84 28 25.0 1914 12 1.47 25 48.0 1915 8 1.06 23 34.8 Average 7 0.87 20 35.0 1916 9 1.24 21 42.9 Such a record as this ought not to be possible if women about to become mothers could be reached by health visitors, and induced to attend to a maternity centre or to consult a doctor before their labour. Showing the Deaths from Puerperal Fever per 1,000 Births in the Sub Districts for each Quarter and the Year 1916. Sub-districts 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deaths per 1,000 Births. Deaths. Deaths per 1,000 Births. Deaths. Deaths per 1,000 Births Deaths Deaths per 1,000 Births. Deaths. Deaths per 1,000 Births Tufnell .. .. .. .. .. .. .. .. .. .. Upper Holloway 1 5.43 .. .. .. •• .. .. 1 1.28 Tollington 1 5.71 1 5.85 .. .. 1 7.87 3 4.81 Lower Holloway .. .. .. .. .. .. .. .. .. .. Highbury 1 4.38 1 3.47 .. 1 3.79 3 2.89 Barnsbury •• .. 1 2.87 1 3.31 .. .. 2 1.53 Islington, South East .. .. .. .. •• .. .. .. .. .. The Borough 3 1.72 3 1.57 1 0.58 2 118 9 1.24 31 [1916 CONSTITUTIONAL DISEASES. Under this heading are included Cancer and Tuberculosis, as well as Rheumatism, Diabetes, Gout, Anaemia, Gangrene and Purpura. These diseases collectively were responsible for 1,095 deaths, and were equal to a death-rate of 3.46 per 1,000 of the civil population; and they represented 23.0 per cent, of the total deaths registered in the Borough during the year. It will be seen from the following statement that the deaths resulting from them averaged 1,035 during the preceding ten years, which represent a death rate of 3.17 per 1,000 inhabitants. Year. Deaths. Death Rates. 1906 1,042 3.15 1907 1,041 3.15 1908 1,048 3.12 1909 1,032 3.14 1910 989 3.01 1911 957 2.92 1912 1,023 3.13 1913 1,032 3.11 1914 1,056 3.24 1915 1,131 3.57 Average 1,035 3.34 CANCER. Cancer, which is now one of the principal Constitutional Diseases, contributed 412 deaths during the year, which represent a death-rate of 1.33 per 1,000 of the civil population. This is the highest toll hitherto demanded in Islington, and is an increase on the previous year's return of 35, or over 9 per cent. Of these deaths 186 were males and 226 females. The deaths were 45 and the death-rate 0.24 per 1,000 above the average of the preceding decennium. 1916] 32 The appended tabular statement gives the number of deaths at ten age periods of life during the past eleven years:— Ages. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915. Average. 1906-1915 . 1916 5 1 1 1 — 2 1 1 1 — — 1 — 5-15 3 3 2 3 1 3 2 — 2 1 2 3 15-25 3 3 8 3 5 4 4 7 2 2 4 — 25-35 7 6 6 10 6 5 7 13 11 7 8 4 35-45 35 39 41 27 40 32 25 31 37 24 33 30 45-55 90 64 63 79 72 67 71 83 69 75 73 86 55-65 110 95 112 96 100 92 130 99 121 120 107 124 65-75 74 102 93 94 85 87 86 115 96 105 94 114 75-85 38 27 39 34 47 31 51 49 40 39 40 48 85&upwards 2 8 2 7 3 7 5 6 6 4 5 3 363 348 367 353 361 329 382 404 384 377 367 412 Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the Year 1916. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islineton, South-East The Borough. 1st 14 14 15 11 21 10 21 106 2nd 8 13 7 9 16 18 19 90 3rd 10 12 10 9 18 24 21 110 4th 8 10 11 9 20 19 29 106 The Year 46 49 43 38 75 71 90 412 33 [1916 TUBERCULOSIS. Pulmonary Phthisis, Tabes Mesenterica, Tubercular Meningitis, Tuberculosis of the Larynx, General Tuberculosis, and other forms of Tuberculosis, such as Lupus, Tuberculous Caries, and Pott's Disease. These diseases were responsible for 513 deaths, which were 58 less than the average number recorded during the past ten years, while they were 118 below the number registered in the present year. The deaths represent 1.66 per 1,000 of the civil population, and 10.8 per cent, of the deaths from all causes during the year. The number of deaths from tuberculosis in each of the preceding ten years has been as follows:— Year. Deaths. Death Rates. 1906 578 1.74 I907 608 1.84 1908 604 1.83 1909 582 1.77 1910 539 1.64 1911 512 1.56 1912 553 1.69 1913 535 1.61 1914 568 1.75 1915 631 1.99 Average 571 1.75 1916 513 1.66 Pulmonary Phthisis.—To this disease 458 deaths were ascribed, as contrasted with a decennial average of 428, while the death-rate was 1.48 per 1,000 of the civil population, as against a decennial rate of 1.30 per 1,000. Thus it is seen there was an increase of 30 on the average number of deaths, and 0.18 on the mean death-rate. 1916] 34 Years Pulmonary Deaths. Phthisis. Death rates per 1,000 inhabitants. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Cause; per 1,000 inhabitants. 1906 411 1.24 8.14 15.3 1907 436 1.32 8.58 15.4 1908 432 1.29 9.23 13.9 1909 424 1.29 8.62 14.9 1910 390 1.19 8.62 13.8 1911 379 1.16 7.88 14.9 1912 427 1.31 9.12 14.3 1913 420 1.26 8.35 15.1 1914 461 1.42 9.33 15.2 1915 496 1.57 8.98 17.4 Average 10 years 428 1.30 8.68 15.1 1916 458 1.48 9.64 15.3 The following return gives the deaths at each age period:— Age periods. Deaths. Age periods. Deaths 0-5 12 55-65 60 5-15 15 65-75 24 15-25 65 75 upwards 1 25-35 91 Total 458 35-45 105 45-55 85 Other Tubercular Diseases.—In addition to the deaths from Phthisis there were 115 from other tubercular diseases, namely:— Tabes Mesenterica 22 deaths. Tubercular Meningitis 60 „ General Tuberculosis 12 „ Other forms of Tuberculosis 21 „ These brought up the total deaths from tubercular diseases to 573, which are equal to an annual death-rate of 1.81 per 1,000 of the civil population. 35 [1916 Their distribution among the sub-registration districts was as follows:— Phthisis. Tabes Mesenterica Tubercular Meningitis. General Tuberculosis. Other forms of Tuberculosis. Totals. Tufnell 37 3 5 — 3 48 Upper Holloway 62 1 8 — 2 73 Tollington 34 1 4 3 2 44 Lower Holloway 54 5 8 3 3 73 Highbury 71 1 9 1 2 84 Bamsbury 78 6 12 3 4 103 Islington South-East 122 5 14 2 5 148 The Borough 458 22 60 12 21 573 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. These diseases, which include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 1,006 deaths, or 135 more than in 1915. They were equal to a death-rate of 325 per 1,000 of the civil population, and represented 21.2 per cent. of the total deaths registered in the borough. Acute Bronchitis.-There were 146 deaths as compared with 192 in the previous year. 69 occurred among males, and 77 among females. No less than 41 deaths of infants under 12 months were registered. In the Public Institutions within the borough 9 deaths occurred. Chronic Bronchitis.—Three hundred and sixty-eight deaths were ascribed to it, 176 being males and 192 females. This return is 23 above the return for 1915. Pneumonia (All forms).— Four hundred and forty-five deaths were registered, of which 233 were males and 212 females. They are 82 above the number who died in 1915. It was very fatal to infants under a year old, among whom it caused 102 deaths, while between the ages of 1 and 5 year 97 died from it. Above 5 years of age the deaths numbered 246. As many as 107 deaths occurred in Public Institutions, chiefly the Workhouse Infirmaries. 1916] 36 Pleurisy—From this disease 14 deaths were registered, of which 2 were under five years old. Only 1 death occurred in a Public Institution. Asthma and Emphysema.—Fifteen deaths were recorded from these diseases, 14 of which were those of adults. Other Diseases of the Respiratory System.—Eighteen deaths were registered from them, as contrasted with 26 in 1915. VENEREAL DISEASES. Fifteen deaths were ascribed to these diseases, which showed a decrease of 8 deaths on the return for 1915. They were 2 below the mean of the preceding ten years 1906-15. The following figures record the number of deaths for each year since 1906:— Under 1 year. 1—5 years. Adults. Total. 1906 9 1 6 16 1907 5 — 11 16 1908 13 1 6 20 1909 10 — 5 15 1910 8 — 7 15 1911 6 — 7 13 1912 8 2 7 17 1913 12 — 7 19 1914 17 1 3 21 1915 13 3 7 23 Mean (10 years) 10 1 6 17 37 [1916 INQUESTS AND MORTUARY. During the year 507 bodies were received into the Mortuary, as compared with an average of 605 in the preceding 10 years. The return is the lowest known for very many years. The daily average number of bodies received was 14 as compared with 1.7 in 1915. In 394 cases inquests were held, as contrasted with an average of 416 in the ten years 1906-1915. Bodies received into Mortuary, Inquests. 1906 642 433 1907 644 441 1908 563 396 1909 592 407 1910 609 385 1911 646 425 1912 634 443 1913 575 384 1914 537 369 1915 612 475 Average 605 416 1916 507 394 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1915 and 1916. 1915. No. of bodies received. Daily Average No. of Inquests held. 1916. No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 165 1.8 126 1st Quarter .. 161 1.7 143 2nd „ 136 1.5 110 2nd ,, 96 1.0 67 3rd ,, 136 1.5 104 3rd „ 106 1.1 69 4th „ 175 1.9 135 4th ,, 144 1.6 115 Total for Year 612 1.7 475 Total for Year 507 1.4 394 1016] 38 THE NOTIFICATION, ISOLATION, FATALITY, and PREVENTION OF INFECTIOUS DISEASES. NOTIFICATION OF INFECTIOUS DISEASES. Under the Provisions of the Public Health (London) Act, 1891. The Principal Diseases Comprise:— Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric Fever, Typhus Fever, Continued Fever, Erysipelas and Puerperal Fever. The number of cases notified was 1,439, which equalled an annual attackrate of 4.65 per 1,000 of the civil population. They were 647 below the average (2,086) which obtained in the preceding ten years l906-15. This decline was mainly due to a decrease, when a comparison is made with the average of these years, of 576 cases of Scarlet Fever, of 48 cases of Enteric Fever and of 87 cases of Erysipelas. On the other hand Diphtheria showed an increase of 62 cases, Membranous Croup 1 case, and Puerperal Fever 1 case when compared with the average. In London the attack-rate was 4.91 per 1,000, or 0.26 higher than in Islington, while in the Encircling Boroughs it was 5.34 or 0.69 higher than here. • Small Pox.—No case was notified in the Borough during the year; neither was any case known since 1910, when one case occurred. Scarlet Fever.—638 cases were notified, and they showed a decrease of 576 or 52½ per cent. on the average (1,214) of the ten years 1900-15, The attack-rate was equal to 2.06 per 1,000 of the civil population annually, which is a decrease of 1.65 per 1,000 on the mean rate (3.71) of the preceding ten years. Diphtheria and Membranous Croup were responsible for 593 cases of illness, and were 63 above the average (530) of the preceding ten years. The attack-rate was equal to 192 per 1,000 of the civil population annually, and was 0.30 above the mean rate (1.62) of these years. In London the attack rate was 2.03 per 1,000, and in the Encircling Boroughs 2.01. Enteric Fever was only notified in 32 instances which is 48 below the average (80) that obtained during the ten years 1906-15. The attack-rate was 0.10 per 1,000 annually, or 0.15 per 1,000 below the mean rate (0.25) of the last ten years. 39 [1916 In London the rate was 0.11 and in the Encircling Boroughs 0.12 per 1,000 of the civil population. Typhus Fever.—Nil return. Continued Fever.—Nil return. Erysipelas.—155 cases were notified, or 87 below the average (242) of the preceding ten years, the attack-rate being 0.50 per 1,000 of the civil population, as compared with 0.67 in London and 0.69 in the Encircling Boroughs. Puerperal Fever.—21 notifications were received, being in the proportion of 2.89 cases per 1,000 births. The cases were 1 above the average number notified during the ten years 1906-15, but show an increase of 0.47 in the proportion of attacks to births. Cases of Puerperal Fever notified and inquired into during the year 1916 Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough. Cases notified by Doctor 2 4 3 2 4 3 3 21 Patient delivered by Doctor 2 4 •• 2 4 3 2 17 ,, ,, by Midwife •• •• 3 •• •• •• 1 4 Cases inquired into 1 4 3 2 2 2 3 17 ,, treated in Hospital 1 2 1 1 3 2 3 13 ,, treated at Home 1 2 2 1 1 1 •• 8 * Three cases were also contracted in hospital and one case was a miscarriage. 40 1916] Showing the number of Cases and Attack-Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 190615 and in 1916. diseases years Average number of cases. 1906-15 Increase or Decrease 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 Small Pox Cases 1 ... ... 3 1 ... ... ... ... ... ... ... ... Rate 0.00 ... ... 0.01 0.00 ... ... ... ... ... ... ... ... Scarlet Fever Cases 1386 1216 1409 1285 730 804 811 1317 1853 1332 1214 638 -576 Rate 4.18 3.68 4.20 3.91 2.22 2.46 2.49 3.97 5.71 4.21 371 2.o6 -1.65 Diphtheria Cases 437 480 522 425 463 590 512 546 651 620 525 587 +62 Rate 1.32 1.45 1.64 1.29 1.41 1.80 1.57 1.65 2.01 1.96 1.61 1.90 +0.29 Membranous Croup Cases 2 1 8 5 8 3 4 4 8 4 5 6 +1 Rate 0.00 0.00 0.02 0.01 0.03 0.01 0.01 0.01 0.02 0.01 0.01 0.02 +0.01 Enteric Fever Cases 149 92 97 95 .89 73 49 50 76 28 80 32 -48 Rate 0.45 0.28 0.29 0.29 0.27 0.22 0.15 0.15 0.23 0.09 0.25 0.10 -0.15 Typhus Fever Cases 1 ... ... 1 1 ... ... ... ... ... ... ... ... Rate 0.00 ... ... 0.00 0.00 ... ... ... ... ... ... ... ... Erysipelas Cases 274 252 235 221 212 275 185 226 334 203 242 155 -87 Rate 0.83 0.76 0.70 0.67 0.84 0.84 0.57 0.68 1.03 0.64 0.74 0.50 —0.24 Puerperal Fever* Cases 24 21 17 14 20 14 16 28 25 23 20 21 + 1 Rate 2.79 2.46 1.96 171 2.44 1.76 1.95 3.41 3.10 3.48 2.42 2.89 +0.47 Continued Fever Cases 1 1 1 ... 1 ... ... ... ... ... ... ... ... Rate 0.00 0.00 0.00 ... 0.00 ... ... ... ... ... ... ... ... Totals Cases 2275 2063 2289 2049 1525 1759 15 77 2171 2947 2210 2086 1439 -647 Rates 6.87 6.25 6.82 6.23 4.65 5.37 4.83 6.54 9.08 6.98 6.38 4.65 -1.73 * Per 1000 Registered Births. 41 [1916 Showing the Cases of the Notifiable Infectious Diseases notified in the Sub-Registration Districts and the Wards during the Year 1916. SUB-REGISTRATION DISTRICTS. WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Tufnell Tufnell ... 57 49 1 1 ... 11 1 ... ... ... 120 Upper Holloway Upper Holloway ... 54 60 1 4 ... 19 4 ... ... ... 142 Tollington Tollington ... 58 77 2 4 ... 21 3 ... ... ... 165 Lower Holloway Lower Holloway ... 62 67 ... 2 ... 20 2 ... ... ... 153 Highbury Highbury ... 66 49 ... 2 ... 7 1 ... ... ... 125 Mildmay ... 29 27 ... 4 ... 13 3 ... ... ... 76 Barnsbury Thornhill ... 52 77 1 2 ... 12 2 ... ... ... 146 Barnsbury ... 45 28 ... 3 ... 9 2 ... ... ... 87 Islington South-East St. Mary's ... 34 39 ... 2 ... 9 1 ... ... ... 85 Canonbury ... 79 48 ... 5 ... 13 2 ... ... ... 147 St. Peter's ... 102 66 1 3 ... 21 ... ... ... ... 193 Totals ... 638 587 6 32 ... 155 21 ... ... ... 1439 Attack-Rates per 1,000 lation. ... 2.06 1.90 0.02 0.0. ... 0.50 2.89* ... ... ... 4.65 42 19161 HOSPITAL ISOLATION OF NOTIFIABLE INFECTIOUS DISEASES. There were 1,296 cases isolated in hospital, or 90 per cent. of the 1,439 cases which were notified during the year. Only 10 per cent. of the patients, therefore, were nursed at home. The percentage of cases treated in hospital during the preceding ten years 1906-15 averaged 84.3. FATALITY FROM NOTIFIABLE INFECTIOUS DISEASES. By "Fatality" is meant the percentage proportion of deaths to attacks of sickness. During the year it was found that out of the 1,439 cases notified 87 deaths occurred, or 6 per cent., which contrasts with an average percentage of 4.7 in the preceding ten years 1906-15. 43 [1916 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 1916. 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 •• •• •• •• •• •• •• •• •• •• •• Scarlet Fever 63 3 5 638 99.2 0.8 17 1 18 2.7 20.0 2.8 Diphtheria 576 17 593 97.1 2.9 42 3 45 7.3 17.6 7.6 Enteric (Typhoid Fever) 27 5 32 84.4 15.6 8 1 9 29.6 20.0 28.1 Typhus Fever •• •• •• •• •• •• •• •• •• •• •• Erysipelas 47 108 155 30.3 69.7 3 3 6 6.4 2.8 3.9 Puerperal Fever 13 8 21 61.9 38.1 4 5 9 30.8 62.5 42.9 Continued Fever •• •• •• •• •• •• •• •• •• •• Relapsing Fever •••• •• •• •• •• •• •• •• •• •• •• Cholera •• •• •• •• •• •• •• •• •• •• •• Total 1,296 143 1,439 90.0 10.0 74 13 87 5.7 9.1 6.0 44 1916 ] OTHER NOTIFIABLE DISEASES. Acute Poliomyelitis, Cerebrospinal Meningitis,Ophthalmia Neonatorum, Tuberculosis, Plague and Cholera. Acute Poliomyelitis. Twelve cases were ascribed to this disease during the year, as contrasted with 15 in 1915. Two deaths, however, were registered. 1916. 1915. Cases. Deaths. Cases. Deaths. 1st quarter 1 nil 2 nil 2nd „ 1 1 4 „ 3rd „ 8 1 5 „ 4th „ 2 nil 4 „ 12 2 15 nil Epidemic Cerebro-Spinal Meningitis. Thirty-nine cases were notified, or one case more than in 1915, In only two of these cases had the patients been in direct contact with soldiers returned from military camps. It is a noticeable fact that whereas before the war (1907-14) the cases averaged 8 per annum, since the war began they have averaged 40. A return of the cases of the disease since it became notifiable is shown in the following statement:— 1907. 1908. 1909. 1910. 1911. 1912. 1913 1914. 1915. 1916. Total Cases 1907-16. Total Deaths. 1907-16 1st quarter — 2 2 3 4 1 1 2 12 7 34 19 2nd „ 3 2 3 7 4 6 3 3 13 17 61 35 3rd „ 5 — 2 1 3 3 1 2 II 8 36 20 4th „ 3 3 3 4 2 3 1 — 4 7 30 18 Year 11 7 10 15 13 13 6 7 40 39 161 92 The deaths during the year numbered 20, and were equal to the very high fatality of 51 per cent, of the cases notified. 45 [1916 Ophthalmia Neonatorum (Purulent Disease of the Eyes of Newly-born Children). This inflammatory disease of the eyes of infants was notified in 32 instances, of which 23 were forwarded by members of the medical profession, and 9 by midwives, and as a result 19 cases were referred to hospitals for treatment, while 13 were attended to in their homes by nurses. The early notification of this disease has been of great benefit to the children, and will be the means of preventing much blindness among them. None of the attacks has resulted in loss of sight. Tufnell. Upper Holloway. Tollington. Lower Holloway Highbury. Barnsbury Islington, South-Kast. The Borough. Cases notified by Doctor .. 3 2 2 1 9 6 23 „ ,, by Midwife .. 1 1 1 3 3 .. 9 Cases inquired into .. 4 3 3 4 12 6 32 ,, treated in Hospital .. 3 2 1 3 6 4 19 „ treated at Home .. 1 1 2 1 6 2 13 ,, attended by Nurse .. 2 .. 2 1 6 2 13 TUBERCULOSIS. During the year 843 cases of Tuberculosis in its several forms were notified. The attack-rate was equal to 2.72 per 1,000 of the civil population. In 1915 the number was 994, and the attack-rate 3.14 per 1,000. The decrease in the number of notifications is being maintained, for they were 151 less than in 1915, and 117 fewer than in 1914. Pulmonary Phthisis.—672 cases of Pulmonary Phthisis were notified, of which 377 were males and 295 females, and they represented an attack-rate equal to 217 per 1,000 of the civil population. The cases notified during the year were 108 less than in 1915. The distribution of the disease is shown in the subjoined Table, wherein it is seen that its highest incidence occurred in the Upper Holloway and St. Peter's Wards, with 83 and 81 notifications respectively. 46 19161 Showing the Notified Cases of Tuberculosis in the Wards During 1916. Registration Sub-Districts. Wards. Pulmonary Phthisis. Other Forms of Tuberculosis. Grand Totals. Tuberculosis Rate per 1,000 of Population, Males. Females. Total. Males. Females. Totals. Tufnell Tufnell 27 23 50 11 6 17 67 .. Upper Holloway Upper Holloway 55 28 83 6 9 15 98 .. Tollington Tollington 34 24 58 9 8 17 75 .. Lower Holloway Lower Holloway 37 32 69 3 8 11 80 .. Highbury Highbury 27 29 56 7 6 13 69 .. Mildmay 15 14 29 6 1 7 36 .. Barnsbury Thornhill 39 26 65 23 10 33 98 .. Barnsbury 38 24 62 6 6 12 74 .. St Man's 25 17 42 8 3 11 53 .. Islington South-East Canonbury 44 33 77 6 5 11 88 .. St. Peter's 36 45 81 12 12 24 105 .. Totals 377 295 672 97 74 171 843 2 72 THE PERIODS OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1916 Tubercular Diseases. Sex. CASES NOTIFIED IN WHOLE DISTRICT. At all ages. At Ages—Years. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Phthisis (including Tuberculosis of M. 377 — 2 17 38 187 118 15 F. 295 — 1 18 68 136 62 10 Tubercular Meningitis M. 20 2 12 5 1 — — — F. 7 2 1 2 1 1 — — Tabes Mesenterica M. 11 — 2 8 — — 1 — F. 11 2 2 1 4 2 — — General Tuberculosis M. 4 1 1 2 — — — — F. 1 — 1 — — — — — Other forms of Tuberculosis M. 62 — 6 34 7 10 5 — F. 55 — 6 29 12 7 1 — All Tubercular Diseases M. 474 3 23 66 46 197 124 15 F. 369 4 11 50 85 146 63 10 Totals 843 7 34 116 131 343 187 25 Percentages at each life period to total cases 100 0.8 4.0 13.8 15.6 40.7 22.2 2.9 47 [1910. Showing the Notified Cases of Tuberculosis in the Quarters during 1916. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. The Year. Males. Pennies. Total. Males Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Phthisis 97 67 164 101 81 182 90 81 171 89 66 155 377 295 672 Tubercular Meningitis 5 2 7 9 4 13 2 — 2 4 1 5 20 7 27 Tabes Mesenterica 4 5 9 3 4 7 2 1 3 2 1 3 11 11 22 General Tuberculosis 2 1 3 2 - 2 - - - - - - 4 1 5 Other Forms of Tuberculosis 12 16 28 25 16 41 10 12 22 15 11 26 62 55 117 120 91 211 140 105 245 104 94 198 110 79 189 474 369 843 Disinfection of Houses and Rooms after Phthisis. The following are he particulars for the year:— Houses. Rooms. 1st quarter 130 168 2nd „ 99 140 3rd „ 110 144 4th „ 84 130 Total 423 582 The figures for the year contrast with those of the preceding ten years as follows:— Houses. Rooms. Houses Rooms. [.###] 1906 258 369 1911 426 579 1907 296 411 1912 554 798 1908 281 361 1913 536 741 1909 514 672 1914 618 810 1910 481 645 1915 582 780 48 1916] TUBERCULOSIS DISPENSARY. The scheme for the Dispensary treatment of Tuberculosis in the Borough, which was approved by the Council on the 14th June, 1914, has, after protracted negotiations, been finally approved by the Local Government Board, the London County Council, the London Insurance Committee, and the Authorities of the Great Northern Central Hospital and of the Royal Hospital for Diseases of the Chest, City Road, for the period ending 31st March, 1918. It will be remembered that the scheme was framed with a view to make the fullest use of available hospitals in accordance with the expressed desire of the Local Government Board; that the Great Northern Central Hospital agreed to provide, at an estimated annual cost of £1,135, a tuberculosis dispensary at that Institution to serve persons suffering from tuberculosis who reside in that part of Islington situate north of the North London Railway; and that the Royal Hospital for Diseases of the Chest agreed to provide at the dispensary established at that Institution, at an estimated cost of £2,000 per annum, the necessary services for persons suffering from tuberculosis who reside in that part of Islington situate south of the North London Railway, and in the Borough of Shoreditch; also that as regards the latter' dispensary the cost of the services to be rendered should be shared by the Islington and Shoreditch Borough Councils. The scheme has been altered in several respects since it was first approved by the Council, and the estimates of the cost of the scheme have been modified. These modifications were the direct result of the two Hospital Authorities substantially increasing their estimates on account of the extra cost of drugs occasioned by the war, the estimated increase in the expenses for attendances at the dispensaries, and the increase in the amounts provided for the services of the Tuberculosis Officers, svhereupon it became necessary to again refer the matter to the Local Government Board. One of the Medical Inspectors of the Board accordingly interviewed representatives of the two Hospital Authorities and was instrumental in securing reductions in the case of the Great Northern Central Hospital from £1,460 to £1,200, and in the case of the City Road Chest Hospital from £2,225 to £1,950. The estimates as thus modified only exceeded by £15 the amounts included in the original scheme. The reductions effected were mainly due to the fact that the Physicians proposed to be appointed by the Hospital Authorities agreed to forego, for the present, the honoraria provided for in the original scheme in respect of services the Physicians might be called upon to render in a 49 [1916 sultative capacity, the Board having pointed out that in no approved London scheme had provision been made for the payment of honoraria to Physicians inasmuch as Physicians had agreed to gratuitously render such services as were required.* In regard to the method of payment to the Hospital Authorities for the ervices to be rendered in accordance with the scheme, the Local Government Board have insisted upon the Hospital Authorities accepting the principle of lump sum payments, and any financial adjustments that may be necessary are to be made after the 31st March, 1918, the period for which the Board's approval of the scheme has been given. Such lump sum payments will be upon the basis of the estimates contained in the scheme. In consequence of the acceptance of this method of payment the Authorities of the City Road Chest Hospital stipulate that it is essential that they should have control of the expenditure in respect of the Southern Dispensary. As this condition differs from the provision contained in Part III. of the original scheme as to the management and control of that Dispensary the Council approached the Local Government Board and the Shoreditch Borough Council upon the matter, and as neither of them raised any objection to the proposed condition of the City Road Hospital Authorities the Council gave their assent thereto and also similar consent in the case of the Great Northern Hospital if need be. Under the altered circumstances the Council considered the question of the amount to be contributed by the Islington and Shoreditch Borough Councils respectively in respect of the cost of the services to be rendered on behalf of each Authority at the Southern Dispensary, which is at the total rate of £1,950 per annum. It has now been arranged with the Shoreditch Borough Council that the cost incurred shall be borne equally by the two Councils. For the period in question, which is until the 31st March, 1918, the cost to this Council of the services to be provided at the Southern Dispensary will be at the rate of £975 per annum, while the cost of the services to be provided at the Northern Dispensary† will be at the rate of £1,200 per annum. The gross total cost to the Council of the services to be provided by the two Dispensaries will thus be at the rate of £2,175 per annum. Of this amount it has been agreed that the London Insurance Committee shall contribute £500 a year in respect of the treatment of insured persons, and the Local Government Board have undertaken to contribute one-half of the remainder, while the London County Council have agreed to * The Medical Officer of Health always advised against the payment of £100 a year to each of the four Physicians, but his advice was not accepted. † This Dispensary was opened on 1st May, 1917 50 1916] contribute one-fourth of such remainder. The net total cost of the scheme to the Council on the present basis will therefore be only £419 a year. Since the foregoing scheme was adopted, the Finsbury Borough Council asked to be allowed to be included in it with the Islington and Shoreditch Borough Councils, and intimated that if this was agreed to, the Hospital Authorities were prepared to provide the necessary services upon the payment at the rate of £900 per annum by each of the Borough Council concerned. Upon the Shoreditch Borough Council assenting to the inclusion of Finsbury in the scheme, and in view of the fact that the cost would thereby be reduced from £975 to £900 per annum, the Council agreed to the proposal of the Finsbury Borough Council. The Islington Southern Tuberculosis Dispensary was opened on the 1st August, 1916, and the work undertaken by the Tuberculosis Officer (Dr. A. J. McFarland) and his staff is shown in the following monthly tabular statement:— 1916. Date. August. Sept. Oct. Nov. Dec. Total. Attendances 53 150 258 274 209 944 New Cases Including Contacts. 35 74 101 64 38 312 Contacts. Tuberculosis — 2 3 1 2 8 Suspects — 1 2 2 1 6 Non-Tuberculous 4 29 57 35 22 147 Nurses' Visits — 53 69 98 95 315 Medical Officer's Visits 9 16 13 15 13 66 51 [1916 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. Five hundred and eighty-two cases of the notifiable infectious diseases, or 40.4 per cent. of all the cases notified under the Public Health (London) Act, 1691, occurred in the Public Elementary Schools of the Borough, of which 319 were Scarlet Fever, 262 Diphtheria, and 1 Enteric Fever. These contrast with a ten years' average of 914 scholars and a percentage of 433 of the total cases notified. 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. 1900 • • 785 177 33 3 998 43.9 1907 • • 608 216 11 1 836 40.5 1908 • • 809 230 19 • • 1058 46.2 1909 • • 737 184 16 1 938 45.8 1910 • • 369 197 13 • • 579 38.0 1911 • • 424 272 14 • • 710 40.4 1912 • • 430 201 7 • • 638 40.5 1913 • • 758 252 3 • • 1,013 46.6 1914 • • 1,032 350 11 • • 1.393 47.3 1915 • • 708 267 1 • • 976 44.2 Ten years' Average • • 666 235 13 • • 914 43.3 1916 • • 319 262 1 • • 582 40.4 Increase or Decrease on Average • • -347 + 27 -12 • • -332 -2.9 Non-Notifiable Diseases.—4,844 cases came to the knowledge of the Medical Officer of Health during the quarter, viz.:—1,259 cases of Measles, 537 of Whooping Cough, 716 of Chicken Pox, and 2,332 cases of other diseases. The information respecting these cases was received from the teachers of 57 schools. 52 1916] Exclusion of Scholars from Schools.—2,134 children were excluded from classrooms of various schools owing to the presence of an infectious disease, principally Scarlet Fever, in the houses wherein they lived. Non-notifiable Diseases among Children attending the Public Elementary Schools. Year. Measles. Chicken Pox. Whooping Cough. Other Diseases. Totals. 1906 1.935 425 300 1,475 4,135 1907 2,065 981 831 1,952 5,829 1908 1,095 624 385 2,255 4,359 1909 1,667 491 708 1,739 4,605 1910 2,194 985 892 2,006 6,077 1911 1,698 585 533 2,060 4,876 1912 1,377 1,156 894 2,541 5,968 1913 1,272 731 578 2,752 5,333 1914 1,375 949 753 2,607 5,684 1915 1,897 1,012 724 2,575 6,208 Ten years' average 1,657 794 660 2,196 5,307 1916 1,259 716 537 2,332 4,844 Increase or Decrease on Average -398 -78 -123 + 136 -463 BACTERIOLOGICAL EXAMINATIONS. During the year 951 examinations were made of sputum and blood of patients for the medical profession for the detection of Diphtheria, Enteric Fever and Phthisis. This number shows a decrease of 333 on the return for 1915, and was 614 less than for 1914. 53 [191*0 Diphtheria.—404 swabs were submitted, of which 127 gave positive results, and 277 negative. The results of the cases were immediately forwarded to the medical practitioners, some being sent by telephone or telegraphed direct to the doctors by the Lister Institute where the examinations were made. Enteric Fever.—32 examinations of blood taken from enteric patients were made, as contrasted with 35 in 1915, of which 10 proved positive and 12 negative. Phthisis.—525 specimens of sputum were examined, of which 135 gave positive results, and 390 negative. This return is 241 less than that for 1915, and 285 below that for 1914. The examinations for Phthisis have of late years largely increased, which is due, of course, to the notification of Tuberculosis. The following Tables give the results of the examinations that have been made during the last 18½ years. Diseases. Total Examinations. Positive Results. Negative Results. Percentage of Positive Results. Diphtheria 5,291 1,659 3,632 31.4 Enteric Fever 1,166 508 658 43.6 Phthisis 5,871 1,572 3,799 29.3 Total 11,828 3,739 8,089 31.6 STATE OF VACCINATION IN ISLINGTON. Of the 7,277 births registered in 1915, the returns of the Vaccination Officers show that only 3,328 infants were successfully vaccinated; while 7 were declared insusceptible to vaccination; 491 died unvaccinated; 1,710 certificates of exemption were produced by parents; and 57 cases were postponed under medical authority, thus leaving 1,684 unaccounted for. Certificates of Exemption.—The following tabular statement shows that these certificates are largely on the increase, more especially during the past six years. 1906 123 1907 259 1908 588 1909 824 1910 1,080 1911 1,241 1912 1,646 1913 1,942 1914 2,124 1915 1,710 54 1916] DISINFECTION. Disinfection of Rooms.—1,349 rooms were disinfected, as contrasted with 2,210 in 1915. For this purpose formaldehyde, either in a gaseous form or in solution, is usually employed, although it is sometimes augmented bysulphur dioxide, when it is necessary to kill vermin, for which purpose it has been found most effective. N.B.—The above figures also include the disinfection of houses and rooms after Tuberculosis, vide p. 47. The Cleansing and Spraying of Rooms.-1,749 rooms, as contrasted with 2,116 in 1915, were cleansed and sprayed. Rooms disinfected. Rooms sprayed. 1916. 1915. 1916. 1915. 1st Quarter 374 521 457 558 2nd „ 354 495 448 648 3rd „ 306 557 465 359 4th „ 315 637 379 551 The Year 1,349 2,210 1,749 2,116 The following class-rooms, etc., were disinfected after the occurrence in them of cases of the diseases mentioned:— 1st Quarter. Sebbon Street, L.C.C. Schools (Scarlet Fever). 2nd Quarter. Duncombe Road, L.C.C. Schools (Cerebro-Spinal Fever). Colebrooke School, Duncan Terrace (Measles). Sebbon Street, L.C.C. Schools (Scarlet Fever). 3rd Quarter. Hanover Street, L.C.C. Schools (Scarlet Fever). 4th Quarter. Canonbury Road, L.C.C. Schools (Measles). Convent Schools, Eden Grove (Scarlet Fever). Guardians' Schools, Hornsey Road (Ringworm). Work at the Disinfecting Station.—50,064 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 65,251 similar articles disinfected during the previous year. This considerable difference was due to the large decrease in the number of cases of Scarlet Fever. In addition to the above articles 54,611 old or second-hand garments mostly soldiers' overcoats, jackets and tunics were disinfected for clothing contractors trading in the borough, who paid the Council for the work, amounting to the sum of £67 6s. 0d. 55 [1916 Altogether 104,675 articles described in the two paragraphs preceding were disinfected, which bring the number of large articles disinfected since the disinfecting station was established to 1,095,910. Summary of the chief articles of Clothing, Bedding, &c., disinfected during the year 1916, and also in the preceding year 1915. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. The Year 1918 1915. Beds 580 557 537 557 2,231 2,985 Blankets 1,389 1,252 1,113 1,303 5,057 5,940 Bolsters 651 563 503 562 2,279 3,139 Carpets 92 111 87 134 424 370 Chair Bed Cushions 75 46 44 39 204 400 Mattresses 630 534 553 494 2,211 3,090 Palliasses 44 73 73 70 260 347 Pillows 1,478 1,234 1,331 1,289 5,332 6,894 Quilts 601 511 476 545 2,133 2,457 Sheets 1,172 1,045 1,015 1,062 4 294 5,332 Other Articles 7,375 5,808 5,903 6,553 25,639 34,297 Totals 14,087 11,734 11,635 12,608 50,064 65,251 The nature of the articles disinfected for the clothing contractors is shown below:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Soldiers' Overcoats 5,516 10,491 2,680 2,750 21,437 „ Jackets 7,462 6,353 5,074 3,875 22,764 „ Tunics 700 2,140 375 775 3,990 ,, Haversacks ... 72 ... ... 72 Trousers ... 425 300 250 975 Frock Coats 550 550 532 ... 1,682 Boots 302 500 500 50 1,302 Other Articles 244 40 49 56 389 14,774 20,571 9,510 7,756 52,611 56 1916] Disinfectants distributed and used.—The following statement give the quantity of disinfectants distributed by the Sanitary Authority, or used in disinfecting and cleansing rooms:— How disposed of. Carbolic Powder. Disinfecting Fluid. Formaldehyde. Powder. Solution. Tons. cwts. Gallons. cwt qr. lbs. Gallons. To Householder 1 5 218 — — Disinfection of Premises. — — 1 0 0 17 Cost = £38 19s. l1d. Shelter House.—The Shelter House was occupied by three persons during the year, pending the disinfection of their homes after infectious diseases. Baths were given to 2 verminous persons, also to 3 persons suffering from Scabies. 85 Soldiers who had been in contact with an infectious disease were also afforded bathing facilities, and their clothing was disinfected before rejoining their units, either at home or abroad. Nine midwives also used it for disinfection, after attending cases of Puerperal Fever. Verminous School Children.—During the year 3,308 baths were given to children from the London County Council Schools, who attended the Disinfecting Station, and were cleansed by the nurse whom the Borough Council appointed for the work, while their clothing was undergoing disinfection. The daily attendance ranged from 3 to 30. A new agreement was entered into between the London County Council and the Borough Council, and came into operation on the 1st November, 1916, for the period of one year, for the cleansing of verminous children, and the guaranteed payment of 1s. for each bath in lieu of the existing arrangement; and also upon the understanding that the minimum amount to be paid to the Borough Council in respect of such cleansing shall be £100 per annum. The total amount received during the year was £150 6s. 0d., being the sum payable for the baths given to the children mentioned above. In 60 cases the London County Council instituted legal proceedings under Section 122 of the Children Act, 1908, and the prosecutions resulted in fines and costs amounting to £18 being inflicted. 57 [1916 FACTORY AND WORKSHOP ADMINISTRATION. In accordance with the Factory and Workshops Act, the Medical Officer of Health, herewith, submits his annual report on the work carried out by the Council's Workshops' Inspectors during the year 1916. Inspections and Visits.—The inspections and visits made by the Inspectors were as under:— Factories, including Factory Laundries 686 Workshops, including Workshop Laundries 2,624 Workplaces, other than outworkers' homes 158 Bakehouses 328 Restaurant Kitchens 380 Outworkers' premises 1,653 Miscellaneous re-inspections and calls 3,732 Total 9,561 Notices served.—In consequence of the 1,030 sanitary defects discovered as the result of the above-mentioned inspections, 252 intimations and 3 statutory notices were served. Of these notices 48 were served on the owners of factories 177 on the owners of workshops, 27 on the owners of restaurant kitchens, and 3 on the owners of Outworkers' premises In addition to these nuisances, 150 were discovered on Outworkers' premises, necessitating the service of 32 notices. Registers.—There were 2,215 workshops on the Register, as contrasted with 2,308 in 1915, while the total number of workrooms was 7,576 as contrasted with 7,531 in the previous year. 1,416 workshops were added to the Register while 797 were removed from it. The various workshops and workplaces are tabulated as below:— Workshops and Workplaces. 1915. 1916. Workshops on Register. Workrooms on Register. Number added during Year. Number removed during Year. Total number of Workshops on Register. Total Number of Workrooms on Register. .hops where Men are employed 512 729 10 95 427 550 Workshops where Women are employed 850 1,818 87 74 863 1,358 Laundries 77 200 .. 5 72 188 Bakehouses 236 246 1 .. 237 247 Restaurant Kitchens 633 862 6 23 616 845 Outworkers' Premises — 3,676 1,312 600 — 4,388 Total 2,308 7,531 1,416 797 2,215 7,576 58 1916] Workshops notified to Home Office, 1916. Trade. Number of Workshops Protected Employed Persons. Women, Male Young Persons. Total. Toys 5 33 5 38 Mantles 3 20 1 21 Blouses 3 44 . . 44 Furrier 2 6 1 7 Robes 2 38 . . 38 Artificial Flowers 2 26 . . 26 Leather Work 2 12 2 14 Brushes 1 30 . . 30 Ties 1 8 . . 8 Millinery 1 6 . . 6 Embroidery 1 2 . . 2 Confectionery 1 4 . . 4 Underwear 1 2 . . 2 Dolls 1 20 . . 20 Perfumery 1 2 . . 2 Dental Work 1 3 . . 3 Scientific Instrument Making 1 5 2 7 Army Work— Munitions 6 70 20 90 Shirts 4 38 . . 38 Dressing Gowns 3 18 . . 18 Leather Cases 2 16 2 18 Balloon Making 2 50 3 53 Propellers 2 75 18 93 Shaving Brushes 2 55 . . 55 Bandoliers 1 50 6 56 Shoulder Straps 1 50 . . 50 Thermometers 1 8 3 11 Surgical Dressings 1 12 . . 12 Overalls 1 50 . . 50 Uniforms . . 8 . . 8 Haversacks 1 20 . . 20 Total 57 781 63 844 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 Inspections. Written Notices. Prosecutions (1) (2) (3) (4) Factories (Including Factory Laundries) 686 48 Nil Workshops (Including Workshop Laundries) 2,624 120 „ Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 866 84 „ Miscellaneous Re-inspections 3,732 .. .. Total 7,908 252 nil. 59 [1916 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 226 215 4 Nil Want of ventilation 19 18 2 „ Overcrowding 5 5 Nil „ Want of drainage of floors 38 36 „ „ Other nuisances 310 284 4 „ Sanitary Accommodation insufficient 18 15 Nil „ unsuitable or defective 379 326 „ M not separate for sexes 28 26 „ „ Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) .. .. .. .. Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) 7 6 .. .. Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) .. .. .. .. Total 1,030 931 10 Nil * Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 60 19161 3. - HOME WORK. NATURE OF WORK. Outworkers' Lists, Section 107. Outwork in Unwholesome Premises, Section 108. outwork in Infected Premises. (Secs. 109, 110). Lists received from Employers Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served under Public Health (London) Act, 1891 Prosecutions Instances. Orders made (S. 110). Prosecutions (Sections 109, 110), Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists,† Outworkers,† Lists. Outworkers. Contractors Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)[/##] Wearing Apparel— a (1) making, &c. 184 96 2,528 33 1 383 260 .. .. 86 21 .. 25 .. .. (2) cleaning and washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Curtains and furniture hangings .. .. .. 1 .. 1 1 .. .. 1 .. .. .. .. .. Furniture and upholstery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Electro-plate .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brass and brass articles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fur pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cables and chains .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anchors and grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cart gear .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, latches and keys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, &c. 2 .. 2 .. .. .. 1 .. .. 2 3 .. .. .. .. Artificial Flowers 8 .. 93 3 .. 21 4 .. .. 27 6 .. 3 .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. 2 3 3 1 .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Racquet and Tennis Balls .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper, etc., Boxes, Paper Bags 18 .. 143 1 .. 56 9 .. .. 20 2 .. 4 .. .. Brush making 4 .. 97 .. .. .. 2 .. .. 14 2 .. .. .. .. Fea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed toys .. .. .. 2 .. 5 2 .. .. .. .. .. .. .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chocolates and Sweetmeats .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cosaques, Christmas Crackers, Christmas Stockings, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Textile weaving .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 216 96 2,863 42 4 469 280 Nil Nil 150 34 Nil 32 Nil Nil * When an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list is included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers are columns 3 and 4 (or 6 and 7) into their respective classes. † The figures in columns 2, 3 and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworks in those lists. a. 4 Umbrellas, 23 Furniture, and 2 Brass are included in lists of wearing Apparel makers 61 [1916 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Workshops where men are employed 427 Workshops where women are employed 863 Laundries 72 Bakehouses 237 Restaurant kitchens 616 Total Number of Workshops on Register 2,215 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, 1901) 74 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, 1901). Notified by H.M. Inspector 3 Reports (of action taken) sent to H.M. Inspector. 3 Other (New Factories reported under Home Office Memorandum, 1912) nil Underground Bakehouses (s. 101) in use at the end of the year.. 164 DISTRICT INSPECTORS' WORK. The reduction in the staff of the District Inspectors owing to five members having joined the Colours has very materially affected the sanitary work of the Department, and consequently the return of improvements effected shows a marked decrease when contrasted with the work performed before the war. 1916] 62 Synopsis of the Inspectors' Work.—The following statement gives a brief synopsis of the district inspector's work in 1916 :— House to house inspections 22 Other inspections of dwelling houses 4,861 Re-inspections and calls- made 38,490 Visits of inquiry re notifiable infectious diseases ,, school cases of infectious 1,439 „ diseases 4,844 Butchers' shops, stalls, etc. (Saturday nights) 182 Ice cream shops and factories 33 Dairies and Milkshops 1,117 Stables and yards 2,175 Manure depots 106 Certificates under the Customs and Inland Revenue Acts 9 Water certificates for newly erected houses or flats 4 Smoke observations 55 Notices Served.—There were 1,777 intimation notices served by the inspectors with respect to nuisances, of which 903 were delivered personally, and 874 by post. In 237 instances it became necessary, as the intimations had not been attended to, to report the nuisances to the Public Health Committee, who ordered statutory notices to be served, of which 65 were delivered personally and 172 by registered letter post. Verminous Premises-Bedding and Clothing —72 premises were found to be in a verminous condition, and these were cleansed by the owners or occupiers upon receiving the Inspectors' intimations. In 24 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification. Smoke Nuisances.—Black smoke was observed to be issuing from the chimneys of the undermentioned premises, and consequently notices were served on the owners of the following businesses requiring the abatement of the nuisance:— Plaistowe's Ltd., Wharfedale Road. King's Cross Laundry, York Road. New River Laundry, Western's Ltd., Drayton Park. Nuisances Discovered.—The following table shows the principal nuisances discovered by the District Sanitary Inspectors, and clearly demonstrates the important character of the work carried out under their supervision :— 63 [1916 Showing summary of Sanitary Work from Inspectors' reports for the Year 1916. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections .. .. 18 4 .. .. .. .. .. .. .. .. 22 Other premise inspected 527 533 488 41 324 333 536 378 471 244 500 486 4861 Re inspections, Calls made, etc. 3346 3529 4211 152 2962 3209 3429 4140 4176 1490 3504 4342 38490 Ice Cream Factories inspected 1 2 19 .. .. .. 8 .. 1 2 .. 33 Dairies and Milkshops ,, 297 95 152 13 101 28 77 192 69 11 45 37 1117 Stables „ 108 14 22 5 129 41 77 14 2 5 67 35 519 Yards ,, 245 143 401 17 45 222 268 49 7 42 135 82 1656 Manure Depots 91 .. .. 3 .. 12 .. .. .. .. .. .. 106 Vacant land, Passages and Courts inspected 44 3 6 .. 16 77 45 1 .. 17 54 15 278 Urinals attached to P.H .'s inspected 117 103 106 2 164 103 26 7 1 26 2 28 685 Premises (re Certificate Customs and Inland Revenue Acts) inspected .. .. 2 .. 2 .. .. 2 .. 3 .. .. 9 Premises (re Water Certificates) inspec ed .. 3 .. .. .. .. .. .. .. .. .. 1 4 Visits re Sale of Food and Drugs Acts .. .. .. .. .. .. .. .. .. .. .. .. .. Smoke observations 2 1 .. .. .. 1 32 2 11 .. 6 .. 55 Shops, Stalls and Markets (Saturday evening) 19 17 16 .. 13 17 20 20 19 7 The Inspections which were made and the improvements effected are included in the returns of Districts 9 and 10. 18 16 182 Total Inspections and calls 4797 4443 5441 237 3756 4043 4518 4805 4757 184 7 4331 5042 48017 Notices Served. Intimation - Personally 164 10 36 12 92 5 113 62 146 66 43 154 903 By Post .. 196 84 9 4 1 136 102 7 62 125 148 874 Statutory—Personally 8 5 6 2 3 1 .. 2 8 11 6 13 65 By Post 12 17 8 2 15 9 14 6 11 26 24 28 172 Improvements Drains- Constructed. 1 .. .. .. .. .. 1 1 1 1 2 .. 7 Re-constructed 12 21 2 .. 2 9 9 12 6 18 22 3 116 Repaired 22 8 8 1 2 6 10 15 16 10 26 18 142 Ventilated 7 21 5 .. 2 10 10 4 5 7 18 6 96 Gully and other traps fixed 65 111 13 .. 11 39 68 59 32 57 64 35 554 Urinals—Water supplied, cleansed 4 1 7 .. .. .. .. .. .. .. .. 1 13 Cesspools—Abolished .. .. .. .. .. .. .. .. .. .. .. .. .. Water Closets— W.C. erected with pan, trap and water supply 1 2 1 .. .. 1 3 2 3 2 3 2 20 Pan and trap only provided 26 33 13 1 4 20 24 19 15 23 40 26 244 Water supply provided 18 40 8 1 27 9 28 8 7 24 26 61 257 Ventilated .. .. 1 .. .. 1 1 2 .. 1 .. 1 7 Position altered .. .. .. .. .. .. 1 .. 1 1 .. 1 4 Dust Bins—Provided 81 142 103 5 52 8 113 61 143 60 52 101 921 Repaired 1 2 1 .. 9 .. 5 .. 1 .. .. 1 20 Areas— constructed .. .. .. .. .. .. .. .. .. .. 1 .. 1 Yards—Paved 3 1 2 1 .. 9 10 1 6 8 4 1 46 Re paved 40 32 13 .. 11 8 26 22 20 32 30 37 271 Sinks-provided 3 12 2 .. .. 2 11 3 4 3 9 9 58 Domestic Water Supply— Cisterns provided .. .. .. .. .. .. 1 .. .. .. .. .. 1 Cisterns repaired and cleansed 12 23 15 1 14 15 30 5 5 11 10 39 180 Water Supply provided to dwelling house 4 2 5 .. .. 1 8 4 2 3 1 9 39 Water supply provided to tenement house .. 4 2 .. 1 .. 4 .. 6 1 1 7 26 Other Improvements— Rooms cleansed and limewashed 93 86 147 6 51 32 108 43 156 43 129 247 1141 Walls and passages repaired, cleansed and limewashed 19 30 22 5 4 6 22 8 18 10 38 81 263 Floor space ventilated 4 4 2 .. .. 2 15 2 2 9 9 5 47 Floors repaired 12 9 5 .. 6 3 7 8 9 7 25 19 110 Roofs repaired 67 43 53 3 15 9 60 29 58 36 63 85 521 Overcrowding abated .. .. 2 .. 2 2 1 2 2 1 5 5 22 Illegal use of underground Rooms for sleeping discontinued .. .. .. .. .. .. .. 1 .. .. 1 14 16 Other Improvements, or Nuisances abated 112 105 82 6 39 55 105 72 95 97 99 243 1110 Rooms Disinfected 162 167 272 14 183 60 112 113 35 139 202 231 1690 Total Improvements 769 899 786 44 435 307 793 496 648 598 880 1288 7943 Total Premises Improved . 417 438 526 24 267 140 394 289 333 309 366 539 4042 Note.—The Inspectors of Districts Nos. 4, 11 and 12 are serving witn the Array. 1916] 64 REMOVAL OF DUST. Only 21 applications were received during the year for the removal of dust, which is 7 below the number recorded last year. The return is eminently satisfactory, showing as it does, that the inhabitants of Islington are well served in the matter of dust collection. The applications received for the past ten years were as follows:— 1906 58 1911 52 1907 55 1912 47 1908 64 1913 32 1909 67 1914 26 1910 44 1915 28 Dust Receptacles Provided.—During the year 921 dust receptacles were provided, while 20 were repaired. STATE OF PAUPERISM IN THE BOROUGH. During the year the decrease in Pauperism was maintained, for the number of paupers relieved weekly averaged only 6,251, as contrasted with 7,424 in 1915, 8,629 in 1914, and 9,399 in 1913. Showing the State of Pauperism in the Borough during the year 1916. Quarters. Average number Relieved during each week. Borough Death rates. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals corresponding periods 1915 Vagrants Relieved. Children Boarded out. Adults. Children Totals. 1 2 3 4 5 6 7 8 9 1st Qr. 3,674 1,918 1,142 6,734 8,280 No Wards. 68 17.55 2nd „ 3,498 1,770 1,021 6,289 7,556 73 15.57 3rd ,, 3,328 1,704 973 6,005 7,041 65 11.23 4 th ,, 3,334 1,712 929 5,975 6,816 51 17.08 TheYear 3,459 1,776 1,016 6,251 7,424 — 64 15.35 65 [1916 INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 1,332 visits to the 22 Slaughter Houses now on the register, and that he has ascertained that 30,740 animals were killed therein, namely:— 843 oxen, 3 calves, and 29,894 sheep and lambs. These were mostly found of very good quality and very free from disease. The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 1 ton 0 cwts. 0 qrs. 10 lbs. The diseases which affected animal food are set out in detail on p. 66. Shops, etc., Inspection of.—The number of shops, etc., where foodstuffs are sold varies somewhat from time to time, but may be approximated for the year as follows :— Butchers, provision dealers, etc., 196, meat and rabbit stalls 6, food preparation establishments 14, fish shops 85, fish stalls 5, fruit shops 188, and about 30 fruit stalls and barrows. To these a total of 13,890 visits were made, apportioned as under, viz. :— Butchers, Provision Dealers, etc., Shops . 7,049 visits. Food Preparation Establishments 306 „ Butcher and Provision Stalls 405 „ Fish Shops 1,712 „ „ Stalls 189 „ Fruit Shops 2,994 „ „ Stalls 1,235 „ Total 13,890 visits. Cowhouses.—There are 4 cowhouses, but only two are actually in use in the borough, and these were visited upon 42 occasions. They were generally found to be satisfactory. Offensive Trades.—The 4 tripe boilers, 2 gut scrapers and the knacker's yard received 114 visits during the year. One tripe boiling establishment was licensed during the year. 19161 66 List of diseased or unsound meat and organs discovered in slaughterbouses during the year 1916 : — No. of Cases Description Animal Affected. Nature of Disease or Affection. Extent of Disease. How disposed of. 2 Sheep Found dead Carcase and all organs Council's Crematory 2 do. Parasitic disease with emaciation do. do. do. 4 Oxen Tuberculous glands Head do. do. 10 do. Parasitic (Dis. Hep.) Whole or part of liver Council's Crematory and small parts on premises 8 do. Abscess do do. do. l6 Sheep Parasitic (various) Liver do. do. 1 do. do. Liver, lungs, and trimmings On the premises 1 do. Abscess Lungs do. 1 do. Tumour and Hydræmia Liver and kidneys do. Milkshops and Dairies. -At the close of the year there were 582 milkshops and dairies on the register, 23 having been added, and 19 removed from it. They received 1,117 visits from the District Sanitary Inspectors, who served notices for the execution of various sanitary improvements and the cleansing of dirty utensils. THE ADULTERATION OF FOODS AND DRUGS. During the year 1,139 samples of various foods and drugs were obtained by Inspector Burrell and submitted by him to the Public Analyst (Mr. Frank L. Teed, D.Sc.) for examination. Of these 1,025 were genuine, while 114, or 10 per cent., were adulterated. This is 0.5 per cent. lower than the percentage of adulteration in the preceding year, but 0'4 per cent. above the average rate during the last 25 years. 67 1916 Prosecutions.—70 summonses were issued under the Sale of Food and Drugs Acts, 42 of which were successfully prosecuted. Altogether penalties and costs to the amount of £150 l1s. 6d. were obtained. The Public Analyst, in his several quarterly reports during the year, reported on the genuineness of the articles examined as follows :— Examined. Genuine. Adulterated. Per cent. 1st Quarter 285 254 31 10.9 2nd 284 244 40 14.1 3rd 285 259 26 9.1 4th „ 285 268 17 5.9 The Year 1.139 1,025 114 10.0 Milk.—The qualitative results of the Analyses of the Milk samples, which have now been published for many years, are as follows :— No. of Samples. Solids not Fat. Fat. Total solids. Milk purchased on Sundays 160 8.60 3.53 12.13 Milk purchased on week-days 319 8.56 3.43 11.99 Milk procured in transit at Finsbury Park Station 120 8.83 3.63 12.46 Official Standard — 8.50 3.00 11.50 The particulars as to the genuineness or otherwise of the samples procured or purchased on Sundays, Week-days, and at Finsbury Park Railway Station are as follows:— Number taken. Genuine. Adulterated. Percentage Adulterated) On Sundays 160 133 27 16.9 On Week-days 319 261 58 18.2 At Railway Stations (Farmers' Milks) 120 112 8 6.7 599 506 93 15.5 1916] 68 Givng the particulars of the Milk taken during each quarter of 1916 on Sundays, Week days, and at the Railway Stations. 1916. 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 31 63 27 121 9 17 3 29 22.5 21.2 10.0 19.3 2nd ,, 40 79 30 149 31 59 26 116 9 20 4 33 22.5 25.3 13.3 22.1 3rd „ 40 80 30 150 34 68 29 131 6 12 1 19 15.0 15.0 3.3 12.7 4th „ 40 80 30 150 37 71 30 138 3 9 .. 12 7.5 11.2 8.0 The Year 160 319 120 599 133 261 112 506 27 58 8 93 16. 9 18.2 6.7 15.5 MILK AND CREAM REGULATIONS, 1912. Altogether eight samples of Cream were submitted to the Public Analys under these Regulations, of which two, taken informally, failed to conforn with the Regulations. 69 [1916 Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1916. Description. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. 1st Quarter. Genuine. 4th Quarter. Totals- Adulterated. 4th Quarter. Totals. 2nd Quarter. 3rd Quarter. 1st Quarter. 2nd Quarter. 3rd Quarter. Milk 148 149 150 150 597 120† 116† 131† 138† 505 28† 33†* 19†* 12† 92 Milk, Separated 2 •• •• •• 2 1† •• •• •• 1 1† •• •• •• 1 Butter 50 50 50 50 200 50 49 50 48 197 •• 1 •• 2 3 Cheese 10 10 10 10 40 10 10 10 10 40 •• •• •• •• •• Lard 5 5 5 5 20 5 5 5 5 20 •• •• •• •• •• Dripping •• •• 7 •• 7 † •• 7 •• 7 •• •• •• •• •• Tea 7 •• •• •• 7 7 •• •• •• 7 •• •• •• •• •• Coffee 7 7 7 5 26 6 7 7 5 25 1 •• •• •• 1 Coffee and Chicory •• •• •• 2 2 •• •• •• 2 2 •• •• •• •• •• Cocoa 7 7 7 7 28 7 7 7 7 28 •• •• •• •• •• Mustard 7 •• •• 5 12 7 •• •• 5 12 •• •• •• •• •• Pepper •• •• 7 •• 7 •• •• 7 •• 7 •• •• •• •• •• Golden Syrup •• 3 •• •• 3 •• 3 •• •• 3 •• •• •• •• •• Malt Vinegar 3 •• •• 2 5 3 •• •• 2 5 •• •• •• •• •• Bread •• •• •• 3 3 •• •• •• 3 3 •• •• •• •• •• Flour 7 7 •• 7 21 7 7 •• 7 21 •• •• •• •• •• Self-raising Flour •• •• •• 7 7 •• •• •• 6║ 0 •• •• •• 1║ 1 Honey •• 7 •• •• 7 •• 7 •• •• 7 •• •• •• •• •• Pickles •• •• 3 •• 3 •• •• 3b •• 3 •• •• •• •• •• Olive Oil •• •• 5 •• 5 •• •• 5 •• 5 •• •• •• •• •• Chutney •• •• 1 •• 1 •• •• 1b •• 1 •• •• •• •• •• Rice •• 7 •• •• 7 •• 7 •• •• 7 •• •• •• •• •• Arrowroot •• 7 •• •• 7 •• 7 •• •• 7 •• •• •• •• •• Black Currant Jam 3 •• 4 •• 7 3‡ •• 4‡ •• 7 •• •• •• •• •• Raspberry Jam 1 •• •• •• 1 1‡ •• •• •• 1 •• •• •• •• •• Apricot Jam 2 •• •• •• 2 2‡ •• •• •• 2 •• •• •• •• •• Strawberry Jam 1 •• 3 •• 4 1‡ •• 3‡ •• 4 •• •• •• •• •• Potted Meat •• •• 1 •• 1 •• •• •• •• •• •• •• 1 •• 1 Salmon & Shrimp Paste •• •• 2 •• 2 •• •• •• •• •• •• •• 2 •• 2 * Free from Boric Acid. † All free from Boric Acid and Formalin. ‡ All free from Sulphurous and Salicylic Acids and Arsenic. ║ All free from Arsenic. b Copper absent. 1916] 70 Samples of Foods and Drugs—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. 4 th Quarter. Totals. Baking Powder .. .. .. 7 7 .. • • • • 7 7 • • • • • • • • • • Beef Sausages .. .. 3 .. 3 .. • • 3a • • 3 • • • • • • • • • • Liquid Paraffin 5 .. .. .. 5 5 • • • • • • 5 • • • • • • • • • • Cream of Tartar 5 .. .. .. 5 5 • • • • • • 5 • • • • • • • • • • Milk of Sulphur 5 .. .. .. 5 5 • • • • • • 5 • • • • • • • • • • Quinine Wine .. 5 .. .. 5 .. 5§ • • • • 5 • • • • • • • • • • Camphorated Oil .. 5 .. 5 10 .. 5 • • 5 10 • • • • • • • • • • Boric Acid Ointment .. 5 .. .. 5 .. 3 • • 3 • • • • • • • • 2 Lime Water .. .. 5 .. 5 .. .. 5 • • 5 • • • • • • • • • • Eucalyptus Ointment .. .. 5 .. 5 .. .. 5 • • 5 • • • • • • • • • • Spirit of Sal Volatile .. .. .. 5 5 .. .. • • 5 5 • • • • • • • • • • Ammon. Tinct. Quinine .. .. .. 5 5 .. .. • • 4 4 • • • • • • 1 1 275 274 275 275 1,099 245 238 253 259 995 30 36 22 16 104 MARGARINE ACT. Margarine 10 10 10 10 40 9 6 6 9 30 1 4 4 1 10 Totals 285 284 285 285 1,139 254 244 259 268 1,025 31 40 26 17 114 § All free from Sulphurous and Salicylic Acids. a, Free from Boric Acid in two cases, trace in one sample. 71 [1916 LOCAL GOVERNMENT BOARD RETURNS. Abstracts from the Public Analyst's Returns, together with the proceedings taken during the Quartern of the Year 1916. ADULTERATED SAMPLES.— First Quarter, 1936. Sample marked. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. 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, with result of prosecution. T.L.B. 132 * Milk Inspector 16 per cent of added water Fined 1os. and 1os. 6d. costs. 140 * „ „ 13 „ ,, No prosecution. Notice exhibited in shop that milk was not guaranteed. 153 * „ „ 2 „ ,, No prosecution, percentage too small 155 * „ „ 8 „ „ Ordered to pay 12s. 6d. costs. 163 * „ „ 2 „ „ No prosecution, percentage too small 165 * „ „ 4 „ „ Cautiontd by letter. 166 * „ „ 4 „ „ „ „ 194 * „ „ 4 „ „ „ „ 195 * „ „ 4 „ „ „ „ 233 * „ „ 6 „ „ Summons withdrawn on payment of ₤i 4s. costs. 239 * „ „ 20 „ „ Fined ₤ 5 and £1 1s costs. 240 * „ „ 20 „ „ Summons withdrawn, as Defendant convicted on above summons. 239 T.L.B. 241 * „ „ 6 „ „ Fined ₤1 2s. and 1os. 6d. costs. 240 * „ „ 48 „ „ Summons dismissed on ground of warranty. 247 * „ „ 29 „ „ Fined £5 or 1 month. 248 * „ „ 37 „ „ Fined ₤5 or 1 month. 251 Margarine „ 100 per cent. of Margarine Fined £1 2s. and 0os. 6d. costs. (Wrapper not labelled .) 252 * Milk „ 10 per cent. of added water Fined 12s. 6d. costs. 254 * „ „ 2 „ „ No prosecution, percentage too small. * All free from Bone Acid and Formalin. 1916] 72 ADULTERATED SAMPLES (First Quarter, 1916)—continued. Sample marked. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. 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, with result of prosecution. TLB. 268 Coffee Inspector 84 per cent. of Chicory No prosecution. Sample sold with a declaration. 880 *Milk „ 12 per cent. of added water Fined 5s. and 1os. 6d. costs. 886 * „ „ 4 „ ,, No prosecution, percentage too small. 889 * „ „ 3 „ ,, No prosecution, percentage too small. 921 *Separated milk „ 7 ,, „ Fined 1os. 6d. and 1os. 6d. costs. 923 *Milk „ 2 ,, ,, No prosecution, percentage too small. 927 * „ „ 35 per cent. of the original fat abstracted Fine1 £1 is. and £1 is. costs. 930 * „ „ 3 per cent. of added water No prosecution, percentage too small. 967 * „ „ 3 „ ,, No prosecution, percentage too small. 969 * „ „ 6 „ ,, Fined 1os. 6d. and 1os. 6d costs. 971 * „ „ 11 „ ,, No prosecution. (Summons against warrantor dismissed.) 981 * „ „ 2 „ ,, No prosecution, percentage too small. * All free from Boric Acid and Formalin. Total number of samples analysed during the Quarter 285. Number of samples adulterated 31. 73 [1916 ADULTERATED SAMPLES.—Second Quarter, 1916. Sample marked. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. 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, with result of prosecution. T.L.B. 6 * Milk Inspector 4 per cent. of added water No prosecution, percentage too small. 10 * „ „ 2 ,, ,, „ „ 21 * „ „ 2 „„ „ „ 1 * „ „ 28 „ „ Dismissed under Probation of Offenders Act upon payment of £1 is. costs. 2 * „ „ 6 „ „ do. do. 46 * „ „ 2 per cent. of added water and 11 per cent. of the original fat abstracted Fined 1os. and 1os. 6d. costs. 49 * „ „ 17 per cent. of added water Summons dismissed on ground of warranty. 64 * „ „ 1 per cent. of added water and 2 per cent. of the original fat abstracted No prosecution. percentage too small. 71 * „ „ 23 per cent. of added water Fined £5 and 1os. 6d. costs. 73 * „ „ 18„ ,, Fired £5 and 1os. 6d. costs. 74 * „ „ 10 „ ,, Fined £6 and 1os. 6d. costs. 78 * „ „ 6 „ „ Fined 1os. and 1os. 6d. costs. 82 * „ „ 6 „ „ Fined ₤1 and 1os. 6d. costs. 84 * „ „ 9„ „ Summons dismissed on ground of warranty. 86 * „ „ 2 per cent. of added water and faint trace of formalin No prosecution, percentage too small. 89 * „ „ 2 per cent. of added water „ „ 92 * „ „ 4 „ „ „ 93 * „ „ 4 „ „ „ 113 * „ „ 3 „ „ „ 116 * „ „ 4 „ „ „ 120 * „ „ 3 „ „ „ 121 * „ „ 22 ,, Fined 1os. and £2 2s. costs. * All free from Boric Acid and Formalin. † Free from Boric Acid. 1916] 74 Total number of samples analysed during the Quarter 284. Number adulterated 40. * A11 free from Boric Acid and Formalin. ADULTERATED SAMPLES (Second Quarter, 1916)—continued. Sample marked. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. 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, with result of prosecution T.L.B. 141 *Milk Inspector 6 per cent. of added water Fined £3 and £1 10s. 6d. costs. 142 * „ „ 5 „„ Fined £3 and £1 10s 6d. costs 145 Margarine „ 100 per cent. of Margarine Summons not served, as Defendant absconded. 146 „ ,, 100 „ „ Fined 5s. 147 „ „ 100 „ Fined 2s. 6d and 10s 6d. costs 148 * Milk „ 2 per cent. of added water and 1 per cent. of the original fat abstracted No prosecution, percentage too small. 149 * „ „ 4 per cent. of added water „ „ „ 158 Boric Acid Ointment .. „ 167 per cent. of the Boric Acid deficient Dismissed on ground of warranty. 160 „ „ 12.7 „ „ ,, „ Dismissed because Somerset House Analyst's Certificate did not show Boric Acid deficiency. 163 * Milk „ 3 per cent. of the original fat ab stracted No prosecution, percentage too small 168 * „ „ 7 „ „ „ Summons dismissed, as Magistrate was satisfied that Defendant sent the milk exactly as it came from the cow. 171 * „ „ 4 per cent. of added water No prosecution, percentage too small. 172 * „ „ 4 „ „ „ „ „ „ 179 Butter „ 49 per cent. of Margarine Fined £3 and £1 11s. 6d. costs. 197 Margarine „ 100 ,, „ No prosecution Cautioned by letter. 364 * Milk „ 6 per cent. of added water Ordered to pay £3 3s costs. 366 * „ „ 15 per cent. of the original fat abstracted. Fined £2. 367 * „ „ 4 per cent. of added water No prosecution, percentage too small. 75 [1916 ADULTERATED SAMPLES.—Third Quarter, 1916. Sample Marked. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. Resclt of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken, with result of prosecution. T.L.B. 382 * Milk Inspector 4 per cent. of added water No prosecution (percentage too small). 388 * „ „ 8 ,, the original fat abstracted Fined 20s. costs. 400 * „ „ 13 ,, „ „ Ordered to pay 12s. 6d costs. 408 * „ „ 4 ,, added water No prosecution (percentage too small). 426 * „ „ 10 „ the original fat abstracted Summons dismissed under Probation of Offenders Act on payment of £1 3s. costs. 448 * „ „ 3 „ added water No prosecution (percentage too small). 450 * „ „ 10 „ „ Fined £2 or 14 days. 464 * „ „ 2 „ „ No prosecution (percentage too small). 495 Margarine „ 100 per cent. of Margarine Ordered to pay 12s 6d. costs. Wrapper not labelled. 496 „ „ 100 „ „ Fined £2 and 12s. 6d. costs. Wrapper not labelled. 497 „ „ 100 „ „ Ordered to pay 12s. 6d. costs. Wrapper not labelled. 523 §Milk „ 0 004 per cent. of Formaldehyde Cautioned by letter. 531 * „ „ 20 per cent. of added water Fined £10 and £2 2s. costs, or 14 days. 533 * „ „ 3 „ „ No prosecution (percentage too small). 534 * „ „ 4 „ „ Fined £10 or 14 days. 538 * „ „ 4 „ „ Fined £10 or 14 days. 557 * „ „ 3 „ „ No prosecution (percentage too small). Cautioned by letter. 573 Margarine „ 100 per cent. of Margarine Fined 5s. and 10s. 6d. costs. Wrapper unstamped. 589 Potted Meat „ 0.51 per cent, of Boric Acid No prosecution (percentage too small). 590 Salmon & Shrimp Paste „ 0.64 „ „ „ „ 591 „ „ „ „ 0.54 „ „ „ „ 597 * Milk „ 4 per cent. of added water .. Cautioned by letter. 625 * „ „ 8 „ „ Dismissed on ground of warranty. 629 * „ „ 3 ,, „ No prosecution (percentage too small). 647 * „ „ 20 per cent. of the original fat abstracted Dismissed. Defendants proved they had no reason to believe warranty was false 659 * „ „ 7 „ „ Fined 10s. and £2 2s. costs. Total number of samples analysed during the Quarter 285 Number of samples adulterated 26 * All free from Boric Acid and Formalin. § Free from Boric Acid. 1916] 76 ADULTERATED SAMPLES.—Fourth Quarter, 1916. Sample marked. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. 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, with result of prosecution. T.L.B. 680 §Self-raising Flour Inspector 0.98 per cent. of Calcium Sulphate.. Cautioned by letter. 689 * „Milk „ 10 „ added water Fined £3, to include costs. 741 * „ „ 37 ,, original fat abstracted Fined £3 and £2 2s. costs. 798 * „ „ 2 „ No action. 815 Ammon. Tinct. Quinine „ Correct as to Quinine Sulphate, but Ammouia rather deficient No action. 844 * Milk „ 4 per cent. of added water No action. 861 * „ „ 7 „ „ Dismissed on ground of warranty. 866 * „ „ 16 „ „ 'Fined £2. 874 Margarine „ 100 „ Margarine Fined £2 and 12s. 6d. costs. „ (Wrapper not marked.) 875 *Milk „ 7 ,, added water Fined £2 and 12s. 6d. costs. 796 * „ „ 17 ,, original fat abstracted Fined £2 and 12s. 6d. costs. 801 802 Butter * „ „ 100 „ Margarine 90 „ „ Informal samples. 815 Milk „ 2 „ added water No prosecution, percentage too small. 829 * „ „ 2 „ „ do. 848 * „ „ 3 „ „ do. 849 * „ „ 3 „ „ do. Total number of samples analysed during the Quarter 285 Number of samples adulterated 17 * All samples free from Boric Acid and Formalin. § All free from Arsenic. 77 [1916 SUMMARY OF PROSECUTIONS.—During year 1916. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties Received. "Public Health (London) Act, 1891 " 5 4 ... 11 ₤ s. d. 21 13 0 " Sale of Food and Drugs Acts, 1875-99 " 64 43 17* 4+ 141 15 6 " Margarine Act, 1887 " 6 6 ... ... 8 16 0 Total 75 53 17 5 171 14 6 * Warranty established in nine summonses. Five cases were dismissed on their merits One summons dismissed under Probation of Offenders Act, on payment of £1 3s. 0d. costs; whilst two were alternative summonses. † These were alternative summonses. Work done prior to hearing of summons. 1916] 78 Table A. Showing the Deaths from All Causes in Islington during the Year 1916. 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. Total 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.E. Small Pox (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. 7 Measles 17 60 3 .. .. .. .. .. .. .. .. .. .. 77 3 1 .. 2 14 4 39 20 43 37 80 Scarlet Fever .. 8 7 1 .. 1 1 .. .. .. .. .. .. 8 10 3 .. 4 1 1 3 6 10 3 18 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Epidemic Influenza .. .. .. .. .. .. .. 1 6 6 10 7 6 .. 36 3 4 .. 4 8 2 10 14 22 36 8 Whooping Cough 31 27 2 .. .. .. .. .. .. .. .. .. .. 58 2 10 4 3 9 4 12 18 25 35 60 3 Diphtheria 3 22 14 3 1 1 1 .. .. .. .. .. .. 25 20 3 5 6 5 3 7 16 20 25 45 1 Enteric Fever .. .. .. 1 .. 1 1 1 5 .. .. .. .. .. 9 1 1 1 1 3 .. 2 3 6 9 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 Diarrhæa, Dysentery 24 5 .. .. .. .. 4 2 4 4 1 1 .. 29 16 5 5 3 1 3 15 8 26 19 45 Epidemic Enteritis 7 4 .. .. .. .. .. .. .. .. .. .. .. 11 .. 3 1 .. 4 2 1 .. 7 4 11 4** Other Allied Diseases *8 *8 .. .. *1 *1 *1 .. +1 .. .. .. .. 16 4 .. 2 1 3 1 4 9 12 8 20 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 2 1 .. .. .. .. .. .. .. .. .. .. .. 3 .. 1 .. .. 1 1 .. .. 2 1 3 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. • • .. .. .. .. 15 2 Syphilis 8 1 .. .. 1 .. 1 1 .. 1 2 .. .. 9 6 .. 4 .. 2 4 3 2 8 7 .. Gonorrhæa .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 3 Erysipelas 1 .. .. .. 1 1 1 .. .. 1 .. 2 .. 1 5 .. 1 .. 2 .. .. 3 3 3 9 1 Puerperal Fever .. .. .. .. .. .. 6 2 .. .. .... .. .. .... 9 .. 1 3 .. 3 2 .. .. 9 8 Pyæmia 3 2 .. .. .. .. .. 1 1 1 .. .. .. 5 3 .. .. .. 1 5 1 1 3 5 8 2 Infective Endocarditis .. .. .. 1 1 3 2 .. 1 .. .. .. .. .. 8 1 .. .. 1 1 3 2 2 6 7 2 Other A llied Diseases 1 .. 1 .. .. .. .. .. .. 4 1 .. .. 1 6 1 .. .. 3 1 1 1 7 .. .. Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 11 Rheumatic Fever .. .. 1 1 2 1 1 2 2 1 .. .. .. .. 11 .. 1 2 1 2 3 2 5 6 3 Rheumatism of Heart .. .. .. .. 2 .. .. .. 1 .. .. .. .. .. 3 .. .. .. .. .. .. 3 1 2 60 11 Tuberculosis of Brain 10 28 15 4 3 .. .. .. .. .. .. .. .. 38 22 5 3 4 3 9 12 14 35 25 3 2 Tuberculosis of Larynx .. .. .. .. .. .. 1 2 .. .. .. .. .. .. 3 .. .... 1 1 .. .. 1 2 1 455 158 Phthisis 3 9 6 9 28 37 90 1U3 85 60 24 1 .. 12 143 37 62 33 53 71 73 121 273 182 22 6 Abdominal Tuberculosis 3 8 .. 2 2 .. 3 2 2 .. .. .. .. 11 11 3 1 1 5 1 6 5 11 11 12 General Tuberculosis 1 3 6 .. .. 1 .. .. .. 1 .. .. .. 4 8 .. .. 3 3 1 3 2 7 5 21 2 Other forms Tuberculosis .. 5 1 2 1 5 4 .. 1 2 .. .. .. 5 16 3 2 2 3 2 4 5 15 6 .. Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Actinomycosis .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Acute Alcoholism .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. Chronic Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Other Chronic Poisonings .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. 1 25 28 1 Osteo-arthritis .. .. 1 .. .. .. 1 .. 4 7 7 7 1 .. 28 3 5 4 2 5 3 6 3 2 3 Gout .. .. .. .. .. .. .. .. .. .. 2 1 .. .. 3 .. .. 1 1 • • .. 1 1 226 412 120 Cancer .. .. 1 2 .. .. 4 30 36 124 114 48 3 .. 412 46 49 43 38 75 71 90 186 12 30 2 Diabetes Mellitus .. .. .. 1 .. 3 3 1 4 8 7 2 1 .. 30 3 4 4 6 6 4 3 18 1 2 Prupura Hæmorrhagica .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 .. .. .. .. .. 2 .. 1 1 1 Hæmophilia .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 8 20 Anæmia .. 4 2 1 .. .. .. .. 3 4 4 .. .. 4 16 3 1 2 3 3 3 5 12 2 4 Lymphadenoma 1 .. .. .. 1 .. 1 .. 1 .. .. .. .. 1 3 .. .. .. 1 1 .. 2 2 42 91 Premature Birth 91 .. .. .. .. .. .. .. .. .. .. .. .. 91 .. 11 9 14 12 10 10 25 49 2 5 Injury at Birth 5 .. .. .. .. .. .. .. .. .. .. .. .. 5 .. .. .. 1 .. .. 1 3 3 6 17 Debility at Birth 17 .. .. .. .. .. .. .. .. .. .. .. .. 17 .. 1 2 .. 5 2 2 5 11 3 12 Atelectasis 12 .. .. .. .. .. .. .. .. .. .. .. .. 12 .. 3 1 1 1 2 2 2 9 11 34 Congenital Defects 33 1 .. .. .. .. .. .. .. .. .. .. .. 34 .. 3 1 4 1 4 11 10 23 1 1 Want of Breast Milk 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 30 94 1 Atrophy, Debility, Marasmus 83 10 1 .. .. .. .. .. .. .. .. .. .. 93 1 5 12 13 18 10 18 18 64 • Cerebro-Spinal Meningitis. 79 [1916 Table a—Continued liorouvh. DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. [-Totals 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. j U.h. Toll. L.H. h. B. S.E. 1 4 1 5 ? ? 1 5 5 4 4 8 1 1 1 3 5 3 8 6 69 380 ?fi 69 51 58 69 56 71 149 ?31 580 Convulsions 17 5 22 2 2 4 4 4 5 13 9 22 Meningitis 3 y 2 1 1 1 12 b 3 1 3 2 5 2 1 6 11 17 Encephalitis i 1 i 3 1 I 1 1 2 3 S 1 fi 17 26 58 ?7 fi ,') 121 ii 17 io 12 29 21 ?,4 56 KK 124 Softening of Brain 1 1 8 5 lb 3 2 2 2 3 3 6 9 15 Hemiplegia 1 3 1 9 3 17 4 1 2 2 6 5 12 17 General Paralysis of the Insane 1 5 b 10 1 1 1 23 2 b 3 7 3 3 17 6 23 Other forms of Insanity 1 1 2 1 1 6 5 7 1 1 26 1 3 3 4 6 6 3 13 13 26 Chorea 1 1 ? 1 ?, 1 11 4 1 5 5 8 3 ?, 1 5 1 s ? 1 9 fi 3? 1 «s 1 8 8 18 14 Laryngismus Stridulus Locomotor Ataxy 1 5 3 2 11 1 1 2 1 1 5 2 10 1 11 1 1 5 8 fi fi 51 | 4 s S 4 11 ?n Other forms, Brain Diseases \2 + 1 1 2 1 2 5 1 ?, 1 1 2 2 5 7 Otitis 2 3 2 1 1 1 5 5 1 i 4 2 2 5 5 10 Disease of Nose, Epistaxis 1 1 1 1 1 1 1 1 1 1 ?, 1 1 4 1 1 ? 1 2 1 ?, 1 ? 1 ? 9 11 1 4 5 1 1 1 q Hypertrophy of Heart Angina Pectoris 1 1 2 3 7 1 1 1 1 1 6 1 7 2 Aneurism 2 5 5 12 1 4 3 2 2 10 ? 12 6 1 1 s 10 1 1 1 s 2 8 ?, 38 1 1 2 4 8 5 ?0 11 ? 54 fi 7 1?, 8 9 fi ?6 ?,8 54 Phlebitis 195 Other Diseases, Heart and 2 1 3 6 12 18 28 37 70 113 162 101 18 3 568 62 73 41 63 96 92 144 253 518 571 1 1 5 2 1 6 ?, 1 l 1 ? 5 s Croup Othei Diseases, Larynx and 9 41 ?S 1 1 5 8 18 ?1 66 SO 9 18 ?fi 17 ?,5 18 35 fi9 77 Mi 4 ? 8 4b fi7 119 4 564 77 58 ?9 45 S5 85 95 176 199 42 1 5 2 ?, ? 11 in 13 ?? lb fi 1 6 84 9 13 S 10 !fi 12 ?5 46 44 bb Lobular Pneumonia 82 7.5 5 1 2 3 3 8 13 11 7 1 155 54 16 /> 17 4,5 24 48 46 107 102 i09 20 19 19 ,5 2 4 1 9 9 ?1 ?3 ?4 <9 38 108 8 15 16 19 25 58 80 fifi i Emphysema, Asthma 1 I 2 2 3 2 3 1 1 14 ?, 2 4 3 4 12 3 15 1 Pleurisy 2 3 2 5 1 1 2 12 1 2 1 1 4 9 5 14 1 Other piseases, Respiratory Systeqi 1 2 3 1 1 2 10 1 2 2 3 2 5 5 1c 1 1 1 1 2 2 1 2 7 1 ? 2 2 2 I fi 9 Diseases of Pharynx 1 1 1 1 1 2 3 1 1 1 2 4 1 5 1 1 1 1 1 Ulcer of Stomach and Duodenum 1 1 1 3 8 7 1 1 ? 1 ?4 4 4 2 3 3 4 5 10 15 25 5 36 Other Diseases of Stomach Enteritis 8 54 1? 1 1 ? 1 1 5 2 ? 0 8 fifi 11 8 9 2 fi 1 8 5 7 4 8 5 17 2 19 7 45 12 51 19 4 1 1 1 1 1 3 ? 1 1 14 ? 1 1 3 4 4 fi q 3 1 1 1 1 ?, s 5 8 4 ?A 4 1 A 5 b 9 10 18 28 Other Diseases of Intestine ? 1 ?, 5 7 1 1 1 4 1 5 9 Cirrhosis of Liver 2 7 12 4 3 28 1 1 2 4 3 12 15 13 ?a 1 1 1 9 1 fi 4 1 1 1 3 i Peritonitis 1 ?, 1 1 1 1 1 8 1 ? 1 ? 1 ? 5 4 Other Diseases, Digestive System 1 1 1 1 2 1 1 1 3 3 Diseases, Lymphatic System and 1 3 1 1 1 4 1 1 4 12 1 1 1 2 5 3 3 fi 10 16 4 Glands 9 1 ? ?, 1 1 ? 11 1 5 1 4 ? 7 4 19 1 1 1 ? 7 10 ?4 18 ?7 1 1 104 10 13 IS in 21 14 ?? 54 51 Calculus 1 1 2 4 1 l 2 1 5 4 Diseases of Bladder and Pros- 1 72 1 ? l 4 q 90 Other Diseases, Urinary System 1 2 1 1 2 1 7 1 1 1 l 2 2 1 4 1 3 7 Diseases of Ovaries 1 2 2 1 1 7 2 l 2 2 7 7 Diseases of Uterus and Appendages 1 1 2 4 1 3 4 4 Diseases of Vagina and External Genitals Diseases of Breast Abortion, Miscarriage 1 1 1 3 1 I 1 3 3 Puerperal Mania Puerperal Convulsions 1 1 2 1 1 2 2 2 2 l 1 •• 2 2 t Acute Poliomyelitis (2). J 1 Female 101 years. * 1 Female, 101 years. 1916] 80 Table A.—Continued. Deaths in Institutions within Borough DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females Total 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 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Pregnancy and Childbirth .. .. .. .. .. .. 3 2 .. .. .. .. .. .. 5 1 .. 1 1 2 .. .. .. 5 5 Arthritis, Ostitis, Periostitis .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 Other Diseases, Osseous System .. 3 1 1 .. .. 1 .. .. 1 1 .. .. 3 5 .. .. 1 1 1 1 4 6 2 8 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Eczema .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pemphigus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Integumentary System .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15 In Vehicular Traffic .. .. 6 1 1 .. 3 3 4 5 15 5 1 .. 44 7 4 4 4 8 8 9 35 9 44 On Railways .. .. 2 .. .. .. .. 1 2 .. .. .. .. .. 5 .. 2 .. .. .. 3 .. 4 i 5 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. 1 2 1 In Building Operations .. .. .. .. .. .. .. .. 2 1 2 .. .. .. 5 .. .. 1 1 1 .. 2 5 .. 5 By Machinery .. .. .. 1 .. .. .. .. .. 2 .. .. .. .. 3 1 .. 1 .. .. 1 .. 3 .. 3 By Weapons and Implements .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 10 Burns and Scalds 1 7 1 .. .. 1 .. .. 2 2 2 .. 8 8 .. 3 1 4 1 4 3 5 11 15 Poisons, Poisnous Vapours .. .. .. .. .. .. .. 1 .. .. 1 .. .. 2 .. .. 1 1 .. .. .. 1 1 2 Surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Effects of Electric Shock .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. 2 3 1 1 1 .. 1 1 .. .. .. .. 10 1 .. .. 3 2 3 1 8 2 10 Suffocation, Overlaid in Bed 4 .. .. .. .. .. .. .. .. .. .. .. 4 .. 1 .. .. 1 .. 1 1 2 2 4 22 Otherwise 7 1 .. .. .. .. .. 1 2 .. .. .. 8 3 .. 2 1 2 .. 3 3 8 3 11 Falls not specified .. 3 2 .. .. 3 2 5 6 10 11 5 3 44 '1 6 5 4 6 9 10 23 24 47 Weather Agencies .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Otherwise not stated 1 1 .... .. .. .. 1 1 .. 2 .. .. .. 2 4 .. 1 .. 1 .. 2 2 4 2 6 Homicide ?, .. .... .. .. 1 .. 1 .. .. .. .. .. 2 2 1 .. .. .. 1 2 .. 2 2 4 Warfare (wounds) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suicide. 1 By Poison .. .. .. .. .. .. 1 1 1 1 .. .. .. .. 4 1 .. 1 .. 1 1 .. 1 3 4 By Asphyxia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 By Hanging and Strangulation .. .. .. .. .. .. .. .. 2 2 .. .. .. .. 4 1 .. .. 1 .. 1 1 3 1 4 By Drowning .. .. .. .. .. .. .. 2 1 .. 1 .. .. .. 5 .. 1 1 1 .. .. 2 2 3 5 By Shooting .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 1 By Cut or Stab .. .. .. .. .. .. .. 2 .. 2 1 .. .. .. 5 1 .. .. 2 1 1 .. 5 .. 5 1 By Precipitation from Elevated Places .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 1 By Crushing .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 3 .. .. 1 1 .. .. 1 3 .. 3 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not ascer- tained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Males 385 201 63 32 42 34 118 167 298 355 393 257 52 586 1811 203 280 194 314 378 434 594 .. .. 2397 Females 249 198 47 26 39 57 125 157 237 295 112 385 127 447 1907 233 284 242 287 354 437 513 .. .. 2364 989 TOTAL DEATHS 634 399 110 58 81 91 243 324 535 650 805 542 179 1033 3718 136 568 —i 436 501 732 871 1107 2397 2354 4751 191] 81 [1916 LOCAL GOVERNMENT BOARD RETURN.—Table III. Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING YEAR. 1916. Causes of Death. Nett Deaths at the subjoined Ages of " Residents " whether occurring within or without the District. Total Deaths whether of "Residents" or " Nonresidents" in Institutions in the District. All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 6 and under 15 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 and upwards. 2 3 4 5 6 7 8 9 10 11 All causes Certified 4751 634 230 169 168 172 567 1185 1626 1714 Uncertified .. .. .. .. .. .. .. .. .. .. Enteric Fever 9 .. .. .. 1 1 2 5 .. 3 Small-pox .. .. .. .. .. .. .. .. .. Measles 80 17 42 19 2 .. .. .. .. 21 Scarlet Fever 18 .. 2 6 8 1 1 .. .. i Whooping Cough 60 31 l6 11 2 .. .. .. .. 8 Diphtheria and Croup 45 3 4 19 16 2 1 .. .. 8 Influenza 36 .. .. .. .. .. 1 12 23 2 Erysipelas 6 1 .. .. .. 1 1 1 2 5 Phthisis (Pulmonary Tuberculosis) 458 3 4 5 15 65 196 145 25 295 Tuberculous Meningitis .. 60 10 11 17 19 3 .. .. .. 18 OtherTuberculous Diseases 55 4 12 4 11 9 9 6 .. 11 Cancer, Malignant Disease 412 .. .. .. 3 .. 34 210 165 185 Rheumatic Fever 11 .. .. .. 2 3 3 3 .. 1 Meningitis 37 11 9 8 2 3 1 3 .. 13 Organic Heart Disease 491 1 .. 1 8 29 61 164 227 272 Bronchitis 514 41 22 7 1 .. 16 136 291 216 Pneumonia (all forms) 445 102 64 33 15 9 45 100 77 168 Other Diseases of Respiratory Organs 47 2 4 3 1 1 11 15 10 19 Diarrhoea and Enteritis 130 85 17 4 1 .. 8 9 6 63 Appendicitis and Typhlitis 15 .. .. 1 4 2 4 2 2 8 Cirrhosis of Liver 28 .. .. .. .. .. 2 18 8 15 Alcoholism 1 .. .. .. .. .. 1 .. .. 1 Nephritis and Bright's Diseases 116 1 .. .. 2 4 20 45 44 48 Puerperal Fever 9 .. .. .. .. 1 8 .. .. 1 Other accidents and diseases of Pregnancy and Parturition 12 .. .. .. .. 2 9 1 3 Congenital Debility and Malformation, including Premature Birth 237 225 7 4 1 .. .. .. .. 24 Violent Deaths, excluding Suicide 159 15 4 8 18 4 20 37 53 77 Suicide 23 .. .. .. .. .. 10 11 2 / / 9 Other Defined Diseases 1237 82 12 19* 36* 32 103 262 691 219 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. 4751 634 230 169 168 172 567 1185 1626 1714 Sub-Entries — included in above figures;— Cerebro-spinal Meningitis 20 8 4 4 .. 2 1 1 .. 6 Poliomyelitis 2 .. .. 1* 1* .. .. .. .. .. 1916] 82 [1916 LOCAL GOVERNMENT BOARD RETURN.—Table IV. Metropolitan Borough op Islington. INFANTILE MORTALITY DURING THE YEAR 1916. Nett Deaths from stated Causes at Various Ages under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under four Weeks. 4 Weeks and under 3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes Certified .. .. .. .. .. .. .. .. .. .. Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. 3 4 10 17 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 9 3 8 11 31 Diphtheria and Croup .. .. .. .. .. 1 .. .. 2 3 Erysipelas .. .. .. .. .. 1 .. .. .. 1 Tuberculous Meningitis .. .. .. .. .. .. 3 4 3 10 Abdominal Tuberculosis .. .. .. .. .. 1 1 1 .. 3 ( Other Tuberculous Diseases .. .. .. .. .. .. 2 2 .. 4 Meningitis (not Tuberculous) .. .. .. .. .. 1 2 5 3 11* Convulsions 4 2 2 .. 8 4 4 .. 1 17 Laryngitis .. .. .. .. .. .. .. 1 .. 1 Bronchitis .. .. 2 1 3 13 12 6 7 41 Pneumonia (all forms) 4 2 1 3 10 18 24 24 26 102 Diarrhœa 1 1 .. 1 3 7 11 5 5 31 Enteritis .. .. 2 1 3 14 13 12 12 54 Gastritis .. .. 1 .. 1 .. 3 .. .. 4 Syphilis .. .. 3 .. 3 3 1 1 .. 8 Rickets .. .. .. .. .. .. .. 2 2 4 Suffocation, overlying 1 .. 1 .. 2 2 .. .. .. 4 Injury at Birth 4 1 .. .. 5 .. .. .. .. 5 Atelectasis 10 1 1 .. 12 .. .. .. .. 12 Congenital Malformations 16 5 2 3 26 7 .. .. .. 33 Premature Birth 59 13 4 6 82 8 1 .. .. 91 Atrophy, Debility and Marasmus 21 5 4 5 35 29 24 10 3 101 Other Causes 9 2 4 1 16 10 9 7 4 46 Totals .. 129 32 27 21 209 128 116 92 89 634 Nett Births in the year legitimate 6,973 Nett Deaths in the year of legitimate infants 599 illegitimate 289 illegitimate infants 35 * Cerebro-Spinal Fever (8). 83 [1916 LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1916. PREMISES. Number of Places— Number of inspections, 1916. Number of Notices. 1916. Number of Prosecutions 1916. On Register at end of 1915. Added in 1916 Removed in 1916. On Register at end of 1916. Milk premises 573 28 19 582 1117 Nil Nil Cowsheds 4 Nil Nil 4 42 „ „ Slaughter-houses 22 Nil „ 22 1332 „ „ Other offensive trade premises 6 Nil Nil 6 114 „ „ Ice cream premises 238 11 14 235 33 „ „ Registered houses let in lodgings ‡ ... ... ... ... *... *... „ * Included in District Inspectors' Summary. ‡ No Register now kept under existing By-Laws. Total number of intimation notices served for all purposes 1777 Overcrowding, 1916. Number of dwelling rooms overcrowded 22 Number remedied 22 Number of prosecutions Nil Underground rooms— Illegal occupation dealt with during year 16 Number of rooms closed 16 Number of prosecutions Nil Insanitary houses— Number closed under the Public Health (London) Act, 1891 Nil Number closed under the Housing of the Working Classes Acts Nil Number of premises cleansed under Sec. 20 of the L.C.C. (General Powers) Act, 1904 72 19161 84 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 3 Revenue Acts— Number of houses for which applications were received during year 8 Number of tenements comprised therein 71 Number of tenements for which certificates were (a) granted 1 (b) refused 7 (c) deferred Nil Num er of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. Nil (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. Nil (c) For the prevention of keeping of animals in such a manner as to be injurious to health Nil (d) As to paving of yards, etc., of dwelling houses Nil (e) In connection with the removal of offensive matter, etc. Nil (f) As to cesspools and privies, removal and disposal of refuse, etc. Nil (g) For securing the cleanliness of tanks, cisterns, etc. Nil (h) With respect to water closets, earth closets, etc. Nil (i) With respect to sufficiency of water supply to water closets ... Nil (j) With respect to drainage, etc. (Metropolis Management Act, section 202) Nil (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) Nil Number of prosecutions under L.C.C. General Powers Act, 1907— (I) With respect to Water Supply to Tenement Houses Nil Mortuaries— Total number of bodies removed 507 Total number of infectious bodies removed 10