4361 4SL 19 1918. SIXTY-THIRD ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE METROPOLITAN Borough of Jslington. ALFRED EDWIN HARRIS, MEDICAL OFFICER OF HEALTH. London Vail & Co., Printers to the Council, 170, Farringdon Road, E.C. 1919. 1918. SIXTY-THIRD ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE METROPOLITAN Borough of Jslington. ALFRED EDWIN HARRIS, MEDICAL OFFICER OF HEALTH. London Vail & Co., Printers to the Council, 170, Farringdon Road, E.C. 1919. iii. INDEX. Page. Adulteration at Food 34 Bacteriological Examinations 23 Births 1 „ Illegitimate 1 „ Notification of 2 „ Stillborn 2 Cancer 12 Chicken Pox 18 Cleansing of Verminous School Children 25 Constitutional Diseases 12 Cow Houses 33 Deaths from All Causes during the year 2, 39 ,, „ Epidemic Diseases 10 ,, ,, Respiratory Diseases 14 „ in Public Institutions 9 Defence of Realms Act, 1914-17, Food Regulations 35 Disinfectants distributed and used 24 Disinfecting Station 24 Disinfection Work 23 District Inspectors' Work 30 Dust, removal of 31 Epidemic Diseases 9 ,, Cerebro-Spinal Meningitis 17 Erysipelas 12 Factories and Workshops Administration '26-30 Fatality from Notifiable Infectious Diseases 17 Food, Adulteration of 34 Food Inspection 32 Hospital Isolation of Infectious Diseases 17 Infant Mortality 3 Infant Welfare Work 6-9 Infectious Diseases in Schools 22 „ ,, (Non-notifiable) in Schools 22 Influenza 10 Inspection of Food 32 „ Kitchens of Restaurants 26 „ Slaughter Houses and Cow Houses 32, 33 Inquests 15 Isolation of Infectious Diseases 17 Local Government Board Returns 42, 43 London County Council Return of Sanitary Work 14, 45 Marriages 1 Measles, Notification of 16 Meat Inspection 32 iv. Page Milk and Cream Regulations 1912 35 Milk Adulteration 34 Milkshops and Dairies 34 Mortuary and Coroner's Court 15 Notification of Infectious Diseases 15 ,, „ Tuberculosis 18 „ „ Births Act 2 Non-notifiable Infectious Diseases in Schools 22 Offensive Trades 33 Ophthalmia Neonatorum 18 Outworkers' Premises 26-29 Other Notifiable Diseases 17 Phthisis 13-18 „ Notification of 18 Population—Estimated in 1918 1 Prosecutions, Summary of 38 Puerperal Septic Diseases 12 Polio-myelitis Acute 17 Pulmonary Phthisis 13-18 Respiratory Diseases 14 Samples analysed in 1918 36, 37 Sanitary Inspectors' Work 30 Septic Diseases 12 Shelter House 25 Slaughter Houses 32 Smoke Nuisances 31 Tubercular Diseases 13 Tuberculosis Dispensaries 20 Tuberculosis, Pulmonary, Notification of 18 Unsound Food 32 Vaccination 23 Venereal Diseases 15 Verminous Children, Cleansing of 25 Verminous Premises 31 Voluntary Maternity and Child Welfare Centres 7 Workshops and Factories. Inspection of 26-30 Welfare Work by Health Visitors 6 1 [1918 REPORT OF THE Medical Officer of Health FOR THE YEAR 1918. Population.—The population of the Borough in the year 1918 has again been divided into two categories by the Registrar-General—the estimated civil population, upon which is calculated the death rate of the persons dying in the Borough, and the estimated total population for the calculation of the birth rate. This includes, and that excludes, the military population. Total population (inclusive of military) 320,900 Civil „ (exclusive of military) 286,400 MARRIAGES. Marriages.—The number of persons married was 5,942, which is 564 more than the number married in the preceding year. The marriage rate, which was 18.51 per 1,000 inhabitants, was the highest rate since 1915, when it was 26.12. BIRTHS. The births registered during 1918 numbered 5,197, as contrasted with 8,359 in the year before the war and with 5,837 in 1917. The birth rate represents 16.20 per 1,000 of the population, and is 4'2 per 1,000 lower than the death rate. The birth rate in 1913 was 25T9, in 1917 it was 17.62 per 1,000 inhabitants. Illegitimate Births.—239 illegitimate births were registered, and were equal to 4.6 per cent. of the total registered births. This number was 58 less than in the previous year, and were 0.4 per cent. of the registered births less than in 1917. 1918] 2 Notification of Births Act, 1907.—4,303 births were notified, or 83 per cent. of the total number that was registered during the year. 83 per cent. of the total number that was registered during the year. They were notified as follows:— Notified by— Still Births. Live Births. Total. Doctors 15 356 371 Certificated Midwives 54 2,540 2,594 Parents and other persons 25 1,313 1,338 94 4,209 4,303 DEATHS. The deaths numbered 5,841, while the death rate was 20.40 per 1,000 of the population or 4'92 above that of the preceding year (15.48), and was 5.3 more than the average of the previous 10 years. The Deaths from All Causes in the Sub registration Districts were as follows:— Sub-Districts. Quarters. The Year. 1 2 3 4 Tufnell 132 103 83 230 548 Upper Holloway 190 121 116 270 697 Tollington 146 101 97 240 584 Lower Holloway 161 143 135 303 742 Highbury 240 177 157 351 925 Barnsbury 258 196 166 354 974 Islington (South-East) 406 250 235 480 1,371 The Borough 1,533 1,091 989 2,228 5,841 3 [1918 INFANT MORTALITY. 571 deaths occurred amongst infants under 12 months old, or '230 below the decennial average of 801. These deaths represented an infant mortality rate of 110 per 1,000 infants born, which is 8 per 1,000 above the mean annual record of the preceding 10 years. Infantile Mortality during each of the Ten Years 1909-18. Deaths at various Ages under One Year of Age. Years. Under 1 week. Weeks. Total under 4 wteks. Months. Total Deaths under 1 year. 1-2 2-3 3-4 4 weeks and under 3 months. 3-6 6-9 9-12 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 24 280 133 131 81 95 710 1918 195 49 47 29 320 187 178 111 102 838 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 1917 93 38 23 7 161 106 108 99 91 565 1918 123 31 19 14 187 87 112 78 107 571 Totals 1553 429 316 260 2558 1427 1461 1125 1119 7690 The mortality in the registration sub-districts ranged from 83 per 1,000 births in Upper Holloway to 135 in Tollington. 4 1918] Showing the Deaths among Infants per 1,000 Births during the year 1918, and also the mortality rates for the years 1908-17. Sub-Districts. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915. 1916. 1917. Mean 10 years. 1918. Increase or decrease on mean. Tufnell 81 107 78 85 6l 108 93 65 84 99 86 93 + 7 Upper Holloway 74 77 88 115 85 119 86 118 67 68 89 83 - 6 Tollington 117 96 88 131 88 104 92 135 93 102 105 135 +30 Lower Holloway 125 101 108 162 94 121 134 118 107 121 119 130 + 11 Highbury 101 93 82 104 80 89 93 109 74 83 91 99 + 8 Barnsbury 119 111 111 162 98 128 119 107 103 114 117 122 + 5 Islington South East 99 117 94 128 94 98 105 108 9i 89 102 107 + 5 The Borough 103 103 95 128 86 107 104 107 87 97 101 110 + 9 5 [1918 In London the infant mortality rate was 107 per 1,000 births, while in the six boroughs encircling Islington it was 101 per 1,000. The rate for England and Wales was 97 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 1908-17; and in 1918 from certain specified causes. Causes of Death. Mean rate of 3 years 1901-2-3 per 1,000 Births. 1918. Mean rate 10 years 1908-17 per 1,000 Bir.ths. Premature Birth and Congenital Defects 24.25 25.01 21 51 Bronchitis and Pneumonia 25.67 22.51 1871 Atrophy and Marasmus .. 20.54 16.93 14.51 Diarrhœal Diseases (all forms) 10.81 11.55 9.29 Convulsions 6.60 2 12 1.91 Whooping Cough 6.44 7.12 4.08 Measles 3.27 4.42 3.06 Phthisis 1.85 0.20 0.38 Other forms of Tuberculosis 5.68 3.46 3.56 Diphtheria 0 43 0.38 0.25 Total of above 105.60 93.70 77.26 All other causes .. 27.11 16.06 24.69 Total 132 .71 10..86000 101 95 1918] 6 WELFARE WORK BY HEALTH VISITORS. For the purpose of carrying out this work, the borough was divided into two districts, i.e., the part of Islington north of the Great Northern Railway, which is called the Northern District, and that south of the railway, which is known as the Southern District. To each a Health Visitor is appointed. The work performed by the two Health Visitors, during the year 1918, is set out in the following summary :— Northern District. Southern District. Total. Investigations. Calls. Investigations. Calls. Investigations. Calls. Measles (notifications) 1200 347 751 569 1951 916 Ophthalmia Neonatorum (notifications) 29 64 22 71 51 135 Diarrhoea and Dysentery (infant deaths) 1 ... 7 18 8 18 Chicken Pox - 1 ... 1 ... 2 ... Small Pox ... 21 ... 34 ... 55 Births (notified) 83 156 9 87 92 243 Complaints {re Welfare of Infants) ... 3 5 3 11 6 16 Afternoons at Maternity Centres 28 ... 5 ... 33 ... Visits to Welfare Centres ... 9 ... 8 ... 17 Do. re Supply of Free Milk - 4 27 21 46 25 73 Do. re Supply of Free Doctors 4 2 3 4 7 6 Other investigations 8 31 ... 46 8 77 Totals 1361 662 822 894 2183 1556 MEASLES. Contacts in Borough11 2246 Close Contacts 1958 7 [1918 WORK PERFORMED BY THE VOLUNTARY MATERNITY AND CHILD WELFARE CENTRES:— North Islington Maternity and Child Welfare Centre. Number of Expectant Mothers 176 „ Attendances 489 „ Consultations held 48 Number of Babies attending (all ages) 1,009 „ „ (under 1 year) 760 „ Attendances 6,400 „ Consultations held 290 Number of Attendances of Morning Callers 1,043 Number of Sewing Classes 72 „ Attendances 592 Number of Health Talks 69 „ Attendances 1,306 Number of Visits—Professional 4,094 „ „ —Voluntary 718 Number of Deaths—Infant 18 „ „ —Other 17 Infant Mortality (based on per 1,000 infants under 1 year) 23.7 Milk for necessitous Mothers 101 South Islington Maternity and Child Welfare Centre. Ante-Natal Cases. Number of Mothers 77 Full Term Births 41 Premature Births 2 Still Births 1 Miscarriages 5 Not yet confined 22 False Pregnancy 1 Left the neighbourhood before confinement 3 Number of Attendances 179 Referred to Hospital for Treatment 3 Home Visits 160 Post-Natal Cases. Number of Mothers 89 Number of Attendances 190 Referred to Hospitals— Medical 10 Surgical 8 1918] 8 Given Convalescent Treatment 11 Number of Deaths—Infant 10 „ „ —Other 13 Infant Mortality (based on per 1,000 infants under 1 year) 34.2 Record of Children. Children on Books 31st March, 1918 753 New Children during the year 348 Children on Books 31st March, 1919 1,101 Ceased to attend since 31st March, 1918 42.5 In attendance at the present time 676 Analysis of Attendances. Children under 1 year 292 Do. over 1 year 394. Weighing and Consultations 5,293 Weighings only 1,292 Special attendances 292 Milk for necessitous Mothers 94 West Islington Maternity and Child Welfare Centre. Patients. Children under 1 year 343 Do. over 1 year 242 Mothers, nursing 118 Do., expectant 33 Consultations 171 New Patients 539 Attendances of Patients 4,272 Home Visits. Supt. 1,930 Do. Assist. 1,989 Do. Nurse 634 Weighings only 1,830 Dressings, etc. 515 Massage 365 Deaths 12 Infant Mortality (based on per 1,000 infants under 1 year) 35.0 9 [1918 East Islington Maternity and Child Welfare Centre. Children under 1 year 190 Do. over 1 year 65 Mothers, nursing 21 Do. expectant 26 Consultations held 50 Total attendances 1,296 Home visits (Supt.) 1,895 Do. (Voluntary) 30 Weighings only 173 Massage 232 Deaths Infant Mortality (based on per 1,000 infants under 1 year) 42.1 Milk for necessitous mothers 23 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—2,521 persons died in the Public Institutions located in Islington, of whom only 1,728 belonged to this borough, the remaining 793 having come here for treatment or relief. Of these 592 died in the Holborn Infirmary and 94 died in the Great Northern Central Hospital. Of the 1,728 deaths of inhabitants, 1,196 occurred in the Islington Infirmary, 364 in the Islington Workhouses, and 110 in the Great Northern Central Hospital. The proportion which the 1,728 deaths in these public institutions bore to the borough mortality was 29.6 per ccnt. Without the Borough.—865 deaths of persons belonging to Islington were registered as occurring in Public Institutions in districts of London outside the borough and in various provincial towns. They included, among others, 35 in the North-Western Fever Hospital, 47 in the Children's Hospital, Great Ormond Street, 81 in St. Bartholomew's Hospital, 53 in the Colney Hatch Asylum, 41 in the Royal Free Hospital, 33 in the University College Hospital, 24 in the North-Eastern Fever Hospital, 37 in the Leavesden Asylum, and 76 in the Claybury Asylum. These 865 deaths represented 14.8 per cent. of all the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians numbered 2,593, and were equal to 44.4 per cent. of the total deaths registered during the year. 1918] 10 Fatal Accidents or Sudden Deaths outside the Borough.— One hundred and thirty-one inhabitants died from accidental deaths, or suddenly, in places outside Islington. Deaths from the principal Epidemic Diseases.—372 persons died from these diseases; and their deaths represented a death-rate of 1320 per 1,000 of the civil population, as contrasted with a decennial average of 387 deaths and a death-rate of V20 per 1,000. In London there were 5,302 deaths from the same diseases, representing a death rate of 132 per 1,000 of the civil population, while in the Boroughs encircling Islington the death rate was 1.38. The following is the record of the various diseases:— Disease Deaths. Death rate. Enteric Fever 7 0.02 per 1,000 Measles 1I4 0.40 Scarlet Fever 8 0.03 Whooping Cough 147 0.51 Diphtheria 45 0.16 Diarrhoea 51 0.18 Total 372 1.30 INFLUENZA. This disease which is very infectious caused 931 deaths. The record of deaths since 1856 are given below in quinquennial periods:— Quinquennia. Deaths. Average number of Deaths per annum. 1856-60 18 3.6 1861-65 12 2.4 1866-70 10 2.0 1871-75 2 0.4 1876-80 2 00.4 1881-85 2 0.04 1886-90 40 8.0 1891-95 718 143.6 1896-00 420 84.0 1901-05 271 54.2 1906-10 329 65.8 1911-I5 224 44.8 1916-18 (3 years) 1,004 334.5 11 [1918 The following statement gives the ages at which persons died in the borough and contrasts them with the returns for the preceding ten years, showing the increased number of deaths at each age:— Ages. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915 1916. 1917. Mean ioyrs. 1918. Difference. 0-5 3 1 2 3 1 5 1 3 — 1 2 106 +104 5-10 — 1 — — — — 1 — — — — 52 + 52 10-15 — — — — — — — — — — — 32 + 32 15-25 5 2 2 1 2 2 1 5 — — 2 141 +139 25-35 3 4 2 4 1 4 1 4 — 2 2 252 + 250 35-45 8 8 3 2 5 8 6 7 1 2 5 109 +104 45-55 14 10 5 6 1 17 5 15 6 7 9 93 + 84 55-65 16 9 5 3 4 5 7 12 6 8 7 69 + 62 65-75 14 20 5 10 7 7 7 11 10 10 11 50 + 39 75.upwards 18 15 12 8 7 10 1 14 13 6 10 27 + 17 All Ages 81 70 36 37 28 58 30 71 36 36 48 931 + 883 Showing the Deaths from Influenza in the Quartets of the Year 1918, together with the averages of the corresponding periods, 1908-17. Years Quarters. Totals. First Second. Third. Fourth. 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 1916 9 7 2 18 36 1917 22 8 1 5 36 Average 27 11 2 8 48 1918 14 8 60 849 931 Increase or Decrease -13 -3 + 58 + 841 + 883 918] 12 SEPTIC DISEASES. Of these diseases Erysipelas and Puerperal Septicaemia are the chief. Erysipelas.—Seven deaths were registered, which is one below the number in 1917, and 3 less than the average of the ten years 1908-17. Puerperal Diseases.—These include Puerperal Pyæmia, Septicaemia, Septic Intoxication and Puerperal Fever, and they caused one death, which is 5 below the return of 1917, and 6 less than the average of the preceding ten years. CONSTITUTIONAL DISEASES. The chief of these diseases are Cancer, Tuberculosis, Rheumatism, Diabetes, Gout, Gangrene and Purpura. They were collectively responsible for 1,110 deaths, as contrasted with an average of 1,048 in the preceding ten years. The death rate represented 3.87 per 1,000, as contrasted with a decennial average of 3.26 Cancer.—There were 393 deaths registered from it during the year, as contrasted with 432 in 1917, and with an average of 380 in the previous decennial period. The deaths represented a death rate of 1.37 per 1,000 of the inhabitants, which is a high rate, although not the highest that has been registered in Islington. 188 deaths occurred among males and 205 among females. It will be noticed in the following tabular statement how fell the disease becomes as age advances:— Ages. 1908. 1909. 1910. 1911. 1912. 1913- 1914. 1915 1916. 1917. Average. 1908-1917. 1918. 0- 5 1 — 2 1 1 1 — — — 2 1 — 5-15 2 3 1 3 2 — 2 1 3 2 2 — 15-25 8 3 5 4 4 7 2 2 — 5 4 — 25-35 6 10 6 5 7 13 11 7 4 8 8 8 35-45 41 27 40 32 25 31 37 24 30 31 32 27 45-55 63 79 72 67 71 83 69 75 86 73 74 75 55-65 112 96 100 92 130 99 121 120 124 131 112 99 65-75 93 94 85 87 86 115 96 105 114 120 99 126 75-85 39 34 47 31 51 49 40 39 48 55 43 52 85 & upwards 2 7 3 7 5 6 6 4 3 5 5 6 367 353 361 329 382 404 384 377 412 432 380 393 13 [1918 TUBERCULOSIS. All the tubercular diseases caused 631 deaths and were 68 above the average of the last decennium, and were also 35 above the number registered in 1917. The death-rate resulting from them was equal to 2.20 per 1,000 of the civil population, and represented 10'8 per cent. of the deaths from all causes during the year. Pulmonary Phthisis.—This disease, which is the principal one of the group, and caused 516 deaths, as contrasted with the decennial average of 437, while the death-rate was T80 per 1,000 of the civil population, as against the decennial rate of T36 per 1,000, which figures are an increase of 79 on the number of deaths and 0'44 on the mean death-rate. number of deaths and 0 44 on the mean death-rate. In 1911 the death-rate from Phthisis was 1.16 per 1,000 of the population, and in 1918 rose to T80 which is the highest rate recorded during 11 years. Years Pulmonary Phthisis. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants Deaths Death rates per 1,000 inhabitants. 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 1.06 7.88 11.9 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 1916 458 1.48 9.64 15.3 1917 485 1.63 10.54 15.5 Average 10 years 437 1.36 9.03 15.0 1918 516 1.80 8.83 2 0. 4 The following return gives the deaths each age period:— Age periods. Deaths. Age periods. Deaths. 0- 5 7 55-65 62 5-15 21 65-75 25 15-25 84 75 upwards 3 25-35 110 Total 516 35-45 113 45-55 91 14 Other Tubercular Diseases.—In addition to the deaths from Phthisis there were 115 from other tubercular diseases, namely:— Tabes Mesenterica 20 deaths. Tubercular Meningitis 67 „ General Tuberculosis 11 Other forms of Tuberculosis 17 „ These brought up the total number of deaths from tubercular diseases to 631, which are equal to an annual death-rate of 2.20 per 1,000 of the civil Populaion. Their distribution among the sub-registration districts was as follows:- Phthisis. Tabes Mesenterica Tubercular Meningitis. General Tuberculosis. Other forms of Tuberculosis. Totals. Tufnell 44 4 4 — 2 54 Upper Holloway 6 7 — 8 — 2 77 Tollington 55 2 8 2 1 68 Lower Holloway 59 4 8 — 2 73 Highbury 65 1 11 4 1 82 Barnsbury 96 5 10 1 4 116 Islington South-East 130 4 18 4 5 161 The Borough 516 20 67 11 17 631 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. These diseases, which include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 1,156 deaths, or 269 more than in 1917. 1 hey were equal to a death-rate of 4.03 per 1,000 of the civil population, and represented 19'8 per cent. of the total deaths registered in the borough. Acute Bronchitis.—There were 144 deaths as compared with 13'2 in the previous year. 55 occurred among males, and 89 among females. The deaths of 28 infants under 12 months were registered. Chronic Bronchitis.—Three hundred and six deaths were ascribed to it, 175 being males and 131 females. This return is 4 below that for 1917. Pneumonia (All forms).—Six hundred and forty-nine deaths were registered, of which 321 were males and 328 females. They are 254 above the number who died in 1917. It was very fatal to infants under a year old, among whom it caused 87 deaths, while between the ages of 1 and 5 years 190 died from it. Above 5 years of age the deaths numbered 372, 15 1918] As many as 208 deaths occurred in Public Institutions, chiefly the Workhouse Infirmaries. Pleurisy—From this disease 19 deaths were registered, of which 2 were under five years old. Only 3 deaths occurred in Public Institutions. Asthma and Emphysema.—Twenty-two deaths were recorded from these diseases, 21 of which were those of adults. Other Diseases of the Respiratory System.— Sixteen deaths were registered from them, as contrasted with 14 in 1917. VENEREAL DISEASES. Fifteen deaths were ascribed to these diseases, which equalled the return for 1917. They were 2 below the mean oi the preceding ten years 1908-17. The annual average number of deaths recorded during ten years from these diseases at three groups of ages has been as follows: — Under 1 year 11 deaths, 1.5 years 1 death, and over 5 jears 5 deaths, making an average total of 17 per annum. INQUESTS AND MORTUARY. During the year 476 bodies were received into the Mortuary, as compared with an average of 575 in the preceding 10 years. The return is the lowest known for forty-one years. The daily average number of bodies received was T3 and equalled that of 1917. In 348 cases inquests were held, as contrasted with an average of 404 in the ten years 1908-1917. 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 1,127, which represent an annual attackrate of 3'93 per 1,000 of the civil population. They were 794 below the average (1,921) which obtained in the preceding ten years 1908-17. This 1918] 16 decline was due to a decrease, when a comparison is made with the average of these years, of 634 cases of Scarlet Fever, of 35 cases of Diphtheria, of 31 cases of Enteric Fever, of 81 cases of Erysipelas, and of 15 cases of Puerperal Fever. On the other hand Small Pox showed an increase of 2 cases when similarly compared. The above rate of 3.93 per 1,000 of the civil population is further increased to 14.90 per 1,000 when the 3,150 cases of Measles notified under the "Public Health (Measles and German Measles) Regulations, 1915,'' are included. In London the attack-rate (less Measles) was 4.37 per 1,000, or 0.44 higher than in Islington, while in the Encirclin Boroughs it was 4.28 or 0.35 higher than here. Small Pox.—Two cases were notified in the Borough during the year; no previous case was known since 1910, when one case was entered. Scarlet Fever.—432 cases were notified, or a decrease of 634 or 40 per cent. on the average (1,066) of the ten years 1908-17. The attack-rate was equal to 1.51 per 1,000 of the civil population annually, which is a decrease of 1.81 per 1,000 on the mean rate (3.32) of the preceding ten years. Diphtheria and Membranous Croup were responsible for 518 cases of illness, and were 35 below the average (553) of the preceding ten years. The attack-rate was equal to 181 per 1,000 of the civil population annually, and was 0.09 above the mean rate (1.72) of the decennial period. In London the attack-rate was (2.03) per 1,000, and in the Encircling Boroughs 2.03. Enteric Fever was only notified in 30 instances which is 31 below the average (61) that obtained during the ten years 1908-17. The attack-rate was 0.10 per 1,000 annually, or 0.09 per 1,000 below the mean rate (0.19) of the last ten years. In London the rate was 0.09 and in the Encircling Boroughs 0.09 per 1,000 of the civil population. Typhus Fever.—Nil return. Continued Fever.—Nil return. Erysipelas—141 cases were notified, or 81 below the average (222) of the preceding ten years, the attack-rate being 0.49 per 1,000 ot the civil population, as compared with 0*50 in London and 0.54 in the Encircling Boroughs. 17 [1918 Puerperal Fever.—4 notifications were received, being in the proportion of 0.77 per 1,000 births. The cases were 3 below the average number notified during the ten years 1908-17, and showed a decrease of 0.12 in the proportion of attacks to a thousand births. HOSPITAL ISOLATION OF NOTIFIABLE INFECTIOUS DISEASES. There were 982 cases isolated in hospital, or 87T per cent. of the 1,127 cases which were notified during the year. Only 129 per cent. of the patients were nursed at home. The percentage of cases treated in hospital during the preceding ten years, 1908-17, averaged 85.0. 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 1,125 cases notified 67 deaths occurred, or 6 per cent., which contrasts with an average percentage of 4*8 in the preceding ten years 1908-17. CASES TREATED IN HOSPITAL. Disease. No. Percentage of known cases. Small Pox 1 50.0 Scarlet Fever 406 94.0 Diphtheria 503 97.1 Enteric Fever 27 90.0 Erysipelas 41 29.1 Puerperal Fever 4 100.0 982 87.1 OTHER NOTIFIABLE DISEASES. ACUTE POLIOMYELITIS. Five cases were notified during the year, as compared with six cases recorded in 1917. One death from the disease was registered EPIDEMIC CEREBRO-SPINAL MENINGITIS. Fourteen cases were notified, being a decrease of 13 on the return for 1917, and eight died, the fatality from the disease being at the rate of 57 per cent. of the cases notified. 1918] 18 CHICKEN POX. This disease was made notifiable by an Order of the London County Council from the 27th March to 30th June, 1918, during which period 652 cases were notified. ophthalmia neonatorum. This disease, which is so frequently caused by Gonorrhoea, was responsible for 39 notifications, of which 28 were forwarded by members of the Medical Piofession, and 11 by Midwives. As the result of visits by the Health Visitors 30 cases were referred to Hospitals for treatment, while 19 were attended at their homes. Nurses were provided by the Council in 11 cases. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury Islington, South-East. The Borough. Cases notified by Doctor 6 4 4 3 .. 4 3 28 ,, „ by Midwife * 1* 5* .. 2* .. 3 11 Cases inquired into 6 5 9 3 6 4 6 39 ,, treated in Hospital 4 4 6 3 6 2 5 30 „ treated at Home 2 1 3 .. .. 2 1 9 ,, attended by Nurse 1 .. 1 .. 4 2 3 11 * Notifications were also received from midwifes which had been notified by doctors. TUBERCULOSIS. 1,189 cases of Tubercular Disease were notified, and represent an attackrate of 4.15 per 1,000 of the civil population. This number is an increase of 134 on the return of the preceding year, and on the attack-rate of 0.60. It was also 346 more than in 1910. Pulmonary Phthisis.—1006 notifications were received, of which 603 referred to males and 403 to females, and represented an attack-rate of 3.51 per 1,000. The return was an increase of 109 on that of 1917. CASES of TUBERCULOSIS in ISLINGTON DURING 1918 BLACK denotes Pul monkryTubercul os/s. WHITE OtherFormsofTuberculosis. 19 [1918 THE PERIODS OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1918 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 Larynx.) M. 603 1 4 52 96 295 137 18 F. 403 — 1 48 79 182 82 11 Tubercular Meningitis M. 10 4 2 3 1 — — — F. 10 3 2 3 2 — — — Tabes Mesenterica M. 14 — 6 5 1 2 — — F. 10 1 1 5 1 1 1 — General Tuberculosis M. 3 — — 1 — 2 — — F. 2 1 1 — — — — — Other forms of Tuberculosis M. 61 1 7 28 10 8 6 1 F 73 — 6 33 15 12 5 2 All Tubercular Diseases M. 691 6 19 89 108 307 143 .19 F. 498 5 11 89 97 195 88 13 Totals 1189 11 30 178 205 502 231 32 Percentages at each life period to total cases 100 1.0 2.5 15.0 17.2 42.2 19.4 2.7 Disinfection of Houses and Rooms after Phthisis. The following statement gives the particulars for the yeax : — Houses. Rooms 1st quarter 97 112 2nd „ 64 92 3rd „ 71 93 4th „ 70 100 Total 302 397 20 1918] TUBERCULOSIS DISPENSARIES. The work of the Tuberculosis Dispensaries has been very satisfactorily performed, and during the year 1,507 persons were examined by the Tuberculosis Officers, and the patients made 10,309 attendances. At the Northern Dispensary there were 635 new cases, and at the Southern 872, while the attendances at the former were 3,798 and at the latter 6,511. The examination of contacts with tuberculous cases showed that 45 were suffering from tuberculosis, 58 were suspect, and 297 were not suffering. The nurses of the Northern Dispensary paid 1,540 visits, and those of the Southern 1,272, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 131 visits and of the Southern 174 visits to the patients' homes for the purpose of examining their patients. The full particulars for each month of the year are set out in the tabular statement which is as follows:— 21 [1918 Table showing the number of Tuberculous Persons attending the Borough T uberculosis Dispensaries and the New Cases during 1916. Date. Dispensary. Jan. Feb. March. April. May. June. July. August. Sept. Oct. Nov Dec. Year. Total. Attendances Northern 258 241 304 390 369 316 389 286 292 344 299 310 3.798 10309 Southern 461 522 585 610 644 562 583 464 533 615 478 454 6,511 New Cases Including Contacts. Northern 54 46 63 62 58 72 41 44 46 40 32 635 1,507 Southern 60 85 92 83 69 85 101 61 84 64 5 53 872 Contacts. Tuberculosis Northern 2 1 4 1 2 — 1 1 3 2 17 45 Southern 4 3 2 — 3 2 1 5 — 6 2 28 Suspects Northern 2 1 3 3 1 1 2 1 1 2 — 1 18 58 Southern 5 7 4 7 3 3 5 — 2 2 1 1 40 Non-Tuberculous Northern 1 3 7 11 10 5 4 4 7 5 6 4 67 297 Southern !9 25 35 17 20 17 21 10 32 22 1 11 230 Nurses' Visits Northern 141 138 131 126 169 137 145 159 122 10 140 122 1,540 2,812 Southern 131 138 122 134 143 131 132 20 137 128 6 50 1,272 Tuberculosis Officers' Visits Northern 12 15 14 14 13 10 10 10 12 10 11 131 305 Southern 14 15 14 15 14 15 13 16 15 14 16 13 174 22 1918] THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 1,545 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 228 were Scarlet Fever, 194 Diphtheria and 1,123 Measles. The number of notifications of the several diseases are given below:— Disease. No. of Notifications. Average of preceding 10 years. Decrease. Scarlet Fever 228 582 354 Diphtheria 194 246 52 Enteric Fever — 8 — * Measles 1,123 — — Total 1,545 * N.B.—Measles only became a notifiable disease from 1st January, 1916. Non-Notifiable Diseases.—3,484 cases came to the knowledge of the Medical Officer of Health during the quarter, viz.:—742 cases of Whooping Cough, 917 of Chicken Pox, and 1,825 cases of other diseases. The information respecting these cases was received from the teachers of 57 schools. Exclusion of Scholars from Schools.—1,524 children were excluded from classrooms of various schools owing to the presence of an infectious disease, chiefly Diphtheria, in the houses wherein they lived. Non-notifiable diseases among children attending the Public Elementary Schools:— Disease. Notifications by Teachers. Average of preceding 10 years. Increase or Decrease. Chicken Pox 917 783 + 134 Whooping Cough 742 644 + 98 Other Diseases 1,825 2,287 -462 3,484 3,714 -230 Note.—"Other Diseases" include Mumps, Scabies, Sore Eyes, Itch, &c. 23 [1918 BACTERIOLOGICAL EXAMINATIONS. During the year 738 examinations were made for the medical profession of the sputum and blood of patients lor the detection of Diphtheria, Enteric Fever anl Phthisis. This number shows a decrease of 183 on the return for 1917, but was 213 less than that for 1916. The following Table gives the results of the examinations that have been made daring the last 20 years. Diseases. Total Examinations. Positive Results. Negative Results. Percentage of Positive Results. Diphtheria 5,852 1,833 4,019 31.3 Enteric Fever 1,210 523 687 43.2 Phthisis 6,425 1,848 4,577 28.8 Total 13,487 4,204 9,283 8l.2 STATE OF VACCINATION IN ISLINGTON. Of the 5,405 births registered in 1917, the returns of the Vaccination Officers show that only 2,379 infants were successfully vaccinated; while 14 were declared insusceptible to vaccination; 314 died unvaccinated; 1,341 certificates of exemption were produced by parents; and 04 cases were postponed under medical authority, thus leaving 1,293 unaccounted for. Certificates of Exemption.—The following tabular statement shows that the increase of these certificates, more especially during the past eight years. 1906 123 1912 1,646 1907 259 1913 1,942 1908 588 1914 2,124 1909 824 1915 1,710 1910 1,080 1916 1,796 1911 1,241 1917 1,341 DISINFECTION. Disinfection of Rooms.—1,037 rooms were disinfected, as contrasted with 1,140 in 1917. For this purpose formaldehyde, either in a gaseous form or in solution, was employed, although it was sometimes augmented by sulphur dioxide, when it was necessary to kill vermin, for which purpose it has been found most effective. These above figures also include the disinfection of houses and rooms after Phthisis, vide p. 19. 24 1918] The Cleansing and Spraying of Rooms—1,802 rooms, as contrasted with 1,628 in 1917, were cleansed and sprayed. Rooms disinfected. Rooms sprayed. 1918. 1917. 1918. 1917. 1st Quarter 311 302 404 413 2nd „ 263 233 . 403 439 3rd „ . 215 240 387 340 4th 248 365 608 436 The Year 1.037 1,140 1,802 1,628 The following class-rooms, etc., were disinfected after the occurrence in them of cases of the diseases mentioned:— 1st Quarter. St. Mark's School, Grove Road (Influenza). 2nd Quarter. Nil. 3rd Quarter. Nil. 4th Quarter. Pakeman Street, L.C.C. Schools (Influenza). Private School, 29, Duncan Terrace (Scarlet Fever). Montem Street, L.C.C. Schools (Influenza). Ecclesbourne Road, L.C.C. Schools (Influenza). Work at the Disinfecting Station.—38,659 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 42,237 similar articles disinfected during the previous year. In addition to the above articles 182,135 old or second-hand garments, mostly soldiers' overcoats, jackets and tunics were disinfected for clothing contractors trading in the borough, who paid the Council £93 12s. 5d. for the work. Disinfectants distributed and used.—The following statement gives 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. qrs. Gallons. cwt. qr lbs. Gallons. To Householders 0 16 3 184 — — Disinfection of Premises — — 0 2 0 24 Cost = £88 14s. 6d. 25 [1918 Shelter House.—The Shelter House was occupied by four persons during the disinfection of their homes after infectious diseases. Baths were given to 9 verminous persons, 13 persons who had been in contact with an infectious disease were also afforded bathing facilities, and their clothing was disinfected. Verminous School Children.—During the year 4,226 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 42. The agreement entered into between the London County Council and the Borough Council, for the cleansing of verminous children, is a payment of 1s. for each bath; 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 amount paid during the year by the London County Council for the baths given to the children was £211 Gs. Od. In one case the London County Council instituted legal proceedings under Section 122 of the Children Act, 1908, and the prosecution resulted in a fine of five shillings being inflicted. 26 1918] FACTORY AND WORKSHOP ADMINISTRATION. In compliance with the requirement of the Factory and Workshops Act, the Medical Officer of Health, herewith, submits his annual report on the work carried out by the Workshops' Inspectors during the year 1918. Inspections and Visits.—The inspections and visits made by the Inspectors were as under:— Factories, including Factory Laundries 952 Workshops, including Workshop Laundries 1,486 Workplaces, other than outworkers' homes 282 Bakehouses 714 Restaurant Kitchens 288 Outworkers' premises 903 Miscellaneous re-inspections and calls 4,680 Total 9,305 Notices served.—In consequence of the 1,178 sanitary defects discovered as the result of the above-mentioned inspections, 213 intimations and 27 statutory notices were served. Of these notices 68 were served on the owners of factories, 148 on the owners of workshops, 24 on the owners of other work places. In addition to these nuisances, 99 were discovered on Outworkers' premises, necessitating the service of 46 notices. Registers.—There were 1,887 workshops on the Register, as contrasted with 1,896 in 1917, while the total number of workrooms was 2,707, as contrasted with 2,624 in the previous year. 106 workshops were added to the Register while 115 were removed from it. The various workshops and workplaces are tabulated as below:— Workshops and Workplaces. 1917. 1918. 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. Workshops where Men are employed 387 488 35 30 392 516 Workshops where Women are employed 858 1,353 52 48 862 1,375 Laundries 67 183 10 8 69 180 Bakehouses 238 248 238 248 Restaurant Kitchens 346 352 9 29 326 388 Total 1,896 2.624 106 115 1,887 2,707 Outworkers' Premises — 1,746 747 217 — 2,276 27 |1918 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. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries) 952 68 Nil Workshops (Including Workshop Laundries) 1,486 148 .. Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 1,284 24 .. Miscellaneous Re-inspections 4,680 .. .. Total 8,402 240 Nil 28 1918] 2.-DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES Particulars. (1) Number of Defects. Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (4) Nuisances under the Public Health Acts:—* Want of cleanliness .. 322 298 2 Nil Want of ventilation 9 9 .. .. Overcrowding 4 4 .. .. Want of drainage of floors 28 20 1 .. Other nuisances 288 214 .. .. Sanitary Accommodation insufficient 29 26 6 .. ursuitable foul or defective .. 476 402 .. .. not separate for sexes 11 11 8 .. Offences under the Factory and Workshop A ct:— Illegal occupation of underground bakehouse (s. 101) .. .. .. .. Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) 11 11 .. .. Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) •• •• .. .. Total 1,178 1,025 17 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. 29 [1918 NATURE OF WORK * Outworkers' Lists, Section 107. u nwholesomk Premises, Section 108. prem i ser (Secs. 109. HO). 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) (16) Wearing Apparel— a (1) making, &c. 126 35 1,522 15 7 89 115 .. .. 115 33 .. 14 .. .. (2) cleaning and washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Curtains and furniture hangings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 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. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. Artficial Flowers ,. 8 .. 119 .. .. .. 6 .. .. 4 3 .. 3 .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Racquet and Tennis Balls .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper, etc., Boxes, Paper Bags 18 .. 222 .. .. .. 21 .. .. 21 6 .. 2 .. .. Brush making 4 .. 122 .. .. .. 2 .. .. 2 2 .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed toys 2 .. 39 .. .. .. 3 .. .. 2 2 .. .. .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chocolates and Sweetmeats .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cosaques, Christmas Crackers, Christmas Stockings, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Textile weaving .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Christmas Stockings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 158 35 2,024 15 7 89 147 Nil Nil 144 46 Nil 20 Nil Nil 30 1018] 4—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Workshops where men are employed 392 Workshops where women are employed 862 Laundries 69 Bakehouses 238 Restaurant kitchens 326 Total Number of Workshops on Register 1,887 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) 24 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 15 Reports (of action taken) sent to H.M. Inspector. 4 Other (New Factories reported under Home Office Memorandum, 1912) nil Underground Bakehouses (s. 101) in use at the end of the year 75 DISTRICT INSPECTORS' WORK. Owing to the War the District Sanitary Inspectors again worked with five men short, and therefore the sanitary improvements effected in the Borough were less than usual. Each of the fourteen sanitary districts contain in ordinary times on an average 23,000 persons for the Inspector to look after, but during the last few years these were reduced to 10 districts, so that each district contained about 33,000 persons, so that the tally of work necessarily shows a decrease, although, if each Inspector's work be taken and compared with previous years, it will be found in each instance to show an increase. It is much to be regretted that house-to-house inspection had to be abandoned during the war. 31 [1918 Synopsis of the Inspectors work,—The following statement gives a brief synopsis of the district inspector's work in 1918:— House to house inspections* 106 Other inspections of dwelling houses 4,029 Re-inspections and calls made 29,584 Visits of inquiry re notifiable infectious diseases 1,127 „ school cases of infectious diseases 1,545 Butchers' shops, stalls, etc. (Saturday nights) 78 Ice cream shops and factories 6 Dairies and Milkshops 805 Stables and yards 1,957 Manure depots 76 Certificates under the Customs and Inland Revenue Acts 3 Smoke observations 16 *These inspections were almost entirely dropped during the war. Notices Served.—There were 1,078 intimation notices served by the inspectors with respect to nuisances, of which 513 were delivered personally, and 565 by post. In 200 instances it became necessary, as the intimations to owners or occupiers of the properties had been ignored, to report the nuisances to the Public Health Committee, who ordered statutory notices to be served. Verminous Premises —Bedding and Clothing.—13 premises which were found to be in a verminous condition, were cleansed by the owners or occupiers upon receiving the Inspectors' intimations. In 22 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification or destruction. Smoke Nuisances.—Black smoke was observed to be issuing from the chimney of the undermentioned premises, and consequently a notice was served on the owner of the following business requiring the abatement of the nuisance:— Mayfield Laundry, 93, Gillespie Road. REMOVAL OF DUST. Only eleven applications were received during the year for the removal of dust, which is 19 below the number recorded last year. The return is the lowest hitherto recorded in the Borough. 1918] 32 The applications received for the past ten years were as follows:— 1908 64 1913 32 1909 67 1914 26 1910 44 1915 28 1911 52 1916 21 1912 47 1917 30 Dust Receptacles Provided.—During the year 243 dust receptacles were provided, while 6 were repaired after the service of sanitary notices. INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 889 visits to the 21 Slaughter Houses now on the register, and that he has ascertained that 17,871 animals were killed therein, namely:— 1,489 oxen and cows, 15,923 sheep and lambs, 51 pigs and 408 horses for human consumption. These were mostly found of good quality and free from disease. The food destroyed or otherwise disposed of (chiefly for pigs' food) so as to prevent its use for human food was as follows:— Tons cwts. qrs. lbs. Diseased meat and organs from slaughter-houses 15 3 7* Diseased or unsound meat, etc., from other sources 1 8 3 4 Fish 2 4 0 23 Bread (mouldy) 6 3 14 Cheese 15 3 19 Tinned Milk 0 2 1 Butter and Margarine 0 3 0 Eggs 0 3 3 Rabbits 3 1 19 Vegetables, etc. 0 0 26 Chocolates (mouldy) 0 0 13 Total Tons 5 17 1 17 The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 5 ton 17 cwts. 1 qr. 17 lbs. The diseases which affected animal food are set out in detail on p. 33. * Of this quantity 1,310 lbs was Tuberculous, 83 [1018 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., 178, meat and rabbit stalls 3, food preparation establishments 16, fish shops 76, fish stalls 5, fruit shops 163, and about 15 fruit stalls and barrows. To these a total of 8,007 visits were made, apportioned as under, viz.:— Butchers, Provision Dealers, etc., Shops 4,544 visits. Food Preparation Establishments 281 „ Butcher and Provision Stalls, 115 „ Fish Shops 1,081 „ „ Stalls 148 „ Fruit Shops 1,467 „ „ Stalls 371 „ Total 8,007 visits. Cowhouses.—There are 4 cowhouses, but only three are actually in use in the borough, and these were visited upon 18 occasions. They were generally found to be satisfactory. Offensive Trades.—The 4 tripe boilers, 2 gut scrapers and the knacker's yard received 69 visits during the year. List of diseased or unsound meat and organs discovered in slaughterhouses during the year 1918:— No. ol Cases Description of Annimal Affected. Nature of Disease or Affection Extent of Disease. How disposed of. 1 Heifer Tuberculosis (generalised) Carcase and all organs N.B. —On the ground of National economy the bulk of the meat and organs found unfit for human food was disposed of to Pig Keepers' for Pigs' food; and in other cases it was destroyed by fire. 4 Cows Tuberculosis (localised) Various organs 6 Oxen do. do. do. 1 Heifer do. do. do. 1 Sheep Parasitic disease with emaciation Carcase and all organs 15 Oxen Parasitic disease and secondary causes Liver 1 Ox Abscess do. 2 Cows Parasitic disease do. 103 Sheep do. do. do. 5 do. do. do, Liver and Lung 1 Ox Decomposition Lungs 1 Horse Hydatid disease Liver 34 1918] Milkshops and Dairies.—At the close of the year there were 586 milkshops and dairies on the register, 21 having been added, and 21 removed from it. These premises received 805 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 1,124 samples of various foods and drugs were obtained by Inspector Burrell and the District Inspectors and submitted by them to the Public Analysts (Mr. Frank L. Teed, D.Sc., and Mr. E. A. Pinchin, B.Sc.) for examination. One sample of milk was also submitted by a private purchaser. Of these 1,017 were genuine, while 108, or 96 per cent., were adulterated. This is 2.2 per cent. higher than the percentage of adulteration in the preceding year, and 0'9 per cent. below the average rate during the last 28 years. Prosecutions.—79 summonses were issued under the Sale of Food and Drugs Acts, 51 of which were successfully prosecuted. Altogether penalties and costs to the amount of £233 7s. 0d. were obtained. The Public Analysts, in the quarterly reports during the year, reported on the genuineness of the articles examined as follows:— Examined. Genuine. Adulterated. Per cent. 1st Quarter 268 236 32 11.9 2nd „ 266 238 28 10.5 3rd „ 284 265 19 6.7 4th „ 307 278 29 9.4 The Year 1,125 1,017 108. 9.6 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 136 8.39 3.60 11.99 Milk purchased on week-days 377 8.44 3.53 11.97 Milk procured in transit at Finsbury Park Station 121 8.61 3.65 12.26 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:— 35 [1.918  Number taken. Genuine. Adulterated. Percentage Adulterated On Sundays 136 1l6 20 14.7 On Week-days 377 310 67 17.8 At Railway Stations (Farmers' Milks) 121 111 10 8.3 634 537 97 15.3 Giving the particulars of the Milk taken during each quarter of 1918 on Sundays, Week-days, and at the Railway Stations. 1911. 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 31 93 20 144 26 70 18 114 5 23 2 30 16 1 24.7 10.0 20.7 2nd ,, 40 117 30 187 34 98 29 161 6 19 1 26 15 0 16.2 3.3 13.9 3rd „ 35 80 30 145 34 70 27 131 1 10 3 14 29 12.0 10.0 9.6 4th „ 30 87 41 158 22 76 30 142 8 15 4 27 26 6 17.2 9.7 17.1 The Year 130 377 121 634 116 310 111 537 20 67 10 97 14 7 17.8 8.3 15.3 MILK AND CREAM REGULATIONS, 1912. No samples of Cream were submitted to the Public Analysts under these Regulations, the use of Cream, for the time, being prohibited. DEFENCE OF THE REALM ACTS, 1914-17. Two samples of Margarine were submitted under the Regulations, both of which conformed with the Food Control Orders. 36 1918] Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1918. Description. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Genuine. Adulterated. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. TotAls. Milk 144 183 149 158 634 114a 157a 135a 131a 537 30a 26a 14a 27a 97 Butter 1 .. 19 47 67 .. .. 19 47 66 1 .. .. .. 1 Lard .. .. 21 6 27 .. .. 21 6 27 .. .. .. .. .. Dripping .. .. 7 12 19 .. .. 7 11 18 .. .. .. 1 1 Coffee 12 13 7 12 44 11 13 7 12 43 1 .. .. .. 1 Cocoa 12 12 .. 16 40 12 12 .. 16 40 .. .. .. .. .. Muslard 12 .. .. .. 12 12 .. .. .. 12 .. .. .. .. .. Pepper 12 .. .. 8 20 12 .. .. 8 20 .. .. .. .. .. Vinegar .. .. .. .. 1 .. 1 .. .. 1 .. 1 .. .. .. .. .. Malt Vinegar .. 3 6 12 21 .. 3 6 11 20 .. .. .. 1 1 Sauce .. 3 10 .. .. 13 3c 10d .. .. 13 .. .. .. .. .. Self-raising Flour 8 11 .. .. 19 8 10 .. .. 18 .. 1 .. .. .. Honey 2 1 .. .. 3 2 1 .. .. 3 .. .. .. .. .. Pickles 2 .. .. .. 2 2d .. .. .. 2 .. .. .. .. .. Ground Ginger 6 .. .. .. 6 6 .. .. .. 6 .. .. .. .. .. Rice 12 .. 12 2 26 12 .. 12 2 26 .. .. .. .. .. Arrowroot 6 .. 12 .. 18 6 .. 12 .. 18 .. .. .. .. .. Pear J am 1 .. .. .. 1 1e .. .. .. 1 .. .. .. .. .. Peach Conserve 1 .. .. .. 1 1e .. .. .. 1 .. .. .. .. .. Marmalade .. .. .. 3 .. .. 3 .. 3 f .. .. 3 .. .. .. .. .. Flour 12 12 .. .. 24 12 12 .. .. 24 .. .. .. .. .. Baking Powder .. .. 10 12 22 .. .. 9b 12g 21 .. .. 1 .. 1 Tomato Ketchup 1 .. .. .. 1 1c .. .. .. 1 .. .. .. .. .. a All tree from Boric Acid and Formalin. b All free from Arsenic and calcium sulphate, or below limit recommended by L.G. Board. c All free from copper. d One sample contained faint trace of copper e Free from Salicylic Acid, Sulphurous Acid and Arsenic. i All free from Arsenic and preservatives. g One sample contained traca of Arsenic, but less than limit recommended by L.G. Board. 37 [1918 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. 4th Quarte. Totals. Olive Oil .. 2 5 2 9 .. 2 5 2 9 .. .. .. .. .. Epsom Salts 16 .. .. .. 16 16* .. .. .. 16 .. .. .. .. .. Cream of Tartar .. 8 .. .. 8 .. 8 .. .. 8 .. .. .. .. .. Tartaric Acid .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Ammon. Tinct. Quinine .. .. 5 5 10 .. .. 5 5 10 .. .. •• .. .. Boric Acid Ointment .. .. 5 .. 5 .. .. 5 .. 5 .. .. .. .. .. Camphorated Oil .. .. 5 .. 5 .. .. 1 .. 1 .. .. 4 .. 4 Comp. Liquorice Powder .. .. .. 2 2 .. .. .. 2 2 .. .. .. .. .. 263 265 264 294 1,086 231 238 245 265 979 32 27 19 29 107 MARGARINE ACT. Margarine 0 1 20 13 39 5 .. 20 13 38 .. 1 .. .. 1 Totals 268 260 284 307 1,125 236 238 265 278 1,017 32 •28 19 29 108 *All samples were either free from lead and arsenic or came within the limits prescribed by the British Pharmacopoeia. 38 1918 SUMMARY OF PROSECUTIONS.—During year 1918. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount Penalties Received. £ s. d. "Public Health (London) Act, 1891" 11 10 ... 1 † 43 19 0 "Sale of Food and Drugs Acts, 1875-99" 78 50 18* 10 † 228 7 0 ‡ ║ "Margarine Act, 1887" 1 1 ... ... 5 0 0 Total 90 61 18 11 277 6 0 * Warranty established in six summonses, † These were alternative summonses. ‡ 3 Defendants died before summonses were heard. ║ One summons not served. 39 [1918 Table A. Showing the Deaths from All Causes in Islington during the Year 1918. Deaths of Non-Residents in Hospitals are excluded Deaths of Residents in Public Institutions are distributed. within Borough. DISEASES. AGES. Under 5 Over 5 districts. Males. Females. Totals. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. s.e. Small Pox (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. "fl Measles 23 83 8 .. .. .. .. .. .. .. .. .. .. 106 8 6 17 15 16 13 19 28 55 59 114 Scarlet Fever .. 3 5 .. .. .. .. .. .. .. .. .. .. 3 5 1 2 .. 1 1 2 1 3 5 8 Thphus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 114 13 Epidemic Influenza 20 86 52 32 67 74 252 109 93 69 50 22 5 106 825 89 112 113 125 131 152 211 374 557 931 Whooping Cough 37 102 7 1 .. .. .. .. .. .. .. .. .. 139 8 14 10 8 22 13 26 54 76 71 147 Diphtheria 2 24 14 3 1 .. 1 .. .. .. .. .. .. 26 19 6 2 7 5 9 3 13 18 27 45 Enteric Fever .. .. 1 1 .. 1 2 1 1 .. .. .. .. .. 7 1 1 .. 2 .. .. 3 .. 7 7 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea, 1 dysentery 10 4 .. .. .. .. 5 1 6 8 4 2 .. 14 28 2 12 1 6 4 8 9 31 21 42 1 Epidemic Enteritis 7 .. .. .. .. .. .. .. 2 .. .. .. .. 7 2 .. 1 1 1 2 2 2 5 4 9 2 Other Allied Diseases .. .. .. 13 13 .. .. .. .. .. .. .. .. .. 6 2 .. 1 1 .. 2 .. 5 1 6 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 10 .. .. .. 1 1 1 .. 1 .. 1 .. .. 10 5 .. 2 2 4 2 4 1 8 7 15 Gonorrhœa .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phagedcena .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 Erysipelas 1 .. .. 2 1 .. .. .. .. 2 1 .. .. 1 8 .. ? 2 1 .. .. 2 4 3 7 Puerperal Fever .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 Phæmia 2 .. 1 .. 1 .. 3 .. 1 2 2 .. .. 2 10 .. .. 2 5 2 .. 3 7 5 12 1 Infective Endocarditis .. .. .. .. .. 1 .. 2 2 .. 1 .. .. .. 6 .. 1 1 .. 2 2 .. 2 4 6 1 Other Allied Diseases l .. .. .. .. 1 .. 2 .. 1 2 1 1 1 8 .. 2 .. ? 2 1 2 4 5 9 Malarial Fever .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. 1 .. 1 .. .. .. 2 .. 2 Rheumatic Fever .. .. .. 1 .. .. .. 3 2 .. .. .. .. .. 6 1 1 1 1 1 .. 1 3 3 6 10 Rheumatism of Heart .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 .. 1 Tuberculosis of Brain 15 .30 10 4 .. 5 2 .. .. 1 .. .. .. 45 22 4 8 8 8 11 10 18 33 34 67 Tuberenosis of Larynx .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 .. .. 1 .. .. .. 1 2 .. 2 146 Phthisis 1 6 9 12 38 46 110 113 91 60 26 3 .. 7 507 44 67 54 59 65 96 129 285 229 514 7 Abdominal Tuberculosis 2 8 .. 1 .. .. 2 2 3 1 1 .. .. 10 10 4 .. 2 4 1 5 4 13 7 20 General Tuberculosis 1 4 2 .. .. 1 1 .. 2 .. .. .. .. 5 6 .. .. 2 .. 4 1 4 6 5 11 5 Other forms Tuberculosis .. 2 1 3 3 .. 1 1 2 3 1 .. .. 2 15 2 2 1 2 1 4 5 7 10 17 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Actinomycosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 2 1 1 .. .. .. .. .. .. 2 2 Food Acute Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chronic Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo-arthritis .. .. 1 1 .. 1 1 2 2 8 8 4 .. .. 28 3 3 2 3 8 3 6 10 18 28 153 Gout .. .. .. .. .. .. .. .. .. 1 1 1 .. .. 3 .. .. .. 1 .. 2 .. 2 1 3 Cancer .. .. .. .. .. .. 8 27 75 99 126 52 6 .. 393 48 43 32 47 82 51 90 185 205 393 3 Diabetes Mellitus .. .. 1 .. 1 1 3 2 4 5 6 2 .. .. 25 3 2 1 3 5 3 8 15 10 25 Purpura Haemorrhgica .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 1 Hæmophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anaemia 1 .. .. .. .. .. .. 1 2 5 1 .. .. .. 9 1 1 .. .. 4 .. 3 5 4 9 Lymphadenoma. .. .. .. .. .. .. 2 .. .. 1 .. .. .. .. 3 1 1 1 .. .. .. .. 1 2 3 Premature Birth 102 .. .. .. .. .. .. .. .. .. .. .. .. 102 .. 10 9 6 7 17 25 28 19 43 102 Injury at Birth 5 .. .. .. .. .. .. .. .. .. .. .. .. 5 .. 1 .. .. .. ? 1 1 4 1 5 Debility at Birth 13 .. .. .. .. .. .... .. .. .. .. .. .. 13 .. 3 .. 1 3 4 1 1 8 5 13 Atelectasis 10 .. .. .. .. .. .. .. .. .. .. .. .. 10 .. 1 .. 2 .. .. 4 5 5 10 Congenital Defects 28 1 .. .. .. .. .. .. .. .. .. .. .. 29 .. 2 2 .. 5 3 8 9 15 14 29 Want of Breast Milk 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 .. 1 Atrophy, Debility, Marasmus 75 15 .. .. .. .. .. .. .. .. .. .. .. 90 .. 7 7 13 17 15 14 17 59 31 90 * Cerebro-Spinal Fever (6). 40 1918] Table A.—Continued. Deaths in Institutions within Borough, DISEASES. AGES. Under b. j Over 5. DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- l5- 20- 25- 35- 45- 55 65- 75- 85- Tuf. U.h. Toll. l.h. H B s.e. Dentition 2 4 .. .. .. .. .. .. .. .. .. .. .. 6 .. .. 1 1 .. .. 2 2 6 .. 6 Rickets 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 1 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. 6 71 190 107 † .. 374 28 68 34 46 36 53 82 139 235 374 Convulsions 11 5 .. 1 .. .. .. .. .. .. .. .. .. 16 1 .. 3 .. 3 .. 3 5 8 9 17 1 Meningitis 3 6 1 1 1 1 .. .. .. 1 3 .. .. 9 8 2 3 5 1 1 1 4 7 10 17 Encephalitis 1 1 .. .... .. .. .. 3 1i .. .. .. .. 2 4 1 1 1 .. .. .. 3 2 4 6 Apoplexy .. .. .. .. .. .. 1 4 19 33 45 27 4 .. 133 12 18 12 l5 36 17 23 54 79 133 Softening of Brain .. .. .. .. .. .. 1 1 2 1 4 1 1 .. 11 5 2 .. .. .. 1 3 3 8 11 Hemiplegia .. .. .. .. .. .. .. .. 2 2 1 2 .. .. 7 1 1 2 .. 1 1 1 3 4 7 General Paralysis of the Insane .. .. .. .. .. .. 5 7 b 4 .. .. .. .. 22 3 5 3 1 5 4 1 18 4 22 Other forms of Insanity .. 2 .. .. 2 .. 2 1 4 9 9 11 .. 2 38 3 7 2 3 7 7 11 22 18 40 Chorea .. .. .. 2 2 1 .. .. 1 .. .. .. .. .. 6 .. 1 1 1 .. 1 2 1 5 6 Cerebral Tumour .. 1 1 .. .. .. .. 3 2 1 .. .. .. 1 7 2 .. 1 3 2 .. .. 5 3 8 Epilepsy .. .. .. .. 2 3 3 1 b 3 5 5 .. .. 27 1 7 4 4 .. 4 7 18 9 27 :aryngismus Stridulus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locomotor Ataxy .. .. .. .. .. .. .. 2 2 3 .. .. .. .. 7 1 2 .. .. 1 1 2 6 1 7 Paraplegia .. .. .. .. .. .. i .. 6 4 7 3 1 .. 22 4 2 3 .. 6 3 4 12 10 22 Other forms, Brain Diseases .. .. .. .. 1* i 1 .. .. 2 1 .. .. 7 1 1 .. 1 3 1 .. 3 4 7 Otitis 1 1 1 2 .. 2 .. .. 2 .. 1 .. .. 2 8 .. 1 1 2 1 4 1 3 7 10 Disease of Nose, Epistaxis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Eye .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Pancarditis .. .. .. i 1 .. .. .. .. 1 1 .. .. .. 4 .. .. 1 1 .. .. 2 3 1 4 2 Endocarditis .. .. .. l .. 3 3 1 .. 1 .. 1 .. .. 10 1 .. .. 2 1 1 5 2 8 10 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Angina Pectoris .. .. .. .. .. .. .. .. .. 2 3 1 .. .. 6 1 1 2 .. 1 1 .. 5 1 6 2 Aneurism .. .. .. .. .. .. .. .. 8 6 2 1 .. .. 17 3 .. 3 1 3 3 4 15 2 17 3 Senile Gangrene .. .. .. .. .. .. .. .. .. 2 2 2 1 .. 7 .. 1 .. 2 1 .. 3 3 4 7 20 Embolism, Thrombosis .. .. .. .. .. .. 1 2 5 10 13 13 .. .. 44 3 4 3 5 11 5 13 21 23 44 Phlebitis .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 .. 1 .. .. 1 .. v 2 .. 2 Varicose Veins .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 190 Other Diseases, Heart and Vessels .. 4 5 9 6 11 28 33 78 120 194 102 ii 4 597 55 72 54 71 105 100 144 311 290 301 2 Laryngitis 1 1 1 .. .. .. .. .. .. .. .. .. .. 2 1 1 1 .. .. .. 1 .. 3 .. 3 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Larynx and Trachea .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 .. 1 10 Acute Bronchitis 28 l5 2 2 1 1 4 2 13 17 29 23 7 43 101 22 16 14 19 25 17 31 55 89 144 117 Chronic Bronchitis 2 3 1 1 .. .. 5 9 44 55 105 74 7 5 301 20 28 21 31 46 84 76 175 131 306 29 Lobar Pneumonia 3 8 2 .. 3 6 14 12 16 11 18 3 .. 11 85 10 14 13 9 20 14 16 55 41 96 74 Lobular Pneumonia 64 136 13 7 3 7 9 8 l6 l5 8 2 4 200 92 21 27 40 52 37 62 53 147 145 .392 105 Pneumonia 20 46 13 6 11 10 36 20 37 23 24 13 2 66 195 26 33 28 28 32 38 76 119 142 261 2 Emphysema, Asthma .. .. 1 .. 1 .. 3 3 7 4 2 .. 1 .. 22 3 4 2 1 6 3 3 9 13 22 3 Pleurisy .. 2 1 i 2 .. 1 .. 5 2 5 .. .. 2 17 .. 2 .. 3 6 1 7 11 8 19 4 Other Diseases, Respiratory System .. .. .. .. .. .. 2 2 4 4 .. .. .. .. 12 .. 3 1 1 2 .. 3 8 4 12 Diseases of Mouth and Annexa .. 2 1 .. 1 .. 1 .. 1 .. .. .. .. 2 4 1 2 .. 3 .. .. .. 3 3 6 Diseases of Pharynx .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Œsophagus .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 .. .. .. .. 1 .. 1 2 .. 2 Ulcer of Stomach and Duo- 1 .. .. .. .. 1 4 3 7 8 5 2 .. 1 30 3 1 3 3 6 8 7 17 14 31 5 Other Diseases of Stomach 9 2 .. .. 1 .. 1 3 4 3 5 .. .. 11 17 4 3 1 7 2 6 5 16 12 23 24 Enteritis 34 11 .. 2 .. 2 1 2 2 3 2 2 .. 45 16 4 5 11 7 12 11 11 26 35 61 8 Appendicitis .. .. 2 5 2 1 1 2 22 .. .. .. .. .. 15 1 3 3 3 1 .. 4 6 9 15 Obstruction of Intestine 7 1 3 1 .. 1 1 2 4 12 7 9 .. 8 40 7 4 6 9 10 4 8 16 32 48 Other Diseases of Intestine .. .. .. .. .. .. .. .. .. 1 .. .. i .. 2 .. .. .. .. 1 .. 1 .. 2 2 4 Cirrhosis of Liver .. .. .. .. .. .. .. 1 3 7 6 .. 1 .. 18 2 4 1 3 1 5 2 12 6 18 Other Diseases of Liver .. .. .. .. .. .. 1 1 4 6 4 1 .. .. 17 1 1 1 2 6 3 3 7 10 17 Peritonitis 1 1 .. 1 .. .. 1 2 .. 1 1 .. .. 2 6 3 .. 1 1 2 1 .. 4 4 8 Other Diseases, Digestive System 2 .. .. .. .. .. .. .. 2 .. .. .. .. 2 2 .. .. 1 2 1 .. .. .. 4 4 Diseases, Lymphatic System and Glands .. .. .. 1 .. .. .. .. 1 1 .. .. .. .. .. .. .. 2 .. .. 1 .. 1 2 3 4 Acute Nephritis .. 2 .. .. 1 1 1 1 4 1 .. .. .. 2 9 1 3 .. .. 1 1 5 8 3 11 26 Bright's Disease .. 1 1 .. 1 2 8 12 18 25 16 10 .. 1 93 10 7 9 17 17 14 20 40 54 94 Calculus .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 1 1 Diseases of Bladder and Prostate .. .. .. .. .. .. .. .. 2 5 8 8 l .. 24 4 2 3 3 8 2 2 18 6 24 Other Diseases, Urinary System 1 .. .. .. 1 .. .. .. 2 2 1 .. .. 1 6 1 1 .. 1 1 .. 3 4 3 7 Diseases of Testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diseases of Uterus and Appendages .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 .. .. .. .. 2 .. .. .. 2 2 Diseases of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ..1 .. Abortion, Miscarriage .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 1 Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Placenta Praevia, Hooding .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 .. .. .. 1 1 .. .. .. 2 2 * Poliomyelities. † 1 Fem. 100 years . 41 [1918 Table A.—Continud. ??? Institutiins within Borough DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. | Totals. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75 85 Tuf. U.H. Toll. L.H. H. B. S.E. Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Pregnancy and Childbirth .. .. .. .. .. 1 .. 2 .. .. .. .. .. .. 3 .. .. .. 1 .. 1 1 3 3 Arthritis, Ostitis, Periostitis .. .. .. .. 1 .. .. .. .. 1 .. 1 .. .. 3 .. .. .. .. 1 .. 2 2 1 3 Other Diseases, Osseous System .. .. 1 .. .. .. 1 2 .. 1 1 .. .. .. 6 .. 2 .. .. 1 2 1 3 3 6 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 2 .. .. .. 1 1 .. .. .. 2 2 Eczema .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Pemphigus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Integumentary System 1 .. .. .. .. .. .. .. .. .. 1 1 .. 1 2 1 .. .. .. 1 1 .. 1 2 3 Accidents and Negligence. In Mnes and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7 In Vehicular Traffic .. 1 2 1 2 .. 3 2 3 7 4 3 .. 1 27 2 1 4 4 4 5 8 17 11 28 On Railways .. .. .. .. .. .. .. 1 2 .. 1 .. .. .. 4 1 .. .. 2 .. 1 .. 4 .. 4 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 .. .. .. .. .. 1 .. 1 1 In Building Operations .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 .. .. .. 1 1 .. .. 2 .. 2 By Machinery .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 2 .. .. .. .. i .. .. 2 .. 2 By Weapons and Implements .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 .. 1 4 Burns and Scalds .. 8 2 2 .. .. .. .. 1 1 2 .. 1 8 9 2 1 1 1 2 5 5 8 9 17 1 Poisons, Poisonous Vapours. .. 1 .. .. .. .. .. .. .. 1 1 .. .. 1 2 .. .. .. .. 1 .. 2 1 2 3 Surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Effects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. 2 .. 1 1 3 2 1 .. 1 .. .. .. 11 1 .. 2 1 1 3 3 11 .. 11 Suffocation, Overlaid in Bed 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. 1 .. .. .. .. .. 2 2 1 „ Otherwise 5 1 .. .. .. .. .. 1 .. .. .. .. .. 6 1 .. .. 2 1 1 .. 3 3 4 7 22 Falls not specified 1 1 1 .. .. 1 1 .. 1 5 11 9 3 2 32 4 4 1 4 2 14 5 10 24 J4 Weather Agencies .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Otherwise, not stated 1 .. .. .. .. .. .. 1 .. .. .. 1 .. 1 2 .. .. .. .. 1 .. 2 2 1 3 Homicide 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. 3 1 2 3 Suicide. By Poison .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. 2 1 .. .. .. 1 .. .. 1 1 2 By Asphyxia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 By Hanging and Strangulation .. .. .. .. .. .. .. 1 3 2 .. .. .. .. 6 1 1 .. .. 2 1 1 4 2 6 By Drowning .. .. .. 1 .. .. .. .. 1 1 1 .. .. .. 4 1 .. .. .. .. .. 3 .. 4 4 By Shooting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 By Cut or Stab .. .. .. .. .. 1 2 4 2 1 2 1 .. .. 12 1 4 1 3 .. 1 2 9 3 12 By Precipitation from Elevated Places .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. 1 By Crushing .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 .. 1 .. .. .. .. 1 2 .. 2 By other and unspecified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not tained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. III-defined and unspecified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Bombs (enemy aircraft) .. .. .. .. .. .. 3 2 1 2 2 1 .. .. 11 .. 1 .. .. .. 2 8 6 5 11 Kales 325 308 75 46 78 70 230 213 353 382 449 266 40 633 2202 269 343 273 371 413 483 683 .. .. 2835 Females 246 328 95 65 88 123 322 221 295 331 420 347 125 574 2432 279 354 311 371 512 491 688 .. .. 3006 1,221 TOTAL DEATHS 571 636 170 111 166 193 552 434 648 713 869 613 165 1207 4634 548 697 584 742 925 974 1371 2835 3006 5841 42 1918] LOCAL GOVERNMENT BOARD RETURN—Table III. Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING THE CALENDAR YEAR, 1918 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 arid under 5 years. 5 and under 15 vrs. 16 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 arid upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified 5710 564 317 308 272 344 947 1333 1625 2068 Uncertified .. .. .. .. .. .. .. .. .. .. Enteric Fever 5 .. .. .. 1 1 3 .. .. .. Small-pox .> .. .. .. .. .. .. .. .. .. .. Measles .. ... 112 24 52 30 6 .. .. .. .. 48 Scarlet Fever 8 .. 1 2 5 .. .. .. .. 2 Whooping Cough 145 37 57 43 8 •• .. •• .. 86 Diphtheria and Croup 44 2 7 17 16 .. 1 .. .. 6 Influenza 912 19 25 60 81 134 358 160 75 237 Erysipelas 7 1 .. .. 2 1 .. 2 1 8 Phthisis (PuIit onary Tuberculosis) 496 1 3 3 21 82 208 149 29 261 Tuberculous Meningitis .. 66 14 11 19 14 5 2 1 .. 17 Other Tuberculous Diseases 45 3 9 4 6 3 7 11 2 23 Cancer, Malignant Disease 383 .. .. .. .. .. 34 170 179 197 Rheumatic Fever .. 9 .. .. .. 1 .. 3 3 2 1 Meningitis .. 20 3 4 2 4 4 .. 1 2 7 Organic Heart Disease 483 .. 1 4 12 12 55 171 228 279 Bronchitis 447 33 15 3 7 2 19 126 242 194 Pneumonia (all forms) 638 86 99 90 41 38 97 115 72 295 Other Diseases of Respiratory Organs 57 1 2 1 5 3 11 24 10 22 Diarrhcea and Enteritis .. 110 52 11 4 2 4 8 18 11 42 Appendicitis and Typhlitis 16 .. .. .. 7 3 3 3 .. 15 Cirrhosis of Liver 18 .. .. .. .. 1 .. 10 7 9 Alcoholism .. .. .. .. .. .. .. .. .. .. Nephritis and Bright's Disease .. 105 .. 1 2 1 4 22 48 27 50 Puerperal Fever 1 .. .. .. .. .. 1 .. .. 2 Other accidents and diseases of Pregnancy and Parturition 6 .. .. .. .. 1 5 .. .. 1 Congenital Debility and Malformation, including Premature Birth 232 217 10 5 .. .. .. .. .. 5 Violent Deaths, excluding Suicide 123 13 3 9 10 7 15 25 41 75 Suicide 26 .. .. .. .. 2 6 14 4 12 Other Defined Diseases . 1196 58 6 10 22 36 89 282 693 174 Diseases ill-defined or un known .. .. .. .. .. .. .. .. .. •• 5710 564 317 308 272 344 947 1333 1625 2068 Sub-Entries — included in above figures:— Cerebro-spinal Meningitis 6 .. .. .. 3 3 .. .. .. 2 Poliomyelitis .. .. .. .. .. •• .. .. .. .. 43 [1918 LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Metropolitan Borough of Islington. INFANTILE MORTALITY DURING THE CALENDAR YEAR 1918. 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 udder 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 122 31 19 14 186 86 112 77 103 564 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chiken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. 2 4 7 11 24 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 4 6 9 18 37 Diphtheria and Croup .. .. .. .. .. .. .. 1 1 2 Erysiipelas .. .. .. .. .. .. .. 1 .. 1 Tuberculous Meningitis 1 .. .. .. 1 1 3 3 6 14 Abdominal Tuverculosis .. .. .. .. .. .. 2 .. .. 2 Other Tuberculous Diseases .. .. .. .. .. .. .. 1 1 2 Meningitis (not Tuberculous) .. .. .. .. .. 1 1 .. 1 3 Convulsions 3 .. .. 1 4 2 1 2 2 11 Laryngitis .. .. .. .. .. .. 1 .. .. 1 Bronchitis .. .. .. .. .. 11 5 7 10 33 Pneumonia (all forms) 2 1 2 2 7 13 18 17 31 86 Diarrhœa .. 1 .. .. 1 2 8 4 2 17 Enteritis .. .. 1 1 2 9 13 3 8 35 Gastritis .. .. .. .. .. 1 1 3 1 6 Syphilis 1 1 1 .. 3 4 1 1 1 10 Rickets .. .. .. .. .. .. .. .. 1 1 Suffocation, overlying .. 1 i .. 2 .. 1 .. .. 3 Injury at Birth 3 2 .. .. 5 .. .. .. .. 5 Atelectasis 8 • • 1 .. 9 1 .. .. .. 10 Congenital Malformations 12 5 I 2 20 2 .. .. 1 26 Premature Birth 70 9 6 5 90 11 1 1 .. 103 Atrophy, Debility and Marasmus 14 9 5 3 31 17 30 7 3 88 Other Causes 8 2 1 .. 11 5 14 9 5 44 Totals 122 31 19 14 186 86 112 77 103 564 Nett Births in the year ligitimate 4,958 Nett Deaths in the year of legitimate infants illegitimate infants 515 illegitimate 239 49 44 1918] LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1918. PREMISES. Number of Places— Number of inspections, 1918. Number of Notices. 1918. Number of Prosecutions 1918. On Register at end of 1917. Added in 1918 Removed in 1918. On Register at end ot 1918. Milk premises 586 21 21 586 805 Nil Nil Cowsheds 4 Nil Nil 4 18 „ „ Slaughter-houses 21 Nil Nil 21 889 „ 2 Other offensive trade premises 7 Nil Nil 7 69 „ Nil Ice cream premises 235 ... ... 235 6 „ „ Registered houses let in lodgings ‡ ... ... ... *... *... „ * Included in District Inspectors' Summary. J No Register now kept under existing By-Laws. Total number of intimation notices served for all purposes 997 Overcrowding, 1918. Number of dwelling rooms overcrowded 8 Number remedied 8 Number of prosecutions Nil Underground rooms— Illegal occupation dealt with during year 1 Number of rooms closed 1 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 13 45 [1918 Shelters provided, under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 4 Revenue Acts— Number of houses for which applications were received during year 5 Number of tenements comprised therein 19 Number of tenements for which certificates were (a) granted 4 (6) refused 15 (c) deferred Nil Number of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. Nil (b) For prevention of nuisance arising from offensive matter ning 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 iespect 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 476 Total number of infectious bodies removed 2