ISL 2O 1920. SIXTY-FIFTH ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE METROPOLITAN Borough of Islington. ALFRED EDWIN HARRIS, MEDICAL OFFICER OF HEALTH. London Vail & Co., Printsrs to the Council, 170, Farringdon Road, E.C. MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1920, to November, 1921.) Mayor. Councillor ERNEST HENRY KING, J.P. A ldermen FREDERICK EDWARD BRADSHAW FREDERICK MONTAGUE Councillors. Ward Ward 1 JOHN DAVID AUBREY 5. MIRIAM PRICE 1. FREDERICK Wm. SEPTIMUS TAYLOR 6. ABRAHAM LEVISON 2. ARTHUR Wm. PALMER 7. CHARLES COX 2. FREDK. JOSEPH SHIRLEY 8. WILLIAM JOHN MITCHELL 2. PEYTON HAMILTON BLACK 10. SARAH JOHNSON 3. WILLIAM SAMPSON CLUSE 11. THOMAS WHITFIELD HUNT 4. SARAH TRAFFORD 11. WILLIAM AWCOCK 5. JAMES BRATTEL Chairman Alderman MONTAGUE. Vice-Chairman Councillor MIRIAM PRICE. OFFICERS OF THE public health Department. Medical Officer oj Health. ALFRED EDWIN HARRIS, L.R.C.S., L.R.C.P.Edin. Public Analysts. FRANK LITHERLAND TEED, D.Sc. (Lond.), F.I.C.. F.C.S. ERNEST ALFRED PINCHIN, B.Sc. 'Loud.), F.I.C., F.R.M.S] Solicitor. ARTHUR MELLOR BRAMALL. Superintendent of Public Health Department and Chief Sanitary Inspector JAMES RICHARD LEGGATT. Inspector of Meat. HARGREAVES WILKINSON, Cert. Sanit. Inst. Inspector appointed under the Sale of Food and Drugs Acts. (vacant) Inspector of Workshops and Bakehouses. HARRY JOHN JAMES WATSON. Inspectors of Workshops, &c., in which Females are employed. ELEANOR HARRIET DANIELL. Cert. Sanit. Insp. Ex. Bd. CONSTANCE HUGHESDON, Cert. Sanit. Insp. Ex Bd. Inspectors of Houses let in Lodgings EGMONT JOSEPH NETHER Cert. Sanit. Insp. Ex. Bd. FRANK HENRY CHUTER Cert Sanit. Insp. Ex. Bd. sanitary inspectors. District 1 WILLIAM COOK, Cert. Sanit. Inst. ,, 2 HARRY JAMES BICKNELL, Cert. Sanit Inst. ,, 3 ALLEN BAGSHAW, Cert. Sanit. Inst. ,, 4 GEORGE JAMES BRIDEL Cert. Sanit. Insp. Ex. Bd. ,, 5 WILLIAM HOLSGROVE FLOOD. Cert. Sanit. Inst. ,, 6 CHARLES EDWIN HORSMAN, Cert. Sanit. Inst. ,, 7 EDWARD ISAAC FORTUNE, Cert Sanit. Inst. ,, 8 JOHN METCALF, Cert. Sanit Inst. ,, 9 THOMAS HENRY HANCOCK, Cert. Sanit. Insp. Ex. B ,, 10 STANLEY PELTON MARKS, Cert. Sanit. Insp. Ex. Bd. ,, 11 ALFRED ERNEST WOOD, Cert. Sanit. Insp. Ex. Bd. ,, 12 EDWARD GEORGE HOLMES. Cert. Sanit. Insp. Ex Bd. ,, 13 THOMAS WALLACE AGAR. Cert. Sanit. Inst. ,, 14 HARRY CALLOW, Cert. Sanit. Inst. Temptrary Sanitary Inspectors. HAROLD HERBERT UREN, Cert Sanit. Insp. Ex. Bd. JAMES ARCHIBALD BINNS, Cert. Sanit. Insp. Ex. Bd. Health Visitors. District 1 Mrs. FRANCES LOOKER, Cert. Cent. Midwives Bd. ,, 2 Miss MONA CARR, Cert Cent. Midwives Bd. ,, 3 ,, ROSINA PALMER, Cert. Cent Midwives Bd. „ 4 ,, LILY FLOWEK, Cert. Cent. Midwives Bd. „ 5 ,, EDITH FOOT, Cert. Cent. Midwives Bd. „ 6 ,, ANNIE TAYLOR. Cert. Cent. Midwives Bd. ,, 7 Mrs. SUSANNAH UNDERY, Cert. Cent. Midwves Bd. Clerical Staff. GEORGE HAROLD KING (First Clerk) NORMAN CLARENCE TURRELL. HENRY ANGEL. ALBERT EDWARD BOOKER. EDWARD ALBERT ABBOTT. WALTER ROBERT CAUSTON (Junor WALTER JOSEPH WOLFE. Clerk) WILLIAM GEORGE BUNCH. FREDERICK CHARLES GREEN ARTHUR ROBERT WITTRICK (Temporary). CLEMENT MARSTONE WHEBLE. CHARLES JOSEPH CRIDLAND Engineer in charge of Steam Disinfectors. Attendant in Charge of Cleansing Station. ALFRED LEWIS. Mrs. HORNE. Stok.er at Disinfecting Station. Mortuary Keeper CLARENCE SADGROVE. SAMUEL MAXWELL. Caretaker of Skelter House. Distributor of Disinfectants. Mrs. LEWIS. JOHN REDDY. Disinfectors. WILLIAM HARDWICK and WILLIAM WOODLEY. iv SUMMARY of Vital Statistics, 1920. Population (Enumerated at Census 1911) 327,403 persons „ Total, Estimated 1920 (for calculating birth rate) 336,190 persons „ Civil, Estimated 1920 (for calculating death rate) 335.907 persons Estimated increase on population, 1911 8,504 persons Mean Population, ten years (1910-1919) 316,412 persons Area 3,092 acres Density 109 persons per acre Marriages 3i370 Persons married 6,740 Persons married rate 20.05 per 1,000 inhabitants Males 4,778 Births Females 4,626 } Person 9.404 Birth rate 28.17 per 1,000 inhabitants Males2,292 Deaths from All Causes Females 2183 } Persons 4.475 Death rate 13.32 per 1,000 inhabitants Males 164 } Deaths from Principal Epidemic Diseases Females 176 } 340 persons Death rate 1.05 per 1,000 inhabitants Males394 } Infantile Deaths under 1 year Females 282}Total 676 Infantile mortality rate 72 per 1,000 births Excess of Births over Deaths 41929 V. INDEX. Page. Adulteration of Food 56 Bacteriological Examinations 40 Births 2 4 ,, Illegitimate 4 ,, from 1841 to 1920 66 „ Notification of „ Stillborn 4 ,, and birth-rates from 1841 to 1920 65 Cancer 20 Chicken Pox 39 Cleansing of Verminous School Children 45 Constitutional Diseases 20 Cow Sheds 55 Deaths from All Causes during the year 4-62 ,, „ Epidemic Diseases 16 ,, ,, Respiratory Diseases 23 ,, in Public Institutions 14 „ and death-rates from 1841 to 1920 67 Disinfectants distributed and used 44 Disinfecting Station 43 Disinfection Work 43 District Inspectors 'Work 49 Dust, removal of 50 Dysentery 32 Encephalitis Lethargica 33 Epidemic Diseases 16 ,, Cerebro-Spinal Meningitis 32 Erysipelas 20-26 Factories and Workshops Administration 45 Fatality from Notifiable Infectious Diseases 27 Food, Adulteration of 56 Food Inspection 53 Hospital Isolation of Infectious Diseases 28 Houses let in Lodgings . 52 Infant Mortality 7 „ ,, from 1841 to 1920 68 Infant Welfare Work 11 Infectious Diseases in Schools 39 „ (Non-notifiable) in Schools 39 „ „ Cases notified from 1891 to 1920 69 Influenza 19 Inspection of Food 53 ,, Kitchens of Restaurants 45 „ Slaughter Houses and Cow Sheds 53 Inquests 24 vi. Page. Isolation of Infectious Diseases 28 London County Council Return of Sanitary Work 72 Malaria 32 Marriages 2 Measles, Notification of 39 Meat Inspection 53 Ministry of Health Returns 70-71 Milk (Mothers and Children) Order, 1918-19 11 Milk Adulteration 56 Milkshopsand Dairies 55 Mortuary and Coroner's Court 24 Notification of Infectious Diseases 25 „ ,, Tuberculosis 34 ,, ,, Births Act 4 Non-notifiable Infectious Diseases in Schools 39 Offensive Trades 55 Ophthalmia Neonatorum 33 Outworkers' Premises 45 Other Notifiable Diseases 32 Pauperism 54 Phthisis 21 ,, Notification of 34 Places where food is prepared 53 Pneumonia 23 Population—Estimated in 1920 1 Prosecutions, Summary of 60 Puerperal Septic Diseases 20-27 Polio-myelitis, Acute 32 Pulmonary Phthisis 34 Respiratory Diseases 23 Samples analysed in 1920 59 Sanitary Inspectors' Work 49 Septic Diseases 20 Shelter House 45 Slaughter Houses 53 Smoke Nuisances 50 Tubercular Diseases 21-34 Tuberculosis Dispensaries 37 Tuberculosis, Pulmonary, Notification of 34 Unsound Food 54 Vaccination 41 Venereal Diseases 23 Verminous Children, Cleansing of 45 Verminous Premises 50 Voluntary Maternity and Child Welfare Centres 12 Workshops and Factories. Inspection of 45 Welfare Work by Health Visitors 11 vii REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1920. Public Health Department, 20, Compton Terrace, Upper Street, Islington, N.l. December, 1921. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. In presenting on behalf of Dr. A. E. Harris the Annual Repoit for 1920, a year for which are recorded the lowest death rate (13.32 per 1,000 of the population) and the Borough's lowest Infantile Mortality Rate (72 per 1,000 births) it is but fitting, in the last report bearing his name, to put on record his long and energetic service to Islington. Dr. Harris was Medical Officer of Health for the County Borough of Sunderland from 1881 to 1892, when he was appointed to Islington. The records of both places bear witness to his admirable work aud assiduity in the Public Health Service. While in his well earned retirement his personality and kindness will be remembered by all classes of the community. I am, Ladies and Gentlemen, Your obedient Servant, M.D., D.P.H., F.R.S.E., Medical Officer of Health. REPORT OF THE Medical Officer of Health FOR THE YEAR 1920. Population.—The population of the Borough has been estimated by the Registrar-General for the calculation of the death rate and birth rate of the Borough for the year 1920, as follows:— For the birth rate, 336,190 Do. death rate, 335,907 Similar to last year the death rate population excludes all non-civilian males, whether serving at home or abroad. These estimates are based mainly upon the rationing returns of the Ministry of Food. The birth rate (and marriage rate) population, on the other hand, is intended to include all elements of the population contributing to the birth and marriage rates and consists of the death rate or civilian population plus all non-civilians enlisted from this borough, whether serving at home or abroad. Showing the Areas, Densities, and Populations at Census 1911, also the 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 /»of Qtity is 1911. Increase or Decrease on Census. Tufnell 411 0.0I2I 83 33,920 33,526 +394 Upper Holloway 299 0*0079 127 37,930 37116 +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 2 1920] MARRIAGES. Marriages, 3,370; Marriage Rate, 20.05.—The number of persons married was 6,740, as contrasted with 6,612 in the preceding year, which is an increase of 128. The marriage rate was 20.05 per thousand inhabitants, as comnared with 10.28 in 1919. The following statement shows the figures for the previous ten years 1990-19, Years, Marriages. Marriage Rate. 1910 2,870 17.50 1911 2,843 17.37 1912 3,091 18.94 1913 2,984 17.98 1914 3,188 19.63 1915 4,252 26.12 1916 3,080 18.30 1917 2,689 16.23 1918 2.971 18.51 1919 3,306 19.28 BIRTHS. There were 9,404 births registered, of which 4,778 were boys, and 4,620 girls. Of this number, however, 781 were born of mothers living in Islington, although they were confined in Lying-in Institutions, and in other homes situated outside the borough. The annual birth rate was equal to 27.97 per 1,000 of the population, as compared with a mean birth rate of 22.75 in the preceding ten years- The birth rate was the highest since 1899, when 9,658 births were registered, the birth rate being 28 72. showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1920, 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 1919; together with the mean Borough Birth-rates for the 10 years 1910-1919. Quarter. Males. Females. Total. Birth Rates. Islington, 1920. Islington, 1910-19. London, 1920. 96 G reat Towns, 1920. First 1,395 1,385 2,780 33.08 23.18 31.4 30.3 Second 1,282 1,201 2,483 29.54 22.93 28.3 27.6 Third 1,170 1,089 2,259 26.88 22.10 25.1 24.8 Fourth 931 951 1,882 22.40 22.77 22.9 22.7 The Year 1920 4,778 4,626 *9,404 27.97 22.75 26.5 26.2 1919 33,22 2,956 6,278 18.30 27.97 18.3 19.0 Increase or decrease + 1,456 +1,670 +3,126 +9.67 + 5.22 +8.2 + 7.2 * These include 784 births which occurred in Lying-in Institutions outside the horough. 3 [1920 Showing the Births of Males and Females in each quarter and for the year, 1920, and in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington South-East. The Borough. Males. Females. Total. Males. 1 Females. Total. Males. Females. Total. Males. Females. Total. Mali i. Females. Total. Males. Females. Total. Males. Females. Total. Malts. Females Total. 1st Qr 164 160 324 134 161 295 119 112 231 190 177 367 178 197 375 272 242 514 338 336 674 1395 1385 2780 2nd ,, 160 148 308 150 123 273 105 99 204 149 168 317 186 180 366 216 226 472 286 257 543 1282 1201 2483 3rd „ 141 130 271 118 103 221 98 95 193 162 118 280 150 164 314 221 219 440 280 260 540 1170 1089 2259 4th ,, 108 132 240 99 106 205 76 74 150 122 130 252 137 129 266 164 171 335 225 209 434 931 951 1882 Year 573 570 1143 501 493 994 398 380 778 623 593 1216 651 670 1321 903 858 1761 1129 1062 2191 4778 4626 9404 4 1920] Illegitimate Births (256).—The number of illegitimate births, 256, shows an increase of 41 on the return of the year 1919. The number of illegitimate births in the borough since 1851 is shown in the following statement:— Periods. (10 years). Illegitimate Births. Total Births. Illegitimate Births per 100 Registered Births. 1851-60 1,335 41,915 3.I8 1861-70 2,651 67,520 3.92 1871.80 3,429 89,627 3.82 1881-90 3,475 97,420 3.57 1891-1900 2,719 97,278 2 .79 1901-1O 2,413 87,361 2.76 1911-20 2,719 74,375 3-66 1920 256 9,404 2.72 Notification of Births Act, 1907.—7,783 births were notified or 82.7 per cent. of the total number that was registered during the year. They were notified by doctors, midwives, parents and guardians as follows :— Notified by Still Births. Live Births. Total. Doctors 37 579 616 Certificated Midwives 130 4,161 4,291 Parents and other persons . 69 2,807 2,876 236 7,547 7,783 DEATHS. The deaths numbered 4,475, while the death-rate was equal to 13.32 per 1,000 of the population or 0.77 lower than that of the preceding year (14.09). and was 2.30 less than the average of the previous 10 years. The death-rate of 13.32 per 1,000 of the population was the lowest rate hitherto recorded in the Borough. The death-rates for each year in Islington since 1841, are given in Table D in the Appendix. 5 [1920 The Deaths from All Causes in the Sub-registration Districts were as follows :— Sub-Districts. Quarters. The Year. i 2 3 4 Tufnell 161 102 100 106 469 Upper Holloway 152 136 89 130 507 Tollington 114 86 74 79 353 Lower Holloway 165 121 91 131 508 Highbury 242 187 121 173 723 Barnsbury 264 180 129 224 797 Islington (South-East) 360 293 205 260 1,118 The Borough i.458 1,105 809 1,103 4-475 Showing the Deaths and Death Rates of Islington in 1920, 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 Rales for the ten years 1910-19, and the deaths and death-rates in the year 1919. Death Rates Quarter. Males. Females. Total. Islington, 1920. Islington, 1910-19 London, 1920. 96 Great towns, 1920. First 739 719 1458 17.36 18.65 16.4 16.1 Second 570 535 1105 13.16 1404 12.5 12.9 Third 418 391 809 9.63 12.41 9.6 10.0 Fourth 565 538 1103 1.13 17.35 131 13.0 The Year 1920 2292 2183 4475 13.32 15.62 12.4 12.5 1919 2305 2335 4640 14.09 13.32 13 4 13.8 Increase or Decrease —13 —152 —165 —0.77 —2-30 —1.0 -1.3 6 1920] Causes of Death (Classified.)—The following table shows the deaths arranged in classes of Disease from All Causes during the ten years 1910-19, and in 1920. Classified Causes of Death. Years. Mean 10 years. 192C Difference. 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 I Specific or Febrile Causes 539 722 397 448 572 618 380 391 1361 579 601 552 - 49 J. Miasmatic Diseases 403 330 300 284 299 451 268 293 1258 466 435 437 + 2 2. Diarrhceal 76 326 36 99 174 94 56 56 51 36 100 28 - 72 3. Malarial 1 .. 1 ... 1 ... ... ... 2 2 1 2 + 1 4. Zoogenous 1 1 ... 4 2 ... 3 2 ... 1 2 2 - 5. Venereal 15 13 17 19 21 23 15 15 15 13 17 13 - 4 6. Septic 43 52 43 42 75 50 38 25 35 61 4b 70 + 24 II. Parasitic Diseases 1 2 ... 1 ... ... 1 1 ... I 1 1 - III. Dietetic 11 18 19 17 11 36 3 3 4 2 12 2 - 10 IV. Constitutional Diseases 989 957 1023 1032 1056 1132 1095 1114 1101 973 1047 918 - 129 V. Developmental 382 429 396 468 512 554 522 486 520 657 493 556 + 63 VI. Local 2303 2401 2500 2718 2488 2847 2457 2344 2596 2177 2483 2172 -311 1. Diseases of Nervous System 282 277 260 376 « 363 418 339 351 330 322 332 341 + 9 2. ,, Organs of Special Sense 7 16 4 20 14 17 12 14 10 11 12 20 + 8 3. „ Circulatory System 645 642 754 733 660 722 669 681 691 654 685 592 - 93 4. ,, Respiratory ,, 870 858 980 958 896 1147 1006 887 1156 770 953 822 -131 5. „ Digestive „ 280 342 290 362 304 319 233 243 246 215 283 224 - 59 6. „ Lymphatic „ 9 10 6 10 15 9 16 9 3 11 10 10 - 7. ,, Urinary „ 177 220 166 213 193 182 149 130 137 151 172 129 - 43 8. ,, Reproductive ,, 17 12 25 26 18 13 24 18 8 17 18 20 + 2 9. „ Bones and Joints 10 19 10 6 10 8 9 5 9 12 10 5 - 5 10. „ Integumentary System 6 5 5 14 15 7 6 6 14 8 9 + 1 VII. Violence 194 213 227 195 201 234 183 159 156 162 192 179 - 13 1 Accident or Negligence 138 167 177 157 165 194 156 122 115 132 152 140 - 12 2. Homicide 6 4 5 3 3 3 4 1 3 2 3 2 - 1 3. Suicide 48 42 45 34 33 37 23 11 27 28 33 37 + 4 4. Execution 2 ... ... 1 ... ... ... ... ... ... ... ... - 5. By Bombs (Enemy Aircraft) ... ... ... ... ... ... ... 25 11 ... 4 ... - 4 VIII. Ill-defined Causes 104 124 120 149 98 125 111 102 103 69 112 98 - 17 All Causes 4523 4866 1682 5028 4938 5546 1752 4600 5841 4640 4941 1475 -466 7 [1920 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 :— Ages. Number of Deaths, 1920. Me in Deaths (10 years), 1910-19. Increase or decrease on mean. 0-1 year 676 737 - 61 1-5 years 372 460 - 88 Under 5 years 1048 1197 - 149 5-15 years 237 178 + 59 15-25 „ 158 192 - 34 25-35 „ 240 287 - 47 35-45 „ 318 378 - 60 45-55 „ 480 542 - 62 55-65 „ 571 648 - 77 65-75 „ 729 775 46 75-85 „ 543 581 - 38 85 upwards 151 163 - 12 4,475 4,941 — 466 INFANTILE MORTALITY. Infant Deaths, 676, Mortality Rate, 72,—There were 676 deaths among infants under twelve months old during the year, or 61 below the decennial average (737), and they represented an infant mortality rate of 72 per 1,000 infants born. This rate is 30 per 1,000 births below the mean annual record of the preceding ten years, and is the lowest infantile mortality rate ever registered in the Borough. The next lowest occurred in the previous year when it was 83 per 1,000 births. Again the third quarter, when the rate is generally very high, only reached the small figure of 43 per 1,000 births. The mortality in the sub-districts ranged from 41 per 1,000 births in Tufnell to 89 in Barnsbury. In London the infant mortality was 75 per 1,000 births, while in the six boroughs encircling Islington it was 79. The rate for England and Wales was 80 per 1,000 births. 8 1920] Infantile Mortality during each of the Ten Years 1910-19, and 1920. Deaths at various Ages under One Year of Age. Years. Under 1 week. Weeks. Total under 4 weeks. Months. Total Deaths under 1 year. s per 1000 births. 1-2 2-3 3-4 4 weeks and under 3 months. 3-6 6-9 9-12 1910 163 45 41 29 278 131 144 106 118 777 95 1911 170 52 34 37 293 207 201 171 168 1040 128 1912 190 41 25 24 280 133 121 81 95 710 86 1913 195 49 47 29 320 187 178 111 102 898 1 07 1914 179 40 39 33 291 159 181 118 100 849 104 1915 155 49 35 31 270 142 152 125 116 805 107 1916 129 32 27 21 209 128 116 92 89 634 87 1917 93 38 23 7 161 106 108 99 91 565 97 1918 123 31 19 14 187 87 112 78 107 571 110 1919 158 32 22 21 233 95 92 60 45 525 83 Mean 10 years 155 41 31 25 252 137 141 104 103 737 95 1920 142 54 37 22 255 141 120 79 81 676 72 Increase or decrease on mean -13 + 13 + 6 -3 +3 + 4 -21 -25 -22 -61 -23 9 [1920 Shewing the Deaths among Infants per 1,000 Births during the year 1920, and also the mortality rates for the years 1910-19. Sub-Districts. 1910. I9II. 1912. 1913. I9I4. I9I5. 1916. 1917. 1918. 1919. Mean 10 years. 1920. Increase or decrease on mean. Tufnell 78 85 61 108 93 65 84 99 93 5o 82 41 41 Upper Hollo 88 115 85 119 86 118 67 68 83 79 91 69 22 way Tollington 88 131 88 104 92 135 93 102 135 98 107 58 49 Lower Hollo 108 162 94 121 134 118 107 121 130 101 120 66 54 way Highbury 82 104 80 89 93 109 74 83 99 83 90 67 23 Barnsbury 111 162 98 128 119 107 103 114 122 91 115 89 —26 Islington South East 94 128 94 98 105 108 91 89 107 81 99 79 —20 The Borough 95 128 86 107 104 107 87 97 110 83 100 72 — 28 10 1920] 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 ten years 1910-19; and in 1920 from certain specified causes. Causes of Death 1920 Mean rate 10 years 1910-19 per 1,000 Births. Difference. Premature Birth and Congenital Defects.. 16.69 20.45 — 3.76 Bronchitis and Pneumonia 19.35 17.99 + 136 Atrophy and Marasmus 8.08 13.33 — 5.25 Diarrhoeal Diseases (all forms) 1.81 8.28 — 6 .47 Convulsions 1.70 1.81 — 0.11 Whooping Cough 2-87 3-88 — 1 .01 Measles 2.13 3.10 — 0.97 Phthisis 0.11 0.39 — 0.28 Other forms of Tuberculosis 0.85 2.85 — 2.00 Diphtheria 0.74 0.26 + 0.48 Total of above 54.33 72.34 18.01 All other causes 17.54 23.03 — 5.49 Total 71.87 — 23.50 11 [1920 WELFARE WORK BY HEALTH VISITORS. This work was carried out during the first six months of the year by the two Health Visitors. Subsequently the Council appointed five additional Health Visitors, who conjointly performed the work set out in the following summary:— Nature of Visits. Districts. Total Visits. 1 2 3 4 5 6 7 Pre-natal 19 10 63 47 88 34 37 298 do. (Home Re-visits) 1 ... ... ... 10 ... ... 11 Births 210 351 382 489 627 352 303 2714 do. (Re-visits) 117 51 277 101 131 135 135 947 Icfant Deaths 1 ... 4 6 8 1 20 Ophthalmia Neonatorum 52 9 12 19 19 12 46 169 do. (Re-visits) 78 3 15 9 3 7 37 152 Puerperal Fever 1 2 • • 1 3 3 3 13 Measles 1 ... ... ... ... 1 ... 2 Tuberculosis ... ... 1 ... ... ... 2 3 Whooping Cough ... ... ... ... 1 ... ... 1 Pneumonia 6 2 1 3 14 .. 1 27 Cerebro-spinal Meningitis 3 1 ... ... 1 ... 2 7 Acute Poliomyelitis 1 ... ... ... 5 .. 1 7 Diarrhoea 1 ... ... 2 1 1 2 7 Chicken Pox ... ... ... ... 2 . . .. 2 Attendance at Welfare Centres 25 ... 31 19 21 26 65 187 Visits re Milk Order 575 842 302 189 438 334 499 2679 Other investigations 287 29 91 64 52 212 216 951 Total Visits 1378 800 1179 943 1422 1124 1351 8197 No. of Attendances at Medical Othcer's Con sultations at Centres 76 121 257 1 18 233 478 1184 No. of Babies seen 80 ... 694 57 1058 29 ... 1918 No, of Babies weighed ,, .. 276 695 782 191 94 2038 Milk Order—Interviews at Office 1199 397 753 467 1354 989 1507 6666 do. New Grants 63 115 209 140 487 203 152 1369 do. Renewals 201 305 559 278 1261 641 636 3881 MILK (MOTHERS AND CHILDREN) ORDER, 1918-19. This order of the Ministry of Health has been in operation since September, 1918, and during the year 1920, the sum of £12,255 16s. 6d. was expended by the Council in the provision of milk to necessitous mothers and children under 5 years of age. The total amount paid since the order was constituted was £14,394 16s. Id. The total number of orders issued during the year was 13,123. Scale of Income for Necessitous Cases. The net income mentioned below is the amount left after deducting the household and husband's expenses from his wages. No. in family. Net income per head per week. 2 10/- 3 8/- 4 7/6 5 6/6 6 or more 6/- Circumstances respecting illness, unemployment, etc., are taken into account when assessing cases. The above Scale is based on income of family from all sources. If any charge is made, the applicants pay according to their circumstances. 12 1920] STATEMENT OF WORK PERFORMED BY THE VOLUNTARY MATERNITY AND CHILD WELFARE CENTRES:— North Islington Maternity and Child Welfare Centre. Number of Expectant Mothers on books - 403 „ Attendances 1,164 „ Consultations held 99 Number of Babies attending (all ages) 1,642 „ „ (under 1 year) 1,341 „ Attendances 12,978 „ Consultations and weighings - 8,954 Number of Attendances of Morning Callers 1,989 Number of Sewing Classes 110 „ Attendances 819 Number of Health Talks 312 „ Attendances 5,504 Number of Visits—Professional 10,426 „ „ —Voluntary 907 Dental Clinic—Attendances 667 „ ,, —Patients treated 256 Convalescent Homes—Mothers and children sent to 163 Number of Patients treated in Wards 162 „ Babies „ „ 122 „ Mothers „ „ 40 Milk for necessitous Mothers (average per month) 179 Number of Deaths—Infant 33 „ „ —Other 17 Infant Mortality (based on per 1,000 infants under 1 year attending centre) 24.6 South Islington Maternity and Child Welfare Centre. Ante-Natal Cases. Number of Mothers 208 Full Term Births 102 Premature Births 6 Still Births 2 Miscarriages 5 Not yet confined 78 13 [1920 False Pregnancy 10 Left the neighbourhood before confinement 3 Number of Attendances 529 Home Visits 448 Number of Deaths—Infant 29 „ „ —(Over one year) 10 Infant Mortality (based on per 1,000 infants under 1 year) 427 Record of Children. Children on Books 31st March, 1920 970 New Children during the year 1,023 Children on Books 31st March, 1921 1,993 Ceased to attend since 31st March, 1920 394 In attendance 31st March. 1921 1,599 Analysis of Attendances. Children under 1 year 679 Do. over 1 year 920 Weighing and Consultations 8,768 Weighings only 5,194 Milk for necessitous Mothers 428 West Islington Maternity and Child Welfare Centre. No. of Expectant mothers on roll 119 Do. Attendances 365 Do. Consultations 47 Do. Ailing mothers on roll 295 Do. Attendances 900 Do. Consultations 51 Total visits—Expectant Mothers 303 Do. —Children 7,717 No, of Children on books 31st March, 1921 1,729 Do. —Attendances under 1 year 555 Do. do. over 1 year 499 No. of Consultations 232 Attendances at Weighings 4,146 Total attendances (Children) 11,364 No. of Deaths 21 Infant Mortality (based on per 1,000 infants under 1 year) 37'8 Massage Attendances 570 14 1920] East Islington Maternity and Child Welfare Centre. Children under 1 year (attending Centred 412 Do. over 1 year „ „ 556 Mothers expectant 175 Consultations held 47 Total attendances (Children) 7,104 Home visits (by staff) 4,326 Do. (Voluntary) 29 Weighings only 2,368 Massage (attendances) 1,095 Deaths (under 1 year) 18 Do. (over 1 year) 10 Infant Mortality (based on per 1,000 infants under 1 year 43.7 Milk for necessitous mothers 220 Dental Clinic—Patients treated 38 Convalescent Homes—Sent for treatment 5 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough. — 1,842 persons died in the Public Institutions located in Islington, of whom 1,322 belonged to this borough, the remaining 520 having come here for treatment or relief. Of these, 337 died in the Holborn Infirmary and gg in the Great Northern Central Hospital. Of the 1,322 deaths of inhabitants, 917 occurred in the Islington Infirmary, 242 in the Islington Institution, and 117 in the Great Northern Central Hospital. The proportion which the 1,322 deaths in these public institutions bore to the borough mortality was 29.5 per cent. Without the Borough.—793 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, 52 in the North-Western Fever Hospital, 47 in the Children's Hospital, Great Ormond Street, 118 in St. Bartholomew's Hospital, 24 in the Colney Hatch Asylum, 50 in the Royal Free Hospital, 63 in the University College Hospital, 53 in the North-Eastern Fever Hospital, 34 in the Eastern Fever Hospital and 36 in the Claybury Asylum. These 793 deaths represented 17.7 per cent. of all the deaths registered in the year. 15 [1920 Within and Without the Borough.—The deaths of Islingtoriians numbered 2,115, and were equal to 47.2 per cent, of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— One-hundred-and-sixteen inhabitants died from accidental deaths, or suddenly, in places outside Islington. Showing the Deaths of Inhabitants in Local Institutions and in Institutions outside the Borough, also the Deaths of Non-Inhabitants in Local Institutions during the ten years 1910-1919 and in 1920. 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 trom all causes (col. 8). 1 2 3 4 5 6 7 8 9 I9IO 1.683 1,120 563 839 97 681 r,8oi 39.8 I9II 1,804 1,181 623 817 1 13 760 1,941 39.9 1912 1,693 1,184 509 846 127 760 i.944 41.5 I9I3 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 2,28s 1,606 682 1,193 98 872 2,478 44.9 1916 2,148 1,460 688 1,027 100 775 2,235 47.o 1917 2,145 1.383 762 952 93 848 2,231 48.5 1918 2,536 1,728 808 1.196 110 865 2,593 44.4 1919 1,946 1.382 564 912 124 730 2,112 45.5 Average 2,021 1.381 640 981 108 801 2,182 44.1 1920 1,842 1,322 250 917 117 793 2,115 47.3 16 1920] Transferable Deaths.—During the year 53 deaths that had occurred in outlying Institutions and other places outside the Borough were transferred by the Registrar-General to Islington. MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES. Small Pox, Measles, Scarlet Fever, Whooping Cough, Fevers—Typhus, Enteric and Continued—and Diarrhceal Diseases. During the year 340 persons died from these diseases, the death rate being 1.01 per 1,000 inhabitants, as contrasted with 0.41 in the corresponding period last year and a decennial average mortality of 360 and a death rate of 1.14 per 1,000. In London the death rate from the epidemic diseases was 0.9 while in the six Boroughs encircling Islington, the death rate was 1.2. 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 1920. 17 SUB-REGISTRATION DISTRICTS. WARDS. Enteric Fever. Small Pox. Measles. Scarlet Fever Whooping Cough. Diphtheria. Diarrhoea. Totals. Deaths. Deaths. Deaths Deaths. Deaths. Deaths. Deaths. Deaths. Tufnell Tufnell ... ... 7 I 11 7 4 30 Upper Holloway Upper Holloway ... ... io I 5 5 1 22 Tollington Tollington I ... 6 ... 3 13 1 24 Lower Holloway Lower Holloway ... ... io ... 14 12 1 37 Highbury Highbury ... ... IO 2 6 10 3 3i Mildmay ... ... 7 ... 2 6 3 18 Barnsbury Thornhill ... ... 19 2 17 16 5 59 Barnsbury ... ... 8 3 2 5 4 22 Islington South East St. Mary's ... ... 4 2 2 7 ... 15 Canonbury ... ... 3 ... 6 10 2 21 St. Peter's 2* ... 8 1 2 44 4 61 The Borough 3 ... 92 12 70 135 28 340 [1920 Total Death Rates 0.0I ... 0.27 0.04 0.2I 040 0.08 1.01 * Malarial Fever. 1920] 18 Showing the Deaths and Death-Rates from the Principal Epidemic Diseases during the ten years 1910-19 and for the Year 1920. 1910. 1911 1912 1913 1914 1915 1916 1917 1918 1919. Mean 10 years. 1920 Deaths Death Rates Deaths Death Rates Deaths Death Rates Deaths Death Rates Deaths Death Rates Deaths Death Rates Deaths Death Rates Deaths Death Rates Deaths Death Fates Deaths Death Rates Deaths Death Rates Deaths Death Rates Enteric Fever 17 0.05 12 0.01 8 0.02 4 0.01 14 0.04 5 0.01 9 0.03 4 0.01 7 0.02 5* 0.02 8 0.02 3* 0.01 Small Pox; .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 0.00 .. .. .. .. Measles 166 0.51 124 0.38 151 0.46 101 0.31 97 0.30 153 0.48 80 0.26 149 0.50 114 0.39 12 0.04 115 0.36 92 0.27 Scarlet Fever 11 0.03 20 0.06 9 0.03 19 0.06 23 0.07 38 0.12 18 0.06 4 0.01 8 0.03 14 0.04 16 0.05 12 0.04 Whooping Cough 124 0.38 71 0.22 54 0.16 62 0.19 83 0.26 103 0.32 60 0.19 45 0.15 147 0.51 17 0.05 77 0.21 70 0.21 Diphtheria 34 0.10 54 0.16 38 0.12 37 0.11 41 0.13 57 0.18 45 0.14 33 0.11 45 0.16 51 0.16 41 0.14 135 0.40 Diarrhæa and Enteritis (under 2 years) 111 13.53 per 1,000 births 362 44.62 per 1,000 births 84 10.96 per 1,000 births 210 25.12 per 1000 births 217 26.63 per 1000 births 154 20.43 per 1,000 births 117 16.11 per 1,000 births 106 18.16 per 1,000 births 82 15.78 per 1,000 births 85 13.53 per 1,000 births 153 19.80 per 1,000 births 77 8.19 per 1,000 births * Including 2 Malarial Fever. Showing the Deaths from Diarrhœal Diseases together with those classed under Enteritis and its sub-headings, arranged in quarterly periods, and in three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhœa Enteritis, etc Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarihœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Under 1 year 4 10 11 6 10 16 2 9 11 5 18 23 17 47 64 1 to 5 years .. 1 1 1 2 3 1 1 2 1 3 4 3 7 10 Over 5 years 6 2 8 1 5 6 .. 2 2 1 2 3 8 11 19 Totals 10 13 23 8 17 25 3 12 15 7 23 30 28 65 93 19 [1920 INFLUENZA. During the year Influenza caused 118 deaths, which is a decrease of 238 on the return lor the year 1919; and 44 less than the average of the preceding ten years 1910-19, Showing the Deaths from Influenza in the Quartets of the Year 1920, together with the averages of the corresponding periods, 1910 19. Years. Quarters. Totals. First Second. Third. Fourth. 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 1918 14 8 60 849 931 1919 294 35 6 21 356 Average 49 11 8 94 162 1920 56 43 7 12 118 Increase or Decrease +7 +32 -1 -82 -44 The following statement gives the ages at death of the persons who suffered from Influenza during the preceding ten years as compared with the return for the year 1920:— Ages. 1910 1911. 1912. 1913. 1914. 1915. 1916. 1917. , 1918. 1919. Mean royrs. 1920. Difference. 0-5 2 3 1 5 1 3 - 1 106 19 14 10 -4 5-10 - - - - 1 - - - 52 5 6 3 -3 10-15 - - - - - - - - 32 8 4 3 -1 15-25 2 1 2 2 1 5 - - 141 48 20 12 -8 25-35 2 4 1 4 1 4 - 2 252 82 35 21 -14 35-45 3 2 5 8 6 7 1 2 109 47 19 18 -1 45-55 5 6 1 17 5 15 6 7 93 48 20 17 -3 55-65 5 3 4 5 7 12 6 8 69 42 16 17 +1 65-75 5 10 7 7 7 11 10 10 50 36 15 13 -2 75 upwards 12 8 7 10 1 14 13 6 27 21 12 4 -8 All Ages 36 37 28 58 30 71 36 36 931 356 161 118 -43 1920] 20 SEPTIC DISEASES. Erysipelas and Puerperal Septicaemia are the principal diseases of this class. Erysipelas.—15 deaths were returned from this disease, or 2 more than in the year 1919, and 5 above the average of the preceding ten years 1910-19. Puerperal Diseases.—These comprise Puerperal Pyaemia, Septicaemia, Septic Intoxication and Puerperal Fever, and they caused 9 deaths, which is 4 below the return of 1919, and 2 more than the average of the ten years 1910-19. CONSTITUTIONAL DISEASES. The chief of these diseases are Cancer, Tuberculosis, Rheumatism, Diabetes, Gout, Gangrene and Purpura. They were collectively responsible for 918 deaths, as contrasted with an average of 1,047 in the preceding ten years. The death rate represented 2.73 per 1,000, as contrasted with a decennial average of 3.31. Cancer.—There were 402 deaths from this malignant disease during the year compared with 438 in 1919, and with an average of 391 in the previous decennium. The deaths represent a death rate of 1.20 per 1,000 of the civil population and is 0.04 below the average rate (1.24) of the last ten years, 200 deaths occurred among males and 202 among females. The following statement shows the ages at death of the persons attacked during the past eleven vears:— Ages. 1910. 1911. 1912. 1913. 1914 1915. 1916. 1917. 1918 1919 Average 19101919. 1920. Difference. 0-5 2 1 1 1 - - - 2 - 2 1 3 +2 5-15 1 3 2 -2 1 3 2 - 1 2 - -2 15-25 5 4 4 7 2 2 - 5 - 4 31 -2 25-35 6 5 7 13 11 7 4 8 8 5 7 10 +3 35-45 40 32 25 31 37 24 30 31 27 36 31 32 +1 45-55 72 67 71 83 69 75 86 73 75 101 77 74 -3 55-65 100 92 130 99 121 120 124 131 99 120 114 110 -4 65-75 85 87 86 115 96 105 114 120 126 123 106 124 +18 75-85 47 31 51 49 40 39 48 55 52 39 45 43 -2 85 & up- wards 375664356758-- 361 329 382 404 384 377 412 432 393 438 391 402 +11 21 [1920 Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the year 1920. Quarters. Tufnell Upper Holloway Tollington Lower Holloway Highbury Barnsbury Islington South-East The Borough First 10 15 10 7 12 16 12 82 Second 10 13 16 10 27 20 24 120 Third 12 6 11 10 15 20 21 95 Fourth 15 13 4 17 19 17 20 105 The Year 47 47 41 44 73 73 77 402 TUBERCULOSIS. The group of diseases, known as Tuberculosis, together caused 425 deaths which were 129 below the average of the last decennium, and were also 42 below the number registered in 1919. The death rate resulting from them was equal to 1.26 per 1,000 of the civil population, and represented 9.5 per cent. of the deaths from all causes during the year. Pulmonary Phthisis.—This is the principal disease of the tubercular group, and it caused 349 deaths, as contrasted with the decennial average of 443, while the death-rate was 1.04 per 1,000 of the civil population, as against the decennial rate of 1.40 per 1,000. There was a decrease of 94 on the number of deaths and of 0.36 on the mean death-rate. The mortality from Phthisis was the lowest hitherto recorded in the Borough and the deathrate correspondingly creates a record. Years polmonary phthisis. Deaths Death rates per 1,000 inhabitants. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. 1910 390 1.09 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 1916 458 1.48 9.64 15.3 1917 485 16.3 10.5415.5 1918 516 1.80 8.83 20.4 1919 388 1.18 8.56 14.1 Average 10 years 443 1.40 8.96 15.6 1920 349 1.04 7.80 13.3 1920] 22 The following return gives the deaths at each age period :—• Age periods. Males. Females. Total Age periods. Males. Females. Total 0-5 4 3 7 45-55 49 28 77 5-15 5 7 12 55-65 26 11 37 15-25 21 30 51 65 upwards 12 12 24 25-35 29 35 64 Total 186 163 349 35-45 40 37 77 Showing the Deaths for Phthisis in the Sub-Districts during the Four Quarters of the Year 1920. Quarters. Tufnell Upper Holloway Tollington Lower Holloway Highbury Barnsbury Islington SouthEast The Borough First 12 7 3 17 21 12 29 101 Second 7 20 10 10 12 13 24 96 Third 7 8 4 9 8 18 13 67 Fourth 6 8 8 11 11 20 21 85 The Year 32 43 25 47 52 63 87 349 Showing the Deaths from the Tubercular Diseases during 1920. Diseases. Ages. Sex. Districts. Total Deaths. 0-1 1-5 over 5 M. F. Tuf U.H. Toll. L.H. H. B. S.E. Phthisis 1 6 341 186 162 31 43 25 47 52 63 87 348 Tuberculosis of the Larynx .. .. 1 .. 1 1 .. .. .. .. .. .. 1 Tubercular Meningitis 7 15 18 22 18 4 3 1 6 7 9 10 40 Abdominal Tuberculosis .. 5 13 8 10 3 2 .. 2 3 3 5 18 General Tuberculosis 1 1 5 4 3 1 .. .. ???1 2 2 1 7 Other Forms of Tuberculosis .. 1 10 7 4 1 2 .. 1 1 2 4 11 All Tubercular Diseases 9 28 388 227 198 41 50 26 57 65 79 107 425 23 [1920 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. These diseases, which include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 822 deaths, or 52 more than in 1919. They were equal to a death-rate of 2.45 per 1,000 of the civil population, and represented 18.4 per cent. of the total deaths registered in the borough. Acute Bronchitis.—There were 106 deaths as compared with 149 in the previous year. 50 occurred among males, and 56 among females. The deaths of 28 infants under 12 months were registered. Chronic Bronchitis.—244 deaths were ascribed to it, 118 being males and 126 females. This return is 1 below that for 1919. Pneumonia (All forms).—Four hundred and nineteen deaths were registered, of which 237 were males and 182 females. They are 95 above the number who died in 1919. It was very fatal to infants under a year old, among whom it caused 125 deaths, while between the ages of 1 and 5 years 95 died from it. Above 5 years of age the deaths numbered 199. 88 Deaths occurred in Public Institutions, chiefly the Workhouse Infirmaries. Pleurisy—From this disease 12 deaths were registered. Only 2 deaths occurred in Public Institutions. Asthma and Emphysema.—Eighteen deaths were recorded from these diseases, all of which were adults. Other Diseases of the Respiratory System.—Twenty-three deaths were registered from them, as contrasted with 9 in 1919. VENEREAL DISEASES. Thirteen deaths were ascribed to these diseases, as compared with an equal number for 1919. They were 4 below the mean of the preceding ten years 1910-19. The annual average number of deaths recorded during ten years from them at three groups of ages has been as follows:—Under 1 year 10 deaths 1-5 years 1 death, and over 5 years 6 deaths, making an average total of 17 per annum. 1920] 24 INQUESTS AND MORTUARY. During the year 340 bodies were received into the Mortuary, as compared with an average of 550 in the preceding 10 years. The return is the lowest known for very many years. Seven infectious bodies were received during the year. The daily average number of bodies received was 0 9 as compared with 11 in 1919. In 312 cases inquests were held, as contrasted with an average of 390 in the ten years 1910-1919. Bodies received into Mortuary. Inquests. 1910 609 385 1911 646 425 1912 634 443 1913 575 384 1914 537 369 1915 612 475 1916 507 394 1917 479 359 1918 476 348 1919 429 321 Average 550 390 1920 340 312 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1920 and 1919. 1919. No. of bodies received. Daily Average. No. of Inquests held. 1920. No. of bodies received. Daily Average. No. of Inquests held 1st Quarter 128 1.4 92 1st Quarter „ 98 1.0 82 2nd „ 94 1.0 76 2nd ,, 82 0.9 76 3rd „ 81 0.9 53 3rd „ 81 0.9 74 4th „ 126 1.3 100 4th „ 79 0.8 80 Total for Year 429 1.1 321 Total for Year 340 0.9 312 25 [1920 THE NOTIFICATION, ISOLATION, FATALITY, and PREVENTION 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. There were 2,853 cases of the diseases which are notifiable under the Public Health (London) Act, 1891, in addition to which there were other communicable ailments, such as Tuberculosis, Ophthalmia Neonatorum, Acute Poliomyelitis, Cerebro-Spinal Fever, Encephalitis Lethargica, Measles, Malaria and Dysentery, which are notifiable either under Orders of the late Local Government Board, or of the London County Council with the approval of that Board. The total cases notified are 860 above those of the previous year (1,993), and 1053 more than the average of the preceding ten years. The largest increases when contrasted with the decennial averages are to be found in the returns from Scarlet Fever and Diphtheria, which were respectively 359 and 755 in excess, while the other diseases all showed a decrease. The 2,853 cases were equal to an attack-rate of 8.49 per 1,000 of the civil population. In London the attack-rate was 8.81 per 1,000 of the civil population, or 0.32 more than in Islington, while in the Encircling Boroughs it was 10.05, or 1.56 above the local rate. The returns for the preceding ten years are given in the following statement:— Year. Cases. Attack-rates per 1,000 civil population. 1910 1,525 4.65 1911 1,759 5.37 1912 1,577 4.83 1913 2,171 6.54 1914 2,947 9.08 1915 2,210 6.98 1916 1,439 4.65 1917 1,251 4.21 1918 1,127 3.93 1919 1,993 6.05 10 years average 1,800 5.69 1920 2,853 8.49 1920] 26 Registration Sub-Districts.—The total number of cases notified in these districts was as follows:— Total cases notified. Tufnell 232 Upper Holloway 198 Tollington 293 Lower Holloway 246 Highbury 377 Barnsbury 586 Islington South-East 921 Total 2,853 Small Pox.—No case was notified in the Borough during the year. The average number of cases during the preceding ten years was only 0'5. Scarlet Fever.—1,307 cases were notified, and they showed an increase of 359 or 38 per cent. on the average (948) of the ten years 1910-19. The attack-rate was equal to 3.89 per 1,000 of the civil population annually, which is an increase of 0.88 per 1,000 on the mean rate (3.00) of the preceding ten years. Diphtheria and Membranous Croup were responsible for 1,328 cases of illness, and were 755 above the average (573??? of the preceding ten years The attack-rate was equal to 395 per 1,000 of the civil population annually and was 2.14 above the mean rate (1.81) of the decennial period. In London the attack-rate was 3.04 per 1,000, and in the Encircling Boroughs 3.56. Enteric Fever was notified in 24 instances which is 23 below the average (47) that obtained during the ten years 1910-19. The attack-rate was 0.07 per 1,000 annually, or 0.08 per 1,000 below the mean rate (0.15) of the last ten years. In London the rate was 0.08 and in the Encircling Boroughs 0.08 per 1,000 of the civil population. Typhus Fever.—Nil return. Continued Fever.—No case was notified. Erysipelas.—165 cases were notified, or 47 below the average (212) of the preceding ten years, the attack-rate being 0.49 per 1,000 of the civil population, as compared with 0.57 in London and 0.68 in the Encircling Boroughs. 27 [1920 Puerperal Fever.-Twenty-nine cases were notified, being in the proportion of 3.08 per 1,000 births. The notifications were 9 above the average (20) of the preceding ten years, and showed an increase of 0.31 in the proportion of attacks to 1,000 births. The deaths numbered 9, which represented a fatality of 31 per cent. The deaths occurring in hospital numbered 5, and equalled a fatalily rate of 25 per cent, of the cases treated. Cases of Puerperal Fever notified and inquired into during the year 1920. Tufnell. Upper Holloway. Tollington Lower Holloway. Highbury. Barnsbury Islington South-East The Borough. Cases notified 6 .. 3 3 4 6 7 29 Patient delivered by Doctor 4* .. .. .. 2 4 6 16 ,, „ by Midwife 1 .. 2* 3 2 2 1 11 Cases inquired into 6 .. 3 3 4 6 7 29 ,, treated in Hospital 5 .. 1 1 2 6 5 20 ,, treated at Home 1 .. 2 2 2 .. 2 9 * There were two cases where miscarriage occurred, FATALITY FROM THE NOTIFIABLE INFECTIOUS DISEASES. By "Fatality" is meant the percentage proportion of deaths to attacks of sickness. During the year it was found that of the 2,870 cases notified 173 deaths occurred, or 6 per cent., which contrasts with an average percentage of 4.8 in the preceding ten years 1910-19. Years. Cases. Deaths. Fatality. 1910 1,525 79 5.2 1911 1,759 104 5.9 1912 1,577 62 3.9 1913 2,171 76 3.5 1914 2,947 112 3.8 1915 2,210 118 5.3 1916 1,439 87 6.0 1917 1,251 55 4.4 1918 1,125 67 6.0 1919 1,913 95 4.8 Total 17,917 855 4.8 1920 2,870 173 6.0 1920] 28 Hospital Isolation.—Of the 2,870 cases of infectious diseases notified, 2,642 were isolated in hospital, or a percentage of 92.0, while only 8 per cent. of the patients, therefore, were nursed at home. The following tabular statement shows the number of cases treated in the various public institutions:— Year Cases treated in Hospital. Percentage of cases treated. 1910 1,247 81.8 1911 1,416 80.5 1912 1,577 84.1 1913 1,866 85.9 1914 2,543 86.3 1915 1,991 90.1 1916 1,269 90.0 1917 1,099 87.8 1918 982 87.1 1919 1,772 88.9 1920 2,642 920 DISEASES TREATED IN HOSPITAL. Disease. Total cases. Cases isolated Percentage of known cases. Smal Pox ... ... ... Scarlet Fever 1,307 1,245 95.2 Diphtheria 1,328 1,287 96.9 Enteric Fever 24 19 79.2 Erysipelas 165 72 43.7 Puerperal Fever 29 18 62.1 Continued Fever 17* 1 5.9 2,870 2,642 92.0 •Malaria, 29 [1920 Summary of Infectious Sickness and of 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 1920. Notified Cases Treated. Percentages of Notified Cases Treated Deaths Occurring. Percentage 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 1245 62 1307 95.2 4.8 12 .. 12 0.9 .. 0.9 Diphtheria 1287 41 1328 96.9 3.1 128 6 134 9.9 14.6 10.1 Enteric (Typhoid Fever) 19 5 24 79.2 20.8 .. 1 1 •• 20.0 4.2 t Typhus Fever .. .. •• •• .. •• •• •• .. .. • • Erysipelas 72 93 165 437 56.3 13 2 15 18.0 2.1 9.1 Puerperal Fever 18 11 29 62.1 37.9 5 4 28.0 36.3 31.0 Continued Fever 1* 16* 17* 5.9 94.1 1 1 2* 100.0 6.2 12.0 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. Cholera •• •• • • •• •• •• .. •• .. •• •• Total 2642 228 2870 92.0 8.0 159 14 173 6.0 6.1 6.0 *Malarial Fever. 1920] 30 Showing the number of Cases and Attack-Rates of the several Notifiable Infectious Diseases which eccurred during each of the Ten Years 1910-19 and in 1920. DISEASES. YEARS Average number of cases 1910-19 1920 Increase or Decrease. 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 Small Pox Cases 1 ... ... ... ... ... ... ... 2 2 ... ... ... Rate 0.00 ... ... ... ... ... ... ... 0.00 0.00 ... ... ... Scarlet Fever Cases 730 804 811 1317 1853 1332 638 478 432 1084 948 307 +359 Rate 2.22 2.46 2.49 3.97 5.71 4.21 2.06 1.61 1.51 3.29 3.00 3.89 +0.88 Diphtheria Cases 463 590 512 546 651 620 587 556 514 645 568 1324 +756 Rate 1.41 1.8o 1.57 1.65 2.01 1.96 1.90 1.87 1.80 1.96 1.81 3.94 + 2.13 Membranous Croup Cases 8 3 4 4 8 4 6 5 4 4 5 4 -1 Rate 0.03 0.01 0.01 0.01 0.02 0.01 0.02 0.02 0.01 0.01 0.02 0.01 -0.01 Enteric Fever Cases 89 73 49 50 76 28 32 23 30 16 47 24 -23 Rate 0.27 0.22 0.15 0.15 0.23 0.09 0.10 0.08 0.10 0.5 0.5 0.07 -0.08 Typhus Fever Cases 1 ... ... ... ... ... ... ... ... ... ... ... ... Rate 0.00 ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas Cases 212 275 185 226 334 203 155 172 141 212 212 l65 -47 Rate 0.84 0.84 0.57 0.68 1.03 0.64 0.50 0.58 0.49 0.64 0.67 0.49 -0.18 Puerperal Fever* Cases 20 14 16 28 25 23 21 l6 4 29 20 29 +9 Rate 2.44 1.76 1.95 3.41 3.10 3.48 2.89 2.74 0.77 0.46 2.77 3.08 +0.31 Continued Fever Cases ??? ... ... ... ... ... ... ... ... 1 ... ... ... Rate 0.00 ... ... ... ... ... ... ... ... 0.00 ... ... ... Totals Cases 1525 1759 1577 2171 2947 2210 1439 1250 1127 1993 1800 2853 +1053 Rates 4.65 5.37 4.83 6.54 9.08 6.98 4.65 4.21 3.93 6.05 5.69 8.49 +2.80 Per 1,000 Registered Births. 31 [1920 Showing the Cases of the Notifiable Infectious Diseases notified in the Sub-Registration Districts and the Wards during the Year 1920. SUB-REGISTRATION DISTRICTS. WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria, Membranous Croup Enleric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Tufnell Tufnell ... 97 111 ... 3 ... 15 6 ... ... ... 232 Upper Holloway Upper Holloway ... 101 75 1 2 ... 19 ... ... ... ... 198 Tollington Tollington ... 139 130 1 3 ... 17 3 ... ... ... 293 Lower Holloway Lower Holloway ... 131 93 ... 2 ... 17 3 ... ... ... 246 Highbur Highbury ... 86 107 ... 1 ... 14 2 ... ... ... 210 Mildmay ... 89 65 ... 5 ... 6 2 ... ... ... 167 Barnsbury Thornhill ... 152 110 ... ... ... 22 4 ... ... ... 288 Barnsbury ... 173 102 ... 2 ... 19 2 ... ... ... 298 Islington South East St. Mary's ... 81 87 1 1 ... 8 2 ... ... ... 180 Canonbury ... 122 139 ... 2 ... 11 2 ... ... ... 276 St. Peter's ... 136 305 1 3 ... 17 3 ... ... ... 465 Totals ... 1307 1324 4 24 ... 165 29 ... ... ... 2853 Attack-Rates per 1,000 population ... 3.89 3.94 0.01 0.07 ... 0.49 0.09 ... ... ... 8.49 1920] 32 OTHER NOTIFIABLE DISEASES. Acute Poliomyelitis, Cerebrospinal Meningitis, Encephalitis Lethargica, Ophthalmia Neonatorum, Tuberculosis and Measles. Acute Poliomyelitis Seven cases were ascribed to this disease during the year, as contrasted with 3 in 1919. No death, however, was registered. 1920. 1919. Cases. Deaths. Cases. Deaths. 1st quarter 1 nil nil nil 2nd „ 1 „ „ „ 3rd „ 5 „ 2 „ 4th „ nil „ 1 1 7 nil 3 1 Epteemic Cerebro-Spinal Meningitis Fourteen cases were notified, or two cases less than in 1919. During the ten years 1910-19 the cases averaged 19 per annum. A return of attacks of the disease during the past ten years is given in the following statement:— 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 Average ten years. 1910-19 1920 Total Deaths. 1910-20 1st quarter 3 4 1 1 2 12 7 15 7 8 6 5 42 2nd „ 7 4 6 3 3 13 17 11 4 7 7 5 58 3rd „ 1 3 3 1 2 11 8 1 1 1 3 2 20 4th „ 4 2 3 1 — 4 7 3 4 nil 3 2 12 Year 15 13 13 6 7 40 39 30 16 16 19 14 132 The deaths during the year numbered 9, and were equal to the very high rate of 64 per cent. of the cases notified. Public Health (Pneumonia, Malaria, Dysentery, etc.), Regulations, 1919. These Regulations came into force on the 7th January, 1919, and during the year the following cases were notified by medical practitioners to the Medical Officer of Health. 1920. 1919. Malaria 17 193 Dysentery 4 14 Acute Primary Pneumonia 34 12 Influenzal Pneumonia 22 12 Pneumonia 3 29 Total 80 260 33 [1920 Acute Encephalitis Lethargica and Acute Polio-Encephalitis. These diseases became notifiable under an Order of the Local Government Board on the 1st January, 1919, and during the year 8 cases of Acute Encephalitis Lethargica were notified, 4 of which proved fatal. 7 cases of Acute Polio-Encephalitis were also known in the Borough, but there was no fatal case. Ophthalmia Neonatorum. Purulent Disease of the Eyes of Newly-born Children. This inflammatory disease of the eyes of infants was notified in 142 instances, of which 78 were attended by Doctors and 48 by Midwives; whilst 8 cases were reported by the London Couuty Council, and 8 by the Health Visitors; and as a result 88 cases were referred to Hospitals for treatment, while 54 were attended to in their homes. Midwives attended 83 cases, and undertook the care of the infants affected. As the result of visits by the Health Visitors, the Council provided Nurses in 105 cases at a cost of £104 13s. Od. This was money well spent, for undoubtedly they have saved many eyes. The cases occurred in the sub-registration districts as follows:— Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough. Cases notified by Doctor 7 9 7 10 6 15 24 78 ,, „ by Midwife 4 9* 13* 3 12 .. 7* 48 ,, reported by L.C.C. .. .. .. 1 1 2 4 8 ,, ,, Health Visitor .. .. .. 2 2 2 2 8 Cases inquired into 11 18 20 16 21 19 37 142 „ treated in Hospital 6 8 14 8 15 14 23 88 „ treated at Home 5 10 6 8 6 5 14 54 ,, attended by Nurse 8 11 11 6 17 8 22 83 * Notifications which were also received from midwives, and had been notified by doctors. are not included. Of the 142 cases investigated, both of the infants' eyes were affected in 73 instances; while in 15 cases the right eye was involved and in 10 the lett. Some of the cases had already recovered at the time of visit by the Health Visitors; whilst in many cases the infants were either in-patients at hospitals, or out-patients receiving hospital treatment, and in these cases the affected eyes were not examined by the Health Visitors. 1920] 34 Tuberculosis. During the year 780 cases of Tuberculosis in its different forms were notified. The attack-rate was equal to 2.32 per 1,000 of the civil population. This number shows a decrease of 100 on the return of the previous year, and of 0.35 per 1,000 on the attack-rate. It was also 409 below the number in 1918. Pulmonary Tuberculosis.—663 notifications were received, of which 381 referred to males and 282 to females, and represented an attack-rate of 1.97 per 1,000. The return was a decrease of 96 on that of 1919, and 343 on 1918. Showing the Notified Cases of Tuberculosis in the Wards during 1920. Tuberculosis Rate per 1,000 of Popuation. .. .. .. .. .. .. .. .. .. .. .. 2.32 Grand Totals. 80 85 63 70 53 51 92 48 59 85 94 780 Other Forms of Tuberculosis. Totals. 16 14 11 14 6 1 16 10 4 13 12 117 Females. 6 5 3 6 1 .. 7 4 1 6 4 43 Males. 10 9 8 8 5 1 9 6 3 7 8 74 Pulmonary Phthisis. Total. 64 71 52 56 47 50 76 38 55 72 82 663 Females. 35 27 34 14 22 20 31 15 26 22 36 282 Males. 29 44 18 42 25 30 45 23 29 50 46 381 Wards. Tufnell UDDer Holloway Tollington Lower Holloway Highbury Mildmay Thornhill Barnsbury Mary's Canonbury St. Peter's Totals Registration Sub-Districts. Tufnell Upper Hollowav Tollington Lower Holloway Highbury Barnsbury Islington South-East 35 [1920 THE PERIOD OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1920. Tubercular Diseases. Sex. At all ages. CASES NOTIFIED IN WHOLE DISTRICT. 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. 381 — 3 20 62 207 84 5 F. 282 — 2 22 68 139 46 5 Tubercular Meningitis M. 6 3 4 — — — — — F. 6 — 1 5 — — — — Tabes Mesenterica M. 5 — 2 1 — 2 — — F. 5 — 2 1 — — 1 1 General Tuberculosis M. 3 — 2 — 1 — — — F. — — — — — — — — Other forms of Tuberculosis M. 60 — 4 24 15 14 1 2 F. 32 — — 17 7 7 1 — All Tubercular Diseases M. 455 2 15 45 78 223 85 7 F. 325 — 5 45 75 146 48 6 Totals 780 2 20 90 153 369 133 13 Percentages at each life period to total cases 100 0.3 2.6 11.5 19.6 47.3 17.0 1.7 From the above statement it will be seen how the disease attacked people at the various ages, viz.: Prime of Life In every hundred cases 0.3 were under 1 year of age. „ „ „ 2.6 were aged 1 to 5 years. „ „ „ 11.5 „ 5 to 15 „ „ „ „ 19.6 were aged 15 to 25 years „ „ „ 47.3 83.9 were aged 15 to 25 years „ 25 to 45 „ „ „ „ 17.0 were aged 45 to 65 years ,, „ „ 1.7 „ 65 and upwards. 1920] 36 Showing the Notified Cases of Tuberculosis in the Quarters during 1920. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. The Year. Males Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Phthisis 125 90 215 95 92 187 83 52 135 78 48 126 381 282 663 Tubercular Meningitis 1 2 3 1 2 3 1 1 2 3 1 4 6 6 12 Tabes Mesenterica 1 2 3 .. 1 1 2 1 3 2 1 3 5 5 10 General Tuberculosis .. .. .. .. .. .. 2 .. 2 1 .. 1 3 .. 3 Other Form of Tuberculosis 18 8 26 10 7 17 16 8 24 16 9 25 60 32 92 145 102 247 106 102 208 104 62 166 100 59 159 455 325 780 37 [1920 Disinfection of Houses and Rooms after Phthisis. The following statement gives the particulars for the year;— Houses. Rooms 1st quarter 105 139 2nd „ 71 100 3rd „ 53 75 4th „ 57 72 Total 286 386 TUBERCULOSIS DISPENSARIES. The work of the Tuberculosis Dispensaries has been very satisfactorily performed, and during the year 1,415 persons were examined by the Tuberculosis Officers, and the patients made 10,816 attendances. At the Northern Dispensary there were 655 new cases, and at the Southern 760, while the attendances at the former were 3,921 and at the latter 6,895. The examination of contacts with tuberculous cases showed that 43 were suffering from tuberculosis, 44 were suspect, and 386 were not suffering. The nurses of the Northern Dispensary paid 1,677 visits, and those of the Southern 1,788, to the homes of the patients, while the Tuberculosis Oifficer of the Northern Dispensary made 226 visits and of the Southern 214 vsits to the patients' homes for the purpose of examining them. The number of persons in attendance at them in each year since their institution is as follows:— TUBERCULOSIS. 1916. 1917. 1918. 1919. 1920. North Dispy. South Dispy. North Dispy. South Dispy. North Dispy. South Dispy. North Dispy. South Dispy. North Dispy. South Dispy. New Cases — 312 628 717 635 872 585 756 655 760 Actual No. of Attendances — 944 2279 4291 3798 6511 4057 6782 3921 6895 Totals — 1256 2907 5008 4433 7383 4642 7538 4576 7655 A summary of this table gives the following figures: Cases. Attendances. 1916 312 944 1917 1,345 6,570 1918 1,507 10,309 1919 1,341 10,839 1920 1,415 10,816 5,920 39,478 Table showing the number of Tuberculous Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1920. Date. Dispensary. Jan. Feb. March. April. May. June. July. August. Sept. Oct. Nov. Dec. Year. Total. Attendances Northern 392 326 376 336 334 302 303 262 289 334 370 297 3,92I 10816 Southern 590 615 686 555 525 598 570 536 586 508 611 515 6,895 New Cases Including Contacts Northern 86 62 63 67 55 51 46 23 49 53 48 52 655 1,415 Southern 61 98 75 63 50 74 56 47 61 57 72 46 760 Contacts. Tuberculosis Northern — 1 — — 1 — — 2 1 21 — 1 27 43 Southern 1 1 2 1 1 1 — 2 — 2 3 2 16 Suspects Northern 2 1 2 2 2 2 3 — 2 2 1 1 20 44 Southern 3 4 1 3 3 1 1 3 — 2 2 1 24 Non-Tuberculous Northern 47 22 21 27 22 14 15 10 21 1 12 24 236 386 Southern 10 14 15 8 10 18 11 7 14 15 15 13 150 Nurses' Visits Northern 145 140 175 124 169 169 124 53 136 169 157 116 1,677 3,465 Southern 177 178 164 129 159 188 140 10 164 149 182 148 1,788 Tuberculosis Officers' Visits Northern 21 18 20 20 19 19 3 21 28 18 17 22 226 440 Southern 19 21 20 20 22 21 17 14 ???3 13 17 17 214 39 [1920 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 1,516 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 791 were Scarlet Fever, 714 Diphtheria, 3 Enteric Fever, and 8 other diseases. The number of notifications of the several diseases are given below:— Disease. No. of Notifications. Average of preceding 10 years. Increase or Decrease. Small Pox — — — Scarlet Fever 791 521 +270 Diphtheria 714 256 + 458 Enteric Fever 3 5 -2 Other Diseases 8 — + 8 Total 1,516 782 + 734 Non-Notifiable Diseases.—6,792 cases came to the knowledge of the Medical Officer of Health during the quarter, viz.:—2,649 cases of Measles, 577 cases of Whooping Cough, 593 of Chicken Pox, and 2,973 of other diseases. The information respecting these cases was received from the teachers of 60 schools. Exclusion of Scholars from Schools.—4,671 children were excluded from classrooms of various schools owing to the presence of an infectious disease, chiefly Diphtheria and Scarlet Fever, in the houses wherein they lived. The non-notifiable diseases among children attending the Public Elementary Schools were: — Disease. Notifications by Teachers. Average of preceding 10 years. Increase or Decrease. Measles 2,649 1,444 +1,205 Chicken Pox 593 825 -232 Whooping Cough 577 634 -57 †Other Diseases 2,973 2,322 +651 6,792 5,225 + 1,567 † Note.—"Other Diseases" include Mumps, Scabies, Ophthalmia, Itch, &c. 1920] 40 BACTERIOLOGICAL EXAMINATIONS. 1419 examinations were made for the medical professio??? of the sputum, of swabs from the throat and of the blood of patients suspected to be suffering from Phthisis, Diphtheria and Enteric Fever. This number is an increase of 491 on that of the preceding year. It is also 403 above the decennial average. Diphtheria.—938 specimens were examined for Diphtheria, of which 261 were found to contain Diphtheria bacilli. Enteric Fever.—23 specimens of blood were examined, of which only three gave positive results. Phthisis.—458 specimens of sputum were examined, only 83 of which showed that the patients were suffering from this disease. Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria Enteric Fever and Phthisis, 1910-20. Pirions. Diphtheria. Enteric Fever. Phthisis. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Totals. 1910 125 276 401 32 29 61 63 157 220 682 1911 157 327 484 19 33 52 66 186 252 788 1912 137 298 435 23 27 50 119 341 460 945 1913 163 418 581 24 28 52 183 546 729 1362 1914 178 518 696 15 44 59 243 567 810 1565 1915 123 360 483 16 19 35 198 568 766 1284 1916 127 277 404 10 12 22 135 390 525 951 1917 100 216 316 12 8 20 165 420 585 921 1918 74 171 245 3 21 24 111 358 469 738 1919 116 352 468 5 15 20 92 348 440 928 Average 10 years 130 321 451 16 24 40 137 388 525 1016 1920 261 677 938 3 20 23 83 375 458 1419 41 [1920 VACCINATION. Of the 5,562 births registered in 1919, the returns of vaccination show that only 2,392 infants were successfully vaccinated, while 20 were found to be insusceptible. The were also 364 who died unvaccinated, and 1,583 statutory declarations of conscientious objection to vaccination were obtained by the parents or guardians. 22 vaccinations were postponed under medical authority, thus leaving 1,181 unaccounted for. The return of certificates of exemption, therefore, represents 28.5 per cent. of the registered births. Years. Vaccination per 100 births, less infants who died unvaccinated. Years. Vaccination per 100 births, less infants who died unvaccinated. 1880 89.8 1900 67.9 1881 90.8 1901 75.8 1882 91.1 1902 80.0 1883 90.4 1903 81.2 1884 90.5 1904 82.3 1885 90.6 1905 80.5 1886 90.8 1906 79.9 1887 90.4 1907 76.9 1888 88.4 1908 72.4 1889 89.0 1909 70.7 1890 89.3 1910 66.7 1891 87.4 1911 62.3 1892 85.5 1912 54.1 1893 85.0 1913 51.1 1894 84.0 1914 46.8 1895 70.9 1915 49.0 1896 73.9 1916 47.5 1897 73.3 1917 46.7 1898 64.9 1918 46.4 1899 66.4 1919 46.0 Certificates of Exemption.—The following tabular statement shows the increase of these certificates, more especially since 1910:— 1906 123 1914 2,124 1907 259 1915 1,710 1908 588 1916 1,796 1909 824 1917 1,341 1910 1,080 1918 1,027 1911 1,241 1919 1,583 1912 1,646 1913 1,942 42 1920] Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the year 1919. REGISTRATION SUB-DISTRICTS. Number of Births registered in 1919. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Statutory Declarations of Conscientious Objection. Died Unvaccinated. Postponement by Medical Certificate. Removed to other Districts. Removed to places Unknown. Number of Children remaining Unvaccinated, or not accounted for in Report Book. Total Number of Certificates of Primary Vaccination at All Ages received during year 1920. Number of Statutory Declarations of Conscientious Objection received during year 1920. 1 2 3 4 5 6 7 8 9 10 11 12 Tufnell 640 304 4 ... 180 36 2 55 21 38 1,995 1,402 Upper Holloway 620 319 1 ... 167 33 5 22 20 53 Tollington 523 219 2 ... 152 33 1 6 24 86 Highbury 749 294 6 ... 253 43 ... 7 26 120 Lower Holloway 722 305 3 ... 160 56 7 2 27 162 2,448 1,543 Barnsbury 1028 496 ... ... 240 68 1 3 63 157 Islington, South East 1280 455 4 ... 431 95 6 3 56 230 The Borough 5,562 2,392 20 ... 1,583 364 22 98 237 846 4,443 2,945 43 [1920 DISINFECTION. Disinfection of Rooms.—2,694 rooms were disinfected, as contrasted with 1,780 in 1919. 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. For the extermination of bugs, however, all the architrave mouldings and skirting boards behind which they breed are removed, and the walls washed with hot lime. The above figures also include the disinfection of houses and rooms after Phthisis, vide p. 37. The Cleansing and Spraying of Room.—1,586 rooms, as contrasted with 1,650 in 1919, were cleansed and sprayed. Rooms disinfected. Rooms sprayed. 1920. 1919. 1920. 1919. 1st Quarter 525 220 397 452 2nd „ 436 293 379 447 3rd „ 654 412 385 333 4th „ 1,079 855 425 418 The Year 2,694 1,780 1,586 1,650 The following class-rooms, etc., were disinfected after the occurrence in them of cases of the diseases mentioned:— 1st Quarter. Nil. 2nd Quarter. Nil. 3rd Quarter. Queen's Head Street L.C.C. Schools (Diphtheria). Hanover Street L.C.C. Schools (Diphtheria). 4th Quarter. Hanover Street L.C.C. Schools (Diphtheria). Work at the Disinfecting Station.—45,433 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 41,336 similar articles disinfected during the previous year. In addition to the above articles 98,720 old or second-hand garments, mostly soldiers' overcoats, jackets, tunics and trousers were disinfected for clothing contractors trading in the borough, who paid the Council for the work, amounting to the sum of £145 8s. 5d. Altogether 144,153 articles described in the two paragraphs preceding were disinfected, which bring the number of large articles disinfected since the disinfecting station was established to 1,641,828. 44 1920] Summary of the chief articles of Clothing, Bedding, &c, disinfected during the year 1920, and also in the preceding year 1919. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter The Year 1920 1919 Beds 695 501 671 1,125 2,992 2,053 Blankets 1,414 854 1,063 2,092 5,423 4,242 Bolsters 462 316 419 843 2,040 1,684 Carpets 9 — — — 9 200 Chair Bed Cushions 4 — — — 4 307 Mattresses 530 343 388 573 1,834 2,019 Palliasses 8 — — — 8 226 Pillows 1,45 7 977 1,335 2,251 6,020 4,568 Quilts 573 395 504 939 2,411 1,949 Sheets 981 628 879 1,754 4,242 3,367 Other Articles 10,306 1,044 3,073 6,027 20,450 20,721 Totals 16,439 5,058 8,332 15,604 45,433 41,336 The nature of the articles disinfected for the clothing contractors is shown below:— 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Year Soldiers' Overcoats 7,354 6,317 2,080 809 16,560 „ Jackets 15,422 17,993 2,713 1,581 37,709 „ Tunics 2,319 2,155 1,064 3 5,541 Tousers 608 4,148 1,036 178 5,970 Frock Coats 1,000 1,575 250 — 2,825 Blankets 147 92 100 1,037 1,376 Other Articles 15,209 11,021 1,847 662 28,739 42,059 43,301 9,090 4,270 98,720 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. Gallons. cwt. qr. lbs. Gallons. To Householders 1 10 224 — — Disinfection of Premises — — — 3 22 30 Cost = £148 10s. 0d. 45 [1920 Shelter House.—The Shelter House was occupied by ten persons during the disinfection of their homes after infectious diseases. Baths were given to 11 verminous persons; and to 7 persons suffering from Scabies whilst their clothing was disinfected. Four midwives also attended for the purpose of disinfection after attendance on cases of Puerperal Fever. Verminous School Children.—During the year 5,405 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 2 to 45. 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 £270 5s. 0d. No legal proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, during the year. FACTORY AND WORKSHOP ADMINISTRATION. In compliance with the requirements of the Factory and Workshops Act, it is the duty of the Medical Officer of Health to submit an annual report on the manner in which its provisions are carried out in his district, and accordingly he herewith submits it for the year 1920. Inspections and Visits.—The inspections and visits made by the Inspectors were as under:— Factories, including Factory Laundries 529 Workshops, including Workshop Laundries 710 Workplaces, other than outworkers' homes 342 Bakehouses 393 Restaurant Kitchens 414 Outworkers' premises 911 Miscellaneous re-inspections and calls 4,274 Total 7,573 Notices served.—In consequence of the 1,014 sanitary defects discovered as the result of the inspections above; 234 intimations and 14 statutory notices were served. Of these notices 59 were served on the owners of factories, 1920] 46 121 on the owners of workshops and workplaces, and 23 on the owners of bakehouses and restaurant kitchens. In addition to these nuisances, 93 were discovered on Outworkers' premises, necessitating the service of 43 notices. Registers.—There were 1,818 workshops on the Register, as contrasted with 1,719 in 1919, while the total number of workrooms was 2,493, as contrasted with 2,319 in the previous year. 212 workshops were added to the Register while 113 were removed from it. The various workshops and workplaces are tabulated as below:— Workshops and Workplaces. 1919. 1920. 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 480 674 132 28 584 855 Workshops where Women are employed 634 925 50 75 609 900 Laundries 31 93 Nil 3 28 85 Bakehouses 237 246 4 Nil 241 253 Restaurant Kitchens 337 381 26 7 356 400 Total 1,719 2,319 212 113 1,818 2,493 Outworkers' Premises — 2,341 946 529 — 2,758 Workshops notified to Home Office, 1920. Trade. Number of Workshops. Protected Employed Persons. Women. Male Young Persons. Total. Blouses 1 2 .. 2 Millinery 5 11 .. 11 Ties 1 4 .. 4 Furrier 2 1 .. 1 Tailoring 4 8 .. 8 Dressmaking 18 79 .. 79 Leather 2 4 .. 4 Embroidery 1 2 .. 2 Chemists (Manufacturing) 3 21 .. 21 Toys 7 27 .. 27 Paper Bags 1 6 .. 6 Waste Paper Sorting 1 2 .. 2 Photographers 1 3 .. 3 Artificial Flowers 1 8 .. 8 Cardboard Boxes 1 10 .. 10 Confectionery 1 1 .. 1 Total 50 189 .. 189 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) 529 59 Nil Workshops (Including Workshop Laundries) 710 70 1 Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 1,149 74 2 Miscellaneous Re-inspection 4,274 .. Nil Total 6,662 203 3 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 161 194 .. Nil Want of ventilation 4 4 .. „ Overcrowding 1 1 .. „ Want of drainage of floors 13 16 .. „ Other nuisances 299 346 .. 1 Sanitary Accommodation insufficient 22 25 .. Nil unsuitable, foul or defective 476 516 .. „ not separate for sexes 30 29 .. 2 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) .. .. .. Nil Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) 8 5 .. „ Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) .. .. .. „ Total 1,014 1,136† Nil 3 * Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Ac 1901, as remediable under the Public Health Acts † Defects found left over from previous year are also included in this total. 48 [1920 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.† Outworkers Contractors. Workmen. Lists. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— a (1) making, &c. 168 128 1,472 15 2 34 188 .. .. 35 22 .. 17 .. .. (2) cleaning and washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Curtains and furniture hangings 2 .. 8 .. .. .. 2 .. .. .. .. .. .. .. .. 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 .. .. .. .. .. Artficial Flowers 20 .. 237 .. .. .. 16 .. .. 13 11 .. 4 .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Racquet and Tennis Balls .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper, etc., Boxes, Paper Bags 22 .. 279 4 .. 67 26 .. .. 17 5 .. 3 .. .. Brush making 6 .. 102 .. .. .. 3 .. .. 1 5 .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed toys 2 .. 8 .. .. .. 2 .. .. .. .. .. .. .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chocolates and Sweetmeats .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cosaques, Christmas Crackers, Christmas Stockings, &c. 2 .. 57 .. .. .. 2 .. .. .. .. .. 1 .. .. Textiles weaving .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 222 128 2,163 19 2 101 239 Nil Nil 68 43 Nil 25 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 assigned in 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 outworkers in those lists. a 4 Umbrellas, 36 Furniture, 2 Basket and 1 Tennis Ball Making are included in lists of Wearing Apparel Makers. [1920 49 4.—REGISTERED WORKSHOPS. Workshops on the Register (s.131) at the end of the year. Number. (1) (2) Workshops where men are employed 584 Workshops where women are employed 609 Laundries 28 Bakehouses 241 Restaurant kitchens 356 Total Number of Workshops on Register 1,818 5.—OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 23 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 39 Reports (of action taken) sent to H.M. Inspector. 37 Other (New Factories reported under Home Office Memorandum, 1912) nil Underground Bakehouses (s. 101) in use at the end of the year 84 DISTRICT INSPECTOR'S WORK. The fourteen district inspectors made a total of 61,765 inspections and calls during the year, an increase of 13,232 inspections on the corresponding period of 1919: while 16,611 improvements were effected in 7,067 premise; as against 8,270 improvements in 3,861 premises for the preceding year. Synopsis of the Inspectors' Work.— The following statement gives a brief synopsis of the district inspector's work in 1920:— House to house inspections 377 Other inspections of dwelling houses 9,055 Re-inspections and calls made 48,816 Visits of inquiry re notifiable infectious diseases 2,853 Butchers' shops, stalls, etc. (Saturday nights) 53 Ice cream shops and factories 44 Dairies and Milkshops 577 Stables and yards 1,018 Manure depôts 120 Smoke observations 64 1920] 50 Notices Served.—There were 3,403 intimation notices served by the inspectors with respect to nuisances, of which 1,713 were delivered personally, and 1,690 by post. In 392 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.—154 premises which were found to be in a verminous condition, were cleansed by the owners or occupiers upon receiving the Inspectors' intimations. In 46 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification or destruction. Smoke Nuisances.—63 complaints of smoke issuing from factory chimneys in the borough were investigated, and as a result of the Inspector's observation notices were served upon the owners of the following businesses requiring the abatement of the nuisance:— Camden Steam Laundry, 260, Yorks Road. Mayfield Laundry, 69, Gillespie Road. REMOVAL OF DUST. Thirty-six applications were received during the year for the removal of duit. which is 17 above the number recorded last vear. The applications received for the previous ten years were as follows:— 1909 67 1914 26 1910 44 1915 28 1911 52 1916 21 1912 47 1917 30 1913 32 1918 11 1919 19 Dust Receptacles Provided.—During the year 2,585 dust receptacles were provided, while 62 were repaired after the service of sanitary notices. 51 [1920 Showing summary of Sanitary Work from Inspectors' Reports for the year 1920. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 59 12 21 16 8 43 54 16 100 25 3 16 .. 4 377 Other premises inspected 539 662 492 882 444 498 565 582 712 928 654 764 620 713 9055 Re-inspections, Calls made, &c. 3095 3018 3370 3389 3286 3126 3344 4336 3710 3597 3067 4136 3229 4113 48816 Ice Cream Factories inspected .. .. 3 26 .. 7 .. .. .. 4 1 3 .. .. 44 Dairies and Milkshops do. 99 18 97 120 16 29 20 25 27 36 15 36 3 36 577 Stables do. 32 8 24 59 30 21 25 6 34 26 2 4 8 6 280 Yards do. 118 75 225 147 12 12 73 .. 31 7 2 7 20 9 738 Manure Depôts do. 71 .. .. 48 .. .. .. .. .. .. .. .. 1 •• 120 Vacant land, Passages and Courts inspected 19 3 1 5 1 4 18 1 1 2 .. .. 34 4 93 Urinals attached to P.H.'s inspected 40 63 107 33 122 16 12 .. 16 18 7 1 .. 3 438 Premises (re Certificate Customs and Inland Revenue Acts) inspected .. .. 1 .. 2 2 4 7 .. .. .. .. .. .. 16 Premises (re Water Certificates) inspected .. 1 .. .. .. .. .. 2 .. .. .. .. .. .. 3 Visits re Sale of Food and Drugs Act 123 121 138 120 121 .. 118 106 .. 1 .. .. 121 122 1091 Smoke observations •• 4 .. 6 5 10 24 •• 5 5 .. 5 .. .. 64 Shops, Stalls and Markets (Saturday evening) 2 5 4 5 5 3 3 5 1 4 4 3 5 4 53 Total Inspections and Calls 4197 3985 4483 4856 4052 3771 4260 5086 4637 4653 3755 4975 4041 5014 61765 Notices Served. Intimation—Personally 207 15 2 199 96 100 168 95 108 254 84 95 54 236 1713 By Post .. 387 26 421 .. .. 230 308 26 7 .. .. 139 146 1690 Statutory—Personally 12 23 1 24 7 10 9 12 1 8 2 2 6 19 136 By Post 29 39 4 26 6 7 35 34 8 13 7 20 13 15 256 Improvements. Drains– Constructed 2 1 .. 2 1 1 .. .. .. .. .. .. .. 1 8 Re-constructed 3 14 8 10 12 5 6 9 4 5 .. 3 21 10 110 Repaired 16 10 9 31 5 9 13 14 23 37 23 33 15 20 258 Ventilated 2 16 5 9 10 2 4 1 2 3 1 4 18 11 94 Gully and other traps fixed 14 73 37 36 71 18 41 26 11 9 16 22 84 32 490 Urinals— Water supplied, cleansed .. 1 4 5 .. 2 3 .. 8 2 3 1 1 1 31 Cesspools— Abolished .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Water Closet— W.C. erected with pan, trap and water supply 2 .. 1 .. 1 1 .. 1 1 .. .. .. 4 6 17 Pan and trap only provided 11 32 9 33 27 18 17 6 16 17 3 19 30 30 268 Water supply provided 25 22 8 29 40 37 23 31 56 28 33 44 38 63 477 Ventilated .. .. .. .. .. .. .. .. 1 .. 3 2 1 6 13 Position altered .. 1 2 .. .. .. .. .. .. .. .. .. 1 .. 4 Dust Bins- Provided 193 210 106 227 175 182 255 217 138 239 97 192 79 275 2585 Repaired 6 1 1 1 5 3 6 .. 21 1 5 3 1 8 62 Areas—Constructed .. .. .. 1 .. .. .. .. .. .. .. .. 1 •• 2 Yards-Paved .. 1 3 9 .. 4 9 4 1 .. .. 1 8 5 45 Repaved 19 36 14 34 25 64 43 19 44 19 15 67 30 40 469 Sinks—Provided 3 4 4 2 2 1 1 4 3 1 1 11 8 5 50 Domestic Water Supply— Cisterns provided 2 .. .. .. .. .. .. .. .. 1 .. .. .. .. 3 Cisterns repaired and cleansed 20 17 21 36 15 41 39 7 19 12 21 11 11 21 291 Water supply provided to dwelling house 7 4 .. 4 8 5 3 3 3 7 1 1 2 8 56 Water supply provided to tenement house 3 1 2 1 2 2 2 1 31 2 .. 14 3 2 66 Other improvements— Rooms cleaned and limewashed 104 131 124 291 183 573 498 215 517 194 433 574 290 428 4555 Walls and passages repaired, cleansed and limewashed 32 37 29 99 29 126 54 64 133 74 118 148 91 153 1187 Floor space ventilated 3 4 3 14 5 1 4 1 3 1 4 5 7 1 56 Floors repaired 15 24 15 42 5 76 14 23 33 19 40 47 41 25 419 Roofs repaired 75 109 52 133 62 163 125 98 185 65 92 118 85 94 1456 Overcrowding abated • • .. .. 1 .. 1 1 . . . . .. .. 1 .. .. 4 Illegal use of underground Rooms for sleeping discontinued .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 3 Other Improvements, or Nuisances abated 121 104 40 171 68 160 116 78 222 132 174 151 147 223 1907 Rooms Disinfected 146 158 166 284 158 55 42 13 143 30 22 37 177 194 1625 Total Improvements 824 1011 663 1505 915 1550 1319 835 1618 898 1106 1509 1194 1664 16611 Total Premises Improved 503 520 348 783 436 498 471 390 685 497 397 484 454 601 7067 52 1920] HOUSES LET IN LODGINGS. There are 1,058 houses under the operation of the bye-laws. 1,137 inspections were made during the year, followed by 7,030 subsequent reinspections and calls, so that the total visits amounted to 8,167. These inspections resulted in 682 intimations being forwarded to the persons responsible, which were followed by 107 statutory notices to demand the abatement of the nuisances discovered by the two inspectors especially engaged upon this work. Three summonses were taken out for non-compliance with the notices served. Altogether 2,605 improvements were effected in 703 premises. Synopsis of Inspectors' Work:— Improvements. Drains Constructed — Reconstructed 1 Repaired 8 Ventilated 2 Gully and other traps fixed — Water Closets W.C. erected with pan, trap and water supply — Pan and trap only provided 14 Water supply provided 23 Ventilated 17 Position altered — Dust Bins Provided 166 Repaired 3 Areas Constructed — Yards Paved 3 Repaved 35 Sinks Provided 1 Domestic Water Supply Cisterns provided — Cisterns repaired and cleansed 8 Water supply provided to dwelling house 1 Water supply provided to tenement house 1 Other Improvements Rooms cleansed and limewashed 1123 Walls and passages repaired, cleansed and Limewashed 79 Floor space ventilated 17 Floors repaired 52 Roofs repaired 186 53 [1920 Overcrowding abated 3 Illegal use of underground rooms for sleeping discontinued — Other Improvements, or Nuisances abated 862 Rooms disinfected — Total Improvements 2,605 Total Premises Improved 703 STATE OF PAUPERISM IN THE BOROUGH. During the year their was an increase in Pauperism, for the number of paupers relieved weekly averaged 5,620, as contrasted with 4,872 in 1919 and 5,078 in 1918. Appended is a statement furnished by the Clerk to the Islington Guardians Showing the State of Pauperism in the Borough during the year 1920. Quarters. Average number Relieved during each week. Borough Death rales, 1920. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals. Totals coriesponding periods 1919. Vagrants Relieved. Children Boarded out. Adults. Children under 16. 1 2 3 4 5 6 7 8 9 1st Qr. 2,751 1,362 1,098 5,211 4,960 No Wards. 55 17.36 2nd ,, 2,772 1,360 1,119 5,251 4,803 52 13.16 3rd „ 2,694 1,375 1,123 5,192 4.779 56 9.63 4th ,, 2,791 2,111 1,923 6,825 4,947 55 13.13 The Year 2,752 1,552 1,316 5,620 4,872 — 54 13.32 INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 810 visits to the 18 Slaughter Houses now on the register, including one Horse Slaughter House, and that he has ascertained that 9,947 animals were killed therein, namely:—1,344 oxen and cows, 54 calves 7,562 sheep and lambs, 132 pigs and 855 horses for human consumption, chiefly for export. These were mostly found of good quality and free from disease, the few exceptions set out in the table on page 55. 54 1920] 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 1 9 3 3* Diseased or unsound meat, etc., from other sources - 7 3 25† Bacon 1 3 0 26 Fish 1 3 0 6 Cheese 4 0 15 Condensed Milk 14 1 24 Butter — — 14 Eggs 3 3 20 Rabbits 4 2 26 Fruit, Vegetables, etc. 1 19 2 1 Dried Fruits (principally Dates) — — 2 14 Various Tinned Foods 13 3 12 Total Tons 8 5 1 18 The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 8 tons 5 cwts. 1 qr. 18 lbs. The diseases which affected animal food are set out in detail on p. 55. Shops, etc., Inspection of.—The number of shops and places where foodstuffs are sold may be approximated for the year as follows:— Butchers, provision dealers, etc. shops, 200, meat, provisions, rabbits, tinned foods, etc., stalls, 20, food preparation establishments 16, fish shops 85, fish stalls 12, fruit shops 185, and about 60 fruit, etc., stalls and barrows. To these 13,427 visits were paid, apportioned as follows:— Butchers, Provision Dealers, etc., Shops 6,061 visits. Food Preparation Establishments 163 „ Butcher, Provision, etc., Stalls 666 „ Fish Shops 1,477 „ „ Stalls 543 „ Fruit Shops 2,247 „ „ Stalls 2,270 „ Total 13,427 visits. Prosecutions.— Inspector Marks seized some small pieces of meat exposed for sale at a butcher's shop, and the case resulted in the discharge of the offender under the Probation Act on payment of £3 3s. costs. Eight tins of condensed milk in a blown condition were seized at the Metropolitan Cattle Market, defendant and his wife swore that they were not offered for sale, and the case was dismissed without costs. * Of this quantity 1 ton, 3 qrs. was Tuberculous. † Of this quantity 1 cwt., 3 qrs., 4 lbs. was Tuberculous. 55 [1920 28 cases of condensed milk which had been sold for pigs' food, was seized at a costermonger's private address, and a fine of £5 and £5 5s. costs was imposed. Two seizures of unsound Australian jam was made at the Cattle Market, and the wholesale dealers were proceeded against on the evidence of the costerrnongers, and were fined £1 and £2 2s. costs in each case. Cowsheds.—There are 4 cowsheds within the borough, and these received 25 visits and were found generally satisfactory. Tabulation of meat and organs diseased or unsound as discovered in slaughter-houses during the year 1920:— No. of Cases. Description of Animal Affected. Nature of Disease or Affection. Extent of Disease. How disposed of. 1 Tuberculosis Fore-quarters, Head, Tongue, Lungs, Heart and Liver Council's Destructor. 2 Cow do. Carcase and all organs do. do. 1 Cow do. Tripe, liver, lungs and loose fat, etc do. do. 1 Cow do. Head, tongue, liver, lungs and mesentery do. do. 3 Pig do. Heads of three, and lungs of two do. do. 1 Heifer do. Head, tongue, lungs and serous membranes do. do. 1 Pig do. Carcase do. do. 1 do. do. Head, Liver, lungs and spleen do. do. 9 Cow's fœtus Immature Entirely unwholesome do. do. 19 Oxen Parasitic (Dis. Hep.) Liver do. do. 5 do. Abscess do. do. do. 1 Cow Hydatid Cysts Lungs do. do. 1 Sheep Parasitic (Ech. Vet.) Liver Destroyed on the premises. Milkshops and Dairies—At the close of the year there were 608 milkshop and dairies on the register, 14 having been added to it. They received 577 visits from the District Sanitary Inspectors, who served 30 notices for the execution of various sanitary improvements and the cleansing of dirty utensils. 1920] 56 ADULTERATION OF FOOD AND DRUGS. One thousand two hundred and thirty-eight samples of foods and drugs were submitted for analysis by the District Inspectors, who purchased the samples for submission to our Analyst, Dr. F. L. Teed, and to the additional Analyst, Mr, A. Pinchin, B.Sc. 1192 samples were reported to be genuine and 46 adulterated, or 3.7 per cent. This percentage is the lowest hitherto recorded, and compares with 56 per cent. in the preceding year, and is 1.9 per cent. lower than obtained then, and 6.7 per cent. below the average rate during the preceding 30 years. The greatest amount of adulteration occurred in the second and third quarters of the year, as is seen by the statement given below, when it was 6.6 and 3.6 per cent. respectively, and contrasted with 10 and 3.5 per cent. respectively in the first and fourth quarters. Examined. Genuine. Adulterated Per cent. 1st Quarter 306 303 3 1.0 2nd „ 319 298 21 6.6 3rd „ 303 292 11 3.6 4th „ 310 299 11 3.5 The Year 1,238 1,192 46 3.7 Prosecutions.—23 summonses were issued under the Sale of Food and Drugs Acts, 12 of which were successfully prosecuted. Altogether penalties and costs to the amount of £47 9s. 6d. were obtained. The Public Analysts, in the quarterly reports during the year, reported on the genuineness of the articles examined as follows:— 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 162 8.71 3.42 12.13 Milk purchased on week-days 338 8.76 3.52 12.28 Milk procured in transit at Finsbury Park Station 142 8.86 3.66 12.52 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 162 153 9 5.6 On Week-days 338 320 18 5.3 At Railway Stations (Farmers' Milks) 142 132 10 7.0 642 605 37 5.7 57 [1920 Giving the particulars of the Milks taken during each quarter of 1920 on Sundays, Week-days, and at the Railway Stations. 1920. 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 84 30 154 39 84 29 152 1 .. 1 2 2.5 .. 3.3 1.3 2nd „ 42 78 52 172 40 70 44 154 2 8 8 18 4.8 10.2 15.4 10.4 3rd „ 40 87 30 157 37 83 29 149 3 4 1 8 7.5 4.6 3.3 5.1 4th ,, 40 89 30 159 37 83 30 150 3 6 .. 9 7.5 6.7 .. 5.6 The Year 162 338 142 642 153 320 132 605 9 18 10 37 5.6 5.3 7.0 5.7 The number of samples or milk purchased was 642, of which 605 were genuine and 37, or 5.7 per cent. were adulterated. The return of the samples of milk reported as adulterated by the Public Analyst, is given in the following tabular statement:— MILK ADULTERATION. Samples Analysed. Genuine. Adulterated Per cent. Adultered. 1892 171 139 32 18.7 1893 213 173 40 18.7 1894 206 169 37 17.9 1895 413 343 70 16.9 1896 468 418 50 10.6 1897 513 464 49 9.5 1898 543 492 51 9.4 1899 532 477 55 10.3 I9OO 541 485 56 10.3 1901 632 556 76 12.0 1902 586 528 58 9.9 1903 508 458 50 9.8 1904 600 553 47 7.8 1905 594 549 45 7.6 1906 634 560 74 11.8 1907 597 557 40 6.7 1908 604 552 52 8.6 1909 605 563 42 6.9 1910 621 563 58 9.3 1911 601 542 59 9.8 1912 606 573 33 5.4 1913 600 555 45 7.5 1914 595 539 56 9.4 1915 605 531 74 12.2 1916 599 506 93 15.5 1917 592 526 66 11.1 1918 634 537 97 15.3 1919 638 579 59 9.2 Totals 15,051 13,487 1,564 10.4 1920 642 605 37 5.7 58 1920] Showing the analyses of 13,040 milks examined in Islington during the twenty two years 1898-1919 and 1920, and distinguishing those purchased on Sundays, on Week-days, and procured at the Railway Stations whilst in transit from the Farmer to the London Milk Purveyor. Years. Sunday Milks. Week-day Milks. Railway Milks (Farmers). No. of Samples. Per cent. of non-fatty solids. Per cent. of fat. No. of Samples. Per cent. of non-fatty solids. Per cent. of fat. No. of Samples. Per cent. of non-fatty solids. Per cent. of fat. 1898 193 8.50 3.50 230 8.56 3.69 120 8.84 4.04 1899 181 8.49 3.50 231 8.53 3.58 120 8.82 4.23 1900 196 8.64 3.62 224 8.55 3.53 121 8.75 3.93 1901 196 8.56 3.64 295 8.60 3.49 141 8.77 3.69 1902 192 8.59 3.60 274 8.64 3.51 90 8.76 3.85 1903 167 8.42 3.86 218 8.47 3.74 120 8.66 3.90 1904 164 8.52 3.78 317 8.48 3.74 120 8.62 3.97 1905 161 8.55 3.68 323 8.51 3.72 112 8.66 3.87 1906 195 8.49 3.58 332 8.52 3.59 110 8.75 3.69 1907 150 8.64 3.63 327 8.65 3.76 120 8.77 3.96 1908 160 8.58 3.69 324 8.58 3.52 120 8.73 3.88 1909 159 8.66 3.67 326 8.85 3.62 120 8.74 3.86 1910 160 8.57 3.55 336 8.50 3.44 125 8.76 3.74 1911 160 8.57 3.63 320 8.54 3.65 121 8.71 3.92 1912 160 8.70 3.67 326 8.76 3.61 120 8.84 3.86 1913 162 8.74 3.56 318 8.72 3.52 120 8.92 3.80 1914 155 8.60 3.42 320 8.71 3.52 120 8.88 3.78 1915 165 8.64 3.43 320 8.76 3.49 120 8.86 3.67 1916 160 8.60 3.53 319 8.56 3.43 120 8.83 3.63 1917 150 8.63 3.45 322 8.60 3.41 120 8.84 3.59 1918 136 8.39 3.60 377 8.44 3.53 121 8.61 3.65 1919 166 8.56 3.56 331 8.56 3.61 141 8.67 3.68 Total samples and average constituents (22 years) 3,688 8.58 3.60 6,710 8.60 3.58 2,642 8.76 3.83 1920 162 8.71 3.42 338 8.76 3.52 142 8.86 3.66- 59 [1920 Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1920. 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 154 170 155 154 633 152a 153a 147a 145a 597 2 17 8d 9 36 Milk (skim) .. 1 .. 1 2 .. .. .. 1 1 .. 1d .. .. 1 Milk (separated) .. 1 2 4 7 .. 1 2 4 7 .. .. .. .. .. Butter 47 26 36 39 148 47 26 36 39 148 .. .. .. .. .. Lard 11 16 13 13 53 11 16 13 13 53 .. .. .. .. .. Dripping 19 20 11 15 65 18 20 11 15 64 1 .. .. .. 1 Coffee 11 10 11 11 43 11 10 11 11 43 .. .. .. .. .. Cocoa 18 18 15 15 66 18 18 15 15 66 .. .. .. .. .. Ground Ginger .. 4 1 3 8 .. 4 1 3 8 .. .. .. .. .. Self Raising Flour .. 1 1 .. 2 .. 1 lb .. 2 .. .. .. .. .. Mustard 9 4 8 5 26 9 3 7 5 24 .. 1 1 .. 2 Pepper 4 8 7 9 28 4 8 7 9 28 .. .. .. .. .. Baking Powder 4 4 4 3 15 4b 4b 4b 3b 15 .. .. .. .. .. Malt Vinegar 2 2 5 5 14 2 2 5 4 13 .. .. .. 1 1 Vinegar 1 1 1 2 5 1 1 1 2 5 .. .. .. .. .. Mustard Condiment 1 .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. Salt and Pepper .. .. .. 1 1 .. .. .. 1 1 .. .. .. .. .. Rice 5 5 3 3 16 5c 5 3 3 16 .. .. .. .. .. Arrowroot .. 12 6 3 21 .. 11 6 2 19 .. 1 .. 1 2 Olive Oil .. .. 3 .. 3 .. .. 3 .. 3 .. .. .. .. .. Sodium Bicarbonate .. .. .. 1 1 •• .. .. 1 1 .. .. .. .. .. Total 286 303 282 287 1,158 283 283 273 276 1,115 3 20 9 11 43 Margarine 20 16 21 23 80 20 15 19 23 77 •• 1 2 .. 3 Totals 306 319 303 310 1,238 303 298 292 299 1,192 3 21 11 11 46 a All free from Boric Acid and Formalin. b Conformed with the Local Government Board requirements for Sulphate of Lime and Arsenic. c Conformed with the Local Government Board requirements for extraneous mineral matter. d Two samples free from Formalin. 60 1920] Milk Prosecutions The summary of prosecutions showed that during the year 16 prosecutions were taken, of which number 6 were successful and 9 were dismissed, while one was withdrawn. SUMMARY OF PROSECUTIONS.—During year 1920. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount Penalties Received. £ s. d. "Public Health (London) Act, 1891 ” 31 23 3* 5† 76 16 0 "Sale of Food and Drugs Acts, 1875-99 " 23 12 10§ 1║ 47 9 6 "Margarine Act, 1887 " Nil. ... ... ... ... Total 54 35 13 6 124 5 6 * 1 summons was dismissed upon payment of costs by defendant; another was dismissed under "Probation of Offenders Act,'' without costs, while the third was an alternative summons. †Withdrawn upon payment of costs. § Warranties were established in three cases; one summons was dismissed on a point of law, while six were dismissed upon payment of costs. || Summons withdrawn as sample burst, APPENDIX. VITAL AND SANITARY STATISTICS, 1920. together with the PRESCRIBED RETURNS OF THE MINISTRY OF HEALTH AND Abstracts for Previous Years. 1920] 62 table a. Showing the Deaths from All Causes in Islington during the Year ending 1st January, 1921.. Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. 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 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 20 64 7 1 .. .. .. .. .. .. .. .. .. 84 8 7 10 6 10 17 27 15 45 47 92 Scarlet Fever .. 5 6 .. .. .. 1 .. .. .. .. .. .. 5 7 1 1 .. .. 2 5 3 9 3 12 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 5 5 3 3 6 6 21 18 17 17 13 3 1 10 108 7 9 12 6 18 22 44 61 57 118 Whooping Cough 27 40 3 .. .. .. .. .. .. .. .. .. 67 3 11 5 3 11 8 19 10 39 31 70 Diphtheria 7 56 57 11 1 1 2 .. .. .. .. .. .. 63 72 7 5 13 12 16 21 61 57 78 135 Enteric Fever .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 1 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea. Dysentery 16 3 .. .. .. .. .. 1 .. 2 2 1 2 19 8 3 1 1 1 6 9 6 11 16 27 Epidemic Enteritis 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 .. 1 Other Allied D iscases *1 *2 *3 *2 .. *1 .. .. *1 .. .. .. .. 3 6 .. 2 1 1 1 1 3 6 3 9 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 1 1 1 1 2 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 6 .. .. .. .. .. 1 .. l .. 1 .. 6 3 .. 2 2 .. 1 1 3 6 3 9 Gonorrhœa .. .. .. .. .. .. 1 .. .. 1 2 .. .. .. 4 .. .. .. .. 1 2 1 3 1 4 Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. 1 .. 2 3 3 1 3 2 .. .. 15 1 4 .. 1 .. 3 4 7 8 15 Puerperal Fever .. .. .. .. .. 2 6 1 .. .. .. .. .. .. 9 4 .. .. .. 1 1 3 .. 9 9 Pyæmia .. .. 2 1 .. .. 4 1 5 1 2 1 .. .. 17 3 1 2 5 3 2 1 7 10 17 Infective Endocarditis .. .. 1 1 1 4 4 5 1 .. 2 .. .. .. 19 2 1 2 3 3 3 5 13 6 19 Other Allied Diseases 2 1 .. .. .. 2 2 .. .. .. 2 1 .. 3 7 3 1 .. 3 2 .. 1 5 5 10 Malarial Fever .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. .. .. .. .. .. 1 2 .. 2 Rheumatic Fever .. .. 3 5 9 1 .. .. 1 .. .. .. .. .. 12 1 2 1 1 2 2 3 6 6 12 Rheumatisms of Heart .. .. 2 1 2 .. 1 .. .. .. .. .. .. .. 6 .. 1 2 1 .. 1 1 3 3 6 Tuberculosis of Brain 7 15 10 6 2 .. .. .. .. .. .. .. .. 22 18 4 3 1 6 7 9 10 22 18 40 Tuberculosis of Larynx .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 Phthisis 1 6 5 7 20 30 64 77 77 37 22 2 .. 7 541 31 43 25 47 52 63 87 186 162 648 Abdominal Tuberculosis .. 5 3 .. 4 1 1 1 2 .. 1 .. .. 5 13 3 2 .. 2 3 3 5 8 10 18 general Tuberculosis 1 1 1 1 1 .. .. 2 .. .. .. .. .. 2 5 1 .. .. 1 2 2 1 4 3 7 Other forms Tuberculosis .. 1 .. 3 1 .. 1 3 .. 1 1 .. .. 1 10 1 2 .. 1 1 2 4 7 4 11 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Actinomycosis .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 .. 1 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Alcoholism .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 .. 1 Chronic Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 .. .. .. .. .. 1 .. 1 Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteoarthritis .. .. 1 .. .. .. .. 1 5 7 3 .. .. 17 2 .. 2 .. 4 4 5 2 15 17 Gout .. .. .. .. .. .. .. .. 1 1 1 .. .. .. 3 .. 1 .. .. .. 1 1 3 .. 3 Cancer .. 3 .. .. .. 1 10 32 74 110 24 43 5 3 399 47 47 41 44 73 73 77 200 202 402 Diabetes Mellitus .. .. .. 2 1 .. 3 3 5 3 4 1 .. .. 22 4 2 1 4 4 1 6 7 15 22 purpura Hemorrhagica 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 1 Hæmophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia .. .. .. .. .. 2 .. 1 4 5 5 1 .. .. 18 3 5 3 1 4 2 .. 11 7 18 Lymphadenoma .. .. .. 1 .. .. 1 .. .. .. 1 .. .. .. 3 .. .. 2 .. 1 .. .. .. 3 3 Premature Birth 115 .. .. .. .. .. .. .. .. .. .. .. .. 115 .. 14 14 10 15 17 29 16 62 53 15 Injury at Birth 5 .. .. .. .. .. .. .. .. .. .. .. .. 5 .. .. 2 .. .. 1 2 .. 5 .. 5 Debility at Birth 14 .. .. .. .. .. .. .. .. .. .. .. 14 .. 1 2 .. 2 4 .. 5 5 9 14 atelectasis 16 .. .. .. .. .. .. .. .. .. .. .. .. 16 .. 2 2 1 4 2 4 1 11 5 16 On genital Defects 4?, 2 .. .. .. .. .. .. .. .. .. 44 .. 5 1 .. 7 6 6 19 29 15 44 Want of Breast milk .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. trophy, Debility. Marasmus 76 4 .. .. .. .. .. .. .. .. .. .. .. 80 .. 6 9 5 11 7 18 24 48 32 80 63 [1920 Table A.—Continued. Deaths in Institutions within Borough. DISEASES. AGES. Under b. Over 5. DISTRICTS. Males. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H B S.E. Dentition 1 3 .. .. .. .. .. .. .. .. .. .. .. 4 .. 1 .. .. 1 .. 1 1 1 Rickets 4 5 .. .. .. .. .. .. .. .. .. .. .. 9 .. .. 1 2 1 23 2 2 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. 3 81 211 78 .. 376 44 59 27 35 64 73 74 153 22 Convulsions 16 4 .. .. .. .. 1 .. .. .. .. .. .. 20 1 2 3 1 2 3 4 6 12 Meningitis 6 7 2 1 .. 1 .. 1 1 .. .. • • .. 13 6 1 2 1 2 5 2 6 12 Encephalitis .. .. .. .. .. 1 1 2 .. .. .. .. .. 4 .. .. .. .. .. 3 1 2 Apoplexy 2 .. .. .. .. .. 3 4 23 34 43 35 15 2 155 26 22 11 19 21 22 36 64 9 Softening of Brain .. .. .. .. .. .. .. .. 1 .. 3 1 .. .. 5 1 • • .. .. 2 1 1 3 Hemiplegia .. .. .. .. .. .. .. 1 4 4 3 6 .. .. 18 3 1 2 4 .. 3 5 10 General Paralysis of the Insane .. .. .. .. 1 .. .. 8 6 4 2 .. .. .. 21 4 1 2 6 2 2 4 16 Other forms of Insanity .. .. .. .. .. .. .. 2 .. 3 2 .. 1 .. 8 1 .. 2 2 2 1 .. 1 Chorea .. .. .. 2 .. .. .. .. .. 1 1 .. .. .. 4 .. 1 .. 1 2 .. .. 1 Cerebral Tumour .. .. 1 .. 1 .. 4 1 5 1 .. .. .. .. 13 1 2 1 1 3 2 3 2 1 Epilepsy .. 1 .. .. .. .. 1 .. 2 3 .. .. .. 1 6 .. .. 1 4 .. 2 .. 1 Laryngismus Stridulus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 Locomotor Ataxy .. .. .. .. .. 1 .. l 3 3 6 .. .. .. 14 .. 2 4 1 5 • • 2 10 Paraplegia .. .. .. .. .. .. 2 3 9 10 10 4 .. .. 38 3 6 4 4 6 5 10 23 1 Other form of Insanity 1 .. .. §2 1 .. 1 §2 1 §2 1 .. .. 1 10 1 2 2 3 1 1 1 9 Otitis .. 2 5 3 4 .. 1 3 1 1 .. .. .. 2 18 3 5 .. 2 4 2 4 7 1 disease of Nose, Eyistaxis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. disease of Eys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Pericarditis 1 .. .. 1 .. .. 1 .. .. .. .. .. .. 1 2 .. .. 1 .. .. .. 2 1 1 Endocarditis .. 1 1 .. 1 2 3 4 2 .. 1 .. .. 1 14 .. 2 1 .. 1 3 8 7 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Angina Pectoris .. .. .. .. .. .. .. .. 1 1 .. 1 .. .. 3 .. .. .. 1 .. .. 2 2 2 Aneurism .. .. .. .. .. .. .. .. 2 6 2 .. .. .. 19 .. 1 .. 2 1 2 4 9 ) 4 Senile Gangrene .. .. .. .. .. .. .. .. 1 1 3 1 1 .. 7 .. 2 .. .. .. 1 4 4 11 Embolism, Thrombosis .. 1 .. 1 .. .. 1 4 3 5 11 9 2 1 35 3 10 3 4 5 4 8 12 2 Phlebitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Varicose veins .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 116 Other Diseases, Heurt and Vessels 5 4 4 9 8 6 21 34 56 118 142 89 21 9 538 64 6/ 3/ 49 84 72 144 257 26 Laryngitis .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. j Othei Diseases, Larynx and Trachea .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 .. .. .. 1 .. .. 1 1 14 Acute Bronchitis 28 7 1 .. .. 1 2 6 8 10 21 16 6 35 71 13 13 12 12 18 10 28 50 5 59 Chronic Bronchitis 29 6 1 .. .. 2 1 9 22 49 63 45 16 35 209 22 18 19 23 36 56 71 118 12 22 Lobar Pneumonia 7 3 2 1 2 1 8 13 19 8 13 3 .. 10 70 8 11 6 6 12 21 16 44 3 54 Lobular Pneumonia 110 ??? 2 1 .. .. 7 11 13 13 6 1 185 64 21 19 18 31 49 49 63 144 16 12 Pneumonia 8 16 4 3 .. .. 11 7 16 9 10 5 .. 24 65 7 17 9 9 11 11 25 49 4 1 Emphysema, Asthma .. .. .. .. .. 1 1 1 5 b 2 2 .. .. 18 .. .. 1 6 2 6 14 2 Pleurisy .. .. .. 1 .. 1 2 .. 4 2 2 .. .. .. 12 2 .. 2 1 2 1 4 5 5 Other Diseases, Respiratory System 3 .. .. .. .. .. .. .. 6 7 2 2 .. 3 17 4 2 2 .. 1 5 6 14 Diseases of Month and Annexa .. 1 1 .. .. .. .. .. .. .. 1 .. .. 1 2 1 .. .. .. .. .. ..2 2 Diseases of Pharynx 1 1 .. 1 .. .. .. .. .. .. .. 1 .. 2 2 4 .. .. .. .. .. .. 1 Diseases of Œsophagus .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. 1 1 Ulcer of Stomach and Duodenum .. .. .. .. 1 .. 3 7 8 8 6 .. .. .. 33 3 7 1 4 8 4 6 25 Other Diseases of Stomach 8 1 .. .. .. .. .. 1 1 1 3 3 .. 9 9 1 4 5 2 3 .. 3 9 21 Enteritis 47 7 1 .. .. 2 2 1 3 1 1 .. .. 54 11 5 8 7 5 6 20 14 35 ??? 26 Appendicitis .. .. 2 5 3 1 .. 1 1 1 2 .. .. .. 16 2 3 .. 4 4 2 1 10 Obstruction of Intestine 4 .. .. 1 .. .. 4 2 6 8 l6 6 .. 4 43 4 4 5 5 7 8 14 23 ??? Other Diseases of Intestine 2 .. .. .. .. .. 1 1 1 1 .. 2 .. 2 6 1 .. .. 1 1 1 4 5 5 Cirrhosis of Liver .. .. .. .. .. .. .. 1 5 3 2 .. .. .. 11 .. 1 .. 3 3 2 2 7 Other Diseases of Liver 1 .. .. .. .. .. .. .. 2 .. 2 2 .. 1 6 .. 1 1 1 2 1 1 3 Peritonitis .. .. .. .. .. 1 1 .. 1 .. .. .. .. 2 3 .. .. .. 1 .. 2 .. 2 Other Diseases, Digestive System 2 .. .. .. .. .. .. 1 .. 1 .. .. .. 1 2 .. .. .. .. 1 .. 3 1 Diseases, Lymphatic System and Glands 1 .. 1 .. .. .. .. 1 4 1 2 .. .. .. 9 .. .. .. 3 .. 3 1 2 6 Acute Nephritis .. .. 1 1 .. .. 1 2 1 2 2 .. .. .. 10 .. 1 1 1 5 1 1 7 16 Bright's Disease .. 2 .. .. .. 1 10 11 8 20 19 5 .. 2 74 4 7 4 7 17 17 20 39 2 Calculus .. .. .. .. .. .. .. 3 1 2 1 .. .. .. 7 1 1 .. .. .. 3 2 3 Diseases of Bladder and Prostate .. .. .. .. .. .. 1 1 1 5 11 8 1 .. 23 2 1 2 7 7 1 8 28 Other Diseases, Urinary System .. .. .. .. .. .. .. 1 1 1 1 3 1 .. 8 3 1 .. 1 1 .. 2 3 Diseases of Testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Diseases of Ovaries .. .. .. .. 1 2 1 .. .. .. 1 .. .. .. 5 2 1 .. .. 1 .. 1 .. 1 Diseases of Uterus and Appendages .. .. .. .. .. .. .. .. 2 .. .. .. .. .. 2 1 .. .. .. .. .. 1 .. Diseases of Vagina and External Gentitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Beast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 Puerperal Mania .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 2 Puerperal Convulsions .. .. .. .. .. 2 1 .. .. .. .. .. .. .. 3 1 .. .. .. 1 .. 1 .. Placenta Praavia, Flooding .. .. .. .. .. .. 3 .. .. .. .. .. .. .. 3 1 .. .. 1 .. .. 1 .. •Cerebro-Spinal Fever (I). (Post Basic Meningitis (1). {Encephalitis Lmhargica (4). 64 1920] Table A.—Continued. DISEASES. 0- AGES. Under 5. Over 5. DISTRICTS. Males. Females. Totals. 1- 5- 10- 15- 20 , 25- 35- 45- 55- 65- 75- 85- *3 h 33 5 h X j H. B. u (/) Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Pregnancy and Childbirth .. .. .. .. .. 3 1 1 .. .. .. .. .. .. 5 .. .. .. .. .. 4 1 .. 5 5 Arthritis, Ostitis, Periostitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Osseous System .. 1 .. 2 .. 1 .. .. .. 1 .. .. .. 1 4 .. .. .. 2 .. 1 2 1 4 5 Ulcer Diseases, Osseous System .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 .. .. .. 1 .. .. 1 .. 2 2 Ecrema .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pemphigus .. 1 .. .. .. .. .. .. .. .. 1 1 .. 1 2 .. .. .. .. 2 .. 1 3 .. 3 Other Diseases, Integumentary System 2 .. .. .. .. .. .. .. 1 .. 1 .. .. 2 2 .. l .. .. 2 1 •• .. 4 4 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. 1 7 5 2 1 2 3 3 7 8 1 .. 1 39 3 5 5 7 8 6 b 28 12 40 On Railways .. .. 1 .. .. 1 .. .. .. 4 1 .. .. .. 7 1 2 1 1 1 1 .. 6 1 7 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Building Operations .. .. .. .. .. .. .. .. 1 1 1 .. .. .. 3 .. 1 .. .. .. .. 2 3 .. 3 By Machinery .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 2 .. 2 By Weapons and Implements .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. 1 Burns and Scal 2 6 2 1 1 .. .. .. 1 1 .. 2 .. 8 8 3 1 1 1 .. 5 5 7 9 16 Poisons Poisonous Vapours .. .. .. .. .. .. 1 .. .. 1 1 .. .. .. 3 .. .. 1 .. .. 1 1 2 i 3 Surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Effects of Electric Shock .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 .. 1 Corrosions by Chemiicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowing .. .. 1 .. .. 2 .. 2 .. .. .. .. .. .. 5 2 .. 1 .. .. .. .. .. .. 5 Suffocation, Overlaid in Bed 7 .. .. .. .. .. .. .. .. .. .. .. .. 7 .. 1 2 2 1 .. 1 5 2 7 ,, Otherwise 8 1 .. .. .. .. .. 1 .. .. 1 .. .. 9 2 1 .. .. 1 4 1 4 7 4 11 Falls not specified 1 .. 4 .. .. .. .. 3 5 6 7 10 1 1 36 4 2 2 4 9 6 10 23 14 37 Weather Agencies .. .. .. .. .. .. .. .. .. .. ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise, not stated 1 .. .. .. 1 .. 2 1 .. 2 .. .. .. 1 b 1 .. .. 2 1 3 .. b 1 7 Homicide 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 .. .. .. .. 1 1 .. 1 1 2 Suicide. By Poison .. .. .. .. .. .. 2 1 7 .. 1 1 .. .. 12 3 2 .. .. 2 .. 5 11 1 12 By Asphyxia .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 .. .. .. .. .. 2 .. 2 .. 2 By Haneing and Strangulation .. .. .. .. .. 1 .. .. 1 .. .. 3 3 By Drowning .. .. .. .. .. 1 .. .. 2 2 .. .. .. .. 7 1 .. 2 1 .. .. 3 3 4 7 By Shooting .. .. .. .. .. • • 1 1 .. .. .. .. .. 2 .. .. .. 1 .. 1 2 .. 2 By Cut or Stab .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Precipitation from Elevated Places l 1 1 1 1 By Crushing .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. 1 Males 394 197 71 39 34 40 99 170 266 331 372 234 45 591 1701 233 269 175 254 J57 426 578 .. .. 2292 Females 282 175 79 48 35 49 141 148 214 240 357 309 106 457 1726 236 238 178 254 366 371 540 .. .. 2183 TOTAL DEATHS 676 372 150 87 69 89 240 318 480 571 729 543 151 1048 3427 469 507 353 508 723 797 1118 2292 2183 4475 65 [1920 TABLE B. Showing the Births and Birth Rates of Islington from 1841 to 1920. Year. Birth*. Birth Rates. Year. Births. Birth Rates. Year. Births Birth Rates. Year. Births. Birth Rates. 1841 1446 25.58 1861 5530 35.31 1881 9894 34.87 1901 9264 27.62 1842* 1508 25.28 1862 5619 34.76 1882 9991 34.9 1902* 9214 27.06 1813 1627 25.86 1863 6094 36.51 1883 9940 34.19 1903 8983 26.95 1844 1804 27.18 1864 6349 36.84 1884* 9872 33.54 1904 8890 26.73 1845 1838 26.20 1865 6743 37.90 1885 9067 32.45 1905 8756 26.39 1846 2152 29.13 1866* 6983 38.02 1886 9849 32.66 1906 8659 26.16 1847 2318 29.75 1867 7391 38.97 1887 9740 31.92 1907 8531 25.83 1848* 2529 30.76 1868 7608 38.86 1888 9609 31.10 1908* 8665 25.80 1849 2613 30.13 1869 7529 37.24 1889 9628 30.79 1909 8198 24.93 1850 3015 32.96 1870 7671 36.77 1890* 9230 29.16 1910 8201 25.01 1841-50 20850 28.65 1861-70 67520 37.20 1881-90 97420 32.49 1901-10 87361 26.36 1851 3033 31.46 1871 7671 35.63 1891 9797 30.61 1911 8113 24.79 1852 3462 34.19 1872* 8048 36.36 1892 9743 30.12 1912 8211 25.15 1853 3701 34.81 1873 8398 36.89 1893 9749 29.81 1913* 8359 25.19 1854* 3961 35.50 1874 8697 37.16 1894 9678 29.28 1914 8177 25.12 1855 4148 35.37 1875 9068 37.67 1895 10183 30.48 1915 7537 23.16 1856 4306 34.97 1876 9225 37.26 1896* 9921 29.38 1916 7262 21.57 1857 4512 34.89 1877 9380 36.85 1897 9842 29.19 1917 5837 17.62 1858 4560 33.57 1878* 9498 36.28 1898 9453 29.07 1918 5197 16.20 1859 5011 35.13 1879 9714 36.08 1899 9658 28.72 1919* 6278 18.30 1860* 5218 34.84 1880 9928 35.86 1900 9254 27.55 1920 9104 27.97 1851-60 *1915 34.54 1871-80 89627 36.60 1891-1900 97278 29.31 1911 20 74375 22.85 * These years contained 53 weeks. 1920] 66 Table C. Showing the Illegitimate Births in Islington from 1841 to 1920. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. Years Births. Years. Births. 1841 * 1851 100 1861 184 1871 280 1881 380 1891 265 1901 228 1911 248 1842 33 1852 100 1862 207 1872 346 1882 353 1892 298 1902 248 1912 3031 1843 * 1853 95 1863 224 1873 335 1883 370 1893 267 1903 242 1913 297 1844 * 1854 125 1864 248 1874 344 1884 341 1894 290 1904 273 1914 304 1845 43 1855 126 1865 291 1875 363 1885 327 1895 286 1905 227 1915 271 1846 53 1856 149 1866 272 1876 361 1886 331 1896 242 1906 244 1916 289 1847 64 1857 151 1867 306 1877 337 1887 350 1897 269 1907 230 1917 297 1848 85 1858 140 1868 317 1878 303 1888 345 1898 262 1908 231 1918 239 1849 74 1859 174 1869 284 1879 401 1889 350 1899 279 1909 250 1919 215 1850 97 1860 175 1870 318 1880 359 1890 328 1900 261 1910 240 1920 256 7 yrs 449 1851 to 1860 1335 1861 to 1870 2651 1871 to 1880 3429 1881 to 1890 3475 1891 to 1900 2719 1901 to 1910 2413 1911 to 1920 2719 * The births in these years cannot be ascertained. [1920 67 TABLE D. Showing the Deaths and Death Rates of Islington from 1841 to 1920 Years. Deaths Death rates. Years. Deaths Death rates. Years. Deaths Death rates. Years. Deaths Death rates. 1841 1013 17.91 1861 3123 19.94 1881 5617 19.79 1901 5361 15.98 1842* 1101 18.46 1862 3496 21.62 1882 5643 19.65 1902* 5635 16.55 1843 1115 17.72 1863 43.40 26.00 1883 5561 19.12 1903 4839 14.52 1844 1294 19.49 1864 4594 26.65 1884* 5515 18.74 1904 5236 15.74 1815 1258 17.96 1865 4617 25.94 1885 5740 19.27 1905 4955 14 .93 1846 1383 18.72 1866* 5154 28.06 1886 5434 18.02 1906 5050 15.26 1847 1624 20.83 1867 4509 24.55 1887 5699 18.67 1907 5079 15.38 1848* 1745 21.22 1868 4886 24.95 1888 5197 16.82 1908* 4679 13.93 1849 1891 21.80 1869 4937 24.42 1889 5035 16.10 1909 4918 14.96 1850 1609 17.58 1870 5078 24.33 1890* 6152 19.43 1910 4523 13.79 1841-50 14033 19.28 1861-70 44734 24.64 1881.90 55593 18.55 1901-10 50275 15.17 1851 2082 21.59 1871 5048 23.44 1891 6326 19.77 1911 4866 14.87 1852 2086 20.60 1872* 4196 18.95 1892 6075 18.78 1912 4682 14.34 1853 2395 22.52 1873 4156 18.25 1893 6391 19.55 1913* 5028 15.15 1854* 2800 25.07 1874 4816 20.57 1894 5263 15. 92 1914 4938 15.20 1855 2680 22.85 1875 4833 20.07 1895 5760 17.24 1915 5546 17.04 1856 2677 21.74 1876 4969 20. 07 1896* 5884 17.42 1916 4751 15.35 1857 2586 20.00 1877 5111 20.07 1897 5395 16.00 1917 4600 15.48 1858 2777 20.44 1878* 5376 20.53 1898 5705 16.94 1918 5841 20.40 1859 2898 20.32 1879 5456 20.27 1899 6293 18.71 1919* 4640 14.09 1860* 3028 21.21 1880 5716 20.65 1900 5721 17.03 1920 4475 13.32 1851-60 26009 21.43 1871.80 49677 20.28 1891-1900 58813 17.72 1911-20 49367 15.56 * These years contained 53 weeks. 1920] 68 * These years contained 53 weeks. TABLE E. Infantile Mortality Returns, extracted from the Annual Reports of the Registrar-General, 1841-55, and from the Annual Reports of the Medical Officer of Health of Islingon, 1856 to 1920. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,ooo Births. 1841 190 131 1861 748 135 1881 1,400 140 1901 1,290 139 1842* 224 149 1862 725 130 1882 1,403 140 1902* 1,219 132 1843 ..—.. ..— 1863 906 147 1883 1,312 133 1903 1.136 126 1844 — — 1864 969 153 1884* 1,506 150 1904 1,140 128 1845 267 164 1865 1,088 161 1885 1,387 143 I905 1,074 123 1846 330 153 1866* 1,170 169 1886 1,517 154 1906 1,083 125 1847 348 150 1867 1,119 152 1887 1,557 160 1907 996 117 1848* 386 152 1868 1,266 164 1888 1,271 132 1908* 894 103 1849 441 168 1869 1,234 165 1889 1,261 131 1909 841 103 1850 360 119 1870 1,135 149 1890* 1,488 161 1910 777 95 1841-50 (8 years) 2,546 146 1861-70 10,360 153 1881-90 14,102 145 1901-10 10.450 120 1851 457 151 1871 1,179 154 1891 1,481 151 1911 1,040 128 1852 457 132 1872* 1,200 150 1892 1,417 145 1912 710 86 1853 571 154 1873 1,172 138 1893 1,595 164 1913* 898 107 1854* 604 152 1874 1,278 147 1894 1,229 127 1914 849 104 1855 605 1,6 1875 1,306 145 1.95 1,416 139 1915 805 107 1856 612 142 1876 1,397 152 1896* 1,491 150 1916 634 87 1857 642 140 1877 1,302 140 1897 1,338 136 1917 565 97 1858 648 142 1878* 1.453 151 1898 1504 159 1918 571 110 1859 665 133 1879 I.340 '35 1899 1.548 160 1919* 525 83 i860* 747 144 i88j 1,517 154 1900 1.340 145 1920 676 72 1851-60 6 008 143 1871-80 13,144 147 1891-1900 14,362 148 1911-20 7,273 99 69 [1920 Table F. Showing the Cases of Infectious Diseases in Islington in Quinquennial Periods, 1891—1920. Year Smallpox. Scarlet Fever. Diphtheria and MembranousCroup. Enteric Fever. Typhus Ftve . Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera Total Notifications. Attack rates per 1,000 Popu. lation. 1891 1 728 756 189 2 343 33 6 1 .. 2059 6.48 1892 42 1709 738 219 .. 550 51 6 .. 3 3318 10.26 1893 118 2880 885 251 1 672 38 7 .. 1 4853 14.34 1894 90 1493 867 245 1 395 23 7 .. .. 3121 9.44 1895 2.5 1692 582 184 5 320 22 9 .. .. 2839 8.50 1891-5 276 8502 3828 1088 9 2280 167 35 1 4 16,190 9.90 1896* 50 2031 1091 229 .. 385 30 6 2 .. 3824 11.32 1897 3 1577 729 256 .. 312 27 1 .. 1 2906 8.62 1898 .. 1336 544 237 2 279 19 1 .. .. 2418 7.18 1899 3 1494 705 353 .. 350 33 2 .. 3 2943 8.75 1900 2 1074 633 259 1 285 16 6 .. •• 2276 6.78 1896-1900 58 7512 37. 2 1334 8 1611 125 16 2 4 14,367 8.53 1901 50 1286 911 281 2 285 34 3 .. .. 2852 8.51 1902* 276 1372 878 257 .. 357 19 5 .. .. 3164 9.29 1903 9 865 455 130 .. 227 19 2 .. .. 1707 5.12 1904 17 1146 347 126 1 280 24 .. .. .. 1941 5.84 1905 3 1198 351 100 .. 252 24 .. .. .. 1928 5.81 1901-05 355 5867 2942 894 3 1401 120 10 .. .. 11,592 6.96 1906 1 1386 439 149 1 274 24 1 .. .. 2275 6.87 1907 .. 1216 481 92 .. 252 21 1 .. .. 2063 6.25 1908* . . 1409 530 97 .. 235 17 1 .. .. 2289 6.82 1909 3 1285 430 95 1 221 14 .. .. .. 2049 6.23 1910 1 730 471 89 1 212 20 1 .. .. 1525 4.55 1906-10 5 6026 2351 522 3 1194 96 4 .. .. 10,201 6.13 1911 .. 804 593 73 .. 275 14 .. .. .. 1759 5.37 1912 .. 811 516 49 .. 185 16 .. .. .. 1577 4.83 1913* .. 1317 550 50 .. 226 28 .. .. .. 2171 6.54 1914 .. 1853 659 76 .. 334 25 .. .. .. 2947 9.08 1915 .. 1332 624 28 .. 203 23 .. .. .. 2210 6.98 1911-15 .. 6117 2942 276 .. 1223 106 .. .. .. 10,664 6.58 1916 .. 638 593 32 .. 155 21 .. .. .. 1439 4.65 1917 .. 478 561 23 .. 173 16 .. .. .. 1251 4.21 1918 2 432 518 30 .. 141 4 .. .. .. 1127 3.93 1919* 2 1084 649 16 .. 212 29 1 .. .. 1993 6.05 1920 .. 1307 1328 24 .. 165 29 .. .. .. 2853 8.49 1916-20 4 3939 3649 125 •• 845 99 1 .. .. 8663 5.47 * These years contained 53 weeks. 1920] 70 MINISTRY OF HEALTH RETURN.—TABLE III. Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING THE CALENDAR YEAR, 1920. Causes of Death. Nett Deaths at the subjoined Ages of " Residence " 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. 5 and under 16 yrs !5 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 and up- wards. I 2 3 4 5 6 7 8 9 IO n All Causes. {Certified 4474 685 189 187 237 156 556 1046 1418 1328 {Uncertified 1 .. .. .. .. .. .. .. I .. Enteric Fever 1 .. .. .. .. .. .. 1 .. .. Small-pox .. .. .. .. .. .. .. .. .. • • Measles 94 20 43 23 8 .. .. .. .. 43 Scarlet Fever 12 .... 1 4 6 .. I .. .. 4 Whooping Cough 71 27 22 19 3 .. .. .. .. 26 Diphtheria and Croup 136 7 10 47 68 2 2 .. .. 11 Influenza 119 5 4 1 6 12 40 33 18 37 Erysipelas 14 .. .. .. .. I 4 4 5 12 Phthisis (Pulmonary Tuber culosis) 350 1 1 5 12 51 141 115 24 150 Tuberculous Meningitis . 40 7 6 9 16 2 .. .. .. 12 Other T uberculous Diseases 36 1 1 6 8 7 8 3 2 10 Cancer, Malignant Disease 400 .. 1 2 .. 1 4l 183 171 204 Rheumatic Fever . 11 .. .. ,. 7 3 .. .. 1 Meningitis 27 8 3 7 5 2 1 1 .. 4 Organic Heart Disease . 437 3 2 2 12 16 56 149 197 192 Bronchitis 355 59 9 5 2 2 17 90 171 117 Pneumonia (all forms) 415 124 61 33 14 3 55 76 49 130 Other Diseases of Respira tory Organs 51 4 .. .. 1 2 5 29 10 17 Diarrhœa and Enteritis . 95 66 5 5 1 2 4 6 6 33 Appendicitis and Typhlitis 16 .. .. .. 7 4 1 2 2 10 Cirrhosis of Liver 11 .. .. , , .. .. 2 7 2 9 Alcoholism 1 .. ,, .. .. .. 1 .. .. .. Nephritis and Bright's Disease 77 .. 2 .. 2 1 23 26 23 32 Puerperal Fever 9 .. ... .. .. 2 7 .. ..• • 2 Other accidents and diseases of Pregnancy and Parturition 13 .. .. .. .. 6 7 .. .. 5 Congenital Debility and Malformation, including Premature Birth 262 256 4 2 .. .. .. .. .. 19 Violent Deaths, excluding Suicide 142 20 4 5 21 9 !7 33 33 57 Suicide 36 .. .. .. .. 2 12 15 7 12 Other Defined Diseases 1244 77 10 12 38 26* 110†* 272 699* 179 Diseases ill-defined or unknown .. .. ... .. .. .. .. .. .. •• Totals 4475 685 189 187 237 156 556 io46 1419 1328 Sub-Entries — included in above figures:— Cerebro spinal Meningitis 8 1 1 i 3 1 .. 1 • • 3 Poliomyelitis .. .. .. .. .. .. . . .. .. .. Encephalitis Lethargica 3 .. .. • • .. 1* 1* .. 1* .. Malaria 1 .. .. * * • • .. 1† .. .. .. 71 [1920 MINISTRY OF HEALTH RETURN.-TABLE IV. Metropolitan Borough of Islington. INFANTILE MORTALITY DURING THE CALENDAR YEAR 1920. 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 143 55 38 21 257 144 119 82 83 685 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. I 2 7 10 20 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. I 1 6 5 7 8 7 Diphtheria and Croup .. 1 .. .. 1 .. .. 3 3 27 Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. 1 .. 1 5 7 Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. 1 1 2 Meningitis (not Tuberculous) .. .. 1 .. 1 2 2 1 †2 8 Convulsions 7 4 3 .. 14 .. 1 1 .. 16 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis 1 .. .. 4 5 22 16 10 6 59 Pneumonia (all forms) .. 6 5 4 15 29 37 16 27 124 Diarrhœa .. .. .. .. .. 7 4 4 1 16 Enteritis .. 5 2 2 9 13 12 12 4 50 Gastritis .. .. 1 .. 1 1 4 1 .. 7 Syphilis .. .. .. .. .. 6 .. .. .. 6 Rickets .. .. .. .. .. .. .. 1 3 4 Suffocation, overlying .. .. 1 .. 1 6 1 .. .. 8 Injury at Birth 6 .. 1 1 8 .. .. .. .. 8 Atelectasis 13 1 .. .. 14 1 .. .. .. 15 CongenitaL Malformations 18 8 3 1 30 6 4 2 1 43 Premature Birth 73 13 9 4 99 11 1 .. .. 111 Atrophy, Debility and Marasmus 18 11 9 3 41 24 28 5 4 102 Other Causes 7 6 3 1 17 8 *2 *10 *8 45 Totals 143 55 38 21 257 144 119 82 83 685 Nett Births in the year legitimate 9,140 Nett Deaths in the year of legitimate infants 655 illegitimate 332 illegitimate infants 30 * Influenza (5). † Cerebro-Spinal Fever (1). 1920] 72 LONDON COUNTY COUNCIL RETURN. Borough of Islingtor. PROCEEDINGS DURING 1920. PREMISES. Number of Places— Number of inspections, 1920. Number of Notices. 1920. Number of Procecutions 1920. On Register at end of 1919. Added in 1920 Removed in 1920. On Register at end ot 1920. Milk premises 594 14 ... 608 577 30 Nil Cowsheds 4 Nil Nil 4 25 Nil " Slaughter-houses 20 Nil 2 18 810 " " Other offensive trade premises 7 Nil Nil 7 48 " " Ice cream premises 242 Nil Nil 242 44 10 " Registered houses let in lodgings 1070 Nil 12 1,058 8,I67 789 3 Total number of intimation notices served for all purposes 4,319 Insanitary house:— Number closed under the Public Health (London) Act, 1891 Nil Number of premises cleansed under section 20 of the L.C.C. (General Powers) Act, 1904 154 Housing of the Working Classes— Number of houses inspected 1 Number of representations by householders Nil Number of representations by Medical Officer 1 Number of houses included in such representations 1 Number of houses remedied without Closing Orders Nil Number of Demolition Orders Nil Number of houses dealt with under section 15 of the Housing, Town Planning, etc., Act, 1909 Nil Number of Closing Orders ... 1 Number of houses included in such Closing Orders 1 Number of Closing Orders determined Nil Number of houses demolished—(a) in pursuance of Orders Nil (b) voluntarily Nil Obstructive buildings— Number of representations under section 38 of the Housing Act, 1890 Nil Number of representations still under consideration Nil 73 [1920 Number of buildings demolished Nil Number of Orders for repairs issued under section 28 of the Housing Act, 1919 26 Number of houses repaired by local authorities Nil Number of houses closed on notice by owner that they could not be made fit 13 Total number of houses in the borough 39,938 Number of houses for the working classes— (a) Erected during year 47 (b) In course of erection (Flats) 325 Number of houses occupied by the working classes Fully two-thirds of the dwelling houses in the borough. Smoke nuisances— Number of observations 64 Number of notices 2 Number of nuisances and complaints 63 Number of summonses Nil Underground Rooms— Number illegally occupied 3 Number closed or illegal occupation discontinued 3 Overcrowding— Number of rooms overcrowded 7 Number remedied 7 Prosecutions Nil Cleansing— Number of adults cleansed 27 Number of children cleansed 5,405 Cleansing— Number of rooms or premises cleansed 5,678 Water supply to tenement houses— Premises supplied 68 Prosecutions Nil Sale of Food— Number of premises used other than ice cream premises, milk shops and cowsheds 486 Number of inspections 9,948 1920 74 Disinfection shelter— Persons accommodated 28 Ophthalmia neonatorum regulations— Number of notifications received during the year from certified midwives 53 Sanitary officers— Number of Sanitary Inspectors (Whole-time) Male 20 Female 2 „ „ (Part-time) Male, Nil Female, Nil Number of Health Visitors ... ... Whole-time, 7 Part-time, Nil Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 10 Revenue Acts— Number of houses for which applications were received during year Nil Number of tenements comprised therein Nil Number of tenements for which certificates were (a) granted Nil (b) refused Nil (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 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— (/) With respect to water supply to tenement houses Nil M ortuaries— Total number of bodies removed 340 Total number of infectious bodies removed 7