ISL 22. 1921 SIXTY-SIXTH ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE METROPOLITAN Borough of Islington. G. CLARK TROTTER, M.D., D.P.H., F.R.S.E. President, Incorporated Sanitary Association of Scotland, Fellow of the Royal Society of Medicine, &c., &c. MEDICAL OFFICER OF HEALTH. London: Wilkinson Bros., Ltd., 37-43, Green Lanes, Stoke Newington, N.16. MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1921, to November, 1922.) Mayor. Alderman HENRY GEORGE COLEMAN, J.P. Aldermen. FREDERICK EDWARD BRADSHAW FREDERICK MONTAGUE Councillors. Ward Ward I. JOHN DAVID AUBREY 5. MIRIAM PRICE 1. EDWARD JAMES BROWN 6. ABRAHAM LEVISON 2. FREDK. WM. SEPTIMUS TAYLOR 7. CHARLES COX 2. FREDK. JOSEPH SHIRLEY 9. WILLIAM FRANCIS GURNEY 2. PEYTON HAMILTON BLACK 10. SARAH JOHNSON 3. WILLIAM SAMPSON CLUSE 11. ARTHUR CAMPBELL 3. WILLIAM JOHN EVERETT 11. ERNEST HENRY KING 4. SARAH TRAFFORD Chairman Councillor CAMPBELL Vice-Chairman Councillor SHIRLEY MEMBERS OF THE MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1921, to November, 1922.) Aldermen. FREDK. E. BRADSHAW RICHARD MONTFORD. J.P. Councillors. Wards Wards 1. JOHN D. AUBREY 6. HENRY B. VORLEY 1. HERBERT TICE 7. CHARLES COX 2. SIDNEY E. RAMSAY 7. JOSEPH A. LINES 3. CHARLES G. W. HILL 8. FRANK S. HILLS 4. FREDK. G. CARESWELL 8. WM. J. MITCHELL 5. MIRAM PRICE 10. SARAH JOHNSON 6. ABRAHAM LEVISON 11. THOS. W. HUNT 6. KATE SHARP 11. REVD. WM. KINGSTON Members appointed by the Council from outside their own body. LADY ANDREWES, 1, North Grove, Highgate, N.6 Mrs. CARESWELL, 55, Huntingdon Street, N.l Mrs. CLUSE, 41, Mildmay Park, N.l Miss P. HACKFORTH JONES, 44, Richmond Road, N.l Mrs. HILL, 21, Thorpedale Road, N.4 Dr. ALICE VANCE KNOX, 15, South Grove, Highgate, N.6 Mrs. RAMSAY, 74, Evershot Road, N.4 Mrs. F. S. TAIT, 48, Highbury Park, N.5 Mrs. VORLEY, " Fern Bank," Holly Park, Crouch Hill, N.4 Chairman Councillor MIRIAM PRICE Vice-Chairman Councillor MITCHELL Staff of the Public Health Department. Medical Officer of Health. GEORGE CLARK TROTTER, M.D., D.P.H., F.R.S.E. Public Analysts. FRANK LITHERLAND TEED, D.Sc. (Lond.), F.I.C., F.C.S. ERNEST ALFRED PINCHIN, B.Sc. (Lond.), 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 Inspector appointed under the Sale of Food and Drugs Acts. GILBERT STANLEY GREEN Inspector of Workshops and Bakehouses. HARRY JOHN JAMES WATSON Inspectors of Workshops, Sec., in which Females are employed. ELEANOR HARRIET DANIELL MRS. SUSANNAH UNDERY Inspectors of Houses let in Lodgings. EGMONT JOSEPH NETHER FRANK HENRY CHUTER Sanitary Inspectors. District District 1. WILLIAM COOK 8. JOHN METCALF 2. HARRY JAMES BICKNELL 9. THOMAS HENRY HANCOCK 3. ALLEN BAGSHAW 10. STANLEY PELTON MARKS 4. GEORGE JAMES BRIDEL 11. ALFRED ERNEST WOOD 5. WILLIAM HOLSGROVE FLOOD 12. EDWARD GEORGE HOLMES 6. CHARLES EDWIN HORSMAN 13. THOMAS WALLACE AGAR 7. EDWARD ISAAC FORTUNE 14. HARRY CALLOW Temporary Sanitary Inspectors. HAROLD HERBERT UREN JAMES ARCHIBALD BINNS Rat Officer (Temporary). ALBERT BUTLIN Health Visitors. District District 1. Mrs. FRANCES LOOKER 5. Miss EDITH FOOT 2. Miss MONA CARR 6. Miss ANNIE TAYLOR 3. Miss ROSINA PALMER 7. Miss EVELYN W. E. JORDAN 4. Miss LILY FLOWER 8. Miss BARBARA DE ROCHFORT (Temp) Clerical Staff. GEORGE HAROLD KING (First Clerk) ALBERT EDWARD BOOKER HENRY ANGEL WALTER ROBERT CAUSTON EDWARD ALBERT ABBOTT FRANK M. CROUCH (Junior Clerk) WALTER JOSEPH WOLFE FREDK. CHARLES GREEN WILLIAM GEORGE BUNCH ALFRED ERNEST VANSTONE (Temp. Clerks) ARTHUR ROBERT WITTRICK CHARLES JOSEPH CRIDLAND CLEMENT MARSTONE WHEBLE DAISY FRANCIS NORMAN H. TURRELL (Resigned) Engineer in charge of Steam Disinfectors. Attendant in Charge of Cleansing Station. ALFRED LEWIS Mrs. HORNE Stoker at Disinfecting Station. Mortuary Keeper. CLARENCE SADGROVE SAMUEL MAXWELL Caretaker of Shelter House. Distributor of Disinfectants. Mrs. LEWIS JOHN REDDY Disinfectors. WILLIAM HARDWICK and WILLIAM WOODLEY IV SUMMARY of Vital Statistics, 1921. Population (Enumerated at Census, 1921) 330,028 persons „ Estimated Mid Year 1921 333,000 persons Increase on Census population, 1911 2,625 persons Mean Population, ten years (1911-1920) 317,204 persons Area 3,092 acres Density 108 persons per acre Marriages 3,141 Persons married 6,282 Persons married rate 18.86 per 1,000 inhabitants Births Males 4,068 Females 3,818 Persons 7,886 Birth rate 23.68 per 1,000 inhabitants Deaths from All Causes Males 2,212 Females 2,156 Persons 4,368 Death rate 13.12 per 1,000 inhabitants Deaths from Principal Epidemic Diseases Males 156 Females 129 285 persons Death rate 0.86 per 1,000 inhabitants Infantile deaths under 1 year Males 362 Females 279 Total 641 Infantile mortality rate 81 per 1,000 births Excess of Births oyer Deaths 3,520 V. INDEX. Page Adulteration of Food 39 Bacteriological Examinations 26 Births 2 „ Illegitimate 3 „ „ from 1841 to 1920 46 „ Notification of 3 „ Stillborn 3 „ and birth rates from 1841 to 1920 46 Cancer 14 Chicken Pox 26 Cleansing of Verminous School Children 30 Constitutional Diseases 14 Cow Houses 38 Deaths from All Causes during the year 3-43 „ „ Epidemic Diseases 11 „ „ Respiratory Diseases 16 „ in Public Institutions 10 „ and death-rates from 1841 to 1920 47 Disinfectants distributed and used 29 Disinfecting Station 29 Disinfection Work 28 District Inspectors' Work 33 Dust, removal of 33 Dysentery 22 Encephalitis Lethargica 22 Epidemic Diseases 12 „ Cerebro-Spinal Meningitis 21 Erysipelas 18 Factories and Workshops Administration 30 Fatality from Notifiable Infectious Diseases 19 Food, Adulteration of 39 Food Inspection 37 Hospital Isolation of Infectious Diseases 19 Houses let in Lodgings 35 Infant Mortality 5 „ „ from 1841 to 1920 47 Infant Welfare work 7 Infectious Diseases in Schools 26 „ „ (Non-notifiable) in Schools 26 „ „ Cases notified from 1891 to 1920 48 Influenza 13 Inspection of Food 37 „ Kitchens of Restaurants 30 ,, Slaughter Houses and Cow Houses 37 Inquests 17 Isolation of Infectious Diseases 19 London County Council Return of Sanitary Work 50 Malaria 22 Marriages 1 Maternity and Child Welfare Work 8 Measles, Notification of 26 VI. Page Meat Inspection 37 Ministry of Health Returns 49-50 Milk (Mothers and Children) Order, 1918-19 7 Milk Adulteration 39 Milkshops and Dairies 39 Mortuary and Coroner's Court 17 Notification of Infectious Diseases 17 „ „ Tuberculosis 24 „ „ Births Act 3 Non-notifiable Infectious Diseases in Schools 26 Offensive Trades 38 Ophthalmia Neonatorum 22 Outworkers' Premises 30 Other Notifiable Diseases 21 Pauperism 37 Phthisis 15 „ Notification of 23 Places where Food is Prepared 37 Pneumonia 16 Population at the Census 1921 1 Population—Estimated in 1921 1 Prosecutions, Summary of 41 Puerperal Septic Diseases 14-19 Polio-myelitis, Acute 21 Pulmonary Phthisis 23 Rat and Mice (Destruction) Act, 1919 35 Respiratory Diseases 16 Samples analysed in 1921 41 Sanitary Inspectors' Work 34 Septic Diseases 14 Shelter House 30 Slaughter Houses 37 Smoke Nuisances 33 Tubercular Diseases 23 Tuberculosis Dispensaries 25 Tuberculosis, Pulmonary, Notification of 23 Unsound Food 38 Vaccination 27 Venereal Diseases 16 Verminous Children, Cleansing of 30 Verminous Premises 33 Voluntary Maternity and Child Welfare Centres 8 Workshops and Factories, Inspection of 30 Welfare Work by Health Visitors 7 vii Public Health Department, 20, Compton Terrace, Upper Street, N.l. June, 1922. To The Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I have the honour to submit the Annual Report on the Health and Sanitary Condition of the Borough for the year 1921. Included are the statistical tables as prescribed by the Ministry of Health. It will be noted that the year was marked by the epidemic prevalence of Scarlet Fever and Diphtheria, but these diseases were mainly of a mild type, and notwithstanding it is gratifying to record that this year the death-rate (13.12) is the lowest rate hitherto recorded in Islington, being 0 20 per 1,000 below the rate of the previous year. As regards infantile mortality, although the rate (81 per 1,000 births) was higher than that of the previous year (when the rate was but 72, the lowest on record) it is creditable to the Infant Welfare work of the Borough notwithstanding, as the conditions, infectious disease, etc., which prevailed were not so favourable. Very shortly after I had taken up my duties in October, Mr. James R. Leggatt, the Superintendent and Chief Sanitary Inspector of the department, from whom I received much assistance, was incapacitated through illness, to which he succumbed on the last day of the year. His service of over 31 years with the Council and Vestry has left its mark on the public health work of the Borough, and outside his official sphere. I have to express my indebtedness to the Public Health and Maternity and Child Welfare Committees for the great interest taken and the assistance they have given me. To the other departments and to the members of my staff I am indebted for much help in the exceptional and sad circumstances which I have recorded. I am, Ladies and Gentlemen, Your obedient Servant, Medical Officer of Health. REPORT of the Medical Officer of Health FOR THE YEAR 1921. POPULATION. The Census enumeration of the population of the Borough took place on the 19th June, 1921, and numbered, according to the preliminary returns, 330,028 persons ; 154,498 being males, and 175,530 females. There were, therefore, 1.14 females to every male. The recent Census, however, only shows an increase of 2,625, corresponding to an intercensal* rate of increase of 0 80 per cent., or a'decennial rate of increase of 0.78 per cent. The following are the figures relating to Islington that were ascertained at the several Census periods from 1801 to 1921. Census Years. Enumerated Population Actual Decennial Increase or Decrease. Percentage Increase + or Decrease — 1801 10,212 - - 1811 15,065 +4,853 +39.7 1821 22,417 +7,352 +40.5 1831 37,316 +14,899 +66.4 1841 55,776 +18,460 +49.4 1851 95,329 +39,553 +70.7 1861 155,341 +60,012 +63.1 1871 213,749 +58,408 +37.1 1881 282,865 +69,116 +32.3 1891 319,155 +36,290 +12.8 1901 334,991 +15,836 +4.9 1911 327,403 -7,588 -2.2 1921 330,028 +2,625 +0.8 * Note.—The intercensal period 1911-1921, being approximately 10 years months. Fuller information regarding the Wards and Sub-Registration Districts are not yet available. The estimated population of the Borough to the middle of the year 1921, has been given by the Registrar-General as 333,000; and the calculations contained in this report relating to the year 1921, are based upon these figures. DENSITY OF POPULATION. The area of the Borough is 3,092 acres, but the actual area on which the people live is approximately 2,800 acres, consequently there are 119 persons living on each acre, while if the gross acreage be taken the number will be 108. The denisty of the population in Islington is very high when compared with that of the administrative County of London, which is 60 persons per acre. MARRIAGES. Marriages, 3,141 ; Marriage Rate, 18'86.—The number of persons married was 6,282, as contrasted with 6,740 in the preceding year, which is a decrease of 458. The marriage rate was 18 86 per thousand inhabitants, as compared with 20 05 in 1920. The following statement shows the figures for the previous ten years 1911-20. Years. Marriages. Marriage Rate. Years. Marriages. Marriage Rate. 1911 2,843 17.37 1916 3,080 18.30 1912 3,091 18.94 1917 2,689 16.23 1913 2,984 17.98 1918 2,971 18.51 1914 3,188 19.63 1919 3,306 19.28 1915 4,252 26.12 1920 3,370 20.05 1921] 2 BIRTHS. There were 7,886 births registered, of which 4,068 were boys, and 3,818 girls. Of this number, however, 834 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 23.68 per 1,000 of the population, as compared with a mean birth rate of 22.58 in the preceding ten years. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1921, 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 1920; together with the mean Borough Birth-rates for the 10 years 1911-1920. Quarter. Males. Females. Total. Birth Rates. Islington, 1921. Islington, 1911-20. London, 1921. 96 Great Towns, 1921. First 1,019 983 2,002 24.05 23.43 23.1 23.8 Second 1,056 957 2,013 24.18 22.87 23.3 24.7 Third 1,031 979 2,010 24.14 21.84 22.5 23.4 Fourth 962 899 1,861 22.35 22.15 21.5 22.0 The Year 1921 4,068 3,818 *7,886 23.68 22.58 22.3 23.3 1920 4,778 4,626 9,404 27.97 23.68 26.5 26.2 Increase or decrease - 710 - 808 - 1,518 - 4.29 + 1.10 - 4.2 - 2.9 * These include 834 births which occurred in Lying-in Institutions, etc., outside the Borough. Showing the Births of Males and Females in each quarter and for the year, 1921 and in the several Sub Registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Males. Females Total. Males. Females Total. Males. Females Total. Males. Females Total. 1st Quarter 113 127 240 107 96 203 78 94 172 136 133 269 2nd „ 129 131 260 98 105 203 88 88 176 135 123 258 3rd „ 122 109 231 97 92 189 95 83 178 143 139 282 4th „ 96 94 190 100 S3 190 114 91 205 115 115 230 Year 460 461 921 402 383 785 375 356 731 529 510 1,039 Highbury. Barnsbury. Islington South-East. The Borough. Males. Females Total. Males. Females Total. Males. Females Total. Males. Females Total. 1st Quarter 154 153 307 181 159 340 250 221 471 1,019 983 2,002 2nd „ 145 138 283 202 176 378 259 196 455 1,056 957 2,013 3rd „ 191 142 333 179 186 365 204 228 432 1,031 979 2,010 4th „ 136 117 253 168 178 346 233 214 447 962 899 1,861 Year 626 550 1,176 730 699 1,429 946 859 1,805 4,068 3,818 7,886 3 [1921 Illegitimate Births (205)—The number of illegitimate births, 205, shows a decrease of 51 on the return of the year 1920. They were equal to a rate of 2.60 per 1,000 registered births. 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 3.18 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 1901-10 2,413 87,361 2.76 1911-20 2,719 74,375 3.66 Notification of Births Act, 1907.—6,467 births were notified or 82 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 27 504 531 Certificated Midwives 89 3,405 3,494 Parents and other persons 51 2,391 2,442 167 6,300 6,467 DEATHS. The deaths numbered 4,368, while the death-rate was equal to 13'12 per 1,000 of the population, or 0 20 lower than that of the preceding year (13 32), and was 2 44 less than the average of the previous 10 years. The death-rate of 1312 per 1,000 oj 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. The Deaths from All Causes in the Sub Registration Districts were as follows:— Sub-Districts. Quarters. The Year. 1 2 3 4 Tufnell 146 94 86 111 437 Upper Holloway 152 106 105 129 492 Tollington 101 83 87 106 377 Lower Holloway 140 118 107 159 524 Highbury 204 141 141 228 714 Barnsbury 205 150 168 192 715 Islington (South-East) 304 252 214 339 1,109 The Borough 1,252 944 908 1,264 4,368 1921) 4 Showing the Deaths and Death Rates of Islington in 1921, and in the four quarters of the year, and of the County of London and the Great Towns during the same period, the mean Borough Death Rates for the 10 years 1911-20, and the deaths and death-rates in the year 1920. Quarter. Males. Females. Total. Death Rates. Islington, 1921. Islington, 1911-20. London, 1921. 96 Great Towns, 1921. First 631 621 1,252 15.04 18.89 13.4 13.9 Second 490 454 944 11.34 14.17 10.9 11.3 Third 469 439 908 10.90 12.29 10.5 10.4 Fourth 622 642 1,264 15.18 16.90 14.3 13.3 The Year 1921 2,212 2,156 4,368 13.12 15.58 12.4 12.3 1920 2,292 2,183 4,475 13.32 13.12 12.4 12.5 Increase or Decrease - 80 - 27 - 107 - 0.20 - 2.44 — - 0.2 Causes of Death (Classified)—The following table shows the deaths arranged in classes of Disease from All Causes during the ten years 1911-20, and in 1921. Classified Causes of Death. Years. Mean 10 Yrs. 1921 Difference. 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1. Specific or Febrile Causes. 722 397 448 572 618 380 391 1361 579 552 602 464 - 138 1. Miasmatic Diseases 330 300 284 299 451 268 293 1258 466 437 439 301 - 138 2. Diarrhœal „ 326 36 99 174 94 56 56 51 36 28 96 85 - 11 3. Malarial „ — 1 — 1 — — — 2 2 2 1 — - 1 4. Zoogenous „ 1 — 4 2 — 3 2 — 1 2 1 1 — 5. Venereal „ 13 17 19 21 23 15 15 15 13 13 16 17 + 1 6. Septic „ 52 43 42 75 50 38 25 35 61 70 49 60 + 11 II. Parasitic Diseases 2 — 1 — — 1 1 — 1 1 1 — - 1 III. Dietetic 18 19 17 11 36 3 3 4 2 2 11 4 - 7 IV. Constitutional Diseases 957 1023 1032 1056 1132 1095 1114 1101 973 918 1040 985 - 55 V. Developmental 429 396 468 512 554 522 486 520 657 556 510 486 - 24 VI. Local 2401 2500 2718 2488 2847 2457 2344 2596 2177 2172 2470 2203 - 267 1. Diseases of Nervous System 277 260 376 363 418 339 351 330 322 341 338 345 + 7 2. „ Organs of Special Sense 16 4 20 14 17 12 14 10 11 20 14 13 - 1 3. „ Circulatory System. 642 754 733 660 722 669 681 691 654 592 680 651 - 29 4. „ Respiratory „ 858 980 958 896 1147 1006 887 1156 770 822 948 717 - 231 5. „ Digestive „ 342 290 362 304 319 233 243 246 215 224 278 260 - 18 6. „ Lymphatic „ 10 6 10 15 9 16 9 3 11 10 10 14 + 4 7. „ Urinary „ 220 166 213 193 182 149 130 137 151 129 167 168 + 1 8. „ Reproductive „ 12 25 26 18 13 24 18 8 17 20 18 13 - 5 9. „ Bones and Joints 19 10 6 10 8 9 5 9 12 5 9 3 - 6 10. „ Integumentary System 5 5 14 15 7 — 6 6 14 9 8 19 + 11 VII. Violence 213 227 195 201 234 183 159 156 162 179 191 142 - 49 1. Accident or Negligence 167 177 157 165 194 156 122 115 132 140 152 99 - 53 2. Homicide 4 5 3 3 3 4 1 3 2 2 3 3 — 3. Suicide 42 45 34 33 37 23 11 27 28 37 32 40 + 8 4. Execution — — 1 — — — — — — — — — — 5. By Bombs (Enemy Aircraft) — — — — — — 25 11 — — 4 — - 4 VIII. Ill-defined Causes 124 120 149 98 125 111 102 103 89 95 112 84 - 28 All Causes 4866 4682 5028 4938 5546 4752 4600 5841 4640 4475 4937 4368 - 569 5 1921 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, 1921. Mean Deaths (10 years), 1911-20. Increase or Decrease on mean. 0-1 year 641 727 - 86 1-5 years 263 446 -183 Under 5 years 904 1,173 -269 5-15 years 177 187 - 10 15-25 „ 172 193 - 21 25-35 „ 178 288 -110 35-45 „ 303 375 - 72 45-55 „ 474 542 - 68 55-65 „ 598 644 - 46 65-75 „ 800 785 + 15 75-85 „ 605 586 + 19 85 upwards 157 164 - 7 4,368 4,937 -569 INFANTILE MORTALITY. Infant Deaths, 641; Mortality Rate, 81—There were 641 deaths among infants under twelve months old during the year, or 86 below the decennial average (727), and they represented an infant mortality rate of 81 per 1,000 infants born. This rate is 18 per 1,000 births below the mean annual record of the preceding ten years, and with but one exception, is the lowest rate hitherto recorded in Islington. In the quarters the mortality ranged from 95 per 1,000 births in the first quarter, 61 in the second, 92 in the third, and 76 in the fourth. In the sub-registration districts the infant mortality was as follows: Sub-District. Infant Deaths. Mortality per 1,000 Births. Tufnell 49 53 Upper Holloway 60 76 Tollington 61 83 Lower Holloway 97 93 Highbury 109 93 Barnsbury 125 87 Islington South East 140 77 In London the infant mortality was 80 per 1,000 births, while in the six boroughs encircling Islington it was 77. The rate for England and Wales was 83 per 1,000 births. 1921] 6 Infantile Mortality during each of the Ten Years 1911 20, and 1921. Deaths at various ages under One Year of Age. Years. Under one week. Weeks. Total under four weeks. Months. Total Deaths under one year. Deaths per 1,000 Births. 4 weeks and under 3 mths. 3-6 6-9 9-12 1-2 2-3 3-4 1911 170 52 34 37 293 207 201 171 168 1,040 128 1912 190 41 25 24 280 133 121 81 95 710 86 1913 195 49 47 29 320 187 178 111 102 898 107 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 1920 142 54 37 22 255 141 120 79 81 676 72 Mean 10 years 153 42 31 24 250 139 138 101 99 727 99 1921 131 34 35 22 222 104 148 96 71 641 81 Increase or decrease on mean - 22 - 8 + 4 - 2 - 28 - 35 + 10 - 5 - 28 - 86 - 18 Showing the Deaths among Infants per 1,000 Births during the Year 1921 and also the mortality rates for the Years 1911-1920. Sub-Districts. 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 Mean 10 years 1921 Increase or decrease on mean Tufnell 85 61 108 93 65 84 99 93 50 41 78 53 -25 Up. Holloway 115 85 119 86 118 67 68 83 79 69 89 76 -13 Tollington 131 88 104 92 135 93 102 135 98 58 104 83 -21 Lr. Holloway 162 94 121 134 118 107 121 130 101 66 115 93 -22 Highbury 104 80 89 93 109 74 83 99 83 67 80 93 +13 Barnsbury 162 98 128 119 107 103 114 122 91 89 113 87 -26 Islington, S.F. 128 94 98 105 108 91 89 107 81 79 98 77 -21 The Borough 128 86 107 104 107 87 97 110 83 72 99 81 -18 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 1911-20; and in 1921 from certain specified causes. Causes of death. 1921 Mean rate 10 years 1911-20 per 1,000 Births. Difference. Premature Birth and Congenital Defects 17.24 21.36 — 4.12 Bronchitis and Pneumonia 14.71 19.19 — 4.48 Atrophy and Marasmus 9.26 13.88 — 4.62 Diarrhœal Diseases (all forms) 8.11 8.44 — 0.33 Convulsions 1.52 1.77 — 0.25 Whooping Cough 2.79 3.54 — 0.75 Measles 0.63 3.13 — 2.50 Diphtheria 0.38 0.41 — 0.03 Phthisis 0.63 0.41 + 0.22 Other forms of Tuberculosis 1.27 2.58 — 1.31 Total of above 56.54 74.71 —18.17 All other causes 24.73 24.21 + 0.52 Total 81.27 98.92 —17.65 7 [1921 WELFARE WORK BY HEALTH VISITORS. This work was carried out during the year by the seven 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 75 66 94 80 135 71 59 580 „ (Home Re-visits) — — — 1 10 9 3 23 Births 1,244 1,480 1,267 1,053 1,623 1,097 801 8,565* „ (Re-visits) 877 574 959 424 1,102 462 419 4,817 Infant Deaths 23 18 15 21 58 6 6 147 Ophthalmia Neonatorum 38 25 27 25 51 32 19 217 „ „ (Re-visits) 39 25 8 2 18 4 14 110 Puerperal Fever 3 6 4 13 7 8 10 51 Measles 2 — — — 4 3 6 15 Tuberculosis — 2 — — 2 — — 4 Whooping Cough 4 2 — — 3 — — 9 Pneumonia 9 5 11 11 12 7 7 62 Cerebro spinal Meningitis — 3 5 2 2 — — 12 Acute Poliomyelitis 1 — — — 1 — — 2 Diarrhœa 16 15 14 — 41 20 2 108 Chicken Pox 1 1 — — 1 — — 3 Attendance at Welfare Centres 23 24 49 12 42 37 31 218 Visits re Milk Order 336 417 401 462 844 392 383 3,235 Other investigations 286 27 228 124 92 180 164 1,101 Total visits 2,977 2,690 3,082 2,230 4,048 2,328 1,924 19,279 No. of Attendances at Medical Officer's Consultations at Centres 11 1,015 94 — 2 665 504 2,291 No. of Babies seen 590 — 835 279 1,708 384 166 3,962 No. of Babies weighed — — 112 1,484 — 28 305 1,929 Milk Order—Interviews at Office 1,645 2,092 6,565 4,149 6,818 2,732 3,907 27,908 „ New Grants 172 246 397 273 502 295 387 2,272 „ Renewals 960 1,240 1,028 2,111 2,933 1,817 2,188 12,277 * Including children up ts 5 years. 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 1921 the sum of £15,822 3s. 9d. 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 first came into operation was £30,216 19s. lOd. The total number of orders issued during the year was 24,271. In view of the requirements of the Ministry of Health as to reducing the expenditure on the Borough Council's milk supply to necessitous expectant and nursing mothers and young children, the Council at its meeting on 30th June, 1921, resolved upon the recommendation of the Maternity and Child Welfare Committee: " That the scheme for the distribution of milk submitted to the Council on the 5th May, 1921, be modified as follows : " 1. That the milk be not supplied to expectant mothers except during the last three months of pregnancy. " 2. That milk be not supplied to children over the age of 18 months, provided that in exceptional cases where children are under 5 years of age a supply may be granted on production of a medical certificate. " 3. That no family, the father of which is in full employment, be granted a supply of milk at less than cost price unless there are more than three children in the family. 1921J 8 "4. That the following scale of income be adopted in lieu of the scale contained in the scheme, and that no deduction other than rent be made from the total family income in order to arrive at the net income:— No. in Family. Scale for Distribution of Free Milk. Scale for Distribution at half-price. s. d. s. d. 1 16 0 after deduction of rent 18 0 after deduction of rent 2 13 0 per head „ 14 6 per head „ 3 10 6 „ „ 11 6 „ „ 4 9 6 „ „ 10 6 „ „ 5 8 6 „ „ 9 6 „ „ 6 8 0 „ „ 9 0 „ „ THE CONFERENCE ON SUPPLY OF MILK TO EXPECTANT AND NURSING MOTHERS AND TO CHILDREN. On the 17th June, 1921, a conference of representatives of Metropolitan Borough Councils met at the Town Hall, Islington, to consider the question of milk supply schemes, and the resolutions passed by the Conference were forwarded to the Ministry of Health. The Conference strongly protested against the restrictions on the issue of free milk to children under 5 years of age, and to expectant mothers (except during the last three months of pregnancy) in accordance with the terms of the Ministry of Health's circular No. 185 as being prejudicial to the welfare of many children belonging to necessitous families. It considered that as the duties of Maternity and Child Welfare Committees are mainly preventive in character it should not be necessary to withhold supplies from necessitous children until the physical condition of those children has become sufficiently impaired to warrant the issue of a medical certificate, and that supplies of milk should be granted to necessitous expectant mothers for at least the last six months of pregnancy. It was also of opinion that the action of the Ministry of Health was economically unsound, as it would necessitate additional expenditure on remedial treatment in future years. A reply was received from the Ministry of Health to the effect that the Minister of Health was aware of the heavy burden of expenditure incurred by local authorities at the present time in distributing milk to necessitous expectant and nursing mothers and to children, but that in the present need for economy in national expenditure he could hold out no hope of an increase in the Government grant of 50 per cent., nor of any modification in the conditions laid down in official circular No. 185 for the distribution of milk ; also that the Minister had no power to refund amounts paid by local authorities for milk supplied to the dependants of reservists and other men serving with the Colours beyond the grant of 50 per cent, paid by the Ministry. 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 388. „ Attendances 1,095 „ Consultations held 98 Number of Babies attending (all ages) 1,786 „ ,, (under 1 year) 1,336 „ Attendances 12,945 „ Consultations and weighings 9,283 9 [1921 Number of Attendances of Morning Callers 1,487 Number of Sewing Classes 143 „ Attendances 1,052 Number of Health Talks 273 „ Attendances 4,467 Number of Visits—Professional 1,409 „ „ —Voluntary 1,110 Dental Clinic—Attendances 766 „ „ —Patients treated 286 Convalescent Homes—Mothers and children sent to 182 Number of Patients treated in Wards 152 ,. Babies „ „ 114 „ Mothers „ „ 38 Number of Deaths—Infant 38 „ , ,, —Other 17 Infant Mortality (based on per 1,000 infants under 1 year attending centre) 28.4 South Islington Maternity and Child Welfare Centre. Ante-Natal Cases. Number of Mothers 235 Full Term Births 109 Premature Births 11 Still Births 5 Miscarriages 5 Not yet confined 80 False Pregnancy 15 Left the neighbourhood before confinement 10 Number of Attendances 583 Staff Visits 8,531 Number of Deaths—Infant 36 „ „ —(Over one year) 15 Infant Mortality (based on per 1,000 infants under 1 year attending centre) 60'2 Record of Children. Children on Books 31st March, 1921 1,599 New Children during the year 940 Children on Books 31st March, 1922 2,539 Ceased to attend since 31st March, 1921 692 In attendance 31st March, 1922 1,847 Analysis of Attendances. Children under 1 year 598 „ over 1 year 1,249 Weighing and Consultations 8,132 Weighings only 4,426 Dental Treatment 92 Convalescent Homes or Holidays 113 1921] 10 West Islington Maternity and Child Welfare Centre. Number of Expectant Mothers on roll 185 „ Attendances 494 „ Consultations 49 „ Ailing Mothers on roll 257 „ Attendances 760 Total visits—Expectant Mothers 430 „ —Children 8,069 Number of Children on books 31st March, 1922 1,819 „ Attendances, under 1 year 443 „ „ over 1 year 801 Number of Consultations 305 Attendances at Consultations 8,224 Attendances at Weighings 4,364 Total attendances (Children) 12,588 Number of deaths under 1 year 43 „ „ over 1 year 15 Infant Mortality (based on per 1,000 infants under 1 year, attending centre) 97.0 Massage Attendances 499 Dental Treatment 96 Convalescent Homes and Holidays 91 East Islington Maternity and Child Welfare Centre. Children under 1 year (attending Centre) 340 „ over 1 year „ „ 774 Mothers expectant 129 Consultations held 40 Attendances 346 Total Attendances (Children) 7,972 Home Visits (by Staff) 5,391 „ (Voluntary) 84 Consultations 5,930 Weighings only 2,042 Massage (Attendances) 1,078 Deaths (under 1 year) 28 „ (over 1 year) 18 Infant Mortality (based on per 1,000 infants under 1 year attending Centre) 82.3 Dental Clinic—Patients treated 43 Convalescent Homes—Sent for treatment 8 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—1,868 persons died in the Public Institutions located in Islington, of whom 1,340 belonged to this Borough, the remaining 528 having come here for treatment or relief. Of these, 353 died in the Holborn Infirmary and 93 in the Great Northern Central Hospital. Of the 1,340 deaths of inhabitants, 936 occurred in the Islington Infirmary, 230 in the Islington Institution, and 131 in the Great Northern Central Hospital. The proportion which the 1,340 deaths in these public institutions bore to the Borough mortality was 30*7 per cent. 11 [1921 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, 41 in the Northwestern Fever Hospital. 55 in the Children's Hospital, Great Ormond Street, 108 in St. Bartholomew's Hospital, 45 in the Colney Hatch Asylum, 60 in the Royal Free Hospital, 48 in the University College Hospital. 53 in the North-Eastern Fever Hospital, 21 in the Eastern Fever Hospital, and 31 in the Middlesex Hospital. These 793 deaths represented 18-1 per cent, of all the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians numbered 2,133 and were equal to 48.8 per cent, of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough-—Ninetythree 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 1911-1920 and in 1921. 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 Great Northern Hospital. Inhabitants of Islington in Institutions outside the Borough. Total Deaths of Inhabitants in all Institutions (cols. 3 and 7). Proportion per 100 deaths from all causes (col. 8). 1 2 3 4 5 6 7 8 9 1911 1,804 1,181 623 817 113 760 1,941 39.9 1912 1,693 1,184 509 846 127 760 1,944 41.5 1913 1,938 1,361 577 980 115 844 2,205 43.8 1914 2,034 1,407 627 1,053 100 875 2,282 46.2 1915 2,288 1,606 682 1,193 98 872 2,478 44.9 1916 2,148 1,460 688 1,027 100 775 2,235 47.0 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 1920 1,842 1,322 520 917 117 793 2,115 47.3 Average 2,037 1,401 636 989 110 812 2,213 44.9 1921 1,868 1,340 528 836 131 793 2,133 48.8 Transferable Deaths.—During the year 60 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 Diarrhoeal Diseases. During the year 285 persons died from these diseases, the death rate being 0.86 per 1,000 inhabitants, as contrasted with 1.01 in the corresponding period last year, and a decennial average mortality of 352 and a death rate of 1.11 per 1,000. In London the death rate from the epidemic diseases was 0.96, while in the six Boroughs encircling Islington the death rate was 1.00. 1921] 12 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 1921. SubRegistration Districts. Wards. Enteric Fever. Small Pox. Measles Scarlet Fever. Whooping Cough. Diphtheria. Diarrhœa. Totals. Deaths Deaths Deaths Deaths Deaths Deaths Deaths Deaths Tufnell Tufnell — — — 2 1 8 11 22 Up. Holloway Up. Holloway — — — 2 4 31 7 44 Tollington Tollington — — 1 — 3 8 11 23 Lr. Holloway Lr.Holloway 1 — 10 2 5 11 17 46 Highbury Highbury — — 1 2 5 7 6 21 Mildmay — — — — 5 4 2 11 Barnsbury Thornhill — — 4 1 6 5 11 27 Barnsbury — — 3 2 2 2 3 12 Islington South East St. Mary's — — 1 2 2 4 3 12 Canonbury — — — 4 6 13 4 27 St. Peter's — — 7 2 4 17 10 40 The Borough 1 — 27 19 43 110 85 285 Total Death Rates 0.00 — 0.08 0.06 0.13 0.33 0.26 0.86 Showing the Deaths and Death Rates from the Principal Epidemic Diseases during the ten years 1911-20 and for the Year 1921. 1911 1912 1913 1914 1915 1916 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 12 0.04 8 0.02 4 0.01 14 0.04 5 0.01 9 0.03 Small Pox — — — — — — — — — — — — Measles 124 0.38 151 0.46 101 0.31 97 0.30 153 0.48 80 0.26 Scarlet Fever 20 0.06 9 0.03 19 0.06 23 0.07 38 0.12 18 0.06 Whooping Cough 71 0.22 54 0.16 62 0.19 83 0.26 103 0.32 60 0.19 Diphtheria 54 0.16 38 0.12 37 0.11 44 0.13 57 0.18 45 0.14 Diarrhœa and Enteritis (under 2 years) 362 44.62 per 1,000 births 84 10.96 per 1,000 births 210 25.12 per 1,000 births 217 26.53 per 1,000 births 154 20.43 per 1,000 births 117 16.11 per 1,000 births 1917 1918 1919 1920 Mean 10 years 1921 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 4 0.01 7 0.02 5* 0.02 3* 0.01 7 0.02 1 0.00 Small Pox — — — — 1 0.00 — — — — — — Measles 149 0.50 114 0.39 12 0.04 92 0.27 107 0.34 27 0.08 Scarlet Fever 4 0.01 8 0.03 14 0.04 12 0.04 16 0.05 19 0.06 Whooping Cough 45 0.15 147 0.51 17 0.05 70 0.21 71 0.22 43 0.13 Diphtheria 33 0.11 45 0.16 51 0.16 135 0.40 54 0.17 110 0.33 Diarrhoea and Enteritis (under 2 years) 106 18.16 per 1,000 births 82 15.78 per 1,000 births 85 13.53 per 1,000 births 77 8.19 per 1,000 births 149 20.27 per 1,000 births 156 19.78 per 1 000 births *Including 2 Malarial Fever, 13 [1921 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, &c. Totals. Diarrhœa. Enteritis, &c. Totals. Diarrhœa Enteritis, &c. Totals. Diarrhœa. Enteritis, &c. Totals. Diarrhœa. Enteritis, &c. Totals. Under 1 year 4 12 16 3 9 12 38 47 85 19 15 34 64 83 147 1 to 5 years — 2 2 — 1 1 6 2 8 3 9 12 9 14 23 Over 5 years 2 6 8 — 3 3 6 3 9 4 8 12 12 20 32 Totals 6 20 26 3 13 16 50 52 102 26 32 58 85 117 202 INFLUENZA. During the year Influenza caused 93 deaths, which is a decrease of 25 on the return for the year 1920 ; and 77 less than the average of the preceding ten years 1911-20. The death rate was equal to 0 28 per 1,000 inhabitants. Showing the Deaths from Influenza in the Quarters of the Year 1921, together with the averages of the corresponding periods, 1911-20. Years. Quarters. Totals. First. Second. Third. Fourth. 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 1920 56 43 7 12 118 Average 52 15 9 94 170 1921 33 17 2 41 93 Increase or Decrease - 19 + 2 - 7 - 53 - 77 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 1921: Ages. 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 Mean 10 yrs 1921 Difference. 0-5 3 1 5 1 3 1 106 19 10 15 5 — 10 5-10 — — — 1 — — — 52 5 3 6 — — 6 10-15 — — — — — — — 32 8 3 4 1 — 3 15-25 1 2 2 1 5 — — 141 48 12 21 5 — 16 25-35 4 1 4 1 4 — 2 252 82 21 37 9 — 28 35-45 2 5 8 6 7 1 2 109 47 18 21 15 — 6 45-55 6 1 17 5 15 6 1 93 48 17 22 18 — 4 55-65 3 4 5 7 12 6 8 69 42 17 17 13 — 4 65-75 10 7 7 7 11 10 10 50 36 13 16 14 — 2 75 &upwards 8 7 10 1 14 13 6 27 21 4 11 13 + 2 All Ages 37 28 58 30 71 36 36 931 356 118 170 93 - 77 1921] 14 SEPTIC DISEASES. Erysipelas and Puerperal Septicæmia are the principal diseases of this class. Erysipelas.—5 deaths were returned from this disease, or 10 less than in the year 1920, and 6 below the average of the preceding ten years 1911-20. Puerperal Diseases.— These comprise Puerperal Pyaemia, Septicaemia, Septic Intoxication and Puerperal Fever, and they caused 12 deaths, which is 3 above the return of 1920, and 5 more than the average of the ten years 1911-20. CONSTITUTIONAL DISEASES. The chief of these diseases are Cancer, Tuberculosis, Rheumatism, Diabetes, Gout Gangrene and Purpura. They were collectively responsible for 985 deaths, as contrasted with an average of 1,040 in the preceding ten years. The death rate represented 2.82 per 1,000 as contrasted with a decennial average of 3 28. Cancer.— There were 475 deaths from this malignant disease during the year compared with 402 in 1920, and with an average of 395 in the previous decennium. The deaths represent a death rate of 143 per 1,000 of the civil population and is 0.19 above the average rate (l.24) of the last ten years, 221 deaths occurred among males and 254 among females. The following statement shows the ages at death of the persons attacked during the past ten years, and the return for the year 1921: Ages. 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 Mean 10 yrs 1921 Difference 0-5 1 1 1 - - - 2 - 2 3 1 2 + 1 5-15 3 2 - 2 1 3 2 — 1 - 1 1 - 15-25 4 4 7 2 2 — 5 — 4 1 3 1 - 2 25-35 5 7 13 11 7 4 8 8 5 10 8 10 + 2 35-45 32 25 31 37 24 30 31 27 36 32 30 34 + 4 45-55 67 71 83 69 75 86 73 75 101 74 77 98 + 21 55—65 92 130 99 121 120 124 131 99 120 110 115 140 + 20 65-75 87 86 115 96 105 114 120 126 123 124 110 131 + 21 75-85 31 51 49 40 39 48 55 52 39 43 45 52 + 7 85 & upwards 7 5 6 6 4 3 5 6 7 5 5 6 + 1 329 382 404 384 377 412 432 393 438 402 395 475 + 80 Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the year 1921. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 21 18 13 5 20 16 29 122 Second 8 13 8 12 23 17 22 103 Third 13 22 6 12 17 21 41 132 Fourth 16 9 13 10 21 25 24 118 The Year 58 62 40 39 81 79 116 475 15 [1921 TUBERCULOSIS. The group of diseases, known as Tuberculosis, together caused 410 deaths, which were 133 below the average of the last decennium, and were 15 also below the number registered in 1920. The death rate resulting from them was equal to 123 per 1,000 of the civil population, and represented 9 4 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 355 deaths, as contrasted with the decennial average of 439, while the death-rate was 107 per 1,000 of the civil population, as against the decennial rate of 139 per 1,000. There was a decrease of 84 on the number of deaths, and of 0 32 on the mean death-rate. The mortality from Phthisis was, without exception, the lowest hitherto recorded in the Borough. Pulmonary Phthisis. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. Years. Deaths. Death rates per 1,000 inhabitants. 1911 389 1.19 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 17.0 1916 458 1.48 9.64 15.3 1917 485 1.63 10.54 15.5 1918 516 1.80 8.83 20.4 1919 388 1.18 8.56 14.1 1920 349 1.04 7.80 13.3 Average 10 years 439 1.39 8.89 15.6 1921 355 1.07 8.13 13.1 The following return gives the deaths at each age period: Age Periods. Males. Females. Total. 0-5 3 8 11 5-15 3 6 9 15-25 20 46 66 25-35 33 33 66 35-45 43 32 75 45-55 60 14 74 55-65 27 12 39 65 upwards 8 7 15 Total 197 158 355 Showing the Deaths from Phthisis in the Sub-Districts during the Four Quarters of the Year 1921. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Burnsbury. Islington, South East. The Borough. First 16 13 4 11 18 16 26 104 Second 12 10 6 9 5 11 19 72 Third 7 12 7 5 10 11 18 70 Fourth 5 15 12 15 20 12 30 109 The Year 40 50 29 40 53 50 93 355 1921] 16 Showing the Deaths from the Tubercular Diseases during 1921. 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 5 6 344 197 158 40 50 29 40 53 50 93 355 Tuberculosis of the Larynx - — - - - - - - - - - - - Tubercular Meningitis 8 10 7 10 15 4 3 3 3 1 5 6 25 Abdominal Tuberculosis 2 3 10 4 11 - 3 1 1 4 2 4 15 General Tuberculosis - 2 2 1 3 1 - - - 1 1 1 4 Other forms of Tuberculosis — 2 9 5 6 — 2 — 2 2 1 4 11 All Tubercular Diseases 15 23 372 217 193 45 58 33 46 61 59 108 410 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. These diseases, which include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 717 deaths, or 105 less than in 1920. They were equal to a death-rate of 2.15 per 1,000 of the civil population, and represented 16.4 per cent. of the total deaths registered in the Borough. Acute Bronchitis.— There were 96 deaths as compared with 106 in the previous year. 44 occurred among males, and 52 among females. The deaths of 14 infants under 12 months were registered. Chronic Bronchitis.— 234 deaths were ascribed to it, 107 being males and 127 females. This return is 10 below that for 1920. Pneumonia (All forms).— Three hundred and thirty-two deaths were registered, of which 192 were males and 140 females. They are 87 less than the number who died in 1920. It was very fatal to infants under a year old, among whom it caused 90 deaths, while between the ages of 1 and 5 years 66 died from it. Above 5 years of age the deaths numbered 176. 64 Deaths occurred in Public Institutions, chiefly the Workhouse Infirmaries. Pleurisy— From this disease 10 deaths were registered. Only 1 death occurred in Public Institutions. Asthma and Emphysema.— Seventeen deaths were recorded from these diseases, all of which were adults. Other Diseases of a Respiratory System.— Twenty eight deaths were registered from them, as contrasted with 23 in 1920. VENEREAL DISEASES. Seventeen deaths were ascribed to these diseases, as compared with 13 in 1920. They were 1 above the mean of the preceding ten years 1911-20. 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. 17 [1921 INQUESTS AND MORTUARY. During the year 313 bodies were received into the Mortuary, as compared with an average of 523 in the preceding 10 years. The return is the lowest since the opening of the building in 1874. Four infectious bodies were received during the year. The daily average number of bodies received was 0.8 as compared with 0.9 in 1920. In 299 cases inquests were held, as contrasted with an average of 383 in the ten years 1911-20. Bodies received into Mortuary. Inquests. 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 1920 340 312 Average 523 383 1921 313 299 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1921 and 1920. 1920 No. of bodies received. Daily Average. No. of Inquests held. 1921 No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 98 1.0 82 1st Quarter 74 0.8 69 2nd „ 82 0.9 76 2nd „ 64 0.7 56 3rd ,, 81 0.9 74 3rd „ 90 1.0 76 4th „ 79 0.8 80 4th „ 85 0.9 98 Total for year 340 0.9 312 Total for year 313 0.8 299 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 4,344 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 1,491 above those of the previous year (2,853), and 2,411 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 1,616 and 893 in excess, while Puerperal Fever cases were 14 above the average. The other diseases all showed a decrease. 1921] 18 The 4,344 cases were equal to an attack-rate of 13 05 per 1,000 of the civil population. In London the attack-rate was 11.60 per 1,000 of the civil population, or 1.45 less than in Islington, while in the Encircling Boroughs it was 12.'73 or 0.32 below 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. 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 1920 2,853 8.49 10 years average 1,933 6.09 1921 4,344 13.05 Registration Sub-Districts.— The total number of cases notified in these districts was as follows: Total cases notified. Tufnell 364 Upper Holloway 591 Tollington 390 Lower Holloway 461 Highbury 718 Barnsbury 693 Islington South-East 1,127 Total 4,344 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 4. Scarlet Fever.— 2,622 cases were notified, and they showed an increase of 1,616 or 161 per cent. on the average (1,006) of the ten years 1911-20. The attack-rate was equal to 787 per 1,000 of the civil population annually, which is an increase of 4 70 per 1,000 of the mean rate (317) of the preceding ten years. In London the attack rate was 7.25 per 1,000 of the civil population, while in the Encircling Boroughs it was 8.16. Diphtheria and Membranous Croup were responsible for 1,553 cases of illness, and were 893 above the average (660) of the preceding ten years. The attack-rate was equal to 4 67 per 1,000 of the civil population annually, and was 2.58 above the mean rate (2.09) of the decennial period. In London the attack-rate was 3.62 per 1,000, and the Encircling Boroughs 3.92. Enteric Fever was notified in 10 instances, which is 30 below the average (40) that obtained during the ten years 1911-20. The attack-rate was 0 03 per 1,000 annually, or 0 09 per 1,000 below the mean rate (0.12) of the last ten years. In London the rate was 0.07, and in the Encircling Boroughs 0.07 per 1,000 of the civil population. Typhus Fever.— Nil return. Continued Fever.— No case was notified. Erysipelas.— 125 cases were notified, or 82 below the average 207 of the preceding ten years, the attack-rate being 0 38 per 1,000 of the civil population, as compared with 0.47 in London and 0.51 in the Encircling Boroughs. 19 [1921 Puerperal Fever.— Thirty-four cases were notified, being in the proportion of 4.31. per 1.000 births. The notifications were 14 above the average (20) of the preceding ten years, and showed an increase of 1.59 in the proportion of attacks to 1,000 births. It was the highest number of cases notified since 1901. The deaths numbered 12, which represented a fatality of 35 per cent. The deaths occurring in hospital numbered 11, and equalled a fatality rate of 52 per cent. of the cases treated. Cases of Puerperal Fever notified and inquired into during the year 1921. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, SouthEast. The Borough Cases notified 5 1 3 2 9 4 10 34 Patient delivered by Doctor - - 1 1 1 2 4 9 Patient delivered by Midwife 4 - - - 5 1 3* 13 Cases inquired into 5 1 3 2 9 4 10 34 ,, treated in Hospital 4 1 1 1 9 4 5 25 „ treated at home 1 — 2 1 - - 5 9 *There was one case 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 4,344 cases notified, 146 deaths occurred, or 3.3 per cent., which contrasts with an average percentage of 4.9 in the preceding ten years 1911-20. Years. Cases. Deaths. Fatality. 1911 1,759 104 5.9 1912 1,577 62 3.9 1913 2,171 76 3.5 1914 2,947 113 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 1,993 96 4.8 1920 2,870 173 6.0 Mean 1,933 95 4.9 1921 4,344 146 3.3 Hospital Isolation.— Of the 4,344 cases of infectious diseases notified, 4,117 were isolated in hospital, or a percentage of 94.8, while only 5.2 per cent. of the patients, therefore, were nursed at home. This is the highest number on record. The following tabular statement shows the number of cases treated in the various public institutions: Year. Cases treated in Hospital. Percentage of cases treated. 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 92.0 1921 4,117 94.8 DISEASES TREATED IN HOSPITAL. Disease. Total cases. Cases isolated. Percentage of known cases. Scarlet Fever 2,622 2,512 95.8 Diphtheria 1,553 1,552 98.6 Enteric Fever 10 8 80.0 Erysipelas 125 44 35.2 Puerperal Fever 34 21 61.8 4,344 4,117 94.8 1921] 20 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 1921. 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 2,512 110 2,622 95.8 4.2 17 2 19 0.7 1.8 0.7 Diphtheria 1,532 21 1,553 98.6 1.4 103 6 109 6.7 28.6 7.0 Enteric (Typhoid Fever) 8 2 10 80.0 20.0 1 - 1 12.5 - 11.1 Typhus Fever - - - - - - - - - - - Erysipelas 44 81 125 35.2 64.8 2 3 5 4.5 3.7 4.0 Puerperal Fever 21 13 34 61.8 38.2 11 1 12 52.4 8.0 35.3 Continued Fever - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - Cholera - - - - - - - - - - - Total 4,117 227 4,344 94.8 5.2 134 12 146 3.2 5.3 3.3 Showing the number of Cases and Attack-Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1911-20 and in 1921. DISEASES. YEARS. Average number of cases, 1911-20 1921 Increase or Decrease 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 Small Pox Cases - - - - - - - 2 2 - - - - Rate — — — — — - - 0.00 0.00 - - - - Scarlet Fever Case 804 811 1317 1853 1332 638 478 432 1084 1307 1006 2622 + 1616 Rate 2.46 2.49 3.97 5.71 4.21 2.06 1.61 1.51 3.29 3.89 3.17 7.87 + 4.70 Diphtheria Cases 590 512 546 651 620 587 556 514 645 1324 655 1548 + 893 Rate 1.80 1.57 1.65 2.01 1.96 1.90 1.87 1.80 1.96 3.94 2.07 4.65 + 2.58 Membranous Croup Cases 3 4 4 8 4 6 5 4 4 4 5 5 - Rate 0.01 0.01 0.01 0.02 0.01 0.02 0.02 0.01 0.01 0.01 0.02 0.02 - Enteric Fever Cases 73 49 50 76 28 32 23 30 16 24 40 10 - 30 Rate 0.22 0.15 0.15 0.23 0.09 0.10 0.08 0.10 0.05 0.07 0.12 0.03 - 0.09 Typhus Fever Cases - - - - - - - - - - - - - Rate — — — — — — — - — - - - - Erysipelas Cases 275 185 226 334 203 155 173 141 212 165 207 125 - 82 Rate 0.84 0.57 0.68 1.03 0.64 0.50 0.58 0.49 0.64 0.49 0.65 0.38 - 0.27 Puerperal Fever* Cases 14 16 28 25 23 21 16 4 29 29 20 34 + 14 Rate 1.76 1.95 3.41 3.10 3.48 2.89 2.74 0.77 0.46 3.08 2.72 4.31 + 1.59 Continued Cases — — — — — — — — 1 — — - - Rate - - - - - - - - 0.00 - - - - Totals Cases 1759 1577 2171 2947 2210 1439 1251 1127 1993 2853 1933 4344 + 2411 Rate 5.37 4.83 6.54 9.08 6.98 4.65 4.21 3.93 6.05 8.49 6.09 13.05 + 6.96 *Per 1,000 Registered Births. 21 [1921 Showing the Cases of the Notifiable Infectious Diseases notified in the SubRegistration Districts and the Wards during the Year 1921. subRegistration Districts. Wards. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Tufnell Tufnell - 257 93 - - - 9 5 - - - 364 Up. Holloway Up. Holloway - 304 273 - - - 13 1 - - - 591 Tollington Tollington - 228 147 1 - - 11 3 - - - 390 Lr. Holloway Lr. Holloway - 288 154 1 2 - 14 2 - - - 461 Highbury Highbury - 263 150 - 2 - 5 4 - - - 424 Mildmay - 181 98 — 4 - 6 5 - - - 294 Barnsbury Thornhill - 291 106 — —' - 20 — - - - 417 Barnsbury - 190 71 — — - 11 4 - - - 276 Islington, S.E. St. Mary's - 156 85 1 1 - 5 3 - - - 251 Canonbury - 201 175 — — - 12 3 - - - 391 St. Peter's - 263 196 2 1 - 19 4 - - - 485 Totals — 2622 1548 5 10 - 125 34 — — — 4344 Attack-Rates per 1.000 population - 7.87 4.'65 0.02 0.03 - 0.38 0.10 — — — 13.05 OTHER NOTIFIABLE DISEASES. Acute Poliomyelitis, Cerebrospinal Meningitis, Encephalitis Lethargica, Ophthalmia Neonatorum, Tuberculosis and Measles. Acute Poliomyelitis. Three cases were ascribed to this disease during the year, as contrasted with 7 in 1920. One death was registered in the fourth quarter. 1921 1920 Cases. Deaths. Cases. Deaths. 1st quarter - - 1 - 2nd ,, 2 - 1 - 3rd „ - - 5 - 4th „ 1 1 — — 3 1 7 nil. Epidemic Cerebro-Spinal Meningitis. Seven cases were notified, or seven cases less than in 1920. During the ten years 1911-20, the cases averaged 19 per annum. A return of attacks of the disease during the past ten years is given in the following statement: 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 Average 10 yrs. 1911-20 1921 Total Deaths, 1911-21. 1st quarter 4 1 1 2 12 7 15 7 8 5 6 3 41 2nd „ 4 6 3 3 13 17 11 4 7 5 7 3 55 3rd 3 3 1 2 11 8 1 1 1 2 3 - 16 4th 2 3 1 — 4 7 3 4 — 2 3 1 11 Year 13 13 6 7 40 39 30 16 16 14 19 7 123 The deaths during the year numbered 6, and were equal to the very high rate of 85 per cent. of the cases notified. 1921] 22 Public Health (Pneumonia, Malaria, Dysentery, etc.), Regulations, 1919. These Regulations came into force on the 7th January, 1919, and during the 3 years the following cases were notified by medical practitioners to the Medical Officer of Health: 1921 1920 1919 Malaria 8 17 193 Dysentery — 4 14 Acute Primary Pneumonia 47 34 12 Influenzal Pneumonia 25 22 12 Pneumonia — 3 29 Total 80 80 260 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 11 cases of Acute Encephalitis Lethargica were notified, 2 of which proved fatal. No case of Acute Polio-Encephalitis was known in the Borough. Ophthalmia Neonatorum. Purulent Disease of the Eyes of Newly-born Children. This inflammatory disease of the eyes of infants was notified in 162 instances, of which 89 were attended by Doctors and 36 by Midwives ; whilst 31 cases were reported by the London County Council, and 6 by the Health Visitors ; and as a result 111 cases were referred to Hospitals for treatment, while 51 were attended to in their homes. Midwives attended 74 cases, and undertook the care of the infants affected. As the result of visits by the Health Visitors, the Council provided Nurses in 78 cases at a cost of ₤66 1s. 0d. This was money well spent, for undoubtedly they have saved many eyes. The cases occurred in the sub-registration districts as follows: Tuffnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough. Cases notified by Doctor 8 10 15 7 6 20 23 89 „ „ Midwife 2* 10* 8* 10* 5* 1* - 36 „ reported by L.C.C. 3 1 3 2 1 10 11 31 „ „ Health Visitor — — — 1 — 4 1 6 „ inquired into 13 21 26 20 12 35 35 162 „ treated in Hospital 6 17 19 13 9 21 26 111 „ treated at Home 7 4 7 7 3 14 9 51 „ attended by Midwife 5 14 14 17 3 12 9 74 * Notifications which were also received from midwives, and had been notified by doctors, are not included. Of the 162 cases investigated, both of the infants' eyes were affected in 96 instances; while in 28 cases the right eye was involved and in 29 the left. 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. 23 L1921 Tuberculosis. During the year 761 cases of Tuberculosis in its different forms were notified. The attack-rate was equal to 2.28 per 1,000 of the civil population. This number shows a decrease of 19 on the return of the previous year, and of 0.04 per 1,000 on the attack-rate. It was also 119 below the number in 1919. Pulmonary Tuberculosis.—652 notifications were received, of which 377 referred to males and 275 to females, and represented an attack-rate of 196 per 1,000. The return was a decrease of 11 on that of 1920, and 107 on 1919. Showing the Notified Cases of Tuberculosis in the Wards during 1921. Registration Sub-Districts. Wards. Pulmonary Phthisis. Other Forms of Tuberculosis. Grand Totals Tuberculosis Rate per 1,000 of Population. Males Females Total Males Females Total Tufnell Tufnell 38 23 61 6 3 9 70 - Up. Holloway Up. Holloway 38 26 64 4 3 7 71 — Tollington Tollington 27 21 48 4 2 6 54 — Lr. Holloway Lr. Holloway 36 27 63 7 10 17 80 — Highbury Highbury 54 29 83 3 8 11 94 — Mildmay 25 15 40 2 5 7 47 — Barnsbury Thornhill 34 36 70 8 6 14 84 — Barnsbury 41 25 66 5 6 11 77 — Islington, S.E. St. Mary's 17 11 28 4 1 5 33 — Canonbury 32 27 59 4 6 10 69 — St. Peter's 35 35 70 6 6 12 82 — Totals 377 275 652 53 56 109 761 2.28 THE PERIOD OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1921. Tubercular Diseases. Sex. Cases Notified in Whole District. At all ages. At Ages- Years. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and wards Phthisis (including Tuberculosis of Larynx) M. 377 2 4 18 61 195 93 4 F. 275 1 — 24 74 132 37 7 Tubercular Meningitis M. 4 2 2 - — — — — F. 7 3 1 2 1 — — — Tabes Mesenterica M. 7 — 2 4 1 — — — F. 10 1 1 2 3 3 - — General Tuberculosis M. - - - - - - - - F - - - - - - - - Other forms of Tuberculosis M. 42 - 3 17 12 5 4 1 F. 39 — 3 18 8 6 2 2 All Tubercular Diseases M. 430 4 11 39 74 200 97 5 F. 331 5 5 46 86 141 39 9 Totals 761 9 16 85 160 341 136 14 Percentages at each life period to total cases 100 1.2 2.1 11.2 21.0 44.8 17.9 1.8 From the above statement it will be seen how the disease attacked people at the various ages, viz.: In every hundred cases 1.2 were under 1 year of age. „ „ 2.1 were aged 1 to 5 years. „ „ 11.2 were aged 5 to 15 years. Prime „ „ 21.0 were aged 15 to 25 years of „ „ 44.8 83.7 were aged 25 to 45 years Life „ ,, 17.9 were aged 45 to 65 years ,, ,, 1.8 were aged 65 and upwards. 1921] 24 Showing the Notified Cases of Tuberculosis in the Quarters during 1921. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Males Females Total Males Females Total Males Females Total Males Females Total Males Females Total Phthisis 132 73 205 87 68 155 78 62 140 80 72 152 377 275 652 Tubercular Meningitis 3 1 4 1 3 4 — 2 2 — 1 1 4 7 11 Tabes Mesenterica — 1 1 2 4 6 1 2 3 4 3 7 7 10 17 General Tuberculosis — — - — — — — — — — — — — — — Other forms of Tuberculosis 6 8 14 15 11 26 7 10 17 14 10 24 42 39 81 Totals 141 83 224 105 86 191 86 76 162 98 86 184 430 331 761 Disinfection of Houses and Rooms after Phthisis. The following statement gives the particulars for the year: Houses. Rooms. 1st quarter 78 95 2nd „ 62 76 3rd „ 46 58 4th „ 50 67 Total 236 296 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 2nd January, 1921, to the 31st December, 1921, in the Metropolitan Borough of Islington. Age-periods Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and up. Total Primary Notifications Pulmonary Males 2 4 10 8 17 46 96 100 70 22 4 379 478 „ Females 1 — 9 12 32 40 76 51 27 11 7 266 366 Non-pulmonary Males 2 6 13 6 9 4 3 2 3 1 1 50 55 „ „ Females 4 6 11 9 5 8 7 4 1 1 2 58 67 Age-periods Notifications on Form B. Number of Notifications on Form C. Number of Primary Notifications. Total Notifications on Form B. Poor Law Institutions Sanatoria. Under 5 5 to 10 10 to 15 Total Primary Notifications Pulmonary Males - - - - - 86 242 Females — 1 — 1 — 73 113 Non-pulmonary Males — 3 — 3 4 4 18 „ „ Females. - 1 2 3 - 11 21 25 [1921 TUBERCULOSIS DISPENSARIES. The work of the Tuberculosis Dispensaries has been very satisfactorily performed, and during the year 1,373 persons were examined by the Tuberculosis Officers, and the patients. made 10,242 attendances. At the Northern Dispensary there were 615 new cases, and at the Southern 758, while the attendances at the former were 3,212 and at the latter 7,030. The examination of contacts with tuberculous cases showed that 29 were suffering from tuberculosis, 35 were suspect, and 388 were not suffering. The nurses of the Northern Dispensary paid 1,294 visits, and those of the Southern 2,056, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 182 visits, and of the Southern 301 visits 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 1921 North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy New Cases - 312 628 717 635 872 585 756 655 760 615 758 Actual number of Attendances - 944 2279 4291 3798 6511 4057 6782 3921 6895 3212 7030 Totals — 1256 2907 5008 4433 7383 4642 7538 4576 7655 3827 7788 A summary of this table gives the following figures: Cases. Attendances. Cases. Attendances. 1916 312 944 1920 1,415 10,816 1917 1,345 6,570 1921 1,373 10,242 1918 1,507 10,309 Totals 7,293 49,720 1919 1,341 10,839 Table showing the number of Tuberculous Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1921. Date. Dispensary. Jan. Feb. Mar. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec. Year. Total. Attendances Northern 340 288 239 260 237 259 287 241 286 311 227 237 3,212 10,242 Southern 607 610 660 616 641 545 511 544 582 578 590 546 7,030 New Cases Including Contacts Northern 63 49 52 75 31 47 64 27 62 67 34 44 615 1,373 Southern 76 94 79 69 73 72 50 45 57 52 43 48 758 Contacts. Tuberculosis Northern 1 1 - - - - 2 - 1 - 1 1 7 29 Southern 2 1 3 1 2 1 - 4 3 2 1 2 22 Suspects Northern 1 — 1 - - - - - 2 — 2 1 7 35 Southern 2 5 2 - 2 3 5 3 1 2 1 2 28 Non-Tuberculous Northern 20 15 18 29 8 6 25 5 19 27 9 19 200 388 Southern 17 22 22 16 18 19 8 13 14 13 14 12 188 Nurses' Visits Northern 135 125 112 140 118 123 91 40 80 114 97 119 1,294 3,350 Southern 164 177 180 211 207 30 170 199 199 177 163 179 2,056 Tuberculosis Officers' Visits Northern 16 18 24 18 13 6 2 1 23 21 20 20 182 483 Southern 17 22 26 24 26 28 26 24 28 27 27 26 301 1921] 26 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 2,432 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 1,653 were Scarlet Fever, and 779 Diphtheria. 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 1,653 563 + 1,090 Diphtheria 779 308 + 471 Enteric Fever - 4 — 4 Other Diseases - 1 — 1 Total 2,432 876 + 1,556 Non-Notifiable Diseases.— 5,782 cases came to the knowledge of the Medical Officer of Health during the quarter, viz.: 617 cases of Measles, 955 cases of Chicken Pox, 687 of Whooping Cough, and 3,523 of other diseases. The information respecting these cases was received from the teachers of 60 schools. Exclusion of Scholars from Schools.— 6,971 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 617 1,490 - 873 Chicken Pox 955 785 + 70 Whooping Cough 687 602 + 85 † Other Diseases 3,523 2,419 + 1,104 5,782 5,296 + 386 † Note.—"Other Diseases" include Mumps, Scabies, Ophthalmia, Itch, etc. BACTERIOLOGICAL EXAMINATIONS. 1,777 examinations were made for the medical profession of the sputum, of swabs from the throat and of the blood of patients suspected to be suffering from Phthisis, Diphtheria and Enteric Fever, respectively. This number is an increase of 358 on that of the preceding year. It is also 687 above the decennial average. Diphtheria.—1,207 specimens were examined for Diphtheria, of which 238, or 19.7 per cent., were found to contain Diphtheria bacilli. Enteric Fever.—22 specimens of blood were examined, of which only 3, or 13 per cent., gave positive results. Phthisis.—548 specimens of sputum were examined, 127, or 23 per cent., of which showed that the patients were suffering from this disease. 27 [1921 Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Phthisis, 1911-21. Periods. Diphtheria. Enteric Fever. Phthisis. Totals. Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined 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 1,362 1914 178 518 696 15 44 59 243 567 810 1,565 1915 123 360 483 16 19 35 198 568 766 1,284 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 1920 261 677 938 3 20 23 83 375 458 1,419 Average 10 years 144 361 505 13 23 36 139 410 549 1,090 1921 238 969 1,207 3 19 22 127 421 548 1,777 VACCINATION. Of the 8,698 births registered in 1920, the returns of vaccination show that only 4,070 infants were successfully vaccinated, while 21 were found to be insusceptible. There were also 437 who died unvaccinated, and 2,866 statutory declarations of conscientious objection to vaccination were obtained by the parents or guardians; 19 vaccinations were postponed under medical authority, thus leaving 1,285 unaccounted for. The return of certificates of exemption, therefore, represents 329 per cent. of the registered births. Vaccination per 100 Vaccination per 100 Vaccination per 100 Years births, less infants who Years. births, less infants who Years. births, less infants who died unvaccinated. died unvaccinated. died unvaccinated. 1880 89.8 1894 84.0 1908 72.4 1881 90.8 1895 70.9 1909 70.7 1882 91.1 1896 73.9 1910 66.7 1883 90.4 1897 73.3 1911 62.3 1884 90.5 1898 64.9 1912 54.1 1885 90.6 1899 66.4 1913 51.1 1886 90.8 1900 67.9 1914 46.8 1887 90.4 1901 75.8 1915 49.0 1888 88.4 1902 80.0 1916 47.5 1889 89.0 1903 81.2 1917 46.7 1890 89.3 1904 82.3 1918 46.4 1891 87.4 1905 80.5 1919 46.0 1892 85.5 1906 79.9 1920 49.3 1893 85.0 1907 76.9 Certificates of Exemption.— The following tabular statement shows the increase of these certificates, more especially since 1909: 1906 123 1911 1,241 1916 1,796 1907 259 1912 1,646 1917 1,341 1908 588 1913 1,942 1918 1,027 1909 824 1914 2,124 1919 1,583 1910 1,080 1915 1,710 1920 2,866 1921] 28 Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub Registration Districts during the year 1920. Registration Sub-Districts. Number of Births registered in 1920. 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 1921. Number of Statutory Declarations of Conscientious Objection received during year 1921. 1 2 3 4 5 6 7 8 9 10 11 12 Tufnell 1078 521 4 - 358 56 1 62 30 46 1,743 1,170 Up. Holloway 938 505 1 - 286 50 1 14 25 56 Tollington 741 329 1 - 241 33 2 4 37 94 Highbury 1184 510 5 — 432 56 3 6 44 128 Lr. Holloway 1156 537 2 — 334 59 1 6 35 182 1,901 1,422 Barnsbury 1608 855 5 — 432 90 5 7 69 145 Islington, S.E. 1993 813 3 — 783 93 6 14 80 201 The Borough. 8698 4070 21 - 2,866 437 19 113 320 852 3,644 2,592 DISINFECTION. Disinfection of Rooms.— 4,081 rooms were disinfected, as contrasted with 2,694 in 1920. 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. 24. The Cleansing and Spraying of Rooms.— 1,653 rooms, as contrasted with 1,586 in 1920, were cleansed and sprayed. Rooms Disinfected. Rooms Sprayed. 1921. 1920. 1921. 1920. 1st Quarter 858 525 463 397 2nd „ 664 436 442 379 3rd „ 955 654 390 385 4th „ 1,604 1,079 358 425 The Year 4,081 2,694 1,653 1,586 The following class-rooms, etc., were disinfected after the occurrence in them of cases of the diseases mentioned : 1st Quarter. Duncombe Road L.C.C. Schools (Diphtheria). 2nd Quarter. Nil. 3rd Quarter. Caledonian Road L.C.C. Schools (by request), 4th Quarter Nil. 29 [1921 Work at the Disinfecting Station.— 75,327 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 45,433 similar articles disinfected during the previous year. In addition to the above articles 46,339 old or second-hand garments, mostly shirts, 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 £74 14s. 5d. Altogether, 121,666 articles described in the two paragraphs preceding were disinfected, which bring the number of large articles disinfected since the disinfecting station was established to 1,763,494. Summary of the chief articles of Clothing, Bedding, etc., disinfected during the year 1921, and also in the preceding year 1920. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1921 1920 Beds 937 635 971 1,677 4,220 2,992 Blankets 1,762 1,481 2,151 2,973 8,367 5,423 Bolsters 720 705 753 1,381 3,559 2,040 Carpets — 33 44 49 126 9 Chair Bed Cushions — 64 106 176 346 4 Mattresses 574 588 799 1,239 3,200 1,834 Palliasses - 18 82 47 147 8 Pillows 1,995 1,695 1,913 3,077 8,680 6,020 Quilts 845 669 747 1,376 3,637 2,411 Sheets 1,503 1,207 1,360 2,708 6,778 4,242 Other Articles 6,470 4,473 7,047 18,277 36,267 20,450 Totals 14,806 11,568 15,973 32,980 75,327 45,433 The nature of the articles disinfected for the clothing contractors is shown below: 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Overcoats 41 275 - - 316 Jackets 228 1,235 172 1,453 3,088 Tunics 3 100 150 198 451 Trousers 343 3,402 244 102 4,091 Shirts 7,700 15,981 12,300 820 36,801 Blankets 100 156 — 1,000 1,256 Other Articles 12 288 36 - 336 8,427 21,437 12,902 3,573 46,339 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 2 0 340 - - Disinfection of Premises - — 1 0 14 66 Cost = £144 10s. 0d. 1921] 30 Shelter House. —The Shelter House was occupied by 16 persons during the disinfection of their homes after infectious diseases. Baths were given to 14 verminous persons; and to 4 persons suffering from Scabies whilst their clothing was disinfected. Nine midwives also attended for the purpose of disinfection after attendance on cases of Puerperal Fever. Verminous School Children.— During the year 4,635 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 40. 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 £373 9s. Proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, in 36 instances during the year, when fines ranging from 5s. to 10s. were inflicted. FACTORY AND WORKSHOP ADMINISTRATION. The Medical Officer of Health submits the annual report on the manner in which the provisions of the Factory and Workshops Act, 1901, were carried out in his district during the year 1921. Inspections and Visits.— The inspections and visits made by the Inspectors were as under: Factories, including Factory Laundries 521 Workshops, including Workshop Laundries 814 Workplaces, other than outworkers' homes 321 Bakehouses 338 Restaurant Kitchens 254 Outworkers' premises 766 Miscellaneous re-inspections and calls 4,295 Total 7,309 Notices Served.— In consequence of the 1,248 sanitary defects discovered as the result of the inspections above; 237 intimations and 26 statutory notices were served. Of these notices 63 were served on the owners of factories, 130 on the owners of workshops, and work places, and 49 on the owners of bakehouses and restaurant kitchens. In addition to these nuisances, 131 were discovered on Outworkers' premises, necessitating the service of 14 notices. Registers.— There were 1,691 workshops on the Register, as contrasted with 1,818 in 1920, while the total number of workrooms was 2,392 as contrasted with 2,493 in the previous year; 174 workshops were added to the Register, while 165 were removed from t. 31 [1921 The various workshops and workplaces are tabulated as below: Workshops and Workplaces. 1921. Total Workshops on Register. Total Workrooms on Register. Number added during Year. Number removed during Year. Workshops were Men are employed 648 958 149 85 Workshops were Women are employed 436 738 23 62 Laundries 21 54 — 5 Bakehouses 240 252 — 1 Restaurant Kitchens 346 390 2 12 Total 1,691 2,392 174 165 Outworkers' Premises 2,211 — 630 303 Workshops Notified to Home Office, 1921. Trade. Number of Workshops. Protected Employed Persons. Women. Male Young Persons. Total. Blouses 3 5 - 5 Millinery 1 1 - 1 Ties 1 1 - 1 Furrier 1 1 — 1 Tailoring 2 2 - 2 Dressmaking 4 26 - 26 Artificial Flowers 3 42 — 42 Machine Knitting 1 5 — 5 French Polishing 1 2 — 2 Lamp Shades 1 5 — 5 Mantles 1 3 — 3 Children's Frocks 1 1 — 1 Christmas Crackers 1 1 — 1 Underclothing 1 1 — 1 Rag Sorting 1 6 - 6 23 102 - 102 SECRETARY OF STATE'S RETURNS on the administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1— INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries) 521 63 Nil Workshops (Including Workshop Laundries) 814 84 „ Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 913 95 „ Miscellaneous Re-Inspections 4,295 — „ Total 6,543 242 Nil 1921] 32 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 ... 335 314 - Nil Want of ventilation 23 19 - „ Overcrowding 5 5 - „ Want of drainage of floors 33 33 - „ Other nuisances 406 364 2 „ Sanitary Accommodation insufficient 24 18 — „ unsuitable, foul or defective ... 413 379 — „ not separate for sexes... 5 5 — „ Offences under the Factory and Workshop Act— Illegal occupation of underground bakehouse (s. 101) „ Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) 4 7 - „ Other offences — — — „ (Excluding offences relating to outwork which are included in Part 3 of this Report)... — — - „ Total 1,248 l,144† 2 Nil * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts, t Defects found left over from previous year are also included in this total. 3—HOME WORK. •NATURE OF WORK. Outworkers Lists (Section 107). Outwork in Unwholesome Premises (Section 108). Outwork in Infected Premises. (Sees. 109. 110). List received from Employers. Notices served on Occupiers a* to keepins or sending lists. I Prosecutions. Instances. Notices served under Public Health (London) Act, 1891. Prosecutions. Instances. Orders mad£ (Section 110). Prosecutions (Sections 109.110). Sending twice in the year. Sending once in the v ar. Failing to keep or permit inspection of lists Failing to send lists. tLists. tOutWorkers. List*. OutWorkers. Contractors. Workmen. Contractors. Workmen. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Wearing Apparel—(1) making, etc. 140 168 845 20 81 59 215 - - 12 5 - 10 10 - (2) cleaning and washing — — - - - - — — — — — — — - Household linen — 3 — - - - - - - - - - __ Lace, lace curtains and nets - - - - - - - - - - - - - - - Curtains and furniture hangings. 4 2 10 - 27 - 3 1 - Furniture and upholstery - - 4 - - - - - - - - - - - - Electro-plate — — — — — — — — — — — — — File making — — — - - Brass and brass articles — — — — — - Fur pulling — 1 - - - - - - - - — — - Cables and chains - — - - Anchors and grapnels — — — - — — — — — — — — — - Cart gear — — — — — — — — — — — — — - Locks, latches and keys - - - - - - - - - - - - - - - Umbrellas, etc — — — — 2 - - - - - - — 1 Artificial Flowers. 20 — 245 2 — 9 21 — — 6 3 — 2 Nets, other than wire nets - - - - - - - - - - - - - - - Tents — — — — — — — - — — — — — Sacks - - Racquet and Tennis Balls - - - - 1 - - - - - - - - - - Paper, etc., Boxes, Paper Bags . 20 — 155 5 — 16 25 — — 2 1 — 3 — — Brush making 6 — 50 1 — 1 4 — — 1 1 — — — — Pea picking — — — — — — — — — — — Feather sorting — 1 - Carding, etc., of buttons, etc. - - - Stuffed toys 4 - 32 - - - 3 - - - - - - - - Basket making - - 1 - - - - - - - - - - Chocolates and Sweetmeats - - - - - - - - - - - - - - - Cosaques, Christmas Crackers, Christmas Stockings, etc. 2 - 8 1 - 2 2 - - - - - 1 - _ Textile weaving — — — — — — — — — — — — — — — Total 196 170 1353 29 112 87 273 — — 21 10 — 19 10 — *When an occupier gives out work of more than one of the classes specified in column 1, and sub-divides 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 71 into their respective classes. † The figures in column 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. 33 [1921 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Workshops where men are employed 648 Workshops where women are employed 436 Laundries 21 Bakehouses 240 Restaurant kitchens 346 Total Number of Workshops on Register 1,691 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories: Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 19 Action taken in matters referred by H.M. Notified by H.M. Inspector 24 Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5, 1901). Reports (of action taken) sent to H.M. Inspector 27 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 62,347 inspections and calls during the year, an increase of 582 inspections on the corresponding period of 1920; while 19,462 improvements were effected in 7.599 premises; as against 16,611 improvements in 7 067 premises for the preceding year. Synopsis of Inspectors' Work.—The following statement gives a brief synopsis of the district inspector's work in 1921. House to house inspections 630 Other inspections of dwelling houses 8,787 Re-inspections and calls made 50,573 Visits of inquiry re notifiable infectious diseases 4,344 Butchers' shops, stalls, etc. (Saturday nights) 43 Ice cream shops and factories 62 Dairies and Milkshops 468 Stables and yards 828 Manure depots 73 Smoke observations 84 Notices Served.—There were 4,373 intimation notices served by the inspectors with respect to nuisances, of which 876 were delivered personally, and 3,497 by post. In 534 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.—283 premises which were found to be in a verminous condition, were cleansed by the owners or occupiers upon receiving the Inspectors' intimations. In 56 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification or destruction. Smoke Nuisances.—114 complaints of smoke issuing from factory chimneys in the borough were investigated, and as a result of the Inspector's observation 3 notices were served upon the owners of the businesses requiring the abatement of the nuisance. REMOVAL OF DUST. Twenty-one applications were received during the year for the removal of dust, which is 15 below the number recorded last year. The applications received for the previous ten years were as follows: 1911 52 1916 21 1912 47 1917 30 1913 32 1918 11 1914 26 1919 19 1915 28 1920 36 Dust Receptacles Provided.—During the year 1,776 dust receptacles, were provided, while 34 were repaired after the service of sanitary notices. 1921] 34 showing the summary of Sanitary Work from District Inspectors' Reports for the year 1921. Districts. Totals 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 76 8 62 57 20 89 73 12 64 71 47 14 10 27 630 Other premises inspected 539 875 394 818 394 512 614 697 538 752 759 695 718 482 8787 Re-inspections, Calls made, etc. 3337 3064 3663 3571 3893 3358 3995 4300 3184 3192 3538 4874 3400 3204 50573 Ice Cream Factories inspected — — 6 26 — 5 1 — — 9 11 2 2 — 62 Dairies and Milkshops ,, 59 9 76 85 38 14 23 54 15 24 32 10 17 12 468 Stables ,, 17 4 12 32 52 3 22 3 — 9 1 1 14 15 185 Yards „ 83 50 236 78 20 2 96 2 18 1 17 2 30 8 643 Manure Depots „ 51 — — 20 1 — - — — — — — 1 — 73 Vacant land, Passages and Courts inspected 7 - 2 1 - 1 16 1 - 3 3 - 14 3 53 Urinals attached to P.H.'s inspected 13 25 68 12 188 6 15 - 1 2 4 1 - 8 343 Premises (re Certificate Customs and Inland Revenue Acts) inspected 2 - - - 14 - - 5 - - - - - - 21 Premises (re Water Certificates) inspected - - 63 1 14 - 1 43 - - - - - 56 178 Visits re Sale of Food and Drugs Acts 32 21 14 33 23 - 21 22 - - - - 20 18 204 Smoke observations — 6 3 5 5 18 5 — 12 9 7 11 3 - 84 Shops, Stalls and Markets (Saturday evening) 2 2 3 2 4 2 4 3 4 4 3 5 3 2 43 Total Inspections and Calls 4218 4064 4602 4741 4668 4010 4886 5142 3836 4076 4422 5615 4232 3835 62347 Notices Served. Intimation Personally 181 6 7 5 72 38 13 65 163 68 130 22 12 94 876 By Post 5 416 — 542 — 268 385 349 261 391 220 266 241 153 3497 Statutory Personally 8 — — 8 11 — 1 2 2 6 15 6 — 20 79 By Post 36 — 3 51 16 146 43 33 62 1 2 12 — 50 455 Improvements. Drains— Constructed - - - - - - - - - - - - - - - Reconstructed 6 7 8 15 7 14 2 14 — 7 5 1 25 9 120 Repaired 25 20 14 36 16 22 31 22 12 29 28 13 37 29 334 Ventilated 3 22 3 17 9 3 6 4 3 10 9 1 24 6 120 Gully and other traps fixed 45 73 32 72 36 12 53 41 30 9 28 1 115 29 576 Urinals— Water supplied, cleansed — — 6 1 — 1 1 — 2 — 1 — — — 12 Cesspools—Abolished — - - - - - - - - - - - - - - Water Closet— W.C. erected with pan, trap and Water Supply 1 - - 1 - - - - 2 - 1 1 - 1 7 Pan and trap only provided 19 58 17 46 19 41 25 31 18 19 55 7 50 31 436 Water supply piovided 49 57 16 53 54 31 54 37 73 29 34 65 47 56 655 Ventilated — 1 3 2 — — — 1 — 1 1 2 1 1 13 Position altered — — — 1 — — — — — — — — — 1 2 Dust Bins Provided 133 136 70 192 74 97 182 181 75 162 129 183 54 108 1776 Repaired 1 1 — — 8 2 7 1 2 2 8 — — 2 34 Areas—Constructed - - - - - - - - - - - - - - - Yards. Paved — — 4 — — 2 3 10 — — 3 — — — 22 Repaved 28 33 9 70 27 47 42 14 37 28 58 38 30 41 502 Sinks—Provided 14 12 3 9 1 — 3 5 7 2 9 — 7 6 78 Domestic Water Supply Cisterns provided - - - - - - - - - - - - - 1 1 Cisterns repaired & cleansed 24 46 31 37 14 26 29 11 21 17 31 14 9 23 333 Water supply provided to dwelling house 9 8 9 8 5 1 6 6 4 5 3 2 9 3 78 Water supply provided to tenement house 11 2 2 5 - - 10 1 12 2 3 6 - 2 56 Other improvements— Rooms cleansed & limewashed 133 184 281 551 366 568 531 303 519 319 756 718 276 395 5900 Walls and passages repaired, cleansed and limewashed 52 55 90 180 67 128 74 74 154 103 193 185 94 143 1592 Floor space ventilated 6 2 7 8 2 3 2 — 15 4 28 1 4 1 83 Floors repaired 26 34 27 67 11 29 15 22 66 41 57 72 58 43 568 Roofs repaired 100 110 76 162 87 110 171 116 121 91 182 196 93 104 1719 Overcrowding abated — — — 1 — — 1 1 — — 1 — 1 1 6 Illegal use of underground rooms for sleeping discontinued - - - 2 - - 1 - - - - - - - 3 Other improvements, or Nuisances abated 178 170 84 252 114 167 144 102 272 206 321 178 159 217 2564 Rooms Disinfected 219 312 226 219 142 33 118 7 22 25 3 52 283 211 1872 Total improvements 1082 1343 1018 2007 1059 1337 1511 1004 1467 1111 1947 1736 1376 1464 19462 Total premises improved 578 696 489 797 399 444 615 404 402 424 602 609 563 577 7599 35 [1921 HOUSES LET IN LODGINGS. There were 1,033 houses under the operation of the bye-laws at the end of the year 1921 ; 855 inspections were made during the year, followed by 7,906 subsequent re-inspections and calls, so that the total visits amounted to 8,761. These inspections resulted in 810 intimations being served on the persons responsible, which were followed by 134 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, 3,931 improvements were effected in 849 premises. Synopsis of Inspectors' Work:— Improvements. Districts. Total. North. South. Drains: Constructed - - - Reconstructed - 4 4 Repaired 6 8 14 Ventilated - 1 1 Gully and other traps fixed 5 - 5 Water Closets: W.C. erected with pan, trap and water supply - - - Pan and trap only provided 17 18 35 Water supply provided 26 - 26 Ventilated - - - Position altered - - - Dust Bins: Provided 88 70 158 Repaired 1 - 1 Areas: Constructed - - - Yards: Paved 2 - 2 Repaved 17 26 43 Sinks: Provided 4 1 5 Domestic Water Supply: Cisterns provided - - — Cisterns repaired and cleansed 8 1 9 Water supply provided to dwelling house 1 — 1 Water supply provided to tenement house 2 4 6 Other Improvements: Rooms cleansed and limewashed 703 745 1,448 Walls and passages repaired, cleansed and limewashed 164 166 330 Floor space ventilated 5 — 5 Floors repaired 79 79 158 Roofs repaired 149 98 247 Miscellaneous improvements 677 756 1,433 Total Improvements 1,954 1,977 3,931 Total Premises Improved 429 420 849 RATS AND MICE (DESTRUCTION) ACT, 1919. (9 and 10 Geo. 5. Ch. 72.) This Act came into operation on the 1st January, 1920, to make further provision for the destruction of rats and mice. The object of the Act is to compel any person who fails to take such steps as may from time to time be necessary and reasonably practicable for the destruction of rats and mice, on or in any land of which he is the occupier, or for preventing such land from becoming infested with rats and mice; and renders him liable on summary conviction to a fine not exceeding Five Pounds, or where he has been served with a notice under this Act, requiring him to take such steps, not exceeding Twenty Pounds. The following public notice was printed and circulated within the Borough by order of the Council: 1921] 36 Metropolitan Borough of Islington. RATS AND MICE (DESTRUCTION) ACT, 1919. This Act came into Operation on 1st January, 1920. PENALTIES FOR FAILURE TO DESTROY RATS AND MICE. Any person who shall fail to take such steps as may from time to time be necessary and reasonably practicable for the destruction of rats and mice on or in any land of which he is the occupier, or for preventing such land from becoming infested with rats and mice, shall be liable on summary conviction to a fine not exceeding Five Pounds, or where he has been served with a notice under this Act requiring him to take such steps, not exceedirg Twenty Pounds. The expression "Occupier" means, in the case of land not occupied by any tenant or other person, the owner of the land. The expression "Land" includes any buildings, and any other erection on land, and any cellar, sewer, drain or culvert in or under land. This Act shall apply to a vessel (such as a barge on the Regent's Canal) as if the vessel were " Land " and the master of the vessel shall be deemed to be the " Occupier " thereof. Methods and Preventive Measures. The most effective methods for destroying rats and mice embrace the use of traps, snares, ferrets, dogs, fumigation, and the use of poisons. The safest poisons have been found to be preparations of squills and barium carbonate. Poison should be laid in such a way that human beings, domestic animals, poultry, etc., cannot obtain access to it. The laying of baits containing any poison should be carried out with the utmost care. The actual amount laid in each single rat-hole or burrow should be as small as possible to obtain the results aimed at. The position of these places should be noted, and any dead rats found afterwards should be burnt or destroyed to prevent domestic animals getting at the carcases. Previous to the laying of poisons the owners of poultry, dogs, pigs and other animals frequenting or likely to come near places where poison has been laid should be warned, and, after an interval of a few days, all unconsumed baits should be removed and destroyed. Attention should be specially directed to all drains, waste, food and grain stores and stacks, etc. Persons desiring information on the subject of rat or mice destruction, or experiencing any difficulty in obtaining suitable materials for that purpose, should apply to The Medical Officer of Health, Town Hall, Upper Street. Islington, N.I., to whom all complaints should be addressed. Town Hall, Upper Street, N. 1. C. G. E. FLETCHER, 22nd January, 1920. Town Clerk. The temporary appointment of a Rat Officer was made by the Council on the 26th January, 1920, to carry out the provisions of the Act, and the following statement shows the work performed by him during the undermentioned periods: SUMMARY OF WORK FROM RAT OFFICER'S REPORTS DURING THE YEARS 1920-21. 1921 1920 Number of Streets visited 669 607 Number of Private Houses visited 805 945 Number of Shops and Factories visited 1,034 1,326 Total Premises inspected 1,839 2,271 Found Rat Infested 1,406 1,355 Found Mice Infested 55 196 Defective Drains Repaired (Cause of Rat trouble) 45 34 Number of Complaints received 175 172 37 [1921 HOUSING, INSPECTIONS, ETC. A special table will be found on page 51. See also the statement of Sanitary Inspectors' work, page 34 . Special House to House Inspections 630 Insanitary Houses— No. of premises cleansed 283 • No. of orders issued for repairs under Section 28 by Housing Committee 62* (* Relating to 132 dwelling houses.) No. of houses closed on notice by owner that they could not be put in habitable condition 12 Housing of Working Classes— Houses— (a) Erected during year (flats) 148 (b) In course of erection (flat tenements) 235 Revenue Acts— Certificates granted (sanitary requirements 47 Water Supply to Tenement Houses— Premises supplied 63 Water certificates to new premises 178 STATE OF PAUPERISM IN THE BOROUGH. During the year there was a considerable increase in Pauperism, for the number of paupers relieved weekly averaged 8,257, as contrasted with 5,620 in 1920 and 4,872 in 1919. Appended is a statement furnished by the Clerk to the Islington Guardians: Showing the State of Pauperism in the Borough during the year 1921. Quarters. Average number Relieved during each week. Borough Death rates, 1921. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals. Totals corresponding periods 1920. Vagrants Relieved. Children Boarded out. Adults. Children under 16. 1 2 3 4 5 6 7 8 9 1st Ouarter 2,850 3,224 3,122 6,346 5,211 No Wards 56 15.04 2nd ,, 2,802 3,246 3,508 6,754 5,251 66 11.34 3rd ,, 2,862 4,363 4,158 8,521 5,192 69 10.90 4th ,, 2,891 6,032 5,376 11,408 6,825 71 15.18 The Year 2,851 4,216 4,041 8,257 5,620 — 65 13.12 INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 925 visits to the 18 Slaughter Houses now on the register, including one Horse Slaughter House, and that he has ascertained that 14,378 animals were killed therein, namely, 736 oxen and cows, 27 calves, 12,395 sheep and lambs, 116 pigs and 1,104 horses for human consumption, chiefly for export, and none of the latter was consumed within the Borough. These were mostly found of good quality and free from disease, the few exceptions are set out in the table on page 39. 1921] 38 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 - 3 2 8* Disesed or unsound meat, etc., from other sources - 4 1 16 Bacon - 1 1 20 Fish 1 13 3 22 Cheese - 2 0 10 Geese - - 2 12 Eggs - - - 7 Rabbits . - 1 2 24 Fruit, Vegetables, etc. 2 11 0 3 Unwholesome Fruit Pulp 3 4 0 0 Unsound tinned foods (various) 5 11 1 13 Total 13 14 0 23 * Of this quantity 2 qrs. 14 lbs. was Tuberculous. The total amount of unsound or diseased meat, fish, fruit and other food destroyed was 13 tons 14 cwts. 0 qr. 23 lb. The diseases which affected animal food are set out in detail on page 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, 206; meat, provisions, rabbits, tinned foods, etc., stalls, 22; food preparation establishments, 16; fish shops, 100; fish stalls, 12; fruit shops, 190; and about 60 fruit, etc., stalls and barrows. To these 17,246 visits were paid, apportioned as follows: Butchers, Provision Dealers, etc., Shops 6,997 visits. Food Preparation Establishments 311 „ Butcher, Provision, etc., Stalls 1,325 „ Fish Shops 1,624 „ Fish Stalls 673 „ Fruit Shops 2,456 „ Fruit Stalls 3,860 „ Total 17,246 „ Prosecutions.—A juvenile was found exposing unsound pears for sale on a barrow at the Metropolitan Cattle Market on behalf of his father who was not present at the time, and summonses were taken out against the father and the son. On the case being heard, the father did not appear, as it was said he had been called up by the Army owing to the coal strike. The summonses were therefore adjourned sine die. Cowsheds.—There are 4 cowsheds within the Borough, and these received 42 visits and were found generally satisfactory. Offensive Trades include 4 tripe dressers, 2 gut scrapers, and the knackers' yard which received a total of 61 visits. No serious complaint was recorded against them. 39 [1921 Tabulation of meat and organs diseased or unsound as discovered in slaughter-houses during the year 1921: No. of Cases. Description of Animal Affected. Nature of Disease or Affection. Extent of Disease. How disposed of. 6 Pig Tuberculosis Head Council's Destructor 1 Sheep Moribund Carcase Do. 3 Fœtus of Heifer Immature Entirely unwholesome Do. 9 Ox Parasitic (Dis. Hep.) Liver Do. 2 Ox Abscess Liver Do. Milkshops and Dairies.—At the close of the year there were 625 milkshops and dailies on the register, 25 having been added to it, while 8 were removed. They received 468 visits from the District Sanitary Inspectors, who served 44 notices, for the execution of various sanitary improvements and the cleansing of dirty utensils. ADULTERATION OF FOOD AND DRUGS. During the year 1,201 samples of foods and drugs were submitted for analysis by the Food and Drugs Inspector and 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. Of the total samples, 1,141 were reported to be genuine, and 60 adulterated, or 4 9 per cent. This percentage is 12 higher than in the previous year, and 3 2 per cent, below the average rate during the preceding 10 years. The greatest amount of adulteration occurred in the first and fourth quarters of the year, as is seen by the statement given below, when it was 5.4 and 7.7 per cent. respectively, and contrasted with 3.3 and 3.7 per cent. respectively in the second and third quarters. Examined. Genuine. Adulterated. Per cent. 1st Quarter 260 246 14 5.4 2nd „ 307 297 10 3.3 3rd „ 320 308 12 3.7 4th „ 314 290 24 7.7 The Year 1,201 1,141 60 4.9 Prosecutions.—37 summonses were issued under the Sale of Food and Drugs Act, of which 25 were successfully prosecuted. Altogether penalties and costs to the amount of £63 5s. 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. No. of Samples. Solids not Fat. Fat. Total Solids. Milk purchased on Sundays 151 8.83 3.34 12.17 Milk purchased on week-days 371 8.79 3.37 12.16 Milk procured in transit at Finsbury Park Station 122 891 3.73 12.64 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 151 145 6 4.0 On Week-days 371 342 29 7.8 At Railway Stations 122 118 4 3.3 (Farmers' Milks) 644 605 39 60 1921] 40 Giving the particulars of the Milks taken during each quarter of 1921 on Sundays, Week-days, and at the Railway Stations. 1921 No. of Samples Taken. Genuine. i Adulterated. Per cent. Adulterated. Quarters. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. AH Milks. Sundays. Weekdays. Railway Stations. All Milks.  1st Quarter 40 102 32 174 37 94 31 162 3 8 1 12 7.5 7.8 3.1 6.9 2nd ,, 41 83 30 154 40 77 29 146 1 6 1 8 2.4 7.2 3.3 5.2 3rd ,, 40 90 30 160 40 82 30 152 — 8 — 8 - 8.9 — 5.0 4th ,, 30 96 30 156 28 89 28 145 2 7 2 11 6.6 7.3 6.6 7.0 The Year 151 371 122 644 145 342 118 605 6 29 4 39 4.0 7.8 3.3 6.0 The number of samples of milk purchased was 644, of which 605 were genuine and 39, or 6.0 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. Adulterated. Samples Analysed. Genuine. Adulterated Per cent. Adulterated. 1892 171 139 32 18.7 1909 605 563 42 6.9 1893 213 173 40 18.7 1910 621 563 58 9.3 1894 206 169 37 17.9 1911 601 542 59 9.8 1895 413 343 70 16.9 1912 606 573 33 5.4 1896 468 418 50 10.6 1913 600 555 45 7.5 1897 513 464 49 9.5 1914 595 539 56 9.4 1898 543 492 51 9.4 1915 605 531 74 12.2 1899 532 477 55 10.3 1916 599 506 93 15.5 1900 541 485 56 10.3 1917 592 526 66 11.1 1901 632 556 76 12.0 1918 634 537 97 15.3 1902 586 528 58 9.9 1919 638 579 59 9.2 1903 508 458 50 9.8 1920 642 605 37 5.7 1904 600 553 47 7.8 Totals 15,693 14,092 1,601 10.2 1905 594 549 45 7.6 1906 634 560 74 11.8 1907 597 557 40 6.7 1921 644 605 39 6.0 1908 604 552 52 8.6 Showing the analyses of 13,139 milks examined in Islington during the 22 years 1899-1920 and 1921 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 nonfatty solids. Per cent. of fat. No. of Samples Per cent. of nonfatty solids. Per cent. of fat. No. of Samples Per cent. of nonfatty solids. Per cent. of fat. 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 1920 162 8.71 3.42 338 8.76 3.52 142 8.86 3.66 Total samples and average constituents (22 years). 3,657 8.58 3.59 6,818 8.31 3.57 2,664 8.76 3.81 1921 151 8.83 3.34 371 8.79 3.37 122 8.91 3.73 41 [1921 Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1921. Description. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Totals. Genuine. Adulterated. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Totals. 1st Qr- 2nd Qr. 3rd Qr- 4 th Qr. Totals. Milk 171 153 157 150 631 161a 145a 149a 139a 594 10a 8a 8a 11a 37 Milk (skim) 2 - - - 2 - - - - - 2a - - - 2 Milk (separated) 1 1 3 6 11 la la 3a 6a 11 - - - - - Butter 31 55 63 70 219 31 55 63 67 216 - - - 3 3 Lard 8 5 6 5 24 7 5 6 5d 23 1 - - - 1 Dripping 4 5 5 5 19 4 5 4 5d 18 - - 1c - 1 Coffee 5 7 12 7 31 5 7 12 7 31 - - - - - Cocoa 8 7 9 13 37 8 7 9 1 37 - - - - - Ground Ginger 1 4 4 - 9 1 4 4 - 9 - - - - - Self-Raising Flour 1 5 2 1 9 1b 5b 2b 1b 9 - - - - - Mustard 3 2 5 - 10 3 1 5 - 9 - 1 - - 1 Pepper 6 8 6 4 24 6 8 6 4 24 - - - - - Baking Powder 2 1 — - 3 2b lb - - 3 - - - - - Malt Vinegar — - 2 16 18 - - 1 11 12 - - 1 5 6 Vinegar - 1 3 3 7 - 1 3 3 7 - - - - - Arrowroot 2 7 3 7 19 2 7 3 7 19 - - - - - Desiccated Cocoanut 1 - - - 1 1 - - - 1 - - - - - Cocoa Powder 1 - - - 1 1 - - - 1 - - - - - Rice 1 7 3 3 14 1 7 3 3 14 - - - - - Demerara Sugar 1 — - - 1 1 - - - 1 - - - - - Cheese - 10 10 10 30 - 10 10 10 30 - - - - - Yeast — 5 1 - 6 - 5 1 - 6 - - - - - Condensed Milk (full cream) - 1 - - 1 - 1 - - 1 - - - - - Crushed Linseed - 4 2 - 6 - 4 2 - 6 - - - - - Frozen Liquid Eggs — - - 2 2 - - - 1 1 - - - 1 1 Melange — - - 1 1 - - - - - - - - 1 1 Sodium Bicarbonate 1 - - - 1 1 - - - 1 - - - - - Olive Oil — 3 8 1 12 - 3 8 1 12 - - - - - Carbonate of Magnesia — 2 - - 2 - 2 - - 2 - - - - - Cream of Tartar — 2 1 - 3 - 2 - - 2 - - 1 - 1 Camnhorated Oil - 2 4 - 6 - 1 4 - 5 - 1 - - 1 Almond Oil — — 1 — 1 — - 1 - 1 - - — — - Margarine 250 297 310 304 1,161 237 287 299 283 1,106 13 10 11 21 55 10 10 10 10 40 9 10 9 7d 35 1 — 1 3d 5 Totals 260 307 320 314 1,201 246 297 308 290 1,141 14 10 12 24 60 a All samples free from Boric Acid and Formalin. b Conformed with the Local Government Board's recommendations as to Arsenic and Calcium Sulphate. c Contrary to Sale of Food Order, 1921. d All samples conformed with Sale of Food Order, 1921. Milk Prosecutions. The summary of prosecutions showed that during the year 34 prosecutions were taken, of which number 18 were successful, and 15 were dismissed, while one was withdrawn. Summary of Prosecutions during year 1921. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties Received. £ s. d. "Public Health (London) Act, 1891 " 45 40 1* 4† 120 19 0 "Sale of Food and Drugs Acts, 1875-99" 37 25 11§ 1|| 63 5 6 "Margarine Act, 1887" Nil — - - — Total 82 65 12 5 184 4 6 * Summons dismissed on a point of law. † Withdrawn upon payment of costs. § Warranties were established in eight cases; one summons was dismissed on a point of law, while two were alternative summonses. || Summons withdrawn owing to smallness of percentage of adulteration. APPENDIX. VITAL AND SANITARY STATISTICS, 1921. together with the PRESCRIBED RETURNS OF THE MINISTRY OF HEALTH AND Abstracts for Previous Years. 43 [1921 STATISTICAL APPENDIX. Table A. Showing the Deaths from all Causes in Islington during the Year 1921 Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. Deaths in Institutions within Borough. diseases. ages. Under 5 Over 5 districts. Males. Females. Totals. 0- 1- 5- 10- 15- 20- 25- 35 45- 55- 85- 75- 85- Tuf. U.H. Toll. L.H. H. B. s.e. Small Pox (a) Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - (b Unvaccinated - - - - - - - - - - - - - - - - - - - - - - - - - - (c) No Statement - - - - - - - - - - - - - - - - - - - - - - - - - 10 Measles 5 22 - - - - - - - - - - - - - - 1 10 1 1 8 l6 11 2/ 2 Scarlet Fever - 2 10 4 - 1 - 1 - 1 - - - 2 17 2 2 — 2 2 3 8 10 9 19 Typhus Fever - - - - - - - - - - - - - - - - - - - - - - - - - 19 Epidemic Influenza 2 3 - 1 2 3 9 15 18 13 14 8 5 5 88 11 15 5 !7 18 11 16 43 50 93 10 Whooping Cough 22 19 1 1 - - - - - - - - - 41 2 1 4 3 5 10 8 12 23 20 43 3 Diphtheria 3 47 47 10 1 1 - - 1 - - - - 50 60 8 31 8 11 11 7 34 61 49 110 Enteric Fever - - - - - - 1 - - - - `- - - 1 - - - 1 - - - 1 - 1 Asiatic Cholera - - - - - - - - - - - - - - - - - - - - - - - - - 19 Diarrhœa, Dysentery 48 6 1 - - - 1 - 1 - - 5 - 54 8 4 5 7 13 8 12 13 30 32 62 3 Epidemic Enteritis 16 3 2 - - - 1 - - - - 1 - 19 4 7 2 4 4 - 2 4 15 8 23 3 Other Allied Diseases **‡3 *‡‡3 - - - *1 - *1 - - - - - 6 2 - - 1 1 1 4 1 4 4 8 Hydrophobia - - - - - - - - - - - - - - - - - - - - - - - - - Glanders - - - - - - - - - - - - - - - - - - - - - - - - - Tetanas - - 1 - - - - - - - - - - - 1 1 - - - - - - 1 - 1 Aetanas - - - - - - - - - - - - - - - - - - - - - - - - - Cow Pox - - - - - - - - - - - - - - - - - - - - - - - - - 3 Syphilis 10 - - - - - - 1 - 2 - - - 10 3 1 - 1 2 5 1 3 7 6 13 Gonorrhœa 1 - - - - - - 1 - 2 - - - 1 3 - 1 1 - 1 - 1 3 1 4 Phagedæa - - - - - - - - - - - - - - - - - - - - - - - - - 2 Erysipelas - - - - - - - 1 1 1 1 1 - - 5 - - 1 1 1 - 2 3 2 5 4 Puerperal Fever - - - - - 1 8 3 - - - - - - 12 - 1 1 1 5 3 1 - 12 12 4 Pyæmia 2 - 1 - - - 1 3 2 3 - - 2 2 12 3 2 — 2 3 2 2 6 8 14 Infective Endocarditis - - - - - 5 6 7 1 1 1 - - - 21 - 2 2 4 2 6 5 8 13 21 5 Other Allied Diseases - - - - 1 1 - 2 2 1 1 - - - 8 - 1 - 1 1 1 4 5 3 8 Malarial Fever - - - - - - - - - - — - - - - - - - - - - - - - - Rheumatic Fever - - 1 4 1 1 2 1 1 1 1 - - - 13 1 2 2 3 3 2 - 5 8 13 Rheumatism of Heart. - - - 2 - 1 1 - - - - - - - 4 - 1 - - 1 - 2 1 3 4 10 Tuberculosis of Brain 8 10 5 1 - - 1 - - - - - - 18 7 4 3 3 3 1 5 6 10 15 25 Tuberculosis of Larynx - - - - - - - - - - - - - - - - - - - - - - - - - 89 Phthisis 5 8 2 7 27 39 66 75 74 39 11 4 - 11 344 40 50 29 40 53 50 93 197 158 355 7 Abdominal Tuberculosis 2 3 1 1 2 3 - 1 1 - 1 - - 5 10 - 3 1 1 4 2 4 4 11 15 1 General Tuberculosis - 2 1 - - - - 1 - - - - - 2 2 1 - - - 1 1 1 1 3 4 3 Other forms Tubercu- - 2 1 1 1 - 3 1 - - 1 1 2 9 - 2 - 2 2 1 4 5 6 11 Other Infective Diseases - - - - - - - - - - - - - - - - - - - - - - - - - Thrus - - - - - - - - - - - - - - - - - - - - - - - - - Actinomycosis - - - - - - - - - - - - - - - - - - - - - - - - - Hydatid Diseases - - - - - - - - - - - - - - - - - - - - - - - - - Scurvy - - - - - - - - - - - - - - - - - - - - - - - - - Other Diseases due to Alter eel Food - - - - - - - - - - - - - - - - - - - - - - - - - Acute Alcoholism - - - - - - - - - - - - - - - - - - - - - - - - - Chronic Alcoholism - - - - - - - - - - - - - - - - - - - - - 1 1 1 2 Chronic Industrial onings - - - - - - - - - - - - - - - - - - - - - - - - - Other Chronic ings - - - - - - - - - 1 - - - - 1 - 1 - - - - - - 1 1 Osteo-arthritis . 1 - - - 1 - - - 1 4 7 4 - 1 17 - 2 1 6 3 3 4 8 10 18 1 Gout - - - - - - - - 1 - 3 - - - 4 - 1 - - 1 - 2 2 2 4 149 Cancer 2 - 1 - 1 - 10 34 98 140 131 52 6 2 173 58 82 40 39 81 79 118 221 54 475 Diabetes Mellitus - - - - - - 1 3 2 7 10 - 1 - 25 3 3 2 3 4 3 7 7 - - Purpura ca 2 - - - - - - - 1 - 1 - - 2 2 1 - - 1 1 - 1 - 4 4 Haemophilia 1 - - - - - - - - - - - - 1 - - - - 1 — - - - 1 1 Anæmia 1 - - 2 - 1 2 4 2 2 5 1 - 1 20 1 - 2 3 3 5 7 10 11 21 Lymphadenoma - - 1 - - - 2 - - - 1 - - - 5 1 - 1 - 1 - 2 5 - 5 Premature Birth 107 1 - - - - - - - - - - - 108 - 12 10 9 12 21 22 22 60 48 108 Iniurv at Birth 10 - - - - - - - - - - - 10 - 2 3 - - - 2 3 6 4 10 Debility at Birth 9 - - - - - - - - - - - - 9 - 1 - - 2 - - - - - - Atelectasis 12 - - - - - - - - - - - - 12 - 2 - 1 1 - - - 6 6 12 Congenital Defects 29 1 1 30 1 1 2 4 8 5 8 5 21 10 31 Want of Breast Milk 1 - - - - - - - - - - - - 1 - - - - - - - - 1 - 1 Atrophy, Debility, Marasmus 73 1 - - - - - - - - - - - 74 - 10 7 7 5 12 12 21 40 34 74 * Cerebro-Spinal Meningitis. †Post Basic Meningitis. ‡ Chicken Pox. || Encephalitis Lethargica. § Po.iomyelitis. 1921] 44 Table A.— Continued. Deaths in Institution? within Borough. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals.| 0- 1- 5- 10- 15- 20- 25- 35- 45 55- 65- 75- 85 Tuf. U.H. Toll. L.H. H. B. S.E. Dentition 2 1 - - - - - - - - - - - 3 - - 2 - - ] - - 2 1 3 Rickets 2 3 - - - - - - - - - - - 5 - - - - 1 - 1 3 2 3 5 Old Age, Senile Decay - - - - - - - - - 2 59 188 76 - 325 37 41 27 30 58 61 71 117 208 325 Convulsions 12 - 1 - - - - - - - - - - 12 1 - 2 1 1 6 2 1 5 8 13 Meningitis 1 2 1 1 3 1 1 - - - - - - 3 7 - 2 - 1 3 1 3 4 6 10 Encephalitis - - 1 - - - - - 1 - - - - - 2 - 1 - - - - 1 1 1 2 Apoplexy - 1 1 - 1 - 1 4 17 32 70 32 3 1 161 17 18 20 18 23 24 42 65 97 162 Softening of Brain - - - - - - - - 1 2 - - - 3 - - - 1 2 - - 2 1 3 Hemiplegia 1 - - - - - - 1 1 6 7 5 1 1 21 2 2 4 1 2 5 6 13 9 22 General Paralysis of the Insane - - - - - 1 1 10 9 9 2 - - - 32 7 1 2 6 5 7 4 27 5 32 Other forms of Insanity - - - - - - 1 2 1 3 4 2 - - 13 3 1 - 1 2 - 6 6 7 13 Chorea - - - - - - - - - - - - - 1 - - - - - - - - - 1 1 Cerebral Tumour - - - 1 - - - 2 1 1 2 - - - 7 1 - 1 2 - 2 1 1 6 7 Epilepsy - - - - 4 - 2 2 4 3 2 - - - 18 - 2 3 5 3 2 3 2 6 12 18 Laryngismus Stridulus - - - - - - - - - - - - - - - - - - - - - - - - - Locomotor Ataxy - - - - - - - - 5 4 5 - - - 14 1 2 - 5 2 2 2 13 1 14 1 Paraplegia 1 - - - 1 - - 3 6 9 11 2 - 1 5 6 4 2 6 1 9 17 33 1 Other foms, Brain Diseases - 1 - - §3 - ||1 - ||3 2 4 1 - 1 14 2 - 3 2 3 2 3 9 6 15 Otitis 1 3 3 1 2 - 1 - - - 1 - - 4 8 - 4 1 2 1 2 2 8 4 12 Disease of Nose, Epistaxis - - - - - - - - - - - - - - - - - - - - - - - - - Disease of Eye - - - - 1 - - - - - - - - - 1 - - - - - - 1 - 1 1 2 Pericarditis - - - 1 2 - - - - - 1 - - - 4 - 1 - - - 2 1 3 1 4 1 Endocarditis - - - - - 1 2 1 2 4 4 4 2 - 20 1 1 2 2 1 6 7 3 11 20 Hypertrophy of Heart. - - - - - - - - - - - - - - - - - - - - - - - - - Angina Pectoris - - - - - - - - 1 2 1 3 1 - 8 2 1 - - 3 - 2 6 2 8 1 Aneurism - - - - - - - 2 3 6 4 - - - 15 1 - 2 2 2 5 3 14 1 15 3 Senile Gangrene - - - - - - - - 1 2 1 4 - - 8 - 1 - 1 2 3 1 5 3 8 5 Embolism, Thrombosis 1 - - - - - - 1 2 6 6 9 2 1 26 4 1 3 3 5 6 5 13 14 27 Phlebitis - - - - - - - 1 — 1 1 1 - - 4 - 1 1 - - 2 - 2 2 4 Varicose Veins - - - - - - - - - 1 - - - - - 1 - - - - 1 - - - 1 1 145 Other Diseases, Heart and Vessels 7 2 6 7 6 10 33 58 109 185 115 26 7 557 69 63 57 43 90 77 165 276 288 564 Laryngitis 2 2 1 - - - - - 1 - - - - 4 2 1 1 - 1 1 1 1 2 4 6 Croup - 1 - - - - - - - - - - - 1 - - - - - 1 - - - 1 1 Other Diseases, Larynx and Trachea . - - - - - - - - - 1 - - - - 1 - - - - - 1 - 1 - 1 20 Acute Bronchitis 14 9 - - - - 1 4 10 8 25 21 4 23 73 4 13 10 11 16 14 28 44 52 96 73 Chronic Bronchitis 12 6 - - 1 - 3 6 17 36 79 64 10 18 216 20 15 14 28 35 57 65 1 0 7 127 234 18 Lobar Pneumonia 2 11 4 - 2 2 7 9 13 11 11 5 - 13 64 6 8 11 14 11 10 17 48 29 77 38 Lobular Pneumonia 76 46 5 2 1 2 2 5 10 10 13 12 2 122 64 10 14 14 35 30 41 42 102 84 186 8 Pneumonia 12 9 2 1 2 1 1 9 6 9 12 4 1 21 48 7 4 7 6 13 7 25 42 27 69 3 Emphysema, Asthma - - - - - - 1 1 5 4 4 2 - - 17 4 - - 4 - 2 7 9 8 17 1 Pleurisy 2 2 - - - - 1 1 - 1 3 - - 4 6 1 - - 3 3 2 1 4 6 10 5 Other Diseases, Respiratory System 2 3 2 - - 2 3 - 5 2 - - 1 5 15 1 3 2 - 4 3 7 12 8 20 Diseases of Mouth and A nnexa - - 1 - - - 1 1 - - - - - - 3 - 1 - 1 - 1 - 3 - 3 Diseases of Pharynx - - 2 - - - - - - 1 - - - - 3 - 2 - - - - J 1 3 Diseases of (Esophagus 1 1 2 - 1 Ulcer of Stomach and Duodenum - - - - - 1 2 7 7 3 4 2 - - 26 3 1 3 8 5 3 3 20 6 26 Other Diseases of the Stomach 9 - 1 - - 1 - - 1 9 1 - - 9 7 2 2 1 1 3 1 6 9 7 16 45 Enteritis 74 14 2 - - - - 2 1 4 3 1 - 13 4 7 11 18 16 21 24 57 44 101 7 Appendicitis - 3 3 1 6 1 1 - 6 2 1 1 - 3 22 5 1 5 2 3 4 5 16 9 25 Obstruction of Intestine 8 1 2 - - - 3 2 4 8 7 6 1 9 33 2 8 5 5 3 5 14 20 22 42 Other Diseases of Intestine 1 - - - - - 1 1 - 2 1 - - 1 5 1 - - 1 1 2 1 3 3 6 5 Cirrhosis of Liver - - - - - - 1 1 3 9 - 2 - - 16 1 3 - 4 3 3 2 10 6 16 Other Diseases of Liver 1 - - - - - 1 1 1 2 3 1 - 1 9 1 - - 3 2 2 2 4 6 10 1 Peritonitis 1 - - 2 - - - - 2 1 1 - - 1 6 1 - - - 1 1 4 3 4 7 Other Diseases, Digestive System .. - - - - - - - - - - 1 - - - 1 1 - - - - - - - 1 1 Diseases, Lymphatic System and Glands - - - - - 2 - 2 2 4 3 l - - 14 2 1 1 6 2 - 2 6 8 14 6 Acute Nephritis - - - - 1 - - 2 3 2 2 - - - 10 - - 3 - 1 1 5 5 5 10 27 Bright s Disease - - - 1 1 1 2 6 22 23 30 13 2 - 101 6 17 6 11 23 11 27 50 51 101 Calculus - - - - - - - 1 1 1 3 - - - 6 - - - 2 1 - 3 3 3 6 Diseases of Bladder and Prostate - - - - - 1 - - 2 8 10 9 3 - 33 2 5 3 5 5 3 10 32 1 33 Other Diseases, Urinary System - 1 1 - - - 2 - 3 3 4 2 2 1 17 3 1 2 1 2 3 6 10 8 18 Diseases of Testis and Penis - - - - - - - - - - - - - - - - - - - - - - - - - Diseases of Ovaries - - - - - 1 - 1 1 1 - - - - 4 1 1 - - 1 1 - - 4 4 Diseases of Uterus and Appendages - - - - - 1 1 1 - - 1 - - - 4 - - - 1 1 1 1 - 4 4 Diseases of Vagina and External Genitals - - - - - - - - - - - - - - - - - - - - - - - - - Diseases of Breast - - - - - - - - - - - - - - - - - - - - - - - - - Abortion, Miscarri.ige. - Puerperal Mania - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Convilsions - - - - - - - 1 - - - - - - 1 - - - - 1 - - - 1 1 Placenta Praevia, Flooding - - - - - 2 - - - - - - - - 2 - - - 1 - 1 - - 2 2 Cerebro spinal Meningitis. † Post Basic Meningitis. ‡ Chicken Pox. || Encephalitis Lethargica § Poliomyelitis. 45 [1921 table A.—Continued. Deaths in Institution within Borough. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Female. Total. 0- 1- 5- 10- 15- 20- 25 35 45- 55- 65- 75 85 Tuf. U.H. Toll. L.H. H. B. S.E Puerperal Thrombosis. — — — — — — — — — — — — — — — — — — — — — — — — — Other Diseases, Pregnancy and Childbirth — — — — — — — 2 — — — — — — 2 1 — _ — — — 1 — 2 2 Arthritis, Ostitis, Periostitis — — — — — — — — — — — — — — — — — — — — — — — — — Other Diseases, Osseous System — 1 — 1 — — — — 1 — — — — 1 2 — — — — 1 1 — — 2 3 Ulcer, Bedsore — — — — — — — — — — — — — — 3 1 — — — 1 1 — 2 1 3 Eczema 2 — — — — — — — — — — — — 1 — — — — — 2 — — 1 1 2 Pemphigus 3 1 — — — — — — — — — 1 1 4 2 1 1 — — 1 — 3 5 1 6 Other Diseases, Integumentary System 2 — — — — 1 1 2 — 2 — 1 — 2 6 3 1 — — 1 2 1 4 4 8 Accidents and Negligence. In Mines and Quarries. — — — — — — — — — — — — — — — — — — — — — — — — — 15 In Vehicular Traffic — 3 3 2 5 — 1 1 4 7 5 5 — 3 33 — 2 2 5 6 9 8 23 13 36 On Railways — — — — — — 1 — 1 — 1 — — — 3 1 1 1 - — — 3 — 3 On Ships, Boats, etc. (not drowning) — — — — — — — — — — — — — — — — — — — — — — — — — 1 In Building Operations — — — — — — — 2 — 1 — — — — 3 ! — 1 — — 1 — 3 — 3 By Machinery . — — — — — — — — — — — — — — — — — — — — — — — — — 1 By Weapons and Implements — — — — — 1 1 — 1 — — — — 3 1 — — 1 — 1 — 3 — 3 6 Burns and Scalds — 6 — — — — — 1 1 — — 2 — 6 4 — — 1 — 4 2 3 4 6 10 2 Poisons, Poisonous Vapours . — — — — — — 1 1 — — — — — — 2 — — — 2 — — — — 2 2 Surgical Narcosis 1 — 1 — — — — — — — — — — 1 1 — — — — 2 — — 2 — 2 Effects of Electric Shock — — — — — — — — — — — — — — — — — — — — — — — — — Corrosions by Chemicals — — — — — — — — — — — — — — — — — — — — — — — — — Drowning — — — — — — — 1 3 — — — — — 4 — — — 2 I — 1 4 — 4 Suffocation, Overlaid in Bed 3 — — — — — — — — — — — — 3 — — — — 1 — 1 1 1 2 3 Suffocation, Otherwise 5 1 1 — — 1 — — — — — — — 6 2 1 2 — — 1 3 l 5 3 8 12 Falls not specified 4 — 2 — — — — 1 2 2 3 4 4 4 18 2 1 1 2 5 6 5 12 10 22 Weather Agencies — — 1 — — — — — — — — — — — 1 — — — — — — — 1 — 1 Otherwise, not stated 1 — — — — — — — — — 1 — — 1 1 — — — — — 1 1 1 1 2 1 Homicide 1 — — — — — 1 1 — — — — — 1 2 — 1 2 — — — — 1 2 3 Suicide. 1 By. Poison — — — — 1 1 2 3 4 3 3 — 1 — 18 3 1 1 2 3 2 6 12 6 18 By Asphyxia — — — — — — — — — — — — — — — — — — — — — — — — — By Hanging and Strangulation — — — — — — — 1 3 2 1 7 1 2 1 1 2 7 7 By Drowning — — — — — 1 — 3 3 — — — — — 7 — 1 — 1 1 2 2 6 1 7 By Shooting — — — — — — — — — — 1 — — — 1 — — — 1 — — — 1 — 1 1 By Cut or Stab — — — — — — — 2 2 1 — — — — 3 1 1 — 1 — — 2 5 — 5 1 By Precipitation from Elevated Places — — — — — — — — — — — — — — — — — — — 2 — — 1 1 2 By Crushing — — — — — — — — — — — — — — — — — — — — — — — — — By other and unspecified methods. — — — — — — — — — — — — — — — — — — — — — — — — — Execution — — — — — — — — — — — — — — — — — — — — — — — — — Sudden Death, cause not ascertained — — — — — — — — — — — — — — — — — — — — — — — — — Ill-defined and unspecified causes — — 1 — — — — — — — — — — — 1 — — — — 1 — — — 1 1 Males 362 138 75 19 34 38 96 162 269 336 384 252 47 500 1712 205 250 181 274 374 362 566 — — 2212 Females 279 125 47 36 48 52 82 141 205 262 416 353 110 404 1752 232 242 196 250 340 353 543 — — 2156 815 TOTAL DEATHS 641 263 122 55 82 90 178 303 474 598 800 605 157 904 3464 437 492 377 524 714 715 1109 2212 2156 4368 1921] 46 TABLE B. Showing the Births and Birth Rates of Islington from 1841 to 1920. Year. Births. 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 34.79 1902* 9214 27.06 1843 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 9667 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 7674 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* 3964 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 28.07 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 9404 27.97 1851-60 41915 34.54 1871-80 89627 36.60 1891-1900 97278 29.31 1911-20 74375 22.85 * These years contained 53 weeks. 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 303 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 1851 1861 1871 1881 1891 1901 1911 7 yrs. 449 to 1,335 to 2,651 to 3,429 to 3,475 to 2,719 to 2,413 to 2,719 1860 1870 1880 1890 1900 1910 1920 * The births in these years cannot be ascertained. 47 [1921 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 4340 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 1845 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. 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 Islington, 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 1,000 births 1841 190 131 1861 748 135 1881 1,400 140 1901 1,290 139 1842* 224 149 1862 725 130 1882 1,403 140 1902* 1,219 132 1843 — — 1863 906 147 1883 1,312 133 1903 1,136 126 1844 — — 1864 969 153 1884* 1,506 150 1904 1,140 128 1845 267 164 1865 1,088 161 1885 1,387 143 1905 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 yrs.) 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 605 146 1875 1,306 145 1895 1,416 139 1915 805 107 1856 612 142 1876 1,397 152 1896* 1,490 150 1916 634 87 1857 642 140 1877 1,302 140 1897 1,338 136 1917 565 97 1858 648 142 1878* 1,453 154 1898 1,504 159 1918 571 110 1859 665 133 1879 1,340 135 1899 1,548 160 1919* 525 83 1860* 747 144 1880 1,517 154 1900 1,344 145 1920 676 72 1851-60 6,008 143 1871-80 13,144 147 1891-1900 14,362 148 1911-20 7,273 99 * These years contained 53 weeks. 1921] 48 TABLE F. Showing the Cases of Infectious Diseases in Islington in Quinquennial Periods, 1891-1920. Year. Smallpox. Scarlet Fever. Diphtheria and Mmbranous Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Notifications. Attack rates per 1,000 Population. 1891 1 728 756 189 2 343 33 6 1 2,059 6.43 1892 42 1,709 738 219 550 51 6 3 3,318 10.26 1893 118 2,880 885 251 1 672 38 7 1 4,853 14.84 1894 90 1,493 867 245 1 395 23 7 — 3,121 9.44 1895 25 1,692 582 184 5 320 22 9 — 2,839 8.50 1891-5 276 8,502 3,828 1,088 9 2,280 167 35 1 4 16,190 9.90 1896* 50 2,031 1,091 229 — 385 30 6 2 3,824 11.32 1897 3 1,577 729 256 312 27 1 — 1 2,906 8.62 1898 1,336 544 237 2 279 19 1 — — 2,418 7.18 1899 3 1,494 705 353 350 33 2 — 3 2,943 8.75 1900 2 1,074 633 259 1 285 16 6 — — 2,276 6.78 1896-1900 58 7,512 3,702 1,334 3 1,611 125 16 2 4 14,367 8.53 1901 50 1.286 911 281 2 285 34 3 — 2,852 8.51 1902* 276 1,372 878 257 — 357 19 5 — — 3,164 9.29 1903 9 865 455 130 — 227 19 2 — — 1,707 5.12 1904 17 1,146 347 126 1 280 24 — — — 1,941 5.84 1905 3 1,198 351 100 — 252 24 — — — 1,928 5.81 1901-05 355 5,867 2,942 894 3 1,401 120 10 — 11,592 6.96 1906 1 1,386 439 149 1 274 24 1 — — 2,275 6.87 1907 — 1,216 481 92 — 252 21 1 — — 2,063 6.25 1908* 1,409 530 97 235 17 1 — — 2,289 6.82 1909 3 1,285 430 95 1 221 14 — — — 2,049 6.23 1910 1 730 471 89 1 212 20 1 — — 1,525 4.65 1906-10 5 6,026 2,351 522 3 1,194 96 4 — — 10,201 6.19 1911 804 593 73 275 14 — 1,759 5.37 1912 — 811 516 49 185 16 — — — 1,577 4.83 1913* 1,317 550 50 226 28 — — — 2,171 6.54 1914 1.853 659 76 334 25 — — — 2,947 9.08 1915 — 1,332 624 28 — 203 23 — — — 2,210 6.98 1911-15 — 6,117 2,942 276 — 1,223 106 — — — 10,664 6.58 1916 — 638 593 32 155 21 — 1,439 4.65 1917 478 561 23 173 16 — — — 1,251 4.21 1918 2 432 518 30 141 4 — — — 1,127 3.93 1919* 2 1,084 649 16 212 29 1 — — 1,993 6.05 1920 1,307 1,328 24 — 165 29 — — 2,853 8.49 1916-20 4 3,939 3,649 125 — 845 99 1 — — 8,663 5.47 49 [1921 Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING THE CALENDAR YEAR, 1921. Causes of Death. Nett Deaths at the subjoined Ages of "Residence" whether occurring within or without the District. All ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 and upwards Total Deaths whether of "Residents" or "Nonresidents" in Institutions in the District. I 2 3 4 5 6 7 8 9 10 l1 All Causes Certified 4332 633 145 119 172 172 474 1059 1558 1375 Uncertified — — — — — — — — Enteric Fever 1 — — — — — 1 — — — Small Pox — — — — — Measles 28 5 17 6 10 Scarlet Fever 19 — 2 2 13 1 1 — — 2 Whooping Cough 43 22 16 3 2 — 17 Diphtheria and Croup 111 3 9 39 57 2 1 14 Influenza 95 2 1 2 1 5 26 31 27 23 Erysipelas 5 — — 1 2 2 9 Phthisis (Pulmonary Tuberculosis) 351 5 3 3 8 65 136 116 15 148 Tuberculous Meningitis 25 8 3 7 6 1 15 Other Tuberculous Diseases 27 2 3 4 4 5 5 1 3 16 Cancer, malignant disease 472 2 — — 1 1 44 236 188 237 Rheumatic Fever . 12 — — 4 2 2 1 3 Meningitis 16 4 3 2 5 2 — — 1 Organic Heart Disease 517 5 — 8 14 44 164 282 210 Bronchitis 333 26 11 4 1 14 73 204 127 Pneumonia (all forms) 328 90 42 24 13 11 32 57 59 114 Other diseases of respiratory organs 53 5 4 2 4 2 7 19 10 15 Diarrhoea and Enteritis 179 134 19 4 5 4 3 10 69 Appendicitis and Typhlitis 24 1 2 4 7 1 7 2 15 Cirrhosis of Liver 16 — — 2 12 2 9 Alcoholism 2 — — — 1 1 Nephritis and Bright's Disease 110 — — — 1 2 10 50 47 54 Puerperal Fever 12 — — — — — 11 — — 6 Other accidents and diseases of Pregnancy and Parturition 7 — — — — 2 5 — — 1 Congenital Debility and Malformation, including Premature Birth 222 218 1 2 1 — — — — 12 Violent Deaths, excluding Suicide 97 15 2 8 8 7 12 19 26 60 Suicide 38 — — — 3 12 16 7 6 Other Defined Diseases 1189 87 8 7 30 36 100* 251 670 185 Diseases ill-defined or unknown — — — — — — — Totals 4332 633 145 119 172 172 474 1059 1558 1375 Sub-entries.—Included in above figures : Cerebro-spinal Meningitis 6 3 1 1 — 1 Poliomyelitis — — — Encephalitis Lethargica 2 — — — — — 1* 1* 1921] 50 Metropolitan Borough of Islington. INFANTILE MORTALITY DURING I HE CALENDAR YEAR 1921. Nett Deaths from stated Causes at Various Ages under One Year of Age. Cause of Death. Weeks. Total under 4 weeks Months. Total Deaths under 1 year Under 1 week 1-2 2-3 3-4 4 weeks and under 3 months 3-6 6-9 9-12 All -Certified 130 34 33 22 219 101 146 96 71 633 Causes. -Uncertified — — — — — — — — — — Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — — — Measles — 1 — — 1 — 1 3 5 Scarlet Fever — — — — — — — — Whooping Cough — — 1 — 1 2 4 7 8 22 Diphthiera, Croup — — — — — — — 2 1 3 Erysipelas — — — — — — — — — — Tuberculous Meningitis — — — — — — 2 5 1 8 Abdominal Tuberculosis — — — — — — — — 2 2 Other Tuberculous Diseases _ 1 — 1 1 1 2 5 Meningitis (not Tuberculous). — — — — — — 2* 1† 1 4 Convulsions. 1 3 1 7 2 2 — 1 12 Laryngitis — — — — — — — 1 1 2 Bronchitis — 1 1 2 4 5 7 5 5 26 Pneumonia (all forms) 2 3 7 2 14 22 22 18 14 90 Diarrhœa — — 1 — 1 13 27 14 6 61 Enteritis — — 2 2 4 13 30 15 11 73 Gastritis — — — — — 1 4 — 1 6 Syphilis. 1 1 — 2 4 2 4 1 — 11 Rickets — — — — — — — — 2 2 Suffocation, overlying 1 1 2 1 3 Injury at birth 9 — — — 9 — — — — 9 Atelectasis 11 — — — 11 1 — — — 12 Congenital Malformations 10 3 2 2 17 7 5 — 1 30 Premature birth 74 9 9 4 96 4 4 3 — 107 Atrophy, Debility and Marasmus 11 7 2 7 27 18 24 11 1 81 Other Causes 11 4 5 — 20 10 8 11 10 59 Totals 130 34 33 22 219 101 146 96 71 633 Nett Births legitimate 7,607 Nett Deaths in legitimate infants 599 in the year illegitimate 205 the year of illegitimate infants 34 * Cerebro Spinal Meningitis (2). † Post Basic Meningitis (1). LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1921. Premises. Number of Places. Number of Inspections 1921 Number of Notices 1921 Number of Prosecutions 1921 On Register at end of 1920 Added in 1921 Removed in 1921 On Register at end of 1921 Milk Premises 608 25 8 625 468 44 Nil Cowsheds 4 — 4 42 — —_ Slaughter-Houses 18 — — 18 925 — — Other Offensive Trade Premises 7 — — 7 61 — — Ice Cream Premises 242 — — 242 62 9 — Registered Houses Let in Lodgings 1,058 1 26 1,033 8,761 944 3 51 [1921 Total number of intimation notices served for all purposes 5,420 Insanitary houses— 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 283 Housing of the Working Classes— Number of houses inspected Nil Number of representations by householders Nil Number of representations by Medical Officer Nil Number of houses included in such representations Nil 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 Nil Number of houses included in such Closing Orders Nil 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 Number of buildings demolished Nil Number of Orders for repairs issued under Section 28 of the Housing Act, 1919 62 notices relating to 132 dwelling houses Number of houses repaired by local authorities Nil Number of houses closed on notice by owner that they could not be made fit 12 Total number of houses in the Borough about 40,000 Number of houses for the working classes— (a) Erected during year (Flats) 148 (b) In course of erection (Flats) 235 Number of houses occupied by the working classes about 26,700 Smoke nuisances— Number of observations 84 Number of warnings (letters sent) 61 Number of notices 3 Number of nuisances and complaints 114 Number of summonses Nil Underground Rooms— Number illegally occupied 3 Number closed or illegal occupation discontinued 3 Overcrowding— Number of rooms overcrowded 6 Number remedied 6 Prosecutions Nil 1921] 52 Cleansing— Number of adults cleansed 18 Number of children cleansed 4,635 Cleansing— Number of rooms or premises cleansed 7,348 Water supply to tenement houses— Premises supplied 63 Prosecutions Nil Sale of Food— Number of premises used other than ice cream premises, milk shops and cowsheds 606 Number of inspections 17,246 Disinfection shelter— Persons accommodated 43 Ophthalmia neonatorum regulations— Number of Notifications received during the year from certified midwives 28 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 43 Revenue Acts— Number of houses for which application were received during year 1 Number of tenements comprised therein 47 Number of tenements for which certificates were (a) granted 47 (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— (l) With respect to water supply to tenement houses Nil Mortuaries— Total number of bodies removed 313 Total number of infectious bodies removed 4