ISL 23 1924 SIXTY-NINTH ANNUAL REPORT ON THE Health and Sanitary Condition OF THE METROPOLITAN Borough of Islington. G. CLARK TROTTER, M.D., D.P.H., F.R.S.E. MEDICAL OFFICER OF HEALTH. London: Vail & Co., 170, Farringdon Road, E.C. 1. 142186 ii MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1924, to November, 1925.) Mayor. SIDNEY CHARLES HARPER. J.P Aldermen. FREDERICK EDWARD BRADSHAW FREDERICK MONTAGUE, M.P. Councillors. FREDERICK COPPING WILLIAM J. MITCHELL WILLIAM H. GALE WALTER FREDERICK NOKES THOS. L. HARROLD HENRY PENN JAMES T. HOARE WILLIAM T. RICKETTS HENRY JOHNSON WILLIAM T. SMITH SARAH JOHNSON WILLIAM GEORGE SPICER HERBERT S. JORDAN EDWARD TOMK1NS ABRAHAM LEVISON Chairman Councillor JORDAN Vice-Chairman Councillor SMITH MEMBERS OF THE MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1924, to November, 1925.) Aldermen. RICHARD MONTFORD, J.P. HENRY B. VORLEY, J.P. Councillors. VINCENT P. CATTERMOLE SARAH JOHNSON- GEORGE T. DICKINSON ARTHUR J. KENT CHARLES FRANCIS WILLIAM J. MITCHELL REGINALD FRANKLIN ALBERT E. PETTET WILLIAM HERBERT GALE WILLIAM T. RICKETTS JAMES T. HOARE KATE SHARP, J.P. ALBERT H. JACKSON HERBERT TICE HENRY JOHNSON GRACE WATSON Members appointed by the Council From outside their cum body. Lady ANDRF.WES, 10, Causton Road, Highgate, N 6 Mrs. COLEMAN, 76, Plimsoll Road, N. 4 Dr. ALICE VANCE KNOX, 15, South Grove, Highgate, N.6 Mrs. MANCHESTER. 12, St. George's Avenue, N. 7 Dr. KATE PLATT, 59, Queen Anne Street, W. 1 Mrs. RAMSAY, 74, Evershot Road, N.4 Mrs. MATILDA SOUTHGATE, J.P., 507, Caledonian Road, N.7. Mrs. VORLEY, "Fern Bank," Holly Part, Crouch Hill, N.4 Mr. WATT, 60, Highbury New Park, N.5 Chairman Councillor TICE, Vice-Chairman Councillor KATE SHARP, J.P. iii. SUMMARY of Vital Statistics in the Registration Year 1924. Population (Enumerated at Census, 1921) 330,737 persons ,, Estimated Mid Year 1921 337,100 persons Increase on Census population, 1921 6,663 persons Mean Population, ten years (1914-1923) 330,587 persons Area 3,092 acres Density (Mid-year 1924) 109 persons per acre Births Males 3,470 persons 6,799 Females 3,329 Birth rate 19.8 per 1,000 inhabitants Deaths from All Causes Males 2,096 persons 4,222 Females 2,126 Death rate 12.3 per 1,000 inhabitants Deaths from Principal Epidemic Diseases Males 109 227 persons Females 118 Death rate 0.66 per 1,000 inhabitants Deaths from All Tuberculosis Males 224 399 persons Females 175 Death rate 1.16 per 1,000 inhabitants Deaths from Respiratory Tuberculosis Males 194 340 persons Females 146 Death rate 0.99 per 1,000 inhabitants Infantile deaths under 1 year Males 261 Total 447 Females 186 Infantile mortality rate 66 per 1,000 births Excess of Births over Deaths 2,577 Rateable value of Borough of Islington £1,893,449 Sum represented by a penny rate £7,895 iv Public Health Department, Municipal Offices, Tyndale Place, N.l. To the Mayor, Aldermen and Councillors of the Mertopolitan Borough of Islington. I have the honour to submit the Annual Report on the Health and Sanitary Conditions of the Borough for the year 1924. Included are the statistical tables as prescribed by the Ministry of Health. The draft Report was submitted to the Public Health Committee in June, 1S)25. The death-rate for 1924 was 12.3. (The lowest recorded in the Borough records, which date from 1841, is that of the year previous 1923, 11.6.) The Maternity and Child Welfare Scheme, both organisations, Municipal and Voluntary, have worked in unison. The Infantile Mortality rate again—66 per 1,000 births—continues to be a record for Islington. During the year, owing to the congestion at Clerkenwell Police Court, the Borough Council supported the establishment of a Petty Sessions Court at the Town Hall. I am, Ladies and Gentlemen, Your obedient S[???]nt, Medical Officer of Health. REPORT OF THE Medical Officer of Health FOR THE YEAR 1924. SPECIAL REPORTS (OTHER THAN THE HEALTH OF THE BOROUGH; AND OUTSTANDING MATTERS BROUGHT BEFORE THE PUBLIC HEALTH OR MATERNITY AND CHILD WELFARE COMMITTEES DURING THE YEAR. SUMMARY. 1. Health Week—As regards educational propaganda, special efforts were made to arouse the interest of the citizens in Child Welfare and Health matters generally during Health Week. See page 9. 2. Petty Sessions.—A Court established to take Public Health cases formerly going to Clerkenwell Police Court, p. 58. 3. Smoke Nuisance, etc.—Observations to the number of 184 were made during the year, and two cases were proceeded with in Court, page 40. 4. Meat, Food and Drugs.—(a) The Labelling of Meat and. Eggs (Food Order, 1921), page 50. (b) Unsound Food, page 49. (c) Preservatives and Colouring Matter in Food, page 52. (d) Sophistication of Milk, page 55. (e) Dispensing of Prescriptions, page 54. (/) Wrapping of Food, page 58. 5. Health Visitation and work of Voluntary Centres, pp. 11-12. 0. Index to Report.—Pages 69-71. 2 1924] POPULATION. The Registrar-General estimated the population of the Borough at the middle of 1021 to have been 337,400. When compared with the previous year the increase is found to number 800 persons. In the Registration Year of 1924 there were 53 weeks, so that in order to obtain the rates comparable with other years they are calculated on a population the one-fifty-second part larger than the estimate. The last time there were 53 weeks in the registration year was in 1919. Where, however, figures are given for the Calendar Year, the calculations are based upon the estimated population of the Registrar-General (337,400). The following tables give the distribution of the population of the several sub-registration districts and wards, together with particulars of their areas and densities. Showing the Areas Densities and Estimated Populations of the Subregistration Districts at the Middle of year 1924, also the Populations at the Census 1921. Sub-Districts. Area. Acres. Estimated Acres to a person. Estimated Persons to an Acre. Estimated Population Mid-year 1924. Enumerated Population at Census 1921. Tufnell 411 0.0120 83 34,197 33,750 Upper Holloway 299 0.0091 110 32,933 35,721 Tollington 315 0.0101 99 31,279 30,832 Lower Holloway 406 0.0097 103 41,711 40,139 Highbury 749 0.0123 82 61,094 58,850 Barnsbury 310 0.0057 176 55,534 53,859 South East Islington 596 0.0074 135 80,652 77,586 The Borough 3,092 0.0092 109 337,400 330,737 Showing the Areas, Densities and Estimated Populations of the Wards at the Middle of the year 1924, also the Populations at the Census 1921. WARDS. Area in Acres Estimated Persons to an Acre or Density of Population. Estimated Population Mid-year, 1924. Enumerated Population Census, 1921 No. 1—Tufnell 411 83 34,197 33,750 2—Upper Holloway 299 110 32,933 35,721 3—Tollington 315 99 31,279 30,832 4—Lower Holloway 406 103 41,711 40,139 5—Highburry 417 78 32,643 33,417 6—Midmay 332 86 28,451 25,433 7—Thornhill 178 173 30,860 31,301 8—Barnsburry 138 179 24,674 22,558 9—St. Marry's 150 122 18,273 17,363 10—Canonburry 290 111 32,146 29,997 11—St. Peter's 156 194 30,233 30,226 The Borough 3,092 109 337,400 330,737 3 [1924 Shoving the Estimated Number of Persons living in Islington at the Mid-year 1924, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 14,844 14,510 29,354 5—15 31,040 30,301 61,401 15—25 25,980 31,720 57,700 25 35 24,907 30,368 55,335 35—45 21,596 25,979 47,575 45—55 18,898 20,578 39,476 55—65 12,149 13,831 25,980 65—75 6,411 8,433 14,844 75 and upwards 2,025 3,710 5,735 All ages 157,910 179,490 337,400 MARRIAGES. Marriages, 2.872; Marriage Rate, 17 0.—The number of persons married was 5,744, as contrasted with 5,528 in the preceding year, which is an increase of 216. The marriage rale was 17.0 per thousand inhabitants, as compared with 16.4 in 1923. The following statement shows the figures for the previous ten years 1914-23. Years. Marriages. Marriage Rate. Years. Marriages. Marriage Rate. 1914 3,188 19.63 1919 3,306 19.28 1915 4,252 26.12 1920 3,370 20.05 1910 3,080 18.30 1921 3,141 18.86 1917 2,689 10.23 1922 2,877 17.23 1918 2,971 18.51 1923 2,764 16.42 BIRTHS. There were 6,799 births registered, of which 3,470 were boys, and 3,329 girls. Of this number, however, 1,065 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 19.8 per 1,000 of the population, as compared with a mean birth-rate of 22.6 in the preceding ten years. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1924, 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 1923; together with the mean Borough Birth-rates for the 10 years 1914-1923. Quarter. Males. Females. Total. Birth Rates. Islington, 1924. Islington, 1914-23. London, 1924. 105 Great Towns, 1924. First 885 854 1,739 20.6 23.2 19.8 20.0 Second 807 835 1,702 20.2 23.1 19.5 20.1 Third 900 820 1,726 20.5 21.7 19.3 19.8 Fourth 818 814 1,632 18.0 21.7 17.6 18.1 The Year 1924 3,470 3,329 *6,799 19.8 22.6 18.7 19.4 1923 3,493 3,607 7,100 21.1 19.8 20.2 20.4 Increase or decrease — 23 — 278 - 301 — 1.3 — 2.8 — 1.5 — 1.0 * These include 1.065 births which occurred in Lying-in Institutions, etc., outside the Borough. N.B. The total registered births given by the Registrar-General for the Calendar year, 1924, will be found at the foot of table on p. 8. 4 1924] Showing the Births of Males and Females and the Birth-rates in each quarter and for the year, 1924, and in the several Sub-Registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. j Females Total. Birth rates. ]st Quarter 70 83 159 18.6 82 83 165 20.0 68 88 156 19.9 129 113 242 23.2 2nd ,, 82 88 170 19.9 81 75 156 18.9 76 71 147 18.8 103 119 222 21.3 3rd ,, 88 77 1G5 19.3 89 84 173 21.0 71 S3 154 19.7 113 112 225 21.6 4th ,, 65 71 136 14.8 80 83 163 18.4 73 73 146 17.3 121 117 238 21.2 Year 311 319 630 18.1 332 325 657 19.6 2S8 315 603 18.9 466 461 927 21.8 Showing the Births of Males and Fewales and the Birth-rates in each quarter and for the year 1924, and in the several Sub-Registration Districts.—contd. Highbury. Barnsbury. Islington Soutk-East. Tke Borougk. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. 1st Quarter 146 143 289 18.9 169 168 337 24.3 215 176 391 19.4 885 854 1,739 20.0 2nd ,, 156 111 267 17.5 167 182 349 25.1 202 189 391 19.4 867 835 1,702 20.2 3rd ,, 148 133 281 18.4 158 148 306 22.0 233 189 422 20.9 900 S20 1,720 20.5 4 th ,, 124 120 250 15.2 137 141 278 18.6 218 203 421 19.4 818 814 1,032 18.0 Year 574 513 1,087 17.4 631 639 1,270 22.4 868 757 1,625 19.8 3,470 3,329 0,799 19.8 Illegitimate Births (186).—The number of illegitimate births, 136, shows a decrease of 33 on the return of the year 1923. They were equal to a rate of 2'7 per 100 registered births. A table for former decennial periods was given in M.O.H. Report 1921. Notification of Births Act, 1907.—5,200 births were notified, exclusive of 132 stillborn, or 76 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: Doctors. Midwives. Parents and otker Persons. Total. Alive. Still born. Alive. Still born. Alive. Still born. Alive. Still born. 1924. 1st Quarter 357 14 693 20 310 6 1,360 40 2nd „ 323 11 669 10 297 7 1,289 28 3rd ,, 313 8 674 21 312 5 1,299 34 4tk „ 308 8 647 16 297 6 1,252 30 Year 1,301 41 2,683 67 1,216 24 5,200 132 5 [1924 DEATHS. The deaths numbered 4,222, while the death-rate was equal to 123 per 1,000 of the population, or 0.7 higher than that of the preceding year (ll.6), but it was 2.1 less than the average of the previous 10 years. The Deaths and Death-rates from All Causes in the Sub-Registration Districts were as follows:— Sub-Districts. Quarters. The Year. 1 2 3 4 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Tufnell 168 19.7 99 11.6 76 8.9 92 9.9 435 12.5 Upper Holloway 156 18.9 104 12.6 83 10.1 107 12.1 450 13.4 Tollington 140 17.9 86 11.0 54 6.9 92 10.9 372 11.7 Lower Holloway 177 17.0 117 11.2 91 8.7 145 12.9 530 12.5 Highbury 245 16.0 150 9.8 156 10.2 192 11.7 743 11.9 Barnsbury 267 19.2 166 12.0 124 8.9 187 12.5 744 13.1 Islington (SouthEast) 317 15.7 228 11.3 168 8.3 235 10.8 948 11.5 The Borough 1,470 17.4 950 11.3 752 8.9 1,050 11.6 4 222 12.3 Showing the Deaths and Death Rates of Islington in 1924, 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 Kates for the 10 years 1914-23, and the deaths and death-rates in the year 1923. Quarter. Males. Females. Total. Death Rates. Islington, 1924. Islington, 1914-23. London, 1924. 105 Great Towns, 1924. First 667 803 1,470 17.4 18.0 17.8 17.0 Second 493 457 950 11.3 13.1 10.7 11.8 Third 400 352 752 8.9 10.9 8.6 9.1 Fourth 536 514 1,050 11.6 15.6 11.1 11.4 The Year 1924 2,096 2,126 4,222 12.3 14.4 12.1 12.3 1923 1,978 1,924 3,902 11.6 12.3 11.2 11.6 Increase or Decrease + 118 202 320 + 0.7 — 2.1 + 0.9 + 0.7 1924] 6 Cause of Death (Classified).—The following table shows the deaths arranged in classes of Disease from All Causes during the ten years 1911-23, and in 1924:— Classified Causes of Death. Years. Mean 10 Yrs. 1924 Difference. 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 I. Specific or Febrile Causes 572 618 380 391 1361 579 552 464 639 273 583 391 — 192 1. Miasmatic Diseases 299 451 268 293 1258 466 437 301 546 155 447 316 — 131 2. Diarrhoeal „ 174 94 56 56 51 36 28 85 29 40 65 20 — 45 3. Malarial „ 1 — — — 2 2 2 — — 1 — — 1 4. Zoogenous „ 2 — 3 — — 1 2 1 — — 1 2 + 1 5. Venereal „ 21 23 15 15 15 13 13 17 17 20 17 9 — 8 6. Septic ,, 75 50 38 25 35 61 70 60 47 58 52 44 — 8 II. Parasitic Diseases — — 1 1 — 1 1 — 3 1 1 2 + 1 III. Dietetic 11 36 3 3 4 2 2 4 7 2 7 3 — 4 IV. Constitutional Diseases 1056 1132 1095 1114 1101 973 918 985 935 945 1025 945 — 80 V. Developmental 512 554 522 486 520 657 556 486 477 377 515 396 — 119 VI. Local 2488 2847 2457 2344 2596 2177 2172 2203 2362 2106 2375 2290 — 85 1. Diseases of Nervous System 363 418 339 351 330 322 341 345 330 294 343 290 — 53 2. „ Organs of Special Sense 14 17 12 14 10 11 20 13 9 16 14 14 — 3. „ Circulatory System 660 722 669 681 691 654 592 651 734 745 680 822 + 142 4. ,, Respiratory 896 1147 1006 887 1156 770 822 717 903 598 890 797 93 5. ,, Digestive „ 304 319 233 243 246 215 224 260 204 259 251 192 — 59 6. „ Lymphatic ,, 15 9 16 9 3 11 10 14 11 11 11 8 — 3 7. „ Urinary ,, 193 182 149 130 137 151 129 168 134 157 153 136 — 17 8. ,, Reproductive ,, 18 18 24 18 8 17 20 13 20 10 16 15 — 1 9. ,, Bones and Joints 10 8 9 5 9 12 5 3 8 8 8 10 + 2 10. „ Integumentary System 15 7 — 6 6 14 9 19 9 8 9 6 — 3 VII. Violence 201 234 183 159 156 162 179 142 137 151 170 156 — 14 1. Accident or Negligence 165 194 156 122 115 132 140 99 94 105 132 115 — 17 2. Homicide 3 3 4 1 3 2 2 3 3 8 3 2 1 3. Suicide 33 37 23 11 27 28 37 40 39 38 31 39 + 8 4. Execution — — — — — — — — 1 — — — — — 5. By Bombs (Enemy Aircraft) — — — 25 11 — — — — — 4 — — 4 VIII. Ill-Defined Causes 98 125 Ill 102 103 89 95 84 54 47 91 39 — 52 All Causes 4938 5546 4752 4600 5841 4640 4475 4368 4614 1902 4767 4222 — 545 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, 1924. Mean Deaths (10 years, 1914-23. Increase or Decrease on mean. 0-1 year 447 631 - 184 1-5 years 311 401 - 90 Under 5 vears 758 1,032 - 274 5-15 years 96 181 - 85 15-25 „ 173 192 - 19 25-35 „ 188 271 - 83 35-45 ,, 291 354 - 63 45-55 „ 416 527 - Ill 55-65 „ 621 643 - 22 65-75 „ 868 797 + 71 75-85 ,, 640 606 + 34 85 upwards 171 164 + 7 4 222 4,767 - 545 7 [ 1924 INFANTILE MORTALITY Infant Deaths, 447; Mortality Rate, 66.—During the year 447 deaths among infants under twelve months old were registered, or 1S5 below the decennial average (632), and they were equal to an infant mortality rate of 66 per 1,000 births. This rate is 21 per 1,000 births below the mean annual record of the preceding ten years, and equals the rate of last year (1923), which was the lowest ever recorded in Islington. In the quarters the mortality ranged from 90 per 1,000 births in the first quarter, 54 in the second, 55 in the third, and 61 in the fourth. In the sub-registration districts the infant mortality was as follows: Sub-District. Infant Deaths. Mortality per 1,000 Births. Tufnell 34 54 Upper Holloway 46 70 Tollington 36 60 Lower Holloway 79 85 Highbury 65 60 Barnsbury 98 77 Islington South East 89 55 In London the infant mortality was 69 per 1,000 births, while in the six boroughs encircling Islington it was 66. The rate for England and Wales was 75 per 1,000 births. Infantile Mortality during each of the Ten Years 1914-23 and 1924. 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 1-2 2-3 3-4 9-12 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 1921 131 34 35 22 222 104 148 96 71 641 81 1922 125 37 29 22 213 80 97 96 93 579 77 1923 128 35 20 11 194 72 104 54 49 473 66 Mean 10 years 136 38 29 20 223 112 123 90 84 632 87 1924 110 33 23 21 187 59 61 64 76 447 66 Increase or decrease on mean — 26 — 5 — 6 + 1 — 36 — 53 — 62 — 26 — 8 —185 — 21 Showing the Deaths among Infants per 1.000 Births during the Year 1924. and also the mortality rates for the Years 1914-1923. Sub-Districts. 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 Mean 10 years 1914 increase or decrease on mean Tufnell 93 65 84 99 93 50 41 53 83 46 71 54 —17 Up. Holloway 86 118 67 68 83 79 69 76 59 64 77 70 — 7 Tollington 92 135 93 102 135 98 58 83 58 55 91 60 —31 Lr. Holloway 134 118 107 121 130 101 66 93 81 '81 103 85 —18 Highbury 93 109 74 83 99 83 67 93 64 61 83 60 —23 Barnsbury 119 107 103 114 122 91 89 87 86 59 98 77 —21 Islington, S.E. 105 108 91 89 107 81 79 77 88 82 91 55 —36 The Borough 104 107 87 97 110 83 72 81 77 66 87 66 —21 8 1924] 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 aiming Infants under one year of age in the ten years 1914-23: and in 1924 from ccrtain specified causes. Causes of death. 1924. Rate per 1,000 Births. Mean rate 10 years 1914-23 per 1,000 Births. Difference. Premature Birth and Congenital Defects 17 20 — 3 Bronchitis and Pneumonia 16 17 — 1 Atrophy and Marasmus 5 11 — 6 Diarrhoeal Disease (all forms) 7 6 + 1 Convulsions 1 2 — 1 Whooping Cough 3 4 — 1 Measles 3 3 — Diphtheria — — — Phthisis — — — Other forms of Tuberculosis 1 2 — 1 Total of above 53 65 — 12 All other causes 13 22 — 9 Total 66 87 — 21 INFANTILE MORTALITY during the Calendar Year 1924. Nett Deaths from stated, causes at various Ages under One Year of Age. Cause of Death. Under 1 week Weeks. Total under 4 weeks 4 weeks and under 3 months Months. Total Deaths under 1 year 1-2 2-3 3-4 3-6 6-9 9-12 All Causes. Certified 110 33 23 21 187 57 58 62 74 438 Uncertified — — — — — — — — — — Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — — — Measles — — — — — — — 6 18 24 Scarlet Fever — — — — — — — — 1 1 Whooping-Cough — — — — — 3 3 6 8 20 Diphtheria, Croup — — — — — — — — — — Erysipelas — — — — — — — — — — Tuberculous Meningitis — — — — — — 1 2 2 5 Abdominal Tuberculosis — — — — — — — 1 — 1 Other Tuberculous Diseases — — — — — 1 2 1 — 4 Meningitis (not Tuberculous) — — 1 — 1 — 1 4 a — 6 Convulsions 2 1 — 1 4 3 2 — — 9 Laryngitis — — — — — — — — — — Bronchitis 2 1 1 3 7 6 6 7 8 34 Pneumonia (all forms) 4 2 5 2 13 12 13 16 22 76 Diarrhoea — 4 2 1 7 5 3 1 1 17 Enteritis — 1 3 1 5 6 6 7 5 29 Gastritis — — — — — — 1 — — 1 Syphilis — 1 — — 1 1 1 1 — 4 Rickets — — — — — — — — — — Suffocation, overlying 2 — — — 2 2 2 — — 6 Injury at birth 2 — — — 2 — — — 1 3 Atelectasis 10 2 — — 12 — — — — 12 Congenital Malformations 18 6 — 1 25 6 3 1 — 35 Premature birth 57 4 5 8 74 2 2 — — 78 Atrophy, Debility and Marasmus 7 4 4 4 19 8 6 2 35 Other causes 6 7 2 — 15 2 6b 7 8b 38 Totals 110 33 23 21 187 57 58 62 74 438 Nett Births in the year {legitimate 6,455 illegitimate 251 6,706 Nett Deaths in the year of legitimate infants 413 illegitimate infants 25 a Cerebro-Spinal Fever (2), b Influenza (5). 9 [1924 REPORT ON MATERNITY AND CHILD WELFARE WORK. Education Propaganda.—During the year the booklet on Infant Care, and intimation of the facilities provided at the Health Department and the Voluntary Welfare Centres, were circulated by post to homes from which a notification of birth was received. This method has been used since the adoption of the Notification of Births Act. As has been usual in recent years, a special effort was made in October designated "Health and Baby Week" to call special attention to infant care as well as the general health of the community. On Thursday, October 9th, in the afternoon, Lady Crosfield presided over a meeting for women only. An instructive film entitled "The Gift of Life" was shown, and Dr. Dorothy Logan delivered a brief lecture. In the evening, under the presidency of The Mayor, Dr. I. Feldman gave an address, and two impressive films were shown, "The Shadow" and "The Public Health Twins." For the films shown during this week the department was indebted to the National Council for Combating Venereal Disease. During the whole week the Council Chamber was used for a Health Exhibition, and the Welfare Centres co-operated by lending exhibits of infant clothing. The film "Waste" was shown on the afternoon of October 10th, under the Presidency of Mrs. Kate Truelove, the speaker being the Medical Officer of Health. In the evening of the same day, Alderman Yorley, J.P., in the Chair ,the film "The End of the Road" was shown, and Mr. E. B. Turner, F.R.C.S., very kindly spoke to a large audience. In addition to the Exhibition and Cinema at the Town Hall, the Welfare Centres had local exhibitions and lectures—the North Centre on October 15th from 10 a.m. to 10 p.m.; the South Centre on October 17th; the East Islington Centre had a Lantern Lecture at Hurlock Street Branch on the evening of October 16th: "Our Teeth, and How to Take Care of Them," by Sir Frank Collyer, under the Presidency of Dr. E. S. Tate. The West Centre had a Lantern Lecture in All Saints' Hall, by Dr. C. W. Saleeby, F.R.S.E., under the Presidency of Dr. Marion Vaughan. OPHTHALMIA NEONATORUM AND OPHTHALMIA. Ophthalmia Neonatorum is an inflammatory disease with purulent discharge occurring in the eyes of infants within three weeks of birth. 77 cases of Ophthalmia Neonatorum were notified. 41 cases of Ophthalmia were reported by the London County Council. 32 out of the 77 cases of Ophthalmia Neonatorum were attended at birth by midwives. The cases occurred in the sub-registration districts as follows:— Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South East. The Borough Cases notified by Doctor 4 8 5 12 5 20 17 71 Cases notified by Certified Midwives — 3 1 2 6 Cases reported by L.C.C. 4 1 1 6 3 6 20 41 Cases reported by Health Visitors 1 — — — — 1 — 2 Of the 120 cases investigated, both of the infants' eyes were affected in 97 instances, whilst in 12 the right eye was involved and in 11 the left. 1924 10 Treatment.—12 of 77 Ophthalmia Neonatorum cases were admitted to St. Margaret's Hospital. 24 of 77 Ophthalmia Neonatorum cases were treated at home by private Doctors. 33 cases of inflammatory disease of infants' eyes were nursed by the North London Nursing Association for the Council at the cost of £38 19s. (In 1923, 17 cases were nursed at the cost of £22 3s. Skilled attention decreases the possibility of partial or complete blindness, and the money was well spent. Results.- Of the 77 Ophthalmia Neonatorum cases : 76 cases completely clear. 1 case partial impairment of both eyes. There was no fatal case during the year. PUERPERAL FEVER. Definition.— The Royal College of Physicians' definition of Puerperal Fever is: Septicæmia, Pyæmia, Septic Peritonitis, Septic Metritis, and other acute septic inflammation in the pelvis occurring as the direct result of child-birlli. Of the 21 cases coming to the knowledge of the Medical Officer of Health during 1924, 19 were notified by Medical Practitioners. The proportion of total cases to births was 3 per thousand. The notifications were three below the average (22) of the preceding 10 years and showed a decrease of 0.26 in the proportion of attacks to 1,000 births. Cases of Puerperal Fever notified and inquired into during the year 1924. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. i South East. The Borough Cases notified 2 2 1 3 2 4 5 19 Private Practitioners' Cases 1 – 1 1 2 1 4 10 Hospital Cases 1 2 – 2 – 3 1 9 Certified Midwives' Cases – – – – – – – – Cases inquired into 2 2 1 4 2 4 6 21 Cases treated in Hospital 2 2 – 4 1 4 5 18 Cases treated at Home – – 1 – 1 – – 2 Of the 21 cases, 19 were notified and treated in Hospitals. One of these contracted the disease in Hospital; 6 cases were removed to Metropolitan Asylums Board Hospitals; and 10 cases were removed to other London Hospitals. Deaths.— Eight deaths were registered as being clue to Puerperal Fever. Two of these were not notified and are not included in the table of notified cases above. THE MILK SCHEME FOR NECESSITOUS EXPECTANT AND NURSING MOTHERS AND CHILDREN UNDER FIVE YEARS OF AGE. During the year 1924, the sum expended in the provision of fresh and dried milk for necessitous, expectant and nursing mothers, and children under five years of age, amounted to £3,186 19s. 2d., as against £3,581 10s. 11d. in 1923. The total amount expended since September, 1918, when the Order came into operation is £39,714 13s. 6d. The total recipients during the year numbered 10,791, and the quantity of milk supplied to them was equal to 253,289 pints (31,661 gallons). The amended scheme for the distribution of milk adopted by resolution of the Council, on the 26th October 1922, is given below:— No. in family. Free. Half-cost. 1 13/- after deduction of rent 15/- after deduction of rent 2 10/6 per head after deduction of rent 12/6 per head alter deduction of rent 3 8/6 ,, ,, 10/- ,, ,, 4 7/6 „ „ 8/6 ,, ,, 5 7/- „ „ 8/- ,, ,, 6 6/6 ,, ,, 7/6 ,, ,, 11 SUMMARY OF VISITS BY MUNICIPAL HEALTH VISITORS. District 1 2 3 4 5 6 Totals I. Births, First Visits, infants under 1 Year 570 770 731 869 1,213 821 810 5,784 II. Births, Re-Visits, Infants under 1 Year 679 507 648 307 611 125 579 3,456 III. Visits to Children, between 1st and 2nd Years 341 341 578 352 640 155 355 2,762 IV. Visits to Children, between 2nd and 5th Years 737 705 775 758 915 374 345 4,609 V. Visits re Still Births 15 14 17 26 30 21 16 139 VI. Deaths, Visits, re Infants under 1 Year 2 5 7 5 12 9 1 41 VII. Deaths, Visits, re Children 1 to 5 years – 1 – 1 3 – – 5 VIII. Ante-Natal, Home Visits 57 76 109 108 107 35 47 539 IX. Puerperal Fever, Home Visits 6 4 3 1 4 3 4 25 Totals 2,407 2,423 2,868 2,427 3,535 1,543 2,157 17,360 X. Attendances at Welfare Centre 22 22 49 46 45 20 48 252 XI. Other Work by Direction 265 388 391 351 149 139 152 1,835 XII. Visits Declined 48 101 23 133 14 22 51 392 XIII. Visits, House Shut 457 665 371 648 490 405 587 3,623 Grand Total of Visits 3,199 3,599 3,702 3,605 4,233 2,129 2,995 23,462 [1924] 12 1924J SUMMARY OF VISITS BY MUNICIPAL HEALTH VISITORS—Continued. District 1 2 3 4 5 6 7 Totals. Analysis of Visits included in I.-IX. relating to (a) Ophthalmia Neonatorum 17 18 17 12 49 19 29 161 (b) Epidemic (Summer) Diarrhœa – – – – 1 – – 1 (c) Other Digestive Diseases 1 15 5 – 8 – 1 30 (d) Pneumonia and Bronchitis 7 20 2 5 25 – 11 70 (e) Rickets 3 34 8 21 53 2 28 149 (f) Measles and German Measles 7 4 5 2 14 – 3 35 (g) Whooping Cough 15 22 32 14 30 2 6 121 (h) Tuberculous Disease – – 1 – 3 – – 4 (i) Convulsions 3 – – – 1 – – 4 (j) Polio-myelitis – – – – – – – – (k) Premature Birth 21 61 36 38 58 20 34 268 (l) Atrophy, Debility and Marasmus 3 4 3 – 12 – – 22 (m) All other investigations ** 30 31 88 77 78 60 104 468 (n) Routine Visits included in I. to IX. and not included in (a) to (m) 2,300 2,214 2,671 2,258 3,203 1,440 1,941 16,027 *** Totals (a) to (n) 2,407 2,423 2,868 2,427 3,535 1,543 2,157 17,360 Total Families Visited 1,719 1,704 2,070 1,723 2,381 1,083 1,705 12,385 **e.g.— Infectious Diseases other than Measles, Whooping Cough, Epidemic Diarrhoea, Polio-myelitis, etc., Syphilis, Rheumatism, Non-notified birth, etc. ***Totals (a) to (n) correspond with Totals I. to IX. Number on Books 1st April, 1925, i.e., Record Cards of Children to be visited. Exclusive of Record Cards marked " Attending Centre," and " Above Standard," "Visits declined," and "Visits not necessary" 20,103 13 1924 REPORT OF WORK OF VOLUNTARY CENTRES. Sunlight as a Preventive Agency.—The North Islington Welfare Centre had gifted to them an Artificial Sunlight Lamp, and at the time it is believed to be the only establishment of the kind in London which had had such an installation introduced. In establishing this sunlight clinic the management were guided by the advice of Professor Leonard Hill, F.R.S., of the Medical Research Institute. On his advice the Eidinow Carbon Arc Lamp was installed, and as a preliminary Professor Hill very kindly had some of the mothers and children treated at the Medical Research Institute, and a nurse accompanied them to have the opportunity of being trained in the use of the lamp under medical supervision. Medical supervision has at the Centre been always consistently carried out, as is mentioned in the summary which follows. Unlike the use to which these lamps are put to in hospitals, the lamp at this Centre is not, strictly speaking, for the treatment of disease, but is being used at present with a view to ascertaining its value as a preventive agency. The cases which are being dealt with at present by means of the light are as follows : 1. Infants—non-thrivers—that is, pre-malnutrition cases. 2. Cases of infants in which it is considered that a course of exposure to the light might act as a preventive of latent rickets. 3. (a) Cases in which the muscular tone is poor—for example, an infant with weak back muscles, where one anticipates the child will not be able to sit up at the time one expects an infant to be able to do so. (b) Infants in whom trouble is experienced as regards regularity of the bowels—that is to say, constipation, which might be considered also a lack of muscular tone in the abdominal muscles, or of peristalsis. 4. Experimental work is also being carried out with regard to faulty lactation in mothers, and there appears to be some indication that "artificial sunlight" in the case of the mother has a "tonic" effect, and lactation can be carried on when otherwise it shows signs of failing. The experience of the mother following a course of exposure is similar to the stimulating feeling felt after a summer holiday. There is, however, sometimes no such experience felt during the period of exposure, but, say, after a fortnight's exposure and then cessation, the feeling referred to makes itself apparent and has its influence on the general health, and resistance to minor ailments, colds, etc. All cases are medically supervised by a qualified practitioner, and the exposure to the lamp is very carefully graduated and careful records of weights, etc., are kept. It is hoped, when the lamp has been longer in use, that its preventive influence may be further confirmed and some inferences will be able to be drawn from those receiving the light, and by comparison with others as to whether they are less liable to infection, colds, etc. It is for these reasons that uniform and careful records are necessary. 1924 14 WORK OF THE CENTRES GENERALLY. The routine work of the centres is undertaken by staffs consisting of doctors, dentists, nurses and masseuses, supplemented by voluntary workers, the consultations being held practically daily, when the babies are examined and weighed and the mothers advised. Home visits are made by the nurses and voluntary workers who give guidance and see that the directions of the doctor are followed. The work is carried out systematically, careful records being kept so that the health of the child and the ante-natal history of the mother, as far as available, can be passed on to the education authorities when the child becomes of school age. Apart from the clinics and consultations for mothers and children are efforts which show well-organised educational propaganda, comprising clubs for thrift, holidays, home-helps, and dental treatment. Individual centres slightly vary in their social methods. For instance, one has a library for mothers and children, while some, under the auspices of committees of fathers, mothers or parents, provide lectures, which are well attended and at which opportunities are given for questions and discussions. These activities are in addition to the routine of health talks and sewing classes for teaching and making of suitable garments, held at all the centres. Several of the centres are recognised for the training of infant welfare students and of infant welfare pupils, scholarship holders of the London County Council. Some provide home-helps; two, indoor treatment for special cases; and all arrange facilities for hospital treatment, convalescence, etc. The various departments of the four voluntary Centres, with the attendances for 1924, may be summarised thus:— North. South. East. West. Total. 1. Ante-Natal Clinics and Ailing Mother Clinics. Number held weekly 3 1½* 1 1 6½* Number of attendances 1,529 639 353 618 3,139 2. Consultation for Children up to 5 Years of Age. Number held weekly 10 8 6 7 31 Number of attendances 14,607 15,446 13,476 16,015 59,544 3. Home Visiting. Number of visits made 12,803 10,225 10,769 6,863 40,660 4. Dental Clinics. Number attending 413 164 74 50 701 Number of attendances or arrangements made for attendances 1,278 301 122 108 1,809 5. Morning Callers. Number of attendances 864 368 192 937 2,361 6. Massage Clinics. Number of cases given massage 86 – 108 35 305 or sent for massage – 76 – – 7. Wards. Number of beds 18 – – 8 26 Number of patients received 173 – – 113 286 8. Number of Children on Books 1,837 1,578 1,216 1,006 5,637 * Two clinics one week; one following week = 1½ weekly. 15 [1924] Each Centre annually reports in detail upon its work for the year, and fur particular information reference should be made to these Reports. It is noticed on lookin0g over the past reports of the Centres that while each year marks advancement and progress in the good work done, conditions of indifference arc gradually disappearing with the higher ideal of home life. New methods of treatment, such as "Artificial Sunlight" and provision for convalescence, must be undertaken; the Centres, indeed, have to keep in advance of the times. I need hardls reiterate the indebtedness of the community to the ladies who wholeheartedly give their time and services in this voluntary work. WELFARE CENTRES' DISTRICTS. POPULATION. NORTH. Wards 1. 2, 3, SOUTH. Wards 9, 10, 11, and Part of 6. EAST. Ward 5, and Parts of 4 and 6. WEST. Wards 7, 8, and Part of 4. Total. 1924 (Approximate Estimate) 98,410 96,610 53,320 89,060 337,400 29,354 up to 5 years old. BIRTHS. 1923 2,063 (Actual) 1,600 (Approximate) 1,123 (Approximate) 2,308 (Approximate) 7,100 1924 1,890 (Actual) 1,625 (Approximate) 1,087 (Approximate) 2,197 (Approximate) 6,799 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—1,903 persons died in the Public Institutions located in Islington, of whom 1,273 belonged to this Borough, the remaining 630 having come here for treatment or relief: Of these, 407 died in the Archway House, 117 in the Royal Northern Central Hospital and 36 in the London Fever Hospital. Of the 1,273 deaths of inhabitants, 891 occurred in the Islington Infirmary, 227 in the Islington Institution, and 133 in the Royal Northern Central Hospital. The proportion which the 1,273 deaths in the Public Institutions bore to the Borough mortality was 30 per cent. Without the Borough.—778 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 North-Western Fever Hospital, 33 in the Children's Hospital, Great Ormond Street, 89 in St. Bartholomew's Hospital, 35 in the Colney Hatch Asylum, 50 in the Royal Free Hospital, 43 in the University College Hospital, 25 in the North-Eastern Fever Hospital, 19 in the Eastern Fever Hospital, 28 in the Middlesex Hospital, and 23 in the City of London Maternity Hospital. These 778 deaths represented 18.4 per cent. of all the deaths registered in the year. Within and Without the Borough.— The deaths of Islingtonians numbered 2,051 and were equal to 48.6 per cent. of the total deaths registered during the year. [1924] 16 Fatal Accidents or Sudden Deaths outside the Borough.— Ninety-nine inhabitants died from accidental deaths, or suddenly, in places outside Islington. During the previous year (1923) the total deaths in Local Institutions numbered 1,772, being 1,218 inhabitants of Islington in Local Institutions, plus 551 non-inhabitants of Islington in Local Institutions, the number in Islington Infirmary being 831, the number in the Royal Northern Hospital 132. The deaths of inhabitants of Islington in Institutions outside the Borough were 706. The total deaths in all Instiutions, 1,924; and the proportion per 100 deaths from all causes, 49.3. A table showing the Institutional deaths of former years appeared in Report, 1922. Transferable Deaths.— During the year 45 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 Diarrhœal Diseases. During the year 227 persons died from these diseases, the death-rate being 0.66 per 1,000 inhabitants, as contrasted with 0.38 in the corresponding period last year, and a decennial average mortality of 305 and a death-rate of 0.92 per 1,000. In London the death-rate from the epidemic diseases was 0.72, while in the six Boroughs encircling Islington the death-rate was 0.74. Locally the deaths in the Sub-Registration Districts and Wards were as follows :— Shewing the Deaths from each of the principal Epidemic Diseases in the several Wards and Sub Registration Districts during the Year 1924. Registration Districts. Wards Enteric Fever. Small Pox. Measles Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea. Totals. Deaths Deaths Deaths Deaths Deaths Deaths Deaths Deaths Tufnell Tufnell – – 9 2 5 4 2 22 Up. Holloway Up. Holloway – – 6 – 6 3 1 16 Tollington Tollington – – 9 – 9 1 1 20 Lr. Holloway Lr. Holloway 9 – 13 1 12 3 1 32 Highbury Highbury 1 – 5 1 4 3 2 16 Mildmay – – 1 – 1 3 2 7 Barnsbury Thornhill – – 20 4 11 10 1 46 Barnsbury 1 – 13 2 4 2 1 23 Islington South East St. Mary's – – 8 – 2 1 1 12 Canonbury – – 8 – 3 2 2 15 St. Peter's – – 11 – – 1 6 18 The Borough 4 – 103 10 57 33 20 227 Total Death Rates 0.01 – 0.30 0.03 0.17 0.09 0.06 0.66 17 1924 Showing the Deaths and Death-Rates from the Principal Epidemic Diseases during the ten years 1914-23 and for the Year 1924. 1914 1915 1916 1917 1918 1919 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death | Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 14 0.04 5 0.01 9 0.03 4 0.01 7 0.02 5* 0.02 Small Pox – – – – – – – – – – 1 0.00 Measles 97 0.30 153 0.48 80 0.26 149 0.50 114 0.39 12 0.04 Scarlet Fever 23 0.07 38 0.12 18 0.06 4 0.01 8 0.03 14 0.04 Whooping Cough 83 0.20 103 0.32 60 0.19 45 0.15 147 0.51 17 0.05 Diphtheria 44 0.13 57 0.18 45 0.14 33 0.11 45 0.16 51 0.16 Diarrhoea and Enteritis (under 2 years) 217 26.53 per 1,000 births 154 20.43 per 1,000 births I 117 16.11 per 1,000 births 106 18.16 per 1,000 births 82 15.78 per 1,000 births 85 13.53 per 1,000 births  1920 1921 1922 1923 Mean 10 years 1924 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 3* 0.01 1 0.00 – – – – 5 0.01 4 0.01 Small Pox – – – – – – – – – – – Measles 92 0.27 27 0.08 134 0.40 16 0.05 87 0.26 103 0.30 Scarlet Fever 12 0.04 19 0.06 29 0.09 13 0.04 18 0.05 10 0.03 Whooping Cough 70 0.21 43 0.13 98 0.29 38 0.11 70 0.21 57 0.17 Diphtheria 135 0.40 110 0.33 59 0.18 21 0.06 60 0.18 33 0.09 Diarrhoea and Enteritis (under 2 years) 77 8.19 per 1,000 births 156 19.78 per 1,000 births 71 9.6 per 1,000 births 103 14.51 per 1,000 births 117 16.21 per 1,000 births 52 7.65 per 1,000 births * Including 2 Malarial Fever. Showing the Deaths from Diarrhœl Diseases together with those classed under Enteritis and its Sub-headings, arranged in quarterly periods, and in three groups of ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhœ. Enteritis. etc. Totals. Diarrhœ. Enteritis. etc. Totals. Diarrhœa Enteritis. etc. Totals. Diarrhœa Enteritis. etc. Totals. Diarrhœa. Enteritis. etc. Totals. Under 1 year 4 10 14 3 8 11 4 8 12 6 2 8 17 28 45 1 to 5 years – 2 2 1 1 2 – – – – 3 3 1 6 7 Over 5 years 1 2 3 – 2 2 1 1 2 – 1 1 2 6 8 Totals 5 14 19 4 11 15 5 9 14 6 6 12 20 40 60 1924 18 INFLUENZA. Influenza caused 10-1 deaths during the year and showed an increase of 46 on the return for the year 1923, but they were 91 below the average of the preceding ten years 1914-23. The death-rate was equal to 0.30 per 1,000 inhabitants. Showing the Deaths from Influenza in the Quarters of the Year 1924, together with the averages of the corresponding periods, 1914-23. Years. Quarters. Totals. First. Second. Third. Fourth. 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 1921 33 17 2 41 93 1922 200 10 3 8 221 1923 21 22 7 8 58 Average 72 17 9 97 195 1924 70 15 4 15 104 Increase or Decrease – 2 – 2 – 5 – 82 – 91 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 1924:— Ages. 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 Mean Difference. 10 yrs 1924 0- 5 1 3 – 1 106 19 10 5 22 5 17 11 – 6 5-10 1 – – – 52 5 3 – 1 – 6 1 – 5 10-15 – – – – 32 8 3 1 – 2 5 o – 3 15-25 1 5 – – 141 48 12 5 11 – 22 10 – 12 25-35 1 4 – 2 252 82 21 9 14 6 39 7 – 32 35-45 6 7 1 2 109 47 18 15 18 4 23 10 – 13 45-55 5 15 6 7 93 48 17 18 42 12 26 12 – 14 55-65 7 12 6 8 69 42 17 13 37 5 22 19 – 3 65-75 7 11 10 10 50 36 13 14 43 16 21 16 – 5 75 & upwards 1 14 13 6 27 21 4 13 33 8 14 16 + 2 All Ages 30 71 36 36 931 356 118 93 221 58 195 104 – 91 SEPTIC DISEASES. Erysipelas and Puerperal Septicaemia are the principal diseases of this class. Erysipelas.—10 deaths were returned from this disease, or 5 more than in the year 1923, and equalled the average of the preceding ten years 1914-23. Puerperal Diseases.— These comprise Puerperal Pyæmia, Septicæmia, Septic Intoxication and Puerperal Fever, and they caused 8 deaths, which is I below the return of 1923, and equal to the average of the ten years 1914-23. The death-rate was equal to 1.18 per 1,000 births. CANCER. Cancer.-—470 deaths were registered from this malignant disease during the year compared with 472 in 1923, and with an average of 421 in the previous decennium. The deaths represent a death-rate of 1.37 per 1,000 of the civil population and is 0.10 above the average rate (1.27) of the last ten years; 214 deaths occurred 19 1924 among males and 256 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 1924:— Ages. 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 Mean 10 Yrs. 1924 Difference. 0–5 – – – 2 – 2 3 2 – 1 1 1 – 5–15 2 1 3 2 – 1 – 1 – – 1 1 – 15–25 2 2 – 5 – 4 1 1 4 6 3 4 + 1 25–35 11 7 4 8 8 5 10 10 8 10 8 9 + 1 35–45 37 24 30 31 27 36 32 34 34 27 31 38 + 7 45–55 69 75 86 73 75 101 74 98 88 88 83 77 – 6 55–65 121 120 124 131 99 120 110 140 124 138 123 131 + 8 65–75 96 105 114 120 126 123 124 131 110 125 117 149 + 32 75–85 40 39 48 55 52 39 43 52 47 68 48 52 + 4 85 & upwards 6 4 3 5 6 7 5 6 6 9 6 8 + 2 384 377 412 432 393 438 402 475 421 472 421 470 + 49 Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the year 1924. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 15 15 8 19 23 13 22 115 Second 6 19 9 15 15 13 31 108 Third 14 12 11 10 27 14 24 112 Fourth 16 15 10 17 25 26 26 135 The Year 51 61 38 61 90 66 103 470 TUBERCULOSIS. Tuberculosis caused 39!) deaths, which were 107 below the average of the last decennium, but were 10 above the number registered in 1923. The death-rate resulting from them was equal to 1.16 per 1,000 of the civil population, and represented 9.4 per cent. of the deaths from all causes during the year. Tuberculosis of the Respiratory System (Phthisis or Pulmonary Tuberculosis), caused 340 deaths, as contrasted with the decennial average of 422, while the death-rate was 0.99 per 1,000 of the civil population, as against the decennial rate of 1.27 per 1.000. There was a decrease of 82 on the ten years' average number of deaths, and of 0.28 on the mean death-rate. Tuberculosis (Respiratory System). Proportion of Deaths from Tuberculosis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. Years. Deaths. Death rates per 1,000 inhabitants. 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 1921 355 1.07 8.13 13.1 1922 378 1.13 8.19 13.8 1923 337 1.00 8.64 11.6 Average 10 years 422 1.27 8.84 14.4 1924 340 0.99 8.05 12.3 20 1924] The following return gives the deaths at each age period:— Age Periods. Males. Females. Total. 0–5 9 7 16 5–15 4 – 4 15–25 30 36 66 25–35 41 36 77 35–45 40 28 68 45–55 38 20 58 55–65 26 11 37 65 upwards 6 8 14 Total 194 140 340 Showing the Deaths from Tuberculosis of Respiratory System in the Sub-Districts during the Four Quarters of the Year 1924. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 13 11 6 10 17 22 24 103 Second 14 11 6 6 13 18 22 90 Third 6 4 7 7 13 12 18 67 Fourth 3 8 11 10 15 13 20 80 The Year 36 34 30 33 58 65 84 340 Showing the Deaths from Tuberculosis daring 1924. Form. Ages. Sex. Districts. Total Deaths. 0-1 1-5 over 5 M. F. Tuf. U.H. Toll. L.H. H. B. S.E. Respiratory 3 13 324 194 146 36 34 30 33 58 65 84 340 Meningeal 5 15 9 17 12 6 2 2 1 7 3 8 29 Abdominal 1 1 13 9 6 – 3 1 1 2 4 4 15 General 1 – 3 4 – – 1 – – 9 1 – 4 Other forms – – 11 – 11 2 1 – 4 1 1 2 11 All Tuberculosis 10 29 360 224 175 44 41 33 39 70 74 98 399 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. (Exclusive of Tuberculosis and Influenza.) These diseases, which include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 797 deaths, or 199 more than in 1923. They were equal to a death-rate of 2.3 per 1,000 of the civil population, and represented 19 per cent. of the total deaths registered in the Borough. Acute Bronchitis —There were 10G deaths as compared with 80 in the previous year. 37 occurred among males, and 69 among females. The deaths of 19 infants under 12 months were registered. Chronic Bronchitis. 277 deaths were ascribed to it, 129 being males and 148 females. This return is 92 above that for 1923, 21 [1921 Pneumonia (All forms).—355 deaths were registered, of which 173 were males and 182 females. They are 73 more than the number who died in 1923. It was very fatal to infants under a year old, among whom it caused 77 deaths, while between the ages of 1 and 5 years 71 died from it. Above 5 years of age the deaths numbered 207. 88 Deaths occurred in Public Institutions, chiefly the Workhouse Infirmaries. Pleurisy.—Of this disease 10 deaths were registered. 4 deaths occurred in Public Institutions. Asthma and Emphysema.—Twenty deaths were recorded from these diseases, all of which were adults. Other Diseases of the Respiratory System.—Twenty deaths were registered, as contrasted with 22 in 1023. VENEREAL DISEASES. Only nine deaths were ascribed to these diseases, as compared with 20 in 1923. Of these 5 were males and 4 females. The mean deaths of the preceding ten years, 1914-23, were 17. The annual average number of deaths recorded during ten years from them at three groups of ages has been as follows: Under 1 year, 9 deaths; 1-5 years, 1 death; and over 5 years, 7 deaths, making an average total of 17 per annum. The nearest treatment centres for these diseases are the Royal Northern, Holloway Road, N., and the Royal Free Hospital, Gray's Inn Road, W.C. DEATHS FROM COAL-GAS POISONING. During the year 10 deaths were registered from asphyxia caused by the inhalation of carbon-monoxide gas. The same number of deaths occurred in 1023. Nine of these deaths were attributable to suicide, while the cause of the remaining death was accidental. Of the 10 deaths, 0 were males and 1 a female, the ages ranging from 28 to 69 years. ACCIDENTAL DEATHS. The deaths due to accident numbered 115. Of this number 41 deaths were ascribed to vehicular traffic, and 20 to accidental falls, including 26 aged people. The persons runover are classified as follows: By motor-car or lorry, 27 (21 males and 6 females); by 'bus or train, 12 (0 males and 3 females); by taxi-cab, 2 (2 males); a total of 41. In addition to these, one could add 6 non-residents known to have been killed from a similar cause in the Borough, namely, 5 by motor-car or lorry, 1 by 'bus or train, that is, G in all, which added to the 41 would give a total of 47. 22 1924] INQUESTS AND MORTUARY. During the year 294 bodies were received into the Mortuary, as compared with an average of 430 in the preceding 10 years. Only two infectious bodies were received during the year. The daily average number of bodies received was 0'8, and was equal to' the average of 1923. In 317 cases inquests were held, as contrasted with an average of 346 in the ten years 1914-23. It will be noticed that the number of inquests exceeds the bodies actually received into the mortuary during the year; which is due to the fact that the total inquests also include those held by the Coroner at the Islington Coroner's Court upon bodies of deceased persons who died in Public Institutions in the Borough Bodies received into Mortuary. Inquests. 1914 537 369 1915 612 475 1916 ... 507 394 1917 479 359 1918 ... 476 348 1919 ... 429 321 1920 340 312 1921 313 299 1922 ... 316 307 1923 ... 288 279 Average 430 346 1924 294 317 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1924 and 1923.:— 1924 No. of bodies received. Daily Average. No. of Inquests held. 1923 No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 101 1.0 110 1st Ouarter 75 08 86 2nd 70 0.7 76 2nd 57 06 59 3rd 44 0.5 55 3rd ,, 81 09 65 4th 79 0.8 76 4th „ 75 08 69 Total for year 294 0.8 317 Total for year 288 08 279 PREVENTION OF INFECTION. Notification, Isolation, Fatality, of Specified Diseases under the Provisions of the Public Health (London) Act, 1891. The Principal Diseases Include : Small Pox, Diphtheria, Scarlet Fever, Enteric Fever, Typhus Fever, Puerperal Fever and Erysipelas. There was 2,085 cases of the diseases which are notifiable under the Public Health (London) Act, 1891. This number does not include other communicable ailments, which are now notifiable. The complete list of infectious diseases which are notifiable in Islington are enumerated on page 26. 23 [1927 The total cases notified arc only 11 less than those of the previous year (2,09(5), and 220 below the average (2,305) of the preceding len years. The increases when contrasted with the decennial averages arc to he found in the returns from Diphtheria and Continued Fever, which were respectively 8 and 3 in excess, while the other diseases all showed a decrease. The 2,085 cases were equal to an attack-rate of 6.0 per 1,000 of the civil population. The returns for the preceding ten years are given in the following statements:— Year. Cases. Attack-rates per 1,000 civil population. 1914 2,947 9.08 1915 2,210 6.98 1910 1,439 4.05 1917 1,251 4.21 1918 1,127 3.93 1919 1,993 6.05 1920 2,853 8.49 1921 4,344 13.05 1922 2,787 8.34 1923 2,090 0.22 10 years average 2,305 0.97 1924 2,085 6.06 Registration Sub-Districts.—The total number of cases notified in these districts was as follows :— Total cases notified. Tufnell 100 Upper Holloway 269 Tollington 103 Lower Holloway 236 Highbury 272 Barnsbury 393 Islington South-East 580 Total 2,085 Small Pox —No case was known in the Borough during the past live years. Diphtheria was responsible for 856 cases of illness, which were 5 above the average (851) of the preceding ten years. The attack-rate was equal to 2.48 per 1,000 of the civil population annually, and was 009 below the mean rate (2.57) of the decennial period. In London the attack-rate was 2 30 per 1,000, and the Encircling Boroughs 2-45. Scarlet Fever—1,077 cases were notified, and they showed a decrease of 155 on the average (1,232) of the ten years 1914-192.3. The attack-rate was equal to 3T3 per 1,000 of the civil population annually, which is a decrease of 0.60 per 1,000 of the mean rate(3.73) of the preceding ten years. In London the attackrate was 2.50 per 1,000 of the civil population, while in the Encircling Boroughs it was 2'86. Enteric Fever.—Only 14 cases were notified, a decrease of 13 on the average (27) that obtained during the ten years 1914-23. The attack-rate was 0 01 per 1,000 annually, or 0.04 per 1,000 below the mean rate (0.08) of the last ten years. In London the rate was 0 09, and in the Encircling Borough 0 04 per 1,000 of the civil population. 24 Typhus Fever. No case was notified. Puerperal Fever. -See page 10. Erysipelas.—116 cases were notified, or 57 below the average 173 of the preceding ten years, the attack-rate being 0.31 per 1,000 of the civil population. FATALITY FROM THE EIGHT PRINCIPAL NOTIFIABLE INFECTIOUS DISEASES. By "Fatality" is meant the percentage proportion of deaths to attacks of sickness. During the year it was found that of the 2,087 cases notified, G6 deaths occurred, or 3'2 per cent., which contrasts with an average percentage of 4'3 in the preceding ten years 1914 13. Years. Cases. Deaths. Fatality. 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 1,127 67 6.0 1919 1,993 96 4.8 1920 2,853 173 6.0 1921 4,344 146 3.3 1922 2,787 102 3.7 1923 2,096 48 2.3 Mean 2,305 100 4.3 1924 2,087 66 3.2 Hospital Isolation.—Of the 2,087 cases of infectious diseases notified, 1,975 were isolated in hospital, or a percentage of 94.G, while only 5.4 per cent. of the patients, therefore, were nursed at home. With two exceptions 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 1914 2,543 86.3 1915 1,991 90.1 1916 1,269 90.0 1917 1,009 87.8 1918 982 87.1 1919 1,772 88.9 1920 2,642 92.0 1921 4,117 94.8 1922 2,621 94.0 1923 1,996 95.2 1924 1,975 94.6 DISEASES TREATED IN HOSPITAL. Disease. Total cases. Cases isolated. Percentage of known cases. Scarlet Fever 1,077 1,049 97.4 Diphtheria 856 848 99.1 Enteric Fever 14 13 92.8 Erysipelas 116 47 40.5 Puerperal Fever 21 15 71.4 Continued Fever 3 3 100.0 2,087 1,975 94.6 25 1924 Summary of Infectious Sickness and of Deaths arising therefrom, distinguishing the Cases treated at Home and in Hospitals ; and showing the percentage of notified Cases removed to Hospitals, together with the Fatality among cases treated at Home and in Hospitals during the year 1924. Notified Cases Treated. Percentage 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 1,049 28 1,077 97.4 26 10 – 10 0 9 – 0 9 Diphtheria Enteric 848 8 856 99.1 09 32 1 33 37 125 3'8 (Typhoid Fever) 13 1 14 97.2 2'8 4 — 4 31 0 – 286 Typhus Fever – – – – – – – – – – – Erysipelas 47 ca 116 40.5 59o 6 4 10 12-7 58 86 Puerperal Fever 15 6* 21 71.4 286 7 1 8 470 16-6 370 Continued Fever 3 3 100.0 Kelapsing Fever – – – – – – – – – – – Cholera — — — — — — – — — — — Total 1,975 112 2,087 94.6 54 59 6 65 30 5'3 31 * including 2 cases which were not notified. Showing the number of Cases and Attack Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1014-23 and in 1924. DISEASES. YEARS. Average number of cases, 1914-23 1924 Increase or Decrease 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 Small Pox Cases — 2 2 — Rate — — 0.00 0.00 — — — — — Diphtheria Cases 651 620 587 556 514 645 1324 1548 1126 889 846 854 8 Rate 2.01 1.96 1.90 1.87 1.80 1.96 3.94 4.65 3.37 2.64 2.56 2.48 — 0.08 Membranous Croup Cases 8 4 6 5 4 4 4 5 4 2 5 2 — 3 Rate 0.02 0.01 0.02 0.02 0.01 0.01 0.01 0.02 0.01 0.00 0.01 0.00 0.01 Scarlet Fever Cases 1853 1332 638 478 432 1084 1307 2622 1496 1080 1232 1077 — 155 Rate 5.71 4.21 2.06 1.61 1.51 3.29 3.89 7.87 4.48 3.21 3.73 3.13 — 0.60 Enteric Fever Cases 76 28 32 23 30 16 24 10 9 16 27 14 — 13 Rate 0.23 0.09 0.10 0.08 0.10 0.05 0.07 0.03 0.03 0.05 0.08 0.04 — 0.04 Continued Fever Cases — — — — — 1 — — — — — 3 + 3 Tate — — — — — 0.00 — — — — 0.01 + 0.01 Puerperal Fever Cases 25 23 21 16 4 29 29 34 20 22 22 19 — 3 Rate 3.10 3.48 2.89 2.74 0.77 0.46 3.08 4.31 2.68 3.10 3.05 2.79 —0.26 Erysipelas Cases 334 203 155 173 141 212 165 125 132 87 173 116 — 57 Rate 1.03 0.64 0.50 0.58 0.49 0.64 0.49 0.38 0.39 0.26 0.52 0.34 — 0.18 Totals Cases 2947 2210 1439 1251 1127 1993 2853 4344 2787 2096 2305 2085 — 220 Rate 9.08 6.98 4.65 4.21 3.93 605 8.49 13.05 8.34 6.22 6.97 606 —0.91 * Per 1,000 Registered Births. 26 1024] Showing the Cases of the Notifiable Infectious Diseases notified in the SubRegistration Districts and the Wards during the Year 1924. 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. Tyfncll Tufncll 81 72 — 1 — 10 2 — — — 166 Up. Holloway Up. Holloway — 112 129 — 1 — 25 2 — — — 269 Tollington Tollington — 91 57 — 1 — 13 1 — — — 163 Lr. Holloway Lr. Holloway — 126 88 — 2 — 16 3 1 — — 236 Highbury Highbury — 124 59 — 2 — 6 1 — — — 192 Mildmay 36 34 — 3 — 6 1 — — — 80 Barnsbury Thornhill — 95 110 — 1 — 11 2 — — — 219 Barnsbury — 75 84 1 — — 10 2 2 — — 174 Islington, S.F St. Mary's — 54 67 1 — — 2 1 — — 125 Canonbury — 100 63 — 1 — 7 3 — — — 174 St. Peter's — 183 91 — 2 — 10 1 — — — 287 Totals — 1077 854 2 14 — 116 19 3 — — 2085 Attack-Rates per 1,000 population — 3.13 2.48 0.00 0-04 — 0.34 0.06 0.01 — — 6.06 OTHER NOTIFIABLE DISEASES. « The diseases which are notifiable in Islington include those which have since been added by Order, and the complete lists is as follows: Small Pox, Cholera, Diphtheria, Membranous Croup, Erysipelas, the disease known as Scarlatina or Scarlet Fever, the fevers known by any of the following names: Typhus, Typhoid, Enteric, Relapsing, Continued or Puerperal, and also the following infectious diseases: Anthrax, Acute Encephalitis Lethargica, Acute Polio-Encephalitis, Acute Polio-myelitis, Acute Primary Pneumonia, Acute Influenzal Pneumonia, Cerebrospinal Fever or Epidemic Cerebro-spinal Meningitis, Dysentery, Glanders or Farcy, Hydrophobia or Rabies, Malaria, Ophthalmia Neonatorum, Plague, Trench Fever, and Tuberculosis. Acute Poliomyelitis. Seven cases were notified from this disease during the year, as contrasted with 1 in 1923, and none in 1922. 1924 1913 Cases. Deaths. Cases. Deaths. 1st Quarter Nil Nil Nil Nil 2nd ,, ,, ,, ,, ,, 3rd ,, 6 2 ,, ,, 4th „ 1 Nil 1 ,, 7 2 1 Nil Epidemic Cerebro-Spinal Meningitis. Six cases were notified, being two cases less than in 1923. During the ten years 1914-23, the cases averaged 18 per annum. 27 [1924 A return of attack of the disease during the past ten years is given in the following statement:— 1914 1915 1910 1917 1918 1919 1920 1921 1922 1923 Average 10 yrs. 1914-23 1924 Total Deaths, 1914-23. 1st Quarter 2 12 7 15 7 8 5 3 1 3 6 – 43 2nd 3 13 17 11 4 7 5 3 2 2 7 51 3rd 2 11 8 1 1 1 2 _ 2 3 2 11 4th — . 4 7 3 4 —| 2 1 — 1 o 4 10 Year 7 40 39 30 16 16 14 7 3 8 18 0 115 The deaths during the year numbered 4, and were equal to the high rate of 07 per cent, of the cases notified. Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations, 1911). These Regulations came into force on the 7th January, 1919, and during the 6 years the following cases were notified by medical practitioners to the Medical Officer of Health : 1919 1920 1921 1922 1923 1924 Malaria 193 17 8 2 2 1 Dysentery 14 4 — 1 3 — Acute Primary Pneumonia 12 34 47 77 120 119 Acute Influenzal Pneumonia 12 22 25 67 58 65 Pneumonia 29 3 — — – — Total 200 80 80 147 183 185 Acute Encephalitis Lethargica and Acute Polio-Encephalitis. These diseases became notifiable under an Order of the Local Government P>oard on the 1st January, 1919, and during the year 39 cases of Acute Encephalitis Lethargica were notified, 4 of which proved fatal. One case of Acute PolioEncephalitis was known in the Borough. Ophthalmia Neonatorum. Purulent Disease of the Eyes of Newly-born Children. See page 9. Tuberculosis. During the year 666 cases of Tuberculosis in its different forms were notified. '[ he attack-rate was equal to 194 per 1,000 of the civil population. This number shows a decrease of 6 on the return of the previous year, and of 0.06 per 1,000 on the attack-rate. It was also 41 below the number in 1922. Respiratory (Pulmonary) Tuberculosis.—540 notifications were received, of which 289 referred to males and 251 to females, and represented an attack-rate of 1.57 per 1,000. The return was a decrease of 2 on that of 1923, and 30 on 1922. 28 1924] Showing the Notified Cases of Tuberculosis in the Wards during 1924. Registration Sub-Districts. Wards. Respiratory Tuberculosis. Other Forms of Tuberculosis. Grand Totals Tuberculosis Kate per 1,000 of Population. Males Females Total Males Females Total Tufnell Tufnell 27 20 47 8 8 16 63 1.81 Up. Holloway Up. Holloway 31 30 til 5 3 8 69 2.06 Tollington Tollington 27 24 51 3 4 7 58 1.82 Lr. Holloway Lr. 1 lolloway 24 21 45 6 13 19 64 1.51 Highbury Highbury 31 20 51 3 2 5 56 1.68 Mildmay 15 17 32 0 1 7 39 1.34 Barnsbury Thornhill 23 17 40 11 4 15 55 1.75 Barnsbury 26 22 48 7 4 11 59 2 .35 Islington, S.E. St. Mary's 25 15 40 4 5 9 49 2.63 Canonburv 31 37 68 7 7 14 82 2.50 St. Peter's 20 28 57 7 8 1:1 72 2.34 Totals 289 251 540 67 59 126 666 1.94 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 up- Respiratory Tuberculosis M. 289 3 5 16 48 135 77 5 F. 251 — 2 13 71 122 37 6 Tubercular Meningitis M. 6 1 3 1 1 — — — F. 3 — 3 — — — — — Tabes Mesenterica M. 11 2 1 5 2 — 1 — F. 4 — 3 — — 1 — — General Tuberculosis M. 1 1 — — — — — — F. 1 — — — — — — 1 Other forms of Tuberculosis M. 49 1 11 21 11 4 1 — F. 51 1 5 15 14 13 2 1 All Tubercular Diseases M. 356 8 20 43 62 139 79 5 F. 310 1 13 28 85 136 39 8 Totals 666 9 33 71 147 275 118 13 Percentages at each life period to total cases 100 1.3 4.9 10.7 22.1 41.3 17.7 2.0 From the above statement it will be seen how the disease attacked people at the various ages, viz.:— In every hundred cases 1*3 were under 1 year of age „ ,, 4.9 were aged 1 to 5 years. „ „ 10.7 were aged 5 to 15 years. Prime of Life „ ,, 22.1 were aged 15 to 25 years „ ,, 41.3 81.1 were aged 25 to 45 years „ ,, 17.7 were aged 15 to 65 years „ „ 2.0 were aged 65 and upwards. 29 11024 Showing the Notified Cases of Tuberculosis in the Quarters during 1924. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Hales Females Total Males Females Total Males | Females Total Males Females Total Males Females Total Respiratory Tuberculosis (15 60 125 69 57 126 80 05 145 75 09 144 289 251 540 Tubercular Meningitis ... 1 1 2 2 1 3 2 1 3 1 — 1 6 3 9 Tabes Mesenterica 3 1 4 — — — 5 2 7 3 1 4 11 4 15 General Tuberculosis — — — — — — — — — 1 1 2 1 1 2 Other forms of Tuberculosis 12 12 24 18 10 28 7 13 20 12 10 28 49 51 100 Totais 81 74 155 89 OS 157 94 81 175 92 87 179 350 310 666 Disinfection of Houses and Rooms after Tuberculosis.—The following- statement gives the particulars for the year:— Houses. Rooms. 1st quarter 128 189 2nd ,, 113 155 3rd „ 92 120 4th ,, 115 139 Total 448 603 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 30th December, 1923, to the 3rd January, 1925, 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 6 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 46 45 to 55 55 to 65 05 and up. Total Primary Notifications. Pulmonary Males ... 3 5 6 10 13 35 08 07 54 23 5 289 403 „ Females – 2 6 7 25 40 07 55 26 11 6 251 379 Non-pulmonary Males 5 15 11 9 6 8 4 – 1 1 60 77 „ ,, Females... 1 10 9 4 4 10 10 4 – 2 2 56 05 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 – – – – – 79 170 ,, Females — – — 68 125 Non-pulmonary Males — 3 4 7 8 10 50 ,, „ Females 1 2 3 4 10 34 30 1924 TUBERCULOSIS DISPENSARIES. The work of the Tuberculosis Dispensaries has been very satisfactorily performed. Dr. McFarland, the Tuberculosis Officer for the southern portion of Islington, and Dr. Comyn, the Tuberculosis Officer for the northern portion, have been constantly in touch with the Public Health Department, and co-ordination lias thus been most satisfactorily maintained. I have to thank personally these two Assistant Medical Officers ( Tuberculosis) for the good results obtained. During the year 1,051 persons were examined by the Tuberculosis Officers, and the patients made 9,490 attendances. At the Northern Dispensary there were 502 new cases, and at the Southern 5-19, while the attendances at the former were 3,374 and at the latter 6,122. The examination of contacts with tuberculous cases showed that 11 were suffering from tuberculosis, 38 were suspect, and 330 were not suffering. The nurses ol the Northern Dispensary paid 1,162 visits ,and those of the Southern 2,288, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 186 visits, and of the Southern 32G visits to the patients' homes for the purpose of examining them. Finsen Light Treatment.—Three patients received treatment by the Finsen Light at the London Hospital at a cost to the Council of £30 10s. Pneumcthorax Treatment was also administered to one patient at a cost of £10 10s. The number of persons in attendance at them in each year is as follows :— TUBERCULOSIS. 1919 1920 1921 1922 1923 1924 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 585 756 655 760 615 758 600 581 721 562 502 549 Actual number of Attendances 4057 6782 3921 6895 3212 7030 3297 6659 4001 6825 3374 6122 Totals 4042 7538 4576 7655 3827 7788 3897 7240 4722 7387 3876 6671 A summary of the combined dispensaries is given for the following years :— Cases. Attendances. Cases. Attendances. 1919 1,341 10,839 1923 1,283 10,826 1920 1,415 10,816 1924 1,051 9,496 1921 1,373 10,242 Totals 7,644 62,175 1922 1,181 9,956 31 [1921 Table showing the number of Tuberculous Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1924. Date. Dispensary Feb. Mar. Apr. May. J line July Aug. Sept. Oct. Nov. Dec. Year. . Attendances Northern 315 302 323 257 314 282 310 227 280 277 224 263 3,374 9,496 Southern 626 058 545 522 522 497 495 434 484 480 458 501 6,122 Mew Cases Including Contacts Northern 35 45 46 38 57 43 50 25 42 63 26 32 502 1,051 Southern 66 52 66 41 47 47 40 41 36 38 39 36 549 Contacts. Tuberculosis Northern 2 1 2 — — — — 1 — 1 . — — 7 41 Southern 2 3 3 4 1 7 3 4 3 1 1 2 34 Suspects Northern 2 2 1 — I 6 2 1 1 1 — 1 18 38 Southern o <> 1 .— 1 — — 1 5 O 3 3 20 Non-Tuberculous Northern 16 14 18 9 27 15 6 1 18 31 4 7 166 330 Southern 16 13 27 13 21 17 12 10 8 6 11 10 164 Nurses' Visits Northern 147 119 72 72 120 86 51 62 104 108 104 117 1,162 3,450 Southern 241 255 245 172 2o2 25 185 160 214 201 205 183 2,288 Tuberculosis Ofiicers' Visits Northern 13 18 19 14 13 12 17 17 18 16 14 15 186 512 Southern 32 34 34 31 30 30 21 20 19 25 24 25 326 DEATHS (CIVILIAN ONLY) FROM TUBERCULOSIS OF THE RESPIRATORY SYSTEM (BOTH SEXES). Reference : Registrar-General's Reports. Metropolitan Borough. 1922 1923 Rate per 1,000 living 1922. City of London 19 15 1.39 Battersea 171 139 1.01 Bermondsey 163 149 1.35 Bethnal Green 188 161 1.59 Cambenvell 292 263 1.08 Chelsea 49 58 .77 Deptford 133 95 1.17 Finsbury 105 94 1.37 Fulham 163 150 1.02 Greenwich 122 116 1.20 Hackney 213 227 .94 Hammersmith 143 130 1.06 Hampstead 52 51 .60 Holborn 43 45 100 Islington 378 341 113 Kensington 144 121 .80 Lambeth 331 300 1.08 Lewisham 138 136 .78 Paddington 122 99 .84 Poplar 180 168 1.09 St. Marylebone 99 97 .94 St. Pancras 262 222 1.23 Shoreditch 152 145 1.44 Southwark 256 242 1.37 Stepney 327 290 1.30 Stoke Newington 42 34 .80 Wandsworth 291 265 .87 Westminster (City) 147 107 1.05 Woolwich 163 172 1.18 Admin. County 4,888 4,432 1.08 Rate per 1,000 108 97 — 32 1!»24J THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 025 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 579 were Scarlet Fever and 3-Mi 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 579 720 — 141 Diphtheria 346 399 — 53 Enteric Fever — 2 — 2 Other Diseases — 1 — 1 Total 925 1,122 — 197 Non-Notifiable Diseases.—G,921 cases came to the knowledge of the Medical Officer of Health during- the year, viz. : 3,038 cases of Measles, 998 cases of Chicken Pox, 703 of Whooping Cough, and 2,185 of other diseases. The information respecting these cases was received from the teachers of CO schools. Exclusion of Scholars from Schools.—3,000 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 3,038 1,523 + 1,515 Chicken Pox 998 757 + 241 Whooping Cough 703 507 + 136 *Other Diseases 2,185 2,480 — 295 6,924 5,327 + 1,597 * Note.—" Other Diseases " include Mumps, Scabies, Ophthalmia, Itch, etc. BACTERIOLOGICAL EXAMINATIONS. 2,307 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 Tuberculosis, Diphtheria and Enteric Fever, respectively. The number is a decrease of 261 on that of the preceding year. It is also 906 above the decennial average. Of the total examinations, 307 or 13.3 per cent. gave positive results. Diphtheria.—1,513 specimens were examined for Diphtheria, or which 180, or 12 per cent., were found to contain Diphtheria bacilli. Enteric Fever.—17 specimens of blood were examined, all of which gave negative results, 33 [ ly2-t Tuberculosis. 777 spccimcns of sputum were examined, 127, or 163 per cent., of which showed thar the patients were suffering from pulmonary tuberculosis. DIPHTHERIA PATHOGENICITY TESTS. 1924. No. Submitted for Examination. Negative Result. (Bacilli) Positive Result. (Bacilli) Non-Virulent. Virulent. 19 15 4 ] 3 Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Pulmonary Tuberculosis, 1014-24. Periods. Diphtheria. Enteric Fever. Pulmonary Tuberculosis. Totals. Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined 1914 178 518 696 15 44 59 243 567 810 1,565 1915 123 360 483 16 19 35 198 568 766 1,284 1913 127 277 404 10 12 135 390 525 951 1917 100 216 316 12 8 20 165 420 585 921 1918 74 171 245 3 21 24 111 358 469 738 1919 110 352 468 5 15 20 92 348 440 928 1920 261 677 938 3 20 23 83 375 458 1,419 1921 238 969 1,207 3 19 22 127 421 548 1,777 1922 291 953 1,244 — 9 9 139 472 611 1,864 1923 306 1,371 1,677 5 15 20 152 719 871 2,568 Average 10 years ... 181 587 768 7 18 25 144 464 608 1,401 1924 180 1,333 1,513 — 17 17 127 650 777 2,307 VACCINATION. Of the 6,098 births registered in 1923, the returns of vaccination show that only 3,169 infants were successfully vaccinated, while 20 were found to be insusceptible. There were also 319 who died unvaccinated, and 1,751 statutory declarations of conscientious objection to vaccination were obtained by the parents or guardians; 79 vaccinations were postponed under medical authority, 253 were removed to other districts or places unknown, thus leaving 507 unaccounted for. The return of certificates of exemption, therefore, represents 28.7 per cent. of the registered births. Years. Vaccination per 100 births, less infants who died unvaccinated. Years. Vaccination per 100 births, less infants who died unvaccinatcd. 1914 46.8 1910 46.0 1915 49.0 1920 49.3 1010 47 5 1921 44.9 1917 46.7 1922 40.3 1918 46.4 1923 54.8 1924] 34 Certificates of Exemption.— The following tabular statement shows the increase of these certificates, more especially since 1911 1911 1,241 1916 1,796 1921 2,506 1912 1,646 1917 1,341 1922 2,347 1913 1,942 1918 1,027 1923 1,751 1914 2,124 1919 1,583 1915 1,710 1920 2,866 Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the previous year 1923. Registration Sub-Districts. Number of Births registered in 1923 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 (cols. 3 to 9). Total Number of Certificates of Primary Vaccination at All Ages received during year 1924. Number of Statutory Declarations of Conscientious Objection received during year 1924. i 2 3 4 5 6 7 8 9 10 11 12 Tufnell 570 335 1 – 135 32 8 16 12 31 1,664 154 Up. Holloway 627 345 5 — 158 39 7 20 19 34 161 Tollington 588 309 1 — 141 29 20 13 17 58 149 Highbury 912 446 8 — 279 45 21 5 30 78 270 Lr. Holloway 827 394 1 – 212 48 14 4 27 127 2,073 197 Barnsbury 1224 713 0 – 338 56 4 5 34 72 314 Islington, S.E. 1350 627 2 — 488 70 5 10 41 107 494 The Borough 6098 3169 20 1751 319 79 73 180 507 3,737 1,739 DISINFECTION. Disinfection of Rooms.—1,942 rooms were disinfected, as contrasted with 2,042 in 1923. For this purpose formaldehyde 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 bug's, 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 Tuberculosis, vide p. 29. The Cleansing and Spraying of Rooms.—1,555 rooms, as contrasted with 1,525 in 1923, were cleansed and sprayed. Rooms Disinfected. Rooms Sprayed. 1924. 1923. 1924. 1923. 1st Quarter 381 409 422 373 2nd ,, 408 441 417 406 3rd „ 537 564 344 386 4th „ 616 628 372 360 The Year 1.942 2,042 1,555 1,525 35 [1924 Work at the Disinfecting Station.-32,129 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 55,693 similar articles disinfected during the previous year. In addition to the above articles, 42,453 second-hand garments, mostly blankets, overcoats, jackets, vests and British warms were disinfected for clothing contractors trading in the Borough, who paid the Council for the work, amounting to the sum of £107 13s. Altogether, 74,582 articles described in the two paragraphs preceding were disinfected, which bring the number of large articles disinfected since the disinfecting station was established to 2, 026, 072. Summary of the chief articles of Clothing, Bedding, etc., disinfected during the year 1924, and also in the preceding year 1923. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1924 1923 Beds 476 479 563 569 2,087 2,512 Blankets 831 881 1,071 1,268 4,051 4,953 Bolsters 174 260 398 410 1,242 1,890 Carpets — 4 4 3 11 30 Chair Bed Cushions — 14 33 30 77 259 Mattresses 267 270 318 388 1,243 2,408 Palliasses 2 — — 2 4 23 Pillows 888 914 1,152 1,255 4,200 5,689 Quilts 390 393 476 501 1,769 2,105 Sheets 740 729 907 000 3,276 3,997 Other Articles 5,487 3,263 2,815 2,595 14,160 31,827 Total's 9,261 7,207 7,737 7,921 32,129 55,693 The nature of the articles disinfected for the clothing contractors is shown below:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Overcoats 3,688 3,607 298 3,098 10,691 Jackets 3,749 5,256 654 4,159 13,818 Blankets 2,312 2,475 — 12 4,799 Trousers 236 129 138 136 639 British Warms 1,231 1,687 — 757 3,675 Other Articles 3,435 2,708 314 2,374 8,831 14,651 15,862 1,404 10,536 42,453 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. Solution. Tons. cwts. Gallons. Gallons To Householders 1 0 320 — Disinfection of Premises - 85 Cost = £70 4s. 2d. 1924] 36 Shelter House.-The Shelter Mouse was occupied by 10 persons during-the disinfection of their homes after infectious diseases. Baths were given to verminous persons; also to 5 persons under the Cleansing of Persons Act, whilst their clothing was disinfected. Five midwives also attended lor the purpose of disinfection after attendance on cases of Puerperal Fever. Disinfestation of School Children (Cleansing from lice and other vermin),—During the year 4,614 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 disinfestation. The daily atendance ranged from 2 to 52. The agreement entered into between the London County Council and the Borough Council from the 1st January, 1921, for the cleansing of verminous children, is a payment at the rate of 2s. for each attendance of each child at Cleansing Station, except when such child is, or is suspected to be, suffering from Scabies, in which case payment by the London County Council will be at the rate of 1s. for each bath given. The minimum payment to be paid to the Borough Council in respect of such cleansing shall be not less than £100 per annum. The amount paid during the year by the London County Council for the baths given to the children was £423 5s. Proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, in 99 istances during the year, when fines ranging from 3s. 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 1924. Inspections and Visits.—The inspections and visits made by the three Inspectors were as under:— Factories, including Factory Laundries 615 Workshops, including Workshop Laundries 968 Workplaces, other than outworkers' homes 419 Bakehouses 324 Restaurant Kitchens 395 Outworkers' premises 1,135 Miscellaneous re-inspection and calls 5,271 Total 9,127 Notices Served —In consequence of the 1,284 sanitary defects discovered as the result of the inspections above ; 298 intimations and 24 statutory notices were served. Of these notices 75 were served on the owners of factories, 156 on the owners of the workshops and workplaces, and 49 on the owners of bakehouses and restaurant kitchens. In addition to these nuisances, 96 were discovered on Outworkers' premises, necessitating the service of 42 notices. Most of these defects were remedied so that it was not found necessary to resort to legal proceedings. Registers.—There were 2,048 workshops on the Register, as contrasted with 1,947 in 1923, while the total number of workrooms were 2,860, as contrasted with 2,766 in the previous year; 220 workshops were added to the Register, while 119 were removed from it, 37 [1924 The various workshops and workplaces are tabulated as below :— 1924. Workshops and Workplaces. Total Workshops on Register. Total Workrooms on Register. Number added during Year. Number removed during Year. Workshops where Men are employed 930 1,384 132 75 Workshops where Women arc employed 470 749 74 38 Laundries 17 43 - 1 Bakehouses 236 245 2 2 Restaurant Kitchens 395 439 12 3 Total 2,048 2,860 220 119 Outworkers' Premises 2,811 - 588 343 Workshops Notified to Home Office, 1924. Trade. Number of Workshops. Protected Employed Persons. Women. Male Young Persons. Total. Dressmaking 12 54 - 54 Furriers 2 4 — 4 Handbags 2 1 1 2 Boxes 1 7 . — 7 Wireless Apparatus 3 9 10 19 Umbrellas 1 1 — 1 Tailor 3 7 — 7 Artificial Flowers 1 50 — 50 Tie making 1 2 — 2 Millinery 3 14 — 14 Photo Frames 1 6 — 6 Mantles 1 4 — 4 Confectionery 4 44 1 45 Dyeing 1 4 — 4 Embroidery 1 3 — 3 Wireworker 1 — 3 3 Wood Carving 1 — 1 1 Clock cases 1 1 I 9 Waterproof Clothing 1 3 — 3 Piano Makers 4 — 6 6 Aluminium Foundry 1 — 2 2 Cabinet Making 1 — 1 1 Cycle Making 1 — 3 3 Patent Flooring 1 — 2 2 Motor Making 2 — 3 3 Baby Carriage Making 1 1 1 Total 52 214 35 249 INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. WrittenNotices Prosecutions. (1) (2) (3) (4) Factories 615 75 Nil. (Including Factory Laundries) Workshops 968 122 ,, (Including Workshop Laundries) Workplaces 1,138 83 ,, (Other than Outworkers' premises) Miscellaneous Re-Inspections and calls 5,271 - - Total 7,992 280 Nil. 1924] 38 DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied Referred to H.M. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts*— Want of cleanliness 302 301 Nil. Nil. Want of ventilation 18 10 ,, ,, Overcrowding 13 13 ,, ,, Want of drainage of floors 37 30 ,, ,, Other nuisances 459 464 ,, ,, Sanitary Accommodation insufficient 31 26 ,, ,, unsuitable or defective 420 419 ,, ,, not separate for sexes 6 5 ,, ,, Offences under the factory and Workshop Arts— Illegal occupation of underground bakehouse (s.101) Nil - - - Other offences ,, - - — (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921.) Total 1,284 1,280 Nil.† Nil. * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshops Act, 1901, as remediable under the Public Health Acts, f 18 Workshops were also notified H.M. Inspector, of failing to affix Abstract of Factory and Workshop Act, (s. 133). OUTWORKERS' PREMISES. Instances. Notices Served. Remedied. Prosecutions. Outwork in unwholesome premises (s. 108) 80 42 80 - Outwork in infected premises (s. 109, 110) 16 - - — Total 96 42 80 - OUTWORKERS' LISTS (s. 107): Lists received from Employers 1,798 Addresses received from Other Councils 2,313 Addresses forwarded to Other Councils 804 Firms failing to send in lists (No. letters sent) 455 OTHER MATTERS. Number. Matters notified to H.M. Inspector of Factories : Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 18 Action taken in matters referreil by H.M." Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5, 1901). Notified by H.M. Inspector 10 Reports (of action taken) sent to H.M Inspector 10 Other (New Factories reported under Home Office Memorandum, 1912) Nil Underground Bakehouses (s. 101) in use at the end of the year. 82 39 [1924 Legal proceedings in connection with workshops, FACTORIES, Etc., IN 1924. In November a complaint was received regarding a chocolate factory, which was visited the same day. The floor of the factory, which was a large one, was coated with a dirty deposit of fat and chocolate; the tables were also dirty, and dirt could be scraped from underneath them; the boiling pans and the receptacles for the boiled sugar were also very dirty. The tables did not appear to have been thoroughly washed for some time; the moulds were also very dirty. It was stated that the moulds seen were not the ones used, but when the others were asked for they could not be produced. The W.C.s were in an unsatisfactory and dirty condition. Forty-eight women and girls were employed in the factory at the time. In reply to a letter written by the Medical Officer of Health, the proprietor expressed regret and stated that the floor had been cleaned, and he hoped in a few days to have everything in a satisfactory condition. On visitation of the factory five days later, things were found in absolutely the same state. Another visit was paid on the 20th November, and the only change was that a small portion of the floor had been partially scraped. Chocolates were laid out in the yard to cool and were open to contamination from blowflies from stables near the factory. Owing to the Christmas vacation proceedings could not be taken at the moment. The case was, however, heard at the Islington Petty Sessions early in January, 1925, when the Chairman said: "The case, which was a very serious one, had been proved up to the hilt. It was unfortunate that the defendant did not take steps to stop the nuisance, which was a disgrace, and had continued for a long time. They could only fine him £1 and 10 guineas costs." Proceedings in this case had been taken under the London County Council (General Powers) Act, which for the first offence allows only a fine of £1. DISTRICT INSPECTORS' WORK. The fourteen district inspectors made a total of 57,907 inspections and calls during the year, an increase of 90 inspections on the corresponding period of 1923; while 13,896 improvements were effected in 6,239 premises; as against 13,175 improvements in 5,762 premises for the preceding year. Synopsis of Inspectors' Work,—The following statement gives a brief synopsis of the district inspectors' work in 1924 :— House to house inspections 3,110 Other inspections of dwelling houses 5,077 Re-inspections and calls made 45,994 Visits of inquiry *e notifiable infectious diseases 2,085 Butchers'shops, stalls, etc. (Saturday nights) 49 Ice cream shops and factories 146 Dairies and Milkshops 1,030 Stables and yards 1,712 Manure depots , 35 Smoke observations 180 Notices Served.—There were 4,385 intimation notices served by the inspectors with respect to nuisances, of which 316 were delivered personally, and 4,069 by post. In 617 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. 1924] 40 Defence of the Realm Act.— Pigs, Under the previsions of the above Act, and in order to ensure sufficient food supply, the provisions of the Public Health (London) Act, 1891, respecting- the keeping- of swine were relaxed somewhat, and occupiers of premises which were considered reasonably suitable were permitted to house and breed pigs. During this year the District Sanitary Inspectors have been successful in persuading the occupiers to dispose of them, and at the end of the year no pigs were housed in Islington. Verminous Premises—Bedding and Clothing.—91 premises which were found to be in a verminous condition, were cleansed by the owners or occupiers upon receiving the Inspectors' intimations. In 16 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification or destruction. Smoke Nuisances.—29 complaints of smoke issuing from factory chimneys in the Borough were investigated, and as a result 184 observations were made by the Districts Inspectors, and 11 notices served upon the owners of the businesses requiring the abatement of the nuisance. In two instances summonses were issued and resulted in orders being obtained in each case to prevent the recurrence of the nuisance and payment of £2 11s. costs. Schools.—A complaint was; received of a nuisance at Yerbury Road London County Council School, and upon visitation it was found that each department had a separate system of trough closet built in ranges with a varied number of compartments. All the trough closets were foul, some particularly so owing to the quantity of excremental matter fixed hard to the outlet sections of the troughs. This was no doubt due to the lips of all the last sections being cut away to lessen the depth of water retained, the cut places having been made good with cement. Some of these sections were cracked. Although the tanks were automatic, the method of Hushing said to be adopted was for the schoolkeeper two or three times a day to open the supply cocks to the several tanks, and after the contents were discharged, shut down the supply. The reason given for this was that "the tanks are not reliable." Two of the independent closets adjoining the ranges in the girls and infants departments were found to be disused, and the traps of each were unsealed and acting as ventilators to the drains. The Medical Officer of Health communicated immediately with the Medical Officer of Health of the London County Council, who had the matter at once put in hand and the apparatus put into thorough working condition. REMOVAL OF DUST. 33 applications were received during the year for the removal of dust, which is 17 above the number recorded last year. The applications received for the previous ten years were as follows:- 1014 26 1919 19 1915 28 1920 36 1916 21 1921 21 1917 30 1922 15 1918 11 1923 16 Dust Receptacles Provided. During the year 1467 dust receptacles were provided, while 18 were repaired after the service of sanitary notices. 41 [ 1924 Summary of Sanitary Work from Inspectors' Reports for the year 1924. Districts. Totals 1 2 4 5 6 8 9 10 11 12 13 14 House to House Inspections 170 230 265 220 208 282 178 49 389 242 212 247 185 233 3110 Other premises inspected 310 333 329 346 166 331 336 473 474 406 385 520 281 381 5077 Re-inspections, Calls made, etc. 2370 2637 3544 2567 2687 3515 .3672 4113 3593 3528 3622 3889 3367 2890 (45994 Ice Cream Factories inspected | — 2 42 26 1 21 3 - 21 3 1 5 19 2 146 Dairies and Milkshops 48 29 109 110 19 60 142 101 87 38 65 113 64 45 1030 Stables ,, 35 1 22 31 138 13 22 3 36 - - 1 2 17 321 Yards „ 150 53 292 105 205 9 365 13 54 2 13 2 94 34 1391 Manure Depots 7 - 1 25 — — — — 2 - ; - - - 35 Vacant land, Passages and Courts inspected 5 2 6 3 10 1 69 8 2 12 1 1 9 12 140 Urinals attached to P.H.'s spected 1 53 60 39 44 47 80 3 17 6 5 - 25 32 412 Premises (re Certificate Customs and Inland Revenue Acts) inspected - - - - - - - 12 - - - - - - 12 Premises (re Water Certificates) inspected — — — — — —- 6 4 - - - - - - 10 Visits re Sale of Food and Drugs Acts - - - - - - - - - - - - - - - Smoke observations 8 7 16 37 6 30 22 3 33 1 6 10 1 - 180 Shops, Stalls and Markets (Saturday evening) 3 4 4 3 5 4 2 5 2 3 3 5 2 4 49 Total Inspections and Calls 3113 3351 4689 3512 3489 4313 4897 4787 4710 4241 4313 4793 4149 3550 57907 Notices Served. . Intimation Personally 1 1 36 7 2 22 17 23 133 24 13 4 12 21 316 By Post 186 295 220 305 106 335 244 314 350 399 385 422 297 211 4069 Statutory Personally 1 3 — 5 3 11 — 1 15 11 — — 3 6 59 By Post 36 44 26 39 11 31 14 28 58 62 51 68 43 47 558 Improvements. Drains— Constructed — — — — 1 1 — — 2 — — — — 3 7 Re-constructed 5 13 7 7 5 15 4 5 7 18 — 2 13 4 105 Repaired 16 6 15 23 15 50 16 22 28 29 43 23 19 16 321 Ventilated 5 19 6 6 7 18 6 3 3 6 4 1 5 11 100 Gully and other taps fixed 26 90 43 38 22 53 26 26 21 39 12 1 14 24 435 Urinals— Water supplied, cleansed — 2 4 3 — 2 1 - 2 3 5 — 2 3 27 Cesspools-Abolished - - - - - - - - - - - - - - - Water Closet— W.C. erected with pan, trap and Water Supply - - 1 2 2 1 - - 5 3 1 - 1 2 18 Pan and trap only provided 12 46 24 23 10 23 17 22 18 47 65 8 17 21 353 Water supply provided 20 37 11 27 3 23 29 22 62 26 47 29 26 26 388 Ventilated - — 1 — — 6 2 — — 1 — 1 1 — 12 Position altered - — 3 1 — — — — — — - — — 4 Dust Bins Provided 86 129 96 89 16 78 172 160 78 151 108 147 98 59 1467 Repaired 1 — 1 — 5 3 1 2 — — 2 — — 3 18 Areas—Cons :ructed - — — — — 6 2 — — — — — 1 — 8 Yards Paved — 1 3 5 4 2 2 — — 3 — — — 2 22 Repaved 12 30 13 27 8 24 29 12 21 52 25 20 42 15 330 Sinks—Provided 4 8 4 10 2 7 4 — 1 3 5 1 1 3 53 Domestic Water Supply— 3 Cisterns Provided — — - — — — — — - — — - 1 4 Cisterns repaired and cleansed 12 15 23 23 6 22 29 5 31 11 12 6 14 12 221 Water supply provided to dwelling house - 1 3 8 1 - 3 5 2 2 — 9 - 2 36 Water supply provided to tenement house 1 4 - 10 1 21 1 2 6 4, 3 2 1 3 59 Other improvements— 260 145 352 306 533 323 Rooms cleansed & limewashed 103 137 318 234 86 196 342 200 3535 Walls and passages repaired, cleansed and limewashed 49 45 93 93 11 78 55 47 91 118 168 96 107 39 1090 Floor space ventilated 3 1 3 2 - 6 1 10 2 6 31 7 1 — 1 — 33 Floors repaired 11 21 38 29 9 37 12 24 36 33 37 26 354 Roofs repaired 58 75 89 94 5 81 96 72 108 133 205 140 145 94 1395 Overcrowding abated ... — — 1 1 — 1 2 — 3 — 1 2 1 — 12 Illegal use of underground rooms for sleeping discontinued - - - - - - - - 1 — 1 1 1 — 4 Other improvements, or 146 onces abated 72 102 94 150 38 184 131 116 137 313 114 134 107 1838 Rooms Disinfected 195 200 181 143 38 32 86 32 168 62 77 135 136 162 1647 Total improvements 691 982 1075 1048 295 1036 921 712 1193 1185 1667 1094 1159 838 13896 Total premises improved ... 359 468 505 495 107 371 446 363 567 439 612 593 512 402 6239 1924] 42 HOUSES LET IN LODGINGS. The 1,012 houses which come under the operation of the bye-laws received 216 inspections during the year, followed by 3,464 subsequent re-inspections and calls, so that the total visits amounted to 3,680. These inspections resulted in 484 intimations being served on the persons responsible, which were followed by 55 statutory notices to demand the abatement of the nuisances discovered by the inspector especially engaged upon this work. Five summonses were taken out for non-compliance with the notices served. Altogether, 1,934 improvements were effected in 486 premises. Synopsis of Inspectors' Work:— Improvements. Drains: Constructed — Reconstructed — Repaired 33 Ventilated — Gully and other traps fixed — Water Closets: W.C. erected with pan, trap and water supply 1 Pan and trap only provided 44 Water supply provided 23 Ventilated 1 Position altered — Dust Bins: Provided 93 Repaired — Areas: Constructed — Yards:: Paved — Repaved 29 Sinks: Provided — Domestic Water Supply: Cisterns provided — Cisterns repaired and cleansed 5 Water supply provided to dwelling house 3 Water supply provided to tenement house 1 Other Improvements: Rooms cleansed and limewashed 649 Walls and passages repaired, cleansed and limewashed 154 Floor space ventilated — Floors repaired 55 Roofs repaired 239 Miscellaneous improvements 604 Total Improvements 1,934 Total Premises Improved 486 RATS AND MICE (DESTRUCTION) ACT, 1919. (9 and 10 Geo. 5. Ch. 72.) Summary of Work under the Rats and Mice (Destruction) Act during the years 1920-24:— 1924 1923 1922 1921 1020 Number of Streets visited 91 544 711 669 607 Number of Private Houses visited 176 650 1,023 805 045 Number of Shops and Factories visited 19 712 1,009 1,034 1,326 Total Premises inspected 195 1,362 2,032 1,830 2,271 Found Rat Infested 61 787 1,331 1,406 1,355 Found Mice Infested 1 66 72 55 106 Defective Drains Repaired (Cause of Rat trouble) 60 13 52 45 34 Number of Complaints received 118 67 177 175 172 43 [1924 HOUSING. Islington Clearance Schemes. George's Road and Brand Street Areas. On 31st August, 1923, the Medical Officer of Health of Islington had made a representation to the London County Council, under Section 4 of the 1890 Housing Act, that owing to the closeness, bad arrangement, and bad condition the houses in the George's Road and Brand Street Areas were insanitary, dangerous and injurious to the health of those who inhabited them. The property was old, worn out, and, generally speaking, unlit for human habitation under modern conditions of sanitation. The areas were 4| acres in extent and were inhabited by 1,320 people. A Public Enquiry, made by order of the Ministry of Health, who appointed Mr. W. H. Collins as Inspector, was held at the Town Hall, Islington, on the 3rd December, when the London County Council were represented by Mr. William Allen, Barrister, who stated that the representation of the Medical Officer of Health of Islington had been very carefully considered by the London County Council, and after inspecting the areas the Council resolved on the 27th November, 1923, to prepare a scheme of improvement. The cost of clearing away at once all the insanitary areas of the metropolis would place too great a burden on the ratepayers. It was, therefore, the policy of the London County to deal with the worst spots first. The witnesses called included Lt.-Col. C. B. Levita, J.P., L.C.C., Dr. Butler, Medical Officer of the London County Council, and the Medical Officer of Health for Islington. Objections were raised regarding particular buildings, but no objection was made to the scheme as a whole. After hearing the evidence, the objections, and visiting the areas, the Inspector from the Ministry of Health stated that the matter would be considered and the decision of the Ministry made known in due course. As the result of actual visitation and enumeration in the areas it had been found in the year 1922 that the death-rate in the Brand Street Area was 34'0 per 1,000 inhabitants; in the George's Road Area 22'0 per 1,000. The rate for the whole Borough was 13.8 per 1,000. This was an indication that these areas needed special attention. The attack-rate for infectious disease (not including pulmonary tuberculosis) for the combined areas was 15.51; that of the whole Borough being but 8'37, while attack-rate when pulmonary tuberculosis was added was 18'38, against 10'08 for the whole Borough. Under the new London County Council Scheme it was proposed to make provision that 900 of the 1,320 inhabitants should be re-housed within the area, and it was proposed to build four blocks of dwellings, each five storeys high, to accommodate that number. The London County Council would provide accommodation elsewhere for the remainder. The cost of the scheme was estimated at ,£42,700, £40,000 for the acquisition of the land and £2,700 for the making of roads. No single trade predominated among the inhabitants; there were a good many costers, and it might be necessary to make some special provision lor sheltering their barrows. 1924] 44 The evidence of the Medical Officer of Health prepared for the Enquiry is appended. Evidence for local enquiry as to the conditioti of premises referred to in official representation, dated 31si August, 192a, made to the London C(Jimty Council by George Clark Trotter, M.D., F.R.S. (Ed.), Medical Officer of Health of the Metropolitan Borough of Islington. 3rd December, 1924. The premises are comprised in an area which may conveniently be divided into two sections, one on either side of Holloway Road, which have been named for convenience the BRAND STREET and GEORGE'S ROAD AREAS, the last-named, the George's Road Area, being in two portions, which may be termed HARTNOLL STREET AND HOPE PLACE SECTIONS. All the premises comprised in these areas have, since 1919, been the subject of Representations to the Islington Borough Council in respect of their serious condition, and my predecessor, the late Medical Officer of Health, had a minute survey made of them at the time. The conditions, however, have progressively become worse with the further deterioration of the properties. Brand Street Area. Many houses are more than a century old and of such construction that to render them suitable for occupation of a family, according to the recognised rules of modern sanitation and domestic hygiene, there would be entailed on the owner such considerable expenditure of money which would be impossible to be recovered from the rents obtained in the locality. Some attempt was made in 1911 to repair three of the houses in Brand Street, but the service of notices for nuisances in 1919 in respect of some of the properties had to be continued, the owner bitterly complaining that the property was carried on at a loss. Similarly in the same year the owner of Osnaburgh Cottages upon acquiring the property attempted to improve their condition in order to comply with the notices served, with indifferent results. The neighbourhood bore a bad reputation because of prostitutes who occupied some of the furnished rooms, but through the vigilence of the Women's Section of the Metropolitan Police Force this evil was removed. The occupiers are now of the working class. The insanitary condition of the properties probably commenced owing to the reputation the area bore, because few respectable people would live there, and subsequently the houses became occupied by people with large families who could ill-afford the rents of houses in better neighbourhoods. George's Road Area. Some years previous to 1919 an attempt was made to improve Bratton Street in this area. Back-to--back houses were converted into single houses; damp-proof courses were inserted in the walls, and a large common yard was converted into private yards. Unequal settlements of the old walls fractured the damp-proof courses in places, the old roofs sagged, and gutterings became 45 [1924 defective, with the result that the houses became damp. The fences dividing the yards were maltreated by the tenants, so also was a great deal of the plaster-work of the houses. The portion of Hope Place in this area consists of a row of one storey houses situated in a hollow of the ground. Most of them have two rooms, small and low, and extremely damp. The staircases are inside the rooms, narrow and badly arranged, brickwork defective and wet. Tiny yards, about four feet square, in some cases woodwork dilapidated. Owing to position and proximity of gardens, it is impossible to keep the houses dry. The general appearance of this row had led to the humorous observation, " this might be part of the old village of Islington." Inhabitants of the Area. Leaving out the few tradesmen in the district, it may be said that the population is of the lower working class. There are a few mechanics, the males who are employed, or are employable, are generally vanmen, porters, labourers, or costermongers. There, is however, an undue proportion of intermittent workers. A fair number of women go out to work. There is a general tendency to ignore dirt, and although there are some clean houses, most of them are very dirty. Statistics are given of the increased amount of infectious disease in the district. That it is not more is probably due to the people spending a considerable amount of their time out of their houses. The people cling to the neighbourhood; if they move from one house, which is now exceptional, it is to go to one next door or a few yards away. There are cases of families who have lived 30 or 40 years in the district. The intellectual level is low, and there is not much desire shown for improvement. From the ineffective attempts that have been made to save the rapidly disintegrating brickwork of these faulty and poorly constructed houses, lacking damp-proof courses, dampness extending in some cases up the walls to three or four feet, with tiny yards, poor ventilation, owing to the height of the walls in comparison with the narrow passageways, deficient light in the back rooms in the ground floors, bad arrangement of staircases, frequently opening out of room, absence of cupboard accommodation and coal storage, bad roofs and bulging walls, internal plaster work in bad condition, broken pavement in yards, etc., all as detailed in the schedules herewith incorporated, it is indeed obvious, considering in addition their faulty lay-out, that the only means of providing healthier accommodation, reducing the infectious and tubercular disease, is their demolition and an improvement scheme on the sites, which is the expressed opinion of my representation. METROPOLITAN BOROUGH OF ISLINGTON. Housing Statistics for Year Ending 31st December, 1924. Number of new houses erected during the year:— (a) Total 9 (/») With State assistance under the Housing Acts, 1919, 1923 or 1924 ; (i) By the Local Authority Nil (ii) By other bodies or persons 9 1924] 46 1. Unfit dwelling-houses. Inspection— (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,489 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 . 3,779 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceeding sub-heading) fonnd not to be in all respects reasonably fit for human habitation 1,698 2. Remedy of defects without service of formal notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers Not recorded 3. Action under Statutory Powers. (a) Proceedings under Section 28 of the Housing, Town Planning, etc. Act., 1919. (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil* (2) Number of dwelling-houses which were rendered fit after service of formal notices— (a) By owners Nil* (b) By local authority in default of owners Nil* (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil* (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which which notices were served requiring defects to be remedied 4,808 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 3,664 (b) By local authority in default of owners Nil *—2,291 houses (under £40 per annum rental) were however inspected under the Public Health Acts, and 1,740 notices were served upon the Owners of these houses, which were subsequently rendered fit for human habitation, 47 [ 1924 (c) Proceedings under Sections li and 18 of the Housing, Town Planning, etc., Act, 1909. (1) Number of representations made with a view to making of Closing Orders Nil (2) Number of dwelling-houses in respect of which Closing Orders were made Nil (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwellinghouses having been rendered fit Nil (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil (5) Number of dwelling houses demolished in pursuance of Demolition Orders Nil HOUSES OCCUPIED BY TWO OR MORE FAMILIES. CENSUS 1921. Metropolitan Borough Number of structurally undivided houses and shops. Number occupied by 2 or more families. Approximate proportion occupied by 2 or more families. 2 families. 3 or more families. Total. Per cent. Islington 36,759 12,604 14,292 26,896 73.2 St. Pancras 20,273 4,685 10,000 14.685 72.4 Finsbury 6,155 1,389 2,807 4,196 68.2 Shoreditch 11,162 3,869 3,144 7,013 62.8 Southwark 17,194 5,532 4,879 10,411 60.6 Fulham 19,105 9,230 2,315 11,545 60.4 Holborn 1,981 333 834 1,167 58.9 Paddington 14,452 2,609 5,773 8,382 58.0 Poplar 21,400 10,479 1,799 12,278 57.4 Bermonsdey 14,243 6,247 1,867 8,114 57.0 Hackney 30,800 13,154 4,265 17,419 56.6 Hammersmith 15,860 5,307 3,476 8,783 55.4 Stoke Newington 7,505 2,921 1,212 4,133 55.1 Bethnal Green 12,940 5,202 1,S97 7,099 54.9 Battersea 23,355 10,201 2,600 12,801 54.8 Deptford 15,983 7,519 1,207 8,726 54.6 Camberwell 37,718 15,670 4,170 19,840 52.6 Stepney 27,972 10,798 3,697 14,495 51.8 Lambeth 39,070 13,295 6,901 20,196 51.7 St. Marylebone 9,145 1,398 2,696 4,094 44.8 Chelsea 6,604 1,097 1,786 2,883 43.7 Kensington 17,825 2,728 4,408 7,136 40.0 Westminster 10,758 1,212 2,878 4,090 38.0 Greenwich 15,120 4,812 778 5,590 37.0 Hampstead 11,043 1,881 2,154 4,035 36.5 Wandsworth 50,643 13,110 2,272 15,382 30.4 Woolwich 25,203 5,892 789 6,681 26.5 Lewisham 31,524 7,137 992 8,129 25.8 City of London 840 68 72 140 16.7 Total (London) 552,632 180,379 95,960 276,339 50.0 48 1924] POPULATION 1021, living more than— Metropolitan Borough. 2 per room 3 per room 4 per room 5 per room 6 per room 7 per room 8 per room 9 per room 10 per room 11 per room 12 per room City of London 689 114 32 13 13 13 13 13 13 13 13 Battersea 20,390 3,260 565 144 61 — — — — — — Bermondsey 27,064 4,893 973 207 50 8 — — — — Bethnal Green 31,692 6,619 1,171 277 89 33 9 — — — — Camberwell 33,321 5,045 876 235 68 19 19 10 — — — Chelsea 7,859 1,469 311 69 33 19 11 11 11 — — Deptford 14,122 2,486 666 175 109 46 30 21 11 — — Finsbury 25,350 7,545 1,811 384 106 37 29 11 11 — — Fulham 20,265 3,643 796 257 79 37 29 20 — — — Greenwich 13,008 2,143 410 111 33 19 11 11 11 — — Hackney 24,859 3,559 521 110 45 17 9 — — — — Hammersmith 16,868 3,239 659 105 29 8 — — — — — Hampstead 5,243 993 224 68 14 — — — — — — Holborn 5,977 1,516 430 86 33 19 11 11 11 — — Islington 62,436 14,980 2,952 637 146 34 10 10 — — — Kensington 26,456 8,314 1,953 496 114 51 35 35 25 25 13 Lambeth 36,644 6,970 1,396 276 98 35 19 10 — — — Lewisham 8,026 1,124 24!) 72 7 — — — — — — Paddington 20,236 4,932 1,041 167 43 8 — — — — — Poplar 33,104 6,184 1,174 268 47 33 9 — — — — St. Marylebone 16,159 4,847 1,119 246 98 57 41 32 22 — — St. Pancras 43,687 11,907 2,889 625 193 95 31 — 22 — — Shoreditch 32,452 8,867 1,999 380 89 40 — — — — — Southwark 41,574 9,302 1,709 273 63 — — — — — — Stepney 68,921 17,1711 3,813 698 184 65 9 — — — — Stoke Newington 4,137 712 121 31 19 19 19 10 — — — Wandsworth 21,325 2,396 372 89 18 11 11 11 11 — — Westminster 11,364 2,066 352 98 15 8 — — — — — Woolwich 10,270 1,290 321 114 72 37 21 12 12 12 — Total (London) 683,498 147,591 30,904 6,711 1,968 763 376 250 160 50 26 STATE OF PAUPERISM IN THE BOROUGH. There was a marked decrease in the number of paupers relieved during the year for the weekly average was 11,792, compared with 13,914 in 1923 and 14,447 in 1922. Appended is a statement furnished bv the Clerk to the Islington Guardians:— Showing the Slate of Pauperism in the Borough during the year 1921. Quarters. 1 Average number Relieved during each week. Borough Death rates, 1924. 8 Indoor Paupers, Adults and Children. 2 Outdoor Paupers. Totals. 5 Totals corresponding periods 1923. 6 Children Boarded out. 7 Adults. 3 Children under 16. 4 1st Quarter 2,978 5,570 4,656 13,204 15,669 54 17.4 2nd 2,857 5,058 3,969 11,884 14,150 50 11.3 3rd 2,787 4,818 3,626 11,231 12,837 49 8.9 4 th „ 2,847 4,628 3,376 10,851 13,003 47 11.6 The Year 2,867 5,018 3,907 11,792 13,914 50 12.3 49 [1924 INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 778 visits to the 11 Slaughter Houses now on the register, including one Horse Slaughter House, and that he has ascertained that 12,202 animals were killed therein, namely, 670 oxen and cow s, 60 calves, 5,854 sheep and lambs, and 5,678 horses for human consumption, practically the whole of which were exported. These were mostly of good quality and free from disease, but in 2G cases meat and organs found to be diseased were destroyed (vide table on page 51). 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 — 5 3 0* Diseased or unsound meat, etc., from other sources — 3 0 11 Ox Feet rendered unsound during transit — 3 0 11 Corned Beef imperfectly preserved — 1 0 27 Fish — 17 2 16 Fruit, Vegetables, etc. 9 — — 8 Unwholesome Fruit Pulp from Jam Factory — 6 2 17 Total 10 17 2 6 * Of this quantity 3 cwt. 11 lbs. was Tuberculous. The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 10 tons 17 cwts. 2 qrs. G lbs. The diseases which affected animal food are set out in detail on page 57. Shops, etc , Inspection of.—The 636 shops and places where foodstuffs are sold may be approximated for the year as follows:— Butchers, provision dealers, etc., shops, 2.'30 ; meat, provisions, rabbits, tinned foods, etc., stalls, 20; food preparation establishments, 12; fish shops, 101; fish stalls, 10; fruit shops, 200; and about 60 fruit, etc., stalls and barrows. To these 18,397 visits were paid, apportioned as follows Butchers, Provision Dealers, etc., Shops7,419 visits. Food Preparation Establishments 133 ,, Butcher, Provision, etc., Stalls 1,639 ,, Fish Shops 1,315 ,, Fish Stalls 672 ,, Fruit Shops 2,713 ,, . Fruit Stalls 1,506 ,, Total 18,397 ,, Restaurant Kitchens.—The work of inspecting restaurant kitchens is tabulated under Workshops. This work is done by two Lady Inspectors. Cleanliness in the preparation of food is of the utmost importance, as any contamination may result in food poisoning, and though undoubtedly many cases of food poisoning are very slight, only resulting apparently in a transient attack of diarrhœa, occasionally public attention is drawn to rapid and fatal cases. It is thus apparent that the inspection of places where food is prepared is work of great importance. 50 1924] The inspection is made for unsatisfactory storage conditions, dirty utensils, and other nuisances. The following is a tabulated statement of the premises examined, and the results. In each case the unsatisfactory conditions were remedied without having to resort to prosecution. There was, however, a prosecution for lack of cleanliness in a factory (see page 39):— Number Inspected. Number found Unsatisfactory. Hotel and Restaurant Kitchens Coffee and Dining Rooms Refreshment Rooms Provision (Cooked Meats, cooked but not consumed on premises) 79 162 47 107 395 20 50 14 43 127 Prosecutions.—Two summonses were issued against a butcher for exposing for sale, and depositing for the purpose of sale, certain unsound turkeys and 1 goose; the defendant being fined .£10 and ordered to pay £3 3s. costs. Sale of Food Order.-Thirty-five summonses were taken out under the "Sale of Food Order, 1921," during the year, 22 of which were for selling Imported Eggs improperly labelled. 10 convictions were obtained, whilst in 5 other cases costs only were imposed. One summons was withdrawn where two were issued and a convictions obtained on the first. 13 prosecutions for Imported Meat not labelled resulted in 12 convictions, the defendant in the remaining case being ordered to pay costs. The total amount of fines and costs obtained was £117 17s. 6d. In addition to above prosecutions numerous warnings, both verbal and by letter, were given. The remarks under heading "Inexperience of Small Shopkeepers—Warnings," annual report, 1923, pages 46 and 47, apply to many who were given another chance. Cowsheds.—The 4 cowsheds within the Borough received 34 visits, and were found generally satisfactory. Offensive Trades include 4 tripe dressers, 3 gut scrapers, and the knackers' yard which received a total of 65 visits. The Inspector reports that he found no cause for complaint in the conduct of the business carried on in them. Removal of Offal.—Three proeecutions were taken against one firm. They had been previously warned, but persisted in removing the offensive matter during prohibited hours. At first the excuse was made that their particular transport arrangements had broken down on the day in question, but definite evidence was obtained that they continued to defy the letter and remove this fish offal during prohibited hours. In the matter of the prosecutions the Borough was assisted with evidence from the Police. Ten shillings and sixpence costs were awarded in the first case, and in the remaining two cases fines of £1 1s. and 1 guinea costs were imposed, 51 [1924 Tabulation of meat and organs diseased as found in slaughter-houses during the year 1924:— No. of Cases. Description of Animal Affected. Nature of Disease. Extent of Disease. How disposed of. 1 Ox Tuberculosis Head, tongue, lungs and membranes Council's Destructor. I Ox Tuberculosis Liver and part diaphragm „ „ 1 Ox Tuberculosis Lungs 1 Heifer Tuberculosis Forequarters, head, tongue, liver, lungs & trimmings „ 6 Oxen Parasitic (Dis Hepatm) Liver, or part of „ „ or on the premises. 14 Oxen Abscess Liver, or part of „ „ 1 Ox Enlarged & congested Liver ,, „ 1 Heifer Abscess Left Mammary gland Burned. Milkshops and Dairies.—At the close of the year there were 574 milkshops and dairies on the register, 29 having been added to it, while 85 were removed. The District Sanitary Inspectors paid 1,030 visits to them, and served 40 notices for the carrying out of various sanitary improvements and the cleansing of dirty utensils. BACTERIOLOGICAL EXAMINATIONS OF MILK. Four milks were bacteriologically examined and the tabular statement given below shows the result of their examination :— MILK AND DAIRIES (AMENDMENT) ACT, 1922. (Section 5.) PROHIBITION OF SALE OF TUBERCULOUS MILK. BACTERIOLOGICAL EXAMINATIONS OF MILK. No. Gelatin count at room temperature 48 hours. B. coli. Acid-fast bacilli in films Guinea-pig inoculation results. absent from present in 1.B 4,600,000 organisms per cc. .0001 cc. .001 cc. Nil. The cream and centrifuged deposits from 10 cc. of each sample were injected intraperitoneally into Guinea-pigs. No loss in weight occurred in any animal from week to week. Post-mortem examination of the animals 5 weeks after innoculation was NEGATIVE for T.B. 2.B 1,000,000 organisms per cc. .001 cc. .01 cc. Nil. 3.B 11,800,000 organisms per cc. .0001 cc. .001 cc. Nil. 4.B 4,000,000 organisms per cc. .001 cc. .01 cc. Nil. 52 19241 REPORT OF THE MEDICAL OFFICER OF HEALTH TO THE MINISTRY OF HEALTH UNDER THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS. 1912 and 1917. During the past year (1924), samples of Milk, Cream and Preserved Cream have been obtained to ascertain the extent to which the provisions of the Regulations are being carried out by the vendors. (1) Milk and Cream NOT Sold as Preserved Cream : Milk. Milk 673 Separated Milk 8 Total number of samples of milk examined for the presence of preservatives 681 Number in which preservative was found to be present Nil Cream. (2) Cream NOT Sold as Preserved Cream : Number of which preservative was found to be present 2 Cream Sold as Preserved Cream : (a) Instances in which samples have been submitted for analysis to ascertain if the statement on the label as to preservative were correct— Correct statements made 1 Statements incorrect — (b) Determination of Milk Fat in cream sold as preserved cream— Above 35 per cent. 1 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream have not been observed Nil (d) Particulars of each case in which the regulations have not been complied with, and action taken Note.—A further 30 informal samples were purchased, but not analysed. They had the orthodox preservatives label. The Public Health (Condensed Milk) Regulations, 1923, came into operation 1st October, 1923. The Public Health (Dried Milk) Regulations, 1923, came into operation 1st May, 1924. Informal samples were taken of both. COLOURING MATTER IN MILK. Three samples of milk were submitted of the Analyst for the detection of colouring matter, of these 2 were found to be coloured with annatto. 53 [1921 THE MILK AND DAIRIES (AMENDMENT) ACT, 1922; THE MILK (SPECIAL DESIGNATIONS) ORDER, 1922-23. The above Order came into force on 1st January, 1923, whereby Section 3 (1), The Milk and Daries (Amendment) Act, 1922:— A person shall not, either by himself or by any servant or agent, except under and in accordance with a licence granted by the Minister of Health, or with his authority under the provisions of an order made by him under this Act— (a) sell or offer or expose for sale any milk as "certified," " Grade A," or "pasteurized," or under such other designation as may be from time to time prescribed by order of the Minister; or (b) on, or in connection with, any sale or offer for sale or proposed sale of any milk, or in any advertisement, circular, or notice relating to any milk, describe or refer to the same as "certified," "Grade A," "pasteurized," or by any other designation prescribed as aforesaid, or use any description or designation, including or resembling any such description or designation. (2) A licence may be granted for the purposes of this section for such period and subject to such terms and conditions (including conditions as to the payment of fees) as may be prescribed by an order made under this Act. During the years 1923 and 1924, the following applications were made for licences under the provisions of the above Order to enable the persons to sell Specially Designated Milk:— LICENCES GRANTED UNDER MILK (SPECIAL DESIGNATIONS) ORDER, 1922-23. Designation. No. of applications. Number granted. Amount of Fees received. 1923 1924 1923 1924 1923 1924 £ s. d. £ s. d. "Certified " 2 2 2 2 0 10 0 () 10 0 "Grade A." (Tuberculin tested) 1 1 1 1 0 5 0 0 5 0 "Grade A." — 1 — 1 — — — 0 5 0 Pasteurized " (Dealer) 1 — 1 — 0 5 0 — — — "Pasteurized " (Pasteurizer) 2 3 2 3 2 2 0 2 9 0 "Pasteurized " (Supplementary) 1 2 1 2 0 2 0 0 4 0 7 9 7 9 3 4 0 3 13 0 ADULTERATION OF FOOD AND DRUGS. During the year 1,255 samples of foods and drugs were submitted for analysis by Mr. Green, the Food and Drugs Inspector, who purchased the samples for submission to our Analyst, Mr. A. Pinchin, B.Sc. Of the total samples 1,109 were reported to be genuine and 146 adulterated, or 11.6 per cent. This percentage is 5'4 higher than in the previous year, and 3.9 per cent. above the average rate during the preceding 10 years. 54 1924] The greatest amount of detected adulteration occurred in the fouth quarter of the year, as shown by the figures given in the statement below, when it was so high as 231 per cent. and contrasted with 76, 8'7 and 8'3 per cent., respectively, in the first, second and third quarters. Examined. Genuine. Adulterated. Per cent. 1st Quarter 393 363 30 7.6 2nd ,, 300 274 26 8.7 3rd ,, 276 253 23 8.3 4th „ 286 219 67 23.4 The Year 1, 255 1,109 146 11.6 Prosecutions.-55 summonses were issued under the "Sale of Food and Drugs Acts," of which 50 were successfully prosecuted. Altogether penalties and costs to the amount of £109 12s. were obtained. Four prosecutions were also taken under the "Milk and Dairies Amendment Act, 1922," resulting in convictions in each case with penalties and costs amounting to £11 11s. One other summons was taken out under the "Milk and Cream Regulations, 1912 and 1917," the defendant being ordered to pay £1 1s. costs. There were other infractions of a minor nature in which warnings were given. Informal Sampling.—This included 8 samples of Dried and 8 of Condensed Milk. DISPENSING OF PRESCRIPTIONS. As in former years (See Reports for 1923 and 1922.) tests were made in regard to the care displayed by Pharmacists in the dispensing of medicines. A simple prescription for neuralgia, containing Quinine Sulphate, Ammonium Bromide and Hydrobromic Acid, was dispensed by twelve chemists, trading in various parts of the Borough—four were far from accurate, and prosecutions were taken. No. 1 showed a deficiency of 45 per cent. in the prescribed amount of Sulphate of Quinine. The defendant's Counsel could offer no explanation except that perhaps the wrong weight had been put in the scales. No. 2 put in 25 per cent. more Quinine than the doctor required. No. 3 was 27 per cent. deficient in Quinine. Each was fined £5 with £2 2s. costs. No. 4 was 23 per cent. deficient in Quinine, 19 per cent. deficient in Ammonium Bromide, and had added 0.5 per cent. Phosphoric Acid, which was not ordered. The name of another person was on the label affixed to the bottle. It transpired that defendant, the proprietor of the shop, was not a qualified Pharmacist. His Solicitor volunteeered the statement " that he did not often make up prescripions, although from long experience, provided that they did not contain anything dangerous, he was capable of doing so. He regretted that the prescription was 55 [192-4 not accurately dispensed. It so happened that when the Inspector's messenger presented the prescription his assistant, who was a qualified chemist, was not in the shop." The Chairman of the Petty Sessions said that "this case was a much more serious one that those previous, and the Bench had decided to inflict a fine of £7 and £2 2s. Od. costs. They viewed with considerable alarm the amount of wrong making up that seemed to take place in regard to prescriptions. If there was one tradesman to whom the public looked for reliability it was the chemist, and they hoped that more care would be taken in the dispensing of prescriptions." Milk.—The qualitative results of the Analyses of the Milk samples, which have now been published for many years, are as follows:— No. of Samples. Solids not Fat. Fat. Total Solids. Milk purchased on Sundays 120. 8.74 3.12 12.16 Milk purchased on week-days 399 8.78 3.48 12.26 Milk procured in transit at Finsbury Park Station 102 8.87 3.65 12.52 Official Standard — 8.50 3.00 11.50 Sophistication of Milk.—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 120 1ll 9 7.5 On Week-days 399 381 18 4.5 At Railway Stations 162 151 8 4.9 (Farmers' Milks) - - - - 681 646 35 5.1 - - Giving the particulars of the Milks taken during each quarter of 1924 on Sundays Week-days, and at the Railway Stations. 1924. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Quarters. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. 1st Quarter 30 123 35 188 28 116 34 178 2 7 1 10 6.6 5.7 3.0 5.3 2nd „ 30 107 54 191 30 101 48 179 — 6 6 12 — 5.6 11.1 6.0 3rd „ 30 122 42 194 27 118 41 186 3 4 1 8 10.0 3.3 2.4 4.1 4th „ 30 47 31 108 26 46 31 103 4 1 — 5 13.3 2.1 — 4.6 The Year ... 120 390 162 681 111 381 154 646 9 18 8 35 7.5 4.5 4.9 5.1 The number of samples of milk purchased was G81, of which 646 were genuine and 35, or 5.1 per cent., were adulterated. 56 1924] Showing the samples of milk reported as genuine or adulterated during the past 10 years and in 1924:— MILK ADULTERATION. Samples Analysed. Genuine. Adulterated Per cent. Adulterated. 1914 595 539 56 9.4 1915 605 531 74 12.2 1916 599 506 93 15.5 1917 592 526 66 11.1 1918 634 537 97 15.3 1919 638 579 59 9.2 1920 642 605 37 5.7 1921 644 605 39 6.0 1922 638 576 62 9.7 1923 676 644 32 4.7 Totals 10 yrs. 6,263 5,648 615 9..7??? 1924 681 646 35 5.1 Showing the analysis of 6,914 milks examined in Islington during the 10 years 1914-23 and l924, 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. 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 1921 151 8.83 3.34 371 8.79 3.37 122 8.91 3.73 1922 120 8.78 3.39 356 8.76 3.34 162 8.75 3.60 1923 120 8.82 3.55 388 9.08 3.63 168 8.90 3.63 Total samples and average constituents (10 years) 1,485 8.66 3.47 3,442 8.70 3.48 1,336 8.81 3.66 1924 120 8.74 3.42 399 8.78 3.48 162 8.87 3.65 57 [1924 The Public Analyst, in the quarterly reports during the year, reported on the genuineness of the articles examined as follows:— Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1924. Description. 1st Qr- 2nd Qr. 3rd Qr. 4th Qr. Total Samples. Genuine. Adulterated. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Totals. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Totals. Milk 181 191 194 107 673 171a 179a 186a 102a 638 10 12 8a 5a 35 Milk (separated) 7 — — 1 8 7 a — —' 1 8 — — — — — Butter 45 34 28 45 152 43 32 25 38 138 2 2 3 7 14 Lard 20 7 3 1 31 20 7 3 1 31 — — — — — Dripping 9 4 2 1 16 9 4 2 1 16 — — — — — Cheese 19 13 3 1 36 19 13 3 1 36 — — — — — Cocoa 29 8 7 — 46 29 8 7 2 46 — — — — — Coffee 9 2 3 1 15 9 2 3 1 15 — — — — — Self-Raising Flour 12 6 1 — 19 126 66 l — 19 — — — — — Pepper 9 1 5 1 16 9 1 5 1 16 — — — — — Custard Powder 7 2 2 1 12 76 26 26 16 12 — — — — — Arrowroot 6 1 2 1 10 6 1 2 1 10 — — — — — Ground Ginger 4 — — — 4 4 — — — 4 — — — — — Rice 4 1 3 1 9 4c 1 c 3 c 1 c 9 — — — — — Raspberry Jam 3 — — — 3 3d — — — 3 — — — — — Black Currant Jam 3 — 1 — 4 3d — 1f — 4 — — — — — Strawberry Jam 2 — 1 — 3 2d — 1f — 3 — — — — — Curry Powder 2 1 — — 3 2e 1e — — 3 — — — — — Crushed Linseed 2 1 — — 3 2 1 — — 3 — — — — — Whisky 1 1 — 7 9 1 1 — 4 6 — — — 3 3 Suet 1 — — — 1 1 — — — 1 — — — — — Malt Vinegar — 10 — 39 49 — 7 — 17 24 — 3 — 22 25 Vinegar — 5 3 24 32 — 5 3 24 32 — — — — — Apricot Jam — 1 — — 1 — 1/ — | — 1 — — — — Wheat Flour — 1 — — 1 — 1 — — 1 — — — — Mustard — 1 2 12 15 — 1 2 11 14 — — — 1 1 Honey — — 2 1 3 — — 2a — 3 — — — — — Ground Cinnamon — — 1 — 1 — — 1 1 — — — — — Tapioca — — 1 — 1 — — 1 — 1 — — — — — Brandy — — — 2 2 — — — 2 2 — — — — — Butterette — — — 1 1 — — — — — — 1 1 Friar's Balsam — — — 1 1 — — — 1 1 — — — — — Prescription — — — 12 12 — — — 8 8 — — — 4 4 375 291 264 262 1,192 363 274 253 219 1,109 12 17 11 43 83 Margarine 18 9 12 24 63 — — — — — 18 9 12 24 63 Totals 393 300 276 286 1,255 363 274 253 219 1,109 30 26 23 67 146 (a) Free from Boric Acid and Formalin. (b) Conformed to the Local Government Board's requirements with regard to Arsenic and Sulphate of Lime. (c) do. do. with regard to extraneous mineral matter. (d) Free from Salicylic Acid, Sulphates and Arsenic except in the case of 639% Raspberry Jam which contained a trace (0.01 % of Sulphur Dioxide. (e) Free from Lead and Arsenic (f) Free from Arsenic and Preservatives. (g) Preservatives absent. 1924] 58 Milk Prosecutions. The summary of prosecutions showed that during the year 23 prosecutions were taken, of which number 16 were successful, and 5 were dismissed, while 2 were withdrawn. Summary of Prosecutions during year 1924. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties Received. £ s. d. "Public Health (London) Act, 1891" 39 33 2 4 69 17 6 "Sale of Food and Drugs Acts, 1875-99" 29 24 4 1 64 17 0 "Margarine Act, 1887" 26 26 — — 44 15 0 "Sale of Food Order, 1921" 35 34 — 1 104 14 6 "Milk & Cream Regulations, 1912-17" 1 1 — — 1 1 0 "Milk & Dairies Amendment Act, 1922" 4 4 — — 11 11 0 "Metropolis Local Management Act 1855" 1 1 — — 1 1 0 "L.C.C. General Powers Act, 1902" 2 2 — — 4 1 0 "L.C.C. By-Laws". 4 4 — — 8 8 0 Totals 141 129 6 6 310 6 0 PETTY SESSIONS. The Public Health Committee had before them during the year representations from the Medical Officer of Health in regard to a congestion of cases at the Clerkenwell Police Court. He gave specific instances of what had happened in the previous year, and how so much of the time of the stall" was wasted by adjournments at this Court, and compared the rapidity of the procedure at the North London Police Court, which serves practically the rest of the Borough, only a small portion going to Old Street. The matter was referred to the Law and General Purposes Committee, and after due consideration steps were taken to support the establishment of a Petty Sessional Court at the Town Hall which would deal with the legal proceedings taken by the Public Health Department which would in the ordinary course go to Clerkenwell Police Court. The Court was established at the Town Hall, Islington, sitting at 2 o'clock in the afternoon, on alternate Fridays from the 20th June, 1924. Paper Wrappings— Sale of Food.—The Borough Council resolved, 21st March, on the motion of Councillor Ricketts, pursuant to notice— (a) That in view of the very great danger to public health from newspapers, which may have been in sick rooms where there are cases of infectious disease, being used for wrapping up food sold for human consumption, the Council are of opinion that all foodstuffs for human consumption should be wrapped in grease-proof or similar paper, free from printer's ink, which often the moisture of the food absorbs from the paper, and that all papers for wrapping up food of any kind should be kept in the shops quite apart from any living room, and open for inspection; and that H.M. Government be asked to introduce legislation to this effect. 59 [1924 (b) That copies of the foregoing resolution be forwarded to the Members of Parliament for Islington, asking their support for such legislation when introduced, and that the other Metropolitan Borough Councils be asked to take similar action. PUBLIC HEALTH STAFF. The staff of the Medical Officer of Health is constituted as follows:— *Chief Sanitary Inspector and Superintendent.—George James Bridel.† *Sanitary Inspectors.—T. W. Agar, H. J. Bicknell, A. Bagshaw, S. P. Marks, E. I. Fortune, J. Metcalf, T. II. Hancock, C. E. Horsman, A. E. Wood, E. G. Holmes, E. J. Nether, F. H. Chuter, II. H. Uren, * C. W. Lewis. (Houses let in Lodgings), H. Dewhurst. *Senior Sanitary Inspector. Inspector oj Workshops and Bakehouses.— H. J. J. Watson. *Inspectors of Workshops, etc., in which Females are Employed.—Eleanor H. Daniell, Mrs. S. Undery. *Inspector of Meat, etc.—H. Wilkinson. *lnspector of Food and Drugs, etc.—G. S. Green. Disinfecting Station.—A. Lewis (Engineer), W. G. Jollie (Handyman— Stoker), Mrs. Home (Cleansing Station Attendant), Mrs. Lewis (Caretaker, Shelter House), G. Cooper (Motor Driver). Disinfcctors.—F. Webb, J. Brown, W. Hardwick, W. Woodley, A. Taylor. Mortuary Keeper.—S. Maxwell. Clerical Staff.—G. II. King (First Clerk), H. Angel, A. E. Abbott, W. J. Wolfe, W. G. Bunch, A. R. Wittrick, *C. M. Wheble, A. E. Booker, W. R. Causton, *C. J. Cridland, L. W. Edis. Milk Grants.—*F. C. Green, *A. E. Vanstone, *Daisy Francis. *Health Visitors.—Mrs. F. Looker, Miss V. A. Lainton, R. Palmer, L. Flower, E. Foot, A. Taylor, E. Neale. *Assistant to Medical Officcr of Health.—Beatrice Garvie, L.R.C.P. & S. (Edin.), D.P.H.§ § Dr. Garvie resigned 21st March, 1924. † Mr. Bridel appointed Superintendent 19th September, 1921. Those marked with an asterisk indicates contribution was expected either under the Public Health Acts or by Exchequer Grants. 60 1924] The following Tables appeared in the Annual Report for 1921. Reference is made here to them as they have not been reprinted to save space this year for other matter:— Illegitimate births in the Borough since 1851 PAGE 3 Deaths of inhabitants in local institutions and in institutions out- side the Borough, deaths of non-inhabitants in local institutions from 1911 11 Births and birth-rates (Islington) 1811 to 1920 46 Illegitimate births (Islington) 1811 to 1920 4G Deaths and death-rate (Islington) 1811 to 1920 47 Infantile mortality returns, 1841 to 1920 47 Cases of infectious disease (Islington) in quinquennial periods, 1891 to 1920 48 The Medical Officer of Health expresses his thanks to the Town Clerk, C. G. E. Fletcher, Esq., C.B.E.; the Solicitor, Arthur M. Bramall, Esq.; the Borough Engineer, J. P. Barber, Esq.; the Public Analyst, A. E. Pinchin, Esq., B.Sc., and to the Heads of other Departments, for their courtesy and assistance in various matters. He takes this opportunity of expressing his indebtedness to the staff for the efficient work and thorough co-operation which has meant so much in attaining the results reported on. APPENDIX. Vital and Sanitary Statistics, 1924. TOGETHER WITH THE PRESCRIBED RETURN OF THE MINISTRY OF HEALTH. 62 1924] STATISTICAL APPENDIX. Showing the Deaths from all Causes in Islington during the Year 1924. 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. Male 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. Small Pox (a) Vaccinated — — — — — — — — — — — — — — — — — — — — — — — — (c) Unvaccinated — — — — — — — — — — — — — — — — — — — — — — — — — (c) No Statement — — — — — — — — — — — — — — — — — — — — — — — — — 17 Measles 24 78 1 — — — — — — — — — — 102 1 9 6 9 13 6 34 26 54 49 103 1 Scarlet Fever 1 8 1 — — — — — — — — — — 9 1 2 — — 1 1 5 1 4 6 10 Typus Fever — — — — — — — — — — — — — — — — — — — — — — — — — 12 Epidemic Influenza 5 6 1 2 3 7 7 10 12 19 10 14 2 11 93 10 10 7 14 24 12 27 57 47 104 5 Whooping Cough 20 35 2 — — — — — — — — _ — 55 2 5 6 9 12 5 15 5 19 38 57 2 Diphtheria — 23 6 3 1 — — — — —_ — — 23 10 4 3 1 3 6 12 4 17 16 33 1 Enteric Fever — 2 — — — — 1 1 — — — — — 2 2 — — — 2 1 1 — 3 1 4 Asiatic Cholera — — — — — — — — — — — — — — — — — — — — — — — — — Diarrhœa Dvsentery 12 — — — — — — — — 2 — — — 12 2 2 1 1 — 2 1 7 10 4 14 Epidemic Enteritis 5 1 — — — — — — — — — — — 6 — — — — 1 2 1 2 2 4 6 1 Other Allied Diseases *2 *1 — — — — — — — — 1 — — 3 2 — — — 1 — 1 3 3 2 5 Hydrophobia — — — — — — — — — — — — — — — — — — — — — — — — — Glanders — — — — — — — — — — — — — — — — — — — — — — — — — Tetanus — — — — — — — 1 1 — — — — — 2 — — 1 — — — 1 1 1 2 Anthrax — — — — — — — — — — — — — — — — — — — — — — — — — Cow Pox — — — — — — — — — — — — — — — — — — — — — — — 3 Syphilis 4 1 — — — — — — — — 1 — — — 1 2 1 — 1 1 — 1 2 4 6 2 Gonorrhœa — — — — — — — 1 1 — — 1 — — 3 — 1 — 1 — — 1 3 — 3 Phaycdæna — — — — — — — — — — — — — — — — — — — — — — — — — 3 Erysipelas — 1 — — — 2 2 — 1 1 1 2 — 1 9 1 2 3 — 1 2 1 4 6 10 2 Puerperol Fever — — — — — 1 4 3 — — — — — — 8 — — — 3 1 1 3 — 8 8 1 Pyæmia — — — — — 1 — 3 1 1 — 1 — — 7 — 2 — — 2 3 — 2 5 7 3 Infective Endocarditis — 2 1 — 1 4 1 5 1 — — — — 2 13 — 1 2 4 1 5 2 8 7 15 1 Other Allied Diseases — — — — — — — — 1 1 2 — — — 4 1 — — 2 1 — — 3 1 4 Malarial Fever — — — — — — — — — — — — — — — — — — — — — — — — — 1 Rheumatic Fever — — 1 2 — — — — — 1 — — — — 4 — 1 — — 1 1 1 3 1 4 Rhedunatism of Heart. — — — 1 1 — — — 1 — — — — — 4 — _ — — 1 — 3 — 4 4 9 Tuberculosis of Brain. 5 15 3 2 1 2 1 — — — — — — 20 9 6 2 2 1 7 3 8 17 12 29 Tuberculosis of Larynx — — — — — 1 — — 1 — — — — — 2 — — — — — 1 1 1 1 2 108 Phthisis 3 13 — 4 25 40 77 68 57 37 12 2 — 16 322 36 34 30 33 58 64 83 193 145 338 3 Abdominal Tuberculosis 1 1 3 1 3 — 2 1 2 1 — — — 2 13 — 3 1 1 2 4 4 9 6 15 1 General Tuberculosis 1 — 1 — — — 1 — 1 — — — — 1 3 — 1 — — 2 1 — 4 — 4 4 Other forms Tuberculosis — — 2 1 3 — 4 1 — — — — — — 11 2 1 — 4 1 1 2 7 4 11 Other Infective Diseases — — — — — — — — — — — — — — — — — — — — — — — — — Thrush 1 — — — — — — — — — — — — 1 — — — — 1 — — — — 1 1 Actinomvcosis — — — — — — — — 1 — — — — — 1 — — — — 1 — — 1 — 1 Hvdatid Diseases — — — — — — — — — — — — — — — — — — — — — — — — — Scurvy — — — — — — — — — — — — — — — — — — — — — — — — — Other Diseases due to Altered Food — — — — — — — — — — — — — — — — — — — — — — — — — Acute Alcoholism — — — — — — — — 1 — — — — — 1 — — — 1 — — — 1 — 1 Chronic Alcoholism — — — — — — — — — 1 1 — — _ 2 — — — — 2 — — 1 1 2 Chronic Industrial Poisonings — — — — — — — — — — — — — — — — — — — — — — — — — Other Chronic Poisonings — — — — — — — — — — — — — — — — — — — — — — — — — Ostoo arthritis — — — — — 1 — 2 1 3 6 5 2 — 20 1 — 2 1 5 5 6 5 15 20 Gout — — — — — — — — — 1 _ 2 — — 3 — — — — 1 1 1 2 1 3 128 Cancer — 1 1 — — 4 9 38 77 131 149 52 8 1 469 51 61 38 61 90 66 103 214 256 470 Diabetes Mellitus — — — — 2 — 1 3 3 6 9 3 — — 27 4 4 3 3 4 3 6 15 12 27 Purpura Hæmorrhagica 1 — — — — — — — — — — — — 1 — — — — — — — — 1 — 1 Haemophilia — — — — — — — — — — — — — — — — — — — — — — — — — Anæmia — — — — 1 — — 1 4 2 4 1 — — 13 1 2 2 1 1 2 4 6 7 13 Lymphadenoma — — — — — — — 1 2 — — — — — 3 1 — — — 1 1 — 2 1 3 Premature Birth 77 — — — — — — — — — — — — 77 — 7 8 9 13 12 13 15 46 31 77 Injury at Birth 3 — — — — — — — — — — — — 3 — — — — 2 — — — 3 — 3 Debility at Birth 3 — — — — — — — — — — — — 3 — 2 — — 1 — — — 2 1 3 Atelectasis 12 — — — — — — — — — — — — 12 — 1 2 — 4 2 2 1 10 2 12 Congenital Defects 36 4 — — — — — — — — — — — 40 — 2 5 3 5 8 8 9 28 12 40 Want of Breast Milk — — — — — — — — — — — — — — — — — — — — — — — — Atrophv, Debility, Marasmus 33 3 — — — — — — — — — — — 36 — 7 4 1 8 2 6 8 21 15 36 * Cerebro-Spinal Fever (4). 63 [1924 Continued. Deaths in Institutions within Borough. DISEASES. AGES. Under 5 Over 5 Tuf. U.H. DISTRICTS. B. S.E. Males. Females. Totals. 0- 1- 5 - 10 15- 20- 25 35 45 55 65 75 85 Toll. L.H. H. Dentition 2 1 — — — — — — — — — — — 3 — — 1 1 — — 1 — 1 2 3 Rickets — l — — — — — — — — — — — 1 — — — — 1 — — — 1 — 1 Old Age, Senile Decay — — — — — — — — — 1 43 140 80 — 264 33 35 24 31 51 39 51 92 172 264 Convulsions 9 — — — — — — — — — — — — 9 — 1 v 1 2 1 3 1 5 4 9 Meningitis 4 3 2 — — — — — — 1 — — — 7 3 1 1 1 3 2 2 — 5 5 10 Encephalitis — 1 — 2 — — — — 1 — 1 — — 1 4 1 — — — 2 2 — 2 3 5 Apoplexy 4 — — — — — — 2 16 30 57 36 4 4 145 6 11 13 16 38 27 38 69 80 149 Softening of Brain — — — — — — — — — — 2 3 — — 5 1 1 — l 2 — — 4 1 5 Hemiplegia — — — — — — — — 2 2 6 2 2 — 14 1 2 — 2 5 2 2 6 8 14 1 General Paralysis of the Insane — — — — — — — 8 6 2 — 1 — — 17 5 — 3 1 2 5 1 16 1 17 Other form of Insanity — — 1 — — — 1 2 1 1 2 1 — — 9 — 1 — 1 4 1 2 4 5 9 Chorea — — — — — — — — — — — — — — — — — — — — — — — — — Cerebral Tumour — 1 3 — — — 4 2 3 — 1 — — 1 13 — 1 — 2 2 3 6 7 7 14 Epilepsy 1 — — 3 1 3 4 2 3 2 2 1 — 1 2 1 4 3 1 3 3 3 5 8 14 22 Laryngismus Stridulus — — — — — — — — — — — — — — — — — — — — — — — — — Locomotor Ataxy — — — — — — — 1 3 2 2 — — — 8 — — — 1 3 2 2 7 1 8 Paraplegia — — — — — 1 — — — 8 3 1 — — 13 — 1 2 1 5 3 1 5 8 13 Other forms, Brain Diseases — ‡1 †l §1 — — †2 †4 2 †3 1 — — 1 14 2 4 1 1 ~~ 3 4 7 8 15 Otitis 2 2 — 1 1 1 — — 1 1 2 — — 4 7 3 — 1 1 1 3 2 6 5 11 Disease of Nose, Epistaxis — — — — — — 1 — — — 1 — — — 2 — — — — 2 — — 2 — 2 Disease of Eye — — — — — — — — — 1 — — — — 1 — — — 1 — — — 1 — 1 Pericarditis — — — — — — — 1 — — — 1 — — 2 — — 2 — — — — — 2 2 9 Endocarditis — — — 1 3 4 1 2 3 2 2 1 1 — 20 2 4 2 2 — 2 8 11 9 20 Hypertrophy of Heart. — — — — — — — — — — — — — — — — — — — — — — — — — 1 Angina Pectoris — — — — — — — 1 3 3 4 — — — 11 2 1 — 1 2 1 4 8 3 11 1 Aneurism — — — — — — — 1 1 2 1 — 1 — 6 — — — 1 1 2 2 3 3 6 1 Senile Gangrene — — — — — — — — — 3 5 2 — — 10 — 2 — 1 2 2 3 1 9 10 31 Embolism, Thrombosis 1 — — — — — 1 3 6 12 22 16 1 1 61 7 4 8 9 8 9 17 27 35 62 5 Phlebitis — — — — — — — 1 1 2 — — — — 4 1 — — 2 — 1 — — 4 4 Varicose Veins — — — — — — — — — — — — — — — — — — — — — — — — — 213 Other Diseases, Heart and Vessels 5 3 5 5 7 5 19 35 67 144 220 167 25 8 699 82 89 65 70 121 126 154 337 370 707 1 Laryngitis — 2 — — — — 1 — — — — — — 2 1 1 — — 1 1 — — 1 2 3 Croup — — — — — — — — — — — — — — — — — — — — — — — — — Other Diseases, Larynx and Trachea. — — — — — — — — — — — — — — — — — — — — — — — — — 25 Acute Bronchitis 19 2 — — 1 — 3 2 4 13 26 28 8 21 85 1 4 14 9 16 18 17 18 37 69 106 61 Chronic Bronchitis 16 5 1 1 — — 1 9 22 39 93 72 18 21 256 23 18 21 38 43 65 69 129 148 277 16 Lobar Pneumonia 5 4 1 1 2 3 3 7 11 13 22 8 — 9 71 8 12 10 11 10 12 17 44 36 80 68 Lobular Pneumonia 62 63 4 — 1 3 2 8 9 14 37 18 4 25 100 17 12 28 34 33 50 51 104 121 225 4 Pneumonia 10 4 — 1 1 1 1 4 7 8 7 5 1 14 36 2 12 3 7 10 3 13 25 25 50 5 Emphysema, Asthma — — — — — — 1 2 2 6 6 3 — — 20 1 5 2 1 4 1 6 7 13 20 4 Pleurisy — — — — — 1 2 4 — 5 3 2 2 — 19 3 2 1 1 6 3 3 11 8 19 2 Other Diseases, Respiratory System — 2 1 — 1 1 3 3 1 3 1 1 — 2 15 2 3 — 4 2 1 5 15 2 17 Diseases of Mouth and Annexa 1 — — — 1 — 1 1 — — — — — 1 3 3 — — — — 1 — — 4 4 Diseases of Pharynx — 2 — — — — — — — — — — — 2 — 3 1 — — — 1 — 2 — 2 Diseases of (Esophagus — — — — — — — 1 — — — 1 — — 2 — 1 — 1 — — — 1 1 2 1 Ulcer of Stomach and Duodenum — — — — — 2 — 7 12 11 6 2 — — 40 — 3 4 3 11 4 7 27 13 40 18 Other Diseases of the Stomach 1 — — — — — — — 1 2 2 1 — 1 6 8 — — — 3 1 3 2 5 7 6 Enteritis 28 6 — — 1 1 — 1 — — 3 — — 34 6 — 3 3 9 6 11 6 24 16 40 Appendicitis 1 2 1 3 2 3 6 1 4 3 1 — — 3 24 2 1 2 4 9 3 15 16 11 27 Obstruction of Intestines 3 — — 1 1 — 1 1 3 5 5 4 — 3 21 3 1 3 4 5 5 5 9 15 24 2 Other Diseases of Intestines — — — — — — — 2 3 3 3 — — — 11 1 1 3 2 2 1 2 5 6 11 Cirrhosis of Liver — — — — — — — 1 1 5 5 1 — — 13 — 1 1 1 4 3 2 8 5 13 1 Other Diseases of Liver — — 1 — 1 — — — 1 — 1 1 — — 5 1 2 — — 1 — 2 2 3 5 Peritonitis — — 1 — 2 — — 3 2 2 — 1 — — 11 — — 1 2 1 — 6 4 7 11 Other Diseases, Digestive System 1 — — — — — — 1 — — 1 — — 1 2 1 — 1 2 — — — 3 — 3 Diseases, Lymphatic System and Glands — — — — — — — 1 2 3 2 — — — 8 — 1 — 1 3 — 3 2 6 8 1 Acute Nephritis 1 — — — — — — l 1 — 1 — — 1 3 — 1 — — — 1 2 — 4 4 20 Bright's Disease 3 — — 1 1 1 5 6 15 20 17 10 1 3 77 12 8 5 5 18 13 19 45 35 80 Calculus — — — — — — — 1 1 — 1 2 — — 5 — — 1 1 — 2 1 1 4 5 Diseases of Bladder and Prostate — — — — — 1 — — — 3 15 7 4 — 30 6 2 5 1 6 5 5 27 3 30 Other Diseases, Urinary System — — — — — — 1 2 4 1 6 3 — — 17 5 — 5 2 3 4 2 9 8 17 Diseases of Testis and — — — — — — — — — — — — — — — — — 1 — — — — — — — 1 Diseases of Ovaries — — — — — — 1 1 — 1 — — — — 3 — — — — 1 — 1 — 3 3 1 Diseases of Uterus and Appendages — — — — — — 1 2 — — — — — — 3 1 — 1 — 2 — — — 3 3 Diseases of Vagina and External Genitals — — — — — — — — — — — — — — — — — — — — — — — — — Diseases of Breast — — — — — — — — — — — — — — — — — — — — — — — — — 1 Abortion, Miscarriage. — — — — — 1 1 — — — — — — — 2 — — — — — 1 1 — 2 2 Puerperal Mania — — — — — — — — — — — — — — — — — — — — — — — — — Puerperal Convulsions — — — — — — — — — — — — — — — — — — — — — — — — — Placenta Prævia, Floorting — — — — — 1 2 1 — — — — — — 4 — — — — — — 3 — 4 4 † Enoophaiitig Lethargica (4). ‡ Aoate Polioencephalitis (1). § Acute Poliomyelitis (1). 64 1924] 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. Puerperal Thrombosis. — — — — — — — 1 — — — — — — — — — — — — — — — 1 1 Other Diseases, Pregnancy and Childbirth — — _ — — 1 1 — — — — — 2 — — — —_ 1 1 — — 2 2 Arthritis, Ostitis, ostitis — — — — — — — — — — — — — — — — — — — — — — — — Other Diseases, Osseous System 4 2 — — — — — 1 1 2 — 4 6 — 4 2 1 — 2 1 7 3 10 Ulcer, Bedsore — — — — — — — — — 1 — — — — 1 — — — — — — 1 — 1 1 Eczema — — — — — — — — — — — — — — — — — — — — — — — — — Pemphigus 1 — — — — 1 — — — — — — — 1 1 — — — 1 — — 1 1 1 2 Other Diseases, Integumentary System 2 — — — — — — — 1 — — — 2 1 — — — 1 2 — — 1 2 3 Accidents and Negligence. In Mines and Quarries. — — — — — — — — — — — — — — — — — — — — — — — — — 16 In Vehicular Traffic — 3 3 7 4 1 2 3 3 5 2 8 — 3 38 6 5 5 4 8 4 9 32 9 41 l On Railways — — — — — — — — 1 2 — — — — 3 1 — 1 — 1 — — 3 — 3 On Ships, Boats, etc. (not drowning) — — — — — — — — — — — — — — — — — — — — — — — — — 1 In Building Operations — — — — — — — — 2 2 2 — — — 6 — 1 — — 2 2 1 6 — 6 By Machinery . — — — — — — 1 — — 1 1 — — — 3 — — — — 2 — 1 3 — 3 By Weapons and Implements — — — — — — — — — — — — _ — — — — — — — — — — — — 3 Burns and Scalds 2 2 — — — — 1 — 1 1 — 1 — 4 4 — — 4 1 1 1 1 2 6 8 Poisons, Poisonous Vapours — — 1 — — — — — _ — — — — — 1 — — — 1 — — — — — 1 1 Surgical Narcosis — — — — — — — — — 1 — — — — 1 — — — — — — 1 1 — 1 Effects of Electric Shock — — — — — — — 1 _ — — _ — — 1 — — 1 — — — — — — 1 Corrosions by Chemicals — — — — — — — — — — — — — — — — — — — — — — — — — Drowning — — — — 1 — — — 1 — — — — — 3 1 — — 1 1 — — 1 2 3 Suffocation, Overlaid in Bed 5 — — — — — — — — — — — — 5 _ — 1 — 1 1 2 — 3 2 5 1 Suffocation, Otherwise 5 — — — — — — 1 2 1 1 — — 5 5 — 2 — 2 1 5 7 3 10 14 Falls, not specified 2 1 — 1 — — — — 2 3 8 7 5 3 26 3 3 2 5 4 3 9 16 13 29 Weather Agencies — — — — — — — — — — — — — — — — — — — — — — — 1 Otherwise, not stated. 1 1 — — — — — 2 — — — — — 2 2 — — — — 2 2 3 1 4 Homicide 1 — — — — — — — 1 — — — — 1 1 — 2 — — — — — 1 1 2 Suicide. 5 By Poison — — — — — 1 2 3 4 7 5 — — — 22 — 3 — 5 4 1 9 18 4 22 By Asphyxia — — — — — — — — — — — — — — — — — — — — — — — — — By Hanging and Strangulation — — — — — 1 — — 1 2 1 — — 5 — j 1 — — — 3 4 1 5 By Drowning — — — — — — 1 — 1 — 1 — — — 3 — — — — — 1 2 1 2 3 By Shooting — — — — — — — — — — — — — — 1 — — — — — — 1 1 — 1 1 By Cut or Stab — — — — — — — 1 — 1 — — —! — 2 — — 1 — _ — 1 2 — 2 i By Precipitation from Elevated Placcs — — — — — — — 1 3 — — — — 4 — 2 — — — — — 2 2 4 By Crushing — — — — — — — 1 — — 1 — — — 2 1 — — — 1 — 1 1 2 By other and unspecified methods. — — — — — — — — — — — — — — — — — — — — — — — — — Execution — — — — — — — — — — — — — — — — — — — — — — — — — Sudden Death, cause — — — — — — — — — — — — — — — — — — — — — — — — — Ill-defined and fied causes — — — — — — — — — — — — — — — — — — — — — — — — — Males 261 165 26 29 42 54 86 145 239 326 421 258 44 426 1670 214 227 187 260 362 373 473 — — 2096 Females 186 146 25 16 31 46 102 146 177 295 447 382 127 332 1794 221 223 185 270 381 371 475 — — 2126 853 TOTAL DEATHS 447 311 51 45 73 100 188 291 416 621 868 610 171 758 3164 135 450 372 530 743 744 948 2096 2126 4222 65 Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING THE CALENDAR YEAR 1024. 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 1 2 3 4 5 6 7 8 9 10 li All Causes Certified . 4100 438 170 135 93 104 462 1010 1037 1512 Uncertified Nil — — — — — — — — — Enteric Fever 4 — — 2 — — 2 — — 3 Small Pox — — — — — — — — — — Measles 101 24 52 24 1 — — — — 33 Scarlet Fever 10 1 2 6 1 — — — — 2 Whooping Cough 57 20 23 12 2 — — — — 12 Diphtheria and Croup 32 — 7 15 9 1 — — — 0 Influenza 103 5 3 3 3 10 17 30 32 31 Erysipelas 8 — — 1 — 1 2 2 2 4 Phthisis (Pulmonary Tuberculosis) 328 3 6 7 4 63 130 92 14 201 Tuberculosis Meningitis 30 5 5 10 6 3 1 — — 9 Other Tuberculous Diseases 28 2 — 1 7 6 8 4 — 15 Cancer, malignant disease 400 — 1 — 1 5 46 203 204 212 Rheumatic Fever 4 — — — 3 — — 1 — 1 Meningitis 12 6* 2 2 1 1* — — — 2 Organic Heart Disease 052 3 3 — 10 16 52 197 371 294 Bronchitis 370 34 4 4 1 2 14 76 241 151 Pneumonia (all forms) 342 76 46 24 5 10 23 60 98 150 Other diseases of respiratory organs 56 2 2 1 3 15 16 17 10 Diarrhœa and Enteritis 50 46 3 2 — 2 1 2 3 24 Appendicitis and Typhlitis 26 1 — 2 4 4 7 7 1 13 Cirrhosis of Liver 14 — — — — — 1 7 6 6 Alcoholism 5 — — — — — — 1 4 Nephritis and Bright's Disease 74 4 — — 1 2 12 31 24 30 Puerperal Fever 8 — — — — 1 7 — — 3 Other accidents and diseases of Pregnancy and Parturition 12 — — — — 2 10 — — 3 Congenital Debility and Malformation, including Premature Birth 155 148 5 2 — — — — — 13 Violent Deaths, excluding Suicide 113 16 — 6 12 6 10 28 34 64 Suicide 37 — — — — 1 8 10 9 13 Other Defined Diseases 1003 44 5 10† 21§|| 25 87|| 234|| 577 105 Diseases Ill-defined or unknown — — — — — — — — — — Totals 4109 438 170 135 93 164 462 1010 1037 1512 Sub-Entries.—Included in above figures: *Cerebro-spinal Meningitis 3 2 — — — 1 — — — — †Acute Polioencephalitis 1 — — 1 — — — — — ||Encephalitis I.ethargica 4 — — — 1 — 2 1 — — §Acute Poliomyelitis 1 — — — 1 — — — — — 66 1924] LONDON COUNTY COUNCIL RETURN. Borougli of Islington. PROCEEDINGS DURING 1924. Premises. Number of Places. Number of Inspections 1924 Number of Notices 1924 Number of Prosecutions 1924 On Register at end of 1923 Added in 1924 Removed in 1924 On Register at end of 1924 Milk Premises 630 29 85 574 1,030 40 Nil Cowsheds 4 — — 4 34 — ,, Slaughter-Houses 17 — 3 14 778 — ,, Other Offensive Premises Trade 17 — — 17* 65 — ,, Ice Cream Premises 242 1 5 238 146 19 1 Registered Houses Lodgings Let in 1,012 — — 1,012 3,680 539 5 * Including the Knacker's Yard. Total number of intimation notices served for all purposes 5,167 Insanitary houses— Number closed under the Public Health (London) Act, 1891 Nil Number of premises cleansed under Section 10, Part 3, of the L.C.C. (General Powers) Act, 1904 91 Housing of the Working Clauses— Number of houses inspected 2,291 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 housesi 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 Nil Number of houses repaired by local authorities 3 Number of houses closed on notice by owner that they could not be made fit Nil Total number of houses in the Borough about43,000 Number of houses for the working classes— (a) Erected during year (Flats) Nil (b) In course of erection (Flats) Nil Number of houses occupied by the working classes about 27,000 67 [1924 Smoke nuisances— Number of observations 180 Number of warnings (letters sent) 8 Number of notices 11 Number of nuisances and complaints 29 Number of summonses 2 Underground Rooms— Number illegally occupied 6 Number closed or illegal occupation discontinued 6 Prosecutions 4 Overcrowding— Number of rooms overcrowded 13 Number remedied 13 Prosecutions Nil Cleansing— Number of adults cleansed 10 Number of children cleansed 4,614 Cleansing— Number of rooms or premises cleansed (L.C.C. General Powers Act, 1922) 91 Water supply to tenement houses— Premises supplied 60 Prosecutions Nil Sale of Food— Number of premises used other than ice cream premises, milk shops and cowsheds 636 Number of inspections ... ... ... ... ... ... .. 18,397 68 1921] Number of prosecutions under By-laws under Public Health Act, 181)1— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. Nil (b) For prevention of nuisancc 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. 8 (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 Mortuaries— Total number of bodies removed 291 Total number of infectious bodies removed 2 (69) INDEX Page Accidental Deaths 16, 21 Acreage 2 Adulteration of Food 53-58 Ages at Death 6 Area 2 Bacteriological Examinations 32 Births 3 „ Illegitimate 4 „ Notification of 4 „ Stillborn 4 Cancer 18 Chicken Pox 32 Cleansing of Verminous School Children 36 Coal gas Poisoning 21 Colouring matter in Milk 52 Cow Sheds 50 Deaths from all causes during the year 4, 62 Deaths from Epidemic Diseases 16 „ „ Respiratory Diseases 20 „ „ in Public Institutions 15 „ „ Classified Causes 6 „ „ Tuberculosis (Respiratory) in London 31 Density 2 Diseases Treated in Hospital 24 Disinfectants distributed and used 35 Disinfecting Station 35 Disinfection Work 29, 34 Disinfestation (Vermin) 36 Dispensing of Prescriptions 54 District Inspectors' Work 39 Drugs 54, 57 Dust, removal of 40 Dysentery 27 Education Propaganda 9 Eggs, labelling of 1, 50 Encephalitis Lethargica 27 Epidemic Diseases 16 „ Cerebro-Spinal Meningitis 26 Erysipelas 18, 24 Factories and Workshops Administration 36 Fatality from Notifiable Infectious Diseases 24 Food, Adulteration of, Inspection of, Unsound 49-57 Food Order 50 Food, wrapping of 58 Gas (Coal) Poisoning 21 Health Visitation 11, 12 Health Week 1-9 Hospital Isolation of Infectious Diseases 24 Housing 43-48 Houses Let in Lodgings 42 70 Page Infantile Mortality 7.8 Infant Welfare Work 9 Infection, Prevention of 22 Infectious Diseases in Schools 32 „ ,, (Non-Notifiable) in Schools 32 Influenza 18 Inspection of Food 49 „ „ Houses 39, 41, 45 „ „ Kitchens of Restaurants 36,49 „ „ Slaughter Houses and Cow Houses 49, 50 „ „ Workshops 36 Inexperience of Small Shopkeepers—Warnings 50 Institutions 15 Inquests 22 Isolation of Infectious Diseases 24 London County Council Return of Sanitary Work 66 Malaria 27 Malignant Diseases 18 Marriages 3 Maternity and Child Welfare Committee ii „ „ „ „ Voluntary Centres 13, 14 Maternity and Child Welfare Work 9 Measles, Notifications by School Teachers 32 Meat Inspection 49 Meat, labelling of 1, 50 Ministry of Health Returns 8, 65 Milk, Bacteriological examination of 51 „ Scheme 10 „ Adulteration 55 „ Shops and Dairies 51 „ and Cream Regulations 52 „ and Dairies (Amendment) Act, 1922 53 Mortuary and Coroner's Court 22 Notification of Infectious Diseases 22 „ „ Tuberculosis 27 „ „ Births Act 4 Non-notifiable Infectious Diseases in Schools 32 Offal, removal of 50 Offensive Trades 50 Ophthalmia Neonatorum 9 Outworkers' Premises 38 Other Notifiable Diseases 26 Pauperism 48 Pathogenicity Tests (Diphtheria) 33 Petty Sessions 1, 58 Pigs, " Defence of the Realm Act " 40 Places where Food is Prepared 49 Pneumonia 21, 27 Population at the Census, 1921 2 „ estimated, 1924 2 „ in Houses and Rooms 47, 48 „ at Nine Age Periods, 1924 3 Prescriptions, Dispensing of 54 Preservatives 1, 52,57 Prevention of Infection 22 Prosecutions, Summary of 58 71 Page Public Health Committee ii „ „ Milk and Cream Regulations 52 Puerperal Diseases 10, 18 Polio-Myelitis, Acute 26 Pulmonary Tuberculosis 19, 27 Rats and Mice (Destruction) Act, 1919 42 Rateable Value iii Removal of Dust 40 Respiratory Diseases 20 „ Tuberculosis 19, 27 Restaurant Kitchens 36, 49 Samples Analysed in 192453-57 Sanitary Inspectors' Work 41 Schools 40 Septic Diseases 18 Shelter House 36 Slaughterhouses 49 Smoke Nuisances 1, 40 Sophistication of Milk 1, 55 Statistics 62 Street Accidents 21 Tuberculous Diseases 19, 27, 31 Tuberculosis Dispensaries 30 ,, Notification of 27 „ Deaths from 19 ,, (Public Health) Regulations, 1912 29 Unsound Food 1, 49 Vaccination 33 Venereal Diseases 21 Verminous Children, Disinfestation of 36 „ Premises 40 Voluntary Maternity and Child Welfare Work 13, 14 Warnings 50 Workshops and Factories, Inspection of 36 ,, and Factories, legal proceedings 39 Welfare Work by Health Visitors 11 „ Centres 13, 15