XI 15627 REPORT ON THE SANITARY CONDITION OF SAINT MARY, ISLINGTON, DURING JANUARY, 1858. No. X. The condition of the Public Health in Islington has somewhat deteriorated since December: this remark does not, however, imply any increase in sickness of the zymotic class. Two hundred and twenty-four persons of all ages were registered as having died during the past month, a number which presents nearly the same weekly mean as in December. The weekly mean of deaths of children and young persons has however fallen from 32 to 27. In the corresponding weeks of last year the registered deaths were 195: if we add 10 to this number, as a correction for an increased population, an excess of 19 deaths appears against the present year. The deaths from diseases of the zymotic class have been less numerous than in December, and four above the corrected mortality from these diseases in January, 1857. There has been little alteration observed in the weekly mortality from measles, but that from hooping cough has been reduced to nearly one half. Six deaths from fever have been registered, one of which was of a nurse in the London Fever Hospital. It is to be observed that five deaths from erysipelas are recorded, among these is included a death from pyaemia in the Great Northern Hospital. A death from "gangrenous inflammation of the throat" is included among the three deaths from scarlatina. Two deaths from "diphtherite" have also been registered: one of these was of a a male child aged 4 years, in Essex Street, and the other a male aged 5 years, in St. Peter's Street, "Within a week, beside the last mentioned patient, two others of the same family died, one a brother, aged 3 years, of "croup," the other a sister, of "enteritis." The house has been visited; it was found that several of the communications with the drain were untrapped, and that there was also an untrapped open privy which permitted the free escape of the sewer gases. The deaths from diseases of the organs of respiration have risen from 55 to 64 but compared with December there is a smaller proportion of young persons comprised, and a larger number above 40 years of age. In January last year, the number registered under this class was 47. Judging by the cases applying for parochial medical relief, the sickness among the poor has rather increased, the difference being mainly due to the greater prevalence of catarrhal and pulmonary affections. The total number of cases of all diseases was 693 ; in the corresponding weeks of last year it was 654, so that making allowance even for the increase of population, the excess is against the present year. Pulmonary diseases, which last year brought 150 applicants to the Parish Surgeons, have this January furnished 250. The reduction in the number of cases of Hooping Cough to about one half, corresponds with the diminished mortality from that disease. Of the six cases of small-pox recorded, three occurred in the neighbourhood of the wharves in the Caledonian Road, and a seventh case which proved fatal, occurred in a child of a wharf-labourer, the only one of a family of children whose vaccination has been neglected (on account it is said of the child being too weakly). Three other children suffered from the disease in a very modified form. The 13 cases of carbuncle and boil against 3 in January last year must not be passed over in our estimate of the state of the public health. Six of these came under observation in the last week of the month, and three in each of the two previous weeks. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddclton Square, February 5th, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JANUARY 30th, 1858. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. West S.D. East S.D. Causes of Death. At all ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80| years of Ape. At 80 years of age and upwards. 115 109 All Causes 224 109 26 33 43 13 .. .. VI. Larugitis .. .. .. .. .. .. 24 16 Bronchitis 40 15 .. 6 16 3 Class. .. .. Pleurisy .. .. .. .. .. .. 22 23 I. Zymotic 45 35 6 2 1 1 5 11 Pneumonia 16 15 .. 1 .. .. 3 4 II. Dropsy, &C 7 1 2 2 2 .. 2 5 Asthma 7 .. .. 2 5 .. 17 18 III. Tubercular 35 14 14 6 1 .. .. 1 Disease of Lungs 1 .. .. 1 .. .. 14 8 IV. Brain and Nerves 22 9 1 5 7 .. 3 4 V. Heart, &c 7 1 1 1 4 .. 31 33 VI. Lungs, &c. 64 30 .. 10 21 3 7 3 VII. Digestive Organs 10 6 .. 4 ... .. 2 1 VII. Teething 3 3 .. .. .. .. .. 1 VIII. Kidney, &c 1 .. .. 1 .. .. .. .. Quinsey .. .. .. .. .. .. 1 1 IX. Childbirth, &c 2 .. 1 .. 1 .. .. .. Gastritis .. .. .. .. .. .. .. .. X. Joints, Bones, &c .. .. .. .. .. .. 1 1 Enteritis 2 2 .. .. .. .. 1 1 XI. Skin, &c 2 2 .. .. .. .. 1 .. Peritonitis 1 1 .. .. .. .. .. 1 XII. Malformations 1 1 .. .. .. .. .. .. Ascites .. .. .. .. .. .. .. 1 XIIl. Prem: Birth and Debility 1 1 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hernia (Rupture) .. .. .. .. .. .. 2 2 XIV. Atrophy 4 4 .. .. .. .. .. .. Ileus .. .. .. .. .. .. 9 8 XV. Old Age 17 .. .. 2 6 9 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. .. Stricture of Intestinal 5 .. XVII. Violent Death 5 4 1 .. .. .. 1 .. Canal 1 .. .. 1 .. .. 1 .. Dis. of Stomach, & c. 1 .. .. .. .. .. .. 1 XVIII. Not Specified 1 1 .. .. .. .. .. .. Disease of Pancreas .. .. .. .. .. .. .. .. I. Small Pox .. .. .. .. .. . .. 1 Inliammation of Liver (hepatitis) l .. .. 1 .. .. .. .. Chicken Pox .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. .. 8 4 Measles 12 12 .. .. .. .. 1 .. Disease of Liver 1 .. .. 1 .. .. .. 3 Scalatina 3 3 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 6 3 Hooping Cough 9 8 1 .. .. .. 2 2 Croup 4 4 .. .. .. .. .. 1 Thrush 1 1 .. .. .. .. .. .. Diarrhœa .. .. .. .. .. .. .. .. VIII. Nephritis .. .. .. .. .. .. .. .. Dysentery .. . . .. .. .. .. .. l Nephria(Bright'sDis) 1 .. .. 1 .. .. .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. 1 .. Influenza 1 1 .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. .. .. Disease of Bladder &c .. .. .. .. .. . 2 4 Typhus Fever 6 1 2 2 l .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. 1 Rheumatic Fever 1 .. 1 .. .. .. .. .. IX. Paramenia .. .. .. .. .. .. 3 2 Erysipelas 5 2 2 .. .. 1 .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. l Childbirth 1 .. 1 .. .. .. .. 1 Noma (Canker) 1 1 .. .. .. .. 1 .. Dis. of Uterus, &c 1 .. .. .. 1 .. .. 2 Diphtherite 2 2 .. .. .. .. .. 1 II. Heamorrhage 1 .. 1 .. .. .. .. .. X. Rheumatism .. .. .. .. .. .. 1 .. Dropsy 1 1 .. .. .. .. .. .. Arthritis .. .. .. .. .. .. .. 1 Abscess 1 .. .. 1 .. .. .. .. Dis. of Joints, &c .. .. .. .. .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 2 2 Cancer 4 .. 1 1 2 .. .. .. Phlegmon Disease of Skin, &c. .. .. .. Gout .. .. .. .. .. .. 1 l 2 2 .. .. .. .. .. 1 III. Scrofula 1 1 .. .. .. .. 1 1 Tabes Mesenterica 2 2 .. .. .. .. .. .. XII. Cyanosis .. .. .. .. .. .. 16 13 Phthisis(Consumpn.) 29 8 14 6 1 .. .. .. Spina Bifida .. .. .. .. .. .. .. 3 Hydrocephalus 3 3 .. .. .. .. .. l Other Malformations 1 1 .. .. .. .. l 3 IV. Cephalitis 4 3 .. .. 1 .. .. 4 1 Apoplexy 5 .. .. 2 3 .. .. .. XIII. Intemperance .. .. .. .. .. .. 4 2 Palsy(paralysis) 6 .. .. 3 3 .. .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Tremens.. .. .. .. .. .. .. 2 .. Want of Breast Milk 2 2 .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 5 .. Convulsions 5 5 .. .. .. .. .. .. Hanging .. .. .. .. .. .. .. 2 Disease of Brain, &c 2 1 1 .. .. .. l .. Suffocation 1 1 .. .. .. .. .. .. Drowning .. .. .. .. .. .. .. .. V. Pericarditis .. .. .. .. .. .. .. .. Fractures & Contus. . .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. .. 3 4 Disease of Heart, &c 7 1 1 1 4 .. 2 .. Other Violence 2 1 1 .. .. .. TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING JANUARY 28th, 1858. [ New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. HoopingCough Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Loca Rheumatism, Other Diseases. Accidents and Injuries. Totals 693 6 0 18 2 13 0 16 0 0 0 2 7 2 5 4 75 250 7 13 27 294 27 Districts, &c. Workhouse 81 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 1 4 24 3 1 5 43 1 Infant Poor House 8 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 .. Northern District 82 1 .. 4 1 5 .. .. .. .. .. 1 1 .. 3 1 17 18 .. 3 35 9 North-Westn. District 118 4 .. 9 1 2 .. 5 .. .. .. 1 4 .. .. .. 26 43 .. 3 2 44 .. South-Westn.District 109 1 .. 5 .. .. .. 1 .. .. .. .. 1 .. .. 1 9 51 2 2 4 39 2 North-Eastn. District 93 .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 33 1 1 7 44 5 South-Eastn. District 202 .. .. .. .. 6 .. 9 .. .. .. .. 1 .. .. 1 17 81 1 6 6 81 10 12 REPORT on th e SANITARY CONDITION OF SAINT MARY, ISLINGTON, DURING FEBRUARY, 1858. No. XI: Both the sickness and mortality as registered in Islington have been less than during January. The deaths of 202 persons (exclusive of strangers dying in the Small-pox and Fever Hospitals) were registered. The number last month was 224 ; in February, last year, it was 189, which, considering our rapidly increasing population, may be regarded as about equivalent to the mortality of the month just closed. On comparing the ages of the persons who have died, it appears that the reduction of mortality since January has taken place chiefly amongst elderly persons. The zymotic mortality has been somewhat higher, especially among children : 48 deaths were registered from diseases of this class; the number registered in February, last year, was 32. Five deaths occurred from small-pox ; three were of infants from 3 weeks to 18 months old, and one of a young man from one of the wharves in Maiden Lane : all five were unvaccinated. They were all but one taken ill in January, and died at periods at from 5 days to 4 weeks from the time of seizure : all these cases occurred in the Thornhill District. I mentioned the existence of small-pox there in my last report. The deaths from hooping cough have risen from 9 to 16, of which 12 occurred in the East SubDistrict. There have been but 2 deaths from fever. Two deaths are registered as from erysipelas, and these again include a death from "pyaemia "* in the Great Northern Hospital. Altogether three deaths have been registered from * Infection of the blood with pus, or the matter of abscesses—a disease accompanied with deep prostration. "diphtherite;"* in one case it was the primary disease, in a second it followed measles, and in a third hooping cough. The deaths from diseases of the chest have been ten fewer than in January ; the infant deaths from these affections being nearly the same. The mortality from this cause continues higher than that of last year, when the deaths in February were 37. Six hundred and thirty eight applicants for medical relief were entered on the books of the Parochial Surgeons. Of these 70 laboured under one or other of the diseases which are grouped together as zymotic ; among these were two cases of ague; one of them occurred in Pembroke Street, in the person of a labourer who had suffered from the disease 8 years ago ; he had not recently been working in the country, and I cannot but think that the filthy and miasmatic condition of the road and neighbouring land was a probable cause of his renewed attack. There have been only two cases of fever recorded. No fresh cases of small-pox have been entered, although I have heard of some under the care of private practitioners. It is desirable that parents should be reminded of the necessity for having their children vaccinated, and that they are breaking the law in neglecting it. Acute diseases of the lungs appear to be declining, the number of cases entered being as nearly as possible the same as in February, 1857. EDWARD BALLARD, M.D., Medical Officer of Health 42, Myddelton Square, March \th, 1858. * A specific inflammation of the throat, less common in this country than in France, which was fatal to many persons at Boulogne in 1856, and during the summer of last year was prevalent in Kent and Essex. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING FEBRUARY 27th, 1868. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S D. Causes of Death. At all Ages. Under 20 years ot 1 age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 j years of age. At 80 years of age and upwards. West S.D. East S.D. Causes of Death. At all ages. Under 20 years of 1 age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 vears of Age. At 80 years of age and upwards. 99 103 All Cause 202 106 22 33 31 10 1 .. VI. Laryngitis 1 1 .. .. .. .. Class 25 13 Bronchitis 38 19 2 6 11 .. 19 29 I. Zymotic 48 42 2 3 1 .. .. .. Pleurisy .. .. .. .. .. .. 5 1 II. Dropsy, &c. 6 .. .. 5 1 .. 6 7 Pneumonia 13 11 1 1 .. .. 13 17 III. Tubercular 30 14 1 1 4 1 .. 1 1 Asthma 2 .. .. 1 1 .. 10 9 IV. Brain and Nerves.. 19 5 .. 5 8 1 .. .. Disease of Lungs .. .. .. .. .. .. 1 6 V. Heart, &c 7 1 3 2 1 .. 33 21 VI. Lungs, &c 54 31 3 8 12 .. 4 7 VII. Digestive Organs. 11 5 1 4 1 .. .. 4 VII. Teething 4 4 .. .. .. .. 1 2 VIII. Kidney, &c 3 .. .. 2 1 .. 1 .. Quinsey 1 .. .. 1 .. .. 1 .. IX, Childbirth, &c 1 .. 1 .. .. .. .. .. Gastritis .. .. .. .. .. .. .. .. X. Joints, Bones, &c .. .. .. .. .. .. .. 1 Enteritis 1 1 .. .. .. .. .. .. XI. Skin, &c .. .. .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. .. 1 XII. Malformations 1 1 .. .. .. .. .. .. Ascites .. .. .. .. .. .. 4 .. XIII. Prem: Birth and Debility 4 4 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Hernia (Rupture) 1 .. .. 1 .. .. .. 2 XIV. Atrophy 2 2 .. .. .. .. .. .. Ileus .. .. .. .. .. .. 7 7 XV. Old Age 14 .. .. .. 5 9 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal 1 .. XVII. Violent Death 1 .. 1 .. .. .. .. .. Canal .. .. .. .. .. .. .. l XVIII. Not Specified 1 1 .. .. .. .. 1 .. Dis. of Stomach, &c. .. .. .. 1 .. .. .. .. Disease of Pancreas .. .. .. .. .. .. 5 .. I. Small Pox 5 4 1 .. .. .. Inflammation of Liver (Hepatitis) .. .. .. Chicken Pox .. .. .. .. .. .. .. .. 6 5 Measles 11 11 .. .. .. .. ..• • .. Jaundice .. .. .. .. .. .. .. 5 Scarlatina 5 5 .. .. .. .. 2 1 Disease of Liver 3 .. 1 1 1 .. 4 12 Hooping Cough 16 16 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 1 .. Croup 1 1 .. .. .. .. .. 1 Thrush 2 2 .. .. .. .. . .. 2 Diarrhoea 2 1 .. .. 1 .. .. .. VIII. Nephritis .. .. .. .. . .. .. .. Dysentery .. .. .. .. .. .. .. .. Nephria(Bright'sDis) .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. 1 2 Disease of Bladder &c 3 .. .. 2 1 .. .. 2 Typhus Fever 2 .. .. 2 .. .. .. 1 Puerperal Fever 1 .. .. 1 .. .. .. .. Rheumatic Fever .. .. .. .. .. .. .. .. IX. Paramenia .. .. .. .. .. .. 2 .. Erysipelas 2 1 1 .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. 1 .. Childbirth .. .. .. .. .. .. .. .. Noma(Cfanker) .. .. .. .. .. .. .. .. Dis. of Uterus, &c .. .. .. .. .. .. .. 1 Diphtherite 1 1 .. .. .. .. .. .. II. Hfaemorrhage .. .. .. .. .. .. .. .. X. Rheumatism .. .. .. .. .. .. .. .. Dropsy .. .. .. .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. Abscess .. .. .. .. .. .. .. .. Dis. of joints, &c .. .. .. .. .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 5 1 Cancer 6 .. .. 5 1 .. .. .. Phlegmon .. .. .. .. .. Gout .. .. .. .. .. .. .. Disease of Skin, &c. .. .. .. .. 1 .. III. Scrofula 1 .. 1 .. .. .. 1 3 Tabes Mesenterica. 4 4 .. .. .. .. .. 1 XII. Cyanosis 1 1 .. .. .. .. 9 10 Phthisis(Con8umpn.) 19 4 10 4 1 .. .. .. Spina Bifida .. .. .. .. .. .. 2 4 Hydrocephalus 6 6 .. .. .. .. .. .. Other Malformations .. .. .. .. .. .. .. 1 IV. Cephalitis 1 1 .. .. .. .. 1 3 Apoolexy 4 .. .. 1 3 .. .. .. XIII. Intemperance .. .. .. .. .. .. 2 3 Palsy (Paralysis) 5 .. .. 1 3 1 .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Tremens .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. 1 .. Epilepsy 1 .. .. 1 .. .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 2 2 Convulsions 4 4 .. .. .. .. .. .. Hanging .. .. .. .. .. .. 4 .. Disease of Brain, &c 4 .. .. 2 2 .. .. .. Suffocation .. .. .. .. .. .. .. .. V. Pericarditis .. .. Drowning .. .. .. .. .. .. .. .. .. .. .. .. 1 .. Fractures & Contus. 1 .. 1 .. .. .. .. .. Aneurism .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. .. 1 6 Disease of Heart, &c. 7 1 3 2 1 .. .. .. Other Violence .. .. .. .. .. .. TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING FEBRUARY 25th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. HoopingCough Crcup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Local Rheumatism. Other Diseases. Accidents and Injuries. Totals 638 0 3 17 0 11 1 13 1 0 2 2 2 4 5 9 70 210 7 8 27 283 33 Districts, &c. Worrkhouse 73 .. .. .. .. .. 1 .. .. .. .. .. 3 2 1 7 19 1 .. 3 40 3 Infant Poor House 6 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 .. Northern District 84 .. 1 4 .. 2 1 .. .. .. 1 2 .. .. 2 6 19 17 .. .. 4 33 11 North-Westn. District 111 .. 1 5 .. 4 .. 4 1 .. 1 .. 1 .. .. .. 17 38 3 .. 4 44 5 South-Westn. District 97 .. 1 7 .. 2 .. 5 .. .. .. .. .. .. .. .. 15 46 2 .. 4 28 2 North-Eastn. District 107 .. .. 1 .. 1 .. .. .. .. .. .. .. 1 1 .. 4 27 .. 4 6 63 3 South-Eastn. District 160 .. .. .. .. 2 .. 3 .. .. .. .. 1 .. .. 2 8 63 1 4 6 69 9 13 REPORT on the . SANITARY CONDITION OF SAINT MARY, ISLINGTON, DURING MARCH 1858. No. XII. The deaths of 289 residents in Islington were recorded by the District Registrars during the 5 weeks ending April the 3rd. Allowing for the difference in the number of weeks embraced, 37 more deaths were registered than in February, an excess attributable to the larger number of infants whose deaths were referred to congenital debility, atrophy, and convulsions; and also to the returns for the past fortnight including deaths in respect of which inquests had been held during the quarter. The latter fact accounts for the 10 deaths from violence noted in Table 1. The zymotic mortality has been considerably less than in February. The deaths from tubercular diseases, and especially from consumption, have been much more numerous. The mortality from hoopingcough, though declining, has continued high : it is to be observed, however, that no death from this disease was registered during the last week of the month. Small-pox has carried off three adult persons and diphtherite has occasioned two deaths of infants. Compared with last year, the mortality of March has been high, especially among children and among persons labouring under acute and chronic inflam matory diseases of the respiratory organs, and among consumptive patients. The number of deaths registered in the corresponding 5 weeks was 234, which 2 raised one-twentieth or to 245 for increase of population, exhibits an excess of 44 deaths against this year. The deaths under 20 years of age in March last year were 119, those from zymotic diseases 41, from hooping-cough 6, and from fever 9; those from diseases of the organs of respiration 52, and from consumption 31. The sickness among the poor appears also to have increased slightly, but the weekly mean of cases of the zymotic class of diseases has not exceeded that of February; taking these diseases separately, hooping-cough and diarrhoea have been more frequently met with in the returns; no variation worth noticing has occurred in respect of pulmonary affections. The total number of cases entered by the Parochial Surgeons last year, during the corresponding 5 weeks, was 886, of which 103 were of the zymotic class of diseases, and of these 40 were diarrhoea and 5 fever. In all these respects the comparison is favourable to the present year, but the acute diseases of the respiratory organs have continued in excess of those which occurred last winter. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddelton Square, April 8th, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING APRIL 3rd, 1858. (Deaths of Non-Residents in Hospitals excluded.) West S.D. .East S.D. Causes of Death. At all Ages. 1 Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. 1 At 80 years of age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. 1 Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 6o and under 80 years of age. At 80 years of age and upwards. 155 134 All causes 289 157 42 44 36 10 1 .. VI. Laryngitis 1 1 .. .. .. .. 25 21 Class. 46 36 7 3 .. .. 23 24 Bronchitis 47 29 .. 7 8 3 .. .. 6 3 I. Zymotic 9 .. .. 4 5 .. 10 12 20 • • 27 20 II. Dropsy, &c 47 17 22 8 .. .. 2 1 Asthma 3 .. .. 2 1 .. 19 13 III. Tubercular 32 17 3 5 7 .. .. 1 Disease of Lungs 1 .. .. 1 .. .. 6 9 IV. Brain and Nerves 15 .. 2 9 4 .. 36 38 V. Heart, &c. 74 50 .. 11 9 4 7 8 VII. Digestive Organs. 15 9 2 l 2 1 2 2 VII. Teething 4 4 .. .. .. .. 1 2 VIII. Kidney, &c 3 .. 1 l 1 .. .. .. Quinsey .. .. .. .. .. .. 2 IX, Childbirth, &c 4 l 2 .. 1 .. .. .. Gastritis .. .. .. .. .. .. l .. X. Joints, Bones, &c 1 .. .. .. 1 .. 3 2 Enteritis 5 3 1 1 .. .. .. .. XI. Skin, &c .. .. .. .. .. .. .. 1 Peritonitis 1 .. 1 .. .. .. .. 1 XII. Malformations 1 1 .. .. .. .. .. 1 Ascites 1 .. .. .. 1 .. 6 2 XIII Prem: Birth and Debility. 8 8 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. 4 2 6 6 .. .. .. .. .. .. Hernia (Rupture) .. .. .. .. .. .. 1 5 XIV. Atrophy 6 6 .. .. .. .. .. .. Ileus .. .. .. .. .. .. 6 3 XV. Old Age 9 .. .. .. 4 5 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal 5 5 XVII. Violent Death 10 5 2 1 2 .. .. .. Canal .. .. .. .. .. .. 3 .. XVIII. Not Specified 3 1 1 1 .. .. .. .. Dis. of Stomach, &c .. .. .. .. .. .. .. .. Disease of Pancreas .. .. .. .. .. .. 2 1 I. Small Pox 3 .. 3 .. .. .. Inflammation of Liver (Hepatitis) .. .. .. .. .. .. .. .. Chicken pox .. .. .. .. .. .. .. .. 4 2 Measles 6 6 .. .. .. .. .. 1 Jaundice 1 1 .. .. .. .. 2 1 Scarlatina 3 3 .. .. .. .. 2 1 Disease of Liver 3 1 .. .. 1 1 5 10 Hooping Cough 15 15 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 2 1 Croup 3 3 .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. 4 Diarrhoea 4 3 .. 1 .. .. 1 .. VIII. Nephritis 1 .. .. .. 1 .. 1 .. Dysentery 1 1 .. .. .. .. .. .. Nephria(Bright'sDis) .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. 1 Diabetes 1 .. .. 1 .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. 1 .. Infantile Fever 1 1 .. .. .. .. .. 1 Disease of Bladder &c 1 .. 1 .. .. .. 2 1 Typhus Fever 3 2 1 .. .. .. 2 .. Puerperal Fever 2 .. 2 .. .. .. 1 .. Rheumatic Fever 1 .. .. 1 .. .. 1 .. IX. Paramenia 1 1 .. .. .. .. 2 .. Erysipelas 2 .. 1 1 .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. 1 1 Childbirth 2 .. 2 .. .. .. .. .. Noma(Cancer) .. .. .. .. .. .. .. 1 Dis. of Uterus, &c 1 .. .. .. 1 .. 1 1 Diphtheria 2 2 .. .. .. .. 1 1 II.Haemorrhage 2 .. .. 2 .. .. 1 .. X. Rheumatis 1 .. .. .. 1 .. 2 .. Dropsy 2 .. .. 1 1 .. .. .. Arthritis .. .. .. .. .. .. .. .. Abscess .. .. .. .. .. .. .. .. Dis. of joints,&c .. .. .. .. 1 .. .. .. Ulcer .. .. .. .. .. .. . .. Fistula .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 2 2 Cancer 4 .. .. 1 3 .. .. .. Phlegmon .. .. .. .. .. .. 1 .. Gout 1 .. .. .. 1 .. .. .. Disease of Skin, &c .. .. .. .. .. .. 1 .. III. Scrofula 1 .. .. 1 .. .. 1 2 Tabes Mesenlerica 3 3 .. .. .. .. .. .. XII. Cyanosis .. .. .. .. .. .. 22 16 Phthisis(Consumpn.) 38 9 22 7 .. .. .. .. Spina Bifida .. .. .. .. .. .. 3 2 Hydrocephalus 5 5 .. .. .. .. .. 1 Other Malformations 1 1 .. .. .. .. 1 1 IV. Cephalitis 2 2 .. .. .. .. .. .. 1 Apoplexy 1 .. .. 1 .. .. 1 .. XIII. Intemperance 1 .. .. .. 1 .. 3 5 Palsy (Paralysis) 8 .. 1 3 4 .. .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Tremens .. .. .. .. .. .. 1 .. Want of Breast Milk 1 1 .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. 2 .. Epilepsy 2 .. 1 .. 1 .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. 1 1 Insanity 2 2 .. .. .. .. .. 1 Burns and Scalds 1 1 .. .. .. .. 9 2 Convulsions 11 11 .. .. .. .. .. Hanging .. .. .. .. .. .. 3 3 Disease of Brain, &c 6 2 1 1 2 .. 1 1 Suffocation 2 2 .. .. .. .. Drowning 1 1 .. .. .. .. .. .. V. Pericarditis .. .. .. .. .. .. 1 1 Fractures & Contus. 2 .. 1 .. 1 .. .. .. Aneurism .. .. .. .. .. .. 1 1 Wounds 2 .. 1 1 .. .. 6 9 Disease of Heart, &c. 15 .. 2 9 4 .. .. .. Other Violence .. .. .. .. .. .. TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FIVE WEEKS ENDING APRIL, 1st, 1858. New Cases. Small-Pox. Chicken Pox Measles. Scarlatina. Hooping Cough Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Local Rheumatism. Other Diseases. Accidents and Injuries. Totals 829 2 1 11 5 19 3 27 0 0 1 0 1 6 5 2 83 266 10 14 27 401 28 Districts, &c. Workhouse 64 .. .. .. .. .. .. 3 .. .. .. .. .. 1 .. .. 4 15 2 .. 6 36 1 Infant Poor House 8 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 7 .. Northern District 94 1 .. 6 .. 7 .. 4 .. .. .. .. .. .. 1 1 20 17 1 1 2 44 9 North-Westn. District 173 1 .. .. *3 4 1 4 .. .. 1 .. .. 3 .. .. 17 51 1 3 4 93 4 South-Westn. District 120 .. .. .. .. 2 .. 2 .. .. .. .. .. .. 1 .. 5 56 3 .. 7 47 2 North-Eastn. District 135 .. .. 4 .. 5 1 .. .. .. .. .. .. 2 2 .. 14 41 .. 1 4 69 6 Soutb-Eastn. District 235 .. 1 1 2 1 1 13 .. .. .. .. 1 .. 1 1 22 86 3 9 4 105 6 * Including a case of " Diphtherite." 14 REPORT on the SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR APRIL 1858. No. XIII. During the four weeks which ended on May 1st, the deaths registered in Islington amounted to 197, almost the precise number registered in 1856, notwithstanding the great increase which the population of the parish is yearly undergoing. It is under the corrected mean mortality of the last two years, and less by 35 than it would have been at the rate of mortality observed last month. The zymotic class of diseases has, however, been unusually busy among our residents, having carried off 48 persons, of which 38 were children under 5 years of age. The greater number of zymotic deaths—viz. 28—occurred in the East Sub district. Measles and hooping-cough, in particular, have both been more fatal than they were either last month or in the corresponding period of the two last years. There have been 2 deaths attributed to diarrhoea, and 6 to fever. In neither of these instances has the mean of the last two years been exceeded. One of the deaths from fever took place in one of the only two houses in Pulteney-terrace which had been exempted from the orders of the Sanitary Committee for improvement in drainage, &c., in 1856. Two deaths from diphtheria were registered: in one instance it was stated as the primary affection; in the other, it succeeded upon another disease. Pulmonary diseases, although less fatal than in March, have continued to supply more than the customary number of deaths. 2 Taking the increase of population into consideration, and the greater facilities granted by the Board of Trustees to all poor persons desirous of obtaining medical relief, the number of cases entered on the books of the Medical Staff cannot be regarded as excessive. It was within two of the number entered in the corresponding weeks of 1856. It is to be observed that measles, hoopingcough, and fever have all been more prevalent than in March; and, in fact, that there has been a considerable increase in the cases of zymotic diseases, taken as a class. As many as 5 cases of ague, a disease arising in connection with marsh miasma, came under the notice of the medical officers. I have inquired into the circumstances under which the disease arose, and find that in every instance the patient had been exposed, during part of the Summer and Autumn of last year, to the influence of malaria in the agueish parts of Essex or Kent. In 3 of the cases, however, no symptoms of ague were observed until shortly before they applied for medical aid in this parish, a period of seven months having elapsed. The cases of acute pulmonary disease have been only one-half of the number which were entered in March. With respect to Table 2, which has undergone a modification in accordance with the re-distribution of the Medical Districts by the Board of Trustees, I must observe, that although the names of the several wards are attached to them, the districts assigned to the medical gentlemen do not correspond strictly with the wards as defined for the purposes of the Local Management Act. EDWARD BALLARD, M.D., Medical Officer of Health• 42, Myddelton Square, May 6th, 1858. TABLE I DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING MAY 1st, 185S. (Deaths of Non-Residents in Hospitals excluded.) West s.d. East s.d. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. ; At 40 and under 60 | years of age. At 60 and under 80 years of age. j At 80 years of age and upwards. West s.d. East. s.d. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 50 years of age. At 60 and under 80 years of age. At 60 years of age and upwards. 101 96 All Causes 197 106 24 27 34 6 1 .. VI. Laryngitis 1 1 .. .. .. .. 17 12 Bronchitis 29 11 3 4 10 1 Class. 1 .. Pleurisy 1 .. 1 .. .. .. 20 28 I. Zymotic 48 40 3 3 2 .. 3 6 Pneumonia 9 7 2 .. .. .. 3 2 II. Dropsy, &c 5 .. .. 3 2 .. 1 .. Asthma 1 .. .. .. 1 .. 19 17 III. Tubercular 36 15 12 9 .. .. 1 .. Disease of Lungs .. .. .. .. .. .. 10 10 IV. Brain and Nerves 20 11 2 1 6 .. .. .. 3 3 V. Heart, &c 6 .. .. .. 5 1 23 18 VI. Lungs, &c 41 19 6 4 11 1 5 3 VII. Digestive Organs 8 6 1 1 .. .. 3 1 VII. Teething 4 4 .. .. .. .. 3 3 VIII. Kidney, &c 6 .. .. 4 2 .. .. 1 Quinsey 1 1 .. .. .. .. .. .. IX. Childbirth, &c .. .. .. .. .. .. .. .. Gastritis .. .. .. .. .. .. 2 .. X. Joints, Bones, &c 2 1 .. 1 .. .. .. .. Enteritis .. .. .. .. .. .. 1 .. XI. Skin, &c l .. .. .. 1 .. 1 .. Peritonitis 1 .. 1 .. .. .. .. 1 XII. Malformations 1 1 .. .. .. .. .. .. Ascites .. .. .. .. .. .. .. 2 XIII. Prem: Birth and Debility. 2 2 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. 2 .. 2 2 .. .. .. .. .. .. Hernia (Rupture) .. .. .. .. .. .. 3 4 XIV. Atrophy 7 7 .. .. .. .. .. 1 Ileus 1 1 .. .. .. .. 5 4 XV. Old Age 9 .. .. .. 5 4 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal 2 1 XVII. Violent Death 3 2 .. 1 .. .. .. .. Canal .. .. .. .. .. .. .. .. XVIII. Not Specified .. .. .. .. .. .. .. .. Dis. of Stomach, &c. .. .. .. .. .. .. Disease of Pancreas .. .. .. .. .. .. .. .. I. Small Pox .. .. .. .. .. .. .. .. Inflammation of Liver (Hepatitis) .. .. .. .. .. .. .. .. Chicken Pox .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. .. 3 7 Measles 10 10 .. .. .. .. 1 .. Disease of Liver 1 1 2 1 Scarlatina 3 3 .. .. .. .. .. .. Disease of Spleen 9 8 Hooping Cough 17 17 .. .. .. .. .. .. Croup .. .. .. 2 Thrush 2 2 .. .. .. .. 1 1 Diarrhoea 2 1 .. .. 1 .. 1 .. VIII. Nephritis 1 1 • • • • .. .. Dysentery .. .. .. .. .. .. 1 1 Nephria(Bright'sDis) 2 2 •• .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. 1 Ague 1 .. .. 1 .. .. .. 1 Cystitis 1 .. .. .. 1 .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. 1 Infantile Fever 1 1 .. .. .. .. 1 1 Disease of Bladder &c 2 ] 1 • • 4 2 Typhus Fever 6 4 .. 1 1 .. .. 1 Puerperal Fever 1 .. 1 .. .. .. 1 2 Rheumatic Fever 3 .. 2 I .. .. .. .. IX. Paramenia .. .. .. .. .. .. .. 1 Erysipelas 1 1 .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. Childbirth .. .. .. .. .. .. .. .. Noma(Canker) .. .. .. .. .. .. .. .. Dis. of Uterus, &c. .. .. .. .. .. .. .. 1 Diphtheria 1 1 .. .. .. .. .. .. II. Haemorrhage .. .. .. .. .. .. 1 .. X. Rheumatism 1 .. .. 1 .. .. 1 1 Dropsy 2 .. .. 1 1 .. .. .. Arthritis .. .. .. .. .. .. .. .. Abscess. .. .. .. .. .. .. 1 .. Dis. of Joints, &c... 1 1 .. .. .. .. .. .. Ulcer .. .. .. .. .. .. . .. Fistula .. .. .. .. .. .. .. 1 Mortification 1 .. .. .. 1 .. 1 .. XI. Carbuncle 1 .. .. .. 1 .. 2 .. Cancer 2 .. .. 2 .. .. .. .. Phlegmon .. .. .. .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Disease of Skin, &c .. .. .. .. .. .. 2 .. III. Scrofula 2 2 .. .. .. .. 3 2 Tabes Mesenterica 5 5 .. .. .. .. .. 1 XII. Cyanosis 1 1 .. .. .. .. 11 14 Phthisis(Consumpn.) 25 4 12 9 .. .. .. .. Spina Bifida .. .. .. .. .. .. 3 1 Hydrocephalus 4 4 .. .. .. .. .. .. Other Malformations .. .. .. .. .. .. .. 2 IV. Cephalitis 2 2 .. .. .. .. 1 2 Apoplexy 3 .. .. .. 3 .. .. .. XIII. Intemperance .. .. .. .. .. 3 .. Palsy (Paralysis) 3 .. .. 1 2 .. .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Tremens .. .. .. .. .. .. 1 .. Want of Breast Milk 1 1 .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. 1 1 Epilepsy 2 .. 2 .. .. .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. 1 Burns and Scalds 1 1 .. .. .. .. 2 4 Convulsions 6 6 .. .. .. .. .. .. Hanging .. .. .. .. .. .. 3 1 Disease of Brain,&c 4 3 .. .. 1 .. Suffocation .. .. Drowning .. .. .. .. .. .. .. .. V. Pericarditis .. .. .. .. .. .. .. .. Fractures & Contus .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. 1 .. Wounds 1 .. .. 1 .. .. 3 3 Disease of Heart, &c. 6 .. .. .. 5 1 .. .. Other Violence .. .. .. .. .. .. TABLE II. RETURN OP CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING APRIL 29th, 1858. New Cases. Small-Pox. Chicken Pox Measles. Scarlatina. Hooping Cough Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Local Rheumatism. Other Diseases. Accidents and Injuries. Totals 691 2 2 12 2 26 0 30 1 0 5 2 7 5 5 7 106 131 13 8 35 361 37 Districts, &c. 67 .. .. .. .. .. .. 9 .. .. 2 .. .. .. .. .. 11 9 4 1 1 40 1 Infant Poor House 8 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 .. Upper Holloway 26 1 .. 2 .. 2 .. 4 .. .. .. .. 2 1 .. .. 12 3 .. .. 1 9 1 Lower Holloway 64 .. .. 2 1 4 .. 1 .. .. 1 1 2 .. .. .. 12 7 .. 1 4 33 7 Highbury 26 .. .. 3 .. 3 .. .. .. .. .. .. .. .. .. 1 7 5 .. 1 2 9 2 Thornhill 157 1 .. 1 .. 8 .. 8 .. .. .. .. .. 4 2 .. 24 41 1 .. 8 77 6 Barnsbury 68 .. .. .. 1 3 .. 2 .. .. .. .. .. .. .. 1 7 17 1 .. 6 34 3 St. Mary *59 .. .. 2 .. 3 .. 2 .. .. 1 . 1 .. .. .. 9 10 .. .. 2 35 3 68 .. 1 .. .. 1 .. 2 .. .. .. 1 .. .. 2 4 11 17 2 1 2 30 5 148 .. 1 2 .. 2 .. 2 1 .. 1 .. 2 .. 1 1 13 22 5 4 9 86 9 * Two weeks only. REPORT on the SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR MAY 1858. No. XIV. The number of persons whose deaths have been registered in Islington during the past month is 163. In the corresponding weeks of 1856 and 1857 the number was 173, and this in a population considerably smaller than at present; neither has the mortality been so high by 34 as it was in April. Of the 163 deaths 95 took place under 20 years of age and of these 40 in the first twelvemonths of life. The deaths from diseases of the zymotic class amounted to 47 ; this is considerably above the mean of the last two years. Twelve deaths occurred from measles, and 19 from hooping cough, both of which diseases, as will appear from the books of the Parochial Surgeons, having prevailed more extensively than in the May of the two previous years. On the other hand, it is satisfactory to observe that both diarrhcea and continued fever have occasioned but lew deaths. it will be seen on reference to the table that 4 deaths from diphtheria aspecific form of sore throat,) are registered; a fifth death might have been included: of these, three occurred in one family, residing at 3, Norfolk Place, Lower Road, viz.: on May 9th, a little girl aged 10 years; on May 14th, her sister, aged 14 years ; and on May 18th, their mother. All of these suffered from the disease in its most malignant form. The first that died was taken ill on May 3rd, after returning home from visiting a female cousin in the City Road, who was herself seized with the same disease at about the same time, but had only a slight attack and recovered. On May 11th, the second of the sisters and the mother were attacked, the former died after three days illness, the mother after about seven days illness. Whatever the mode in which the first of the sisters that died 2 became infected, it is tolerably clear from the enquiries I have instituted that she received the morbid poison which generates the disease during her visit in the City Road, and probably at the same time and in the same manner as her cousin that recovered ; that she brought it home with her and infected her sister and mother. A servant in the house where the cousin resided also took the disease and died. Mr. King of East Road, Hoxton, who attended the cousin and the servant, informs me that there has been a large number of cases of this disease in that immediate neighbourhood. A fourth death of a child aged 5 years, the son of a commercial clerk, occurred in Hawthorn Street; another child of the same family subsequently had a mild attack, and on my visiting the house on June 2nd I found another of the children suffering from sore throat. The fifth death was of a female aged 39 years, the wife of a chemist who resided in Arlington Square. It ought to be known that caution should be exercised in communicating with persons suffering, during the prevalence of this epidemic, from any attack of sore throat, and when the characteristic features of diphtheria are recognized, the patient should be at once separated from the rest of the family, with as much care as if he were labouring under scarlet fever. One of the deaths from typhus occurred in Myrtle Street, Highbury Vale. Every death from fever that occurs in this row of houses is another imperative call to cover in the Hackney Brook Sewer. We shall some day be able to count the cost, in lixes, of the delays in adopting a scheme for the main drainage of London. Six hundred and sixty persons applied for Parochial Medical Relief during the four weeks ending May 27th. This is about the average sickness of May in the last two years. Ninety-five of these were cases of zymotic disease. The general sickness and the zymotic sickness then have both been less than in April. In May, last year, 110 cases of diseases of this class were entered. Measles, scarlatina, and hooping cough, have all been unusually prevalent, but cases of diarrhcea have been less abundant. The acute attacks of disease of the organs of respiration have not materially lessened in number, and have formed a larger proportion of all the cases applying for relief than they did in May, last year. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddelton Square, June 3rd, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING MAY 29th, 1858. (Deaths Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Under 20 years of nge. At 20 and under 40 years of age. At 40 and under 60 | years of age. At 60 and under 80 years of age. At 80 years of age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 6o and under 80 years of age. At 80 years of age and upwards. 81 82 All Causes 163 95 17 18 28 5 2 .. VI. Laryngitis 2 2 .. .. .. .. 6 6 Bronchitis 12 6 .. .. 6 1 Class. .. .. Pleurisy .. .. .. .. .. .. 17 30 I. Zymotic 47 41 3 2 1 .. 8 5 Pneumonia 13 9 1 .. 3 .. 4 3 II. Dropsv, &c 7 .. .. 4 2 1 .. .. Asthma .. .. .. .. .. .. 20 11 III. Tubercular 31 15 9 5 2 .. .. .. Disease of Lungs .. .. .. .. .. 7 9 IV. Brain and Nerves 16 10 .. .. 5 1 2 5 V. Heart, &c 7 1 1 2 3 .. 16 11 VI. Lungs, &c 27 l6 1 .. 9 1 VII. Teething 1 1 .. .. .. .. 7 4 VII. Digestive Organs 11 2 2 5 1 1 1 .. Quinsey 1 .. .. 1 .. .. .. 2 VIII. Kidney, &c 2 .. .. .. 2 .. .. 1 Gastritis .. .. .. .. .. .. 1 .. IX. Childbirth, &c 1 .. 1 .. .. .. .. .. Enteritis .. .. .. .. .. .. .. 1 X. Joints, Bones, &c 1 1 .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. .. .. XI. Skin, & .. .. .. .. .. .. .. .. Ascites .. .. .. .. .. .. 1 1 XII. Malformations 2 2 .. .. .. .. .. .. Ulceration of Intest .. .. .. .. .. .. 2 1 XIII. Prem. Birth and Debility. 3 3 •* Hernia (Rupture) .. .. .. .. .. .. .. .. Ileus 2 1 1 .. .. .. 3 .. XIV. Atrophy 3 3 .. .. .. .. 1 1 Intussusception .. .. .. .. .. .. 1 3 XV. Old age 4 .. .. .. 3 1 .. .. Stricture of Intestinal .. .. XVI. Sudden .. .. .. .. .. .. .. .. Canal .. .. .. .. .. .. .. 1 XVII. Violent Death 1 1 .. .. .. .. 2 .. Dis. of Stomach, &c. 2 .. .. 1 .. .. .. .. XVIII. Not Specified. .. .. .. .. .. .. .. .. Disease of Pancreas . .. .. .. .. .. .. .. .. I. Small Pox .. .. .. .. .. .. .. .. Inflammation of Liver (Hepatitis) .. .. .. .. .. .. .. .. Chicken Pox .. .. .. .. .. .. 1 1 Jaundice 2 .. .. 1 .. 1 4 8 Measles 12 12 .. .. .. .. 2 1 Disease of Liver 3 .. .. 2 1 .. .. 1 Scarlatina 1 1 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 8 11 Hooping Cough 19 19 .. .. .. .. .. 1 Croup 1 1 .. .. .. .. .. 1 Thrush 1 1 .. .. .. .. 1 .. Diarrhoea 1 1 .. .. .. .. .. .. VIII. Nephritis .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. 1 Nephria(Bright's Dis) 1 .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. 1 .. Ague 1 .. 1 .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. 1 .. Infantile Fever 1 1 .. .. .. .. .. 1 Disease of Bladder &c 1 .. .. .. 1 .. 1 2 Typhus Fever 3 1 .. 1 1 .. .. 1 Puerperal Fever 1 .. 1 .. .. .. .. .. Rheumatic lever .. .. .. .. .. .. .. .. IX. Paramania .. .. .. .. .. .. 1 Erysipelas 1 .. .. 1 .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. 1 .. Childbirth 1 .. 1 .. .. .. 1 .. Noma (Canker) 1 l .. .. .. .. .. .. Dis. of Uterus, &c .. .. .. .. .. .. .. 4 Diphtheria 4 3 1 .. .. .. .. .. II. Haemorrhage .. .. .. .. .. .. .. .. X. Rheumatism .. .. .. .. .. .. 1 .. Dropsy 1 .. .. 1 .. .. .. .. Arthritis .. .. .. .. .. .. .. .. Abscess .. .. .. .. .. .. .. 1 Dis. of Joints, &c 1 1 .. .. .. .. .. .. Ulcer .. .. .. .. .. .. . . . Fistula .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 3 3 Cancer 6 .. .. 3 2 1 .. .. Phlegmon .. .. .. .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Disease of Skin, &c .. .. .. .. .. .. .. .. III. Scrofula .. .. .. .. .. .. 1 .. Tabes Mesenterica 1 1 .. .. .. .. .. .. XII. Cyanosis .. .. .. .. .. .. 16 10 Pbthisis(Consumpn.) 26 10 9 5 2 .. .. 1 Spina Bifida 1 1 .. .. .. .. 3 1 Hydrocephalus 4 4 .. .. .. .. 1 .. Other Malformations 1 1 .. .. .. .. 1 .. IV. Cephalitis 1 1 .. .. .. .. .. 1 Apoplexy 1 .. .. .. 1 .. .. .. XIII. Intemperance .. .. .. .. .. .. 2 11 Palsy (Paralysis) 3 .. .. .. 2 1 .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Tremens .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. 1 Epilepsy 1 .. .. .. 1 .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 2 6 Convulsions 8 8 .. .. .. .. .. ..,. Hanging .. .. .. .. .. .. 2 .. Disease of Brain, &c 2 1 .. .. 1 .. .. .. Suffocation .. .. .. .. .. .. Drowning .. .. .. .. .. .. .. .. V. Pericarditis .. .. .. .. .. .. .. .. Fractures & Contus. .. .. .. .. .. .. .. 1 Aneurism 1 .. .. 1 .. .. .. .. Wounds .. .. .. .. .. .. 2 4 Disease of Heart, &c. 6 1 1 1 3 .. ... 1 Other Violence 1 1 .. .. .. .. TABLE II. RETURN OT CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING MAY 27th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. Hooping Cough Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases- Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Local Rheumatism. Other Diseases. Accidents and Injuries. Totals 660 0 2 18 9 29 0 22 1 0 ? 0 2 1 5 3 95 127 10 6 17 372 33 Districts, &c. 48 .. .. .. .. 1 .. 3 .. .. .. .. .. .. .. 1 6 7 2 .. 1 30 2 Infant Poor House 7 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7 .. Upper Holloway 30 .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. 2 3 1 .. .. 22 2 Lower Holloway 68 .. .. 4 1 7 .. 4 .. .. .. .. .. .. 1 1 18 11 1 .. .. 32 6 Highbury 21 .. .. 1 .. 2 .. .. .. .. .. .. .. .. .. .. 3 1 1 .. 2 12 2 Thornhill 139 .. 2 2 3 11 .. 7 .. .. .. .. 1 .. .. 1 27 42 2 1 2 61 4 Barmbury 80 .. .. .. 2 .. .. 4 .. .. .. .. .. .. .. .. 7 23 .. .. 3 45 2 St. Mary 95 .. .. 5 .. 4 .. 3 .. .. 2 . .. .. 2 .. 16 22 2 3 2 44 6 Canonbury 8 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 .. 1 5 .. St. Peter 164 .. .. 6 3 4 .. 1 .. .. .. .. .. .. 1 .. 15 18 .. 2 6 114 9 16 REPORT on the SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR JUNE 1858. No. XV. The mortality of the residents in Islington, during the 5 weeks which terminated on the 3rd of July, has been slightly in excess of the corrected mean mortality of the last two years. Two hundred and twenty-seven deaths have been registered, but this number includes 14 deaths from violent causes, and altogether 17, respecting which Inquests have been held, in the months of March, April and May. It is the custom to register these deaths at the close of each quarter. The excessively hot weather which distinguished the first half of the month has not been without an influence upon the public health, an influence which may be seen both in the registered mortality and in the sickness which has been noticed to prevail amongst the poor. Sixty-four deaths from zymotic diseases were registered; in the corresponding weeks of 1856 and 1857 they amounted to 47 and 41 respectively. It will appear from Table 1 hat the following are the principal diseases which contributed to this high number, viz.:—hooping cough, 16 deaths; diarrhcea, 14; fever, 7; puerperal (or child-bed) fever, 4 ; and diphtheria, 9. As respects hoopingcough, it is to be remarked that although the mortality has been above the average, it rapidly declined as the hot weather advanced. Summer diarrhoea has made its attack upon our population (and as usual especially upon our infant population) ealrie even than it did last year. I have resumed the table which I furnished in my monthly reports last summer, and which exhibits the relation which the atmospheric temperature bears to the prevalence of this disease. I have also this month to record a fatal case of malignant cholera The subject of it was a railway labourer, aged 28 years; who resided at a common lodging-house, No. 15, Ingram Place, Hornsey Road. He had been ailing for some weeks ; and on the 24th, 25th and 26th of June was known to have been troubled with diarrhcea. On the evening of Saturday the 26th, while walking home from his work, he drank at different houses five or six pints of porter. In the course of the night the diarrhcea increased, and he vomited. When visited by Mr. Donald, at 9 a.m. on the 27th, he was passing choleraic rice-water evacuations, had cramps, and was cold and collapsed. He died at half-past 5 p.m. None of the other residents in the house have suffered from bowel complaint. The sleeping-room was well ventilated and 2 not overcrowded ; but there was a great stench in one of the rooms from the water-closet of the adjoining house, the cause of which I immediately investigated, and had rectified. The medical gentlemen who attended the cases of diphtheria and malignant sore throat, have courteously furnished me with all the particulars I required respecting them. One of them occurred at No. 8, Hawthorn Street—the second death at that house from diphtheria. It was the child I alluded to in my last report as suffering from sore throat, at the time of my visit of enquiry. An order has been issued for the necessary amendments of the drainage and ventilation of the basement of the house. Two of the deaths occurred in scholars of a large academy, in which sore throat had for some weeks prevailed extensively among the boys; and one case at Paradise Terrace was imported from Uckfield. I feel bound to repeat that these sore throats certainly manifest an infectious character. It is important that medical advice should be taken early in the disease, and not be deferred until alarming symptoms are exhibited. Mean Temperature (Greenwich.) Par sh cases of Diarrhcea. Deaths from Diarrhoea and Cholera Pariah Cases ol Fever. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1st Week of M onth . 53.3° 60.6° 66.2° 4 8 9 0 2 1 2 2 1 2nd 567° 56 0° 63.8° 4 8 20 0 1 3 5 0 1 3rd 59.1° 60.3° 67.7° 12 12 12 3 1 2 2 7 0 4th 55.6° 67.3° 64.5° 11 25 28 0 2 5 2 4 1 5th 6 3.4° 62.4° 58.6° 8 30 38 1 3 4 0 2 1 Total mean 57.6° mean 61.3° mean 64.1° 39 83 107 4 9 15 11 15 4 One thousand and eighty-one persons have applied for medical relief to the District Surgeons, or have fallen sick at the Workhouse and Infant Poorhouse: of these 247 were cases of diseases of the zymotic class ; the number of this class in the corresponding five weeks last year having been 173. The difference has been mainly due to the greater number of cases of diarrhcea and measles. The comparison with former years as respects diarrhcea may be made by the aid of the Table above. No less than 72 cases of measles have come under treatment this month, against 39 in the 5 weeks of June 1856, and 14 in the corresponding weeks of 18,57. The high number of 1,081 cases is also swollen by an unusual influx of cases of acute and chronic maladies not included in the zymotic class, nor specially named in Table 2. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddelton Square, July 8th, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING JULY 3rd, 1858. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Uuder 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 6o and under 80 years of age. At 80 years of age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. 114 113 All causes 227 120 41 24 35 7 1 1 VI. Laryngitis 2 2 .. .. .. .. Class 8 6 Bronchitis 14 3 2 4 5 .. 30 34 I.Zymotic 64 54 8 2 .. .. .. .. Pleurisy .. .. .. .. .. .. 4 4 II. Dropsy, &c 8 3 2 .. 3 .. 3 3 Pneumonia 6 4 .. 1 1 .. 15 18 III. Tubercular 33 10 17 6 .. .. .. .. Asthma .. .. .. .. .. .. 11 13 IV. Brain and Nerves 24 8 l 5 10 .. .. .. Disease of Lungs .. .. .. .. .. .. 4 5 V. Heart, &c. 9 2 .. 3 4 .. 12 10 VI. Lungs, &c 22 9 2 5 6 .. 12 7 VII. Digestive Organs. 19 9 3 .. 6 4 1 VII. Teething 5 5 .. .. .. .. 1 .. VIII. Kidney, &c 1 .. .. .. 1 .. 1 .. Quinsey 1 1 .. .. .. .. .. 2 IX. Childbirth, &c 2 .. 2 .. .. .. .. .. Gastritis .. .. .. .. .. .. 1 1 X. Joints, Bones, &c 2 2 .. .. .. .. 2 .. Enteritis 2 2 .. .. .. .. 1 .. XI. Skin, &c 1 .. .. 1 .. .. .. 1 Peritonitis 1 .. 1 .. .. .. 1 .. XII. Malformations 1 1 .. .. .. .. .. .. Ascites .. .. .. .. .. .. 4 .. XIII. Prem. Birth and Debility 4 4 .. .. .. .. .. .. Ulceration of Intest .. .. .. .. .. .. 1 1 2 2 .. .. .. .. 1 .. Hernia (Rupture) 1 .. .. .. 1 .. 4 6 XIV. Atrophy 10 10 .. .. .. .. 1 .. Ileus 1 .. .. .. .. 1 3 6 XV. Old Age 9 .. .. .. 3 6 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal 9 5 XVII. Violent Death 14 6 5 2 1 .. .. .. Canal .. .. .. .. .. .. 1 1 XVIII. Not Specified 2 .. 1 .. 1 .. 1 Dis. of Stomach, &c. 1 1 .. .. .. .. 1 .. Disease of Pancreas. l .. .. .. 1 .. .. .. I. Small pox .. .. .. .. .. .. l 1 Inflammation of Liver (Hepatitis) .. .. Chicken Pox .. .. .. .. .. .. 2 .. 1 .. 1 .. 3 2 Measles 5 5 .. .. .. .. .. .. Jaundice .. .. .. .. .. .. .. .. Scarlatina .. .. .. .. .. .. 1 3 Disease of Liver 4 1 .. .. 3 .. 9 7 Hooping Cough 16 16 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 2 l Croup 3 3 .. .. .. .. 1 l Thrush 2 2 .. .. .. .. 4 10 Diarrhoea 14 14 .. .. .. .. .. .. VIII. Nephritis .. .. .. .. .. .. 1 .. Dysentery 1 .. .. 1 .. .. .. .. Nephria(Bright'sDis) .. .. .. .. .. .. .. 1 Cholera 1 .. 1 .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. 1 .. Disease of Bladder &c 1 .. .. .. 1 .. 2 5 Tuphus Fever 7 4 2 1 .. .. 2 2 Puerperal Fever 4 .. 4 .. .. .. 1 .. Rheumatic Fever 1 .. 1 .. .. .. .. .. IX. Paramenia .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 1 .. Syphilis 1 1 .. .. .. .. .. 2 Childbirth 2 .. 2 .. .. .. .. .. Noma (Canker) .. .. .. .. .. .. .. .. Dis. of Uterus, &c .. .. .. .. .. .. 4 5 Diphtheria 9 9 .. .. .. .. .. .. II. Haemorrhage .. .. .. .. .. .. .. .. X. Rheumatism .. .. .. .. .. .. 1 1 Dropsy 2 l 1 .. .. .. .. .. Arthritis .. .. .. .. .. .. 1 2 Abscess 3 2 .. .. 1 .. 1 1 Dis. of Joints, &c 2 2 .. .. .. .. .. .. Ulcer .. .. .. .. .. .. . 1 Fistula 1 .. .. .. 1 .. .. .. Mortification .. .. .. .. .. .. 1 .. XI. Carbuncle 1 .. .. 1 .. .. 2 .. Cancer 2 .. 1 .. 1 .. .. .. Phlegmon .. .. .. .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Disease of Skin, &c .. .. .. .. .. .. .. .. III.Scrofula .. .. .. .. .. .. .. 1 Tabes Mesenterica. 1 1 .. .. .. .. .. .. XIII. Cyanosis 1 1 .. .. .. .. 13 14 Phthisis(Consumpn.) 27 4 17 6 .. .. .. .. Spina Bifida .. .. .. .. .. .. 2 3 Hydrocephalus 5 5 .. .. .. .. .. .. Other Malformations .. .. .. .. .. .. 2 1 IV. Cephalitis 3 3 .. .. .. .. .. 4 Apoplexy 4 .. .. l 3 .. .. .. XIII. Intemperance .. .. .. .. .. .. 5 4 Palsy (Paralysis) 9 1 .. 2 6 .. .. .. Privation of Food .. .. .. .. .. .. .. .. Deluium Tremens .. .. .. .. .. .. 1 .. Want of Breast Milk 1 1 .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Negleet .. .. .. .. .. .. 1 .. Epilepsy l .. .. 1 .. .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 2 1 Convulsions 3 3 .. .. .. .. .. 1 Hanging 1 .. 1 .. .. .. 1 3 Disease of Brain, &c 4 1 1 1 1 .. 3 1 Suffocation 4 4 .. .. .. .. .. 2 Drowning 2 1 .. .. 1 .. .. .. V. Pericarditis .. .. .. .. .. .. 2 .. Fractures & Contus. 2 .. 1 .. .. .. .. Aneurism .. .. .. .. .. .. 3 1 Wounds 4 .. 3 .. .. 4 5 Disease of Heart, &c. 9 2 .. 3 4 .. .. .. Other Violence .. .. .. .. .. TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FIVE WEEKS ENDING JULY 1st, 1858. New Cases. Small-Pox. Chicken Pox Measles. Scarlatina. Hooping Cough Crcup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Disease? Total of Zymotic Dis. Dis. of Resp. I Organs. Phthisis. Carbuncles & Boils. Chron.& Local Rheumatism. Other Diseases. Accidents and Injuries. Totals 1081 1 11 72 3 17 0 107 2 0 3 1 4 5 7 14 247 108 9 4 42 621 50 Districts, &c. 70 .. .. .. .. .. .. 6 .. .. .. .. .. 2 1 3 12 4 1 .. 9 40 4 Infant Poor House 17 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17 .. Upppr Hollo way 44 .. .. .. .. 3 .. 3 2 .. 1 .. .. .. .. .. 9 1 1 .. 2 30 1 Lower Holloway 92 .. 1 5 1 3 .. 5 .. .. .. 1 .. 1 .. 4 21 11 .. .. 5 39 16 Highbury 33 .. .. .. .. .. .. 5 .. .. .. .. .. .. 2 .. 7 5 .. .. .. 19 2 Thornhill 218 1 7 7 1 7 .. 30 .. .. 2 .. 1 .. .. 4 60 27 1 .. 7 119 4 Barnsbury 86 .. .. 1 .. .. .. 14 .. .. .. .. .. .. .. 1 16 19 4 2 10 31 4 St. Mary 172 .. 3 13 .. 1 .. 24 .. .. .. .. 1 .. 1 .. 43 16 .. .. 1 108 4 Canonbury 15 .. .. 3 .. .. .. .. .. .. .. .. .. .. 1 .. 4 .. .. .. 4 6 1 St. peter 334 .. .. 43 1 3 .. 20 .. .. .. .. 2 2 2 2 75 25 2 2 4 212 14 14 REPORT on the SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR JULY, 1858. No. XVI. The public health in Islington, as measured by the mortality, appears to have been slightly above the average of the last two years. One hundred and ninety deaths from all causes were registered, inclusive of eight, in respect of which inquests were held during the month. One hundred and eighty-eight, exclusive of inquests, represents the mean number of deaths in July 1856-7, which, raised one-tenth for probable increase of population, gives 206 deaths for comparison with the present year. The mortality from zymotic diseases (73) while differing little from the corrected mean of 1856-7, has been less by 13 than it was in the corresponding four weeks of last year. Making a comparison with last month, it is to be observed, that while the weekly mortality from all causes has been slightly higher than in June, that from zymotic disease has increased by about one-half. The increase is due to twice as many cases of summer diarrhoea and measles having been fatal, and to the addition of four deaths from scarlet fever, and two from small pox. The deaths registered from diarrhcea were 29 (all but one, young children,) and there has been one death from infantile cholera. The deaths from diarrhcea and cholera last year amounted in the four weeks of July to 50. There were only 5 deaths from typhus. Seven deaths have been attributed to epidemic sore-throat (or " diphtheria ") as the primary disease ; and in an additional case diphtheria occurred in conjunction with measles. Of the 7 deaths, six occurred in the East sub-district. They have not been confined to the families of the poor. In two instances very clear evidence was afforded of the infectious character of the disease, which spread through each family, on the arrival from school of children suffering from sore-throat. I regret to say that scarlet fever has broken out in James Street, Stroud's Vale, and proved fatal to a child at No. 4. From the unhealthy mode in which many of the houses are constructed, and the manner in which the children are permitted to intermingle out of doors, I fear it will not be the last we shall hear of the disease in this locality. The 2 two deaths from small pox occurred in young children who are reported to have been "vaccinated." It is by no means rare for the uneducated to rest satisfied with the mere performance of the operation, and to be careless as to the result. Parents should understand that a child cannot be regarded as exempt from the infection of this loathsome disease, unless at least three or four pocks be produced by the operation, and be certified as satisfactory in their character by a qualified medical gentleman. The succeeding Table is a continuation of that in last month's report:— Mean Temperature (Greenwich.) Parish cases of Diarrhcea & Cholera. Deaths from Diarrhoea and Cholera Parish Cases of Fever. 1856. 1857- 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1st Week of Month . .59.2° 59.6° 55.9° 19 34 22 3 8 7 1 2 2 2nd 57.6° 68.0° 66.4° 25 38 30 0 6 5 5 3 0 3rd 60.1° 68,3° 62.9° 20 94 27 4 20 5 1 8 1 4th 64.2° 65.6° 59.6° 31 88 29 3 20 13 1 10 0 Total mean 60.2° mean 65.3° mean 61.2° 95 254 108 10 54 30 8 23 3 Eight hundred and thirty-five new cases of disease have been entered on the books of the Parochial Surgeons ; the mean of the corresponding week of the last two years being 820. The cases of disease of the zymotic class have been much less numerous than last year, viz. :—213 against 329. Diarrhcea has made but little progress; and both measles and hoopig-cough have abated. The number of cases of diarrhcea has been only 108 against 253 in 1857, and 95 in 1856. Only 3 cases of typhus came under observation: the number in July last year was 23, and in 1856 it was 8. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddelton Square, August 4th 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JULY 31st, 1858. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. | Under 20 years of age. | At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. | At 80 years of age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 60 years of age and upwards. 84 106 All causes 190 116 19 24 24 7 .. .. VI. Laryngitis .. .. .. .. .. .. Class. 3 2 Bronchitis 5 1 •• .. 4 .. 32 41 I. Zymotic 73 65 1 4 2 1 ... .. Pleurisy .. .. .. .. .. .. 6 3 II. Dropsy, &c. 9 .. 1 4 4 .. .. 4 Pneumonia 4 3 1 .. .. .. 11 18 III. Tubercular 29 12 10 7 .. .. .. .. Asthma .. .. .. .. .. .. 14 10 IV. Brain and Nerves 24 9 2 4 8 l .. .. Disease of Lungs .. .. .. .. .. .. 2 2 V. Heart, &c 4 1 1 2 .. .. 3 6 VI. Lungs &c. 9 4 1 .. 4 .. 3 4 VII. Digestive Organs 7 2 2 1 1 1 1 .. VII. Teething 1 1 .. .. .. .. 1 1 VIII. Kidney, &c. 2 .. .. 2 .. .. .. .. Quinsery .. .. .. .. .. .. 1 1 IX, Childbirth, &c 2 .. 1 .. 1 .. .. 1 Gastritis 1 .. .. .. .. 1 X. Joints, Bone9, &c.. .. .. .. .. .. .. .. .. Enteritis .. .. .. .. .. .. .. .. XI. Skin, &c .. .. .. .. .. .. .. .. Peritonitis .. .. .. .. .. .. .. .. XII. Malformations .. .. .. .. .. .. .. .. Ascites .. .. .. .. .. .. 3 3 XIII. Prem. Birth and Debility. 6 6 .. .. .. .. • • 1 Ulceration of Intest. 1 .. .. .. .. .. .. 1 1 l .. .. .. .. .. .. Hernia (Rupture) .. .. .. .. .. .. 3 3 XIV. Atrophy 6 6 .. .. .. .. .. .. Henus .. .. .. .. .. .. 3 4 XV. Old Age 7 .. .. .. 3 4 1 .. Intussusception 1 1 .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal Canal .. .. .. .. .. .. 2 7 XVII. Violent Death 9 8 .. .. 1 .. .. .. Dis. of Stomach, &c. .. .. .. .. .. .. " 2 XVIII. Not Specified 2 2 .. .. .. .. .. .. Disease of Pancreas . .. .. .. .. .. .. 2 .. I. Small Pox 2 2 .. .. .. .. •• .. Inflammation of Liver (Hepatitis) .. .. .. .. .. .. .. .. Chicken Pox .. .. .. .. •• .. .. 1 Jaundice 1 .. 1 .. .. .. 2 8 Measles 10 10 .. .. .. .. 1 1 Disease of Liver 2 .. 1 1 .. .. 1 3 Scarlatina 4 4 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 5 5 Hooping Cough 10 10 .. .. .. .. .. .. 1 .. Croup 4 4 .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. 15 14 Diarrhæa 29 28 .. 1 .. .. .. .. VIII. Nephritis .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. • • 1 Nephria(Bright'sDis) 1 .. .. 1 .. .. 1 .. Cholera 1 1 .. .. .. .. • • • • Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Diabetes .. .. • • .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. 1 .. Stone 1 .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. •• .. Stricture of Urethra .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. • • • • Disease of Urethra .. .. .. .. .. .. 2 3 Typhus Fever 5 2 1 1 1 .. Disease of Bladder &c .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. 1 Rheumatic Fever 1 .. .. 1 .. .. .. .. IX. Paramenia .. .. .. •• •• •• 2 1 Erysipelas 3 .. .. 1 1 1 .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. 1 Childbirth 1 .. 1 .. .. .. .. .. Noma (Canker) .. .. .. .. .. .. 1 .. Dis. of Uterus, &c.. 1 .. .. .. 1 .. 1 6 Diphtheria 7 7 .. .. .. .. .. 1 II. Haemorrhage 1 .. .. 1 .. .. .. .. X. Rheumatism .. .. .. .. .. .. 1 .. Dropsy 1 .. .. .. I .. .. .. Arthritis .. .. .. .. .. • • .. .. Abscess .. .. .. .. .. .. .. .. Dis. of Joints, &c .. .. .. .. .. .. .. 1 Ulcer 1 .. .. .. 1 .. .. .. Fistula .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 5 1 Cancer 6 .. 1 3 2 .. .. .. Phlegmon .. .. .. .. .. .. •• .. Gout •• .. .. •• •• .. •• .. Disease of Skin, &c .. .. .. .. .. .. 1 1 III. Scrofula 2 2 .. .. .. .. .. 3 Tabes Mesenterica 3 3 .. .. .. .. .. .. XII. Cyanosis .. .. .. .. .. .. 7 12 Phthisis(Consumpn.) 19 2 10 7 .. .. .. .. Spina Bifida .. .. .. .. .. .. 3 2 Hydrocephalus 6 5 .. .. .. .. .. •• Other Malformations .. .. .. .. .. .. .. 1 IV. Cephalitis 1 1 .. .. .. .. 1 4 Apoplexy 5 .. .. .. 5 .. .. .. XIII. Intemperance .. .. .. .. .. .. 4 1 Palsy (Paralysis) 5 .. .. 1 3 1 .. 2 Privation of Food 2 2 .. .. .. .. 4 .. Delirium Tremens 4 .. 2 2 .. .. 1 .. Want of Breast Milk 1 1 .. .. .. .. .. • • Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. .. Epilepsy .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. • • Insanity .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 5 3 Convulsions 8 8 .. .. .. .. .. .. Hanging .. .. .. .. .. .. .. 1 Disease of Brain, &c 1 .. .. 1 .. .. .. 2 Suffocation 2 2 .. .. .. .. 2 Drowning 2 1 .. .. 1 .. .. .. V. Pericarditis .. .. .. .. .. .. .. .. Fractures & Contus. .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. .. 2 2 Disease of Heart, &c. 4 1 1 2 •• .. 1 1 Other Violence 2 2 .. .. .. .. TABLE II. RFTURN OF CASES Of DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING JULY 29th, 1858. New Cases. Small-Pox. Chicken Pcx Measles. Scarlatina. HoopingCough Crcup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. ' Organs. Phthisis. Carbuncles & Boils. Chron.& Local Rheumatism. Other Diseases. Accidents and Injuries. Totals 835 5 2 39 7 13 1 108 3 0 2 8 3 2 10 10 213 115 6 2 15 452 32 Districts, &c. Workhouse 53 •• •• •• •• •• •• 4 •• •• •• •• •• •• 1 3 8 8 •• •• 3 32 2 Infant Poor House 4 •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 4 •• Upper Holloway 45 3 •• •• •• 7 •• 5 1 •• •• •• •• •• •• •• 16 4 •• • • 1 29 4 Lower Holloway 60 1 •• 2 •• 3 •• 4 •• •• •• 5 2 •• •• 1 18 12 •• •• 2 26 15 2 Highbury 38 •• •• •• •• •• •• 9 •• •• 1 3 1 •• 3 2 19 5 •• •• •• Thornhill 175 • • 2 1 1 1 •• 33 •• •• •• •• •• 1 2 3 44 33 4 •• 1 86 7 Barnibury 70 1 •• •• •• 1 •• 11 •• •• •• •• •• •• 1 1 15 13 1 •• 1 40 •• St. Mary 134 •• •• 11 •• •• •• 26 •• •• 1 •• •• .. 1 •• 39 12 1 2 2 73 5 Canonbury 7 •• •• •• •• •• •• 1 •• •• •• •• •• •• •• •• 1 •• •• •• 1 4 1 St. Peter 249 .. •• 25 6 1 1 15 2 •• •• •• •• 1 2 •• 53 30 •• •• 3 152 11 REPORT on the SANITARY CONDITION OF SAINT MAM, ISLINGTON, FOR AUGUST, 1858. No. XVII. The month which terminated on August 28th, has been comparatively healthy, and in great measure free from the ordinary malady of the season. The mortality table annexed and the table representing the sickness among the poor, both testify to this fact. One hundred and sixty nine deaths of residents have been registered within the parish. The mean mortality of August during the last two years was 177This comparison will appear in a more favourable light when the great increase of population is considered, and the fact, that deaths on which Inquests have been held have this year been included in the month's return. The deaths under three years of age, which last year amounted to 83, and in 1856 to 91, have this year numbered only 68. Diseases of the zymotic class, taken together, have been fatal to 56 persons, the mean of the last two years being 63. Diarrhoea, which occasioned 40 deaths in August 1856, and 30 last year, has only been fatal to 21 persons. There have been two deaths referred to Cholera, one of an infant in Osborn place, and the other of a female aged 63, who was seized while nursing a person who had just been confined, at Rheidol terrace, St. Peters. She died in 35 hours. The atmosphere of the room that she occupied with her patient had become so offensive, from the closure of all the windows and doors, that the medical gentleman in attendance could scarcely breathe in it when called to see the poor woman. There have only been three deaths attributable to fever against 9 and 10 in August of the two previous years. One of the 7 deaths from scarlet fever occurred in a house in James Street, Stroud's Vale, at which the first death from fever in that locality took place last year. Every member -of the family has suffered. As the house is arranged no medical man could be astonished at its becoming a focus for infectious disease, or at a yearly sacrifice of one or more of its inhabitants, being the penalty demanded for its occupation. Epidemic sore throat (diphtheria) has carried off 8 children, five of whom died in the East sub-district. At a house in Pierrepont row where a drain had recently been broken in, and where there were other grievous sanitary deficiencies, three deaths of children took place within eight days, viz. on August 1st, a child, aged 2 years, of croup ; on August 3rd, another, aged 2 18 days, of ulceration of the navel; on August 8th, the sister of the first mentioned child, aged 4 years, of diphtheria. There is not a family in this house which has not been suffering from illness of some kind. There has been no death from measles during the month. Mean Temperature (Greenwich.) Parish cases of Diarrhoea & Cholera. Deaths from Diarrhoea and Cholera Parish Cases ol Fever. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 67.6 º 65.2 º 62.4 º 40 69 29 6 10 5 3 14 0 2nd 66.1 º 63.7 º 65-4 º 102 74 26 11 11 4 1 3 2 3rd 66.9 º t)5.1° 63.3 º 101 83 46 14 5 12 1 6 2 4th 57.8 º 66.9° 59.2° 81 99 36 14 6 2 1 3 2 Total mean 64.6° mean 65.2° mean 62.5° 324 325 137 45 31 23 6 26 Although increased facilities are now afforded to the poor for obtaining medical aid from the parochial surgeons, the number of new cases which these gentlemen have entered upon their books during the month, has only been 850 against 870 last year, and 911 in August, 1856. Of these, only 227 were cases of the zymotic class of diseases, the corresponding number last year having been 392. The ordinary zymotic diseases which have been in excess of the average, are measles 25 cases, scarlatina 13 cases, and hooping cough 19 cases ; the mean for August of the last two years being 10, 7, and 8, of these diseases respectively. There have been two fatal cases of cholera in St. Peter's district already referred to, and 135 cases of diarrhoea against 324 in each August of the last two years. This difference is most worthy of being noted, inasmuch as the whole metropolis has this summer enjoyed, hitherto, a comparative immunity from bowel complaints, notwithstanding that fruits of all kinds have been both very abundant and very cheap. They have, however, ripened well, and the quality of those supplied to the poor has appeared to be above the average. But the less exalted temperature of the season, and the energetic removal of sources of atmospheric contamination which has been going on for the last two years, have probably more to do with this improvement. Only 6 cases of low fever have been entered against 26 in the corresponding four weeks of last year. EDWARD BALLARD, M.D., Medical Officer of Health 42, Myddelton Square, September 2nd, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING AUGUST 28th, 1858, (Deaths of Non-Residents in Hospitals excluded.) West S.D, East S.D. Causes of Death. At all Ages. 1 Under 20 years of age. At 20 and under 40 years of age. At 40 and under (iO years of age. At 60 and under 80 yeare of ape. At 80 years ot age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. ! Under 20 years of age. At 20 and under 40 years of ape. 1 At 40 and under 60 years of ape. At flu and under 80 years of ape. At 80 years of age and upwards. 78 51 All causcs 169 93 19 32 2o| 5 .. .. VI. Laryngitis .. .. .. .. .. .. Class 4 3 Bronchitis 7 3 .. 2 1 1 24 32 I Zymotic 56 48 2 3 3 .. .. • • Pleurisy .. .. .. .. .. .. 4 6 II. Dropsy, &c 10 1 1 7 1 .. 3 4 Pneumonia 1 5 2 .. .. .. 12 14 III. Tubercular 26 9 11 4 2 .. .. .. Asthma .. .. • * .. • * • • 11 7 IV. Brain and Nerves 18 7 .. 5 6 .. 1 • * Disease of Lungs 1 .. .. 1 • * .. 2 5 V. Heart, &c 7 1 .. 3 2 1 8 7 VI. Lungs, &c 15 8 2 3 1 1 5 4 VII. Digestive Organs 9 2 .. 3 3 1 1 1 VII. Teething 2 2 .. .. .. .. 1 3 VIII. Kidney, &c 4 1 1 1 1 .. .. .. Quinsey .. .. .. .. .. .. .. 1 IX. Childbirth,&c 1 .. .. 1 .. .. .. .. Gastritis .. .. .. .. .. 1 .. •• X. Joints, Bones, &c .. .. .. .. .. .. .. .. Enteritis .. .. .. .. .. .. .. .. XI. Skin, &c. .. .. .. .. .. .. 1 .. Peritonitis 1 .. .. .. 1 .. .. .. XII. Malformations .. .. .. .. .. .. .. 1 Ascites 1 .. .. .. .. 1 2 3 XIII. Prem. Birth and Debility 5 5 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. .. 1 1 .. .. 1 .. .. .. .. Hernia (Rupture) .. .. .. .. .. .. 2 5 XIV. Atrophy 7 7 .. .. .. .. 1 1 Ileus 2 •• • • 1 1 .. 1 1 XV. Old Age 2 .. .. .. .. 2 .. •• Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal Canal XVII. Violent Death. 7 4 2 •• 1 .. .. .. * * •• .. .. • • .. 1 * * XVIII. Not Specified 1 .. .. 1 .. .. .. .. Disease of Pancreas . .. .. .. .. .. .. 1 1 I. Small Pox 2 1 .. 1 .. .. •• •• Inflammation of Liver (Hepatitis) .. .. .. .. .. .. .. .. Chicken Pox .. .. .. .. .. .. ,, .. Jaundice .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. 2 1 Disease of Liver 3 .. .. 2 1 .. 4 3 Scarlatina 7 7 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 2 5 Hooping Cough 7 7 .. .. .. .. .. 1 Croup 1 l .. .. .. .. .. .. Thrush .. .. .. .. .. .. 9 12 Diarrhoea 21 18 1 1 1 .. .. .. VIII. Nephritis .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. 1 .. Nephria(Brigbt'sDis) 1 .. 1 .. .. .. .. 2 Cholera 2 1 .. .. 1 .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Diabetes .. .. .. .. •• • • .. .. Scurvy and Purpura .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. 1 .. Infantile Fever 1 .. .. .. .. .. .. 3 Disease of Bladder &c 3 1 .. 1 1 •• 1 2 Typhus Fever 3 1 .. 1 1 .. .. .. Puerperal Fever .. .. .. .. .. 1 .. Rheumatic Fever 1 .. 1 .. .. .. .. .. IX. Paramenia .. .. .. .. .. .. .. 1 Erysipleas 1 1 .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 2 .. Syphilis 2 2 .. .. .. .. .. 1 Childbirth 1 .. .. 1 .. .. .. .. Noma (Canker) .. .. .. .. .. .. .. Dis. ol Uterus, &c .. .. .. .. .. .. 3 5 Diphtheria 8 8 .. .. .. .. 1 2 II. Hæmorrhage 3 .. .. 3 .. .. .. .. X. Rheumatism .. .. .. .. .. .. 1 .. Dropsy 1 .. 1 .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. Abscess .. .. .. .. .. .. .. .. Dis. of Joints, &c .. .. .. .. .. .. .. 1 Ulcer 1 1 .. .. .. .. • .. Fistula .. .. .. .. .. .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 1 3 Cancer 4 .. .. 3 1 .. .. .. Phlegmon .. .. .. .. .. .. 1 .. Gout 1 .. .. 1 .. .. .. .. Disease of Skin, &c. .. .. .. .. .. .. .. .. III. Scrofula .. .. .. .. .. .. 3 1 Tabes Mesenterica. 4 4 .. .. .. .. .. .. XII. Cyanosis .. .. .. .. .. .. 7 12 Phthisis(Consumpn.) 19 2 11 4 2 .. .. .. Spina Bifida .. .. .. .. .. .. 2 1 Hydrocephalus 3 3 .. .. .. .. .. - Other Malformations .. .. .. .. .. .. 4 1 VI. Cephalitis 5 5 .. .. .. .. 3 2 Apoplexy 5 .. .. 1 4 .. 1 .. XIII. Intemperance 1 .. .. .. 1 .. 4 .. Palsy (Paralysis) 4 .. .. 3 1 .. .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Tremens .. .. .. .. .. .. 1 1 Want of Breast Milk 2 2 .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. 1 Epilepsy 1 .. .. 1 .. .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. .. 2 Convulsions 2 2 .. .. .. .. .. .. Hanging .. .. .. .. .. .. .. 1 Disease of Brain,&c 1 .. .. .. 1 .. .. .. Suffocation .. .. .. .. .. .. 1 .. Drowning 1 1 .. .. .. .. .. .. V. Pericarditis .. .. .. .. .. .. .. 1 Fractures & Contus. 1 .. 1 .. .. .. .. .. Aneurism. .. .. .. .. .. .. 1 .. Wounds 1 .. 1 .. .. .. 2 5 Disease of Heart, &c. 7 1 .. 3 2 1 1 •• Other Violence 1 1 .. .. •• .. TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING AUGUST 26th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. Hooping Cough Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Hesp. Organs. Phthisis. Carbuncles & Boils. I Cliron.& Local Rheumatism. Othe.r Diseases. Accidents and Injuries. Totals 850 6 3 25 13 19 0 1 135 1 2 4 1 6 3 3 6 227 63 13 1 18 492 36 Districts, &c. Workhouse 76 .. .. .. .. .. .. 8 .. .. .. .. .. 1 .. 1 10 3 3 .. 6 50 4 Infant Poor House 4 .. .. .. 1 .. .. .. .. .. .. .. .. •• .. .. 1 .. .. .. .. 3 .. Upper Holloway 26 3 .. .. .. 7 .. 4 .. .. .. .. .. .. .. .. 14 1 1 .. •• 10 .. Lower Holloway 74 1 .. 4 •• 3 .. 14 .. .. .. 1 2 •• 1 .. 26 5 .. •• 1 34 8 Highbury 48 .. .. .. 1 1 .. 13 .. .. 1 .. .. .. .. .. 16 .. 3 •• 3 25 1 Thornhill 155 1 3 1 7 4 .. 27 .. .. 3 .. 2 1 .. 4 53 12 2 .. 3 80 5 Barnsbury 80 1 •• .. .. .. .. 14 1 .. .. .. 1 .. •• • • 17' 7 1 .. .. 52 3 St. Mary 130 .. .. 10 1 • • .. 28 .. .. .. .. .. .. 1 1 41 21 1 1 1 61 4 Canonbury 2 .. .. .. .. .. .. .. .. .. .. .. •• •• .. .. .. .. .. .. .. 1 1 St. Peter 255 .. .. 10 3 4 .. 27 .. 2 .. •• 1 1 1 .. 49 14 2 .. 4 176 10 REPOET on the SANITARY CONDITION OP SAINT MARY, ISLINGTON, FOR SEPTEMBER, 1858. No. XVIII. Although the total mortality of the month of September just terminated does not exceed the mean of the last two years, I am far from regarding the sanitary condition of the Parish as having been satisfactory. Scarlet fever, which in July showed a tendency to increase, has spread somewhat rapidly, and epidemic sore throat exhibits no evidence of decline. These two diseases have raised the mortality from zymotic diseases above the mean of the two previous years. The number of deaths from all causes registered in the 5 weeks was 206, of which 72 were attributed to diseases of the zymotic and epidemic class : 119 of the whole number occurred under 20 years of age, and 53 under one year. No less than 21 deaths, all but one under 4 years of age, are referred to scarlet fever against 4 in July last, and against 2 and 7 in September, 1856 and 1857 respectively. The deaths from epidemic sore-throat (diphtheria) have amounted to 9. It appears from the weekly returns of the Registrar General that the mortality from these two diseases, taken together, has been during the month to excess in London, predominating in the Nothern, Southern, and Eastern districts, especially the two latter, and unfortunately still inclines to an increase. The deaths from fever have been 8 against 8 in 1856, and 13 in 1857. One thousand and ninety-one new cases of disease have come under the notice of the Parochial Medical Officers. This number is unusually large, but is swollen by an unusual proportion of chronic cases. The cases of zymotic disease and disorders of the respiratory organs being about the same in number as last year. The most remarkable features in the Table (II.) are the occurrence of 9 cases of small-pox, the entry of no less than 50 new cases of of scarlet fever, and the small proportion (for the season) of cases of diarrhoea. With respect to small-pox, the cases which have occurrcd have been limited to a small area in the vicinity of the Small-Pox Hospital. It seized the largest number of persons in a dirty place called Gordon Court, most of the cases, however, that I saw were of a mild type; I requested the district vaccinator to vaccinate several persons whom I found unprotected in the adjoining part of Highgate-hill. The outbreak of scarlet fever has not been general in the Parish; it h is selected the districts of St. Peter's and Thornhill, especially Siroud's-vale and its vicinity, towards which zymotic disease invariably gravitates. This will partly appear from Table II. Of ilie 14 deaths from scarlatina in the East sub-district, 12 occurred in St. Peter's, and of the 7 registered in the West sub-district, 3 occurred in Stroud's-vale and Belle-Isle Towards the close of the month, my attention was callcd to an outbreak of fever, about the Balls-pond Road, which I immediately investigated, and I saw, I believe, nearly every case that had not proved fatal at the time of my visit. The outbreak was very limited in extent, and had its principal origin in a Public House, to which were attached a very offensive stable«nd urinal. The particulars, with my opinion upon the cause of the fever, have been communicated to the Sanitary Committee. All the eases that 1 saw were of the " Typhoid " or " Abdominal " type. I have included the weekly progress of scarlct fever in the following table, which is otherwise a continuation of that presented last month. Mean Temperature (Greenwich.) Parish cases of Diarrhoea & Cholera. Deaths from Diarrhoea and Cholera Parish Cases oi Fever. Scarlet Fever. Deaths Parish Cases. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1856. 1857. 1858. 1858. 1858. 1st Wk. of Mon. 61.0° 60'4° 59.4° 62 62 32 9 4 7 0 1 1 0 10 2nd 57.5° 60.5° 59.4° 1 ,3rd 58.7° 62. 1° 63*4° 39 16 22 6 6 4th 53.7* 59.1° 58.6° 48 25 17 3 2 2 5 ! 3 5th 52-9° 58.4° 57.6° 27 15 7 0 2 0 3 2 8 11 Total mean 56.7° mean 60.1° mean 59. 6° 22 7 164 108 28 18 14 9 12 9 21 50 EDWARD BALLAUD, M.D., Medical OJJiccr of Health. 24, Myddelton Square, October 6th, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING OCTOBER 2nd, 1853. (Deaths of Non-Residents in Hospitals -excluded.) West S.D. East S.D. Causes of Death. At all Ages. ; Under 20 years of age. 1 At 20 and under 40 I years of age. At 40 and under 69 years of age. At 60 and under 80 years of aee. At 80 years ot age and upwards. West S.D. East. S.D. Causes of Death. At fell Ages. Under 20 years of 1 At 20 and under 40 years of ase. At 40 and under 60 ypar* of aee. 1 Ac Oo and miner 80 years of age. | At fco years o) a-e and upwards. 83 123 All causes 206 119 27 23 29 8 1 2 VI. Laryngitis 3 3 •• •• •• •• Class 1 4 Bronchitis 5 1 •• 1 3 •• 29 43 I. Zymotic 72 66 4 2 •• •• •• •• Pleurisy •• •• •• •• •• •• 3 II. Dropsy, &c. 7 1 1 1 3 1 2 4 Pneumonia 6 1 1 1 3 •• 12 20 III. Tubercular 32 9 14 7 2 •• •• 1 Asthma 1 •• •• •• 1 •• 7 8 IV. Brain and Nerves 15 6 .. 2 4 3 2 ** Disease of Lungs 2 •• 2 •• •• •• 7 6 V. Heart, &c 13 •• 1 4 7 1 6 11 VI. Lungs, &c 17 5 3 2 7 •• 2 9 VII. Digestive Organs. 11 4 1 3 2 1 •• 1 VII. Teething 1 1 •• •• •• •• •• •• VIII. Kidney, &c •• •• •• •• •• •• •• •• Quinsey •• •• •• •• •• •• 4 •• IX, Childbirth, &c 4 •• 2 2 •• •• •• ••.. Gastritis •• •• •• •• •• •• 2 •• X. Joints, IJones, &c 2 1 1 •• •• •• •• 1 Enteritis 1 •• 1 •• •• •• •• •• XI. Skin, &c •• •• •• •• •• 1 •• Peritonitis 1 1 •• •• •• •• 1 •• XII. Malformations 1 1 •• •• •• •• •• 1 Ascites 1 •• •• 1 •• .. 3 4 XIII, Pretn. Birth and Debility. 7 7 •• •• •• •• •• •• Ulceration of Intest. •• •• •• •• •• •• •• 4 4 3 •• •• 1 •• . •• .. Hernia (Kupture) •• •• •• •• •• •• 1 8 XIV. Atrophy 9 9 •• •• •• •• •• •• Ileus •• •• •• •• •• •• 1 4 XV. Old Age 5 •• •• •• 3 2 •• •• Intussusception •• •• •• •• •• •• •• .. XVI. Sudden •• •• •• •• •• •• Stricture of Intestinal Canal •• •• •• •• •• •• 5 1 XVII. Violent Death. 6 6 •• •• •• •• •• •• •• 1 XVIII. NotSpecified. 1 1 •• •• •• •• •• •• Dis. of Stomach, &c. •• •• •• •• •• •• - •• •• Disease of Pancreas . •• •• •• •• •• •• 1 2 I. Small Pox 3 2 1 •• •• •• •• •• Inflammation ot Liver (Hepatitis; •• •• •• •• •• •• •• •• Chicken Pox •• •• •• •• •• •• •• 1 Jaundice 1 1 •• •• •• •• 2 2 Measles 4 4 •• •• •• •• 1 4 Disease of Liver 5 •• •• 2 2 •• 7 14 Scarlatina 21 21 •• •• •• •• •• 1 Disease of Spleen 1 1 •• •• •• 1 3 5 Hooping Cough 8 8 •• •• •• •• • • •• •• Croup •• •• •• •• •• •• •• •• Thrush •• •• •• •• •• •• VIII. Nephritis •• •• •• •• •• •• 6 5 Diarrhoea 1 1 1 1 •• •• •• •• •• •• •• •• Dysentery •• .. •• .. •• •• •• •• Nephria(Bright'sDis) •• •• •• •• •• •• •• 3 Cholera 3 3 •• •• •• •• •• •• Ischuria •• •• ..•• •• •• •• •• •• •• Influenza •• •• •• •• •• •• •• •• .. Diabetes •• •• •• •• •• •• 1 •• Scurvy and Purpura 1 •• •• 1 •• •• .. •• Stone .. •• •• .. •• •• •• •• Ague •• •• .. •• •• •• •• •• Cystitis •• •• •• •• .. •• •• •• Remittent Fever •• •• •• •• •• •• •• •• Stricture ol Urethra •• •• •• •• •• •• •• 1 Infantile Fever 1 1 •• •• •• •• •• •• Diseases if Bladder &c •• •• •• • • •• .. 1 7 Typhus Fever 8 5 2 1 •• •• •• l Puerperal Fever 1 •• 1 •• •• •• •• .. Rheumatic Fever •• •• •• •• •• •• •• IX. Paramenia •• .. •• •• ..•• •• •• 2 •• Erysipelas 2 2 •• •• •• •• •• •• .. Ovarian Dropsy •• •• •• •• •• •• •• .. Syphilis •• •• •• •• •• •• 4 •• Childbirth 4 •• 2 2 •• •• •• •• Noma (Canker) •• •• •• •• •• •• •• •• Dis. ot Uterus, &c.- •• •• •• •• •• •• 6 3 Diphtheria 9 9 •• •• •• •• 1 •• II. Haemorrhage 1 •• •• •• 1 •• •• •• X. Rheumatism •• •• •• •• •• •• •• 1 Dropsy 1 l •• •• •• •• •• •• Arthritis •• •• •• •• •• •• ..•• •• Abscess •• •• •• •• •• •• 2 •• Dis. ol Joints, &c. 2 1 1 •• •• •• •• •• Ulcer •• 1 •• •• •• •• . •• FUtula •• •• •• •• •• •• •• 2 Mortification 2 •• •• •• 1 1 " XI.C arbuncle •• •• •• •• •• •• 2 1 Cmce 3 •• I 1 1 •• •• •• Phlegmon .. . .. .. •• •• •• •• Gout •• •• •• •• •• •• • • •• Disease of Skin, &c. •• •• •• •• •• •• •• •• III. Scrofula •• •• •• •• •• •• •• 1 Tabes Mescnlerica. 1 4 •• •• •• •• 1 XII. Cyanosis 1 1 •• •• •• •• 11 17 Phthiais(Consumpn. 28 5 14 7 2 •• •• •• Spina Bifida •• •• •• •• •• 1 2 Hydrocephalus 3 3 •• •• •• •• •• •• Other Mallormations •• •• •• •• •• •• 1 .. IV. Cephalitis 1 •• •• 1 •• •• •• 2 Apoplexy 2 •• •• •• 1 1 XIII.Intemperance •• •• •• •• •• •• 2 4 Palsy (Paralysis) 6 •• •• 1 3 2 •• •• Privation of Food •• •• •• •• •• •• .. •• Delirium Tremens. •• •• •• •• •• •• •• •• Want of Breast Milk •• •• •• •• •• •• •• •• Chorea •• •• •• •• •• •• •• •• Neglect •• •• •• •• •• •• .•• •• Epitepsy •• •• •• •• •• •• •• •• Cold .. •• •• •• •• •• •• •• Tetanus •• •• •• .. •• •• •• •• •• Poison •• •• •• .. •• •• •• •• •• Insanity •• •• •• •• .. •• 1 •• Burns and Scalds 1 1 •• •• •• •• 4 2 Convulsions 6 6 •• •• •• •• •• •• Hanging •• •• Disease of Brain, &c •• •• •• •• •• •• •• 1 Suffocation 1 1 •• •• •• •• •• •• Drowning •• •• •• .. •• •• .. 1 V. Pericarditis 1 .. 1 •• •• •• 1 •• Fractures & Contus. 1 1 •• •• •• •• •• •• Aneurism •• .. .. •• •• •• 1 •• Wounds 1 1 •• •• •• •• 7 5 Disease of Heart, &c. 12 •• •• 4 7 1 2 .. Other Violence 2 2 •• *' •• •• TABLE II. RETURN OP CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FIVE WEEKS ENDING SEPTEMBER 30th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. HoopingCough Crcup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fevei Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Loca] Rheumatism. Other Diseases. Accidents anJ Injuries. Totals. 1091 9 10 25 50 14 0 107 2 1 0 1 9 9 10 10 257 108 14 2 49 625 36 Districts,Sic. Workhouse 78 .. .. .. .. .. .. 3 .. .. .. .. .. 1 .. 1 5 5 6 8 54 •• Infant Poor House 18 .. .. .. 5 .. .. .. .. .. .. .. .. .. .. .. 5 .. .. .. .. 13 •• Upper Holloway 52 9 .. .. .. .. .. 8 .. .. .. .. 2 .. 2 1 22 4 .. 1 1 24 •• Lower Holloway 104 .. 3 6 1 3 .. 13 .. 1 • • •• 1 • • 2 2 32 11 .. •• 2 53 6 Highbury 79 .. 5 1 1 2 .. 8 .. .. .. 1 .. .. 1 3 22 4 1 •• •• 51 1 Thornhill 219 .. 1 6 21 3 .. 23 .. .. .. .. .. 3 .. 1 58 27 1 .. 14 116 3 Barnsbury 93 .. 1 3 • • 2 .. 9 .. .. .. .. 1 .. 2 1 19 12 •• •• 5 53 4 St. Mary 134 . . .. 8 4 .. .. 16 1 .. .. .. 2 .. 2 • • 33 18 1 1 10 70 1 Canonbury 11 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 •• •• 4 3 2 St. Peter 303 .. .. 1 18 4 .. 27 1 .. .. .. 2 5 1 1 60 26 5 .. 5 188 19 REPORT on the SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR OCTOBER, 1858. No. XIX. One hundred and eighty-two deaths exclusive of those of strangers in hospitals, have been registered in Islington during the four weeks which terminated on October 30th. This number is at least 20 above the mean mortality of the last two Octobers, making every allowance for increase of population. The mortality from scarlet fever which has increased since last month, suffices alone to account for this fact. It constitutes the leading feature of the Mortuary Table. Of 25 deaths from this disease, 19 occurred in the East sub-district, where it has in many instances, assumed a virulent type. The deaths in the four weeks respectively were, 6, 2, 7, and 10. It is to be hoped that, as but little variation has been observed during the last three weeks, in the mortality from scarlet fever in the Metropolis, the epidemic may be regarded as at its height. During the month, 617 deaths from scarlet fever have been registered in London, of which 156 have been furnished by the Northern districts alone. Five deaths from diphtheria have been registered ; and a sixth fatal case occurred secondarily to scarlet fever. From the efficient manner in which redistribution of the Parish into medical districts is for the most part working, and the readiness with which the poor have availed themselves of the facilities provided for them, it has now become scarcely possible to compare fairly the sickness among the poor 2 with that of former years. During the past month, 868 new cases were admitted under treatment by the Parochial Surgeons, of which 152 were instances of diseases of the zymotic class. It is a favourable omen that, notwithstanding the high mortality from scarlet fever, only 25 new cases wer e attended by these gentlemen, against 50 in the month of September. There have been 14 cases of fever, mostly of the typhoid or abdominal type, and 14 cases of erysipelas. * EDWARD BALLARD, M.D., Medical Officer of Health. 24, Myddelton Square, November 4th, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING OCTOBER 30th, 1858. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Uuder 20 years of age. At 20 and under 40 years of age. At 40 and under bo years of ape. At 6o and under 80 years of ace. At 80 yeais ot age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of ace. i At 40 and under 60 yEars of ape. 1 At bu and unaer 80| years of age. i At bO jiears of age and upwards.| 96 86 All causes 182 98 28 20 31 5 2 1 VI. Laryngitis 3 3 •• •• •• •• Class. 8 3 Bronchitis 11 5 2 • • 4 •• 25 34 I. Zymotic 59 53 1 1 4 •• 1 •• Pleurisy 1 •• 1 •• •• •• 3 3 II. Dropsy, &c. 6 1 l 2 2 •• 3 3 Pneumonia 6 6 •• •• •• •• 19 10 III. Tubercular 29 11 15 2 1 •• •• •• Asthma •• •• •• •• •• •• 9 14 IV. Brain and Nerves 2 3 6 4 4 9 •• 1 •• Disease of Lungs 1 •• 1 •• •• •• b 2 V. Heart, &c. 8 •• •• 6 2 •• 15 7 VI. Lungs, &c 22 14 4 •• 4 •• 4 4 VII. Digestive Organs. 8 2 2 •• 4 •• •• •• VII. Teething •• •• •• •• •• •• 2 2 VIII. Kidney, &c 4 1 •• 2 1 •• •• •• Quinsey •• •• •• •• .. •• .. .. IX. Childbirth, &c. •• •• •• •• •• •• •• •• Gastritis •• •• •• •• •• •• 1 .. X. Joints, Bones, &c 1 •• 1 .. •• •• •• 1 Enteritis 1 1 •• •• • • •• .. • • XI. Skin, &c • • •• •• • • .. •• 1 1 Peritonitis 2 1 1 •• •• •• 1 .. XII. Malformations 1 1 •• •• •• •• •• •• Ascites •• •• •• • • • • •• 2 1 XIII. Prem. Birth and Debility. 3 3 •• •• •• •• 2 •• Ulceration of Intest. 2 •• 1 •• 1 •• .. .. •• •• •• •• •• •• •• •• Hernia (Rupture) •• •• •• •• •• •• 4 2 XIV. Atrophy 6 6 •• •• •• •• •• 1 Ileus 1 •• •• •• I •• 4 5 XV. Old Age 9 •• •• •• 4 5 .. •• Intussusception •• •• •• •• •• •• .. .. XVI. Sudden .. •• •• ••..•• .. •• Stricture of Intestinal Canal 1 1 XVII. Violent Death.. 2 •• •• 2 •• •• .. •• •• •• •• •• •• •• .. 1 XVIII. Not Specified 1 •• •• 1 •• •• •• 1 Dis. of Stomach, &c. 1 •• •• •• 1 •• .. Disease of Pancreas . •• •• •• •• •• •• .. .. I. Small Pox .. •• •• •• •• •• •• •• Inflammation of Liver (Hepatitis) .. .. Chicken Pox •• •• •• •• •• •• •• •• •• •• •• 4 .. Measles 4 4 •• •• •• •• .. •• Jaundice • • •• •• •• •• •• 6 19 Scarlatina 25 25 •• •• •• •• 1 •• Disease of Liver 1 •• •• •• 1 •• 3 3 Hooping Cough 6 6 •• .. •• •• • • •• Disease of Spleen •• •• •• •• •• 2 1 Croup 3 3 •• •• •• •• 2 .. Thrush 2 2 •• •• •• •• .. 2 Diarrhæa 2 2 •• •• •• •• •• .. VIII. Nephritis •• •• •• •• •• •• .. .. Dysentery .. •• •• •• •• •• 1 2 Nephria(Bright'sDis) 3 1 .. 1 1 •• .. .. Cholera •• •• •• •• •• •• •• •• Ischuria •• .. .. •• • • •• .. .. Influenza •• •• •• •• •• •• •• •• Diabetes •• •• •• •• •• •• .. .. Scurvy and Purpura •• •• •• •• •• •• •• •• Stone •• .. •• • • •• •• .. .. Ague •• •• •• ••..•• •• •• • • •• Cystitis •• •• • • • • • • •• .. .. Remittent Fever •• •• •• •• •• •• 1 •• Stricture of Urethra 1 •• .. 1 •• •• .. .. Infautile Fever •• •• •• •• •• •• •• •• Disease of Bladder &c •• •• •• •• •• •• 4 4 Typhus Fever 8 5 1 .. 2 •• .. .. Puerperal Fever •• •• •• •• •• •• .. . . Rheumatic t ever •• •• •• •• •• •• •• •• IX. Paramenia •• •• •• .. .. •• .. 4 Erysipelas 4 1 •• 1 2 •• .. •• Ovarian Dropsy •• •• •• •• •• •• .. • • Syphilis •• •• •• • • •• .. •• Childbirth •• •• •• • • •• •• .. .. Noma (Canker) •• •• •• •• •• •• •• •• Dis. of Uterus, &c •• •• •• •• •• •• 4 1 Diphtheria 5 5 •• •• •• •• .. .. II. Hæmorrhage •• •• •• •• •• •• •• •• X. Rheumatism •• •• •• •• •• •• 1 2 Dropsy 3 1 •• 2 .. •• •• •• Arthritis .. •• .. .. .. .. 1 .. Abscess 1 •• 1 •• •• •• 1 •• Dis. of Joints, &c 1 .. 1 •• •• •• .. .. Ulcer •• .. •• .. •• •• .. .. Fistula • • •• •• •• .. •• .. • • Mortification •• •• •• • • .. •• •• •• XI. Carbuncle •• •• •• •• •• •• 1 1 Cancer 2 •• •• •• 2 •• •• •• Phlegmon .. . .. .. . •• .. .. Gout * * •• •• •• •• •• •• •• Disease of Skin, &c. •• •• •• •• •• . .. .. III. Scrofula •• •• •• •• .. •• 3 1 Tabes Mescnlerica 4 4 •• •• •• •• 1 •• XII. Cyanosis 1 1 •• •• •• •• 13 8 Phthisis(Consumpn.) 21 3 15 2 1 •• •• •• Spina Bifida .. •• .. •• .. •• 3 1 Hydrocephalus 4 4 •• •• •• •• •• •• Other Malformations •• •• •• •• •• •• 2 2 IV. Cephalitis 4 3 •• •• 1 •• 4 2 Apoplexy 6 .. •• 1 5 •• •• •• XIII. Intemperance •• •• •• •• •• •• 1 2 Palsy (Paralysis) 3 •• 1 1 1 •• •• •• Privation of Food •• .. •• .. . •• • • 2 Delirium Tremens 2 •• 1 1 .. •• •• Want of Breast Milk •• •• •• •• •• •• .. • • Chorea • • •• •• •• •• •• •• •• Neglect •• •• •• •• •• •• 1 2 Epilepsy 3 • • 2 • • 1 •• •• •• Cold •• •• •• .. •• •• .. • • Tetanus •• •• •• •• •• •• •• •• Poison •• •• •• •• •• •• .. • • Insanity •• •• •• •• •• •• •• •• Burns and Scalds •• •• •• •• •• •• • • 3 Convulsions 3 3 •• • • .. •• •• 1 Hanging 1 •• •• 1 •• •• 1 1 Disease of Brain, &c 2 •• •• 1 1 •• •• •• Suffocation •• .. •• •• •• •• •• •• Drowning • • •• •• ' • * •• •• • • V. Pericarditis •• •• •• •• •• •• 1 •• Fractures & Contus. 1 •• • • 1 •• •• • • Aneurism •• •• •• •• •• •• •• •• Wounds .. •• .. • • • • •• 6 2 Disease of Heart, &c. 8 * * •• 6 2 •• •• •• Other Violence •• •• •• •• * * •• TABLE II. RETURN OP CASES OP DISEASE TREATED BY THE PAROCHIAL MEDICAL OPPICERS DURING FOUR WEEKS ENDING OCTOBER 28th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. H oopingCougli Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Reap. Organs. Phthisis. Carbuncles & Boils. Chron.& Locai Rheumatism. Other Diseases. Accidents and Injuries. Totals. 868 2 2 16 25 15 1 37 4 0 3 1 14 5 14 13 152 157 ii 2 28 480 38 Districts, &c. Workhouse 60 • • • • • • • • • • • • • • • • • • • • • • 1 1 1 1 4 7 1 1 7 39 1 Infant Poor House 5 • • • • • • 3 • • • • • • • • • • • • • • • • • • • • • • 3 • • • • • • • • 2 •• Upper Holloway 37 2 • • • • • • 1 .. 3 1 • • • • • • 2 1 2 • • 12 2 •• 1 1 16 5 Lower Holloway 90 • • 1 4 • • 4 • • 4 • • • • • • • • 3 •• 1 4 21 13 2 • • 3 44 13 Highbury 71 • • • • 1 • • • • • • 2 • • • • 2 1 • • • • 1 2 9 7 • • • • 2 49 4 Thornhill 157 • • • • 4 4 1 • • 9 • • • • • • • • 1 2 1 4 26 37 3 • • 5 84 2 Barnsbury 83 • • 1 5 2 2 1 6 • • • • • • • • 1 • • 2 • • 20 18 1 • • 6 37 1 St. Mary 121 • • • • • • 7 • • • • 5 1 • • • • • • 2 • • • • 1 16 29 • • • • • • 72 4 Canonbury 13 • • • • • • 5 • • • • • • • • • • • • • • 2 •• 2 .. 9 1 .. • • 2 1 •• St. Peter 225 .. .. 2 4 7 .. 8 2 .. 1 • • 2 1 4 1 32 43 4 • • 2 136 8 REPORT ON THE SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR NOVEMBER, 1858. No. XX. The mortality of the past month has been unusually high. Independently of the strangers who have died in the several hospitals in the Parish,— the deaths of 231 persons havebeen registered. The mortality of November, 1856, was 194, and that of last year, 198. The deaths registered in each of the four weeks were 44, 53, 61, and 73 respectively. The mortality of London generally in the same weeks was 1217, 1349, 1487, and 1802; and of the Northern districts alone, 268, 294, 313, and 358. The gradual increase in fatality, week by week, has thus only been in accordance with a similar occurrence observed throughout the Metropolis. Part of this high mortality is to be accounted for by the continued prevalence of scarlet fever, especially in the Northern parts of London, and pnrtly by the unusually inclement weather which November exhibited. According to Mr. Glaisher, of the Greenwich Observatory, the mean temperature of the air in the first w eek of the month was 43.3°, or 27 degs. below that of the corresponding week in 43 years; in the second week it was 39.0°, or 5.3 degs. below the average; in the third week, 35.5°, or 7 degs. below the average; and in the fourth week, 37.4°, or 3.9 degs. below the average. In this last week, "Tuesday (November 23d), was the coldest day in Novembersince November23d, 1827, and the mean temperature of Tuesday and Wednesday was lower than that of any two consecutive days in November, so far back as authentic records extend." On the 24th, the mean daily temperature was 26.5°, and on the 25th, it suddenly rose to 42.5°, 2 The excess of mortality has fallen almost solely upon infants and young persons. Last year the deaths under 20 years of age were 99, or exactly half the total mortality; this year they have amounted to 137. The deaths above 20 years of age were 92, or rather less than in November last year. The diseases which have occasioned the excess have been scarlet fever, of which 29 children have died ; diseases of the nervous system, including infantile convulsions, of which 15 children died, and inflammatory affections of the lungs, of which 32 children died. Measles have carried off 8 children. The weekly deaths from scarlet fever have been respectively 7, 7, 8, and 7. Coincidently with the high mortality is the increase in the sickness among the poor, as gathered from the books kept by the Parochial Surgeons. Altogether, 1070 new cases were admitted under treatment, the weekly numbers being 213,236, 307, and 314. Of these, 158 were cases of disease of the zymotic or contagious class, 51 of them were cases of measles, which has made some progress during November, and 21 were cases of scarlet fever. There were 384 cases of acute pulmonary affections, the numbers entered in the respective weeks being 50, 78, 115, and 141. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddelton Square, December Ini, 1858. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING NOVEMBER 27th, 1858. {Deaths of Non-Residents in Hospitals excluded.) West s.o. East S.D. ( auses of Death. At all Ages. Under 20 years of age. At 20 and under 40 years ot nge. At 40 and under 60 veal's of age» At 6o and under 80 years of age. At 80 years ot age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. Under 20 years of At 20 and under 40 years of age. At 40 and under 60 years of age. At 6o and under 80 years of age. At 80 years of age and upwards. 138 93 All causes 231 137 25 30 35 4 1 •• VI. Laryngitis 1 1 •• •• •• •• Class. 2b 8 Bronchitis 24 24 1 3 5 1 27 38 I. Zymotic 65 60 2 1 2 •• 1 5 •• 4 Pleurisy 9 7 •• •• 2 •• 6 3 II. Dropsy, &c 9 1 3 4 1 •• •• •• Asthma •• •• •• •• •• •• 12 10 III. Tubercular 32 9 16 6 1 •• 1 1 Disease of Lungs 2 •• •• 2 •• •• 19 12 IV. Brain and Nerves.. 31 l5 1 5 10 •• 6 4 V. Heart, &c. 10 1 1 3 5 •• 34 13 VI. Lungs, &c. 47 39 1 6 7 1 9 4 VII. Digestive Organs. 13 6 •• 3 4 •• 2 •• VII. Teething 2 2 •• •• •• •• 2 1 VIII. Kidney, &c 3 •• •• 1 2 •• 1 •• Quinsey 1 1 •• •• •• •• 1 •• IX, Childbirth, &c 1 •• 1 •• •• •• 1 .. Gastritis 1 •• •• •• 1 •• •• •• X. Joints, Benes, &c •• •• •• •• •• •• •• •• Enteritis •• •• •• •• •• •• 1 •• XI. Skin, &c 1 •• •• •• 1 •• .. 1 Peritonitis 1 •• •• 1 •• •• 1 1 XII. Malformations 2 2 •• •• •• •• •• •• Ascites •• •• •• •• • • •• •• 1 XIII. Prem. Birth and Debility. 1 1 Ulceration of Intest. I •• •• 1 • • •• •• 1 1 1 •• •• .. •• •• • • Hernia (Rupture) •• •• •• •• •• •• 3 3 XIV. Atrophy 6 6 •• •• •• •• •• •• Ileus •• •• •• •• •• •• 3 2 XV. Old Age 6 •• •• •• 2 3 •• 1 Intussusception 1 1 •• •• •• •• .. .. XVI. Sudden •• •• •• •• •• •• Stricture of Intestinal Canal .. •• .. •• .. •• 4 •• XVII. Violent Death 4 3 •• 1 •• •• •• •• •• •• XVIII. Not Specified •• •• •• •• •• •• 3 1 Dis. of Stomach, &c. Disease of Pancreas . 4 1 •• 1 2 •• •• 1 I. Small Pox 1 1 •• •• •• •• •• •• Inflammation of Liver (Hepatitis) •• •• •• •• •• •• •• •• Chicken Pox •• •• •• •• •• •• •• 1 Jaundice l 1 •• •• •• •• 4 4 Measles 8 8 •• •• •• •• 1 •• Disease of Liver •• •• •• •• 1 •• 14 15 Scarlatina 29 29 •• •• •• •• Disease of Spleen •• •• •• •• •• •• 5 3 Hooping Cough 8 8 •• •• •• •• •• •• •• 2 Croup 2 2 •• .. •• •• •• 1 Thrush 1 1 •• •• •• •• •• 3 Diarrhoea 3 3 •• •• •• •• •• .. VIII. Nephritis •• •• •• •• •• •• •• •• Dysentery •• •• •• •• •• •• .. •• Nephria(Bright'sDis) •• •• •• •• 1 • • •• •• Cholera •• •• .. •• •• •• • • .. Ischuria •• •• •• •• •• •• •• •• Influenza •• •• •• •• •• •• •• .. Diabetes •• •• • • •• •• • • •• •• Scurvy and Purpura •• •• •• •• •• •• •• •• Stone •• .. .. •• •• • • •• •• Ague •• •• •• .. •• •• • • • • Cystitis • • .. • • •• • • •• •• •• Remittent Fever •• •• •• •• •• •• •• •• Stricture of Urethra •• •• •• •• •• •• •• •• Infantile Fever •• •• •• •• •• •• 2 1 Disease of Bladder &c 3 •• •• 1 2 •• 2 4 Typhus Fever 6 3 1 1 1 •• •• 1 Puerperal Fever 1 •• 1 •• •• •• 1 •• Rheumatic Fever 1 1 •• •• •• •• •• •• IX. Psramenia •• •• •• •• •• •• 1 2 Erysipelas 3 2 •• •• 1 •• •• •• Ovarian Dropsy •• •• •• •• •• •• •• •• Syphilis •• .. •• •• •• •• 1 •• Childbirth 1 •• 1 •• •• •• •• 1 Noma (Canker) 1 1 •• •• •• •• •• •• Dis. of Uterus, &c. •• •• •• •• •• •• •• 1 Diphtheria 1 1 •• •• •• •• 1 1 II. Haemorrhage 2 •• 1 1 •• •• •• •• X. Rheumatism •• •• •• •• •• •• 2 1 Dropsy 3 1 1 •• 1 •• •• •• Arthritis .. •• .. •• .. .. 1 •• Abscess 1 •• .. 1 •• •• •• •• Dis. of Joints, &c •• •• •• •• •• •• .. •• Ulcer •• .. •• .. •• •• ,. •• Fistula .. •• .. •• •• •• .. •• Mortification •• •• •• •• •• •• •• •• XI. Carbuncle •• •• •• •• •• •• 2 1 Cancer 3 .. 1 2 •• •• 1 •• Phlegmon 1 •• •• .. 1 .. •• •• Gout •* •• •• •• •• •• •• •• Disease of Skin, &c •• •• •• •• •• • •• 1 III.Scrofula 1 •• •• 1 •• •• 1 •• Tabes Mesenterica 1 •• •• •• •• •• •• •• XII. Cyanosis •• •• •• •• •• •• 18 8 Phthisis(Consumpn.) 2b 4 16 5 1 •• •• 1 Spina Bifida 1 1 •• •• •• •• 3 1 Hydrocephalus 4 4 •• •• •• •• 1 •• Other Malformations 1 1 •• •• •• •• 4 3 IV. Cephalitis 7 •• •• •• •• •• 2 2 Apoplexy 4 •• •• 1 3 •• XIII. Intemperance •• •• •• •• •• •• 5 2 Palsy (Paralysis) 7 •• •• 1 •• •• •• •• Privation of Food .. •• •• •• •• •• •• •• • • Delirium Ireinens •• •• •• •• •• •• 1 •• Want of Breast Milk 1 1 •• •• •• •• • • •• Chorea •• •• •• •• •• •• •• •• Neglect •• •• .. •• .. •• 2 •• Epilepsy 2 1 •• 1 •• •• •• •• Cold •• •• •• •• •• •• •• 1 Tetanus Insanity 1 .. •• •• •• •• •• •• Poison Burns and Scalds •• •• •• •• •• •• 6 3 Convulsions 9 8 •• 1 •• •• •• •• Hanging .. •• .. •• •• •• •' 1 Disease of Brain, &c 1 •• •• •• 1 •• 2 •• Suffocation Drowning 2 2 •• •• •• •• .. .. V. Pericarditis •• •• •• •• •• •• 1 •• Fractures & Contus. 1 .. .. 1 .. •• .. .. Aneurism •• .. •• •• .. .. .. Wounds .. •• .. .. .. •• 6 4 Disease of Heart, &c. 10 1 1 3 5 •• •• •• Other Violence ** •• • •• ** •• TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FOUR WEEKS ENDING NOVEMBER 25th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. HoopingCough Crcup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Disease.1- Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Loca Rheumatism. Other Diseases. Accidents and Injuries. Totals 1070 2 4 51 21 25 0 21 1 0 1 0 9 3 7 13 158 384 5 3 36 445 39 Districts,&c. Workhouse 53 .. .. .. .. .. .. 3 .. .. .. .. .. .. .. 1 4 15 .. 2 7 24 1 Infant Poor House 12 .. .. .. 4 .. .. .. .. .. .. .. .. .. .. .. 4 .. .. .. .. 8 .. Upper Holloway 40 .. .. .. 2 .. .. 1 .. .. .. .. 1 .. .. 1 5 8 1 •• 4 19 3 Lower Holloway 95 .. 1 6 .. 2 .. .. .. .. .. .. .. .. .. 3 12 29 • • • • 4 40 10 Highbury 74 .. .. .. 1 1 .. 2 .. .. .. .. .. 1 .. 4 9 24 .. .. 1 37 3 Thornhill 232 1 2 27 4 2 .. 8 .. .. 1 .. 5 2 2 2 50 85 2 .. 8 75 6 Barnsbury 91 .. .. 5 1 9 .. 3 .. .. .. .. .. .. 2 1 21 42 .. 1 1 22 4 St. Mary 161 1 .. 11 8 1 .. 1 .. .. .. .. 1 .. .. .. 23 77 .. .. 5 54 2 Canonbury 14 .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 4 1 .. .. 6 1 St. Peter 298 .. 1 2 1 10 , , 3 1 .. .. .. .. .. 3 1 22 100 1 .. 6 160 9 REPORT on the SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR DECEMBER, 1858. No. XXI. With the exception of the 6th of January, the 23d and 24th of November were the coldest days in 1858. How very unseasonable was this depression of temperature, is shown in the following tabular statement:— Temperature. (Greenwich.) Adopted mean temperature of same day in 42 years. 1858. Highest. Lowest. Mean. Jan. 6 29.8° 20.9° 25.4° 36.0° Nov. 23 34.0° 21.0° 26.4° 41.4° Nov. 24 30.5° 20.5° 26.5° 41.0° It was accompanied by sickness and mortality, such as the greater but more seasonable cold of the early weeks of January failed to call forth. I have already mentioned (Report for November) that the registered deaths in the last week of November were 73. I find that the number of persons that actually died that week was 82. Notwithstanding the abatement of the cold, the injurious operation of this inclement weather on the public health did not subside for several weeks ; hence, in the five weeks which terminated on January 1st, 1859, the registered mortality in Islington attained the high number of 364, no approach to which will be found during any of the twenty months over which these Reports have extended. The registered mortality of January 1856 was 232, and that of 1857, 286. The number of persons who actually died in the week ending December 4 th, was 92, and on that ending December 11th, 78. On referring to my Annual Tables, it will be found, that the deaths which took place in the two first weeks of December, 1856, were 54 and 37, and in the corresponding weeks of 1857, they were 55 and 68. 2 Of the 364~registered deaths, 221 were of persons under 20 years of age ; and of these, 91 were infants under 1 year, 44 werejbetween 1 and 2 years of age, and 27 between 2 and 3 years. The principal maladies from which the excess of mortality issued were, acute and chronic pulmonary affections, and those diseases of the zymotic class in the course of which the organs of respiration * are especially liable to be involved. The deaths from diseases of the lungs, exclusive of consumption were 104 against 63 in 1856, and 55 in 1857. There were 16 deaths from measles, and 28 from hooping cough. It is, however, satisfactory to observe, that the progress of scarlet fever in the parish experienced a decided check from the cold. Prior to the last week in November, the deaths from scarlet fever had ranged between 8 and 9 weekly ; but the succeeding week they fell to 3, and have not exceeded that number since. There have been registered 7 deaths from epidemic sore throat. Twelve hundred and eighty-five new patients sought medical advice at the hands of the Parochial Surgeons, the weekly numbers being 331, 295, 275, 215, and 169; of these, 434, or about a third, were labouring under acute pulmonary affections. In the last week of November, there were 141 entries of this kind. During December, the prevalence of pulmonary ailments became gradually reduced, the number of cases admitted each week being 118, 114, 96, 59, and 47. Measles, hooping cough, and local rheumatic affections, were all more prevalent towards the commencement than towards the close of the month. EDWARD BALLARD, M.D., Medical Officer of Health 42, Myddelton Square, January 7 th, 1859. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING JANUARY 1st, 1859. (Deaths of Non-Residents in Hospitals excluded.) West s.d. East s.d. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of aee. At 80 years oi age ana upwards. West s.d. East. s.d. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of ape. At 40 and under 60 years of age. At 6o and under 80 years of age. At 80 years ot age and upwards. 172 192 All causes 364 221 44 38 48 12 .. .. VI. Laryngitis .. .. .. .. .. .. Class. 36 35 Bronchitis 71 46 l 7 12 5 41 50 I. Zymotic 91 79 5 2 3 2 .. .. Pleurisy * * .. .. .. .. .. 7 3 II. Dropsy,&c. 10 l 1 3 4 1 13 13 Pneumonia 26 22 2 1 1 .. 23 26 III. Tubercular 49 19 17 9 4 .. 4 2 Asthma 6 .. • • 1 5 .. 13 16 IV. Brain and Nerves 29 15 4 3 6 1 •• 1 Disease of Lungs 1 •• 1 .. .. .. 10 8 V. Heart, &c 18 2 6 6 3 1 53 51 VI. Lungs, &c 104 68 4 9 18 5 11 11 VII. Digestive Organs 22 12 4 3 3 .. 2 3 VII. Teething 5 5 .. .. .. .. 3 .. VIII. Kidney, &c 3 .. .. 1 2 .. .. 1 Quinsey 1 1 .. .. .. .. .. 2 IX. Childbirth,&c 2 .. 2 .. .. .. 1 .. Gastritis 1 .. .. .. 1 .. .. .. X. Joints, Bones, &c .. .. .. .. .. .. 1 3 Enteritis 4 2 1 1 .. .. .. .. XI. Skin, &c. .. .. .. .. .. .. 1 1 Peritonitis 2 1 1 .. .. .. 1 2 XII. Malformations 3 3 .. .. .. .. .. .. Ascites .. .. .. .. .. .. 1 2 XIII, Prem. Birth and Debility. 3 3 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. .. 3 3 3 .. .. .. .. .. • • Hernia (ltupture) .. .. .. .. .. .. 2 8 XIV. Atrophy 10 10 .. .. .. .. .. 1 Ileus 1 .. 1 .. .. .. 1 5 XV. Old Atje 6 .. .. .. 4 2 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. Stricture of Intestinal Canal 5 5 XVII. Violent Death.. 10 5 1 2 1 .. .. .. .. .. .. .. .. .. 1 .. XVIII. Not Specified 1 1 .. .. .. .. .. • • Dis. of Stomach, &c. .. .. .. .. .. .. .. .. Disease of Pancreas . .. .. .. .. .. .. .. 2 I. Small pox 2 2 .. .. .. .. .. •• Inflammation of Liver (Hepatitis) 2 .. .. 1 1 .. .. .. Chicken Pox .. .. .. .. .. .. 2 •• Jaundice 2 2 .. .. .. .. 8 8 Measles 16 16 .. .. .. .. 2 .. 8 5 Scarlatina 13 13 .. .. .. .. 2 2 Disease of Liver 4 1 1 1 1 .. 10 18 Hooping Cough 28 28 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. 3 1 Croup 4 3 1 .. .. .. .. .. Thrush .. .. .. .. .. .. 1 1 Diarrhoea 2 2 .. .. .. .. .. .. VIII. Nephritis .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. 1 .. Nephria(Bright'sDis) 1 .. .. .. 1 .. .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. 2 Influenza 2 1 .. .. .. 1 .. .. Diabetes .. .. .. .. .. .. .. .. Scurvy and Purpura .. .. .. .. .. .. 1 • • Stone 1 .. .. 1 .. .. .. .. Ague .. .. • • .. .. .. .. .. Cystitis .. • • • • •• •• •• .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. 1 .. Disease of Bladder &c 1 .. .. .. 1 • • 6 3 Typhus Fever 9 5 1 .. 2 1 .. 3 Puerperal Fever 3 .. 2 1 .. .. 1 .. Rheumatic Fever 1 .. .. 1 .. .. .. .. IX. Paramenia .. .. .. .. .. .. 1 2 Erysipelas 3 1 1 .. 1 .. • • .. Ovarian Dropsy .. .. .. .. .. .. 1 .. Syphilis 1 1 .. .. .. .. .. 2 Childbirth 2 .. 2 .. .. .. .. .. Noma (Canker) .. .. .. .. .. .. .. .. Dis. of Uterus, &c .. .. .. .. .. .. 2 5 Diphtheria 7 7 .. .. .. .. 1 .. II. Haemorrhage 1 .. .. 1 .. .. .. .. X. Rheumatism .. .. .. .. .. .. • • .. Dropsy .. .. .. .. .. .. .. .. Arthritis .. .. .. .. .. .. • • .. Abscess .. .. .. .. .. .. .. .. Dis. of Joints, &c .. .. .. .. .. .. 1 1 Ulcer Fistula 1 1 .. .. 1 .. .. .. Mortification .. .. .. .. .. .. .. .. XI. Carbuncle .. .. .. .. .. .. 4 2 Cancer 6 •• 1 2 3 .. .. .. Phlegmon .. .. .. .. .. .. 1 * * Gout 1 .. .. .. .. 1 •• .. Disease of Skin, &c. .. .. .. .. .. .. 1 .. III. Scrofula 1 1 .. .. .. .. 1 3 Tabes Mesenterica 4 4 .. .. .. .. .. .. XII. Cyanosis .. .. .. .. .. .. 19 20 Phtisis(Consumpn.) 39 9 17 9 4 .. 1 1 Spina Bifida 2 2 .. .. .. .. 2 3 Hydrocephalus 5 5 .. .. .. .. .. 1 Other Malformations 1 1 .. .. .. .. 5 4 IV. Cephalitis 9 7 .. .. 2 .. 3 1 Apoplexy 4 .. .. 2 2 .. .. .. XIII. Intemperance .. .. .. .. .. .. 1 4 Palsy (Paralysis) 5 .. 2 .. 2 1 .. .. Privation of food .. .. .. .. .. .. • • .. Delirium Tremens .. .. .. .. .. .. 2 .. Want of Breast Milk 2 2 .. .. .. .. • • .. Chorea .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. •• .. Epilepsy .. .. • • .. .. .. .. .. Cold .. .. .. .. .. .. .. •• Tetanus .. .. •• •• .. .. 1 .. Poison 1 .. 1 .. .. .. .. .. Insanity .. .. • • • • .. .. 1 1 Burns and Scalds 2 2 .. .. .. .. 3 4 Convulsions '7 7 .. .. .. .. .. .. Hanging .. .. .. .. .. .. 1 3 Disease of Brain, &c 4 1 2 1 .. .. 1 .. Sufiocahon 1 1 .. .. .. .. .. 1 Drowning 1 .. .. 1 .. .. 2 1 V. Pericarditis 3 2 .. 1 .. .. .. 1 Fractures & Contus. 1 .. .. .. 1 .. 1 .. Aneurism 1 .. .. .. 1 .. .. 2 Wounds 2* .. .. 1 .. .. 7 7 Disease of Heart, &c. 14 .. 6 5 2 1 •• •• Other Violence •• .. • .. .. •• •Age of one unspecified. TABLE II. RETURN OF CASES OF DISEASE TREATED BY THE PAROCHIAL MEDICAL OFFICERS DURING FIVE WEEKS ENDING DECEMBER 30th, 1858. New Cases. Small-Pox. Chicken Pox. Measles. Scarlatina. HoopingCough Croup. Diarrhoea. Dysentery. Cholera. Ague. Infantile Fever Typhus. Rheumatic Fever. Erysipelas. Other Zymotic Diseases Total of Zymotic Dis. Dis. of Resp. Organs. Phthisis. Carbuncles & Boils. Chron.& Loca Rheumatism. Other Diseases. Accidents and Injuries. Totals 1285 2 5 44 17 46 2 25 2 0 2 0 5 10 12 12 184 434 15 4 54 541 53 Districts, &c. Workhouse 83 .. .. .. .. .. .. 2 .. .. .. .. .. 1 .. 1 4 30 .. .. 7 41 1 Infant Poor House 24 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. 22 .. Upper Holloway 71 • • 2 .. 1 .. .. 2 1 .. .. .. .. 1 1 1 9 12 2 1 4 40 3 Lower Holloway 117 .. 1 8 .. 8 .. 1 .. .. .. .. 2 .. 4 3 27 32 1 .. 8 36 13 Highbury 127 .. .. .. 4 1 1 11 .. .. 1 .. .. 1 1 3 23 39 .. 1 2 54 8 Thornhill 253 1 1 30 5 3 1 5 .. .. 1 .. 2 4 1 1 55 102 1 .. 9 83 3 Barnsbury 128 .. .. .. 2 14 .. 1 .. .. .. .. .. .. 1 2 20 60 1 .. 3 38 6 St. Mary 170 .. 1 6 1 9 .. 2 .. .. .. .. 1 .. 2 .. 22 70 5 .. 8 58 7 Canonbury 18 .. .. .. .. 1 .. 1 .. .. .. .. .. 1 .. .. 3 6 .. .. 4 4 1 St. Peter 294 1 .. .. 3 10 .. .. 1 .. .. .. .. 2 2 1 20 82 5 2 9 165 11 REPORT ON THE SANITARY CONDITION Of the Parish of St. Marg, Islington, DURING THE YEAR 1858. BY EDWARD BALLARD, M.D., (LOND.) Licentiate of the Royal College of Fhysicians; Fellow of the Royal Medical and Chiritrgical Society of London, etc.; MEDICAL OFFICER OF HEALTH. LONDON! J. & I. TIREBUCK, PRINTERS AND LITHOGRAPHERS, Monkwell Street, City, and Islington. TO THE VESTRY OF ST. MARY, ISLINGTON. Gentlemen, 1. My Third Annual Report, that for 1858, which I have now the honor to submit, will consist of the usual summary of the Sanitary condition of the parish during the year, and of the work that has been accomplished in the removal of nuisances and of various other conditions calculated to affect injuriously the health of the inhabitants of the district. Latterly the public ear has unfortunately become familiar with the name of a disease to which it had hitherto been unaccustomed, and with the appearance of the term "Diphtheria" in my monthly reports, the unusual prevalence of sore throats has excited much inquiry into the nature of that malady and the circumstances under which it becomes developed. It was clearly my duty to study the disease and to avail myself of all the advantages for this purpose that my position afforded me. As soon therefore as it became apparent that it was making way as an epidemic in Islington, I set myself to inquire into the particulars of each fatal case, both at the house where it occurred and from the medical gentlemen who attended it. I desire thus early to make my public acknowledgment of the services which these gentlemen have rendered me in replying immediately and most courteously to the questions I addressed to them. Several of the cases came once or oftener under my own observation. It has appeared to me desirable to present you with a somewhat detailed account of the disease as it appeared in Islington, although in order to do so it becomes necessary to abridge other portions of my report. MORTALITY. 2. Following my usual practice, I have thrown the particulars of the mortality that has occurred in the parish into the form of Tables, which will be found at the end of the Report, and which are comparable with those of former years. Excluding persons from other parishes who have died in the Fever and Small-pox Hospitals, 2,642 individuals died in Islington between the 1st day of January and the 31st of December, 1858. We may calculate that, in addition to these, about 149 others fell victims to disease or accident in the various general and special Hospitals, Lunatic Asylums and Lying-in Hospitals of the Metropolis, which receive patients from all parts of town indiscriminately. Adding these, our mortality for the year will be raised to 2,791, an excess of 235 above that of last year. An unfavourable circumstance attending this comparison is the fact that whereas the births in 1857 exceeded the deaths by 2,035, they exceeded them in 1858 by a much smaller number, namely 1,771. The registration of births, however, might have been unusually imperfect. 3. The proportion of the entire corrected mortality which must be estimated to belong to the West Sub-district is 1401 and to the East 1390. With the exception of about 30 deaths, the whole excess of mortality of the year occurred in the East Subdistrict. 4. The weekly deaths varied from 31 (in the week ending August 21st) to 92 (in the week that ended on December 4th). The mean weekly mortality of the first quarter of the year was 55, of the second 44, of the third 43, and of the fourth quarter 60. 5. Of the 2,642 persons of whose deaths I possess particulars, 1,280 were male and 1,362 females. 4 CAUSES OF DEATH. The causes of death of 2,642 persons are detailed in Table 1. As usual the diseases of the zymotic class stand at the head of the list as occasioning the largest number, and next to them stand the pulmonary and tubercular diseases. a. Zymotic Diseases* 6. Of the 2,642 deaths 721 arose from diseases of this class. This is a per centage of27'2. In 1856 the per centage was 23 6, and in 1857 it was 22'4. It is in the Eastern half of the parish that the excessive zymotic mortality has prevailed. The difference in this respect between the two sub-districts is too great to be readily explicable on any other hypothesis than the really greater prevalence or greater fatality of these diseases in this sub-district. The per centage in the West Sub-district was 23.8 and in the East 30.6. 7. The greatest weekly zymotic mortality, viz. 24, occurred (Table II.) in the week which ended November 27, at the period therefore of the most unseasonable cold (See Monthly Report, No. XX ) In the following week it reached 22. It is remarkable on a survey of the year how little effect the excessively hot weather in June had upon the mortality. In the week ending June 19lb, the hottest week of the year, the total mortality did not exceed 45, and the zymotic mortality was only 8. It is true that the zymotic deaths became more frequent in the following weeks, but they never attained a high number. 8. The most fatal diseases of this class were Hooping Cough which occasioned 159 deaths, Scarlet Fever which occasioned 116 deaths, Measles 98, Diarrhoea 90, Fever 65, and Diphtheria and epidemic sore throat 59. All of these, with the exception of Measles, carried off by far the largest number of persons in the East Sub-district. Hooping Covgh has been unusually prevalent throughout the year, although subsiding a little in the summer months. The largest monthly mortality from Hooping Cough, viz. 27, occurred in the five weeks which succeeded the very cold weather in November. Scarlet Fever, which only occasioned 13 deaths during the first half of the year, began to present an epidemic character about the end of July, and between this time and the close of the year carried off 103 persons, of whom all but five were under 10 years of age. Its progress week by week is shown in Table II. The mortality suddenly subsided in Islington after the cold weather of the last week in November. The deaths from Measles were slightly in excess of previous years in the 1st, 2nd, and 4th quarters. Considering the excessive heat of the summer and the prolonged dry weather, it is highly worthy of remark that Islington, in common with the rest of the Metropolis, enjoyed a comparative immunity from the bowel complaints which we annually look for at that season. When Cholera approached this island so closely as it did in 1857, and when an outbreak to a limited extent actually took place in a metropolitan suburb, we certainly did look with anxiety to the progress of events in the succeeding summer. The result in Islington was that only 59 deaths from Diarrhoea occurred in the quarter against 99 in 1857 and 78 in 1856. The deaths from Fever have also been reduced in number, since they only amounted to 65. In 1857 they were 84, and in the previous year 74. Another important and interesting fact is that true Typhus has been almost completely absent from London. *"Tins class comprises diseases winch have been observed to be epidemic, endemic, or contagious. The blood is probably, in the greater number of thee, the primary seat of disease ; and they may be considered, by hypotheses, the result of specific poisons of organic origin, either derived from without or generated vfitbin the body."—Statistical Nosology, 1815. p. 14. 5 The form of fever which has been met with is "Typhoid," a distinct disease characterized by certain specific changes in the glands of the intestines. This form is less infectious than true Typhus. Out of all the cases of continued Fever admitted into the London Fever Hospital only 15 were Typhus while 180 were Typhoid. From the week ending May 1st to the end of the year, although 132 cases of Typhoid entered the Hospital, only a single case of Typhus was received, and that not strongly marked. Recent researches appear to shew that Typhus mainly originates in overcrowding and destitution, while Typhoid is connected more or iess closely with the emanations from decomposing organic matter and organic impurities in the water that is drunk. The very existence of this disease may indicate to us that although much has been done to purify the atmosphere about our habitations and to improve the condition of our drinking water, there still remains much to be effected in the same direction. I reserve my remarks upon Diphtheria to the close of the Report. 9. Tubercular diseases, including Pulmonary Consumption, carried off during the year 408 persons, or 15 4 out of every hundred that died from all causes. This proportion is unusually low; and there can be no fallacy about it, inasmuch as the actual number is less than in previous years. The reduction that took place, however, was only observed in the West Sub-district. 10. Consumption alone occasioned 316 of these deaths, or 11.9 per cent. In the East Sub-district, the mortality from Phthisis was higher than in either 1856 or 1857; the improvement observed having reference only to the West Sub-district. 11. The mortality from acute and chronic pulmonary affections (exclusive of Consumption) was unusually high, especially in the first and fourth quarters of the year. It will be recollected that the close of 1857 was marked by a slight epidemic of influenza, which had not entirely subsided when the new year commenced; and the deaths in the fourth quarter were concentrated almost into the last six weeks of the year, commencing with the cold weather at the end of November. Of the 494 deaths from these diseases, 238 were of males and 256 of females, constituting together 18.6 per cent, of the deaths from all causes. In the West Sub-district there were 264 deaths, or 20.1 per cent. of all deaths; and in the East Sub-district 230, or 17.2 p;r cent. of all deaths : in each case the mortality was higher than prevailed in either of the two previous years. 12. Table I. shows the age at death in 2,641 instances. It will be observed that of this number 1,238, or 46 8 per cent, of all deaths, occurred under five years of nge. Of these children, 648, or more than half, died during the first year of their existence, and 276 before they had completed their second year. The diseases which have been most fatal to children may be thus arranged: — b. Tubercular Diseases. c. Diseases of the Organs of Respiration. AGE AT DEATH. Deaths. Diseases of the organs of res261 piration of an acute character Hooping-cough 149 Convulsions, and other cerebral affections 105 Measles 92 Scarlet fever 82 Diarrhoea 80 Deaths. Atrophy 74 Debility from premature birth 47 Hydrocephalus 43 Violent causes 40 Epidemic sore-throat 33 (Diphtheria Teething 30 Tabes mesenterica 27 6 13. In order to remove the causes of a high mortality, it is not only necessary to know what are the diseases or classes of diseases that occasion it, but also where, in what parts of a district, and among what ranks of our population the fatality exists. Much of the time of an officer of health is necessarily devoted to this inquiry; and in each of my reports I have endeaveured to represent as clearly as I could, in various tables, the results that I have been able to arrive at—not only with respect to the mortality generally, but to that of infants in particular, and of those classes of disease which occupy the most prominent places in the returns. With a view to indicate the relation borne by the mortality under these more important conditions to the rank in life of the individuals, I have this year a contribution of a different kind to offer. From the street-list that I keep, I have taken out the names of 109 streets and places, the houses of which, I know, are occupied almost uniformly by single families in easy circumstances, and counted up the deaths in them during the three years (1856-7-8) from all causes, from zymotic and tubercular diseases, and also of children under five years of age. I have formed another list of 150 streets, &c., the houses in which I know to be either let to two or more families, or occupied by those of labouring men. I have compared the totals of deaths in these two distinct classes of our community, and here is the result:— No. of Streets, etc. Total Deaths in 3 years. Deaths from Zymotic Diseases. Per Ct. of all Deaths. Dea»hs from tubercular Diseases. Per Ct. of all Deaths. Deaths under 5 years. Per Ct. of I a11 Deaths. Class I. Occupied by the wealthier part of our population 109 734 133 18.1 107 14.5 216 29.4 Class II. Occupied by the less wealthy, or labouring part of our population 150 2237 687 30.7 333 14.8 1333 5.98 14. These numbers will almost speak for themselves. Of course they do not indicate the absolute liability of the two classes to suffer from these forms of mortality, but only of their liability to them relatively to the mortality from other diseases. The former could only be settled by a comparison with the number of persons of each class living— a datum which I do not possess. I may state that I selected the streets for comparison as fairly as I could, according to my knowledge of the nature of their occupancy, taking into account none but those respecting which I was certain. SICKNESS. The Table of Sickness (Table IV.) that is given, as it presented itself at the several Institutions from which I receive returns, and among the poor who are attended by the Parochial Surgeons is constructed in such a manner as to show a total only in respect of those cases which can with strictness be said to belong to our Parish, the sickness in the two Special Hospitals being placed in columns apart from the rest. The only comparison with the returns of the previous year that I can institute concerns the sickness at the Workhouse, the Infant Poor-house and the out-patient paupers at large; selecting as in Table V. some of the more important forms of disease. This Table renders apparent the greater prevalence during the year of smallpox, chicken pox, measles, scarlet fever, hooping cough, erysipelas, thrush, ague, and acute diseases of the organs of respiration. On the other hand diarrhoea was reduced to nearly half the number of cases met with in 1857, and there was a very much smaller number of continued fever. Of the 358 cases of small pox that entered the Hospital on Highgate Hill 32 were from the Parish of Islington. There has been during the year an increase of this disease throughout the Metropolis. I am informed by Dr. Scurrah that not a single case of true Typhus has been received during the year into the London Fever Hospital from any part of this Parish. 7 SANITARY IMPROVEMENTS DURING THE YEAR. 15. I have thrown into a tabular form (Table VII.) a summary of the house improvements effected under the orders of the Sanitary Committee and to the satisfaction of the Inspectors, from the period of my last Report to the 25th of March, 1859. Nearly all these works were completed without the necessity of appealing to the authority of the Police Magistrate. In addition, however, to the work thus specified, I have to mention the abatement of overcrowding in several instances which came under my notice, and concerning which I certified to the Sanitary Committee that the amount of space allotted to each inhabitant was below that requisite for the maintainance of health. At one house in the West. Sub-district, where a murder and suicide occurred during the hot weather of June, the nuisance that arose was so intolerable that the inspector was compelled to destroy the beds and bedding and to superintend the cleansing and disinfecting of the house. It is unnecessary to specify also the removal of a variety of noxious accumulations under the superintendence of the Sanitary Inspectors, of which complaint has been made from time to time at the offices. 16. The Slaughter-houses throughout the parish were visited in the month of September, and, with but few exceptions, were found to be in a satisfactory condition. The butchers, who kill upon their own premises, are now generally aware of what is required of them for the preservation of cleanliness and the avoidance of nuisances in their trade. 17. One of the most important works of the year has been the improvement of the Vaults beneath the Parish Church. I mentioned in my last report that they had been visited by Mr. Grainger from the Burial Acts Office, under the orders of the Home Secretary. After several conferences between myself and that gentleman, and full canvassing of the various plans that might be adopted, it was finally arranged that the coffins should be placed in a single, and in some places in a double layer upon the floor of the vaults; that they should then be covered with a layer of gravel to the depth of eight inches, and that over this should be placed a layer of concrete four inches in thickness. The private vaults were to be subjected to the same treatment as the public ones. This plan was submitted to the Vicar and Churchwardens, and having received their ready acquiescence, was made the subject of an order in council on the 26th of February. A public notice to that effect was given and opportunity afforded for the removal of any remains prior to the 26th of March. The arrangement, however, was so completely consonant with the feelings of the friends of those who were there deposited, that no notice of removal was received, and the work was accordingly proceeded with by Mr. Pelling. Mr. Churchwarden Jenkin, who manifested great interest in the proceeding, and myself visited the vaults daily and sometimes twice a day, and although from the decayed state of the coffins and the leakage from them of putrid fluids, the workmen were exposed to unquestionable danger on several occasions, the precautions adopted and the free use of Macdougal's disinfecting powder enabled the whole to be completed without a single casualty. In some respects this was an experiment; it was this first work of the kind instituted in the Metropolis under new powers vested in the Privy Council, and we were all quite in the dark as to the manner in which the suggested improvement would be received by the public. It was so successful as to constitute a precedent for similar improvements which have since been carried out in other Metropolitan Churches. 18. An order in Council for the levelling and planting of Jones's Burial Ground, in Church Street, has proved abortive from the absence of any power to enforce 8 obedienee. Rubbish of all kinds has been carted into it during the whole year, and matters still more objectionable have on various occasions been deposited there. It is perfectly clear that the law must be amended before these disgraceful proceedings can be brought to an end. TRADE NUISANCES. 19. But little has been done during the year in the matter of nuisances arising out of trades. In one or two instances where complaints have been made, I have communicated either personally or by letter with the parties complained of, and the cause of complaint has been done away. For the suppression of tha nuisances proceeding from the group of manufactories at Belle Isle, the sitting magistrate at the Clerkenwell Police Court has repeatedly recommended indictment at the sessions; for, notwithstanding that some means of arresting the offensive emanations have been generally adopted, and as a consequence the nuisances are not so intolerable as they were three years ago, there still remains such an amount as to inconvenience the inhabitants of the surrounding district. This recommendation met with the concurrence of the Vestry. The selection of a case for trial arose in the ordinary course of events out of the first official complaint of a Belle Isle nuisance made at the office subsequently to the resolution of the Vestry. On this complaint an information was first laid at the Police Court against Mr. Schweizef, the varnish manufacturer, under the provisions of the Parish Act. A difficulty having arisen as to the applicability of this statute, the magistrate again suggested the propriety of an indictment; and as the counsel retained by the parish on that occasion advised the same course, the recommendation to indict was adopted by the Vestry. The burden of providing evidence such as will satisfy a jury now lies, where it always ought to have lain, with the complainants. It should suffice them in such a case as this, that the Vestry is prepared to advocate their cause as that of the parish generally, if they will themselves take the trouble to ascertain unquestionably, and to the satisfaction of your legal advisers, the particular establishment which occasions their discomfort. EPIDEMIC SORE-THROAT AND DIPHTHERIA. 20. In order to be in a position to present as complete a history as possible of this epidemic malady as it has occurred in Islington, I have tabulated all the cases which proved fatal in the parish from January, 1858, up to the close of the first quarter of 1859. The Table which I have thus formed relates to 80 cases. 21. Assuming the presence of the peculiar exudation upon the interior of the throat as the characteristic sign by which true diphtheria is to be distinguished from the other forms which epidemic sore-throat has presented, I have taken the pains to ascertain by careful inquiry in how many of the 80 fatal cases this symptom was present. I obtained the information I desired in 67 instances. In the remaining 13 I failed to do so: most of them were the earlier cases in 1858. I propose, then, to divide the 80 cases into three classes:—Class 1. Those in which I have obtained satisfactory evidence of the presence of the exudation, or in which I saw it myself— Class 2. Those which were certified as deaths from Diphtheria by the medical attendant, but in which I have obtained no particulars of the appearances in the throat, and Class 3. Those in which I am assured by the medical attendant that the exudation was absent. These last cases were returned as deaths from "Tonsillitis," "Quinsey," "Gangrenous Quinsey," Inflammatory Sore-throat," "Gangrenous Sore-throat," and 9 in one instance as " Diphtheria." With respect to Class 2, I may say, that whereas out of 58 deaths returned as from Diphtheria there were only 2 in which the peculiar exudation and other symptoms of the disease were ascertained, by inquiry, to have been absent; it is probable that of the 13 not inquired into the majority, if not all of the cases, were really instances of the true disease. At all events, I can not agree with those who hold that the term "Diphtheria" has been loosely applied by the medical practitioners in this parish to sore-throats of all kinds. The numbers of each Class stand thus:— Males. Females. Total. Class 1 Class 2 Class 3 31 4 6 26 9 6 66 13 11 Total 41 39 80 By far the greater number of deaths from epidemic sore-throat have been of that class which presented the characteristic marks of true Diphtheria. Of these the male deaths have somewhat exceeded those of females, (see also Sect. 24), the proportion however being brought nearly the same if the cases of Class 2 are included. 22. Age.—The ages of the 80 persons varied from 16 days to 61 years. There were 5 infants who died under 1 year; they were aged respectively 16 days, 5 weeks, 8 months, 9 months, and 9 months. It is remarkable that all these were male children. There were 6 persons who died at ages above 20 years, and these were aged respectively 26, 29, 37, 49 and 61 years; all but one of these were females. The deaths were distributed among the ages thus:— Ages. Under 1 year. 1— 2— 3— 4— 5— 10— 20 and upwards Class 1 4 9 7 10 6 14 o 4 — 2 2 1 1 4 2 1 Class 3 1 1 2 2 — 1 3 1 Total 5 12 11 13 7 19 7 6 Of course, unless numbers such as these are compared with the numbers living at each age, no accurate conclusion can be drawn as to liability of the different ages to fatal attacks of this epidemic. Apart from this comparison, however, the following facts appear deducible.—1st. That the disease has been comparatively rarely fatal to infants in their first year of life.—2nd. That it has been chiefly fatal to children under 10 years of age.—3rd. That up to 10 years of age the greater number of fatal cases were in males; the numbers being 39 males and 28 females : that at ages above 10 years the preponderance was disproportionately on the side of the females, the numbers being 2 males and 11 females. 10 23. Social Position. Dividing the cases into two groups, according to the plan adopted at p. 6 of this report, I find the following result:— Class 1. Class 2. Class 3. Total. Mean Mortality of three years in streets, &c., where those deaths occurred. Percentage of Deaths from Epidemic Sore-throat. Superior Group 36 7 7 50 142 35.2 Inferior Group 20 6 4 30 124 24.2 Here, then, we meet with the very reverse of that which obtains in the instance of other zymotic maladies, (p. 6). The numbers favour an idea which has been floating in the minds of many medical men that I have conversed with, viz., that epidemic sore throat and diphtheria attack the middle and comfortable classes of our population in preference to those who occupy the lower walks in life. The above proportion is preserved when merely the true and reputed deaths from diphtheria are compared with the mean mortality of the streets in which they occurred, the numbers then being for the superior group 32.8 per cent., and for the inferior 21.6 per cent. Taking the ascertained deaths from diphtheria alone, viz., Class 1, the proportion for the superior group is 32.1 per cent., and of the inferior 23.5. The fatality of epidemic sore throat appears to have been half again as great in the middle as in the lower ranks of society, where a comparison is made with that arising out of diseases of all other kinds. The absolute frequency of the disease in the two groups is another question for the solution of which I do not possess the necessary data. 24. The following Table represents the frequency with which the disease in the 80 cases is stated to have occurred primarily or secondarily to other maladies:— Primary. Secondary to Scarlatina. Measles. Hoopingcouifh. Croup. Influenza. Class 1 47 5 2 1 1 Class 2 9 1 1 1 1 — Class 3 10 — — 1 — — Total 66 6 3 3 1 1 It is to be observed, however, that in the certificates of death furnished to the registrars by medical men, the secondary disease of which a patient died is not constantly entered. Of the primary cases in Class 1, 29 were males and 18 females. 25. Duration of the Disease.—In only 2 cases did I fail to ascertain this point, which is represented in the following table:— DAYS. 1 2 3 4 5 6 7 8 to 14 15 to 21 22 to 28 Class 1 — 1 7 4 e 5 5 18 6 4 Class 2 1 1 1 1 2 1 2 3 — — Class 3 — — — 3 — 1 1 4 1 — 1 2 8 8 8 7 8 25 7 4 11 The sex scarcely affected the duration of the fatal cases, and the age of the patient appeared to have equally little influence over it, except in the instance of the 4 infants under 1 year, included in Class 1. The mean duration in these four cases was 4 days; at each of the other ages the mean duration before death was from 9 to 11 days. 26. Mode of Death.—In 59 of the cases inquired into, the mode of death was stated by the medical attendant as follows;— Class 1. Class 2. Class 3. Total. From extension of the disease to the larynx, oedema of the glottis, or suffocation 22 — 5 27 Sudden 4 — 1 6 From exhaustion 20 1 2 23 ,, disease of the brain 1 — — 1 „ convulsions — 1 1 2 ,, suppression of urine and dropsy 1 — — 1 Total 48 2 9 59 These numbers will also assist in determining the periods of the disease at which these several modes of death are imminent. The following table embraces 58 cases :— 1st Week. 2nd Week. 3rd Week. 4th Week. Laryngeal Complication. Sudden. Exhaustion. Brain Disease. Convulsions. Laryngeal Complication. Exhaustion. Convulsions. Suppressed Urine. Laryngeal Complication. Sudden. Exhaustion. Exhaustion. Class 1 15 2 7 1 — 7 7 — 1 1 2 2 4 Class 2 — — — — 1 — — — — — — — Class 3 3 1 — — — 1 1 1 — — — 1 — Total 18 3 7 1 1 8 8 1 1 1 2 3 4 The danger from which a fatal result is mainly to be apprehended in the course of the first week of the disease, is extension of the latter to the upper part of the air passages, and consequent suffocation. The sudden deaths in this week are probably due to the same cause giving rise to spasmodic closure of the glottis. As the malady advances into the second week the chances of death from this cause are only equal to those from the general prostration of the vital powers. In the third and fourth weeks, the latter is the condition chiefly to be dreaded; the sudden deaths at this time are probably due to syncope or fainting. 12 The following table is constructed to show the mode of death of 59 patients at various ages. AGES. Under 5 years. 5 to 9 years. 10 to 19 years. 20 years and upwards. Laryngeal Complication. Sudden. Exhaustion. Convulsions. Laryngeal Complication. Exhaustion. Suppressed Urine. Laryngeal Complication. Sudden. Exhaustion. Laryngeal Complication. Exhaustion. Brain Disease. Class 1 14 4 12 — 7 4 1 — — 2 1 2 1 Class 2 — — — 1 — 1 — — — — — — — Class 3 3 — 1 1 — — — 1 1 1 1 — — Total 17 4 13 2 7 5 1 1 1 3 2 2 1 27. Relation of Diphtheria to Scarlet Fever. —This is clearly not the proper place for the discussion of theoretical questions, and I shall therfore address myself merely to the practical inquiry whether scarlet fever and diphtheria are or are not mutually protective against each other, as they would be expected to be, if merely phases, as some suppose, of the same disease. The following facts may be regarded as a contribution to the solution of this question; and in themselves point to a reply in the negative. 1.° In 7 cases of class I the diphtheritic sore throat was stated to have been associated with recent scarlet fever. In only 2 of these cases did the rash appear in the course of the throat affection. Out of the remaining 5 cases in which the rash appeared first, and the diphtheritic sore throat secondarily to it, the rash had in 4 cases left the skin before the exudation upon the mucous membrane made its appearance. 2.° In 47 cases I was able to obtain satisfactory information as to the patient having suffered from scarlet fever at more distant periods. The following represents the proportion of those who had and had not thus suffered. carlatina previously. Not had Scarlatina previously. Total. Class1 9 29 38 Class2 1 2 3 Class3 2 4 6 Total 12 35 47 This proportion of 1 to 3 docs not I imagine differ greatly from that which would be found to exist among persons selected in any other manner from the same ages, and the same station in life. In the 12 patients who had had scarlatina, the occurrence of the disease was dated back to periods varying from 6 months to 5 or 6 years. Now it may positively be asserted that of the cases of scarlet fever that are met with in practice, second attacks of the disease do not constitute one-third or any proportion approaching this. A second attack of scarlet fever is indeed so uncommon, that well authenticated cases are among the rarest occurrences in medical experience. 13 3.° Neither is the occurrence of an attack of diphtheria a protection against scarlet fever. The following instance is an illustration. Three children of a family in the West Sub-district, were attacked with Diphtheria in August, 1858, two of them died, and the third, aged 3 years, recovered. I satisfied myself on visiting these patients, that they were cases of true diphtheria. In January, 1859, the child that recovered was attacked by scarlet fever, after playing upon a carpet brought from a house where this disease had been fatal. There was the usual throat affection of scarlet fever, but no diphtheritic exudation, and the child died. I may mention in passing, that among all the cases fatal, or otherwise, that I have investigated, I have not met with any instance in which diphtheria has been apparently communicated from a patient with scarlatina, except where the latter disease has been communicated also. Neither have I at present met with more than one instance in which cases of diphtheria and scarlet fever occurred in the same family about the same time, in such a manner as to favour the idea that they were varieties of the same disease. Some other members of the family suffered from diphtheria in other forms of sore throat in Some members suffered from diphtheria and other forms of sore throat in Neither diphtheria nor sore throat occurred in other members of the family 9 Families 15 ,, 8 ,, 15 ,, Total 47 The severity of these cases of sore throat varied considerably. In some it was a slight attack, congestive in character and lasting but a few days; in others there was so much febrile disturbance as to demand medical assistance; in others again there was ulceration, suppuration of the tonsils or mortification. In some families the earlier cases were sore throat, in others the earlier cases were diphtheritic. 29. Is Diphtheria Contagious ?—This again is a practical question to which you may fairly look to me for a reply. The following considerations may prove of value in assisting to determine this important point. Their tendency is towards the affirmative. 28. Relation of Diphtheria to other forms of Sore Throat.—The prevalence of other and non-diphtheritic forms of sore throat during the past year has been matter of general remark. Congestive and Inflammatory sore throats have appeared to bear the same relation to diphtheria as diarrhoea bears to cholera in epidemic seasons. With respect to the latter diseases, the general opinion in the profession is, that they arise from the operation of the same morbid poison. I think it may be maintained that diphtheria and the other varieties of sore throat I have mentioned are similarly related. As is any case of diarrhtea in an epidemic season, it is impossible to predicate that it will not pass into cholera if neglected, so in the cases of ordinary sore throat which have lately presented themselves, no one would be bold enough to assert, that any one might not before long exhibit the characteristic symptoms of true dipththeria. A fact upon which I would especially rely in the support of this view, is the occurrence of ordinary sore throats equally with diphtheritic sore throats among the number of families where deaths from diphtheria had taken place. Out of 47 families in which a death from diphtheria had occurred, (Class 1.) 14 1.° There is a prima facie case made out in favour of the affirmative, by the facts mentioned in the former section. Infectious diseases habitually spread in families they invade. Out of 47 families in which fatal diphtheria occurred, there were only 15 in which the other members all remained healthy. Of course it may be argued in opposition that all the members of a family are equally exposed to the operation of local causes of disease. 2.° As a rule, it spread in the house3 it invaded, chiefly among those members of the several families who were most closely in communication. 3.° In no case, where separation from the sick person has been effected early in the disease, have I noticed that it has spread to the separated individuals. In one case where communication had been allowed for 3 days before separation, a child was seized with diphtheria on the 6th day from removal from home. 4.° The following special cases may be mentioned of communication from one house to another, viz.:— On May 1st and 2nd, Jane, aged 10 years, was on a visit to a cousin, who on the 2nd manifested decided symptoms of diphtheria, but recovered; another person in the house, a servant, subsequently dying of the disease. On the 3rd having returned home to Islington, Jane was attacked with diphtheria, and died in 7 days. Her mother, and her sister aged 14 years, were both taken ill on the 11th. In each of these instances there was sloughing of the tissues, and the mother expectorated a complete cast of windpipe. Both died. Other members of the family had slight sore throat. On September 18th, George, aged 2 years, was attacked with what was believed to be diphtheria. There was much swelling behind and below the angles of the jaw, with loss of voice and great fætor of the breath. He died on the 24th. His brother Edward, aged 9 months, was attacked on the 22nd, i. e., on the 4th day of George's illness. The exudation was present, there was much swelling of the throat with fætor of the breath, and bloody discharge from the nose. He died on the 24th also. Beside other members of the family, and other persons in the house, who had been in communication with these children and consequently suffered from sore throat, the child's grand-mother had sore throat on the 24th, 25th, and 26th. She laid out the children, and on the 24th returned to her own home, at another part of the parish. A child who lived with her, aged 16 months, cousin of those who died, was seized with diphtheritic sore throat and fever on the 29th, and died on October 19 th. In the middle of June a boy brought home diphtheria from school and shortly after his recovery a sister, aged 2 years, was attacked with the disease, in a marked form, and died in 11 days. Almost every other member of the family suffered either from diphtheria or some other form of sore throat. A little girl, aged 6 years, went to a day school where a case of diphtheria occurred; she was attacked with the disease in a characteristic form and died in 22 days. Her father and mother both suffered from a slight attack of sore throat. Another child in the family, who was kept apart from her, and subsequently sent out of the house, escaped. In view, therefore, of those facts alone which I have ascertained in your own district, I may well repeat the admonition in No. 14 of my Monthly Reports, and impress upon all in whose families this disease may appear, the importance of at once interdicting any but the most necessary intercourse with the sick individual, and especially any communication with the younger persons in the house. 15 30. Local Sources of Miasma, &c. at the houses invaded. The following table exhibits the results of inquiries instituted at 57 houses where fatal cases occurred:— Number of Houses. House Damp, Drains defective, or Offensive Smells on or near the Premises. Overcrowding, or Defective Ventilation. Foul Drinking Water and other Nuisances and Noxious Accumulations of various kinds. Nothing Amiss. Class 1 46 19 4 6 20 Class 2 6 3 — — 3 Class 3 5 2 — 2 2 Total 57 24 4 8 25 In more than half the houses examined there was some defect or other in the sanitary arrangements or surrounding conditions of the patient. In the greater number of houses thus deficient the fault was discovered in the state of the drainage. 31. The full discussion which I have given to these 80 cases enables me to dismiss in a very few words the subject of epidemic sore throat, so far as it relates to the year 1858. The total number of primary cases was 59, of which 37 occurred in the East Sub-district. Their distribution over the various periods of the year may be seen in Table II. The frequency of the deaths from this disease, relatively to those from other diseases in the several Wards of the Parish may be gathered from Table III. I have the honour to be, Gentlemen, Your very obedient Servant, EDWARD BALLARD, M.D., L.RC.P. Medical Officer of Health. 42, Myddelton Square, April 4th, 1859. TABLE I. DEATHS WHICH HAVE OCCURRED IN ISLINGTON AND ITS SUB-DISTRICTS DURING THE YEAR 1858 Distinguishing the Ages and Causes of Deaths—(Deaths of Strangers in Hospitals excluded.) All Ages. Und 1 AGES. 1- 2- 3- 4- Under 5 1 5- | 10- 15- 25- 1 35- 45- 55- 65- 75- 85- 95 Un West Sub-district. Population, 1851 47881 .. .. .. .. .. 6135 4911 4254 96 46 9188 6010 3958 2355 1050 331 4 2 Deaths, all causes 1311 329 129 73 46 21 598 64 16 66 81 105 89 93 115 67 IS 2 East Sub-district. Population, 1851 47448 .. .. .. .. .. 6055 5021 4457 9457 8544 5860 4134 2325 1164 379 47 5 Deaths, all causes 133) 319 147 76 52 46 640 71 25 63 88 84 74 78 115 71 20 1 Whole Par.sh. Population, 1861 95329 .. .. .. .. .. 12190 9932 8711 19103 17732 11870 8092 4680 2214 710 86 7 Deaths, all causes 2642 648 276 149 98 67 1238 135 43 129 169 189 163 171 230 138 33 a West S.D. East s.d. Class. 313 408 I.Zymotic 721 188 132 90 64 44 518 76 17 25 24 15 18 10 13 4 1 .. 53 10 II. Dropsy, &c 93 4 .. .. 1 .. 5 2 .. .. 6 17 22 18 14 8 1 .. 212 196 III. Tubercular 408 38 28 13 9 6 94 19 14 61 89 71 34 20 6 .. .. .. 146 133 IV. Brain and Nerves 279 67 23 6 6 4 105 11 2 7 6 18 19 32 48 28 2 1 53 58 V.Heart,&c. 111 2 .. .. .. .. 2 3 1 4 5 22 19 19 27 8 1 .. 264 230 VII.Digestive Organs 494 145 70 25 13 8 261 17 2 14 11 18 25 40 bo 31 .. 73 62 VII. Digestive Organs. 135 31 9 9 1 1 51 2 3 6 8 11 11 17 17 8 1 .. 16 15 VIII. Kidney, &c 31 .. .. 1 .. .. 1 .. 1 .. 2 2 6 9 8 2 .. .. 11 9 IX. Childbirth, &c. 20 .. .. .. .. .. .. .. .. l 12 4 .. 2 1 .. .. .. 6 4 X. Joints, Bones, &c. 10 1 .. .. .. .. 1 2 1 4 .. 1 .. .. 1 .. .. .. 4 1 XI. Skin, &c 5 .. 1 .. .. .. 1 .. .. 1 .. 1 .. .. 2 .. .. .. 6 8 XII. Malformations 14 14 .. .. .. .. 14 .. .. .. .. .. .. .. .. .. .. .. 34 32 XIII. Prem. Birth; and Debility. 66 47 .. .. .. .. 47 .. .. .. .. .. .. .. .. .. .. .. 1 17 1 .. .. .. 18 .. .. .. .. .. 1 .. .. .. .. .. 26 50 XIV. Atrophy 76 56 10 3 2 3 74 1 .. .. .. .. l .. .. .. .. .. 43 50 XV. Old Age 93 .. .. .. .. .. .. .. .. .. .. .. .. 2 19 49 21 2 .. .. XVI. Sudden .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 45 27 XVII. Violent Death 72 32 2 3 2 1 40 1 2 5 5 7 5 2 4 .. .. .. 6 8 XVIII. NotSpecified 14 6 .. .. .. .. 6 1 .. 1 1 2 2 1 .. .. .. 11 7 1.Small Pox 18 4 2 1 2 .. 9 2 .. 3 3 .. 1 .. .. .. .. .. 49 49 Measles 98 15 34 27 10 6 92 5 1 .. .. .. .. .. .. .. .. .. 46 70 Scarlatina 116 3 18 25 17 19 82 29 5 .. .. .. .. .. .. .. .. .. 60 90 Hooping Cough 159 64 48 16 15 6 149 9 1 .. .. .. .. .. .. 13 11 Croup 24 1 7 6 6 1 21 2 .. 1 .. .. .. .. .. .. .. .. 5 7 Thrush 12 12 .. .. .. .. 12 .. .. .. .. .. .. .. .. .. .. .. 36 54 Diarrhœa 90 64 12 1 3 .. 80 3 .. 1 .. .. 2 1 3 .. .. .. 2 .. Dysentery 2 1 1 .. .. .. .. i .. .. .. .. 1 6 Cholera 7 3 1 .. 1 5 .. .. 1 .. .. 1 .. .. .. .. 1 2 Influenza 3 .. 1 1 .. 2 a . .. .. .. .. .. .. .. 1 .. .. 1 .. Scurvy and Purpura 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Ague 2 .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 2 Infantile Fever 5 2 1 1 .. .. 4 1 .. .. .. .. .. .. .. .. .. .. 25 40 Continued Fever 65 .. 1 3 1 6 11 6 .. 15 4 5 7 6 6 .. 1 .. 4 10 Puerperal Fever 14 .. .. .. .. .. .. .. .. 2 9 3 .. .. .. .. .. .. 6 5 Rheumatic Fever 11 .. .. .. .. .. .. 1 .. 2 2 2 4 .. .. .. .. .. 13 14 Erysipelas 27 11 .. .. .. .. 11 .. .. .. 4 3 l 2 3 3 .. .. 4 1 Syphilis 5 4 .. .. .. .. 4 .. .. .. .. .. .. .. 1 .. .. .. 1 2 Noma (Canker) 3 1 1 .. .. .. 2 1 .. .. .. .. .. .. .. .. .. .. 22 37 Epid. Sore Throat 59 3 7 9 9 5 33 17 6 .. .. 1 1 .. .. .. .. .. 5 7 II.Hæmorrhage 12 .. .. .. .. .. .. .. .. .. 1 4 4 ] 1 1 .. .. 10 6 Dropsy 16 2 .. .. .. .. 2 2 .. .. 1 5 2 1 2 1 .. .. 4 3 Abscess 7 .. .. .. 1 .. 1 .. .. .. 2 .. 2 1 1 .. .. .. .. 4 Ulcer 4 2 .. .. .. .. 2 .. .. .. .. .. 1 .. 1 .. .. .. 1 1 Fistula 2 .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 3 Mortification 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 .. .. 30 16 Cancer 46 .. .. .. .. .. .. .. .. .. 2 8 12 14 7 3 .. .. 3 .. Gout 3 .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 .. 8 3 III.Scrofula 11 .. 2 .. 1 .. 3 3 2 1 .. 1 1 .. .. .. .. .. 15 16 Tabes Mesenterica 31 12 8 3 3 1 27 1 3 .. .. .. .. .. .. .. .. .. 162 154 Phthisis(Consumpn.) 316 8 5 5 1 2 21 8 9 60 89 70 33 20 6 .. .. .. 27 23 Hydrocephalus 50 18 13 6 4 3 43 7 .. .. .. .. .. .. .. .. .. .. 23 19 IV.Cephalitis 42 14 7 1 3 1 26 8 1 1 1 .. 1 .. 3 1 .. .. 19 24 Apoplexy 43 .. .. .. .. .. .. .. .. .. .. 1 2 12 18 10 .. .. 37 29 Palsy (Paralysis) 66 .. .. .. .. .. .. .. .. 1 .. 6 9 14 20 13 2 1 5 2 Delirium Tremens 7 .. .. .. .. .. .. .. .. .. .. 6 1 .. .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 6 Epilepsy 14 .. .. .. 1 .. 1 .. .. 1 3 2 3 1 3 .. .. .. .. .. Tetanus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 2 Insanity 3 .. .. .. .. .. .. 1 .. 1 .. .. 1 .. .. .. .. .. 40 35 Convulsions 75 51 15 3 1 3 73 1 .. .. .. .. .. 1 .. .. .. .. 13 16 Disease of Brain, &c 29 2 1 1 1 .. 5 1 1 3 2 3 2 4 4 4 .. .. TABLE I. DISTINGUISHING THE AGES AND CAUSES OF DEATH (Deaths of Strangers in Hospitals excluded.) West. S.D. East. S.D. Causes of Death. All Ages 1 AGES. Und 1 1- 2- 3- 4- Und 6 5- 10- 15- 25- 35- 45- 55- 65- 75- 85- 95 Up 2 1 V. Peritonitis 3 .. .. .. .. .. .. .. 1 1 .. 1 .. .. .. .. .. .. 1 2 Ascites 3 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 .. .. .. 50 55 Disease of Heart, &c. 105 2 .. .. .. .. 2 3 .. 3 5 20 18 19 26 8 1 .. 10 4 VI. Laryngiris 14 6 6 .. .. .. 12 2 .. .. .. .. .. .. .. .. .. .. 177 136 Bronchitis 313 88 35 l6 5 5 149 8 1 5 6 10 19 26 59 24 6 .. 3 .. Pleurisy 3 .. .. .. .. .. .. .. .. 1 .. 2 .. .. .. .. .. .. 59 76 Pneumonia 135 51 29 9 8 3 100 7 1 7 3 3 2 5 3 4 .. .. 10 10 Asthma 20 .. .. .. .. .. .. .. .. .. .. 1 3 6 7 3 .. .. 5 Disease of Lungs 9 .. .. .. .. .. .. .. .. 1 2 2 1 3 .. .. .. .. 18 12 VII.Teething 30 18 9 3 .. .. 30 .. .. .. .. .. .. .. .. .. .. .. .. .. Quinsey .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 1 Gastritis 4 .. .. .. .. .. .. .. .. .. .. .. 1 1 1 .. l .. 7 9 Enteritis l6 5 .. 1 1 1 8 1 1 1 2 1 .. 2 .. .. .. .. 6 5 Peritonitis 11 1 .. 2 .. .. 3 l .. 2 2 .. .. .. l .. .. .. .. 3 Ascites 3 .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 .. .. 3 1 Ulceration of Intest. 4 .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 1 .. .. 1 1 Hernia (Rupture) 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 3 4 Ileus 7 .. .. .. .. .. .. .. .. 1 1 1 .. 2 l 1 .. .. 1 1 Intussusception . 2 1 .. 1 .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 1 .. Stricture of Intestinal Canal 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 3 Dis. of Stomach, &c. 9 1 .. 1 .. .. 2 .. .. .. 1 1 1 1 3 .. .. .. 1 .. Disease of Pancreas 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 2 3 Inflammation of Liver (Hepatitis) 5 .. .. .. .. .. .. .. .. 1 .. 1 .. 2 1 .. .. .. 3 5 Jaundice 8 5 .. .. .. .. 5 .. .. 1 .. .. 1 .. .. 1 .. .. 18 13 Disease of Liver 31 .. .. 1 .. .. 1 .. 1 .. 2 4 6 6 7 4 .. .. .. 1 Disease of Spleen 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 2 1 VIII. Nephritis 3 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 .. .. 4 4 Nephria(Bright's Dis) 8 .. .. 1 .. .. 1 .. .. .. 1 1 1 2 2 .. .. .. 1 .. Ischuria 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 Diabetes 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 3 .. Stone 3 .. .. .. .. .. .. .. .. .. .. .. 1 2 .. .. .. .. .. 1 Cystitis 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. Stricture of Urethra 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 5 8 Disease of Bladder &c 13 .. .. .. .. .. .. .. 1 1 1 2 3 5 .. .. .. 1 .. IX. Paramenia 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 8 Childbirth(seeMetria) 16 .. .. .. .. .. .. .. .. .. 12 4 .. .. .. .. .. .. 2 1 Dis. of Uterus, &c 3 .. .. .. .. .. .. .. .. .. .. .. .. 2 1 .. .. .. 2 .. X. Rheumatism 2 .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. Arthritis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 4 Dis. of Joints, &c 8 1 .. .. .. .. 1 2 1 4 .. .. .. .. .. .. .. .. 2 .. XI. Carbuncle 2 .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. 1 .. Phlegmon 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 Disease of Skin, &c 2 .. 1 .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. 3 2 XII. Cyanosis 5 5 .. .. .. .. 5 .. .. .. .. .. .. .. .. .. .. .. 1 3 Spina Bifida 4 4 .. .. .. .. 4 .. .. .. .. .. .. .. .. .. .. .. 2 3 Other Malformations 5 5 .. .. .. .. 5 .. .. .. .. .. .. .. .. .. .. .. 2 .. XIII. Intemperance 2 .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Privation of Food 1 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 11 2 Want of Breast Milk 13 12 1 .. .. .. 13 .. .. .. .. .. .. .. .. .. .. .. .. .. Neglect .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cold .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. Poison 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 3 Burns and Scalds 5 1 1 3 .. .. 5 .. .. .. .. .. .. .. .. .. .. .. .. 2 Hanging 2 .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 6 5 Suffocation 11 9 .. .. 1 1 11 .. .. .. .. .. .. .. .. .. .. .. 1 6 Drowning 7 .. .. .. 1 .. 1 1 1 1 .. .. 1 .. 1 .. .. .. 7 2 Fractures & Contus. 9 .. .. .. .. .. .. .. 1 1 1 3 1 .. 2 .. .. .. 7 4 Wounds *11 1 .. .. .. .. 1 .. .. 3 2 1 3 .. .. .. .. .. 8 2 Other Violence 10 8 .. .. .. .. 8 .. .. .. .. 2 .. .. .. .. .. .. * Age of one, unspecified, TABLE II. DEATHS OCCURRING IN EACH WEEK AND QUARTER, DISTINGUISHING CERTAIN IMPORTANT DISEASES AND AGES. [Deaths of Non-Residents in Hospitals, and of Islington Patients in Hospitals elsewhere, not included.] 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Week ending Jan. 9 Jan. 16 Jan. 23 Fan. 30 Feb. 6 Feb. 13 Feb. 20 Feb. 27 Mar 6 Mar 13 Mar 20 Mar 27 Apr. 3 1st Quarter. Apr. 10 Apr. 17 Apr. 24 May 1 May 8 May 15 May 22 May 29 Jun 5 Jun 12 Jun 19 Jun 26 July 3. 2nd Quarter Total 55 56 52 71 53 54 47 42 71 59 59 44 57 720 53 47 47 48 36 43 43 42 37 35 45 51 50 5 77 Under 3 years 20 16 20 19 20 29 21 14 25 27 36 16 23 286 21 23 21 25 12 11 17 18 10 10 16 19 225 70 years and upwards 6 10 6 11 3 4 4 10 8 7 3 2 10 89 7 4 3 4 3 4 6 4 1 6 4 7 3 56 Zymotinc diseases 13 13 7 13 14 14 14 11 4 11 16 7 7 137 12 16 8 15 6 12 12 15 13 12 8 17 20 166 Measles 4 5 .. 4 4 4 .. 2 .. 1 4 .. 3 31 4 2 2 2 2 3 1 6 .. .. .. 3 8 28 Scarlatma 1 .. .. 3 .. 1 .. 2 .. 1 .. 1 .. 9 .. 1 .. 1 .. .. .. 1 .. .. .. 1 .. 4 Epidemic Sore Throat 1 .. 1 .. .. 1 .. .. .. 1 1 .. .. 5 1 1 .. .. .. 3 1 .. 1 2 1 2 3 15 Hooping Cough 1 .. 3 3 4 7 1 3 1 5 7 1 2 41 2 5 3 8 2 4 5 6 7 4 2 2 3 53 Diarrhœa .. .. .. .. 1 1 1 .. .. .. .. .. 7 1 .. 1 .. .. .. 1 1 .. 3 2 6 4 19 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Contiuned Fever 1 2 1 .. 1 .. .. 1 .. 1 .. 1 1 9 2 3 .. 3 2 .. 1 .. .. 1 2 .. 4 18 Phthisis 6 8 8 7 7 4 4 1 12 5 9 7 8 86 6 4 9 6 4 10 3 5 7 5 4 5 2 70 Diseases of Respiratory Organs 16 13 14 24 17 12 12 8 27 14 13 9 13 192 10 10 5 12 7 4 9 4 4 5 6 4 2 82 Mean Wkly. Temperature 34.5° 39.8° 37.5° 37.5° 37.8° 34.3° 34.0° 33.1o 31.5° 34.7° 48.00 46.6° 44.6° 40.3° 46.7° 52.8° 47.1° 45.6° 49.6° 54.9° 53.9° 66.2° 63.8° 67.7° 64.5° 58.6° 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 Week ending July 10 July 17 July 24 July 31 Aug 7 Aug 14 Aug 21 Aug 28 Sept 4 Sept 11 Sept 18 Sept 25 Oct. 2 3rd Quarter. Oct. 9 Oct. 16 Oct. 23 Oct. 30 Nov 6 Nov 13 Nov 20 Nov 27 Dec 4 Dec 11 Dec 18 Dec 25 Jan. 1 4th Quarter Total 45 44 52 47 33 56 31 47 50 29 41 42 4'2 559 45 43 55 43 54 55 69 82 92 78 57 67 52 782 Under 3 years 24 17 24 20 19 23 10 19 21 13 14 15 17 236 13 21 11 15 24 21 30 38 42 35 26 32 19 327 70 years and upwards 6 6 5 4 2 2 2 9 4 3 9 4 1 57 9 6 6 5 2 5 4 7 9 10 2 8 6 79 Zymotic diseases 14 15 20 20 13 21 11 8 16 10 10 22 16 196 15 13 17 14 16 12 16 24 22 19 16 10 15 218 Measles 3 1 3 .. .. .. .. .. 2 .. 1 1 .. 11 1 1 .. 2 2 .. 2 4 2 4 3 2 5 28 Scarlatina .. .. 2 2 4 2 1 .. 2 6 2 8 5 34 5 4 9 8 7 6 9 9 3 2 2 3 2 39 Epidemic Sore Throat 1 1 3 2 .. 7 .. .. 1 1 1 4 1 22 .. 2 3 .. .. .. .. 2 1 2 2 3 .. 15 Hooping 1 3 2 3 1 4 .. 2 2 1 1 1 2 23 2 2 .. 2 1 5 2 1 6 5 5 6 5 42 Diarrhœa 6 7 6 9 5 6 7 3 6 1 1 .. .. 59 1 1 .. 1 1 .. .. 1 .. 1 1 .. .. 7 Cholera .. .. .. 1 .. .. 2 1 1 .. 1 .. .. 6 .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever 2 2 1 1 .. .. 1 1 1 .. .. 4 5 18 4 2 1 .. 3 .. .. 4 4 2 2 2 24 Phthisis 6 3 8 4 4 8 4 3 10 7 4 3 4 68 7 3 7 4 7 5 8 8 10 7 5 5 9 85 Diseases of Respiratory Organs 2 3 3 4 1 4 2 4 5 4 5 2 2 41 3 7 7 5 6 13 13 22 25 24 16 24 13 178 Mean Wkly. Temperature 55.9° 66.4° 62.9° 59.6° j62.4c ,65.4° 63.3° 59.2° 59.4° 59.4° 63.4° 58.-6° 57.6° 52.1° 53.1° 51.1° 47.2° 43.3° 39.0° 35.5° 37.4° 46.3° 36.5° 38.9° 44.5 41.4° TABLE III. Shewing the Number of Deaths registered in each Ward, distinguishing those from certain important Diseases and Classes of Disease, and the proportion borne by these Deaths to the total mortality of the Ward. [Omitting Deaths in the Workhouse and Infant Poor-honse, and such Deaths as could not be correctly referred to the Ward in which they occurred.] Ward 1 Ward 2 Ward 3. Ward 4. Ward 5. Ward 6. Ward 7. Ward 8. Per cent. of all dths. Per cent. of all dths. Per cent. of all dths. Per cent of all dths. Per cent. of all dths. Per cent. of all dths. Per cent. of all dths. Per cent. of all dths. All Causes. 153 221 234 508 265 228 276 553 Zymotic diseases 32 20.9 60 27.1 92 32.3 135 26.5 59 22.2 54 23.6 76 27.5 189 34.1 Tubercular diseases 24 15.6 21 10.8 36 12.6 86 16.9 44 16.6 36 15.7 42 15.2 83 15.0 Deaths under 5 yrs. 52 33.9 106 47.9 130 45.7 280 55.1 125 47.1 94 41.2 128 46.1 288 52.0 Phthisis 20 13.0 20 9.0 30 10.5 69 13.5 32 12.0 27 11.8 29 10.5 65 11.7 Dis. of Org. of Res. 20 13.0 58 26.2 51 179 103 20.2 51 20.3 46 20.1 48 17.3 91 16.4 Small Pox 3 1.9 .. .. 1 0.3 6 1.1 2 0.7 .. .. .. .. 6 1.0 Meales 1 0.6 14 6.3 12 4.2 22 4.3 5 1.8 7 3.0 6 2 1 28 5.0 Scarlatina 5 3.2 5 2.2 15 5.2 19 3.7 11 4.1 12 5.2 7 2.5 41 7.4 Epc. Sore Throat 3 1.9 4 1 8 9 3.1 7 1.3 2 0.7 11 4 8 6 2 1 15 2.7 Hooping Cough 11 7.1 21 95 20 7.0 24 4.7 11 4.1 11 4.8 17 6.1 33 5.9 Diarrhoea & Cholera 3 1.9 7 3.1 14 49 20 3.9 9 3.3 4 1.7 9 3.2 32 5.7 Fever 1 0.6 8 3.6 12 4.2 10 1.9 4 1.5 4 1.7 15 5.4 13 2.3 TABLE IV. New Cases of Disease coming under Treatment during the Year ending Saturday the 1st day of January, 1859, at the following Institutions:— Workhouse. Infant Poor House. Out Patient Paupers. Hollow ay Dispensary. Pentonville Convict Prison. Total. London Fever Hospital. Small Pox Hospital. Small Pox .. .. 37 10 .. 47 2 358* Chicken Pox .. .. 45 13 .. 58 2 1 Measles .. .. 348 84 .. 432 4 6 Scarlatina .. 14 140 17 .. 171 111 .. Hooping Cough 1 .. 246 166 .. 413 4 .. Croup .. .. 8 1 .. 9 .. .. Diarrhœa 43 1 604 321 62 1031 5 .. Dysentery .. .. 18 12 .. 30 1 .. Cholera .. .. 3 4 .. 7 .. .. Ague 2 .. 24 23 .. 49 10 .. Continued Fever 1 .. 67 103 .. 171 202 .. Puerperal Fever .. .. 1 3 .. 4 .. .. Rheumatic Fever 12 .. 43 34 .. 89 4 .. Erysipelas 6 .. 82 24 5 117 4 .. Diphtheria .. .. 6 2 .. 8 .. .. Pyaemia .. .. .. .. .. .. .. .. Bronchitis and Catarrh 144 1 2140 782 343 3410 25 .. Pneumonia 2 .. 40 45 .. 87 30 1 Pleurisy .. .. 26 8 .. 34 2 .. Delirium Tremens 5 .. 8 1 .. 14 1 .. Insanity 16 .. 37 1 2 56 1 .. Carbuncle 2 .. 15 2 .. 19 1 .. All other Diseases 572 105 5726 3670 499 10,572 112 2 Total 806 121 9664 5326 911 16,628 521 368 * Thirty-two of these from Islington. TABLE V. COMPARATIVE TABLE OF SICKNESS AMONG PAUPER PATIENTS DURING 1857 & 1858. Total. Per cent. of all Cases. 1857. 1858. 1857. 1858. New Cases 9432 10591 Small Pox 23 37 0.24 0.34 Chicken Pox 35 45 0.37 0.42 Measles 138 348 1.46 3.28 Scarlatina 61 154 0.64 1.45 Hooping Cough 189 247 2.0 2.33 Croup 5 8 .. .. Thrush 10 39 .. .. Diarrhœa 1078 648 11.4 61 Dysentery 6 18 .. .. Cholera 2 3 .. .. Purpura, Scurvy 2 3 .. .. Ague 9 26 .. .. Remittent Fever 2 0 .. .. Infantile Fever 27 18 .. .. Continued Fever 118 69 1.25 0.65 Puerperal Fever 0 1 .. .. Rheumatic Fever 99 55 1.49 0.51 Erysipelas 54 88 0.57 0.83 Syphilis 70 55 0.74 0.51 Noma (Canker) 5 4 .. .. Total of Zymotic Diseases 1933 1866 20.49 17.6 Diseases of Respiratory Organs 1997 2353 21.17 22.2 Phthisis 103 120 1.09 1.13 Carbuncles and Boils 44 67 0.46 0.63 Chronic and Local Rheumatism 299 375 3.17 3.54 Other Diseases 4668 5368 49.49 5.0 Accidents and Injuries 388 442 4.11 4.17 TABLE VI; LIST of STREETS, Etc. in which the Zymotic Mortality has exceeded one-fourth of the total mortality of the Street; where the mortality from Tubercular Diseases has exceeded one-sixth, or the Infant mortality under 5 years of age) one-half. Streets where only one death has occurred omitted. Wherever the Population is stated, it is that ascertained at the time the Street was inspected. The * against any Street indicates that its Death-rate exceeded 20 per 1000 of those living. Population, 1856-7-8. Total Mortality. Zymotic Mortality. Mortality from Tubercular Diseases. M totality under 5 yrs Population; 1856"7-8. Total Mortality. Zymotic Mortality. Mortality liom Tubercular Diseases. Mortality under 5 yrs.  Ward 1. Sum. Per Room. Sum. Per Room. Archway Place .. .. 6 2 1 2 Salisbfcrv Terrace .. .. 2 .. .. 2 Blenheim Road .. .. 2 1 .. 2 Stanley Road .. .. 8 2 1 4 Bowman's Place North 248 1.7 6 1 1 8 *Victoria Place, Hornsev Road 67 2.1 2 .. .. 2 Brunswick Road .. .. 8 .. 2 3 Victoria Road .. .. 3 1 .. 2 Craven Terrace .. .. 2 2 .. 1 Ward 4. *Gordon Place 117 2.1 4 3 1 1 John Street .. .. 3 2 .. 2 Albion Street .. .. 8 .. 5 4 Junction villas .. .. 2 .. .. 2 *Bath Place 271 1.2 10 2 .. 7 Mitford Road .. .. 5 3 .. 4 *Bemmerton Street 581 1.3 20 6 1 15 Regina Road .. .. 2 .. 2 1 *Bemmerton Terrace 159 1.2 5 1 2 Upper Hornsey Rise .. .. 3 1 .. 3 Binutield Street .. .. 7 2 .. 6 Ward 2. Bryan Place .. .. 3 .. 1 2 Buckinghan Street .. .. 7 1 .. 5 Artur Terrace .. .. 8 1 . . 2 Caledonia Crescent .. .. 8 2 3 5 Blundell Street .. .. 7 2 .. 4 Caledonia Place .. 4 .. 1 4 B randon Road, Belle Isle .. .. 4 2 2 3 Caledonia Street .. .. 6 1 1 4 Devonshire Street .. .. 3 .. .. 2 *Canal Terrace 189 1.2 9 1 2 6 Edward Terrace .. .. 2 1 .. 2 Clayton Street .. .. 20 7 3 9 Frederick Place .. .. 8 .. 1 2 Diddington Place .. .. 3 3 .. 2 Frederick Street .. .. 8 3 1 4 *Edward Square 451 1.2 18 6 1 12 George Street .. .. 7 3 .. 1 *Edward Street 188 1.6 10 .. 2 6 George's Grove .. .. 4 2 .. 3 Edward Terrace .. .. 6 3 .. 4 Hollingsworth Street 191 1.2 3 1 .. 3 *Freeling Street .. 1.5 13 4 1 9 Little Bride Street 166 1.1 3 .. 1 3 Gifford Street .. .. 7 2 2 4 Loaine Place .. .. 3 2 .. 2 Gordon Terrace .. .. 4 .. 2 3 Palmer Street .. .. 4 3 .. 4 Huntingdon Street .. .. 5 2 .. 3 Pocock's Fields, (Cottages) .. .. 3 .. 1 2 Stroud's Vale, & Sutton's Gdris. 1335 1.6 20 6 4 12 Stock-Oichard Crescent .. .. 2 2 .. 1 Land?downe Terrace .. .. 7 3 2 3 Sutterton Street .. .. 6 .. 2 2 *Lavinia Grove 122 1.1 3 1 2 .. *Upper Victoria Road 292 1.0 7 4 .. 5 London Street .. .. 5 1 3 2 St. James's Road .. .. 3 .. .. 2 Luard Street .. .. 5 .. 2 1 Wellington Terrace .. .. 4 2 .. 3 Lyon Street .. .. 2 .. .. 2 Wilson Street .. .. 3 .. .. 2 Matilda Street .. .. 9 4 6 Ward 3. Mexican Terrace .. .. 5 2 1 4 Pembroke Cottages .. .. 3 .. .. 2 *Albany Place, Hornsey Road 208 1.8 7 3 .. 3 Pembrike Sterrt .. .. 7 .. 1 4 *Arundel Road 83 2.1 3 1 1 2 Princes Terrace .. .. 4 1 1 4 *Aston Buildings 83 1.7 2 2 .. 1 Randall's Tile Kilns .. .. 2 2 .. 2 Blackstock Lane .. .. 5 2 1 2 Randall's Cottages 214 2.4 2 2 .. 2 *Brand street 297 2.7 9 5 1 7 Rivers Terrace .. .. 5 2 2 3 *Brunswick Grove 46 1.6 2 1 .. 2 *Rivers Street 414 1.3 5 2 .. 4 Canterbury Road .. .. 10 4 1 4 St. James's Terrace .. .. 2 .. 2 1 Canterbury Terrace .. .. 3 .. 2 2 Salisbury Terrace 203 1.4 4 1 2 2 Caroline Place .. .. 3 2 .. 2 *Sidney Street 550 1.7 19 6 2 12 College Terrace, Highbury Vale.. .. .. 2 .. 2 .. Stanmore Street .. .. 2 .. .. 2 *Granby Terrace 43 2.0 4 4 .. 4 Sutherland Terrace .. .. 2 2 .. 2 *Hawthorn Street 150 1.0 7 5 1 3 Thornhill Bridge Place .. .. 7 4 2 3 Ingram Place .. .. 3 2 .. 2 Thornhill Street .. .. 12 4 1 7 Kelso Terrace .. .. 2 2 .. 1 Twyford Street .. .. 4 .. .. 3 *Keppel Place 44 1.6 2 ? .. 2 Upper Bingfield Street .. .. 6 5 .. King's Road, Balls Pond .. .. 6 2 1 4 *Upper Bemmerton Street 731 1.7 27 7 3 1 *Litchfield Terrace 92 2.1 4 2 .. 2 Uppe Freelmg Street .. .. 5 2 .. *Mildmay Street 353 1.0 12 2 5 Upper Winchester Street .. .. 3 1 .. Myrtle Street, Highbury Vale .. .. 5 2 1 1 William Street North .. .. 12 5 2 Newington Crescent .. 2 1 1 2 Ward 5. Northampton Park .,.. .. 3 2 1 1 *Prince Edward Street 128 2.2 9 4 1 9 Albert Street .. .. 10 2 4 Radnor Terrace .. .. 5 4 .. 4 Albion Grove, West .. .. 2 1 .. Rutland Terrace 128 1.4 3 .. .. 2 Barnsbury Grove .. .. 4 1 2 TABLE VI. (Continued.) Population, 1856-7-8. Total Mortality. Zymotic Mortality. Mortality from Tubercular Diseases. Mortality under 5 yrs. Population, 1856-7-8. Total Mortality. Zymotic Mortality. Mortality from Tubercular Diseases. Mortality under 5 yrs. Ward 5, continued. Sum. Per Room. Sum. Per Room. Brooksby Street .. .. 4 .. 2 1 ltotherfield Street .. .. 7 .. 2 2 Brunswick Place .. .. 6 .. 3 2 St. Mary's Road .. .. 3 2 .. 1 Charlotte Terrace .. .. 9 5 .. 7 Shepperton Cottazes .. .. 5 .. 2 1 Felix Terrace .. .. 2 .. .. 2 Spencer Terrace .. .. 3 1 .. 2 Gainford Street .. .. 3 .. .. 2 Strahan Place .. .. 3 1 .. 2 Half-moon Crescent 147 1.1 2 2 .. 2 Sussex Place .. .. 3 .. .. 2 *Henry Place 106 1.8 4 .. .. 3 Victoria Road .. .. 3 .. 2 .. Lower Islington Terrace .. .. 4 2 .. 3 Wilton Square .. .. 3 2 1 5 *Milton's Yard and Court 101 3.1 4 1 1 4 Ward 8. Payne Street 535 1.9 11 4 9 9 Prospect Cottages .. .. 3 .. 2 3 *Adelaide Square .. .. 9 1 2 4 Pulteney Street .. .. 9 3 1 3 Alfred Mews .. .. 2 2 .. 2 Pulteney Terrace .. .. 3 1 1 2 Alfred Street .. .. 5 2 .. 1 Richmond Grove .. .. 4 .. 2 .. Angel Terrace .. .. 3 1 .. 2 Richmond Terrace .. .. 2 .. .. 2 *Anglers' Gardens 255 1.8 7 2 2 4 Titterton Terrace 114 2.5 2 2 .. 2 Arlington Square .. .. 5 3 2 2 *Vittoria Street 295 1.8 9 1 2 7 Baldwin Terrace .. .. 4 3 .. 1 Ward 6. Bird's Buldings 78 1.0 2 2 .. 1 Britannia Row .. .. 20 10 6 10 Allan Street .. .. 2 1 .. 2 Camden Street .... .. 8 1 1 5 *Broad Yard 51 2.1 2 .. .. 2 Charlton Crescent .. .. 6 3 1 4 Chapel Sterrt .. .. 6 2 .. 2 Charlton Place .. .. 2 2 1 2 *Charles Street, Upper Street 276 2.1 9 2 3 4 City Gardens 634 2.3 7 3 .. 4 Church Lane .. .. 3 2 .. 2 *Elder Walk and Place .. .. 24 2 6 14 Cross Street .. .. 11 4 2 4 Dalby Terrace .. .. 6 9 2 2 *Duddies Rents 71 2.1 3 2 .. 2 Dame Street .. .. 15 2 • • 11 Felix Place .. .. 4 2 1 2 Duncan Terrace 148 2.3 4 2 .. .. Florence Street .. .. 3 2 .. 2 *Elliott's Place and Gardens .. .. 6 2 1 6 Gloucester Crescent .. .. 9 5 .. 9 Frederick's Place, Goswell Road 132 1.3 9 2 2 5 *Halton Place 155 1.8 7 .. 2 3 *Frog Lane 228 1.6 3 .. 2 .. Halton Street .. .. 6 .. 2 .. *Graham Street .. .. 13 5 2 11 Hardinge Street .. .. 4 .. 1 3 Grosvenor Street .. .. 7 3 .. 4 Little Cross Street .. .. 2 1 .. 2 Hall Street .. .. 2 2 1 Nowell's Buildings .. .. 3 1 .. 2 Hanover Street .. .. 8 2 5 Park Street .. .. 5 .. 3 3 James Street .. .. 5 2 • • 4 St. Alban's Place .. .. 4 .. 3 .. Kinp Street, South side .. 1.1 3 .. 3 *Studd Street 94 1.3 3 2 .. 3 "King Street Terrace, South side 128 1.5 3 1 •• 2 Thatched House Row .. .. 2 1 .. 2 *Nelson Place 28 .. 3 2 •• 3 Upper Street .. .. 17 5 3 8 Nelson Terrace & York Cottages .. 2.0 4 2 • • 4 Ward 7. *Newhall Street 201 .. 10 4 . • 6 Norfolk Place .. 1.4 2 2 .. • • Aberystwith Terrace .. 3 .. 2 2 Norfolk Street 221 1.7 8 .. 2 2 *Albion Place, Balls Pond 224 1.4 15 1 3 9 *Paradise Place 232 2.0 4 3 •• 4 Albion Terrace .. .. 5 .. 2 1 *Parcel's Court 112 .. 6 .. 2 6 Annet's Crescent .. .. 4 2 .. .. Pierrepont Row .. 1.8 6 4 • • .. Brunswick Place .. .. 3 1 .. 3 *Popham Street 335 .. 13 3 2 2 Canonbury Street .. .. 8 3 3 4 Prebend Street .. .. 8 2 2 4 Cardigan Street .. .. 3 2 .. 1 Rgcidol Terrace .. 3 3 .. 5 Clarence Place, Culford Road .. .. 2 .. .. 2 *Rose and Crown Court 123 2.3 6 3 2 4 Clephane Road .. .. 5 2 .. 1 Russell Place .. .. 3 1 .. 10 Cleveland Road .. .. 3 .. .. 2 Rydon Street .. .. 3 1 1 5 *Cross Street, Balls Pond 99 2.1 3 .. .. 2 St. James Street .. .. 8 4 3 2 * Dorset Street, Balls Pond 136 1.8 3 .. .. 2 St. John Street .. .. 3 .. 1 2 Downham Road .. .. 7 2 2 3 St. Paul Street .. .. 11 5 3 4 Elizabeth Place, Balls Pond .. .. 6 2 1 .. St. Peter's Street .. .. 17 7 1 8 Friends Cottages .. .. 3 2 .. 3 St. Thomas Street .. .. 3 2 .. 2 George Street 181 1.7 3 .. .. 3 Sidney Place 105 1.6 2 2 .. .. Goucester Road .. .. 2 .. .. 2 *Sidney Grove 224 1.8 4 2 .. 1 Goulds mi th's Place .. .. 3 3 .. 3 South Street .. .. 8 3 .. 4 *Lower Queen Street 320 1.9 13 4 2 9 Sudeley Street .. .. 5 3 .. 2 Marquis Road .. .. 3 2 .. 3 *Swan Yard 66 4.7 3 2 .. 3 *New Norfolk Street 134 3.0 8 3 .. 5 Tibberton Square .. .. 6 3 .. 3 Northampton Street .. .. 10 3 .. 6 Victoria Plac 101 1.5 9 3 2 4 Northampton Terrace, .. .. 2 .. 1 2 Vincent Terrace .. •• 3 .. 2 .. Orchard Street, Ball Pond 300 2.0 5 2 .. 3 *Water's Court 133 3 3 6 4 .. 5 Oxford Street .. .. 2 2 .. 1 *Ward's Place 292 2.8 11 4 1 7 Pleasant Row .. .. 4 2 .. 4 William Street .. .. 10 1 1 7 *Queen's Street 223 1.5 6 2 1 3 *Windsor Street 639 1.9 27 9 5 12 TABLE VII. HOtJSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From January 1st, 1858, to March 25th, 1869. West SubDistrict. East SubDistrict. Whole Parish. Number of House inspected 1168 1036 2204 Drains Constructed 97 256 353 Improved or repaired 152 327 479 Traps Fixed 827 805 1632 Cesspools Abolished 330 316 646 Cleansed or disinfected 2 .. 2 Privies and Water Closets Pan, trap, and water supply furnished.. 220 271 491 Pan and trap only furnished 129 95 224 Water supplu furnished 108 244 352 Dust-bins Constructed 250 514 764 Repaired and covers adapted 340 217 557 Surface Drains and Pavements or Yards Constructed 98 149 247 Relaid 563 167 730 General Water Scpplt New receptacle provided 171 186 357 Receptacle repaired and cleansed 72 83 155 Water supply provided 26 22 48 Other Improve-_ ments Houses generally repaired 100 98 198 ,, cleansed or limewashed 123 297 420 ,, ventilated 28 93 121 24 REPORT ON THE SANITARY CONDITION OF SAINT MARY, ISLINGTON, FOR JANUARY, 1859. No. XXII. I am happy to be able to report that the mortality in Islington, which had been excessive during November and December, fell, during the month which has just expired, to about the mean of the same month in the two previous years, allowance being made for increased population. Two hundred and twenty deaths were registered, of which 108 were of persons under 20 years of age, and 89 under 5 years. Scarlet fever and hooping cough have continued to add to the mortality among children, and there have been four fatal cases of epidemic sore throat, including diphtheria, two of which were in adults. There have been only three deaths from fever. The mortality from respiratory diseases did not reach half the number registered in December. The table which relates to the sickness in the parish, which has hitherto been confined to that among absolute paupers, is this month made to include that in some other establishments in the parish. Mr. Whittingham, the resident medical officer of the Holloway Dispensary, has kindly consented to continue furnishing me with a weekly return of new cases treated in that institution and its several^branches; and I am indebted for similar returns to Mr. Bradley, the surgeon to the Pentonville Prison, and to Dr. Scurrah, the resident physician to the London Fever Hospital. The table which I furnish this month has reference to 1658 cases of sickness. A special interest attaches to the column relating to the prison, inasmuch as the inmates are comfortably 2 clothed, healthily lodged and well fed, and are in great measure removed from the influence of infection and of those accidental circumstances which often originate acute diseases out of doors : it is amongst these men, therefore, that epidemic and atmospheric influences may be most clearly seen in operation. The Fever Hospital, of course, admits patients from all parts of London. The three columns relating to the Workhouse, Infant Poor-house, and out-patient paupers, may be compared with the tables of sickness published in previous monthly reports. EDWARD BALLARD, M.D., Medical Officer of Health. 42, Myddelton Square, February 5th, 1859. TABLE 1. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JANUARY 29th, 1859. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age and upwards. West S.D. East. S.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 6u and under 80 years of age. At 80 years of age and upwards. 110 110 220 108 32 33 40 6 1 .. VI. Laryngitis 1 1 .. .. .. .. Class. 13 19 Bronchitis 32 11 1 7 12 1 25 25 I.Zymotic 50 44 4 .. 2 .. .. .. Pleurisy .. .. .. .. .. .. 5 3 II. Dropsy, &c 8 2 1 1 3 1 5 8 Pnenmonia 13 9 2 .. 2 .. 20 21 III. Tubercular 41 10 15 10 .. 3 2 Asthma 5 .. .. 1 4 .. 15 9 IV. Brain and Nerves 24 9 1 5 4 2 .. .. Disease of Lungs .. .. .. .. .. .. 3 5 V. Heart, &c 8 2 3 3 .. 22 29 VI.Lungs,&c 51 91 3 8 18 1 6 5 VII.Digestive Organs. 11 4 3 1 2 1 3 .. VII. Teething 3 3 .. .. .. .. 1 1 VIII. kidney,&c 2 .. .. 2 .. .. .. .. Quinsey • • .. .. • • • • .. 1 1 IX, Childbirth, ike 2 .. 1 1 .. .. 1 .. Gastritis 1 .. 1 •• •• ... .. 2 X. Joints, Bones, &c 2 .. 1 1 .. .. .. l Enteritis .. 1 .. •• •• .. .. .. XI. Skin, &c .. .. .. .. .. .. .. .. Peritonitis .. .. .. •• .. .. .. .. XII. Malformations .. .. .. .. .. .. .. .. Ascites • • • • .. • • • • • • 2 2 XIII.Prem,Birth 4 4 .. .. .. .. .. .. Ulceration of Intest. .. .. .. .. .. .. 1 .. and Debility. 1 1 .. .. .. .. .. .. Hernia (Rupture) .. .. .. .. .. .. 1 2 XIV. Atrophy 3 3 .. .. .. .. .. l Ileus 2 • • 1 • • .. 4 4 XV. Old Age 8 .. .. .. 7 1 .. .. Intussusception .. .. .. .. .. .. .. .. XVI. Sudden .. .. .. .. .. .. .. .. Stricture of Intestinal Canal .. .. .. .. .. .. 4 1 XVII. Violent Death 5 2 1 1 l .. .. .. .. .. XVIII. Not Specified .. .. .. .. .. .. .. l Dis. of Stomach, &c. 1 .. 1 .. .. .. •• .. Disease of Pancreas . .. .. .. .. .. .. .. .. I. Small Pox .. .. .. .. .. .. .. •• Inflammation of Liver (Hepatitis) 1 .. .. .. 1 •• .. .. Chicken Pox .. .. .. .. .. .. 1 1 3 1 Measles 4 4 .. .. .. .. 1 .. Jaundice 1 .. .. .. .. 1 6 7 Scarlatina 13 13 .. .. .. .. .. 1 Disease of Liver .. .. .. .. .. .. 7 11 Hooping Cough 18 18 .. .. .. .. .. .. Disease of Spleen .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. l Thrush 1 1 .. .. .. .. 2 l Diarrhœa 3 2 .. .. l .. .. .. VIII.Nephritis .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. Nepharia(Bright's Dis) .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. Ischuria .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. 1 Diabetes 1 .. .. 1 .. .. 1 .. Scurvy and Purpura 1 1 .. .. .. .. 1 .. Stone 1 .. l .. .. .. .. Ague .. .. .. .. .. .. .. .. Cystitis .. .. .. • • .. .. .. .. Remittent Fever .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Infantile Fever .. .. .. .. .. .. .. .. Disease of Bladder &c .. .. .. .. .. .. 2 1 Typhus Fever 3 1 1 .. 1 .. .. l Puerperal Fever 1 .. 1 .. .. .. ,, .. Rheumatic Fever .. .. .. .. .. .. .. .. IX. Paramenia .. .. .. .. .. .. 1 .. Erysipelas 1 1 .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 1 .. Syphilis 1 1 .. .. .. .. .. 1 Childbirth 1 .. 1 .. .. .. .. .. Noma (Canker) .. .. .. .. .. .. 1 .. Dis. of Uterus, &c 1 .. .. l .. .. 2 2 Epid. Sore Throat 4 2 2 .. .. .. .. .. II. Hæmorrhage .. .. .. .. .. .. .. 1 X.Rheumatism 1 .. .. l .. .. 1 .. Dropsy 1 1 .. .. .. .. .. .. Arthritis .. .. .. .. .. .. 1 .. Abscess 1 1 .. .. .. .. .. 1 Dis. of Joints, &c... 1 .. 1 .. .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Fistula .. .. .. .. .. .. .. 1 Mortification 1 .. .. .. .. 1 .. .. XI. Carbuncle .. .. .. .. .. .. 3 2 Cancer 5 1 1 3 .. .. Phlegmon .. .. .. .. .. .. .. •• Gout .. .. .. .. .. .. .. .. Disease of Skin, ike. .. .. .. .. .. .. 1 1 111. Scrofula 2 1 .. 1 .. .. .. 1 Tabes Mesenlerica 1 1 .. .. .. .. .. .. XII.Cyanosis .. .. .. .. .. .. 17 15 Phthisis(Consumpn.) 32 8 15 9 .. .. .. .. Spina Bifida .. .. .. .. .. .. 2 4 Hydrocephalus 6 6 .. .. .. .. .. .. Other Malformations .. .. .. .. .. .. 7 2 IV. Cephalitis 9 3 1 2 3 .. l 1 Apoplexy 2 .. .. 1 .. 1 .. .. XIII.Intemperance .. .. .. .. .. .. l 3 Palsy (Paralysis) 4 .. .. 2 1 1 .. .. Privation of Food .. .. .. .. .. .. .. .. Delirium Iremens .. .. .. .. .. .. 1 .. Want of Breast Milk 1 1 .. .. .. .. .. .. Chorea •. .. •• .. .. .. Neglect .. .. .. .. .. .. .. 1 Epilepsy 1 .. 1 .. .. .. .. .. Cold .. .. .. .. .. .. .. .. Tetanus .. .. .. .. .. .. .. Poison .. .. .. .. .. .. l .. Insanity i .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 4 2 Convulsions 6 6 .. .. .. .. 1 .. Hanging 1 .. 1 .. .. .. .. .. Disease of Brain,&c 1 .. .. .. .. .. .. .. Suffocation .. .. .. .. .. .. .. .. Drowning .. .. .. .. .. .. 1 .. V.Pericarditis 1 1 .. .. .. .. 1 .. Fractures & Contus. 1 .. .. .. 1 .. • • .. Aneurism .. .. .. .. .. .. .. 1 Wounds 1 .. .. l .. .. 2 5 Disease of Heart, &c. 7 l .. 1 3 3 .. 1 •• Other Violence 1 1 .. .. .. .. TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 29th DAY OF JANUARY, 1859, AT THE FOLLOWING INSTITUTIONS IN ISLINGTON. Workhouse. Infant Poor House. Out-patient Paupers. I I olio way Dispensary. Pentonville Prison. London Fever Hospital. Total. Small Pox 3 3 .. i 7 •• 1 •• 2 3 24 1 .. 1 26 1 15 8 •• 17 41 48 5 •• •• 53 •• •• •• • • 2 16 10 i 2 31 Dysentery ., • • .. • • .. .. .. .. .. .. .. Continued Fever and Infantile Fever 6 11 .. 12* 20 .. .. .. .. 6 4" .. 10 14 .. • • 14 2 .. • • 2 Sorethroat or Tonsillitis 25 3+ i • • 29 .. .. .. .. 7 298 89 33 1 428 7 2 .. 9 .. 8 1 • • 1 10 Delirium Tremens • • ! 2 • • • • •• 2 1 • • • • • • •• 1 • • • • • • •• • • 30 7 571 302 42 11 963 40 S 1045 440 77 48 1658 * Two of these were "Typhus," and ten * Typhoid." t Cases of sore throat in the first three weeks included among " All other diseases."