ISL 34 59 REPORT on the SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR JANUARY, 1865. No. XCIV. We have commenced the new year with a mortality of 48 above the corrected mean of eight years, the deaths registered during the four weeks of January amounting to 369. The mortality has been especially great amongst the old. In the last week of the month—the snowy week which succeeded the dense fog of the 21st of January—107 persons died. The zymotic mortality has been increased by an unusual number of deaths for the month from measles and hooping-cough. The deaths from measles took place chiefly amongst the children attacked in the White Conduit district, to whom I alluded in my last report. The deaths from so-called local diseases, and especially from diseases of the respiratory organs, have been somewhat numerous—the immediate result of the inclement weather; but these diseases have nevertheless been less fatal than they were in January last year. 2 Fire of the deaths from fever were attributed to typhus; one of these fatal cases was that of a nurse in the Fever Hospital, and another was the mother of the family in Crescent Avenue whose illness I mentioned last month. Of the 50 cases of measles amongst the out-patient paupers recorded in Table 2, all but six occurred in the White Conduit district. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, February 9th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING THE FOUR WEEKS ENDING JANUARY 28th, 1865. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Under 20 years 01 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 80 years of age and upwards. 210 159 All Causes 369 184 46 50 6£ 21 59 37 3. Respirat. Orgs. 96 41 7 21 23 4 3 4 Laryngitis 7 6 1 .. .. .. (Classes.) 39 23 Bronchitis 62 24 4 12 19 3 1 .. Pleurisy 1 .. • • 1 .. .. 65 36 I. ZYMOTIC DIS 101 78 9 8 6 .. 11 5 Pneumonia 16 11 .. 3 2 .. 24 29 II. CONSTITUTE. 53 17 21 11 3 1 4 4 Asthma 8 .. 2 3 2 1 1 1 Lung Diseases, &c. 2 .. 2 .. .. 92 73 III LocAL 165 64 15 29 50 7 2 4 4. Digestive Orgs. 6 .. 1 1 2 2 25 17 IV. DEVELOPMNL. 42 21 .. .. 9 13 .. .. Gastritis .. .. .* .. .. .. .. .. Enteritis .. .. .. .. .. 4 3 V. VIOLENTDTHS. 7 4 1 2 .. .. .. 1 Peritonitis 1 .. .. 1 .. .. 1 Not Specified 1 1 .. .. .. .. .. 1 Ascites 1 .. .. .. 1 .. .. .. Ulceration of Intes. .. .. .. .. .. 1 1 Hernia 2 .. .. .. 2 (Orders.) .. .. Ileus .. .. ,, .. .. .. .. .. Intussusception .. .. .. .. .. 60 34 I. 1. Miasmatic Dis 94 75 9 4 6 .. .. .. Stricture of Intest .. .. .. .. .. 2 1 Small Pox 3 2 .. 1 .. .. .. .. Fistula .. .. .. .. .. 18 3 Measles 21 20 1 .. .. .. 1 1 Stomach Dis., &c. 2 .. 1 1 .. .. .. 11 Scarlatina 19 18 1 .. .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. 3 Diphtheria 3 3 .. .. .. .. .. .. Hepatitis .. .. .. .. .. .. 1 1 Quinsey 1 1 .. .. .. .. .. .. Jaundice .. .. .. .. .. 15 2 Croup 3 3 .. .. .. .. .. .. Liver Disease .. .. .. .. .. 8 5 Hooping Cough. 20 20 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. 3 1 Typhus & Typhoid 9 2 4 3 .. .. 3 4 5. Urinary Orgs. 7 1 2 1 3 .. .. 1 Erysipelas 4 2 1 .. 1 .. .. .. Nephritis .. .. .. .. .. 1 .. Pyœmia .. .. .. .. .. .. 1 .. Disease of Bladder 1 .. .. .. 1 .. .. .. Puerperal Fever 1 .. 1 .. .. .. 1 4 Nephria 5 1 2 1 1 .. .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. 1 Influenza 1 .. .. .. 1 .. .. .. Stone .. .. ,, .. .. .. 2 .. Dysentery .. .. .. .. .. .. 1 .. Prostrate Disease 1 .. .. 1 .. .. 2 Diarrhœa 4 2 .. .. 2 .. .. .. Kidney Disase,&c. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. 6. Genera. Organs .. .. .. .. .. 2 .. Ague .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. 3 3 Rheumatism 5 2 1 .. 2 .. .. .. Uterine Diseases .. .. .. .. .. 3 .. 2. Enthetic 3 1 .. 2 .. .. 2 .. 7. Orgs. of Locomo. 2 2 .. .. .. .. .. Syphilis 3 1 .. 2 .. .. 2 .. Spine Diseases 2 2 .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Bone Diseases .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. 8. Skin, &c. .. .. .. .. .. .. 2 .. Glanders .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. .. .. .. 2 3. Dietic 4 2 .. 2 .. .. .. .. Ulcer .. .. .. .. .. .. 2 1 Privation l .. .. 1 .. .. .. .. Skin Diseases .. .. .. .. .. .. 2 .. Want of Br. Milk. 2 2 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 3 6 IV. 1. Dis. of Childn. 9 9 .. .. .. .. .. 1 Alcoholism 1 .. .. 1 .. .. .. .. 4. Parasitic .. .. .. .. .. .. 1 4 Premature Birth 5 5 .. .. .. .. .. .. Thrush .. .. .. .. .. .. 2 1 Cyanosis 3 3 .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. Other Malformation .. .. .. .. .. .. 3 4 II. 1.Diathetic .. .. 4 2 1 .. 1 Teething 1 1 .. .. .. .. .. .. Gout 7 .. .. .. .. .. .. .. 2. Dis. of Adults . .. .. .. .. .. .. 2 .. Dropsy • • .. .. 1 1 .. .. .. Paramenia .. .. .. .. .. .. .. .. Hæmorrhage 2 .. .. .. .. .. .. .. Childbirth .. .. .. .. .. .. .. 3 Cancer .. .. 3 .. .. 17 5 3. Dis. of Aged 22 .. .. .. 9 13 .. .. Noma 3 .. .. .. .. .. 17 5 Old Age 22 .. .. .. 9 13 1 1 Mortification •• .. .. .. 1 1 5 6 4. Dis. of Nutritn. 11 11 .. .. .. .. 21 25 2. Tubercular 46 17 21 7 1 .. 5 6 Atrophy & Debility 11 11 .. .. .. .. 1 .. Scrofula l 1 .. .. .. .. 2 3 V. 1. Acci.or Neg. 5 4 .. 1 .. .. .. 2 Tabes Mesenterica 3 .. .. .. .. .. .. Fract. and Contus. .. .. .. .. .. .. 16 17 Phthisis 4 21 7 1 .. .. .. Wounds .. .. .. .. .. .. 4 6 Hydrocephalus 10 .. .. .. .. 1 .. Burns and Scalds 1 1 .. .. .. .. 14 21 III. 1. Nervous Syst. 35 17 .. 5 13 .. .. .. Poison .. .. .. .. .. .. .. .. Drowning .. .. .. .. .. .. 2 2 Cephalitis 4 3 .. 1 .. .. 1 3 Suffocation 4 3 .. 1 .. .. 2 5 Apoplexy 7 1 .. 1 5 .. .. .. Otherwise .. .. .. .. .. .. 1 4 Paralysis 5 .. .. 1 4 .. .. .. 2. Homicide .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. 2 .. 3. Suicide 2 .. 1 1 .. .. .. 1 Chorea 1 1 .. .. .. .. .. .. Wounds .. .. .. .. .. .. 2 1 Epilepsy 3 1 .. 1 1 .. .. .. Poison .. .. .. .. .. .. 4 7 Convulsions 11 11 .. .. .. .. .. .. Drowning .. .. .. .. .. .. 3 1 Brain Diseases, &c. 4 .. .. 1 3 .. 2 .. Suffocat. and Hang. .. .. 1 1 .. .. 12 7 2. Organs of Circ. 19 3 5 1 9 1 .. .. Otherwise .. .. .. .. .. .. .. 1 Pericarditis 1 .. .. 1 .. .. .. .. 4. Unclassed .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. 12 6 Heart Diseases 18 3 5 .. 9 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 28th DAY OF JANUARY, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 7 1 2 .. 10 Chicken Pox .. .. 2 5 .. .. 7 Measles 5 5 50 9 5 .. 74 Scarlatina .. .. 16 6 3 .. 25 Whooping Cough .. .. 11 .. 11 .. 22 Croup .. .. 2 1 .. .. 3 Diarrhœa .. .. 15 7 4 .. 26 Dysentery .. .. 1 .. .. .. 1 Cholera .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. Continued Fever 1 .. 8 2 4 .. 15 Puerperal Fever .. .. 1 .. .. .. 1 Rheumatic Fever .. .. .. 2 4 .. 6 Erysipelas .. .. 9 4 2 .. 15 Diphtheria .. .. 1 .. 2 .. 3 Sorethroat or Tonsillitis .. .. 15 9 7 1 32 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 22 .. 291 117 95 34 559 Pneumonia .. .. .. 2 1 .. 3 Pleurisy .. .. 6 1 1 1 9 Delirium Tremens 1 .. 2 .. .. .. 3 Insanity 4 .. 4 .. .. .. 8 Carbuncle .. .. .. .. .. .. .. All other Diseases 35 7 470 465 414 110 1531 Total 68 12 912 631 585 146 2354 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From January 1st, 1865, to January 28th, 1865. West SubDistrict. East SubDistrict. Whole Parish. Number of houses inspected 111 28 139 Drains Constructed 10 .. 10 Improved or repaired 10 15 25 Traps fixed 13 8 21 Cesspools Abolished 1 .. 1 Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 4 1 5 Pan and trap only furnished .. 2 2 Water supply furnished 10 5 15 Dust bins Constructed 1 6 7 Repaired and covers adapted 10 3 13 Surface Drains and Pavements of Yards Constructed .. 2 2 Relaid 9 7 16 General Water Supply New receptacle provided 3 .. 3 Receptacle repaired and cleansed 6 3 9 Water supply provided .. .. .. Other Improvements Houses generally repaired 1 3 4 „ cleansed or lime washed 3 15 18 ,, ventilated .. .. .. Overcrowding abated 3 5 8 Illegal use of underground Rooms for sleeping discontinued. .. 2 2 60 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR FEBRUARY, 1866. No. XCV. The registered mortality, 318, is the same as in February last year. Indeed there is a remarkable parallelism throughout between the mortality table for the past month and that of the corresponding month last year. The total mortality represents an excess of 15 oyer the corrected average of eight years. The excess is due entirely to the large number of deaths referred to the so-called local diseases. The amount of zymotic disease has been comparatively small, as appears from Table II. There have been three deaths from small-pox. In the case of one infant who died from this disease, Dr. Lankester held an inquest. Of the deaths from fever, three are said to have been from Typhus, one of these, however, caught the disease at the Fever Hospital, and another is doubtful. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, March 6th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING THE FOUR WEEKS ENDING FEBRUARY 25th, 1865. (Deaths of Non-Residents in Hospitals excluded.) Weat S. D. East S. D. Causes of Death. At all Ages. Under 20 years 0 age- At 20 and under 40 years of age. At ana under 60 years of age. At 60 and under 80 years of age. At 60 years of age and upwards. West S. D. East S. D. Causes of Death. At all Ages. Under 2o 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. 166 182 All Causes ....... 318 161 35 43 69 10 50 3. Respirat. Orgs 87 43 .. 13 28 .. 2 Laryngitis 5 5 .. .. .. .. (Classes.) 36 Bronchitis 61 27 .. 11 20 3 .. Pleurisy .. .. .. .. .. .. 39 30 I. ZYMOTIC DIS. 69 52 7 7 3 .. 8 Pneumonia 1/ 11 .. .. 6 .. 25 27 II. CONSTITUTL. 52 22 14 9 7 .. 4 Asthma 4 .. .. 2 2 .. .. Lung Diseases. &c. .. .. .. .. .. .. 81 80 III. LOCAL 161 66 10 26 54 5 7 4. Digestive Orgs. 17 5 3 5 4 .. 16 13 IV. DEVELOPMNL. 29 16 2 1 5 5 .. Gastritis .. .. .. .. .. .. 2 Enteritis 3 3 .. .. .. .. 4 2 V. VIOLENT DTHS. 6 4 2 .. .. .. .. Peritonitis .. .. .. .. .. .. .. Ascites .. .. .. .. .. .. 1 .. Not Specified 1 1 .. .. .. .. .. Ulceration of Intes. .. .. .. .. .. .. .. Hernia .. .. .. .. .. .. (Orders.) 1 Ileus 2 .. 1 1 .. .. .. Intussusception .. .. .. .. .. .. 35 28 I. 1. Miasmatic Dis. 63 47 1 7 3 .. .. Stricture of Intest. .. .. .. .. .. .. 2 1 Small Pox 3 1 .. 1 .. .. .. Fistula .. .. .. .. .. .. 1 1 Measles 2 2 1 .. .. .. .. Stomach Dis., &c. 1 .. .. .. 1 .. 8 7 Scarlatina 15 14 .. .. .. .. .. Pancreas Dis., &.C. 1 .. 1 .. .. .. .. .. Diphtheria .. .. .. .. .. .. .. Hepatitis 2 .. 1 .. 1 .. .. .. Qunisey .. .. .. .. .. .. 2 jaundice 2 2 .. .. .. .. 1 .. Croup 1 1 .. .. .. .. 2 Liver Disease 6 .. .. 4 2 .. 8 8 Hooping Cough 16 16 1 .. .. .. .. Spleen Diseases .. .. .. .. .. .. 6 4 Typhus & Typhoid 10 3 .. 5 1 .. 1 5. Urinary Orgs. 7 1 2 .. 3 1 1 1 Erysipelas 2 1 .. .. 1 .. .. Nephritis 1 .. .. .. .. .. 1 .. Pyæmia 1 1 2 .. .. .. .. Diseses of Bladder 1 .. 1 .. .. .. 3 .. Puerperal Fever . 3 .. .. 1 .. .. .. Nephria 1 .. .. .. 1 .. .. .. Carbuncle .. .. .. .. .. .. .. Diabetes 1 .. 1 .. .. .. .. 1 Influenza 1 1 .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. Prostrate Disease 1 .. .. .. .. 1 .. 3 Diarrhœa 3 3 .. .. .. .. 1 Kidney Diseases, &c. 3 1 .. .. 2 .. .. .. Cholera .. .. .. .. .. .. 1 6. Genera. Organs 1 .. .. 1 .. .. .. .. Ague .. .. 1 .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 4 2 Rheumatism 6 4 .. .. 1 .. 1 Uterine Diseases 1 .. .. 1 .. .. 2 .. 2. Enthetic 2 2 .. .. .. .. .. 7 Orgs.of Locomo. .. .. .. .. .. .. 2 .. Syphilis 2 2 .. .. .. .. .. Spine Diseases .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. Bone Diseases .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. 1 8. Skin, &c. 1 .. .. .. 1 .. .. .. Glanders .. .. 1 .. .. .. .. Phlegmon .. .. .. .. .. .. 2 2 3. Dietic 4 3 .. .. .. .. 1 Ulcer 1 .. .. .. 1 .. .. .. Privation .. .. .. .. .. .. .. Skin Diseases .. .. .. .. .. .. 1 2 Want of Br. Milk 3 3 .. .. .. .. .. .. Purpura and Scurvy .. .. 1 .. .. .. 4 IV. 1.Dis. of childn. 8 8 .. .. .. .. 1 .. Alcoholism 1 .. .. .. .. .. 3 Premature Birth 5 5 .. .. .. .. .. .. 4. Parasitic .. .. .. .. .. .. .. Cyanosis .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. Spina Bifida 1 1 .. .. .. .. .. .. Worms .. .. .. .. .. .. 1 Other Mallormation 1 1 .. .. .. .. 3 6 II. 1. Diathetic 9 2 .. 2 5 .. .. Teething 1 1 .. .. .. .. .. .. Gout .. .. .. .. .. .. 2 2. Dis. of Adults. 3 .. 2 1 .. .. .. .. Dropsy .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. Hæmorrage .. .. .. .. .. .. Childbirth 3 .. 2 1 .. .. 3 4 Cancer 6 2 .. 2 4 .. 3. Dis. of Aged 10 .. .. .. 5 5 1 1 Noma 2 2 .. .. .. .. Old Age 10 .. .. .. 5 5 .. 1 MOrtification 1 .. .. .. 1 .. 4. Dis. of Nutritn. 8 8 .. .. .. .. 22 21 2. Tubercular 43 20 14 7 2 .. Atrophy & Debility 8 | 8 .. .. .. .. 1 .. Scrofula 1 1 .. .. .. .. V. 1. Acci. or Neg. 5 4 1 .. .. .. 1 2 Tabes Messenterica 3 3 .. .. .. .. 14 14 Phthisis 28 5 14 7 2 .. Fract. and Contus. 2 1 1 .. .. .. 6 5 Hydrocephalis 11 11 .. .. .. .. Wounds .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 7 20 III. 1. Nervous Syst. 27 14 1 4 8 .. Poison .. .. .. .. .. .. Drowning .. .. .. .. .. .. l 2 Cephalitis 3 1 1 .. 1 .. Suffocation 3 3 .. .. .. .. •• 6 Apology 6 .. .. 4 2 .. Otherwise .. .. .. .. .. .. 3 Paralysis 4 .. .. .. 4 .. 2. Homicide .. .. .. .. .. .. • • • Insanity .. .. .. .. .. .. 3. Suicide 1 .. 1 .. .. .. " •• Chorea .. .. .. .. .. .. Wounds .. .. .. .. .. .. Epilepsy 2 1 .. .. 1 .. Poison .. .. .. .. .. .. Convulsions 12 12 .. .. .. .. Drowning .. .. .. .. .. .. Brain diseases,&c. .. .. .. .. .. .. Suffocat. and hang .. .. .. .. .. .. 7 2. Organs of Circ. 21 3 4 3 10 1 Otherwise 1 .. 1 .. .. .. 1 Pericarditis 1 .. 1 .. .. .. 4. Unclassed .. .. .. .. .. .. 14 Aneurism .. .. .. .. .. .. heart Dieases 20 3 3 3 10 1 TABLE II. NEW CASKS OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 25th DAY OF FEBRUARY, 1865, AT THE FOLLOWING INSTITUTIONS:— workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 13 .. 1 .. 14 Chicken Pox .. .. 3 2 1 .. 6 Measles .. .. 16 5 2 .. 23 Scarlatina .. .. 19 8 9 .. 36 Whooping Cough .. .. 23 4 12 .. 39 Croup .. .. .. .. .. .. .. Diarrhœa 2 .. 8 7 4 .. 21 Dysentery .. .. 1 .. .. .. 1 Cholera .. .. .. .. .. .. .. Ague .. .. .. 14 .. .. 1 Continued Fever 3 .. 6 6 .. .. 15 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever 4 .. 3 4 5 1 17 Erysipelas .. .. 3 4 2 .. 9 Diphtheria .. .. .. .. 11 .. .. Sorethroat or Tonsillitis .. .. 15 12 .. 38 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 16 .. 239 113 81 29 478 Pneumonia .. .. 4 4 .. .. 8 Pleurisy .. .. 3 .. 1 .. 4 Delirium Tremens .. .. .. .. .. .. .. Insanity .. .. 2 .. .. .. 2 Carbuncle .. .. 1 .. 1 .. 2 All other Diseases 31 13 398 389 416 107 1354 Total 56 13 758 559 546 137 2069 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From January 29th, 1865, to February 28th, 1865. West SubDistrict. East SubDistrict. Whole Parish. Number of houses inspected 31 27 58 Drains Constructed 7 6 13 Improved or repaired .. 16 16 Traps fixed 18 13 31 Cesspools Abolished 2 .. 2 Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 2 .. 2 Pan and trap only furnished .. .. .. Water supply furnished 13 11 24 Dust bins Constructed 1 2 3 Repaired and covers adapted 10 5 15 Surface Drains and Pavements of Yards Constructed .. .. .. Relaid 12 6 18 General Water Supply New receptacle provided 3 .. 3 Receptacle repaired and cleansed 16 4 20 Water supply provided .. .. .. Other Improvements Houses generally repaired 1 .. 1 „ cleansed or limewashed 2 7 9 „ ventilated 2 .. 2 Overcrowding abated .. 1 1 Illegal use of underground Rooms for sleeping discontinued .. .. .. 61 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR MARCH, 1865. No. XCVI. The mortality of the past month, 382, has been nearly the same as the corrected mean for the past eight years, 377. The mortality and prevalence of the miasmatic and contagious class of disease have been very small, small-pox alone showing an unusual number of cases and deaths. The deaths amounted to 7, and the new cases met with by the Parochial Medical Officers, &c., to 21, (14 during the last two weeks of the month.) It is a great pity that after all the public experience of small-pox during the last few years, and the overwhelming evidence, even in our own parish, of the efficacy of vaccination as a protective measure, parents should still neglect the vaccination of their children as they do, and that grown up persons who have been vaccinated in infancy should require almost a panic to rouse them to consult a qualified practitioner as to the present efficacy of the protection they are supposed to have received. Four of the deaths from fever are said to have been from "typhus." 2 The most remarkable number in the mortuary table is that of 42 deaths from chronic heart diseases, most of which happened to persons between forty and eighty years of age. Diseases of the organs of respiration also carried off 97 persons. The deaths of young persons under 20 years of age have been remarkably few : they usually constitute half, or more than half of all the deaths registered. EDWARD BALLARD, M.D., Medical Officer of Health Vestry Offices, April 10th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING THE FIVE WEEKS ENDING APRIL 1st, 1865. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Under 20 years 0 age. At 20 and under 40 years of age. At 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 80 years of age and upwards. 184 198 All Causes 382 178 52 62 74 16 50 47 3. Respirat. Orgs. 97 47 8 10 25 7 4 2 Laryngitis 6 6 .. .. .. .. (Classes.) 31 36 Bronchitis 67 27 5 7 22 6 .. .. Pleurisy .. .. .. .. .. .. 35 37 I. ZYMOTIC DIS. 72 52 12 5 3 .. 12 9 Pneumonia 21 14 3 3 .. 1 24 31 II. CONSTITUTL 55 21 22 6 5 1 3 .. Asthma 3 .. .. .. 3 .. .. .. Lung Diseases, &c. .. .. .. .. .. .. 103 108 III. LOCAL 211 79 17 48 57 10 6 10 4. Digestive Orgs. 16 3 1 7 5 .. 14 19 IV. DEVELOPMNL. 33 18 1 1 8 5 .. .. Gastritis .. .. .. .. .. .. .. 1 Enteritis 1 .. .. 1 .. .. 8 3 V. VIOLENT DTHS. 11 8 .. 2 1 .. 1 1 Peritonitis 2 2 .. .. .. .. .. .. Not Specified .. .. .. .. .. .. .. 2 Ascites 2 .. .. 1 1 .. .. .. Ulceration of Intes. .. .. .. .. .. .. 1 .. Hernia 1 .. .. .. 1 .. (Orders.) .. .. Ileus .. .. .. .. .. .. .. .. Intussusception .. .. .. .. .. .. 35 31 I. 1. Miasmatic Dis. 66 49 11 5 1 .. .. .. Stricture of Intest. .. .. .. .. .. .. 7 .. Small Pox 7 4 3 .. .. .. .. .. Fistula .. .. .. .. .. .. 2 2 Measles 4 4 .. .. .. .. .. 2 Stomach Dis., &c 2 1 .. 1 .. .. 7 6 Scarlatina 13 12 1 .. .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. 2 2 Diphtheria 4 3 1 .. .. .. .. .. Hepatitis .. .. .. .. .. .. .. .. Qunisey .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. .. .. 1 Croup 1 1 .. .. .. .. 4 4 Liver Dieases 8 .. 1 4 3 .. 8 9 Hooping Cough 17 17 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 6 6 Typhus & Typhoid 12 4 3 4 1 .. 1 3 5. Urinary Orgs. 4 .. .. 2 2 .. .. 1 Erysipelas 1 1 .. .. .. .. .. .. Nephritis .. .. .. .. .. .. .. 1 Pyæmia 1 .. 1 .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. 2 .. Puerperal Fever 2 .. 2 .. .. .. .. 2 Nephria 2 .. .. 2 .. .. .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. 1 Prostrate Disease . 1 .. .. .. 1 .. 1 .. Diarrhœa 1 1 .. .. .. .. 1 .. Kidney Disease,&c. 1 .. .. .. 1 .. .. .. Cholera .. .. .. .. .. .. .. .. 6. Genera. Organs .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. .. 3 Rheumatism 3 2 .. 1 .. .. .. .. Uterine Diseases .. .. .. .. .. .. .. 1 2. Enthetic 1 1 .. .. .. .. .. .. 7. Orgs.of Locomo. .. .. .. .. .. .. .. 1 Syphilis 1 1 .. .. .. .. .. .. Spine Diseases .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Bone Diseases .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. 1 1 8. Skin, &c 2 .. .. 1 1 .. .. .. Glanders .. .. .. .. .. .. .. 1 Phlegmon 1 .. .. .. 1 .. .. 4 3. Dietic 4 1 1 .. 2 .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. 1 .. Skin Diseases 1 .. .. 1 .. .. .. .. Want of Br. Milk.. .. .. .. .. .. .. .. 3 Purpura and Scurvy 3 1 .. .. 2 .. 2 5 IV. 1. Dis. of Childu. 7 7 .. .. .. .. .. 1 Alcoholism 1 .. 1 .. .. .. 3 3 Premature Birth 5 5 .. .. .. .. .. 1 4. Parasitic 1 1 .. .. .. .. .. .. Cyanosis .. .. .. .. .. .. .. 1 Thrush 1 1 .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. 2 Other Malformation 2 2 .. .. .. .. 3 4 II. 1. Diathetic 7 1 .. .. 5 1 .. .. teething .. .. .. .. .. .. .. 2 2. Dis. of Adults . 2 .. 1 1 .. .. .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. Dropsy .. .. .. .. .. .. .. 2 Childbirth 2 .. 1 1 .. .. .. .. Hæmorrhage .. .. .. .. .. .. 8 5 3. Dis. of Aged 13 .. .. .. 8 5 3 1 Cancer 4 .. .. .. 3 1 8 5 Old Age 13 .. .. .. 8 5 .. 2 Noma 2 1 .. .. 1 .. 4 7 4. Dis. of Nutritn. 11 11 .. .. .. .. .. 1 Mortification 1 .. .. .. 1 .. 4 7 Atrophy & Debility 11 11 .. .. .. .. 21 27 2. TUbercular 48 20 22 6 .. .. 2 .. Scrofula 2 2 .. .. .. .. 6 2 V. 1. Acci. or Neg. 8 6 .. 1 1 .. 1 2 Tabes Mesenterica 3 3 .. .. .. .. 1 .. Fract. and Contus. 1 .. .. 1 .. .. 12 19 Phthisis 31 3 22 6 .. .. .. .. Wounds .. .. .. .. .. .. 6 5 Hydrocephalus 12 12 .. .. .. .. 14 .. Burns and Scalds.. 1 .. .. .. 1 .. .. .. Poison .. .. .. .. .. .. 19 29 III. 1. Nervous Syst. 48 20 4 12 10 2 .. .. Drowning .. .. .. .. .. .. 2 2 Cephalitis 4 3 .. l .. .. 3 2 Suffocation 5 5 .. .. .. .. 4 6 Apoplexy 10 .. 1 2 6 1 1 .. Otherwise 1 1 .. .. .. .. 4 4 Paralysis 8 .. .. 6 1 1 1 1 2. Homicide 2 2 .. .. .. .. .. 1 Insanity 1 .. 1 .. .. .. 1 .. 3. Suicide 1 .. .. 1 .. .. .. .. Chorea .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. .. .. 2 Epilepsy 2 1 1 .. .. .. .. .. Poison .. .. .. .. .. .. 8 7 Convulsions 15 15 .. .. .. .. 1 .. Drowning 1 .. .. 1 .. .. 1 7 Brain Diseases, &c. 8 1 1 3 3 .. .. .. Suffocat. and Hang. .. .. .. .. .. .. 26 18 2. Organs of Circ. 44 9 4 16 14 1 .. .. Otherwise .. .. .. .. .. .. .. 1 Pericarditis 1 l .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. .. 1 .. Aneurism 1 .. .. 1 .. .. 25 17 Heart diseases 42 8 4 15 14 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 1st DAY OF APRIL, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Hollo way Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox 1 .. 16 3 1 .. 21 Chicken Pox .. .. 3 2 .. .. 5 Measles .. .. 4 1 .. .. 5 Scarlatina .. .. 10 12 2 .. 24 Whooping Cough .. 1 14 13 18 .. 46 Croup .. .. .. 3 .. .. 3 Diarrhœa 2 .. 16 17 8 4 47 Dysentery .. .. 1 1 .. .. 2 Cholera .. .. .. .. .. .. .. Ague .. .. .. 1 .. .. 1 Continued Fever .. .. 5 12 .. .. 17 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever 1 .. 2 2 1 .. 6 Erysipelas .. .. 8 6 1 .. 15 Diphtheria .. .. .. .. .. .. .. Sore throat or Tonsillitis .. .. 17 22 6 2 47 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 25 .. 300 131 99 24 579 Pneumonia 2 .. 2 5 4 .. 13 Pleurisy .. .. 3 2 4 .. 9 Delirium Tremens .. .. 1 .. .. .. 1 Insanity 1 .. 7 .. .. .. 8 Carbuncle .. .. 2 1 .. .. 3 All other Diseases 56 16 514 599 641 121 1947 Total 88 17 926 833 785 151 2800 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From February 29th, 1865, to April 1st, 1865. West SubDistrict. East SubDistrict. Whole Parish. Number of houses inspected 82 100 182 Drains Constructed 1 4 5 Improved or repaired 2 17 19 Traps fixed 18 27 45 Cesspools Abolished .. 1 1 Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 2 5 7 Pan and trap only furnished .. .. .. Water supply furnished 5 30 35 Dust bins Constructed 5 6 11 Repaired and covers adapted 10 4 14 Surface Drains and Pavements of Yards Constructed .. .. .. Relaid 3 24 27 General Water Supply New receptacle provided .. 14 14 Receptacle repaired and cleansed 8 2 10 Water supply provided .. 13 13 Other Improvements Houses generally repaired .. 21 21 „ cleansed or lime washed 13 28 41 „ ventilated 1 1 2 Overcrowding abated 6 .. 6 Illegal use of underground Rooms for sleeping discontinued .. .. .. 62 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR APRIL, 1865. No. XCVII. The registered mortality of the month is 313. The corrected mean of the previous nine years is 294; so that if our population has been increasing at the same rate as between 1851 and 1861, our mortality must be stated at 19 above the average for April. There has been an unusually large mortality from the so-called local diseases, and also an unusually large number of deaths from violent causes. The zymotic maladies produced only 54 deaths, the most fatal being hooping cough. This and small-pox are the only diseases of this class that exhibit unusual prevalence The mortality from small-pox is rising. The amount of sickness generally during the month has been moderate. Small-pox, however, is most decidedly on the increase. In the four weeks of January I recorded 10 cases as reported to me; in the four weeks of February, 14 cases; in the five weeks of March, 21 cases; and now, in the four weeks of April, I have to record 25 cases. The greater number, but not all, have been met with in the northern part of the parish. In two houses, one in the Upper Cottenham road and one in Campbell road, containing a large number of inhabitants, which were reported to me, nearly every person was attacked; and other instances (not counted into my table) have been brought to my knowledge in which whole families have been laid down with small-pox- It is said to have been brought into the parish by some navvies engaged upon one of the new railway lines; but whether this be true or not, I have been able to ascertain that houses occupied by navvies have 2 suffered severely. Against such a disease as this, our ordinary sanitary measures are nearly powerless; and we have no exceptional powers to meet special outbreaks of contagious disease,—activity on the part of the parochial vaccinators is what we must chiefly rely upon. I have hesitated in giving any directions at present respecting the closure and cleansing of the infected houses, in the dread of the convalescents communicating the disease in quarters yet free. This step must he delayed for the present. I am informed that there is a foolish prejudice against the Small-Pox Hospital on the part of some of the poorer classes. This is greatly to be regretted, inasmuch as nothing is more likely to promote recovery than removal to the admirably arranged wards of that Institution. The Board of Trustees have, at my request, issued printed hand-bills, respecting vaccination, through the districts affected. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, May 8th, 1865 TABLE I DEATHS REGISTERED IN ISLINGTON DURING THE FOUR WEEKS ENDING APRIL 29th, 1865. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S.D. Causes of Death. At all Ages. Under 20 years 01 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 80 years of age and upwards. 142 171 All Causes 313 156 40 51 58 8 28 44 3. Respirat. Orgs. 72 43 5 12 11 1 2 5 Laryngitis 7 7 .. .. .. .. (Classes.) 15 26 Bronchitis 41 21 4 5 10 1 .. .. Pleurisy .. .. .. .. .. .. 26 30 I. ZYMOTIC DIS 56 42 6 1 6 1 10 13 Pneumonia 23 15 1 6 1 .. 27 37 II. CONSTITUTL 64 22 20 15 7 .. 1 .. Asthma 1 .. .. 1 .. .. .. .. Lung Diseases, &c. .. .. .. .. .. .. 67 83 III. LOCAL 150 64 11 31 41 3 9 6 4. Digestive Orgs. 15 2 1 6 5 1 16 17 lV. DEVELOPMNL. 33 22 3 .. 4 4 1 .. Gastritis 1 .. .. 1 .. .. .. 1 Enteritis 1 .. .. .. 1 .. 6 4 V. VIOLENT DTHS. 10 6 .. 4 .. .. .. 1 Peritonitis 1 .. 1 .. .. .. .. Not Specified .. .. .. .. .. .. .. .. Ascites .. .. .. .. .. .. .. .. Ulceration of Intes. .. .. .. .. .. .. 1 .. Hernia 1 .. .. .. 1 .. (Orders.) 2 .. Ileus 2 1 .. .. 1 .. .. .. Intussusception .. .. .. .. .. .. 24 30 I. 1. Miasmatic Dis. 54 41 5 1 6 1 .. .. Stricture of Intest. .. .. .. .. .. .. 7 .. Small Pox 7 3 2 .. 2 .. .. .. Fistula .. .. .. .. .. .. 1 .. Measles 1 1 .. .. .. .. .. 1 Stomach Dis., &c. 1 1 .. .. .. .. 2 2 Scarlatina 4 4 .. .. .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. 1 2 Diphtheria 3 3 .. .. .. .. 1 .. Hepatitis 1 .. .. 1 .. .. .. 1 Quinsey 1 .. .. .. 1 .. .. .. Jaundice .. .. .. .. .. .. .. 1 Croup 1 1 .. .. .. .. 4 3 Liver Disease 7 .. .. 4 2 1 6 14 Hooping Cough 20 20 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 3 5 Typhus & Typhoid 8 4 1 1 1 1 1 2 5. Urinary Orgs. 3 .. 2 1 .. .. 1 .. Erysipelas 1 1 .. .. .. .. .. .. Nephritis .. .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. 2 Nephria 2 .. 1 1 .. .. .. .. Carbuncle .. .. .. .. .. .. 1 .. Diabetes 1 .. 1 .. .. .. .. .. Influnenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. Prostrate Diseases .. .. .. .. .. .. 2 4 Diarrhœa 6 4 .. .. 2 .. .. .. Kidney Disease,&c. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. 1 6. Genera. Organs 1 .. .. .. 1 .. .. .. Ague .. .. .. .. .. .. .. 1 Ovarian Dropsy 1 .. .. .. 1 .. 1 1 Rheumatism 2 .. 2 .. .. .. .. .. Uterine Diseases .. .. .. .. .. .. .. .. 2. Enthetic .. .. .. .. .. .. 2 .. 7. Orgs.of Locomo. 2 1 .. 1 .. .. .. .. Syphilis .. .. .. .. .. .. 1 .. Spine Diseases 1 1 .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. 1 .. Bone Diseases 1 .. .. 1 .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. 8. Skin, &c. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. .. .. 2 .. 3. Dietic 2 1 1 .. .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. .. .. Skin Diseases .. .. .. .. .. .. 1 .. Want of Br. Milk.. 1 1 .. .. .. .. 5 6 IV. 1. Dis. of Childn. 11 11 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 1 .. Alcoholism 1 .. 1 .. .. .. 4 5 Premature Birth 9 9 .. .. .. .. .. .. 4. Parasitic .. .. .. .. .. .. .. .. Cyanosis .. 1 .. .. .. .. .. .. Thrush .. .. .. .. .. .. 1 .. Spina Bifida 1 1 .. .. .. .. .. .. Worms .. .. .. .. .. .. .. 1 Other Malformation 1 .. .. .. .. .. .. .. Teething .. .. .. .. .. .. 3 4 II. 1. Diathetic 7 .. 1 2 4 .. 1 2 2. Dis. of Adults 3 .. 3 .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. Dropsy .. .. .. .. .. .. 1 2 Child birth 3 .. 3 .. .. .. 1 .. Hæmorrhage 1 .. .. 1 .. .. 5 3 3. Dis. of Aged 8 .. .. .. 4 4 2 4 Cancer 6 .. 1 1 4 .. 5 3 Old Age 8 .. .. .. 4 4 .. .. Noma .. .. .. .. .. .. 5 6 4. Dis. of Nutritn. 11 11 .. .. .. .. .. .. Mortification .. .. .. .. .. .. 5 6 atrophy & Debility 11 11 .. .. .. .. 24 33 2. Tubercular 57 22 19 13 3 .. 4 3 V. 1. Acci. or Neg. .. 4 .. 3 .. .. .. .. Scrolula .. .. .. .. .. .. 1 2 Tabes Mesenterica 3 3 .. .. .. .. 2 .. Fract. and Contus. 2 .. .. 2 .. .. 20 28 Phthisis 48 13 19 13 3 .. .. .. Wounds .. .. .. .. .. .. 3 3 Hydrocephalus 6 6 .. .. .. .. .. .. Burns and Scalds .. .. .. .. 1 .. .. .. Poison .. .. .. .. .. .. 20 16 III. 1. Nervous Syst. 36 17 1 3 14 1 .. .. Drowning .. .. .. .. .. .. 5 1 Cephalitis 6 6 .. .. .. .. 2 3 Suffocation 5 4 .. 1 .. .. 5 2 Apoplexy 7 1 1 1 4 .. .. .. Otherwise .. .. .. .. .. .. 4 4 Paralysis 8 .. .. .. 7 1 2 .. 2. Homicide 2 2 .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. 1 3. Suicide 1 .. .. 1 .. .. .. .. Chorea .. .. .. .. .. .. .. 1 Wounds 1 .. .. 1 .. .. .. 1 Epilepsy 1 .. .. 1 .. .. .. .. Poison .. .. .. .. .. .. 5 4 Convulsions 9 9 .. .. .. .. .. .. Drowning .. .. .. .. .. .. 1 4 Brain Diseases, &c. 5 1 .. 1 3 .. .. .. Suffocat. and Hang. .. .. .. .. .. .. 7 14 2. Organs of Circ 21 1 2 8 10 .. .. .. Otherwise .. .. .. .. .. .. .. 2 Pericarditis 2 .. .. 2 .. .. .. .. 4. Unclassed .. .. .. .. .. .. 1 .. Aneurism .. .. .. .. .. .. 7 12 Heart Disease 19 1 2 6 10 .. TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 29TH DAY OF APRIL, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 19 5 .. 1 25 Chicken Fox .. .. 5 2 .. .. 7 Measles .. .. 5 .. .. .. 5 Scarlatina .. .. 5 5 1 .. 11 hooping Cough .. .. 20 11 5 .. 36 Croup .. .. 1 1 1 .. 3 Diarrhœa 1 .. 25 10 3 1 40 Dysentery .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. Ague .. .. 2 .. .. .. 2 Continued Fever 2 .. 1 7 .. .. 10 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever 1 .. 1 9 1 .. 12 Erysipelas .. .. 2 1 .. .. 3 Diphtheria .. .. .. 1 .. .. 1 Sore throat or Tonsillitis .. .. 25 19 10 .. 54 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 12 .. 223 125 58 20 433 Pneumonia .. .. .. 2 .. .. 2 Pleurisy .. .. 5 3 2 .. 10 Delirium Tremens .. .. 2 .. .. .. 2 Insanity 3 .. 3 .. .. .. 6 Carbuncle .. .. 1 1 .. .. 2 All other Diseases 49 12 452 491 500 93 1597 Total 68 12 798 693 581 115 2267 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From April 2nd, 1865, to April 29th, 1865. West SubDistrict. East SubDistrict. Whole Parish. Number of houses inspected 69 52 121 Drains Constructed 12 4 16 Improved or repaired 28 26 54 Traps fixed 22 26 48 Cesspools Abolished .. .. .. Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 2 1 3 Pan and trap only furnished 1 .. 1 Water supply furnished 8 23 31 Dust bins Constructed 4 7 11 Repaired and covers adapted 11 18 29 Surface Drains and Pavements of Yards Constructed .. .. .. Relaid 22 19 41 General Water Supply New receptacle provided .. .. .. Receptacle repaired and cleansed 10 7 17 Water supply provided 2 8 10 Other Improvements Houses generally repaired 1 11 12 „ cleansed or limewashed 4 38 42 „ ventilated 1 .. 1 Overcrowding abated 6 2 8 Illegal use of underground Rooms for sleeping discontinued 2 .. 2 63 REPORT on THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR MAY, 1865. No. XCVIII. The registered mortality of the four weeks of May has been 272, a diminution of 41 upon the mortality of April. The corrected mean mortality of nine years being 263, it follows that we have had nine deaths only above the average. The deaths from the tubercular class of diseases, especially consumption, have been unusually numerous. The only epidemic diseases in excess appear to be hooping cough and smallpox. The new cases of hooping cough have risen from 36 to 66, and the deaths have been the same number as in April. Of small-pox 22 cases have been registered, and four deaths—twelve of the 19 cases' attended by the Parochial Surgeon occurred in Upper Holloway. There has been a slight increase in the number of cases of scarlet fever and diarrhoea. Two deaths were registered within a week of one another as occurring from "cerebro spinal nemingitis." This being the designation of a disease now epidemic on the continent, I think it right to mention the fact, although I lay no great stress upon it. In neither case was the diagnosis verified by post mortem examination; but the account of the illness as given me by the medical gentlemen in attendance shows that the cases were of an unusual character, and my enquiry into their nature was evidently anticipated. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, June 8th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING THE FOUR WEEKS ENDING MAY 27th, 1805. (Deaths of Non-Residents in Hospitals excluded.) West S.D. East S. D. Causes of Death. At all Ages. Under 20 years 01 age. At 20 and under 40 years of age. At 40 ana 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 80 years of age 142 130 All Causes 272 113 52 45 51 11 20 13 3. Respirat. Orgs 33 11 1 7 11 ??? .. 1 Laryngitis 1 1 .. .. .. ??? (Classes.) 16 8 Bronchitis 24 7 1 5 8 ??? .. 1 Pleurisy 1 .. .. ..1 .. ??? 26 35 I. ZYMOTIC DIS 61 41 7 6 7 .. 4 2 Pneumonia 6 3 .. 1 2 ??? 35 43 II. CONSTITUTL 78 26 30 19 3 .. .. 1 Asthma 1 .. .. .. 1 ??? .. .. Lung Diseases, &c. .. .. .. .. .. ??? 57 40 III. LOCAL 97 31 11 18 31 6 6 10 4. Digestive Orgs. 16 4 4 5 2 ??? 19 9 IV. DEVELOPMNL. 28 13 1 .. 10 4 .. 1 Gastritis 1 1 .. .. .. ??? 1 1 Enteritis 2 1 .. 1 .. ??? 4 3 V. VIOLENT DTHS. 7 2 2 2 .. 1 2 .. Peritonitis 2 .. 2 .. .. ??? .. .. Ascites .. .. .. .. .. ??? 1 .. Not Specified 1 .. 1 .. .. .. .. .. Ulceration of Intes. .. .. .. .. .. ??? .. Ilernia .. .. .. .. .. ??? (Orders.) .. .. 1 .. Ileus 1 1 .. .. .. ??? .. .. Intussusception .. .. .. .. .. ??? 23 33 I. 1. Miasmatic Dis. 56 38 7 4 7 .. .. .. Stricture of Intest. .. .. .. .. .. ??? 4 .. Small Fox 4 1 2 1 .. .. .. .. Fistula .. .. .. .. .. ??? 1 .. Measles 1 1 .. .. .. .. .. 2 Stomach Dis., &c. 2 .. .. 1 1 ??? 2 4 Scarlatina 6 6 .. .. .. .. .. .. pancreas Dis., &c .. .. .. .. .. ??? 1 1 Diphtheria 2 2 .. .. .. .. 1 1 Hepatitis 2 .. 1 .. 1 ??? .. .. Quinsey .. .. .. .. 1 .. .. 1 Jaundice 1 .. .. .. .. ??? 1 4 Croup 5 5 .. .. .. .. 1 4 Liver Disease 5 .. 1 3 .. ??? 7 13 Hooping Cough 20 20 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. ??? 3 3 Typhus & Typhoid 6 1 2 2 1 .. 1 1 5. Urinary Orgs. 2 .. .. 1 1 ??? 2 1 Erysipelas 3 .. .. .. 3 .. .. .. Nephritis .. .. .. .. .. ??? .. .. Pyæmia .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. ??? 2 .. Puerperal Fever 2 .. 2 .. .. .. .. .. Nephria .. .. .. .. .. ??? .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. ??? .. .. Influenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. ??? .. .. Dysentery .. .. .. .. .. .. 1 .. Prostrate Disease . 1 .. .. 1 .. ??? .. 3 Diarrhœa 3 1 .. .. 2 .. .. 1 Kidney Disease,&c. 1 .. .. .. 1 ??? .. .. Cholera .. .. .. .. .. .. .. .. 6. Genera. Organs .. .. .. .. .. ??? .. 1 Ague 1 .. .. .. 1 .. .. .. Ovarian Dropsy .. .. .. .. .. ??? .. 3 Rheumatism 3 1 1 1 .. .. .. .. Uterine Diseases .. .. .. .. .. ??? 1 2 2. Enthetic 3 2 .. 1 .. .. 1 .. 7. Orgs.of Locomo. 1 1 .. .. .. ??? .. 2 Syphilis 2 2 .. .. .. .. 1 .. Spine Diseases 1 1 .. .. .. ??? 1 .. Stricture of Urethra 1 .. .. ..1 .. .. .. .. Bone Diseases .. .. .. .. .. ??? .. .. Hydrophobia .. .. .. .. .. .. .. .. 8. Skin, &c. .. .. .. .. .. ??? .. .. Glanders .. .. .. .. .. .. .. .. Phlegmon .. .. .. .. .. ??? 2 .. 3. Dietis 2 1 1 .. .. .. .. .. Ulcer .. .. .. .. .. ??? .. .. Privation .. .. .. .. .. .. .. .. Skin Diseases .. .. .. .. .. ??? 1 .. Want of Br. Milk.. 1 1 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 4 1 IV. 1. Dis. of Childu. 5 5 .. .. .. ??? 1 .. Alcoholism 1 .. .. 1 .. .. 3 .. Premature Birth 3 3 .. .. .. ??? .. .. 4. Parasitic .. .. .. .. .. .. .. .. Cyanosis .. .. .. .. .. ??? .. .. Thrush .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. ??? .. .. Worms .. .. .. .. .. .. .. 1 Other Malformation 1 1 .. .. .. ??? 3 4 II. 1. Diathetic 7 .. .. 4 8 .. 1 .. Teething 1 1 .. .. .. ??? 1 .. 2. Dis. of Adults . 1 .. 1 .. .. ??? .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. ??? .. .. Dropsy .. .. .. .. .. .. 1 .. Childbirth 1 .. 1 .. .. ??? .. .. Hæmorrhage .. .. .. .. .. .. 10 4 3. Dis. of Aged 14 .. .. .. 10 ??? 3 4 Cancer 7 .. .. 4 3 .. 10 4 Old Age 14 .. .. .. 10 ??? .. .. Noma .. .. .. .. .. .. 4 4 4. Dis. of Nutritn. 8 8 .. .. .. ??? .. .. Mortification .. .. .. .. .. .. 4 4 Atrophy & Debility 8 8 .. .. .. ??? 32 39 2. Tubercular 71 26 30 15 .. .. 2 3 V. 1. Acci.or Neg. 5 2 .. 2 .. ??? 3 1 Scrolula 4 4 .. .. .. .. 1 5 Tabes Mesenterica 6 6 .. .. .. .. 1 2 Fract. and Contus. 3 .. .. 2 .. ??? 21 27 Phthisis 51 6 30 15 .. .. .. .. Wounds .. .. .. .. .. ??? 4 6 Hydrocephalus 10 10 .. .. .. .. 1 .. Burns and Scalds 1 1 .. .. .. ??? .. .. Poison .. .. .. .. .. ??? 20 10 III. 1.Nervous Syst 30 13 3 2 10 2 .. 1 Drowning 1 1 .. .. .. ??? 4 1 Cephalitis 5 4 .. .. 1 .. .. .. Suffocation .. .. .. .. .. ??? 4 3 Apoplexy 7 .. .. .. 6 1 .. .. Otherwise .. .. .. .. .. ??? 3 2 Paralysis 5 .. .. 2 2 1 1 .. 2. Homicide 1 .. 1 .. .. ??? .. .. Insanity .. .. .. .. .. .. 1 .. 3. Suicide 1 .. 1 .. .. ??? .. .. Chorea .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. ??? 2 .. Epilespy 2 .. 2 .. .. .. 1 .. Poison 1 .. 1 .. .. ??? 2 3 Convulsions 5 5 .. .. .. .. .. .. Drowning .. .. .. .. .. ??? 5 1 Brain Diseases &c 6 4 1 .. 1 .. .. .. Suffocat. and Hang. .. .. .. .. .. ??? 9 6 2. Organs of Circ. 15 2 3 3 7 .. .. .. Otherwise .. .. .. .. .. ??? l .. Pericarditis 1 1 .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. ??? .. .. Aneurism .. .. .. .. .. .. 8 6 Heart Disease 14 1 3 8 7 .. TABLE II. NSW CASES OP DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 27th DAY OF MAY, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Fox .. .. 19 2 1 .. 22 Chicken Pox .. .. 8 .. .. .. 8 Measles .. .. 7 2 .. .. 9 Scarlatina .. .. 8 7 2 .. 17 Whooping Cough 1 2 38 18 7 .. 66 Croup .. .. .. 2 .. .. 2 Diarrhœa 1 .. 29 23 7 2 62 Dysentery .. .. 1 1 .. .. 2 Cholera .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. Continued Fever 1 .. 2 12 1 .. 16 Puerperal Fever .. .. .. .. .. .. 8 Rheumatic Fever .. .. 2 5 1 .. Erysipelas 1 .. 6 1 2 .. 10 Diphtheria .. .. .. 1 .. .. 1 Sore throat or Tonsillitis .. .. 13 17 9 .. 39 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 5 .. 128 65 41 14 253 Pneumonia .. .. 1 2 3 .. 6 Pleurisy .. .. 7 5 1 .. 13 Delirium Tremens 5 .. 1 .. .. .. 6 Insanity 2 .. 7 .. .. .. 9 Carbuncle .. .. .. .. 1 .. 1 All other Diseases 33 11 458 491 521 76 1590 Total 49 13 736 654 597 92 2141 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From April 30th, 1865, to May 27th, 1865. West SubDistrict. East SubDistrict. Whole Parish. Number of houses inspected 54 49 103 Drains Constructed 5 2 7 Improved or repaired 10 17 27 Traps fixed 13 24 37 Cesspools Abolished 1 .. 1 Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 7 .. 7 Pan and trap only furnished .. .. .. Water supply furnished 38 23 61 Dust bins Constructed 14 17 31 Repaired and covers adapted 6 12 18 Surface Drains and Pavements of Yards Constructed .. 5 5 Relaid 15 22 37 General Water Supply New receptacle provided 8 .. 8 Receptacle repaired and cleansed 9 16 25 Water supply provided 5 .. 5 Other Improvements Houses generally repaired 1 .. 1 ,, cleansed or limewashed 12 43 60 ,, ventilated .. .. .. Overcrowding abated 3 2 5 Illegal use of underground Rooms for sleepin discontinued 3 .. 3 64 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR JUNE, 1865. No. XCIX. The unusually early summer heats that we have experienced have assimilated our mortality for June to that usually met with a month later. The registered deaths have amounted, during the five weeks, to 367, a number which is 63 in excess of the mean mortality of the corresponding weeks for nine years past, corrected for increased population. The excess is made up principally by small-pox, from which seven deaths were registered; hooping cough, from which 26 deaths (an exceedingly high number) were registered; and bowel complaints, from which 48 deaths were registered. The deaths registered under the head "Diseases of the Nervous System" have been as high as they were in June last year. The general sickness among the poor, when the difference of the number of weeks included is allowed for, has not been very much larger than in May, but the character of the prevailing sickness is such as to have been unusually fatal, especially diarrhoea and hooping cough to young children. Forty of the deaths from bowel complaints were of infants in their first year of life. Such infants as are fed artificially during hot seasons, and who are injudiciously weaned at such times, are the first to suffer from summer diarrhoea, and are those most likelv to 2 die when attacked with it. I have mentioned this fact before; but I mention it again, because there are so few mothers who are alive to the danger of weaning their infants in hot weather, when diarrhoea prevails, and because those who visit among the poor may have the opportunity, by a word in season, of saving many infant lives. Small-pox prevails to some extent among those unprotected by vaccination, in most parts of the parish. There is very much more of it among us than there was at this time last year. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, July 10th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING THE FIVE WEEKS ENDING JULY 1st, 1865. (Deaths of Non - Residents in Hospitals excluded.) west S.D. East S. D. Causes of Death At all Ages. Under 20 years 01 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 80 years of age and upwards. 185 182 All Causes 367 219 43 40 56 9 17 20 3. Respirat. Orgs 37 17 1 8 10 1 .. 1 Laryngitis 1 1 .. .. .. .. (Classes.) 11 12 Bronchitis 23 9 1 4 9 .. 1 .. Pleurisy 1 1 .. .. .. .. 64 56 I. ZYMOTIC DIS. 120 105 7 2 6 .. 4 6 Pneumonia 10 6 .. 2 1 1 38 37 II. CONSTITUTL 75 32 23 7 12 1 .. .. Asthma .. .. .. .. .. .. 1 1 Lung Diseases, &c. 2 .. .. 2 .. .. 62 62 III. LOCAL 124 50 9 29 32 4 7 7 4. Digestive Orgs. 14 5 2 4 3 .. 19 24 IV. DEVELOPMNL. 43 31 2 1 5 4 .. 1 Gastritis 1 1 .. .. .. .. 1 3 Enteritis 4 4 .. .. .. .. 2 3 V. VIOLENT DTHS. 5 1 2 1 1 .. 1 .. Peritonitis 1 .. 1 .. .. .. .. .... Ascites .. .. .. .. .. .. .. .. Not Specified .. .. .. .. .. .. .. .. Ulceration of Intes. .. .. .. .. .. .... .. .. Hernia .. .. .. .. .. .. (Orders.) .. .. Ileus .. .. .. .. .. .. .. .. Intussusception .. .. .. .. .. .. 60 54 I. 1. Miasmatic Dis. 114 101 6 2 5 .. .. .. Stricture of Intest. .. .. .. .. .. .. 5 2 Small Pox 7 5 2 .. .. .. .. .. Fistula .. .. .. .. .. .. 2 .. Measles 2 2 .. .. .. .. 2 1 Stomach Dis., &c. 3 .. 1 .. 2 .. 6 5 Scarlatina 11 11 .. .. .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. 1 2 Diphtheria 3 3 .. .. .. .. .. .. Hepatiis .. .. .. .. .. .. .. .. Quinsey .. .. .. .. .. .. .. .. Jaundice .. .. .. .. .. .. .. 2 Croup 2 2 .. .. .. .. 3 2 Liver Disease 5 .. .. 4 1 .. 13 13 Hooping Cough 26 26 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 6 4 Typhus & Typhoid 10 6 3 .. 1 .. 3 1 5. Urinary Orgs. 4 .. 1 2 1 .. 2 1 Erysipelas 3 2 .. .. 1 .. 1 .. Nephritis 1 .. 1 .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. 1 1 Puerperal Fever 2 1 .. 1 .. .. 1 .. Nephria 1 .. .. 1 .. .. .. .. Carbuncle .. .. .. .. .. .. .. 1 Diabetes 1 .. .. 1 .. .. .. .. Influenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. 1 .. Prostrate Disease 1 .. .. .. 1 .. 24 22 Diarrhœa 46 42 .. 1 3 .. .. .. Kidney Disease,&c. .. .. .. .. .. .. .. 2 Cholera 2 1 1 .. .. .. 1 3 6. Genera. Organs 4 .. .. 1 3 .. .. .. Ague .. .. .. .. .. .. 1 2 Ovarian Dropsy 3 .. .. .. 3 .. .. .. Rheumatism .. .. .. .. .. .. .. 1 Uterine Diseases 1 .. .. 1 .. .. 2 1 2. Enthetic 3 2 1 .. .. .. .. 1 7. Orgs.of Locomo. 1 .. .. .. 1 .. 2 1 Syphilis 3 2 1 .. .. .. .. 1 Spine Diseases 1 .. .. .. 1 .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Bone Diseases .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. 2 1 8. Skin, &c 3 2 .. 1 .. .. .. .. Glanders .. .. .. .. .. .. .. 1 Phlegmon & Abran 1 .. .. 1 .. .. 2 1 3. Dietic 3 2 .. .. 1 .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. 2 .. Skin Diseases 2 2 .. .. .. .. 2 .. Want of Br. Milk.. 2 2 .. .. .. .. 3 5 IV. 1. Dis. of Childn. 8 8 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. .. 1 Alcoholism 1 .. .. .. 1 .. 3 4 Premature Birth 7 7 .. .. .. .. .. .. 4. Parasitic .. .. .. .. .. .. .. 1 Cyanosis 1 1 .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. Other Malformation .. .. .. .. .. .. .. .. teething .. .. .. .. .. .. 8 6 II. 1. Diathetic 14 .. 1 3 9 1 .. 3 2. Dis. of Adults . 3 .. 2 1 .. .. .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. 1 1 Dropsy 2 .. .. .. 1 1 .. 3 Childbirth 3 .. 2 1 .. .. .. .. hæmorrhage .. .. .. .. .. .. 5 4 3. Dis. of Aged 9 .. .. .. 5 4 5 4 Cancer 9 .. 1 3 5 .. 5 4 Old Age 9 .. .. .. 5 4 .. .. Noma .. .. .. .. .. .. 11 12 4. Dis. of Nutritn. 23 23 .. .. .. .. 2 1 Mortification 3 .. .. .. ..3 .. 11 12 Atrophy & Debility 23 22 .. .. .. .. 30 31 2. Tubercular 61 32 22 4 3 .. 2 2 V. 1. Acci.or Neg. 4 1 1 1 1 .. 1 2 Scrofula 3 3 .. .. .. .. 2 6 Tabes Mesenterica 8 8 .. .. .. .. 1 1 Fract. and Contus. 2 .. .. 1 1 .. 18 18 Phthisis 36 7 22 4 3 .. 1 .. Wounds 1 .. 1 .. .. .. 9 5 Hydrocephalus 14 14 .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. 22 23 III. 1. Nervous Syst. 45 24 4 5 9 3 .. 1 Drowning 1 1 .. .. .. .. 2 2 Cephalitis 4 3 .. .. 1 .. .. .. Suffocation .. .. .. .. .. .. 3 1 Apoplexy 4 .. .. 2 2 .. .. .. Otherwise .. .. .. .. .. .. 3 5 Paralysis 8 1 .. .. ..5 2 .. .. 2, Homicide .. .. .. .. .. .. .. .. Insanity .. .. .. .. .. .. .. 1 3. Suicide 1 .. 1 .. .. .. .. .. Chorea .. .. .. .. .. .. .. 1 Wounds 1 .. 1 .. .. .. 5 .. Epilepsy 5 2 2 1 .. .. .. .. Poison .. .. .. .. .. .. 5 10 Convulsions 15 15 .. .. .. .. .. .. Drowning .. .. .. .. .. 4 5 Brain Diseases, Sec. 9 3 2 2 1 1 .. .. Suffocat. and Hang. .. .. .. .. .. .. 10 6 2. Organs of Circ. 16 2 1 8 5 .. .. .. Otherwise .. .. .. .. .. .. .. .. Pericarditis .. .. .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. 10 6 Heart Disease 16 2 1 8 5 .. TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From May 28th, 1865, to July 1st, 1865. West SubDistrict. East SubDistrict. Whole Parish. Number of houses inspected 37 56 93 Drains Constructed 5 12 17 Improved or repaired 12 11 23 Traps fixed 12 12 24 Cesspools Abolished 1 .. 1 Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 1 5 6 Pan and trap only furnished .. .. .. Water supply furnished 5 12 17 Dust bins Constructed 1 10 11 Repaired and covers adapted .. 4 4 Surface Drains and Pavements of Yards Constructed .. 5 5 Relaid 15 11 26 General Water Supply New receptacle provided .. 6 6 Receptacle repaired and cleansed 4 7 11 Water supply provided .. 2 2 Other Improvements Houses generally repaired 1 .. 1 ,, cleansed or limewashed 16 16 32 ,, ventilated 4 .. 4 Overerowding abated 2 .. 10 Illegal use of underground Rooms for sleep in discontinued 1 2 3 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 1ST DAY OF JULY, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 8 9 5 1 23 Chicken Pox .. .. 11 2 1 .. 14 Measles .. .. 5 6 1 .. 12 Scarlatina .. .. 25 7 5 .. 37 Whooping Cough 1 1 47 43 14 .. 106 Croup .. .. .. 1 .. .. 1 Diarrhœa 1 .. 125 58 40 5 229 Dysentery .. .. 1 .. .. .. 1 Cholera .. .. .. .. .. .. .. Ague .. .. 1 2 .. .. 3 Continued Fever .. .. 11 9 .. .. 20 Puerperal Fever 1 .. .. .. .. .. 1 Rheumatic Fever .. .. 3 6 1 .. 10 Erysipelas .. .. 7 3 4 .. 14 Diphtheria .. .. 1 .. .. .. 1 Sorethroat or Tonsillitis .. .. 15 20 9 1 45 Mumps .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 7 .. 136 46 50 10 249 Pneumonia .. .. .. 1 8 .. 9 Pleurisy .. .. 5 .. 3 .. 8 Delirium Tremens 2 .. .. .. .. .. 2 Insanity 5 .. 8 1 .. .. 14 Carbuncle .. .. 1 .. .. .. 1 All other Diseases 37 20 591 607 619 83 1957 Total 54 21 1001 821 760 100 2757 65 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR JULY, 1865. No. C. The past month has again been characterised by an unusually high mortality. The registered deaths amounted to 329, a number which is 46 above what it would have been had the customary mortality of July taken place. The excess is more than accounted for by the deaths from diarrhoea, &c., amounting together to 94. The corrected mean of the previous nine years for the corresponding weeks is 40. The highest number I have hitherto recorded in July was 55 in 1859. The weekly cases of bowel complaint returned by the Parochial Medical Officers and the Islington Dispensary were 68,74,57, and 65. It is to be hoped, that while the Inspectors appointed by the Vestry are striving to put the houses inhabited by the poor into a good sanitary condition this summer, householders, where it is presumed their visits are unnecessary, will themselves look to the general cleanliness of their houses, that their cisterns and water butts are thoroughly cleansed, that their house drains are flushed, by receiving all available water through them at intervals of a few days, that the inlets of their drains are trapped, and that no accumulations of rubbish or filth be permitted anywhere on their premises. The deaths from small-pox have risen from 23 in five weeks to 40 in four weeks. Most of these are of unvaccinated, and the rest of badlyvaccinated persons. The cases attended weekly by the Parochial Officers and the Islington Dispensary were 6, 17, 5, 5. The large number of new cases in the second week of the month is remarkable. 2 Since my last report, the outbreak of contagious disease amongst the dairy cows in this parish has taken place, and bids fair to extend throughout the kingdom. As soon as I heard of it, I took the proper measures to make myself acquainted with its nature, and communicated the result of my inquiries to the Sanitary Committee. As the Vestry have sanctioned the only proceeding which gives any prospect of success in checking the progress of the plague, it is needless that I should say more about it now. The sad consequences of a high price of meat during the coming winter, and of a deficiency of milk, can only be averted by the most strenuous efforts at checking the malady, and by the united exertions of the owners of stock and local authorities throughout the kingdom, who should act together, in a friendly spirit, for the attainment of a common object. EDWARD BALLARD, M.D., Medical Officer of Health' Vestry Offices, August 9th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JULY 29th, 1865. (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 80 years of age and upwards. 162 167 All Causes 329 231 31 31 30 6 9 13 3. Respirat. Orgs. 22 11 3 3 5 .. (Classes.) .. .. Laryngitis .. .. .. .. .. .. 7 7 Bronchitis 14 5 2 2 5 .. .. .. Pleurisy .. .. .. .. .. .. 86 70 I. ZYMOTIC DIS. 156 141 5 5 5 .. 2 5 Pneumonia 7 6 1 .. .. .. 20 29 II. CONSTITUTL 49 22 12 13 2 .. .. .. Asthma .. .. .. .. .. .. .. 1 Lung Diseases, &c. 1 .. .. 1 .. .. 36 44 III. LOCAL 80 35 13 11 19 2 8 12 4. Digestive Orgs. 20 8 2 4 5 1 17 21 IV. DEVELOPMNL. 38 29 .. 1 4 4 .. .. Gastritis .. .. .. .. .. .. 4 Enteritis 4 3 1 .. .. .. 3 3 V. VIOLENT DTHS. 6 4 1 1 .. .. .. .. Peritonitis .. .. .. .. .. .. .. .. Not Specified .. .. .. .. .. .. 1 .. Ascites 1 .. .. .. l .. .. 1 Ulceration of Intes. 1 1 .. .. .. .. (Orders.) .. .. Hernia .. .. .. .. .. .. .. 1 Ileus 1 .. .. .. 1 .. .. 1 Intussusception 1 1 .. .. .. .. 78 67 I. 1. Miasmatic Dis. 145 132 4 4 5 .. 1 .. Stricture of Intest. 1 .. .. 1 .. .. 7 .. Small pox 7 4 3 .. .. .. .. .. Fistula .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. 2 1 Stomach Dis., &c. 3 1 .. .. 1 1 5 7 Scarlatina 12 9 1 2 .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. 2 1 Diphtheria 3 3 .. .. .. .. .. .. Hepatitis .. .. .. .. .. .. .. .. Quinsey .. .. .. .. .. .. .. 1 Jaundice 1 1 .. .. .. .. .. 2 Croup 2 2 .. .. .. .. 4 3 Liver Disease 7 1 1 3 2 .. 4 14 Hooping Cough 18 18 .. .. .. .. .. .. Spleen disease .. .. .. .. .. .. 4 3 Typhus & Typhoid 7 6 .. .. 1 .. 2 4 5. Urinary Orgs. 6 1 2 .. 3 .. 1 .. Erysipelas 1 1 .. .. .. .. .. .. Nephritis .. .. .. .. .. .. .. .. Pyœmia .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. 2 3 Nephria 5 1 2 .. 2 .. .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Infulenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. 1 Prostrate Disease 1 .. .. .. 1 .. 54 37 Dirrhœa 91 86 .. 2 3 .. .. .. Kidney Disease, &c. .. .. .. .. .. .. .. 3 Cholera 3 2 .. .. 1 .. .. 1 6. Genera. Organs 1 .. .. .. 1 .. .. .. Ague .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 1 .. Rheumatiam 1 1 .. .. .. .. .. 1 Uterine Disease 1 .. .. .. 1 .. 1 .. 2. Enthetic 1 1 .. .. .. .. 1 2 7. Orgs.of Locomo. 3 1 2 .. .. .. 1 .. Syphilis 1 1 .. .. .. .. 1 .. Spine Diseases l 1 .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. 2 Bone Diseases 2 .. 2 .. .. .. .. .. Hydrophobia .. .. .. .. .. .. 1 .. 8. Skin, &c. 1 1 .. .. .. .. .. .. Glanders .. .. .. .. .. .. 1 .. Phlegmon & Abran 1 1 .. .. .. .. 6 l 3. Dietic 7 5 1 1 .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. .. .. Skin Disease .. .. .. .. .. .. 5 .. Want of Br. Milk 5 5 .. .. .. .. 4 5 IV. 1 Dis. of Childn. 9 9 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 1 1 Alcoholism 2 .. l 1 .. .. 4 3 Premature Birth 7 7 .. .. .. .. 1 2 4. Parasitic 3 3 .. .. .. .. .. 1 Cyanosis 1 1 .. .. .. .. 1 2 Thrush 3 3 .. .. .. .. .. 1 Spina Bifida 1 1 .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. Other Malformation .. .. .. .. .. .. 1 3 II. 1. Diathetic 4 .. .. 4 .. .. .. .. Teething .. .. .. .. .. .. .. .. 2. Dis. of Adults .. .. .. .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. Dropsy .. .. .. .. .. .. .. .. Childbirth .. .. .. .. .. .. .. .. Hæmorrhage .. .. .. .. .. .. 5 4 3. Dis. of Aged 9 .. .. l 4 4 1 3 Cancer 4 .. .. 4 .. .. 5 4 Old Age 9 .. .. I 4 4 .. .. Noma .. .. .. .. .. .. 8 12 4. Dis. of Nutritn. 20 20 .. .. .. .. .. .. Mortification .. .. 8 12 Atrophy & Debility 20 20 .. .. .. .. 19 26 2. Tubercular 45 22 12 9 2 .. 3 2 V. 1. Acci. or Neg. 5 4 .. 1 .. .. .. 3 Scrofula 3 3 .. .. .. .. 1 5 Tabes Mesenterica 6 6 .. .. .. .. Fraet, and Centus. .. .. .. .. .. .. 13 14 Phthisis 27 4 12 9 2 .. .. .. Wounds .. .. .. .. .. .. 5 4 Hydrocephalus 9 9 .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. 11 6 III. 1. Nervous Syst. 17 11 2 1 2 1 .. .. Poison .. .. .. .. .. .. .. .. Drowing .. .. .. .. .. .. 1 2 Cephalitis 3 3 .. .. .. .. .. .. Suffocation 4 4 .. .. .. .. 1 .. Apoplexy 1 .. .. 1 .. .. 2 2 Otherwise 1 .. .. 1 .. .. 2 .. Paralysis 2 .. .. .. 1 1 1 .. 2. Homicide .. .. .. .. .. .. 2 .. Chorea 2 1 1 .. .. .. .. .. 3. Suicide 1 .. 1 .. .. .. .. .. Chorea .. .. .. .. .. .. .. 1 Wounds .. .. .. .. .. .. 1 1 Epilepsy 2 .. 1 .. 1 .. .. .. Poison .. .. .. .. .. .. 4 3 Convulsions 7 7 .. .. .. .. .. .. Drowning 1 .. 1 .. .. .. .. .. Brain Diseases, &c. .. .. .. .. .. .. .. 1 Suffocat. and Hang. .. .. .. .. .. .. 4 6 2. Organs of Circ. 10 2 2 3 3 .. .. .. Otherwise .. .. .. .. .. .. .. l Pericarditis l l .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. .. .. 1 Aneurism 1 .. 1 .. .. .. .. .. 4 4 Heart Disease 8 1 1 3 3 .. TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 29th DAY OF JULY, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 28 7 5 .. 40 Chicken Pox .. .. 5 .. 2 .. 7 Measles .. .. 4 1 1 .. 6 Scarlatina .. .. 27 6 .. .. 39 Whooping Cough .. 2 22 16 7 .. 47 Croup .. .. 1 1 .. .. 2 Dearrhœa .. .. 220 115 42 .. 397 Dysentery .. .. 1 .. .. .. 1 Cholera .. .. 1 .. .. .. 1 Ague .. .. .. .. .. .. .. Continued Fever .. .. 6 15 1 .. 22 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. .. 5 1 .. 6 Erysipelas .. .. 5 6 2 .. 13 Diphtheria .. .. .. 1 .. .. 1 Sorethroat or Tonsillitis .. .. 17 17 9 .. 43 Mumps .. .. 2 .. .. .. 2 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 8 .. 79 19 22 20 143 Pneumonia .. .. .. 6 .. .. 6 Pleurisy .. .. 5 4 2 .. 11 Delirium Tremens 1 .. 1 .. .. .. 2 Insanity 6 .. 7 .. .. .. 13 Carbuncle .. .. .. 1 .. .. 1 All other Disease 41 7 475 499 500 117 1639 Total 65 9 906 719 600 148 2447 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From July 2nd, 1865, to July 29th, 1865. West SubDistrict. East SubDistrict. Total. Number of houses inspected .. .. ..* Constructed 3 3 6 Improved or repaired 9 11 20 Traps fixed 16 13 29 Abolished .. .. .. Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished .. .. .. Pan and trap only furnished 2 .. 2 Water supply furnished 13 11 24 Dust bins Constructed 2 3 5 Repaired and covers adapted 3 7 10 Surface Drains and Pavements of Yards Constructed 1 3 4 Relaid 5 4 9 General Water Supply New receptacle provided .. .. .. Receptacle repaired and cleansed 3 4 7 Water supply provided .. .. .. Other Improvements Houses generally repaired .. .. .. „ cleansed or limewashed .. 7 7 ,, ventilated .. .. .. Overcrowding abated 2 2 4 Illegal use of underground Rooms for sleeping discontinued 4 .. 4 * The Inspectors, since the close of the month, have been occupied entirely with work arising out of the New Cattle Disease, and hence this Table is very imperfect. The inspections made during July will be included in the Table for August. 66 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR AUGUST, 1865. No. CI. The reduction of temperature together with an increased rain fall has had a beneficial influence upon the public health of the district. The mortality has fallen from 329 in four weeks to 215. In fact, whereas the deaths during July were 46 above the average, those that have been registered during August have been 57 below the average. The deaths from diarrhoea, &c., have fallen suddenly,and from being 94 in July have amounted only to 28 during the past few weeks. Indeed the mortality from bowel complaints has been very much less than is usual in August. Altogether it has been with us a healthy month. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, September 8th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING AUGUST 26th, 1865, (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 80 years of age and upwards. 111 104 215 121 21 40 26 7 7 14 3. Respirat. Orgs. 21 10 2 4 4 1 (Classes.) .. .. Laryngitis .. .. .. .. .. .. 4 9 Bronchitis 13 5 1 3 3 1 .. .. Pleurisy .. .. .. .. .. .. 37 26 I. ZYMOTIC DIS. 63 54 1 3 5 .. 2 5 Pneumonia 7 5 1 1 .. .. 26 23 II. CONSTITUTL 49 19 10 18 1 1 1 .. Asthma .. .. .. .. 1 .. .. .. Lung Diseases, &c. .. .. .. .. .. .. 33 35 III. LOCAL 68 24 7 16 19 2 5 6 4- Digestive Orgs. 11 4 .. 4 2 1 11 14 IV. DEVELOPMNL. 25 19 .. 1 1 4 .. .. Gastritis .. .. .. .. .. .. l 1 Enteritis 2 2 .. .. .. .. 4 5 V. VIOLENT DTHS. 9 5 2 2 .. .. l .. Peritonitis l 1 .. .. .. .. .. 1 Not Specified 1 .. 1 .. .. .. .. 1 Ascites 1 .. .. l .. .. .. .. Ulceration of Intes. .. .. .. .. .. .. (Orders.) .. .. Hernia .. .. .. .. .. .. .. 1 Ileus 1 1 .. .. .. .. .. .. Intussusception .. .. .. .. .. .. 34 26 I. 1. Miasmatic Dis. 60 52 1 3 4 .. .. .. Stricture of Intest. .. .. .. .. .. .. 4 1 Small Pox 5 5 .. .. .. .. .. .. Fistula .. .. .. .. .. .. 3 .. Measles 3 3 .. .. .. .. 1 .. Stomach Dis., &c. 1 .. .. 1 .. .. 5 1 Scarlatina 6 6 .. .. .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. 2 1 Diphtheria 3 2 1 .. .. .. l .. Hepatitis l .. .. .. l .. .. .. Quinsey .. .. .. .. .. .. .. 1 Jaundice 1 .. .. .. .. 1 .. .. Croup .. .. .. .. .. .. l 2 Liver Disease 3 .. .. 2 1 .. 3 5 Hooping Cough 8 8 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 1 4 Typhus & Typhoid 5 4 .. 1 .. .. 2 1 5. Urinary Orgs. 3 1 .. 1 1 .. 1 .. Erysipelas 1 .. .. .. l .. .. .. Nephritis .. .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. 2 .. Nephria 2 .. .. 1 1 .. .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. 1 1 Dysentery 2 .. .. .. 2 .. .. .. Prostrate Disease .. .. .. .. .. .. 12 10 Diarrhœa 22 22 .. .. .. .. .. 1 Kidney Disease, &c. 1 1 .. .. .. .. 1 3 Cholera 4 2 .. 2 .. .. .. .. 6. Genera, Organs .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 1 .. Rheumatism 1 .. .. .. 1 .. .. .. Uterine Diseases .. .. .. .. .. .. 1 .. 2. Enthetic 1 1 .. .. .. .. .. 2 7. Orgs. of Locomo. 2 1 1 .. .. .. 1 .. Syphilis 1 1 .. .. .. .. .. 2 Spine Diseases 2 1 1 .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Bone Disease .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. 1 8. Skin, &c. 1 .. .. 1 .. .. .. .. Glanders .. .. .. .. .. .. .. 1 Phlegmon & Abscess 1 .. .. 1 .. .. 2 .. 3. Dietic 2 1 .. .. 1 .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. .. .. Skin Disease .. .. .. .. .. .. l .. Want of Br. Milk. l 1 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 5 3 IV. 1. Dis. of Childn. 8 8 .. .. .. .. l .. Alcoholism l .. .. .. 1 .. .. .. 4. Parasitic .. .. .. .. .. .. 5 3 Premature Birth 8 8 .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. Cyanosis .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. Spina Bfidis .. .. .. .. .. .. .. .. Other Malformation .. .. .. .. .. .. .. .. Teething .. .. .. .. .. .. 7 2 II. 1. Diathetic 9 .. 1 6 1 1 .. .. 2. Dis. of Adults .. .. .. .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. 1 .. Dropsy 1 .. .. .. .. 1 .. .. Childbirth .. .. .. .. .. .. .. .. Haemorrhage .. .. .. .. .. .. 2 3 3. Dis. of Aged 5 .. .. .. 1 4 6 2 Cancer 8 .. 1 6 1 .. 2 3 Old Age 5 .. .. .. 1 4 .. .. Noma. .. .. .. .. .. .. 4 8 4. Dis. of Nutritn. 12 11 .. 1 .. .. .. .. Mortification .. .. .. .. .. .. 4 8 Atrophy & Debility 12 11 .. 1 .. .. 19 21 2. Tubercular 40 19 9 12 .. .. .. .. Scrofula .. .. .. .. .. .. 3 4 V. 1. Acci. or Neg. 7 4 2 1 .. .. 1 6 Tabes Mesenterica 7 7 .. .. .. .. 16 12 Phthisis 28 7 9 12 .. .. 3 1 Fract. and Contus. 4 l 2 1 .. .. 2 3 Hydrocephalus 5 5 .. .. .. .. .. 1 Wounds 1 1 .. .. .. .. 12 7 III. 1. Nervous Syst. 19 6 2 2 9 .. .. .. Burns and Scalds .. .. .. .. .. .. Poison 1 1 .. .. .. .. .. 1 Drowing 1 1 .. .. .. .. 3 .. Cephalitis 3 2 1 .. .. .. .. 1 Suffocation .. .. .. .. .. .. 2 .. Apoplexy 2 .. 1 1 .. .. .. .. Otherwise .. .. .. .. .. .. 4 2 Paralysis 6 .. .. .. 6 .. .. .. 2. Homicide 1 1 .. .. .. .. .. .. Insanity .. .. .. .. .. .. 1 .. 3. Suicide 1 .. .. 1 .. .. .. .. Cholera .. .. .. .. .. .. .. 1 Wounds .. .. .. .. .. .. 1 .. Epilepsy 1 .. .. 1 .. .. .. .. Poison 1 .. .. 1 .. .. 2 2 Convulsions 4 4 .. .. .. .. .. 1 Drowing .. .. .. .. .. .. .. 3 Brain Diseases, &c. 3 .. .. .. 3 .. .. .. Suffocat, and Hang. .. .. .. .. .. .. 7 4 2. Organs of Circ. 11 2 2 4 3 .. .. .. Otherwise .. .. .. .. .. .. .. .. Pericarditis .. .. .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. .. .. 7 4 Heart Disease 11 2 2 4 3 .. TABLE II. New cases of disease coming under treatment during the four weeks ending saturday, the 26th day of august, 1865, at the following institutions:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox 1 .. 20 3 2 .. 26 Chicken Pox .. .. 5 2 .. .. 7 Measles .. .. 10 3 1 .. 14 Scarlatina .. .. 16 9 .. .. 25 Whooping Cough .. .. 28 23 5 .. 56 Croup .. .. .. 1 .. .. 1 Diarrhœa 6 .. 83 74 19 189 Dysentery .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. Ague .. .. 1 .. .. .. 1 Continued Fever .. .. 4 13 2 .. 19 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever 1 .. .. 2 2 .. 5 Erysipelas 1 .. 9 .. 4 .. 14 Diphtheria .. .. .. 2 .. .. 2 Sorethroat or Tonsillitis .. .. 8 12 11 .. 31 Mumps .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 2 .. 88 34 20 27 171 Pneumonia .. 1 4 1 1 .. 7 Pleurisy 1 .. 4 2 2 .. 9 Delirium Tremens .. .. 1 .. .. .. 1 Insanity 6 .. 5 1 .. .. 12 Carbuncle .. .. .. 1 .. .. 1 All other Diseases 29 8 371 490 441 129 1468 Total 47 9 657 673 510 163 2059 TABLE III, HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From July 30th, 1865, to August 26th, 1865. West SubDistrict. East SubDistrict. Total. Number of houses inspected 140 196 336* Drains Constructed 13 2 15 Improved or repaired 21 30 51 Traps fixed 20 34 54 Cesspools Abolished .. .. .. Cleansed or disinfected .. .. .. Privies and Water Closets Pan, trap, and water supply furnished .. .. .. Pan and trap only furnished 34 .. 34 Water supply furnished 3 27 30 Dust bins Constructed 8 4 12 Repaired and covers adapted 3 13 16 Surface Drains and Pavements of Yards Constructed .. 7 7 Relaid 31 14 45 General Water Supply New receptacle provided 6 2 8 Receptacle repaired and cleansed 2 11 13 Water supply provided .. .. .. Other Improvements Houses generally repaired .. 5 5 ,, cleansed or limewashed 4 17 21 ,, ventilated 1 .. 1 Overcrowding abated 3 2 5 Illegal use of underground Rooms for sleeping discontinued 9 .. 9 *These houses were inspected by Inspectors Durham and Mayes during the months of July and August. 67 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR SEPTEMBER, 1865. No. CII. The mortality of Islington during the five weeks ending the 30th of September was 306. The corrected mean mortality for September during the previous nine years amounts to 318. There were five deaths from small-pox, but with this exception the contagious diseases which commonly attack children have been much less fatal than usual at this season of the year. There were only 24 deaths from bowel complaints, a diminution of one-fifth in the weekly average of last month. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, October 9th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING SEPTEMBER 30th, 1865, (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 80 years of age and upwards. 166 140 All Causes 306 180 38 44 43 11 14 18 3. Respirat. Orgs. 32 19 2 1 9 1 (Classes.) 1 I Laryngitis 2 2 .. .. .. .. 9 9 Bronchitis 18 11 l .. 6 .. .. 1 Pleurisy 1 .. .. .. l .. 49 41 I. ZYMOTIC DIS. 90 78 3 5 4 .. 4 5 Pneumonia 9 6 l .. l 1 43 25 II. CONSTITUTL 68 23 19 21 5 .. .. 2 Asthma 2 .. .. 1 l .. 48 50 III. LOCAL 98 45 15 15 27 6 .. .. Lung Diseases, &c. .. .. .. .. .. .. 11 10 4 Digestive Orgs. 21 5 5 7 4 .. 2 17 IV DEVELOPMNL 39 28 .. 1 6 4 2 .. Gastritis 2 .. 1 1 .. .. 4 4 V. VIOLENT DTHS. 8 4 1 1 1 1 1 2 Enteritis 3 3 .. .. .. .. 1 .. Peritonitis 1 1 .. .. .. .. .... 3 Not Specified 3 2 .. 1 .. .. .. .. Ascites .. .. .. .. .. .. .. .. Ulceration of Intes. .. .. .. .. .. .. (Orders.) .... .. Hernia .. .. .. .. .. .. .. 1 Ileus 1 .. .. 1 .. .. 42 37 I. 1. Miasmatic Dis. 79 69 3 3 4 .. .. .. Intussusception .. .. .. .. .. .. .. .. Stricture of Intest. .. .. .. .. .. .. 3 2 Small Pox 5 5 .. .. .. .. 1 .. Fistula 1 .. l .. .. .. 2 .. Measles 2 2 .. .. .. .. 1 1 Stomach Dis., &c. 2 .. .. 1 1 .. 8 7 Scarlatina 15 14 .. 1 .. .. .. .. Pancreas Dis., &c. .. .. .. .. .. .. .. 3 Diphtheria 3 3 .. .. .. .. 1 2 Hepatitis 3 .. l 1 1 .. .. .. Quinsey .. .. .. .. .. .. 1 .. Jaundice 1 1 .. .. .. .. 2 2 Croup 4 4 .. .. .. .. 3 4 Liver Disease 7 .. 2 3 2 .. 7 5 Hooping Cough 12 12 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 5 2 Typhus & Typhoid 7 5 1 1 .. .. 1 3 5. Urinary Orgs. 4 .. .. .. 3 1 .. 2 Erysipelas 2 2 .. .. .. .. .. .. Nephritis .. .. .. .. .. .. 1 .. Pyaemia 1 1 .. .. .. .. 1 1 Disease of Bladder 2 .. .. .. 1 1 2 .. Puerperal Fever 2 .. 2 .. .. .. .. .. Nephria .. .. .. .. .. .. .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. 1 Stone 1 .. .. .. 1 .. .. .. Dysentery .. .. .. .. .. .. .. .. Prostrate Disease .. .. .. .. .. .. 11 13 Diarrhoea 24 20 .. 1 3 .. .. 1 Kidney Desease, &c. 1 .. .. .. 1 .. .. .. Cholera .. .. .. .. .. .. .. .. 6. Genera, Organs .. .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 1 1 Rheumatism 2 1 .. .. .. .. .. .. Uterine Diseases .. .. .. .. .. .. 2 1 2. Enthetic 3 3 .. .. .. .. 1 1 7. Orgs, of Locomo. 2 2 .. .. .. .. 2 1 Syphilis 3 3 .. .. .. .. .. 1 Spine Diseases 1 1 .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. 1 .. Bone Diseases 1 1 .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. 8. Skin, &c. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. Phlegmon & Abscess .. .. .. .. .. .. 4 2 3. Dietic 6 4 .. 2 .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. .. .. Skin .. .. .. .. .. .. 4 .. Want of Br. Milk 4 4 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 4 6 IV. 1. Dis. of Childn. 10 10 .. .. .. .. .. 2 Alcoholism 2 .. .. 2 .. .. 1 1 4. Parasitic 2 2 .. .. .. .. 4 4 Premature Birth 8 8 .. .. .. .. 1 1 Thrush 2 2 .. .. .. .. .. .. Cyanosis .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. .. Other Malformation .. .. .. .. .. .. 6 4 II. 1. Diathetic 10 .. .. 6 4 .. .. 2 Teething 2 2 .. .. .. .. .. .. Gout .. .. .. .. .. .. .. 1 2. Dis. of Adults . 1 .. .. 1 .. .. .. .. Dropsy .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. .. .. Hæmerrhage .. .. .. .. .. .. .. 1 Childbirth 1 .. .. 1 .. .. 5 4 Cancer 9 .. .. 6 3 .. 5 5 3. Dis. of Aged 10 .. .. .. 6 4 .. .. Noma .. .. .. .. .. .. 5 5 Old Age 10 .. .. .. 6 4 1 .. Mortification 1 .. .. .. 1 .. 13 5 4. Dis. of Nutritn. 18 18 .. .. .. .. 37 21 2. Tubercular 58 23 19 15 1 .. 13 5 . Atrophy & Debility 18 18 .. .. .. .. 3 .. Scrofula 3 3 .. .. .. .. 4 3 V. 1. Acci. or Neg. 7 4 1 1 .. 1 .. 6 Tabes Mesenterica 6 6 .. .. .. .. 1 2 Fract. and Contus. 3 .. 1 1 .. 1 30 13 Phthisis 43 8 19 15 1 .. .. .. Wounds .. .. .. .. .. .. 4 2 Hydrocephalus 6 6 .. .. .. .. 1 1 Burns and Scalds.. 2 2 .. .. .. .. 15 11 III. 1. Nervous Syst. 26 7 5 6 5 3 .. .. Poison .. .. .. .. .. .. .. .. Cephalitis .. .. .. .. .. .. .. .. Drowning .. .. .. .. .. .. 3 1 Apoplexy 4 .. .. 1 2 1 2 .. Suffocation 2 2 .. .. .. .. 5 4 Paralysis 9 .. 2 3 2 2 .. .. Otherwise .. .. .. .. .. .. .. 1 Insanity 1 .. 1 .. .. .. .. .. 2. Homicide .. .. .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. 1 3. Suicide 1 .. .. .. 1 .. 1 .. Epilepsy 1 .. 1 .. .. .. .. .. Wounds .. .. .. .. .. .. 4 3 Convulsions 7 7 .. .. .. .. .. .. Poison .. .. .. .. .. .. 2 2 Brain Diseases, &c. 4 .. 1 2 1 .. .. .. Drowning .. .. .. .. .. .. 6 7 2. Organs of Circ. 13 2 3 1 6 1 .. .. Suffocat. and Hang. .. .. .. .. .. .. .. 1 Otherwise 1 .. .. .. 1 .. 1 .. Pericarditis 1 1 .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. .. .. 1 Aneurism 1 .. .. .. 1 .. 5 6 Heart Disease 11 1 3 1 5 l TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 30th DAY OF SEPTEMBER, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 12 1 .. .. 13 Chicken Pox .. .. 4 2 .. .. 6 Measles .. .. 11 .. 1 .. 12 Scarlatina .. .. 15 27 5 .. 47 Whooping Cough .. .. 42 26 1 .. 69 Croup .. .. 2 .. .. .. 2 Diarrhœa 3 .. 118 63 22 8 214 Dysentery .. .. .. 1 .. .. 1 Cholera .. .. .. 1 .. .. 1 Ague .. .. .. .. .. .. .. Continued Fever .. .. 9 19 4 .. 32 Puerperal Fever .. .. .. 2 .. .. 2 Rheumatic Fever 2 .. .. 3 5 .. 10 Erysipelas .. .. 5 10 2 .. 17 Diphtheria .. .. 1 3 .. .. 4 Sorethroat or Tonsillitis .. .. 21 30 16 .. 67 Mumps .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 6 .. 113 42 35 .. 247 Pneumonia .. .. 5 .. 3 .. 8 Pleurisy .. .. 6 4 .. .. 10 Delirium Tremens 2 .. 4 1 .. .. 7 Insanity 4 .. 11 .. .. 1 16 Carbuncle .. .. .. .. .. .. .. All other Diseases 43 16 620 645 594 216 2134 Total 60 16 1029 880 683 246 2919 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From August 27th. 1865, to September 30th, 1865. West SubDistrict. East SubDistrict. Total. Number of houses inspected 113 131 244* Drains Constructed 13 4 17 Improved or repaired 21 24 27 48 55 Traps fixed 31 Abolished 1 .. 1 Cleansed or disinfected .. .. .. Privies and Water Pan, trap, and water supply furnished 4 2 6 Pan and trap only furnished 2 .. 2 Water supply furnished .. 13 13 Dust bins Constructed .. 6 6 Repaired and covers adapted 14 19 33 Surface Drains and Pavements of Yards Constructed .. 3 3 Relaid 13 18 31 General Water Supply New receptacle provided .. 1 1 Receptacle repaired and cleansed 12 11 23 Water supply provided .. .. .. Other Improvements Houses generally repaired .. 9 9 ,, cleansed or limewashed 17 19 36 ,, ventilated .. .. .. Overcrowding abated .. 2 2 Illegal use of underground Rooms for sleeping discontinued 4 .. 4 * In addition to these, 3130 houses have been visited by the Special Inspectors. 68 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR OCTOBER, 1865. No. C II. Our mortality during the four weeks of October has been excessive. The registered deaths amounted to 290—a number which is 33 above the corrected mean of nine years. When, however, the Mortuary Table is examined more closely, it becomes apparent that the excess is not occasioned by any increase of acute sickness in our population, but by the fact that an unusual number of persons, suffering from such chronic disorders as consumption, diseases of the liver, kidneys, &c., have died during the month, while a remarkably large number of deaths have taken place amongst infants prematurely born or constitutionally weak. Our Sickness Table also demonstrates, that notwithstanding the high mortality, the general health of the district, as measured by the cases of sickness, has been unusually good. There have been 14 deaths from diarrhoea, and two reputed deaths from cholera—one of an infant, and one of an old woman who had been ill for many months, and at last succumbed with choleraic symptoms. There is nothing unusual in this. It is observable that, although the deaths from diarrhoea were less than happened in September, they have been more numerous than is customary with us during October. Still diarrhoea prevailed to an equal extent in October, 1862. The cases recorded by the Parochial Officers, &c., have been lessening week by week, as is usual at this season of the year. At the same time, as something more than the mere shadow of the approaching epidemic has fallen upon one of our seaports, and as isolated outbreaks of undoubted cholera have occurred elsewhere, it behoves the sanitary authorities to remain on the alert. I append two Special Tables, which for the present I shall continue, as giving important information under the present circumstances. TABLE A. Shewing the Number of Cases of disease generally, and of Bowel Complaints particularly, recorded in the corresponding month for the last five years; and also the total of the deaths from all causes, and from Bowel Complaints. October. Total Sickness. Total Deaths. Diarrhœa. Dysentery. Cholera. Total. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1865 2275 290 164 14 — — — 2 164 16 1864 2370 216 70 8 2 1 — — 72 9 1863 2581 282 92 7 — — — 2 92 9 1862 2352 205 146 10 4 — — 1 150 10 1861 2382 223 94 6 7 — — — 101 6 1860 2030 215 87 9 1 — — — 88 9 TABLE B. Results of a Special Analysis of the Water supplied by the Metropolitan Water Companies during October, as made and published by the Metropolitan Association of Medical Officers of Health. Total solid matter per Imperial gallon. Losa by Ignition. Oxydisable Organic Matter. Hardness. Before Boiling. After Boiling. Thames Water Companies. grains. grains. grains. degrees. degrees. Grand Junction 17.0 0.85 0.64 13 4 West Middlesex 16.3 0.54 0.36 13 4 Southwark and Vauxhal 15.2 1.01 0.40 12 4 Chelsea 16.7 0.55 0.40 12 4 Lambeth 17.5 0.88 0.64 13 4 Other Companies. Kent 23.6 0.75 0.24 17 6 New River 16.9 0.56 0.16 12 3 East London 17.6 0.89 0.24 13 4 I must add, with respect to this analysis, that it relates to water as taken from the mains of the several companies. Water, in itself good, in many instances becomes unwholesome, and apt to promote diarrhœal and choleraic diseases, from negligence as to the cleanly condition of the butts and cisterns in which it is preserved. In some poor districts this is fearful to contemplate. It appears such an easy thing to cleanse the domestic water receptacles, and to provide them with a proper cover. In Water's Court the cistern for the supply of the whole court is uncovered, and situated over the filthy privies, for some weeks quite choked up. A few days ago we took out of this cistern what appeared to be a horribly dirty sweep's shirt, a portion of an old hat, some beastly clouts, &c. The sides of the tank were grown over also with vegetable matter of low organisation. The whole condition of the water is such as to render it highly dangerous to persons drinking it, should epidemic cholera arrive in the metropolis. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, November 6th, 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING OCTOBER 28th, 1865, (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 80 years of age and upwards. 164 126 90 164 44 37 36 9 28 17 3. Respirat. Orgs 45 31 3 3 8 .. (Classes.) 2 4 Laryngitis 6 .. .. .. .. .. 19 2 Brpmcjotos 21 14 2 1 4 .. .. .. Pleurisy .. .. .. .. .. .. 43 25 I. ZYMOTIC DIS. 68 56 6 3 3 .. 6 10 Pneumonia 16 12 1 1 2 .. 30 41 II. CONSTITUTE 71 20 29 13 7 2 .. 1 Asthma .. .. .. .. 1 .. 1 .. Lung Diseases, &c. 1 .. .. 1 .. .. 59 41 III. LOCAL 100 48 8 20 22 2 7 7 4- Digestive Orgs. 14 5 1 4 4 .. 25 16 IV. DEVELOPMNL. 41 33 .. .. 3 5 .. .. Gastritis .. .. .. .. .. .. .. 1 Enteritis 1 1 .. .. .. .. 6 3 V. VIOLENTDTHS. 9 6 1 1 1 .. 1 2 Peritonitis 2 2 1 .. .. .. 1 .. Not Specified 1 1 .. .. .. .. .. .. Ascites .. .. .. .. .. .. .. .. Ulceration of Intes. .. .. .. .. .. .. .. .. Hernia .. .. .. .. .. .. (Orders.) 2 1 Ileus 3 2 .. .. l .. 35 21 I. 1. Miasmatic Dis. 56 46 6 2 2 .. .. .. Intussusception .. .. .. .. .. .. .. .. Stricture of Intest. .. .. .. .. .. .. .. 2 Small Pox 2 2 .. .. .. .. .. .. Fistula .. .. .. .. .. .. 4 1 Measles 5 5 .. .. .. .. .. .. Stomach Dis. &c. .. .. .. .. .. .. 4 3 Scarlatina 7 6 1 .. .. .. .. .. Pancreas Dis. &c. .. .. .. .. .. .. 1 .. Diphtheria l 1 .. .. .. .. .. .. Hepatitis .. .. .. .. .. .. .. 1 Quinsey 1 1 .. .. .. .. .. .. Jaundice .. .. .. .. .. .. l 1 Croup 2 2 .. .. .. .. 4 3 Liver Disease 7 .. .. 4 3 .. 6 4 Hooping Cough 10 10 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 6 3 Typhus & Typhoid 9 4 2 2 1 .. 3 4 5. Urinary Orgs. 7 .. 2 3 2 .. .. 1 Erysipelas 1 .. 1 .. .. .. .. .. Nephritis .. .. .. .. .. .. .. .. Pyœrmia .. .. .. .. .. .. .. .. Disease of Bladder .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. 1 3 Nephria 4 .. 1 2 1 .. .. .. Carbuncle .. .. .. .. .. .. .. .. Diabetes .. .. .. .. .. .. .. .. Influenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. 1 .. Prostrate Disease l .. .. .. 1 .. 10 4 Diarrhœa 14 13 1 .. .. .. l 1 Kidney Disease &c. 2 .. 1 1 .. .. 1 1 Cholera 2 l .. .. 1 .. 1 .. 6. Genera. Organs 1 .. .. .. 1 .. .. .. Ague .. .. .. .. .. .. .. .. Ovarian Dropsy .. .. .. .. .. .. 2 .. Rheumatism 2 1 1 .. .. .. 1 .. Uterine Diseases l .. .. .. l .. 5 2 2. Enthetic 7 6 .. .. 1 .. .. .. 7. Orgs. of Locomo. .. .. .. .. .. .. 4 2 Syphilis 6 6 .. .. .. .. .. .. Spine Diseases .. .. .. .. .. .. 1 .. Stricture of Urethra 1 .. .. .. 1 .. .. .. Bone Diseases .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. 8. Skin, &c. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. Phlegmon & Abscess. .. .. .. .. .. .. .. 2 3. Dietic 2 1 .. 1 .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. .. .. Skin Diseases .. .. .. .. .. .. .. 1 Want of Br. Milk l 1 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 5 7 IV. 1. Dis. of Childs. 12 12 .. .. .. .. .. 1 Alcoholism 1 .. .. 1 .. .. 3 .. 4. Parasitic 3 3 .. .. .. .. 4 6 Premature Birth 10 10 .. .. .. .. 3 .. Thrush 3 3 .. .. .. .. .. .. Cyanosis .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. Spina Bifida .. .. .. .. .. .. .. 1 Other Malformation 1 1 .. .. .. .. 3 8 II. 1. Diathetic 11 .. 1 3 5 2 1 .. Teething 1 1 .. .. .. .. 1 .. Gout 1 .. .. .. 1 .. .. .. 2. Dis. of Adults .. .. .. .. .. .. 1 2 Dropsy 3 .. 1 .. 1 1 .. .. Paramenia .. .. .. .. .. .. .. .. Hæmorrhage .. .. .. .. .. .. .. .. Childbirth .. .. .. .. .. .. 1 6 Cancer 7 .. .. 3 3 1 5 3 3. Dis. of Aged 8 .. .. .. 3 5 .. .. Noma .. .. .. .. .. .. 5 3 Old Age 8 .. .. .. 3 5 .. .. Mortification .. .. .. .. .. .. 15 6 4. Dis. of Nutritn. 21 21 .. .. .. .. 27 33 2. Tubercular 60 20 28 10 2 .. 15 6 Atrophy & Debility 21 21 .. .. .. .. 1 .. Scrofula 1 1 .. .. .. .. 3 2 V. 1. Acci. or Neg. 5 4 1 .. .. .. 1 5 Tabes Mesenterica 6 6 .. .. .. .. 21 24 hthisis 45 2 28 10 2 .. 2 2 Fract. and Contus. 4 3 1 .. .. .. 4 4 Hydrocephalus 8 8 .. .. .. .. .. .. Wounds .. .. .. .. .. .. .. .. Burns and Scalds .. .. .. .. .. .. .. .. Poison .. .. .. .. .. .. 15 9 III. 1. Nervous Syst. 24 11 .. 7 5 1 .. .. Drowing .. .. .. .. .. .. 2 .. Cephalitis 2 2 .. .. .. .. 1 .. Suffocation .. 1 .. .. .. .. 6 1 Apoplexy 7 .. .. 2 4 1 .. .. Otherwise .. .. .. .. .. .. .. 1 Paralysis 1 .. .. 1 .. .. 2 .. 2. Homicide 2 2 .. .. .. .. .. .. Insanity .. .. .. .. .. .. 1 1 3. Suicide 2 .. .. 1 1 .. .. .. Chorea .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. .. 2 .. Epilepsy 2 .. .. 2 .. .. .. .. Poison .. .. .. .. .. .. 4 5 Convulsions 9 9 .. .. .. .. 1 1 Drowing 2 .. .. 1 1 .. 1 2 Brain Diseases, &c. ??? .. .. 2 1 .. .. .. Suffocat, and Hang .. .. .. .. .. .. 5 4 2. Organs of Circ. 9 1 2 3 2 1 .. .. Otherwise .. .. .. .. .. .. .. .. Pericarditis .. .. .. .. .. .. .. .. 4.Unclassed .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. 5 4 Heart Disease 9 1 2 3 2 l TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 28TH DAY OF OCTOBER, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 4 1 2 .. 7 Chicken Pox .. .. 2 2 .. .. 4 Measles .. .. 3 .. 2 .. 5 Scarlatina .. .. 14 6 2 .. 22 Whooping cough .. .. 28 15 10 .. 53 Croup .. .. 2 .. .. .. 2 Diarrhœa 1 1 81 61 15 .. 164 Dysentery .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. Ague 1 .. 3 1 .. .. 5 Continued Fever .. .. 10 14 2 .. 26 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever 4 .. 1 4 2 .. 11 Erysipelas 1 .. 8 8 .. .. 17 Diphtheria .. .. . 1 4 4 .. 9 Sorethroat or Tonsillitis 1 .. 20 16 11 .. 48 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 11 .. 240 89 37 37 414 Pneumonia .. .. 4 4 3 .. 11 Pleurisy .. .. 1 .. .. 1 2 Delirium Tremens 1 .. 2 .. .. .. 3 Insanity 4 .. 5 1 .. 1 11 Carbuncle .. .. 1 1 3 .. 5 All other Diseases 33 8 439 456 356 163 1455 Total 57 9 870 683 449 207 2275 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From October 1st, 1865, to October 28th, 1865. West SubDistrict. East SubDistrict. Special Inspection Total. Number of houses inspected 87 98 302 487 Constructed 11 1 .. 12 Improved or repaired 28 22 40 90 Traps fixed 9 27 323 359 Cesspools Abolished 1 1 1 3 Cleansed or disinfected .. .. .. .. Privies and Water J Closets Pan, trap, and water supply furnished 14 .. .. 14 Pan and trap only furnished .. .. 5 5 Water supply furnished 4 13 140 157 Dust bins Constructed 4 7 1 12 Repaired and covers adapted 3 17 6 26 Surface Drains and Pavements of Yards Constructed 2 11 .. 13 Relaid 23 22 6 51 General Water Supply New receptacle provided 3 1 .. 4 Receptacle repaired and cleansed 11 9 6 26 Water supply provided 12 .. .. 12 Other Improvements Houses generally repaired 12 4 12 28 „ cleansed or limewashed 25 7 .. 32 ,, ventilated 3 .. .. 3 Overcrowding abated 9 6 .. 15 Illegal use of underground Rooms for sleeping discontinued 2 .. .. 2 69 REPORT ON THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR NOVEMBER, 1865. No. C III. The registered mortality of the four weeks ending November 25th was 277, a number which does not reach by 30 deaths the corrected mean mortality of the previous nine years. There has, throughout the month, been a remarkable freedom from all the ordinary contagious diseases of children, with the solitary exception of whooping cough. The cases of continued fever, however, have risen from 26 in October to 40. The largest number of cases I have recorded in any November was 33 in 1863. Most of the cases were of the enteric form (typhoid), occurring in connection with local sources of miasma, but a few cases of typhus have also been observed, the contagious source of which has been traced, in some instances, to importation from the country. The cases of bowel complaint returned to me have fallen from 164 in October to 70. This number, although in excess of the two previous Novembers, is close upon the number returned in November, 1860 and 1861, while 88 cases were returned in 1862. TABLE A. Shewing the Number of Cases of disease generally, and of Bowel Complaints particularly, recorded in the corresponding month for the last five years ; and also the total of the deaths from all causes, and from Bowel Complaints. November Total Sickness. Total Deaths. Diarrhœa. Dysentery. Cholera. Bowel Complaints. Total. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1865 2372 277 68 7 2 — — — 70 7 1864 2286 308 40 6 — — — 1 40 7 1863 2511 290 55 3 — — — — 55 3 1862 2519 282 86 8 2 1 — — 88 9 1861 2217 215 69 3 4 — — 1 73 4 1860 2004 226 67 8 2 — — — 69 8 TABLE B. Results of a Special Analysis of the Water supplied by the Metropolitan Water Companies during November, as made and published by the Metropolitan Association of Medical Officers of Health. Total solid matter per Imperial gallon. Loss by Ignition. Oxydisable Organic Matter. Hardness. Before Boiling. After Boiling. Thames Water Companies. grains. grains. grains. degrees. degrees. Grand Junction 20.37 0.90 0.69 13.9 3.0 West Middlesex 19.00 0.75 0.91 13.7 3.0 Soutliwark and Vauxhall 20.25 0.80 1.03 14.0 3.0 Chelsea 20.75 0.75 0.73 14.1 3.2 Lambeth 18.88 1.00 1.06 13.7 3.0 Other Companies. Kent 25.50 0.70 0.27 18.0 5.9 New River 20.18 0.65 0.79 14.0 3.1 East London 22.67 1.00 1.10 14.9 4.0 EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, December 4th. 1865. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING NOVEMBER 25th, 1365, (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 80 years of age and upwards. 131 146 All Causes 277 153 38 19 56 11 28 27 3. Respirat. Orgs. 55 36 4 .. 10 .. .. .. Laryngitis .. .. .. .. .. .. (Classes.) 20 14 Bronchitis 34 20 3 .. 8 .. 1 .. Pleurisy 1 1 .. .. .. .. 30 31 I. ZYMOTIC DIS. 61 43 11 2 5 .. 6 12 Pneumonia 18 14 1 .. 1 .. 25 26 II. CONSTITUTL 51 22 13 10 6 .. 1 .. Asthma 1 .. .. .. 1 .. .. 1 Lung Diseases, &c. 1 1 .. .. .. .. 58 63 III. LOCAL 121 54 12 7 41 7 6 5 4. Digestive Orgs. 11 2 1 1 7 .. 15 23 IV. DEVELOPMNL. 38 29 2 .. 4 3 .. 1 Gastritis 1 .. .. .. 1 .. 1 .. Enteritis 1 .. 1 .. .. .. 3 3 V. VIOLENT DTHS. 6 5 .. .. .. 1 .. .. Peritonitis .. .. .. .. .. .. .. .. Not Specified .. .. .. .. .. .. .. .. Ascites .. .. .. .. .. .. 1 .. Ulceration of Intes. 1 1 .. .. .. .. 1 .. Hernia 1 .. .. .. 1 .. (Orders) .. 1 Ileus 1 .. .. .. 1 .. 26 27 I. 1. Miasmatic Dis. 53 36 10 2 5 .. .. .. Intussusception .. .. .. .. .. .. .. .. Stricture of Intest. .. .. .. .. .. .. 1 3 Small Pox 4 1 3 .. .. .. .. .. Fistula .. .. .. .. .. .. 2 .. Measles 2 2 .. .. .. .. .. .. Stomach Dis. &c. .. .. .. .. .. .. 6 2 Scarlatina 8 7 1 .. .. .. .. .. Pancreas Dis. &c. .. .. .. .. .. .. .. 2 Diphtheria 2 2 .. .. .. .. .. .. Hepatitis .. .. .. .. .. .. .. .. Quinsey .. .. .. .. .. .. 1 1 Jaundice 2 1 .. .. 1 .. 1 .. Croup 1 1 .. .. .. .. 2 2 Liver Disease 4 .. .. 1 3 .. 6 4 Hooping Cough 10 10 .. .. .. .. .. .. Spleen Disease .. .. .. .. .. .. 7 7 Typhus & Typhoid 14 6 4 2 2 .. 3 .. 5. Urinary Orgs. 3 .. .. 2 1 .. 1 .. Erysipelas 1 1 .. .. .. .. .. .. Nephritis .. .. .. .. .. .. .. 1 Pyœmia 1 .. .. .. 1 .. .. .. Disease of Bladder .. .. .. .. .. .. .. 1 Puerperal Fever 1 .. 1 .. .. .. 1 .. Nephria 1 .. .. .. 1 .. .. .. Carbuncle .. .. .. .. .. .. 1 .. Diabetes 1 .. .. 1 .. .. .. .. Influenza .. .. .. .. .. .. .. .. Stone .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. Prostrate Disease .. .. .. .. .. .. 1 6 Diarrhœa 7 5 1 .. 1 .. 1 .. Kidney Disease, &c. 1 .. .. 1 .. .. .. .. Cholera .. .. .. .. .. .. .. 1 6. Genera. Organs 1 .. 1 .. .. .. .. .. Ague .. .. .. .. .. .. .. 1 Ovarian Dropsy 1 .. 1 .. .. .. 1 l Rheumatism 2 1 .. .. 1 .. .. .. Uterine Diseases .. .. .. .. .. .. l3 1 2. Enthetic 4 4 .. .. .. .. .. .. 7. Orgs. of Locomo. .. .. .. .. .. .. 3 1 Syphilis 4 4 .. .. .. .. .. .. Spine Diseases .. .. .. .. .. .. .. .. Stricture of Urethra .. .. .. .. .. .. .. .. Bone Diseases .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. 8. Skin, &c. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. Phlegmon & Abscess .. .. .. .. .. .. 1 2 3. Dietic 3 2 1 .. .. .. .. .. Ulcer .. .. .. .. .. .. .. .. Privation .. .. .. .. .. .. .. .. Skin Diseases .. .. .. .. .. .. .. 2 Want of Br. Milk 2 2 .. .. .. .. .. .. Purpura and Scurvy .. .. .. .. .. .. 3 3 IV. 1. Dis. of Childn. 6 6 .. .. .. .. 1 .. Aleoholism 1 .. 1 .. .. .. .. 1 4. Parasitic 1 1 .. .. .. .. 3 2 Premature Birth 5 5 .. .. .. .. .. 1 Thrush 1 1 .. .. .. .. .. .. Cyanosis .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. 1 Spina Bifida 1 1 .. .. .. .. .. .. Other Malformation .. .. .. .. .. .. 1 5 II. 1. Diathetic 6 .. .. 2 4 .. .. .. Teething .. .. .. .. .. .. .. 2 2. Dis. of Adults. 2 .. 2 .. .. .. .. .. Gout .. .. .. .. .. .. .. .. Paramenia .. .. .. .. .. .. 1 1 Dropsy 2 .. .. .. 2 .. .. 2 Childbirth 2 .. 2 .. .. .. .. .. Hæmorrhage .. .. .. .. .. .. 1 6 3. Dis. of Aged 7 .. .. .. 4 3 .. 4 Cancer 4 .. .. 2 2 .. 1 6 Old Age 7 .. .. .. 4 3 .. .. Noma .. .. .. .. .. .. 11 12 4. Dis. of Nutritn. 23 23 .. .. .. .. .. .. Mortification .. .. .. .. .. .. 11 12 ///Atrophy & Debility 23 23 .. .. .. .. 24 21 2. Tubercular 45 22 13 8 2 .. 2 1 Scrofula 3 3 .. .. .. .. 3 2 V. 1. Acci. or Neg. 5 4 .. .. .. 1 3 2 Tabes Mesenterica 5 5 .. .. .. .. 15 13 Phthisis 28 5 13 8 2 .. .. 1 Fract. and Contus. 1 .. .. .. .. 1 4 5 Hydrocephalus 9 9 .. .. .. .. .. .. Wounds .. .. .. .. .. .. 1 .. Burns and Scalds 1 1 .. .. .. .. 16 25 III. 1. Nervous Syst. 41 16 5 4 14 2 .. .. Poison .. .. .. .. .. .. .. .. Drowing .. .. .. .. .. .. 1 2 Cephalitis 3 2 1 .. .. .. 2 1 Suffocation 3 3 .. .. .. .. 2 6 Apoplexy 8 1 2 .. 4 1 .. .. Otherwise .. .. .. .. .. .. 4 7 Paralysis 11 .. 1 2 7 1 .. 1 2. Homicide 1 1 .. .. .. .. 1 .. Insanity 1 .. 1 .. .. .. .. .. 3. Suicide .. .. .. .. .. .. .. .. Chorea .. .. .. .. .. .. .. .. Wounds .. .. .. .. .. .. 2 .. Epilepsy 2 .. .. 2 .. .. .. .. Poison .. .. .. .. .. .. 5 6 Convulsions 11 11 .. .. .. .. 1 1 Drowing .. .. .. .. .. .. 1 4 Brain Diseases, &c. 5 2 .. .. 3 .. .. .. Suffocat, and Hang. .. .. .. .. .. .. 5 5 2. Organs of Circ. 10 .. 1 .. 9 .. .. .. Otherwise .. .. .. .. .. .. .. .. Pericarditis .. .. .. .. .. .. .. .. 4. Unclassed .. .. .. .. .. .. .. .. Aneurism .. .. .. .. .. .. 5 5 Heart Disease 10 .. 1 .. 9 .. 1 i TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 25th DAY OF NOVEMBER, 1865, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison. Total. Small Pox .. .. 6 2 .. .. 8 Chicken Pox .. .. 3 1 .. .. 4 Measles .. .. 9 3 .. .. 12 Scarlatina .. .. 16 4 4 .. 24 Whooping Cough .. .. 38 5 7 .. 50 Croup .. .. .. .. .. .. .. Diarrhœa 3 .. 12 14 7 2 68 Dysentery .. .. 1 1 .. .. 2 Cholera .. .. .. .. .. .. .. Ague .. .. .. 1 .. .. 1 Continued Fever .. .. 23 10 7 .. 40 Puerperal Fever .. .. .. 1 .. .. 1 Rheumatic Fever 3 .. 4 7 6 .. 20 Erysipelas 3 .. 10 3 .. .. 16 Dephtheria .. .. .. .. 1 .. 1 Sorethroat or Tonsillitis .. .. 18 27 5 .. 50 Mumps .. .. 2 .. .. .. 2 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 11 1 268 136 52 42 513 Pneumonia 1 .. 8 2 9 .. 20 Pleurisy .. .. 3 3 1 .. 7 Delirium 2 .. .. .. .. .. 2 Insanity 4 .. 5 .. .. 1 10 Carbuncle .. .. .. 2 .. .. 2 All other Diseases 44 4 429 476 438 128 1519 Total 74 5 885 698 537 173 2372 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From October 29th, 1865, to November 25th, 1865. West SubDistrict. East SubDistrict. Special Inspection Total. Number of houses inspected 94 96 478 608* Constructed 2 3 .. 5 Improved or repaired ?4 25 26 75 Traps fixed 14 29 143 186 Cesspools Abolished 1 .. .. 1 Cleansed or disinfected .. 1 .. 1 Privies and Water Closets Pan, trap, and water supply furnished 6 1 .. 7 Pan and trap only furnished .. .. 15 15 Water supply furnished 12 13 87 112 Dust bins Constructed 4 3 31 38 Repaired and covers adapted 10 11 73 94 Surface Drains and Pavements of Yards Constructed 4 6 7 17 Relaid 14 17 6 37 General Water New receptacle provided 4 9 .. 6 Receptacle repaired and cleansed 4 4 69 77 Water supply provided .. .. .. .. Other Improvements Houses generally repaired 4 3 31 38 „ cleansed or limewashed 20 14 .. 34 ,, ventilated 2 .. .. 2 Overcrowding abated 3 2 .. 5 Illegal use of underground Rooms for sleeping discontinued 2 .. .. 2 *Re-inspections by Special Inspectors, 906 additional. 70 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR, DECEMBER, 1865. No. CIV. The number of deaths registered during the five weeks ending December 30th was 375. The corrected mean mortality of the corresponding period of the year, estimated on the nine previous Decembers, is 419, so that we have had about 49 deaths less than is customary: and this low mortality has been observed in respect of each class of causes of death. A death from hydrophobia has been recorded. The only disease of the zymotic class, the mortality from which has been excessive—is "Fever." Most of the 18 deaths were from typhoid. This disease, the principal local operation of which is concentrated upon the small intestines, is more prevalent now than it has been at any period during my tenure of office, and has found its way into houses both of the well-to-do and of the poor. It is a disease, if not absolutely generated from the putrefaction and fermentation of animal excretions, and of other organic refuse matters, yet certainly one, the effectual poison of which is received into the system with air contaminated by the consequent emanations, or with food or water similarly defiled. I wish this to be thoroughly understood by the public, because the conditions which are now developing typhoid fever are the very same which will determine outbreaks of cholera, should that disease become epidemic in the summer. Nothing in "preventive medicine" is better established than this connection. Typhoid fever is now giving to our population a lesson in the laws of health, which it will be at the peril of us all that we disregard. Cases of typhoid now and recently existent I have traced, without a shadow of doubt, to the following sources:—Sewer and drain emanations sucked up into houses from 2 untrapped or imperfectly trapped inlets at sinks, &c., and stoppages in closets, rat-holes, communications with old brick drains, emanations from horse-dung left to ferment in mews, &c., and from heaps of house refuse deposited and sorted by one of your dust contractors (Mr. Winn) in the neighbourhood of inhabited residences, and also to the domestic use of water from cisterns foul from long neglect of cleansing. Most of these causes of disease are within the control of householders themselves; and in decent houses it might have been reasonably expected that they would have been guarded against. It is for the Vestry, however, to insist upon the dust contractors not breaking through their agreement by making shoots within this parish. As regards accumulations of dung, I have something more to say. It is not the large but the small accumulations of dung which are proving most dangerous to the public health; and the reason is, that, while it is worth the while of a contractor to remove the former frequently, the latter are left day after day to ferment, until a sufficient load has collected. It is true that when mischief results we can demand the removal of the accumulation, but this is a very inefficient remedy, and the more so because the accumulation immediately re-commences. The only effectual remedy that I know of as applicable under the existing circumstances, would be the exercise of the power of collecting manure, given to the Vestry by the 95th clause of the 25 & 26 Vic., c. 102. This will require the consent of the owners of the dung, and from inquiries I have had made among small cowkeepers, butchers, &c., I apprehend no difficulty will be experienced on this score, since many of them have stated that they would regard such a proceeding as a boon. Nor have I any doubt that private owners, keeping one or two horses in mews, &c. would also readily give their consent. At all events I would press upon the Vestry the importance, at the present time, of ascertaining, by an extended inquiry, how far such a proceeding would be acceptable, and then, should the result be favourable, of adopting the course I propose. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, January 6th, 1866. 71 REPORT on THE SANITARY CONDITION OF The Parish of St. Mary, Islington, DURING THE YEAR 1865. BY EDWARD BALLARD, M.D. (Lond.) member of the royal college of physicians; fellow of the royal medical and chirurg1cal society of london, etc. MEDICAL OFFICER OF HEALTH. J. & I. TIREBUCK, STEAM PRINTERS & LITHOGRAPHERS Monk-well street, E.C., and Islington. 1866. LONDON: PRINTED BY J. AND I, TIREBUCK, MONKWELL STREET, EC., AND ISLINGTON. TO THE VESTRY OF SAINT MARY, ISLINGTON, Gentlemen, My Tenth Annual Report on the sanitary condition of Islington would have been a favourable one, were it not that it embraces some account of the outbreak of a disease amongst the cows, which, commencing here in the month of June, has, since that time, spread generally over the United Kingdom. Such an account constitutes a necessary part of my report, first, because it is essential to the completeness of the sanitary history of the parish of which my reports are the record; secondly, because of the results of the cattle plague as affecting the food of the people; and thirdly, because my observations of its rise and progress remarkably illustrate and throw additional light upon the operation of those influences which we habitually recognise as affecting the health of mankind. MORTALITY, DEATH-RATE, and SICKNESS. The number of deaths registered in Islington (omitting those of non-residents in hospitals, and also those in the Clerkenwell Infant Poor-house) during the fifty-two weeks ending December 30th, amounted to 3813. To these we must add 222 more deaths as our share (proportionally to our population) of the deaths which took place in the several metropolitan institutions for the reception of sick persons, lunatics, etc. The mortality thus corrected amounts to 4035. Assuming that our population has increased to the extent of 5 per cent. upon that of 1864. (the rate of increase in the decenniad 1851-61) it will have numbered in the middle of 1865, 181,897 persons. Our death-rate calculated upon this number was, for the year 1865,221.8 per 10,000. Notwithstanding that 8662 persons may be believed to have been added to our population during the year, it is worth noticing that the deaths registered here during 1865 were less numerous than those registered during 1864 (corrected to the same number of weeks) by 133. In London generally, during 1865, the death-rate was 246.2. In 1864 the death-rate with us was 224 per 10,000, and in 1863 it was 227 per 10,000. 4 The following table shows the births which have taken place in the parish during 1865 1865 West Sub-District East Sub-District. Whole Parish. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Quarter 428 414 842 425 430 855 853 844 1697 2nd Quarter 440 408 848 395 401 796 835 809 1644 3rd Quarter 401 446 847 437 408 845 838 854 1692 4th Quarter 432 395 827 451 436 887 883 831 1714 Total 1701 1663 3364 1708 1675 3383 3409 3338 6747 The registered births exceed the registered deaths by 2934; hence we may conclude that all further increase of our population, probably to the extent of 6728 persons, have come into the parish from without. Table IV. shows the number of new cases of disease recorded as happening during the year in the pauper practice of the parish, and in the books of the Holloway and of the Islington Dispensaries, and the Pentonville Convict Prison. I am greatly indebted to the medical gentlemen who are at the pains of furnishing me with these returns, and who frequently take advantage of their weekly sheet to draw my attention to local unwholesome conditions. I am especially under obligations in this respect to Dr. Osborne, the late resident medical officer of the Islington Dispensary, and take this, the first opportunity that has presented itself after his retirement from that post, to express them. Thanks to the assistance that I have thus constantly received from these gentlemen and from the board of trustees, the statistics of sickness amongst the poorer classes in the parish are complete from 1860 to 18G5, a period of six years, and in the Table IV. the general result is exhibited in such a way as to facilitate a comparison between the several years. The total amount of sickness recorded during the past year was 29,098 cases, a number only 282 above the total for 1864, and an increase by no means commensurate with the increase of population. Comparing the sickness table with those of previous years, it appears that the number of cases of small-pox has again risen from 86 to 222, only about 32 cases short of half the small-pox cases during the epidemic year 1863. The number of cases of measles was absolutely small, and the cases of scarlet fever by no means excessive. Hooping cough however has prevailed to an unusual extent, and of the infectious diseases of children has been the leading disease of tho year. Bowel complaints prevailed less than they did either in 1861 or 1863, but somewhat more than in 1864. There was a good deal of fever in the parish towards the close of the year, but not enough to raise the total number of cases so high as in 1862-3, Chest affections altogether prevailed less than during the two previous years. 5 DISTRICT MORTALITY. Table II. represents the deaths that have taken place during the year in each of the 35 districts into which I have divided the parish for sanitary purposes. Dividing these districts as I have been accustomed to do into three groups according to their character, and calculating the death-rate upon the population of each at the time of the census in 1861, the following is the result. || Group 1. Group 2. Group 3. Districts. Death-rate per 1000. Districts. Death-rate per 1000. Districts. Death-rate per 1000. 1865 1864 1865 1864 1865 1864 *Mildmay 35.3 32.6 *Freehold 42.9 33.3 Battle Bridge 32.2 22.6 *Hornsey Road 35.0 32.6 *Lr. Holloway 32.5 30.3 *Balls Pond 31.8 29.9 *Shepherdess 24.7 29.7 *Archway 31.7 23.6 *Queen's Road 29.1 24.8 Duncan 24.4 9.7 *Highgate Hill 30.2 22.3 WhiteConduit 26.9 27.7 *Tufnell 21.7 13.8 St. Peters 26.0 21.0 Belle Isle 26.2 28.0 Barnsbury 20.9 22.2 Kingsland 23.2 27.0 *Bemerton . 25.0 27.1 *Hornsey Rise 20.8 18.9 Palmer 21.0 19.9 Irish Courts 22.0 31.0 Canonbury 16.7 16.9 Rotherfield 20.7 25.9 Lower Road 22.0 24.1 *Market 16.3 22.4 St. Thomas 20.2 22.8 Canal 38.8 19.7 *Rydon 15.3 13.7 Trinity 19.9 20.0 City Road 18.1 23.4 Highbury Hill 14.3 14.7 Highbury Vale 16.5 19.4 Church 16.3 24.5 Theberton 15.3 21.1 Park Street 13.9 17.9 Mean of Group 20.8 20.6 Mean of Group 24.5 23.5 Mean of Group 24.0 25.9 It is worthy of remark in this table that the poorest districts of the parish, those to which naturally our sanitary efforts have of late been chiefly directed, have becomo lowered in their death-rate from 29.3 in 1863 to 25.9 in 1854, and to 24.0 per 1000 in 1865. The improvement in respect of the Irish courts is especially noticeable. From presenting for several years in succession the highest or nearly the highest death-rate in group three, this district has fallen to stand seventh on the list, and from a deathrate of 42.2 in 1863 to a death-rate of no more than 22 per 1000. These courts have taken up a scarcely credible amount of time and labour on the part of your sanitary staff. CAUSES OF DEATH. The causes which led to the death of 3813 persons appear upon Table I. Of these persons 1836 were males and 1977 were female. 0 The First group embraces the more wealthy districts, of which the numbers aro not underlined on the map. The Second group embraces those with a more mixei population, of which the numbers are singly under lined on the map. The Third group embraces those with a population more or less poor and negligent, doubly underlined on the map. * Those districts marked thus (*) have increased to such an extent by new buildings since the census that the death-rate calculated upon the population of these in 1861 is fir above tho correct rate. 6 Zymotic Diseases. The diseases grouped together under this term occasioned 1015 deaths, of which 637 were of children under five years of age. The distribution of these deaths amongst the several sanitary districts may be studied upon Table II. Small-Pox occasioned 58 deaths—more than half the number registered in the epidemic year 1863, and more than twice the number registered in 1860 and 1864. Of these 58 deaths, 21 were of children under five years of age, who, if they had not been left unvaccinated, or rather if they had been vaccinated properly, never would have died. They are 21 victims of ignorance, prejudice, or neglect. Twenty-three of the deaths took place in adults who had either never bean vaccinated at all, or in whom the protection once obtained had worn out by lapse of time. Deaths by smallpox are the most unsatisfactory deaths that an Health Officer has to record, because he feels that they need never have happened. Hooping Cough is the only other contagious disease of this class that I need specially allude to, as it alone occasioned an excessive mortality. It carried off 187 children, of whom all but four were under 5 years of age. Diarrhœa and other bowel complaints together occasioned 240 deaths. The mortality from this cause broke out with unusual suddenness in the week ending June 24th, when 25 deaths from diarrhoea occurred, while in the previous week only four had occurred. This was the 25th week of the year, which was remarkable for an extreme dryness of atmosphere conjoined with a temperature, which, although only 61.1° as the mean of the week, attained as the mean of the highest readings of the thermometer a temperature of 76.5°. No rain had fallen during that or the two preceding weeks. With the prospect of epidemic disease during the coming summer, I have thought it right to point out where diarrhœal affections have prevailed most during the last five years. This is done in Table III., where the total deaths in each district from this cause are stated, and the per centage in the population calculated. The percentage in those districts marked * is of course in excess of the truth; but where the districts are not thus marked the numbers represent tolerably accurately the relative tendencies of the districts to suffer from a choleraic outbreak. In the districts against which an high number stands in the Table, every house should be visited, and there should not be in any house a foul or untrapped drain, dirty tenement, or an uncleansed water-cistern. INFANT MORTALITY. You are aware that it has been my habit to state upon my annual Table of the district mortality the number of deaths of children under 5 years of age. I have made no alteration in this Table for the present year: nevertheless in the book into which I enter the deaths in every street and house, and from which this Table is compiled, I have distinguished this year between the deaths of children under 1 year of age, and those of children between 1 year and 5 years of age; and I have done so because it has been asserted that local unwholesomeness is not especially fatal to 7 children, and that the high mortality of children in London and other large towns is due to confinement within doors from lack of play out of doors Under one year of age infants are necessarily much at home with their mothers; so in endeavouring to ascertain what causes are actually operating to enhance our child death-rate, it is necessary to distinguish between children old enough to run about, and those who are not. The influences which appear most calculated to operate in promoting disease and death amongst young children, are poverty and its associated neglect, etc., a contaminated atmosphere within doors, of which the amount of crowding into houses may be taken as the index, and thirdly, the closeness with which houses are packed together, impeding light and free circulation, of air, and depriving children of space for play out of doors. The following is the result of my tabulation for a single year:— I have confined my statement of results to those districts which have remained since 1861 pretty stationary as to population. These districts are, in Group I. Barnsbury, Canonbury, Highbury Hill and Duncan; in Group II., Kingsland, Botherfield, Church, St. Thomas, Theberton, St. Peters, Trinity, Palmer, Highbury Vale and Park-street. In group III., Irish Courts, Belle Isle, White Conduit, Lower Boad, City Boad, Battle Bridge and Canal. First then as to Children over One Year and under Five Years of aye. 1. Influence of poverty and its attendant circumstances. In the 4 districts of group 1. together, such deaths occurred in 9.1 per 1000 of the families „ 10 „ ,, 2. „ 13.3 ,, „ 7 „ „ 3. „ 20.5 „ 2. Influence of crowding, as measured by the average number of persons in a house. In 15 districts where every 10 houses lodge on an average 60 or less than 80 persons, (the mean being 70) such deaths occurred in 12.3 per 1000 of the families. In 5 districts „ „ „ 80 or less than 100 persons (the mean being 87.0) 19.0 In 1 district „ „ „ over 100 persons (the mean being 103.7) 49.3 3. Influence of crowding as measured by the Number of Families in a house. In 6 districts where every 10 houses lodge on an average less than 15 families (the mean being 13.0), such deaths occurred in 8.9 per 1000 families. In 8 districts „ „ ,, 15 and under 20 families. (the mean being 17.3 14.5 In 7 districts „ „ „ 20 families and upwards, (the mean being 20.9) 19.2 4. Influence of closeness of buildings and deficient play space. In 11 of the most open districts,* such deaths occurred in 10 per 1000 families. In 6 „ closer „ || „ 19 per 1000 „ In 4 „ closest „ § „ 17.3 per 1000 „ * Barnsbury, Canonbury, Highbury Hill, Duncan, Rotherfield, Church (which includes Islington Green) Theberton, Palmer, Highbury Vale, Park-street, Belle Isle. || Kingsland, St. Thomas, St. Peter's, Trinity, Battle Bridge, Canal. § Irish Courts, White Conduit, Lower Road, City Road. 8 The reduction in the last upon the preceding number may be due to the fact that in these very close localities, children play about more or less in the streets and courts. I think that it is a fair conclusion from these facts to say that all of the influence considered have an effect upon the death-rate of children, old enough to run about and play, and who require plenty of fresh air and light if they are to grow up healthy and strong : that the more poverty there is in any district, the larger the population of the houses the children live in, the more exposed they are to intimate association with other children living in the same house, and from whom they may contract contagious maladies, and especially the less open space there is about their dwellings, and the less opportunity there is for direct sun-light to reach-the streets, &c., the higher is the mortality between the ages under consideration. It may also perhaps be concluded that where free ventilation and access of direct sun-light and sufficient play room are denied to children by close buildings, it matters little what the relative degree of closeness may be, the mortality in the two closest districts, not differing greatly, while both sets of districts contrast strongly in mortality with the more open districts, being nearly double in amount. In view of this result we may well regret that the formation of the Finsbury Park was so long delayed, as at last to lead to its location at a distance from the more densely populated portions of our parish. It should also lead you to guard most jealously from encroachment by buildings, etc. the few open spaces, however small, now left to us in the parts of the parish most built over, and to seize upon every opportunity that presents itself to reserve, whereever new buildings are contemplated, as much open space for public benefit as can by any means be kept free. Next as to Children under One Year of age. 1. The influence of poverty and its attendant circumstances. In the 4 districts of group 1. together such deaths occurred in 17.7 per 1000 of the „ 10 „ „ 2. „ 23.6 „ [families „ 7 „ „ 3 „ 29.4 „ The difference of death-rate between these groups is sufficiently obvious to show that some influence is exerted by the circumstances of life of the parents of the infants, but the influence is on the whole not so strongly marked as with older children. 2. Influence of crowding as measured by the average number of persons in a house. In 15 districts where every 10 houses lodge on an average 60 and under 80 persons. Such deaths occurred in 22.3 per 1000 of the families. „ 5 districts 80 and under 100 persons. Such deaths occurred in 27.2 per 1000 of the families. „ 1 district over 100 persons. Such deaths occurred in 54.8 per 1000 of the families. Although this sort of crowding evidently exerts some influencs, it is again less with such young infants than with older children, 9 3. Influence of crowding as measured by the average number of families in a house. In 6 districts where every 10 houses lodge on an average less than 15 families. Such deaths occurred in 16.5 per 1000 of the families. „ 8 districts 15 and under 20 families. Such deaths occurred in 26.2 per 1000 of the families. „ 7 districts 20 families and upwards. Such deaths occurred in 27.G per 1000 of the families. Again, although the tenancy of a house by several families evidently favours a higher infant death-rate, the degree of this sort of crowding also has less influence than with older children who associate in a manner that young infants do not. 4. Influence of closeness of buildings, and its attendant circumstances. In the 11 most open districts such deaths occurred in 19.1 per 1000 of the families. „ 6 closer „ „ „ 28.8 „ „ „ 4 closest „ „ „ 27.5 „ ,, A distinct influence is here again apparent, but to a less extent than with older children. It would seem as if there were some cause thus arising operating both upon very young infants and upon older children ; probably deficiency of sun light and general atmospheric deterioration; but that in the case of older children an additional cause is to be found in the want of sufficient room for exercise and play in the open air. It is a common taunt that "anything may be proved by statistics;" and no doubt a man whose data are too limited in number, who selects his facts unfairly, who observes them inaccurately, and groups them carelessly, or who dishonestly seeks to convince rather than to discover the truth, is apt to fall into error himself, and to lead others astray also. But in medical matters there is a test applicable to arithmetical results, the application of which I cannot better express than in the words of Dr. Beneke, of Marburg: "The numbers in which the results of our researches are expressed, carry with them intrinsically, more or less of our confidence, in proportion as they agree or not with general physiological or medical experience. If such an agreement be wanting, both experimenter and critic will alike, and with justice, feel equal doubt with regard to the results obtained. If on the other hand, the harmony with well-known physiological facts is evident, there will be less doubt; and however much further examination may be desirable, the result obtained will nevertheless, on independent grounds, deserve consideration as throwing light upon the question under investigation." Dealing as a Health-officer necessarily at present does very much with the statistics of mortality, those whom he addresses are very apt to forget that he uses them merely as an index of the current amount of debility and disease amongst the population, whose health it is his business to investigate. Local sanitary boards are not established for the mere purpose of saving alive so many children to grow up as useful and productive member* of the commonwealth, nor even solely to prevent th 10 premature loss of the heads of families, who have to provide for the necessities of those too young to gain their own living, although these are grand and noble objects which they most properly seek to attain ; but rather to maintain amongst the people a general standard of healthiness consistent with the full and satisfactory discharge of all the duties of life. A large preventible mortality amongst children represents a proportionately large diffusion of preventible debility, issuing in a weakly adult age, producing by and by an adult population which is ready to break down under the pressure of a variety of adverse conditions to which they must assuredly be exposed. And if many of the circumstances which I have shown to influence the mortality of young children be not in your power to remove now, yet as popular sanitary knowledge advances, and as confidence in the teaching of sanitary science becomes more established, Parliament will not fail to follow the lead of popular opinion, and furnish you with levers which it will be your duty to employ. The Labouring Classes Lodging House Act has been in your hands for a long period of time, but for some cause or other, that it is not my business to inquire into, it has failed in being adopted, Two or more Bills are now before Parliament, which appear well calculated to promote a similar object, and it is much to be hoped that should they pass into law, the Islington Vestry will be amongst the first to avail themselves of their admirable provisions. CATTLE PLAGUE. "A contagious disease appeared amongst the milch cows about the middle of July, , at Islington. At first the cows refused their food : the next day had huskish coughs, and voided excrements like clay; the heads swelled, and sometimes their bodies. In a day or two more there was a great discharge of mucous matter by the nose, and their breaths smelt offensively. Lastly, a severe purging, (sometimes bloody,) which terminated in death. Some died in three days, others in five or six; but the bulls lived eight or ten. During the whole illness they refused all manner of food, and were very hot. . . . Several physicians attempted the cure, and made many essays for that purpose . . . I think there is no one method in practice but what was tried on this occasion . . . but the instances of success were so few that they do not deserve any further mention." I copy this extract not from any account of the Rinderpest as it has occurred amongst us recently, but from an old volume of the "Philosophical Transactions," containing a history, by a Mr. Bates, of an outbreak of the same disease in 1714, when it first appeared, as nearly as possible, on the very spot where it broke out in 1865. Mr. Bates says: "We went to Islington and found that Mr. Ratcliffe had lost 120 out of 200; Mr. Ruffold, 62 out of 72, and Mr. Pullen, 38 out of 87. They were very unwilling to own it, because so soon as it should be known none would buy their milk." Thus does history repeat itself: "The thing that has been, it is that which shall be, and that which is done is that which shall be done, and there is no new thing under the sun." Origin and Progress of the Disease in Islington. The first cases in the parish appeared in the dairy sheds of Mrs. Nicholls, in the Liverpool Road, on June 27th—at least that was the day on which the specific and 11 unusual character of the disease was first recognised. The cows first attacked were standing with some others in a quarantine shed, and had been purchased at the Metropolitan Cattle Market, on June 19th. It is stated that these cases were not absolutely the first in the kingdom. These were English cows ; but it is stated that two Dutch cows, purchased at the same market on the same day, had been attacked at Lambeth on the 24th. From the quarantine shed the disease passed across the yard in which the dung from all the animals is placed to the large shed, containing 80 or 90 cows. Several of the cases speedily died, or were destroyed, and a great many of the cows were sent from the shed to the market for sale. In fact, on the Monday succeeding the outbreak of the disease, Mr. Priestman asserts that he saw from 200 to 300 diseased cows which had been brought from various dairies. From these centres in Islington, the disease rapidly spread; but the fact of its existence was kept so secret between the cow-keepers and the Veterinary Surgeons that it was not until July 7th that I became acquainted with it. I immtfdiately made the necessary inquiries and took opportunities of studying the disease by personal examination of affected beasts, both alive and after death. The results of my inquiries I communicated at once to the Sanitary Committee, and at their recommendation the Vestry appointed special Inspectors to visit sheds, and report under my direction. From that time I had facilities for watching the progress of the disease. At the outbreak of the disease in June, there were in the parish 71 licensed cow-sheds, (or rather separate establishments), containing an average of 1,317 cows. By the close of September, 2G of these establishments were quite empty, and the number of cows in the parish was reduced to 314, distributed among 45 establishments. Many of the cow-keepers had sent away or sold off their stock, merely from alarm. The number of cows which I learned up to this time had been attacked with the disease was 628. The earliest sheds attacked by the disease, after Mr. Nicholls', were Dennison's, in Swan Yard; Wingroves', in Queen Street; Wingroves', in Elmore Street; Liddiard's, in Hale Street; and Harvey's, in Duncan Street. After these it spread generally. The order of attack, as nearly as it could be traced, is stated in my Table, published in the Appendix to the 2nd Report of the Cattle Plague Commissioners. By the close of October only 23 establishments were quite empty, partly because cows had been again brought in as the first panic subsided. The disease had spread altogether to 40 sheds, (one of them unlicensed), and the total number of cows that had been attacked was 643. By the close of Novetnber—when I was examined by the Royal Commissioners—the disease had appeared in 47 sheds, and there were 23 sheds empty. The total number of cases had risen to 694, of which 611 had died or been slaughtered on account of the plague. The number of cows then in the parish was 314, of which 5 were at that time ill. By the end of December 48 sheds had been attacked, and 25 sheds out of those licensed at the Michaelmas Sessions were empty. From the commencement 12 of the outbreak till the end of the year 706 cows had been attacked, and of these 025 had either died or been slaughtered on account of the plague. There were only 274 cows altogether being kept in the parish, of which one was ill with the plague. What was done with the Diseased Cows ? I have already stated that 625 cows died or were slaughtered on account of the disease, and that a large number were sent from infected sheds early in the outbreak for sale in the Metropolitan Cattle Market. A certain number of those sent to market doubtless fouud their way into other sheds, carrying infection with them. I know that this occurred in one instance in our parish, even after the Order of the Privy Council was issued prohibiting sales of cattle unless for immediate slaughter. There is reason to believe that this order was frequently evaded. Such cases came to the notice of the Cattle Plague Commissioners. Again, a certain number, how many it is impossible to ascertain, were assuredly sold to butchers, and the carcasses came into consumption as human food. So long as the cowkeepers could obtain a better price from the butcher than from the knacker, the existence of disease in the beast sold was not too curiously inquired into. Even after your special Inspectors were appointed, two striking instances of the facility with which diseased beasts were disposed of to the butcher came under Mr. Murray's notice.* It certainly is a significant fact that out of Oil cows which died or were slaughtered for disease up to the end of November, not more than 77 were received at the several knackeries at Belle Isle. In fact, up to the end of November the knackeries-and boiling-houses there only received from all parts of London 003 beasts dead and alive. There was a great deal of difficulty at one time in disposing of the diseased carcasses at the Belle Isle establishments in consequence of the inadequacy of the means of destruction. In one of the establishments (Ford's) at the early part of September, heaps of putrefying carcasses and barrels full of refuse and maggots were accumulated in the yard, and at Atchelor's over 50 diseased carcasses of cows were interred in a vacant piece of ground upon the premises. Cause of the Disease. That the disease arises through the introduction of a specific poison generated in the system of an animal previously diseased, and given off from its frame by the usual exhalations, and present in the excretions and secretions, and existing in a special manner in the manure is a fact now to be regarded as thoroughly established. That it either arose in the first place, or subsequently in any unwholesome condition of the London cow-sheds is a view which cannot be held for one moment in the face of my own observations. The two earliest instances of the disease in Islington were met with in two of the very cleanest, best ventilated, and best managed sheds in the parish, viz.: Nicholl's and Dennison's new shed; at Harvey's the cows first attacked were those in his large new shed, those in * See 2nd Rport of Commissioners, p. 2½. 13 his older and worse arranged slieds not suffering until a later period; and, generally speaking, it turned out that 6ome of the very worst managed sheds, as for example, Webb's, Humphrey's and Cook's were not attacked for several months. The causes which led to the selection by the disease of one shed in preference to another were in fact exactly similar causes to those which determine the preference shown by scarlet fever, cholera, or any similar zymotic disease for one house or family rather than another, and lead forcibly to the conclusion that, given a certain infectious material, it will take effect only when introduced in some way from without, and then the more readily the more certain predisposing influences co-exist and operate.* What these localising circumstances are appears from a full table relating to all the sheds in our parish, which I furnished to the Commissioners, and which is published in the appendix to their Second Report, (p. 67), and from the following statistical analysis of the facts observed. A. Relation of size of establishment to outbrenl; of disease. Of 35 establishments containing less than 10 cows, 22 were attacked, or 62 . 8 per cent. 22 „ „ 10 to 20 „ 15 „ 68.1 „ 6 „ „ 20 „ 40 „ 5 „ 83 . 3 ,, 5 „ „ 40 „ 400 „ 5 „ 100.0 „ The liability to suffer, increasing with the number of cows kept, favours the view that attributes the origin to contagion, since large cow-keepers buy in now cows more frequently than others and are thus more likely to introduce disease into their sheds. B. Relation of Cleanliness or Dirtiness to Outbreaks. Of 53 establishments habitually clean 37 were attacked or 69.8 per cent. „ 14 „ „ dirty 10 „ „ 71.4 „ The difference is not sufficient to establish any connection between outbreaks and mere want of cleanliness. C. Relation between Crowding in Sheds and Outbreaks. Of 44 sheds affording 200 to 600 cub. ft. of space per cow 35 were attacked or 79.5 pr.cnt. »20 ,, „ 600 ,,1000 „ ,, 14 ,, 10.0 „ „ 9 „ „ 1000 and upwards „ 4 „ 44.4 „ This is in favour of crowding as promoting outbreaks. Distributing the above instances into groups, according to the size of the establishment, it comes out that the influence of crowding is only perceived distinctly in the smallest establishments. In the larger establishments other causes may have operated more forcibly.* * "The theory that the disease originated in the London cow-sheds is inconsistent, not only with the evidence appended to our First Report, but with that which we have since received. The careful observations made by Dr. Ballard, Medical Officer of Health for St. Mary's, Islington, confirmed by those of the Medical Officers for Marylebone and St. Pancras, and the experience of other metropolitan districts, arc in direct conflict with this theory, and point distinctly to contagion as the means by which the plague was originated and propagated in London."—Second Report of the Cattle Plague Commissioners, (p. v.). 14 Relation between the Source of Water Supply and Outbreaks. Of 10 establishments supplied from superfl. wells on premises 9 attacked or 90 pr. cnt. „ 55 „ „ New River Company 37 „ 64.9 „ This influence of water, probably more or less contaminated, was most marked in establishments of medium size, little marked in the smallest establishments where the chances of any one cow suffering from this cause were less; and not obvious at all in the largest establishments where some other causes, such as liability to infection, predominate.* E. Relation between the mode of Storing the Dung and Outbreaks. Of 11 establishments storing dung of ithin the shed itself 10 were attacked or 90.9 pr. cnt. „ 56 „ not thus storing it 37 „ 66.0 „ The influence of the emanations from fermenting dung stored within the sheds is here obvious. Arranging the establishments * in the order of their size, it is found that this influence is only distinctly perceived in the smallest establishments The reason appears to be that in these the dung is retained longer and undergoes more fermentation, since it is not worth the while of a contractor to remove it until a sufficient load has collected. In my monthly report No. CIV. I have pointed out a similar relation in respect of typhoid fever in man. The general capaciousness of the shed, or the reverse, appear to have exercised no remarkable influence over the general result of this infringement of a sanitary law,* and the influence of crowding of the cows seems to have predominated over the influence of dung emanations where the crowding was excessive.* In 1857 I traced a similar relation between the storing of dung in sheds and the occurrence of lung disease.† The smallest establishments, from the less liability to any introduction of contagion, exhibit more distinctly than larger establishments the baneful predisposing influence of crowding, and the emanations from retained and fermenting dung stored within the sheds. The influence of a supply of water derived from superficial wells is most obvious in establishments of medium size. In the largest establishments the influence of all these predisposing causes seems to have been over ridden by some more important and immediate cause, such as would be the very much greater liability to the introduction of the specific poison from without. Proceedings of the Vestry in relation to the Plague. Having become acquainted with the existence and leading characteristics of the plague, on and after July 27th, I reported what I had ascertained to the Sanitary Committee on July 31st, and recommended the appointment of Special Inspectors to visit the sheds and slaughter-houses regularly; and I sent to all the cowkeepers in the parish a circular letter, containing sanitary advice. By the direction of the * Tables showing these points are published in the appendix to my evidence in the Commissioners report. I reproduce here only the most important tables. † The statistics are given in my evidence, p. 27. 15 Vestry, two such Inspectors were appointed, one an army veterinary surgeon on furlough from India, and another gentleman who had passed through a medical education. I found them very efficient. They were in constant communication with the Privy Council Inspector, and informed him wherever cases of plague broke out. They looked personally to the disinfection of sheds, dung, litter, &c. Towards the close of August, all your Inspectors received authority from the Local Magistrates to act as Inspectors under the Orders of the Privy Council: it was thought that in this way the hands of the local sanitary authorities would be strengthened. On October the 9th, Belle Isle had become so objectionable, and the practices there in the disposal of beasts so loose, that the Vestry saw proper to appoint an additional Inspector to watch proceedings there, and Mr. Godbold was constant in visiting the knackeries, superintending disinfection, &c. every day, and frequently also at night. On several occasions he was successful in arresting diseased oarcases of sheep, which were being removed for human consumption. When the year drew to a close it was thought unnecessary, from the changes which had been made in the orders issued by the Privy Council, to continue the services of these Inspectors any longer. That some such aotion as the Vestry took was necessary at the time, was shown by the fact that I had myself directed, just previously, tho seizure of 11 Dutch cows suffering from cattle plague, which I saw standing and awaiting slaughter in the pound attached to one of the ordinary slaughter-houses in the Metropolitan Cattle Market. Two large seizures of beef had also been made, one of 33 quarters, and the other of 32 quarters, on the premises of a salesman at Belle Isle; some of the beef had been salted, and the whole was destined as we afterwards discovered to conversion into German sausages. SANITARY WORK OF THE YEAR. Part of the work that has been done is mentioned in my remarks upon the Cattle Plague. Table V. shows that which relates to the house improvements carried into effect. At the time that the cattle Inspectors were appointed, two additional Inspectors were temporarily placed under my direction, in order to hasten on the house-to-house visitations, which were necessary in order to prepare for tho threatened invasion of cholera in the coming summer. The work before them was enough for a twelve month, and we did not begin it a day too soon. It was important that all drainage improvoments should be executed in the winter, and I confess to having felt disappointment when the Vestry declined to sanction the continuance of the services of the Special Inspectors beyond the close of the year. There was then a considerable amount of work ordered to be done, and notices to that effect had been served, but it bscame impossible to proceed, except in one or two very flagrant instances; while half of the districts which it remained to inspect and improve were left to be visited, as opportunity occurred, by your ordinary staff* Much improvement has been effected in the Irish Courts. Rose and Crown Court, what with the amendments in the houses, in the character of the tenants * Since this was written, the Vestry has appointed two additional Inspectors, whom I have employed upon the work thus left incomplete. 16 in the privies and water supply, and in the removal of the slaughter house—the licence for which was refused at the Michaelmas Sessions of 18G4, is quite ft different place to what it used to be. Some amendments have also been made, and are making in Waters Court, where a constant supply of water with Jenning's Waste Preventer has been given. The privies there caused some trouble at the commencement of the present year, but we are promised amendment in them, and a more careful selection of tenants to occupy the dwellings. During the summer also the Courts were cleansed by the contractor daily instead of once a week as heretofore* The privies and water supply in Swan Yard have also been improved. At the annual licensing of cow-sheds and slaughter-houses, licences were refused to Mr. Wace on account of the complaints made by the neighbours of the annoyance created by the manner in which he carried on his business as a slaughterman. Licences for cow-sheds were also refused to Mr. Liddiard of Hale-street, and Mr. Maynard in Giffard-street, on account of their having converted their cowsheds into stables. The former has been since convicted at the Police-court of keeping cows without a licence. Licences were granted for 105 slaughter-houses and 65 cow-sheds. The magistrates announced their intention of granting no licences at the next Sessions unless all the requirements of the Medical Officer of Health were complied with, and unless the cubical space allotted to each cow intended to be kept, amounted to 1000 feet. They stated that it was their intention to request a return specifiying these points from the Health Officer, and that they should in future state upon the licence the number of cows permitted to be kept in any shedSeveral of the licences for slaughter-houses were given for sheep only, where the arrangements for slaughtering oxen were insufficient. They expressed their intention to refuse another applic ation where in any instance this condition may have been infringed. It is right to chronicle the erection of model buildings, by the trustees of the Peabody gift, on the site formerly occupicd by Ward's Place. They are erected in four blocks bounding an open paved square for the recreation of the children. There are 32 tenements of three rooms each, for which five shillings weekly are charged; 104 tenements of two rooms each, for which four shi llings are charged, and 19 of one room each, for which two shillings and sixpence are charged. They were tenanted when the account, which I saw, was made up by C74 persons, viz. : man and wife 272, widows 19, children 383. The rooms struck me, in some instances, as rather small for the number in family; but the general arrangements are worthy of all commendation. The tenants also were of a class which it has always appeared to mo most desirable to provide suitable accommodation for. I may mention, in illustration, that some were persons whose average weekly wages were as low as 7s., and many were families where the available wages were from 24s. to 15s. Among the occupations of the tenants, I noticed "needlewoman," "charwoman," &c. I am. + Directions have also isccn given that during the present year certiin of the poorer localities shall be claeaned daily. 17 told that many are in receipt of parochial relief. I cannot see myself how this impairs the value of the erection to the poor. I shall keep a special record of the sickness and mortality in the Pcabody Buildings during the year, so far as my means for doing so extend, in order to make them the subject of a comparison with the sickness and mortality of the same classes of persons residing elsewhere. I must mention in conclusion, that I have been much dissatisfied with the manner in which of late the cleansing of the courts and alleys have been carried out by your contractor. Nor have the dust contracts been fulfilled in a manner to give me satisfaction. The custom of the men employed to collect the dust, of requiring payment of beer-money, and the mistaken good nature of those householders who habitually give it has led to the men almost looking upon the gift of money as their right. The result has been that in many poor localities the dust has been left to accumulate for weeks together, and then only to be removed on a special requisition to the Contractor from the Vestry Offices. I do not suppose that the tenants of such houses as I refer to are altogether free from blame themselves; but they have told me that the visitation of the dust cart is a rare event. This is certainly not as it ought to be, and points to the necessity either of some more stringent provisions for regular visiting of poor localities especially being inserted in the contracts, or else for a more regular and systematic inspection of dust collecting than is at the present time in force—perhaps to both of these amendments. I have also had to complain of the practice, in direct violation of the contracts, of making dust-heaps and sifting the dust within the parish, and in the immediate neighbourhood of inhabited houses* This should on no account be allowed. In one case I traced distinctly an outbreak of typhoid fever to this cause, one patient dying from the disease. The practice is most dangerous, and for the coming year, at any rate, should be strictly prohibited I have already in one of my Monthly Reports (No. CIV.) made a recommendation with respect to the Vestry undertaking the collection of the manure. I have the honour to remain, Gentlemen, Your very obedient servant, EDWARD BALLARD, M.D., M.R.O.P. April, I860. * Various amendments have, on my representation of these facts, been made in the Dusting Contract for the current year. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING (Deaths of Non-Residents West. East. Causes of Death. All Ages. AGES. Und. 1 1- 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80 Up. 1947 L866 All Causes 3813 1088 352 179 101 61 1781 142 63 72 486 512 625 13 (Classes.) 546 469 I. ZYMOTIC DIS. 1015 370 138 95 57 36 696 78 23 27 86 50 54 1 346 387 II. CONSTITUTL. 733 89 63 28 14 14 208 32 13 21 233 157 63 6 774 758 III. LOCAL 1532 328 130 50 25 10 548 29 24 22 133 282 434 60 225 210 IV. DEVELOPMNL. 435 259 20 2 .. 1 282 1 .. .. 14 6 70 62 52 37 V. VIOLENT DTHS. 89 36 1 4 5 .. 46 2 3 2 13 16 4 3 4 5 Not Specified 9 6 .. .. .. .. 6 .. .. .. 2 1 .. .. 494 438 (Orders.) I. 1. Miasmatic Dis 932 315 135 95 57 35 637 77 23 27 78 40 49 1 15 Small pox 58 11 6 1 1 2 21 6 3 5 18 3 2 .. 41 13 Measles 54 10 18 13 3 6 50 3 .. .. 1 .. .. .. 63 76 Scarlatina 144 9 19 21 26 13 88 40 4 3 6 3 .. .. 10 20 Diphtheria 30 5 5 2 5 2 19 6 1 2 2 .. .. .. .. 3 Quinsey 3 .. 1 .. .. .. 1 .. 1 .. .. .. 1 .. 9 16 Croup 25 3 6 4 5 5 2 19 6 1 2 2 .. .. 89 98 Hooping Cough 187 75 51 44 10 3 183 4 .. .. .. .. .. .. 65 50 Typhus & Typhoic 115 5 9 4 4 3 25 13 8 10 27 21 10 1 14 10 Erysipelas 24 8 2 1 1 .. 12 .. .. .. 3 2 7 .. 1 2 Pyœmia 3 .. .. 1 1 .. 2 .. .. .. .. .. 1 .. 12 2 Puerperal Fever 14 .. .. .. .. .. .. .. .. 1 11 2 .. .. .. .. Carbuncle .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 2 Influenza 3 .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 Dysentery 2 .. .. .. .. .. .. .. .. .. .. .. 2 .. 120 106 Diarrhœa 226 182 18 3 1 .. 204 .. .. .. 2 4 16 .. 3 9 Cholera 12 7 .. .. .. .. 7 .. .. .. 1 2 2 .. .. 1 Ague 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 17 14 Rheumatism 31 .. .. .. .. .. 2 4 4 6 7 2 6 .. 20 9 2. Enthetic 29 20 3 .. .. 1 24 .. .. .. 1 3 1 .. 18 8 Syphilis 26 20 3 .. .. .. 23 .. .. .. 1 2 .. .. 2 .. Stricture of Urethra 2 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Hydrophobia 1 .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. 28 17 3. Dietic 43 24 .. .. .. .. 24 1 .. .. 7 7 4 .. .. .. Privation 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 18 6 Want of Br. Milk 21 24 .. .. .. .. 24 .. .. .. .. .. .. .. .. 3 Purpura and Scurvy 3 .. .. .. .. .. .. 1 .. .. .. .. 2 .. 8 7 Alcoholism 15 .. .. .. .. .. .. .. .. .. 7 6 .. .. 6 5 4. Parasitic 11 11 .. .. .. .. 11 .. .. .. .. .. .. .. 6 5 Thrush 11 11 .. .. .. .. 11 .. .. .. .. .. .. .. .. .. Worms .. .. .. .. .. .. .. .. .. .. .. .. .. .. 43 56 II. 1. Diathetic 99 1 3 .. .. .. 4 .. .. .. 6 39 44 6 1 .. Gout 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. 8 7 Dropsy 15 .. .. .. .. .. .. .. .. .. 3 3 6 3 .. .. Hæmorrhage .. .. .. .. .. .. .. .. .. .. .. .. .. .. 29 42 Cancer 71 .. 1 .. .. .. 1 .. .. .. 3 36 29 2 l 3 Noma 4 1 2 .. .. .. 3 .. .. .. .. .. 1 .. 4 4 Mortification 8 .. .. .. .. .. .. .. .. .. .. .. 7 1 303 331 2. Tubercular 634 88 60 28 14 14 204 32 13 21 227 118 19 .. 14 7 Scrofula 21 7 4 2 1 .. 14 2 3 2 .. .. .. .. 15 46 Tabes Mesenterica 61 32 14 10 1 1 58 .. 2 1 .. .. .. .. 216 222 Phthisis 438 16 9 5 2 3 35 14 7 18 227 118 19 .. 58 66 Hydrocephalus 114 33 33 11 10 10 97 16 1 .. .. .. .. .. 197 191 III. 1. Nervous Syst 388 103 27 14 8 5 157 5 4 6 29 58 112 17 25 14 Cephalitis 3D 14 5 2 4 2 27 2 1 1 3 2 3 .. 38 36 Apoplexy 74 1 .. 1 .. .. 2 .. 1 .. 5 20 39 7 38 37 Paralysis 75 .. .. .. .. 1 1 .. .. .. .. .. 46 9 4 2 Insanity 6 .. .. .. .. .. .. .. .. 1 4 1 .. .. .. 1 Chorea l .. .. .. .. .. .. 1 .. .. .. .. .. .. 19 8 Epilepsy 27 .. .. 1 .. 1 2 2 1 2 8 8 4 .. 62 63 Convulsions 115 82 21 9 3 .. 115 .. .. .. .. .. .. .. 21 30 Brain Diseases, &c 51 6 1 1 1 1 10 .. 1 2 6 11 20 1 112 92 2. Organs of Circ. 204 6 .. .. .. .. 7 6 9 5 33 55 84 5 2 6 Pericarditis 8 .. .. .. 1 .. 1 1 1 1 1 3 .. .. 2 2 Aneurism 4 .. .. .. .. .. .. .. .. .. 1 2 1 .. 108 84 Heart Disease 192 6 .. .. .. .. 6 5 8 4 31 50 83 5 TABLE I. THE YEAR ENDING DECEMBER 80th, 1865. in Hospitals excluded). West. East. Causes of Death. All Ages. AGES. Und. 1 1- 2- 3- 4- Under 5yrs. 5- 10- 15- 20- 40- 60- 80 Up. 347 328 3. Respirat. Orgs. 675 192 100 32 151 3 342 9 .. 4 39 92 160 29 17 22 Laryngitis 39 20 9 5 2 1 37 .. .. .. l .. l .. 229 194 Bronchitis 423 107 54 15 9 l 186 3 .. l 26 57 127 23 4 2 Pleurisy 6 1 .. .. .. .. .. 1 .. .. l 2 1 .. 76 97 Pneumonia 173 64 36 12 4 1 117 5 .. 2 9 18 17 5 17 6 Asthma 25 .. .. .. .. .. .. .. .. .. 2 8 14 1 4 5 Lung Diseases, &c. 9 .. 1 .. .. .. l .. .. 1 .. 7 .. .. 79 96 4 Digestive Orgs 175 26 1 3 .. 1 31 6 5 3 22 64 47 7 3 3 Gastritis 6 2 .. .. .. .. 2 .. .. .. 1 2 1 .. 7 16 Enteritis 23 10 .. 2 .. .. 12 2 .. 2 3 2 1 .. 7 5 Peritonitis 12 2 .. .. .. l 3 1 .. .. 5 .. 1 .. 2 4 Ascites 6 .. .. .. .. .. .. .. .. .. .. 2 4 .. 1 2 Ulceration of Intes 3 1 .. .. .. .. 1 .. 2 .. .. .. .. .. 4 1 Hernia 5 .. .. .. .. .. .. .. .. .. .. .. 3 2 6 6 Ileus 12 1 1 .. .. .. .. 2 .. 1 1 2 4 .. .. 1 Intussusception ] 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. Stricture of Intest 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. Fistula 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. 7 10 Stomach Dis., &c 17 5 .. .. .. .. 3 .. .. .. 2 5 6 1 .. 1 Pancreas Dis., &c l .. .. .. .. .. .. .. .. .. 1 .. .. .. 4 8 Hepatitis 12 .. .. .. .. .. .. .. .. .. 3 4 5 .. 4 6 Jaundice 10 6 .. 1 .. .. 6 1 .. .. .. .. 1 2 32 33 Liver Disease 65 1 .. .. .. .. 1 .. .. .. 5 36 21 2 .. .. Spleen Disease .. .. .. .. .. .. .. .. .. .. .. .. .. .. 23 33 5. Urinary Orgs. 56 .. .. .. .. .. .. .. .. 3 11 16 22 2 1 .. Nephritis 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. 3 2 Nepnna 5 .. .. .. .. .. .. .. .. .. 1 .. 3 1 3 2 Disease of Bladder 26 .. .. .. .. .. .. .. .. 2 6 11 7 .. 2 2 Diabetes 4 .. .. .. .. .. .. .. .. .. 2 2 .. .. .. 1 Stone 1 .. .. .. .. .. .. .. .. .. .. .. l .. 5 3 Prostrate Disease 8 .. .. .. .. .. .. .. .. .. .. 1 6 1 4 7 Kidney Disease,&c 11 .. .. .. .. .. .. .. 2 1 1 2 5 .. 3 7 6. Genera. Organs 10 .. .. .. .. .. .. .. .. .. 1 3 6 .. i 4 Ovarian Dropsy 6 .. .. .. .. .. .. .. .. .. .. .. .. .. 2 3 Uterine Diseases. 5 .. .. .. .. .. .. .. .. .. .. 3 2 .. 7 8 7. Orgs.of Locomo. 15 .. 1 .. 1 .. 2 3 4 1 3 1 1 .. 5 6 Spine Diseases 11 .. 1 .. 1 .. 2 2 4 1 1 .. 1 .. 2 2 Bone Diseases 4 .. .. .. .. .. .. 1 .. .. 2 1 .. .. 6 3 8. Skin, &c. 9 1 1 .. .. 1 4 .. .. .. .. 3 2 .. 2 3 Phlegmon & Abscess 5 .. .. .. .. .. 2 .. .. .. .. 2 1 1 .. Ulcer 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. 3 .. Skin Diseases 3 1 1 .. .. .. 2 .. .. .. .. l .. .. 43 57 IV.1 Dis.of Childn. 100 93 6 .. .. .. 99 1 .. .. .. .. .. .. 37 40 Premature Birth 77 76 1 .. .. .. 77 .. .. .. .. .. .. .. 2 4 Cyanosis 6 5 .. .. .. .. 5 1 .. .. .. .. .. .. 1 3 Spina Bifida 4 4 .. .. .. .. 4 .. .. .. .. .. .. .. l 6 Other Malformatior .. 6 .. .. .. .. 6 .. .. .. .. .. .. .. 2 5 Teething 7 2 5 .. .. .. 7 .. .. .. .. .. .. .. 6 12 2. Dis. of Adults 18 .. .. .. .. .. .. .. .. .. 14 4 .. .. .. .. Paramenia .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6 12 Childbirth 18 .. .. .. .. .. .. .. .. .. 14 .. .. .. 78 55 3. Dis. of Aged. 133 .. .. .. .. .. .. .. .. .. .. 1 70 62 78 55 Old Age 133 .. .. .. .. .. .. .. .. .. .. 1 70 62 98 86 4. Dis. of Nutritn 184 166 14 2 .. 1 183 .. .. .. .. 1 .. .. 98 86 Atrophy & Debility 184 166 14 2 .. 1 183 .. .. .. .. 1 .. .. 38 29 V. 1. Acci.orNeg 67 27 1 4 5 .. 37 2 3 2 7 11 2 3 12 11 Fract. and Contus. 23 .. .. .. 1 .. 3 l 2 .. 5 8 1 3 1 1 Wounds 2 .. .. .. 1 .. 1 .. .. .. 1 .. .. .. 5 1 Burns and Scalds. 6 .. .. .. 3 .. 5 .. .. .. .. .. 1 .. .. 1 Poison 1 .. .. .. .. .. .. .. .. l .. .. .. .. .. 3 Drowning .. .. .. .. .. .. .. 1 1 l .. .. .. .. 17 12 Suffocation 29 26 1 .. .. .. 27 .. .. .. .. 2 .. .. 3 .. Otherwise 3 1 .. .. .. .. 1 .. .. .. 1 1 .. .. 8 2 2. Homicide 10 .. 9 .. .. .. .. .. .. .. 1 .. .. .. 6 6 3. Suicide 12 .. .. .. .. .. .. .. .. .. 5 5 2 .. .. 2 Wounds 2 .. .. .. .. .. .. .. .. .. 1 1 .. .. l 1 Poison 2 .. .. .. .. .. .. .. .. .. 1 1 .. .. 2 2 Drowning 4 .. .. .. .. .. .. .. .. .. 1 2 1 .. 2 .. Suffocat. and Hang 2 .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 1 Otherwise 2 .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 4. Unclassed .. .. .. .. .. .. .. .. .. .. .. .. .. .. TABLE II. SHOWING THE DEATHS FROM ALL CAUSES, AND FROM CERTAIN IMPORTANT DISEASES, AND CLASSES OF DISEASE, IN EACH SANITARY DISTRICT. Deaths in the Workhouse, and also those which could not be correctly referred to their proper District, omitted. Population, 1861 Districts. Total. Zymotic Diseases. Tubercular Diseases. Under 5 years. Phthisis. Respiratory Diseases. Small Pox. Measles. Scarlatina. Diphtheria. Hooping Cough. Diarrhœa, &c. Fever. 3306 *1. Highgate Hill 1OO 38 10 44 7 9 9 6 1 3 11 I 4118 *2. Tufnell 96 22 12 33 4 16 1 2 4 1 3 5 3 2096 *3. Belle Isle 55 12 9 24 7 15 2 3 4 1 9247 *4. Lowr.Holloway 301 83 37 152 29 53 8 5 12 16 18 10 903 5. Palmer 19 6 2 8 2 2 5 1 11542 *6. Bemerton 299 98 49 175 34 63 2 7 16 1 19 19 16 9039 7. Barnsbury 189 30 27 65 19 33 1 2 5 4 8 2 2793 8. Park Street 39 12 7 8 4 7 2 5 1 1 1 5202 9. Theberton 80 22 19 37 13 10 5 5 0 4 5826 10. Trinity 116 29 22 57 14 26 4 3 2 4 9 5 3892 11. St. Thomas 79 17 14 37 9 10 2 4 4 1 2451 12. White Conduit 66 18 7 35 6 10 1 7 4 6 10428 13. Canal 197 59 32 110 25 43 3 5 8 2 11 15 7 2822 14. Battle Bridge 91 35 11 57 9 18 3 2 1 13 8 4 5860 *15. Archway 186 43 38 88 22 34 7 3 7 2 8 7 5 1632 *16. Hornsey Rise 34 9 3 15 2 6 2 1 1 1 1 2097 *17. Freehold 90 23 16 59 8 16 1 3 3 9 5 2145 *18. Hornsey Road 76 15 14 33 9 18 2 1 3 2 4 3053 *19. Queen's Road 89 25 12 45 11 23 2 6 1 4 5 4 2231 20. Highbury Hill 32 7 3 7 3 7 4 1 1 1029 21. Highbury Yale 17 4 5 6 3 1 3 1 9299 22. Canonbury 156 31 | 21 47 18 27 1 9 4 2 8 4 3711 *23. Rydon 57 13 9 19 6 11 2 1 2 5 2 2176 *24. Mildmay 77 17 13 29 11 11 1 7 1 5 1 4431 25. Kingsland 103 33 16 61 12 11 1 1 10 1 10 4 3 3041 26. Balls Pond 97 25 16 64 7 16 4 10 8 1 3739 *27. Market 61 17 12 22 10 8 1 2 1 1 7 1 5700 28. Rotherfield 118 31 25 46 18 16 1 3 1 5 10 7 2685 29. Church 44 12 3 24 2 13 1 7 1 10539 30. Lower Road 232 64 37 111 30 37 2 2 7 2 14 15 7 5411 *31. Shepherdess 134 43 16 69 11 24 1 5 3 8 15 7 5609 32. St. Peter's 146 29 31 70 24 30 4 7 7 3 819 33. Duncan 20 1 3 1 2 1 1 1042 34. Irish Courts 23 4 7 12 6 3 3 2 2979 85. City Road 54 14 15 28 6 10 1 3 4 4 * Districts in which Building was in progress at the time of the Census. TABLE III. DEATHS FROM DIARRHÆAL AFFECTIONS DURING FIVE YEARS IN THE SEVERAL DISTRICTS OF ISLINGTON. 1861 1862 1863 1864 1865 Total. Per 1000 Persons. *Highgate Hill 1 2 3 4 11 21 6.3 *Tufnell 2 — 2 1 5 10 2 .2 *Belle Isle 1 a 5 2 4 14 6.6 *Lower Holloway 12 7 16 15 18 68 7.3 Palmer 2 — 1 3 5 11 12.1 *Bemerton 19 8 30 26 19 102 8.8 Barnsbury 3 6 7 8 8 82 3.5 Park Street 1 — 3 2 1 7 2.5 Theberton 6 4 6 7 6 27 5.1 Trinity 3 3 4 1 9 20 3.4 St. Thomas 3 2 3 5 4 17 4.3 White Conduit 6 1 3 4 6 20 8.1 Canal 13 15 12 10 15 65 6.2 Battle Bridge. 4 2 2 2 8 18 6.3 *Archway 4 1 1 9 7 22 3.7 *Hornsey Rise 1 — — 1 1 3 1.8 *Freehold 3 — 6 4 5 18 8.6 *Hornsey Road 3 1 1 5 2 12 5.5 *Queen's Road 3 1 4 9 5 22 7.2 Highbury Hill — 1 1 1 1 4 1.7 Highbury Vale 1 2 — 1 — 4 3.8 Canonbury 6 1 9 4 8 28 3.0 *Rydon 2 1 — 2 5 10 2.6 *Mildmay 3 2 2 6 5 18 8.2 Kingsland 6 — 5 3 4 18 4.0 Balls Pond 4 4 7 5 8 28 9.2 *Market 2 3 4 5 7 21 5.6 Rotherfield 10 7 2 3 10 32 5.6 Church 3 2 5 5 1 16 5.9 Lower Road 13 10 19 11 15 68 6.4 *Shepherdess 9 2 3 8 15 37 6.8 St. Peter's 1 2 4 4 7 18 3.2 Duncan 1 — — — — 1 1.2 Irish Courts 2 2 2 2 2 10 9.5 City Road 1 1 3 1 4 10 3.3 TABLE IV. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIFTY-TWO WEEKS ENDING SATURDAY, THE 30TH DAY OF DECEMBER, 1865, AT THE FOLLOWING INSTITUTIONS, WITH THE TOTALS FOR EACH YEAR FROM 1860 ONWARDS. 1860. 1861. 1862. 1863.* 1864. Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. 142 27 80 509 86 Small Fox 3 11 163 35 19 2 222 96 92 86 83 89 Chicken Pox .. .. 55 21 4 .. 80 672 289 740 410 719 Measles 5 5 149 44 14 .. 217 253 281 321 672 293 Scarlatina .. .. 192 106 40 .. 338 304 529 304 579 314 Whooping Cough 2 6 340 197 97 .. 642 14 15 18 24 45 Croup .. .. 8 12 1 .. 21 878 1641 1137 1549 1367 Diarrhœa 30 1 784 472 172 52 1511 26 65 31 7 11 Dysentery .. .. 7 5 .. .. 12 1 8 1 1 9 Cholera .. .. 1 2 .. .. 3 58 21 11 11 3 Ague 1 .. 7 6 .. .. 14 152 284 348 363 261 Continued Fever 11 .. 104 153 27 .. 295 2 1 6 2 .. Puerperal Fever 1 .. 1 4 .. .. 6 77 112 99 119 89 Rheumatic Fever 19 .. 19 65 34 1 138 128 150 167 164 142 Erysipelas 7 .. 81 47 19 .. 154 8 11 24 28 16 Diphtheria .. .. 6 13 7 .. 25 376 507 536 741 569 Sorethroat or Tonsillitis 1 .. 202 214 118 7 542 Not specially noted. 13 6 Mumps .. .. 12 .. .. .. 12 .. 1 Pyæmia .. .. .. .. .. .. .. 4521 3968 4660 5157 4703 Bronchitis and Catarrh 156 4 2411 1080 642 314 4607 110 61 54 100 116 Pneumonia 3 1 36 30 35 .. 105 34 57 44 76 83 Pleurisy 1 .. 58 26 20 2 107 14 6 11 10 17 Delirium Tremens 15 .. 16 1 .. .. 32 61 61 72 72 83 Insanity 42 .. 71 3 .. 3 119 16 17 20 20 16 Carbuncle .. .. 7 8 .. 6 20 17257 19807 20192 21716 19778 All other Diseases 486 124 5740 6126 5920 1480 19876 25100 28000 29011 32426 28816 Total 783 141 10469 8670 7174 1861 29098 * Includes fifty-three weeks. No correction is made for this, TABLE V. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From March 26th, 1865, to March 25th, 1866. West SubDistrict East SubDistrict. Whol Parish Number of houses inspected 1040 1157 6798 Drains Constructed 94 57 151 Improved or repaired 257 253 610 Traps fixed 247 288 1041 Cesspools Abolished 9 3 14 Cleansed or disinfected 1 1 2 Privies and Water Closets Pan, trap, and water supply furnished 38 21 66 Pan and trap only furnished 44 1 72 Water supply furnished 113 67 548 Dust bins Constructed 45 89 189 Repaired and covers adapted 60 135 309 Surface Drains and Pavements of Yards Constructed 8 64 79 Relaid 213 169 401 General Water Supply New receptacle provided Receptacle repaired and cleansed 32 86 13 99 45 293 Water supply provided 27 10 37 Other Improvements Houses generally repaired 51 42 181 „ cleansed or limewashed 133 175 314 „ ventilated 17 •• 17 Overcrowding abated 43 24 79 Illegal use of underground Rooms for sleeping discontinued 39 41 * Including Special Inspections and work done under direction of Special Inspectors. As these gentlemen were discharged at the end of December, the Table does not include all the work done under notice from them.