ISC REPORT ON THE SANITARY CONDITION OF The Parish of St. Btarg, Islington, DURING THE YEAR 1868. by EDWARD BALLARD, M.D., (Lond.) MEMBER of THE ROYAL COLLEGE of physicians ; fellow of the royal MEDICAL AND chirurgical society OF london, etc. MEDICAL OFFICER OF HEALTH. J. & I. TIREBUCK, STEAM PRINTERS AND LITHOGRAPHERS Monkiyell Street, E.C., and Islington. 1869. 1 TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, The year 1868, to which this my Thirteenth Annual Report relates, has been a remarkable and will be a memorable year, in respect of three conditions which have important bearings upon public health. It has been a year of depressed trade, of high prices of provisions, especially of bread, and of unusual heat and dryness. Pauperism has been excessive; the average price of wheat, prior to the harvest, reached 72s.; the temperature in August rose to 93° in the shade (at Greenwich to 96 6°), and the land was universally parched up for lack of rain. In the regions of the globe, most liable to such convulsions, devastating earthquakes, volcanic eruptions, and marine inundations have been the order of the day. How have these unfavourable conditions affected us here ? I may reply in brief, that they resulted in an amount of general sickness among the poor, which, measured by the records which I keep, has been unprecedented during the thirteen years that I have held my present office; but that the mortality of our population has not been by any means excessive. The contrast between the sickness and mortality tables, as presented by their totals, is striking. Had I merely the latter to guide me, I should have called 1868, notwithstanding its meterological characters, a healthy year. It was a year in which fewer people died than has been customary with us, but the general health of the mass of the population, of that part of it which is most open to the operation of the influences I have mentioned, was depressed. MORTALITY AND SICKNESS. Four thousand two hundred and ten deaths of residents in the parish were registered during the 53 weeks ending January 2nd, 1869. To this number we may add 247 deaths as our share of those occurring in various prisons, hospitals, &c. in the metropolis. The total 4457 being reduced for comparison with former years, will give us 4373 deaths. 1 estimate our population, in the middle of 1868, (at the ordinary rate of increase) at 210,568 persons. Hence our death-rate for the year may be stated at 207 per 10,000 living. The death-rate in London at large was 235. 4 The Births registered during the year are represented in the following table:— West Sub-district. East Sub-district. Whole Parish. Males. Fems. Total. Males. Fems. Total. Males. Fems. Total. 1st Quarter. 492 490 982 502 477 979 994 967 1961 2nd Quarter. 489 462 951 479 466 945 968 928 1896 3rd Quarter. 475 413 888 485 438 923 960 851 1811 4th Quarter. 519 465 984 533 533 1066 1052 998 2050 1975 1830 3805 1999 1914 3913 3974 3744 7718 It is clear that of late the eastern half of our parish has been growing in population more rapidly than the western half. Yet the deaths registered in the former have been less numerous than in the latter. The excess of births oyer deaths has been 3261; rather less than last year; a result which corresponds with the slightly increased death-rate. Probably about 6766 persons have been added to our population, during the year, by the difference between immigration and emigration. Of the 4210 deaths registered, 2118 were of males and 2092 of females. The number of new cases of sickness recorded during the 53 weeks in the pauper practice of the parish, at the Dispensaries and the Pentonville Convict Prison, was 41,077. Reducing this number by 1/53, we have 40,302 for comparison with former years. In 1867 the number was 34,692. CAUSES OF SICKNESS AND DEATH. Table I. exhibits the several causes of the deaths registered in the parish during the year, and Table II. the nature of the more important cases of sickness which have been recorded in the books to which I have access. The diseases which have prevailed most extensively have been measles, scarlet fever, hooping-cough, diarrheal affections, erysipelas, and inflammatory affections of the throat. Diseases of the Organs of Respiration occasioned 737 deaths, just about half of which, namely 365, were of children under five years of age, and 296 of adults, aged forty years and upwards. This total was exceeded in 1867 and 1864. The number of cases recorded in the public practice of the parish was 7267. In 1867 it was 6552. Compared with the eleven previous years, these diseases prevailed most during the spring, summer, and autumn quarters, especially in the last of them. 5 Diarrheal affections, including cholera and dysentery, occasioned 293 deaths; a number which exceeded the mortality from similar affections, even of the cholera year 1860, when diarrhoea, cholera, and dysentery together occasioned 245 deaths. The number of cases recorded in the public practice of the parish was 2514. In 1867 it was 1750, which, with the exception of 1866, was the largest number registered up to that time. The summer outbreak of these affections commenced as usual in the fourth week of June, but previously to this the number of cases had been more numerous than is customary. The maximum number of cases was attained in the first week of August, after which they declined. The severity with which in any year the diarrhoeal season sets in, in the month of June, depends very clearly upon the heat and dryness of the atmosphere, and similar conditions govern the prevalence of diarrhoeal affections throughout the summer quarter. This being so, the meteorological conditions of last year sufficiently account for the high number of cases recorded in the month of June and the succeeding months of July and August. An analysis which I have made of the records of sickness here, as compared with the weather during the past twelve years, shows that nothing like an abrupt increase of diarrhoea happens until the mean temperature rises above 60°. Last year the outbreak of diarrhoea followed this observation, for in the second week of June the mean temperature rose from 60.3° to 65 4°, and in the same week the first indication of the commencement of the diarrhoeal wave was given. I have also found that the summit of the diarrhoeal wave is not reached until about two weeks after the highest summer temperature has been attained. So also last year, the highest mean temperature of any week, 70'7° was attained in the third week of July, and the largest number of cases of diarrhcea was recorded two weeks later, viz.: in the first week of August, the greatest atmospheric dryness having been observed in the preceding week. Measles, as I pointed out in my last Annual Report, is a disease which only spreads extensively among us every second year, having thus a biennial period of cyclical recurrence as a severe epidemic. As a rule, however, it spreads, more or less, every spring and autumn, never being completely absent; thus it was due, as a severe epidemic, last year. The number of deaths registered from this disease was 147. In 1867, they only amounted to 39. The number of cases occurring in the public practice of the parish was 838; in 1867 it was 336. The experience of the past twelve years teaches us that, although the autumnal epidemic, commencing usually about the month of November, is the more constant and certain in its occurrence, and also the more fatal in consequence of its pulmonary complications, yet that on the whole the spring epidemic, usually commencing in May, is that which is the wider in its extension among our population. Comparing the prevalence of measles with conditions of season and weather, I have arrived, among others, at the following inferences, from observations made during the years 1857 to 1868:—1st. That the condition promotive of an outbreak of measles, in any year, is a mean temperature between 43° and 48°, especially if assisted by 6 comparative atmospheric dryness, and. little rainfall. 2nd. That a rise of mean temperature above 60°, and a fall below 42°, tend to arrest an existant epidemic. 3rd. In the spring, the spread of measles is promoted by comparative coolness and dryness of the atmosphere, with excess of rainfall; and in the autumn, by comparative warmth and dryness of the air, especially when the rainfall is small. Last year, the spring epidemic was lessened in duration and extent by the comparatively high temperature of the season, the severity of the epidemic due that year being reserved until the temperature fell to below 49° in the beginning of November. December being very mild, the disease extended most in that month. Scarlet Fever furnished 160 deaths to our Mortuary Table, so that, taking into account the additional week, it was quite as fatal as in 1867. The number of cases recorded in the public practice of the parish, however, was smaller, namely, 494 against 641 in 1867. The disease, then, must be regarded as probably more deadly, though less extended, than it was in 1867. The experience of 12 years led me to expect that the disease would have abated in the course of the winter of last year, and that the year 1868 would not have been marked by a continuance of the epidemic. Scarlatina is essentially an autumnal disease. An analysis of my records from 1857 to 1868 has led me to the following inferences respecting it:—1st. That a mean atmospheric temperature about 60°, or between 56° and 60° is that most favourable to its outbreak as an epidemic. 2nd. That for its free development, it is necessary that the humidity of the atmosphere shall not exceed 86, or much less than 74 (saturation = 100). 3rd. That while a higher mean temperature than 60° does not appear to be in itself unfavourable to its spread, a fall of mean temperature below 53° tends to arrest an epidemic of the disease. 4th. That in all seasons of the year,—but more decidedly in the winter and spring,—seasons in which scarlatina is not commonly epidemic—its extension is favoured by a mean temperature above the average. Applying these results of my experience to the events of last year, a sufficient explanation is afforded of the continuance of the epidemic. This epidemic commenced with an outburst of the disease in the autumn of 1866. It subsided a little during the winter quarter of 1867, but then increased, as it usually does, month by month, from April until October, upon which month, the chief violence of the epidemic was expended. A partial subsidence of the disease then occurred, continuing through January, February, and March, 1868. The spring months of this year—which, with the winter months, were remarkable for high temperature—saw, however, the epidemic reviving, and it was as severe, to say the least of it, in the spring and summer of last year, as in those of 1867. After September, the susceptibility of the population having been tolerably exhausted, the epidemic declined. Unless we have a recurrence of the remarkable seasons which marked 1868, we may expect now to be free, for some time, from any severe epidemic of this disease. Hooping Cough prevailed extensively in 1868, especially in June and December. There is nothing cyclical in the recurrence of epidemics of hooping cough; nor does it appear to prefer for its extension one season of the year much before another. All 7 that need be said of it is, that it is usually rather more prevalent in the spring than in the autumn and winter, and that it is least prevalent in the summer. An analysis of my records for 12 years, however, leads to the following conclusions:—1st. That the spread of hooping cough is favoured by a mean temperature above 46°, and especially by one between 57° and 60°. 2nd. That a mean temperature above 60° is very unfavourable to the disease, and distinctly promotive of its decline when epidemic. 3rd. That a mean temperature below 40° is also less favourable than one between 40° and 46°, but more favourable to the spread of the disease than a mean temperature above 60°. 4th. That in all seasons of the year, with the exception of the autumn, the extension of hooping cough is promoted by a comparatively warm and dry atmosphere; in the autumn, a warmer and moist season seems most favourable to it. Great atmospheric dryness, and little rainfall, appears capable of counteracting, to some extent, the unfavourable operation of a mean temperature above 60°. The peculiar conditions of weather, during 1868, then, were just those which were likely to be promotive of an extension of hooping cough among our population. One hundred and fifty-eight deaths are recorded in the Mortuary Table, and 668 cases in the public practice of the parish. Erysipelas prevailed unusually during the months of September, October, and December. It abated during the cold weather of Novomber, to revive as soon as the temperature rose above the average in December. Ninety-three out of the 197 cases on our Sickness Table happened in these four months. The number of deaths registered, during the year, was 32. Sore Throat, or a disease thus designated, gives the high number of 950 cases to our Sickness Table. In 1867, only 543 cases were recorded. It had been very prevalent all the year; but in September, when scarlet fever was abating, the monthly number of cases rose suddenly from 69 to 135. Ninety cases were recorded in October, 110 in November, and 159 in December. I am not prepared to say to what form of disease these cases were allied, but it is remarkable that the increase of cases coincided, in point of time, with the extension of erysipelas. THE EPIDEMIC OF SMALL-POX, 1862-68. At the close of July, last year, or the beginning of August, came to an end an epidemic of small-pox with which we had been plagued, with little remission, for nearly six years. It commenced in the middle of November, 1862—the disease spreading extensively in the month of December. It was preceded by a very heavy epidemic of measles, the principal violence of which was expended upon the months of June and July. This subsided through August and September; but an autumnal epidemic occurred concurrently with the small-pox outbreak in November and December. Both diseases subsided during the early months of 1863. In the spring of 1863, the severest burst of small-pox occurred, 239 cases having been recorded in the public practice of the parish during the months of May and June alone. In the summer of this year the cases became fewer; they wero still less numerous in the autumn, and the disease was very 8 much less prevalent throughout 1864. In the first quarter of 1865, smallpox began to revive, increasing in extent till the end of July, or the beginning of August, after which, it again declined till the month of March, 1866. In 1863, 609 cases were recorded in the public practice of the parish, and 108 deaths on the Mortuary Table; in 1864, 86 cases, and 26 deaths; in 1865, 222 cases, and 58 deaths. Small-pox prevailed extensively throughout 1866, and towards November assumed still more serious proportions, continuing severe during the whole of the first two quarters of 1867. It subsided considerably in the summer of 1867, but recovered itself somewhat in the autumn; after which, little change occurred until August last year, when it almost suddenly disappeared. In 1866, 332 cases were recorded in the public practice of the parish, and 67 deaths on the Mortuary Table; in 1867, 349 cases, and 71 deaths; and last year, 182 cases only, and 45 deaths; almost all of them prior to the month of August. The November outburst of smallpox, in 1866, was preceded by a heavy spring and summer epidemic of measles, and the subsidence of the disease in 1868 was followed by the epidemic of measles recorded in an earlier part of this Report. Altogether, from the beginning to the end of the epidemic, we have lost by death, from small-pox, above 480 persons. The disease prevailed at first most extensively in the Thornhill Ward, and especially among the poor population of the Bemerton District, where measles had prevailed greatly in the earlier part of 1862. From this part of the parish, it extended to Lower Holloway; and in the early part of 1863 to the Balls Pond and Queen's Road districts, where measles, in 1862, had been severely epidemic, and where the population was poor and negligent. In these districts, and in the Barnsbury district, the small-pox was most prevalent in the months of May and June, 1863. At later periods of the epidemic, Upper Holloway and the new streets— inhabited by the labouring classes in that part of the parish—suffered considerably. It is interesting to note the ages of the persons who were thus attacked, because this is a point which has a practical bearing upon the protective influence which the vaccination of the people has had in the progress of the epidemic. I have recorded the ages of 1,359 of those attached. They were as follows :— Total Under Under Age 70 and Cases. 1 year 1- 2- 3- 4- 5yrs. 5- 10- 15- 20- 25- 30- 35- 40- 50- 60- upwards In 1862 61 1 3 1 6 11 8 5 13 9 7 3 3 2 1863 393 10 11 16 14 14 65 60 59 67 60,43 14 11 10 1 3 1864 76 4 2 3 1 7 17 12 ,9 14 6 7 4 3 4 1863 167 3 3 3 3 12 16 32 33 30 14 9 6 8 1 I860 276 10 7 10 4 8 39 30 27 41 69 39 10 12 8 1 1867 255 11 9 10 8 10 48 37 23 37 51 22 17 7 8 4 1 1868 131 3 1 2 4 3 13 16 17 24 24 20 6 7 3 1 Total 1359 41 j 34 47 35 48 205 179 172 229 255 152 63 49 43 7 4 1 Of the infants under 1 year of age, there were aged:—Under 3 months, 10; under 6 months, 11; under 9 months, 10; and under 12 months, 10. 9 This table is highly instructive, because the accumulated experience of 70 years has demonstrated that there is a vast difference in the manner in which small-pox attacks persons of different ages, according to whether they have, or have not, been vaccinated, and according to the excellence or badness of the vaccination they have received. We deal here with a population which is supposed to be a vaccinated one, and no doubt the vast majority have undergone the operation, more or less successfully; but among our 210,000 of people, there are a good many who have not been vaccinated at all, so that the result of an epidemic of small-pox is a mixed one, so far as the ages at seizure are concerned. It may be taken as certain, that the more perfect and complete the vaccination of a population, the later in age will be the period at which the small-pox virus will operate during an epidemic epoch. Thus it comes to pass, that the numbers attacked at ages under five, or under ten, as compared with the total attacks at all ages, is an index tolerably faithful of the completeness or incompleteness of its vaccination. Between the ages of 15 and 25 years, there is a natural tendency, both in the vaccinated and unvaccinated, to suffer from small-pox contagion, although these two classes of persons suffer very unequally; but in young children, well vaccinated, the protection afforded by vaccination is almost perfect, if the vaccination be good. It is no matter of surprise, then, that 36 per cent. of the cases of small-pox happened at ages between 15 and 25; but it is a matter of practical import, and one which demands serious consideration, that as many as 21 per cent., or about a fifth of the attacks, occurred in children under 10 years of age. If the whole population had been vaccinated—assuming the ordinary proportion of bad vaccination to have prevailed—not more than 10 per cent, ought to have suffered under this age; and if the vaccination of all had been good, still fewer. The infantile attacks of small-pox, then, was at least twice as numerous as they should have been, and as they would have been, had the vaccination of all the children in the parish been properly attended to. Still we owe it to the general vaccination of our population, that the epidemic of 1862-8 was not a far more serious affair than it actually was. A severe epidemic of small-pox tends to drive parents to obtain for their children a long-neglected protection, and hence, perhaps, in part, it is that the proportion of children attacked varied in the several years during which the epidemic lasted. Thus:— In 1862 31 per cent, of those attacked were under 10 years of age — 1863 31 „ „ „ 1864 39 ,, „ „ — 1865 17 „ „ „ — 1866 25 „ „ „ — 1867 33 -1868 22 People of the lower classes are slow to learn, slow to receive warning, and quick to forget. 10 The results of a consideration of the ages of those attacked are confirmed by the records of small-pox mortality throughout the parish. The ages of 390 person who died of this disease, during the epidemic period, were as follows:— Years. Total Deaths. AGES. Under | 1 year 1- 2- 3- 4- Under 5 years. 5- 10- 15- 20- 40- 60 & upw da. 3862 15 3 1 3 1 1 9 .. .. 5 1 .. .. 1863 108 20 10 6 6 4 46 9 4 6 33 9 1 1864 26 5 3 .. 1 5 14 2 1 2 4 3 .. 1865 58 11 6 1 1 2 21 6 3 6 18 3 2 1866 67 14 6 3 3 4 30 7 4 3 20 3 .. 1867 71 17 1 4 4 3 29 5 3 7 20 6 1 186S 45 8 4 3 7 3 25 4 1 5 7 3 Totals 390 78 31 20 23 22 174 33 16 33 103 27 4 Out of 390 deaths, 207, or more than half, were of children under 10 years of age. The following numbers represent the proportionate degree in which our population suffered at different ages, when the numbers living at the several ages is taken into account. Cases generally. Total Cases. Per 10,000, living at each age (1861.) Under 5 years 98 84 5 and under 10 years 10519 10 „ 15 „ 12111 15 „ 20 „ 153.22 20 „ 25 „ 160} 25 ,, 30 ,, 106} 19 30 „ 35 „ 51} 35 „ 40 „ 46} 97 40 „ 50 „ 26} 50 „ 60 „ 7}19 10 60 ,, 70 ,, 7} 70 and upwards „ 4 } 6 4 That is to say, taking equal numbers of persons at the different ages, the first column shows the proportionate number at each age attacked during the epidemic; and the second column the proportionate numbers of those attacked fatally. The second column is a true statement of the fatal cases throughout the parish, which occurred during the epidemic. The first refers not to the cases generally per 10,000 living, but, supposing merely an equal number of each age had been living during 1862—8, they would have been attacked in the relative proportion which these numbers indicate. I have not a record in ages of more than a small number of the cases that occurred. 11 The lessons which a comparison of these two columns teach us are:—1st. The increase in liability to attack, which our population exhibited as age advanced with them up to the age of 25 years, a liability most marked between the ages of 15 and 25 years, steadily lessening after the age of 25 years. If we had had to do with a population entirely unvaccinated, we should have had a much larger proportion under five years. Secondly. The extreme fatality of small-pox under five years of age, its greatly lessened fatality when the attack takes place at an age increasing up to 15 years, and its increased fatality again as age advances from 15 to the end of life, that is to say, as the weakening of the influence of early vaccination proceeds with lapse of time, and the vital resistance to disease become impaired with advanced age. Thirdly. The practical importance of renewing the protection of a primary vaccination at the age of 15 or 16 years. Among the poor, re-vaccination is rarely if ever sought, and no encouragement or facilities are afforded to its performance, and yet its neglect is one of the most serious aids to the spread of an epidemic. It is true that the male labouring population cannot afford the loss of time which it would involve, and I do not see how they could be reached effectually. But it is otherwise with the young women of the same class, who, living in service or being occupied in light trades, would not suffer so much inconvenience: these might be reached easily enough, and facilities might be given them by the appointment of a time of day for re-vaccination, at which it would be convenient for them to attend at the vaccinating station. The circumstances under which the epidemic was brought to a close are worthy of being noted. It did not terminate because the children of the parish had all been well vaccinated, and the adults protected by re-vaccination; this protection had nothing to do with it. It came to an end, as a result of climatic conditions of the atmosphere. One of the results of my experience here, during twelve years, is that the mean temperature of 52° marks off a condition of atmosphere which has a great deal to do with the spread of small-pox, since a temperature below this favours its extension, while a temperature higher than this tends to check it. Now the month of July was one of very exceptional heat; the mean temperature of the third week in July was 70 7 ; of the fourth 69 2°; of the first week in August 67.6, and of the second 69.8°. It was this which apparently extinguished small-pox. SANITARY WORK OF THE YEAR. The mode in which the work of the Sanitary Department is now recorded by Mr. ColliDgwood, enables me to furnish a more extended table than it has been my custom to give of the inspections and visits made by our inspectors, and of the improvements carried out upon premises under the direction of the Committee. I need do no more than refer you to this table for any information desired upon this subject, except to say, that we have continued the practice of carrying out any necessary disinfections in poor houses ourselves and, I have reason to believe, with the best results. With respect to the factories at Belle Isle, we have had complaints, chiefly from one individual, of the nuisance arising from Fretwell's Manure Works, 12 and Turner's Varnish Factory. Both complaints appeared to me to be well founded. The manure being made from fish refuge, coprolites, and sulphuric acid, gives rise, on the mixing, to very offensive vapours; and, although means were in use to carry off these vapours into the furnace, they did not appear to me to be effectual, and there were occasions on which the escape of effluvia was not obviated. I have accordingly suggested certain structural alterations in the works, and the adoption of mechanical appliances, which are now being carried into effect; and although I can scarcely hope that the nuisance will be entirely done away with, I look for its being reduced to the practical minimum. With Mr. Turner I have had more difficulty, in consequence of obstructions which we have met with from his workpeople, who not only neglected to use the Heywood fan, with which they were provided, but on several occasions impeded our entry for the purpose of inspection. The serious representations I made to Mr. Turner have resulted in some improvement, however, in both these respects, and, at my request, he has now provided a hotair engine to work the fan, so as to remove the difficulty which invariably arises, where mechanical appliances, for the prevention of trade nuisances, are not selfacting. In the course of the year, an attempt was made to establish, at Belle Isle, an offensive trade, connected with cloth-workers' refuge. In this instance the strong representation I immediately made had the effect of leading to its speedy abandonment, and the premises are now occupied, without producing any nuisance, by a soapboiler. The only remaining trade nuisance I have had to deal with was one arising from the japanning of wicker baskets, at some works established at Balls Pond. I explained to the principals that this could not possibly be permitted; accordingly, they applied to the Surveyor of the Metropolitan Board of Works, who permitted them to establish the business at Belle Isle. Two new sanitary statutes came into operation during the year. 1. The Workshops' Regulation Act, which professes to regulate the hours of work of children, young persons, and women, in establishments where less than 50 hands are employed, and to provide for the use of a fan, or other mechanical means of obviating injury to workpeople in dusty trades. An inquiry which I instituted here has demonstrated that there exists, in this parish, a very large number of such establishments as would fall naturally under the operation of this Act. The most numerous trades are those of artificial flower making, millinering, and mantle making; and it was thought, that to these, and especially to the first of them, it would be highly desirable that the Act should be applied. The difficulties we have met with, however, are such as have entirely prevented our taking any action to enforce its provisions. First of all, the local authority has only power of entry on complaint, and with the order of a magistrate. Secondly. When entry has been obtained into a place where children are employed, there is no way of arriving at their age, except by interrogating the children themselves, who find it to the interest of themselves and their parents to tell the most palpable falsehoods upon this subject. Thirdly. The permanent exceptions are of such a nature as render it 13 morally impossible to bring home to offenders an infringement of the Act, without such an expenditure of time in inquiry by our inspectors, as I have not felt warranted in sanctioning under the circumstances; and, lastly, a number of representations made to me by artificial flower makers, has convinced me that the exigencies of their trade, from the great irregularity of the orders they receive, are such that, for the present, it would be inexpedient to press this Act stringently against them. Excellent, then, as the provisions of the Act are in their intention, and highly necessary as I find it to be that the hours of labour of young children and young women in this parish should be regulated authoritively, I have felt it beyond my power to enforce them here as yet, and have consequently limited myself to requiring the provisions of the Sanitary Act to be observed, which enables us to deal with such questions as unwholesome crowding, cleanliness, and ventilation. In these respects, a good many amendments have been made. Two summonses were taken out, under this Act, during the year, one resulting in an improvement as to crowding and ventilation, the other in the abandonment of some unwholesome dark underground rooms as workrooms for children employed in artificial flower making. A handbill has also been distributed to the several workshops known, calling attention to the provisions both of the Workshops' and of the Sanitary Act. 2. The Artizans' and Labourers' Dwellings' Act.—This Act throws upon the Officer of Health the duty of reporting to the local authority any premises which are in a condition or state dangerous to health, so as to be unfit for human habitation, so long as the premises are occupied by working men and their families. I had, therefore, to consider what the cases are in which it would be more desirable to apply this Act than those Acts which we have hitherto used, namely, the Nuisances Removal and the Sanitary Acts. It was evidently the intention of the Legislature, by the passing of Torrens' Act, to afford to local authorities a remedy for local defects, more radical in its character than they yet possessed, inasmuch as they are empowered to require demolition, partial or entire, where it appears to them that nothing short of this will render premises wholesome. Taking this view, I determined that the following cases would constitute a series in which it would be right for me to sot the Vestry in motion, with the object of obtaining radical amendments. First.—Where unwholesomeness exists, dependent on dampness arising from the foundation, and where consequently structural alterations, drainage, &c. had to be made, to obviate it; or where it appears to me that the dampness was such as could not be obviated at all. Second.—Where unwholesomeness exists, dependent upon insufficient lighting, a state of things for which the Nuisances Removal Acts afford no remedy, but which is a fruitful source of dirtiness and depraved health. Third.—Where unwholesomeness exists, dependent upon bad provision for the ventilation of a house, and where, as far as I can see, the ventilation cannot be rendered satisfactory without serious structural alterations. 14 Fourth.—Where unwholesomeness exists, dependent not only upon these causes, but upon such close building in of houses in courts as would render nugatory any efforts at ventilating individual houses, from the fact, that the air thus admitted would be almost as unwholesome as that which exists in the houses themselves; or where in courts and other places let in tenements to dirty people, privies and water cisterns are so situated as to be a cause of disease or mortality to the inhabitants of the place. The opening out of these places appear to have been an object contemplated by the promoters of the Bill, as well as by Parliament. Fifth.—Where, from extreme dilapidation and consequent incorrigible dirtiness, premises could not be rendered wholesome for habitation without almost complete reconstruction within the four walls. Sixth.—Where landlords, having been repeatedly subjected to the operation of the Nuisances Removal Acts, with the object of obtaining such amendments as these Acts contemplate, have habitually so imperfectly performed the work assigned them, that the houses have speedily fallen into their former state, and have consequently caused a waste of time and labour to the sanitary officers of the Vestry. It has been argued as against the application of this statute that the local authority has power, under the Nuisances Removal Act, to obtain the closure of unwholesome houses. Theoretically this is true, but practically this provision has failed in operation; inasmuch as the Magistrates at the Police Court have decided, that although they may order the closure of a house, no means are prescribed for evicting existent tenants. Acting upon the principles which I have explained—for it was clear that some principles of action must be previously settled—I have reported to the Vestry three series of premises, which, taken together, illustrate the class of cases to which I am disposed to think this Act is peculiarly applicable, namely, Parcells Court, in the High Street; certain houses and shanties in Brand Street, Holloway ; and certain houses in Albert Square, with which the Vestry will deal according to their judgment. As to the last of these, my report has had the effect of hastening a closure long contemplated, bat which was injuriously delayed, of several houses purchased by the Railway Company. In the instance of Parcells Court and Albert Square, I appended to my report a statement of the grouads on which I regarded the premises to be unwholesome, that is to say, of the conditions or evils existent, on account of which I held the medical opinion that the premises were dangerous to health. And I did this because I could not see in what other way I could make it evident to the Vestry, and through the Vestry to the surveyor, to whom my report was to be submitted, what the evils were upon the cause and remedy of which he would be called upon to report. Simply to report that such and such premises were dangerous to health, and so unfit for human habitation, although a sufficient compliance with the strict letter of the statute, would have thrown upon him the task of forming a medical opinion, for which he would be as little qualified as I should be to direct in technical detail the alterations which would be requisite. Had I neglected to do so, 15 I might have been driven to report repeatedly the same premises as often as the surveyor failed to strike upon what I held to be the causes of unwholesomeness. In the instance of the houses in Brand Street, however, I simply reported in the words of the statute, because the case was one of mere extensive dilapidation, and of the occupation of huts as residences contrary to the provisions of the Building Act. The only other matter I think it necessary to mention, is the practice we have adopted of condemning unwholesome fish. The large quantity of bad fish which is sold to costermongers in Billingsgate Market, is scarcely credible by any one not conversant with the trade. So great was the amount of work, and so great was the loss of time which devolved upon our inspectors, in consequence of this, that I submitted to the Sanitary Committee a suggestion that costermongers, who, in the hurry of the market, had been supplied with unwholesome fish, should be encouraged, instead of selling it for food, to bring it to us at once for condemnation, and that we should give them a certificate of condemnation, armed with which they might obtain from the salesman the return of their money, while at the same time, our own poor population, to whom cheap fish is a great boon, might be protected. Since the beginning of November, 1867, no less than fifty such applications have been made to us, showing if not the full extent of the evil—for our remedy involves great loss of time to the poor costermongers—yet that it is one loudly calling for redress. Repayment upon production of our certificate has only been resisted in three or four cases, and in each unsuccessfully, since it has been upheld in the City Courts. Two cases, I thought it right to take to the Police Court, in order to obtain a magisterial condemnation, so as to strengthen our hands. Only one instance occurred in which a fraud was attempted by the use of our certificate, and the offending persons were condemned to 21 days' imprisonment. Thus far, then, the plan has worked well; but the Sanitary Committee has authorised a communication to the Corporation of the City, calling attention to the facts, remonstrating against the practice of permitting bad fish to be sold in the market at all, and suggesting that, where such a thing accidentally occurs, a City Inspector should be present at all times to give the redress which is now only obtainable here. I have the honour to remain, Gentlemen, Your very obedient Servant, EDWARD BALLARD, M.D., M.R.C.P., Vestry Office, Medical Officer of Health. May 1st, 1869. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING (Deaths of Non-Residents West. Eastt Causes of Death. All Ages. AGES. Und. 1. 1- 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80 Up. 2120 2090 All Causes 4210 1266 371 201 125 80 2043 148 61 80 523 582 622 150 581 562 (Classes.) I. ZYMOTIC DIS 1143 458 155 117 70 53 853 71 27 21 71 49 43 8 381 393 II. CONSTITUTL. 774 106 65 19 16 5 211 30 13 29 245 175 63 8 868 853 III. LOCAL 1721 370 138 60 35 20 623 42 18 27 164 338 445 64 250 236 IV. DEVELOPMNL 486 297 10 2 1 ... 310 1 ... 2 31 11 63 68 39 44 V. VIOLENT DTHS 83 34 3 3 3 2 45 4 3 1 11 9 7 2 1 2 Not Specified 3 1 ... ... ... ... 1 ... ... 1 ... 1 ... (Orders.) 524 512 I. 1. Miasmatic Dis 1036 379 152 117 69 53 770 69 25 21 63 41 39 8 16 29 Small Pox 45 8 4 3 7 3 25 4 1 5 7 3 ... ... 81 66 Measles 147 35 52 29 16 7 139 7 ... ... ... ... ... ... 93 67 Scarlatina 160 14 17 36 23 20 110 31 9 ... 8 2 ... ... 16 17 Diphtheria 33 8 4 3 ... 3 23 7 ... ... ... 1 2 ... ... 1 Quinesy 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 3 15 Croup 18 2 ... 5 ... 3 17 1 ... ... ... ... ... ... 86 72 Hooping Cough 158 64 46 30 1 5 153 5 ... ... ... ... ... ... 39 50 Typhus & Typhoid 89 7 ... 2 ... 8 22 10 7 9 14 18 8 ... 15 17 Erysipelas 32 8 ... 1 ... ... 11 1 1 1 6 5 7 ... 2 4 Pyœ mia 6 ... ... 2 ... ... ... ... ... ... ... ... ... ... 5 8 Puerperal Fever 13 ... ... ... ... ... ... ... ... ... 11 ... ... ... 3 4 Carbuncle 7 ... ... ... ... ... ... ... ... ... ... 4 3 ... ... 1 Influenza 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Dysentery 4 ... ... ... ... ... 1 ... ... ... ... ... 1 ... 141 133 Diarrhoea 274 226 25 5 ... ... 256 ... ... 2 ... 8 6 6 9 Cholera 15 6 ... 1 ... ... 11 1 1 ... ... ... 1 1 ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 17 Rheumatism 33 ... ... ... ... ... ... 2 6 3 10 4 8 ... 12 20 2.Enthetic 32 28 ... ... ... ... 30 ... ... ... 1 1 ... ... 12 19 Syphilis 31 28 ... ... ... ... 30 ... ... ... 1 ... ... ... ... ... Stricture of Urethr ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Glanders 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 35 25 3. Dietic 60 38 ... ... ... ... 38 2 ... ... 7 7 4 ... 2 ... Privation 2 ... ... ... ... ... ... 2 ... ... ... ... ... ... 21 16 Want of Br. Milk 37 37 ... ... ... 37 ... ... ... ... ... ... ... 3 3 Purpura and Scury 6 1 ... ... ... ... 1 ... ... ... ... ... 2 ... 9 6 Alcoholism 15 ... ... ... ... ... ... ... ... ... b 7 2 ... 10 5 4. Parasitic 15 13 ...: ... 1 ... 15 ... ... ... ... ... ... ... 10 5 Thrush Worms 15 13 ... ... 1 ... 15 ... ... ... ... ... ... ... 50 83 I. 1. Diathetic 133 4 ... ... 2 ... 7 1 1 1 19 63 43 1 6 4 Gout 10 ... ... ... ... ... ... ... ... ... ... 6 3 1 12 16 Dropsy 28 ... ... ... 1 ... 3 1 ... l 5 7 11 ... 2 ... Hæ morrhage 6 ... ... ... ... ... 3 ... ... ... 2 ... 1 ... 25 55 Cancer 80 ... ... ... 1 ... 1 ... 1 ... 11 38 25 4 ... ... Noma ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 ... Mortification ... ... ... ... ... ... ... ... ... ... 1 2 3 3 331 310 2. Tubercular 641 102 64 19 14 5 204 29 12 28 226 122 20 ... 12 14 Scrofula 26 ... ... 1 2 ... 17 4 3 1 ... ... l ... 26 31 Tabes Mesenteria 57 28 1. 4 4 1 52 4 1 ... ...... ... ... 241 217 Phthisis 458 20 17 5 3 1 46 11 8 26 226 122 19 ... 52 48 Hydrocephalus 100 47 2i 9 5 3 89 10 ... 1 ... ... ... ... 224 257 III. 1. NervousSyst 481 140 35 15 16 2 208 7 3 9 34 74 128 16 19 36 Cephalitis 55 17 ... 3 7 ... 34 5 3 5 6 2 ... ... 37 45 Apoplexy 82 ... ... ... ... ... ... ... ... 1 6 31 37 6 57 42 Paralvsis 99 ... ... ... 2 ... 2 ... ... ... 6 21 64 6 4 2 Insanity 6 ... ... 1 ... ... ... ... ... ... 2 1 3 ... ... ... Chorea ... ... ... ... ... ... ... ... ... ... ... ... .... 8 12 Epilepsy 20 1 ... ... ... ... 1 1 ... 1 7 7 2 l 69 97 Convulsions 166 121 24 1 5 2 163 1 ... 1 ... ... ... ... 30 23 Brain Diseases, &c 53 1 4 1 1 ... 7 ... ... 1 7 12 22 4 108 108 2. Organs of Circ. 216 3 ... ... 1 1 6 9 7 4 29 79 76 6 3 5 Pericarditis 8 ... ... ... ... ... ... 1 1 ... 2 3 ... ... 5 2 Aneurism 7 ... 1... ... ... ... ... ... ... 1 ... ... ...... 100 101 Heart Disease 201 3 1 ... 1 1 6 8 6 4 2b 73 72 6 TABLE I. THE YEAR ENDING 2nd JANUARY, 1869. in Hospitals excluded).  East. Causes of Death. | All Ages. AGES. Un 1. 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80 Up. 408 329 3. Respirat. Ores. 737 188 100 45 18 14 365 18 4 6 48 105162 29 17 23 Laryngitis 40 11 11 3 2 3 30 4 1 ... 3 ... 2 ... 267 191 Bronchitis 458 122 53 22 9 8 214 9 ... ... 16 64 130 25 7 7 Pleurisy 1-1 2 ... ... ... 2 ... ... 2 4 3 2 1 87 91 Pneumonia 178 51 35 18 6 2 112 5 3 4 20 20 13 1 10 13 Asthma 23 ... ... ... ... ... ... ... ... 1 12 9 1 20 4 Lung Diseases, &c. 24 2 ... 2 1 l 7 ... ... ... 4 6 6 1 87 112 4. Digestive Orgs 199 31 1 ... ... 1 33 7 2 4 35 50 59 9 2 3 Gastritis 5 1 ... ... ... 1 1 ... ... ... ... 3 ... 9 12 Enteritis 21 9 1 ... ... 10 l 1 1 2 3 3 ... 13 12 Peritonitis 25 3 ... ... 1 4 2 1 1 9 6 1 1 1 2 Ascites 3 ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... 2 Ulceration of Intes 2 ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 6 Hernia 6 ... ... ... ... ... ... 1 ... ... l ... 4 ... 4 8 Ileus 12 3 ... ... ... ... 3 ... ... ... 4 1 3 1 1 1 Intussusception . 2 ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 1 Stricture of latest. 2 ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 2 Fistula 2 ... ... ... ... ... ... ... ... l 1 ... ... 15 16 Stomach Dis., &c 31 2 ... ... ... ... 2 1 ... 1 5 9 13 ... ... ... Pancreas Dis., &c ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 9 Hepatitis 16 ... ... ... ... ... ... ... ... ... 3 8 4 1 10 9 Jaundice 19 10 ... ... ... ... 10 1 ... ... 1 1 4 2 24 29 Liver Disease 53 3 ... ... ... ... 3 ... ... 1 8 17 20 4 ... ... Spleen Disease ... ... ... ... ... ... ... ... ... ... ... ... ... 23 25 5. urinary Orgs. 48 1 ... ... ... 1 2 ... ... 2 11 19 12 2 2 ,, Nephritis 2 ... ... ... ... 1 l ... ... ... ... ... 1 ... 4 5 Disease of Bladder 9 ... ... ... ... ... ... ... ... ... 1 2 4 2 7 7 Nephria 14 ... ... ... ... ... ... ... ... 1 4 9 ... ... 3 6 Diabetes 9 ... ... ... ... ... ... ... 1 3 3 2 ... 1 1 Stone 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Prostrate Disease . 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 5 Kidney Disease,&c. 11 1 ... ... ... ... 1 ... ... ... 3 3 4 ... 4 4 6. Genera. Organs 8 ... ... ... ... ... ... ... ... ... 2 5 1 ... 1 3 Ovarian Dropsy 4 ... ... ... ... ... ... ... ... ... 1 3 ... ... 3 1 Uterine Diseases 4 ... ... ... ... ... ... ... ... ... 1 2 1 ... 4 10 7. Orgs.of Locomo. 14 1 ... ... ... ... 1 1 1 2 5 2 2 ... 3 6 Spine Diseases 9 1 ... ... ... ... 1 ... 1 1 3 2 ... ... 1 4 Bone Diseases 5 ... ... ... ... ... ... ... ... 1 2 ... 2 ... 10 8 8. Skin, &c 18 6 1 ... ... 1 8 ... 1 ... ... 4 5 ... ... 3 Phlegmon&Abscess 3 1 ... ... ... ... 1 ... ... ... ... 1 1 ... 6 3 Ulcer 9 2 ... ... ... ... 2 ... 1 ... ... 3 3 ... 4 2 Skin Diseases 6 3 1 ... ... 1 5 ... ... ... ... ... 1 ... 57 66 IV. 1. Dis.. of Childn. 123 120 3 ... ... ... 123 ... ... ... ... ... ... ... 49 54 Premature Birth . 10.3 103 ... ... ... 103 ... ... ... ... ... ... ... 3 4 Cyanosis 7 7 ... ... ... ... 7 ... ... ... ... ... ... ... 1 1 Spina Bifida 2 2 ... ... ... ... 2 ... ... ... ... ... ... ... 2 5 Other Malformation 7 7 ... ... ... ... 7 ... ... ... ... ... ... ... 2 2 Teething 4 1 3 ... ... 4 ... ... ... ... ... ... ... 14 24 2. Dis. of Adults . 38 2 31 5 ... ... Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... 14 24 Childbirth 38 ... ... ... ... ... ... ... ... 2 31 5 ... ... 72 65 3. Dis. of Aged 137 ... ... ... ... ... ... ... ... ... ... 6 63 68 72 65 Old Age 137 ... ... ... ... ... ... ... ... ... ... 6 63 68 107 81 4. Dis.of Nutritn. 188 177 7 2 l ... 187 1 ... ... ... ... ... ... 107 81 Atrophy & Debility 188 177 7 2 1 ... 187 1 ... ... ... ... ... ... 30 30 V. 1. Acci.orNeg. 60 24 3 3 3 2 35 4 2 1 5 5 6 2 8 7 Fract. and Contus. 15 1 1 2 1 ... 5 1 3 1 3 2 1 1 Wounds 2 ... 1 ... ... ... 1 1 ... ... ... ... ... 4 2 Burns and Scalds 6 1 1 1 2 ... 5 1 ... ... ... ... ... 1 3 Poison 4 1 ... ... ... ... 1 ... ... ... ... ... ... 2 4 Drowning 6 ... ... ... ... 2 2 2 ... ... ... 1 ... 8 10 Suffocation. 18 16 ... ... ... ... 16 ... ... 1 ... ... 1 ... 6 3 Otherwise 9 5 ... ... ... ... 5 ... ... ... 1 ... 1 ... 5 6 2. Homicide 11 10 ... ... ... ... 10 ... ... ... 1 ... ... ... 4 6 3. Suicide 10 ... ...... ... ... ... ... ... ... 5 4 1 ... 1 1 Wounds 2 ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... Poison 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 Drowning 2 ... ... ... ... ... ... ... ... 1 1 ... ... 2 2 Suffocat. and Hang. 4 ... ... ... ... ... ... ... ... 2 1 1 ... ... 1 Otherwise 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... 2 4. Unclassed 2 ... ... ... ... ... ... ... 1 ... ... ... ... ... * Age not specified of One Person. TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIFTY THREE WEEKS ENDING SATURDAY, THE 2nd DAY OF JANUARY, 1869, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Fox 5 .. 134 36 7 .. 182 Chicken Pax .. 2 54 67 39 .. 162 Measles 2 10 411 268 147 .. 838 Scarlatina 2 8 206 158 120 •• 494 Whooping Cough 1 15 250 173 229 •• 668 Croup •• .. 12 12 14 •• 38 Diarrhoea 87 .. 977 651 556 214 2485 Dysentery 2 .. 3 9 8 •• 22 Cholera .. .. 4 2 1 7 Ague 4 .. 6 7 1 •• 18 Continued Fever 30 .. 104 76 69 • • 287 Influenza .. .. .. • • .. • • Puerperal Fever ... .. 7 • • 1 • • 8 Rheumatic Fever 2 .. 15 22 35 • • 74 Erysipelas 8 .. 102 46 41 • • 197 Diphtheria • • .. 5 12 10 •• 27 Sorethroat or Tonsillitis 7 .. 237 351 355 • • 950 Mumps .. .. 19 • • 10 •• 29 Pyaemia • • .. .. •• •• •• •• Bronchitis and Catarrh 238 6 2982 1519 1555 658 6958 Pneumonia 3 1 50 60 52 .. 166 Pleurisy 2 .. 60 49 31 1 143 Delirium Tremens 8 .. 7 1 3 • • 19 Insanity 46 .. 67 3 6 1 123 Carbuncle 2 1 11 8 5 • • 27 All other Diseases 713 222 7100 7335 9181 2604 27155 Total 1162 273 12823 10865 12476 3478 41077 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From March 26th, 1868, to March 25th, 1869. South East District. South "West District. North District. Total. Number of houses inspected 2209 2044 1372 5625 Re-inspections, Calls made, &c. 5386 2114 2887 10387 Visits to 200 Bakehouses 252 303 186 741 Do. 68 Cowhouses 102 186 111 399 Do. 114 Slaughter houses 205 269 191 665 Do. Stables and Yards 87 136 42 265 Do. Factories 16 8 1 25 Do. Fields, Lanes, &c. 48 • • 10 58 Do Factories, Horse Slaughterhouses,Piggeries,&c., 50 at Belle Isle .. 443 .. 443 Do. Workshops 71 199 71 341 Do. 110 Courts and Alleys 3216 973 593 4782 Total Inspections, &c 11592 6675 5464 23731 IMPROVEMENTS. Drains 49 19 71 139 Improved or repaired 232 230 124 586 Traps fixed 225 111 342 678 Cesspools Abolished 31 7 5 43 Cleansed or disinfected .. 1 3 51 4 97 Privies and Water Closets Pan, trap, and water supply furnished 43 3 Pan and trap only furnished 14 27 17 58 Water supply furnished 145 133 206 484 Dust bins Constructed 13 23 89 125 Repaired and covers adapted 23 45 132 200 Surface Drains and Pavements of Yards Constructed 19 6 45 70 Relaid. 270 231 206 707 General Water Supply New receptacles provided 31 24 27 82 Receptacles repaired and cleansed.. 286 157 91 534 Water supply provided 10 18 15 43 General Report Houses generally repaired 168 63 47 278 „ &c., cleansed or limewashed 891 385 281 1557 „ ventilated 11 10 3 24 Overcrowding abated 27 27 5 59 Illegal use of underground Rooms for sleeping discontinued. 1 8 .. 9 Other Amendments, or Nuisances Abated 141 28 144 313 Total Improvements 2630 1556 1904 6090 Total Premises Improved 1411 919 975 3305 Houses or Drains Disinfected 664 340 175 1179 TABLE IV. MONTHLY RESULTS OP METEOROLOGICAL OBSERVATIONS MADE AT COMPTON TERRACE. THERMOMETER. Mean Atmospheric Humidity. Saturation = 100. Rainfall in Inches. Number of days on which Rain fell in appreciable quantity. Periods embraced. Adopted Mean Temperature. Mean of Highest Daily Readings. Mean of Lowest Daily Readings. Mean Daily Range. January 36.2° 39.6° 32.3° 7.3° 91 3 36 18 * 1867 1868 4 wks. Dec. 29—Jan. 25 1868 February 42.3° 47.7° 37 4° 10.4° 86 1.28 11 4 „ Jan. 26—Feb. 22 March 44.8° 50.9° 38.3° 12.6° 80 1.67 19 5 „ Feb. 23—Mar. 28 April 47.8° 588° 40.5° 18.3° 79 1.40 11 4 „ Mar.29—April 25 May 567° 69.2° 47.4° 21.8° 70 055 6 4 „ April 26—May 23 June 621° 75.3° 52.3° 22.9° 66 1.57 6 5 „ May 24—June 27 67.8° 83.3° 570° 26.3° 66 0.19 2 4 „ June 28—July 25 August 664° 77.8° 58.1° 19.8° 72 250 14 4 „ July 26—Aug. 22 September. 60.8° 72.7° 51.4° 213° 75 1.01 7 5 „ Aug. 23—Sept. 26 October 50.1° 589° 43.4° 15.5° 83 2.61 14 4 „ Sept. 27—Oct. 24 November 433° 492° 380° 11.2° 84 1.50 10 4 „ Oct. 25—Nov. 21 1869 December. 44.9° 488° 40.1° 8.7° 85 5.33 30 6 „ Nov. 22—Jan. 2 Means of Year J 51.9° 61.0° 44.7° 16.3° 78 Sum 22.97 Sum 148 1867 1869 Dec. 29th to Jan. 2nd Snow fell in the 1st, 2nd, 46th, and 53rd weeks of the year. The only thunder storms were on April 27th, May 29th, July 11th, September 27th, and September 30th. Thunder was heard, or lightning seen, on June 21st, July 12th, and 15th. The highest temperature attained was 93.5° on July 22nd. The lowest temperature reached was 23.0° on January 3rd. • Instead of stating the Means of Observations for each Calendar Month, I have state them in periods corresponding with those used in my Monthly Tables, which alone can serve any useful purpose for comparison with the accompanying Sickness and Mortality. REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR JANUARY, 1868. No. CXXIX. A miserable month of snow, rain, and wind has resulted in a mortality very much below the average for the last ten Januaries. The number of deaths registered was only 338 against a corrected mean of 403, the mortality of the corresponding weeks of the previous ten years. There was no one class of diseases the deaths from which manifested any remarkable or unusual predominence. This satisfactory state of the public health leaves me at liberty to say a word respecting the new Vaccination Act, which came into force on the first day of January. I am not about to subject it to criticism. It is on all hands, I believe, admitted to be a somewhat lame piece of legislation, but I presume it is as good as the present state of public opinion would have tolerated. When the public mind is better educated, and the prejudice engendered by the disappointment of extravagant expectations, which a due acquaintance with the very constitution of man ought from the first to have moderated, have passed away,we may hope that Parliament will adopt some more satisfactory method of ensuring to our population the protection against small-pox which effectual vaccination is calculated to confer. In the meantime we are bound to make the best of what is placed in our hands. Two clauses alone I wish now to direct attention to: The 26th clause directs that the Eegistrar of Births in each district "shall, within one month after the first day of January and the first day of July in each year, make a list of all cases in which certificates of vaccination have 2 not been duly received by him during the last preceding half-year, and shall submit the same to the next meeting of the Guardians of the Union or Parish wherein he acts, and the said Guardians shall forthwith make inquiry into the circumstances of the cases contained in the list, and if they find that the provisions of the Act have been neglected, shall cause proceedings to be taken against the persons in default." Here then is a distinct direction by which Registrars are bound to furnish information upon which the Guardians of the poor are not merely permitted but bound to act. The 27th clause enables the latter to pay out of the funds at their disposal all the expenses which the inquiry they are required to institute and the proceedings they are required to take may give rise to. I would earnestly urge upon the Guardians in Islington the great importance of these clauses, and the necessity which there is for a sincere and hearty adoption of their provisions. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, February 1st, 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JANUARY 25th, 1868. (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 00 and under 80 years of age. Ac 80 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 GO years of age. At 60 and under 80 years of age. At 80 years of age and upwards. 185 153 All Causes 161 34 60 74 9 59 3B 3. Reapirat. Orgs. 95 48 3 27 20 3 1 1 3 Laryngitis 4 4 ... ... ... ... ■ Bronchitis 78 41 ... ... 17 3 (Classes.) 1 1 Pleurisy 2 1 1 ... ... ... 33 22 I. ZYMOTIC DIS 55 46 3 2 4 ... 1 2 Pneumonia . 3 ... 1 1 1 ... 30 24 II. CONSTITUTL. 54 16 18 14 5 1 2 3 Asthma 5 ... ... 3 2 ... 96 84 III. LOCAL 180 72 10 42 52 4 5 9 4. Digestive Orgs. 14 ... 1 4 6 ... 23 20 IV. DEVELOPMNL 43 22 3 1 13 4 1 1 Gastritis 2 ... ... ... 2 ... 3 3 V VIOLENT DTHS 6 5 ... 1 ... ... ... ... Enteritis ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... Hernia ... ...... ... ... ... Ileus ... ...... ... ... ... (orders) Intussusception ... ... ... ... ... ... 32 21 I. 1. Miasmatic Dis 53 45 3 1 4 ... ... ... Strieture of Intest ... ... ...... ... ... 1 ... Small Pox 1 ... 1 ... ... ... ... ... Fistula ... ... ... ... ... ... 5 5 Measles 10 10 ... ... ... ... 1 1 Stomach Dis., &c. 2 ... ... 2 ... ... 9 5 Scarlatina 14 14 ... ... ... ... ... ... Pancreas Dis., &c ... ...... ... ... ... ... ... Diphtheria ••• ... ... ... ... ... ... ... Hepatitis ... ...... ... ... ... ... ... Quinsey ... ... ... ... ... ... ... ... Jaundice ... 1 Croup 1 1 ... ... ... ... 3 5 Liver Disease 8 1 1 2 4 ... 10 3 Hoooping cough 13 13 ... ... ... ... ... ... Spleen Diseases ... ... ... ... ... ... 2 2 Typhus & Typhoid 4 2 1 ... 1 ... ... 2 5. Urinary Orgs. ... 1 1 ... 1 ... 1 3 Erysipelas 4 1 1 1 1 ... ... ... Nephritis ... ... ... ... ... ... Pyœ mia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... ... Puerperal Fever . ... ... ... ... ... ... 1 ... Nephria 1 ... ... 1 ... ... ... ... Carbuncle ... ... ... ... ... ... 1 1 Diabetes 2 ... ... 1 1 ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease . ... ... ... ... ... ... 3 1 Diarrhoea 4 ... ... ... 1 ... 2 1 Kidney Disease,&c. 3 1 1 2 ... ... 1 ... Cholera 1 ... ... ... ... ... 1 ... 6. Gemera, Organs 1 ... ... 1 ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ...... ... ... ... ... 1 Rheumatism 1 ... ... ... 1 ... 1 ... 7. Orgs. of Locomo 1 ... ... 1 ... ... 1 ... 2. Enthetic l 1 ... ... ... ... ... ... Spine Diseases ... ...... ... ... ... 1 ... Syphilis l 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... 1 Bone Diseases 1 ... ... ... l ... ... ... Hydrophobia ... ... ... ... ... ... ... 1 8. Skin, &c 1 ... ... ... ... ... Glanders ••• ... ... ... ... ... ... ... Phlegmon &Abscess ... ... ... ... ... ... ... ... 3. Dietic 1 ... ... ... ... ... ... ... Ulcer ... ... ...... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... ... ... Want of Br. Milk ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... ... ... IV. 1. Dis of childn. ... ... ... ... ... ... ... 1 Alcoholism 1 ... ... 1 ... ... ... ... Premature Birth ... ... ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... 1 Other Malformation 1 1 ... ... ... ... 2 2 II. 1. Diathetic 4 ... 1 ... 2 1 2 1 Teething 2. Dis. of Adults 3 ... 3 ... ... ... ... ... Gout ... ... ... ... ... ... ... 1 Paramenia ... ... ... ...... ... ... ... Dropsy ... ... ... ... ... ... 2 1 Childbirth 3 ... 3 ... ... ... ... ... Haemorrhage ... ... ... ... ... ... 9 9 3. Dis .of Aged. 18 ... ... 1 13 4 1 2 Cancer 3 ... 1 ... 1 1 9 9 old Age 18 ... ... 1 13 4 ... ... Noma ... ... ... ... ... ... 8 5 4. Dis. of Nutritn. 13 13 ... ... ... ... 28 22 2. Tubercular 50 16 17 14 3 ... 8 5 Atrophy & Debility 13 13 ... ... ... ... ... ... Scrofula ... ... ... ... ... ... 2 2 V.1. Acci. or Neg. 4 3 ... 1 ... ... 1 3 'labes Mesenterica 4 4 ... ... ... ... ... ... Eract and Contus ... ... ... ... ... ... 25 14 Phthisis 39 5 17 14 3 ... ... ... Wounds ... ... ... ... ... ... 2 5 Hydrocephalus ... ... ... ... ... ... l ... Burns and Scalds 1 l ... ... ... ... 12 2 Poison 2 l ... 1 ... ... 12 27 III. 1. NervousSyst. 39 16 2 5 15 1 ... ... Drowning ... ... ...... ... ... 4 10 Apoplexy 14 ... 1 3 9 1 ... ... Suffocation 1 ... ... ... ... ... 3 3 Paralysis 6 1 ... 1 4 ... 1 1 2. Homicide 2 2 ... ... ... ... ... 1 Insanity 1 ... ... ... 1 ... ... ... 3. Suicide ... ...... ... ... ... ... Chorea ... ... ... ... ... ... ... ... wounds ... ... ... ... ... ... ... 1 Epilepsy 111 ... ... 1 ... ... ... ... Poison. ... ... ... ... ... ... 3 9 Convulsions 12 1 ... ... ... ... ... ... Drowning ... ... ... ... ... ... ... 1 Brain Diseases, &c. 1 ... ... ... 1 ... ... ... Suffocat. and Hang. ... ... ... ... ... ... 15 8 2. Organs of Circ. 23 4 3 7 9 ... ... ... Otherwise ... ... ... ... ... ... ... 1 Pericarditis l 1 ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... 1 ... Aneurism l ... ... 1 ... ... ... ... ... ... ... ... ... ... 14 7 Heart Disease 21 3 3 6 9 ... ... ... TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 25th DAY OF JANUARY, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox 2 .. 20 6 .. .. 28 Chicken Pox .. .. 3 7 i .. 11 Measles .. 17 8 4 29 Scarlatina .. .. 20 8 5 .. 33 Whooping Cough .. .. 9 8 6 .. 25 Croup .. .. 1 2 .. .. 3 Diarrhoea 4 .. 22 15 10 7 58 Dysentery .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. Continued Fever 1 .. 5 .. 5 .. 14 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. 2 .. 7 .. 9 Erysipelas .. .. 7 1 5 .. 13 Diphtheria .. .. •• 1 .. .. 1 Sorethroat or Tonsillitis 1 .. 21 24 10 .. 56 Mumps .. .. .. .. .. .. .. Pyaemia .. .. .. .. .. .. .. Bronchitis and Catarrh 18 .. 365 144 90 54 671 Pneumonia .. .. 7 4 4 .. 15 Pleurisy .. .. 8 1 3 .. 12 Delirium Tremens .. .. 1 ,, 1 .. 2 Insanity 4 .. 2 .. .. .. 6 Carbuncle .. 1 .. 1 .. .. 2 All other Diseases 45 25 599 527 476 152 1824 Total 75 28 1109 760 627 213 2812 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From December 30th, 1867, to January 31st, 1868. South East District. South West District. North District. Total. Number of houses inspected 186 196 169 551 Drains Constructed 3 1 6 10 Improved or repaired 18 11 9 38 Traps fixed 20 11 7 38 Cesspools Abolished Cleansed or disinfected 1 •• •• 1 Privies and Water Closets Pan, trap, and water supply furnished 2 .. .. 2 Pan and trap only furnished 3 .. 3 6 Water supply furnished 5 .. 4 13 Dust bins Constructed 1 1 1 9 1 10 A Surface Drains and Pavements of Yards Constructed 2 2 Relaid 12 19 4 35 General Water Supply New receptacle provided .. .. .. .. Receptacle repaired and cleansed 6 14 9 29 Water supply provided .. .. .. .. Other Improvements 3 1 9 13 „ cleansed or limewashed 13 7 9 29 „ ventilated .. .. .. .. Overcrowding abated .. 1 .. 1 Illegal use of underground Rooms for sleeping discontinued 1 •• •• 1 REPORT •ON THE SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR FEBRUARY, 1868. No. CXXX. The mortality that has taken place during the four weeks ending February 22nd has been again comparatively small. Three hundred and six deaths only were registered, whereas 351 is the number which the experience of the last ten years would hare led us to expect, when the increase of our population is taken into account. With the exception of Small Pox, the only deaths which have been registered in excess of what is customary, are those from Apoplexy and Paralysis. One death from Glanders was registered, the attack as usual originating from contagion from the horse. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, February 29tht 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING FEBRUARY 22nd, 1868. (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 2o years of Age. At 20 and under 40 years of age. At 40 and under 60 years of age. At 60 and under 8o Years of age. At 80 years of age and upwards. 160 146 All Causes 1 303 145 33 55 60 13 31 24 3. Respirat. Orgs. 55 33 1 11 18 2 2 2 Laryngitis 4 3 .... 1 .... (Classes.) 24 13 Bronchitis 37 14 6 16 1 1 1 Pleurisy 2 .... 1 1 29 31 I. ZYMOTIC DIS 60 50 3 3 4 .... 3 6 Pneumonia 9 6 .... 3 .... .... 30 28 II. CONSTITUTL 58 22 15 17 4 ........ ... 2 Asthma 2 .... .... 2 .... .... .... 1 ... Lung Diseases, &c. 1 .... .... .... 1 .... 76 68 III. LOCAL 144 43 15 33 47 6 8 10 4. Digestive Orgs. 18 2 3 6 6 1 23 14 IV. DEVELOPMNT 37 25 .... 1 4 7 ... ... Gastritis .... ... .... .... .... ... 2 ... Enteritis 3 1 ... 1 1 ... 2 4 V. VIOLENT DTHS. 6 5 .... 1 ... .... ... 2 Peritonitis 2 .... 2 .... ... ... ... 1 Ascites 1 .... .... .... 1 ... .... 1 Not Specified 1 .... .... .... 1 .... ... ... Ulceration of Intes. .... .... .... .... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... 1 Ileus 1 1 ... ... ... ... ... 1 Intussusception .. 1 ... ... 1 ... ... 26 29 I. 1. Miasmatic Dis. 55 46 3 2 4 ... ... ... Stricture of latest. ... ... ... ... ... ... 3 6 Small Pox 9 8 l ... ... ... ... ... Fistula ... ... ... ... ... ... 2 2 Measles 4 4 ... ... ... ... 2 ... Stomach Dis., &c. 2 ... ... 1 1 ... 7 4 Scarlatina 11 9 1 1 ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 1 .... Diphtheria 1 1 ... ... ... ... 1 1 Hepatitis 2 ... ... 2 ... ... .... 1 Quinsey 1 1 ... ... ... ... ... ... Jaundice ... ... ... ... ... ... .... 1 Croup 1 1 ... ... ... ... 3 3 Liver Disease 6 ... 1 1 3 1 10 6 Hooping Cough .. 16 ... ... ... ... ... ... Spleen Disease. ... ... ... ... ... ... .... 4 Typhus & Typhoid 4 3 ... ... 1 ... 1 4 5. Urinary Orgs. 5 ... 1 2 2 ... .... 1 Erysipelas 1 ... 1 ... ... ... ... ... Nephritis ... ... ... ... ... ... .... .... Pyæmia ... ... ... ... ... ... 2 Disease of Bladder 2 ... ... ... 2 ... .... ... Puerperal Fever . ... ... ... ... ... ... 1 1 Nephria 2 ... i l ... ... .... ... Carbuncle ... ... ... ... ... ... ... 1 Diabetes 1 ... ... 1 ... ... .... .... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... .... .... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 1 3 Diarrhoea 4 3 ... ... 1 ... ... ... Kidney Disease,&c ... ... ... ... ... ... .... .... Cholera ... ... ... ... ... ... ... 1 6. Genera. Organs 1 ... 1 ... ... ... .... .... Ague ... ... ... ... ... ... ... 1 Ovarian Dropsy 1 ... i ... ... ... 2 1 Rheumatism 3 ... ... 1 2 ... ... ... Uterine disease. ... ... ... ... ... ... 2 1 2. Enthetic 3 2 ... 1 ... ... ... 3 7. Orgs. of Locomo. 3 1 l 1 ... ... 2 .... Syphilis 2 2 ... ... ... ... ... 1 Spine Diseases 1 ... ... 1 ... ... .... ... Stricture of Urethra ... ... ... ... ... ... ... 2 Bone Diseases 2 1 i ... ... ... .... ... Hydrophobia ... ... ... ... ... ... 1 ... 8. Skin, &c 1 ... ... ... 1 ... .... 1 Glanders 1 ... ... 1 ... ... ... ... Phlegmon & Absence ... ... ... ... ... ... 1 1 3. Dietic 2 2 ... ... ... ... 1 ... Ulcer 1 ... ... ... 1 ... .... .... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 1 Want of Br. Milk.. 2 2 ... ... ... ... .... ... Purpura and Scurvy ... ... ... ... ... ... 9 4 IV. 1. Dis of Childn. 13 13 ... ... ... ... .... .... Alcoholism ... ... ... ... ... ... 7 4 Premature Birth 11 11 ... ... ... ... .... .... 4. Parasitic ... ... ... ... ... ... 1 ... Cyanosis 1 1 ... ... ... ... .... .... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... .... Worms ... ... ... ... ... ... 1 ... Other Malformation 1 1 ... ... ... ... ...... ... Teething ... ... ... ... ... ... 4 7 11. 1. Diathetic 11 ... 2 6 3 ... 1 ... 2. Dis. of Adults 1 ... ... 1 ... ... .... .... Gout ... ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... 2 2 Dropsy 4 ... 2 1 1 ... 1 ... Childbirth 1 ... ... 1 ... ... .... .... Haemorrhage ... ... ... ... ... ... 6 5 3. Dis. of Aged 11 ... ... ... 4 7 2 4 Cancer 6 ... ... 5 1 ... 6 5 Old Age 11 ... ... ... 4 7 .... .... Noma ... ... ... ... ... ... 7 5 4. Dis. of Nutritn. 12 12 ... ... ... ... .... 1 Mortification 1 ... ... ... I ... 7 5 Atrophy & Debility 12 12 ... ... ... ... 26 21 2. Tubercular 47 22 13 11 1 ... 1 .... Scrofula 1 l ... ... ... ... 2 3 V. 1. Acci. or Neg. 5 5 ... ... ... ... 1 l Tabes Mesenterica 2 2 ... ... ... ... ... ... Fract. and contus. ... ... ... 1 ... ... 20 16 Phthisis 36 11 13 11 I ... ... ... Wounds ... ... ... ... ... ... 4 4 Hydrocephalus 8 8 ... ... ... ... ... ... Burns and Scalds. ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 26 22 III. 1. Nervous Syst. 48 16 6 11 12 3 ... ... Drowning ... ... ... ... ... ... .... 1 Cephalitis 1 l ... ... 2 2 Suffocation 4 4 ... ... ... ... 8 4 Apoplexy 12 ... 2 7 3 ... ... 1 Otherwise 1 1 ... ... ... ... 12 4 Paralysis 16 ... 3 4 7 2 ... ... 2. Homocide ... ... ... ... ... ... .... .... Insanity ... ... ... ...... ... ... ... 1 3. Suicide l ... ... 1 ... ... .... .... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... .... .... Epilepsy ... ... ... ... ... ... ... ... Poison. ... ... ... ... ... ... 5 9 Convulsions 14 14 ... ... ... 1 ... 1 Drowning 1 ... ... 1 ... ... 1 4 Brain Diseases, &c. 5 1 1 ... 2 1 ... ... Suffocat, and Hang ... ... ... ... ... ... 9 4 2. Organs of Circ. 13 1 2 2 8 ... ... ... Otherwise ... ... ... ... ... ... .... .... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... .... .... Aneurism ... ... ... ... ... ... 9 4 Heart Disease 13 1 2 2 8 ... TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 22nd DAY OF FEBRUARY, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant, Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensarv. Pentonville Convict Prison Total. Small Pox 2 .. 12 4 3 .. 21 Chicken Pox .. 6 3 2 .. 11 Measles .. .. 7 9 1 .. 17 Scarlatina 1 .. 13 13 15 .. 42 Whooping Cough 1 23 9 3 37 Croup .. .. .. 2 1 .. 3 Diarrhoea 5 .. 22 10 7 .. 58 Dysentery .. .. .. .. 1 .. 1 Cholera .. .. .. .. .. .. .. Ague 1 .. 1 .. .. .. 2 Continued Fever 2 .. 4 4 2 .. 12 Influenza .. .. .. .. .. .. .. Puerperal Fever . . .. 3 .. .. .. 3 Rheumatic Fever .. .. 1 2 5 .. 8 Erysipelas . . .. 6 5 .. .. 11 Diphtheria .. .. .. 1 2 .. 3 Sorethroat or Tonsillitis 3 10 21 3 .. 37 Mumps .. .. 1 .. .. 1 Pyaemia .. .. .. .. .. .. .. Bronchitis and Catarrh 15 .. 246 129 92 .. 517 Pneumonia .. .. 3 4 .. .. 7 Pleurisy .. .. 5 1 2 .. 8 Delirium Tremens .. .. . . .. .. .. .. Insanity 2 6 1 1 10 Carbuncle 2 1 3 All other Diseases 44 4 614 589 642 152 2045 Total 76 5 985 807 783 201 2857 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From February 3rd, 1868, to February 29th, 1868. South East District. South West District. North District. Total. Number of houses inspected 163 189 82 434 Drains Constructed 3 .. 11 14 Improved or repaired 25 14 5 44 Traps fixed 19 24 6 49 Cesspools Abolished 5 1 .. 6 Cleansed or disinfected 1 .. .. 1 Privies and Water Closets Pan, trap, and water supply furnished 3 .. 1 4 Fan and trap only furnished .. 4 2 6 Water supply furnished 3 16 6 25 Dust bins [Constructed 1 .. 7 8 Repaired and covers adapted .. 6 1 7 Surface Drains and Pavements of Yards Constructed .. 4 1 5 Relaid 6 19 5 30 General Water Supply New receptacle provided .. 3 4 7 Receptacle repaired and cleansed 5 6 39 50 Water supply provided .. 1 1 Other Improvements Houses generally repaired .. 4 4 ,, cleansed or limewashed 18 4 3 25 „ ventilated .. .. .. .. Overcrowding abated .. 1 .. 1 Illegal use of underground Rooms for sleeping discontinued.... .. 2 .. 2 * There were also inspected 200 Bakehouses, 63 Cowhouses, and 106 Slaughterhouses. REPORT ON THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR MARCH, 1868. No. CXXXI. The death-rate during the month of March has been just one-sixth less than the average death-rate of the corresponding five weeks during the ten previous years. The deaths registered were 374, whereas the customary death-rate would have brought them up to 450. There is no one class of causes of death which has contributed more than usually to the mortality. Small-pox alone has given me any uneasiness. Not only should I be glad to see re-vaccination more extensively practised among persons who have arrived at adult age, but I should also be glad could any means be devised by which the character of the vaccination effected could be improved. I fear the reputation of the preventive is more or less risked by the difficulty in obtaining a more energetic virus when that in use shows signs of defective power. The results commonly obtained by vaccination now are poor when compared with those obtained in the early days of vaccination, or when compared with those produced when the lymph has passed through but few human transmissions from the cow. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, April 6th, 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING MARCH 28th, 1868. (Deaths of Non-Residents in Hospitals excluded). West S.D. East S.D. Causes of Death. At all Ages. 1 Under 20 years of age 1 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 2o 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. 188 188 All Causes 374 198 51 55 55 12 41 37 3. Respirat. Orgs. 78 45 5 6 18 4 1 4 Laryngitis 5 5 ... ... ... ... (Classes.) 26 23 Bronchitis 49 24 2 3 16 4 1 ... Pleurisy 1 ... 1 ... ... ... 44 32 I. ZYMOTIC DIS. 76 60 11 2 3 ... 11 10 Pneumonia 21 16 1 3 1 ... 36 34 II. CONSTITUTL 70 28 21 19 2 ... ... ... Asthma ... ... ... ... ... ... 2 ... Lung Diseases, &c. 2 ... 1 ... 1 ... 82 94 III. LOCAL 176 76 19 33 42 6 10 16 4- Digestive Orgs. 26 8 6 4 7 1 19 22 IV. DEVELOPMNL. 41 26 1 1 7 6 1 ... Gastritis 1 1 ... ... ... ... 1 ... Enteritis 1 ... 1 ... ... ... 4 5 V. VIOLENT DTHS. 9 7 1 ... 1 ... 4 1 Peritonitis 5 3 1 ... 1 ... 1 1 Not Specified 2 1 1 ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... 2 Ileus 2 ... l ... ... 1 ... Intussusception ... ... ... ... ... ... 38 30 I. 1. Miasmatic Dis. 68 55 10 1 2 ... ... Stricture of Intest. ... ... ... ... ... ... 1 6 Small Pox 7 5 2 ... ... ... ... 1 Fistula 1 ... 1 ... ... ... 3 ... Measles 3 3 ... ... ... ... 1 3 Stomach dis., &c. 4 1 i 1 l ... 8 5 Scarlatina 13 13 ... •• ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... ...... 1 Diphtheria 1 ... ... ... ... 1 2 Hepatitis 3 ... ... 2 1 ... ... ... Quinsey ... ... ... ... ... ... 1 1 Jaundice 2 1 ... ... i ... 1 2 Croup 3 ... ... ... ... 1 6 Liver Disease 7 2 I 1 3 ... 10 7 Hooping Cough 17 1/ ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 6 2 Typhus & Typhoid 8 5 2 1 ... ... ... 4 5. Urinary Orgs. 6 1 ... 3 2 ... 1 1 Erysipelas 2 1 1 ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyæmia ... ... ... ... ... ...... ...... 1 Disease of Bladder 1 ... ... l ... ... 1 1 Puerperal Fever . 2 ... 2 ... ... ... ... 1 Nephria 1 ... ... l ... ... ... 1 Carbuncle 1 ... ... ... 1 ... 1 1 Diabetes 2 1 ... ... 1 ... ... ... Influenza ... ... ... ... ... ... 1 Stone 1 ... ... l ... ... ... ... Dysentery ... ... ... ... ... ... ... Prostrate Disease. . ... ... ... ... ... ... 5 1 Diarrhoea 6 4 1 ... i ... 1 ... Kidney Disease,&c. 1 ... ... ... 1 ... 1 ... Cholera 1 1 ... ... ... ......... ... 8 6. Genera. Organs 3 ... ... 8 ... ... .... ... Ague ... ... ... ... ... ... ... 2 Ovarian Dropsy 2 ... ... 2 ... ... 1 3 Rheumatism 4 2 2 ... ... ... ... l Uterine Diseases 1 ... ... 1 ... ... ... 1 2. Enthetic 1 1 ... ... ... ... ... 1 7. Orgs.of Locomo. 1 ... 1 ... ... ... ... 1 Syphilis 1 1 ... ... ... ... ... ... Spine Diseases, ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... 1 Bone Diseases 1 ... i ... ... ... ... ... Hydrophobia ... 1 ... 8. Skin, &c 1 ... ... ... 1 ... ... ... Glanders ... ... ... Phlegmone & Abscess ... ... ... ... ... ... 6 1 3. Dietic 7 4 1 1 1 ... 1 ... Ulcer 1 ... ... ... 1 ... 2 ... Privation 2 2 ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 ... Want of Br. Milk.. 1 I ... ... ... ... ... ... ... ... 2 ... Purpura and Scurvy 2 1 ... l ... 1 5 IV. 1. Dis. of Childn. 6 6 ... ... ... ... 1 1 Aleoholism 2 ... 1 1 ... ... ... 3 Premature Birth 3 3 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... 1 Cynosis 1 1 ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... 1 1 Teething 2 2 ... ... ... ... 3 10 II. 1. Diathetic 13 2 2 8 1 ... 1 ... 2. Dis. of Adults . 1 ... 1 ... ... ... ... 1 Gout 1 ... 1 ... ... ... ... Paramenia ... ... ... ... ... ... 1 3 Dropsy 4 l 1 2 ... ... 1 ... Childbirth 1 ... 1 ... ... ... ... 1 Haemorrhage 1 l ... ... ... 8 6 3. Dis. of Aged 14 ... ... 1 7 6 2 5 Cancer 7 ... 1 i I ... 8 6 Old Age 14 ... ... 1 7 6 ... ... Noma ... ... ... ... ... ... 9 11 4. Dis. of Nutritn. 20 20 ... ... ... ... ... ... Mortification ... ... ... ... ... ... 9 11 Atrophy & Debility 20 20 ... ... ... ... 33 24 2. Tubercular 57 28 19 11 l ... 1 1 Scrotula 2 2 ... ... ... ... 2 3 V. 1. Acci, or Neg. 5 5 ... ... ... ... 2 2 Tabes Mesenterica 4 4 ... ... ... ... ... 1 Fract. and Contus. l 1 ... ... ... ... 24 15 Phthisis 39 8 19 11 I ... ... ... Wounds ... ... ... ... ... ... 6 6 Hydrocephalus 12 12 ... ... ... ... 1 ... Burns and Scalds 1 1 ... ... ... ... ... Poison ... ... ... ... ... ... 20 23 III. 1. Nervous Syst. 43 21 4 7 10 1 ... ... Drowning ... ... ... ... ... ... ... 1 Cephalitis 1 1 ... ... ... ... ... 2 Suffocation 2 2 ... ... ... ... 4 2 Apoplexy 6 ... l 1 4 ... 1 ... Otherwise 1 1 ... ... ... ... 3 7 Paralysis 10 ... i 4 5 ... 1 1 2. Homicide 2 2 ... ... ... ... ... ... Insanity ... ... ... ... ... ... 1 1 3. Suicide 2 ... 1 ... 1 ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... i Epilepsy 1 ... 1 ... ... ... ... ... Poison ... ... ... ... ... ... 10 10 Convulsions 20 20 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 3 2 Brain Diseases, &c 5 ... l 2 1 l 1 1 Suffocat. and Hang. 2 ... l ... 1 ... 8 10 2. Organs of Circ. 18 1 3 10 4 ... ... ... Otherwise ... ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... 8 10 Heart Disease 18 1 3 10 4 ... ... TABLE II. NEW CASES OF DISEASE COMING UNDER. TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 28th DAY OF MARCH, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Hollowly Dispensary. Islington ! Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 16 4 .. .. 20 Chicken Pox .. .. 7 7 2 .. 16 Measle .. .. 2 7 3 .. 12 Scarlatina .. .. 12 20 3 .. 35 hooping Cough .. 1 25 12 11 .. 49 Croup .. .. 2 .. 6 .. 8 Diarrhoea 3 .. 28 21 17 15 84 Dysentery .. .. .. .. 2 .. 2 Cholera .. .. .. .. .. .. .. Ague 1 .. 1 1 .. .. 3 Continued Fever 5 1 5 6 6 .. 23 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. 1 .. .. .. 1 Rheumatic Fever 1 .. .. .. 4 .. 5 Erysipelas .. .. 10 6 4 .. 20 Diphtheria .. .. .. 3 1 .. 4 Sorethroat or Tonsillitis . . .. 14 30 20 .. 64 Mumps . . .. 4 .. • • .. 4 Pyaemia ., ... ,. • • .. .. Bronchitis and Catarrh 28 .. 266 158 125 93 670 Pneumonia .. 6 8 8 .. 22 Pleurisy . . .. 5 7 2 .. 14 Delirium Tremens 2 .. 1 .. .. .. 3 Insanity 0 .. 7 ,. .. .. 13 Carbuncle .. .. 2 .. .. 2 All other Diseases 69 26 756 768 774 304 2697 Total 115 28 1168 1060 988 412 3771 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From March 2nd, 1868, to March 28th, 1868. Sout East | District. South West District. North District. Total. Number of houses inspected 151 243 169 563 Drains Constructed 2 . . 4 6 Improved or repaired 27 17 10 54 Traps fixed 30 13 20 63 Cesspools Abolished 2 1 .. 3 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished .. .. 10 10 Pan and trap only furnished 1 .. 3 4 Water supply furnished 14 5 9 28 • Dust bins Constructed .. 1 1 2 Repaired and covers adapte 2 5 4 11 Surface Drains and Pavements of Yards Constructed .. 3 14 17 Relaid 22 27 15 64 General Water Supply New receptacle provided .. 1 6 7 Receptacle repaired and cleansed 18 1 13 32 Water supply provided .. 6 1 7 Other Improve- ments Houses genernlly repaired .. 2 17 19 ,, cleansed or limewashed 54 32 43 129 ,, ventilated .. .. .. .. Overcrowding abated 3 .. • • 3 Illegal use of underground Rooms for sleeping discontinued •• 4 •• 4 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR APRIL, 1868. No. CXXXII. The mean corrected mortality for April during the past ten years is 336. In the April just passed the registered deaths, 305, have not reached this number by 31. Respiratory diseases alone (consumption excepted) have produced any unusual mortality. There has been some increase during the month in the cases of small-pox and whooping cough. I have been endeavouring to meet the former, so far as my means permit, by communicating with the District Vaccinators, and by carbolic acid disinfections. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, May 1st, 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING APRIL 25th, 1868. (Deaths of Non-Residents in Hospitals excluded). West S.D. East S.D. Causes of Death. At all Ages. Under 20 years of age. 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. 150 155 All Causes 305 166 36 39 45 19 40 30 3. Respirat. Orgs. 70 49 2 7 10 2 3 3 Laryngitis 6 6 ... ... ... ... (Classes.) 26 18 Bronchitis 44 26 ... 7 10 1 ... ... Pleurisy ... ... ... ... ... ... 32 31 I. ZYMOTIC DIS. 63 50 5 6 2 ... 11 9 Pneumonia 20 17 2 ... ... 1 27 29 II. CONSTITUTL 56 16 18 12 10 ... ... Asthma ... ... ... ... ... ... ... ... Lung Diseases, &c. ... ... ... ... ... ... 68 71 III. LOCAL 139 72 9 20 32 6 7 4 4- Digestive Orgs. 11 3 1 3 2 2 20 21 IV. DEVELOPMNL. 41 24 ... ... 1 12 ... ... Gastritis ... ... ... ... ... ... 2 1 Enteritis 3 2 ... 1 ... ... 3 3 V. VIOLENT DTHS. 6 4 ... 1 ... 1 2 1 Peritonitis 3 1 1 1 ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... ... Ileus ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... 23 28 I. 1. Miasmatic Dis. 51 4 4 4 2 ... ... ... Stricture of Intest. ... ... ... ... ... ... 1 3 Small Pox 4 3 ... 1 ... ... ... ... Fistula ... ... ... ... ... ... 1 4 Measles 5 5 ... ... ... ... ... ... Stomach Dis., &c. ... ... ... ... ... ... 4 6 Scarlatina 10 7 2 1 ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 2 3 Diphtheria 5 4 ... ... 1 ... ... ... Hepatitis ... ... ... ... ... ... ... ... Quinsey ... I ... ... ... ... ... ... 1 Jaundice 1 ... ... ... 1 ... Croup ... ... ... ... ... ... 3 1 Liver Disease 4 ... ... 1 1 2 9 8 Hooping Cough 17 17 ... ... ... ... ... ... Spleen Disease. ... ... ...... ... ... ... 1 3 Typhus Si Typhoid 4 4 ... ... ... ... 1 1 5. Urinary Orgs. 2 ... ...1 ... 1 ... 3 ... Erysipelas 3 1 ... 1 1 ... ... ... Nephritis ... ... ... ... ... ... 1 1 Pyæmia 2 ... 2 ... ... ... ... 1 ... Disease of Bladder ... ... ... ... ... ... ... ... Puerperal Fever . ... ... ... ... ... ... ...... ... Nephria ... ... ... ... ... ... 1 ... Carbuncle 1 ... ... 1 ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... 1 Prostrate Disease 1 ... ... ... 1 ... ... ... Diarrhoea ... ... ... ... ... ... 1 ... Kidney Disease,&c. 1 ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... ... ... Rheumatism ... ... ... ... ... ... ... Uterine Diseases ... ... ... ...... ...... ... 1 ... 2. Enthetic 1 1 ... ... ... ... ... 1 7. Orgs.of Locomo. 1 ... 1 ... ... ... 1 ... Syphilis 1 1 ... ... ... ... ... 1 Spine Diseases. 1 ... 1 ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases . ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 1 ... 8. Skin, &c 1 1 ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... ... 8 3 3. Die tic 11 8 1 2 ... ... 1 ... Ulcer 1 1 ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 6 2 Want of Br. Milk.. 8 8 ... ... ... ... ... . ... 1 Purpura and Scurvy 1 ... 1 ... ... ... 5 6 IV-1. Dis. of Childn 11 11 ... ... ... ... 2 ... Alcoholism 2 ... ... 2 ... ... 5 5 Premature Birth 10 10 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... .... 1 Teething 1 1 ... ... ... ... 6 6 II. 1. Diathetic 12 .... 1 3 8 .. 2 2 2. Dis. of Adults . 4 ... 4 ... ... ... 1 Gout 2 .... .... 2 .... ... .... .... Paramenia ... ... ... ... ... ... 2 1 Dropsy 3 .... .... .... 3 .... 2 2 Childbirth 4 ... 4 ... ... ... ... ... Haemorrhage .... .... .... .... .... .... 5 8 3. Dis. of Aged .. 13 ... ... ... 1 12 2 4 Cancer 6 .... 1 1 4 .... 5 8 Old Age. 13 ... ... ... 1 12 ... ... Noma .... .... .... .... .... .... 8 5 4. Dis. of Nutritn. 13 13 ... ... ... ... 1 ... Mortification 1 .... .... .... 1 .... 8 5 Atrophy & Debility 13 13 ... ... ... ... 21 23 2. Tubercular 44 16 17 9 2 .... .... l 2 Scrofula 3 3 .... .... .... ... 1 3 V. 1. Aeci. orNeg. 4 3 ... ... ... 1 3 1 Tabes Mesenterica 4 4 ... .... .... .... .... 1 Fract. and Contus. 1 ... ... ... ... ... 15 18 Phthisis 33 5 .... 9 2 .... .... .... Woundss ... ... ... ... ... ... 2 2 Hydrocephalus 4 4 .... .... .... .... .... 1 Burns and Scalds.. 1 1 ... ... ... ... .... .... Poison ... ... ... ... ... ... 14 22 III. 1. Nervous Syst 36 17 1 6 12 .... .... 1 Drowning 1 1 ... ... ... ... ... 3 Cephalitis 3 3 .... .... .... .... 1 .... Suffocation 1 1 ... ... ... ... ... 4 Apoplexy 4 .... .... 3 1 .... .... .... Otherwise ... ... ... ... ... ... 6 3 Paralysis 9 1 .... 2 6 .... 1 .... 2. Homicide 1 1 ... ... ... ... 1 ... Insanity 1 .... .... .... 1 ... 1 .... 3. Suicide 1 ... ... 1 ... ...... ... ... Chorea ... .... .... .... .... .... .... .... Wounds ... ... ... ... ... ... ... 1 Epilepsy 1 .... .... .... 1 .... 1 .... Poison 1 ... ... 1 ... ... 5 8 Convulsions 13 13 .... .... .... .... .... .... Drowning ... ... ... ... ... ... 2 3 Brain Diseases, &c 5 .... 1 1 3 .... .... .... Sulfocat. and Hang. ... ... ... ... ... ... 5 13 2. Organs of Circ. 18 2 3 4 7 2 .... .... Otherwise ... ... ... ... ... ... 1 2 Pericarditis 3 .... 2 .... 1 .... .... .... 4. Unclassed ... ... ... ... ...... ... ... 1 Aneurism 1 ... .... .... 1 .... 4 10 Heart Disease 14 2 1 '4 5 2 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 25th DAY OF APRIL, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Hollo way Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 17 10 2 .. 29 Chicken .. .. 6 7 6 .. 20 Measles0 .. .. 18 1 10 .. 29 Scarlatina .. .. 15 10 12 .. 37 Whooping Cough .. .. 24 10 20 .. 54 Croup .. .. .. 1 .. .. 1 Diarrhoea 10 .. 30 22 7 10 79 Dysentery0 .. .. 1 1 .. .. 2 Cholera .. .. .. .. .. .. .. Ague .. .. .. 2 .. .. 2 Continued Fever 5 .. 7 5 5 .. 22 Influenza .. .. .. .. .. .. .. Puerperal .. .. 1 .. .. .. 1 Rheumatic Fever 1 .. 1 .. 1 .. 3 Erusipelas 1 .. 7 3 2 .. 13 Diphtheria .. .. .. 1 .. .. 1 Sorethroat or Tonsillitis .. .. 8 22 17 .. 47 Mumps .. .. 3 .. .. .. 3 Pyaemia .. .. .. .. .. .. .. Bronchitis and Catarrh 23 .. 297 133 151 .. 640 Pneumonia 2 .. 5 6 11 .. 24 Pleurisy .. .. 3 9 5 .. 17 Delirium Tremen 1 .. 1 .. 1 .. 3 Insanity 2 .. 2 1 .. .. 5 Carbuncle 1 .. 1 .. .. .. 2 All other Diseases 49 20 524 569 653 227 2042 Total 95 21 971 813 903 273 3076 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From March 30th, 1868, to April 25tb, 1868. South East District. South West District. . North District. Total. Number of houses inspected 149 197 169 515 Drains Constructed 10 2 12 24 Improved or repaired 36 16 5 57 Traps fixed 18 4 32 54 Cesspools Abolished .. .. .. .. Cleansed or disinfected .. .. 1 1 Privies and Water Closets Pan, trap, and water supply furnished 4 .. 5 9 Pan and trap only furnished 2 2 .. 4 Water supply furnished 7 9 5 21 Dust bins "Constructed 2 1 11 14 Repaired and covers adapted .. 6 .. 6 Surface Drains and Pavements of Yards Constructed .. .. 19 19 Relaid. 31 20 5 56 General Water New receptacle provided 7 2 4 13 Receptacle repaired and cleansed 23 16 16 55 Water supply provided .. 1 .. 1 Other Improve- ments Houses generally repaired 19 2 6 27 ,, cleansed or liraewashed 91 24 13 131 ,, ventilated .. .. .. .. Overcrowding abated 14 1 .. 15 Illegal use of underground Rooms for sleeping discontinued .. •• •• •• REPORT on the SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR MAY, 1868. No. CXXXIII. The mortality registered during May in Islington has been in exact accordance with the average death-rate of the corresponding four weeks during the previous ten years. Three hundred and twelve deaths were recorded, of which eighty were attributed to maladies of the zymotic class. But even this number is not in excess of the average zymotic death-rate of the month, although it fully comes up to it. This has been a very remarkable month for heat and dryness. According to Mr. Glaisher, the mean temperature of the air has each week exceeded the average of the corresponding week for fifty years past: the first week it was 4.1°, in the second 1.9°, in the third 6.0°, and in the fourth 5.9° in excess of the average. The maximum temperature registered in my garden during the month was 86.75° on May 19th; on the same day at Greenwich Mr. Glaisher registered 87° as the maximum, a temperature (as he tells us) higher than has been recorded in the month of May as far back as authentic records extend. In accordance with what I believe to be the rule under such conditions, it will be observed that the amount of general sickness prevalent during the month has been unusually great when compared with that noted in previous and cooler Mays. A fatal case of cholera in Brand Street, mentioned in one of the Registrar-General's Reports, occurred at a house where the disease has appeared before ; the proper steps were taken to disinfect the clothing and premises. An outbreak of measles of a local character has happened in the neighbourhood of Elder Walk and the Essex Road, but it appears to be now subsiding. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, June 1st, 1S6S. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING POOR WEEKS ENDING MAY 23rd, 1868. (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. 155 157 All Causes 312 162 52 42 42 14 30 27 3. Respirat. Orgs. 57 25 9 7 14 2 4 2 Laryngitis 6 5 1 ... ... ... (Classes) 15 11 Bronchitis 26 9 2 3 10 2 35 45 I. ZYMOTIC DIS. 80 61 8 5 5 1 ... 1 Pleurisy 1 ... ... 1 ... ... 9 11 Pneumonia 20 11 5 2 2 ... 28 29 II. CONSTITUTL. 57 23 19 13 2 ... 1 1 Asthma 2 ... ... ... 2 ... 1 1 Lung, diseases &c. 2 ... 1 1 ... ... 65 65 III. LOCAL 130 50 18 24 30 8 7 11 4. Digestive Orgs. 18 5 5 3 3 2 22 15 IV. DEVELOPMNL. 37 24 4 ... 4 5 ... ... Gastritis ... ... ... ... ... ... 1 1 Enteritis 2 2 ... ... ... ... 5 3 V. VIOLENT DTHS. 8 4 3 ... 1 ... 2 1 Peritonitis 3 1 ... 2 ... ... ... ... Not Specified ... ... ... ... ... ... 1 ... Ascites 1 ... 1 ... ... ... ... 1 Ulceration of Intes. 1 ... ... 1 ... ... (Orders.) ... 1 Hernia 1 .. .. .. 1 ... ... ... Ileus .. .. .. .. ... ... 29 44 I. 1, Miasmatic Dia. 73 66 7 5 4 1 ... ... Intussusception .. .. .. .. ... ... ... ... Stricture of Iutest. .. ... .. .. ... ... ... 3 Small Pox 3 1 1 1 ... ... ... ... Fistula .. .. .. .. ... ... 3 8 Measles 11 10 1 ... ... ... 1 3 Stomach Dis, &c 4 .. 2 .. 2 ... 8 9 Scarlatina 17 16 1 ... ... ... ... ... Pancreas Dis., &c. .. .. .. .. ... ... 2 1 Diphtheria 3 2 ... 1 ... ... ... 1 Hepatitis 1 .. .. .. ... 1 ... ... Quinsey ... ... ... ... ... ... l 2 Jaundice 3 2 .. .. ... 1 ... 2 Croup 2 2 ... ... ... ... l 1 Liver Disease . 2 .. 2 .. ... ... 7 9 Hooping Cough 16 16 ... ... ... ... ... ... Spleen Disease. .. ... ... .. ... ... 5 4 Typhus & Typhoid 9 2 2 3 1 1 1 2 5. Urinary Orgs. 3 .. 1 1 ... 1 ... ... Erysipelas ... ... ... ... ... ... ... ... Nephritis .. .. ... ... ... ... ... ... Pyænia ... ... ... ... ... ... l ... Disease of Bladder 1 .. ... ... ... 1 1 3 Puerperal Fever 4 2 2 ... ... ... ... l Nephria 1 .. ... 1 ... ... ... ... Carbuncle ... ... ... ... 1 ... ... ... Diabetes .. .. ... ... ... ... ... 1 Influenza 1 ... ... ... ... ... ... ... Stone .. .. ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease . .. .. ... ...... ... ... 1 3 Diarrhoea 4 3 ... ... 1 ... ... l Kidney Disease,&c. 1 ... 1 ... ... ... ... 1 Cholera 1 1 ... ... ... ... 1 ... 6. Genera. Organs 1 ... ... 1 ... ... ... ... Ague ... ... ... ... ... ... 1 ... Ovarian Dropsy 1 ... ... 1 ... ... 2 ... Rheumatism, 2 1 ... ... 1 ... ... ... Uterine Diseases ... ... ... ... ... ... 2 1 2. Enthetic 3 2 1 ... ... ... ... ... 7. Orgs.of Locomo. ... ... ... ... ... ... 2 1 Syphilis 3 ... 1 ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ...... 1 8. Skin, &c 1 1 ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... 1 Phlegmon & Abscess 1 1 ... ... ... ... 4 ... 3. Dietic 4 3 ... ... 1 ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 3 ... Want of Br. Milk 3 3 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 6 3 IV. 1 Dis of Childn. 9 9 ... ... ... ... 1 ... Alcoholism 1 ... ... ... 1 ... 6 3 Premature Birth 9 9 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spins Bifida ... ... ... ... ... ... ... ...... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... 4 2 II. 1. Diathetic 6 ... ... 5 1 ... ... ... Teething ... ... ... ... ... ... 1 8 2. Dis. of Adults . 4 ... 4 ... ... ... 1 ... Gout 1 ... ... 1 ... ... ... ... Paramenia ... ... ... ... ... ... ... ... Dropsy ... ... ... ... ... ... 1 3 Childbirth 4 ... 4 ... ... ... ... ... Haemorrhage ... ... ... ... ... ... 6 3 3. Dis. of Aged 9 ... ... ... 4 ...5 3 2 Cancer 5 ... ... 4 1 ... ... 3 Old Age 9 ... ... ... 4 5 ... ... Noma ... ... ... ... ... ...... 9 6 4. Dis. of Nutritn. 15 15 ... ... ... ... ... ... Mortification ... ... ... ... ... ... 9 6 Atrophy & Debility 15 15 ... ... ... ... 24 27 2. Tubercular 51 23 19 8 1 ... ... ... ... 2 Scrofula 2 2 ... ... ... ... 4 2 V. 1. Acci or Neg. 6 3 2 ... 1 ... 2 1 Tabes Mesenterica 3 3 ... ... ... ... 3 1 Fract. and Contus 4 1 2 ... 1 ... 16 18 Phthisis 34 6 19 8 1 ... ... ... Wouud ... ... ... ... ... ... 6 6 Hydrocephalus 12 12 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... 21 16 III. 1. Nervous Syst. 37 17 2 8 8 2 ... ... Poison ... ... ... ... ... ... ... ... Drowning ... ... ... ... ... ... ... 1 Cephalitis 1 1 ... ... ... ... ... 1 Suffocation 1 ... ... ... ... 4 3 Apoplexy 7 ... ... 6 ... 1 1 ... Otherwise 1 1 ... ... ... ... 5 2 Paralysis 7 ... ... 1 6 ... 1 ... 2. Homicide 1 1 ... ... ... ... 1 ... Insanity 1 ... 1 ... ... ... ... 1 3. Suicide 1 ... 1 ... ... ... ... ... Chores ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... 1 ... Epilepsy 1 ... l ... ... ... ... ... Poison ... ... ... ... ... ... 7 8 Convulsions 15 15 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 3 2 Brain Diseases, &c. 5 1 ... 1 ... 1 ... ... Suffocat. and Hang. ... ... ... ... ... ... 5 8 2. Organs of Circ. 13 2 1 4 6 1 ... 1 Otherwise 1 ... 1 ... ... ... ... ... Pericarditis ... ... ... ... ... ... ...... ... 4. Unclassed ... ... ... ...... ... ...... ... ... Aneurism ... ... ... ... ... ... 5 8 Heart Disease 13 2 1 4 5 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 23rd DAY OF MAY, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox 1 .. 17 4 .. .. 22 Chicken Pox .. .. 3 6 1 .. 10 Measles .. .. 54 11 26 .. 91 Scarlatina .. .. 10 23 11 .. 44 Whooping Cough .. .. 27 13 26 .. 66 Croup .. .. .. 1 .. .. 1 Diarrhoea 3 .. 35 35 27 12 112 Dysentery • • .. 1 1 • • .. 2 Cholera .. .. 1 .. .. .. 1 Ague .. .. .. 1 .. .. 1 Continued Fever 5 .. 10 12 2 .. 29 Influenza .. .. .. .. .. .. 2 Puerperal Fever .. .. 2 .. • • 2 Rheumatic Fever • • .. .. 1 .. .. 1 Erysipela 1 .. 11 1 • • .. 13 Diphtheria .. .. • • .. • • .. • • Sorethroat or Tonsillitis 1 .. 18 23 15 .. 57 Mumps .. .. 2 • • • • .. 2 Pyaemia .. .. .. .. .. .. .. Bronchitis and Catarrh 9 .. 198 117 115 40 479 Pneumonia .. .. 1 1 4 .. 6 Pleurisy .. .. 4 7 3 1 15 Delirium Tremens 2 .. 2 .. .. 4 Insanity 2 .. 4 .. .. .. 6 Carbuncle .. .. .. .. .. .. .. All other Diseases 62 23 602 580 735 188 2190 Total 86 23 1002 837 965 241 3154 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From April 27th, 1868. t,o May 30th, 1868. South East District. South West District. North District. Total. *Number of houses inspected 217 139 213 569 Drains Constructed 15 5 19 39 Improved or repaired 18 38 19 75 Traps fixed 37 41 52 130 Cesspools Abolished 10 1 1 12 Ceansed or disinfected . . .. .. Privies and Water Closets Pan, trap, and water supply furnished . 7 2 23 32 1 2 1 4 Water supply furnished 6 25 29 60 Dust bins Constructed .. 9 .. 9 Repaired and covers adapted 11 9 18 38 Surface Drains and Pavements of Yards Constructed 6 9 15 Relaid 32 42 30 104 General Water Supply New receptacle provided 7 6 16 29 Receptacle repaired and cleansed 17 8 15 40 Water supply provided .. 3 8 11 Other Improvements Houses generally repaired 18 13 24 55 ,, cleansed or limewashed 53 60 38 151 ,, ventilated .. • • .. .. Overcrowding abated • • 6 .. 6 Illegal use of underground Rooms for sleeping discontinued .. 1 .. 1 Other Amendments 6 .. 28 34 * In addition to the above, Belle Isle, in the South-West District, was inspected during twelve conbecutive days and on eleven nights between the hours of 8 and 11. REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR JUNE, 1868. No. CXXXIV. Again we have passed through a month remarkable for heat and drought. As measured at Greenwich, the mean temperature has been constantly week after week above the average. In the first week it was 3.7°, in the second 1.5°, in the third 2.3°, in the fourth 6.2°, in the fifth 2.6° above the average of fifty years. The air has been unusually dry—rain only fell on seven days out of the thirty-five to which this Report relates, and the rain-fall only amounted to 1.85 in., of which 1.38 in. fell nearly all on one day in the first week. Following the law of sickness which I have established, the general sickness, as gathered from the books of the public institutions in the parish, has been unusually large. The total of new cases entered being 3906. In June, 1867, it was 2977; in 1866, 2892; in 1865, 2757; in 1864, 2701; in 1863, 3059 ; in 1862, 2558 ; and in 1861, 2715 new cases. We saw that the sickness was high last month, and that the mortality, after being for many months below, had come to equal the average. This past month the rate of mortality has increased with the increased sickness, so as to exceed the corrected mean of ten years by eleven deaths. Comparing the sickness table with that of the corresponding period for ten years back, I find that the diseases which have been prevailing amongst us more than usual in June, have been hooping cough, (151 cases), bowel affections (298 cases, the highest number yet recorded in June), sore throats (73 cases), and acute pulmonary affections (494 cases). Of the total number of 373 deaths, 104 arose from maladies of the miasmatic order, 84 of which occurred in children under five years of age. Hooping cough gave 28 and bowel affections 25 deaths; of the latter, 3 are returned as cholera or choleraic diarrhoea—nothing unusual in so hot a season. Nevertheless, I have thought it right to carry out disinfection of drains and closets with carbolic acid in these instances. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, July 4th, 186S. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING JUNE 27th, 1868. (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 ace. 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. 00 and under 80 years of age. At 80 years of age and upwards. 194 179 All Causes 373 212 48 64 44 5 23 25 3. Respirat. Orgs. 48 23 4 8 12 1 1 2 Laryngitis 3 2 ... ... 1 ... (Classes.) 14 9 Bronchitis 23 11 ... 4 7 1 1 1 Pleurisy 2 ... l ... 1 ... 62 61 I. ZYMOTIC DIS. 113 102 3 5 3 ... 5 10 Pneumonia 15 10 3 2 ... ... 47 35 II. CONSTITUTL 82 35 24 17 6 ... ... 2 Asthma 2 ... ... ... 2 ... 2 1 Lung Diseases. &c. 3 ... ... 2 1 ... 80 65 III. LOCAL 145 55 17 38 32 3 12 6 4. Digestive Orgs. 18 3 3 7 5 ... 11 14 IV. DEVELOPMNL. 25 18 1 2 2 2 ... ... Gastritis ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... 4 4 V. VIOLENT DTHS. 8 2 3 2 1 ... ... ... Peritonitis ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... ... Ileus ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... 50 54 I. 1. Miasmatic Dis. 104 93 3 1 5 3 ... ... ... Stricture of Intest. ... ... ... ... ... ... 4 2 Small Pox 6 5 ... ... ... ... ... Fistula ... ... ... ... ... ... 2 9 Measles 11 11 ... ... ... ... 3 2 Stomach Dis., &c. 5 1 1 ... 3 ... 11 5 Scarlatina 16 16 ... ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ...... 1 1 Diphtheria 2 2 ... ... ... ... 1 1 Hepatitis 2 ... ... 1 1 ... ... ... Quinsey ... ... ... ... ... ... 3 1 Jaundice 4 2 1 1 ... ... ... 2 Croup 2 2 ... ... ... ... 5 2 Liver Disease 7 ... 1 5 1 ... 12 10 Hooping Cough 28 28 ... ... ... ... ... Spleen 1 mease. ... ... ... ... ... ... 5 5 Typhus & Typhoid 10 5 2 2 1 ... 2 2 5. Urinary Orgs. 4 ... 1 2 1 ... 1 ... Erysipelas 1 1 ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyæmia ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... 1 2 Nephria 3 ... 1 2 ... ... ... 1 Carbuncle 1 ... 1 ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Infiuenea ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... 1 Dysentery 1 1 ... ... ... ... ... Prostrate Disease . ... ... ... ... ... ... 12 9 Diarrhoea 21 20 ... 1 ... 1 ... Kidney Disease,&c. 1 ... ... ... 1 ... 1 2 Cholera 3 2 ... 1 ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 1 1 Rheumatism 2 ... 2 ... ... ... ... Uterine Diseases ... ... ... ... l 2 2. Enthetic 3 3 ... ... ... ... 1 1 7. Orgs. of Locomo. 2 2 ... ... ... ... I 2 Syphilis 3 3 ... ... ... ... 1 1 Spine Diseases 2 2 ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... ... 1 4 3. Dietic 5 5 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 3 Warft of Br. Milk.. 4 4 ... ... ... ... ... 1 Purpura and Scurvy 1 1 ... ... ... ... ... ... IV. 1. Dis. of childn. 9 9 ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... 4 5 Premature Birth 7 7 ... ... ... ... ... 1 4. Parasitic 1 1 ... ... ... ... 3 4 Gyanosie 2 2 ... ... ... ... ... l Thrush 1 1 ... ... ... ... 1 1 Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... ... ... ... ... Teething ... ... ... ... .... ... 6 6 II. 1. Diathetic 12 ... 2 6 4 ... 1 2 2. Dis. of Adults . 3 ... 1 2 ... ... 1 ... Gout 1 ... ... 1 ... ... ... Paramenia ... ... ... ... ... ... 2 2 Dropsy 4 ... 1 2 1 ... 1 2 Childbirth 3 ... 1 2 ... ... ... ... Hemorrhage . ... ... ... ... ... ... 2 2 3. Dis. of Aged 4 ... ... ... 2 2 3 4 Cancer 7 ... 1 3 3 ... 2 Old Age 4 ... ... ... 2 2 ... ... Noma ... ... ... ... ... ... 4 5 4. Dis. of Nutritn. 9 9 ... ... ... ... ... ... Mortification ... ... ... ... ... ... 4 5 Atrophy & Debility 9 9 ... ... ... ... 41 29 2. Tubercular 70 35 22 11 2 ... 3 2 Scrofula 5 5 ... ... 3 1 V.1. Acci or Neg. 4 1 1 1 1 ...... 1 5 Tabes Mesenterica 6 6 ... ... ... ... 2 ... Fract. and Contus. 2 ... 1 1 ... ... 29 17 Phthisis 46 1 22 11 2 ... ... ... Wounds ... ... ... ... ... ... 8 5 Hydrocephalus 13 13 ... ... ... ... ... ... Burns and Scalds.. ... ... ... ... ... ... 30 15 III. 1. Nervous Syat. 45 25 4 9 6 1 ... ... Poison ... ... ... ... ... ... ... ... Drowning ... ... ... ... ... ... 7 3 Cephalitis 10 10 ... ... ... ... 1 ... Suffocation 1 1 ... ... ... ... 2 2 Apoplexy 4 ... ... 3 ... 1 ... 1 Otherwise 1 ... ... ... 1 ... 3 1 Paralysis 4 ... ... 1 3 ... ... 1 2. Homicide 1 1 ... ... ... ... 2 ... Insanity 2 ... 1 1 ... ... 1 2 3. Suicide 3 ... 2 1 ... ... ... ... Chorea ... ... ... ... ... ... 1 1 Wounds 2 ... 1 1 ... ... 2 4 Epilepsy 6 1 2 2 1 ... ... ... Poison ... ... ... ... ...... 10 4 Convulsions 14 14 ... ... ... ... ... 1 Drowning 1 ... 1 ... ... ... 4 1 Brain Diseases, &c. 5 ... 1 2 2 ... ... ... Suffocat. and Hang. ... ... ... ... ... ... 12 16 2. Organs of Circ. 28 2 5 12 8 1 ... ... Otherwise ... ... ... ... ... ... 1 1 Pericarditis 2 ... ... 2 ... ... ... ... 4. Unclassed ... ... ... ... ... ... 2 1 Aneurism 3 ... ... 1 2 ... ... 9 14 Heart Disease 23 2 5 9 6 1 ... TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 27th DAY OF JUNE, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 19 3 2 .. 24 Chicken Pox .. .. 5 7 . . .. 12 Measles . . .. 48 16 12 .. 76 Scarlatina .. 1 16 19 6 .. 42 Whooping Cough .. 1 57 38 55 .. 151 Croup .. .. .. 1 1 .. 2 Diarrhoea 7 .. 108 73 91 .. 293 Dysentery .. .. 1 2 .. .. 3 Cholera .. .. 1 .. 1 .. 2 Ague 1 .. .. .. .. .. 1 Continued Fever 2 .. 6 4 8 .. 20 Influenza .. .. .. .. .. .. . . Puerperal Fever .. .. • • .. .. .. .. Rheumatic Fever .. .. .. 3 1 .. 4 Erysipelas 2 .. 9 1 1 .. 13 Diphtheria .. .. .. 1 .. .. 1 Sorethroat or Tonsillitis .. .. 28 32 13 .. 73 Mumps .. .. 1 .. .. .. 1 Pyaemia .. .. .. .. .. .. .. Bronchitis and Catarrh 15 .. 191 108 113 .. 479 Pneumonia .. .. 1 9 .. .. 10 Pleurisy .. .. 1 3 1 .. 5 Delirium Tremens 3 .. 1 .. .. .. 4 Insanity 8 .. 7 .. 1 .. 16 Carbuncle .. .. .. 1 1 .. 2 All other Diseases 56 16 670 756 934 240 2672 Total 94 18 1170 1077 1241 306 3906 TABLE III HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From June 1st, 1868, to June 27th, 1868. South East District. South West District. North District. Total. *Number of houses inspected 130 117 ' 89 336 Drains Constructed 3 .. 15 18 Improved or repaired 49 18 8 75 Traps fixed 37 9 24 70 Cesspools Abolished 1 .. 1 2 Cleansed or disinfected • • .. .. Privies and Water Closets Pan, trap, and water supply furnished 1 1 5 7 Pan and trap only furnished .. 2 2 Water supply furnished 10 7 14 31 Dust bins Constructed 3 2 4 9 Repaired and covers adapted 2 5 5 12 Surface Drains and Pavements of Yards Constructed .. .. 1 1 Re-laid 30 11 4 45 General Water Supply New receptacle provided . . 1 .. 1 19 9 4 32 Water supply provided .. .. 1 1 Other Improvements 98 l 7 36 „ cleansed or limewashed 53 45 23 121 „ ventilated .. .. .. .. Overcrowding abated 8 4 .. 12 Illegal use of underground Rooms for sleeping discontinued .. 2 .. 2 Other Amendments 13 .. 7 20 * In addition to the above, the whole of the Bakehouses and Cow and Slaughter-houses, and several Work ltooms and places, under the Workshop .Regulation Act, 1867, have been visited. REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR, JULY, 1868. No. CXXXY. The month just passed through is, although not the most fatal July (considering the population) that we have had since I have held office here, yet by far the most sickly. July 1863 and 1865 were relatively more deadly, but they did not present any approach to the amount of sickness of July this year. The deaths registered in the four weeks amounted to 363, an excess of 33 over the corrected mean mortality of the previous ten Julies. Of these, 181 were of infants under one year of age. The new cases of sickness recorded upon my table amount to 3402. In July last year, 2766 new cases were recorded; in 1866, 2536; in 1865, 2447 ; in 1864, 2152; in 1863, 2567. One hundred and sixty-five of the deaths resulted from the zymotic class of causes. The diseases which have been most unusually prevalent have been measles, scarlet fever, whooping cough, and diarrhœal affections. As to the last of these, I have recorded no less than 596 cases of diarrhoea (which do not include all that were relieved in the several institutions), two cases of dysentery, and one of cholera. I have recorded nothing like this number in any former July, my highest number of cases of diarrhoea being 397 in 1865. The deaths from diarrhoea were 90, and a similar number was recorded in July, 1865. All but two of these deaths were of infants under three years of age; 81 were of infants under one year. The extraordinary heat and drought have had much to do with this high mortality and sickness. In the second week of the month the mean temperature was 3.9 deg. above the mean of the same week in fifty years; in the third week of the month it was 8.5 deg. above the mean; and in the fourth week it was 7.6 deg. above the mean (Glaisher). On the 14th of July I registered a temperature of 90° in the shade, on the 15th of 91°, on the 16th of 91°, on the 21st of 93°, and on the 22nd of 93.5°, and again of 90°, on the 27th. During the whole four weeks rain fell only on two days, namely, to the extent of O O1in. on the 4th, and of 018 on the 11th—not a fifth of an inch altogether. The air also has been unusually free from moisture. 2 The general sickness, which was represented by 807 new cases in the first week of the month, rose to 819 in the second week, to 846 in the third week, and 930 in the fourth week. The cases of diarrhœal affection recorded week by week were 122, 127, 141, and 209. One word now about the Vaccinations. In my Annual Report I mentioned the desirableness of renewing the vaccine virus in habitual use, and that I intended to take some steps to effect this object here. I have now obtained a supply of virus direct from the calf, and vaccinated several children with it successfully. From these the virus has now been propagated in other children up to the second and third human generation, and I have arranged with four of our public vaccinators to continue its use instead of that of the current lymph, much of which has probably been in use since the time of Jenner. I shall shortly be able to supply the remaining four Vaccinators. Vestry Offices, August 3rd, 1868. EDWARD BALLARD, M.D., Medical Officer of Health. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JULY 25th, 1868. (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. 183 180 All Causes 363 254 31 27 34 17 17 6 3. Respirat. Orgs. 23 7 3 5 6 2 ... 1 Laryngitis 1 1 ... ... ... ... (Classes.) 12 1 Bronchtis 13 2 1 4 4 2 1 2 Pleurisy 3 2 ... ... 1 ... 77 88 I. ZYMOTIC DIS. 165 150 10 2 1 2 2 2 Pneumonia 4 2 1 ... 1 ... 24 26 II. CONSTITUTL 50 24 11 9 4 2 1 ... Asthma 1 ... ... 1 ... ... 1 ... Lung Diseases, &c. 1 ... 1 ... ... ... 49 41 III. LOCAL 90 36 8 14 23 9 6 8 4- Digestive Orgs. 14 3 4 2 3 2 25 23 IV. DEVELOPMNL. 48 37 2 1 5 3 ... ... Gastritis ... ... ... ... ... ... ... ... Enteritis ... ... ... ... ... ... 8 2 V. VIOLENT DTHS. 10 7 ... 1 1 1 1 1 Peritonitis 2 ... 1 ... ... 1 ... ... Ascites ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... 2 Hernia 2 1 ... ... 1 ... (Orders.) 1 1 Ileus 2 ... 2 ... ... ... ... ... Intussusception ... ... ... ... ... ... 73 77 I. 1. Miasmatic Dis. 150 137 8 2 1 2 ... ... Stricture of Intest. ... ... ... ... ... ... 1 3 Small Pox 4 3 1 ... ... ... ... ... Fistula ... ... ... ... ... ... 3 7 Measles 10 10 ... ... ... ... 1 ... Stomach Dis., &c. 1 1 ... ... ... ... 8 3 Scarlatina 11 9 2 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 2 2 Diphtheria 4 3 ... ... 1 ... ... ... Hepatitis ... ... ... ... ... ... ... ... Quinsey ... ... ... ... ... ... ... 1 Jaundice 1 ... ... ... ... 1 ... ... Croup 18 18 ... ... ... ... 3 3 Liver Disease 6 1 1 2 2 ... 8 10 Hooping Cough ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 4 2 Typhus & Typhoid 6 3 1 2 ... ... ... ... 5. Urinary Orgs. ... ... ... ... ... ... 1 ... Erysipelas 1 1 ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... 1 Pyæmia 1 1 ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... 2 ... Puerperal Fever 2 ... 2 ... ... ... ... ... Nephria ... ... ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease . ... ... ... ... ... ... 43 47 Diarrhoea 90 89 ... ... ... 1 ... ... Kidney Disease,&c. ... ... ... ... ... ... ... 1 Cholera 1 ... ... ... ... 1 ... ... 6. Genera. Organs ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 1 1 Rheumatism 2 ... 2 ... ... ... ... ... Uterine Diseases ... ... ... ... ... ... 1 4 2. Enthetic 5 5 ... ... ... ... ... 1 7. Orgs.of Locomo. 1 ... ... 1 ... ... 1 4 Syphilis ... 5 ... ... ... ... ... 1 Spine Diseases 1 ... ... 1 ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 4 2 8. Skin, &c 6 ... 1 1 ... ... ... Glanders ... ... ... ... ...... ... ... ... Phlegmon & Abscess ... ... ... ... ... 2 5 3. Dietic 7 5 2 ... ... ... 1 ... Ulcer 1 ... 1 ... ... ... ... Privation ... ... ... ... ... ... 3 2 Skin Diseases 5 4 ... ... 1 ... 2 3 Want of Br. Milk.. 5 5 ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 7 10 IV. 1. Dis of Childn. 17 17 ... ... ... ... ... 2 Alcoholism 2 ... 2 ... ... ... 6 7 Premature Birth 13 13 ... ... ... ... 1 2 4. Parasitic 3 3 ... ... ... ... ... 1 Cyanosis 1 1 ... ... ... ... 1 2 Thrush 3 3 ... ... ... ... 1 1 Spina Bifida 2 2 ... ... ... ... ... ... Worms ... ... ... ... ... ... ... 1 Other Malformation 1 1 ... ... ... ... ... ... Teething ... ... ... ... ... ... 4 8 II. 1. Diathetic 12 2 3 2 3 2 ... 2 2. Dis. of Adults . 2 ... 2 ... ... ... ... ... Gout ... ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... ... 3 Dropsy 3 1 ... ... 2 ... ... 2 Childbirth 2 ... 2 ... ... ... 1 1 Hœmorrhage 2 l 1 ... ... ... 4 5 3. Dis. of Aged 9 ... ... 1 5 3 2 4 Cancer 6 ... 2 2 1 1 4 5 Old Age 9 ... 1 5 3 ... ... Noma ... ... ... ... ... ... 14 6 4. Dis. of Nutritn. 20 20 ... ... ... ... i ... Mortification 1 ... ... ... ... 1 14 6 Atrophy & Debility 20 20 ... ... ... ... 20 18 2. Tubercular 38 22 8 7 1 ... 1 3 Scrofula 4 4 ... ... ... ... 8 2 V 1 Acci. or Neg 10 7 ... 1 1 I 2 3 Tabes Mesenterica 5 5 ... ... ... ... 2 1 Fract. and Contus. 3 2 ... ... ... I 13 7 Phthisis 20 4 8 7 1 ... 1 ... Wounds 1 1 ... ... ... ... 4 5 Hydrocephalus 9 9 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 14 21 III. 1. Nervous Syst. 35 21 ... 1 9 4 1 ... Drowning 1 1 ... ... ... ... 3 4 Cephalitis 7 7 ... ... ... ... 2 1 Suffocation 3 2 ... ... 1 ... 1 3 Apoplexy 4 ... ... 1 3 1 2 ... Otherwise 2 1 ... 1 ... ... 3 2 Paralysis 5 ... ... 3 1 ... ... 2. Homicide ... ... ... ... ... ... ... ... Insanity ... ... ... ... ... ... ... ... 3. Suicide ... ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... ... Epilepsy ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 4 10 Convulsions 14 13 ... ... ... 1 ... ... Drowning ... ... ... ... ... ... 3 2 Brain Diseases, &c, 5 1 ... ... 3 1 ... ... Suffocat. and Hang. ... ... ... ... ... ... 8 3 2. Organs of Circ. 11 1 1 4 4 1 ... ... Otherwise ... ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... ... 8 3 Heart Disease 11 1 1 4 4 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 25th DAY OF JULY, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox • • • • 14 2 • • • • 16 Chicken Pox • • • • 2 4 5 • • 11 Measles • • • • 43 35 12 • • 90 Scarlatina • • 1 26 13 17 • • 57 Whooping Cough • • • • 16 14 22 • • 52 Croup • • • • 1 1 .. • • 2 Diarrhoea 9 • • 271 184 111 21 596 Dysentery 1 • • • • 1 • • .. 2 Cholera • • • • • • 1 • • .. 1 Ague 1 • • 1 1 .. .. 3 Continued Fever 1 1 11 6 2 .. 21 Influenza .. • • • • .. .. .. .. Puerperal Fever • • • • • • .. .. .. .. Rheumatic Fever • • • • • • .. .. .. .. Erysipelas .. • • 8 3 2 .. 13 Diphtheria .. • • • • 2 .. .. 2 Sorethroat or Tonsillitis • • • • 17 27 9 .. 53 Mumps • • • • 1 • • .. .. 1 Pyaemia • • • • • • .. .. .. .. Bronchitis and Catarrh 8 • • 160 41 62 22 293 Pneumonia • • • • 1 2 2 .. 5 Pleurisy • • • • 8 2 3 .. 13 Delirium Tremens • • • • • • 1 .. .. 1 Insanity 4 • • 7 .. .. 1 12 Carbuncle 1 • • 3 1 .. .. 5 All other Diseases 58 21 559 556 746 213 2153 Total 83 23 1149 897 993 257 3402 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From June 29th, 1868, to August 1st, 1868. South East District. South West District. North District. Total. Number of houses inspected 243 309 172 724 Drains Constructed 5 .. 6 11 Improved or repaired 23 25 11 40 59 68 Traps fixed 26 2 Cesspools Abolished 4 .. 2 6 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 7 .. 1 8 Pan and trap only furnished 1 .. 2 3 Water supply furnished 13 12 36 61 Dust bins Constructed .. 1 6 7 Repaired and covers adapted .. 4 2 6 Surface Drains and Pavements of Yards Constructed .. .. 1 1 Relaid 25 16 23 64 General Water Supply New receptacle provided 2 1 1 4 Receptacle repaired and cleansed 38 14 3 55 Water supply provided .. 4 1 5 Other Improvements Houses generally repaired 19 4 6 29 „ cleansed or limewashed 118 76 63 257 „ ventilated .. .. .. .. Overcrowding abated • • 3 1 4 Illegal use of underground Rooms for sleeping discontinued.... .. • • .. .. Other Amendments 20 .. 24 44 .. REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR AUGUST, 1868. No. CXXXVI. The extreme heat of the present summer began to abate in the third week of the month to which this Report relates. In the week ending August 1st, the mean temperature was 5.3 deg. above the average of fifty years (Glaisher); in that ending August 8th it was 7.6 deg. above the average, while in the weeks ending August 15th and 22nd it was only 2.4 and 1.0 deg. above the average. Rain also fell each week but only in large quantity in the fourth week. The meteorological characters of the month then have, in these two very important elements, been such as to promote general sickness and diarrhoeal affections, and to favour a high mortality. And the result of examination of the sickness and mortality returns corresponds with this anticipation. The number of deaths recorded during these four weeks is 342, or 26 above the corrected average mortality of August during the past ten years. The excess is mainly dependent upon a high death rate from bowel affections. There were 94 deaths from diarrhoea registered, and seven from summer cholera. The total new cases of sickness taken on the books of the Institutions, which furnish me with returns, was 3515. With the exception of the cholera year, 1866, this is by far the largest number I have yet registered in August. In August last year the number of new cases was 2831. The diseases which have been unusually prevalent, for the season, have been measles, scarlatina, bowel complaints, continued fever, acute throat affections, and bronchitic and catarrhal affections. The total new cases of bowel complaints recorded is 661. With the 2 exception of the cholera year (1794 cases) I have never registered so many cases in August or indeed in any month of any year. The following have been my highest numbers:— August, 1857 327 cases „ 1859 304 „ „ 1861 434 „ ,,1863408 „ „ 1864 407 „ ,,1867 326 „ With respect to the bronchitic affections, it is worthy of observation that the diarrhæal season of this and the two last years has been marked by an unusual prevalence of diseases of this class. After a summer so hot as the present one has been, it behoves all persons who are liable to suffer from chest affections in the winter to be unusually careful in the avoidance of chills, and of exposure to other known causes of bronchitis and catarrh. My tabulated experience here has demonstrated that after summers of unusual heat, the winter increase of these maladies takes place earlier than it does after cooler summers. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, September 1st, 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 22nd AUGUST, 1868. (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 bu and under 80 years of age. At 80 years of age and upwards. 181 161 I All Causes 342 243 30 29 38 2 11 11 3. Respirat. Orgs. 22 11 3 4 4 ... 1 ... Laryngitis l 1 ... ... ... ... (Classes.) 7 7 Bronchitis 14 6 2 3 3 ... ... ... Pleurisy ... ... ... ... ... ... 89 79 I. ZYMOTIC DIS. 168 157 5 2 3 1 3 4 Pneumonia 7 4 1 1 1 ... 26 30 II. CONSTITUTL. 56 26 15 12 2 1 ... ... Asthma ... ... ... ... ... ... ... ... Lung Diseases, &c. ... ... ... ... ... ... 43 36 III. LOCAL 79 33 9 14 23 ... 5 6 4- Digestive Orgs. 11 4 1 2 4 ... 21 15 IV. DEVELOPMNL. 36 26 1 ... 9 ... ... ... Gastritis ... ... ... ... ... ... 1 2 Enteritis 3 3 ... ... ... ... 2 1 V. VIOLENT DTHS. 3 1 ... 1 1 .. ... 2 Peritonitis 2 1 ... 1 ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... 1 Ileus 1 ... ... ... 1 ... ... ... Intussusception ... ... ... ... ... ... 79 71 I. 1. Miasmatic Dis. 150 141 3 2 3 1 1 ... Stricture of Intest. 1 ... ... ... 1 ... 2 l Small Pox 3 ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... 11 6 Measles 17 17 ... ... ... ... 2 ... Stomach Dis., &c. 2 ... ... ... l ... 5 2 Scarlatina 7 7 ... ... ... ... ... ... Pancrcas Dis., &c. ... ... ... ... ... ... 3 ... Diphtheria 3 3 ... ... ... ... ... l Hepatitis 1 ... ... ... 1 ... ... ... Quinsey ... ... ... ... ... ... ... ... Jaundice ... ... ... ... ... ... ... ... Croup ... ... ... ... ... ... 1 ... Liver Disease 1 ... 1 ... ... ... 2 6 Hooping Cough 8 8 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 1 9 Typhus & Typhoid 10 6 2 1 1 ... 2 ... 5. Urinary Orgs. 2 2 ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... 1 ... Nephritis 1 1 ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... 1 ... Nephria 1 1 ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery .... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 52 42 Diarrhœa 94 90 ... 1 2 1 ... ... Kidner Diseases ... ... ... ... ... ... 2 5 Cholera 7 7 ... ... ... ... 1 ... 6. Genera. Organs 1 ... 1 ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 1 ... Rheumatism 1 ... 1 ... ... ... 1 ... Uterine Diseases 1 ... l ... ... ... 2 2 2. Enthetic 4 4 ... ... ... ... 1 ... 7. Orgs.of Locomo. 1 ... 1 ... ... ... 2 2 Syphilis 4 4 ... ... ... ... 1 ... Spine Diseases 1 ... 1 ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 1 1 8. Skin, &c. 2 1 ... ... l ... ... ... Glanders ... ... ... ... ... ... ... l Phlegmon & Abscess 1 ... ... ... 1 ... 5 4 3. Dietic. 9 7 2 ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation .. ... ... ... ... ... 1 ... Skin Diseases 1 1 ... ... ... ... 4 3 Want of Br. Milk 7 7 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 5 5 IV. 1. Dis. of Childn. 10 10 ... ... ... ... 1 1 Alcoholish 2 ... 2 ... ... ... 3 4 Premature Birth 7 7 ... ... ... ... 3 2 4. Parasitic 5 5 ... ... ... ... 1 ... Cyanosis 1 1 ... ... ... ... 3 2 Thrush 5 5 ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... 1 1 Other Malformation 2 2 ... ... ... ... ... ... Teething ... ... ... ... ... ... 3 5 II. 1. Diathetic 8 1 ... 4 2 1 ... 1 2. Sis. of Adults. 1 ... 1 ... ... ... l ... Gout 1 ... ... ... 1 ... ... ... Paramenia ... ... ... ... ... ... l ... Dropsy 1 1 ... ... ... ... ... 1 Childbirth 1 ... 1 ... ... ... ... ... Hæmorrhage ... ... ... ... ... ... 7 2 3. Dis. of Aged 9 ... ... ... 9 ... 1 5 Cancer 6 ... ... 4 1 1 7 2 Old Age 9 ... ... ... 9 ... ... ... Noma ... ... ... ... ... ... 9 7 4. Dis. of N utritn. 16 16 ... ... ... ... ... ... Mortification ... ... ... ... ... ... 9 7 Arophy & Debilitya 16 16 ... ... ... ... 23 25 2. Tubercular— 48 25 15 8 ... ... 1 2 Scrofula 3 3 ... ... ... ... 1 ... V. 1. Acci.orNeg. 1 ... ... ... 1 ... 3 3 Tabes Mesenterica 6 6 ... ... ... ... 1 ... Fract. and Contus. 1 ... ... ... 1 ... 13 18 Phthisis 31 8 15 8 ... ... ... ... Wounds ... ... ... ... ... ... 6 2 Hydrocephalus 8 8 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 14 16 III. 1. NervousSyst. 30 15 1 4 10 ... ... ... Drowning ... ... ... ... ... ... ... 1 Cephalitis 1 1 ... ... ... ... ... ... Suffocation ... ... ... ... ... ... 2 2 Apoplexy 4 1 1 ... 2 ... ... ... Otherwise ... ... ... ... ... ... 5 5 Paralysis 10 ... ... 2 8 ... ... 1 2. Homicide 1 1 ... ... ... ... ... ... Insanity ... ... ... ... ... ... 1 ... 3. Suicide 1 ... ... 1 ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... 1 ... Epilepsy 1 ... ... 1 ... ... ... ... Poison ... ... ... ... ... ... 4 8 Convulsions 12 12 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 2 ... Brain Diseases, &c. 2 1 ... 1 ... ... 1 ... Surtocat.and Hang. 1 ... ... 1 ... ... 8 2 2. Organs of Circ. 10 ... 2 4 4 ... ... ... Otherwise ... ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unciassed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... ... 8 2 Heart Disease 10 ... 2 4 4 ... TABLE II. NEW CASES OF DISEASE COMING UNDER. TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 22nd DAY OF AUGUST, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 4 .. .. .. 4 Chicken Pox .. .. 5 2 1 .. 8 Measles .. .. 36 7 14 .. 57 Scarlatina .. 2 22 16 7 .. 47 Wgooping Cough .. .. 8 10 6 .. 24 Croup .. .. 3 .. .. .. 3 Diarrhœa 19 .. 283 163 156 32 653 Dysentery 1 .. .. 3 1 .. 5 Cholera .. .. 2 1 .. .. 3 Ague .. .. .. .. .. .. .. Continued Fever 2 2 11 5 13 .. 33 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. .. .. 2 .. 2 Erysipelas .. .. 5 1 2 .. 8 Diphtheria .. .. 1 .. 3 .. 4 Sorethroat or Tonsillitis .. .. 20 19 30 .. 69 Momps ... .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. •• Bronchitis and Catarrh 16 .. 144 46 65 28 299 Pneumonia .. .. 1 3 5 ., 9 Pleurisy .. .. 5 3 1 .. 9 Delirium Tremens .. .. .. .. .. .. .. Insanity 3 .. 5 .. 2 .. 10 Carbuncle .. .. 1 .. .. .. 1 All other Diseases 69 17 589 561 857 174 2267 Total 110 21 1145 840 1165 234 3515 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From August 3rd 1868, to August 29th, 1868. South East | District. South "West District. North District. Total. Number of houses inspected 128 174 .. 302 Drains Constructed 3 2 .. 5 Improved or repaired 17 35 .. 52 Traps fixed 1 6 .. 7 Cesspools Abolished .. 3 .. 3 Cleansed or disinfected •• •• .. .. Privies and Water Closets Pan, trap, and water supply furnished .. .. .. .. Pan and trap only furnished 1 2 .. 3 Water supply furnished 5 18 .. 23 Dust bins Constructed 2 .. .. 2 Repaired and covers adapted .. 6 .. 6 Surface Drains and Pavements of Yards Constructed .. .. .. .. Relaid 7 28 .. 35 General Water New receptacle provided 1 2 .. 3 Receptacle repaired and cleansed 21 16 .. 37 Water supply provided .. 8 .. 8 Other Improvements Houses generally repaired 1 2 .. 3 „ cleansed or limewashed 49 17 .. 66 „ ventilated •• •• .. •• Overcrowding abated •• 1 .. 1 Illegal use of underground Rooms for sleeping discontinued .. 1 .. 1 Other Amendments 12 7 .. 19 REPORT ON THE SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR SEPTEMBER, 1868. No. CXXXYII. The mortality of the Parish during the five weeks ending September 26th—namely, 362 deaths—has been rather below the corrected mean mortality of the corresponding period during the last ten years (370 deaths). The most remarkable mortality has taken place among persons advanced in years, and persons who have been suffering from phthisis. The latter have appeared to be benefitted by the weather of July and August, but have succumbed under the atmospheric changes of the past month. The mean temperature of the air has been above the average every week except the first. In the second and third weeks it was more than six degrees above the average; and the weather, after the considerable rains in the middle of August, again became dry. All this was prejudicial to public health, and we find accordingly that our Sickness table exhibits an unusually large number of new cases of disease, namely, 3887 cases, nearly 400 more than occurred among the same sort of population in September last year. I have especially to note as respects the Sickness, (1) that small-pox has, during the last two months, undergone a remarkable diminution among us. (2). That scarlet fever, which has been increasing a good deal in other parts of London, especially in the Western districts, St. Pancras, and Clerkenwell, has not been increasing yet similarly with us, although my tables, carried on for many years now, show that it is in September that our largest number of cases usually occurs. (3). That we have this month registered by far the largest number of cases of erysipelas and sore throat (probably erysipelatous) that I have ever noted in September. The cases of erysipelas have been 23, and of sorethroat 135. I have never registered more than 18 cases of the former, and 88 of the latter disease. (4). Bronchitic and catarrhal diseases, with pneumonia and pleurisy, have all been unusually frequent. 2 Torrens' Act for providing better dwellings for artisans and labourers, which was passed in the recent session of Parliament, throws upon me a new duty, namely, to set the Yestry in motion, "for the taking down or improving dwellings occupied by working men and their families which are unfit for human habitation." The premises which I propose reporting upon under this statute are those, the unsanitary conditions of which we have been unable to deal with, permanently and effectually, by the aid of the statutes hitherto in force. The statutes under which we have more especially acted up to the present time, have been the "Nuisances Removal" and "Sanitary" Acts, but these are inapplicable where the unwholesome condition of houses is dependent upon faults of original construction and arrangement, extensive dilapidation, defective land drainage, bad lighting, &c.—and yet these and the like faults are among the most important of those which call for remedy in the interest of the health of the labouring classes. One great value of the present statute lies in this:—that it in no way limits the ground on which I am at liberty to form or express a valid opinion as to the unwholesomeness of habitations, and it therefore enables us now to grapple with conditions over which we have hitherto had no control, or only an imperfect control. EDWARD BALLARD, M.D., Medical Officer of Health. Yestry Offices, October 5th, 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING 26th SEPTEMBER, 1868. (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. 169 193 All Casuses 362 183 46 63 54 15 19 18 3. Respirat. Orgs 37 11 3 11 11 1 1 ... Laryngitis 1 1 .. ... ... ... (Classes.) 12 14 Bronchitis 26 6 3 8 9 ... ... ... Pleurisy ... ... ... ... ... ... 47 47 I. ZYMOTIC DIS. 94 78 2 8 1 2 3 3 Pneumonia 6 3 ... 1 2 ... 35 48 II. CONSTITUTL. 83 29 27 23 3 1 2 ... Asthma 2 ... ... 1 ... 1 1 1 Lung Diseases, &c. 2 1 ... 1 ... ... 58 59 III. LOCAL 117 32 12 29 41 3 9 15 4. Digestive Orgs 24 3 4 7 9 1 29 32 IV. DEVELOPMNL. 61 39 4 3 6 9 ... ... Gastritis 1 ... ... ... 1 ... 2 1 Enteritis 3 1 ... 1 1 ... ... 7 V. VIOLENT DTHS. 7 5 1 ... ... ... ... 2 Peritonitis 2 ... 1 l ... ... ... ... Ascites ... ... ... ... ... ... ... ... Not Specified— ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) 2 1 Ileus 3 ... 1 1 1 ... ... ... Intussusception ... ... ... ... ... ... 42 41 I. 1. Miasmatic Dis. 83 70 2 6 3 2 ... 1 Stricture of latest 1 ... ... ... 1 ... ... 1 Small Pox 1 1 ... ... ... ... ... ... Fistula ... ... ... ... ... ... 6 8 Measles 14 14 ... ... ... ... ... 2 Stomach Dis., &c. 2 ... ... 1 1 ... 11 1 Scarlatina 12 12 ... ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 2 3 Diphtheria 5 5 ... ... ... ... 1 1 Hepatitis 2 ... 2 ... ... ... ... ... Quinsey ... ... ... ... ... ... 2 1 Jaundice 3 2 ... ... l ... ... ... Croup ... ... ... ... ... ... 2 5 Liver Disease 7 ... ... 3 3 1 1 3 Hooping Cough 4 4 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 3 3 Typhus & Typhoid 6 4 ... 2 ... ... 3 3 5. Urinary Orgs. 6 ... ... 3 3 ... 2 2 Ervsipelas 4 1 ... 1 2 ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... 1 1 Disease Ot Bladde 2 ... ... ... 2 ... ... ... Puerperal Fever ... ... ... ... ... ... 1 ... Nephria 1 ... ... 1 ... ... ... 1 Carbuncle 1 ... ... 1 ... ... l ... Diabetes 1 ... ... 1 ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... 1 ... Dysentery 1 ... ... 1 ... ... ... ... Prostrate Disease ... ... ... ... ... ... 13 13 Diarrhœa 31 27 1 1 ... 2 ... 2 Kidney Disease,&c. 2 ... ... 1 1 ... 1 ... Cholera 1 1 ... ... ... ... 1 ... 6. Genera. Organs 1 ... ... ... 1 ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 2 1 Rheumatism 3 1 1 ... 1 ... 1 ... Uterine Diseases. 1 ... ... ... 1 ... ... 4 2. Enthetic 4 4 ... ... ... ... 1 1 7. Orgs.of Locomo 2 2 ... ... ... ... ... 4 Syphilis 4 4 ... ... ... ... 1 1 Spine Diseases 2 2 ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... 2 8. Skin, &c. 2 1 ... ... 1 ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Absces ... ... ... ... ... ... 3 2 3. Dietic 5 2 ... 2 1 ... ... 2 Ulcer 2 1 ... ... 1 ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 1 Want of Br. Milk.. 2 2 ... ... ... ... ... ... Purpura and Scurry ... ... ... ... ... ... 5 8 IV. 1. Dis. of Childn 13 13 ... ... ... ... 2 1 Alcoholism 3 ... ... 2 1 ... 5 7 Premature Birth 12 12 ... ... ... ... 2 ... 4. Parasitic 2 2 ... ... ... ... ... 1 Cyanosis 1 1 ... ... ... ... 2 ... Thrush 2 2 ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 4 8 II. 1. Diathetic 12 ... 3 5 3 1 2 2 2. Dis. of Adults 4 ... 4 ... ... ... ... 2 Gout 2 ... ... ... 1 1 ... ... Paramenia ... ... ... ... ... ... 1 ... Dropsy 1 ... ... 1 ... ... 2 2 Childbirth 4 ... 4 ... ... ... 1 1 Iltemorrhage 2 ... 1 ... 1 ... 10 8 3. Dis. of Aged 18 ... ... 3 6 9 2 5 Cancer 7 ... 2 4 1 ... 10 8 Old Age 18 ... ... 3 6 9 ... ... Noma ... ... ... ... ... ... 12 14 4. Dis. of Nutritn 26 26 ... ... ... ... ... ... Mortification ... ... ... ... ... ... 12 14 Atrophy & Debility 26 26 ... ... ... ... 31 40 2. Tubercular 71 29 24 18 ... ... ... l Scrofula l l ... ... ... ... ... 4 V. 1. Acci. of Neg. 4 4 ... ... ... ... 4 6 Tabes Mesenterica 10 10 ... ... ... ... ... 1 Fract. and Contus. 1 1 ... ... ... ... 22 28 Phthisis 50 8 24 18 ... ... ... Wouods ... ... ... ... ... ... 5 5 Hydrocephalus 10 10 ... ... ... ... ... ... Burns and Scalds. ... ... ... ... ... ... ... ... 17 12 III. 1. Nervous Syst. 29 14 1 1 12 1 ... ... Poison ... ... ... ... ... ... ... 2 Drowning 2 2 ... ... ... ... 2 2 Cephalitis 4 ... ... 1 ... ... ... 1 Suffocation 1 1 ... ... ... ... 3 1 Apoplexy 4 ... ... ... 3 1 ... ... Otherwise ... ... ... ... ... ... 4 3 Paralysis 7 ... ... ... ... ... ... 1 2. Homicide 1 1 ... ... ... ... ... ... Insanity ... ... ... ... ... ... ... 1 3. Suicide 1 ... 1 ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... ... Epilepsy 1 ... 1 ... ... ... ... ... Poison ... ... ... ... ... ... 5 5 Convulsion 10 10 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 3 ... Brain Deseases, &c. 3 1 ... ... 2 ... ... 1 Suffocat. and Hang 1 ... 1 ... ... ... 8 8 2. Organs of Circ. 16 1 4 7 4 ... ... ... Otherwise ... ... ... ... ... ... 1 ... Pericardities 1 ... ... 1 ... ... ... *1 4. Unciassed *1 ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... 7 8 Heart Disease 15 l 4 6 4 *Age not specified. TABLE II. NEW CASES OF DISEASE COMING UNDEIl TREATMENT DURING THE ^IVE WERKS ENDING SATURDAY, THE 26th DAY OF SEPTEMBER, 1868, AT 1HE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. .. 2 .. .. 2 Chicken Pox .. .. 4 4 .. .. 8 Measles .. •• 51 33 5 .. 89 Scarlatina .. 2 27 12 7 .. 48 Whooping Cough .. .. 14 9 2 .. 25 Croup .. .. 2 1 1 .. 4 Diarrhœa 10 .. 124 73 54 33 294 Dysentery .. .. • • .. .. .. •• Cholera .. .. .. .. .. .. •• Ague .. .. 3 2 .. .. 5 Continued Fever .. 4 14 8 8 .. 34 Influenza .. .. .. • • .. .. •• Puerperal Fever .. .. • • .. .. .. •• Rheumatic Fever .. .. 5 .. 3 .. 8 Erysipelas 3 .. 9 7 4 .. 23 Diphtheria .. .. .. 1 2 .. 3 Screthroat of Tonsillitis 1 .. 36 46 52 .. 135 Mumps .. .. 2 .. .. .. 2 Pyæmia .. .. .. .. • • .. .. Bronchitis and Catarrh 21 .. 228 96 66 .. 459 Pneumonia .. .. 4 3 3 .. 10 Pleurisy 1 .. 8 4 .. .. 13 Delirium Tremens .. .. .. •• 1 .. 1 Insanity 3 .. 8 • • 1 .. 12 Carbuncle .. .. 3 1 1 .. 5 All other Diseases 69 23 679 685 938 313 2707 Total 108 29 1221 987 1148 394 3887 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From August 31st, 1868, to October 3rd, 1868. South East District. South West District. North District. Total. Number of houses inspected 67 144 104 315 Drains Construted .. .. 6 6 Improved or repaired 9 12 8 29 Traps fixed 15 7 14 36 Cesspools Abolished 9 .. 1 10 Cleansed or disnfacted .. 1 • • 1 Privies and Water Closets Pan, trap, and water supply furnished 10 .. 1 11 Pan and trap only furnished 3 .. 2 5 Water supply furnished 11 11 15 37 Dust bins Constructed .. .. 15 15 Repaired and covers adapted •• 5 21 26 Surface Drains and Pavements of Yards Constructed 10 .. .. 10 Relaid 19 13 13 45 General Water Supply New receptacle provided 11 1 1 13 Receptacle repaired and cleansed 9 13 9 31 Water supply provided 10 .. .. 10 Other Improvements Houses generally repaired 15 7 1 23 „ cleansed or limewashed 47 32 13 92 „ ventilated 10 •• •• 10 Overcrowding abated •• 2 •• 2 Illegal use of underground Rooms for sleeping discontinued .. 1 .. 1 Other Amendments 5 6 11 22 REPORT ON THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR OCTOBER, 1868. No. CXXXVIII. The deaths which have occurred during the four weeks of October were 295. This is a mortality lower than the corrected mortality of the ten previous Octobers by 16 deaths. It is satisfactory to observe that no death is recorded from small pox, and moreover there was only one case of, that disease met with during the month in the public practice of the parish. The only deseases of the zymotic class which have prevailed in excess have been measles, erysipelas, and sorethroats. The first of these alone has effected our mortality table. Up to the end of the month scarlet fever had made no inroad upon our population beyond what is always to be anticipated at this period of the year. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, November 2nd, 1868. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 24th OCTOBER, 1868. (Deaths of Non-Residents in Hospitals excluded). West 8.D. East 8.D. Causes of Death. At all Ages. i 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 j ears of age. At 80 years of age and upwards. 152 143 295 160 47 40 40 1— 25 20 3. Respirat. Orgs 45 24 4 8 7 2 1 l 2 2 (Classes.) 16 12 28 lto 9 R 1 1 1 44 36 I. ZYMOTIC DIS. .. 80 ! 65 6 3 5 i 5 7 12 6 3 l 35 27 II. CONSTITUTE... 62 20 24 11 7 1 Asthma 1 1 1 1 51 58 III. LOCAL 109 47 12 23 24 3 3 5 4- Digestive Orgs. 8 2 3 9 19 18 IV. DEVELOPMNL. 37 25 3 2 3 4 Gastritis Enteritis ........ 3 4 V. VIOLENT DTHS. 7 3 2 1 1 2 2 1 1 1 1 Not Specified .... Ulceration of Intes. Hernia (Orders.) 1 Ileus 1 1 1 Intussusception .. 1 1 40 32 I. 1. Miasmatic Dis. TZ i)0 b * i Stricture of Intest. ••• ... Fistula 14 4 18 1 Stomach Dis., &c. 1 1 7 6 13 Pancreas Dis., &c. 3 3 i ... i 1 Quinsey Jaundice ........ 1 3 1 Croup 4 4 1 Liver Disease I 1 2 1 Hooping Cough .. 3 Spleen Disease.... 4 6 Typhus & Typhoid 10 2 i 5. Urinary Orgs. 3 1 1 1 2 Erysipelas 1 Nephritis 1 1 1 I 1 Disease of Bladder 1 Puerperal Fever . 1 1 1 i Nephria 2 1 1 1 Diabetes.. Stone Prostrate Disease . 8 5 ... Kidney Disease,&c. Cholera 6. Genera. Organs ... Ague Ovarian Dropsy .. 2 2 Uterine Diseases.. 2 2 2 i 1 2 Syphilis 2 2 i Spine Diseases.... 1 Stricture of Urethra Bone Diseases .... Hydrophobia .... ... 2 8. Skin, &c 2 1 1 Glanders Phlegmon&Abscess 2 3 2 i 2 Privation Skin Diseases .... 1 2 i 2 1 Purpura and Scurvy 1 i 4 5 IV. 1. Di«. ofChildn. *>! 9 *« 3 3 5 Premature Birth .. 8 8 3 Cyanosis 3 Spina Bifida Other Malformation i 1 i 5 6 II. 1. Diathetic •••• 11 1 b b 3 3 2. Dis. of Adults . 6 1 1 Gout 1 Paramenia ... 1 i 2 2 3 3 6 I I lite morrhage .... 1 i 4 3 3. Dis. ot Aged .. 7 3 4 2 4 6 6 3 4 3 Old Age 7 3 4 ... 8 7 4. Dis. of Nutritn. 15 15 1 1 1 8 7 Atrophy & Debility 15 15 21 51 94 K V 1 i 3 3 V. 1. Acci.orNeg. 6 2 2 1 1 ,»> 24 15 Phthisis Wounds 2 4 Burns and Scalds.. ... 1 l Poison 2 1 16 21 III. 1. NervousSyst. 37 19 4 5 8 1 1 l 2 1 1 7 8 7 l 1 1 3 4 7 1 to 1 1 1 3 2 5 i 2 1 2. Homicide 1 i ... ... 3. Suicide ... Wounds 3 2 5 1 2 1 •• 1 Poison 6 5 ... Drowning ... 1 Brain Diseases, &c. 1 1 • • Suffocat. and Hang. 3 10 2. Organs of Circ. 13 1 i 5 b Otherwise Pericarditis 4. Unclassed 1 Aneurism i i 2 10 Heart Disease •• 12 i 4 TABLE II. NEW CASES OF DISEASE COMING UNDEIl TREATMENT DURING} THE FOUR WEEKS ENDING SATURDAY, THE 24th DAY OF OCTOBER, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 1 .. .. .. 1 Chicken Pox .. 1 9 .. 2 .. 12 Measles 2 .. 28 39 9 .. 78 Scarlatina 1 2 2 10 12 .. 27 Whooping Cough .. .. 5 17 13 .. 35 Croup .. .. 2 .. 2 .. 4 Diarrhœa 7 .. 26 30 22 16 101 Dysentery .. .. .. 1 .. .. 1 Cholera .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. Continued Fever 3 .. 9 5 4 .. 21 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. .. 5 2 .. 7 Erysipelas 1 .. 12 10 4 .. 27 Diphtheria .. .. .. 1 .. .. 1 Sorethroat or Tonsillitis .. .. 24 33 33 .. 90 Mumps .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 20 2 258 148 90 55 573 Pneumonia .. .. 6 5 5 .. 16 Pleurisy 1 .. 3 2 1 .. 7 Delirium Tremens .. .. .. .. .. .. .. Insanity 3 .. 6 1 .. .. 10 Carbuncle .. .. .. .. .. .. .. All other Diseases 53 15 476 513 746 219 2022 Total 91 20 867 820 945 290 3033 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From October 5th, 1868, to October 31st, 1868. South East District. South West District. North District. Total. *Number of houses inspected 130 101 100 331 Drains Constructed 4 4 .. 8 Improved or repaired 10 2 11 23 Traps Fixed 18 5 25 48 Cesspools Abolished 2 .. .. 2 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supplv furnished 7 .. 5 12 Pan and trap only furnished 1 .. 2 3 Wsater supply furnished 23 3 11 37 Dust bins Constructed 2 1 9 12 Repaired and covers adapted .. 1 11 12 Surface Drains and Pavements of Yards Constructed 1 .. .. 1 Relaid 37 25 25 87 General Water Supply New receptacle provided 2 1 1 4 Receptacle repaired and cleansed 20 .. 7 27 Water supply provided .. .. 2 2 Other Improvements Houses generally repaired 18 3 .. 21 ,, cleansed or limewashed 130 45 60 235 „ venttilated 1 .. .. 1 Overcrowding abated .. 1 .. 1 Illegal use of underground Rooms for sleeping discontinued .. 1 .. 1 Other Amendments 14 2 14 30 *The Bakehouses, Cowhouses, Slaughterhouses, and several Work rooms were also inspected. REPORT ON THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR NOVEMBER, 1868. No. CXXXIX. Although I have registered a large amount of general sickness during the past four weeks, it has not been of a character to express itself to an unusual extent in our mortuary table. The deaths registered amounted to 318, and the diseases which were more than usually fatal were mostly those of a chronic and lingering character, such as cancer, consumption, heart disease, and paralysis. The corrected mean mortality of the corresponding period, during ten years past, is 354. Referring to our sickness table, which year by year becomes more perfect and reliable, it will be found that measles has been very prevalent among our population, 109 cases having been recorded, 87 cases in 1862 being the highest number yet registered in the month of November: still even these have not materially affected our deathrate, since only thirteen deaths from this disease are recorded, five less than were recorded in the corresponding weeks of 1862. Again, scarlet fever, which has been prevailing largely in London, has touched us but lightly. I have only registered thirty cases among the recipients of eleemosynary medical aid, unless, indeed—as is probably the case—a large number of the 110 cases registered as ''sorethroat" were cases of scarlet fever without rash: still this would show that with us the epidemic has been of a mild character. The same seems to be shown by the fact that only seventeen deaths from scarlet fever have been registered throughout the Parish. Now I do not think I am given to exaggerate the benefits conferred by preventive proceedings,—I very rarely allude to them, preferring to allow them to make their own way into your consciousness. I am far too deeply impressed with the 2 powerful influence exerted over the occurrence and mortality of epidemic diseases by meteorological and other conditions over whieh we have no control. But here has been a severe epidemic prevailing throughout the metropolis, an epidemic the severity of which on former occasions we have shared pretty equally with our neighbours. On this occasion we have not shared equally with them, and there is this difference to be placed side by side with this fact, namely, that during the present epidemic, I have adopted the practice of supplying immediately to each family attacked among such as came under my notice, one of the best and cheapest disinfectant preparations for use in the sick room, and have taken care that the discharges which are probably capable of conveying the contagion, through the medium of the drains and sewers, from one house to another, are rendered harmless by the use of carbolic acid. I cannot honestly ignore this, or divest myself, in the face of it, of the belief that, universally, scarlet fever might be rendered a far less formidable disease were a similar custom adopted in all houses where the disease breaks out, the sick room being constantly pervaded sensibly with the vapour of carbolic acid or chlorine gas, and a little carbolic acid being now and then poured into the pan of the closet. I would desire earnestly to press the adoption of this plan upon my brethren engaged in private as well as in public practice in the Parish. Vestry Offices, December lst, 1868. EDWARD BALLARD, M.D., Medical OJJicer of Health. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 21st NOVEMBER, 1868. (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. 150 168 318 171 43 39 53 12 47 38 3. Respirat. Orgs. 85 52 6 4 20 3 ... 2 Laryngitis 2 2 ... ... ... ... (Classes.) 29 22 Bronchitis 51 31 2 ... 16 2 1 1 Pleurisy 2 1 ... 1 ... ... 31 37 I. ZYMOTIC DIS. 68 56 3 7 2 ... 11 10 Pneumonia 21 15 3 1 2 ... 1 2 Asthma 3 ... 1 2 ... ... 26 35 II. CONSTITUTE. 61 19 24 8 9 1 5 1 Lung Diseases, &c. 6 3 ... ... 2 1 79 78 III. LOCAL 157 76 12 23 40 6 3 5 4. Digestive Orgs. 8 3 ... 2 3 ... ... ... Gastritis ... ... ... ... ... ... 14 15 IV. DEVELOPMNL. 29 18 4 ... 2 5 ... 2 Enteritis 2 1 ... ... 1 ... ... 3 V. VIOLENT DTHS. 3 2 ... 1 ... ... 1 ... Peritonitis 1 i ... ... ... ...... ... ... ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... ... Ileus ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ...... 26 36 I. 1. Miasmatic Dis 62 51 3 6 2 ... ... ... Stricture of Intest. ... ... ... ... ... ...... l 1 Small Pox 2 2 ... ... ... ... ... ... Fistula ... ... ... ... ... ...... 8 5 Measles 13 13 ... ... ... ... 1 2 Stomach Dis., &c. 3 1 ... I 1 ... 5 12 Scarlatina 17 17 ... ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 1 3 Diphtheria 4 4 ... ... ... ... 1 1 Hepatitis 2 ... ... 1 1 ... ... ... Qulnsey ... ... ... ... ... ... ... ... Jaundice ... ... ... ... ... ... ... 2 Croup 2 2 ... ... ... ... ... ... Liver Disease ... ... ... ... ... ... 3 ... Hooping CoQgh . 3 3 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 3 7 Typhus & Typhoic 10 3 1 4 2 ... 2 1 5. Urinary Orgs. 3 ... ... 2 ... 1 1 3 Erysipelas 4 3 ... 1 ... ... ... ... Nephritis ... ... ... ... ... ... ... Pyeemia ... ... ... ... ... ... 1 ... Disease of Bladder 1 ... ... ... ... 1 ... ... Puerperal Fever ... ... ... ... ... ... 1 ... Nephria 1 ... ... 1 ... ... ... ... Carnimcle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... 1 ... Dusemtery 1 ... ... 1 ... ... ... ... Prostrate Disease ... ... ... ... ... ... ... 1 Diarrhœa I 1 ... ... ... ... ... 1 Kidney Disease,&c. 1 ... ... 1 ... ... ... ... Cholera ... ... ... ... ... ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 3 2 Rheumatism 5 3 2 ... ... ... ... ... Uterine Diseases ... ... ... ... ... ... 1 1 2. Enthetic 2 2 ... ... ... ... ... ... 7. Orgs.ofLocomo. ... ... ... ... ... ... 1 1 Syphilis 2 2 ... ... ... ... ... ... Spine Diseases, ... ... ... ... ... ... ... ... Stricture of Urethra ..... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon&Abseess ... ... ... ... ... ... 3 ... 3. Dietio 3 2 ... 1 ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 ... Want of Br.Milk 1 ... ... ... ... ... 1 ... Purpura and Scurvy 1 1 ... ... ... ... 2 1 IV. 1. Dis. of Childn. 3 3 ... ... ... ... 1 ... Alcoholism 1 ... ... 1 ... ... 2 1 Premature Birth 3 3 ... ... ... ... 1 ... Parasitic 1 1 ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... 1 ... Thrish 1 1 ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 4 11 II. 1. Diathetic 15 ... 4 4 6 1 1 4 2. Dis. of Adults 5 1 4 ... ... ... 1 ... Gout 1 ... ... ... 1 ... ... ... Paramenia ... ... ... ... ... ... 1 1 Dropsy 2 ... 1 ... 1 ... 4 Childbirth 5 1 4 ... ... ... ... ... Haemorrhage ... ... ... ... ... ... 2 5 3. Dis. of Aged 7 ... ... ... 2 5 1 10 Camcer 11 ... 2 4 4 1 2 5 Old Age 7 ... ... ... 2 5 ... ... Noma ... ... ... ... ... ... 9 5 4. Dis. of Nutritn. 14 14 ... ... ...... ... 1 ... Mortification I ... i ... ... ... 9 5 Atrophy & Debility 14 14 ... ... ... ... 22 24 2. Tubercular 46 19 20 4 ... ... 1 1 Scrofula 2 2 ... ... ... ... ... 3 V. 1. Acci.orNeg 3 2 ... 1 ... ... ... 3 Tabes Mesenterica 3 3 ... ... ... ... ... l Fract. and Contu 1 l ... ... ... ... 17 17 Phthisis 34 7 20 4 ... ... ... ... Wounds ... ... ... ... ... ... 4 3 Hydrocephalus 7 7 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ...... ... ... 14 24 III. 1. Nervous Syst 38 16 3 8 10 1 ... ... Drowning ... ... ... ...... ... ... ... 3 Cephalitis 3 ... 3 ... ... ... 1 Suffocation 1 1 ... ... ... ... 1 5 Apoplexy 6 1 ... 3 2 ... ... 1 Otherwise 1 ... ... 1 ... ... 6 4 Paralysis 10 | ... ... 3 6 1 ... ... 2. Homicide ... ... ... ... ... ... ... ... Insanity ... ... ... ... ... ... ... ... Suicide ... ... ... ... ... ... ... ... Chorea ... ...... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... 1 Epilepsy 1 1 ... ... ... ... ... ... Poison ... ... ... ... ... ... 5 8 Convulsions 13 13 ... ... ... ...... ... ... Drowning ... ... ... ... ... ... 2 3 Brain Diseases, &c 5 1 ... 2 2 ... ... ... Suffocat.and Han ... ... ... ...... ... ... 13 10 2. Organs of Circ. 23 5 3 7 7 1 ... ... Otherwise ... ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... 13 10 Heart Disease 23 5 3 7 7 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 21st DAY OF NOVEMBER, 1868, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 7 .. .. .. 7 Chicken Pox .. .. 1 4 5 .. 10 Measles .. 10 31 40 28 .. 109 Scarlatina .. .. 20 3 7 .. 30 Whooping Cough .. 2 14 14 13 .. 43 Croup .. .. 1 1 1 .. 3 Diarrhœa .. .. 14 12 20 20 66 Dusentery .. .. .. .. 3 .. 3 Cholera .. .. .. .. .. .. .. Ague .. .. .. .. .. .. .. Continued Fever 2 .. 9 6 3 .. 20 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. 1 .. 1 Rheumatic Fever .. .. 5 4 7 .. 16 Erysipelas .. .. 12 4 1 .. 17 Diphtheria .. .. .. .. .. .. .. Sorethroat or Tonsillitis .. .. 20 31 59 .. 110 Mumps .. .. 4 .. .. .. 4 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 26 4 286 182 235 .. 824 Pneumonia .. .. 8 4 5 .. 17 Pleurisy .. .. 3 3 5 .. 11 Delirium Tremens .. .. .. .. .. .. .. Insanity 3 .. 6 .. 1 .. 10 Carbuncle .. .. 1 1 2 .. 4 All other Diseases 60 13 473 496 748 183 1973 TOTAL 91 29 915 805 1144 294 3278 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From November 2nd, 1868, to November 28th, 1868. South 1 East District. South "West District. North District. Total. Number of houses inspected 143 249 143 535 Drains Constucted 7 1 3 11 Improved or repaired 8 16 16 40 Traps fixed 14 11 38 63 Cesspools Abolished .. .. .. .. Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished .. .. 4 4 Pan and trap only furnished 4 1 4 9 Water supply furnished 19 10 27 56 Dust bins Cpmstricted .. 1 7 8 Repaired and covers adapted .. 1 15 16 Surface Drains and Pavements of Yards Constructed 2 3 1 6 Relaid 28 14 32 74 General Water Supply New receptacle repaired and cleansed .. 1 2 3 Receptacle repaired and cleansed 10 4 17 31 Water supply provided .. .. 2 2 Other Improvements Houses generally repaired 26 2 .. 28 ,, cleansed or limewashed 54 14 18 86 ventilated .. 1 .. 1 Overcrowding abated .. 2 .. 2 Illegal use of underground Rooms for sleeping discontinued .. .. .. .. Other Amendments 5 3 13 21 REPORT ON THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR DECEMBER, 1868. No. CXL. We are this year under the necessity of counting six weeks into December. The deaths registered in this period, 522, reduced by onesixth, give us 435 deaths for comparison with the corrected average mortality of December for 10 years past, viz.: 479 deaths. Hence we infer that our deaths this month have been about one-eleventh less than they would have been had the average mortality of December prevailed. This low mortality is probably due very much to the mildness of the season. The sickness among those who receive gratuitous medical relief has however continued to be excessive. Happily, small-pox continues to present but few cases, and scarlet fever exhibits a disposition to decline. Measles, however, which the extreme heat of the spring and summer appears to have kept in abeyance during the year, attained its greatest prevalence among us in December. One hundred and sixty-one cases and 31 deaths appear respectively upon the sickness and mortality tables. Hooping Cough has also been very prevalent. I have still to record a large number of cases entered in the books of Medical Officers as " Sorethroat " and " Mumps." EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, January 12 th, 1869. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING SIX WEEKS ENDING 2nd JANUARY, 1869. (Deaths of Non-Residents in Hospitals excluded). West S.D. East 8.D. Causes of Death. At all Ages. Under 20 years of aee. At 20 and under 40 vears of aep. 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 2o 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. 255 | 267 522 277 69 69 83 24 65 57 3. Respirat. Orgs. 122 75 5 13 22 7 2 3 Laryngitis 5 3 2 ... ... ... (Classes.) 35 34 Bronchitis 69 37 2 7 16 7 ... ... Pleurisy ... ... ... ... ... ... 68 53 I. ZYMOTIC DIS. 121 97 12 4 7 1 23 17 Pneumonia 40 34 1 3 2 ... 48 CONSTITUTL 85 25 29 20 9 2 2 3 Asthma 5 ... 2 3 ... 3 ... Lung Diseases, &c. 3 1 1 1 ... m 134 I. LOCAL 255 118 21 45 9 10 12 17 4- Digestive Orgs. 29 7 7 9 ... ... 59 ... ... 1 Gastritis 1 1 ... ... ... 24 27 V. DEVELOPMNL. 51 29 4 ... 7 ... ... 2 Enteritis 2 1 1 ... ... ... 5 5 /. VIOLENT DTHS. 10 8 1 ... 1 ... 3 ... Pertonitis 3 ... 2 1 ... ... ... ... Ascites ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... 1 Ulceration of Intes. 11 ... ... I ... ... ... 3 Hernia 3 ... 1 ?, ... (Orders.) 1 1 Ileus 2 1 ... 1 ... ... ... Intussusception ... ... ... ... ... 66 49 I. 1. Miasmatic Dis. 115 92 11 4 7 1 ... ... Stricture of Intest. ... ... ... ... ... 2 3 Small Pox 5 4 ... 1 ... ... ... 1 Fistula 1 ... ... l ... ... 23 8 Measles 31 31 ... ... ... ... 2 3 Stomach Dis., &c. 5 ... ... l 3 ... 10 9 Scarlatina 19 18 1 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... 2 ... Diphtheria 2 2 ... ... ... ... 1 1 Hepatitis 2 ... ... l ... ... ... ... Quinsey ... ... ... ... ... ... 3 2 Jaundice 5 4 ... 1 ... 1 2 Croup 3 3 ... ... ... ... 2 2 Liver Disease 4 ... ... 2 2 ... 12 3 Hooping Cough 15 15 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... 5 3 Typhus & Typhoid 8 5 2 ... ... ... 3 5 5. Urinary Orgs. 8 ... 5 2 1 ... 4 5 Erysipelas 9 5 1 1 2 ... ... ... Nephritis ... ... ... ... ... 1 1 Pyœmia 2 1 1 ... ... ... l 1 Disease of Bladder 2 ... l l ... ... 1 3 Puerperal Fever . 4 ... 4 ... ... ... ... 1 Bephria 1 ... 1 ... ... 1 1 Carbuncle 2 ... ... 1 1 ... ... 3 Diabetes 3 ... 3 ... ... ... ... Influenza ... ... ... ... ... ... 1 ... Stone 1 ... ... l ... ... ... 1 Dusemteru 1 ... ... ... l ... ... ... Prostrate Disease ... ... ... ... ... 3 3 Diarrhœa 6 5 ... ... ... 1 1 ... Kidney Disease,&c. 1 ... ... 1 ... ... ... Cholera ... ... ... ... ... ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... 1 7 Rheumatism 8 2 2 1 ... ... ... ... Uterine Diseases ... ... ... ... ... 1 2 2. Enthetic 3 3 ... ... 3 ... 1 ... 7. Orgs.ofLocomo 1 ... ... 1 ... I 2 Syphilis ... 3 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... Stricture of Urethr ... ... ... ... ... ...... l ... Bone Diseases 1 ... ... ... 1i ... ... ... Hydrophobia ... ... ... .... ... ... ... 1 8. Skin, &c. l ... ... 1 ... ... ... ... Glanders ... ... ... ... ... ... ... Phlegmon&Abseess ... ... ... ... ... 1 2 3. Dietic 3 2 1 ... ... ... ... 1 Ulcer I ... ... l ... ... ... ... Privation ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 2 Want of Br. Milk 2 2 ... ... ... ... ... Purpura and Scurv ... ... ... ... ... 5 9 IV. 1. Dis. of Childn 14 14 ... ... ... 1 ... Alcoholism 1 ... ... ... ... 5 7 Premature Birth 12 12 ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... Worms ... ... ... ... ... 2 Other Mallormation 2 2 ... ... ... ... ... Teething ... ... ... ... ... 5 12 II. 1. Diathetic 17 4 1 5 5 2 ... 4 2. Dis. of Adults 4 ... 4 ... ... ... ... Gout ... ... ... ... ... ... ... Paramenia ... ... ... ... ... 1 3 Dropsy 4 2 1 1 ... ... 4 Childbirth 4 ... 4 ... ... ... ... Hæmorrhage ... ... ... ... ... 9 9 3. Dis. of Aged .. 18 ... ... 7 11 4 6 Cancer 10 2 3 4 ... 9 Old Age 18 ... ... 7 11 ... ... Noma ... ... ... ... ... 10 5 4. Dis. of Nutritn. 15 15 ... ... ... ... 3 Mortification 3 ... 1 ... 2 10 5 Atrophy & Debility 15 15 ... ... ... 32 36 2. Tubercular 68 21 2 15 4 ... 2 ... Scrofula 2 l ... 1 ... 4 4 V. 1. Acci.orNeg. 8 7 ... 1 ... 4 1 Phthisis 5 5 ... ... ... ... 1 Fract. and Contus. 1 ... ... 1 ... ... 34 Hydrocephalus 4 11 ... 3 ... ... l Wounds 1 l ... ... ... 3 1 4 ... ... ... 2 1 Burns and Scalds 3 3 ... ... ... ... ... Poison ... ... ... ... ... 26 38 III. 1. Nervous Syst 64 30 6 9 16 3 ... ... Drowning ... ... ... ... ... ... 4 8 Cephalitis 12 10 J 1 ... ... ... ... Suffocation 3 3 ... ... ... 5 5 Ppoplexy 10 ... 1 4 4 1 ... ... Otherwise ... ... ... ... ... 4 6 Paralysis 10 ... 1 ... 7 2 1 ... 2. Homicide i ... 1 ... ... ... 1 Insanity l ... ... 1 ... ... ... 3. Suicide ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... Wounds ... ... ... ... ... 1 1 Epilepsy 2 ... 2 ... ... ... ... Poison ... ... ... ... 5 13 Convulsions 18 18 ... ... ... ... ... Drowning ... ... ... ... ... 4 Brain Diseases, &c 11 2 3 2 4 ... ... ... Suffocat. and Hang ...... ... ... ... ... 14 16 2. Organs of Circ. 30 6 1 13 10 ... ... ... Otherwise ... ... ... ... ... 1 Pericarditis 1 1 ... ... ... ... 1 4. Unclassed 1 1 ... ... ... 1 ... Aneuism 1 ... 1 ... ... ... 13 15 Heart Disease 28 5 13 10 ... TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE SIX WEEKS ENDING SATURDAY, THE 2nd DAY OF JANUARY, 1869, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 7 1 .. .. 8 Chicken Pox .. .. 3 16 14 .. 33 Measles .. .. 76 62 23 .. 161 Scarlatina .. .. 23 11 18 .. 52 Whooping cough .. .. 28 19 52 .. 107 Croup .. .. .. 2 2 .. 4 Diarrhœa .. .. 14 13 34 20 91 Dysentery .. .. .. .. 1 .. 1 Cholera .. .. .. .. .. .. .. Ague .. .. .. .. 1 .. 1 Continued Fever .. .. 13 12 11 .. 38 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. 1 7 3 .. .. Erysipelas .. .. 6 4 16 .. 2 Diphtheria .. .. 4 1 2 .. Sorethroat or Tonsillitis .. .. 21 43 94 .. 159 Mumps .. .. 1 .. 10 .. 11 Pyaemia .. .. .. .. .. .. .. Bronchitis and Cararrh 39 .. 343 217 351 104 1054 Pneumonia 1 .. 7 11 5 .. 25 Pleurisy .. .. 7 7 5 .. 19 Delirium Tremens .. .. 1 .. .. .. 1 Insanity 6 .. 7 .. .. .. 13 Carbuncle .. .. .. 1 .. .. 1 All other Diseases 79 19 559 735 932 239 2563 Total 138 28 1121 1162 1574 363 4386 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From November 30th, 1868, to January 2nd, 1869. South East District. South "West District. North District. Total. Number of houses inspected 247 263 178 688 Drains Constructed 1 2 6 9 Improved or repaired 18 26 25 69 Traps fixed 22 7 61 90 Cesspools Abolished 3 1 .. 4 Cleansed or disinfected .. .. 2 2 Privies and Water Closets Pan, trap, and water supply furnished 4 .. 3 7 Pan and teap only furnished .. .. 4 4 Water supply furnished 15 22 41 78 Dust bins Constructed 3 1 16 20 Repaired and covers adapted 4 5 31 40 Surface Drains and Pavements of Yards Consturcted .. .. 7 7 Relaid 17 21 11 82 General Water Supply New receptacle provided 1 3 1 5 Receptacle repaired and cleansed 21 11 11 43 Water supply Provided .. 2 1 3 Other Improve- ments Houses generally repaired 18 4 .. 22 ,, cleansed or limewashed 91 22 21 134 ,, ventilated .. 3 2 5 Overcrowding abated 4 3 2 9 Illegal use of underground Rooms for sleeping discontinued 1 1 .. 2 Other Amendments 16 5 13 34