ISL39 REPORT on THE SANITARY CONDITION Parish of Saint Marn Jaslington DURING THE YEAR 1870. 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, Monkwell Street, E.C., and Islington. 1871. TO THE VESTRY OF ST. MARY, ISLINGTON. Gentlemen, My Fifteenth Annual Eeport, which. I have now the honour of submitting to your consideration, is written under the advantage furnished by a recent census of the population. This census was taken on the night of Palm Sunday, April 2nd. and the general result, so far as our parish is concerned, is that within the last ten years, 58,408 persons have been added to the inhabitants of the district over which you exercise sanitary jurisdiction. The sum of our population at the census of 1861 was 155,341. On Palm Sunday, 1871, it amounted to 213,749. The rate of increase has been less than it was between 1851 and 1861. In that decenniad the increase was at the rate of 5 per cent. each year, calculated upon the population in 1851 as ascertained, and of each succeeding year as estimated, that is, calculated in the way in which we calculate compound interest. Between 1861 and 1871, the rate of increase similarly calculated, was only 3.243 per cent.* Hence it follows that, on the assumption that the rate of increase in the last decenniad was the same as in the previous decenniad—the only assumption practically available until the population in 1871 was ascertained—our death-rates as I have calculated and stated them year by year, from 1861 to 1868, have on the whole been below the true death-rates. It is my business now to make the correction of the error thus arising. Taking into * The rate of increase was not the same on the two sides of the parish, inasmuch as while the population of the East Sub-district increased from 79,899, to 115,948, that is to say, by 36,049 persons, and that of the West only increased from 75,442 to 97,801, that is to say, by 22,359 persons. 4 MOETALITY AND SICKNESS. The number of deaths registered in Islington (omitting those of nonresidents occurring in the Small Pox and Fever Hospitals, and in the West London Union Workhouse) were 4370. To these must be added 248, our proportion (as calculated upon the population) of the deaths occurring in the various Hospitals, Lunatic Asylums, Prisons, &c, in other parts of London—a number, however, as I have shown before, probably in excess of the true number for which we are bound to take credit. With this addition our deaths become raised to 4618. Our population in the middle of 1870 was probably about 208,709 persons, and thus our estimated death-rate comes to be for that year, 221 per 10,000 persons living. The death rate of London at large, as calculated by the Registrar General, was 241 per 10,000. Of the deaths registered, 2,105 were deaths of males, and 2,265 of females. Of the 4,370 deaths registered here, less than half, namely, 2,018 were of children under 5 years of age. account the period of the year at which the census was taken, we may adopt as a near approximation to truth, the following figures:- year. Estimated Population in the Middle of each Year. Number of Deaths Registered and Corrected for Deaths in Hospitals &c. Estimated Deathrate per 10,000 Population. Death-rate per 10,000 Population in London generally as eatimated by Re gistrar General. Principal Epidemics. 1861 156,600 3,150 201 332 Hooping Cough 1862 161,679 3,217 199 234 Measles 1863 166,922 3,946 236 245 Small Pox,Scarlet Fever, and Hooping Cough 1861 172,336 4,077 237 264 Measles, Small Pox 1865 177,925 4,035 227 246 Hooping Cough, Small Pox 1866 183,695 4,424 241 265 Cholera, Measles, Hooping Cough, and Small 1867 189,652 4,009 211 230 Scarlet Fever and Small Pox [Pox 1868 195,802 4,373 223 235 Scarlet Fever, Measles, Hooping Cough, [Small Pox 1869 202,152 4,502 223 247 Scarlet Fever, (severe) Hooping Cough, [Relapsing Fevre 5 The Births registered during the year are represented quarter by quarter in the following table:— West Sub-district. East Sub-district. Whole Parish. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Quarter 616 464 980 496 545 1,041 1,012 1,009 2,021 2nd „ 475 499 974 617 446 963 992 945 1,937 3rd „ 426 430 856 451 610 961 877 940 1,817 4th „ 600 392 892 500 449 949 1,000 841 1,841 1,917 1,785 3,702 1,964 1,950 3,914 3,881 3,735 7,616 The excess of births over deaths (corrected) was 2,998. The number of new cases of sickness of all kinds, recorded in the books of the poor-law surgeons, in those of the two Dispensaries and of the Pentonville Convict Prison amount together to 38,397, or 1,682 in excess of the number recorded in 1869. The epidemic maladies of the year were Measles, Scarlet Fever, and as the year began to wane, Small Pox. In one circumscribed district of the parish, a very curious outbreak of Typhoid Fever occurred, due to the operation of a special cause. 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 eases of public sickness recorded in the books to which I have access. Diseases of the Organs of Respiration occasioned 218 deaths nearly equally distributed between the two sub-districts, which is equivalent to saying that they produced a larger proportion of deaths in the west than in the east. Three hundred and twenty-one were deaths of children under 5 years of age, and 233 were of persons over 60 years. The number of cases recorded in the public practice was 8,141. Diarrhœal affections, including dysentery and summer cholera occasioned 259 deaths, of which 218 were of children under 5 years of age. The total number of cases of these affections recorded in the public practice was 2,019. Small Pox. From the time when in 1868 a tedious epidemic of Small Pox was suddenly brought to an end about the month of July or August, until October, 1870, this disease was in abeyance. Throughout the whole 6 of the year 1869, there were only 69 oases observed in the publio practice of the parish, and only 14 deaths were attributed to it. The numbers month by month up to the end of the year 1870 were as follows;— Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Death Jan. 14 4 April 4 0 July 10 4 Oct. 31 3 Feb 7 0 May 11 0 Aug. 12 4 Nov. 36 13 Mar. 3 1 June 10 3 Sept. 13 4 Deo. 104 17 24 5 25 3 35 12 171 33 Hence, although we speak of the epidemic as commencing in October, it must be observed that the first threatenings of the outbreak, which has since proved to be the most serious in the memory of the majority of persons now living, were apparent some months earlier. As I write, the epidemic, which has been scourging us throughout the winter, is only just abating in Islington, so that its history as a whole, must be reserved to my next report. I shall content myself in this place by merely recording its progress week by week, from October to the end of the year. Public Cases. Deaths in whole Parish. Week ending October 6 8 „ „ 152 31 3 „ „ 22 2 „ „ 29 17 „ November 5 3 „ 12 4 36 13 „ „ 19 11 26 17 „ Decomber 3 17 „ 10 23 „ 17 24 104 17 „ 24 24 „ 31 16 Measles. In accordance with my prolonged observations in the parish, the year 1870 was one in which some prevalence of this disease was anticipated. The deaths which it occasioned were 110, and the number of cases in the public practice amounted to 975. Commencing in the month of March with a total of 54 cases, it attained its maximum prevalence in the month June, when 246 cases and 26 deaths, were recorded, from which period it died away as an epidemic through July, August, and September. 7 Scarlet Fever. When the year commenced, Scarlet Fever, which had been very severe in 1869 appeared to be dying away, and we were in hopes that it would not extend materially as an epidemic into 1870. In this, however, we were disappointed. Taking the year as a whole, although there were rather fewer cases in the public practice, the mortality due to the affection was much higher than in 1869. The public cases numbered 644 against 714 in 1869, and the deaths registered 465 against the 313 registered in 1869. Of these 465 deaths, 262 oocurred in the east and 203 in the west sub-district. Its progress month was as follows:— New Public Cases. Deaths in whole Parish. New Publio Cases, Deaths in whole Pariah. New Publio Cases. Deaths in whole Parish. New Public Cases, Deaths in whole Parissh Jan. 29 41 April 38 21 July 36 26 Oct. 72 60 Feb. 35 27 May 62 27 Aug. 49 30 Nov. 81 65 Mar. 45 29 June 42 45 Sept. 83 46 Dec. 82 45 109 97 132 96 168 102 236 170 Scarlet Fever is especially an autumnal disease, and so in point of fact we were in this position in the last quarter of the year, that the epidemic of Scarlatina appeared to have taken a new start, while another epidemic, namely that of Small Pox, was commencing vigorously. Hooping Cough has not troubled us in an epidemic form since the early months of the year. I said all that it was necessary to say about the localized outbreak of Relapsing Fever in my last annual report. The Localized Outbreak of Typhoid Fever in Holloway. Many of the details of this very remarkable outbreak of a fatal disease will possess little interest for the non-professional reader, and hence, in the account I am now about to give of it, I shall confine myself as far as possible to those facts the inferences from which are of the highest practical importance. Such of you as may desire fuller information, will find it in a pamphlet which I have placed in the Library.* At no time during the year was Typhoid Fever unusually prevalent among our population generally, but between July 3rd and September 10th in one circumscribed locality no fewer than 168 individuals of different ages, and the inhabitants of 67 different houses were attacked with this form of Fever, and of them 26 died. In pursuing the inquiry which this * "On a localized outbreak of Typhoid Fever in Islington, traced to the use of impuro Milk."—Churchill and Sons, 1871. 8 outbreak gave rise to, I found that the outbreak had a few ramifications to the outside of the limited distriot I have mentioned, and that in fact to the one and the same cause over 70 families owed an invasion of Typhoid. The majority of those attacked passed through the disease in Islington, but several were attaoked in various parts of the country, having carried away the morbid cause in their system, although it did not operate until they were fairly away from home. This is explicable by the period of incubation of typhoid. The facts as to these latter cases were furnished me courteously by the medical gentlemen who attended them, and with whom I placed myself in communication. One of the remarkable features of the outbreak was that, with few exceptions, the persons who suffered were not of the class among whom fevers are most commonly observed, but were persons in very comfortable positions in society, attended by private medical men, and residing in some of the best houses in the parish. Altogether it was exceptional and not least so in this, that, in consequence of the class of persons attacked being such as it was, a large number of cases had occurred and several deaths before I became at all aware of the extent to which it was spread. Still as soon as the medical gentlemen here came to know that I desired information, they furnished it with the greatest readiness and evinced an interest in my investigation, which did not flag until the true cause of the disaster was brought to light. The enquiry occupied me unremitingly for several months and eventuated in a discovery which imparts a serious public warning. This discovery was, that the fever was confined to persons who had consumed milk issued from one particular dairy, and that the typhoid poison was distributed with the milk and taken with it into the systems of the persons who used it. This was a conclusion which I could not have arrived at without the assistance of the proprietor of the dairy, who, in a manner that did him the highest honour, furnished me with a list of the customers and houses supplied from the establishment. The list was as accurate as it could be made at the time, and on comparing it with my list of typhoid invasions, I found that the residents in one half of the houses supplied had been attacked with typhoid. Since the enquiry has been completed and the facts made public, other instances have been made known to me with which I was not then acquainted, for I did not make enquiries from house to house. In 70 families, there happened 175 cases, of which 30 died. Comparing again the list of houses supplied with my mortuary records, I found but three other deaths altogether to have occurred in these houses from any 9 other disease than Typhoid Fever. There were some other important facti which assisted to fix the outbreak upon this particular milk supply. First. In particular streets, rows of houses, &c., the typhoid picked out as it were the customers of the dairy, leaving the others free from attack. Secondly. In the several families invaded there were only 25 per cent. in which only one individual of a family was attacked. In the rest, the number of cases in a family varied from 2 to 8, the average being a little over three cases in a family. This is not a common feature of typhoid, except where all the members of a family have been exposed to the same morbid influenceThirdly. There was no instance in which two families occupying the same house were attacked, except where both families used the same milk. Fourthly. The attacks in families appeared to have a relation to the quantity of milk consumed. Thus it was observed that, taking those over ten years of age and adults, the females who habitually use more milk than the males, constituted 69 per cent. of those attacked. I am not aware that under ordinary circumstances typhoid shows any such decided preference for the female sex. Several very remarkable illustrations of this relation came to my knowledge. I shall here only mention two of them. In a family consisting of father and mother, who never took milk at any time, two servants and four children, all had typhoid except the father and mother, the children commencing. In another family consisting of mother, two servants, three girls, and a boy of 17, one of the girls and the boy took milk porridge daily at breakfast; the other girls with the mother took little milk comparatively. The servants, complaining that the beer was sour, asked permission to have milk instead of beer. The girl and boy who ate porridge and the two servants were alone attacked. I was told also of another case in the person of a young lady whose family was supplied by some other purveyor, but who fancied to drink daily a glass of milk from the dairy in question. No one else in the house ever took this milk and she alone suffered an attack of typhoid. The question now came to be how the contagion of typhoid got into the milk; for that it was in it and was distributed with it there was proof of so absolute a nature that it could not be gainsaid. I do not propose to trouble you with all the steps by which I arrived at the conclusion that it got into it from a water tank upon the premises of the dairyman. The method of investigation I used was one which is particularly applicable to difficult problems in etiology; and, as to its application to this individual enquiry, I may say that although the facts and arguments have been extensively 10 made known, and have been largely canvassed by authorities upon sanitary subjects, no adverse criticism has yet appeared, but on the contrary the inference I drew has been universally accepted as the only one which could by any possibility have been adopted. The offending tank was a wooden one sunk into the earth. It had become decayed and a portion of it had given way. From this point there was a communication by means of a rat burrow with some old drains, from which there is no doubt that the contagion proceeding from the drains had reached the contents of the tank. But while I may fairly leave such of you as desire to follow the argument to consult my detailed account of the accident, I may mention here the following case as curiously confirmatory of the view I have taken of it. In a street of about fifty villa residences two of the houses only were supplied from the dairy. In only one of these did typhoid occur. The family, consisting of the father and mother, three boys, aged two, four and five years, a baby aged ten months, two servants, and a governess. Two kinds of milk were supplied to the house from the dairy, namely, ordinary milk at fourpence per quart, and " babies milk" at five pence. Only the baby got the latter. It was better than the ordinary milk as "it threw up more cream." It kept well. The master of the house on one occasion before the outbreak had the curiosity to examine the ordinary milk with a specific gravity galactometer, and following the directions accompanying the instrument, inferred that one-fourth of the bulk was added water. The youngest boy took most of this milk, but all three boys had bread and milk for breakfast. The boys and the mother were ill with typhoid in tho country, whither the family had gone for their summer trip immediately after the youngest boy, who was the first of the family attacked, was taken ill. The baby remained well, as also did the father, the governess and one servant. Of all the family, one servant only remained at home and continued to use the milk. She was taken ill later, and had a sharp attack of typhoid. At the other house in the street, the part of the family at home during June, July, and August wa3 the father, mother and one servant. At this house nothing but "babies milk" was taken in, the extra prico being habitually paid. No fever occurred at this house. The practice of watering milk is all but universal among milk sellers in London. That it is in the nature of a fraud upon the purchasers must be generally allowed, but it is one which the public seem to unite in condoning. The excuse commonly made is that with the price of dairy stock, keep, &c., no dairyman could make a profit upon milk at the ordinary retail price if 11 he were to sell it as it comes from the cow. With this excuse I have nothing to do. If the public choose to be parties to the arrangement by which an indefinite amount of dilution, according as may be convenient to the seller or necessary for his trade interests, shall be permitted, provided that the price of the article sold be not varied, no one can interfere with the tacit contract. But it is my place to proclaim the risk which the public run in thus submitting to the habitual adulteration of so common an article of food as milk, and especially to raise my voioe against a practice the danger of which the poorer classes of the community cannot guard against, even if they should be aware of its extent. We take a great deal of trouble to secure the purity of the water in dwelling houses, and to guard against its contamination from house-drain emanations, and from the emanations from cesspools; but with all our care a wholesale poisoning may take place because the article received into houses and used as milk is diluted with water mixed with the contagium of typhoid fever. That Islington is no better than other parts of London with regard to the purity of the milk sold in it, has been shown by a series of analyses made by Professor Wanklyn, some of which I proceed now to extract from the account given of them in the "Milk Journal." I shall abstain from mentioning on this occasion the names of the delinquents : they may be discovered in the periodical from which I quote. But, should the fraud be perpetuated, I shall keep at my office a record of the names and of the results On the analyses which any of our parishioners may inspect. Presuming that good milk of average richness and neither skimmed nor watered, contains approximately, according to Professor Wanklyn's analysis, 12.0 per cent. of solid matters (dry at 212°) and gives about 10 per cent. of cream, and that milk which has been skimmed, but not watered, contains about 10 per cent, of solids, the figures which follow will tell their own tale of adulteration practised upon the milk. I only give instances where the milk has been found deteriorated on more occasions than one and recently; and I may add that the list includes the names of dairymen not supplying the poor exclusively, some of them being persons carrying on a large trade among well-to-do families. Date Cream Solids 1871. percent. percent A March 3 6.0 9.56 „ 3 10.0 10.76 June 6 11.24 „ 9 9.0 10.94 „ 17 6.0 9.62 12 Date Cream Solids 1871. percent. percent. B June 13 10.0 9.32 14 7.0 9.66 C June 16 6.0 8.52 „ 17 5.0 7.56 D June 13 5.0 7.94 „ 14 778 E „ 13 5.0 7.92 „ 14 7.10 F June 13 5.0 8.26 „ 14 — 8.22 G June 16 5.0 8.14 „ 17 5.0 8.40 H June 16 5.0 8.48 „ 17 5.0 8.26 I June 16 5.0 7.98 „ 17 5.0 7.66 J June 16 7.0 9.66 „ 17 4.0 8.48 K June 16 8.0 10.84 „ 17 6.0 10.21 L June 6 - 9.38 „ 9 6.0 9.30 M June 16 3.0 8.28 „ 17 5.0 9.24 N June 6 — 9.92 „ 9 7.0 9.44 O June 6 — 10.56 „ 9 8.0 10.22 P June 6 — 9.74 „ 9 5.0 9.42 Q June 13 5.0 8.02 „ 14 — 9.30 R June 13 4.0 9.36 „ 14 3.0 7.02 S June 6 — 10.02 „ 9 6.0 10.38 T June 13 5.0 7.92 „ 14 — 11.58 U June 13 — 7.80 „ 14 — 6.18 V June 14 5.0 8.90 „ 17 5.0 7.96 13 Data Cream Solids 1871. per cent. per cent, W June 16 7.0 11.54 „ 17 10.0 11.36 X June 6 — 10.06 „ 9 10.0 9.74 Y June 13 8.0 10.80 „ 14 — 6.16 Z June 16 6.0 10.06 „ 17 5.0 9.70 A A June 13 4.0 7.26 „ 14 4.0 7.56 B B June 6— 11.12 „ 19 7.0 9.90 C C June 13 1.0 7.06 „ 14 4.0 7.22 D D June 6 — 8.52 „ 9 5.0 8.14 E E June 13 6.0 8.96 „ 14 5.0 8.42 F F June 13 7.0 9.00 „ 14 — 11.02 GG June 6 — 9.36 „ 9 8.0 9.58 H H June 16 6.0 8.92 „ 17 5.0 8.78 All the above specimens were skimmed or watered, or both, some outrageously. Some of the worst of these specimens of milk were purchased at shops in low neighbourhoods near the Essex Road, the worst of all, C.C. , in the neighbourhood of Frog Lane. But A. and B.B. are very extensive milk sellers, supplying some of the best houses in the parish. Several of them keep cows in the parish, so that, in their cases, there can be no excuse of their being themselves defrauded by the wholesale purveyor. The editor of the journal in which these analyses are published (himself no mean authority) adds this remark, "If Dr. Ballard calculates the amount of milk consumed by his fellow parishioners, and remembers that they are paying for skimmed and watered milk the price of the genuine article, he will find that in Islington alone dairymen receive many thousand pounds annually for water." One startling fact comes out of the investigation, to which it would be well to give heed, namely, that at present, although the 14 milk from 34 retail purveyors in Islington has been analysed, not one among these persons has been found who does not skim and water his milk before selling it, and some to an extent which is hideous to contemplate. Is it credible, in the face of all the facts recorded, that the individual who distributed the poison of Typhoid Fever to his customers, was an exception to the general rule.* I have said that Typhoid Fever was not usually prevalent in the parish during the year. This remark applies to the parish generally, but beside the Holloway outbreak just referred to, there was another localized outbreak in the school belonging to the Holborn Union on the rise of Highgate Hill. Altogether 34 cases arose in the building, including one of the nurses and a washerwoman, and of these cases four were fatal. The first recognised case was observed on February 24th. The last cases were sent to the hospital on April 10th. This outbreak was also due to the drinking of water from a cistern contaminated by the emanations from drains and cesspools with which the waste pipe was connected. On cutting the connection and cleansing and disinfecting the cistern, no fresh case occurred, allowing for the period of incubation of the disorder. SANITAEY WORK OF THE YEAE. Table III. exhibits the ordinary work performed by and under the superintendence of the inspectors during the past year. In addition I must say, that the Sanitary Committee gave their sanction to the use of carbolic acid in watering certain of the streets in the lowest parts of the parish; and that we again undertook to. have the road side and gutter in the Essex Eoad cleansed and deodorized after the Saturday night market—both proceedings boing limited to the hot weather in the summer. As soon as it became apparent that an epidemic of small-pox had certainly commenced, all my efforts were directed to its limitation, so far as the machinery at my disposal permitted this to be effected. The most valuable of all the means of checking the progress of the disease—namely, vaccination of all who had not been vaccinated, and re-vaccination of those who had only their primary vaccination to rely upon, was a matter out of my province. All I could do in regard to it I did—that is to say, I gave to our parishioners good advice which, as usual, some took and others neglected; and I wrote to the Board of Guardians as the local vaccination authority, urging them to the adoption of such measures as appeared to be applicable to the occasion. *Since this was written additional analyses have been made of the milk supplied by 33 cowkeepera in Islington. All but two skimmed and watered their milk before selling it. The only two, yet found in the parish, out of 67 milk-sellere, who sold milk without thus deteriorating it, were Mr. Stainton, of Raglan Terrace, Highbury; and Mr. King, of 11, Hemingford Eoad. 15 I also re-issued a circular, accompanied by instructional papers to all the ministers of religion in the parish, to the masters of public schools, to the dispensaries, to the parochial medical officers, and to all our private medical practitioners, begging of all the favour of their undertaking to distribute the papers, and from the medical men early information of any case coming to their knowledge. Handbills, calling attention to the necessity of vaccination and re-vaccination, were distributed about the parish, and many thousand copies of directions for the prevention of the disease were given away in neighbourhoods which were threatened by the epidemic. I am satisfied that no one could fairly plead ignorance as to what to do, or how to do what was necessary for the prevention of an attack. Early in the outbreak the deficiency of hospital accommodation became apparent, and even when the hospitals established by the Metropolitan District Asylum Board were opened, the amount of accommodation at first was too limited to allow of the reception even of our paupers. It was at this crisis that the Guardians opened the old workhouse as a temporary hospital, and imperfect and rough as the accommodation was, it served well as a means of isolation up to the time when the building was taken up by the Asylum Board as a convalescent hospital. Subsequently to that, the delays in removing patients became often embarrassing, and, with all the efforts I could make to prevent it, the disease often spread in individual houses, from one person to another, often scarcely sparing one of their inhabitants. There was then often only one thing left for us to do, and that was to secure, as far as possible, the destruction of the contagion upon infected premises, when it appeared that the disease had ceased to spread in them. There was ample power in the hands of the Vestry to that effect, and I received directions from the Sanitary Committee to put strictly into force the 22nd and 39th sections of the Sanitary Act, 1866. The terms of the 22nd section are that "If the nuisance authority shall bo of opinion, upon the certificate of any legally qualified medical practitioner, that the cleansing and disinfecting of any house or part thereof, and of the articles therein likely to retain infection, would tend to prevent or check infectious or contagious disease, it shall be the duty of the Nuisance Authority to give notice in writing requiring the owner or occupier of such house or part thereof to cleanse and disinfect the same as the case may require; and if the person to whom notice is so given fail to comply therewith within the time specified in the notice, he shall be liable to a penalty of not less than one shilling and not exceeding ten shillings for 16 every day during which he continues to make default; and the Nuisance Authority shall cause such house or part thereof to be cleansed and disinfected, and may recover the expenses from the owner or occupier in default in a summary manner." Accordingly, wherever small-pox occurred within my' knowledge, the necessary notices were served as soon as the patient had removed, had died, or recovered, and they were accompanied in every instance with full directions as to the mode in which disinfection should be carried out, and the necessary chemical substances for the purpose were gratuitously supplied from my office. Usually the time given for the commencement of the work has been 48 hours, and then, if at the expiration of that period the inspector found on visiting the premises that no commencement had been made, we sent in a workman to perform the work, keeping an account of the expenses for recovery from the person liable. With the sanction of the Committee, large quantities of filthy bedding and valueless clothing have been burned, their equivalent being supplied at contract price by the Guardians, who make it a charge upon the Vestry. All this work has been superintended by the inspectors, and has so occupied their time, that nearly all the ordinary systematic work of the department has had to stand aside. The cholera epidemic of 1866 was a trifle compared with the outbreak of Small Pox in regard to the labour it has imposed upon all connected with my department. Still it has not been labour or pains thrown away. I have good reason for believing, that had it not been for the efforts made to destroy the contagion as it became deposited, and the perfect manner in which its destruction (disinfection) has been accomplished, we should have suffered yet more severely than we have suffered. In several instances too, we have had occasions to put into force the 39th section of the Sanitary Act, which relates to the letting of houses or rooms in which any person suffering from a dangerous infectious disorder has been, without a previous disinfection, certified by a medical practitioner to be satisfactory. We found, for instance, in several cases, that Small Pox had occurred in families put in charge of empty houses, sometimes without the knowledge of the owner or agent, and every day some person or other was unwittingly being exposed to contagion in being shown over such houses. In all such instances we have required disinfection to be carried out, and the bill, for a time, to be taken out of the window. In two or three instances, an attempt has been made to evade the law, by bringing me a certificate from a medical man to the effect that disinfection had been carried out to 17 his satisfaction, when I had discovered on enquiry that the certificate had been given as a matter of form, the medical man taking the word of the applicant, and knowing nothing of his own knowledge upon the matter. Whenever this has been attempted, I have refused to accept it, and have warned the owner, that if it were produced in answer to a summons, we should put the writer of the certificate into the witness box.* Prior to the October licensing, I visited personally, as is my custom, all the slaughter-houses and cow-houses in the parish. The magistrates granted licenses to 114 slaughter-houses, and to 56 cow-houses. On the opposition of the vestry, a license was refused to two applicants for slaughterhouses, and to one for a cow-house. Several licenses were held back until the works on the premises, which I regarded as necessary to be carried out> were completed. Two of these require special mention, namely, Huckett's cow-shed in Mildmay Avenue, and Mason's in Upper Queen Street. The latter is an old establishment which was very crowded and otherwise imperfect, and with a superficial well upon the premises, which supplied all the water used for the purposes of the dairy. With the concurrence of the Sanitary Committee, a reduction of the number of the cows, and other ordinary amendments were made conditions of the license; but I also pressed, as another important condition, the abolition of the well. Upon this latter p oint there was a good deal of discussion, both in the Committee and in the Yestry, and among other reasons assigned in the Yestry was this, that to the knowledge of one member, the well was not a superficial well, having been sunk within late years to a depth of 70 feet. I was satisfied that there must have been some mistake here, and I had the well opened, and found that it was only 21 feet in depth, from the surface of the yard to the bottom of the well, and that there were only 2 feet of water in it. As I made a report upon the subject in writing to the Sanitary Committee, I think it best to quote from it my grounds for insisting upon the importance of the abolition of the well. They were as follows: " 1st. That it is a well-known—a notorious fact, that London dairymen add a certain proportion of water to their milk before they send it out for distribution (the exceptions are very few indeed) and that therefore, it is of great importance that the water on the premises should be such as is not likely to endanger public health by its distribution with the milk. 2nd. That it was clear that the pump on Mason's premises was used for all dairy purposes—the people engaged there knowing of no other supply, and the water being held in high estimation. 3rd. That the well is what is * This has since teen done and a conviction obtained 18 technically known as a 'superficial well' —that is to say, it is one sunk into the gravel of the London basin. 4th. That it is a fact, notorious to engineers, chemists, and sanitarians, that the water of such wells, is obtained by filtration through the porous strata on the surface, which strata in London are charged with excremental filth of all kinds, which the water dissolves and carries with it into the wells thus sunk. That in fact the water of the well is nothing but 'filtered sewage.' It is the carbonic acid and nitrates formed by the partial oxidation of such matters which render such water agreeable. 5th. That these wells are liable to receive such matters in an unoxidized as well as in an oxidized condition, and when this happens, the water becomes a means of producing disease. 6th. That this accident may happen at any time, from a variety of causes, and without warning; and hence, that a well water which may have been drunk for years with impunity, may suddenly assume characters extremely dangerous to the health and life of people using it. 7th. Not a year passes without illustrations of this truth being furnished by the investigations into outbreaks of such diseases as Typhoid Fever and Cholera, by the officers of the Privy Council, the results of which are published in the annual reports of its medical officer. I may further allude to the sudden outbreaks of the latter disease from this cause in Soho in 1854, and later at "West Ham and Theydon Bois, in Essex, as examples of the same thing. 8th. That I have long suspected the possibility of the propagation of Typhoid Fever by milk in this way, the water added to it being contaminated; but that this year, I have for the first time, had experience of such an occurrence, producing among the customers of one milkman 170 cases of Typhoid Fever, and 30 deaths within a period of ten weeks. 9th. That with these facts, and with this experienee, I am bound to express my professional opinion of the danger to the public health, arising out of the existence of such a well on Mason's premises; this well especially being from its surroundings very liable to the accidental contaminations I allude to." I stated further, that if the well were simply closed, it would become in course of time a mere stagnant pool, and so poisonous that its re-opening would almost inevitably lead to fatal consequences. On these grounds, I thought it ought to be abolished. The Committee thought so too, and its abolition, so long fought against, was ultimately accomplished, and a proper water supply from the main of the New River Company provided in its place. Huckett's was a new establishment, and the license was held back, partly because the necessary works had not been completed, and partly because the 19 proprietor had dug a superficial well for the supply of water to the establishment contrary to my distinct prohibition, and refused to fill it up. On the general grounds above stated in Mason's case, the Sanitary Committee supported me in my opinion, and the filling up of the well, and obtaining a supply of water from the New River Company were made part of the conditions of the license. The proprietor has even now not performed all the required work, and is not in possession of his license, although keeping cows upon the premises. There have been but few proceedings taken at the Police Court by the Sanitary Committee during the year. One baker in the Holloway Road, was summoned and convicted, on account of the filthy condition of his bake-house which he refused to amend; he has since left the premises. A cow-keeper in Barnsbury Grove was summoned for keepiug cows in an unlicensed place, where moreover they were a nuisance to the neighbours, and he was convicted and fined. A summons was taken out against a slaughter-man, in George's Road, where the carcase of a cow had been seized, which had been brought from Hatfield into the licensed slaughter-house dead and emaciated by disease, and there dressed in the way in which beasts are ordinarily dressed for the market. The magistrate said that he was not satisfied that the meat was intended for human food, and dismissed the summons, but without costs. Since my last annual report, Messrs. Turner have discontinued the use of premises in Belle Isle, where they were previously carrying on their business of varnish making, contrary to the G4th Section of the Building Act, 1844. Two other varnish-making firms at Belle Isle, viz., Messrs. Hatfield and Wallis, in the York Eoad, have received warning to discontinue, under the same section. During the past year, I have reported to the Vestry, under the Artizans' and Labourers' Dwellings Act, upon the condition of 12 houses, viz., Nos. 1, 2, and 3, Caroline Court, in the Holloway Eoad, and Nos. 2, 3, 4 5, 6, 7, 8, 9, and 10, Bowman's Place, in the Seven Sisters' Eoad. EDWARD BALLARD, M.D. Medical Officer of Health, Vestry Offices, June 30th, 1871. TABLE 1. DEATHS REGISTERED IN ISLINGTON DURING (Deaths of Non-Residents West. East. Causes of Death. All Ages. AGES. Und. 1. 1- 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80 2153 2212 All Causes 4370 1135 406 207 166 104 2018 219 82 85 574 599 650 143 604 701 (Classes.) I. ZYMOTIC DIS 1305 378 181 130 120 62 871 154 44 31 115 55 27 8 427 384 II. CONSTITUTL 811 102 58 32 18 19 229 25 17 27 262 179 66 6 870 902 III. LOCAL 1772 394 149 42 24 22 631 34 21 25 170 349 483 59 222 188 IV. DEVELOPMNL. 410 233 14 1 ... ... 248 2 ... 2 15 5 68 70 33 37 V. VIOLENT DTHS. 70 28 4 2 2 1 37 4 ... ... 12 11 6 ... 2 Not Specified 2 ... ... ... 2 ... 2 ... ... ... ... ... ... ... 560 663 (Orders.) I. 1. Miasmatic Dis. 1223 313 180 129 120 62 804 154 44 31 110 46 26 8 20 27 Small Pox 53 7 2 5 3 3 20 3 4 3 16 / ... ... 5 55 Measles 110 25 39 23 14 5 106 3 1 ... ... ... ... ... 203 262 Scarlatina 465 20 64 77 82 39 282 123 22 12 24 2 ... ... 14 13 Diptheria 27 1 6 2 1 2 12 8 4 ... 2 1 ... ... 2 1 Quinsey 3 1 ... 1 ... ... 2 1 ... ... ... ... ... ... 8 18 Croup 26 4 5 6 7 3 25 1 ... ... ... ... ... ... 37 50 Hooping Crough 87 38 35 9 2 2 86 1 ... ... ... ... ... ... 74 52 Typhus & Typhoid 126 7 3 2 9 5 26 12 9 12 37 21 9 ... 8 9 Erysipelas 17 8 1 ... ... ... 9 ... ... ... 2 3 2 1 1 5 Pyœmia 6 2 ... ... ... 1 3 ... 1 ... 2 ... ... ... 6 10 Puerperal Fever 16 ... ... ... ... ... ... ... ... ... 15 1 ... ... 1 ... Carbuncle 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Dysentery 2 1 ... 1 ... ... 2 ... ... ... ... ... ... ... 102 139 Diarrhoea 241 189 22 3 ... 2 218 1 ... 1 ... 4 10 7 10 6 Cholera 16 10 3 ... ... ... 13 ... ... 1 1 1 ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 14 Rheumatism 27 ... ... ... ... ... ... 1 3 2 10 6 5 ... 14 14 2. Enthetic 28 23 ... 1 ... ... 24 ... ... ... 2 2 ... ... 13 13 Syphilis 26 23 ... 1 ... ... 24 ... ... ... ... ... ... ... 1 1 Stricture of Urethra 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... 29 20 3. Dietic 49 3 1 ... ... ... 38 ... ... ... 3 7 1 ... l l Privation 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... 24 13 Want of Br. Milk 37 37 ... ... ... ... 37 ... ... ... ... ... ... ... ... 2 Purpura and Scurvy 2 ... 1 ... ... ... 1 ... ... ... ... 1 ... ... 4 4 Alcoholism 8 ... ... ... ... ... ... ... ... ... 2 5 1 ... 1 4 4. Parasitic 5 5 ... ... ... ... 5 ... ... ... ... ... ... ... 1 4 Thrush 5 5 ... ... ... ... 5 ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... ... ... ... ... ... ... 71 72 II. 1. Diathetic 143 8 2 2 2 1 15 1 ... 2 14 56 49 6 4 5 Gout 9 ... ... ... ... ... ... ... ... ... ... 7 2 ... 10 9 Dropsy 19 ... ... 1 ... 1 2 ... ... ... 6 3 7 4 2 4 Hæmorrhage 6 3 ... ... ... ... 3 ... ... ... 2 1 ... ... 40 44 Cancer 84 ... ... 1 2 ... 3 1 ... l 7 38 32 2 ... ... Noma ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 10 Mortification 25 5 2 ... ... ... 7 ... ... 1 2 7 8 ... 356 312 2. Tubercular 638 94 56 30 16 18 214 24 17 25 248 123 17 ... 20 12 Scrotula 32 9 6 3 2 1 21 3 4 ... 3 1 ... ... 22 30 Tabes Mesenterica 52 29 13 2 1 3 48 3 1 ... ... ... ... ... 251 210 Phthisis 461 16 7 11 3 1 38 6 9 24 245 122 17 ... 63 60 Hydrocephalus 123 40 30 14 10 13 107 12 3 1 ... ... ... ... 236 242 III.1. Nervous Syst. 478 140 46 13 6 8 213 13 7 9 40 66 112 18 37 43 Cephalitis 80 22 14 7 4 6 53 8 5 3 7 2 2 ... 45 36 Apoplexy 81 1 1 ... ... ... 2 1 1 1 16 28 29 3 43 48 Paralysis 91 ... ... ... ... ... ... ... 1 1 7 21 53 8 8 ... Insanity 8 ... ... ... ... ... ... ... ... 1 3 ... 3 1 ... ... Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 7 Epilepsy 12 ... ... ... ... ... ... ... ... 1 4 5 1 1 69 83 Ccnvulsions 152 113 29 5 2 ... 149 3 ... ... ... ... ... ... 29 25 Brain Diseases, &c. 54 4 2 1 ... 2 2 1 ... 2 3 10 24 5 101 103 3. Organs of Circ. 204 4 2 ... ... 1 7 3 5 5 33 54 83 14 6 5 Pericarditis 11 2 ... ... ... ... 2 1 ... 2 ... 3 1 2 3 3 Aneurism 6 ... ... ... ... ... ... ... ... ... 1 2 1 2 92 95 Heart Diseas 187 2 2 ... ... 1 5 2 5 3 32 49 81 10 TABLE I. FIFTY-TWO WEEKS ENDING 31st DECEMBER, 1870. in Hospitals excluded). West. East. Causes of Death. All Ages. AGES. Un. 1. 1- 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80 Up. 404 414 3. Respirat. Orgs. 818 217 100 29 16 9 371 13 4 7 6l 128 212 21 17 29 Laryngitis 46 27 8 5 2 1 43 2 ... ... 1 ... ... ... 238 259 Bronchitis 49'/ 130 56 15 7 3 211 4 2 3 25 75 164 16 5 3 Pleurisy 8 ... ... ... ... ... ... ... ... ... 5 3 ... ... 101 97 Pneumonia 198 59 33 9 7 5 113 7 2 3 27 18 24 4 14 20 Asthma 34 1 3 ... ... ... ... ... ... ... ... 18 16 ... 29 6 Lung Diseases, &c. 35 1 3 ... ... ... 4 ... ... l 3 18 8 1 89 97 4. Digestive Orgs. 186 25 1 ... 1 2 29 4 2 2 22 70 52 5 8 4 Gastritis 12 1 ... ... ... ... 1 ... 1 1 2 3 4 ... 9 9 Enteritis 18 7 ... ... ... 1 8 2 ... 1 1 2 4 ... 5 6 Peritonitis 11 3 ... ... ... ... 3 ... ... ... 5 2 ... 1 6 Ascites 6 ... ... ... ... ... ... ... ... ... 1 1 4 ... 2 4 Ulceration of Intes 6 ... ... ... ... 1 1 ... ... ... 1 3 1 ... 4 3 Hernia 7 ... ... ... ... ... ... ... ... ... ... 5 2 ... 5 7 Ileus 12 3 ... ... ... ... 3 ... ... ... 2 1 5 1 2 2 Intussusception 4 ... ... ... ... ... ... 1 ... ... 1 2 ... ... 3 1 Stricture of Intes 4 ... ... ... ... ... ... 1 ... ... ... 2 1 ... ... ... Fistula ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 *8 Stomach Dis., &c. 12 1 l ... 1 ... 3 ... ... ... 2 5 2 ... ... 1 Pancreas Dis., &c 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 10 Hepatitis 14 ... ... ... ... ... ... ... ... ... l 9 4 ... 12 11 Jaundice 23 8 ... ... ... ... 8 ... 1 ... 2 7 4 1 31 24 Liver Disease 55 1 ... ... ... ... 1 ... ... ... 4 28 20 2 ... 1 Spleen Disease 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... 23 32 6. Urinary Orgs. 55 1 ... ... 1 1 3 1 ... 1 9 21 19 1 3 ... Nephritis 3 ... ... ... 1 1 2 ... ... ... ... 1 ... ... 1 3 Disease of Bladder 4 ... ... ... ... ... ... ... ... ... ... ... 4 ... 11 13 Nephria 24 ... ... ... ... ... ... ... ... ... 6 9 8 1 1 3 Diabetes 4 ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 1 Stone 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Prostrate Disease . 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 7 12 Kidney Disease,&c. 19 1 ... ... ... ... 1 1 ... 1 3 8 5 ... 8 3 6. Genera. Organs 11 ... ... ... ... ... ... ... ... ... 2 7 2 ... 2 1 Ovarian Dropsy 3 ... ... ... ... ... ... ... ... ... ... l 2 ... 6 2 Uterine Diseases 8 ... ... ... ... ... ... ... ... ... 2 6 ... ... 4 5 7. Orgs.of Locomo. 9 1 ... ... ... 1 2 ... 3 1 2 1 ... ... 2 2 Spine Diseases 4 ... ... ... ... 1 1 ... 1 1 1 ... ... ... 2 3 Bone Diseases 5 1 ... ... ... ... 1 ... 2 ... 1 1 ... ... 5 6 8. Skin, &c. 11 6 ... ... ... ... 6 ... ... ... 1 1 3 ... Phlegmon&Abscess ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 Ulcer 4 1 ... ... ... ... 1 ... ... ... 1 1 1 ... 4 3 Skin Diseases 7 5 ... ... ... ... 5 ... ... ... ... ... 2 ... 62 44 IV. 1. Dis. of Childn. 106 104 1 ... ... ... 105 1 ... ... ... ... ... ... 51 40 Premature Birth 91 91 ... ... ... ... 91 ... ... ... ... ... ... ... 2 2 Cyanosis 4 3 ... ... ... 3 1 ... ... ... ... ... ... 4 ... Spina Bifida 4 4 ... ... ... ... 4 ... ... ... ... ... ... ... 5 i Other Malformation 6 6 ... ... ... ... 6 ... ... ... ... ... ... ... ... 1 Teething 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... 12 6 2. Dis. of Adults . 18 ... ... ... ... ... ... ... 2 15 1 ... ... ... ... Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 6 Childbirth 18 ... ... ... ... ... ... ... ... 2 15 1 ... ... 82 60 3. Dis. of Aged 142 ... ... ... ... ... ... ... ... ... ... 4 68 70 82 60 Old Age 142 ... ... ... ... ... ... ... ... ... ... 4 68 70 66 78 4. Dis. of Nutritn. 144 129 13 1 ... ... 143 1 ... ... ... ... ... ... 66 78 Atrophy & Debility 144 1 129 13 1 ... ... 143 1 ... ... ... ... ... ... 21 24 V. 1. Acci.orNeg. 45 18 4 2 2 1 27 4 ... ... 6 4 4 ... 6 8 Fract. and Contus. 14 ... ... 1 1 ... 2 3 ... ... 4 3 2 ... ... ... Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 4 Burns and Scalds 6 ... 3 ... 1 1 5 1 ... ... ... ... ... ... 2 3 Poison 5 2 ... ... ... ... 2 ... ... ... l 1 l ... 2 ... Drowning 2 ... 1 ... ... ... 1 ... ... ... 1 ... ... ... 8 8 Suffocation. 16 15 ... ... ... ... 15 ... ... ... ... ... 1 ... 1 1 Other wise 2 1 ... 1 ... ... 2 ... ... ... ... ... ... ... 4 6 2. Homicide 10 10 ... ... ... ... 10 ... ... ... ... ... ... ... 8 7 3. Suicide 15 ... ... ... ... ... ... ... ... ... 6 7 2 ... 3 ... Wounds 3 ... ... ... ... ... ... ... ... ... 3 ... ... ... 4 1 Poison 5 ... ... ... ... ... ... ... ... ... 1 4 ... ... ... 3 Drowning 3 ... ... ... ... ... ... ... ... ... 2 1 ... ... ... 3 Suffocat. and Hang. 3 ... ... ... ... ... ... ... ... ... ... 2 1 ... l ... Otherwise 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... ... ... ... ... ... ... TABLE 11. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FIFTY-TWO WEEKS ENDING SATURDAY, THE 31st DAY OF DECEMBER, 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Fox 4 6 150 41 54 .. 255 Chicken Fox .. 1 22 65 71 .. 159 Measles 4 .. 333 289 349 .. 975 Scarlatina .. .. 225 288 131 .. 644 Whooping Cough 14 2 74 116 136 .. 342 Croup .. .. 6 9 20 .. 35 Diarrhœa 99 .. 441 589 533 313 1975 Dysentery 1 .. 7 17 17 .. 42 Cholera .. .. 1 1 .. .. 2 Ague 3 .. 5 6 1 9 24 Continued Fever 15 2 108 178 165 .. 468 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. 5 1 .. .. 6 Rheumatic Fever 1 .. 8 14 26 .. 49 Erysipelas 18 .. 70 43 57 .. 188 Diphtheria .. .. 3 5 3 .. 11 Sorethroat or Tonsillitis 3 .. 190 348 540 3 1084 Mumps .. .. 14 .. 10 .. 24 Pyœmia .. .. .. .. .. .. .. Bronchitis and Catarrh 304 4 2132 2024 2767 523 7754 Pneumonia 1 2 62 53 68 .. 186 Pleurisy 1 .. 45 79 76 .. 201 Delirium Tremens 8 .. 5 2 .. .. 15 Insanity 70 .. 84 1 2 .. 157 Carbuncle 2 .. 12 7 22 .. 43 All other Diseases 858 183 5246 7378 8316 1777 23758 Total 1406 200 9248 11554 13364 2625 38397 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From March 26th, 1870, to March 25th, 1871. South East District. South West District. North District. Total. Number o Houses inspected 1575 1826 741 4142 Re-inspection,Calls made ,&c. 4388 2474 1886 8748 Visit to 211 Bakehouses 184 20 82 286 Do. 65 Cow houses 120 139 88 347 Do. 114 Slaughter houses 149 156 118 423 Do. Stable and Yards 30 80 32 142 Do. Factories and Workshops 10 11 4 25 Do. Fields, Lanes,&c. 39 .. 36 75 Do. 50 Factories, Horse Slaughter-houses,Piggeries,&c., at Bell Isle .. 172 .. 172 Do. 110 Courts and Alleys 2840 769 469 4078 Total Inspections,&c. 9335 5647 3456 18438 IMPROVEMENTS. Drains Constructed 15 7 19 41 Improved or repaired 135 196 50 381 Traps fixed 142 132 88 362 Cesspools Abolished 15 8 17 40 Cleansed or disinfected .. .. 9 9 Privies and Water Closets Pan, trap, and water supply furnished 26 9 9 44 Pan and trap only furnished 7 17 9 33 Water supply furnished 43 44 51 138 Dust bins Constructed 10 23 2 35 Repaired and covers adapted 9 26 40 75 Surface Drains and Pavements of Yards Constructed .. 8 2 10 Relaid 141 208 61 410 General Water Supply New receptacles provided 14 19 2 35 Receptacles repaired and cleansed 318 131 15 4C4 Water supply provided 1 3 2 6 Other Improvements Houses generally repaired 53 32 74 159 „ &c., cleansed or lime washed 936 435 337 1708 „ ventilated .. 82 2 84 Overcrowding abated 15 8 5 28 Illegal use of underground Rooms for sleeping discontinued 9 7 .. 16 Other Amendments, or Nuisances abated 94 53 463 610 Total Improvements 1983 144S 1257 4688 Total Premises Improved 998 811 586 2395 Houses or Drains Disinfected 1562 545 738 2845 *During the latter three months of this period the Inspections, Disinfections, Burnings, &c., in connection with the Small Fox Epidemic, and the necessary attention to Complaints, engrossed more than the ordinary time of the Inspectors, to the unavoidable neglect of much other Sanitary work. TABLE IV. MONTHLY RESULTS OF METEROLOGICAL 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 Headings. Mean of Lowest Daily Readings. Mean Daily Range. * 1870 January 38.7° 42.2° 35.3° 6.9° 86 1.28 16 4 wks. Jan. 2—Jan. 29 February 35.8° 40.3° 32.1° 8.2° 79 1.24 15 4 „ Jan. 30—Feb. 26 March 40.8° 47.9° 35.8° 12.0° 81 2.13 13 5 „ Feb. 27—April 2 April 50.1° 62.9° 40.6° 22.2° 67 0.40 5 4 „ April 3—Apr. 30 May 53.5° 66.7° 43.8° 22.8° 64 0.69 6 4 „ May 1—May 28 June 61.4° 74.6° 52.4° 22.2° 64 0.79 4 5 „ May 29—July 2 July 66.2° 79.7° 67.7° 21.9° 68 1.15 9 4 „ July 3—July 30 August 63.0° 76.1° 54.6° 21.4° 69 1.92 7 4 „ July 31—Aug. 27 September. 57.0° 68.2° 48.3° 19.9° 73 201 10 5 „ Aug. 28—Oct. 1 October 50.1° 58.1° 44.0° 141° 80 3.06 17 4 „ Oct. 2—Oct. 29 November. 42.1° 48.3° 36.7° 11.6° 85 2.28 15 4 „ Oct. 30—Nov. 26 December . 349° 389° 30.7° 8.2º 79 309 21 5 „ Nov. 27—Dec. 31 Means of Year. 49.4° 58.6° 42.6° 15.9° 74 Sum 20.04 Sum 138 1870 1870 Jan. 2nd to Dec. 31. The highest temperature in the shade attained was 92 5° on July 22nd. The lowest temperature reached was 9 5° on December 26th. Snow fell in the 6th, 7th, 8th, 9th, 10th, 12th, 17th, 45th, 49th, 51st, and 52nd weeks of the year. The almond was in bloom in the first week in April. The pear was in full bloom in the third week in April, and the elm bursting into leaf. Lilac and horse chestnut in bloom in first week in May. The hawthorn and laburnum in the third week in May. Thunder storms occurred on February 5th, April 10th, June 16th, July 15th, July 26th, July 30th, July 31st, August 1st, November 22nd. On the evening of October 24th, there was a magnificent display of the "aurora borealia," and again on the 25th. December 22nd, the day of the solar eclipse, was a very cold day and snow fell in the forenoon ; the maximum temperature was 27.5° • Instead of stating the Means of Observations for each Calendar Month, I have stated them in periods corresponding with those ueed in my monthly Tables, which alone can serve any useful purpose for comparison with the accompanying Sicknces and Mortality. REPORT ON THE SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR JANUARY, 1870. No. CLXXIII. We commence the new year with a mortality in the parish considerably below the average. The deaths registered were 379, the mean corrected mortality of the preceding ten Januaries being 434. The sickness table shows a total of public cases rather over that of January last year, and very much larger than was observed in previous years. The general distress among the poor will account for a good deal of this. It is satisfactory to observe that a further great reduction has taken place in the public cases of scarlet fever, the number of cases beng 29 in the four weeks, against 50 in the five weeks of December. The registered mortality from this disease throughout the parish has fallen also from 68 to 41. Some distressing instances of a local outbreak of this disease in Highbury have, however, come to my knowledge, and I have taken such steps to inquire into the cases, and to reassure the inhabitants, as appeared to me appropriate. In the course of the month complaint was made to me of the practice of carrying the bodies of infants to the burial ground in mourning coaches, and a special instance was given me in which this dangerous proceeding was adopted in the case of a child who had died of scarlet fever. The case is still under investigation, but I mention it now because the public and undertakers should both be made aware of the fact that the practice is unsafe and calculated to spread a fatal disease. The next case of the kind that comes under my notice, after this warning, will probably be dealt with by the Sanitary Committee in the manner that the Sanitary Act directs. Relapsing fever has declined in Rose and Crown Court, where only two cases occurred during the month in families previously affected. The convalesents, however, are sadly weakened, and require to be well supported. Two fresh cases also occurred at a house in Windsor Street. They were the parents of a young man, a porter in the city, who first underwent a slight attack; all the four cases are in the hospital. The house in Windsor Street is undergoing a thorough purification, but the 2 bedding has been removed and cannot be traced. The dwellings in Rose and Crown Court have been recommended by your Surveyor for demolition. In one of the more recent returns of the Registrar General, a note is quoted as having been appended to the certificate of death of a child at 11, Bowman's Place, North, from 'sewer-poisoning,' that "the house was inspected in the summer and something was promised to be done." On inquiry I found that the child had died from ulceration of the mouth, no doubt properly attributed by the certifying surgeon, Mr. Kesteven, to its true cause. It was found that some rat holes communicated with a receiver or cesspool in the water closet, which was not known previously to exist, as no complaint of bad smells had ever been made by the occupiers of the house. The owner of this and the adjoining house is under orders now to reconstruct the drainage. Other neighbouring dwellings have also been inspected by my direction, and it is probable that I shall consider them proper subjects for report under the Artizans' and Labourers' Dwellings' Act. We have always had much trouble with these houses, which, originally badly constructed, have never been able to be dealt with efficiently under the Acts hitherto in force. METEOROLOGY OF JANUARY. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inchcs, read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Weekending Jan. 8th 46.4° 48.9° 43.5° 5.4° 86 0.68 7 „ „ 15th 39.9° 44.3° 35.6° 8.7° 87 0.52 5 „ 22nd 36.7° 38.4° 35.3" 3.2° 84 0.07 3 ,,29th 31.9° 37.4° 27.1° 10.3° 90 0.01 1 Means. 38.7° 42.2° 35.3° 6.9° 86 Sum. 1.28 Sum. 16 The highest day temperature, observed on January 7th was 510° The lowest night temperature, observed on January 28th was 21.5°. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, February 5th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 29th JANUARY, 1870. (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. 175 204 All causes 379 189 43 55 80 12 50 60 3. Respirat. Orgs. 110 47 6 19 34 4 2 6 Laryngitis 8 8 ... ... ... ... 32 40 Bronchitis 72 26 3 11 29 3 (Classes.) ... ... Pleurisy ... ... ... ... ... ... 29 50 I. ZYMOTIC DIS 79 74 1 3 1 ... 11 10 Pneumonia 21 12 3 3 2 1 2 3 Asthma 5 ... ... 3 2 ... 27 36 II. CONSTITUTL 63 19 25 12 7 ... 3 1 Lung Diseases, &c. 4 1 ... 2 1 ... 100 101 III. LOCAL 201 77 15 37 67 5 7 8 4. Digestive Orgs. 15 4 ... 5 5 1 ... ... Gastritis ... ... ... ... ... ... 18 14 IV. DEVELOPMNL. 32 17 2 1 5 7 1 ... Enteritis 1 ... ... ... 1 ... 1 3 V. VIOLENT DTHS. 4 2 ... 2 ... ... 1 1 Peritonitis 2 2 ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... 1 Ulceration of Intes. 1 ... ... 1 ... ... 1 ... Hernia 1 ... ... 1 ... ... (Orders.) 2 ... Ileus 2 ... ... ... 2 ... ... ... Intussusception ... ... ... ... ... ... 26 43 I. 1. Miasmatic Dis. 74 69 1 3 1 ... ... ... Stricture of Intest. ... ... ... ... ... ... ... 4 I. 1. Miasmatic Dis. 4 4 ... ... ... ... ... ... Fistula ... ... ... ... ... ... 2 5 Measles 7 7 ... ... ... ... 1 2 Stomach Dis., &c. 3 2 ... ... 1 ... 17 24 Scarlatina 41 41 ... ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... ... Hepatitis ... ... ... ... ... ... ... ... Quinsey ... ... ... ... ... ... ... 2 Jaundice 2 ... ... ... 1 1 1 1 Croup 2 2 ... ... ... ... 1 2 Liver Disease 3 ... ... 3 ... ... 2 8 Hooping Cough 10 10 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 2 4 Typhus & Typhoid 6 2 1 3 ... ... 1 2 5. Urinary Orgs. 3 ... ... 1 2 ... ... 1 Erysipelas 1 1 ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... ...... 1 Disease of Bladder 1 ... ... ... 1 ... ... ... Puerperal Fever ... ... ... ... ... ... 1 ... Nephria 1 ... ... ... 1 ... ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ...... ... ... ... ... Stone ... ... ... ... ... ... ...••• ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 1 1 Diarrhœa 2 1 ... ... 1 ... ... 1 Kidney Disease,&c. 1 ... ... 1 ... ... ... ... Cholera ... ... ... ... ... ... 1 ... 6. Genera. Organs 1 ... 1 ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 1 ... Rheumatiom 1 1 ... ... ... ... 1 ... Uterine Diseases.. 1 ... 1 ... ... ... 2 2 2. Enthetic 4 4 ... ... ... ... ... ... 7. Orgs.of Locomo. ... ... ... ... ... ... 2 2 Syphilis 4 4 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 1 ... 8. Skin, &c 1 ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon&Abseess ... ... ... ... ... ... 1 ... 3. Dietic 1 1 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... 1 ... Skin Diseases 1 ... ... ... ... ... 1 ... Want of Br. Milk 1 1 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 5 4 IV. 1. Dis. of Childn. 9 9 ... ... ... ... ... Alcoholism ... ... ... ... ... ... 5 4 Premature Birth 9 9 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 6 6 II. 1. Diathetic 12 2 2 3 5 ... 1 1 2. Dis. of Adults 2 ... 2 ... ... ... ... ... Gout ... ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... 1 1 Dropsy 2 ... 1 ... 1 ... 1 1 Childbirth 2 ... 2 ... ... ... 1 ... Haemorrhage ... ... ... ... ... ... 7 6 3. Dis. of Aged 13 ... ... 1 5 ... 3 1 Cancer 7 ... 1 2 4 ... 7 6 Old Age 13 ... ... 1 5 7 ... ... Noma ... ... ... ... ... ... 5 3 4. Dis. of Nutritn. 8 8 ... ... ... ... 2 1 Mortification 3 2 ... 1 ... ... 5 3 Atrophy & Debility 8 8 ... ... ... ... 21 30 2. Tubercular 51 17 23 9 2 ... ... ... Scrofula ... ... ... ... ... ... ... 2 V. 1. Acci. orNeg. 2 2 ... ... ... ... 5 1 Tabes Mesenterica 4 4 ... ... ... ... ... Fract. and Contus. ... ... ... ... ... ... 14 23 Phthisis 37 3 23 9 2 ... ... ... Wounds ... ... ... ... ... ... 5 5 Hydrocephalus 10 10 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 25 94 III. 1. Nervous Syst. 49 21 6 8 14 ... ... ... Drowning ... ... ... ... ... ... 5 4 Cephalitis 9 8 1 ... ... ... ... 2 Suffocation 2 ... ... ... ... ... 7 1 Apoplexy 8 ... 3 1 4 ... ... ... Otherwise ... ... ... ... ... ... 4 4 Paralysis 8 ... ... 3 5 ... ... ... 2. Homicide ... ... ... ... ... ... ... ... Insanity ... ... ... ... ... ... 1 1 3. Suicide 2 ... ... 2 ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... 1 2 Epilepsy 3 1 1 1 ... ... ... 1 Poison 2 ... ... 2 ... ... 6 5 Convulsions 11 11 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 2 8 Brain Diseases, &c. 10 1 1 3 5 ... ... ... Sutfocat. and Hang. ... ... ... ... ... ... 15 7 2. Organs of Circ. 22 4 2 4 12 ... ... ... Otherwise ... ... ... ... ... ... 12 2 Pericarditis 4 3 ... ... 1 ... ... ... 4. Unclassed ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... 13 5 Heart Disease 18 1 2 4 11 ... TABLE II. NEW CARES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WKEKS ENDING SATURDAY, THE 29th DAY OF JANUARY, 1870, AT THE FOLLOWING INSTITUTIONS:— V0rkh0use. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small POx .. .. 10 4 .. .. 14 Chicken Pox .. 1 1 .. 4 .. 6 Measles .. .. 24 1 17 .. 42 Scarlatina .. • • 12 8 9 .. 29 Whooping Cough •• • • 8 16 22 .. 46 Croup .. • • .. .. 2 .. 2 Diarrhœa 7 • • 16 15 22 .. 111 Dysentery .. • • 1 3 .. .. 4 Cholera .. .. .. .. .. .. .. Ague .. • • .. 1 .. .. 1 Continued Fever 5 .. *12 15 7 .. 39 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatie Fever .. .. .. 2 2 .. 4 Erysipelas 1 .. 6 7 6 .. 20 Diphteria .. .. .. 2 .. .. 2 Sorethroat or Tonsillitis 1 • • 8 26 54 .. 89 Mumps .. .. 2 .. 2 .. 4 Pyæmia .. • • .. .. .. .. .. Bronchitis and Catarrh 36 .. 247 225 254 86 848 Pneumonia .. .. 8 3 7 .. 18 Pleurisy .. .. 4 4 4 .. 12 DElirium Tremens .. .. .. .. .. .. .. Insanity 8 .. 8 .. 1 .. 17 Carbuncle 1 .. 3 1 2 .. 7 All other Diseases 73 24 391 559 655 316 2018 Total 132 25 761 892 1070 453 3333 *Four of these cases were "Relapsing Fever." TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From January 3rd, 1870, to January, 29, 1870. South East District. South "West District. North District. Total Number of houses inspected 142 243 138 523 Drains Constructed , . 4 3 7 Improved or repaired 11 36 3 50 Traps fixed 5 21 12 38 Cesspools Abolished , , .. .. .. Cleansed or disinfected • • • • .. .. Privies and Water Closets Pan, trap, and water supply furnished .. 2 1 1 4 Pan and trap only furnished 1 3 1 5 Water supply furnished 1 6 14 21 Dust bins Constructed .. 2 2 4 repaired and covers adapted .. 1 6 7 Surface Drains and Pavements of Yards Constructed .. 1 4 5 Relaid 6 23 .. 29 General Water Supply New receptacles provided .. .. 1 I Receptacles repaired and cleansed 38 16 4 58 Water supply provided .. .. 1 1 Other Improve- ments Houses generally repaired .. 22 4 26 ,, &c., cleansed or limewashed 53 41 25 119 Ventilated • • 3 .. 3 Overcrowding abated 5 7 .. 12 Illegal Use of underground Rooms for sleeping discontinued .. 7 .. 7 Other Amendments 7 7 11 25 REPORT on the SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR FEBRUARY, 1870. No. CLXXIV. Three hundred and seventy-four deaths of residents were registered in the Parish during the four weeks ending February 26th. As the period of the new census approaches, less and less reliance is to be placed upon any calculations based upon the annual increase of our population between 1851 and 1861. But assuming no alteration to have taken place in the ratio of increase, we may compare this mortality with 388 deaths, the corrected mean of the previous ten years for the corresponding period of the year. The most serious item in the mortality is the 115 deaths from bronchitis, pneumonia, and allied chest affections, a mortality due in great measure to the severe cold experienced in the middle of the month. In the second week of the month the mean temperature at Greenwich is stated to have been 6.3 degrees, and in the third week 7.5 degrees below the average of 50 years. The total number of new cases of bronchial affections, pleurisy, and pneumonia recorded in the public practice was 1008, the highest in any former February being 731 last year. It is observable that both in this month and in January we have recorded a very unusual number of cases of diarrhoea, in January 111 and now 102, and that in both instances a large proportion happened in the Pentonville Convict Prison. A slight increase in the number of cases of scarlet fever has been observed over the number recorded in January. The number of deaths registered, however, has fallen from 41 to 27. We may regard the epidemic as dying out. There have been four cases of relapsing fever, three in a family formerly reported at 8, Rose and Crown Court, and one of a girl in Rosemary Street, who was engaged in service in the Parish. There has been no fresh case since February 9th. 2 Two cases have come under my notice on complaint during the month in which houses infected from scarlet fever have been let and occupied by new tenants without previous disinfection. In the one case, the tenants moved into the house recklessly and knowingly, before the owner had carried out the disinfection which he proposed, the new tenant taking the house of the previous tenant for an unexpired period. In the other, the new tenant was accepted by the owner at the request of the out-going tenant in ignorance of the fact that scarlet fever had occurred in the house. The Sanitary Act appears unable to meet the latter case; the former is one for the consideration of the Committee. METEOROLOGY OP FEBRUARY. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Feb. 5th 41.7° 46.0° 37.39° 8.1° 90 0.49 6 „ 12th 33.7° 37.5° 30.9° 6.6° 76 0.67 4 „ 19th 31.3° 34.6° 28.5° 6.1° 76 0.02 2 „ 26th 36.8° 43.2° 31.2° 12.0° 75 0.06 3 Means. 35.8° 40.3° 32.1° 8.2° 79 Sum. 1.24 Sum. 15 The highest day temperature, observed on February 26th was 49.5° The lowest night temperature, observed on February 11th and 12th was 20.8°. A little Snow fell at intervals from February 8th to Feb. 12th, and on the 21st. EDWARD BALLARD, M.D. Medical Officer of Health. Vestry Offices, March 5th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 26th FEBRUARY, 1870. (Deaths of Non-Residenis in Hospitals excluded). West 8.D. East 8.D. Causes of Death. At all Ages. Under 20 years of age. At 20 and under 40 years of aee. 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.I. 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. 184 190 All causes 374 180 49 62 69 14 60 55 3. Respirat. Orgs. 115 46 9 22 33 5 2 2 Laryngitis 4 4 ... ... ... ... 41 38 Bronchitis 79 30 5 12 28 4 (Classes) 1 1 Pleurisy 2 ... 2 ... ... 30 50 I. ZYMOTIC DIS. 80 67 7 3 2 1 12 9 Pneumonia 21 12 4 2 3 ... 34 II. CONSTITUTE 65 18 23 21 3 ... 1 4 Asthma 5 ... ... 4 1 ... 31 3 1 Lung Diseases, &c. 4 ... ... 2 1 1 102 92 III. LOCAL 194 76 19 37 55 7 3 3 4. Digestive Orgs. 6 1 1 2 2 ... ... ... Gastritis ... ... ... ... ... ... 17 11 IV. DEVELOPMNL. 28 18 ... 1 8 6 ... ... Enteritis ... ... ... ... ... ... 4 3 V. VIOLENT DTHS. 7 6 ... ... 1 ... ... ... Peritonitis ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... 1 Ileus 1 1 ... ... ... ... ... ... Intussusception ... ... ... ... ... ... 26 44 I. 1. Miasmatic Dis. 70 60 6 1 2 1 ... ... Stricture of Inter ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... ... 3 measles 3 ... ... ... ... ... ... Stomach Dis., &c. ... ... ... ... ... ... 8 19 scarlatina 27 25 2 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 2 2 Diphtheria 4 4 ... ... ... ... ... ... Hepatitis ... ... ... ... ... ... ... ... Quinsey ... ... ... ... ... ... 1 ... Jaundice 1 ... ... 1 ... ... 1 ... Croup 1 1 ... ... ... ... 2 2 Liver Disease 4 ... 1 1 2 ... 6 13 Hooping Cough 19 19 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 2 13 Typhus & Typhoid 5 3 1 ... 1 ... 1 3 5. Urinary Orgs. 4 ... 1 2 1 ... ... ... Ervsipelas ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... 3 ... Puerperal Fever 3 ... 3 ... ... ... 1 1 Nephria 2 ... ... 1 1 ... ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentry ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 2 3 Diarrhœa 5 4 ... ... ... 1 ... 2 Kidney Disease,&c. 2 ... 1 1 ... ... ... ... Cholera ... ... ... ... ... ... 1 ... 6. Genera. Organs 1 ... 1 ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 2 1 Rheumatism 3 1 ... 1 1 ... 1 ... Uterine Diseases 1 ... 1 ... ... ... 2 2 2. Enthetic 4 4 ... ... ... ... ... 1 7. Orgs.ofLocomo. 1 ... 1 ... ... ... 2 2 Syphilis 4 4 ... ... ... ... ... 1 Spine Diseases 1 ... 1 ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... 8. Skill, &c. ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... ... 2 4 3. Dietic 6 3 1 2 ... ... ... ... Ulcer ... ... ... ... ... ... ... 1 Privation 1 ... 1 ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 1 Want of Br. Milk 2 2 ... ... ... ... ... ... ... 1 Purpura and Scurvy 1 1 ... ... ... ... 4 5 IV. 1. Dis. of Childn. 9 9 ... ... ... ... 1 1 Alcoholism 2 ... ... 2 ... ... 4 5 Premature Birth 9 9 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 4 7 II. 1. Diathetic 11 ... 2 6 3 ... ... ... 2. Dis. of Adults ... ... ... ... ... ... ... ... Gout ... ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... ... 2 Dropsy 2 ... l ... 1 ... ... ... Childbirth ... ... ... ... ... ... ... ... Hæmorrhage ... ... ... ... ... 10 5 3. Dis. of Aged 15 ... ... 1 8 6 4 3 Cancer 7 ... ... 6 1 ... 10 5 Old Age 15 ... ... 1 8 6 ... ... Noma ... ... ... ... ... ... 3 1 4. Dis. of Nutritn. 4 4 ... ... ... ... ... 2 Mortification 2 ... 1 ... 1 ... 3 1 Atrophy & Debility 4 4 ... ... ... ... 27 27 2. Tubercular 5 18 21 15 ... ... 2 3 Scrotula 5 4 l ... ... ... 3 3 V. 1. Acci. orNeg. 6 6 ... ... ... ... ... 2 Tabes Mesenterica 2 2 ... ... ... ... ... ... Fract. and Contus. ... ... ... ... ... ... 21 19 Phthisis 40 5 20 15 ... ... ... ... Wounds ... ... ... ... ... ... 4 3 Hydrocephalus 7 ... ... ... ... ... l Burns and Scalds 1 1 ... ... ... ... ... l Poison 1 1 ... ... ... ... 28 17 III. 1. Nervous Syst. 45 28 4 3 9 1 ... ... Drowning ... ... ... ... ... ... 6 2 Cephalitis 8 7 1 ... ... ... ... 1 Suffocation 4 4 ... ... ... ... 7 2 Apoplexy 9 2 ... 2 5 ... ... ... Otherwise ... ... ... ... ... ... 3 2 Paralysisi 5 ... 1 1 3 ... ... ... 2. Homicide ... ... ... ... ... ... ... ... Insanity ... ... ... ... ... ... 1 ... 3. Suicide 1 ... ... ... 1 ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... 1 Epilepsy 1 ... 1 ... ... ... ... ... Poison ... ... ... ... ... ... 10 9 Convulsions 19 19 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 2 1 Brain Diseases,&c. 3 ... 1 ... 1 1 ... ... Suftocat. and Hang. ... ... ... ... ... ... 9 13 2. Organs of Circ. 22 1 2 8 10 1 1 ... Otherwise 1 ... ... ... 1 ... 1 ... Pericarditis l ... ... ... ... ... ... ... 4. Unclasaed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... 8 13 Heart Disease 21 ... 2 8 10 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 26th DAY OF FEBRUARY, 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 5 2 .. .. 7 Chicken Pox .. .. 2 1 1 .. 4 Measkes .. .. 6 9 9 .. 24 Scarlatina .. .. 20 10 5 .. 35 Whooping Cough 3 .. 9 13 24 .. 49 Croup • • .. 1 2 2 .. 5 Diarrhœa 8 .. 8 25 21 40 102 Dysentery • • .. .. 1 .. .. 1 Cholera • • .. .. .. • • .. • • Ague .. .. .. .. .. .. • • Continued Fever 2 .. *8 11 11 .. 32 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. 1 1 .. .. 2 Rheumatic Fever .. .. 3 1 2 .. 6 Erysipelas .. .. 3 7 2 .. 12 Diphtheria .. .. .. • • .. .. • • Sorethriat or Tonsillitis .. .. 14 12 49 .. 75 Mumps .. .. 3 .. 1 .. 4 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 50 .. 319 242 269 .. 973 Pneumonia .. .. 6 8 4 .. 19 Pleurisy .. .. 1 6 9 .. 16 Delirium Tremens .. .. .. .. .. .. .. Insanity 3 .. 6 .. .. .. 9 Carbuncle .. .. 1 1 4 .. 6 All other Diseases 64 19 435 487 593 280 1878 Total 130 20 851 839 1006 413 3259 *Four of these cases were "Relapsing Fever." TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From January 31st, 1870, to February, 26, 1870. South East District. South West District. North District. Total. Number of houses inspected 147 380 110 637 Drains Constructed 9 1 1 11 Improved or repaired 21 18 8 47 Traps Fixed 38 21 26 85 Ceesspools Abolished 2 .. .. 2 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished .. 1 .. 6 Pan and trap only furnished .. .. 1 1 Water supply furnished 13 11 18 42 Dust bins Constructed .. .. 4 4 Repaired and covers adapted .. 8 6 14 Surface Drains and Pavements of Yards Constructed .. 3 .. 3 Receptacles repaired and cleansed 19 20 3 42 General Water Supply New receptacles provided 4 6 .. 10 Receptacles repaired and cleansed 33 13 4 50 Water supply provided .. .. .. .. Other Improve- ments Houses generally repaired 1 7 2 10 „ &c., cleansed or limewashed 31 22 19 72 ,, Ventilated .. .. .. .. Overcrowding abated 3 5 1 9 Illegal use of underground Rooms for sleeping discontinued 1 4 .. 5 the Amendments 31 •• 8 39 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR MARCH, 1870. No. CLXXV. If our estimate of the increase of our population is reliable, the corrected mean mortality of the last ten Marches may be stated at 483, for comparison with the 458 deaths registered in the fire weeks ending April 2nd. At all events our mortality is not to be regarded as excessive. The whole month has been comparatively cold. The principal fatality has fallen upon persons suffering from pulmonary diseases of various kinds, including phthisis, and upon old people. The epidemic of hooping cough is apparently at an end, and the deaths from scarlet fever have been less numerous than in February; the prevalence of the disease, however, does not seem to have continued to decline during March. It is to be observed that although only six deaths from measles have been registered, this disease is now spreading, 54 new cases having been recorded against 24 in February. In accordance with our observations in this parish we have to expect the epidemic extension of measles this year, either in the approaching month or in the autumn. Fortunately, it is a less fatal disease than scarlet fever, but still it is very fatal to young infants attacked, especially to infants under two years of age; after this age the fatality lessens. It is ten or fifteen times more fatal under two years of age (according to my observations here) than between five and fifteen years of age. Under five years of age, too, young children are about 2½ times more likely to take it than between five and ten years, and about 17 times more likely to take it than between 10 and 15 years of age. Hence, as the disease spreads like scarlet fever by contagion, especial care should betaken to separate the younger children of a family when the disease attacks one member, so that they shall not associate with the sick child. We still have an unusually large number of cases of diarrheal affections recorded on our Sickness Table. 2 A severe outbreak of typhoid (enteric) fever has occurred in the School belonging to the Holborn Union on the rise of Highgate Hill. As I receive no sickness returns from that establishment, I knew nothing of it until twenty-six cases had been received into the London Fever Hospital. My attention was first called to the probability of there being something amiss in the sanitary arrangements of the establishment by the return of a death from "cancrum oris" in the schedule which came to me on March 24th. This death took place on March 18th. The first death from typhoid fever was recorded in the mortuary schedule which reached me on 31st March, that is to say, five weeks after the first recognised case of typhoid had occurred in the house. I mention this because it is a striking illustration of the necessity of weekly returns of public sickness being forwarded to sanitary authorities, as well as returns of deaths. I am morally certain that the disease might have been prevented from spreading as it did in the School had I been in a position to interfere at its first onset. The first recognised case occurred in a boy who was sent to the Fever Hospital on February 24th; afterwards the fever attacked both boys and girls. On visiting the house on March 31st, I found that the children were in the habit of drinking from a closely covered cistern, the waste-pipe of which, untrapped, entered directly into the drain which conducted the overflow of a cesspool communicating with the boys' closet. Both the boys' and the girls' closets, in separate parts of the premises, are defective in construction. Up to the close of the month of March, 31 cases, including a nurse and a washerwoman, had been sent to the Hospital. I directed the waste-pipes of the cisterns to be at once disconnected from the drains, and the cisterns themselves to be cleansed and disinfected, and that carbolic acid should be thrown daily into each drain inlet on the premises and used for flushing the closets, and that the night-stools in the infirmary and dormitories should be charged with the same disinfectant. Up to the date of this report only three fresh cases have been sent to the Hospital, and one of these patients was ailing at the time of my first visit. Five cases of typhoid fever with two deaths in a house in the Barnsbury Road have been traced to a similar cause. Householders are scarcely even now aware of the danger to which they are exposed from the stupid but common practice of covering the water 3 cistern and then carrying a waste pipe from the vacant space directly into the house drain, by which this space becomes virtually a receptacle for the light gases generated in the latter and for any poisonous matter which they convey. The inmates of houses where this arrangement exists are at the mercy of an accident which may happen any day. METEOROLOGY OF MARCH. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temr. Weekending Mar. 5th 46.3° 61.7° 42.1° 9.5° 84 1.30 3 „ 12th 39.0° 44.6° 35.1° 9.5° 82 0°16 3 ,, „ 19th 41.7° 49°6° 36.1° 13°4° 84 0°30 2 „ 26th 39.3° 46.6° 34.6° 12.0° 80 0.37 5 „ April 2nd 37.8° 47.0° 31.4° 15.6° 78 o.oo 0 Means. 40.8° 47.9° 35.8° 12.0° 81 Sum. 2.13 Sum. 13 The highest day temperature, observed on April 2nd was 60.0° The lowest night temperature, observed on March 14th was 25.75°. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, April 12th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING 2nd APRIL, 1870. (Deaths of Noil-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. 223 235 All Causes 458 215 63 70 90 20 53 67 3. Respirat. Orgs. 120 56 8 18 34 4 5 8 Laryngitis 13 13 ... ... ... ... (Classes.) 32 45 Bronchitis 77 25 3 14 31 4 ... ... Pleurisy ... ... ... ... ... ... 35 43 I. ZYMOTIC DIS. 78 62 7 5 4 ... 13 14 Pneumonia 27 18 4 3 2 ... 57 42 II. CONSTITUTL. 99 34 34 20 10 1 1 ... Asthma 1 ... ... ... 1 ... 2 ... Lung Diseases, &c. 2 ... 1 1 ... ... 101 122 III. LOCAL 223 88 20 44 63 8 7 10 4. Digestive Orgs. 17 2 3 6 5 1 26 20 IV. DEVELOPMNL. 46 23 1 ... 11 11 ... ... Gastritis ... ... ... ... ... ... l 1 Enteritis 2 ... ... 1 1 ... 4 8 V. VIOLENT DTHS. 12 8 1 1 2 ... 1 ... Peritonitis 1 ... 1 ... ... ... ... 1 Ascites 1 ... 1 ... ... ... ... ... Not specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... 1 Hernia 1 ... ... ... 1 ... (Orders.) ... ... 2 Ileus 2 1 ... ... ... 1 ... ... Intussusception ... ... ... ... ... ... 31 42 I. 1. Miasmatic Dis. 73 59 6 4 4 ... ... ... Stricture of Intesi. ... ... ... ... ... ... ... 1 Small Pox 1 ... 1 ... ... ... ... ... Fistula ... ... ... ... ... ... 3 3 Measles 6 6 ... ... ... ... ... 1 Stomach Dis., &c. 1 ... ... 1 ... ... 12 17 Scarlatina 29 28 1 ... ... ... ... 1 Pancreas Dis., &c. 1 ... ... ... 1 ... ... 2 Diphtheria 2 2 ... ... ... ... 2 3 Hepatitis 5 ... 1 3 1 ... ... ... Quinsey ... ... ... ... ... ... 1 ... Jaundice 1 1 ... ... ... ... ... 2 Croup 2 2 ... ... ... ... 2 ... Liver Disease 2 ... ... 1 1 ... 7 7 Hooping Cough 14 14 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 6 3 Typhus & Typhoid 9 4 1 2 2 ... 2 3 5. Urinary Orgs. 5 1 1 1 2 ... ... 1 Erysipelas 1 1 ... ... ... ... 1 ... Nephritis 1 1 ... ... ... ... 1 2 Pyaemia 3 2 1 ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... 2 Puerperal Fever 2 ... 1 1 ... ... 1 1 Nephria 2 ... 1 ... l ... ... ... Carbucle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... 1 Prostrate Disease 1 ... ... ... 1 ... ... 1 Diarrhœa 1 ... ... ... 1 ... ... l Kidney Disease,&c. 1 ... ... 1 ... ... ... ... Cholera ... ... ... ... ... ... 2 ... 6. Genera. Organs 2 ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 2 1 Rheumatism 3 ... 1 1 1 ... 2 ... Uterine Diseases 2 ... ... ... ... ... ... ... 2. Enthetic ... ... ... ... ... ... 2 ... 7. Orgs. of Locomo. 2 2 ... ... ... ... ... ... Syphilis ... ... ... ... ... ... 1 ... Spine Diseases l 1 ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... l ... Bone Diseases 1 1 ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegimon & Abseess ... ... ... ... ... ... 3 1 3. Dietic 4 2 1 1 ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 2 ... Want of Br. Milk. 2 2 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 6 l IV. 1. Dis. of Childn. 7 7 ... ... ... ... 1 ... Alcoholism 2 ... 1 ... ... ... 5 l Premature Birth 6 6 ... ... ... ... 1 ... 4. Parasitic 1 1 ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... 1 ... Thrush 1 1 ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... 1 ... Other Malformation 1 1 ... ... ... ... ... ... Teething ... ... ... ... ... ... 10 6 II. 1. Diathetic 16 1 ... 6 8 1 1 ... 2. Dis. of Adults 1 ... 1 ... ... ... ... 1 Gout 1 ... ... 1 ... ... ... ... Paramenia ... ...... ... ... ... ... 4 1 Dropsy 5 1 ... 1 3 ... 1 ... Chidbirth 1 ... 1 ... ... ... ... ... Hæmorrhage ... ... ... ... ... ... 15 7 3. Dis. of Aged 22 ... ... ... 11 11 4 4 Cancer 8 ... ... 3 4 1 15 7 Old Age 22 ... ... ... 11 11 ... ... Noma ... ... ... ... ... ... 4 12 4. Dis. of Nutritn. 16 16 ... ... ... ... 2 ... Mortification 2 ... ... 1 1 ... 4 12 Atrophy & Debility 16 16 ... ... ... ... 47 36 2. Tubercular 83 33 34 14 2 ... 2 1 Scrofula 3 3 ... ... ... ... 3 4 V. 1. Acci.orNeg. 7 6 ... ... 1 ... 2 5 Tabes Mesenterica 7 7 ... ... ... ... ... Fract. and Contua. ... ... ... ... ... ... 35 23 Phthisis 58 8 34 14 2 ... ... ... Wounds ... ... ... ... ... ... 8 7 Hydrocephalus 15 15 ... ... ... ... 1 1 Burns and Scalds 2 2 ... ... ... ... ... ... Poison ... ... ... ... ... ... 26 25 III. 1. Nervous Syst. 51 25 2 10 12 2 ... ... Drowning ... ... ... ... ... ... 4 3 Cephalitis 7 7 ... ... ... ... 2 2 Suffocation 4 3 ... ... 1 ... 7 4 Apoplexy 11 1 2 5 3 ... ... 1 Otherwise 1 1 ... ... ... ... 5 7 Paralysis 12 1 ... 3 7 1 1 1 2. Homicide 2 ... ... ... ... ... ... ... Insanity ... ... ... ... ... ... ... 3 3. Suicide 3 ... 1 1 1 ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... 1 Epilepsy 1 ... ... 1 ... ... ... ... Poison ... ... ... ... ... ... 6 9 Convulsions 15 15 ... ... ... ... ... 2 Drowning 2 ... 1 1 ... ... 4 1 Brain Diseases, &c. 5 1 ... 1 2 1 ... 1 Suftocat. and Hang. 1 ... ... ... 1 ... 9 17 2. Organs of Circ. 26 2 6 7 10 1 ... ... Otherwise ... ... ... ... ... ... l ... Pericarditis l ... ... 1 ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... 8 17 Heart Disease 25 2 6 6 10 1 TABLE II. NEW CASES OF DISEASE COMING UNDEIR TREATMENT DURING THE FIVE WFEKS ENDING SATURDAY, THE 2nd DAY OF APRIL, 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox • • • • 3 • • • • • • 3 Chicken Pox • • • • .. 3 8 • • 11 Measles • • • • 32 5 17 • • 54 Scarlatina • • • • 24 15 6 • • 45 whooping Cough 2 • • 8 25 23 • • 58 Croup • • • • • • 2 3 • • 5 Disrrhœa 10 • • 20 36 24 • • 110 Dysentery • • • • 1 5 •• • • 6 Dysntery • • • • • • • • • • • • • • Cholera .. • • • • • • •• • • •• Ague 1 • • • • 2 7 • • 10 Continued Fever ,, • • • • • • • • • • • • Influenza • • • • 1 • • .. • • 1 Puerperal fever • • • • .. 2 4 • • 6 Reumatic Fever 1 • • 7 5 5 • • 18 Erysipelas • • • • • • 1 • • • • 1 Diphtheria 1 • • 15 16 53 • • 85 Sorthroat or Tonsillitis .. • • 1 .. • • • • 1 Mumps • • • • • • • • • • • • • • Pyæmia 42 1 312 280 297 • • 998 Bronchitis and Catarrh • • 1 4 2 7 • • 14 Pneumonia • • • • 5 8 7 • • 20 Pleurisy • • .. 2 .. .. • • 2 Delirium Tremens 7 • • 4 .. 1 • • 12 Insanity .. .. .. .. 3 • • 3 Carbuncle 99 27 534 759 856 262 2537 All other Disesases 163 29 973 1166 1321 348 4000 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From February. 28th, 1870, to March, 26th, 1870. South East District. South West District. North District. Total. *Number of houses inspected 152 192 31 375 Drains Constructed 4 2 • • 6 Improved or repaired 26 28 6 60 Traps fixed 29 15 19 63 Cesspools Abolished 3 • • • • 3 Cleansed or disinfected • • • • • • • • Privies and Water Closets Pan, trap, and water supply furnished 4 • • • • 4 Pan and trap only furnished 2 • • 1 3 Water supply furnisbed 13 9 14 36 Dust bins Constructed • • 1 1 2 Repaired and covers adapted 6 4 3 13 Surface Drains and Pavements of Yards Constructed • • • • • • • • Relaid 32 16 1 49 General Water Supply New receptacles provided 3 1 • • 4 Receptacles repaired and cleansed 61 6 • • 67 Water supply provided • • 5 • • 5 Other Improvements Houses generally repaired 10 4 • • 14 ,, &c., cleansed or limewashed 69 14 36 119 ,, ventilated • • 1 • • 1 Overcrowding abated • • 4 2 6 Illegal use of underground Rooms for sleeping discontinued • • 4 • • 4 Other Amendments 10 1 11 22 *The Bakehouses, Cowhouses, and Slaughterhouses were also inspected. REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR APRIL, 1870. No. CLXXVI. Although the 343 deaths recorded on our Mortuary Table exceed by 33 the deaths in April last year, it would not appear that they exceed the deaths which the average of the last ten Aprils corrected for increase of population would represent. The death rate has been less than that of March. Scarlet fever remains stationary, neither advancing nor declining in prevalence or fatality. Measles, however, as was anticipated, has made a considerable advance, 104 cases having been recorded in the public practice against 64 in the five weeks of March, and 24 in the four weeks of February. The mortality at present has been small, only 4 deaths from the disease having been registered during the month. The weather has been most unusual. The range of temperature from the lowest to the highest in the shade, has been 51.3 degrees. On the 20th the temperature rose to 80.3, and on the 28th some snow fell. The drought for the season has been remarkable. From the 27 th of March to the 30th of April, a period of 5 weeks, rain only fell on 5 days, and the total amount was less than half an inch. METEOROLOGY OF APRIL. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 A.M., Collected on the ground. Sum. Number of days on which Rain feli in appreciable quant ity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Apr. 9th 45.8° 60.2° 35.0° 25.1° 70 0.12 1 „ „ I6th 50.2° 62.2° 41.5° 20.7° 67 0.09 1 „ „ 23rd 55.8° 70.2° 44.4° 25.8° 63 o.oo 0 „ 30th 48.8° 59.1° 41.5° 17.5° 71 0.19 3 Means. 50.1° 62.9° 40.6° 22.2° 67 Sum. 0.40 Sum. 5 The highest day temperature, observed on April 20th was 80.3°. The lowest night temperature, observed on April 4th was 29.0°. Hailstorm with thunder and lightning on April 10th. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, May 8th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING POOR WEEKS ENDING 30th APRIL, 1870. (Deaths of Non-Residents in Hospitals excluded). Wost 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. 180 163 All Causes 343 179 42 56 53 13 33 44 3. Respirat. Orgs. 77 44 3 13 15 2 3 6 Laryngitis 9 9 ... ... ... ... (Classes.) 15 23 Bronchitis 38 21 1 6 9 1 1 ... pleurisy 1 ... 1 ... ... ... 37 31 I. ZYMOTIC DIS. 68 59 6 2 1 ... 8 11 Pneumonia 19 13 1 1 3 1 1 4 Asthma 5 ... ... 3 2 ... 40 31 II. CONSTITUTE 71 24 22 17 7 1 5 ... Lung Diseases, &c. 5 1 ... 3 1 ... 85 82 III. LOCAL 167 73 12 36 39 7 10 7 4. Digestive Orgs. 17 1 2 6 8 ... 1 Gastritis 2 ... ... ... 2 ... 10 16 IV. DEVELOPMNL. 26 16 ... ... 5 5 ... ... Enteritis ... ... ... ... ... ... 6 3 V. VIOLENT DTHS. 9 5 2 1 1 ... 1 ... Peritonits 1 ... 1 ... ... ... ... 3 Ascites 3 ... ... 1 2 ... 2 ... Not Specified 2 2 ... ... ... ... ... 1 Ulceration of Intes 1 1 ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... 1 Ileus 1 ... ... ... 1 ... ... ... Intussusception ... ... ... ... ... ... 34 30 I. 1. Miasmatic Dis. 64 55 6 2 1 ... ... ... Stricture of Inter ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... 3 1 Measles 4 4 ... ... ... ... ... ... Stomach Dis., &c. ... ... ... ... ... ... 14 10 Seariatina 24 22 1 1 ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 5 1 Diphtheria 6 5 1 ... ... ... 1 ... Hepatits 1 ... ... ... 1 ... 1 ... Quinsey 1 1 ... ... ... ... 2 ... jaundice 2 ... ... 1 ... ... ... 1 Croup 1 1 ... ... ... ... 5 1 Liver Disease 6 ... ... 4 2 ... 7 4 Hooping Cough 11 11 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 1 3 Typhus & Typhoid 4 2 ... 1 ... ... 2 2 5. Urinary Orgs. 4 1 1 1 1 1 ... ... Erysipelas ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... 1 Puerperal Fever 1 ... 1 ... ... ... 2 1 Nephria 3 ... 1 1 ... 1 ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 3 5 Diarrhœa 8 7 ... ... 1 ... ... 1 Kidney Disease,&c. 1 1 ... ... ... ... ... ... Cholear ... ... ... ... ... ... 1 ... 6. Genera. Organs 1 ... ... 1 ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... ... 4 Rheumatism 4 2 2 ... ... ... 1 ... Uterine Diseases 1 ... ... 1 ... ... 1 ... 2. Enthetic 1 1 ... ... ... ... ... ... 7. Orgs.of Locomo. ... ... ... ... ... ... 1 ... Syphilis 1 1 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... ... 2 1 3. Dietic 3 3 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... 2 1 Want of Br. Milk 3 3 ... ... ... ... ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 2 5 IV. 1. Dis. of Childn. 7 7 ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... 2 5 Premature Birth 7 7 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Trush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 5 6 II. 1. Diathetic 11 1 1 2 6 1 ... ... 2. Dis. of Adults . ... ... ... ... ... ... 1 ... Gout 1 ... ... ... 1 ... ... ... Paramenia ... ... ... ... ... ... ... 1 Dropsy 1 ... ... ... ... 1 ... ... Childbirth ... ... ... ... ... ... 1 1 Haemorrhage 2 1 1 ... ... ... 4 6 3. Dis. of Aged 10 ... ... ... 5 5 3 4 Canser 7 ... ... 2 5 ... 4 6 Old Age 10 ... ... ... 5 5 ... ... Noma ... ... ... ... ... ... 4 5 4. Dis. of Nutritn. 9 9 ... ... ... ... ... ... Mortification ... ... ... ...... ... ... 4 5 Atrophy & Debility 9 9 ... ... ... ... 35 25 2. Tubercular 60 23 21 15 1 ... ... 3 Scrofula 3 3 ... ... ... ... 4 2 V. 1. Acci. or Neg. 6 4 1 ... 1 ... 2 1 Tabes Mesenterica 3 3 ... ... ... ... 1 1 Fract and Contus 2 1 1 ... ... ... 29 18 Phthisis 47 10 21 15 1 ... ... ... Wounds ... ... ... ... ... ... 4 3 Hydrocephalus 7 7 ... ... ... ... ... 1 Burns and Scalds 1 1 ... ... ... ... ... ... Poison 1 ... ... ... 1 ... 30 24 III. 1. Nervous Syst. 64 27 4 8 12 3 1 ... Drowning ... ... ... ... ... ... 7 4 Cephalitis 11 8 1 1 1 ... 1 ... Suffocation 1 1 ... ... ... ... 4 3 Apoplexy 7 ... 2 2 2 1 ... ... Otherwise 1 1 ... ... ... ... 8 4 Paralysis 12 ... ... 5 6 ... 2 1 2. Homicide 1 1 ... ... ... ... ... ... Insanity ... ... ... ... ... ... ... ... 3. Suicide 2 ... 1 ... ... ... ... ... Chorea ... ... ... ... ... ... 1 ... Wounds 1 ... 1 ... ... ... ... 1 Epilepsy 1 ... ... ... 1 ... 1 ... Poison 1 ... ... ... ... ... 7 11 Convulsions 18 18 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 4 1 Brain Diseases, &c. 5 1 ... ... 2 2 ... ... Suffocat.and Hang. ... ... ... ... ... ... 9 5 2. 14 ... 2 7 4 1 ... ... Otherwise ... ... ... ... ... ... 1 ... Pericarditis 1 ... ... 1 ... ... ... ... 4. Unclassed ...... ... ... ... ... ... 1 1 Aneurism 2 ... ... 1 ... ... 7 4 Heart Disease 11 ... 2 5 3 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 30th DAY OF APRIL, 1870, 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 4 .. 9 Measles 4 .. 50 16 34 .. 104 Scarlatina .. .. 16 14 8 .. 38 Whooping Cough 3 .. 5 14 13 .. 35 Croup • • .. • • • • .. .. 4 Diarrhœa 7 .. 22 26 27 .. 91 Dysentery 1 .. .. 1 .. .. 2 Cholers • • .. .. • • .. .. .. Ague .. .. 1 1 .. .. 2 Continued Fever 1 •• 3 8 17 .. 29 Influenze .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. • • Rheumsatic Fever .. .. .. .. 1 .. 1 Erysipelas 2 .. 3 1 1 .. 7 Diphtheria .. .. 3 .. .. .. 3 Sorethroat or Tonsillitis 1 .. 13 27 25 .. 66 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 45 .. 155 165 227 .. 602 Pneunia .. .. 7 2 7 .. 16 Pleurisy .. .. 7 5 11 .. 23 Delirium Tremens 1 .. .. .. • • .. 1 Insanity 10 .. 7 .. .. .. 17 Carbuncle 1 .. .. .. 1 .. 2 All other Diseases 48 13 355 624 686 165 1891 Total 124 13 652 909 1066 184 2948 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From March, 28th, 1870, to April, 30th, 1870. South East District. South West District. North District. Total. Number of houses inspected 237 235 20 492 Drains Constructed 1 .. .. 1 Improved or repaired 19 17 9 45 Traps fixed 9 9 32 50 Cesspools Abolished 3 .. .. 3 Clensed or disinfected .. . . .. .. Privies and Water Closets Pan, trap, and water supply furnished 4 1 4 9 Pan and trap only furnished .. .. 1 1 Water supply furnished 9 9 31 49 Dust bins Constructed 1 3 1 5 Repaired and covers adapted .. 9 3 14 Surface Drains and Pavements of Yards Constructed .. .. .. .. Relaid 16 13 6 35 General Water Supply New receptacles provided .. 2 .. 2 Receptacles repaired and cleansed 30 11 .. 41 Water supply provided .. .. .. Other Improve- ments Houses generally repaired 10 4 .. 14 „ &c., cleansed or limewashed 48 23 39 110 ,, ventrilated .. 20 .. 20 Overcrowding abated 1 .. .. 1 Illegal use of underground Rooms for sleeping discontinued .. 1 .. 1 Other Amendments 13 3 19 35 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOR MAY, 1870. No. CLXXVII. The registered mortality of the four weeks ending May 28th is 298. It is less than that of May 1866, 1868, and 1869, and very little higher than that of May 1863, 1864, and 1865, in years when our population was not so great as it is now. Probably it is somewhere about 50 less than it would have been had the average mortality of the month prevailed. The amount of public sickness, however, has been higher than it ought to be for May. It is the highest I have recorded with the exception of May 1868, when a similar drought prevailed in this month. Had the temperature been as persistently high as it was at that time, we should probably have had to record even more sickness. Fortunately the drought this month has not been thus associated, with the exception of the third week, when the mean temperature was 6'9 degrees above the average of 50 years (Glaisher). The continued absence of rain and the unusual dryness of the air have favoured the spread of three of the diseases which are propagated bv the diffusion of a morbid virus, small-pox, measles, and scarlet fever. Small-pox, which everybody is aware is raging with great severity in Paris, has again appeared amongst ourselves, and threatens to become epidemic. Since its sudden arrest in the summer of 1868, we have been nearly free from it, but it is re-appearing in its old quarters about Upper Holloway. Six out of the eleven cases recorded in the sickness table having occurred in that district. The houses where it has appeared have been well looked after by the Sanitary Officers of the parish; but measures should be taken to remind the inhabitants of the importance of vaccination for their children, and of re-vaccination for their own personal protection. 2 The cases of measles recorded have risen from 104 in April to 170, and the deaths registered from 4 to 17—all but one being children under five years of age. Scarlet fever has risen from 38 cases in April to 52, with 27 registered deaths, the largest number registered in any May for 15 years, with the exception of the very unhealthy year 1863, when, at this season, after a droughty April, small-pox and scarlet fever both prevailed excessively. Eain has only fallen on six days, and to a total amount of 0-69 inch. During the nine weeks since March 27, only 1.09 inch has fallen, being distributed over only 11 days out of the 63. A great part, moreover, namely, 0.53 inch, fell on only 2 days, namely, 0'30 inch on the 11th of May and 0.23 inch on the 13th of May. On Sunday the 29th, I seized, at a licensed slaughter house in the George's Road, where beasts are killed for the dead meat market, the carcass of a much diseased and emaciated cow, which had been sent up from Hatfield dead, and without the pass necessary for transmitting a live beast. It had been dressed at the slaughter house in the same way as other carcasses prepared for the market. Being unfit for human food, it was destroyed the next morning by order of the magistrate sitting at Clerkenwell. The Sanitary Committee will, doubtless, deal with this case according to its judgment. METEOROLOGY OF MAY. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Weekending May 7th 46.9° 59.1° 38.5° 20.6° 67 0.06 1 „ 14th 50.0° 61.2° 42.2° 19.0° 71 0.54 3 „ 21st 58.7° 72.8° 48.5° 24.40° 63 0.09 2 „ 28th 58.4° 73.7° 46.3° 27.3° 57 0.00 0 Means. 53.5° 66.7° 43.8° 22.8° 64 Sum. 0.69 Sum. 6 The highest day temperature, observed on May 21st was 83.5°. The lowest night temperature, observed on May 3rd was 33.5°. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, June 6th 1870 TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 28th MAY, 1870. (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 80 Vears of age. At 80 years of age and upwards. 149 149 All Causes 298 161 40 38 50 9 21 26 3. Respirat. Orgs. 47 26 3 6 12 ... ... 2 Laryngitis 2 2 ... ... ... ... (Classes.) 9 16 Bronchitis 25 16 ... 1 8 ... 1 ... Pleurisy 1 ... ... 1 ... ... 34 40 I. ZYMOTIC DIS. 74 62 7 4 1 ... 6 7 Pneumonia 13 7 3 2 1 ... 38 32 II. CONSTITUTL. 70 29 21 13 7 3 ... Asthma 3 ... ... 1 ... ... 2 1 Lung Diseases, &c. 3 1 ... 1 1 ... 60 61 III. LOCAL 121 48 10 21 37 5 11 6 4. Digestive Orgs. 17 3 2 5 6 1 16 15 IV. DEVELOPMNL. 31 21 2 ... 4 4 3 ... Gastritis 3 ... 1 ... 2 ... 1 1 Enteritis 2 1 ... ... ... ... 1 1 V. VIOLENT DTHS. 2 1 ... ... 1 ... 2 1 Peritonitis 3 1 1 ... ... 1 ... ... Ascites ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) 1 ... Ileus 1 ... ... ... 1 ... l ... Intussusception 1 ... ... 1 ... ... 31 38 I. 1. Miasmatic Dis 69 57 7 4 1 ... ... ... Stricture of Iutes ... ... ... ...... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... 10 7 Measles 17 17 ... ... ... ... ... ... Stomach Dis., &e. ... ... ... ... ... ... 15 12 Scarlatina 27 25 2 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... 1 Diphtheria 1 l ... ... ... ... ... 1 Hepatitis 1 ... ... 1 ... ... 1 ... Quinsey 1 1 ... ... ... ... 2 ... jaundice 2 ... ... 1 1 ... ... ... Croup ... ... ... ... ... ... 1 2 Liver Disease 3 ... ... 2 1 ... ... 7 Hooping Cough 7 7 ... ... ... ... ... 1 Spleen Disease 1 1 ... ... ... ... 3 5 Typhus & Typhoid 8 4 2 2 ... ... 2 3 5. Urinary Orgs. 5 ... 1 1 3 ... ... ... Erysipelas ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... 1 Pyœmia 1 ... l ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... 2 Puerperal Fever . 2 ... 2 ... ... ... 1 1 Nephria 2 ... 1 ... l ... ... ... Carbuncle ... ... ... ... ... ... ... 1 Diabetes 1 ... ... 1 ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease . ... ... ...... ... ... ... 1 1 Diarrhœa 2 2 ... ... ... ... 1 1 Kidney Disease,&c. 2 ... ... ... 2 ... ... ... Cholera ... ... ... ... ... ... 2 ... 6. Genera. Organs 2 ... ... 1 1 ... ... ... Ague ... ... ... ... ... ... 1 ... Ovarian Dropsy 1 ... ... ... 1 ... 1 2 Rheumatism 3 ... ... 2 1 ... 1 ... Uterine Diseases 1 ... ... 1 ... ... 2 2 2. Enthetic 4 4 ... ... ... ... 1 1 7. Orgs.of Locomo. 2 ... 1 1 ... ... 2 2 Syphilis 4 4 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... 1 1 Bone Diseases 2 ... 1 1 ... ... ... ... Hydrophobia ... ... ... ... ... ... ... 1 8. Skin, & c. 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... ... 1 ... 3. Dietic 1 1 ... ... ... ... ... 1 Ulcer 1 ... 1 ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 ... Want of Br. Milk 1 1 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... 5 7 IV. 1. Dis of Childn. 12 12 ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... 5 ... Premature Birth 12 12 ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Worms ...... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... 6 4 II. 1. Diathetic 10 1 1 3 5 ... ... ... Teething ... ... ... ... ... ... 1 1 2. Dis. of Adults 2 ... 2 ... ... ... ...... ... Gout ... ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... ...... 1 Dropsy 1 ... 1 ... ... ... 1 1 Childbirth 2 ... 2 ... ... ... ... ... Hæmorrhage ... ... ... ... ... ... 5 3 3. Dis. of Aged 8 ... ... ... 4 4 6 3 Cancer 9 1 ... ... 5 ... 5 3 Old Age 8 ... ... ... 4 4 ... ... Noma ... ... ... ... ... ... 5 4 4. Dis. of Nutritn. 9 9 ... ... ... ... ... ... Mortification ... ... ... ... ... ... 5 4 Atrophy & Debility 9 9 ... ... ... ... 32 28 2. Tubercular 60 28 20 10 ... ... 1 1 Scrofula 2 2 ... ... ... ... 1 1 ... ... ... 3 2 Tabes Mesenterica 5 5 ... ... ... ... 1 1 V. 1. Acci. or Neg. 2 1 ... ... 1 ... 22 14 Phthisis 36 4 20 10 2 ... ... ... Fract. and Contus. 2 1 ... ... 1 ... 6 11 Hydrocephalus 17 17 ... ... ... ... ... Wounds ... ... ... ... ... ... ... ... Burns and Scalds.. ... ... ... ... ... ... 11 19 III. 1. Nervous Syst. 30 17 1 4 7 1 ... ... Poison ... ... ... ... ... ... ... ... Drowing ... ... ... ... ... ... 1 2 cephalitis 3 3 ... ... ... ... ... ... Suffocation ... ... ... ... ... ... 1 3 Apoplexy 4 ... ... 3 1 ... ... ... Otherwise ... ... ... ... ... ... 3 2 Paralysis 5 ... ... ... 4 1 ... ... 2. Homicide ... ... ... ... ... ... ... ... insanity ... ... ... ... ... ... ... ... 3. Suicide ... ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... 1 Epilepsy 1 ... ... 1 ... ... ... ... Poison ... ... ... ... ... ... 1 9 Convulsion 10 10 ... ... ...••• ... ... ... Drowning ... ... ... ... ... ... 5 2 Brain Diseases, &c. 7 4 1 ... 2 3 ... ... Suffocat. and Hang. ... ... ... ... ... ... 12 5 2. Organs of Circ. 17 2 1 ... 8 1 ... Otherwise ... ... ... ... ... ... ... 1 Pericarditis 1 ... ... ... ... 1 ... ... 4. Unclassed ... ... ... ... ... ... ... 1 Aneurism l ... ... ... ... 11 ... 12 3 Heart Disease 15 2 1 3 8 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 28th DAY OF MAY, 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 9 1 1 .. 11 Chicken Pox .. .. 2 7 7 .. 16 measles • • .. 79 29 62 .. 170 Scarlatina .. .. 10 34 8 .. 52 Whooping Cough • • .. 8 2 2 .. 12 Croup • • .. .. .. 1 .. 1 Diarrhœa 4 .. 19 26 18 .. 75 Dysentery .. .. .. 1 2 .. 3 Cholera • • .. .. .. .. .. .. Ague .. .. 1 1 .. .. 2 Continued Fever 1 .. 4 10 5 .. 20 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever 1 .. .. .. 3 .. 4 Erysipelas .. .. 2 3 6 .. 11 Diphtheria .. .. • • 1 .. .. 1 Sorethroat or Tonsillitis .. .. 9 25 36 .. 70 Mumps .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh 15 .. 115 97 151 .. 379 Pneumonia 1 .. 2 3 5 .. 11 Pleurisy 1 .. 6 6 8 .. 21 Delirium Tremens .. .. .. .. .. .. .. Insanity 5 .. 5 1 •• .. 11 Carbuncle .. .. .. 1 .. .. 1 All other Diseases 79 17 431 651 692 100 1970 Total 107 17 702 899 1007 109 2841 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From May, 2nd, 1870, to May, 28th, 1870. South East District. South "West District. North District. Total. Number of houses inspected 157 169 5 331 Drains Constructed 3 .. .. 3 Improved or repaired 13 12 2 27 Traps fixed 3 11 4 18 Cesspools Abolished 1 4 .. 5 Cleansed or cisinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 2 3 .. 5 Pan and trap only furnished 4 3 .. 7 Water supply furnished .. 4 2 6 Dust bins New receptacles Provided .. 5 .. 5 Receptacles repaired and clensed .. 6 4 10 Surface Drains and Pavements of Yards Constructed .. .. .. .. Relaid 8 13 .. 21 General Water Supply New receptacles provided 2 4 .. 6 Receptacles repaired and cleansed 9 8 .. 17 Water supply provided .. .. .. .. Other Improve- ments Houses generally repaired 2 1 2 5 „ &c., cleansed or limewashed 35 29 3 67 ,, ventilated .. 25 .. 25 Overcrowding abated .. 1 .. 1 Illegal use of underground Rooms for sleeping discontinued .. 2 .. 2 Other Amendments 9 2 4 15 REPORT on the SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR JUNE, 1870. No. CLXXVIII. The deaths registered during the five weeks ending July 2nd were 878, a number which certainly does not represent a high mortality for the season. In June 1868, 373 deaths were registered and in June last year 370. The sickness table gives us a total of 3361 new cases, a number very little in excess of those recorded last year at the same season. In June 1868, 39C6 cases were recorded. Measles has prevailed more than in the month of May, 264 cases having been recorded in the public practice and 26 deaths registered from this disease. The deaths from scarlet fever, also, have risen from 27 in the four weeks of May to 45 in the five weeks of June : but the prevalence of the disease appears to be somewhat abated, since only 42 cases have been recorded against 52 in May. Small-pox has not spread. Diarrhceal affections began to increase materially in the fourth week of the month, the mean temperature in the previous week having risen above 60 degrees, 205 cases have been recorded, while there have been 19 deaths referred to diarrhoea and 1 to summer cholera. These are smaller numbers than were recorded with a smaller population in the years 1865 and 1868. With the sanction of the Sanitary Committee, it has been arranged that once in the week certain of the low streets shall be watered with a weak solution of carbolic acid, and that Macdougal's powder shall be used in courts and other places where the water carts cannot reach, and upon common dust-bins and accumulations of decomposing matter in our courts and near the residences of the poor. If those of our parishioners who can help themselves would this summer adopt a similar practice in their own premises, would see to the cleansing of their water cisterns, insist upon the frequent emptying of their dust-bins by the contractor, and require their servants to burn their vegetable refuse, instead of throwing it into the dust-bin to decompose, they would be doing that which is calculated to preserve themselvcs and their families from disease. 2 There were only four days altogether in which any rain-fall was measured here, and the total amount in the five weeks was only 079 inches. The mean temperature of each week, except the last, has also been above the average. METEOROLOGY OF JUNE. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending June 4th 59.1° 71.6° 50.9° 20.7° 69 0.07 1 ,, 11th 59.8° 74.40 49.5° 25.0° 60 o.oo 0 „ 18th 64.3° 77.9° 55.6° 22.3° 65 0.42 1 „ 25th 64.8° 78.3° 55.5° 2i.7° 61 0.23 1 „ July 2nd ,59.1° 71.1° 50.7° 20.4° 66 0.07 1 Means. 61.4° 74.6° 52.4° 22.2° 64 Sum. 0.79 Sum. 4 The highest day temperature, observed on June 22nd was 90.3°. The lowest night temperature, observed on June 6th was 43.5°. A thunderstorm on 16th, when 0.42 inches of rain fell. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, July 9th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING 2nd JULY, 1870. (Deaths of Non-Kesidents 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. 180 198 All Causes 378 230 55 47 42 4 16 24 3. Respirat. Orgs. 40 17 9 8 6 ... l 1 Laryngitis 2 2 ... ... ... (Classes.) 4 12 Bronchitis 16 7 4 2 3 ... 1 1 Pleurisy 2 ... 2 ... ... ... 51 74 I. ZYMOTIC DIS. 125 116 7 1 1 ... 6 8 Pneumonia 14 8 3 2 1 ... 1 1 Astma 2 ... 1 1 ... 44 35 II. CONSTITUTL. 79 37 24 12 6 ... 3 1 Lung Diseases, &c. 4 ... 3 1 ... 57 69 III. LOCAL 126 46 19 31 30 ... 12 12 4. Digestive Orgs. 24 5 4 8 7 ... ... 1 Gastritis 1 1 ... ... ... 26 16 IV. DEVELOPMNL. 42 29 4 ... 5 4 1 2 Enteritis 3 2 i ... ... ... 2 4 V. VIOLENT DTHS. 6 2 1 3 ... ... ... ... Peritonitis ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... 1 ... Hernia 1 ... ... ... ... (Orders.) ... ... Ileus 2 1 j ... ... ... ... ... 1 Intussusception ... ... ... ... ... 46 70 I. 1. Miasmatic Dis. 116 107 7 1 1 ... ... ...... Stricture of Intear ... ... ... ... ... 1 2 Small Pox 3 3 ... ... ... ... ... ... Fistula ... ... ... ... ... 11 15 Measles 26 26 ... ... ... ... 1 1 Stomach Dis., &c. 2 ... ... ... ... 16 29 Scarlatina 45 42 3 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 1 Diphtheria 1 1 ... ... ... ... 1 2 Hepatitis 3 ... 2 1 ... ... ... Quinsey ... ... ... ... ... ... 1 1 Jaundice 2 ... ... 1 1 ... 2 ... Croup 2 ... ... ... ... ... ... 5 Liver Disease 10 ... j 4 5 ... 3 3 Hooping Cough 6 ... ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 1 5 Typing & Typhoid 6 4 2 ... ... ... 1 5 5. Urinary Orgs. 6 ... 3 3 ... 3 ... Erysipelas 3 3 ... ... ... ... ... ... 1 Nephritis ... ... ... ... ... ... 1 Pyœmia 1 1 ... ... ... ... ... 1 Disease of Bladder 1 ... ... 1 ... 2 ... puerperal Fever 2 ... 2 ... ... ... 1 3 Nephria 4 ... 2 2 ... ... ... carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease . ... ... ... ... ... 5 14 Diarrhœa 19 17 ... 1 ... ... ... 1 Kidney Disease,&c. 1 ... ... 1 ... ... 1 ... Cholera 1 1 ... ... ... ....M ... 2 6. Genera. Organs 2 ... ... 2 ... ... ... ... Ague ... ... ... ... ... ... ... 1 Ovarian Dropsy 1 ... 1 ... ... 1 ... Rheumatiom 1 1 ... ... ... ... ... 1 Uterine Diseases 1 ... 1 ... ... 1 2 2. Enthetic 3 3 ... ... ... ... ... 3 7. Orgs.of Locoino. 3 3 ... ... ... 1 2 Syphillis 3 3 ... ... ... ... ... 1 Spine Diseases 1 1 ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... 2 Bone Diseases 2 2 ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... 4 2 3. Dietic 6 6 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... 4 2 Want of Br. Milk 6 6 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 6 3 IV. 1. Dis. of Childn. 9 9 ... ... ... ... ... Alcoholism ... ... ... ... ... ... 6 2 Premature Birth 8 8 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... 1 Other Malformation 1 1 ... ... ... ... ... Teething ... ... ... ... ... 3 6 II. 1. Diathetic 9 2 ... 4 3 ... 2 2 2. Dis. of Adults 4 ... 4 ... ... ... ... ... Gout ... ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... ... Dropsy ... ... ... ... ... ... 2 2 Chidbirth 4 ... 4 ... ... ... ... 1 Hæmorrhage 1 l ... ... ... ... 6 3 3. Dis. of Aged 9 ... ... 5 4 1 4 Cancer 5 1 ... 2 2 ... 6 3 Old Age 9 ... ... 5 ... ... ... Noma ... ... ... ... ... ... 12 8 4. Dis. of Nutritn. 20 20 ... ... ... 2 l Mortification 3 ... ... 2 1 ... 12 8 Atrophy & Debility 20 20 ... ... ... 41 29 2. Tubercular 70 35 24 8 3 ... 3 1 Scrotula 4 ... 1 ... ... ... 1 2 V. 1. Acci.orNeg. 3 1 2 ... ... 3 4 Tabes Mesenterica ... ... ... ... ... ...... ... 1 Fract. and Coutus. 1 ... 1 ... ... 29 16 Phthisis 45 ... 23 3 ... ... ... Wounds ... ... ... ... ... 6 5 Hydrocephalus 14 14 ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... Poison 1 ... 1 ... ... 19 19 III. 1. Nervous Syst. 38 18 2 7 11 ... ... ... Drowning ... ... ... ... ... 3 3 Cephalitis 6 5 ... 1 ... ... ... l Suffocation 1 1 ... ... ... 5 5 Apoplexy 10 ... 1 5 4 ... ... ... Otherwise ... ... ... ... ... 4 4 paralysis 8 1 ... 1 6 ... 1 ... 2.Homicide 1 1 ... ... ... 1 Insanity 1 ... ... ... 1 ... ... 2 3. Suicide 2 ... 1 ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... 1 Epilepsy 1 ... 1 ... ... ... ... ... Poison ... ... ... ... ... ... 4 6 Convulsions 10 10 ... ... ... ... ... 1 Drowning 1 1 ... ... ... 1 1 Brain Diseases, &c. 2 2 ... ... ... ... ... 1 Suffocat. and Hang. 1 ... ... 1 ... ... 9 4 2. Organs of Circ 13 3 4 3 3 ... ... ... Otherwise ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Uuclassed ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... ... 9 4 Heart Disease 13 3 4 3 3 ... ... ... TABLE II. NEW CASES OF DISEASE COMING UNDER. TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 2nd DAY OF JULY, 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway | Dispensary. Islington Dispensary. Pentonville Convict Prison . Smoll Pox .. .. 6 4 .. .. 10 Chicken Pox .. .. 3 7 6 .. 16 Measles • • .. 87 109 68 .. 264 Scarlatina .. .. 16 21 5 .. 42 Whooping Cough •• .. 5 10 10 .. 25 Croup •• .. 1 • • 1 .. 2 Diarrhœa 5 .. 42 58 80 .. 205 Dysentery .. .. .. .. 2 .. 2 Cholera .. .. .. 1 • • .. 1 Ague 1 .. 1 .. •• .. 2 Continued Fever .. .. 5 13 3 .. 21 Influenza .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. • • 2 1 2 5 Erysipelas 1 .. 5 4 8 .. 18 Diphteris • • .. .. 1 .. .. 1 Sorethroat or Tonsillitis .. .. 13 34 40 .. 87 Mumps .. .. 1 .. .. .. 1 Pyæmia .. .. .. • • .. .. .. Bronchitis and Catarrh 18 .. 92 104 204 .. 432 Pneumonia .. .. 3 8 4 .. 15 Pleurisy .. .. 6 2 4 .. 12 Delirium Tremens .. .. .. .. .. .. .. Insanity 6 .. 12 .. .. .. 18 Carbuncle .. .. 2 .. 3 .. 5 All other Discases 92 16 474 738 768 89 2177 Total 123 16 776 1115 1208 123 3361 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From May 30th, 1870, to July 2nd, 1870. South East District. J South "West District. North District. Total. Number of houses inspected 112 123 .. 235 Drains Constructed 2 .. .. 2 Improved or repaired 18 28 .. 46 Traps Fixed 23 15 .. 38 Cesspools Abolished .. .. .. .. Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 4 1 .. 5 Pan and trap only furished 2 1 .. 3 Water supply Furnished .. 7 .. 7 Dust bins Constructed 2 6 .. 8 Repsired and coves adapted 2 6 .. 8 Surface Drains and Pavements of Yards Constructed • • .. .. .. Repired and covers adapted 35 10 .. 45 General Water Supply New receptacles provided .. 1 .. 1 Receptacles repaired and cleansed 10 16 .. 26 Water supply provided •• • • .. .. Other Improve- ments House generally repaired 19 6 .. 25 „ &c., cleansed or limewashed 89 28 .. 117 ,, ventilated .. 17 .. 17 Overcrowding abated .. 4 .. 4 Illegal use of underground Rooms for sleeping discontinued 2 .. .. 2 Other Amendments, or Nuisances abated 9 2 •• 11 REPORT on the SANITARY CONDITION OF ST. MAM, ISLINGTON, FOR JULY, 1870. No. CLXXIX. Taking the difference of the number of weeks into consideration, the tables for this month show some slight increase of sickness and considerable increase of mortality since the close of June. The number of deaths registered in the four weeks of July was 373, and the number of cases of disease newly treated in the public practice of the parish was 2917. The mortality appears high also, as compared with recent Julies with the exception of July 1868 when 363 deaths were registered. The sickness, however, has been rather less than in July last year, and considerably less than in July, 1868. The spring epidemic of measles has a good deal abated, 110 cases having been recorded against 264 in June, and 18 deaths againt 26. There has been no remarkable difference in the prevalence of scarlet fever, but the mortality from it has fallen from 45 in five weeks to 26 in four weeks. The prevalence of diarrhœal affections has been about double what it was in June : 75 deaths have been registered, and in addition, 11 from summer cholera or choleraic diarrhoea. This last number is unquestionably very high. Twenty-six cases of fever, mostly typhoid, have been recorded, and 9 deaths—again high numbers—a considerable number of cases also have been brought to my knowledge by private practitioners. In nearly all these cases I have traced the origin of the disease to some defect in the arrangement or condition of house drainage, and exposure to sewage effluvia; the attacks in one house appeared to have originated from the use of water contaminated through the waste pipe, and that of one person from the effluvia arising from a neglected dust bin. In one district of the parish typhoid is so prevalent that I requested our Surveyor to take measures for the disinfection of the sewers, while the house drains in the immediate neighbourhood of the infected places were disinfected under my own direction. We found very few persons object to our Inspectors carrying out the sanitary work in private 2 houses under such circumstances. The occasional use of a disinfectant to the closets and house drains when typhoid is prevalent is a wise precaution for householders to adopt, and as crude carbolic acid is that which we employ there would be an advantage if private persons would make use of it also, in preference to other disinfectants. The acid supplied to us by McDougall, Bros, is free from any objectionable smell of sulphide of ammonium. I must call attention to the fact that 1.15 inch of rain has fallen here in the course of the month. The temperature has been above the mean every week. METEOROLOGY OF JULY. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 A.M., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily. Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending July 9th 64.2° 76.0° 56.5° 19.4° 71 0.24 4 „ „16th 66.6° 80.0° 57.9° 22.1° 65 0.33 3 „ „23rd 68.8° 83.4° 59.0° 24.40 62 0.00 0 „ „ 30th 65.5° 79.7° 57.6° 22.0° 77 0.58 2 Means. 66.2° 79.7° 57.7° 21.9° 68 Sum. 1.15 Sum. 9 The highest day temperature, observed on July 22nd .was 92.5°. The lowest night temperature, observed on July 3rd was 49.3°. Thunderstorms on 16th, 26th, and 31st. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, August 6th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 30th JULY, 1870. (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 80 years of age. At 80 years of age and upwards. 190 183 All Causes 373 247 42 49 27 8 20 11 3. Respirat. Orgs. 31 15 3 6 7 ... 2 Laryngitis 2 l 1 ... ... ... (Classes.) 13 5 Bronchitis lb ... ... ... ... ... Pleurisy ... ... ... ... ... 77 93 I. ZYMOTIC DIS 170 149 10 7 3 1 2 4 Pneumonia 6 3 1 ... 2 ... 37 27 II. CONSTITUTE 64 24 20 15 5 ... 1 2 Asthma 3 ... ... ... ... 2 ... Lung Diseases, &c. 2 1 ... ... ... ... 56 45 III. LOCAL 101 48 10 25 16 2 5 10 4- Digestive Orgs. 15 5 2 6 ... 1 19 11 IV. DEVELOPMNL 30 22 ... ... 3 5 ... ... Gastritis ... ... ... ... ... ... 1 2 Enteritis 5 3 ... ... ... ... 1 7 V. VIOLENT DTHS 8 4 2 2 ... ... ... 1 Peritonitis 1 ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... Ulceration of Intcs. ... ... ... ... ... ... ... ... 1 2 Hernia 3 ... ... 2 ... ... (Orders.) ... ... ... ... ... Ileus ... ... ... ... ... ... ... ... Intussusception ... ... ... ... ... ... 69 87 I. 1. Miasmatic Dis. 156 139 9 5 2 1 1 ... Stricture ot lutes- 1 ... ... 1 ... ... 2 2 Small Pox 4 2 l 1 ... ... ... ... Fistula ... ... ... ... ... ... 11 7 measles 18 IS ... ... ... ... ... ... Stomach Dis., &c. ... ... ... ... ... ... 9 17 Scarlatina 26 25 l ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ...... ... ... Hepatitis ... ... ... ... ... ... ... ... Quinsey ... ... ... ... ... ... 1 3 Jaundice 4 2 ... 2 ... ... 1 3 Croup 4 4 ... ... ... ... 1 2 Liver Disease 3 ... ... 1 ... ... 2 3 Hooping Cough 5 b ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 5 4 Typhus & Typhoid 9 3 4 1 1 ... 1 ... 5. Urinary Orgs. 1 ... ... 1 ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... Pycemia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... ... Puerperal Fever .. ... ... ... ... ... 1 ... Nephria 1 ... ... 1 ... ... ... ... Carbuncle ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ...... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... dysentery ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 32 43 Diarrhœa 75 72 ... l l 1 ... Kidney Disease,&c. ... ... ... ... ... ... 5 6 Cholera 11 10 ... 1 ... ... ... 1 6. Genera. Organs l ... ... 1 ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 2 2 Rheumatism 4 ... 3 l ... ... ... I Uterine Diseases 1 ... ... 1 ... ... 1 2 2. Enthetic 3 2 ... 1 ... ... ... ... 7. Orgs. ofLocomo ... ... ... ... ... ... 1 2 Syphilis 2 2 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... 1 Stricture of Urethra 1 ... ... 1 ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... ... Glanders ... ... ... ...1 I ... ... Phlegmon&Abscess ... ... ... ... ... ... 7 2 3. Dietic 9 6 1 1 1 ... ... ... Ulcer ... ... ... ... ... ... 1 ... Privation 1 ... ... 1 ... ... ... ... Skin Diseases ... ... ... ... ... ... 4 2 Want of Br. Milk 6 6 ... ... ... ... ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... .. ... ... ... 1 IV. 1. Die. of Childn 5 5 ... ... ... ... 2 ... Alcoholism 2 ... 1 ... ... ... ... ... Premature Birth 1 l ... ... ... ... ... 2 4. Parasitic 2 2 ... ... ... ... ... ... cyanosis 1 1 ... ... ... ... ... 2 thrush 2 2 ... ... ... ... ... ... spina bifida ... 1 ... ... ... ... ... ... Worms ... ... ... ... ... ... 1 1 ... Other Malformation 1 1 ... ... ... ... ... ... ... ... ... 1 Teething 1 1 ... ... ... ... 6 6 II. 1. Diathetic 12 2 ... 6 4 ... ... 1 2. Dis. of Adults 1 1 ... ... ... ... ... 1 Gout l ... ... 1 ... ... ... ... Paramenia ... ... ... ... ... ... 1 ... dropsy 1 ... ... ... 1 ... ... ... Childbirth 1 1 ... ... ... ... ... ... Hemorrhage ... ... ... ... ... ... ... 1 3. Dis. of Aged 8 ... ... ... ... 5 4 4 Cancer 8 1 ... 5 2 ... 7 1 Old Age 8 ... ... ... ... ... ... ... Noma ... ...... ... ... ... ... 8 8 4. Dis. of Nutritn 16 16 ... ... ... ... 1 1 Mortification 2 l ... ... 1 ... ... Atrophy & Debility 16 16 ... ... ... 31 21 2. Tubercular 52 22 20 9 1 ... ... ... ... ... ... ... 2 ... Scrofula 2 ... l 1 ... ... ... ... V.I. ACCO. PR MEG. 4 1 2 1 ... ... 1 2 Tabes Meaenterica 3 3 ... ... ... ... ... ... Fract. and Contus. 2 ... 1 I ... ... 29 13 Phthisis 33 b 11 8 1 ... ... ... Wounds ... ... ... ... ... ... 8 6 Hydrocephalus 14 14 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... 25 17 III. 1. NervousSyst. 42 28 3 6 4 1 ... 1 Poison 1 ... 1 ... ... ... ... ... Drowning ... ... ... ... ... 4 6 Cephalitis 10 8 2 ... ... ... ... ... suffocat. and Hand 1 1 ... ... ... ... 1 2 apoplexy 3 ... ... ... l ... ... Otherwise ... ... ... ... ... ... 4 2 Paralysis 6 ... 1 ... 3 1 ... 2 2. Homicide 3 3 ...... ... ... ... ... ... Insanity ... ... ... ... ... ... 1 3. Suicide 1 ... ... 1 ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... 1 ... Epilepsy 1 ... ... 1 ... ... ... ... Poison ... ... ... ... ... ... 13 5 Convulsions 18 18 ... ... ... ... ... ... Drowing ... ... ... ... ... ... 2 2 Brain Diseases &c. 4 2 ... 2 ... ... ... Suffocat. and Hang. 1 ... ... 1 ... ... 5 6 2. Oreans of Circ. 11 ... 2 5 4 ... ... ... Otherwise ... ... ... ... ... ... ... 1 Pericarditis 1 ... ... 1 ... ... ... ... 4. Unclassed ... ... ... ... ... ••• ... ... Aneurism ... ... ... ... ... ... ... 5 5 Heart Disease 10 ... 2 4 4 ... TABLE II NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 30th DAY OF JULY, 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox 1 1 5 . . 3 .. 10 Chicken Pox • • .. 5 2 6 .. 13 Measles • • .. 15 44 51 .. 116 Scarlatina • • .. 21 12 3 .. 36 Whooping Cough •* .. 9 6 3 .. 18 Croup .. .. ... .. 90 .. .. Dirrhoea 16 .. 118 3 37 .. Dysentery .. .. 2 1 .. .. 6 Cholera •' .. 1 • • .. .. .. Ague *• .. .. 18 1 .. 26 Continued Fever •* .. 7 .. .. Influenza *• ... •• •• • • .. •• Puerperal Fever •* .. •• •• 1 .. .. Rheumatic Fever • • .. • • • • 5 .. 1 Erysipelas 1 .. 3 2 .. 11 Diptheria • • .. . • • • • • .. •• Sorethroat or Tonsillitis •• .. 12 33 49 1 95 Mumps .. .. 1 •• •• .. 1 Bronchitis and Catarrh i"i .. 65 60 180 22 338 Pneumonia .. .. 3 3 .. 9 Pleurisy • • .. 3 9 1 .. 13 DeliriuDelirium Tremens 5 .. .. • • • • .. 6 Insanity 2 .. .. • • • • .. 7 Carbuncle • • .. • • 1 All other Diseases 100 7 414 595 617 84 1817 Total 136 8 691 922 1016 144 2917 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From Julv 4th. 1870, to July 30th, 1870. South East District. South West District. North District. Total. Number of houses inspected 104 38 109 451 Drains Constructed 1 • • •• 1 improved or repaired 14 20 2 36 Traps fixed 12 4 3 19 Cesspools Abolished 4 • • 1 5 Cleansed or disinfected • • .. •• •• Privies and Water Closets Pan, trap, and water supply furnished 6 •• 1 7 Pan and trap only furnished • • .. Water supply furnished 7 2 •• y Dust bins Constructed .. 1 ..• 1 Repaired and covers adapted •• 3 9 3 Surface Drains and Pavements of Yards constructed • • 1 •• I Relaid 11 12 1 24 General Water Supply New receptacles provided 4 .. 1 5 Receptacles repaired and cleansed 36 47 •• 83 Water supply provided i .. 1 i Other Improve ments Houses generally repaired 10 3 14 „ &c., cleansed or limewashed 124 72 8 204 „ &c., cleansed or limewashed •• 20 •• 20 overcrowding abated 2 1 •• 3 Illegal use of underground Rooms for sleeping discontinued 4 2 •• 6 Other Amendments, or Nuisances abated 9 4 21 34 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON FOR AUGUST, 1870. No. CLXXX. The registered mortality for August, namely 360 deaths, is unquestionably high for the season—that from diseases of the "miasmatic" class especially so. The latter includes 30 deaths from scarlet fever, 23 from continued fever, chiefly typhoid, and 89 bowel affections. The records of public sickness which I tabulate indicate no increase of sickness in the bulk since July, and a total amount of 2939 cases of all kinds, which cannot be regarded as above the average of the season. The table, however, shows an increase of new cases of scarlet fever from 36 to 66 in four weeks, a moderate increase in cases of diarrhoea, and above all that the new cases of continued fever have been doubled in the course of the month. In my last Report I mentioned the occurrence of an outbreak of typhoid in one district of the Parish, which may be roughly defined as extending on both sides of the Holloway Road, from a little to the south of the North London Railway to Hornsey Eoad. Other parts of the Parish have suffered, but not to such an extent. Most of the cases I have on record occurred in respectable families, and were attended by private practitioners. Hence there has been often delay in the transmission of information to our office, and difficulties have arisen in tracing the mode in which the disease has spread. There have been various speculations as to the cause localizing the fever. It may suffice to say, for the present, that in the premises where the earliest cases occurred, we found on investigation, various faults in drainage or old and defective brick drains and cesspools, through which soakage into the soil readily occurred, and in nearly all the houses the waste-pipe of the cistern either communicated with the house drain or with some part of the water closet system. The greater part of the scarlet fever cases happened in the western part of the Parish. 2 METEOROLOGY OF AUGUST. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches, read at 9 A.M., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Aug. 6th 65.7° 77.8° 59.40 18.4° 81 0.42 2 66.7° 80.1° 57.5° 22.°6 69 0.08 2 „ „ 20th 61.6' 75.8° 52.3° 23.4° 64 000 0 ,, 27th 58.2° 70.8° 49.3° 21.5° 65 1.42 3 MEAN8. 63.0° 76.1° 54.6° 214° 69 Sum. 1.92 Sum. 7 The highest day temperature, observed on August 12th, was 85°. The lowest night temperature, observed on August 27th, was 45.8° EDWARD BALLARD, M.D., Medical OJJicar of Health. Vastry Offices, September 9th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 27th AUGUST, 1870. (Deaths of Non-Residents in Hospitals excluded). West S.D. East S.D. Oauses 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. 1 At 20 and under 40 1 years of age. At 40 and under 60 years of age. | At ou and under 80 \ ears of age. At 80 years of age and unwards. 189 171 All Causes 360 241 41 29 41 8 10 5 3. Respirat. Orgs 15 4 1 4 6 ... Laryngitis ... ... ... ... ... ... (Classes.) 4 3 Bronchitis 7 1 ... 2 ... ... ... ... Pleurisy ... ... ... ... ... ... 89 93 I. ZYMOTIC DIS 182 161 11 6 3 1 2 2 Pneumonia 4 3 ... ... ... ... II. CONSTITUTL 84 24 18 8 6 ... ... Asthma ... ... ... ... ... ... 26 28 III. LOCAL 45 ... 4 Lung Diseases, &c. 4 ... 1 2 1 ... 49 29 III. LOCAL 78 24 11 16 23 4 11 6 4. Digestive Orgs. 17 5 2 6 3 1 9 ... 1 Gastritis 1 1 ... ... ... ... 25 21 IV. DEVELOPMNL 46 32 1 1 ... 3 ... 1 Enteritis 1 1 ... ... ... ... ... ... V. VIOLENT DTHS ... ... ... ... ... ... ... Peritonitis ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... 1 1 Ulceration of Intes 2 ... ... 1 1 ... ... ... Hernia ... ... ... ... ... ... ... ... Ileus ... ... ... ... ... ... Orders ... ... Intussusception ... ... ... ... ... ... 85 88 I. 1, Miasmatic Dis. 173 153 11 5 3 1 ... ... Stricture of Intes.. ... ... ... ... ... ... 2 2 Small Poz 4 2 1 1 ... ... ... ... Fistula ... ... ... ... ... ... g 8 Measles 14 14 ... ... ... ... 1 ... Stomach Dis., &e. 1 ... 1 ... ... ... 18 12 Scarlatina 30 29 1 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 2 Diphtheria 2 1 ... 1 ... ... ... 1 Hepatitis 1 ... ... 1 ... ... ... ... Quinsey ... ... ... ... ... ... 3 1 Jaundice 4 4 ... ... 1 ... 1 1 Croup 2 2 ... ... ... ... 6 1 Liver Disease 7 ... ... 4 ... 1 3 2 Hooping Cough 5 5 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 17 6 Typhus & Typhoid 23 15 5 3 ... ... 5 3 6. Urinary Orgs. 8 2 3 2 1 ... 1 1 Erysipelas 2 ... 1 ... 1 ... 1 ... Nephritis 1 1 ... ... ... ... ... ... Pycemia ... ... ... ... ... ... ... 1 Disease of Bladder 1 ... ... ... 1 ... ... 1 Puerperal Fever 1 ... 1 ... ... ... 2 1 Nephria 3 ... 2 1 ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ...**• ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 33 52 Diarrhoea 85 82 ... ... 2 1 2 1 Kidney Disease,&e 3 1 1 1 ... ... Phnlfra 4 3 1 ... ... ... 6. Genera. Organ 1 ... ... ... 1 ... 4 ... A rriip ... ... ... ... ... ... 1 ... Ovarian Dropsy 1 ... ... ... 1 ... ... 1 Rheumatism 1 ... 1 ... ... ... ... Uterine Diseases ... ... ... ... ... ... ... 2 2. Enthetic 2 1 ... 1 ... ... ... 7. Orgs.ofLocomo ... ... ... ... ... ... ... 2 Syphilis 2 1 ... 1 ... ... ... ... Spine Diseases ... ... ... ...... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... 1 8. Skin, &c 1 ... ... 1 ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon&Absees? 2 ... ... ... ... ... 4 3 3. Dietic 7 7 ... ... ... ... ... 1 Ulcer ... ... ... 1 ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 4 3 Want of Br. Milk "7 7 ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 8 7 IV. 1. Dip. ofChildn. 15 15 ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... 5 6 Premature Birth 11 11 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... 1 1 Cyanosis 2 2 2 ... ... ... ... ... ... Thrush ... ... ... ... ... ... 2 Spina Bifida 2 ...... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 2 6 II. 1. Diathetic 11 3 3 2 3 ... 1 ... 2. Dis. of Adults 1 ... 1 ... ... ... ... 1 Gout 1 ... ... l ... ... ... ... Paramenia ... ... ... ... ... ... ... ... Dropsy ... ... ... ... ... ... 1 8 ... Childbirth 1 ... 1 ... ... ... ... Haemorrhage ... ... ... ... ... ... 5 3. Dis. of Aged 13 ... 1 9 3 2 4 Cancer 6 l 2 l 2 ... 8 5 Old Age 13 ... ... 1 9 3 ... ... Name ... ... ... ... ... ... 8 9 4. Dis. of Nutritn 17 17 17 ... ... ... ... 3 1 Mortification 4 2 1 ... 1 ... 8 9 Atrophy & Debility 17 ... ... ... ... 22 2 2. Tubercular Scrofula 43 5 21 5 15 ... 3 ... ... ... 21 3 ... ... ... ... V. 1. Acci. orNeg. ... ... ... ... ... ... 3 1 Tabes Mesenterica 4 4 ... ... ... ... ... ... Fract. and Contu ... ... ... ... ... ... 14 1 15 4 Phthisis 29 7 15 4 3 ... ... ... Wounds ... ... ... ... ... ... Hydrocephalus 5 5 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 13 11 III. 1. NervousSyst. 24 9 3 ... 10 2 ... ... Drowning ... ... ... ... ... ... 1 3 Cephalitis 4 4 ... ... ... ... ... ... Suffocation ... ... ... ... ... ... 1 A nnnlpTv 2 ... 1 ... 1 ... ... ... Otherwise ... ... ... ... ... ... i 5 Pnralvaia 7 ... ... ... 6 1 ... ... 2. Homicide ... ... ... ... ... ... 2 3 ... Insanity 3 ... 2 ... 1 ... ... ... 3. Suicide ... ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... 1 Epilepsy 1 ... ... ... ... 1 ... ... Poison ... ... ... ... ... ... 4 ... Convulsions 4 4 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 3 Brain Diseases, &c. 3 1 ... 2 ... ... ... Suft'ocat. and Hang. ... ... ... ... ... ... 2 9 3 2. Organs of Circ. 12 4 2 3 2 1 ... ... Otherwise ... ... ... ... ... ... 1 Pericarditis 1 1 ... ... ... ... ... 4. Uuclassed ... ... ... ... ... ... ... 1 Aneurism 1 ... ... ... 1 8 2 Heart Disease 10 3 2 3 2 ... TABLE II. NEW CASES OP DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY. THE 27th DAY OF AUGUST 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Pauper6. Hollo way Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 6 1 5 .. 12 Chicken Pox .. .. . . 8 5 .. 13 Measles .. .. 18 28 20 ,. 66 Scarlatina .. .. 12 20 17 .. 49 Whooping Cough .... .. 5 2 11 .. 18 Croup .. .. .. .. 1 .. 1 Diarrhoea 18 .. 108 137 151 43 457 • • .. 1 1 .. 2 Cholera .. .. .. .. .. .. • • Ague .. .. 1 .. 14 2 3 Continued Fever M .. 12 25 .. 51 Influenza . . .. aa .. .. .. .. Puerperal Fever .. .. 1 .. • • .. 1 Rheumatic Fever . . .. . , 1 2 .. 3 Erysipelas • • .. 3 2 7 .. 12 Diphtheria •• .. .. .. • • .. .. Sorethroat or Tonsillitis • • .. 15 25 38 1 79 Mumps • • .. 1 .. • • .. 1 Pyaemia •• .. .. .. >• .. .. Bronchitis and Catarrh 10 .. 50 47 175 17 299 Pneumonia .. .. 4 3 3 ., 10 Pleurisy .... .. 1 6 3 .. 10 Delirium Tremens .. .. 1 1 .. .. 2 Insanity 4 .. 6 .. .... .. 10 Carbuncle .. .. .. 3 .. 3 All other Diseases 82 12 449 584 610 90 1827 Total 114 12 693 891 1066 153 2929 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From July 31st, 1870, to August 27th, 1870. [ South East District. south District. North District. Total. Number of bouses inspected 72 79 75 226 Drains Constructed 1 2 1 4 Improved or repaired 14 14 2 30 Traps fixed 23 8 3 34 Cesspools Abolished 2 .. .. 2 Cleansed or disinfected .. .. 1 1 Privies and Water Closets Pan. trap, and water supply furnished 3 1 .. 4 Pan and trap only furnished .. 8 . . 8 Water supply furnished 8 2 .. 10 Dust bins Constructed 2 4 . . 6 Repaired and covers adapted 2 1 • • 3 Surface Drains and Pavements of Yards Constructed . . 1 . . 1 Relaid 12 6 2 20 General Water Supply New receptacles provided 3 1 • • 4 Receptacles repaired and cleansed 16 24 . . 40 Water supply provided • • .. 2 2 Other Improve¬ments Houses generally repaired 2 1 4 7 „ &c., cleansed or limewashed 42 43 6 91 „ ventilated .. • • •• . . Overcrowding abated 2 . . . . 2 Illegal use of underground Rooms for sleeping discontinued 1 1 .. 2 Other Amendments, or Nuisances abated 9 4 29 42 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON, FOE, SEPTEMBER, 1870. No. CLXXXI. The general mortality in the Parish during September, viz.: 328 deaths, has been unusually small: when the increase in population is kept in mind, it has been lower than that of any September since 1862. Nor can it be said that the public sickness on the whole has been excessive. Kegarding, however, the sickness and mortality more in detail, it is to be observed that scarlet fever has been advancing, as it so often does at this season of the year, and threatens us with an autumnal epidemic; and that the diseases grouped together under the term 'continued fever,' have been unusually prevalent, and have also made an unusually strong mark upon our mortuary table. In the records of public sickness forwarded to me, the diseases thus grouped are not distinguished; but from the inquiries I have made, it appears that while some of these were decided cases of typhoid, a good many were attacks of mild fever probably also of an enteric character. The 18 deaths recorded were, with the exception perhaps of two, cases of typhoid; and of the 16 thus registered, six were the result of the localized outbreak which I mentioned in my last Report. Of the remainder, distributed in various parts of the Parish, there were two or three deaths of persons who brought the disease with them from the country, or from situations in the city where they were in domestic service. With respect to the Holloway outbreak of typhoid, which has attracted a great deal of attention in tbe neighbourhood, it is satisfactory to know that it has been at an end for some weeks, so far as the invasion of fresh bouses is concerned, and that I have spared no pr.ins in making a searching inquiry into its origin. I believe, with the assistance of the private practitioners in the neighbourhood, to 2 whom my own acknowledgments and those of the Sanitary Committee are due, I have now a pretty correct list of all the cases that have occurred in connection with it. The cases amount to about 160, and although, in the houses where the first cases that came to my knowledge occurred, there were some flagrant sanitary defects which were calculated to promote the occurrence of fever, I am satisfied that in other instances, and probably the major part of them, the invasion of fever was due to a cause with which this class of defects had little or nothing to do. My inquiries into the cause of the extension of the fever have therefore been pursued in quite a different direction. They are not yet completed, but so far as they have gone, they point to nothing which requires any further action than that which has been already taken. Both the cause and the effect have ceased to exist. METEOLOROGY OF SEPTEMBER. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Tempera. tuxes. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Sept. 3rd 58.5° 70.6° 49.9° 20.6° 72 0.29 4 „ „ 10th 57.9° 65.2° 61.9° 133° 70 1.49 5 „ 17 th 55.1° 65.1° 46.5° 18.6° 69 0.23 1 „ 24th 56 2° 68.1° 46.6° 21.5° 76 o.oo 0 „ October 1st 57.6° 72.5° 47'0° 25.6° 82 0.00 0 Means. 57.0° 68.2° 48.3° 19.9° 73 Sum. 201 Sum. 10 The highest day temperature, observed on September 28th 29th was 75°. The lowest night temperature, observed on September 16th, was 40°. EDWARD BALLARD, M.D., Medical Officer of Health. Yestry Offices, October 9th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING 1st OCTOBER, 1870. (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. 170 158 All Causes 328 191 46 40 41 10 14 13 3. Respirat. Orgs. 27 17 2 2 6 ... 1 Laryngitis 1 1 ... ... ... ... (Classes.) 11 9 Bronchitis 20 11 ... 2 6 ... ... ... Pleurisy ... ... ... ... ... 66 52 I. ZYMOTIC DIS 118 97 11 5 4 1 3 3 Pneumonia 6 5 ... ... 1 ... 34 30 II. CONSTITUTE 64 26 19 15 4 ... ... Asthma ... ... ... ... ... ... ... ... Lung Diseases, &c. ... ... ... ... ... ... 47 57 III. LOCAL 104 44 11 19 28 2 8 9 4- Digestive Orgs. 17 6 ... 7 5 ... 16 17 IY. DEVELOPMNL 33 20 1 ... 5 7 1 ... Gastritis 1 1 ... ... ... 1 ... Enteritis 1 1 ... ... ... ... 7 2 V. VIOLENT DTHS 9 4 4 1 ... ... ... ... Peritonitis ... ...... ... ... ... ... ... ... ... Ascitea ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) ... ... 1 Ileus 1 ... ... ... 1 ... ... ... ... Intussusception ,, ... ... ... ... ... ... 50 I. 1. Miasmatic Sis. 112 91 11 5 4 1 1 1 Stricture of Intea 2 1 ... ... 1 ... 4 ... Small Pox 4 »j 2 ... ... ... ... Fistula ... ... ... ... ... ... 6 1 Measles 7 7 ... ... ... 1 2 Stomach Dis., &c. 3 ... ... 3 ... ... 22 24 Scarlatina 46 44 2 ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 1 2 Diphtgheria 3 3 ... ... ... ... ... 1 Hepatitis 1 ... ... 1 ... ... ... ... Quinsey ... ... ... ... ... ... 1 Jaundice 1 1 ... ... ... ... ... 1 Croup 1 1 ... ... ... ... 4 3 Liver Disease 7 1 ... 3 3 ... ... 1 Hooping Cough I 1 ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 12 6 Typhus & Typhoid 18 7 5 4 1 4 8, 5. Urinary Orgs. 6 1 ... 2 2 ... ... ... Erysipelas ... ... ... ... ... 1 ... Nephritis 11 ... ... I ... ... ... ... Pyoemia ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... 2 Puerperal Fever 2 ... ... ... ... ... 1 ... Nephria 1 ... ... 1 ... ... ... Carbuncle ... ... ... ... ... 1 ... Diabetes 1 ... ... 1 ... ... ... ... Influencza ... ... ... ... ... ... 1 Stone 1 ... ... ... 1 ... ... 1 Dysentery 1 1 ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 17 12 Diarrhoea 29 25 ... 1 2 1 1 1 Kidney Disease,&c. 2 1 ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... ... ... Rheumatism ... ... ... ... ... ... ... ... Uterine Diseases ... ... ... ... ... ... 1 ... 2. Enthetic 1 1 ... ... ... ... ... ... 7. Orgs.ofLocomo ... ... ... ... ... ... 1 ... Syphilis 1 1 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 1 1 8. Skin, &c 2 1 ... ... 1 ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon&Abscess ... ... ... ... ... ... 3 1 3. Dietic 4 4 ... ... ... ... 1 ... Ulcer 1 ... ... ... 1 ... ... ... Privation ... ... ... ... ... ... ... 1 Skin Diseases 1 1 ... ... ... ... 3 1 Want of Br. Milk 4 4 ... ... ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 5 1 IV. 1. Dis. of Childn. 6 6 ... ... ... ... ... Alcoholism ... ... ... ... ... ... 5 1 Premature Birth 6 6 ... ... ... 1 4. Parasitic 1 1 ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... l Thrush 1 1 ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... Teething ... ... ... ... ... ... 8 3 II. 1. Diathetic •••• 11 I 2 5 3 ... 1 ... 2. Dis. of Adults . 1 ... 1 ... ... ... 2 1 Gout 3 ... ... 3 ... ... ... ... Paramenia ... ... ... ... ... ... ... Dropsy ... ... ... ... ... ... 1 ... Childbirth 1 ... 1 ... ... ... ... ... Hemorrhage ... ... ... ... ... ... 6 6 3. Dis. of Aged 12 ... ... ... 5 7 3 1 Cancer 4 ... 2 1 l ... 6 6 Old Age 12 ... ... ... 5 ... ... ... Noma ... ... ... ... ... ... 4 10 4. Dis. of Nutritn. 14 14 ... ... ... ... 3 1 Mortification 4 1 ... 1 2 ... 4 10 Atrophy & Debility 14 14 ... ... ... ... 26 27 2. Tubercular 53 25 17 10 1 ... — 2 ... Scrofula 2 2 ... ... ... ... 4 2 V. 1. Acci.orNeg. 6 3 2 1 v ... 3 3 Tabes Mesenterica 6 ... ... ... ... 1 Fract. an d Contus. 3 1 1 1 ... ... 18 19 Phthisis 37 9 17 10 1 ... ... ... Wounds ... ... ... ... ... 3 5 Hydrocephalus 8 8 ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... Poison ... ... ... ... 13 21 III. 1. NervousSyst 34 18 5 3 7 1 ... ... Drowning 2 1 1 ... ... 2 6 Cephalitis 6 6 2 ... ... ... ... l suffocation 1 I ... ... ... 3 3 Apoplexy 6 2 1 1 2 ... ... ... Otherwise ... ... ... ... ... 3 2 Paralysis 5 ... 1 1 2 1 1 ... 2. Homicide 1 1 ... ... ... 2 ... Insanity 2 ... 1 ... 1 ... 2 ... 3. Suicide 2 ... 2 ... ... ... ... Chorea ... ... ... ... ... ... 1 ... Wounds l ... 1 ... ... ... ... Epilepsy ... ... ... ... ... ... 1 ... Poison 1 ... 1 ... ... 3 ... Convyusions 10 10 ... ... ... ... ... Drowning ... ... ... ... ... ... 3 Brain Diseases, &c. 3 ... ... 1 2 ... ... ... Suffocat. and Hang. ... ... ... ... ... 7 11 2. Organs of Circ 18 2 3 5 7 1 ... ... Otherwise ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... Aneurism ... ... ... ... ... 7 11 Heart Disease 18 2 3 5 7 1 TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING T1IE FIVE WEEKS ENDING SATURDAY. THE 1st DAY OF OCTOBER 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox .. .. 9 4 .. 13 Chicken Pox .. .. 2 9 6 .. 17 Measles .. .. 5 32 36 .. 53 Scarlatina .. .. 19 51 13 .. 83 Whooping Cough 1 .. 3 .. 6 .. 12 Croup . . .. 2 .. 1 .. 3 Diarrhoea 6 .. 41 73 43 31 194 Dysentery .. .. 1 2 1 .. 4 Cholera .. .. .. • • .. •• Ague 2 .. 1 1 33 3 7 Continued Fever 3 ... 9 32 .. 77 Influenza .. .. .. •• .. •• Puerperal Fever .. .. .. .. •• .. •• Rheumatic Fever • • .. 1 2 4 .. 7 Erysipelas 2 .. 10 1 8 3 .. 21 Diphtheria .. .. .. 46 .. 3 Sorethroat or Tonsillitis .. .. 28 54 1 129 Mumps .. .. 1 • • 1 .. 2 Pyaemia • • .. ., •• • • .. •• Bronchitis and Catarrh 19 • • 127 167 236 41 590 Pneumonia .. .. 4 3 2 .. 9 Pleurisy .. 3 11 7 .. 21 Delirium Tremens 1 .. .. • • • • .. 1 Insanity 7 .. 8 .. .. .. 15 Carbuncle .. .. 3 1 2 .. 6 All other Diseases 78 18 546 735 819 138 2334 Total 119 20 823 1166 1259 214 3601 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From August 29th, 1870, to October 1st, 1870. South East District. South "West District. North District. Total. Number of houses inspected 119 215 95 429 Drains Constructed 2 2 Improved or repaired 7 8 8 23 Traps fixed 3 6 1 19 Cesspools Abolished .. .. 2 2 Cleansed or disinfected . . .. 1 1 Privies and Water Closets Pan, trap, and water supply furnished 1 .. 2 3 Pan and trap only furnished .. .. 3 3 Water supply furnished 1 3 3 7 Dust bins Constructed ,, 1 1 2 Repaired and covers adapted • • •• 5 5 Surface Drains and Pavements of Yards Constructed .. .. 1 1 Relaid 1 6 3 10 General Water Supply New receptacles provided .. .. .. .. Receptacles repaired and cleansed 10 7 .. 17 Water supply provided •- .. • • .. Other Improve ments house generally repaired 3 1 11 15 „ &c., cleansed or limewashed 19 5 11 35 ,, ventilated .. .. • • • • Overcrowding abated 3 .. 1 4 Illegal use of underground Rooms for sleeping discontinued .. .. .. .. Other Amendments, or Nuisanceg abated 1 5 32 38 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON. FOR OCTOBER, 1870. No. CLXXXII. Neither the general public sickness nor the mortality can be regarded as having been excessive during the past month. The 308 deaths registered were less numerous than in October last year by 20, and only 13 more than in October, 1868. The 2945 cases of public sickness recorded were exceeded considerably in each of the preceding four Octobers. Of the contagious diseases, small-pox and scarlet fever have been most prevalent. The cases of small-pox newly met with having been 31 against 13 in the five weeks of September, and those of scarlet fever 72 against 83 in five weeks. The deaths from scarlet fever have amounted to 60. Sixty-eight cases of fever have been reported, mostly typhoid. I have heard of one or two cases of relapsing fever among the poor. Pulmonary affections have run up to a high number of cases, unusually early this year; 701 cases of bronchitis and catarrh, 28 of pneumonia and 17 of pleurisy, form a total very far larger than the highest total of cases which I have yet recorded in October, viz:—482 in 1868. In the presence of rapidly-advancing smallpox, I cannot urge too strenuously upon all persons above the age of 15 or 16 years, the importance of renewing their protection by revaccination. Under the new regulations, infants are now looked after, and we must hope that few will escape protection, but all young persons from the ages mentioned, are still liable to attack, notwithstanding their vaccination, although much less liable than if they had never been vaccinated at all. It is the ages from about 16 to 26 years, which in a vaccinated population furnish the large majority of cases, during the epidemic season. Domestic precautions are the most effectual in preventing the spread of scarlet fever They are fully detailed in the Papers issued from our Office, We afford every assistance and advice in our power to persons desirous of carrying them into effect.+ 2 METEOROLOGY OF OCTOBER. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches read at 9 A.M., Collected on the ground. Sum. Number of days ich Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Oct. 8th 54.7° 64.5° 47.6° 17.0° 86 0.18 2 47.6° 574° 39.9° 17.5° 75 0.33 5 „ 22nd 49.9° 56.9° 43.6° 13.3° 78 1.70 6 „ „ 29th 48.5° 53.6° 44.90 8.8° 82 0.85 4 Means. 50.1° 58.1° 44.0° 14.1° 80 Sum. 306 Sum, 17 The highest day temperature, observed on October 3rd was 71°. The lowest night temperature, observed on October 15th, was 33°, Gales of wind on 12th, 13th, 20th, and 21st. Thick fog in forenoon of 15th. Extraordinary display of Aurora Borealis on evening of 24th, and again on evening of 25th. EDWARD BALLARD, M.D., Medical Officer of Health. Vestry Offices, November 7th, 1870. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 29th OCTOBER, 1870. (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 aire. At 60 and under 80 years of age. At 80 years oi age and upwards. 153 155 All Causes 308 176 38 45 39 10 28 24 3. Respirat. Orgs. 5 32 4 5 9 2 1 Larvnpitis 1 1 ... ... ... ... (Classes.) 17 15 Bronchitis 3-2 23 ... ... 5 2 1 1 Pleurisy '2 ... 2 ... ... ... 75 11 7 6 1 8 7 Pneumonia 15 8 '2 2 3 ... 51 16 3 1 ... Asthma 1 ... ... ... 1 ... 33 24 II. CONSTITUTL 57 19 1 1 ... Lung Diseases. &c. 1 ... ... 1 ... ... 48 67 III. LOCAL 115 57 8 18 28 4 5 11 4 Digestive Orps. 16 4 2 7 3 ... 2 2 4 1 1 Gastritis '2 l ... 1 ... ... 18 12 lV, DEVELOPMNL 30 1 ... 2 1 Enteritis 3 2 ... ... 1 ... 3 3 V. VIOLENT DTHS 6 5 1 ... ... ... ... 1 Peritonitis 1 ... 1 ... ... ... 1 ... ... ... ... ... ... Ascites ... .. ... ... ... ... ... ... Not Specified ... ... ... ... ... 1 Ulceration of Jntes. 1 ...] 1 ... ... 1 ... ... Hernia ... ... ... ... ... ... (Orders.) ... 1 Ileus ] ... ... 1 ... 1 1 Intussusception 2 1 ... l ... ... 49 47 I. 1. Miasmatic Dis 96 73 11 8 6 1 ... ... Stricture of Inte ... ... ... ... ... ... l 2 Small Pox 3 ... 1 2 ... ... ... ... Fistula ... ... ... ... ... ... 1 ... Measles 1 ... ... ... ... ... ... 1 Stomach Dis., &c. 1 ... ... 1 ... 27 33 Scarlatina 60 54 ... ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... 2 ... Diphtheria 2 21 ... ... ... ... ... ... Hepatitis ... ... ... ... ... ... ... 1 Quinsey 1 1 ... ... ... ... ... 2 Jaundice 2 ... ... 1 1 ... 1 Croup 1 1 ... ... ... ... 1 2 Liver Disease 3 ... ... 2 l ... 1 ... Hooping Cough 1 1 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... 10 3 Typhus & Typhoid 13 5 3 3 2 ... ... 3 5. Urinary Orgs 3 ... 1 1 1 ... 1 ... Erysipelas 1 ... ... ... 1 ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyoemia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... Puerperal Fever ... 1 ... ... ... ... ... 2 Nephria 2 ... 1 1 ... ... ... ... Carbuncle ... I ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... 1 Dysentery 1 1 ... ... ... ... ... ... Prostrate Disease . ... ... ... ... ... ... 4 5 Diarrhoea 9 7 ... ... 1 1 ... 1 Kidney Disease,&c. 1 ... ... ... 1 ... ... Cholera ... ...... ... ... ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... 2 1 Rheumatism 3 ... ... ... 2 ... ... ... Uterine Diseases ... ... ... ... ... ... 1 ... 2. Enthetic 1 1 ... ... ... ... ... ... 7. Orgs.ofLocomo ... ... ... ... ... 1 ... Syphilis 1 1 ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 1 2 8. Skill, &c 3 3 ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon&Abscess ... ... ... ... ... 1 2 3. Dietic 3 1 ... 2 ... ... ... 1 Ulcer 1 1 ... ... ... ... ... ... Privation ... ... ... ... ... ... 1 1 Skin Diseases 2 2 ... ... ... ... 1 ... Purpura and Scurvy 1 ... ... 1 ... ... 6 3 IV. 1. Dis. of Childn. 9 9 ... ... ... ... ... l Alcoholism ... ... ... 1 ... ... 5 3 Premature Birth 8 8 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ...... Worms ... ... ... ... ... ... 1 ... Other Malformation 1 1 ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 6 9 II. 1. Diathetic 15 2 ... 9 3 1 2 ... 2. Dis. of Adults 2 ... 2 ... ... ... ... Gout 1 ... ... l ... ... ... ... Paramenia ... ... ... ... ... ... 1 1 Dropsy 2 1 ... ... ... 1 2 ... Childbirth 2 ... 2 ... ... ... 1 ... Hiemorrhage 1 ... ... 1 ... ... 3 4 3. Dis. of Aged 7 ... ... 1 2 4 1 6 Cancer 8 ... ... 5 3 ... 3 4 old age 7 ... ... 1 2 4 2 ... Noma ... ... ... ... ... ... 7 5 4. Dis. of Nutritn. 12 12 ... ... ... ... 1 2 Mortification 3 1 ... 2 ... ... 7 5 Atrophy & Debility 12 12 ... ... ... ... 27 15 2. Tubercular 42 16 16 10 ... ... ... 3 ... Scrotula 3 3 ... ... ... ... 2 2 V. 1. Acci. orNeg. 4 4 ... ... ... ... 1 2 Tabes Mesenterica 3 3 ... ... ... ... ... 1 Fract. and Contus. 1 1 ... ... ... ... 18 11 Phthisis 29 ... 16 ... ... ... ... ... Wounds ... ... ... ... ... ... 5 2 Hydrocephalus 7 7 ... ... ... ... ... 1 Burns and Scalds 1 1 ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 10 22 III. 1. HervousSyst 32 18 ... 3 11 ... ... ... Drowning ... ... ... ... ... ... ... 4 Cephalitis 4 4 ... ... ... ... 2 ... Suffocation 2 2 ... ... ... ... 1 3 Apoplexy 4 ... ... 1 ... ... ... ... Otherwise ... ... ... ... ... ... 2 3 Paralysis 5 ... ... 1 4 ... ... 1 2. Homicide 1 1 ... ... ... ... ... ... Insanity ... ... 1 ... ... ... 1 ... 3. Suicide 1 ... 1 ... ... ... ... ... Chorea ... ... 1 ... ... ... 1 ... Wouuds 1 ... 1 ... ... ... ... ... Epilepsy ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 4 10 Convulsions 14 14 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 3 2 Brain Diseases, &e. 5 ... ... 1 4 ... ... ... Suffocat.and Hang. ... ... .... ... ... ... 4 55 2. Organs of Circ. 9 ... 1 2 4 2 ... ... Otherwise ... ... ... ... ... ... ... 1 Pericarditis 1 ... ... ... ... 1 ... ... 4. Unclassed ... ... ... ... ... ... 1 ... Aneurism 1 ... ... 1 ... ... ... ... 3 4 Heart Disease 7 ... 1 1 4 1 TABLE II. NEW CASKS OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 29th DAY OF OCTOBER 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison | Total. Small Pox 2 .. 16 4 9 .. 31 chicken Pox .. .. 4 8 • • .. 12 Measles .. .. 2 12 21 .. 35 Scarlatina .. .. 29 29 14 .. 72 Whooping Cough .. .. 4 14 9 .. 27 Croup .. .. .. 2 2 .. 4 Diarrhoea .. .. 13 27 27 10 79 Dysentery .. .. 2 I .. 3 Cholera .. .. .. .. • • .. •• Ague .. .. .. 2 1 2 5 Continued Fever .. .. 19 20 28 .. 68 Influenza .. .. .. .. • • .. .. Puerperal Fever .. .. 1 .. •• ... 1 Rheumatic Fever .. .. .. 2 .. .. 2 Erysipelas .. .. 8 5 2 .. 16 Diphtheria .. .. .. • • • • .. • • Sorethroat or Tonsillitis .. .. 19 48 65 .. 132 Mumps .. .. .. • • • • .. •. Pyaemia .. .. • • .. • • .. . • Bronchitis and Catarrh 21 .. 197 197 258 28 701 Pneumonia .. .. 10 8 10 .. 28 Pleurisy .. .. 2 7 8 .. 17 Delirium Tremens 1 .. 1 • • .. .. 2 insanity 7 .. 9 .. .. .. 16 Carbuncle .. .. a. 3 2 .. 5 All other Diseases 61 8 394 555 568 103 1689 Total 96 8 730 943 1025 143 2945 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From October 3rd, 1870, to October 29th. 1870.N South I East District. South West District. North District. Total. Number of houses inspected 101 110 52 263 Drains Constructed 1 2 4 7 19 9 7 35 Traps fixed 13 15 4 32 Cesspools Abolished 3 .. 2 5 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan. trap, and water supplv furnished .. 4 .. 2 6 Pan and trap onlv furnished • • .. 3 3 Water supply furnished 6 2 10 18 Dust bins Constructed .. .. a. .. Repaired and covers adapted 4 .. 4 8 1 Surface Drains and Pavements of Yards Constructed .. 1 .. Relaid 31 67 23 121 General Water Supply New receptacles provided .. 1 1 2 Receptacles repaired and cleansed 72 2 3 77 Water supply provided .. ,, ., .. Other Improve ments Houses generally repaired .. .. 13 13 ,, &c., cleansed or limewashed 187 60 47 2114 ,, ventilated .. .. .. Overcrowding abated .. .. 1 1 Illegal use of underground Rooms for sleeping discontinued.... • • .. .. •• Other Amendments, or Nuisances abated 7 9 59 75 | * The whole of the Slaughter and Cow Houses, and some of the Bake-houses were also inspected durin the mont REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON. FOR NOVEMBER, 1870. No. CLXXXIII. Considering the increase of our population, the 339 deaths recorded in November would appear to correspond with our expectations.—In the five previous years the numbers were 277, 333, 309, 318, and 396. The public sickness too has on the whole been less than in 1868 (3,278) and in 1869 (3,206.) The two contagious or epidemic diseases which were reported as spreading in October have advanced during November.—Small-pox has furnished to our table of public sickness 35 cases against 31 last month, still it is not yet so prevalent as it was in November, 1866, when 50 cases were recorded. Neaily all the pauper cases were sent to Hospital. The deaths from small pox have been 13, the largest number yet registered in any November. Small-pox has been chiefly observed in the district of Upper Holloway, but towards the close of the month a good many cases have occurred in Lower Holloway. There have been 81 cases of scarlet fever, against 72 last month. The fatal cases recorded have been 65, a number which is 9 more than in November last year. It is only during the month of November that I have been able to complete the laborious investigation of the outbreak of Typhoid, which occurred in Holloway during the summer. The facts I have succeeded in gathering, prove conclusively that it was distributed by milk proceeding from a particular dairy. Those families suffered first who were exposed, in addition, to nuisances of local or domestic origin. This startling result is pregnant with grave practical inferences, but it will be convenient to deler entering upon details until the issue of my Annual Hi port. 2 METEOROLOGY OF NOVEMBER. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches read at 9 A.M., Collected on the ground. Sum. Number of days on which. Rain fell in appreciable quantity Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Nov.5th 45.8° 53.2° 39 8° 13.4° 89 0.05 3 » 12th 39.2° 44.70 35-2° 9.5° 85 0.09 2 „ „ 19th 36.o° 43.1° 30 9° 12.2° 88 0.29 4 » 26th 47.0° 52.5° 40-9° 11.6° 81 1.35 6 Means. 42.1° 48.3° 36.7° 11.6° 85 Sura. 2.28 Sum. 15 The highest day temperature, observed on November 1st was S6°. The lowest night temperature, observed on November 19th, was 27°. Remarkable darkness with fog at Mid-day, on November 9th. Snow fell on 10th and 13th. Thunder and Lightning with violent storms of wind and rain at intervals on November 22nd. EDWARD BALLARD, M.D., Medical Officer of Health. Vostry Offices, December 5th, 1S70. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING 26th NOVEMBER, 1870. (Deaths of Nod-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 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 and under 8r> years of age. At 80 years of age and upwards. 165 184 All Causes 339 189 46 45 49 10 48 39 3. Resoirat. Orgs. 87 50 4 16 17 ... 1 Larvngitis 1 1 ... ... ... (Classes.) 30 26 Bronchitis 50 31 2 10 13 ... Pleurisy ... ... ... ... ... ... 52 67 I. ZYMOTIC DIS 119 92 19 6 ... ?, 14 9 Pneumonia 23 18 2 1 2 ... 2 3 Asthma 5 ... ... 4 1 ... 20 2b II. CONSTITUTE 48 20 14 9 4 1 1 1 Lung Diseases, &c. 2 ... ... 1 1 ... 69 76 III. LOCAL 145 60 11 29 40 5 4 5 4. Digestive Or^s. 9 1 2 4 2 ... ... ... Gastritis ... ... ... ... ... ... 13 12 IV. DEVELOPMNL 25 17 2 ... 2 1 ... i Enteritis l ... ... 1 ... ... 1 1 V. VIOLENT DTHS 2 ... 1 1 ... ... 1 Peritonitis 1 ... ... 1 ... ... . I ... ... l Ascites l ... ... ... 1 ... ... ... Not Specified ... ... ... ... ... 1 ... Ulceration of Intes. 1 ... ... 1 ... ... ... ... Hernia ... ... ... ... ... ... (Orders.) | ... ... Ileus ... ... ... ... ... ... ... 1 Intussusception 1 ... 1 ... ... ... 51 63 I. 1. Miasmatic Dis 114 88 19 5 ... 2 ... ... Stricture of Inte . ... ... ... ... ... ... 8 5 Small Pox 13 6 6 1 ... ... ... ... Fistula ... ... ... ... ... ... 1 3 Measles 4 4 ... ... ... ... ... ... Stomach Dis., &c. ... ... ... ... ... ... 28 37 Scarlatina 65 62 3 ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... ... Diphtheria ... ... ... ... ... ... ... Hepatitis ... ... ... ... ... ... ... ... Quinsey ... ... ... ... ... I 1 Jaundice 2 1 1 ... ... ... ... 3 Croup 3 ... ... ... ... I 1 Liver Disease 2 ... ... 1 1 ... I 2 Hooping Couerh 3 3 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 8 5 Typhus & Typhoid 13 6 1 ... ... 2 5 5. Urinary Orgs. 7 ... ... 5 2 ... 1 1 Ervsipelas 2 ... 2 ... ... ... ... Nephritis ... ... ... ... ... ... ... 1 Pycemia 1 i ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... 2 Puerperal Fever 2 ... 2 ... ... ... ... 3 Nephria 3 ... ... 2 1 ... 1 ... Carbuncle 1 1 ... ... ... ... 1 Diabetes 1 ... ... 1 ... ... ... ... Influenza ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dvsentery ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 2 2 Diarrhoea 4 ... ... ... 2 2 1 Kidney Disease,&c. 3 ... ... 2 1 ... ... ... Cholera ... ... ... ... ... ... ... ... 6. Genera. Organs ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 1 2 Rheumatism 3 i 1 1 ... ... ... ... Uterine Diseases ... ... ... ... ... ... ... 1 2. Enthetic 1 l ... ... ... ... ... ... 7. Orgs.ol'Loeomo ... ... ... ... ... ... ... 1 Syphilis 1 l ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... 1 ... 8. Skin, &c 1 ... ... ... 1 ... ... ... Glanders ... ... ... ... ... ... ... Phlegmon&Abscess ... ... ... ... ... ... 2 Dietic 3 2 ... 1 ... ... ... ... Ulcer ... ... ... ... ... ... 1 ... Privation ... ... ... ... ... 1 ... Skin Diseases 1 ... ... ... 1 ... 1 1 Want of Br. Milk Purpura and Scurvy 2 2 ... ... ... ... 7 3 IV. 1. Di«. ofChildn. 10 10 ... ... ... ... ... ... Alcoholism 1 ... 1 ... ... 6 2 Premature Birth 8 8| ... ... ... ... ... 1 4. Parasitic 1 ... ... ... ... 1 Cyanosis 1 1 1 ... ... ... ... ... 1 Thrush 1 1 ... ... ... ...... 1 ... Spina Bifida l l ... ... ... ... ... ... worms ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... ... ... ... Teething ... ... ... ... ... ... 3 3 Li. 1. Diathetic 6 ... 3 2 1 2 1 2. Dib. or Adults 3 1 2 ... ... ... ... ... Gout ... ... ... ... ... ... ... Paramenia ... ... ... ... ... ... 1 1 Dropsy 2 ... 1 ... 1 2 1 Childbirth 3 1 2 ... ... ... ... ... Hemorrhage ... ...... ... ... ... 4 2 3. Dis. ol Aged 6 ... ... ... 4 2 2 2 Cancer 4 ... 2 2 ... 4 2 Old Age 6 ... 1 ... 4 2 ... ... Noma ... ... ... ... ... ... 6 4. Dis. of Nutritn. 6 6 ... ... ... ... ... ... Mortification ... ... ... ... ... 6 Atrophy & Debility 6 6 ... ... ... ... 17 25 2. Tubercular 42 20 14 6 2 ... ... ... ... ... 1 Scrofula 1 1 ... ... ... ... ... 1 V. 1. Acci.orNeg. 1 ... ... ... 1 ... 1 3 Tabes Mesecterica 4 4 ... ... ... ... ... 1 Fract. and Contua. 1 ... ... ... 1 ... 12 16 Phthisis 28 6 14 6 2 ... ... ... Wounds ... ... ... ... ... ... 4 5 Hydrocephalus 9 9 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 10 13 11.1. Nervous Sys 23 9 4 2 3 5 ... ... Drowning ... ... ... ... ... ... ... 3 Cephalitis. 3 2 ... ... i ... ... ... Suffocation ... ... ... ... ... ... 3 3 Apoplexy 6 ... 2 1 1 2 ... ... Otherwise ... ... ... ... ... ... 1 2 Paralysis 3 ... 1 ... 1 i ... ... 2. Homicide ... ... ... ... ... ... 2 ... Insamtv 2 1 ... ... 1 1 ... 3. Suicide 1 ... ... 1 ... ... ... ... Chorea ... ... ... ••• ... ... ... ... Wounds ... ... ... ... ... ... 2 ... hpilepoy 2 ... l I ... ... 1 ... POISOn 1 ... ... 1 ... ... 2 ... Convulsions 6 6 ... ... ... ... ... ... Drowning ... ... ... ... ... ... ... 1 Brain Diseases, &c. 1 ... ... ... ... 1 ... ... Sutfocat. and Hang. ... ... ... ... ... ... 4 14 2. Organs of Oirc 18 ... 1 2 15 ... ... ... Otherwise ... ... ... ...1 ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Uuclassaed ... ... ... ...1 ... ... ... ... Aneurism ... ... ... ... ... ... 4 14 Heart Disease 18 ... I 2 15 ... .. TABLE ii NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 26th DAY OF NOVEMBER 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Hollo way Dispensary. Islington Dispensary. Pen ton vi lie 'Jonvict Prison Total Small Pox 1 .. 23 10 2 .. 36 Chicken Pox .. .. 3 2 9 •. 14 Measles .. .. 2 2 17 .. 21 Scarlatina .. .. 20 41 20 •. 81 Whooping Cough .. .. 5 9 11 .. 25 Croup .. .. .. 1 2 • - 3 Diarrhoea 1 .. 16 20 16 16 69 Dysentery .. .. • • • • 1 .. 1 Cholera .. .. • • • • • • .. • • Ague .. .. • • • • •• 2 2 Continued Fever 1 .. 11 15 14 .. 43 Influenza • • .. • • • • .. .. .• Puerperal Fever • • .. 1 • • •• .. 1 Rheumatic Fever • • .. 2 I 3 6 Erysipelas 3 .. 10 3 5 .. 21 1 Diphtheria .. .. .. .. ., Sorethroat or Tonsillitis .. .. 22 33 42 .. 97 Mumps .. .. 3 .. 3 .. 6 Pyaemia .. .. • • .. Bronchitis and Catarrh 17 .. 235 239 292 49 832 Pneumonia • • .. 4 5 8 • • 17 Pleurisy .. .. 1 9 5 .. 15 Delirium Tremens .. .. .. 1 • • .. 1 Insanity 3 .. 5 •• 8 Carbuncle .. .. 2 .. 1 3 All other Diseases 47 11 398 517 562 69 1594 Total 73 13 763 908 1013 126 2896 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From October 31t-t, 1870, to November 26th, 1870. South | East District. | | South West District. North District. Total. Number of housess inspected 142 76 06 284 Drains Constructed 1 7 8 Improved or repaired 12 18 7 37 Traps fixed 21 16 12 49 Cesspools Aholished .. 1 2 3 Cleansed or disinfected .. .. 1 1 Privies and Water Closets Pan. trap, and water supply furnished Pan and trap only furnished 1 .. .. 1 Water supply furnished 3 5 1 9 Dust bins Constructed 1 .. 1 Repaired and covers adapted .. 1 2 3 Surface Drains and Pavements of Yards Constructed Relaid 11 23 8 42 General Water Supply Nevv receptacles provided 5 4 9 Receptacles repaired and cleansed.. .. 8 5 2 87 Water supply provided .. .. .. Other Improvements | Houses generally repaired 3 16 19 „ &c., cleansed or limewashed 118 19 30 167 ,, ventilated • • • • .. .. Overcrowding abated 7 .. 1 8 Illegal use of underground Rooms for sleeping discontinued • . .. .. Other Amendments, or Nuisances abated 21 4 69 94 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON. FOE, DECEMBER, 1870. No. CLXXXIY. Notwithstanding the very cold weather which prevailed during the last three weeks of December, our mortality has differed little from that of December, 1868 and 1869. The total deaths registered were 432. In 1869, they were 437, in 1868 (corrected) 435, and in 1867, 460 deaths. The main feature of the month has been the continued prevalence of Scarlet fever, and the alarming increase of Small-pox. The latter has attained the full proportions of an epidemic demanding the adoption of the most energetic measures for its suppression, In the month of November I registered only 36 cases. In the five weeks of December, the public practice of the Parish alone included 104 cases, and probably among all classes of our population not fewer than 250 cases happened. I hear of it on all sides, in the houses of the well to do as well as those of the poor, and it is taxing the strength and resources of the Sanitary Department of the Vestry to the utmost; for we have to deal with an epidemic of Scarlet fever at the same time. It speaks well for the vaccination of the Parish, that comparatively very few young children are included in my list of cases; the large majority of patients being persons between 12 and 25 years of age. As I have over and over again pointed out, we might defy Small-pox as an epidemic, if, in addition to the universal vaccination of infants, we could secure the re-vaccination of all young persons on their arriving at 15 or 16 years of age. But the vaccination arrangements are not in the hands of the Vestry; the Board of Guardians have full powers of dealing with this protective measure, and a memorandum has been issued to them by the Privy Council, urging them to put all their powers into exercise, and to make special provisions adapted to the 2 present emergency. The work of my department lies in another direction, and is determined by the sections of the Sanitary Act relating to infectious diseases. Under these sections we visit every house where we learn that Small.pox has entered, and give printed directions for the prevention of contagion; we supply disinfectants for use during the illness, and when the disease is over, direct, and so far as we can superintend such disinfections as we have it in our power to order. The great difficulty in dealing with the epidemic at the present time is, that of providing for the proper isolation of the sick. The Hospitals at Highgate and Hampstead are overflowing,so that numerous cases have to be treated at home in the rooms occupied by other members of the same family, and where every facility exists for the diffusion of the disease. The present want is Hospital accommodation, and this the Yestry, as the nuisance authority, is empowered by the 37 section of the Sanitary Act to provide. I beg to suggest that they should lose no time in availing themselves of this power. Of coarse, it will involve some expense for furniture and a small staff; but there are now in the possession of the Parish unoccupied buildings, a part of which might be appropriated to the purpose with great advantage to the public. Another difficulty I meet with, lies in the absence of any place to which a family can be temporarily removed while the necessary disinfections are being carried out. I should be glad if a furnished room or two could be placed at our disposal in the same buildings, as a place of temporary refuge under such circumstances. METEOROLOGY OF DECEMBER. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches read at 9 a.m., Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Temperatures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Dec. 3rd 39.8° 43.4° 36.'4° 7 0° 80 0.16 2 32.8° 35.3° 29.8° 5.40 84 0.60 5 „ 17 th 43.1° 47.0° 382° 8'8° 91 1.79 6 „ 24th 33.2° 37.0° 29 3" 7.70 74 0.23 4 „ 31st 26.0° 32 1° 19'8° 12.3° 67 0.31 4 Means. 34.9° 33.9° 30.7° 8.2° 79 Sum. 3 09 Sum, 21 The highest day temperature, observed on December 14th was 56.5° The lowest night temperature, observed on December 25th, was 9.5° Snow fell on eleven days. EDWARD BALLARD, M.D., Medical Officer of Health. Yestry Offices, January 9 th, 1871. TABLE I. DEATHS REGISTERED IN ISLINGTON DURING FIVE WEEKS ENDING 31st DECEMBER, 1870. (Deaths of Non-Residents in Hospitals excluded). West S.D. East 8.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 \ ears of age. At 80 years ol age and upwards. 210 222 All Causes 432 06 69 63 G9 25 51 46 3. Respirat. Orgs 97 411 9 10 33 4 l 2 Laryngitis 3 3 ... ... ... ... 30 27 Bronchitis 57 19 4 6 26 2 (Classes.) ... ... Pleurisy ... ... ... ... ... ... 53 59 I. ZYMOTIC DIS. 112 86 18 6 1 1 16 13 Pneumonia 29 18 4 2 3 2 40 37 II. CON STITUTL 77 25 26 20 4 2 1 3 Asthma 4 ... ... 1 3 ... 3 1 LUng Diseases. &c. 4 1 1 1 1 ... 96 101 III. LOCAL 197 70 24 36 57 10 6 10 4- Digestive Orgs 16 1 2 8 5 ... 2 ... Gastritis 2 ... ... .2 ... ... 18 23 IV. DEVEL0PMNL 41 21 ... 1 7 12 ... 1 Enteritis 1 1 ... ... ... ... 3 2 V. VIOLENT DTHS 6 4 I 1 ... ... ... ... 1 Peritonitis 1 ... ... 1 ... ... ... 1 Ascites 1 ... ... ... 1 ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes ... ... ... ... ... ... 1 ... Hernia 1 ... ... 1 ... ... (Orders.) 1 ... ... ... ... 1 Ileus 1 ... 1 ... ... ... ... ... Intussusception ... ... ... ... ... 50 56 I. 1. Miasmatic Dis. 106 82 16 6 1 1 l ... Stricture of Inte 1 ... ... 1 ... ... 8 9 Small Pox 17 ll 4 2 ... ... ... ... Fistula ... ... ... ... ... ... 1 2 Measles 3 3 ... ... ... ... ... 1 Stomach Dis., &e ] ... ... ... I ... 17 28 Scarlatina 45 42 2 1 ... ... ... ... Pancrcas Dis., ike ... ... ... ... ... ... 4 2 Diphtheria 6 5 1 ... ... ... ... 2 Hepatitis 2 ... ... 1 1 ... ... ... quinsey ...... ... ... ... ... ... ... Jaundice ... ... ... ... ... ... 2 5 Croup 7 7 ... ... ... ... 2 3 Liver Disease 5 ... 1 2 2 ... 5 ... Hooping Cough 5 5 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 7 5 Typhus & Typhoid 12 ...4 6 1 ... ... 2 1 5. Urinary Orgs. 3 ... ... 1 2 ... 2 5 F.rvsipclas 7 ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... Pycemia ... ... ... ... ... ... 1 ... Disease ot Bladdc l ... ... ... l ... 1 ... Puerperal Fever 1 ... 1 ... ... ... ... ... Nephria ... ... ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... ... Diabetes ... ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dv«entery ... ... ... ... ... ... ... ... Prostrate Disease . ... ... ... ... ... ... 2 ... Diarrhoea 2 1 ... l ... ... 1 1 Kidney Disease,&c. 2 ... ... 1 l ... ... ... Cholera ... ... ... ... ... ... ... ... 6. Genera. 0rgan ... ... ... ... ... ... ... ... ague ... ... ... ... ... ... ... ... Ovarian Dropsy ... ... ... ... ... ... 1 ... Rheumatism 1 ... 1 ... ... ... ... ... Uterine Diseases ... ... ... ... ... ... 3 1 2. Enthetic 4 2 2 ... ... ... l ... 7. Orgs.ofLocom 1 1 ... ... ... ... 2 1 Syphilis 3 2 1 ... ... ... l ... Spine Diseases 1 1 ... ... ... ... 1 ... Stricture of Urethra 1 ... 1 ... ... ... ... ... Bone Diseases ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 1 1 8. Skin, &c 2 l ... ... 1 ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon & Abscess ... ... ... ... ... ... ... 2 3. Dietic 2 2 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... l 1 Skin Diseases 2 1 ... ... l ... ... 2 Want ot Br. Milk 2 2 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 4 4 IV. 1. Dis. of Childn. 8 8 ... ... ... Alcoholism ... ... ... ... ... ... 2 4 Premature Birth 6 6 ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... Thrust ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... Worms ... ... ... ... ... ... 2 ... Other Malformation 2 2 ... ... ... ... ... ... ... ... ... ... Teething ... ... ... 9 10 II. 1. Diathetic 19 3 3 7 4 2 1 ... 2. Dis. of Adults 1 ... ... 1 ... ... ... 1 Gout 1 ... ... ... 1 ... ... ... Paramenia ... ... ... 2 1 Dropsy 3 ... ... 1 1 1 1 ... Childbirth 1 ... ... 1 ... 2 Hemorrhage 2 1 1 ... ... ... 7 12 3. Dis. of Aged 19 ... ... 7 12 6 5 Cancer 11 l 2 6 1 1 7 12 Old Age 19 ... ... 7 12 ... ... Noma ... ... ... ... ... ... 6 7 4. Dis. of Nutritn 13 13 ... ... 1 1 Mortification 2 l ... ... 1 ... 6 7 Atrophy & Debility 13 13 ... ... 31 27 2. Tubercular 58 22 23 13 ... ... 2 ... Scrotula 4 42 4 6 ... 23 13 ... ... 3 2 1 V.I. Acce. or Neg. 4 3 1 1 3 Tabes Meaenterica ... Fract. and Contus. 2 1 l ... 9 1 Hydrocephalus 10| 10 ... 1 ... Wounds Burns and Scalds 1 1 ... ... 26 30 111. 1. Nervous Syst 56 24 6 12 12 2 ... 1 Poison 1 l ... ... ... ... Drowning ... ... ... 4 3 Cephalitis / 7 ... ... ... ... ... Suffocation ... ... ... ... 5 6 Apoplexy 11 11 4 5 2 ... ... ... Otherwise ... ... ... ... ... 4 11 Paralysis 15 15 2 5 6 2 ... 1 2. Homicide 1 1 ... ... ... ... Insanity. ... ... ... ... ... ... ... ... 3. Suicide ... ... ... ... ... ... ... Chorea ... ...... ... ... ... ... ... ... Wounds ... ... ... ... ... Epilepsy ... ... ... ... ... ... l ... Poisou ... ... ... ... ... 9 8 Convulsions 17 1/ ... ... ... ... ... ... Drowning ... ... ... 4 2 Brain Diseases, &c 6 ... ... 2 4 ... ... ... Suffocat.and Hang. ... ... ... ... 9 13 2. Organs of Uirc. 22 2 7 5 4 ... ... ... Otherwise ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... 1 ... aneurism l ... 1 ... ... 8 13 Heart Disease 21 2 6 5 4 4 TABLE II. NEW CASES OP DISEASE COMING UNDER TREATMENT DURING THE FIVE WEEKS ENDING SATURDAY, THE 31st DAY OF DECEMBER 1870, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary. Pentonville Convict Prison Total. Small Pox 5 51 15 30 .. 104 Chicken Pox . . .. 13 15 .. 28 Measles .. .. 13 2 17 .. 32 Scarlatina •• .. 26 33 23 .. 82 Whooping Cough 5 .. 5 5 2 .. 17 Croup .. .. 2 1 .. 5 Diarrhoea 15 .. 18 9 14 28 84 Dysentery .. .. .. 2 6 .. 8 cholera • • .. .. • • • • .. .. Ague • • .. .. .. • • .. .. Continued Fever • • .. 18 9 25 .. 52 Influenza .. .. .. .. • • .. .. Puerperal Fever .. .. • • .. • • .. .• .. Rheumatic Fever •. .. ,, 2 2 .. 4 Erysipelas 6 .. 10 3 * .. 21 Diphtheria .. .. .. ■ . • • .. .. Sorethroat or Tonsillitis .. .. 22 23 35 .. 80 Mumps • • .. .. .. 3 .. 3 Pyaemia .. .. .. .. 224 .. .. Bronchitis and Catarrh 20 3 218 201 96 762 Pneumonia .. .. 7 5 8 .. 20 Pleurisy •. .. 6 6 9 .. 21 Delirium Tremens .. .. .. .. •. .. .. Insanity 8 .. 9 .. .. .. 17 Carbuncle .. .. .. 1 .. 1 All other Diseases 35 11 425 574 890 91 2026 Total 89 19 833 901 1307 215 3367 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From November 28th, 1870, to D-cembpr 31st, 1870. South East District. South West District. North District. | Total. 108 99 123 330 Drains Constructed 1 1 2 improved or repaired 4 44 4 52 Traps fixed 13 35 17 65 Cesspools Abolishe .. 3 7 10 Cleansed or disinfected .. .. 6 6 Privies and Water Closets Pan, trap, and water supply furnished Pan and trap only furnished 1 3 3 •• 4 3 Water supply furnished ... 9 2 14 Dust bins Constructed 3 3 4 [Repaired and covers adapted 1 .. 11 11 Surface Drains and Pavements of Yards Constructed .. 5 ... 5 Relaid .. 37 6 49 General Water Supply New receptacles provided .. 6 ... 6 Receptacles repaired and cleansed 34 10 9 53 Water supply provided .. 2 .. 2 Other Improve ments Houses generally repaired 6 9 8 23 ,, &c., cleansed or limewashed 31 28 41 100 ,, ventilated .. .. 2 2 Overcrowding abated .. 2 .. 2 Illegal use of underground Rooms for sleeping discontinued .. 1 .. 1 Other Amendments, or Nuisances abated 9 12 65 86