ISL 41 REPORT on THE SANITARY CONDITION of the Parish of Saint Marg, Islington, DURING THE YEAR 1872. by CHARLES MEYMOTT TIDY, M.B., Joint-Lecturer on Chemistry and Professor op Medical Jurisprudence and Public Health at the London Hospital;—Master op Surgery;—Fellow op the Chemical Society;— and MEDICAL OFFICER OF HEALTH AND FOOD ANALYST FOR THE PARISH. J. & I. TIEEBUCK, STEAM PRINTEES & LITHOGRAPHERS, Monkwell Street, E.O., and Islington. 1873. TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, My first report is written under difficulties that demand your indulgence. Of several matters to which I could wish to have referred I have no personal knowledge. And further, the first six months work of a health officer must of necessity be largely occupied in obtaining an acquaintance with the state of the district and its needs, and with acquiring such preliminary information as may fit him for his after-work. And here I feel it is only right that I should express my deep obligations to Mr. Collingwood for the willing and able assistance he has always, and at all times, courteously and kindly given me. MARRIAGES. Mr. Hicks, the Superintendent Registrar, informs me that during the year 1872, 1,952 marriages took place in the parish. This is at the rate of 8.8 per 1,000 of the population. The average proportion in the City of London is 15.6 per 1,000—in all England 8.4—in France 8.0—in Austria 8.4—in Italy 7.5. BIRTHS. Table No. I. 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 473 482 955 552 510 1,062 1,025 992 2,017 2nd ,, 464 421 885 582 507 1,089 1,046 928 1,974 3rd ,, 450 448 898 549 551 1,100 999 999 1,998 4th „ 459 494 953 522 536 1,058 981 1,030 2,011 1,846 1,845 3,691 2,205 2,104 4,309 4,051 3,949 8,000 4 Of the 8,000 births registered in the parish last year, 4,051 were males, and 3,949 females, or in the proportion of 97-4 females to 100 males. In the whole of England the proportion is 100 males to 95.8 females. The average proportion of births for the whole district is therefore 36.2 per 1000 of the population. The average birth-rate in Islington during the last ten years is 367 per 1000; in all England 35.4; in France 26.5; in Austria 40.1;—3,691 of the births were in the West Sub-district, and here the proportion of male and female is uniform, whilst 4,309 births occurred in the East Sub-district. The largest number of births occurred in the winter quarter ending March, the smallest in the spring ending June. The registered births exceed the registered deaths by 3,970. DEATHS. The number of deaths registered in Islington, omitting those of non-residents in hospitals, were 4,030. To these we must add 201 as our proportion (calculated on the population) of the deaths occurring in the various hospitals in other parts of London. I consider the method of estimating this number very unsatisfactory, but it has always been adopted, and I can devise no better plan even if I wished. With this addition our deaths are raised to 4,231, the smallest actual number since 1867, as will be seen in Table No. II., and the smallest estimated death-rate per 1000 of which I have records; of the 4,030 deaths, 1,727 were in the West district, and 2,303 in the East, that is the proportion of 17 per 1,000 in the former, and nearly 19 per 1,000 in the latter, with an average of 18.2 per 1,000 of the entire population. In the preceding 10 years the average mortality has been at the rate of 212 per 1,000, whilst in the chief towns of England it is 26.1 per 1,000, and of all England 22.5. Table No. II. will shew these facts in further detail. 5 TABLE No. II. The Estimated Population, Registered Deaths and Registered Births, compared with the Birth and Death. rate of London during the past Ten Years. Year. Estimated population in the middle of each year. Deaths registered in Islington, excluding Non-residents. Deaths in hospitals,Ac. : not accounted for in previous column, and calculated on population Total Deaths registered with corrections for deaths in Hospitals. Death-rate per 1000, excluding deaths in Hospitals. Death-rate per 1000, inclusive of deaths in Hospitals. Death-rate per 1000 in London, estimated by .Registrar-General Total Births in Islington. Males. Females. Proportion of Females to every 100 Males. Birth-rate per 1000 of the Population in Islington. Excess of Registered Births over Registered Deaths in Islington. Birth-rate for the whole of the Metropolis. Marriages in Islington. Rate per 1000. Average proportion per 1000 of all England. 1861 156,600 2941 209 3150 18.7 20.1 33.2 5526 2891 2635 91.1 35.2 2585 33.0 1862 161,679 3010 207 3217 18.6 19.9 23.4 5580 2773 2807 101.2 34.5 2570 33.1 1863 166,922 3854 92 3946 23.0 23.6 24.5 6164 3073 3091 100.5 36.9 2310 34.0 1864 172,336 3843 234 4077 22.3 23.7 26.4 6317 3211 3106 96.7 36.6 2474 34.0 1865 177,925 3813 222 4035 21.4 22.7 24.6 6747 3409 3338 97.9 37.9 2934 33.3 1866 183,695 4172 252 4424 22.6 24.1 26.5 6908 .... .... .... 37.0 2736 34.8 1867 189,652 3760 249 4009 19.7 21.1 23.0 7374 3831 3543 92.5 39.0 3614 34.9 1868 195,802 4210 247 4457 21.4 22.3 23.5 7718 3974 3744 94.2 39.3 3508 35.08 1869 202,152 4265 237 4502 211 22.3 24.7 7483 3820 3663 95.8 37.0 3218 35.0 1870 209,057 4370 248 4618 20.9 22.0 24.1 7616 3881 3735 97.5 36.4 3246 35.35 1871 214,932 4626 297 4923 21.5 22.9 24.7 7655 3824 3831 100.1 35.6 3029 35.1 1760 8.1 8.4 1872 220,807 4030 201 4231 18.2 19.6 20.4 8000 4051 3949 97.4 36.2 3970 35.4 1952 8.8 8.4 6 The following table gives the number of deaths in the several Institutions named during 1871 and 1872. TABLE No. III. Deaths in 1871 1872 City of London Workhouse 52 43 Pentonville Prison 8 8 City Prison 4 2 Great Northern Hospital 26 24 Small Pox Hospital 188 50 London Fever Hospital 227 21 Small Pox, Old Islington Workhouse 40 ... Total 545 148 AGES AT DEATH. Of the 4,030 deaths, 1,200 were of children less than 1 year old, 765 of children between the ages of 1 and 5—231 between 5 and 20— 463 of persons from 20 to 40—551 from 40 to 60, and 820 of 60 years and upwards. These facts will be more readily seen by reference to the following table:— Table No. IV. Proportion of Deaths at different ages in every 1,000 Deaths. Under 1 year 297.8 From 1 to 5 years 189.9 ,, 5 to 20 „ 57.3 ,, 20 to 40 „ 114.8 ,, 40 to 60 ,, 136.7 At 60 and over 203.5 Total 1,000.0 Of every 1,000 children born therefore in Islington, 150 die before they are a year old. The average for all England is 153, and for the chief towns of England 197. 7 CAUSES OF DEATH. The year 1872 has been an exceptionally healthy one. The causes of death are stated in the usual manner and will be found in the first table at the end, No. XIII. There has been nothing during the year that can be called an epidemic. We find in comparison with last year there has been a great decrease in the number of deaths from Scarlatina, Small-Pox, Typhoid, Diseases of the Respiratory Organs, and from old age; a marked rise from Whooping Cough, whilst deaths from Accident, Diseases of Children, Diseases of the Digestive Organs, Diseases of the Nervous System, and Diathetic Diseases remain nearly the same. The following table will shew the number of deaths from several classes of disease during the past ten years. I have in each case stated the deaths before 5 years old and after that age. Table No, V. Shewing the deaths during the past ten years from the several diseases specified, and the number of deaths before and after five years of age. Estimated Population. Deaths from the principal diseases of a Zymotic nature Deaths from Tubercular Diseases. Deaths from Diseases of the Respiratory Organs. Deaths from Diarrhoea. Deaths from Diseases of the Digestive Organs. Deaths from Violence. Total. Total. Total. Total. Total. Total. 1863 166,922 before 5 years 642 980 171 557 329 619 152 168 16 146 32 51 after 5 „ 338 386 290 16 130 19 1864 172,336 before 5 years 405 577 174 576 331 794 154 170 27 164 35 62 after 5 „ 172 402 463 16 137 27 1865 177,925 before 5 years 386 588 204 634 342 675 204 226 31 175 37 67 after 5 „ 202 430 333 22 144 30 1866 183,695 before 5 years 505 703 203 677 375 692 142 165 30 195 42 64 after 5 „ 198 474 317 23 165 22 1867 189,652 before 5 years 310 495 193 598 398 791 158 170 37 181 43 70 after 5 „ 185 405 313 12 144 27 1868 195,802 before 5 years 472 632 204 641 365 737 256 274 33 199 35 58 after 5 „ 160 437 372 18 166 23 1869 202,152 before 5 years 624 828 190 606 393 796 201 223 27 165 42 70 after 5 „ 204 416 403 22 138 28 1870 209,057 before 5 years 532 868 214 668 371 818 218 241 29 186 27 45 after 5 „ 336 454 447 23 157 18 1871 214,932 before 5 years 530 943 199 665 384 872 210 235 20 197 41 62 after 5 „ 413 466 488 25 177 21 1872 220,807 before 5 years 457 570 210 665 413 791 204 222 27 168 33 59 after 5 „ 113 455 378 18 141 26 9 I am desirous here of briefly considering some of the facts ascertained by the last and previous Censuses, and which I regard as of very great value. TABLE No. VI. Shewing Area, Houses, and Population of Sub-districts in 1861 and 1871. SuperintendentRegistrar's District Registrar's SubDistrict Area in Statute Acres Houses. Houses. Population. 1861 1871 Persons Males Females Inhabited Uninha bited Building Inhabited Uninhabited Building 1861 1871 1861 1871 1861 1871 Islington 1 Islington, W. 1226 9,427 401 125 11,559 810 150 75,442 97,820 34,78b 45,988 40,654 51,832 2 Islington, E. 1881 11,277 430 426 15,520 1604 342 79,899 115,958 35,279 51,757 44,620 64,201 TABLE No. VII. Shewing Public Institutions and Number of Persons therein in Islington in 1871. No. Of SuperintendentRegistrar's District Registrar's Sub-District Parish or Place Name of Institution. Total number in Institution, including officers, &c. Number of Special inmates such as Paupers, Patients, Lunatics, &c. District Sub-District Persons Males Females Persons Males Females 8 1 Islington Islington, W. Islington Small Pox Convalescent Hos. (Old Islington Workhouse) 154 12 142 143 10 133 Small Pox and Vacoination Hospital 121 53 68 93 48 45 London Fever Hospital 144 48 96 91 40 61 Great Northern Hospital 38 16 22 24 14 10 lieformitory School 40 39 1 38 38 — City (Holloway) Prison 315 269 46 287 255 32 Pentonville Model Prison 726 635 91 557 557 — Royal Caledonian Asylum 116 70 46 107 68 39 Saint Joseph's Retreat 16 16 — 16 16 — 8 2 „ Islington, ft. Islington Islington Workhouse 746 357 389 709 346 363 London City (Upper Holloway)Union Workhouse 453 189 264 440 184 256 Highgate Branch of Holborn Union 129 9 120 117 6 112 Metropolitan Asylum Almshouses 72 32 40 55 25 30 Islington W. H. Schools 266 143 123 248 139 109 St. Saviour's Lying-in Hos. 26 6 20 19 5 14 Alexandra Orphanage 128 68 60 109 58 61 Church Missionary Children's Home 100 40 60 65 34 31 Cloth-workers' Almshouses 17 — 17 17 — 17 Dyers' Almshouses 32 7 25 32 7 25 Tylers' Almshouses 15 4 11 15 4 11 Cutlers' Almshouses 31 15 16 31 15 16 Bookbinders' Almshouses 32 13 19 32 13 19 Whittington's College Alms-houses 47 2 45 27 — 27 10 I venture to lay before you the following table showing the date of formation, the area in acres, the number of inhabited and uninhabited houses, and of persons, male and female, in the 27 ecclesiastical districts into which the original parish is now divided. The importance of this table is self-evident. Table No. VIII. Area, Houses, and Population of Ecclesiastical Districts, or New Parishes, in Islington. Original or Mother Parish. Ecclesiastical District. Date of Formation. Area in Acres. HOUSES. POPULATION. Inhabited. Uninhabited. Building Persons. Males. Females. Islington St. Mary - 242 2,381 126 - 16,624 7,245 9,379 All Saints, Battle-bridgo 1839 70 1,483 22 3 14,517 7,268 7,249 Christchurch, Highbury 1849 164 449 46 21 3,077 1,189 1,888 Holy Trinity,Cloudesley-square 1830 95 1,370 51 9,595 4,144 5,451 St. Andrew, Thornhill-square 1854 111 1,285 35 2 12,520 6,133 6,387 St. Anne, Seven Sisters'-road 1871 159 819 198 27 5,840 2,744 3,096 St. Augustine,Highbury-new-pk 1871 134 426 25 18 3,442 1,167 2,275 St. Barnabas. Harvist-road 1866 133 1,088 132 9 7,849 3,546 4,303 St. Bartholomew, Essex-road 1865 15 444 16 - 4,490 2,170 2,320 St. Clements, Arundel-square 1862 68 908 44 - 8,589 4,255 4,334 St. David, Westbourne-road N. 1869 29 573 101 - 5,928 2,875 3,053 St. George, Tufnell-park 1868 189 425 76 26 3,211 1,468 1,743 St. James, Victoria-road 1839 76 717 49 — 5,110 2,333 2,777 St. John, Holloway-road 1830 340 1,381 375 61 10,427 4,881 6,546 St. Jude, Mildmay-park 1866 86 1,319 107 96 8,952 4,046 4,906 St. Luke, Hillmarten-road 1861 215 984 90 67 6,608 2,464 4,044 St. Mark, Tollington-park 1854 193 1,447 313 76 9,208 4,086 5,122 St. Mary, Horn6ey-rise 1865 190 503 130 57 4,140 1,658 2,482 St. Matthew, Essex-road 1851 67 991 55 2 7,748 3,495 4,253 St. Michael, Caledonian-road 1864 42 708 7 19 7,338 3,819 3,519 St. Paul, Balls Pond-road 1830 185 2,059 117 3 14,737 6,312 8,425 St. Paul, Upper Holloway 1870 49 694 158 2 4,652 2,056 2,496 St. Peter, River-lane 1830 89 1,681 42 — 13,918 6,542 7,376 St. Philip the Evangelist, Arlington-square 1858 59 1,318 37 1 10,882 5,124 5,758 St. Saviour, Aberdeen-nark 1866 23 43 2 — 322 131 191 St. Silas, Penton-street 1868 16 444 22 2 4,566 2,148 2,418 St Stephen, Canonbury-road 1839 36 482 27 — 3,690 1,610 2,080 St. Thomas, Hemingford-road 1862 32 657 11 — 5,998 2,836 3,162 11 Table No. IX. Area and Population of Islington in Census years 1801-71 of the parishes, &c., included at different periods within the London Bills of Mortality. Pariah. Area in acres. Population. 1801 1811 1821 1831 1841 1851 1861 1871 St. Mary, Islington 3,107 10,212 15,065 22,417 37,316 55,690 95,329 155,341 213,778 This table illustrates how enormous the population of Islington has become since 1801. Then there were but 10,212 persons. It had more than doubled in 1821 (22,417)—nearly quadrupled in 1831 (37,316)—whilst in 1871 it had increased to nearly four times what it was in 1841, and over 21 times what it was in 1801. Some explanation of how this increase is to be accounted for during the last decade will be apparent by the next table. Table No. X. Marriages, Births, and Deaths, 1861-71. Registration or Union, County and Superintendent-Registrar's District. Population. Registered in the 10 years, 1861 to 1871. Excess of Registered Births over Deaths, 1861-71 Increase of Population between the Census of 1861 and 1871. Increase. 1861 1871 Marriages Births Deaths St. Mary, Islington. 155,341 213,778 16,194 67,520 44,734 22,786 58,437 From this it will be noted that from 1861 to 1871 the excess of registered births over deaths is 22,786. Hence it follows that over 35,000 immigrants came to reside in the district during the decade of 1861—1871. I may just note here the extent of Land and Water included in the parish of Islington. Table No. XI. Extent of Land and Water in parish of Islington. Sub-District. Land in acres. Water in acres. West Sub-District 1,222 4 East Sub-District 1,870 11 12 Lastly, I may just say that the Census of 1871 shows that there were 10,548 domestic servants in Islington. Of these 244 were male, and 10,304 female—or in other words there was a domestic servant to about every 20.1 of the population—a proportion that is higher than in many parts. Upon a subject that has been for a long time a constant matter of consideration, both by your Vestry and the Sanitary Committee, I am anxious to say just a word. That is the Mortuary. Owing to some objection as to the site, the arrangements that were well nigh completed for its erection, had to be abandoned. I sincerely hope that nothing now will interfere with its being built on the new site that has been decided upon. The importance of Mortuary buildings is self-evident. But I am most desirous that when they are erected the Vestry should at the same time agree to erect a chamber for disinfecting clothes and also one for burning them when necessary. It will of course be said, " We do burn them when there is a need." But we have no place to burn them in. It is true we destroy them in some open field, or any where where good luck has left a vacant spot, but a complaint that has only just lately reached the sanitary department, proves what a nuisance this process may cause to the houses surrounding the place where the operation is carried on. The extra expense will be small, and I most anxiously urge on the Vestry the paramount importance of giving this subject their consideration. If this necessary addition is not made I have grievous doubts whether the Mortuary itself will be of so much value; at any rate it is perfectly certain it will be wanting in what I am persuaded will be found to be one of its most essential features. It is my duty, as the Analyst appointed by the Vestry, and approved by the Local Government Board, to report to you quarterly, as the Local Authority, the results in this department of my work. Although I have for the past six months been engaged in putting this Act into active operation, I have delayed writing my first report until the present time, although I am conscious that, in accordance with Section VII., I should have reported to you the results of my first investigations three months ago. This delay shall not occur again; but it was necessitated by the anxiety I felt that the new Adulteration Act should, as far as I could render it, be no mere 13 piece of useless legislation, and destined like its predecessors to be bound up with many other Acts of Parliament in some large folio, located on the top shelf of the magistrate's library, never possibly to see the light of day, nor even to be a subject of reference. I felt strongly it was my duty to render it, as far as possible, a means of preventing the dishonest tradesman robbing the poor man of his money, and the rich and poor alike of their health. Holding this view, that adulteration is an iniquitous system, demanding from the public with more than the urgency of a highwayman, not its money or its life, but its money and its life, I hail this Act with no little pleasure, believing it may prove to be a great benefit to the community. It is I consider a matter for congratulation that almost the first prosecutions under the Act were prosecutions instituted by your Vestry. This will show that you have, at any rate, not desired, as some seem to have desired, that the Act should be the same lifeless corpse its predecessors proved. But I am equally certain of this, that this Act needs, and must before long receive a considerable amount of very careful revision, and that at present there are some marked omissions and defects to which I should earnestly desire to draw the attention of the authorities. And one is the great need in the Act of a definition of adulteration. In the public mind, adulteration seems to imply the addition to an article of one of less value. Thus a sad confusion exists between the words adulteration and addition. They have no relationship whatever. Adulteration means the defiling an article, no matter how the defiling is effected: it may be (1) by addition, as when water is added to milk to increase its bulk, or (2) by the subtraction of the active principles or principal constituents of an article—as when cream is removed from milk, thereby lessening its nutritive value, or when dried, used-up, secondhand tea leaves are sold as genuine—or (3) adulteration may even be the addition of one article to another, although the article added is infinitely more valuable than the article to which it is added. In this sense, a great English writer speaks of the addition of gold to brass as an adulteration of the brass. Again, the Act being a severe one, (and nothing but a severe one would meet the case), it seems to me desirable that the Analyst should, in no case, know from whom the article submitted to him 14 is obtained. This, as you are aware, is the plan adopted in our parish. Under no circumstances do I know the source of the sample submitted to me. The Inspector hands it in marked with a number or a letter, and that only. In my certificate, I merely refer to the sample by its mark. In this way we prevent certificates being used for trade purposes. Again, I should much wish that the words in Section VI., "suspected to be adulterated," were omitted. Although I am convinced they are intended to be taken in a general sense, and not a special one, they may give rise to difficulties by captious word-splitters. I have in Islington made an examination of articles of food from every shop selling those articles, in localities decided by me. In this way only do I consider we can prevent this Act becoming the handle for intolerable persecution and unlimited annoyance to tradesmen— and this it is our duty to prevent. The Court of Queen's Bench has decided, in the case of "Fitzpatrick v. Kelly," that it is not necessary on the part of the prosecution to prove the guilty knowledge of the seller of the article in question ; and further, that when a purchaser asked for an article and was served with it, and the purchaser not told it was adulterated, the seller represented thereby that it was pure. Mr. Justice Blackburn pointed out there was no hardship in this, as any tradesman who was desirous of selling adulterated articles could always escape the penalties of the Act by informing the purchaser that the articles were adulterated. But this being the meaning of the Act, I could much wish for some alteration in the wording of Sections II. and III. I am anxious moreover to draw your attention to another point. I have, up to this period, personally attended to give evidence in prosecutions under the Act in Islington. The Act however does not require it. Section IX. declares that the certificate is sufficient evidence of the matters therein certified, unless the magistrate has scientific evidence of an error in the analysis. Mr. Lushington, at the Thames Police Court, in a case I was engaged upon a short time back, further gave his opinion that the Analyst need not appear. Under these circumstances I have decided not to give evidence again personally, but, as the Act directs, to allow my certificate to be sufficient evidence of the adulteration. 15 I have considered it advisable to begin my food investigations with the common food of the common people. For this purpose I examined first of all, milk. In all, 70 samples were submitted to me by the Inspectors appointed under the Act. I gave certificates in eleven cases that the milk was adulterated with water. In no case, except a little salt, did I find any other matter added. These cases were heard at the Clerkenwell Police Court. In two cases, owing to some legal difficulty, the magistrate considering that the removal of the cream was not an adulteration, the parties got off. In one other, owing to some flaw in the evidence of the Inspector, the case broke down. In eight cases the offence was proved, and the parties fined : three £5. and 2s. costs; one 40s. and 2s. costs; and four (the parties pleading guilty) were fined 10s. and 2s. costs. As a proof that the prosecutions in these milk cases have been of very considerable benefit, I may just add that the last twenty samples of milk I examined proved to be very superior in quality to those I previously analyzed. I did not consider it necessary in one of these cases to advise a prosecution. I have also examined twenty samples of bread, and it is a matter for congratulation that only in four cases did I find alum. The amount in these even was small, and therefore no action was taken. I am, however, of opinion that the Act allows me no alternative if I find any foreign matter or adulterant whatever, but to certify to that effect, the Inspector having no alternative on receipt of my certificate but to proceed. In future, therefore, I shall be compelled to adopt these measures, leaving it to the magistrate to apportion the fine to the urgency of the case. I have also examined two samples of tea, both of which were pure. Only one sample of food (viz.: milk) was submitted to me by a customer and this I found to be good. A specimen of Syrup of Senna was brought to the Vestry Hall on another occasion, but the quantity was not sufficient for analysis and was consequently returned. Such has been the working of the Act in your parish. I believe it has been as complete as possible ; and I am desirous of expressing my satisfaction in the way in which your Inspectors have performed their duties, and the assistance they have rendered me in carrying out the provisions of the Act. I must say one word more as a protest against irregularities in the working of the Act, which in 16 some places, unfortunately, seem to be the rule. To purchase articles irregularly—to find them adulterated, and then to tell the tradesman (which the Act does not sanction) rather than to summons him, is merely playing with an important Act of Parliament; it is treating it as a creature of circumstances, to be toyed with after one's own liking, and it can only end in bringing disgrace on chemical analysis and on the law which employs science for its help to punish the guilty and to let go the innocent. To prevent the Act being a means of persecuting the dealer, and of interfering with just trading on the one hand, or allowing our certificates to be the means of trade advertisements on the other, should be a matter of constant concern—whilst at the same time we should allow no false feeling to prevent our putting a stop to what has been too long an enormous source of addition to the money bags of the fraudulent dealer, and so necessarily a cheat on the poor, and a curse to us all. This is, I believe, the true object of these Acts of Parliament, and to carry them out honestly and faithfully is the duty of those to whom the working of the same is entrusted. Another matter to which it is my duty to draw you attention, involves perhaps one of the most important sanitary questions that has been brought before us of late. In the year 1844 (7 & 8 Vict. cap. 86) an Act was passed relating to the continuance of noxious trades. The Act refers especially to the following businesses:— Blood-boiling, Bone-boiling, Fellmongery, Slaughtering of Cattle, Sheep or Horses, Soap-boiling, Tallow-melting, Tripe-boiling, and any like business offensive or noxious, so far as relates to the killing of animals for human food. These, if carried on in the Metropolis at limited distances from houses and roads, were to be abolished. In order that due respect and consideration might be paid to interests existing at the time the Act was passed, thirty years were allowed before it was to come into operation. In 1874 (next year) the thirty years have expired. At this very time, and be it remembered not until this very time, sanitarians having considered the whole matter settled and arranged, the butchers raise an outcry against the abolition of private slaughter-houses. Convinced it seems that their appeal would fail if they urged it on the ground that the Act of 1844 was an attack merely on their own till, they have, with an importunacy worthy of a better cause, tried to persuade the 17 public, and unfortunately in some cases succeeded, that it was a matter that concerned the people at large and the people's pockets. As the result, Dr. Brewer, M.P., brought a bill before Parliament to repeal this Act, which at the second reading was referred to a Select Committee. I am given to understand that this committee have recommended the repeal of the clause relating to slaughterers of cattle and sheep, and in addition to many other recommendations, they suggest that with regard to all other businesses that may be called noxious, they should not be banished from the Metropolis unless a case of nuisance can be established against them. Your Vestry agreed to petition in favor of Dr. Brewer's " Metropolitan Buildings Act Amendment Bill." I feel, therefore, that inasmuch as from the first I have given the Bill of Dr. Brewer my most unqualified opposition, it is my duty to lay before you the reasons why I have been compelled to do so. This Act was passed in 1844; the census returns show that the population of the Metropolis in 1871 is almost double what it was in 1841. (1841, population 1,948,417—1871, population 3,251,814). If, therefore, in 1843, with a comparatively small population, this bill was necessary, a fortiori it is necessary in 1873. But it will be said true, but with sanitary improvements and our complete system of inspection, they have ceased to be the nuisances in 1873 that they were in 1843. To that I reply I am convinced that, though the slaughter-houses are better conducted than they were, they are now as ever, and nothing can make them other than atrocious nuisances. On this I write strongly, for I am convinced that no one who is familiar, as I happen to be, with the slaughter-houses of London, can have an honest doubt but that they are so. The number of our inspectors is totally inadequate to carry on the complete supervision these slaughter-houses require. Indeed, nothing less than an inspector for each house would meet the difficulty. The great facilities, not merely for slaughtering diseased animals, but for disposing of the unwholesome meat when it is slaughtered in the private slaughter-houses, must be self evident; and it is practically impossible, because of their large number scattered amongst a population of more than three millions, to suggest any means whatsoever to carry on that complete inspection of meat sold and consumed by all, and be it remembered, by the poor especially, 18 and which inspection I know too well the emergencies of the case demand. Private slaughter-houses are a curse to the poor. The true friend of the poor must, in my opinion, be the sworn enemy of the private slaughter-house. It is the birth-place, or rather the cradle, of disease—it is a nursery for the " ills that flesh is heir to." The public abattoirs would remedy this. Each animal as it enters could be inspected, each carcase as it leaves could be examined. And this systematic inspection is the only remedy for the evil. I am sure, moreover, that the supporters of Dr. Brewer's bill cannot have had any practical experience of the terrible cruelties practised in these unwatched dens in killing animals by the butchers. Although one's profession does not tend to create or to foster any extreme scruples in this respect, I should shudder to describe, as I have shuddered to look at, the unheard of and wanton cruelties I have over and over again been an eye witness of in the private slaughter-house. The arrangements of the public abattoir would at any rate be a means of keeping watch on those who needlessly torture rather than kill. Nor again can we be ignorant of the annoyance and danger to the public, occasioned by driving cattle through the public streets. This would be remedied if slaughter-houses were abolished. Again, the slaughterhouses attract a large number of rats by the offal, and by permitting a quantity of filthy washings to be daily poured down our drains, conduce in no slight degree to a very considerable nuisance apart from themselves. There is no doubt that the public abattoir would be a great public advantage. Cruelty in killing would be kept in check, a proper and complete supervision of the animal and of the carcase prepared for sale would follow as a matter of course. The diseased animal would be condemned by authority and got rid of. Besides all this, we know as a matter of fact, that the flesh of an animal slaughtered in a large, airy, well-ventilated slaughter-house is not only better, but keeps fresh longer than when killed in the miserable, ill-ventilated slaughter-houses of the Metropolis. I have no doubt, moreover, that country-killed meat is superior to London killed. On this point I will quote the opinion of no second-rate authority. He says:— "The public must be made aware of the fact that about seventy per cent. of the butchers in London do not kill their own 19 meat, but buy it dead. Those butchers who supply the nobility and gentry, with scarcely any exceptions, buy country-killed meat in preference to London-killed; and, during nine months in the year, there are hundreds of first-class butchers who will never buy anything else but country-killed—for this reason, that if they gave their customers London-killed, they would have but few customers left. Butchers who kill their own beasts will tell you they prefer country-killed for their own eating. Anyone can ask himself this question : can it be possible for meat to eat better when the animal has been journeying about entirely out of its element ? Any butcher will tell you that, after beasts, sheep, lambs, or calves have left their element, and have been brought to London, and kept on the best of food, they pine and lose weight the longer they are kept; thereby, evidently, the animal cannot be in a healthy state." And now we ask, what are the arguments on the other side of the question ? It is said that the poor purchase the offal saved in the private slaughter-house which would otherwise be wasted. To that I ask, why should the offal be wasted in the abattoir ? Or it is said that the interests of the public would suffer by the price of meat being thereby increased. But I beg to say, this is not an argument. It is a mere assertion, and it is an assertion unsupported by any evidence. On the contrary, we know that when there is a combination of work of any kind in one large building, the work is done cheaper than when it is divided and subdivided out amongst many smaller ones. And what is more to the purpose, all the facts are against the idea of the abattoir being a means of increasing the price of food. My own firm conviction is it would decrease it. I know well that this has heen the result on the Continent. A letter from Dr. Littlejohn, the Medical Officer of Health for Edinburgh, is before me. " Here," he says, " there are no private slaughter-houses, but one large public abattoir." And what is his experience about price ? " Meat," he says, " is decidedly cheaper in consequence of the unusual facilities afforded in the abattoir," besides which, as Dr. Littlejohn says, " The public, but especially the poor, are benefited, not only in the cheapening of the food, but also in securing to them that they get value for their money, in the form of sound wholesome food. Without a public abattoir, in which all animals used for food must be brought for inspection, and to be slaughtered, there a20 cannot be a satisfactory inspection of butcher's meat. If private slaughter-houses are allowed, the opportunities for deception are so great, that no amount of inspection can prevent the sale of meat from unsound animals." It is on these grounds amongst others, which I humbly submit to you that I am unable to agree with the opinion at which a majority of the Vestry arrived, although my remarks must not for a moment be taken as in any way calling in question the perfect and undoubted right which the Vestry exercised in coming to the decision which they did, and which decision has received an authoritative sanction in the similarity of the view which has been adopted by the Select Committee of the House of Commons. Every month I place before you in my reports analyses both of the water of the New River Company as taken from the works, as well as of samples taken by myself from other parts of the main, and also the quantity per head daily supplied by the company. It may be interesting to know that, taking the whole of London, the supply to each house during the year 1872 averages rather more than 218 gallons per day, whilst per head of the population it ranges from 30.5 gallons to 36.2. For this purpose about 60 million gallons of each day's supply were derived from the River Thames, 4.5 million gallons from the New River and the River Lea, and the remainder from the deep chalk wells of the Kent company. The average chemical composition of the water, of the New River company during the year 1872 is as follows:— TABLE No. XII. PER GALLON. GRAINS. Total Solid Matter 18.97 Organic Matter 0-312 Chloride of Sodium 1.77 Nitrogen as Nitrates 0.134 Actual or Saline Ammonia 0.001 Organic Ammonia 0.001 Hardness before boiling, degrees 14.7 Hardness after boiling, degrees 3.6 21 The water on examination in bulk, i.e. in a glass tube two feet in length, is almost colorless, perfectly free from all turbidity, as well as from living organisms of every kind. I have had occasion of late to examine with the utmost care the water of the New River Company, and it affords me pleasure to speak of the great care taken both in the preservation of the river and the filtration of the water. I should naturally be led here to speak of what has been so frequently a subject-matter of debate, viz.: the desirability of a constant water supply. But this is now rendered unnecessary by the fact that the water companies have at length yielded to the popular clamor and granted the constant service. That this will be an enormous gain in the case of the courts and crowded homes of the poor there can be no second opinion. But I must confess, that to the well-to-do classes, with the present daily supply (Sundays not excepted), a supply little short of constant, I have yet to be convinced that the constant service is so great a boon or so desirable as some seem to regard it. However, this is not a matter for discussion now, because as I said the popular cry has been yielded to. And now a complaint of a different character reaches us, that the conditions required by the companies in granting the constant supply are unfair. To me their most manifest fault is their indefinite character. One certainly could have wished that the companies (who were better judges than anybody else) would have decided on some special form of apparatus to recommend for the adoption of the public, rather than leave them to choose and shift for themselves, floundering about amongst the numerous patents of almost daily creation. These I know very well are in many cases absolutely worthless. Thus a new expense is incurred for further changes of fittings that might just as well have been advised in the first instance. But the complaint we hear is one of a deeper character than this. The public no doubt imagined when, in the first instance, they loudly asked for a constant supply, that " constant supply "meant" unlimited waste." To one with even a mere chance knowledge of the important question of the water supply to London, a work, be it remembered, of gigantic magnitude, and what is more, a work of daily increasing magnitude, it will be seen that this never could be permitted. And hence the water companies have drawn up a series of regulations in accordance with 22 the provisions of the Metropolis Water Acts of 1852 and 1871, which regulations have, after due and very full inquiry, received the sanction of the Board of Trade. These regulations provide for the prevention of improper waste and contamination of the water, and also, as far as possible, an equal delivery to houses on different levels: having been in force now since the 10th of August of last year, and a sum of £5 being the penalty for their violation, it is advisable that the public should clearly understand their nature. The regulations provide that the water companies must be consulted previously to the water supply to new dwelling houses being fixed; that no house may have more than one pipe of communication, but that every house must have its own pipe, except in the case of blocks of houses, the water-rate of which is paid by one owner; that screw taps only shall be employed ; that no water-pipe shall, if it can possibly be prevented, be laid through a drain, but, if impossible to avoid, that certain precautions shall be adopted to prevent contamination; that to prevent the action of frost, the pipe shall be of a certain depth ; that no pipe in connection with the Company shall be connected with a rain-water receptacle; that no waste pipe shall hereafter be allowed, and that all wastepipes—that is, pipes the ends of which are not visible, and the outlet of which may be into drains—shall be converted into warning-pipes, the ends of which are visible, and so easily examined ; that except under certain conditions, no underground cistern or wooden butt without a proper metallic lining shall be allowed; that where a stand-pipe is erected for the supply of a group of houses, or for other purposes, "a waste-water preventer" must be employed; that in the case of water-closets, a service-box so constructed as not to deliver more than 2 gallons of water at each flush to the pan, shall be erected, this service-box being refilled from a store cistern ; that under no circumstances shall any pipe communicating with the water-closet be in direct communication with the Companies' pipes; that Bath apparatus shall be constructed so as to prevent undue waste. It is provided, however, "that all existing fittings, if sound and efficient, which are not required to be removed or altered under these regulations, shall be deemed to be prescribed fittings under the Metropolis Water Act of 1871." But the public must be prepared for further changes in rendering the constant supply more universal. Fittings for the present supply will not answer for the 23 constant service. The Company may give notice to the public requiring an alteration of these fittings within two months, and if the order is not carried out, the Company can do the work themselves at the expense of the owner or consumer. Such is a summary of the new regulations. And no words are now-a-days spared in their condemnation. On this matter, further, the public have a right to be heard. The water supply is a great public question, and directors of Water Companies should remember that they are the custodians of what is intended for the use of all, and which the public have entrusted to their care to deal with in the best possible way, and with the greatest possible consideration for the whole community. Immediately directors cease to remember they are accountable to a higher tribunal than a company of shareholders, they then mistake their position, and fall short in what society naturally demands from them. The Water Companies are the creation of the people, permitted by the people, and in all they do accountable to the people. For the benefit of the one and all—for the greatest possible good to the greatest possible number; these are the terms of the Company's trust-deed—the contract between Company and people. And of course, if the Company are unmindful of the trust, the public have a perfect right to complain. But not only must the Company remember the terms of the contract, but the people must remember them too. And if the Water Companies allowed a whole district to run short because they were not sufficiently careful to prevent waste by a few, or the supply of a whole parish to be contaminated by the carelessness of an individual, then the public would be justified in complaining that the provisions of the trust had been violated. It could not be expected that a constant service, which public and press have demanded so vigorously, could be granted except under certain conditions. These conditions should be so drawn as not to be unnecessarily burdensome or troublesome to the public, whilst sufficient to guard the water both as to quality and quantity. That to the uninitiated and uneducated there are difficulties in the regulations, there cannot be a doubt. In the case of the service-box of the water-closet— e.g., so constructed as to deliver two gallons —if this quantity is used up at one time by keeping the valve raised, we shall have a dry pan until used by the next comer. This is objectionable ; but then, Londoners require education in the use of the constant supply, 24 and that this education is no hopeless or difficult task, the success which has attended the constant service in other places abundantly testifies. All at any rate will agree to this, that some measure must be adopted to prevent the waste of water which would otherwise be inevitable, and from which sooner or later we should be sad sufferers, and also the possibility of the contamination of the water, with all the horrors of disease in its train. The question in dispute is—Are the regulations proposed unnecessarily stringent for the purpose of avoiding the dangers that may arise from these causes ? In answering this question, both companies and people must remember that a very false view will be obtained if they regard it merely from a single stand-point, that stand-point being their own likes and dislikes. I cannot resist setting before you most strongly the enormous gain the establishment of waste-water preventers, with a constant service, would be in our poor courts, which, since my appointment, I have particularly inspected, and I shall, therefore, certainly do all in my power, when opportunity occurs, to bring the change about. The storage of water in the poorer parts of Islington (as I have pointed out elsewhere) is in a very unsatisfactory condition. In Whitechapel, by the perseverance of Mr. Liddle, a large number of waste-water preventers have been erected, and both landlord and people are loud in their praise. SANITARY WORK OF THE YEAR 1872—73. Table XIV. The latter portion of this table represents the Sanitary Amendments which have been accomplished through the activities of the Inspectors, as set forth in the former part, which shows the number of inspections which were made by them in the course of the year. The improvements which are enumerated do not, however, exhibit all the good which undoubtedly results from the important work of Sanitary Inspection, as there are many things which could not be tabulated. For instance, the 5345 visits paid to the 110 courts aud alleys during the year, add very little comparatively to the latter portion of the table, though most essential as keeping a check upon the Contractor, and in securing the cleanliness of places, any one of 25 which might at any moment become a focus of disease. Many of the other inspections also tend rather to the prevention than to the removal of nuisances, which might otherwise exist and give cause for well-grounded complaints, or become the means of serious mischief; and this preventive side of our sanitary work should not be forgotten when such work is under review, although we cannot measure it in exact quantities. The Removal of Dust and House-refuse is also frequently the result of your Inspectors' visits and observations, though these removals are not included as amendments in the table. The absence of any contagious epidemic has considerably lessened the number of houses and rooms disinfected, but when found requisite such disinfections have been effectually carried out. The Saturday night cleansing of portions of the Channels of the Essex and Caledonian Roads, and the summer use of carbolic acid in the watering of some of the streets, and of powder in the manner described in previous Reports, were again sanctioned by the Sanitary Committee. BELLE ISLE. Another matter of considerable importance connected with Table XIV. deserves our notice and consideration. The District of Belle Isle and its factories, to which I refer, is admittedly a vexed question, and it appears to me likely that so long as it exists at all, it will always remain so, as it must of necessity occasionally give rise to complaint, until it ceases to be the centre for an aggregation of a number of offensive businesses. Since my appointment as your Medical Officer of Health, I have very carefully inspected the whole of these establishments, now numbering 38 (being 13 less than in 1868), and found them to be in a most satisfactory condition, completely fitted as they are with every requisite apparatus and appliance, both for preventing the escape and for destroying the noxious fumes which are generated in such places, and except in two or three instances, where trifling amendments and improvements were needed, the state of the whole was all but absolutely perfect—reflecting the highest credit upon the Sanitary Committee, my predecessors in office and your Inspector. 26 Why, then, it may be asked, should complaints ever be made of Belle Isle ? Unfortunately we have not to go far to obtain an answer; for although the best available means may exist upon premises for the carrying on of a noxious manufacture, with the least possible annoyance to the public, yet the workmen may, from thoughtlessness, and sometimes to save themselves trouble, neglect to use the costly and efficient provision which has been made, and this, together with certain conditions of the atmosphere which may exist, or the direction of the wind, may create at any moment a general outcry against Belle Isle, and of course against your Medical Officer of Health and Inspectors; whereas the primary part of their duty has already been thoroughly done, when they know from recent inspection the places to be in the excellent condition in which I found them. An Inspector resident at each factory could not do more than entirely prevent the kind of neglect among the workpeople, which has just been referred to, although the unexpected visits of your Inspector no doubt tend to keep it in check, as well as to secure such reparations as ordinary wear and tear may render needful. The other matters, I need scarcely add, are beyond control. SUMMONSES. During the year ending 25th March 1873, the Sanitary Committee directed the issue of 35 summonses; of these two were for carrying on the business of a dairyman, and keeping cows without a licence, in one of which only a conviction was obtained, a penalty of forty shillings being inflicted; in the other, the evidence was defective, there being no proof that the milk had been actually sold, the defendant alleging that he had given it away; but having subsequently obtained a licence to keep cows upon his premises, he can now sell the milk, as well as give it away, without fear of prosecution. Three were for animals being so kept as to be a nuisance. Two were on account of offensive accumulations, and three in respect to defective drainage and the necessity for general repairs. In all of these orders were duly made. 27 Six others were issued for non-compliance with the orders of the Justices, five of which had been made in relation to summonses, which were heard prior to the 25th March 1872. In two of these cases the penalties enforced amounted in each to £1 18s. The nineteen remaining summonses were in connection with a swampy strip of land lying between the backs of the houses on the south side of the Camden Road, and the backs of the houses on the north side of the Hungerford Road, with an entrance under a gateway in York Terrace, York Road. These summonses were taken out under the Nuisances Removal Acts, against the Trustees of the freeholders, jointly with each lessee of the houses in the Camden Road (to whom portions of the passage had also been demised), as the parties by whose act, default, permission, or sufferance the nuisance had arisen and continued. The passage had been often complained of as a nuisance, and your then Medical Officer of Health, Dr. Corfield, gave evidence of the fact that in his opinion the condition of the ground was a nuisance, likely to prove dangerous to health : but the Justices holding that no nuisance had been proved, dismissed the summonses, and awarded twenty guineas costs to the defendants, ten to the solicitors of the trustees, and ten to the solicitor engaged by some of the lessees, one of whom only had consented to an order. The decision that swampy land in proximity to inhabited houses, with offensive refuse mixed with its mud, and having holes and deep ruts containing stagnant water is not a " nuisance," may be understood, although our opinions may be in direct opposition to it, especially when we consider that evidence was called by the defendants in favor of that view; and the adjudication may also be useful in relieving your officers from some of the responsibility attaching to similar matters when complaints are made. But the process of reasoning by which it was deemed right to virtually punish a body like the Vestry for taking proceedings in the interest of the public health, by inflicting in the form of costs a penalty of £21, would seem to be perfectly inexplicable, and such awards are much to be regretted, as they can only tend to make public bodies and their Committees less willing than they are to take up cases of nuisance in which there may be the slightest possibility of defeat, 28 THE DUSTING OF THE PARISH. From a note at the bottom of Table XIV., it will be seen that during the 12 months to which the Table refers, viz.: from Ladyday 1872 to Lady-day 1873, your Inspector of Dust visited 26,279 houses, and found that dust was required to be removed from 10,112, or rather more than 38 per cent. of the houses visited. To these 10,112 there must be added 2508 removals, which were consequent upon reports from the other Inspectors, making a total of 12,620 premises from which the Contractors were required to remove dust owing to the work of your Inspectors. During the same period Letters and Postal Cards were recorded in the Sanitary Department, requesting the removal of dust from 9434 premises, and entries were also made in relation to removal from 4750 premises from personal applications, which were made at the Vestry Hall, making a total of 14,184 premises from which dust was ordered to be removed in consequence of requests from parishioners, so that including the 12,620 mentioned above, the Contractors were required in writing by your officers to remove refuse from 26,804 premises. I have given the statistics from March 1872 to March 1873, although that period includes the last three months of the year's figures, which were presented to you by my predecessor in his Annual Report for 1871, because, as thus stated, they will be more useful for future comparison, as the period named will correspond both with respect to the 12 months comprehended in the Annual Table of our Sanitary Works, and also of the Annual Contracts for Dusting, which will not extend from June to June as formerly, but from March to March, as in the contracts last entered into by the Vestry. In order to effect this change, the contracts which expired at Lady-day 1873, had extended over a period of nine months only, from the 24th June 1872, during which time requests for removal were made by inhabitants in relation to 9656 premises, 6148 were by letter or postal card, and 3508 by personal application at the Vestry Hall. Of these 9,656 requests, 5,364 or about five-ninths of the whole were received during the last three months of the nine months' contracts, 4,292 or about four-ninths only having been received 29 during the first six months, and this will be clearly seen on reference being made to Table XVI., in which I have given a summary of the statistics relating to this period. Now taking these tabulated applications, as indeed we must in general, as an index to the manner in which a Contract has been executed, we find that those for the nine months, viz.:—9,656 were 1,474 less than the threefourths, viz.:—11,130, of those for the previous twelve months of which we retain a record and which amounted in the whole to 14,841. From this fact it may be rightly assumed that the shorter contracts were not quite so badly carried out as the former ones, but this favorable contrast can only be taken as applying to the first six months, as nothing could possibly have been much worse than it was during the last three months. Repeated applications, or "second complaints," as well as complaints of neglect, refusal, and incivility, were certainly of less frequent occurrence, although your Sanitary Committee had occasion to inflict penalties amounting to £53. From the table of applications, as stated quarter by quarter, and ward by ward, it will be seen that during the whole of the nine months in question, Ward 4 was the best attended to, the number of applications, viz.:—952 being actually the lowest of the eight Wards, although owing to the quantity of dust which is made, it is considered the heaviest in the parish, and the largest sum is always paid to the Contractors for the work connected with it. Of the 952, however, 578 or more than three-fifths occurred during the last three months, and to state this fact generally as it applies to each Ward, as it has been already stated in respect to the whole parish, it may be observed that all through the table more than one-half of each total will be found to have been received during the last three of the nine months, showing most forcibly the struggle in which the Contractors now engage, by endeavouring to do no more than they are compelled to do towards the end of their contracts, and confining themselves as much as possible, as they certainly appear to have done during these three months, to the carrying out of the orders which they receive daily from the Vestry. I am assured that as yet no attempt has even been made by any one Contractor to do the last quarter's work in any other way than so 30 as to leave the largest quantity of dust he can for his successor to remove, and indeed some Contractors boast of this proceeding as an act of cleverness. Unfortunately, the mischievous consequences and irritation which attend and follow this questionable effort are not at an end when it ceases, for its full effects are generally quite as apparent, for at least the first few weeks of the new contracts. I now wish to point out from internal evidence furnished in connection with this table, how greatly the applications were in excess of what they either should or might have been if the work had been uniformly done even as well as it was in respect to Ward 4, during both the first and second three months when the applications were respectively 190 and 184, numbers which so nearly approach the number of pounds sterling £1962/3) paid each quarter to the Contractor, that for the purposes of comparison here the money paid over any particular period may be supposed to represent roundly the number of applications (one to each pound) which might be expected to be received during such period, It should be borne in mind that this approximate standard is based upon what is seen to have been the actual fact during six months in Ward 4. The test, as first applied to this Ward, shows that as the sum of £590 was paid to Mr, William Irons, the Contractor, during the nine months that 590 applications only should have been received in the same time, whereas they were 952, being 362 in excess, the whole of which occurred during the last three months of the contract. For Wards 2 and 3, the amounts paid to Mr. Henry Crane were £454 and £460 and the applications were 1,201 and 1,239, being 747 and 779 in excess. For Ward 1, Messrs. Jackson and Son were paid £500 and the applications were 1,761 or 1,261 in excess. For Wards 5, 6, 7 and 8, Mr. William Irons was paid £1,200 and the applications numbered 4,503, the excess being 3,303. Again, in Ward 4, the excess was for the whole period at the rate of 61.3 per cent.; in Wards 2 and 3, it was equal to 166.9 per cent.; in Ward 1, to 252.2 per cent.; and in Wards 5,6,7 and 8, to 275.2 per cent. For the whole parish the total sum paid was £3,204, and the applications being 9,656, or three times as numerous as they should have been, the excess amounted to 6,452, and was therefore at the rate of 201.3 per cent. During the first three months the excess upon the whole parish was equal to 92.6 per cent., in the second three months it was 109.2 per cent., and in the 31 third and last three months, it was equal to 402.2 per cent.; the average excess for the nine months being 201.3 per cent., as stated above. These facts and figures exhibiting as they do the irregular and unsatisfactory way in which the Contractors may perform their work, or may not perform it, almost with impunity, especially when considered in connection with the firmness of your Sanitary Committee in dealing with cases of proved neglect, &c., and the penalties which they consequently inflict, together with the thorough supervision which the work receives, so far as it is capable of control, and the exertions of your Inspectors, have led me most irresistibly to the conclusion that the Dusting Contracts of the parish are never likely to be well carried out until the present system of contracting is revised. In my opinion, therefore, an entire or partial change is most desirable in order to secure a regular and thoroughly efficient performance of this work, which is of such vast importance in its bearing upon the health of the public. The changes which have created this necessity and the circumstances now attendant upon the collection of Dust as a consequence, were so fully and graphically described by Dr. Corfield, in the last Annual Report, that I do not purpose to do more than advert to them here, my own remarks being intended rather as a sequel which I desire to make of a remedial character; for the evils inherent to the present system having now been more than once plainly demonstrated, a cure should be sought and if found should be promptly applied, as the symptons, I fear, are not likely to become much, if at all, less aggravated by the lapse of time. We have seen that it is too much to expect of the Contractors that they should be able to resist the temptation which is offered to them by the payment of a fixed sum for certain work over which a complete control cannot be exercised by the Vestry, and which it is therefore the interest of the Contractors to neglect if they can, especially, as we have proved they do, towards the termination of a contract, the profits being calculated not so much upon the quantity of the worse than valueless article which they do remove, but upon the quantity they can leave unremoved to the great inconvenience, trouble and annoyance of all concerned, except 32 themselves, and what is far worse, no doubt to the injury of the health of some. Upon these assumptions the reversal of the one primary but vicious condition is the most obvious remedy, and to effect this the payments should of course be made dependent upon the removal of ascertained quantities, and to this point my enquiries have been directed, in order that I might have some practical suggestion to offer to the Vestry for their consideration. Circular letters upon this subject were, therefore, recently sent to the various Vestries and District Boards of the Metropolis, most of whom still adhere to the old plan, though none appear to like the vexatious nature of the circumstances now accompanying it. Different courses have, however, in several instances been tried and finally adopted with considerable success, and wherever it was found that changes had been made, I there sought personally for further information, which was most courteously afforded, and which convinced me that for the work of dusting alone, the least radical change would be the most advisable. In one case only I learned that the Vestry had reverted to the old method, and had therefore again launched themselves upon a sea of troubles, from which they would now perhaps gladly escape safe back to land. The new plan had proved exceedingly beneficial, comparatively few applications and no grievous complaints having been received ; but an apparently cheap contract at a fixed sum could not be refused, and to effect a probable saving, they have again venturously faced the public odium and complaining, which will return with re-doubled force after the interval of general tranquillity and satisfaction. In some districts railway sidings have been constructed, and shoots and wharves have been either purchased or rented. Horses and plant have also been bought, and the dusting, scavengering, and watering are all done by men employed by the Board. In others, plant only has been purchased, and places of deposit provided, the horses and drivers being hired from contractors by the day, and the work being superintended by men engaged by the Board direct. I do not recommend either of these plans, as experience testifies strongly in favor of leaving the Contractor to provide all that may be needed, so far as it shall be deemed consistent, with a due regard to efficiency. The method which I beg, therefore, to submit for the consideration of the Vestry, and which is described 33 below, is one which perpetuates, though it considerably modifies the contract system, while it commends itself to our judgment by the fact of its having been already adopted and applied to the dusting alone with complete success, and as consequently the best adapted for our own purpose, and most calculated to ensure that result which we all desire, although it may not be accomplished without incurring the small additional cost which this change has undoubtedly involved wherever it has been effected. I deem it only candid to acknowledge this contingency at the outset, while still according to the plan my warmest adhesion, but I do not accept as inevitable a permanently increased annual outlay, as such matters must always adjust themselves in time, though on the first year the cost might for several reasons certainly be in advance of the price which the Contractors would ask if the old plan were continued, as they infinitely prefer the latter, and perhaps would endeavour to prove it to be the more economical. Under this proposed new system the Contractor would be required to find his own places of deposit, and to remove all the Dust and House Refuse at a price per load—say of two or three cubic yards—providing carts, horses, baskets, ladders, and shovels, and also a man to each cart, who would be responsible to the Contractor for the cart, horse, and implements in his charge. Several men would also have to be engaged by the Vestry as dust collectors, in the proportion of one man to every two carts employed, to assist the Contractor's men in their filling, and to direct and control their movements in accordance with such instructions as they may receive from time to time. The men thus in the direct employment of the Vestry, should have no interest in the number of loads removed, of which each would have to keep an account, but should be paid by the day instead, and be held responsible that no gratuities are demanded, although they should be allowed to share in any which may be received; but waste of time in "totting" should be strictly prohibited. A thorough system of check will be necessary, but can only be properly worked out in practice, although much will depend upon the shoots as it is there, or in their vicinity, that it may be deemed expedient that reliable checkers should be placed. The unreasonable condition now imposed upon the Contractors to remove all the refuse collected entirely away out of the parish is frequently evaded, and should not 34 again be made, but proposed shoots within the district should be subject to the approval of your Medical Officer of Health. With the new plan it has been found practicable, on dividing a district into six equal divisions, to put the whole of the strength employed into each of the divisions successively, and always into the same division upon the same day in each week, every street of the division being traversed in the day, and this no doubt has its advantages, but I do not suggest it now as I should deem it wiser for the present to leave untouched any parts of the old system, such as Dusting by Wards, which would not of necessity militate against the success of the new. Contracting for the carts, horses, implements, and men, at so much per day for each cart, &c. employed, and superintended by men in the service of the Vestries, has also been tried and found wanting, the experiment in this direction not having as yet been continued beyond the first few months or year at most, although in two other Metropolitan Districts they have during the present year commenced working upon this system, which having regard to its failure in the hands of others, it would be well I think for us to avoid. There are some other matters of detail connected with the plan suggested, more particularly with regard to the possibility of collusion and fraud among the men, which it would be better just now to reserve as rather fitted for deliberation in Committee, than for statement here; but I wish to notice briefly two or three of the more palpable benefits which we shall derive from its adoption, and which will tend to the promotion of its successful working. 1St.—The work would be under the immediate and entire control and direction of the Sanitary Committee and your officers, and every cart and man hired of the Contractor would be under the observation of men in the employ and payment of the Vestry only. 2nd.—The Contractors would be paid for the actual amount of work done, and not, as formerly, for the work they undertake to do, and thus the greatest evil of the old system would be at once eradicated. 3rd.—Regularity in removal would be attained, as the number of carts engaged daily in the work would of course be known, and would be regulated according to the season and with reference to the exigencies of the parish, and would no longer depend upon the 35 number of carts or horses which the Contractors may be able to spare from the slopping in winter, or from the street scavengering and watering in summer. These latter contingencies, it is well known, have often seriously affected the Dusting of the Parish, which has been made subservient to them, as they, for obvious reasons, are considered as having the first claim, the results of neglect in the public roads being more generally observable than they can be in connection with the 28,000 private dust bins. On occasions, especially when much slopping has been required, very few carts, if any, have been seen engaged in Dusting; but it is not the needs of our own Parish alone which may thus affect us, for in one instance, at least, carts were taken off work in one parish where they were urgently needed, and sent for hire into an adjoining district to the same kind of work, in the performance of which another Contractor was not succeeding, and although the Contractor who thus acted was fined for neglecting his own contract, it was afterwards a subject of self congratulation that the balance upon the transaction was such that it could be regarded as an amply sufficient reward for the imminence of the risk. The adoption of the new system would render such improper irregularities as these an utter impossibility, and the sooner the fatal blow is struck the better it will be. In conclusion, I very heartily commend it to you, as I believe that it would prove to be in Islington, what it has already been proved to be elsewhere, a most satisfactory solution of the important and importunate problem which has of late years forced itself into prominence throughout the Metropolis, and which, under the continuance of the older system of contracting is not capable of being solved, either by the bestowal upon it of any amount of energetic labor and anxiety alone, or by the exercise of any kind of administrative ability. ANNUAL LICENSING OF SLAUGHTER AND COWHOUSES. The Annual Licensing of the Slaughter Houses and Cow Houses in the parish had taken place before my appointment, and I shall therefore only refer to it in connection with one circumstance which I deem it proper to record, viz.:—the granting by the 36 Justices of Licences to several Cow-keepers upon whose premises superficial wells existed, which your Medical Officer of Health and Sanitary Committee were strongly of opinion should be filled up, for which reason their Licences were on that occasion opposed for the second time by the Vestry. My own professional view of the question is most completely in accord with the views of my predecessors, Dr. Ballard and Dr. Corfield, and I must express my deep regret that the wells should not have been abolished, the water from which might at any moment become extremely dangerous both to health and life. Had I consulted my own feelings, I should very much have preferred to have given you in this report an outline of some scientific work with which I have been occupied during the past year, and what I regard as its practical bearings. But as I have with great labor (as I deemed it my duty) endeavoured thoroughly to comprehend the exact state of our parish statistics as a guide to my future work, I have thought some of these might be of interest to the members of the Vestry. This must be my excuse for a lengthy and I fear not very interesting report. Lastly, let me say the duties of a Medical Officer of Health are now-a-days not easy, for they are duties about which every body has formed his own opinion. One will be always accusing him of doing too much, another of not doing enough. Nor do I expect to please all in this matter. I am perfectly conscious of two grand pitfalls in Sanitary Science. Into both men have fallen ; and having fallen into either, it seems well nigh hopeless for them to extricate themselves. One is an extreme sensationalism, bordering on the ridiculous—the other, an extreme indifference, bordering on carelessness. The one side see a camel in every gnat, the other fail to see a camel though it may be before their very eyes. It seems to me that before long we shall be fearful of drinking a drop of water lest some imaginary "previous sewage contamination'' of an age long gone by may be present, an age probably before a human soul had been called into existence; or we shall tremble as we look at our milk jug for fear it may contain the seeds of Typhoid. We shall sit down with a shudder to our very meals, lest the life-sustaining food may have become by the adulterator's hand little less than a dish of poison. We shall fear to breathe a breath of the air of heaven, lest we inhale with it the germs of 37 some terrible disease. Life, under such circumstances, instead of being a pleasure, a happiness, and a comfort, as the beneficent Creator intended, will be a terror, a misery, and a trouble. The revolt against these needless alarms has (naturally I think) created another class. They cry "Peace, peace, when there is no peace." Constantly do they preach "Do nothing, lest you alarm the public —let the enemy attack you before you attack him." I am fully aware how dangerous this theory also is, and to steer the middle course between these extremes, will, therefore be my constant desire as your medical adviser. To be on the watch for the enemy when his approach is heralded, and to have our armour in readiness when he comes, is surely proper generalship. But it shall also be my aim to keep our sanitary defences always so prepared, that there shall be no need to put them in order when we hear the warning note of an approaching epidemic. I do not say that these defences will be impregnable, though I may be pardoned in expressing the opinion that my eminent predecessor, Dr. Ballard, has done much to render them so. But the work of your sanitary officers must have (if it is to be of any use) the active and intelligent support of the public. Each member of the community must strive to be a Sanitarian. I conclude with the words of my friend and lecture-colleague, Dr. Letheby, written many years ago on the eve of a Cholera outbreak (but they are words of universal application), "To all I would "say the most powerful means of repelling the disease are "prudence and cleanliness. Avoid all those circumstances "which lower the vital powers, and remove the putrid filth "which gives the malady a footing. If I were to write an "essay on the subject I could tell you no more." These are the views I hold strongly on the means to be adopted in effecting sanitary reforms, and in the attempt to carry them out in Islington, I hope and believe I shall receive the cordial support of your Vestry. I have the honor, Gentlemen, To remain your obedient Servant, C.MEYMOTT TIDY. 1st July, 1873. TABLE XIII. DEATHS REGISTERED IS ISLINGTON DURING (Deaths of Non-Residents West. East. Cause of Death. All Ages. AGES. Und. 1. 1- 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80 Tip 1727 2303 All Causes i030 1200 412 202 94 57 1965 108 52 71 463 5 51 696 124 (Classes.) 422 535 I. ZYMOTIC DIS. 957 379 189 94 56 36 754 53 11 10 60 20 42 7 332 485 II. CONSTITUTL 817 100 69 29 10 12 220 23 18 40 232 188 91 5 747 962 III. LOCAL 1709 399 146 72 24 9 650 30 21 20 139 327 472 50 185 286 IV. DEVELOPMNL 471 291 7 4 1 ... 303 ... ... ... 20 6 85 57 41 35 V. VIOLENT DTHS. 76 31 1 3 3 ... 38 2 2 1 12 10 6 5 Not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... (Orders.) 387 502 I. 1. Miasmatic Dis- 889 325 186 94 56 35 696 53 11 10 56 16 40 7 14 24 Small Pox 38 9 3 3 2 1 18 1 2 3 12 2 ... ... 47 73 Measles 120 21 51 25 10 2 109 10 ... ... 1 ... ... ... 21 31 Scarlatina 52 2 8 9 8 8 35 14 1 ... 2 ... ... ... 13 13 Diphtheria 26 6 ... 4 5 2 17 4 2 1 2 ... ... ... ... ... Quinsey ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 16 Croup 24 3 7 7 3 1 21 3 ... ... ... ... ... ... 120 Whooping 273 94 95 40 23 15 267 6 ... ... ... ... ... ... 29 32 Typhus & Typhoid 61 2 1 2 3 3 11 12 4 3 18 4 9 ... 8 9 Erysipelas 17 5 ... ... ... 1 6 1 ... ... 1 3 6 ... 1 ... Pyœmia 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 4 Puerperal Fever 7 ... ... ... ... ... ... ... ... 1 5 1 ... ... 1 1 Carbuncle 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... Influenza ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Dysentery 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 97 125 Diarrhœa 222 178 20 3 2 1 204 ... ... 1 1 12 4 5 8 Cholera 13 5 1 1 ... ... 7 1 ... 1 1 1 2 ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 18 Rheumatism 31 ... ... ... ... 1 1 1 2 1 11 3 9 3 18 10 2. Enthetic 28 21 2 ... ... 1 24 ... ... ... ... 2 2 ... 15 10 syphilis 25 21 2 ... ... 1 24 ... ... ... ... 1 ... ... 3 ... Stricture of Urethra 3 ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 18 3. Dietic 30 23 1 ... ... ... 24 ... ... ... 4 2 ... ... ... ... Privation ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 15 Want of Br. Milk 23 23 ... ... ... 23 ... ... ... ... ... ... ... ... 2 Purpura and Scurvy 2 ... 1 ... ... ... 1 ... ... ... 1 ... ... ... 4 1 Alcoholism 5 ... ... ... ... ... ... ... ... ... 3 2 ... ... 5 5 4. Parasitic 10 10 ... ... ... ... 10 ... ... ... ... ... ... ... 5 5 Thrush 10 10 ... ... ... ... 10 ... ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... ... ... ... ... ... ... 59 93 II. 1. Diathetic 159. 4 4 ... 2 ... 10 1 ... 1 12 56 68 4 2 6 Gout 8 ... ... ... ... ... ... ... ... ... 2 6 ... 5 13 Dropsy 18 2 1 ... 1 ... 4 ... ... ... 2 7 5 ... 3 ... Hæmorrhage 3 1 ... ... ... ... 1 ... ... ... 1 1 ... ... 44 63 Cancer 107 ... 1 ... ... ... 1 ... ... 1 8 45 51 1 ... ... Cancrum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... 5 11 Mortification 16 1 2 ... 1 ... 4 1 ... ... 1 1 6 3 273 392 2. Tubercular 665 96 65 29 8 12 210 22 18 39 220 132 23 1 19 16 Scorofula 35 13 8 2 1 1 25 2 2 1 4 1 ... ... 21 33 Tabes Mesenterica 54 27 16 6 2 1 52 1 1 ... ... ... ... ... 193 278 Phthisis 471 17 14 8 2 5 46 6 10 38 216 131 23 1 40 65 Hydrocephalus 105 39 27 13 3 5 87 13 5 ... ... ... ... ... 184 252 III.1. Nervous Syst. 436 119 43 21 9 5 197 10 6 3 22 68 121 9 36 44 Cephalitis 80 22 17 14 6 4 63 7 4 ... 4 2 ... ... 34 56 Apoplexy 90 1 1 ... ... 2 ... ... ... 6 30 47 5 33 30 Paralysis 63 ... ... ... ... ... 1 ... ... 4 10 44 4 ... 2 Insanity 2 ... ... ... ... ... ... 1 ... 1 ... ... ... ... Chorea ... ... ... ... ... ... ... ... ... .. ... ... 5 11 Epilepsy 16 ... ... 2 ... 2 ... ... 2 2 8 2 ... 56 76 Convulsions 132 96 25 5 3 130 1 ... ... ... 1 ... ... 20 33 Brain Diseases, &C. 53 ... ... ... ... ... 1 1 1 5 17 28 ... 79 133 2. Organs of Circ 212 2 ... 1 ... ... 3 6 5 3 35 81 73 6 1 6 Pericarditis 7 ... ... 1 ... 1 1 1 ... ... 3 1 ... 3 4 Aneurism 7 ... ... ... ... ... ... ... ... 1 5 1 ... 75 123 Heart Disease 198 2 ... ... ... 2 5 4 3 34 73 71 6 TABLE XIII. FIFTY-TWO WEEKS, ENDING 28TH DECEMBER, 1872. 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. 361 430 3. Respirat. Orgs. 791 251 101 46 11 4 413 8 4 4 30 106 200 26 17 14 Laryngitis 31 1 8 1 ... 1 28 2 1 ... ... ... ... ... 203 253 Bronchitis 456 135 53 19 5 ... 212 3 ... 2 10 64 145 20 3 5 Pleurisy 8 ... ... ... ... ... ... 1 ... ... ... 2 2 3 107 127 Pneumonia 234 89 38 25 6 3 161 1 3 1 17 19 30 2 11 12 Asthma 23 ... ... ... ... ... ... ... ... 1 ... 10 11 1 20 19 Lung Diseases, &c. 39 9 2 1 ... ... 12 1 ... ... 3 11 12 ... 80 88 4. Digestive Orgs. 168 18 2 4 1 ... 27 5 4 4 30 37 55 6 4 4 Gastritis 8 ... ... ... 1 ... 1 1 ... 1 3 ... 2 ... 2 11 Enteritis 13 3 1 1 1 ... 6 2 1 ... ... 2 2 ... 8 8 Peritonitis 16 2 ... ... ... ... 2 ... 2 2 6 2 2 ... ... 3 Ascites 3 ... ... ... ... ... ... ... ... ... ... 2 1 ... 2 4 Ulceration of Intes. 6 ... ... ... ... ... ... ... ... ... 1 2 3 ... 7 4 Hernia 11 ... ... ... ... ... ... ... ... ... 3 1 5 2 3 4 Ileus 7 ... ... ... ... ... ... 1 ... ... 1 2 3 ... 1 2 Intussusception 3 1 ... 1 ... ... 2 ... ... ... ... 1 ... ... 3 ... Stricture of Intest. 3 ... ... ... ... ... ... ... ... ... 3 ... ... ... ... 2 Fistula 2 ... ... ... ... ... ... ... ... ... ... 1 1 ... 12 13 Stomach Dis., &c. 25 4 1 2 ... ... 7 ... ... ... 2 3 12 1 ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 2 Hepatitis 6 ... ... ... ... ... ... ... 1 1 1 1 2 ... 5 9 Jaundice 14 7 ... ... 1 ... 8 ... ... ... 1 3 2 ... 29 20 Liver Disease 49 1 ... ... ... ... 1 ... ... ... 9 16 20 3 ... 2 Spleen Disease 2 ... ... ... ... ... ... 1 ... ... ... 1 ... ... 25 24 5. Urinary Organs 49 2 ... ... ... ... 2 ... ... 2 11 20 12 2 ... ... Nephritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 3 Disease of Bladder 10 ... ... ... ... ... ... ... ... ... 1 3 5 1 6 11 Albuminuria 17 1 ... ... ... ... 1 ... ... 1 5 8 2 ... 3 1 Diabetes 4 ... ... ... ... ... ... ... ... 1 1 2 ... ... ... ... Stone ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Prostrate Disease 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 9 8 Kidney Diseas 17 1 ... ... ... ... 1 ... ... ... 4 7 4 1 7 12 6. Genera. Organs 19 ... ... ... ... ... ... ... ... 1 5 9 4 ... 4 3 Ovarian Dropsy 7 ... ... ... ... ... ...... ... ... ... 2 3 2 ... 3 9 Uterine Diseases 12 ... ... ... ... ... ... ... ... 1 3 6 2 ... 8 12 7. Orgs, of Locomo, 20 3 ... ... 1 ... 4 1 2 3 3 3 4 ... 3 7 Spine Diseases 10 ... ... ... ... ... ... ... 1 2 2 3 2 ... 5 5 Bone Diseases 10 3 ... ... 1 ... 4 1 1 1 1 ... 2 ... 3 11 8. Skin, &c 14 4 ... ... ... ... 4 ... ... ... 3 3 3 1 1 2 Phiegmon & Abscess 3 ... ... ... ... ... ... ... ... ... 2 1 ... ... ... 6 Ulcer 6 1 ... ... ... ... 1 ... ... ... 1 1 3 ... 2 3 Skin Diseases 5 3 ... ... ... ... 3 ... ... ... ... 1 ... 1 60 58 IV. 1. Dis. of Childn. 118 118 ... ... ... 118 ... ... ... ... ... ... ... 55 52 Premature Birth 107 107 ... ... ... ... 107 ... ... ... ... ... ... ... 2 3 Cyanosis 5 5 ... ... ... ... 5 ... ... ... ... ... ... ... ... 1 Spina Bifida l 1 ... ... ... ... 1 ... ... ... ... ... ... ... 3 1 Other Malformation 4 4 ... ... ... ... 4 ... ... ... ... ... ... ... ... 1 Teething 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... 6 14 2. Dis. of Adults 20 ... ... ... ... ... ... ... ... ... 19 1 ... ... ... ... Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 14 Childbirth 20 ... ... ... ... ... ... ... ... ... 19 1 ... ... 44 103 3. Dis. of Aged 147 ... ... ... ... ... ... ... ... ... ... 5 85 57 44 103 Old Age 147 ... ... ... ... ... ... ... ... ... ... 5 85 57 75 111 4. Dis. of Nutritn. 186 173 7 4 1 ... 185 ... ... ... 1 ... ... ... 75 111 Atrophy & Debility 186 173 7 4 1 ... 185 ... ... ... 1 ... ... ... 30 29 V. 1. Aoci. or Neg. 59 27 1 3 2 ... 33 2 1 1 7 6 4 5 12 12 Fract, and Contus. 24 3 ... 3 1 ... 7 1 1 1 3 3 4 4 ... ... Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Burns and Scalds... 2 1 ... ... 1 ... 2 ... ... ... ... ... ... ... 2 1 Potson 3 1 1 ... ... ... 2 ... ... ... 1 ... ... ... 1 2 Drowning 3 ... ... ... ... ... ... ... ... ... 3 ... ... ... 13 8 Suffocation 21 20 ... ... ... ... 20 ... ... ... ... 1 ... ... 1 5 Otherwise 6 2 ... ... ... ... 2 1 ... ... ... 2 ... 1 3 3 2. Homicide 6 4 ... ... 1 ... 5 ... ... ... 1 ... ... ... 8 3 3. Suicide 11 ... ... ... ... ... ... ... 1 ... 4 4 2 ... 2 2 Wounds 4 ... ... ... ... ... ... ... ... ... 1 2 1 ... ... ... Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... Drowning 3 ... ... ... ... ... ... ... 1 ... 1 1 ... ... 2 1 Suffocat. and Hang. 3 ... ... ... ... ... ... ... ... 1 1 1 ... 1 ... Otherwise 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... ... ... ... ... ... ... TABLE XIV. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From March 26th., 1872, to March 25th, 1873. South East District. South West District. North District. Total.. Number of Houses inspected 1143 1136 1470 3749 Re-inspections, Calls made, &c. 6845 3229 3219 13293 Visists to 216 Bakehouses 212 115 140 467 Do. 73 Cowhouses 100 85 94 279 Do. 110 Slaughter-houses 196 216 123 535 Do. Stables and Yards 151 116 26 293 Do. Factories and Workshops 4 .. 2 6 Do. Fields, Lanes, &c. 133 1 40 174 Do. 38 Factories, Horse Slaughter-houses, Piggeries, &c. .. 102 4 106 Belle Isle. Do. 110 Courts and Alleys 3500 1094 751 5345 Total Inspection, &c. 12234 6094 5869 24247 IMPROVEMENTS. Drains Constructed 50 32 70 152 Improved or repaired 176 217 135 528 Traps fixed 211 193 219 623 Cesspools Abolished 14 5 29 48 Cleansed or disinfected .. .. 1 1 Privies and Water Closets Pan, trap, and water supply furnished 24 8 24 56 Pan and trap only furnished 10 26 18 54 Water supply furnished 56 78 163 297 Dust bins Constructed 17 22 26 65 Repaired and covers adapted 8 14 55 77 Surface Drains and Pavements of Yards Constructed 19 21 4 44 Relaid 179 303 183 665 General Water Supply New receptacles provided 11 26 6 43 Receptacles repaired and cleansed 427 152 63 642 Water supply provided .. 1 12 13 Other Improvements Houses generally repaired 66 34 165 265 ,, &c., cleansed or limewashed 494 332 397 1223 ,, Ventilated 1 16 8 25 Overcrowding abated 5 13 9 27 Illegal use of underground Booms for sleeping discontinued .. 22 .. 22 Other Amendments, or Nuisances abated 189 72 431 692 Houses or Rooms Disinfected 34 137 79 250 Total Improvements 1991 1724 2097 5812 Total Premises Improved 1044 826 871 2741 N.B.—From the 26th March, 1872, to the 22nd March, 1873, the Inspector of Dust visited 26,279 houses and found that Dust was required to be removed from 10,112 of these houses. TABLE XV. 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 Readings. Mean of Lowest Daily Readings. Mean Daily | Range. January 41.0° 45.4° 36.3° 9.0 87 3.49 21 1871. 1872. 4 wks. Dec. 31—Jan. 27 1872. February 44.9° 50.4° 40.3° 10.0 88 0.85 14 4 „ Jan. 28—Feb. 24 March 44.3° 52.3° 38.1° 14.1 84 2.56 19 5 „ Feb. 25—Mar. 30 April 48.9° 59.3° 41.5° 17.8 69 1.15 15 4 „ Mar. 31—Apr. 27 May 50.4° 61.1° 42.9° 18.2 69 2.25 17 4 „ Apr. 28—May 25 June 59.8° 71.3° 51.8° 19.5 66 2.20 16 5 „ May 26—June 29 July 65.7° 79.3° 56.7° 22.6 68 3.20 15 4 „ June 30—July 27 August 62.4° 74.70 54.3° 20.4 72 1.85 10 4 „ July 28—Aug. 24 September. 58.7° 68.0° 51.6° 16.4 72 2.08 14 5 „ Aug. 25—Sep. 28 October 47.8° 55.8° 41.7° 14.1 85 4.17 19 4 „ Sep. 29—Oct. 26 November 45.3° 50.7° 40.5° 10.1 84 2.96 18 4 „ Oct. 27—Nov. 23 December 43.6° 47.6° 39.6° 7.9 85 5.26 26 5 „ Nov. 24—Dec. 28 Means of Year, 51.0° 59.6° 44.6° 15.0 Sum. 32.02 Sum. 204 1871. 1872. Dec. 31 to Dec. 28 The highest temperature in the shade attained was 92.5° on July 25th. The lowest temperature reached was 27.8° on March 22nd and 25th. Snow fell in the 12th, 13th, 16th, and 45th weeks of the year. Thunder storms occurred on May 7th and 9th, June 24th, July 11th, 12th, 13th, 22nd, 23rd, and 25th, August 2nd, and 7th, September 3rd and 29th, and October 3rd. Instead of stating the Means of Observations for each Calendar Month, I have stated them in periods corresponding with those used in my monthly Tables, which alone can serve any useful purpose for comparison with the coincident Mortality. TABLE XVI. Summary of Applications for Removal of Dust, from 24th of June, 1872, to 25th of March, 1873. Contractor. Ward. Three months ending 21st Sept., 1872. Three months ending 21st Dec., 1872. Three months ending 22nd March, 1873. Total during Nine months Contract. Amount paid to Contractors for whole period. Jackson and Son 1 393 438 930 1761 £500 Henry Crane 2 243 234 724 1201 £454 Do. 3 386 222 631 1239 £460 William Irons 4 190 184 578 952 £590 Do. 5 188 222 544 954 £1200 Do. Do. 6 7 210 205 339 226 593 700 1142 1131 Do. 8 242 370 664 1276 Totals 2057 2235 5364 9656 £3204 Removals ordered from Reports of the In- spector of Dust and other Inspectors. ) 2523 2872 3353 8748 Total Removals 4580 5107 8717 18404 REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON FOR JULY, 1872. No. CCII. The total number of deaths registered in the parish during the week ending July 27th, viz.; 304, although higher than the corresponding number last year was decidedly lower than the average for the month, only giving a death-rate of 18 per 1000 per annum on the estimated population, while that of London generally was 22 per 1000 per annum during the same period: the rate has steadily increased during the four weeks in question, as was to be expected from the exceptionally low rates in May and June, and it is possible that it may further increase in the succeeding months. We are still remarkably free from epidemic diseases; no death has been recorded from Small-Pox in the parish during the four weeks; and this is the first time that such has been the case since May, 1870. On the other hand to Diarrhoea, which only caused 6 deaths in June, 49 deaths have been attributed, of which 45 were among children under 1 year of age. Under the heading Cholera five deaths are recorded, three being those of infants under 1 year old, and the other two of adults; I see no reason to believe that any of them were anything more than cases of Choleraic Diarrhœa, or so-called English Cholera; indeed it appears on enquiry, that the death of one of the adults was brought about by eating a quantity of unripe fruit. Last month I thought it necessary to point out the great danger of connecting the waste pipes of cisterns with the traps or soil-pipes of water-closets; while repeating this caution, I must now refer to the fact that there is a form of trap in common use in areas, and even in the sinks, &c., in the kitchens and back-kitchens of houses, which is not only very often useless, but worse than useless, as I shall presently show:—1 mean the ordinary bell-trap; this trap is so well known, that I need hardly describe it; when there is plenty of water and the moveable top is in its place, with the rim of the bell in the water, all is well, provided the pressure of gas in the sewer is not sufficient to cause it to force its way through the half inch of water which is between 2 it and the air of the house, but let the area be dry for a few days, or the sink disused, and then the small quantity of water is very soon evaporated, and the foul air rises up as if there were no trap at all, while the inhabitants think themselves secure as "the trap is on." Nay, more than this, water does not run easily through these traps, so it is quite usual for servants to take off the tops to let the water run away, and then they are of course often left off, perhaps for a whole night, and the sewer is ventilated into the area, or even into the house. As I walked along a street in Islington the other day, I saw that the tops of nearly all the bell-traps had been taken off during the heavy rains of the previous day, and were left lying in the areas, and this induced me to make the above remarks. Almost any trap is better than the bell-trap, but I think that on the whole, the glazed earthenware syphon traps now made are the best for areas, as they hold a large quantity o f water, and if the top is broken or left off it matters little, as the trap is still effective; these traps are also easily cleaned. Where sink pipes cannot be taken outside and made to end on the surface of the yard they should have a syphon bend on them. These matters are of essential importance, especially at a time when the air in the sewers is liable to be unusually foul. 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 Tempera tures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending July 6th 65.2 79.6 54.9 24.7 58 0.53 2 „ „ 13th 63.6 75.8 57.2 18.6 78 1.02 6 „ „ 20th 61.9 75.0 53.4 21.5 71 0.17 3 „ „ 27th 72.1 87.1 61.6 25.6 65 1.48 4 Means. 65.7 79.3 56.7 22.6 68 Sum. 3.20 Sum. 15 The highest day temperature, observed on July 25th, was 92.5° The lowest night temperature, observed on June 30th, was 47.3° Thunder Storms on July 11th, 12th, 13th, 22nd, 23rd, 25th. W. H. CORFIELD, M.A., M.D., (Oxon). Medical Officer of Health Vestry Offices, August 3rd, 1872. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING JULY 27th, 1872. (Deaths of Non-Rcsidents io 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 rears of age. At 80 years of age and upwards. 118 186 All Causes 304 194 27 35 38 10 17 22 3. Respirat, Orgs 39 26 2 5 6 ... 1 ... Laryngitis 1 1 ... ... ... ... 8 8 Bronchitis 16 10 1 1 4 ... (Classes.) ... ... Pleurisy ... ... ... ... ... ... 38 49 I. ZYMOTIC DIS. 87 82 1 2 2 ... 6 10 Pneumonia 16 11 1 2 2 ... ... ... Asthma ... ... ... ... ... ... 23 50 II. CONSTITUTL 73 35 17 14 6 1 2 4 Lung Diseases, & c. 6 4 ... 2 ... ... 1 4. Digestive Orgs. 12 3 1 2 6 ... 42 50 III. LOCAL 92 48 5 19 20 ... 11 ... Gastritis 1 ... ... ... 1 ... 15 34 IV. DEVELOPMNL 49 28 2 ... 10 9 1 ... Enteritis 1 1 ... ... ... ... ... 3 V. VIOLENT DTHS 3 1 2 ... ... ... ... ... Peritonitis ... ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... ... Not Specified ... ... ... ... ... ... ... ... Ulceration of Intes. ... ... ... ... ... ... ... ... Hernia ... ... ... ... ... ... ... ... Ileus ... ... ... ... ... ... (Orders) ... ... Intussusoeption ... ... ... ... ... ... 38 47 I. 1. Miasmatic Dis. 85 80 1 2 2 ... ... ... Stricture of Intest ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... 2 7 Measles 9 9 ... ... ... ... 3 ... Stomach Dis., & c. 3 1 1 ... 1 ... ... 1 Scarlatina 1 1 ... ... ... ... ... ... Pancreas Dis., &c. ... ... ... ... ... ... 1 1 Diphtheria 2 2 ... ... ... ... 2 ... Hepatitis 2 1 ... ... 1 ... ... ... Quinsey ... ... ... ... ... ... ... ... Jaundice ... ... ... ... ... ... 1 2 Croup 3 3 ... ... ... ... 4 1 Liver Disease 5 ... ... 2 3 ... 5 5 Hooping Cough 10 10 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... 2 1 Typhus & Typhoid 3 1 ... 1 1 ... 2 3 5. Urinary Orgs. 5 1 ... 2 2 ... ... 1 Erysipelas 1 1 ... ... ... ... ... Nephritis ... ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... ... ... Diseases of Biaderi ... ... ... ... 1 ... ... ... Puerperal Fever ... ... ... ... ... ... ... 1 Nephria 1 ... ... ... ... ... ... Carbuncle ... ... ... ... ... ... ... 1 Diabetes 1 ... 1 ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease ... ... ... ... ... ... 14 25 Diarrhœa 49 48 ... ... 1 ... 2 1 Kidney Disease,&c. 3 1 ... 1 1 ... 1 4 Cholera 5 3 1 1 ... ... 1 2 6. Genera. Organs 3 ... ... 2 1 ... ... ... Ague ... ... ... ... ... ... ... Overian Dropay ... ... ... ... ... ... 2 ... Rheumatism 2 2 ... ... ... ... 1 2 Uterine Diseases ... ... 2 1 ... ... ... 2. Enthetic ... ... ... ... ... ... ... ... 7. Orgs.of Locomo. ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... Spine Diseases ... ... ... ... ... ... ... ... Stricture of Urethra ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... 2 ... 8. Skin, &c. 2 1 ... ... ... ... ... ... Glanders ... ... ... ... ... ... l ... Phlegmon & Abscess 1 ... ... ... ... ... ... 1 3. Dietic 1 1 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... 1 ... Skin Diseases 1 1 ... ... ... ... ... 1 Want of Br Milk 1 1 ... ... ... ... ... ... Purpura and Scurvy ... ... ... ... ... ... 4 6 IV. 1. Dis. of Childn. 10 10 ... ... ... ... ... ... Alcoholism ... ... ... ... ... ... 4 4 Premature Birth 8 8 ... ... ... ... ... 1 4. Parasitic 1 1 ... ... ... ... ... 2 Cyanosis 2 2 ... ... ... ... ... 1 Thrush 1 1 ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... Other Malformation ... ... ... ... ... ... 2 9 IX 1 Diathetic 11 ... 1 5 4 1 ... 2 Teething 2 ... 2 ... ... ... ... ... Gout ... ... ... ... ... ... ... ... 2. Dis. of Adults. ... ... ... ... ... ... ... 1 Dropsy 1 ... 1 ... ... ... ... 2 Paramenia 2 ... 2 ... ... ... ... ... Hæmorrhage ... ... ... ... ... ... 3 16 Childbirth 19 ... ... ... 10 9 2 7 Cancer 9 ... ... 5 4 ... 3 16 3. Dis. of Aged 19 ... ... ... 10 9 ... ... Noma ... ... ... ... ... ... 8 10 Old Age 18 18 ... ... ... ... ... 1 Mortification 1 ... ... ... ... 1 8 10 4. Dis. of Nutritn. 18 18 ... ... ... ... 21 41 2. Tubercular — 62 35 16 9 2 ... ... Atrophy & Debility 1 1 Scrofula 2 2 ... ... ... ... ... 2 V. 1. Acci. or Neg. 2 1 1 ... ... ... 1 7 Tabes Mesenterica 8 8 ... ... ... ... ... Fract. and Contus. ... ... ... ... ... ... 14 22 Phthisis 36 9 16 9 2 ... ... ... Wounds ... ... ... ... ... ... 5 11 Hydrocephalus 16 16 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... 8 18 III. 1. Nervous Syst. 26 17 ... 5 4 ... ... ... Poison 1 ... 1 ... ... ... ... 5 Cephalitis 5 5 ... ... ... ... ... 1 Drowning 1 1 ... ... ... ... 1 4 Apoplexy 5 2 ... l 2 ... ... 1 Suffocation ... ... ... ... ... ... ... 1 Paralysis 1 ... ... ... 1 ... ... ... Otherwise 1 ... ... ... ... ... ... 1 Insanity 1 1 ... ... ... ... ... 1 2. Homicide ... ... ... ... ... ... ... ... Chorea ... ... ... ... ... ... ... ... 3. Suicide ...... ... ... ... ... ... 1 ... Epilepsy 1 ... ... 1 ... ... ... ... Wounds ... ... ... ... ... ... 5 4 Convulsions 9 9 ... ... ... ... ... ... Poison ... ... ... ... ... ... 1 3 Brain Diseases, &e. 4 ... ... 3 1 ... ... ... Drowning ... ... ... ... ... ... 1 4 2. Organs of Circ. 5 ... 1 3 1 ... ... ... Sutfocat.and Hang. ... ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4, Otherwise ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... 1 4 Heart Disease 5 ... 1 3 1 ... TABLE II. NEW CASES OP DISEASE COMING UNDER TREATMENT DURING THE FOUR WEEKS ENDING SATURDAY, THE 27th DAY of JULY, 1872, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infants Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary Pentonville Convict Prison Total. Small Pox .. .. .. 11 2 .. 13 Chicken Pox .. .. .. 7 6 .. 13 Measles .. 26 .. 1 17 .. 44 Scarlatina .. .. .. 2 10 .. 12 Whooping Cough .. .. .. 17 14 .. 31 Croup .. .. .. .. .. .. .. Diarrhœa .. .. .. 67 84 29 180 Dysentery .. .. .. .. 2 .. 2 Cholera .. .. .. .. .. .. .. Ague .. .. .. 1 .. 1 2 Continued Fever .. .. .. 10 4 .. 14 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. .. 5 2 .. 7 Erysipelas .. .. .. 2 3 .. 5 Diphteria .. .. .. 1 .. .. 1 Sorethroat or Tonsillitis .. .. .. 10 21 5 36 Mumps .. .. .. .. .. .. .. Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh .. 3 .. 47 93 14 157 Pneumonia .. 1 .. 4 3 .. 8 Pleurisy .. .. .. 4 3 .. 7 Delirium Tremens .. .. .. 1 .. .. 1 Insanity .. .. .. .. .. .. .. Carbuncle .. .. .. .. 1 .. 1 All other Diseases .. 27 .. 443 641 138 249 Total .. 57 .. 633 906 187 1783 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From July 1st, 1872, to July 27th, 1872. South East District. South "West District. North District. Tc Number of Houses inspected 176 140 191 507 Drains Constructed 2 6 2 10 Improved or repaired 18 44 7 69 Traps fixed 17 48 35 100 Cesspools Abolished 2 .. 23 25 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 2 5 9 16 Pan and trap only furnished 3 4 7 Water supply furnished 12 10 22 44 Dust bins Constructed 3 2 1 6 Repaired and covers adapted .. 5 11 16 Surface Drains and Pavements of Yards Constructed 1 11 1 13 Relaid 16 46 24 86 General Water Supply New receptacles provided .. 2 1 3 Receptacles repaired and cleansed 36 10 11 57 Water supply provided .. .. 3 3 Other Improve- ments Houses generally repaired 9 1 33 43 ,, &c., cleansed or limewashed. 55 13 73 141 .. .. .. .. 1 1 1 3 Illegal use of underground Rooms for sleeping discontinued .. 9 .. 9 Other Amendments, or Nuisances abated 9 11 59 79 N.B.—From July 1st, to July 27th, the Inspector of Dust visited 2071 houses and found Dust was required to be removed from 707 of these. REPORT on the SANITARY CONDITION OF ST. MARY, ISLINGTON FOR AUGUST, 1872. No. CIII. The total number of deaths during the four weeks ending August 24th, namely, 347, is smaller than the number for the same month was in 1870 and 71, the reason being that our comparative immunity from epidemic diseases still continues; the amount of seasonal Diarrhoea is rather high, and is as usual very fatal to infants under 1 year of age: Small-Pox shows again to a slight extent in the mortality table, and Hooping Cough, which has never left us, caused 19 deaths, a large number for the month. Nevertheless the parish is altogether in a healthy condition, the deaths during the month being only at the rate of 20½ per 1000 per annum, the rate for London generally having been 233/4. METEOROLOGY OP AUGUST. Thermometers 4 feet from ground. Degree of Atmospheric Humidity, Saturation being represented by 100. Rain in inches read at Collected on the ground. Sum. Number of days on which Rain fell in appreciable quantity. Sum. Mean of Daily Values. Mean of Highest Tempera tures. Mean of Lowest Temperatures. Mean Daily Range of Temp. Week ending Aug. 3rd 63.0 74.8 55.8 19.0 69 1.03 4 ,, ,, 10th 60.0 70.0 54.0 16.0 80 0.82 6 ,, ,, 17th 61.2 74.2 51.7 2 2 .5 67 0.00 0 ,, 24th 65.6 79.8 55.7 24.1 73 0.00 0 Means. 62 4 74.7 54.3 20.4 72 Sum. 1.85 Sum. 10 The highest day temperature, observed on August 17th, was 84.0° The lowest night temperature, observed on August 13th, was 47.0° Thunder Storms on August 3rd, and 7th. W. H. CORFIELD M.A., M.D., (Oxon). Medical Officer of Health. Vestry Offices, August 31 st, 1872. DEATHS REGISTERED IN ISLINGTON DURING FOUR WEEKS ENDING AUGUST 24th, 1872. (Deaths of Non-Residents 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 age. At 40 and under 60 years of age. At 60 and under 80 years of age. At 80 years of age j 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 rears of age. At 80 years of age and upwards. 138 209 All Causes 347 222 35 38 47 5 10 10 3. Respirat. Orgs 20 12 ... 2 5 1 " ... ... Laryngitis ... ... ... ... ... ... 5 7 Bronchitis 12 5 ... 2 4 1 (Classes.) ... ... Pleurisy ... ... ... ... ... ... 62 81 I. ZYMOTIC DIS 143 130 3 7 3 5 2 Pneumonia 7 6 ... ... 1 ... 17 19 15 12 ... ... Asthma ... ... ... ... ... ... 16 II CONSTITUTL 63 ... ... 1 Lung Diseases, &c. 1 1 ... ... ... ... 39 51 III. LOCAL 90 32 11 21 24 2 7 9 4. Digestive Orgs. 16 3 3 6 4 ... ... ... Gastritis ... ... ... ... ... ... 16 24 IV. DEVELOPMNL 40 35 1 1 3 ... ... 1 Enteritis 1 1 ... ... ... ... 5 6 V. VIOLENT DTHS 11 8 1 1 1 ... ... ... Peritonitis ... ... ... ... ... ... ... 1 Ascites 1 ... ... 1 ... ... ... ... Not Specified ... ... ... ... ... ... 1 ... Ulceration of Intes. 1 ... ... ... 1 ... ... ... Hernia ... ... ... ... ... ... (Orders.) 1 ... Ileus 1 ... ... 1 ... ... ... ... Intussusception ... ... ... ... ... ... 58 78 I. 1. Miasmatic Dis. 136 123 3 ... 7 3 1 ... Stricture of Inter 1 ... 1 ... ... ... 3 1 Small Pox 4 2 2 ... ... ... ... ... Fistula ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 2 Stomach Dis., & c. 3 ... ... 1 2 ... ... ... Scarlatina ... ... ... ... ... ... ... ... Pancreas Dis., &c ... ... ... ... ... ... 1 2 Diphtheria 3 3 ... ... ... ... 1 1 Hepatitis 2 1 ... 1 ... ... ... ... Quinsey ... ... ... ... ... ... 1 Jaundice 1 1 ... ... ... ... ... 1 Croup 1 1 ... ... ... ... 1 4 Liver Disease 5 ... 2 2 1 ... 7 12 Hooping Cough 19 19 ... ... ... ... ... ... Spleen Disease ... ... ... ... ... ... ... 3 Typhus & Typhoid 3 2 1 ... ... ... 1 3 5. Urinary Orgs. 4 ... 1 3 ... ... 1 1 Erysipelas 2 1 ... ... 1 ... ... ... Nephritis ... ... ... ... ... ... ... ... Pyœmia ... ... ... ... ... ... ... ... Disease of Bladder ... ... ... ... ... ... ... 1 Puerperal Fever 1 1 ... ... ... ... ... 2 Nephria 2 ... ... 2 ... ... ... ... Carbuncle ... ... ... ... ... ... 1 ... Diabetes 1 ... ... 1 ... ... ... ... Influenza ... ... ... ... ... ... ... ... Stone ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Prostrate Disease . ... ... ... ... ... ... 44 53 Diarrhœa 97 91 ... ... 3 3 ... 1 Kidney Disease,&c. 1 ... 1 ... ... ... 2 3 Cholera 5 3 ... ... 2 ... 1 1 6. Genera. Organs 2 ... ... 1 1 ... ... ... Ague ... ... ... ... ... ... 1 1 Ovarian Dropsy 2 ... ... 1 1 ... ... 1 Rheumatism 1 ... ... ... 1 ... ... ... Uterine Diseases ... ... ... ... ... ... 3 1 2. Enthetic 4 4 ... ... ... ... ... 2 7. Orgs.of Locomo 2 1 ... 1 ... ... 3 1 Syphilis 4 4 ... ... ... ... ... l Spine Diseases 1 ... ... 1 ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... 1 Bone Diseases 1 1 ... ... ... ... ... ... Hydrophobia ... ... ... ... ... ... ... ... 8. Skin, &c ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... Phlegmon &Abscess ... ... ... ... ... ... 1 2 3. Dietic 3 3 ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... ... Privation ... ... ... ... ... ... ... ... Skin Diseases ... ... ... ... ... ... 1 1 Want of Br. Milk 2 2 ... ... ... ... ... 1 Purpura and Scurvy 1 1 ... ... ... ... 6 4 IV. 1. Dis. of Childn. 10 10 ... ... ... ... ... ... Aleoholism ... ... ... ... ... ... 5 3 Premature Birth .. 8 8 ... ... ... ... ... ... 4. Parasitic ... ... ... ... ... ... ... ... Cyanosis ... ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... ... Spina Bifida ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... 1 ... Other Malformation. 1 1 ... ... ... ... 2 13 II. 1. Diathetic 15 ... ... 5 10 ... ... 1 Teething 1 1 ... ... ... ... ... 1 Gout 1 ... ... ... 1 ... 1 1 2. Dis. of Adults . 2 ... 1 1 ... ... 1 2 Dropsy 3 ... ... 1 2 ... ... ... Paramenia ... ... ... ... ... ... ... ... Hæmorrhage ... ... ... ... ... ... 1 1 Childbirth 2 ... 1 1 3 ... 1 10 Cancer 11 ... ... 4 7 ... 1 2 3. Dis. of Aged 3 ... ... ... 3 ... ... ... Noma ... ... ... ... ... ... 1 2 Old Age 3 ... ... ... ... ... ... ... Mortification ... ... ... ... ... ... 8 17 4. Dis. of Nutritn.. 25 25 ... ... ... ... 14 34 2. Tubercular — 48 17 19 10 2 ... 8 17 Atrophy & Debility 25 25 ... ... 2 ... Serofula 2 2 ... ... ... ... 3 6 V. 1. Acci. or Neg. 9 7 1 ... 1 ... 1 3 Tabes Mesenterica 4 4 ... ... ... ... 1 3 Fract, and Contue 4 2 1 ... 1 ... 8 27 Phthisis 35 4 19 10 2 ... ... ... Wounds ... ... ... ... ... ... 3 4 Hydrocephalus 7 7 ... ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 16 21 III. 1. Nervous Syst. 37 14 5 6 11 1 ... ... Drowning . ... ... ... ... ... ... 4 2 Cephalitis 6 5 1 ... ... ... 2 1 Suffocation 3 3 ... ... ... ... 3 8 Apoplexy 11 ... 1 1 8 1 ... 2 Otherwise 2 2 ... ... ... ... 4 3 1 aralysis 7 ... 2 3 2 ... 1 ... 2. Homicide 1 1 ... ... ... ... ... 1 Insanity 1 ... 1 ... ... ... 1 ... 3. Suicide 1 ... ... 1 ... ... ... ... Chorea ... ... ... ... ... ... ... ... Wounds ... ... ... ... ... ... ... ... Epilepsy ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... 3 6 Convulsions 9 9 ... ... ... ... ... ... Drowning ... ... ... ... ... ... 2 1 Brain Diseases, &c. 3 ... ... 2 1 ... 1 ... Suffocat. and Hang 1 ... ... 1 ... ... 4 5 2. Organs of Circ. 9 2 2 2 3 ... ... ... Otherwise ... ... ... ... ... ... ... ... Pericarditis ... ... ... ... ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... Aneurism ... ... ... ... ... ... ... 4 5 Heart Disease 9 2 2 2 3 ... TABLE II. NEW CASES OF DISEASE COMING UNDER TREATMENT DURING THE FOUP WEEKS ENDING SATURDAY, THE 24th DAY OF AUGUST, 1872, AT THE FOLLOWING INSTITUTIONS:— Workhouse. Infant Poor House. Out Patient Paupers. Holloway Dispensary. Islington Dispensary Pentonville Convict Prison Total. Small Pox .. .. .. 4 1 .. 5 Chicken Pox .. .. .. 2 4 .. 6 Measles .. .. .. 1 4 .. 5 Scarlatina .. .. .. 3 3 .. 6 Whooping Cough .. .. .. 8 22 .. 30 Croup .. .. .. .. 2 .. 2 Diarrhœa .. .. .. 91 54 41 186 Dysentery .. .. .. 5 .. .. 5 Cholera .. .. .. .. .. .. .. Ague .. .. .. 1 1 .. 2 Continued Fever .. .. .. 6 11 .. 17 Puerperal Fever .. .. .. .. .. .. .. Rheumatic Fever .. .. .. 2 4 .. 6 Erysipelas .. .. .. 3 5 .. 8 Diphteria .. .. .. .. .. .. .. Sorethroat or Tonsillitis .. .. .. 14 17 6 37 Mumps .. .. .. .. 1 .. 1 Pyæmia .. .. .. .. .. .. .. Bronchitis and Catarrh .. .. .. 36 49 42 127 Pneumonia .. .. .. .. 5 .. 5 Pleurisy .. .. .. .. 1 .. 1 Delirium Tremens .. .. .. .. 1 .. 1 Insanity .. .. .. .. .. .. .. Carbuncle .. .. .. .. .. .. .. All other Diseases .. 28 .. 375 560 130 1093 Total .. 28 .. 551 745 219 1543 TABLE III. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED. From July 29th, 1872, to August 24th, 1872. South East District. South West District. North District. Total. Number of Houses inspected 67 103 123 293 Drains Constructed 3 .. 5 8 Improved or repaired 13 26 12 51 Traps fixed 22 24 11 57 Cesspools Abolished 1 .. .. 1 Cleansed or disinfected .. .. .. .. Privies and Water Closets Pan, trap, and water supply furnished 2 .. 2 4 Pan and trap only furnished .. 12 .. 12 Water supply furnished 1 5 15 21 Dust bins Constructed 1 2 .. 3 Repaired and covers adapted .. 3 4 7 Surface Drains and Pavements of Yards Constructed .. 2 .. 2 Relaid 14 22 20 56 General Water Supply New receptacles provided 3 5 .. 8 Receptacles repaired and cleansed 83 15 8 106 Water supply provided .. .. .. .. Other Improve- ments Houses generally repaired 6 4 9 19 &c., cleansed or limewashed 62 35 27 124 ,, Ventilated .. 6 .. 6 Overcrowding abated .. 2 .. 2 Illegal use of underground Rooms for sleeping discontinued. .. .. .. .. Other Amendments, or Nuisances abated 9 9 19 37 N.B.—From July 29th, to August 24th, the Inspector of Dust visited 2409 houses and found that Dust was required to he removed from 671 of these.