ISL 46 REPORT on THE SANITARY CONDITION of the Parish of St. Marry, Islington, DURING THE YEAR 1 8 7 8. by CHARLES MEYMOTT TIDY, M.B., F.C.S., Fellow of the Institute of Chemistry, Professor of Chemistry and of Medical Jurisprudence, and Public Health at the London Hospital;—Master of Surgery; Fellow of the Medical Society;— Late Deputy Medical Officer of Health and Food Analyst for the City of London ;— and MEDICAL OFFICER OF HEALTH AND FOOD ANALYST FOR THE PARISH. J. & I. TIREBUCK, STEAM PRINTERS & LITHOGRAPHERS, Monkwell Street, E.C., and Islington. 1879. TABLE OF CONTENTS. page Marriages 3 Births 5 Deaths 7 Meteorology 10 Water Supply and Analyses 11 The "Sale of Food and Drugs Act, 1875," and Analyses made 14 The Mortuary 15 Sanitary Work 15 Summonses 16 Slaughter Houses and Cow Houses 17 Dusting of the Parish 18 Conclusion 19 Tables 12 TO THE VESTRY OF ST. MARY, ISLINGTON. Gentlemen, I place before you the several statistical tables, recording the number of births, deaths, and marriages in our parish for 1878, and such other sanitary information as my duty requires as your Health Officer. MARRIAGES, 1878.—Table No. I. Islington. England and Wales. In the quarter ending March 394 78,212 „ „ June 593 96,866 „ „ September 612 93,020 „ „ December 592 111,216 Total 2,191 379,314 The one marked feature of the past year was, as we know too well, great commercial depression; and sadly, although naturally enough, this has shown itself in our low marriage rate. In 1878 the marriage rate—15.3 per 1,000—was lower than in any year since 1842 and 1813, when it was 14.7 and 15.2 per 1,000 respectively. In 1873, it was 17.6; in 1877, 15.8; and now 4 in 1878 it is 15.3 per 1,000. London suffers in this respect as all other places suffer, but not in so marked a degree as the towns in Durham and Northumberland and other mining counties, where the marriage rate has decreased to an alarming extent. Nor can we expect that at present, at any rate, this can improve. Perhaps in London we scarcely realise what this decrease of the marriage rate means in its fulness. Nor is it my duty to dwell upon it, for it is a subject for the moralist rather than for the sanitarian; and yet for the sanitarian too, these facts have a deep significance, which must be apparent to every thoughtful man. We must do our best to prevent all the diseases that can be prevented:—and to my mind, with these facts before us, taken in conjunction with the present terrible depression in commerce and agriculture, and the necessary results of such depression, there is a voice crying in our midst with no uncertain sound, which, however some may pooh-pooh by urging sentimental difficulties and even religious objections to its orthodoxy, and others may tell us is the voice of the serpent rather than that of the Author of Good, nevertheless speaks to us in words of gradually increasing intensity, and if we neglect it Ave neglect it at our peril, "Let not the innocent suffer for the guilty." It is no use to tell us about laws of Nature, for the whole of our work in the world seems to be in some respects at least to alter and to change these laws—not to improve them I admit, but to regulate them. The same voice that spoke too of "Visiting the sins of the fathers on the children," said also, "Vengeance is mine, I will repay;" and for us to say "Let such and such things be, let us not interfere with them, for they are the laws of God and not of man," appears to me to be arrogating to ourselves a right which is not ours, claiming, in fact, Heaven as our throne, and Earth as our footstool, and omitting that first great duty of humanity, to be doing good in our generation. Men are always asking and always answering in their own words that old old question of the schools, "And who is my neighbour?" Because it is a law of nature that man should die, should we cease to endeavour to cure when he is sick, or ceasc to prevent him as far as we can from being sick? I say no more on this subject. 5 BIRTHS, 1878.—Table No. II. Western District. Eastern District. Whole Parish. Male. Female. Total. Male. Female. Total. Male. Female. Total. 1st Qtr. 520 547 1,067 652 682 1,334 1,172 1,229 2,401 2nd „ 525 498 1,023 643 700 1,343 1,168 1,198 2,366 3rd „ 532 516 1,048 714 636 1,350 1,246 1,152 2,398 4th „ 495 543 1,038 655 598 1,253 1,150 1,141 2,291 Total 2,072 2,104 4,176 2,664 2,6l6 5,280 4.736 4,720 9,456 The birth rate for Islington in 1878 was 35.1 per 1,000, against 363 per 1,000 in 1876, and 35.6 per 1,000 in 1877. The natural increase of population in Islington therefore during 1878 was 4.298. In London 129,184 births were registered. The birth rate, therefore, for all London was 36.2 per 1,000, the natural increase of the population of London being 45,489 souls. During the year 1,142,525 births were registered in the United Kingdom, and 716,165 deaths. This gives, therefore, a natural increase of the population of 426,360. I append a table giving certain details since 1857 of the birth rate in our parish, and its relationship to the death rate as shown by the excess of registered births over registered deaths. 6 Table No. III. Showing Births, Birth Rate, &c., in Islington for the past Twenty Years. Total Births. Birth-rate per 1,000 of the Population. Males. Females. Excess of Registered Births over Registered Deaths. Proportion of Females to every 100 Males. 1857 4591 34.9 2391 2200 2181 92.0 1858 4413 32.1 * * 1771 * 1859 4997 34.8 2595 2402 2327 92.5 1860 5184 34.7 2655 2529 2339 95.2 1861 5526 35.5 2891 2635 2585 91.1 1862 558o 34.5 2773 2807 2570 101.2 1863 6164 36.9 3073 3091 2310 100.5 1864 6317 36.6 3211 31,06 2474 96.7 1865 6747 37.9 3409 3338 2934 97.9 1866 6908 37.0 * * 2736 * 1867 7374 39.0 3831 3543 3614 92.5 1868 7718 39.3 3974 3744 3508 94.2 1869 7483 37.0 3820 3663 3218 95.8 1870 7616 36.4 3881 3735 3246 97.5 1871 7655 35.6 3824 3831 3026 100.1 1872 8000 36.2 4051 3949 3970 97.4 1873 8522 38.5 4364 4158 4129 95.2 1874 8669 36.5 4316 4353 3989 100.85 1875 9032 36.9 4657 4375 4376 93.9 1876 9186 36.3 4735 4451 4397 94.0 1877 9310 35.6 4807 4503 4472 92.59 1878 9456 35.1 4736 4720 4298 99.66 7 DEATHS. In 1878, 5,158 deaths were registered in the parish of Islington Our death rate, therefore, for the year was 19.1 per 1,000. In 1877, 4,838 deaths were recorded, making our death rate for that year 18.5 per 1,000, the death rate of London being 21.9 per 1,000. Of the 5,158 deaths in 1878, 2,551 were males, and 2,607 were females; 2,059 of the deaths occurred in the western district (of which number 1,022 were males,) and 3,099 in the eastern, 1,529 being males. The death rate of Rome was 29.8 per 1,000 in 1878, of Naples 33.1, of Munich 34.6, and of St. Petersburgh 47.1. The death rate of New York was 24.8 per 1,000 for 1878, of Philadelphia 18.0, and of Montreal 30.9. The death rate of Calcutta was 37.7 per 1,000, of Madras 48.0, and of Alexandria 45.4. MORTALITY AT DIFFERENT AGES. In the following table I have arranged according to the ages the number of deaths that have taken place in Islington during the years 1876 to 1878. 1876. 1877. 1878. Under 1 year old 1,397 1,302 1,453 From 1 to 2 years 459 500 522 „ 2 to 3 199 199 225 „ 3 to 4 132 131 137 „ 4 to 5 77 86 105 „ 5 to 10 141 210 196 „ 10 to 15 66 77 75 „ 15 to 20 73 64 92 „ 20 to 40 580 563 534 „ 40 to 60 705 718 762 „ 60 to 80 778 811 873 „ 80 and upwards 182 177 184 8 Table No. IV. Showing 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 RespiratoryOrgans. Deaths from Diarrhœa. Deaths from Diseases of the Digestive Organs. Deaths from Violence. Total. Total. Total. Total. Total. Total. 1869 202,162 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 532 863 214 668 371 818 218 241 29 186 27 45 after 5 „ 336 454 447 23 157 18 1871 214,532 before 5 years 530 943 199 665 384 872 210 235 20 197 41 62 after 5 „ 413 466 488 25 177 21 1872 221,902 before 5 years 457 570 210 665 413 791 204 222 27 168 33 59 after 5 ,, 113 455 378 18 141 26 1873 229,071 before 5 years 377 430 233 700 484 983 258 273 32 215 46 64 after 5 „ 53 467 499 15 182 18 1874 236,899 before 5 years 384 501 257 728 503 1022 185 202 27 216 48 81 after 6 „ 117 471 519 17 189 33 1875 244,680 before 5 years 413 653 305 771 459 978 197 214 33 221 53 76 after 6 ,, 140 466 519 17 188 22 1876 252,790 before 5 years 405 547 292 824 490 928 259 285 35 223 42 70 after 6 „ 142 532 438 26 188 28 1877 260,900 before 5 years 468 684 200 805 514 984 139 149 38 214 36 60 after 5 „ 216 605 470 10 176 24 1878 269,350 before 5 years 560 772 333 845 605 996 230 247 30 216 42 78 after 5 „ 212 512 491 186 36 * This Includes Small-Pox, Measles, Scarlatina, Typhoid Fever, Diphtheria, and Whooping Cough. 9 CAUSES OP DEATH. These are tabulated as usual in Table No. V. Nearly one-fourth of the deaths recorded in our parish are tabulated by the Registrar-General as Zymotic. This is a larger per-centage than I have had to record since 1871. Small-pox was fatal to 66 persons. In the whole of London, 1416 cases of death from this cause are recorded in 1878, and only 17 in 19 country towns. Partial isolation, it is evident, is not very successful, for 897 of these 1416 cases died in small-pox hospitals, ilore is required in the direction of complete, isolation. At present, however, there is no outbreak to alarm us, and probably we must wait for some renewed epidemic in order to arouse further attention. Measles and Scarlatina were both less fatal than last year; but (as in the rest of London) Whooping-cough has been more than usually fatal; in fact, we have passed through a whooping-cough epidemic, there being 296 deaths from this cause this year against 165 in 1877, and 181 in 1876. Diarrhoea, moreover, has been specially fatal, 217 cases of death being recorded. Seventy-eight cases of death from accident or negligence are recorded as having occurred in the parish. I may mention that in the United Kingdom, during the past year, 17,771 deaths were ascribed to violence. There were, moreover, no less than 26,980 inquests held, which is at the rate of 5 per cent. of the total deaths. I had intended to set before you my views as a medical jurist in some detail on this question. It is a very serious one indeed, and I abstain from doing so for reasons that in the present state of legislation will be obvious. What is the meaning of these 17,771 deaths from violence, and 26,980 inquests per year in a 10 civilized country ? How is it that in Sheffield no less than 6.9 per cent. of deaths are unregistered ? How is it that in certain places the number of inquests should be only 2.9 per cent. of the deaths, and in other places 9 per cent. ? The answers to these questions are not easily given, but they arc subjects well worth attention. They would lead me to discuss many questions bearing on Criminal Procedure, which might very properly find place here; and I leave them with the intention of returning to the subject another time. There were 12 cases of death recorded from puerperal fever. In 1874 there were 26 cases; in 1875, 19 cases; in 1876, 16 cases; in 1877, 8 cases; and in 1878, 12 cases. METEOROLOGY. In 1878 the mean temperature at Greenwich was, during the first three quarters, above the average, and in the fourth quarter below the average. According to Mr. Glaisher the highest reading by day was 85.8 Fahrenheit, and the lowest by night 122 Fahr., 49.6 being the mean of all the observations recorded:— Thermometer. Mean Highest by day Lowest by night Fahr. Fahr. Fahr. March quarter 41.5 60.5 25.1 June „ 54.6 85.8 26.9 September „ 60.8 84.6 38.2 December „ 41.6 74.5 12.2 The rainfall of the year was 29.2 inches, which is 3.8 inches above the average. In the next table I give the analyses of monthly samples of the New River Company's Water during 1878. It has always been of excellent quality, and perfectly bright and well filtered. 11 Analyses of Samples taken from the Mains of the Company. 1878. Total Solid Matter per Gallon. Chloride of Sodium. Nitrogen as Nitrates. Organic Matter. Actual or Saline Ammonia. Organic Ammonia. Hardness before Toiling. Hardness after Boiling fifteen minutes. grs. grs. grs. grs. grs. grs. degs. degs. January 22.2 1.42 0.135 0.464 0.001 0.007 15.4 3.7 February 21.80 1.42 0.195 0.304 0.000 0.009 15.9 4.2 March 20.30 1.54 0.135 0.136 0.000 0.007 13.7 2.8 April 17.50 1.54 0.165 0.200 0.000 0.007 12.6 2.4 May 15.70 1.65 0.150 0.280 0.000 0.007 12.5 3.8 June 19.60 1.65 0.159 0.416 0.000 0.007 14.8 3.3 July 18.90 1.54 0.135 0.336 0.000 0.008 13.7 3.3 August 17.40 1.65 0.135 0.168 0.000 0.006 13.7 3.3 September 19.40 1.65 0.150 0.456 0.000 0.007 14.3 3.3 October 19.40 1.298 0.180 0.080 0.000 0.016 12.6 2.0 November 20.60 1.18 0.180 0.136 0.000 0.006 13.7 3.3 December 22.90 0.l62 0.180 0.512 0.000 0.005 15.4 4.2 Average 19.64 1.383 0.155 0.290 0.000 0.007 14.0 3.3 Analyses of Samples taken from the Cab.rank at Islington Green. 1878. Total Solid Matter per ! Gallon. Chloride of Sodium. Nitrogen as Nitrates. Organic Matter. Actual or Saline Ammonia. Organic Ammonia. Hardness before Boiling. Hardness after Boiling fifteen Minutes. grs. grs. grs. grs. grs. grs. degs. degs. January 21.9 1.42 0.135 0.200 0.001 0.008 15.4 2.8 February 21.80 1.42 0.195 0.304 0.000 0.009 13.7 3.7 March 20.30 1.54 0.134 0.192 0.000 0.007 13.7 2.8 April 17.40 1.42 0.165 0.336 0.000 0.006 12.6 2.4 May 17.60 1.65 0.144 0.192 0.000 0.005 12.6 3.7 June 19.90 1.65 0.144 0.360 0.000 0.006 14.8 3.3 July 18.30 1.54 0.135 0.368 0.000 0.008 13.2 3.3 August 17.40 1.65 0.135 0.136 0.000 0.006 13.7 3.3 September 19.30 1.65 0.150 0.456 0.000 0.007 14.3 3.3 October 19.30 1.18 0.135 0.136 0.000 0.007 12.6 2.8 November 20.40 1.29 0.180 0.136 0.000 0.005 13.7 2.8 December 19.57 1.43 0.151 2.944 0.000 0.006 13.7 3.1 Average 10.43 1.48 0.150 0.480 0.000 0.006 136 3.1 12 I now place before you the quantity of water supplied by the New River Company, month by month, during 1878, the number of inhabited houses to which it was delivered, and a calculation of the number of gallons daily supplied to each house. 1878. Nos. of Houses. No. of Gallons daily Gallons of Water to each House. January 126,084 26,843,000 212.8 February 126,240 25,501,000 202.0 March 126,300 26,214,000 207.5 April 126,573 25,315,000 207.9 May 126,629 28,305,000 223.5 June 126,819 28,361,000 223.6 July 126,987 37,779,000 250.3 August 127,127 31,091,000 244.5 September 127,267 29,205,000 229.4 October 127,577 28,878,000 226.4 November 127,561 27,583,000 2l6.2 December 127,673 25,961,000 203.3 13 Lastly, 1 think it may be interesting to state in a tabular form, the number of gallons of water, and the number of houses, supplied daily by the eight Metropolitan Water Companies, month by month. 1878. Gallons per diem. Houses Supplied. January 117,475.799 541,265 February 117,265,890 541,779 March 120,026,106 541,894 April 118,335,453 544,381 May 125,453,161 544,217 June 130,142,204 545,040 July 147,960,686 547,987 August 144,956,441 549,801 September 137,639,505 549,726 October 135,676,172 551,972 November 130,876,054 553,394 December 130,086,702 553,975 Mean 129,657,848 547,11 Of the daily supply, 258,268 houses are supplied from the River Thames, and 288,871 houses from the River Lea and other sources. 14 "THE SALE OF FOOD AND DRUGS ACT. 1875," FOR YEAR 1878-9. During the year ending Lady Day, 1879, I examined one hundred and seventy-two samples of food which were submitted to me for analysis by your Inspectors. These consisted of— 73 Milk 28 White Pepper 47 Coffee 13 Black Tea 11 Green Tea. In addition to these, a resident in the parish submitted to me a sample of whisky. This makes in all 764 samples examined for Islington since my appointment. I did not find in any of the samples, other than the milk, such evidence of adulteration as in my opinion warranted me in advising prosecution. In 12 of the milk cases I gave certificates of adulteration. They were all cases of added water, the quantity of water in excess of that present in normal milk, varying on the lowest possible calculation from 10 to 30 per cent. The milk sellers have raised the price of their milk, but I can scarcely say that the quality has been improved, the price being in fact no guarantee of genuineness. The extent to which milk is adulterated is serious. For we must remember that to many (and these for the most part the very old and the very young) milk constitutes the sole article of diet. The doctor can easily be thwarted in his treatment of a patient by the dairyman. The public are in this way cheated of their money: and if that were all it would be bad enough, but they are cheated of their health too. And yet during this year only a single sample of food was submitted to me by the public for examination—and that one article was not milk but whisky. Proceedings were taken against the offenders in all the twelve cases of milk adulteration, and the result of the prosecutions will be found in this Report under the head of Summonses. 15 THE MORTUARY AND CORONER'S COURT, 1878-9. Prom the 1st of April, 1878, to the 31st of March, 1879, 566 bodies have been received at the Mortuary, the daily average being 1.28 as against l.32 in the previous year. 311 inquests have been held during the same period, the sum of £48 15s. 0d. having been paid to the Vestry for the accommodation afforded by the Coroner's Court. SANITARY WORK OF THE YEAR, 1878-9. (Table No. VI.) This table of our Sanitary work has been prepared in the usual manner, showing in the upper portion the number and variety of the inspections, re-inspections, and calls made by the District Inspectors during the year, and in the second part the amendments which have been effected. In addition to these improvements, the three District Inspectors reported that dust was required to be removed from 1,136 houses, this number not being included in the removals ordered as the result of the special work of the Inspector of Dust, which will be found stated in the note at the bottom of the table. The disinfections (836), were again far more numerous than in ordinary years owing to the continuance, during the several months extending from March to October, 1878, of the small-pox epidemic, as shown in my last Report, in which I made reference to the extra labour devolving upon the District Inspectors in attending to cases of infectious disease, and the impediments which this special and exceptional work occasions, from the time it occupies, to the systematic inspection of the houses of the poorer class, and to the supervision of those general improvements which are also recorded in this table. Ry the authority of the Sanitary Committee, carbolic acid was again used during the summer as in previous years, in watering some of the streets. McDougall's powder was also used in the hottest and driest part of the season in the courts, and in connection with the Sunday morning cleansing of the channels of the Essex, Caledonian, and Holloway Roads, where these thoroughfares are used as market-places until late on Saturday night. 16 SUMMONSES. During the year ending the 25th March, 1879, the Sanitary Committee authorised the issue of twenty-six summonses, twelve of which were in relation to milk adulteration. One of the twelve defendants, an aged man, escaped through illness, but the remainder were convicted, and penalties varying from 10s. to £5 were imposed, the fines in the aggregate amounting to £18. Two of the twelve were fined £5, and 2s. costs each; one £2, and 2s. costs; four £1, and 2s. costs each; and four 10s., and 2s. costs each. Seven of the milk cases stood over for adjudication for some months, owing to the Magistrate being unwilling to convict, pending a decision in an appeal to the Superior Court upon a case in which a Metropolitan Police-Magistrate, following the precedent created by the Scotch Law Courts, had held that an Inspector purchasing was not 'a prejudiced person' as he did not buy with his own money for consumption, but with the money of the Local Authority for analysis. The Judges of the Queen's Bench Division of the High Court of Justice, reversed this decision of the Magistrate. The Vestry prosecutions, which had remained in abeyance, were then adjudicated upon, a conviction following in each case, although small penalties only were inflicted in consideration of the loss of time occasioned to the defendants by their several attendances at the Police Court. One person was prosecuted and fined £3, and 2s. costs, for exposing for sale unsound fruit, which was seized by one of the Inspectors. In a similar case a conviction could not be obtained owing to the severe illness of the defendant. One person was summoned twice for keeping cows without a licence, the Magistrate on the first occasion inflicting the modified penalty of £1 and 2s. costs; but on the second conviction he imposed the full penalty of £5 and 2s. costs. A judicial order was also obtained upon a separate summons against the same person, prohibiting an accumulation of manure upon his premises. Two summonses were issued against the owners of houses for the recovery of the expense incurred by the Vestry in carrying out disinfection work in consequence of the owners having failed 17 to comply with the Statutory Notices of the Sanitary Authority under the 22nd section of "The Sanitary Act, 1866." The usual orders for payment were made, in the one case for £6 15s. and £1 6s. costs, and in the other for £1 15s. and 4s. costs. These sums were paid to the Vestry in due course. Of the remaining seven summonses, six were in respect to the foul and defective condition of house drainage. In each case an order was made by the Magistrate for the abatement of the nuisance, and for the carrying out of such works as were necessary for that purpose. New drains were provided for three of the houses, and the other works ordered were also carried out, a second summons for non-compliance being issued only in one instance, when the owner at once did the work, so that the enforcement of penalties was rendered unnecessary. THE SLAUGHTER HOUSES AND COW HOUSES IN ISLINGTON 1878-9. During the earlier part of the year one new licence was granted for a Slaughter-house to be used in connection with a bacon-curing establishment in the Brewery Road, the sanction of the Metropolitan Board of Works as the local authority under "The Slaughter Houses, &c. Act, 1874," having been previously obtained for the establishing anew the business of a slaughterer of cattle. To this sanction no opposition was offered by the Vestry, the premises being in every way excellently adapted for the purpose. At the Annual Licensing of 1878 there were 93 applications for the renewal of licences to slaughter houses, all of which were granted. For the renewal of licences to cow houses 62 applications were made, and these also were all granted. In addition, one fresh application for a licence to cow-house premises, which had been refused at the previous year's licensing, was again opposed by the Vestry and refused by the Justices. Three of the cow houses have been rebuilt during the year, two of them since the licensing and one previously, and fifteen others have been considerably improved and enlarged by the removal of lofts, and by structural alterations made in accordance 18 with plans submitted in each case to the Sanitary Department. Re-measurements of the altered sheds were furnished to the Justices who have now fixed the number of cows they will permit to be kept in each shed, the licence in every instance being endorsed with the number allowed, 800 cubic feet being the space set apart for each cow. On the 62 premises licensed in 1878, there are 66 sheds for 1054 cows, 795 only having been found by the Inspectors prior to the licensing. Upon my annual inspection of slaughter houses and cow houses, I had every reason to be well satisfied with their general condition, and improved appearance. THE DUSTING OF THE PARISH 1878-9. I have appended, agreeably to my custom, a tabulated statement (Table No. VII.) of the applications for the removal of Dust received during the year ending Lady Day, 1879, showing the number received during each quarter from the eight different Wards of the Parish. Of the total number of 15,559 received from residents during the year, 10,912 were by letter or postal card, and 4,647 were made personally, or by messengers sent to the Vestry Offices. In addition, the Inspector of Dust reported 6,283 cases for removal, and the District Inspectors 1,136, so that with these 7,419 added, the number of removals ordered during the year was 22,978. The 15,559 applications received from the inhabitants were at the rate of 47 per cent. of the inhabited houses as against 43.8 per cent. in 1877-8, 71.7 per cent. in 1876-7, and 116.6 per cent. in the last contractors' year 1875-6. I continue to observe with much interest the progress of the great work entrusted by the Vestry to the Dusting and Slopping Committee; and without being over sanguine, I hope constantly to see signs of an increasing efficiency being attained. 19 Exceptional circumstances, and exceptional and trying seasons such as we have had for the last three years with their almost unprecedented rainfall, must and will arise to test both branches of the work; but with the proved capacity the Committee have manifested not only for grappling with such immense difficulties as attended their first organization scheme, but of overcoming them, we need feel no concern as to the perpetuity of their success. It used, indeed, to be said that a Vestry could never perform this kind of work either so economically or so efficiently as a Contractor could—in other words, that the Contractors who were engaged in this special business were in possession of facilities for the work, and of opportunities arising from their vocation generally, to which Vestries could never attain. This egregious fallacy is no longer in favour here, as it is now happily an established fact in the experience of the Islington Vestry, that the work which the Contractors used to do badly at an enormous cost, they, as a Vestry, can do efficiently with a very moderate expenditure, and at the same time save the Parish those exorbitant profits which the Contractors reaped exclusively in their own personal interests. CONCLUSION. And one word more. The Registrar General, for reasons known to himself, fixes 17 deaths per 1,000 as an ideal death rate, but regards 20 per 1,000 as about the extent of perfection we can hope to reach. Why it should be 17 I know not, and if 17 why not 16, why not 15 ? But we have reached in Islington the 20, and we rejoice at it. And so the improvements in our water and drainage schemes have done a great work. Would it not be worth while, remembering that there are yet so many things to be attended to, and so many reforms needed, in respect, chiefly, to the drinking habits of the people and their method of life, for sanitarians to turn their attention for a few years to these sadly neglected topics, instead of confining their thoughts almost exclusively, as they have been doing of late years, to the water as the source of all ills and 20 miseries. It is not simply the time wasted on the subject that is to be deplored, but it is the unnecessary alarm the discussion of such topics excite in the public mind. To your Vestry as a body, but more especially to the Members of the Sanitary Committee, I desire to offer my cordial thanks for their kind and constant support. The Sanitary Inspectors, who have all now been in your service for some years, have done their work excellently well, and if I say nothing of Mr. Collingwood's judicious and indefatigable labours, I shall not be misunderstood. They are too well known to need a word of praise from me. I have the honour to remain, Gentlemen, Your obedient Servant, C. MEYMOTT TIDY, Vestry Offices, Medical Officer of Health, 31st July, 1879. DEATHS REGISTERED IN ISLINGTON during FIFTY-TWO WEEKS ENDING 28th DECEMBER, 1878. 22 THE YEAR 1878. TABLE No. V. DEATHS REGISTERED IN ISLINGTON DURING [Deaths of Non-Residents West. East. Causes of Death. All Ages AGES. Un. 1- 1- 2- 3- 4- Under 5yrs. 5- 10- 15- 20- 40- 60- 80- up. 2059 3099 All Causes 5158 1453 522 225 137 105 2442 |196 75 92 1534 762 873 184 502 696 (Classes.) I. ZYMOTIC DIS. 1198 423 220 116 71 63 893 98 28 17 91 39 29 3 405 636 II. CONSTITUTL. 1041 175 94 36 17 20 342 31 21 40 243 244 109 11 909 1404 III. LOCAL 2313 499 194 72 45 22 832 63 25 30 181 455 639 88 210 290 IV. DEVELOPMNL 500 315 11 ... ... ... 326 ... ... 3 3 5 83 80 33 73 IV. VIOLENT DTHS. 106 41 3 1 4 ... 49 4 l 2 16 19 13 2 ... ... Not Specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... (Orders.) 484 646 I.1. Miasmatio Dis. 1130 374 219 115 71 63 342 95 28 17 86 32 27 3 32 34 Small Pox 66 12 6 2 4 4 28 4 5 2 23 2 2 ... 43 65 Measles 108 17 38 23 11 8 97 10 1 ... ... ... ... ... 68 105 Scarlatina 173 5 32 29 20 30 116 37 12 3 3 2 ... ... 13 25 Diphtheria 38 2 7 4 7 1 21 11 1 2 2 1 ... ... ... 2 Quinsey 2 ... ... ... ... ... ... ... 1 ... ... 1 ... ... 13 13 Croup 26 3 9 5 4 4 25 1 ... ... ... ... ... ... 26 170 Whooping Cough 296 126 91 38 17 11 283 13 ... ... ... ... ... ... 36 55 Typhus & Typhoid 91 1 3 6 4 1 15 13 6 5 34 12 6 ... 14 7 Erysipelas 21 14 ... ... ... ... 14 ... ... ... 1 1 5 ... 4 1 Pyæmia 5 3 ... ... 1 .. 4 .. .. ... 1 ... ... ... 3 7 Puerperal Fever 12 ... ... ... ... ... ... ... ... ... 9 3 ... ... 1 2 Carbuncle 3 ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... 1 Influenza 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... l 2 Dysentery 3 2 ... ... ... ... 2 ... ... ... 1 ... ... ... 116 131 Diarrhœa 247 186 33 7 3 1 230 1 ... ... 2 2 9 3 ... 7 Cholera 7 2 ... 1 ... 1 4 ... ... 1 1 1 ... ... ... ... Agrue ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 19 Rheumatism 31 ... ... ... ... 2 2 5 2 3 9 6 4 ... 6 18 2. Enthetic 24 21 1 ... ... ... 22 1 ... ... 1 ... ... ... 5 17 Syphilis 22 21 1 ... ... ... 22 ... ... ... ... ... ... ... 1 ... Stricture of Urethra 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Hydrophobia 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 27 3. Dietic 33 19 ... 1 ... ... 20 1 ... ... 4 6 2 ... ... 1 Privation 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 16 Want of Br. Milk 19 19 ... ... ... ... 19 ... ... ... ... ... ... ... 1 2 Purpura and Scurvy 3 ... ... 1 ... ... 1 1 ... ... ... 1 ... ... 2 8 Alcoholism 10 ... ... ... ... ... ... ... ... ... 4 4 2 ... 6 5 4. Parasitic 11 9 ... ... ... ... 9 1 ... ... ... 1 ... ... 6 3 Thrush 9 9 ... ... ... ... 9 ... ... ... ... ... ... ... ... 2 Worms 2 ... ... ... ... ... ... 1 ... ... ... 1 ... ... 63 133 II. 1. Diathetic 196 7 1 ... ... 1 9 2 ... 2 11 79 82 11 9 4 Gout 13 ... ... ... ... ... ... ... ... ... 1 5 7 ... 6 20 Dropsy 26 ... ... ... ... 1 1 ... 1 1 1 7 14 2 2 8 Hæmorrhage 10 4 ... ... ... ... 4 ... ... ... 3 1 2 ... 40 89 Cancer 129 ... ... ... ... ... ... 1 ... ... 6 62 54 6 ... ... Cancrum Oris(Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 12 Mortification 18 3 1 ... ... ... 4 1 ... 1 ... 4 5 3 342 503 2. Tubercular 845 168 93 36 17 19 333 29 21 38 232 165 27 ... 40 44 Scrolula 84 35 27 10 4 2 78 1 ... 2 3 ... ... ... 38 85 j Tabes Mesenterica 123 73 30 5 4 3 115 7 1 ... ... ... ... ... 200 316 Phthisis 516 14 111 5 2 3 35 9 15 36 229 165 27 ... 61 58 Hydrocephalus 122 46 25 16 7 11 105 12 5 ... ... ... ... ... 252 415 III. 1. Nervous Syst. 667 191 47 20 14 7 279 24 3 5 34 97 203 22 41 57 Cephalitis 98 27 181 12 9 5 71 12 3 1 6 4 1 ... 67 89 Apoplexy 156 4 ... ... ... ... 4 1 ... 1 10 50 81 9 24 87 Paralysis 111 ... ... ... 2 ... 2 ... ... 1 4 19 77 8 1 1 Insanity 2 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 10 Epilepsy 19 ... ... ... ... 1 1 3 ... 1 4 6 3 1 88 111 Convulsions 199 155 27 7 2 1 192 5 ... ... 1 1 ... ... 22 60 Brain Diseases, &c. 82 5 2 1 1 ... 9 3 ... 1 9 16 40 4 88 216 2 Organs of Circ. 304 2 2 ... ... ... 4 4 11 9 41 107 119 9 1 3 Pericarditis 4 1 ... ... ... ... 1 ... ... ... 2 ... 1 ... 5 8 Aneurism 13 ... ... ... ... ... ... ... ... ... 5 6 2 ... 82 205 Heart Disease 287 1 2 ... ... ... 3 4 11 9 31 101 116 9 23 TABLE No. V. FIFTY-TWO WEEKS ENDING 28TH DECEMBER, 1878. in Hospitals excluded.] Wtst. East. Causes of Death. All Ages. AGES. Un. 1- 1- 2- 3- 4- Under 5 yrs. 5- 10- 15- 20- 40- 60- 80up. 430 566 3. Respirat. Orgs. 996 277 140 49 28 11 505 26 5 8 46 146 209 51 24 21 Laryngitis 45 22 11 l 2 3 39 4 ... ... 2 ... ... ... 256 348 Bronchitis 604 154 73 21 6 3 267 9 4 ... 18 87 174 45 1 8 Pleurisy 9 ... ... ... 1 ... 1 1 ... ... 2 3 2 ... 136 164 Pneumonia 300 98 56 25 7 5 191 10 1 6 21 45 23 3 8 18 Asthma 20 ... ... ... ... ... ... 2 ... 1 2 10 9 2 5 7 Lung Diseases, &c. 12 3 ... 2 2 ... 7 ... ... 1 1 1 1 1 87 129 4. Digestive Orgs. 216 23 3 3 1 ... 30 5 3 4 34 67 69 4 4 4 Gastritis 8 3 ... ... ... ... 3 ... 1 ... 1 ... 3 ... 15 8 Enteritis 23 8 ... 2 ... ... 10 2 ... ... 4 4 2 1 8 13 Peritonitis 21 ... l ... 1 ... 2 2 1 2 8 2 4 ... 1 3 Ascites 4 ... ... ... ... ... ... ... ... ... ... 3 1 ... 1 1 Ulceration of Intes. 2 1 ... ... ... ... 1 ... ... ... ... 1 ... ... 1 5 Hernia 6 ... ... ... ... ... ... ... ... ... 1 1 4 ... 10 11 Ileus 21 1 ... ... ... ... l ... 1 2 2 7 8 ... 1 3 Intussusception 4 1 ... ... ... ... 1 ... ... ... ... ... 3 ... ... ... Stricture of Intest. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... Fistula 1 ... ... ... ... ... ... ... ... ... ... ... l ... 6 14 Stomach Dis., &c. 20 2 1 ... ... ... 3 1 ... ... 4 5 6 1 ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4 Hepatitis 7 1 ... ... ... ... 1 ... ... ... ... 3 3 ... 2 9 Jaundice 11 6 ... 1 ... ... 7 ... ... ... ... 1 2 1 34 54 Liver Disease 88 ... 1 ... ... ... 1 ... ... ... 14 40 32 1 ... ... Spleen Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... 38 52 5. Urinary Organs 90 1 2 ... 2 1 6 2 2 2 18 26 32 2 2 10 Nephritis 12 ... ... ... ... ... ... ... 1 1 2 4 4 ... 6 3 Disease of Bladder 9 1 ... ... ... ... 1 ... ... ... 1 1 5 1 10 20 Nephria 30 ... 1 ... 2 1 4 1 ... ... 7 10 8 ... 3 1 Diabetes 4 ... ... ... ... ... ... ... ... ... 3 ... 1 ... 1 1 Stone 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... Prostate Disease 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 15 17 Kidney Disease 32 ... 1 ... ... ... 1 1 1 1 4 10 13 1 1 7 6. Genera. Organs 8 ... ... ... ... ... ... ... ... ... 3 3 2 ... 1 4 Ovarian Dropsy 5 ... ... ... ... ... ... ... ... ... 2 1 2 ... ... 3 Uterine Diseases 3 ... ... ... ... ... ... ... ... ... 1 2 ... ... 6 13 7. Orgs, of Locomo. 19 2 ... ... ... 3 5 2 1 2 4 3 2 ... 5 6 Spine Diseases l1 2 ... ... ... 2 4 1 ... 2 3 ... l ... 1 7 Bone Diseases 8 ... ... ... ... 1 1 1 1 ... 1 3 1 ... 7 6 8. Skin, &c. 13 3 ... ... ... ... 3 ... ... ... 1 6 3 ... ... ... Phlegmon & Abscess ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 Ulcer 6 ... ... ... ... ... ... ... ... ... ... 5 1 ... 4 3 Skin Diseases 7 3 ... ... ... ... 3 ... ... ... 1 l 2 ... 68 70 IV. 1. Dis. of Childn 138 137 l ... ... ... 138 ... ... ... ... ... ... ... 50 50 Premature Birth 100 100 ... ... ... ... 100 ... ... ... ... ... ... ... 8 10 Cyanosis 18 18 ... ... ... ... 18 ... ... ... ... ... ... ... 6 2 Spina Bifida 8 8 ... ... ... ... 8 ... ... ... ... ... ... ... 3 8 Other Malformation 11 11 ... ... ... ... 11 ... ... ... ... ... ... ... 1 ... Teething 1 ... 1 ... ... ... 1 ... ... ... ... ... ... ... 3 7 2. Dis. of Adults 10 ... ... ... ... ... ... ... ... 3 3 4 ... ... ... ... Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 7 Childbirth 10 ... ... ... ... ... ... ... ... 3 3 4 ... ... 53 109 3. Dis. of Aged 162 ... ... ... ... ... ... ... ... ... ... 1 81 80 53 109 Old Age l62 ... ... ... ... ... ... ... ... ... ... 1 81 80 86 104 4. Dis. of Nutritn. 190 178 10 ... ... ... 188 ... ... ... ... ... 2 ... 86 104 Atrophy & Debility 190 178 10 ... ... ... 188 ... ... ... ... ... 2 ... 24 54 V. 1. Acci. or Neg. 78 35 3 ... 4 ... 42 4 1 ... 11 8 10 2 11 19 Fract. and Contus. 30 2 l ... 2 ... 5 2 1 ... 8 5 8 1 ... 2 Wounds 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 4 2 Burns and Scalds 6 2 1 ... 1 ... 4 ... ... ... 1 ... ... 1 1 3 Poison 4 1 1 ... ... ... 2 1 ... ... ... 1 ... ... ... 2 Drowning 2 ... ... ... ... ... ... 1 ... ... ... 1 ... ... 6 23 Suffocation 29 28 ... ... ... ... 28 ... ... ... ... 1 ... ... 2 3 Otherwise 5 2 ... ... 1 ... 3 ... ... ... 1 ... 1 ... 3 3 2. Homicide 6 6 ... ... ... ... 6 ... ... ... ... ... ... ... 6 16 3. Suicide 22 ... ... 1 ... ... 1 ... ... 2 5 11 3 ... 2 5 Wounds 7 ... ... ... ... ... ... ... ... ... 2 3 2 ... 2 5 Poison 7 ... ... 1 ... ... 1 ... ... ... 2 3 1 ... ... 3 Drowning 3 ... ... ... ... ... ... ... ... 2 1 ... ... ... 2 1 Suffocat. and Hang. 3 ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 2 Otherwise 2 ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 4. Unclassed ... ... ... ... ... ... ... ... ... ... ... ... ... ... 24 TABLE VI. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From March 25th, 1878, to March 25th, 1879. South East District. South West District. North District. Total. Number of Houses inspected 1,041 988 947 2,976 Re-inspections, Calls made, &c. 2,985 2,572 2,793 8,350 Visits to 231 Bakehouses 243 230 245 718 Do. 62 Cowhouses 139 155 154 448 Do. 93 Slaughter-houses 144 131 126 401 Do. Stables and yards 96 35 25 156 Do. Factories and Workshops 28 ... 5 33 Do. Fields, Lanes, &c. 77 17 110 204 Do. 32 Factories, Horse Slaughter-houses, Piggeries, &c., Belle Isle ... 190 ... 190 Total Inspections, &c. 4,753 4,318 4,405 13,476 IMPROVEMENTS. Drains Constructed 15 34 15 64 Improved or repaired 64 92 89 245 Traps fixed 63 128 127 318 Cesspools Abolished ... 3 7 10 Cleansed or disinfected ... ... ... ... Privies and Water Closets Pan, Trap and water supply furnished 1 10 15 26 Pan and trap only furnished 12 13 4 29 Water supply furnished 12 20 24 56 Dust Bins Constructed 11 3 12 26 Repaired and covers adapted 11 9 13 33 Surface Drains and Pavements of Yards. Constructed ... 3 3 26 Relaid 123 133 128 384 General Water Supply New receptacles provided 4 3 5 12 Receptacles repaired and cleansed ... 6 16 22 Water supply provided. 7 ... 5 12 Other improvements Houses generally repaired 139 68 32 239 „ &c., cleansed or limewashed 220 205 102 527 „ ventilated ... ... ... ... Overcrowding abated 10 7 9 26 Illegal use of underground Rooms for sleeping discontinued 3 1 2 6 Other Amendments, or Nuisances abated 47 74 75 196 Houses or Rooms Disinfected 264 287 305 856 Total improvements 1,006 1,099 1,008 3,113 Total Premises Improved 524 520 454 1,498 N.B.—From the 25th March, 1878, to the 25th March, 1879, the Inspector of Dust visited 18,712 houses, and found that Dust was required to be removed from 6,283 of these houses. 25 Table No. VII. Summary of Applications for Removal of Dust from 25th March 1878, to 25th March 1879. CONTRACTORS. Ward. Three Months ending 22nd June, 1878, Three Months ending 21st Sep., 1878. Three Months ending 21st Dec., 1878. Three Months ending 29th Mar., 1879. Total during Twelve Months. Number of Inhabited Houses, 1878. Number of Applications to every 100 Houses. Applications during previous Twelve Months Applications to every 100 Houses during same period. The Vestry. 1 627 460 332 1,254 2,673 7.597 35.1 2,333 33.8 Do. 2 317 345 227 1,095 1,984 3,885 51.0 1,474 38.4 Do. 3 657 538 366 1,271 2,832 6,888 41.1 2,348 38.1 Do. 4 259 169 221 849 1,498 3,294 45.4 1,416 42.4 Do. 5 451 277 204 592 1,524 2,512 60.6 1,469 58.2 Do. 6 540 420 363 612 1,935 2,143 90.2 1,758 81.9 Do. 7 541 203 468 734 1,946 3,207 60.6 1,644 51.2 Do. 8 241 161 141 624 1,167 3,531 33.0 1,416 40.3 Totals. ... 3,633 2,573 2,322 7,031 15,559 33,057 47.0 13,858 43.8 Removals ordered from Reports of the Inspector of Dust and other Inspectors ... 1,085 1,584 1,961 2,789 7,419 Total Removals ... 4,718 4,157 4,283 9,820 22,978