1 SL 49 REPORT ON THE SANITARY CONDITION OF THE Parish of St. Mary. Islington DURING THE YEAR 1881. BY CHARLES MEYMOTT TIDY, M.B., F.C.S., Fellow of the Institute or Chemistry, Professor of Chemistry and of Medical Jurisprudence and Public Health at the London Hospital ;—Master of Surgery;— 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. TABLE OF CONTENTS. page. Marriages 3 Births 3,4 Deaths 5, 6, 7 Small Pox Epidemic 7—12 The Census of 1881 and previous decades 13 Water Analysis and Supply 14, 15 The " Sale of Food and Drugs Acts," and Analyses made 16 The Mortuary and Coroner's Court 16 Sanitary Work 17 Slaughter Houses and Cow Houses 18 The Bakehouses of Islington 18—21 Dusting of the Parish 22 Conclusion 22, 23 Tables 24— 27 Appendix—(Small Pox Camp Hospital Reports of Sanitary Committee) 28—40 TO THE VESTRY OF ST. MARY, ISLINGTON. Gentlemen, I submit herewith the statistics of births, deaths, and marriages for the year ending December 31st, 1881, and also the details of our sanitary work (in accordance with the requirements of the Act of Parliament) for the year ending March 25th, 1882. MARRIAGES, 1880 and 1881.—TABLE NO. 1. Islington. England and Wales. 1880. 1881. 1880. 1881. In the quarter ending March 466 400 41,202 37,914 „ „ June 533 563 45,851 50,230 „ „ September 642 683 47,662 48,529 „ ,. December 651 653 57,019 60,204 Total 2,192 2,299 191,734 196,877 The marriage rate in Islington is 161 per 1000 of the population, against 15 8 of last year. There was therefore a slight increase in the marriage rate of the district. BIRTHS, 1881.—TABLE NO II. Western District. Eastern District. Whole Parish. Male. Female. Total. Male. Female. Total. Male. Female. Total. 1st Qr. 601 549 1,150 780 709 1,489 1,381 1,258 2,639 2nd „ 582 530 1,112 727 678 1,405 1,309 1,208 2,517 3rd „ 525 526 1,051 705 655 1,360 1,230 1,181 2,411 4th „ 549 501 1,050 707 644 1,351 1,256 1,145 2,401 Total 2,257 2,106 4,363 2,919 2,686 5,605 5,176 4,792 9,968 The birth-rate is 35 0 per 1000 of the population, against 355 in 1880, and 368 in 1879. This is the smallest birth-rate recorded in our parish since the year 1862. I now give in tabular form the birth-rates for the last twentyone years, with certain statistical details arising therefrom. 4 Table No. III. Showing Births, Birth-Rate, &c., in Islington for the past 21 years. Total Births. Birth Bate per 1000 of the Population. Males. Females. Excess of Registered Births over Registered Deaths. Proportion of Females to every 100 Males. 1861 5526 35.3 2891 2635 2585 91.1 1862 5580 34.5 2773 2807 2570 101.2 1863 6164 36.9 3073 3091 2310 100.6 1864 6317 36.7 3211 3106 2474 96.7 1865 6747 37.9 3409 3338 2934 97.9 1866 6908 37.6 * * 2736 * 1867 7374 38.9 3831 3543 3614 92.5 1868 7718 39.4 3974 3744 3508 94.2 1869 7483 37.0 3820 3663 3218 95.9 1870 7616 36.5 3881 3735 3246 96.2 1871 7655 35.6 3824 3831 3026 100.2 1872 8000 36.1 4051 3949 3970 97.5 1873 8522 37.4 4364 4158 4129 95.3 1874 8669 37.0 4316 4353 3989 100.9 1875 9032 37.5 4657 4375 4376 93.9 1876 9186 37.1 4735 4451 4397 94.0 1877 9310 36.6 4807 4503 4472 93.7 1878 9456 36.1 4736 4720 4298 99.7 1879 9917 368 4965 4952 4596 99.7 1880 9846 35.5 5153 4693 4560 91.1 1881 9968 35.0 5176 4792 4852 92.6 5 DEATHS. The death-rate during the past year in the district has been 18.0 per 1000 of the population. There has been a total of 5116 deaths recorded in the parish, of which 2521 were males and 2595 females. Of the total deaths, 2058 cases occurred in the western and 3058 in the eastern division of the district. The total number of deaths this year compares favourably with the numbers of the last three years. Notwithstanding the increase of population the actual number has been less than in any year since 1877, and the death-rate of 18.0 per 1000 is the lowest for many years. MORTALITY AT DIFFERENT AGES. In the following table I have arranged according to ages the deaths that have taken place in Islington from the year 1877 to 1881 inclusive:— 1877 1878 1879 1880 1881 Under 1 year old 1,302 1,453 1,340 1,517 1,400 From 1 to 2 years 500 522 565 521 480 „ 2 to 3 „ 199 225 253 194 218 „ 3 to 4 „ 131 137 138 131 117 „ 4 to 5 „ 86 105 90 102 94 „ 5 to 10 „ 210 196 184 176 148 „ 10 to 15 „ 77 75 51 66 59 „ 15 to 20 „ 64 92 84 92 82 „ 20 to 40 „ 563 534 588 529 645 „ 40 to 60 „ 718 762 784 799 742 ,, 60 to 80 „ 811 873 1,015 961 913 „ 80 and upwards 177 184 229 198 218 Table No. IV. Showing the deaths since 1871 from the several diseases specified, before and after five years of age, and the total number of deaths, with death rate per 1000. Population in the middle of the year. 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 Deaths. Death Rate per 1000. 1571 215,295 Total. Total. Total. Total. Total. Total. before 6 year 520 943 199 665 384 872 210 235 20 197 50 94 4,626 21.5 after 6 „ 413 466 488 25 177 44 1872 221,409 before 5 years 457 670 210 665 413 791 204 222 27 168 38 76 4,030 18.2 after 5 „ 113 465 378 18 141 38 1873 227,697 before 5 years 377 430 233 700 484 983 258 273 32 214 59 92 4,393 19.3 after 5 „ 63 467 499 15 182 33 1874 234,163 before 6 years 384 501 257 723 603 1022 186 202 27 216 60 104 4,680 20.0 after 5 „ 117 471 519 17 189 44 1875 240,813 before 5 years 413 553 305 771 459 978 197 214 33 221 61 94 4,656 19.3 after 5 „ 140 466 519 17 188 33 1876 247,652 before 5 years 405 547 292 824 490 928 259 285 35 223 49 88 4,789 19.3 after 6 „ 142 632 438 26 188 39 1877 264,685 before 5 years 468 684 200 805 614 984 139 149 38 214 42 82 4,838 19.0 after 5 „ 216 606 470 10 176 40 1878 261,918 before 5 years 560 772 333 845 505 996 230 247 80 216 49 106 5,158 19.7 after 5 „ 212 612 491 17 186 57 1879 269,366 before 5 years 659 694 305 847 605 1282 91 104 27 217 54 112 5,321 19.8 after 6 „ 135 542 677 13 190 58 1880 277,005 before 5 years 492 648 283 793 532 1151 276 295 32 267 62 108 5,286 19.1 after 5 „ 156 610 619 18 235 56 1881 284,873 before 6 years 457 636 276 822 491 1025 201 216 67 247 61 111 5,116 18.0 after 5 „ 179 649 534 15 180 50 * This includes Small-Pox, Measles, Scarlatina, Typhoid Fever, Diphtheria, and Whooping Cough. 7 The epidemics of the year have been Small Pox, Measles, Scarlatina, and Whooping Cough. Of Small Pox I shall speak further on. Measles caused 161 deaths as against the exceptionally small number of 48 in the previous year. The disease was not so severely epidemic as in 1879, when the mortality reached 219, this being the highest number recorded. Scarlatina caused 116 deaths, but it was less fatal as an epidemic than in any year since 1873, the number of deaths in 1880 and previous years being 198, 135, 173, 200, 125, 222, and 129 respectively. The epidemic of Whooping Cough was comparatively mild in its character, causing only 172 deaths, as compared with 299, 229, and 296 in the three previous years. Typhoid Fever was somewhat more prevalent during a part of the year than usual, but it neither spread so extensively nor was it so fatal as we at first anticipated. 75 deaths were attributed to Typhoid, Typhus, and to Fever generally. SMALL POX. The chief Epidemic of the year was undoubtedly Small Pox, and this not only in Islington, but in London generally. The renewed activity of small pox in Islington, became first decidedly apparent in December, 1880, when 29 cases were reported as against 3 cases recorded during the nine previous weeks. I have, however, limited the details of the following table (No. V.), to the year 1881, and have shown the number of cases of sickness as they occurred week by week, as well as the deaths month by month, (including those that occurred in hospitals). The progress, extent, and decline of the disease may thus be very easily traced. Beginning with 7 cases in the first week of January, the numbers increased with some little weekly variation, until the intensity of the disease culminated with 53 reported cases in the first week of June. Table No. V. Table of 797 Cases of Small Pox recorded weekly, and 129 Deaths recorded monthly as occurring in Islington from the 1st January, 1881, to the 31st December, 1881. Week ending. Cases in Week. Cases in Month. Deaths in Month. Week ending. Cases in Week. Cases in Month. Deaths in Month. Brought forward 576 84 8 January, 1881 7 ... ... 9 July, 1881 19 ... ... 15 ,, ,, 16 ... ... 16 ,, ,, 8 ... ... 22 ,, ,, 12 ... ... 23 ,, „ 17 ... ... 29 „ „ 3 38 10 30 ,, ,, 24 68 13 5 February, „ 21 ... ... 6 August, ,, 9 ... ... 12 „ „ 13 ... ... 13 ,, ,, 22 ... ... 19 „ „ 4 ... ... 20 „ „ 14 ... ... 26 ,, ,, 9 47 10 27 „ „ 8 53 12 5 March, „ 22 ... ... 3 September, ,, 6 ... ... 12 „ „ 20 ... ... 10 ,, ,, 17 ... ... 19 „ „ 13 ... ... 17 ,, ,, 4 ... ... 26 „ „ 22 ... ... 24 „ „ 6 ... ... 2 April, „ 36 113 13 1 October, „ 5 38 8 9 „ „ 22 ... ... 8 ,, ,, 4 ... ... 16 ,, ,, 30 ... ... 15 ,, ,, 2 ... ... 23 „ „ 38 ... ... 22 „ „ 1 ... ... 30 „ „ 38 128 18 29 ,, ,, 5 12 4 7 May, „ 17 ... ... 5 November, 8 ... ... 14 ,, ,, 29 ... ... 12 „ „ 8 ... ... 21 „ „ 23 ... ... 19 ,, ,, ... ... ... 28 „ „ 32 101 15 26 „ ,, 15 31 4 4 June, „ 53 ... ... 3 December, ,, 6 ... ... 11 „ „ 25 ... ... 10 ,, ,, 4 ... ... 18 „ „ 34 ... ... 17 „ ,, 3 ... ... 25 ,, „ 20 ... ... 24 „ ,, 2 ... ... 2 July, „ 17 149 18 31 ,, ,, 4 18 4 Carried forward 576 84 Total Cases 797 Deaths 129 Removed to Hospital, 522, including 51 to Highgate, and 62 to Islington Camp Hospital at Finchley. Remained at home, 275. Total, 797. 9 By the end of that month the decline in the epidemic became apparent, although as usual signs of renewed vigor occasionally appeared. These renewed outbreaks seemed to threaten another rise in the epidemic wave, which, happily, did not occur. The months in which the epidemic was most prevalent were March, April, May, and June, with 113, 128, 101, and 110 cases resp ectively. The total number of cases during the year was 797, with 129 deaths, or 16.2 per cent. Of 78 unvaccinated persons attacked, 39, or 50 per cent., died. Of the 719 persons said to have been vaccinated (however imperfectly) 90 died, or 125 per cent. 522 patients were removed to the various hospitals of the Metropolis, and of these 69 died, or 13.2 per cent. 275 patients were treated at their own homes, and of these 60 died, or 218 per cent. Of the 522 cases removed, 409 were admitted to the hospitals of the District Asylums Board, and of these57, or 13.9 per cent. died. 51 were received at the Highgate Hospital, and 6 died, or 11.7 per cent., and the remaining 62 were conveyed to the Islington Camp Hospital at Finchley, where 6 died, or 9.6 per cent. During the epidemic the different wards of the Parish suffered in the order shown in the following Table. TABLE No. VI. Cases of Sickness. Deaths, Per Cent. 1. Upper Holloway 249 49 19.7 2. Saint Peter's 131 15 11.5 3. Highbury 92 19 20.7 4. Thornhill 92 10 10.9 5. Lower Holloway 73 9 12.3 6. Canonbury 68 12 17.6 7. Barnsbury 46 9 19.6 8. Saint Mary's 45 6 13.3 (Camp Hospital Staff) 1 ... ... 797 129 162 10 The characteristic features of small pox epidemics repeated themselves. In the emergency of such outbreaks, the Metropolis is ever found insufficiently provided with hospital accommodation. The Hospitals of the great District Asylums Board were speedily filled, and then arose a loud outcry for increased accommodation. The fanciful distinction between pauper and non -pauper patients was again revived, and the Asylums Board, although making great and praiseworthy efforts appealed in their difficulties to the Local Government Board to help them, and both in turn applied to the local sanitary authorities to provide for their own nonpauper cases, and had this request been generally complied with, and further, had all accepted and acted upon the official definition as to what constitutes a pauper, the local sanitary authorities would have relieved the Asylums Board of about 90 per cent. of those requiring hospital accommodation. For it has been more than once stated that less than 10 patients out of every 100, admit that they have received parochial relief. As a matter of fact, our experience in Islington is that even that per centage is considerably above the fact. The poor for whom hospital accommodation is so essential should, without doubt, be provided with it free of cost, and this fruitless discussion about pauper and non-pauper patients should not be allowed to be continually recurring. Divided counsels in the presence of the enemy have always proved nugatory in the results, and commonly end in defeat. Every exertion, it is only right to admit, was made by the Asylums Board to meet the necessity for increased accommodation, and some of the sanitary authorities supplemented these exertions. Notably amongst such authorities were those of Islington and St. Pancras, who each formed a temporary Camp Hospital upon portions of adjacent vacant lands at Finchley. I have no hesitation in pronouncing your Finchley Hospital a great success, the mortality amongst the patients being exceptionally low. The history of the Islington Camp Hospital belongs especially 11 to the Sanitary Committee, and in order that it may be complete I append to this report the several reports made by them to your Vestry, numbered 1 to 7, together with a Statement of the expenditure incurred in the carrying out of this most praiseworthy undertaking. I shall leave those interesting reports upon the Camp Hospital to speak for themselves, and will content myself with merely ex pressing my own strong conviction that the step taken by your Vestry was a wise one, and that it would be still wiser never to be without such an invaluable resource as a Camp Hospital for use in times of emergency and danger. I would remind the Vestry that an outbreak of Small Pox never occurs without creating considerable alarm, (I had almost written, panic,) and that infectious hospitals in our midst are decidedly unpopular. Witness for instance the outcry that occurred in connection with the late City of London Workhouse in the Shadwell Road, Holloway. The loathsomeness of this terrible and disfiguring scourge makes it even more dreaded than the most fatal of the other infectious diseases. It is the one disease of all others which is most likely to loosen the family tie, and break the social bond; which even makes the husband willing to part with the wife, the wife with the husband, parents with the children, the friend with the friend. Like the leper, indeed, the sufferer must go without the City, though, happily, not without hope. Facts are not wanting to support this view. In perhaps no other disease and upon no other hypothesis would 522 out of 797 persons have been prevailed upon to go to hospital. Hence the urgent necessity for having ample hospital accommodation always available. The disease, moreover, when once started, spreads with curious rapidity, and the demand for Hospital accommodation increases in 12 the game manner and proportion. Strenuous, and at times almost superhumam, efforts have to be made in order to overtake the demand. Upon these considerations alone it would in my opinion be most judicious on the part of the Yestry to maintain the position they have so creditably taken, and determine never to be without a place of refuge for the isolation and treatment of parishioners who may in the future be attacked by small pox or other infectious and contagious diseases. The usual disinfection was, during the epidemic, most thoroughly carried out in every case of small pox which came to the knowledge of your Sanitary Department, no less than 1,082 rooms and passages having been disinfected. The following particulars relate to infected beds and bedding destroyed, and the cost of their replacement. Also to the eost of the purification and re-covering of other infected beds and bedding during the small pox epidemic of 1881. Summary of infected Beds and Bedding destroyed and replaced with new, during the year 1881, at a cost to the Yestry of £130 14 0 97 Beds 319 brought forward 56 Mattresses 6 Blankets 3 Palliasses 13 Sheets 47 Bolsters 15 Rugs 113 Pillows 4 Articles of 3 Pillow-covers Clothing 319 carried forward 357 Total Summary of articles disinfected and returned to poor owners, during the year 1881, at a cost to the Vestry of 44 4 5 Disinfected. Disinfected and 30 Beds Re-covered. 28 Bolsters 24 Beds 61 Pillows 15 Bolsters 8 Mattresses 36 Pillows 57 Other articles of ding and Clothing 184 Total 75 Total Total 259. Total cost of 616 articles replaced or disinfected &c., during the year 1881 £174 18 5 13 THE CENSUS 1881. I was desirous of laying before you some of the facts ascertained by this last Census and those of the previous decades, many of which we may fairly regard as of very great value, but the details of the Census of 1881 not yet being in print I must content myself with submitting the following Table, and leave any further remarks which I may have to make for a future report. TABLE No. VII. Area and Population of Saint Mary, Islington, in the Census years from 1801 to 1881. Area in Arres Census Year3. Population at Census. Increase in decade. Annnal Kate of increase per cent. Number of Inhabited Houses. Number of Inhabitants to each house. 3107 1801 10,212 * * * * * * * * 1811 15,065 4,853 3.965 2,399 6.3 1821 22,417 7,352 4.054 3,495 6.4 1831 37,316 14,899 5.230 5,797 6.4 1811 55,690 18,374 40.73 8,508 6.5 1851 95,329 39,639 5.522 13,528 7.0 1861 155,341 60,012 5.003 20,704 7.5 1871 213,778 58,437 3.243 27,079 7.9 1881 282,865 69,087 2.840 34,046 8.3 This Table shows how vast the population of Islington has become, and at what rate this enormous increase has taken place during the interval of each ten years. In the last two decades, however, it is noticeable that the higher rate of increase has not been maintained, the 5 per cent. per annum between 1851 and 1861 being reduced to about 3¼ per cent. between 1861 and 1871, and to a little over 2¾ per cent. per annum during the last decade. As the ground of the Parish becomes more covered, there is less scope for builders, and without a proportional increase in the number of habitable houses, it is not desirable that even the reduced rate of increase in the population should be maintained, for it will be seen that the number of persons to each inhabited house has been steadily increasing during the last 40 years. 14 WATER ANALYSIS. In the following tables I have stated the analyses made monthly of the New River Company's Water, and recorded by me during the year. Analyses of Samples taken from the Works of the Company. 1831. Total Solid Matter. Chloride of Sodium. Nitrogen as Nitrates. Nitrogen as Ammonia. Oxygen required to oxidise Organic Matter. Degree of Hardness. Degree of Hardness after boiling ¼ of an hour. Organic Carbon. Organic Nitrogen. January 22.25 1.77 0.229 0.000 0.078 16.0° 3.7° ...... ...... February 21.90 1.77 0.250 0.000 0.036 16.5° 4.2° ...... ...... March 21.15 1.888 0.292 0.000 0053 17.6° 3.7° ...... ...... April 17.60 2.242 0.271 0.000 0.003 16.5° 3.8° ...... ...... May 18.60 1.770 0.240 0.000 00.12 15.4° 3.0° ...... ...... June 18.40 1.65 0 .14 0.000 0.020 15.4° 4.37° ...... ...... July 17.30 1.65 0.10 0.000 0.012 13.7° 2.9° ...... ...... August 20.70 1.534 0140 0.000 0.018 14.3° 3.3° ...... ...... September 18.94 1.77 0.156 0.002 0.027 15.5° 3.9° ...... ...... October 20.30 1.88 0.167 0.000 0014 16.0° 3.3° ...... ...... November 22.10 1.88 0271 0.000 0.023 17.5° 3.0° ...... ...... December 22.05 1.88 0.261 0.001 0.063 17.0° 4.2° ...... ...... Average 20.27 1.806 0.209 0.000 0030 15.9° 3.6° ...... ...... Analyses of Samples taken from the Mains of the Company. 1881. Total Solid Matter. Chloride of Sodium. Nitrogen as Nitrates. Nitrogen as Ammonia. Oxygen required to oxidise Organic Matter. Degree of Hardness. Degree of Hardness after boiling ¼ of an hour. Organic Carbon. Organic Nitrogen. January ...... 1.711 0.234 0.000 0.039 15.6° ...... ...... ...... February ...... 1.770 0.239 0.000 0.033 17.0° ...... 0.106 0.024 March ...... 1.798 0.256 0.000 0.048 17.40° ...... 0.093 0.017 April ...... 1 .809 0.274 0.000 0.032 17.20° ...... 0.096 0.007 May ...... 1.770 0.224 0.000 0.016 15.7° ...... 0.055 0012 June ...... 1.70 0.15 0.000 0.017 15.0° ...... 0.075 0.018 July ...... 1.82 0.11 0 000 0.021 14.0° ...... 0.062 0.018 August ...... 1.65 0120 0.000 0.009 13.8° ...... 0.047 0.012 September ...... 1.77 0.153 0.000 0.019 13.9° ...... 0.057 0.008 October ...... 1.82 0.203 0.000 0.021 15.7° ...... 0055 0.009 November ...... 1.88 0.234 0.000 0.022 16.8° ...... 0.074 0.021 December ...... 1.88 0.250 0.001 0.053 15.6° ...... 0.142 0.025 Average ...... 1.788 0.204 0.000 0.027 15.6° ...... 0.072 0.014 15 I now place before you the quantity of water supplied by the New River Company, month by month, during 1881, the number of inhabited houses to which it was delivered, and a calculation of the number of gallons daily supplied to each house. 1881. No. of Houses. No. of Gallons daily. Gallons of Water to each House. January 0 132,665 24,948,000 188.1 February 132,471 25,344,000 191.3 March 132,809 26,664,000 200.1 April 133,055 27,949,000 210.1 May 133,219 30,885,000 231.8 June 133,706 32,725,000 244.8 July 134,148 34,611,000 258.0 August 134,498 31,843,000 236.8 September 134,831 29,153,000 216.2 October 135,258 28,516,000 210.8 November 135,430 26,511,000 195.7 December 135,454 26,027,000 192.1 16 THE " SALE OF FOOD AND DRUGS ACTS," FOR YEAR 1881 During the twelve months ending December, 1881, I examined 103 samples of food, 100 of which were submitted to me for analysis by your Inspectors, and 3 were submitted by the public. This makes in all 1,007 samples of food examined for Islington since my appointment. The 100 samples submitted by your Inspectors, consisted of— 24 Sweets 12 Green Tea 12 Milk 8 Mustard 12 Sugar 8 Cocoa 12 Coffee 8 Arrowroot 4 Cayenne Pepper. In the 24 samples of Common Sweets (which were chiefly coloured) I was unable to detect any injurious matters. I certified one sample of Milk to be adulterated, and the vendor was summoned and fined £5, with 2s. costs. In no other samples of the various articles submitted by the Inspectors did I find any adulteration. Of the three samples submitted for analysis by the public, one was Milk which I found to be genuine, one was Flour of an inferior quality, but not in my judgment adulterated, and the third was a sample of Butter of somewhat doubtful composition. THE MORTUARY AND CORONER'S COURT, 1881-82. From the 1st April, 1881, to 31st March, 1882, 628 bodies were received at the Mortuary, the daily average being 1.72 against 1.56 and 1.71 in the two previous years. 330 inquests have been held, during the same period, the sum of £50 10s. having been paid to the Vestry for the accommodation afforded by the Coroner's Court. The proportion of Inquests to deaths was about 6 35 per cent. for the whole year. 17 SANITARY WORK FOR THE YEAR 1881-82. Table No. IX. This table of our Sanitary work has been prepared in the usual way, and shows in the first part the number and variety of the inspections, re-inspections and calls made by the district inspectors during the year. In the second part are shown the amendments which have been effected. In addition to these improvements the district inspectors reported during the year the premises from which they found that dust was required to be removed By the authority of the Sanitary Committee carbolic acid was again employed during the summer, as in former years for 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, these thoroughfares being used as market places until late on Saturday night. One summons only was issued during the year, and was in the case of a prosecution under " The Sale of Food and Drugs Acts," against a milk dealer for selling adulterated milk, the result of which has been already stated. 18 THE SLAUGHTER AND COW-HOUSES IN ISLINGTON, 1881-82. At the annual licensing of 1881, there were 85 applications for the renewal of licenses to slaughter-houses, which were all granted. For the renewal of licenses to cow-houses 47 applications were made and granted. One fresh application for a license to keep cows was also granted without opposition. 85 slaughter-houses and 48 cow-houses were therefore licensed. The result of my annual inspection was satisfactory. THE BAKEHOUSES OF ISLINGTON. In my Report for the year 1879, I wrote as follows, and I reproduce it here owing to what has since transpired with reference to the condition of some of the bakehouses of the Metropolis. "The visits to bakehouses were not so numerous as in former "years, "The Bakehouse Regulation Act, 1863," having been "repealed by the consolidated "Factory and Workshops Act, "1878," which came into operation on the 1st of January, 1879, "and under which the bakehouses will now be inspected by Her ''Majesty's Inspectors of Factories, who, by the 4th section, are "directed to give notice of any nuisance remediable under " The "Nuisances' Removal Acts," to the sanitary authority. "Whether this new legislation will tend to the improvement "of the condition of the bakehouses, or whether they will gradually "fall into the state of neglect they were in prior to the passing of "the Act of 1863, time alone will show ; but there can be no "doubt as to the beneficial results of the supervision constantly "exercised since the end of 1866-67 by the Vestry as the Local 19 "authority, the reality of which is attested by the 8,279 visits made "by your Inspectors to the bakehouses of the Parish, as well as by "the summonses issued in the worst cases from time to time, when "it has been necessary as an example, to enforce the regulations of "the Act, although it must be acknowledged that the bakers of "Islington, as a rule, have not been unwilling to meet the require"ments of the Sanitary Committee under the Act now repealed." The foregoing comments have a renewed interest at the present time owing to the extract from the Report of H.M. Chief Inspector of Factories and Workshops upon London bakehouses, which recently went the round of the newspapers, and in which the condition of the Bakehouses is alleged to be most unsatisfactory. H.M. Inspector having stated in writing that the report in question refers only to the East End of London, I do not propose to do more than mention it here, more especially as your Vestry have received no notice of any sanitary defects from H.M. Inspector as provided in the 4th Section of "The Factory and Workshops Act, 1878." I have, nevertheless, felt it my duty to direct an inspection to be made of the bakehouses in Islington, with a view to ascertain their present condition under the new regime as contrasted with their condition in the beginning of the year 1879, when they were first taken under the supervision of H.M. Inspectors, and also, for the purpose of having any defects now existing remedied as speedily as possible. This inspection has just been carried out under the powers given by "The Nuisances Removal Acts," which provide for an order of admission to be obtained from the Magistrate in cases of refusal, the inference being in such instances, that nuisances exist, which it is desired to conceal. In March, 1879, when the bakehouses were last previously inpected by your Sanitary Officers, it was found that of the 232 there 20 were 6 empty, and that of the 226 which were being used, 133 required to be limewhited. In one instance only was any accumulation of refuse found under the troughs, and there were no other sanitary defects observed at that time. Of the 232 bakehouses, 129 were underground, there being nothing in the Building Acts to prevent the construction or adaptation of underground premises for such a purpose. The following abstract will show the result of the inspection just made. Since the inspection of March, 1879, twelve of the old bakehouses have been abolished, and 23 new ones have been added to the number, the nett increase being 11. The total number at the present time is therefore 243, of which 144 are underground Of the 23 new bakehouses, 14 are underground, and 9 are not. Of the 213 bakehouses six are empty, and of the 237 being used, 101 require to be limewhited. In 45 instances accumulations of refuse were found under the troughs, and 25 inlets to drains were untrapped. In eight bakehouses the paving was defective. In two there were stack pipes open at the top and connected with the drains at the bottom. One of these is new, and in the other case the stack pipe had been altered. In a single instance a drain pipe was found open for the reception of the water overflowing from the water receptacle. Three of the more recently constructed bakehouses have waterclosets in them, while five old ones are similarly circumstanced. I must say that from this abstract it would seem that my 21 anticipation of three years since, has been realized, for there are certainly signs of much neglect, which nothing but constant supervision will remedy. It is true that a smaller number, 101 against 133, requires limewhiting, but that has always been the case at midsummer as compared with the spring, when a much larger number was always found to require cleansing after the winter months. But 45 accumulations of refuse under the troughs against one in 1879, and 25 untrapped drains against none, are matters of serious import, and prove conclusively that the average three visits a year of your sanitary officers were far more effectual than the one possible visit of H.M. Inspector in every two years and six months, that being the time it would take him on his own calculation to make one visit to each of the 1890 bakehouses included in the district referred to in the Report of H.M.Chief Inspector of Factories and Workshops. The change was evidently a step in the wrong direction for what was wanted then and what is still wanted was not centralization but registration, which should have been left in the hands of the local sanitary authority, for this it is which would alone absolutely prevent the use of unfit places as bakehouses, as it would also prevent the improper construction of places intended for this purpose. In my opinion The Bakehouses Regulation Act, 1863, should not have been revoked, but it should rather have been amended in the direction now indicated, in which case, I am sure that the results would have been most salutary and beneficial. I know it is the fashion to decry the Vestries of the Metropolis, and that their powers have been sometimes curtailed owing partly to this fashion, and partly to the centralising tendencies of our present legislation, but in the case of the bakehouses, there is no doubt that centralisation has produced very decidedly bad results. 22 It is much to be regretted that such a step should have been taken without first ascertaining what the Vestries were doing, and their opinion as to the proposed change, or what other course they could recommend by way of improvement for adoption by the legislature. THE DUSTING OF THE PARISH, 1881-82. I have appended as usual a tabulated statement (Table No. X.) of the applications for the removal of dust during the year ending Lady Day, 1882, showing the number received during each quarter from the eight different Wards of the Parish. Of the total number of 12,993 applications received from residents during the year, 9,065 were by letter or postal card, and 3,928 were made personally, or through messengers sent to the Vestry Offices. The 12,993 applications received from inhabitants, were at the rate of 37.5 per cent. of the inhabited houses, against 39.8 per cent. in 1880-81. CONCLUSION. It is unnecessary for me to enlarge on the ability and indefatigable industry of your Sanitary Superintendent, Mr. Collingwood; of these you may know something, but that something is comparatively little compared with what I know. Permit me, however, to speak of the work done during the past year by your four Sanitary Inspectors. They have now been in your service for eleven, eight, seven and six years respectively, and I am bound to say, their work, during the time they have been with you, has been 23 intelligently and loyally performed. A sanitary inspector's duties are not always agreeable, and, I am compelled to say, have often to be done amidst considerable discouragement. For I fear the public have not even yet learnt to regard health as a matter of infinitely greater moment than rates and taxes. There are few things of greater importance in your sanitary machinery than constancy in your band of workers. Constant change always means loss to the department, for a new man has to learn his work, and time is lost in learning it. I remain, Gentlemen, Your obedient Servant, C. MEYMOTT TIDY, M.B., Medical Officer of Health. 30th June, 1882. TABLE VIII DEATHS REGISTERED IN ISLINGTON DURING (Deaths of Non- Residents West S.D. East S.D. Causes of death. At all Ages. Under 1 year 1 year 2 years 3 years 4 years Under 5 years. 5 years 10 years 15 years. 20 years 40 years 60 years At 80 years of age and upwards. 2058 3058 All Causes 5116 1400 480 218 117 94 2309 14 59 82 645 742 913 21 (Classes.) 432 615 I. ZYMOTIC DIS. 1047 360 192 94 63 44 753 77 18 19 102 47 21 6 432 611 II. CONSTITUTL. 1043 156 76 37 12 10 291 23 19 36 295 245 123 11 941 1453 III. LOCAL 2394 522 202 81 40 35 880 47 21 25 208 436 663 114 200 321 IV. DEVELOPMNL 521 319 3 2 .. ... 324 .. .. .. 16 3 93 86 53 58 V. VIOLENT DTHS 111 43 7 4 2 5 61 1 1 2 24 11 9 2 ... ... Not Specified ... ... ... ... ... ... ... ... ... ... ... ... (Orders.) 404 574 I. 1. Miasmatic Dis. 978 317 187 93 63 44 704 75 18 19 93 39 24 6 22 44 Small Pox 66 14 9 4 2 1 30 4 2 l 19 7 3 ... 54 107 Measles 161 38 61 28 15 9 151 8 1 ... 1 ... ... ... 57 59 Scarlatina 116 7 20 15 20 16 78 25 3 2 6 2 ... ... 17 25 Diphtheria 42 1 4 6 8 9 28 11 1 ... 2 ... ... ... 1 1 Quinsey 2 1 ... ... ... ... 1 ... ... ... ... ... ... 15 21 Croup 36 7 12 8 4 32 4 ... ... ... ... ... ... 72 100 Whooping Cough 172 60 60 23 15 3 161 11 ... ... ... ... ... ...4. 32 47 Typhus & Typhoid 79 2 1 4 ... 2 9 8 7 11 -9 12 3 . 5 12 Erysipelas 17 6 ... ... ... ... 6 ... .. ... 1 7 2 1 1 6 Pyæmia 7 2 ... ... ... ... 2 ... ... ... 2 1 2 13 11 Puerperal Fever 24 ... ... ... ... ... ... ... ... 1 20 3 1 1 Carbuncle 2 ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 Influenza 1 1 ... ... ... ... 1 ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... ... 101 115 Diarrhœa 216 177 20 2 2 ... 201 2 ... ... 3 3 5 2 3 ... Cholera 3 ... ... 2 ... ... 2 ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... 10 24 Rheumatism 34 1 ... 1 ... ... 2 2 4 4 8 4 7 3 11 22 2. Enthetic 33 22 4 1 ..... ... 27 2 ... ... 3 1 ... ... ... 20 Syphilis 30 22 4 ... ... 27 J ... ... 2 ... ... ... 1 2 Stricture of Urethra 2 ... ... ... ... ... ... ... ... 1 1 ... ... 1 ... Hydrophobia 1 ... ... ... ... ... ... 1... ... ... ... ... ...... ... ... ... Glanders ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 13 3. Dietic 26 12 ... ... ... ... 12 ... ... ... 6 7 1 ... ... ... Privation ... ... ... ... ...... ... ... ... ... ... ... ... ... ... 7 4 Want of Br. Milk 11 11 ... ... ... ... 11 ... ... ... ... ... ... ... 2 1 Purpura and Scurvy 3 l ... ... ... ... l ... ... ... 2 ... ... ... 4 8 Alcoholism 12 ... ... ... ... ... ... ... ...... ... ... 7 1 ... 4 6 4. Parasitic 10 9 1 ... ... ... 10 ... ... ... ... ... ... ... 4 6 Thrush 10 9 1 ... ... ... 10 ... ... ... ... ... ... ... ... ... Worms ... ... ... ... ... ... ... ... ... ... ... ... ... ... 83 138 II.1. Diathetic 221 11 3 1 15 1 1 17 81 96 10 3 15 Gout 18 4 12 2 5 10 Dropsy 15 ... l 6 6 2 3 8 Hæmorrhage 11 3 3 3 5 60 91 Cancer 151 1 1 1 11 01 72 5 ... ... Cancrum Oris(Noma) ... ... ... ... ... ... ... ... ... ... 12 14 26 8 2 11 1 2 6 349349 473 3. Tubercular 822 115 73 37 11 10 276 23 18 35 278 164 27 i 43 43 Scrofula 86 36 19 6 1 1 63 4 2 1 40 57 Tabes Mesenterica 97 63 15 9 l 213 312 Phthisis 525 6 6 6 18 8 13 27 270 162 26 1 53 61 Hydrocephalus 114 40 33 16 7 7 103 8 2 1 258 438 III. 1. Nervous Syst. 696 196 55 21 14 12 304 19 7 7 42 84 201 32 55 86 Cephalitis 141 45 24 13 11 12 105 l5 4 2 7 3 ... 52 70 Apoplexy 122 1 ... ... ... ... 1 ... ... l 8 30 73 9 36 90 Paralysis 126 ... ... ... ... ... ... ... l 5 19 84 17 1 11 Insanity 12 ... ... ... ... ... ... ... ... ... 2 1 7 2 ... 2 Cholera 2 ... ... ... ... ... ... ... ... ... ... 1 ... 1 8 15 Epilepsy 23 ... ... ... ... ... ... ... ... ... 8 8 7 ... 80 112 Convulsions 192 141 30 13 2 ... 186 3 1 ... 1 1 ... ... 26 52 Brain Diseases, & c. 78 9 1 1 1 ... 12 1 2 3 13 17 27 3 101 157 2.Organs of Circ. 258 4 ... ... ... 1 5 5 4 6 47 95 84 12 3 4 Pericarditis 7 ... ... ... ... ... ... 2 i ... ... 2 1 ... 1 4 Anueuris 5 ... ... ... ... ... ... 3 ... 1 3 1 ... 97 149 Heart Disease 246 4 ... ... ... 1 5 3 3 6 46 90 82 11 TABLE VIII. FIFTY-TWO WEEKS ENDING 31ST DECEMBER, 1881: in Hospitals excluded.) West S.D. East S.D. Causes of death. At all Ages. Under 1 year. 1 year. 2 years. 3 years. 4 years. Under 5 years. 5 years. 10 years. 15 years. 50 years. 40 years. 60 years. At 80 years of age and upward. 407 618 3. Respirat. Orgs. 1025 267 136 50 23 15 491 12 6 8 54 149 256 49 19 21 Laryngitis 40 21 9 2 2 3 37 ... 1 ... 1 1 ... ... 233 411 Bronchitis 644 164 82 24 15 4 289 1 ... 1 17 98 195 40 5 2 Pleurisy 7 ... ... ... ... ... ... ... ... ... 1 2 3 1 124 153 Pneumonia 277 76 42 23 4 7 152 7 5 6 30 32 39 6 14 17 Asthma 31 ... ... ... ... ... ... ... ... ... 4 11 15 1 12 14 Lung Diseases, &c. 26 6 3 1 2 1 13 1 ... 1 1 5 4 1 105 142 4. Digestive Orgs. 247 50 9 2 3 3 67 8 ... 2 27 68 64 11 10 13 Gastritis 23 8 l ... 1 ... 10 ... ... ... 1 3 8 1 19 17 Enteritis 36 17 3 1 1 ... 22 1 ... ... 5 6 2 ... 9 27 Peritonitis 36 6 2 ... ... ... 8 3 ... ... 6 11 7 1 1 2 Ascites 3 ... ... ... ... 1 1 ... ... ... ... ... 2 ... 3 1 Ulceration of Intes. 4 ... 1 ... ... ... 1 1 ... ... 1 1 ... ... 2 8 Hernia 10 1 ... ... ... ... 1 ... ... ... ... 3 4 2 3 8 Ileus 11 1 ... ... ... ... 1 ... ... 1 1 1 7 ... 1 2 Intussusception 3 1 ... ... 1 ... 2 1 ... ... ... ... ... Stricture of Intest. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 15 8tomach Dis., &c. 20 5 1 1 ... ... 7 ... ... ... 6 2 1 4 ... ... Pancreas Dis., &c. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 5 Hepatitis 8 ... ... ... ... ... ... ... ... ... ... 5 2 1 9 7 Jaundice 16 8 1 ... ... 1 10 1 ... ... ... 1 4 ... 39 34 Liver Disease 73 2 ... ... ... ... 2 1 ... 1 7 34 26 2 1 3 Spleen Disease 4 1 ... ... ... 1 2 ... ... ... ... 1 1 ... 46 60 5. Urinary Organs 106 2 1 ... ... 2 5 1 2 ... 24 25 44 5 7 5 Nephritis 12 1 ... ... ... 1 2 ... ... ... 4 3 3 ... 2 11 Disease of Bladder 13 ... ... ... ... ... ... ... ... ... 1 ... 11 1 13 24 Nephria 37 ... 1 ... ... 1 2 ... 1 ... 9 11 13 1 7 7 Diabetes 14 ... ... ... ... ... ... ... ... ... 4 5 5 ... 1 ... Stone 1 ... ... ... ... ... ... ... ... ... ... ... 1 3 1 Prostate Disease 4 ... ... ... ... ... ... ... ... ... ... ... 2 2 13 12 Kidney Disease 25 1 ... ... ... ... 1 1 1 ... 6 6 10 ... 9 14 6. Genera. Organs 23 ... ... ... ... ... ... ... ... ... 8 7 6 2 3 ,3 Ovarian Dropsy 6 ... ... ... ... ... ... ... ... ... 2 2 2 ... 6 11 Uterine Diseases 17 ... ... ... ... ... ... ... ... ... 6 5 4 2 7 15 7. Orgs. of Locomo. 22 1 1 ... ... 2 4 2 2 2 3 4 5 ... 7 8 Spine Diseases 15 1 ... ... ... 2 3 2 1 2 3 3 1 ... ... 7 Bone Diseases 7 ... 1 ... ... ... 1 ... 1 ... ... 1 4 ... 8 9 8. Skin, &c 17 2 ... 2 ... ... 4 ... ... ... 3 4 3 3 ... ... Phlegmon & Absces ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 Ulcer 10 ... ... ... ... ... ... ... ... ... 3 4 3 ... 3 4 Skin Diseases 7 2 ... 2 ... ... 4 ... ... ... ... ... ... 3 59 68 IV. 1. Dis. of Childn 127 27 ... ... ... ... 127 ... ... ... ... ... ... ... 53 53 Premature Birth 106 106 ... ... ... ... 106 ... ... ... ... ... ... ... 2 4 Cyanosis 6 6 ... ... ... ... 6 ... ... ... ... ... ... ... 2 4 Spina Bifida 6 6 ... ... ... ... 6 ... ... ... ... ... ... ... 1 5 Other Malformation 6 6 ... ... ... ... 6 ... ... ... ... ... ... ... 1 2 Teething 3 3 ... ... ... ... 3 ... ... ... ... ... ... ... 9 10 2. Dis. of Adults 19 ... ... ... ... ... ... ... ... ... 16 3 ... ... Paramenia ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 10 Childbirth 19 ... ... ... ... ... ... ... ... ... 16 3 ... ... 40 135 3. Dis. of Aged 175 ... ... ... ... ... ... ... ... ... ... ... 93 82 40 1 135 Old Age 175 ... ... ... ... ... ... ... ... ... ... ... 93 82 92 108 4. Dis. of Nutritn. 200 192 3 2 ... ... 197 ... ... ... ... ... ... 3 92 108 Atrophy & Debility 200 192 3 2 ... ... 197 ... ... ... ... ... ... 3 39 42 V. 1. Acci. or Neg. 31 31 7 4 2 5 49 1 1 17 4 6 2 16 11 Fract. and Contus 27 ... l 1 1 3 6 1 1 ... 12 2 1 1 Wounds 1 ... ... ... ... ... ... ... ... ... l ... ... ... 5 7 Hums and Scalds 12 2 4 2 1 ... 9 ... ... ... 1 1 ... 1 I 5 Poison 6 ... 2 ... ... ... 2 ... ... ... 2 1 1 1 Drowning 1 ... ... ... ... ... ... ... ... ... 1 ... 12 17 Sutfocation 29 ... ... ... ... 28 28 ... ... ... 1 ... 4 1 Otherwise 5 1 ... 1 ... 2 4 ... ... 1 ... ... 3 9 2. Homicide 12 12 ... ... ... ... 12 ... ... ... ... ... ... ... 11 6 3. Suicide 17 ... ... ... ... ... ... ... ... 1 7 6 3 ... 0 2 Wounds 8 ... ... ... ... ... ... ... ... ... 3 4 1 ... 1 ... Poison 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 Suffocat and Hang. 5 ... ... ... ... ... ... ... ... 1 3 ... 1 ... 1 2 Otherwise 3 ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 1 4. Unclassed 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... 26 TABLE IX. HOUSES INSPECTED AND SANITARY IMPROVEMENTS EFFECTED, From March 25th, 1881, to March 25th, 1882. South East District. South West District. North District. Total. Number of Houses inspectod 1,373 1,336 1,066 3,775 Re-inspections, Calls made, &c 3,702 3,610 3,186 10,498 Visits to 48 Cowhouses 61 81 56 198 Do. 85 Slaughter-houses 128 114 86 328 Do. Stables and Yards 95 42 22 169 Do. Factories and Workshops 7 5 12 Do. Fields, Lanes, & c. 17 9 59 85 Do. 32 Factories, Horse Slaughter-houses, Piggeries, &c., Belle Isle 197 - 197 Total Inspections, &c 5,383 5,389 4,480 15,252 IMPROVEMENTS. Drains Constructed 56 38 14 108 Improved or repaired 135 123 96 354 Traps fixed 161 173 119 453 Cesspools Abolished ... 5 2 7 Cleansed or disinfected ... ... ... ... Privies and Water Closets Pan, Trap & water supply furnished ... 7 21 28 Pan and trap only furnished 6 12 8 26 Water supply furnished 10 44 17 71 Dust Bins Constructed 1 3 10 14 Repaired and covers adapted 2 13 11 26 Surface Drains and Pavements of Yards Constructed 85 79 36 200 Relaid 127 173 79 379 General Water Supply New receptacles provided 2 9 8 19 Receptacles repaired and cleansed 30 60 41 131 Water supply provided 11 6 9 26 Other improvements Houses generally repaired 53 56 62 171 ,, &c., cleansed or lime washed 69 106 101 276 „ ventilated ... 2 ... 2 Overcrowding abated 10 4 4 18 Illegal use of underground Rooms for sleeping discontinued 8 3 ... 11 Other Amendments, or Nuisances abated 78 27 63 168 Houses or Rooms disinfected 372 335 375 1082 Total improvements 1,216 1,278 1,076 3,570 Total Premises Improved 630 501 542 1,673 N.B.—From the 25th March, 1881, to the 25th March, 1882, the Inspector of Dust visited 23,009 houses, and found that Dust was required to be removed from 8,149 of these houses Table No. X. Summary of Applications for Removal of Dust from 25th March, 1881, to 25th March, 1882. Ward. Three Months ending 25th June, 1881. Three Months ending 24th Sep., 1881. Three Months ending 24th Dec., 1881. Three Months ending 25th Mar., 1882. Total during Twelve Months. Number of Inhabited Houses, 1881. Number of Applications to every 100 Houses. Applications during previous Twelve Months Applications to every 100 Houses during same period. The Vestry. 1 1070 437 376 511 2394 8486 28.2 2307 30.4 Do. 2 521 242 197 233 1193 3962 30.1 1176 30.3 Do. 3 1099 376 345 546 2366 7292 32.4 2807 40.8 Do. 4 393 243 198 282 1116 3320 33.6 108.1 328 Do. 5 431 255 214 308 1808 2545 710 1352 53.8 Do. 6 733 360 352 427 1872 2200 851 2069 96.5 Do. 7 693 214 187 342 1436 3246 44.2 1350 42.1 Do. 8 574 225 185 424 1408 3562 39.5 999 28.3 Totals. ... 5514 2352 2054 3073 12993 34613 37.5 13141 39.8 Removals ordered from Reports of the Inspector of Dust and other Inspectors ... 2008 1528 2061 2662 8259 Total Removals ... 7522 3880 4115 5735 21252 28 APPENDIX. Small Pox Camp Hospital Reports. Report No. I. TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report:— That they have for some time been watching with considerable anxiety the progress of the small pox epidemic now so seriously affecting the Metropolis, and with it the increasing difficulty experienced by the District Asylums Board in providing sufficient hospital accommodation for the isolation of patients whose removal becomes necessary. This difficulty was especially felt during the weeks ending the 23rd and 30th April. During the latter week, in Islington alone, 21 persons were unable to obtain admission to the Asylums District Hospitals, and although some of the patients were subsequently admitted, others had become too ill to bear removal. In view of the possible recurrence of a similar contingency, your Committee deem it desirable that the Vestry should be prepared to meet promptly such an emergency in future, either by being in readiness to provide temporary hospital accommodation themselves, or by some arrangement having been made for the reception of patients by another authority who may have already made such provision, in accordance with the 37th section of "The Sanitary Act, 1866." Your Committee therefore put themselves in communication with the Burial Board, who at once accorded their permission for the erection by the Vestry of tents or other temporary accommodation for small pox patients, on a portion of the spire ground adjoining the Finchley Cemetery. 29 As the Guardians however were contemplating a similar step, your Committee submitted to them the desirability of taking united action, and they expressed their willingness to do so, but for the fact that they no longer regarded it as necessary for them to make any provision owing to the increased accommodation being provided for pauper patients by the District Asylums Board, through the removal of a large number of convalescents to the camp established by them at Darenth. Your Committee have also been in communication with the Vestry of St. Pancras, who have erected hospital marquees upon the piece of land immediately adjoining the field pointed out for the use of this Vestry, and your Committee propose to make if possible, an arrangement with them on the part of your Vestry for the reception and treatment of Islington non-pauper patients, upon a specific payment for each case, or in some other way to make the services of one staff available for both Parishes, but they have not as yet received a final answer to their enquiry. Failing such arrangements it is proposed, should the emergency again arise, to have at once temporary hospital accommodation provided for non-pauper patients upon the land at Finchley, together with all other necessary accommodation, and to engage such staff and attendants as may be found requisite. Your Committee therefore— RECOMMEND the Vestry to authorise Hospital accommodation to be provided for 32 small pox patients, at an estimated cost of £300, should this course, in the opinion of the Sanitary Committee become urgently necessary during the present prevalance of small pox, or to make such arrangements with St. Pancras, or some other authority, as may be practicable, for the reception of Islington cases. All which is submitted. (Signed) W. M. MOXON, Chairman, Sanitary Committee. Vestry Offices, Upper Street, 16th May, 1881. 30 Report No. II. TO THE VESTRY OF ST. MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report:— That in view of the increasing prevalence of small pox they have taken steps towards immediately providing the Camp Hospital accommodation for patients, at Finchley, already authorised by the Vestry. Owing to the larger number of cases now occurring, they consider it also expedient that increased provision should be made, and therefore recommend the Vestry to grant them further authority to make all requisite arrangements for providing additional hospital tents for the reception of such number of small pox patients as the Committee may find to be necessary, so that ample accommodation may be provided, without distinction, for all the cases arising in Islington, and to take all such other steps as they shall deem desirable in connection with the prevailing epidemic, but that they shall not incur an expenditure of more than £2,000, in excess of the £300 already granted, without first obtaining further power from the Vestry. Out of the sum now asked to be appropriated, the Committee recommend that a payment of £400 be made to Mr. Thos. Sketchley, the present tenant of the land of about 24 acres, for its immediate possession, subject to the concurrence of the Burial Board. All which is submitted. (Signed) W. M. MOXON, Chairman, Sanitary Committee. Vestry Offices, May 30th, 1881. 31 Report No. III. TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report:— That in pursuance of the Vestry Resolution of the 3rd June 1881, they have proceeded as rapidly as possible to provide tent accommodation for all cases of small pox arising in Islington, without distinction of class. In the three weeks ending the 11th instant, 85 Islington cases were removed to hospital, and your Committee therefore provided eight marquees, capable of holding, if necessary, 128 patients, 6 of the marquees being for acute cases, and 2 for convalescents. Bedding, furniture, clothing, and other necessaries have been provided for 75 patients, 50 beds being for acute cases, and 25 for convalescents. A Medical Superintendent, a Matron, Nurses, and other attendants have been engaged. In preparing the camp for occupation a great deal of work of a more permanent character than the erection of tents became essential, and these works have now nearly been completed. In the establishing of this temporary hospital, opened for the 32 reception of patients on the 15th instant, the following liabilities, some of which are estimated, have been incurred 1. For Tents, with extras £940 0 0 2. „ Bedding, Furniture, Clothing, Camp and Kitchen Utensils and other necessaries 770 14 2 3. „ Surgical Instruments, Drugs, Wines, &c. 86 15 0 4. „ Earth Closets, Wages, Labour, Advertising, and other expenses 156 0 11 5. „ Tradesmens' Bills (2 weeks) 50 0 0 6. „ Contingencies. 50 0 0 £2,053 10 1 In the more permanent works of Drainage, Water supply, Fencing in Ground, erection of Kitchen and Laundry £874 0 0 Hot Water and Heating Apparatus 300 0 0 Machinery for Washing, Disinfection, &c. 117 0 0 1,291 0 0 (Exclusive of £400 paid for the possession of land) £3,344 10 1 After deducting the £400 paid to Mr. Sketchley for possession of the land from the £2,300 granted by the Vestry, there remains but £1,900 to meet this liability of £3,344, so that a further sum of £1,444 is necessary to make up the deficiency, and your Committee Recommend the Vestry to grant a further sum of £2,000 which will enable the Committee to meet their liability, and to carry on the hospital for some weeks, before again applying to the Vestry. All which is submitted. (Signed) JOHN LAMB, Chairman, Sanitary Committee. Vestry Offices, 20th June, 1881. 33 Report No. IV. TO THE VESTRY OF ST. MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report :— That they will be able, as they anticipated in their Report of the 20th of June, 1881, to meet their liability in respect to the preliminary and other expenses incurred in connection with the Camp Hospital and Small Pox Epidemic, out of the sum of £4,300 voted by the Vestry, and that they now only require the cost of maintenance, which they have estimated at £600 up to the end of September next. In case the necessity should continue, a further sum of £300 per month would be required, as stated in their estimated expenditure of £1,800 for the six months ending Lady-day, 1882, subject to the approval of the Vestry. As regards the epidemic, your Committee do not consider its present decline in London, generally, as any certain indication of its passing altogether away, for until the Autumn shall have gone they believe that it is impossible to predict whether or not a renewed or even a severer outbreak may be likely to take place. That the decline has been liable to sudden fluctuations in different localities there can be no doubt, and in Islington alone, during the last week, ending 30th July, 24 fresh cases occurred, this number being larger than in any week since that ending the 18th June, and out of these 24 cases, 15 were received into your Camp Hospital, 34 Your Committee have taken into consideration the question of payment by the patients, or their friends, for treatment and maintenance, but, as advised by your Vestry Clerk, it appears that the Vestry possess no statutory power of recovering such cost. Of the total number of 59 patients admitted, 5 have died, 11 have been discharged, and 43 remain. For two patients the sum of £4 4s. each has been paid to the Vestry for admission, but in the remaining 57 cases the friends, when asked, stated that neither they nor the patients could afford to pay. From the nominal roll of the patients attached hereto, with particulars as to their position, it will be seen that the patients and their friends are, as usual in small pox epidemics, generally in poor circumstances, although not a single patient admitted was in receipt of Parish relief, except in one case of a girl sent from the Workhouse Schools by the Guardians. Your Committee recommend the Vestry to authorise the continuance and maintenance of the Camp Hospital during the vacation, the Committee to again report to the Vestry on the 7 th of October next, no patients to be received after the 20th August, 1881, unless in the opinion of the Sanitary Committee it is desirable that further admissions should take place All which is submitted. Vestry Offices, 5th August, 1881. (Signed) JOHN LAMB, Chairman, Sanitary Committee. 35 Report No. V. TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report:— That in pursuance of the recommendation made in their Report of the 5th of August, 1881, and adopted by the Vestry, the temporary Small Pox Camp Hospital at Finchley was closed to the reception of patients on the 20th August, 1881, only three fresh cases having been received after the announcement was made of the intention of the Vestry to discontinue such admissions. The patients who remained under treatment having been gradually discharged, your Committee were enabled finally to close the hospital on the 24th of September last. In the period extending from the opening (on the 15th of June) to the 20th August, during which patients were received, 62 were admitted, one of whom was found not to be suffering from small pox. Of these 61 cases, 27 were of a serious type, and of these 6 died, whilst 34 of the cases were of a less severe character. As regards vaccination, and the comparative safety which efficient vaccination affords to persons when attacked by the disease, it appears that only one death occurred amongst the 45 vaccinated patients, whilst 5 deaths occurred out of the 16 unvaccinated and doubtful cases. The largest number of patients under treatment at one time was 44. "The Medical Superintendent at the Camp has reported that "the progress of the patients during convalescence was rapid, and "unimpeded by complications; that only a few suffered, and those "very slightly, from any after consequences of the disease; and 36 "that no bad catarrhs or pulmonary diseases occurred amongst "the convalescents, notwithstanding that the month of August was "very wet and somewhat cold. "These favourable results (he adds) were probably due to the "perfect ventilation that the tents afforded, and to the efficient "means of wanning them, when necessary, and also to the good "and sufficient diet given to the patients." In this opinion your Medical Officer of Health most fully concurs. The whole of the bedding and other articles have, since the discharge of the patients, been thoroughly disinfected and stored in good condition. This also has been done in respect to the tents, which your Committee recently inspected on the ground before giving directions as to their disposal. Your Committee have also given instructions for the flooring of the tents to be taken up and stacked, and protected from the weather; but as these works cannot be completed for a short time, your Committee propose to make their final report to the Vestry as soon as possible after their instructions, in respect to the Camp and its arrangements, shall have been carried out. As regards their expenditure, your Committee are glad to be able to report that it has been within their estimate, and that the sums voted by the Vestry, amounting in the whole to £4,900, will be sufficient to meet every expense, including the cost of maintenance, and also of the work now being executed for the protection and safe-keeping of the property of the Vestry at Finchley. All which is submitted. (Signed) JOHN LAMB, Chairman, Sanitary Committee, Vestry Offices, Upper Street. 29th September, 1881. 37 Report No. VI. TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report— That the works and arrangements indicated in their Report of the 29th of September, 1881, are now complete in respect to the temporary Camp Hospital at Finchley, the flooring of the tents having been stacked and roofed over and the whole of the goods stored. The expenditure account for hospital and dismantling purposes being thus closed, your Committee submit herewith a summary statement of the whole of the expenses incurred by them, between the 8th of June, 1881, and the 17th October, 1881, amounting to £4,885 13s. Of this sum it will be seen that £3,776 was expended in obtaining possession of the land and in the more permanent portion of the works, as also in the purchase of beds, bedding, furniture, and other necessaries which are now stored upon the ground and available for future use should such an unfortunate necessity again arise. Your Committee have insured the buildings and stores from fire in the sum of £2,000 Deducting from the £3,776 the sum of £400 paid for the surrender of the land the difference of £3,376 may be taken as the cost of the works executed and the property purchased by the Vestry, and now remaining as stock at Finchley. 38 The cost of maintenance (£471) and the wages (£248) added together amount to £719, leaving the balance of £390 as the amount accounted for in the several other items of expenditure. With a very few days' notice the Camp Hospital could be again got ready for the reception of patients at an estimated cost of £100. Subject to direction from the Vestry, your Committee have placed a man and his wife in charge of the camp and the Vestry's stores, and your Committee RECOMMEND the Vestry to sanction the appointment of a caretaker, and to authorise the maintenance of the camp for the protection of the tents, stores and other property of the Vestry, at an estimated annual expense of £200. Your Committee cannot conclude their sixth and last Report upon the subject of camp hospital accommodation without expressing the very high opinion which they entertain of the judicious, able and energetic assistance which they have received in connection with this work from your Medical Officer of Health, Dr. Tidy, the Surveyor, Mr. Higgins, and the Sanitary Superintendent, Mr. Collingwood, to whom your Committee feel that the Vestry are greatly indebted for most valuable services of no ordinary or perfunctory kind. All which is submitted. Vestry Offices, 17th October, 1881. (Signed) JOHN LAMB, Chairman, Sanitary Committee. 39 THE VESTRY OF ST. MARY, ISLINGTON. Summary Statement of the whole of the Expenditure incurred by the Sanitary Committee in connection with the temporary Small Pox Camp Hospital at Finchley, between the 8th of June and the 17th of October, 1881. 1. Paid as Compensation for surrender of Land 400 0 0 2. Eight Hospital Marquees and Hot Water paratus for heating same £882 10 0 3. Fifteen Staff, Store, and other Tents 407 10 0 1,290 0 0 4. Drainage, Fencing, Building of Laundry, Kitchen, Water Supply, and other Works 1,273 19 6 5. Beds, Bedding, Furniture, Kitchen Utensils, and other necessaries 812 4 5 £3,776 3 11 6. Tradesmen's Bills, including Coals, &c 471 3 10 7. Wages of Staff 247 18 0 8. Surgical Instruments, Drugs, &c 49 14 0 9. Cost of Cab and Conveyance of Patients, &c 32 3 6 10. Paid for Labour, &c., at opening and closing 64 2 3 11. Advertisements, Printing, Cartage of Goods, and other expenses 74 8 1 12. Inspectors and others, for extra work 56 9 0 13. Petty Cash, Expenses of Committee, and Insurance 37 5 5 14. The Surveyor (Mr. Higging), extra services and expenses 26 5 0 15. Sanitary Superintendent (Mr. Collingwood), extra services* 50 0 0 £4,885 13 0 * Reduced by a Vote In the Vestry to £26 5s. 40 REPORT No. VII. TO THE VESTRY OF SAINT MARY, ISLINGTON. Gentlemen, Your Sanitary Committee Report:— That they have taken into consideration the two references made to them by the Vestry on the 9th of December, 1881, in respect to the Camp Hospital Reports of the 29th September, and 17th October, 1881, and they now re-submit such Reports, with the summary statement of the expenditure, to the Vestry, except in so much as they are modified by this Report; and your Committee state as follows:— 1.—That there are no premises anywhere belonging to, or under the control of the Parish where the Camp furniture can be stored or stacked with comparative safety, and without any expense beyond that of a Fire Insurance "Premium," but, that having regard to the opinion of the Vestry, they Recommend, that the Camp be maintained in its present form for nine months ending 29th September, 1882, at a nominal estimated cost of £103; of which sum £11 10s. is a liability already incurred to the Barnet Water Company to Midsummer 1882, and £32 16s. 3d. for nine months rent payable to the Burial Board, which latter sum will not be an extra charge upon the rates as it will be returned to the Vestry as a part of the annual balance of the Burial Board, the actual additional cost for the care and preservation of the camp and furniture for the nine months being only £58 13s. 6d. 41 2.—That they have re-considered the question of the amount of remuneration, to which they consider Mr. Collingwood fairly entitled, and are still of opinion, that the sum of £50 would be only a proper payment to him for extra services. In deference, however, to the feeling of the Vestry, they withdraw this item from the statement of their expenditure, and Recommend the Vestry to authorise the payment to the Sanitary Superintendent, Mr. Collingwood, of the sum of £50 for his extra services in connection with the Camp Hospital and Small Pox epidemic. All which is submitted. (Signed) JOHN LAMB, Chairman, Sanitary Committee. Vestry Offices, Upper Street, N., 2nd January, 1882.