The Metropolitan Borough of Holborn. REPORT FOR THE YEAR 1908 OF The medical Officer of health WILLIAM ARTHUR BOND, M.A., M.D., D.P.H. Camb.. Bach. Surgery Camb,, M.R.C.P Lond. Fellow, Member of Council, and President of the Metropolitan Branch, of the Society of Medical Officers of Health; Fellow, and Member of Council, late Hon. Sec. of the Royal Institute of Public Health; Member, late Lecturer and Demonstrator, of the Royal Sanitary Institute ; late Medical Officer of Health to the St. Olave District, Southwark, and the Holborn District Boards of Works. London: DIPROSE, BATEMAN & CO., SHEFFIELD STREET, LINCOLN'S INN FIELDS, W.C. 1909. CONTENTS. page- Introduction 5 Registration Year 5 Birth-rates 5 Death-rates 6 Zymotic Death-rates 6 Consumption, Death-rate 6 Infectious Diseases. Prevalence of 6 ,, Notification-rate 6 Anti-Diptheritic serum 6 Cerebro-spinal Fever 6 Glanders, Anthrax and Hydrophobia 6 Royal Commission on Tuberculosis 6 Notification of Births Act, 1907 7 Cleansing of Persons Act, 1897 7 Union Buildings Area 7 London County Council (General Powers) Act, 1907 7 House Refuse, Removal of 7 Manure, Removal of 7 London County Council (General Powers) Act, 1908 7 Inspections, &c 7 Area, Houses and Population 7 Estimated Population, 1908 8 Rateable Value, 1908 9 Number of Tenements 9 Births and Birth-rates 9 Ditto ditto corrected 9 Mortality 10 Deaths Registered 10 Deaths in Public Institutions within the Borough 10 Ditto ditto outside the Borough 11 Corrected deaths and death-rates 11 Infantile Mortality 11 Care and Feeding of Infants 12 Notification of Births Act, 1907 12 Modified Milk for Infants 14 Senile Mortality 15 Deaths from Zymotic Diseases 15 Ditto ditto during 1908 and ten preceding years 16 Ditto Influenza 17 Ditto Alcoholism 17 Ditto Cancer 17 Sudden and Violent Deaths 17 Inquests 17 The Public Mortuary 18 Infectious Diseases 18 Notification of Infectious Diseases during 1908 and ten preceding years 19 Small Pox 20 Scarlet Fever 20 Ditto Secondary Cases 2() Ditto Return Cases 21 Ditto Errors in Diagnosis 21 Diphtheria 21 Ditto Secondary Cases 21 Ditto Return Cases 21 Ditto Errors in Diagnosis 21 Ditto Anti-toxin 21 Enteric Fever 22 A 2 4 page Infectious Diseases— Cerebro-Spinal Fever 22 Measles 22 Whooping Cough 23 Diarrhoea 23 Phthisis or Consumption 23 Ditto ditto Voluntary Notification 24 Ditto ditto Public Health (Tuberculosis) Regulations, 1908 24 Ditto ditto Royal Commission on Tuberculosis 24 Disinfections 25 Shelter 25 Bacteriology 26 Cleansing of Persons Act, 1897 26 Housing of the Working Classes Acts. Union Buildings Area 26 Premises Closed Voluntarily, Demolished, Rebuilt, etc. 27 Sanitary Work 29 House to House Inspections 29 Water Supply to New Buildings 30 Ditto to Tenement Houses 30 By-laws as to Houses let in Lodgings 30 Overcrowding 31 Removal of House Refuse 31 Removal of Manure 31 Common Lodging Houses 32 Factories, Workshops and Workplaces 33 Bakehouses 33 Home Work 34 Industrial Employment of Women . 34 Places where Food is prepared for Sale 35 Slaughter House 35 Dairies, Cowsheds and Milkshops 35 Ice Cream 36 Unsound Food 36 Smoke Abatement 36 Meteorology 37 APPENDICES. Table I. Vital Statistics of whole Borough during 1908 and previous 10 years 38 Table II. Vital Statistics of whole Borough and Separate Localities in 1908 and previous 10 years 39 Table III. Cases of Infectious Disease notified during the year 1908 40 Table IV. Causes of, and Ages at Death during the year 1908 41 Table V. Infantile Mortality during the year 1908 42 Table VI. Sanitary Inspectors' Work—Inspections, Ac. 43 Table VII. Ditto Notices, &c 44 Table VIII. Proceedings during 1908 46 Table IX. Factories, Workshops, Workplaces and Homework 47 (1) Inspections 47 (2) Defects found 47 (3) Homework 48 (4) Registered Workshops 49 (5) Other matters 49 Table X. Legal Proceedings under the Public Health (London) Act, 1891 50 Table XI. Legal Proceedings under the Sale of Food and Drugs Acts 50 Table XII Meteorology 52 The Metropolitan Borough of Holborn REPORT of the Medical Officer of Health For the Year 1908. PUBLIC HEALTH DEPARTMENT, 197, HIGH HOLBORN, W.C. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Holborn. Gentlemen, In this Annual Report for the year 1908, the various statistics for the year refer to the fifty-three weeks ended Saturday, January 2nd, 1909, as adopted by the Registrar-General, and known as the Registration year. The death statistics do not exactly correspond with those of the RegistrarGeneral for the following reasons: The Holborn Union includes the area of the old Holborn District Board of Works, Clerkenwell and St. Luke's. In many of the deaths registered in outlying public institutions the only address given is that of the Union, and from enquiries respecting these deaths which I have made of the authorities of the public institutions, I have ascertained that the previous addresses of the deceased before removal to the public institutions were not in this Borough, and these deaths, although returned by the Registrars as belonging to this Borough, have therefore been excluded. The various birth and death rates have been corrected as far as possible by the exclusion of births and deaths of "non-residents" occurring in the Borough, and the inclusion of those of "residents" occurring in institutions outside the Borough. 6 The Holborn birth-rate was 19.2 per 1,000 in comparison with 18.3 for the preceding year. The London rate was 25.2 in comparison with 25.6 for the preceding year. The Holborn death-rate, 15.7, and the London death-rate 13.8 per 1,000 are both the lowest death-rates recorded. The lowest death-rates in previous years in Holborn were 16'6 in 1907, 16.9 in 1905, and 17.0 in 1906. The average death-rate for the preceding decennium was 19.5 per 1,000, and for London 16.7 per 1,000. The corrected infantile mortality was 111 compared with 113 for London, which are both the lowest recorded. Last year these rates were 131 and 116 respectively. The death-rate from zymotic diseases in Holborn was again very low, and for the sixth year in succession, below that for London, viz.: l.02 in comparison with 1.35 for London. Both are less than the preceding year, and it is the lowest rate recorded for Holborn. The death-rate from phthisis was 1.89 per 1,000 in comparison with 132 per 1,000 for London. Both rates were also the lowest recorded. In Holborn nearly 30 per cent, of the deaths were of persons who had been removed to Infirmaries from common lodging houses. The rates of the preceding decennium were 2.66 in Holborn and 1.56 in London. Although there was increased prevalence of scarlet fever and enteric fever, the number of notifications was again small, having been 316 in comparison with a decennial average of 425. The notification rate for Holborn was again lower than for London generally being 5.8 per 1,000 in comparison with 7.5 for London. For each of the past seven years the Holborn notification rate has been lower than the London rate. The Council agreed, with the sanction of the Local Government Board, to supply anti-diphtheritic serum free of charge to the poor inhabitants of the Borough on the application of medical practitioners. The London County Council, with the approval of the Local Government Board, made an order for the extension of the notification of cases of cerebrospinal fever (epidemic cerebro-spinal meningitis) for a further period of 12 months, and a further order has since been issued extending the notification for 12 months from March 13th, 1909. The London County Council has also recently made an order requiring the notification of cases of glanders, anthrax and hydrophobia in man. The Third Interim Report of the Royal Commission on Human and Animal Tuberculosis gives details of a series of experiments which show that not only cows with tuberculosis of the udder but all tuberculous cows should be excluded from cowsheds. 7 The Council adopted the Notification of Births Act, 1907. The Local Government Board afterwards gave its consent and fixed 9th March, 1908, as the day on which such adoption came into operation. During the year, under the Cleansing of Persons Act, 235 persons (217 men 9 women and 9 children) infested with vermin, had their bodies and clothing disinfected free of charge. The erection of houses for the working classes on the site of the Union Buildings Area (Bourne Estate) which was begun in August, 1906 was completed in October, 1908. Under Section 78 of the London County Council (General Powers) Act, 1907, which came into force on the 1st day of January, 1908, and provides for the provision of a water supply in tenement houses for families on separate floors, 403 notices were served during the year. The removal of house refuse was again satisfactorily carried out during the year. The number of complaints received from householders, which in the previous year had been very much diminished, was still further reduced. For the second year in succession no complaint was received respecting the non-removal of manure. Under the London County Council (General Powers) Act, 1908, power is given to remove from, or refuse to enter on, the register, the names of dairymen if the premises are in the opinion of the Sanitary Authority (Borough Councils) unsuitable for the sale of milk therein. Power is also given to appoint Health Visitors; to enforce sufficient and suitable accommodation for the cooking of food in new tenement houses; and increased powers for the sanitary regulation of premises used for the sale or preparation for sale of food for human consumption. Power is also given to the London County Council and the City Corporation to make by-laws with respect to the businesses of a vendor of fried fish, fish curer, or rag and bone dealer. During the year 22,990 inspections were made, 1,422 Intimation Notices, and 270 Statutory Notices for sanitary defects were served; 675 notices for the cleansing of lodging houses and 273 notices for breaches of by-laws. The market streets are inspected daily, including Saturday nights and Sunday mornings. For further details see the various headings of the Report. AREA, HOUSES AND POPULATION. Area. From the report of the Census. 1901, the area of the Borough is 405.1 acres. 8 Houses. The number of inhabited houses 4,703 The number of houses occupied for business purposes only 989 The number of houses not in occupation 219 The number of houses building 29 Population. Males 29,489 Females 29,916 Total 59,405 Density of population 147 persons per acre. „ ,, for London 61 ,, „ Details for the different parts of the Borough, and details of the changes in the population due to changes in the boundaries under the London Government Act, were given in the Annual Report for the year 1901. Details of the age and sex distribution of the population were given in the Annual Report for the year 1902. The number of persons of foreign nationality in the Borough at the last Census was 5,706; 3,978 males and 1,728 females. Of these 2,029 were Italians, 1,098 Germans and 660 French. In the County of London the total number of foreigners was 135,377; 79,804 males and 55,573 females. Other details were given in the Annual Report for the year 1902. ESTIMATED POPULATION, 1908. The following are the estimated populations at the middle of the year 1908:- Bloomsbury and St. Giles 28,830 Holborn Sub-District 25,742 Holborn Borough 54,572 London 4,795,757 England and Wales 35,348,780 United Kingdom 44,539,593 9 RATEABLE VALUE, 1908. Bloomsbury and St. Giles £594,456 Holborn £459,061 Holborn Borough £1,053,517 NUMBER OF TENEMENTS. At the Census of 1901, the total number of tenements in the Holborn Borough was 13,790. As large a proportion as 37.5 per cent. of the population lived in tenements of one or two rooms, and 60.1 per cent. of the population lived in tenements of one to four rooms. There were 3,725 tenements of 1 room. „ 3,834 „ 2 rooms. 2,224 „ 3 „ 989 „ 4 „ REGISTERED BIRTHS AND BIRTH-RATES. Both Sexes. District. Males. Females. Legitimate. Illegitimate. Total. Birth rate per 1,000. St. Giles and Bloomsbury 509 457 902 64 96 33.0 Holborn 295 282 564 13 577 22.1 Whole Borough 804 739 1,466 77 1,543 27.8 CORRECTED BIRTHS AND BIRTH-RATES The Registrar-General gave permission at the latter part of the year 1904 for details of births to be supplied by the Sub-Registrars. These details were at once supplied to us, so that I have been able since then to exclude the births of infants whose mothers were "non-residents." Of the 966 registered births in St. Giles and Bloomsbury, a large proportion of which took place at the British Lying-in Hospital, Endell Street, as many as 527 were of infants whose mothers were non-residents in the Borough. B 10 The corrected numbers are as follows:— District Corrected number of Births of Residents. Corrected Birth-rate per 1000. Legitimate. Illegitimate. Total. 1908. 1907. St. Giles and Bloomsbury 412 27 489 15.0 13.9 Holborn 608 10 627 24.0 23.2 Whole Borough 1,020 46 1,066 19.2 18.3 In London the corrected number of births was 122,898, or a rate of 25.2 per 1,000. In England and Wales the number of births was 942,611, or a rate of 26.5 per 1,000. MORTALITY. The following deaths have been registered in the Borough (1908):— St. Giles and Bloomsbury. Holborn. Total. Males 159 441 600 Females 128 336 464 Total 287 777 1,064 Of these deaths the following occurred in Public Institutions, &c., within the area of the Borough:— INSTITUTION. Residents. Non-Residents. St. Giles and Bloomsbury. Holborn. St. Giles and Bloomsbury. Holborn. St. Giles Workhouse 54 1 7 - French Hospital 2 1 28 - British Lying-in Hospital 2 - 13 - Children's Hospital 8 16 - 414 National Hospital 1 - - 40 London Homœopathic Hospital — 9 - 45 Italian Hospital 2 4 - 15 Alexandra Hospital - - - 7 Private 1 - 18 12 Total 70 31 66 533 11 There were 403 deaths of "Residents" in various Workhouses, Infirmaries, Asylums, Hospitals, &c., outside the Borough. Of these, 182 formerly resided in St. Giles and Bloomsbury, and 221 in the Holborn District. CORRECTED DEATHS AND DEATH-RATES, 1908. District. Total Deaths at all ages registered in District. Deaths in Public Institutions in District. Deaths of nonresidents of Borough registered in District. Deaths of Residents registered beyond the District. Deaths at all ages. Nett. Death Rate for 1908. Corresponding period 1907. In Borough. Beyond Borough. St. Giles and Bloomsbury Holborn Sub-District 287 777 108 561 66 533 11 2 182 221 412 456 141 17.4 14..3 19.1 Whole Borough 1,064 669 599 — 403 868 15.7 16.6 Registration London 67,353 13.8 14.6 England and Wales 521,643 14.7 15.0 The average death-rate of the Borough for the preceding decennium was 19.5 per 1,000. The lowest death-rates in previous years were 16.6 in 1907, 17.0 in 1906, 16.9 in 1905, 17.9 in 1904, and 18.3 in 1903. INFANTILE MORTALITY. The number of deaths of children under five years of age was:— St. Giles and Bloomsbury 82 Holborn Sub-District 107 Holborn Borough 189 The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1,000 total registered births and per 1,000 corrected births, were the following for:— Deaths under 1 year of age. Deaths under 1 year per 1,000 births. Deaths under 1 year per 1,000 corrected births. St. Giles and Bloomsbury 51 53 116 Holborn Sub-District 67 116 10??? Holborn Borough 118 76 111 London 13,943 - 113 The principal causes of death of these 118 children under one year of age are given in Table V. of the Appendix. b 2 12 CARE AND FEEDING OF INFANTS In previous Annual Reports I have given details respecting visits and inquiries made by the Lady Sanitary Inspector with a view to diminishing the infantile mortality in the Borough. If thought desirable, instructions are given respecting the care and feeding of the child and a leaflet left. Notices are also served for any sanitary defects found. On account of the Notification of Births Act a large number of visits were made much earlier than in previous years. As doctors and midwives object to visits being made until after they have ceased attendance on the patient, the first visit is now made when the child is about a fortnight old. Of the 913 first visits made full inquiries were able to be made in 828 cases. Excluding 16 still births and 8 children who did not live long enough to take any food, of the remaining 804 children, 697 were found to be naturally fed, 107 to be partly or entirely artificially fed at the time of the first visit. A large number of revisits were made, particularly in the cases of children who were not breast fed. NOTIFICATION OF BIRTHS ACT, 1907. The Local Government Board consented to the adoption of the Act and fixed Monday, the 9th March, 1908, as the day on which the adoption came into operation. The Act provides:— "In the case of every child born in an area in which this Act is adopted it shall be the duty of the father of the Child, if he is actually residing in the house where the birth takes place at the time of its occurrence, and of any person in attendance upon the mother at the time of, or within six hours after the birth, to give notice in writing of the birth to the Medical Officer of Health of the District in which the child is born." Notice is to be given by posting a prepaid letter or post-card addressed to the Medical Officer of Health, Council Offices, 197, High Holborn, giving the necessary information of the birth within 36 hours after the birth, or by delivering a written notice of the birth at the Office of the Medical Officer of Health within the same term. The Council is to supply, without charge, addressed and stamped post-cards containing the form of notice to any Medical Practitioner or Midwife residing or practising in the Borough who applies for the same. Any person who fails to give notice of a birth in accordance with the Act will be liable to a penalty not exceeding 20s. 13 The notification is in addition to, and not in substitution for, the requirements of any Act relating to the registration of births. The Act applies to any child which has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. It will be seen that deaths under one year of age per 1,000 corrected births were only 111 which is the lowest recorded infantile mortality in the Borough. The deaths of legitimate children under one year of age per 1,000 corrected births were 104, and the deaths of illegitimate children under one year per 1,000 corrected births were 261. The principal causes of death of these 118 children (of which 12 were illegitimate) under one year of age are given in Table V. of the Appendix. Of the 118 deaths of infants during the year further details were able to be obtained by the Lady Sanitary Inspector respecting 111. In some cases, particularly in the case of illegitimate births, the mothers could not be found owing to change of address or an incorrect address having been given. In a few cases, also, details were not obtained, as the infants had only lived a few hours. Of the 118 deaths, 19 died before taking food; 55 were naturally fed including one that was artificially fed from seven months old; 42 were artificially fed and in two cases no information could be obtained. Of the 42 artificially fed, 30 used boat bottles, 7 were spoon fed and only 5 used tube bottles. Eleven of the mothers worked in factories or workshops, 13 did charing or other work outside the home, 3 were in domestic service, 1 engaged in homework (tailoring), 3 mothers died and the remainder were engaged in household duties. Of the 20 deaths of infants from diarrhceal diseases all but 2 had been artificially fed. The total number of births notified in the Borough from 9th March, 1908 to the end of the registration year 1908, was as follows:— Notified once only (a) By Doctors 842 (b) „ Midwives 143 (c) „ Parents and others 54 Notified twice (a) By Doctors and Parents 15 (b) „ Midwives and Parents 4 1,058 During the same period 1,264 births were registered. From the 9th March, 1908, to the end of the year, Miss Orange made 627 primary visits respecting newly-born children. She found that in 526 cases the 14 births had been notified and in 101 cases not notified. Of the 101 cases not notified, 16 were attended by doctors, 17 by midwives, 22 by students and 2 by neighbours. In 12 cases wrong addresses were registered, and in 2 cases the person in attendance on the mother at the time of the birth could not be ascertained. I wrote to the various doctors who had not notified and had replies giving reasonable grounds for their not having done so. In the cases of midwives and students of hospitals the reasons given were that the students or midwives had only been recently appointed and were not aware of the Act. In all cases where the births had not been notified, Miss Orange informed the mothers that it was the duty of the father and of any person in attendance on the mother at the time of or within six hours after the birth to notify the same. The mothers always replied that their husbands were ignorant of the Act. MODIFIED MILK FOR INFANTS. In my Annual Report for 1906 I gave a detailed report respecting this matter and the arrangements made with the Express Dairy Company who have various depots in and near the Borough to supply modified milk for infants of the working classes at the reduced rate of 4d. per day on production of a certificate from me. During the year 39 new certificates were issued of which 9 were not used for various reasons, in comparison with 48 that were used during the year 1907. Including 11 children who had taken the milk at the beginning of the year 1908, the milk was used by 41 children during the year. In the majority of cases the mothers were very well satisfied and the infants thrived well on the milk. In seven cases it was for various reasons discontinued; in five cases on account of the mothers leaving the Borough. Of the 41 children, two died. One child had taken prepared milk for six months. It was much wasted when it began to do so at three months old, but improved rapidly, and just before its death in September, from enteritis, was a healthy well-developed child of nine months. The patient lived over a stable. The other was an illegitimate child, who took the milk for three weeks until seven weeks old. The patient was taken to hospital and died of diarrhoea three weeks after the beginning of the illness. Councillor Walter Hazell, J.P., has kindly continued to assist those parents who cannot afford to pay the whole amount. Twenty-two such cases were assisted during the year. 15 SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in:— St. Giles and Bloomsbury 122 Holborn Sub-District 111 Holborn Borough 233 St. Giles and Bloomsbury. Holborn Sub-District. Total. Of these the numbers were— 65 years and under 70 36 31 67 70 „ „ 75 34 31 65 75 ,, ,, 80 23 30 53 80 „ „ 85 17 14 31 85 „ „ 90 10 5 15 93 years of age 1 - 1 95 „ 1 - 1 122 111 233 DEATHS FROM ZYMOTIC DISEASES. The following tables give details respecting the number of deaths, and the deathrates, from the seven principal zymotic diseases, viz.:—Small-pox, Measles, Scarlet Fever, Diphtheria (including Membranous Croup), Whooping Cough, Fever (including Enteric or Typhoid, Typhus and Continued), and Diarrhoea. It will be seen that the number is only 58 in comparison with a decennial average of 108. The death-rate for the Borough was only 1.02 in comparison with 1.35 for London. Number. Zymotic Death-Rate. St. Giles and Bloomsbury 19 0.65 Holborn Sub-District 39 1.45 Holborn Borough 58 1.02 And for Loudon 6,599 1.35 The following are the number of deaths from the separate diseases:— St. Giles and Bloomsbury. Holborn Sub-District. Holborn Borough. Small-pox - - - Measles 4 6 10 Scarlet Fever 1 5 6 Diphtheria and Membranous Croup 1 4 5 Whooping Cough 3 4 7 Typhoid Fever - 4 4 Typhus - - - Diarrhoea 10 16 26 Total 19 39 58 16 DEATHS FROM ZYMOTIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1908 AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Smallpox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1898 - 26 2 6 9 5 22 70 1899 - 16 - 4 1 4 30 55 1900 - 11 4 9 13 6 20 63 1901 19 9 1 6 4 7 18 64 1902 37 11 6 5 11 5 5 80 1903 - 3 3 5 9 4 8 32 1904 2 12 - 4 2 2 10 32 1905 - 3 1 - 6 3 10 23 1906 - 8 2 1 4 1 10 26 1907 - 2 1 5 7 1 6 22 Average for 10 years 1898-1907. 5.8 10.1 2.0 4.5 6.6 3.8 14.9 46.7 1908 - 4 1 1 3 - 10 29 Holborn Division. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1898 - 36 2 21 12 2 29 102 1899 - 11 3 5 12 7 26 64 1900 - 20 ??? 4 10 3 25 65 1901 11 13 2 8 6 5 24 69 1902 9 19 2 6 16 1 9 62 1903 - 14 1 2 6 1 14 38 1904 - 31 - 3 6 2 25 67 1905 - 8 2 4 9 1 12 36 1906 - 17 - 6 6 - 29 58 1907 - 11 2 5 20 1 10 49 Average tor 10 years 1898-1907. 2.0 18.0 1.7 6.4 10.3 2.3 20.3 61.0 1908 - 6 5 4 4 4 16 39 17 Whole Borough. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1898 - 62 4 27 21 7 51 172 1899 - 27 3 9 13 11 56 119 1900 - 31 7 13 23 9 45 128 1901 30 22 3 14 10 12 42 133 1902 46 30 8 11 27 6 14 142 1903 - 17 4 7 15 5 22 70 1904 2 43 - 7 8 4 35 99 1905 - 11 3 4 15 4 22 59 1906 - 25 2 7 10 1 39 84 1907 - 13 3 10 2 2 16 71 Average for 10 years 1898-1907. 7.8 28.1 3.7 10.9 17.9 6.1 34.2 107.7 1908 - 10 6 5 7 4 26 58 INFLUENZA. During the year there were 25 deaths registered as due to influenza, 16 in St. Giles and Bloomsbury and 9 in the Holborn District. ALCOHOLISM. Only 25 deaths were assigned to alcoholism or cirrhosis of liver, 13 in St. Giles and Bloomsbury. and 12 in the Holborn District. These represent only a portion of the deaths really caused by alcoholism as they are frequently registered under the headings of other secondary causes. CANCER. Fifty-three deaths were registered as due to cancer or malignant disease, 32 belonging to St. Giles and Bloomsbury and 21 to the Holborn District. SUDDEN AND VIOLENT DEATHS. Inquests. The following inquests on the bodies of Parishioners were held Coroner: Dr. G. P. Danford Thomas, Paddington Mortuary, Paddington. Inquiry Officer: Mr. Richard Powell, 58, Hemingford Road, Barnsbury, N. 18 District. Total Number. Cause of Death. Natural. Accidents. Suicide. Murder. St. Giles and Bloomsbury 46 23 16 7 — Holborn 45 16 23 6 — Total 91 39 39 13 — THE PUBLIC MORTUARY, GOLDSMITH STREET. 146 bodies were received (43 being non-parishioners), and on these 81 inquests were held, and 51 post-mortems made. District. Bodies Received. Inquests held. Post-mortems. Non-Parishioners. St. Giles and Bloomsbury 69 41 28 24 Holborn 77 40 23 19 Total 146 81 51 43 Further details as to the causes of and ages at death are given in Table IV. of the Appendix. INFECTIOUS DISEASES The number of notifications of infectious diseases in the Borough during 1908 was again small, having been only 316 in comparison with a decennial average of 424. During the past six years the notifications per 1,000 of the population have been less than for London, and last year were 5.8 per 1,000 in comparison with 7.5 for London. 19 NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1908, AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1898 - 39 65 23 - 72 1 - 200 1899 - 28 76 23 - 56 1 - 184 1900 - 58 98 31 - 49 1 - 237 1901 158 60 150 17 - 58 1 1 445 1902 159 44 90 24 - 45 2 - 364 1903 1 22 55 36 2 65 1 - 182 1904 5 19 37 22 - 38 4 - 125 1905 1 10 68 14 - 20 1 - 114 1906 - 14 74 9 - 22 1 - 120 1907 - 32 58 6 - 18 - 1 115 Average for 10 years 1898-1907. 32.4 32.6 77.1 20.5 .2 44.3 1.8 .2 208.6 1908 - 21 81 12 - 28 2 - 144 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 114 notifications were received, and from April 8th to November 6th, 1904, inclusive, during which time 27 notifications were received. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907. There were also the following voluntary notifications of Phthisis :—1904 157. 1905 99. 1906 98. 1907 74. 1908 61. Holborn District. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1898 - 138 96 9 - 38 2 - 283 1899 - 63 117 32 2 43 1 - 258 1900 - 65 96 24 - 40 - - 225 1901 53 101 104 22 - 31 1 - 312 1902 58 69 112 15 - 40 4 - 298 1903 1 31 89 17 - 25 3 - 166 1904 1 27 62 19 - 39 3 - 151 1905 - 37 88 7 1 15 1 - 149 1906 - 52 63 6 - 34 1 - 156 1907 - 32 98 8 - 22 1 - 161 Average for 10 years. 1898-1907. 11.3 61.5 92.5 15.9 .3 32.7 1.7 .0 215.9 1908 - 29 112 13 - 18 - - 172 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 168 notifications were received, and from April 8th to November 6th, 1904, inclusive, during which time 34 notifications were received. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907; notifications received, 1907, 2; 1908, nil. There were also the following voluntary notifications of Phthisis:—1904 187. 1905 109. 1906 95. 1907 97. 1908 91. 20 Whole Borough. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1898 - 177 161 32 - 110 3 - 483 1899 - 91 193 55 2 99 2 - 442 1900 - 123 194 55 - 89 1 - 462 1901 211 161 254 39 - 89 2 1 757 1902 217 113 202 39 - 85 6 - 662 1903 2 53 144 53 2 90 4 - 348 1904 6 46 99 41 - 77 7 - 276 1905 1 47 156 21 1 35 2 - 263 1906 - 66 137 15 - 56 2 - 276 1907 - 64 156 14 - 40 1 1 276 Average for 10 years 1898-1907. 43.7 941 169.6 36.4 .5 77.0 3.0 .2 424.5 1908 - 60 193 25 - 46 2 - 316 Chicken-pox was notifiable from October 19th, 1901,to January 6th, 1903, inclusive, during which time 282 notifications were received, and from April 8th to November 6th, 1904, inclusive, during which time 61 notifications were received. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907; notifications were received, 1907, 2; 1908, ml. There were also the following voluntary notifications of Phthisis 1904 344. 1905 208. 1906 191. 1907 171. 1908 152. SMALL POX. There was no notification of small-pox in the Borough during the year. SCARLET FEVER. During the 53 weeks ended Saturday, January 2nd, 1909, the number of scarlet fever notifications, excluding duplicates, was 193, 81 belonging to St. Giles and Bloomsbury and 112 to the Holborn District. In St. Giles District 79 cases were removed to hospital, and in the Holborn District 111. The number of notifications was only 3.5 per 1,000 in comparison with 4.6 for London. Secondary Cases of Scarlet Fever. Of the 193 notifications, 145 occurred at houses in which there was no secondary case. In two houses there were four cases, including three cases which occurred in the preceding year. There were four cases amongst the staff of the Hospital for Sick Children. In five houses there were three cases, and in twelve houses two cases. 21 Return Cases of Scablet Fever. Of the secondary cases of scarlet fever, six were "return" cases i.e. cases which occurred in a house soon after the return home of a patient from hospital. There was also another case in which the primary case was removed to hospital from a house outside the Borough. Errors in Diagnosis. During the year only seven patients were returned home from the Metropolitan Asylums Board Hospitals reported as not suffering from scarlet fever, or only 3.6 per cent. DIPHTHERIA. The number of cases of diphtheria notified was 50, of which, 21 belonged to St. Giles and Bloomsbury, and 29 to the Holborn District. All but one were removed to hospital. The average number of notifications for the preceding decennium was 94, 33 for St. Giles and Bloomsbury, and 61 for the Holborn District. Three of the cases were on the nursing staff of the Hospital for Sick Children. Secondary Cases. In one house three secondary cases occurred all notified within a week of the first case. At another house two secondary cases occurred, notified three days after the primary case. At one house there was one secondary case which occurred after the return home from the hospital of the primary case. Return Cases. There was only one return case being the one mentioned above. Errors in Diagnosis. Five patients were returned from the hospitals of the Metropolitan Asylums Board as not suffering from diphtheria, or 10 per cent. of the patients removed. Diphtheria Anti-toxin. With a view of diminishing the mortality from, and severity of, the disease, in persons suffering from diphtheria it is desirable that anti-toxin serum should be administered as early as possible. In many doubtful cases 22 the doctors in attendance do not like to have the patient removed to hospital until the diagnosis has been confirmed or otherwise by bacteriological examination. If there is a reasonable suspicion that the case is one of diphtheria, an injection of anti-toxin should be given at once. The Council therefore, with the sanction of the Local Government Board agreed to supply anti-toxin serum free of charge to the poorer inhabitants of the Borough on the application of medical practitioners. Tubes containing 500 c.c. of the serum, prepared by the Lister Institute, were accordingly obtained, and information of these arrangements was sent to all the medical practitioners practising in the Borough. Only four such tubes were asked for during the year. ENTERIC FEVER Although below the average for the preceding decennlum, enteric fever was rather more prevalent than during the preceding two years. There were, excluding duplicates, 25 notifications in comparison with 14 the previous year. 12 belonged to St. Giles and Bloomsbury, and 13 to Holborn District. All but three of the cases were removed to hospital. Of the 25 cases two were afterwards returned as not suffering from enteric fever. Of the remainder, four were nurses who had been attending patients suffering from the disease; four were certainly not contracted in the Borough, and four were probably contracted from the eating of oysters, cockles or mussels. CEREBRO-SPINAL FEVER. Epidemic Cerebro-Spinal Meningitis. No case was notified during the year. MEASLES. Measles was again much less prevalent than it was in the year 1906. We received information of only 86 cases in comparison with 370 in 1906. The schools principally affected were St. Martin, St. Giles, Tower Street, Christ Church and Princeton Street. Of the 86 cases, 77 were children attending school, and of the remaining nine, four were traced to school infection. In only 10 cases was there no doctor in attendance. Seventy-five cases occurred in tenements of only one or two rooms. There were only 10 deaths in comparison with a decennial average of 28. Of these, four belonged to St. Giles and Bloomstiury and six to the Holborn District. 23 WHOOPING COUGH. Whooping cough was little prevalent during the year there having been only seven deaths registered in comparison with 27 in the preceding year and a decennial average of 17. Three of the deaths were in St. Giles and Bloomsbury and four in the Holborn District. All were children under five years of age. DIARRHEA. The number of deaths from diarrhœa was 26, in comparison with a decennial average of 34. Ten belonged to St. Giles and Bloomsbury and 16 to the Holborn District. All but one were children under five years of age, 20 being under one year of age. As desired by the Local Government Board, under the heading Diarrhoea, as regards children under one year of age, all the deaths classified as diarrhœal diseases in Table V. have been included. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year was 105, or a death rate of 1.89 per 1,000, the lowest recorded for the Borough. Of these, 35 belonged to St. Giles and Bloomsbury, a death rate of 1.19, and 70 to the Holborn District or a death-rate of 2.68 per 1,000. Of the 105 deaths, 29 were of persons who had been removed to Infirmary from Common Lodging Houses in the Borough, 17 from St. Giles and Bloomsbury and 12 from the Holborn District. The corrected number of deaths in London was 6,419 equal to a rate of 1.32 per 1,000, being the lowest recorded. The following table gives the number of deaths in the Holborn Borough, and the rate per 1,000, and the corresponding rates for London, for the 10 years 1899-1908 inclusive:— Year. Holborn Borough. London. Rate per 1,000 Deaths. Rate per 1,000. 1899 207 3.12 1.85 1900 193 2.96 1.74 1901 166 2.81 1.66 1902 182 3.06 1.60 1903 170 2.94 1.55 1904 157 2.75 1.62 1905 149 2.65 1.42 1906 118 2.12 1.44 1907 125 2.28 1.40 1908 105 l.89 1.32 24 VOLUNTARY NOTIFICATION OF CONSUMPTION. The Voluntary Notification of Consumption, which was in the first instance put into force for a period of 12 months from the 1st January, 1904, the fees to be paid being the same as for the notifiable diseases, was extended to the year 1905, further extended for the three years 1906-08, and has since been still further extended for the three years 1909-11 inclusive. Excluding a few duplicates there were 152 cases notified, 61 belonging to St. Giles and Bloomsbury and 91 to the Holborn District. The corresponding numbers for the year 1907 were respectively 171, 74 and 97. Of the 152 cases notified, 85 or 57 per cent., had been living in common lodging houses, and these were all, at once or soon afterwards, removed to infirmaries. With a few exceptions the remaining 67 lived in tenement houses, and 55 of them were soon removed to infirmaries or hospitals, so that only 12 remained at home. In previous Annual Reports for 1904-5 I gave details as to the action that is taken and the various results that were obtained from the enquiries made, and I think it is now unnecessary to repeat these. I may, however, remind the Council that a printed leaflet on the Prevention of Consumption giving instructions for measures to be taken to prevent the spread of the disease is left in all cases occurring in tenement houses. After death, or removal to infirmary or hospital, disinfection is advised; consent for this was, however, obtained in only 70 cases. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1908. On the 18th December, 1908, the Local Government Board with a view to affording facilities for the extension of administrative action for the prevention of tuberculosis, issued an order in pursuance of section 130 of the Public Health Act, 1875, as amended and extended by the Public Health (London) Act, 1891, and the Public Health Act, 1896, to provide for the notification to Medical Officers of Health of Sanitary Authorities of cases of pulmonary tuberculosis occurring amongst the inmates of Poor Law Institutions or amongst persons under the care of District Medical Officers, and for the taking of certain measures in such cases. ROYAL COMMISSION ON TUBERCULOSIS (HUMAN AND BOVINE). The Third Interim Report of the Royal Commission appointed to inquire into the relations of human and animal tuberculosis was published in January, 25 1909. This further report contains an account of certain experiments which have been carried out regarding the infectivity of the milk and faeces of naturally infected tuberculous cows, i.e. cows that had contracted the disease in the ordinary way. These experiments show that the presence of tubercle bacilli in the milk of cows, clinically recognisable as tuberculous, confirms the opinion expressed in the Second Interim Report, that the milk of such cows must be considered dangerous for human beings. The experiments with regard to the infectivity of the fæces of tuberculous cows were dictated by knowledge of the fact that dirt of various kinds from cows and the cowshed is almost constantly present in milk as it reaches the consumer. Cows suffering from extensive tuberculosis of the lungs must discharge considerable numbers of bacilli from the air passages in the act of coughing, and some of the bacilli thus expelled may find their way into the milk. But the experiments indicate that the excrement of cows obviously suffering from tuberculosis of the lungs or alimentary canal must be regarded as much more dangerous than the matter discharged from the mouth or nostrils. It was found that even in the case of cows with slight tuberculous lesions tubercle bacilli in small numbers are discharged in the fæces, whilst as regards cows clinically tuberculous, the experiments show that the faeces, contain large numbers of living and virulent tubercle bacilli. The presence of tuberculous cows in company with healthy cows in the cowshed is therefore distinctly dangerous, as some of the tubercle bacilli which escape from their bodies in the excrement are almost certain to find their way into the milk. DISINFECTIONS. During the 53 weeks ended January 2nd, 1909. District. Rooms. Bedding, &c. Number of Articles. Number of Persons using Shelter. St. Giles and Bloomsbury 190 4,290 - Holborn 235 3,520 - Whole Borough 425 7,810 - SHELTER DURING DISINFECTION OF HOUSES. As the Council's Shelter for the accommodation of persons during the disinfection of their houses at No. 191, High Holborn, was demolished in July, D 26 1906, the Council made arrangements with the adjoining Borough of Finsbury for the use of their shelter. As the disinfectors work very early and very late, if required, it was not necessary to use the shelter during the year. BACTERIOLOGY. The following table gives details of the examinations made by the Lister Institute of Preventive Medicine during the year. District. Diphtheria. Enteric Fever. Consumption. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. St. Giles and Bloomsbury 10 8 bacilli not found 1 1 Positive 6 4 bacilli not found 2 bacilli found 2 bacilli found Holborn 6 3 bacilli not found 1 1 Positive 3 1 bacilli not found 3 bacilli found 2 bacilli found Whole Borough 16 11 bacilli not found 2 2 Positive 9 5 bacilli not found 5 bacilli found 4 bacilli found CLEANSING OF PERSONS ACT. During the year 235 persons (217 men, 9 women, and 9 children), infested with vermin, had their bodies and clothing disinfected free of charge. Of the 235 persons, 214 had their bodies cleansed in the baths of the St. Giles and Bloomsbury Casual Wards in Goldsmith Street, and 1,211 articles were disinfected in the Council's steam apparatus. The remaining 21 had their bodies cleansed in the baths of the Holborn Casual Wards, Little Gray's Inn Lane, and their 168 articles of clothing disinfected in the steam apparatus at that Casual Ward. On account of the large number of persons applying in the latter part of 1905 the cleansing of persons had to be limited to those living in the Borough. Under the London County Council (General Powers) Act, 1907, powers are given for the compulsory cleansing of verminous children attending any of the Council's schools, and verminous inmates of any common lodging house. HOUSING OF THE WORKING CLASSES ACT, 1890 Action under Part I. of the Act. UNION BUILDINGS AREA. Aylesbury Place, Clerkenwell, and Union Buildings, Holborn. Improvement Scheme, 1890. Details of the action taken and progress made each year have been given in successive Annual Reports. 27 The erection of houses for the working classes on the site of this area was begun in 1906 and was completed in October, 1908. LIST OF PREMISES CLOSED, DEMOLISHED OR REBUILT DURING 1908. St. Giles and Bloomsbury. Alfred Place, Nos. 20—27. New factories built. do. No. 32. New premises (Home for Jewish Working Girls) being rebuilt, nearly complete. Bloomsbury Square, Nos. 42 and 42a. Demolished and part rebuilding. Broad Street, No. 11. New premises built. Chenies Street, Nos. 12—14. New factories built. Francis Street, No. 14—18. Site still vacant. Gate Street, Nos. 22, 23, 24 (Great Northern, Piccadilly and Brompton Railway). Offices over built. Grape Street. New premises built. Great St. Andrew Street, Nos. 43—47. Site still vacant. Great White Lion Street, Nos. 1, 2, 3, 4. Site still vacant. Gower Street Nos. 82, 84, 86, and Tavistock Place. New shops and Hats built. High Holborn, Nos. 162, 163, 164, 168, 169. Closed. Do. Nos. 193 to 196. Rebuilt. Do. Nos. 210 and 211. Demolished. Do. Nos. 223—228. Offices over. High Street, No. 24a. Partly demolished, to be rebuilt. Keppel Street (South side). No. 12 standing, 11 and 13 part demolished, remained demolished. Kingsway (south side of Gate Street). Building in progress. Do. Lincoln House, north—east corner of Great Queen Street. Built. Do. north side of Lincoln House extending through to Gate Street). Building in progress. Little Russell Street, Nos. 5—8a. Rebuilt. Montague Place (north side). All demolished except Nos. 17, 18, 19. Do. (south side). Do. and rebuilding except Nos. 1 and 2. Museum Street, No. 60. Closed. Macklin Street School and Convent. Rebuilt. New Compton Street, Nos. 26—30. Demolished. North Crescent, Nos. 2, 3, 4, 5, 7 and 12. Closed to be demolished Shaftesbury Avenue, Nos. 166—177. Demolished. Short's Gardens, No. 62. New generating station being built. d 2 28 South Crescent, Nos. 1 to 5. New premises built at rear; front portion of site still vacant. Southampton Row, Nos. 12 to 42. Rebuilt. „ Nos. 23 to 35. Rebuilding. „ Rear of. Demolished and part re—building. Store Street, Nos. 24, 25 and 25a. New premises built at rear; front portion of site still vacant. Torrington Mews, Nos. 2 to 9. Demolished and part rebuilding. „ East, Nos. 7 and 8. Closed. Torrington Square, Nos. 70 and 71. Demolished and part rebuilding. Tcrrington Street, No. 4. Demolished and part rebuilding. Tottenham Court Road, Nos. 193—5. Site still vacant. „ No. 205. Closed to be demolished. Vernon Place, South Side. Rebuilding. Wild Court, Nos. 8 to 11. Being rebuilt. Holborn Sub—District. Bourne Estate— Buckridge Buildings Kirkeby „ Nigel „ (Nos. 28 to 71) Built. Castle Court, Nos. 5, 6 and 7. Demolished. Charles Street, Nos. 29, 30 and 31. Being demolished. Dunstable Court, Nos. 1, 2, 3, 4, 10, 11 and 12. Closed. Fulwood's Rents, Nos. 19, 20 and 21. Demolished. „ No. 18. Closed. Gloucester Street, No. 3. Rebuilt (shops with flats above). Great Ormond Street, No. 46. Rebuilt. „ No. 58. Closed for demolition. Hatton Garden, No. 57. Rebuilt. „ Nos. 26 and 27. Demolished. Hatton Yard, No. 7. Rebuilt. Harpur Mews, Nos. 3 and 4. Demolished. Kir by Street, No. 1. Demolished. Laystall Street, Nos. 17 and 18. Rebuilt. Leather Lane, No. 10. Rebuilt. Little Saffron Hill, Nos. 11, 12 and 13. Rebuilt. May's Yard, Eagle Street. Part rebuilt. Powis Place, No. 10. Rebuilt. Queen Square, Nos. 34, 35 and 36. Closed for demolition. Red Lion Street, No. 18. Demolished. 29 Robin Hood Yard, No. 3. Rebuilt. „ Nos. 6 and 7. Closed. Verulam Street, Nos. 20 and 21, through to Baldwin's Place. Rebuilt Factory. Vine Street, Nos. 13, 15, 17 and 19. Being rebuilt. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1908. St. Giles and Bloomsbury. Alfred Place. Arthur Street. Betterton Street. Bucknall Street. Castle Street. Charing Cross Road (part of). Clark's Buildings. Clark's Mews. Denmark Place. Denmark Street. Drury Lane (part of). Dyott Street. Endell Street. Goldsmith Buildings. Goldsmith Street. Great Earl Street. Great St. Andrew Street. Great White Lion Street. High Street. Kenton Street. Little Denmark Street. Little Earl Street. Little St Andrew Street. Little White Lion Street. Lumber Court. Neal Street. New Compton Street. New Oxford Street (part of). Nottingham Court. Phoenix Street. Ridgmount Street. Shaftesbury Avenue (part of). Short's Gardens. Smart's Buildings. Stacey Street. Tottenham Court Road (part of). Tower Street. West Street. Wild Court. Wild Street. Holborn. Back Hill. Beauchamp Street. Bishop's Head Court. Boswell Court (South Side). Chapel Street. Charles Street. Cross Street. Cockpit Yard. Dane Street. Devonshire Street. Eagle Street. Emerald Street. Evelyn Buildings. Eyre Street Hill. Farringdon Road (part of). Fox Court. Gloucester Street. Gray's Inn Road (part of). Hatton Garden. Hatton Wall. Hatton Yard. Kirby Street. John's Mews. Lamb's Conduit Passage. Lamb's Conduit Street. Leather Lane Buildings. Little Gray's Inn Lane. Little James Street. Mount Pleasant. New North Street. Old North Street. Ormond Yard. Poole's Buildings. Red Lion Passage. Robert Street. Summer Street. Verulam Street. Vine Street. Warner Street. 30 WATER SUPPLY TO NEW BUILDINGS. During the year I inspected and gave certificates for the following premises:— Great Ormond Street. Hospital for Sick Children, Nurses' Dormitories. Laney Buildings, Nos. 1—26, 27—44, 45—62, 63—71. Kirkeby Buildings, Nos. 1—10, 11—30, 31—45. Nigel Buildings, Nos. 28—49, 50—71. High Holborn, Nos. 193—196, Municipal Offices. Buckridge Buildings, Nos. 1—10, 11—30, 31—40. Gloucester Street, No. 3. WATER SUPPLY TO TENEMENT HOUSES. In accordance with Section 78 of the London Uounty Council (General Powers) Act, 1907:— "For the purposes of Section 48 (provision as to houses without proper water supply) of the Public Health (London) Act, 1891, a tenement house shall be deemed to be a house without a proper and sufficient supply of water unless there shall be provided on the storey or one of the storeys in which the rooms or lodgings in the separate occupation of each family occupying such house are situate a sufficient provision for the supply of water for domestic purposes: "Provided that with respect to any building existing and in use as a tenement house at the passing of this Act this section shall not come into operation until the 1st day of January, 1908." In accordance with the above 403 notices were served for the provision of additional water supply in tenement houses, and in the majority of cases the work required was completed during the year. In eases where the lease of the premises expired within twelve months the notices were allowed to stand over. BY—LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 681 houses were registered under these By—laws, of these, 361 are in St. Giles and Bloomsbury, and 320 in the Holborn District. During the year, there were 1,436 inspections of these premises, excluding a very large number of periodical inspections and re—inspections. 17 notices were served for 24 overcrowded rooms, and 229 notices for other breaches of the By—laws, exclusive of 675 notices that were served for annual cleansing as required by the By—laws. 31 During the year, it was necessary to take legal proceedings for breaches of the By—laws respecting cleansing of 14 houses let in lodgings. In one case, fines amounting to £15 and £2. 2s. costs were inflicted. Further details are given in the Appendix, Table 11. OVERCROWDING. The number of dwelling rooms found to be overcrowded was 46, in comparison with 44 in the previous year. 24 of these were dealt with as breaches of the By—laws as to houses let in lodgings. REMOVAL OF HOUSE REFUSE. In accordance with the Contract, all house refuse has to be removed during the months of April to October inclusive at least twice a week, and oftener if required by the Medical Officer of Health, and in the remaining months November to March, at least once in each week and oftener if required. In the main thoroughfares there is a daily collection. In the main thoroughfares Police regulations prohibit the removal of house refuse after 10 a.m. The occupiers of many of the shops in the main thoroughfares do not live on the premises and many of the shops are not open until after 9 a.m. With a view of having all refuse removed as early as practicable, the Council resolved that the occupiers of premises in thoroughfares where a daily removal of refuse is in force should be required to place the refuse on the footway in proper receptacles not later than 9.30 a.m. Public announcement of this was given by means of printed notices attached to the public lamp posts and by hand bills left at every house. During the year, 17,203 loads of house refuse were removed. Only 31 complaints were received from householders as to the non—removal of house refuse and 173 notices were served for the provision of proper dust receptacles. During the year, a number of applications were received for the removal of trade refuse for which the Contractor is paid by the owners in accordance with Section 33 of the Public Health (London) Act, 1891. REMOVAL OF MANURE. The removal of manure was again carried out satisfactorily For the second successive year no complaint was received. Posters requiring the periodical removal of manure and other refuse matter from all stables, cowhouses, or other premises in the Borough not less frequently than every 48 hours were again posted in the various mews in the Borough. 32 COMMON LODGING HOUSES ACTS 1851 AND 1853. The Secretary of State by a Provisional Order which came into operation on the 1st November, 1894, transferred to the London County Council the powers of the Commissioner of Metropolitan Police in respect of common lodging houses. The following is a list of the Common Lodging Houses registered in this Borough at the end of the year 1908 :— Of these 17 are in St. Giles and Bloomsbury for 1,273 lodgers. „ 8 „ Holborn District for 694 „ Total 25 in the Borough for 1,967 „ St. Giles and Bloomsbury. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 6, Betterton Street 83 M 8, Kennedy Court 34 W 9, Dyott Street 28 M 14, Lumber Court 68 M 25, Great Queen Street 117 M 1—7, Macklin Street 96 M and 19,do. 40 W 36, Parker Street 21, do. 26 W 2, Kennedy Court 8 W Parker Street Municipal 345 M 3. do. 10 w 7, 9, and 11, Short's 311 M 4, do. 19 w Gardens, and 5, do. 8 w 3, Neal's Yard 6, do. 8 w 6 and 7, Wild Court 63 M 7, do. 9 w A total of 17 Common Lodging Houses registered for 1,273 lodgers. Holborn District. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 25, Charles Street 241 M 28, Orde Hall Street ... 22 M 40, Eagle Street 50 M 39, Queen Square 52 M 4, Greville Street 53 M 28, Red Lion Square ... 72 M 29, Hatton Wall 94 M 12 and 13, Took's Court 110 M A total of 8 Common Lodging Houses registered for 694 lodgers. 33 FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 126 inspections of factories, 968 inspections of workshops and 2,538 of workplaces. 301 Intimation Notices for sanitary defects were served and 42 Statutory Notices. The following table gives the changes that have taken place during the year, details of the number of premises on the Register at the end of the year, number of inspections, etc. Inspections of Factories, Workshops and Workplaces. Class of Work. Number of Places. Number of Inspections. 1908. Number of Notices 1908. Number of Prosecutions 1908. On Register at end of 1907. Aided in 1908. Removed in 1908. On Register at end of 1908. Premises. Rooms intimations. Statutory. Factories.‡ Factory Laundries 3 1 – 4 – 4 – – – Factory Bakehouses 2 – – 2 – 42 – – – Other Factories — – – – – 80 31 3 – Workshops. Workshop Laundries 13 – 2 11 30 17 3 – – Workshop Bakehouses 31 – 2 29 274 14 1 – Other Workshops 952 44 8 988 1,615 677 90 21 – Workplaces. Home workers' Premises * 168 57 39 186 226 188 9 – – Places where Food is prepared for Sale † 359 35 6 388 – 2,117 70 8 1 Workplaces other than the the above § – – – – – 233 84 9 – Total 1,528 137 57 1,608 1,871 3,682 301 42 1 * There were in addition, many inspections of Homeworkers' Premises made during the house—to—house and periodical inspections of Lodging Houses and other Dwelling Houses. † Under this head are included the Kitchens of Hotels, Restaurants and Eating—houses of all sorts. Slaughter Houses, Tripe, Offal, and other Meat Shops, Fried Fish, Eel, and other Fish Shops, Ice Cream Shops, and other places where food is prepared for sale, excluding Bakehouses which are given above. ‡ Registration of Factories is not required by the Factory and Workshop Act, 1901, but most of them were inspected during 1908, and notices served where necessary. $ There is a very large number of workplaces other than the above, the registration of which is not required, and many of them were inspected and notices served where necessary. BAKEHOUSES. At the end of the year 1908, there were 31 bakehouses in the Borough, of which 15 were in St. Giles and Bloomsbury and 16 in the Holborn District. e 34 The following is a list of the bakehouses in the Borough, all of which are underground except those marked * :— St. Giles and Bloomsbury. *2 Bloomsbury Court. 10 Bury Street. 166 Drury Lane. 155 High Holborn. 217 & 218 High Holborn (Holborn Restaurant). 63 High Street. 19 Little Earl Street. 5 Little St. Andrew Street. 21 Marchmont Street. 77 Marchmont Street. 8 Museum Street. 24, 26 and 28 New Oxford Street. 200 Shaftesbury Avenue. *88 Southampton Row. 6 Torrington Place. Holborn. 172 Clerkenwell Road. 9 Cosmo Place. 49 to 57 Farringdon Road (Factory). 33 Great Ormond Street. 1 Greville Street. *91 Leather Lane. *6 Lamb's Conduit Street. 50 Lamb's Conduit Street. 13 Leigh Street. 19 Red Lion Street. 50 Red Lion Street. *74 Red Lion Street. 92 Theobald's Road. 124 Theobald's Road. Viaduct Buildings, also 17 Charterhouse Street (Factory). 36 Warner Street. During the year, in addition to my inspections, there were 316 inspections of bakehouses, including 42 inspections of the factory bakehouses. Fourteen notices were served for various sanitary defects. HOME WORK. All the out—workers' premises were inspected at least once during the year by the Lady Sanitary Inspector, details of which are given in the table. Many inspections of home—workers' premises are also made during house to house and periodical inspections of lodging houses and dwelling houses in which home— workers reside. Further details respecting factories, workshops, laundries, workplaces and homework are given in Table IX. of the Appendix. INDUSTRIAL EMPLOYMENT OF WOMEN The present Factory and Workshop Act prohibits the employment of a woman or girl within four weeks after she has given birth to a child. Further regulation was recommended by the Physical Deterioration Committee in 1904, and the Conference on Infantile Mortality in 1906. 35 The latter Conference resolved (1) the extension of the period from one month to three months; (2) the prohibition of the employment of women advanced in pregnancy unless medically certified as fit for work. It appeared to the Secretary of State that a simultaneous and systematic inquiry into the subject, on uniform lines, by the Medical Officers of Health of a number of representative industrial centres would yield the best results. The Holborn Borough Council approved of my co—operation and my attendance at a conference of representatives of the Home Office and Medical Officers of Health, held at the Home Office on the 6th November, 1907, at which the details of the form which the inquiry should take were agreed to. Details were being obtained during the year and will be completed by the end of the year 1909. PLACES WHERE FOOD IS PREPARED FOR SALE. Under this head are included kitchens of hotels, restaurants and eating—houses of all sorts, slaughter—houses, tripe, offal and other meat shops, fried fish, eel and other fish shops, premises where ice cream is made, and other places where food is prepared for sale, excluding bakehouses which are given on previous page. The number of these places on the register at the end of 1908 was 388; 2,117 inspections were made, and 78 notices were served during the year for sanitary defects found. In addition to the above inspections of places where food is prepared for sale, here were also 740 inspections of market streets, each of which includes a number of stalls at which meat, fish, fruit and vegetables are sold. These streets are also regularly inspected on Saturday evenings and Sunday mornings. SLAUGHTER—HOUSE. There is now only one slaughter—house in the Borough, viz., No. 29, lied Lion Street, which, in addition to my inspections, was inspected on 11 occasions during the year, and one notice was served for sanitary defects found. DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 178, of which 76 were in St. Giles and Bloomsbury, and 102 in the Holborn District. During the year 15 dairies and milk shops were newly registered, 7 belonging to St. Giles and Bloomsbury, and 8 to the Holborn District. On application for e 2 36 registration under the Dairies, Cowsheds and Milkshops Order of 1885, the premises were also carefully inspected by me, and notices served to remedy any sanitary defects. In addition to my inspections the Sanitary Inspectors made 995 inspections of these premises, and 5 notices were served for sanitary defects or breaches of regulations. There is now only one cowshed in the Borough, at No. 4, Goldsmith Street. It was frequently inspected during the year, and no sanitary defects nor breaches of regulations were found. ICE CREAM. During the year there were 40 premises in the Borough where ice cream was manufactured or sold, and 187 inspections of these premises were made It was not found necessary for any notices to be served for sanitary defects. As ice cream is often made in the early morning, inspections between 6 and 9 a.m. were also occasionally made in order to ascertain whether there were any infringements of the London County Council (General Powers) Act, 1902. UNSOUND FOOD. Applications were received for removal and destruction as trade refuse of the following articles of food, all of which were unsound and unfit for the food of man:— 7 Cod roes. 1 case Herrings. 5 boxes Kippers. 1 bag Mussels. 1311 lbs. Meat. 2 bushels Cherries. 32 bags Parsnips. 657 crates Bananas. 290 bundles Tomatoes. 12 boxes Grapes. 2 boxes Oranges. 124 half—sieves Plums. 57 sacks Potatoes. During the year there was one seizure of a quantity of unsound beef and mutton. The Defendant was convicted and fined £50. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 142 cases the inspections were recorded. 12 intimation notices and 1 statutory notice was served. For further details of Sanitary Work and Legal Proceedings see Tables VI., VII., VIII., IX., X. and XI. 37 METEOROLOGY. The mean temperature of the year was 50.1 degrees, which is exactly the average for the preceding 65 years. The rainfall was 23.78 inches, and was 0.34 inches below the average for the preceding 65 years. In the year 1903 there was the large amount of 35.54 inches. The total amount of bright sunshine recorded was 1,634 hours, out of a total possible 4,458 hours or about 37 per cent., and it was 132 hours above the average for the preceding 10 years. Further details are given in Table XII. In conclusion, I desire to express my appreciation of the excellent assistance and hearty co—operation that I have received from the staff of the Public Health Department during the year. I have the honour to be, Gentlemen, Your obedient servant, Public Health Department, W. A. BOND. 197, High Holborn, W.C. 38 APPENDIX. TABLE I. Vital Statistics of Whole District during 1908 and Previous Years. Name of District—The Metropolitan Borough of Holborn. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths nr Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District Under 1 Age. Year of (Nett.) At all Ages. Number. Rate. * Number. Rate per. 1,000 Births registered Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1898 66,371 1,840 27.8 336 183 1,467 22.2 605 461 477 1,483 22.4 1899 65,677 1,857 28.4 298 161 1,439 22.0 628 471 496 1,464 22.4 1900 64,990 1,762 27.2 311 177 1,326 20.5 516 412 514 1,428 22.1 1901 59,232 1,660 28.4 203 122 1,214 20.5 572 481 448 1,181 20.0 1902 53 weeks) 58,642 1,646 27.7 213 129 1,283 21.9 627 517 494 1,260 21.2 1903 67,861 1,621 28.1 154 95 1,088 18.8 587 496 462 1,054 18.3 1904 67,188 1,632 28.6 179 109 1,134 19.8 696 540 426 1,020 17.9 1905 56,522 1,601 28.4 145 91 1,131 20.1 680 604 427 954 16.9 1906 55,865 1,640 29.7 147 90 1,212 21.8 745 673 410 949 17.0 1907 55,215 1,570 28.6 132 84 1,131 20.6 685 606 387 912 16.6 Averages for years 1898—1907 59,746 1,682 28.3 212 124 1,242 20.8 624 526 454 1,170 19.5 1908 (53 weeks.) 54,572 1,543 27.8 118 76 1,064 19.2 669 599 403 868 16.7 * Rates in columns 4, S, and 13 calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the number in Column 7 corrected by (he subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non—residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents'" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. N.B.—The years 1898 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works Area of District in acres (inclusive of area covered by water) 405.1 Total population at all ages 59,405 at Census of 1901. Number of inhabited houses 4,703 „ Average number of persons per house 12.6 ,, ,, 39 TABLE II. Vital Statistics of separate Localities in 1908 and Previous Years. Names of Localities. Holborn Borough. St. Giles and Bloomsbury. Holborn Sub—District Year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all Ages Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d.. 1898 66,371 1,840 1,483 336 36,108 1,027 746 158 30,263 813 737 178 1899 65,677 1,857 1,464 298 35,824 1,132 748 136 29,853 725 716 162 1900 64,930 1,762 1,428 311 35,542 1,018 679 137 29,448 744 749 174 1901 59,232 1,660 1,181 203 31,401 1,040 575 88 27,831 620 606 115 1902 58,542 1,646 1,260 213 31,020 994 594 86 27,522 652 666 127 1903 57,861 1,621 1,054 154 30,644 991 490 68 27,217 630 564 86 1904 57,188 1,632 1,020 179 30,272 991 444 78 26,916 641 576 101 1905 56,522 1,601 954 115 29,905 988 452 61 26,617 613 502 84 1906 55,865 1,640 949 147 29,543 1,020 443 63 26,322 620 506 84 1907 65,215 1,570 912 132 29,184 1,014 416 49 26,031 556 496 83 Averages of Years 1898 to 1907 59,746 1,683 1,171 212 31,944 1,022 559 92 27,802 661 612 119 1908 54,572 1,543 868 118 28,830 966 412 51 25^742 577 456 67 Notes.—(a) The separate localities adopted for this table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes, or registration sub—districts. Block 1 may, if desired, be used for the whole district; and blocks 2, 3, &c., for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub—columns c of this Table, and those of non—residents registered in public institutions in the district excluded. (See note on Table I. as to mtanicg of terms "resident" and " non—resident.") (c) Deaths of residents occurring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. N.B.—The years 1898 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. 40 TABLE III. Cases of Infectious Disease notified during the year 1908. Notifiable Disease. Cases notified in whole Distbict. Total Cases notified in each Locality. No. of Cases removed to h08pital from each Locality. At all Ages. At Ages—Years. St. Giles and Bloomsbury. Holborn. St. Giles and Bloomsbury. Holborn. Under 1. 1 to 5 6 to 16. 15 to 25. 25 to 65. 65 and upwards. Small—pox — — — — — — — — — — — Cholera — — — — — — — — — — — Diphtheria and Membranous Croup 50 4 19 15 7 5 — 21 29 20 29 Erysipelas 46 3 — 3 5 30 5 28 18 11 9 Scarlet Fever 193 1 61 96 23 12 — 81 112 79 111 Typhus Fever — — — — — — — — — — — Enteric Fever 25 — 1 2 10 12 —— 12 13 10 12 Relapsing Fever — — — — — — — — — — — Continued Fever — — — — — — — — — — — Puerperal Fever 2 — — — 1 1 — 2 — 1 — Plague — — — — — — — — — — — Cerebro—Spinal Meningiti s — — — — — — — — — — — Totals 316 8 81 116 46 60 5 144 172 121 161 Note.—The Isolation Hospitals are those of the Metropolitan Asylums Board, and the London Fever Hospital. A few cases are treated at General Hospitals. There wore also 152 voluntary notifications of Phthisis (Consumption), 61 belonging to Giles and Bloomsbury, and 91 to the Holborn Division. 41 TABLE IV. Causes of, and Ages at, Death during the year 1908. Causes of Death. Deaths at the Subjoined Aoes of " Residents" whether occurring in OR beyond the district. Deaths at all Aoes ok " Residents " belonging TO Lot Al l 1 IKS \\ 1111 111 1. occurring in or beyond the district. Total Death whether of " Residents or " Now— Residfntb ik public Institution in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. St. Giles and Bloomsbury Holborn. Small—pox — — — — — — — — — — Measles 10 — 9 1 — — — 4 6 1 Scarlet Fever 6 — 5 — 1 — — 1 5 — Whooping Cough 7 1 6 — — — — 3 4 39 Diphtheria and Membranous Croup 5 — 3 2 — — — 1 4 2 Croup — — — — — — — — — — Fever Typhus — — — — — — — — — — Enteric 4 — — — 2 2 — I 4 Other Continued — — — — — — — — — — Cerebro—Spinal Meningitis — — — — — — — — — 2 Epidemic Influenza 25 1 — 1 1 9 13 16 9 9 Cholera — — — — — — — — — — Plague — — — — — — — — — — Diarrhoea 26* 20* 5 — — — 1 10* 16* 74 Enteritis 2 — — — — — 2 — 2 9 Puerperal Fever 2 — — — — 2 — 1 1 1 Erysipelas 5 — — — 1 3 1 2 3 — Other Septic Diseases 11 1 — — — 6 4 5 6 20 Phthisis 105 — 3 1 7 87 7 35 70 30 Other Tubercular Diseases 25 6 9 4 — 6 — 8 17 106 Cancer, Malignant Disease 53 — — — — 34 19 32 21 19 Bronchitis 77 7 2 — — 21 47 38 39 15 Pneumonia 66 10 14 3 2 26 11 38 28 74 Pleurisy 4 1 — — — 3 — 4 — 3 Other Diseases of Respiratory Organs 6 1 1 — — 4 — 3 3 4 Alcoholism ) Cirrhosis of Liver j 25 — — — — 22 3 13 12 7 Venereal Diseases 11 5 1 — — 4 1 5 6 5 Premature Birth 29 29 — — — — — 15 14 14 Diseases and Accidents of Parturition 4 — — — — 4 — 3 1 1 Heart Diseases 74 1 — 1 4 38 30 35 39 24 Accidents 41 o 6 1 2 19 8 17 24 13 Suicides 14 — — — — 13 1 7 7 I All other causes 231 30 7 7 3 Si 9 85 116 115 192 All causes 868 118 71 21 23 402 233 412 456 669 ♦Under the heading Diarrhoea, as regards children under one year of age are included all deaths classified as Diarrhoeal diseases in Table V. as requested by the Local Uoveimnriit. P.c.inl 42 TABLE V. Infantile Mortality during the Year 1908. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 1 Month. 1—2 Months. 2—3 Months. 3—4 Months. 4—5 Month«. 5—6 Months. 6—7 Months. 7—8 Months. 8—9 Months. 9—10 Months. 10—11 Months. 11—12 Months. Total Deaths under One Year. All Causes. Certified 28 7 8 3 46 15 12 10 6 4 1 2 5 4, 5 8 118 Uncertified — — — — — — — — — — — — — — — Common Infectious Diseases. Small Pox Chicken Pox — — — — — — — — — — — — — — — — — Measles Scarlet Fever — — — — — — — — — — — — — — — — — Diphtheria including Membranous Croup — — — — — — — — — — — — — — — — — Whooping Cough — — — — — — — — — — — — — — — 1 1 Diarrhceal Diseases. Diarrhoea, all forms — — — — — 2 1 6 1 1 — — 2 2 — 2 17 Enteritis Muco— Enteritis, Gastro— Enteritis — — — — — — 1 — — — — — — — 1 — 2 Gastritis, Gastro— intestinal Catarrh — — — — — — — — 1 — — — — — — — 1 Wasting Diseases. Premature Birth 20 2 2 24 4 1 — — — — — — — — — 29 Congenital Defects 1 1 1 1 4 1 1 1 — — — — — — — — 7 Injury at Birth — — — — — — — — — — — — — — — — — Want of Breast—milk, Starvation — — — — — — — — — — — — — — — — — Atrophy, Debility, Marasmus 1 1 3 1 6 — 2 1 1 — — — — — 1 — 11 Tuberculous Diseases. Tuberculous Meningitis — — — — — — — — — — — — — — — — 1 Tuberculous Peritonitis: Tabes Mesenterica — — — — — — 1 ... 1 — — 1 — — 1 — 4 Other Tuberculous Diseases — — — — — — — — — — — — — — — — 1 Other Causes. Syphilis 1 — 1 — 2 2 1 — — — — — — — — — 5 Rickets — — — — — — — — — — — — — — — — Meningitis (not Tuberculous) — — — — — 1 — — — 1 — — 1 — — — 3 Convulsions 1 1 — 2 1 — 1 — — — — — — 4 Bronchitis — — — — — 2 2 1 — — — — — 1 — 1 7 Laryngitis 1 1 Pneumonia ; — 1 i — 1 — 1 1 2 4 11 Suffocation, overlying ... 2 1 — — 3 1 — — 1 — — — — — — — 5 Other causes o 1 — 1 4 1 1 — 1 — — 1 — — — — 8 28 7 8 3 46 15 12 10 6 4 1 2 5 4 5 8 118 Births in the year legitimate, total registered 1,466; " Residents" 1010. illegitimate do. 77: do. 46. Deaths in the year of legitimate infants 106. illegitimate „ 12. Deaths from all Causes at all Ages 868. Population estimated to middle of 1908, 54,572. 43 TABLE VI— Sanitary Inspectors' Work.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange Whole Borough. Complaints 52 82 70 11 215 SO a .2 | CO fl M ' Infectious Diseases 107 98 122 163 490 Dwelling Houses 189 312 98 566 1,165 Lodging Houses 341 215 249 689 1,494 Common Lodging Houses. 18 34 50 — 102 Dairies, Cowsheds and Milkshops 326 248 420 1 995 Ice Cream—Manufacture or Storage 19 13 155 — 187 Slaughter—houses — 11 — — 11 Market Streets 333 65 342 — 740 Butchers' Shops 275 281 316 — 872 Bakehouses 83 92 99 — 274 Laundries 2 3 1 11 17 Other Food Shops 399 251 262 135 1,047 Other Workshops 257 135 148 101 641 Out—Workers' Rooms and Registers 32 32 58 188 310 Workplaces 60 46 103 24 233 Factories 32 2 63 29 126 Schools — 1 — — 1 Smoke shafts 3 16 122 1 142 Urinals — 98 28 — 126 Miscellaneous 148 29 95 2 275 Periodical Inspections 1,252 1,583 1,317 — 4,151* Dust 62 144 44 — 250 Mews — 140 6 — 146 Total Inspections 3,938 3,849 4,098 1,910 13,795 No. of Re—Inspections 1,493 1,925 956 1,652 6,026 Visits other than Inspections and Re—Inspections 548 1,042 953 626 3,169 Total 5,979 6,816 6,007 4,188 22,990 * The majority of these are weekly inspections of Registered Lodging Houses. f 2 44 TABLE VII. Sanitary Inspectors' Work.—Notices served. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. Intimation Notices—Total served 336 602 398 186 1.422 Houses 282 443 245 151 1,121 The house or part of the house in a dirty condition 40 78 47 20 185 The house or part of the house in a damp condition 3 6 4 — 12 The house in a dilapidated condition 5 53 15 3 76 The watercloset so foul as to be a nuisance 15 27 31 3 76 Do. without a water supply 18 40 14 1 73 Do. with a deficient supply of water 8 19 — 4 31 Do. improperly constructed — — — — — Do. so defective as to be a nuisance 24 45 36 15 120 Do. stopped 40 76 45 7 168 Do placed in an improper position — — 1 — I Insufficient external ventilation to watercloset — 5 2 — 7 Insufficient watercloset accommodation 2 8 1 11 22 Absence of watercloset accommodation — — — — Absence of proper watercloset accommodation for persons of each sex See under Workshops &c. The soil pipe defective 1 — 1 — 2 Do. unventilated 1 — — — I Do. improperly ventilated 1 — 1 — 2 The yard paving defective 14 3 2 — 19 Do. dirty 6 13 8 1 28 Do. undrained — — — — — The area improperly paved — 1 3 — 4 Do. dirty 1 21 4 — 26 Do. undrained — — — — The inlet of surface drain improperly trapped — 3 — — 3 A gully trap improperly placed within the house — — — — — The waste pipe of sink improperly connected with the drain I 1 4 f, Do. do. improperly trapped 1 1 2 1 5 Do. do. untrapped 6 25 1 32 Do. of lavatory improperly connected with the drain _ _ _ _ Do. do. improperly trapped — — — — _ Do. do. untrapped — — 2 — 2 Do. of bath directly connected witn the drain _ _ __ _ _ Do. do. improperly trapped — — 2 _ 2 Do. do. untrapped 2 2 — _ 4 The water cistern so foul as to be a nuisance 5 3 4 6 18 Do. being without a close fitting cover 5 3 3 _ 11 Do. being placed in an improper position ... _ _ _ _ Do. defective 1 6 1 1 9 An accumulation or deposit of refuse 5 28 24 4 61 The absence of proper ashbin 52 18 23 12 105 The ashbin defective 35 19 3 11 68 The drain foul — 2 3 — 5 Do. defective 8 10 10 1 29 Do. choked or stopped 8 36 15 12 71 Do. unventilated 2 2 — — 4 45 TABLE VII.—continued. Sanitary Inspectors' Work.—Notices served.—continued. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. 11 —use The rainwater pipe in direct communication with the drain 1 1 Do. do. do. with the soil pipe 1 — 1 2 Do. do. defective 4 14 3 3 24 The water supply used for domestic purposes connected with the cistern which is used for flushing the watercloset — — — — — The absence of proper water supply 141 122 95 45 403 The roof defective 9 29 17 8 63 The guttering defective — 1 5 — 6 The paving of wash—house defective 1 3 1 — 5 The want of proper manure receptacle 1 5 2 — 8 An animal kept in such place or manner as to be a nuisance _ — The house or part of the house overcrowded 4 8 6 4 22 An underground room occupied as a dwelling contrary to the provisions of the Act 2 8 _ 6 16 The space below floor in the basement or ground floor being unventilated — 1 1 Do. improperly or insufficiently ventilated — — — A chimney sending forth black smoke in such quantity as to be a nuisance See under Workshops A urinal improperly constructed, drained or offensive — — — Do. with no supply of water — — 2 — 2 Other nuisances — 89 8 3 50 * Factories, Workshops and Work Places 54 59 153 35 301 Dirty 24 5 34 27 90 Waterclosets, defective or dirty 12 20 25 14 71 Do. insufficient 2 1 1 4 Do. absence of separate accommodation for sexes 2 1 3 6 12 Drains, soil pipes, &c., defective 9 9 24 1 43 Improperly ventilated — 4 1 2 7 Overcrowded — — — 2 2 Chimney sending forth black smoke 1 2 9 — 12 Other nuisances 11 20 28 5 64 Breach of Bye—laws or Regulations— t Lodging—houses 78 67 41 63 252 Dairies, cowsheds, milkshops and slaughterhouses — — 1 — I Keeping of animals 1 5 2 — 8 London County Council (General Towers Acts) Urinals — 1 — — 1 Verminous Booms 3 7 11 1 22 Ashpits 2 2 — 4 Statutory Notices 28 115 98 29 270 * Many nuisances at workshops, that are parts of dwelling houses, are included in the Intimation Notices served under " Houses." j— Many breaches of bye—laws are included in Intimation Notices served under " Houses." 46 TABLE VIII. Proceedings during 1908. PREMISES. NUMBER OF PLACES— Number of Inspections 1908. Number of Notices 1908. Number of Prosecutions 1908. On register at end of 1907. Added ill 1908. Removed in 1908. On register at end of 1908. Milk premises 178 15 15 178 995 5 0 Cowsheds 1 0 0 1 weekly 0 0 Slaughter—houses 1 0 0 1 11 0 0 Other offensive trade premises 0 0 0 0 0 0 0 tee Cream premises 41 0 0 0 187 0 0 Registered houses let in lodgings 686 0 5 681 1,436 (a)* 17 (a)* 0 (b)* 229 (b)* 14 * (a) For overcrowding. * (4) For other conditions. Total number of Intimation notices served for all purposes ... ... ... ... ... ... ... 1,420 Overcrowding, 1908— Number of Dwelling Rooms overcrowded 46 Number remedied 46 Number of prosecutions 0 Underground Rooms — Illegal occupation dealt with during year ... ... ... ... ... ... ... ... 16 Number of rooms closed ... ... ... ... ... ... ... ... ... ... 16 Insanitary Houses— Number closed under the Public Health (London) Act, 1891 ... ... ... ... ... 0 „ „ „ „ Housing of the Working Classes Act 0 Ice Cream— Proceedings under London County Council (General Powers) Act, 1902 0 Verminous Rooms— Numbers of premises cleansed under Section 20 of the London County Council (General Powers) Act, 1901 22 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year... ... ... ... ... ... ... 0 Revenue Acts— Number of houses for which applications were received during the year 14 Number of dwellings comprised therein ... 229 Number of tenements for which certificates were (a) granted 229 ; (6) refused 0 ; (c) deferred 0 Number of prosecutions under Bye—laws under Public Health (London) Act, 1891—— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc 0 (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc 0 (c) For the prevention of keeping of animals in such a manner as to be injurious to health 0 (rf) As to paving of yards, etc., of dwelling houses ... 0 («) In connection with the removal of offensive matter, etc 0 (/) As to cesspools and privies, removal and disposal of refuse, etc. ... ... ... ... O ( g) For securing the cleanliness of tanks, cisterns, etc 0 (A) With respect to water closets, earth closets, etc. 0 (») With respect to sufficiency of water supply to water closets 0 ( j) With respect to drainage, etc. (Metropolis Management Act, Section 202) 0 (A) With respect to deposit of plans as to drainage, etc. (Metropolis Management Act, Section 202) 0 Mortuaries — Total number of bodies removed 146 Total number of infectious bodies removed ... ... ... ... ... ... ... ... 0 47 TABLE IX. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory. Factories (including Factory Laundries) 126 31 3 Workshops (including Workshop Laundries) 968 107 22 — Workplaces (other than Outworkers' Premises included in Part 3 of this Report) 2,350 154 17 1 Total 3,444 292 42 1 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to h.m. Inspector. ♦Nuisances under the Public Health Acts:— Want of cleanliness 90 90 — — Want of ventilation 7 7 — — Overcrowding 2 2 — — Want of drainage of floors — — — — Other nuisances 64 64 — — Sanitary accommodation r insufficient 4 4 — — unsuitable or defective 71 71 — — not separate for sexes 12 12 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 14 14 — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 264 264 — — * Including those specified in Sections 2, 3, 7 and 8, of the Factory and \York»h«p Act as remediable under the Public Health Acts. NATURE OF WORK.* Outworkers' Lists, Section 107. 00 u 0> u o £ 5 | o £ §1 o ^ v o a> Oh co a t—h Outwork in Unwholesome Premises. Section 108. Outwork in Infected Premises, Sections 109, 110. Lists received from Employers. Addresses of Outworkers. § Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110) Sending twice in the year Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Received from other Councils Forwarded to other Councils. Lists, t Outworkers.f Lists. Outworkers. Contractors. Workmen. Contractors Workmen. (<!< (3) (4) (5) (6) (7) (8) (9) (10) a") (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— (1) Making, &c. 110 — 701 7 — 2G 282 446 120 — — 174 — — — — — (2) Cleaning and washing — — — — — — 1 — — — — 1 — — — — — Lace, lace curtains and nets — — — — — — — — — — — Artificial Flowers — - — — - — Nets, other than Wire Nets — - — — — — — Tents — — - — — - — —• — — — — — — — — ■ Sacks — - — — - — — — — — Furniture and Upholstery — — — — 3 — — — — 3 — — Fur pulling — — — — — — — — — — — — Feather sortin g — — — — — — — — — — — — — — — Umbrellas &c — — — — — — — — Carding, &c., of buttons, Ac. — — — — — — Paper Bags and Boxes 4 — 28 — — — 3 16 4 7 Basket making — — — — — — — — — — I __ Brush making 2 — 6 — — — 1 4 2 2 Racquet and Tennis balls — — — — — — — — Stuffed Toys — — — — — — — — — File making — — — — — — — — — — — Electro Plate — — — — — — — — — Cables and Chains — — — — — — Anchors and Grapnels — — — — — — — — — __ Cart Gear — — — — — — — — Locks, Latches and Keys — — — — — — — — — Pea Picking — — — — — — — — — — — — — — — — — — Total 116 — 735 7 — 26 290 466 126 — — 188 — — — — — * If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list should he included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in column 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. t The figures required in columns 2, 3 and 4 are the total number of lists received from those employers who comply strictly with the statutory duty of sendiDg two lists each year and of the entries of names of outworkers in thoce lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. § In view of the wide discrepancies found to exist between the totals in the two columns when the returns are added together, it is desired that care may be taken to give exact figures. Only those addresses should be counted which have actually been received from or forwarded to other Councils during the year covered by the report. 49 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop, bakehouses, may be enumerated here. Laundries 13 Bakehouses 29 Other Workshops 988 Total number of workshops on Register 1,030 5.—Other Matters. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 19 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (s. 5) Notified by H.M. Inspector 12 Report (action being taken) sent to H.M. Inspector 15 Other 1 Underground Bakehouses (s. 101): — Certificates granted during the year - In use at the end of the year 24 50 TABLE X. Legal Proceedings under Public Health (London) Act, 1891. Date. Name. Premises. Offence. Result. 1908. Feb. 7th H. Busby 26, New North Street Nuisance W.C. stopped Order to abate nuisance. Defendant to pay Gs. costs. July 1st A. Newman 1 -8, Clark's Buildings Breach of lodging house by-laws Defendant dead; summons withdrawn. „ 1st, 8th and 18 th A. H. Wilson 6, 20. 21 & 22, New North Street Bo. do. Defendant convicted and fined £3 and £2. 2s. costs. Aug. 5th H. Morrell 27, Gloucester Street Insufficient water supply Defendant convicted and fined £3 and 3s. costs. „ „ Bullen & Debenham 7, Gloucester Street Do. do. Work done; summonswithdrawn on payment of 10s. 6d. costs „ 19th and 25th Barry & Barry 11, Verulam Street Do. do. Defendant convicted and fined £3 and 2s. costs. Sept. 11th A. J. Walke Evelyn Buildings Breach of lodging house by-laws Defendant convicted and fined 10s. and 10s. 6d. costs „ 17th Edward Wright 67, Red Lion Street Unsound meat exposed for sale Defendant convicted and fined £50. Nov. 3rd Patman & Fotheiingham 11, New North Street Breach of lodging house by-laws Defendant convicted and fined £5 and a continuing penalty of £2 a day for five days and £2. 2s. costs. TABLE XI. Legal Proceedings under Sale of Food and Drugs Acts. Date. Name. Premises. Offence. Result. 1908. Mar. 10th G. Labram 8, Francis Street Selling whiskey 52-77 per cent, under proof Defendant convicted and ordered to pay £2. 2s. costs. „ 17th Eliza Williams 13, Dean Street Selling milk 6-6 per cent, deficient in fat Defendant convicted and fined 10s. and 12s. 6d. costs. „ 18th J. Chiappa 24, Eyre Street Hill Selling milk 12-3 per cent, deficient in fat Warranty produced. Summons withdrawn. Defendant to pay 10s. 6d. costs. „ 31st Julia Thwaites 11, Marchmont Street Selling milk !23 per cent, deficient in fat and containing 4 per cent, added water Defendant convicted and ordered to pay 12s. 6d. costs. 51 TABLE XI —continued. Date. Name. Premises. Offence. Result. 1908. April 14th A. Terroni 138, Clerkenwell Road Selling butter containing 2.03 per cent, excess of water Defendant convicted and order to pay 2s. fine and 10s. 6d costs. „ 14th and 26th T. Matthias 22, Cross Street Selling milk 10 per cent, deficient in fat Defendant convicted and fine £2 and 12s. 6d. costs. May 26th D. Lloyd 73, Mount Pleasant Selling milk 9.6 per cent, deficient in fat Warranty pleaded Summons withdrawn; defendant payii 10s. 6d. costs. „ 27th Alice Carden 30, New North Street Selling milk 27 per cent, deficient in fat Defendant convicted and fine 20s. and 12s. 6d. costs. July 8th James Millbourne 13, Beauchamp Street Selling milk containing 0.0038 per cent, of formaldehyde Defendant convicted and fine £1 and 12s. 6d. costs. Aug. 5th William Sharp 19a, Endell Street Selling margarine for butter Defendant convicted and fine £5 and 12s. 6d. costs. „ „ David Lott 33, Great Ormond Street Selling milk 5 per cent, deficient in fat Warranty pleaded. Summoi withdrawn on payment of 14s. 6d. costs. „ 6th Julia Thwaites 11, Marchmont Street Selling milk 10 per cent, deficient in fat Defendant convicted and fine £3 and 12s. 6d. costs. „ 6th and 13th Thos. Matthias 22, Cross Street Selling milk containing 5.1 per cent. of added water Defendant convicted and fine £20 and 12s. 6d. costs. „ 10th Williamsons, Limited 111, High Holborn Selling milk 6.6 per cent, deficient in fat Warranty pleaded. Summon withdrawn on defendant paying 10s. 6d. costs. „ 18th J. B. Cox 71, Theobald's Boad Selling margarine for butter Defendant convicted and fine 20s and 12s. 6d. costs. „ „ Ada Carter 22, West Street Selling milk 5 per cent, deficient in fat Defendant convicted and fine 20s. and 12s. 6d. costs. Sept. 8th and 29th David Lott 33, Great Ormond Street Selling milk containing 0.003 per cent, of formaldehyde Defendant convicted and fine £ 1. 1s. and 15s. 6d. costs. 52 TABLE XII. Meteorology of London, 1908. (Deduced from observations at Greenwich under the superintendence of the Astronomer Royal.) 1908. Air Temperature. Bright Sunshine. Rain and other forms of Precipitation. Mean of— Mean of A. and B. Difference from Average. Total observed. Difference from Average. Per cent, of possible. Total fall. Difference from Average. * Minimum. A. Maximum- B. Q Q Q Q hrs. hrs. % ins ins. January 30.9 41.7 36.3 - 2.1 57 + 16 22 1.51 - 0.37 February 35.7 47.5 41.6 + 1.8 63 + 6 22 1046 - 0.02 March 33.9 47.6 40.7 - 1.8 102 + 3 28 2.22 + 0.70 April 36.8 51.7 44.3 - 3.8 137 - 10 33 2.10 + 0.53 May 47.2 66.2 56.7 + 2.9 200 + 14 41 1.53 - 0.39 June 49.7 71.0 60.4 + 0.1 262 + 65 53 2.07 + 0.03 July 53.2 73.0 63.1 - 0.6 202 - 34 41 3.66 + 1.26 August 51.4 70.1 60.7 - 2.2 214 + 4 48 3.28 + 0.94 September 47.7 66.4 67.0 - 1.2 165 + 10 44 1.22 - 0.93 October 46.0 62.9 54.5 + 4.1 133 + 38 40 1.97 - 0.81 November 39.8 52.1 45.9 + 2.5 77 + 29 29 0.76 - 1.46 December 35.3 43.5 39.4 - 0.2 22 - 11 9 2.00 + 0.17 Year 42.3 57.8 50.1 0.0 1634 + 132 37 23.78 - 0.34 * The averages used are obtained from observations extending over 50 years for Rain and Temperature. and 15 years for Sunshine. 1908. FIFTY-THIRD ANNUAL REPORT ON THE HEALTH & SANITARY CONDITION OF THE METROPOLITAN Borough of Islington. ALFRED EDWIN HARRIS, MEDICAL OFFICER OF HEALTH. London : Vail & Co., Printers to the Council, 170, Farringdon Road, E C. 1909. MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1907, to November, 1908). Mayor. Alderman GEORGE SAMUEL ELLIOTT, J.P. Aldermen. H. GODDARD EGGETT, J.P. ALFRED MYERS. HENRY MILLS, J.P. EDWARD SMALLWOOD, J.P. ALEXANDER G. WYLIE. Councilors. Ward. 1. REUBEN LOOMES. 2. JAMES WM. COWLING. 3. WILLIaM PRYOR. 4. WM. EDWIN MANCHESTER. 5. THOS. LUKE HARWOOD. 6. GEORGE AUBER. Ward. 6. CHAS. CROLE REES, 7. HENRY MARK KINGSTON. 9. WM. THORESBY COOKSEY. 9. WM. JOHN MERRINGTON. 10. ARTHUR L. WILLIAMS. 11. WALTER E. MARKHAM. Chairman Councillor JAMES WM. COWLING. Vice-Chairman Alderman H. GODDARD EGGETT, J.P. OFFICERS OF THE Public Healtlh Department. Medical Officer of Health. ALFRED EDWIN HARRIS, L.R.C.S., L.R.C P.Edin. Solicitor. ARTHUR MELLOR BRAMALL. Public Analyst. FRANK LITHERLAND TEED, D.Sc., F.I.C., F.C.S. Superintendent of Public Health Department and Chief Sanitary Inspector. JAMES RICHARD LEGGATT. Inspector of Meat. HARGREAVES WILKINSON, Cert. Sanit. Inst. Inspector of Workshops and Bakehouses. GEORGE WEST. Inspectors of Workshops &c., in which Females art employed. JOSEPHINE JANE BROWN, B.A., Cert. Sanit. Insp. Ex. Bd. ANNIE CATHERINE YOUNG, Cert. Sanit. Insp. Ex. Bd. Inspectors of Houses let in Lodgings. WILLIAM WALTER WARD. THOMAS HENRY HANCOCK, Cert. Sanit. Insp. Ex. Bd. Inspector appointed under the Sale of Food and Drugs Acts. TOM LEONARD BURRELL, Cert. Sanit. Inst. Inspectors of Nuisances and Sanitary Inspectors. District 1 ... WILLIAM COOK, Cert. Sanit. Inst. „ 2 HARRY JAMES BICKNELL, Cert. Sanit. Inst. „ 3 ALLEN BAGSHAW, Cert. Sanit. Inst. „ 4 CHARLES THOMAS BACON, Cert. Sanit. Inst. „ 5 WILLIAM HOLSGROVE FLOOD, Cert. Sanit. Inst. „ 6 CHARLES EDWIN HORSMAN, Cert. Sanit. Inst. „ 7 EDWARD ISAAC FORTUNE, Cert. Sanit. Inst. ,, 8 JOHN METCALF, Cert. Sanit. Inst. „ 9 WILLIAM IRVING, Cert. Sanit. Inst. „ 10 HARRY JOHN JAMES WATSON, Cert. Sanit.Inst. „ 11 GEORGE JAMES BRIDEL, Cert. Sanit. Insp. Ex. Bd. „ 12 THOMAS WALLACE AGAR, Cert. Sanit. Inst. „ 13 JAMES JARVIS JORDAN. „ 14 HARRY CALLOW, Cert. Sanit. Inst. Engineer in charge of Steam Disinfectors. JOSEPH TWIZELL. Caretaker of Shelter House. Mrs. TWIZELL. Mortuary Keeper. ARTHUR ROBINSON. Distributor of Disinfectants. JOHN REDDY. Disinfectors. JOHN WRIGHT and THOMAS DIXON. Clerical Staff. Chief Clerk GEORGE HAROLD KING. Second Clerk HENRY ANGEL Third Clerk GEORGE JAMES ELDRIDGE. Fourth Clerk EDWARD ALBERT ABBOTT. Fifth Clerk WALTER JOSEPH WOLFE. Sixth Clerk WILLIAM GEORGE BUNCH. Junior Clerk ARTHUR R. WITTRICK. Messenger. EDWARD JOHN DURLEY. iv INDEX. Page Adulteration of Food 263-289 Ages at Death 29, 34 Alcoholism 102 Analyst's quarterly reports 284-289 Annual Birth and Death rates, and Death-rates of Children 301 Appendicitis 84 Area of Borough 5 Areas and Densities of Metropolitan Boroughs ... 7 Artizans and other Dwellings 243 Bacteriological Diagnoses 179 Bakehouses 200 Baths and Washhouses 318 Births 11 „ in Decennial periods from 1841 314 Births, notification of 12 Butcher's Shops and Shops where food is sold 254 Butter and Margarine 276 Cancer 87 Cattle, Warranty with 249 Common Lodging Houses 242 Constitutional Diseases 87, 101 Continued Fevsr 71, 136 Cow Houses 254 Deaths 23 „ from Classified Causes 37, 38 „ at different age periods 29, 34 „in the Quarters 28, 33, 35, 36 „ „ Sub-Districts 27, 30, 32 „ „ Wards 28, 31 ,, „ Encircling Boroughs 78, 79 ,, from Epidemic Diseases 52-80 Deaths registered from all causes during the Year 294 Deaths registered from all causes in each Quarter 297 Deaths in Decennial periods from 1841 315 Deaths in Public Institutions 106 Death-rates of Metropolitan Boroughs 39 Density of Borough 5 Diabetes Mellitus 104 Diarrhœa 71 Diphtheria 67 ,. Fatality from 126-130 ,, Notification of 126 Diphtheria and Croup 128, 126 Disinfectants used 194 Disinfecting Station 192 Disinfection Work 190 V. Page District Inspection 226 Dust, removal of 238 Enteric Fever 70 „ Fatality from 132 „ Notification of 131 Epidemic Diseases 52-80 „ Cerebro-Spinal Meningitis 148 Erysipelas, Fatality from 85, 134 ,, Notification 133 Factories and Workshops 198 Fatality from Infectious Diseases 155 Food, Adulteration of 263-289 Food Inspection 248 Health Visitors 12 Hospital Isolation of Infectious Diseases 154-156 Houses Let in Lodgings 224 Ice Creams 263 Illegitimate Births 12 ,, ,, in Decennial periods from 1841 313 Infantile Mortality 41-51, 304 „ ,, in Decennial ppriods from 1841 316 Infectious Diseases on Business Premises 156 Infectious Diseases in Schools 149 153 Infectious Sickness in the several Wards from 1891-1908 308-313 „ ,, in Quinquennial periods from 1891 307 Influenza 81 Inspection of Food 248 „ Kitchens of Restaurants 206 „ Slaughter Houses and Cow Houses 251, 254 Inquests 113 Isolation of Notifiable Epidemic Diseases 154 Local Government Board Returns 302-304,306 London County Council Return of Sanitary Work 319 Margarine Act 276, 283 Marriages 10 Measles 61 Meat Inspection 248 Midwives attending Disinfecting Station 195 Milk Shops and Dairies 261 Mortality in Sub-Registration Districts 27 Mortuary and Coroner's Court 113 Notification of Infectious Diseases 116, 136, 137 „ ,, ,, ,, in Registration Sub-Districts 117,138,139 „ „ „ „ in the Sanitary Inspectors' Districts 142 „ „ „ „ in the Wards 140, 141 „ „ ,, „ during the several Months 143 „ „ ,, „ in the Encircling Districts 144, 145 „ „ „ „ in Metropolitan Boroughs 146, 147 „ „ Phthisis 148 ,, ,, Births Act 12 Non-notifiable Infectious Diseases in Schools 152 vi. Page Occupation of persons attacked with Infectious Disease 159 Offensive Trades 261 Outworkers' Premises 206, 220 Pauperism 240 Persons to an Acre 5 Persons living at different Ages 6 Phthisis 148 ,, Voluntary Notification of 148 Places where Food is prepared 206, 218 Population—Estimated in 1908 3 „ Sex and Age Distribution 8 „ in Sub-Districts 5 „ and Density of Wards 6 Population, Inhabited Houses, Marriages, Births, and Deaths 300 Prosecutions, Summary of 290 Public House Urinals in Streets 234 Puerperal Septic Diseases 85 Puerperal Fever 86 „ „ Notification of 134 „ „ Fatality from 135 Pulmonary Consumption 96, 148 Registered Lodging Houses 224 Respiratory Diseases 101 Restaurant Kitchens 206, 218 Sanitary Inspectors' Work 227, 235 Scarlet Fever 66 „ Notification of 120 „ Fatality from 126 Scarlet Fever—Inquiry as to cause of 121 School Children cleansed and bathed 195 Seasonal Mortality 28 Septic Diseases 88 Shelter House 194 Slaughter Houses 251 Small Pox 61 „ Notification of 119 Smoke Nuisances 229 Streets where Infectious Disease occurred 163 Summary of Sanitary Work in fourteen Districts 235 Summary of Applications for Removal of Dust 239 Trades carried on in Houses where Infectious Disease has occurred 156 Tubercular Diseases 96 Typhus Fever 71, 132 Vaccination 180 Venereal Diseases 104 Verminous Persons 195 Water Certificates 229 Water Supply 229, 291 „ to Tenement Houses 229 Whooping Cough 69 Workshops and Factories, Inspection of 198 Work of Public Health Department, Summary of 317 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1908. To the Worshipful the Mayor, Aldermen and Councillors of the Borough of Islington. Gentlemen, It affords me much pleasure to present to you the fifty-third annual report on the health and sanitary condition of your borough which relates to the year 1908, particularly as the statistics show that it enjoyed a very high state of health during that period. Indeed, the death-rate was the lowest on record, viz., 13.1 per thousand of its inhabitants. This is a state of health of which any borough might well be proud, especially such a one as Islington, where there is a very large working class population. I would take this opportunity of tendering my thanks to the Council in general and to the Public Health Committee in particular for the interest that has always been taken in the Public Health Department. I cannot, however, fail to regret that in your wisdom you did not see fit to adopt my advice with respect to health visitors, but, nevertheless, I am not without hope, that at some future time you will see how necessary they are if the mortality amongst infants is to be seriously checked, and tuberculosis prevented. In conclusion I would like to.place on record that I have received during the year full and cordial support from the staff of my department, to each of whom I would tender my sincere thanks, especially to Mr. J. R. Leggatt, the Superintendent and Chief Sanitary Inspector, and to Mr. G. H. King, the Chief Clerk. I am, Your faithful servant, Medical Officer of Health. lst June, 1909. viii. SUMMARY of Vital Statistics, 1908. Population (Estimated) Males 165,971 ) Females 183,120 Persons 349.091 Estimated increase on population,1907 2,074 persons. Area 3,092 acres. Density 113 persons per acre. Marriages 2,781 Persons married 5,562 Persons married rate 15.63 per 1,000 inhabitants. Births Males 4.447 Persons 8,665 Females 4,218 * Birth rate 24.35 per 1,000 inhabitants. Deaths from All Causes Males 2,348) Persons4,679 Females 2,331 Death rate ,, „ 13.15 Per 1,000 inhabitants. Deaths from principal Epidemic Diseases Males 188 358 persons Females 170 Death rate 1.01 per 1,000 inhabitants. Infantile Deaths under 1 year Males 522 Total 894 Females 372 Infantile mortality rate 103 per 1,000 births Excess of Births over Deaths 3,986 PART I. THE POPULATIONS, AREAS AND DENSITIES OF THE SUB-REGISTRATION DISTRICTS, THE WARDS AND THE BOROUGH. ERRATA. Page 12, line 12, for "birth rate is" read, "birth rates are." „ „ line 13, for "classes" read "class." „ 13, line 17, for "has" read "have." ,, 17, par. 3, line 1, for "easy" read "easily." ,, 24, line 13, for "nutritous" read "nutritious." ,, 66, line 5 from bottom of page, for "first" read "firstly." „ 69, line 4, for "average quinquennial" read "average of the quinquennial, etc." „ 84, line 11. Delete "The ages at death are given in the following statement." ,, 96, line 10 from bottom, for "puplic" read "public." „ 117, line 7 from bottom, for "349" read "345." ,, 120, line 17, for "of the year" read "of the preceding ten years." „ 126, line 8 from bottom, for "3,704" read "3,702." ,, 131, lines 7 and 8. Delete words beginning "been a very regular decline" and ending "decreased." ,, 163, last line, for "accomodation" read "accommodation." ,, 185, line 23. Delete "and consequently his attack was slight." „ 190, line 9, for "spirit" read "fluid." ,, „ line 10, for "was" read "were." ,, 199, line 10 from bottom, for "in 176 was" read "in 176 it was." ,, 262, line 8 from bottom, for "respectively," read "respectfully." ,, 269, line 12 from bottom, for "separate" read "separated." ,, 270, line 8, for "satisfed" read "satisfied." „ 273, line 2, for "2,115" read "2,116." ,, ,, wherever "2.76" occurs in this page read "2.74." ,, ,, wherever "8.24" occurs in this page read "8.25." „ 274, line 18 (last word), for "it" read "is." „ 314, Table X, last line, for "23.31" read "29.31." „ 315, Table Y, line 2, last 2 cols., for "5,365 and 16.71 " read "5,635 and 16.39." 3 [1908 REPORT OF THE Medical Officer of health FOR THE YEAR 1908. POPULATIONS, AREAS AND DENSITIES OF THE REGISTRATION DISTRICTS AND WARDS, AND OF THE BOROUGH. Population of the Borough.-The Registiar-General estimated the population of the Borough at the middle of 1908 to have been 349,091. It is, however, difficult to say that this is an exact figure. It is probably overstated, because, in making his calculation, he has relied on the inhabitants increasing since 1901 in the same geometrical ratio as in the decade 1891-1900. Now when the percentage rates of increase of the population of Islington between the mtercensal periods are examined it is found that for a long while they have been declining, indeed, ever since 1851, so that it is hardly to be expected that the rate of increase between 1901 and the present time has been maintained. The rate of increase is seen in the fourth column of the following statement; while the enumerated population, and the actual increase of population, is given in the second and third columns. Census Years. Enumerated Populations 1 Actual Decennial Increases. Percentage Increases. 1801 10,212 — — 1811 15,065 4,853 39.7 1821 22,417 7,352 40.5 1831 37,316 14,899 66.4 1841 55,776 18,460 49.4 1851 95,329 39,553 70.7 1861 155,341 60,012 63.1 1871 213,749 58,408 37.1 1881 282,865 69,116 32.3 1891 319,I55 36,290 12.8 1901 334.991 15,836 4.9 B 2 1908] 4 The percentage increases then have regularly fallen since 1851, while the actual increases have diminished since 1881. This being so, it is only fair to assume that the population has not increased at the rate of 4.9 per cent, which obtained in the decade ending 1900, and that the estimate of the Registrar-General is over-stated. If this be so, of course the rates calculated on his figures are not accurate. Fortunately the error cannot be very large, and assuming that the increase was only that with which the borough is credited it will affect the several birth, death, and marriage rates to only a very small degree. Thus the death rate of the year calculated on the basis of the Registrar-General's population is 13.15 per 1,000 of the population, while the same rate if calculated on the smaller estimate of half the assumed increase is 13.47 per 1,000. Under these circumstances and because of the great uncertainty that exists, it is proposed in this report to calculate all the rates on the Registrar-General's figures. Nevertheless, it is unsatisfactory to have to do so, for mortality returns should be as accurate as possible; and were it not for the action of the Government in 1905 a census of the population of London would have been taken then, as it had been taken in 1895, there would be no doubt now as to the accuracy of the birth and death-rates. It has been suggested that an accurate estimate of the population might be made from the natural increase of the Borough, that is to say the difference between the registered deaths and the registered births. Unfortunately this is not so. Indeed, contrary to what one might suppose, it would have led to a very serious over-estimate, for the population ascertained in 1901 would have to be increased by 30,128, which would make the population for 1908 15,363 more than the Registrar-General's estimate. An attempt was made to estimate the population on the basis of the inhabited houses, which the Borough Treasurer gives at 33,000, (clearly not an exact figure), and of the average number of persons (8.6) inhabiting each house at the census, but this gave only a population of 283,800, or 66,091 less than the Registrar-General's estimate. With these doubtful figures before the Medical Officer of Health he had no hesitation in selecting the official estimate, as he believed the figures were less erroneous than those calculated by other methods. In 1908 there were 53 weeks in the official year, so that in order to obtain rates comparable with other years, they are calculated on a population the one-fifty-second part larger than the estimate. The last time there were 53 weeks in the official year was in 1902, and previous to that in 1896. 5 [1908 Table I. Showing the Areas, Densities, and Estimated Populations of the Sub-registration Districts at the middle of the year 1908. Sub-Districts. Area. Acres. Acres to a person. Persons to an Acre. Estimated Population Mid-year 1908 Tufnell 417 0.0120 83 34,863 Upper Holloway 290 0.0078 127 36,847 Tollington 320 0.0087 115 36,788 Lower Holloway 413 0.0098 101 41,807 Highbury 798 0.0017 85 68,271 Barnsbury 309 0.0057 174 53,797 South-East Islington 545 0.0071 141 76,718 The Borough 3.092 0.0088 113 349,091 Table II. Showing the Areas, Densities and Estimated Populations of the Wards at the middle of the year 1908. WARDS. Area in Acres. Persons to an Acre, or Density of Population. Estimated Population Mid-year, 1908. No. 1—Tufnell 417 83 34,863 2—Upper Holloway 290 127 36,847 3—Tollington 320 115 36,788 4—Lower Holloway 413 101 41,807 5—Highbury 417 84 35,207 6—Mildmay 337 75 25,211 7—Thornhill 172 195 33,526 8—Barnsbury 137 148 20,271 9—St. Mary's 148 118 17,533 10—Canonbury 286 119 33,969 11—St. Peter's 155 213 33,069 The Borough 3,092 113 349,091 6 1908] Table III. Showing the Estimated Number of Persons living in Islington at the middle of 1908, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 18,986 18,555 37,541 5—15 32,191 32,295 64,486 15—25 32,763 36,711 69,474 25—35 30,013 33,565 63,578 35—45 21,624 23,843 45,467 45—55 15,126 17,330 32,456 55—65 9,498 11,562 21,060 65—75 4,308 6,390 10,698 75 and upwards 1,462 2,869 4,331 All ages 165,971 183,120 349,091 Table IV. Showing the number of Persons in the several Places mentioned living a Nine Groups of Ages in every thousand of their populations, according to the census 1901. DISTRICTS. —5 -15 —25 —35 -45 —55 -65 —75 75 and upwards England and Wales 114 210 196 162 123 89 60 33 13 Urban Districts 114 207 201 168 124 88 57 30 11 Rural ,, 114 221 177 142 118 92 70 45 21 London 109 190 203 179 130 91 57 29 12 Islington 108 185 199 182 130 93 60 31 12 7 [1908 Table V. Showing the Estimated Populations, Areas, Densities ana Death-rates of London and of the several Metropolitan Boroughs in 1908, arranged in order of Density. Boroughs. Estimated Population, 1908. Area in Acres. (Density) Persons to each Acre. Death Rates. All Causes. Epidemic Diseases. Cols. 1 2 3 4 5 County of London 4,795,757 74,839 64.1 13.8 1.35 Woolwich 131,346 8,277 15.9 11.4 0.92 Lewisham 156,627 7,014 22.3 11.0 1.25 Greenwich 109,110 3,852 28.3 12.6 1.25 City of London 19,252 673 28.6 17.7 0.40 Wandsworth 289,506 9,130 31.7 11.6 0.93 Hampstead 92,654 2,265 40.9 8.5 0.40 Hammersmith 124,012 2,286 54.2 14.0 1.09 Camberwell 280,022 4,480 62.5 12.7 1.06 Stoke Newington 54,015 863 62.6 12.3 0.82 City of Westminster 170,545 2,503 68.1 12.6 0.58 Hackney 235,253 3,289 71.5 13.2 1.52 Poplar 171,516 2,328 73.7 15.9 2.26 Deptford 117,539 1,563 75.2 13.8 1.32 Lambeth 321,344 4,080 78.8 13.3 1.18 Kensington 182,752 2,291 79.8 12.9 0.92 Battersea 183,873 2,160 85.1 12.2 1.19 Bermondsey 127,910 1,500 85.3 18.8 2.30 St. Marylebone 126,867 1,473 86.1 14.2 0.85 St. Pancras 237,075 2,694 88.0 14.7 1.06 Fulham 171,562 1,703 100.7 12.4 1.59 Paddington 150,923 1,356 111.2 12.4 0.87 Islington 349,091 3,092 112.9 13.1 1.01 Chelsea 75,049 660 113.7 14 .5 1.18 Holborn 54,466 405 134.5 16.4 1.07 Finsbury 96,007 589 163.0 18.6 2.09 Bethnal Green 131,066 759 172.6 17.1 2.48 Shoreditch 115,227 658 175.1 17.4 2.09 Stepney 310,706 1,766 175.9 16.4 2.53 Southwark 210,442 1,131 186.0 16.3 1.76 PART II. MARRIAGES, BIRTHS AND DEATHS. 1908] 10 MARRIAGES. The number ol persons married in 1908 was 5,562, which corresponds to a rate of 15.63 per 1,000 of the population. This is the lowest marriaee rate recorded since 1889. TABLE VI. Showing the number of Persons Married and the Marriage Rates in the Borough in 1908. No. persons married. Persons married per 1,000 inhabitants. 1st quarter 842 9.65 2nd „ 1,508 17.28 3rd „ 1,772 20.30 4th „ 1,440 15.32 The year 5,562 15.63 These figures compare with a yearly average or 6,088 persons married, and a rate of 17.92 per 1,000 inhabitants during the ten years 1898-1907. The record of marriages in Islington since 1841, given in decades and as abstracted and collected from the Registrar-General's annual reports is as follows :— Table VII. Showing the Marriages and Marriage Rates in Six Decennial Periods, 1841-1900, and in 1901-1908. Periods. Marriages. Persons married per 1,000 of the Population. 1841-50 6,109 l6.81 1851-60 10,901 17.96 1861-70 16,194 17.84 1871-80 20,889 17.06 1881-90 23,322 15.55 1891-1900 28,947 17.44 1901-08 (8 years) 26,937 19.68 1908 5,562 15.63 11 [1908 Table VIII. Showing the Marriages and the Marriage Rates in the Borough during 1908 and in the preceding ten years. Years. No. persons married. Persons married per 1000, inhabitants. 1898 6,410 19.03 1899 6,508 19.35 1900 5,936 17.67 1900 5,988 17.85 1902 6,216 18.08 1903 6,106 18.00 1904 5,896 17.29 1905 5,968 17.18 1906 5,928 17.18 1907 5,924 17.07 Average of 10 years 6,088 17.92 1908 5,562 15.63 Decrease on mean 526 2.29 BIRTHS. The number of births registered during the year was 8,065, of whom 4,447 were males and 4,218 females, as compared with an average of 9,066 in the preceding ten years. These represented a birth-rate of 24.35 per 1,000 inhabitants, as against a decennial rate of 20.6; thus there was a decrease of 401 in the number of births, and of 2.3 in the birth-rate. 1908] 12 The birth-rate in London during the same period was 25.2, and in the 76 Great Towns 27.0 per 1,000 of the population. The birth-rate now reported is the lowest that has been hitherto recorded in Islington, where for many years it has shown a persistent fall, as may be seen in Table X in Appendix, which gives the births and birth-rates in the Borough from 1841 to the present time. Illegitimate Births.—The number of illegitimate births registered in 1908 was 231, as compared with 230,244,227 and 223 in the preceding four years. Births in the Sub - Registration Districts.— Full particulars respecting these are set out in Tables X. and XI., in the latter of which it will be noticed that The birth-rate is greatest in the districts where the people are mostly of the working classes and lowest in the districts where the social position of the people is good. Thus it happens that persons who can least afford to bring up families are blessed with the greatest number of children, while those in better circumstances either refrain from getting them or use methods of prevention. The Notification of Births.—The Notification of Births Act, 1907 was adopted by a resolution of the Council of Islington on 12th June, 1908, and the consent of the Local Government Board given thereto on 29th June, 1908. The Act came into force on 16th July, 1908. "The object of this Act, which will only be in operation where it has been adopted by the Local Authority with the consent of the Board, or has been declared to be in force by the Board, is to provide a speedy means whereby information of a birth of a child may be given to the Medical Officer of Health of the Local Authority, so that, if necessary, advice may be given to the mother in regard to the rearing and nurture of the child." (L.G.B. Circular, Sept. 27, 1907.) In order to meet the obligations which this Act implicitly places on Local Authorities, and which the Local Government Board Circular states to be its object, the Medical Officer of Health advised the Council to appoint Health Visitors to advise and give instruction to the mothers, but the Council would have none of them, notwithstanding the circular letter of the Local Government Board, which in another paragraph says "The Board may observe that in their opinion there is no occasion for impressing upon parents and others the obligation of notifying births unless steps are taken to carry out the 13 [1908 ultimate object of the measure, viz., the giving of advice and instruction to those who have charge of the infants, and in ordinary circumstances they would not be prepared to consent to the adoption of the Act unless it appears that arrangements had been made for this purpose. These arrangements would usually be best carried out by local agencies under the Medical Officer of Health." During the discussion of the subject, both in the Public Health Committee and in the Council, it was frequently stated that there would be an ample number of voluntary visitors and social and religious agencies quite willing to undertake the work of visiting and imparting instruction. Up to the date of the issue of this report no voluntary visitors or agencies have come forward, and, therefore, the object of the Act, as stated by its framers, remains unattained, and, so far as it is possible to foresee, unattainable. Months prior to the adoption of the Act, that is since March, 1907, it had been the custom of the Medical Officer of Health to send printed instructions on the rearing and feeding of infants to the mother of every newly-born child, which doubtless has effected some good, but which can never replace the verbal instructions and object lessons which can be given, and are given elsewhere, by properly qualified and trained health visitors. How can instruction, for instance, be given on the question of breastfeeding—its necessity alike for the good of the mother and (particularly) of the child to whom such feeding is of the utmost importance and to whom it will make, it may be, the difference between life and death in the immediate present, and if it should live the difference between a healthy life and one of decrepitude? In the last Blue Book issued (Cd. 4671) under the heading "Local Authorities and Infant Mortality" the following paragraph appears: "In view of the decline of the birth-rate during the last 30 years, and the fact that the infantile death-rate has until the last few years remained almost stationary, it is important that special attention should be directed to the problem of mortality in early life. Certain causes of infant mortality are inevitable, but others, and particularly those which are connected with improper feeding and sanitary conditions, can be prevented. The efforts to reduce infantile mortality in which the central and many local health authorities are now engaged are, therefore, mainly directed to the removal of ignorance as to the feeding and general hygiene of infants. The Notification of Births Act, 1907, has enabled local authorities adopting the Act to secure that all births occurring in their district shall be notified to 1908] 14 the Medical Officer of Health within 36 hours, w hereas, previously, information of a birth might not be received for six weeks—the statutory time within which registration of births must be effected. At the end of November, 1908, the Local Government Board had sanctioned the adoption of this action in 119 urban districts, laying it down in each case that suitable arrangements should be made for the employment of health visitors, voluntary or official. Such health visitors exist in about 150 districts. The health visitor visits the houses in the poorer districts from which a notification has been received, and advises the mother as to the best means of feeding the infant and as to the general hygiene of infancy. Breast-feeding is strongly advocated; where this is impossible, careful instructions are given for the artificial feeding of the infant, and the home is re-visited to encourage the carrying out of the instructions." None of this work can be done in Islington because the health visitors are non-existent, and \et the Act is in force and there is "imposed upon parents and others the obligation of notifying births," although no "steps are taken to carry out the ultimate object of the measure, viz., the giving of advice and instruction to those who have charge of the infants." Recollecting the intention with which the Act was passed and the object which the Local Government Board had in view, it has been a matter of surprise to the Medical Officer of Health that its adoption by the Borough Council was ever sanctioned. The advice of the Medical Officer of Health to the Council has been put forward in a long report, in which he maintained that three official health visitors are required in Islington, and now, after the expiration of eighteen months—and with much more experience—he is still of that opinion. The instructions on the care and feeding of infants, to which allusion was made above, are as follows :— METROPOLITAN BOROUGH OF ISLINGTON. THE CARE AND FEEDING OF INFANTS. 1.—The Mother's Health. The mother's health is most important. She should therefore take greatest care of it both before and after the baby's birth. She should take regular gentle walking exercise in the open air, so as to keep herself strong and robust. 15 [1908 A mother who improves her own health will also improve her baby's health, both before and after its birth. She should avoid alcoholic drinks of all kinds, beer, spirits or wines, unless ordered them by a doctor. She should have good, plain, wholesome, nourishing food. Let her drink plenty of milk or take milk puddings or cocoa and milk. 2.—Feeding Baby Put the infant to the breast as soon as possible, that is, as soon as the mother has sufficiently recovered from the fatigue of her labour. This draws out the nipples, while the fluid, although it is not yet milk, acts as a gentle purge to the baby's bowels. This is nature's medicine Castor oil or any purgative drug should not be given. The Natural Food of the baby is its mother's milk, and therefore it should be reared on it alone until the eighth or ninth month if the mother have sufficient This is important, because breast-fed infants are less liable to bowel complaints such as diarrhoea, which is very fatal in the summer months, as well as to many other ailments, such as rickets. During the first four weeks suckle the baby every two hours. During the second month suckle it every two and a half hours. During the next seven months suckle it every three hours. The first feed should be given at 5 a.m., and the last at 11 p.m. In the case of delicate infants it may be necessary to suckle it once or twice during the night. Regularity of feeding is necessary for the baby, who will wake up at its accustomed time for its food, while irregularity affects the quantity and the quality of the milk. Weaning should be gradual, and should never be effected in July, August or September, as bottle fed or artificially fed babies aie much more likely to die from "Summer Diarrhoea" than infants that are suckled. A mother should always suckle her infant. Artificial feeding must only be resorted to when her health is bad, and under medical advice. Feeding with Cows Milk. If the mother cannot suckle her infant, it should be fed with cow's milk and water or barley water, with a little sugar. Skimmed or separated milk should not be used, as it contains practically no fat, which is most necessary for the baby. Boil the milk as soon as bought or delivered ; store it in scrupulously clean covered vessels, keep it in a cool place and protect it from flies or dust. Use a boat shaped bottle, but never one with a long tube. Well wash the bottle and teat in very hot water with soda after each feed, and keep it standing in cold clear water until again required. 1908] 16 Prepare each meal in the following manner:— For a Baby undeb Two Weeks Old. Milk, 1 tablespoonful; water, 2 tablespoonfuls. Mix and warm. Give this to the baby every two hours in the day. Fob a Baby from a Fortnight to One Month Old. Milk li tablespoonfuls, gradually increasing to 3 Water, 3 tablespoonfuls. Mix and warm. Give this to the baby every two hours. For a Baby from One to Two Months Old. Give the same feed every two and a half hours. For a Baby between Two and Four Months Old. Milk, 3 tablespoonfuls, gradually increasing to 4. Water, 3 tablespoonfuls, gradually increasing to 4. Mix and warm. Give this every three hours during the day. For a Baby between Four and Six Months Old. Milk, 5 tablespoonfuls, gradually increasing to 8. Water, 5 tablespoonfuls, gradually decreasing to 4. Mix and warm. Give this every three hours during the day. For a Baby between Six and Nine Months Old. Milk, 9 tablespoonfuls, gradually increasing to 11. Water, 3 tablespoonfuls. Mix and warm. Give this every three hours during the day. Use water which has been boiled to mix with the milk, and add a teaspoonful of sugar to each meal. At nine months the milk may be given without any water added, and the number of tablespoonfuls in each meal increased from 14 to 10. Thin barley water may be used instead of water. Never keep food over in the bottle for the next meal. At twelve months the milk may be thickened with cornflour, and some broth or beef tea given. The child may also have bread and milk, porridge, and milk puddings. Children require plenty of milk until the age of three years, as they cannot digest the same food as grown-up persons. After eighteen months they may also have fresh fish, gravy and bread-crumbs or eggs, etc., once a day. GENERAL DIRECTIONS. Never give a baby a comforter or dummy teat to suck. They are a fruitful source of wind in the bowels and griping. Do not give baby teething powders, sleeping draughts or soothing syrups. Eyes. As soon as the baby is born, the eyelids and about the eyes should be carefully cleansed and washed. If the eyes run with matter and look 17 [1908 red for a few days after birth, let a doctor see them at once. Delay is dangerous, for one or both eyes may be destroyed if not treated immediately. The discharge is infectious. Bathing Baby. Give baby a tepid bath night and morning, using a little curd soap. II accustomed from the first, the youngest infant will enjoy it. Sponge and wash gently with flannel, and dry with a soft cloth, especially the folds of the skin, and use a dusting powder. Dressing Baby. The clothing should be warm, and fit easy, with flannel next the skin. Tight bandages are not necessary and are hurtful. If possible use strings and not pins, and if the latter, only safety pins. Weaning Baby. The baby should be weaned by degrees and as a rule should not have the breast after the ninth month. A good plan is to begin at the end of the ninth month by substituting milk for the breast once each day during the first week; twice during the second week ; three times during the third week ; four times during the fourth week; and five times during the fifth week. In the sixth week baby might be fed altogether on milk. Do not wean baby (1) if it is debilitated ; (2) in hot weather, especially in the months of July, August and September; and (3) if the teething is painful and the child is fretful. The baby should never be given a share of its parents food. It is a bad habit, for tea, toast, meat, fish and the like ruin a baby's constitution, and cause many deaths. A Crying Baby. If a baby cries, search to find out if anything is hurting it. It may be that a pin, or a tight garment, or the chafing of the napkin, or a wet napkin is causing pain. It is not always hunger that causes it to cry. Fresh Air and Exercise. Infants suffer from badly ventilated rooms. Therefore open the windows a little at the top. Take the infant out for a walk every fine day. Do not take it out at night and in wet weather. Sleep. Do not accustom the baby to be rocked or nursed to sleep, or to sleep on your arms. It is best to put it to sleep in a cot or cradle rather than in a bed with the parents, where it may be smothered. If you have not a cradle, use a clean box or a clothes basket. Washing Baby's Clothes. Do not use soda in washing baby's napkins or flannels as it irritates the skin. BB 1908] 18 To make Barley Water. Put a teaspoonful of well crushed barley or of prepared barley in a jug and pour on it a half-pint of boiling water, add a pinch of salt and stand it by the fire for an hour, stir frequently. Strain through muslin. Make it twice a day. TO PARENTS. No advice can be of the slightest use unless the parents, or the guardians, of the child honestly resolve to let no selfish motive of convenience, pleasure, or profit divert them from that which must be their first thought in the morning and last at night, to cherish and make happy the life which is so unreservedly put under their control. They must make up their minds to sacrifice themselves for it, and do as they would be done by were they equally dependent and helpless. The mother especially must remember that at least for the first year of the child's life she must devote herself body and mind to it. Any reason or argument for shirking the duty of suckling must be looked upon with suspicion, however plausible. A woman who can suckle her child and will not. increases a hundred-fold the risk that the child runs of losing its life, and should it die, to that extent she causes its death. Number of Notifications received.—Up to the end of the year, from July 16th, 3,211 notifications were received, of which 483 came from medical practitioners, 974 from midwives, and 1,754 from parents or guardians or other persons present at the time of birth. Prior to the Act coming into force the following circular letter was addressed to each medical practioner in Islington:— METROPOLITAN BOROUGH OF ISLINGTON. Town Hall, Enclosures. Upper Street, N. 15th July, 1908. Dear Sir, NOTIFICATION OF BIRTHS' ACT. 1907. I beg to inform you that the above Act has been adopted by the Borough Council and that such adoption has received the consent of the Local Government Board who have notified that the provisions of the Act shall come into force within the Borough on 16th July, 1908. As required by Section 2 (3) of the Act, I direct your attention to its provisions. Section 1 (1) provides that in the case of every child born in an area in which the Act is adopted notice in writing of the birth must be given 19 [1908 to the Medical Officer of Health of the district in which the child is born, and that the persons upon whom the duty of notifying devolves are the father of the child, if he is actually residing in the house where the birth takes place at the time of its occurrence, and any person in attendance upon the mother at the time of, or within six hours after, the birth. Section 1 (2) enacts that notice is to be given by posting a prepaid letter or postcard addressed to the Medical Officer of Health, or by delivering a written notice at his office or residence, giving the necessary information of the birth within thirty-six hours after the birth. This Sub-section also provides that stamped addressed postcards containing the form of notice are to be supplied free of charge by the Council to any medical practitioner or midwife residing or practising in the area who applies for the same. By Section 1 (3) it is enacted that any person who fails to give notice of a birth as required by the Act is liable on summary conviction to a penalty not exceeding twenty shillings. Section 1 (4) provides that the notification to be made under this Act is in addition to and not in substitution for the requirements of any Act relating to the registration of births. Section 1 (5) enacts that the notification shall apply to any child which has issued forth from its mother after the expiration of the twentyeighth week of pregnancy, whether alive or dead. A supply of stamped addressed notification forms is enclosed for use in your midwifery practice, and it is suggested you should arrange, in any case you are attending, for one to be handed to the person responsible for notification in order that he or she may transmit the same to the Medical Officer of Health. In the absence of any other person you yourself will, of course, be held responsible for sending in the notification within the time stated. Additional stamped addressed notification forms will be supplied on application to the Medical Officer of Health. I am, Yours faithfully, Wm. F. DEWEY, Town Clerk. A fairly large number of medical men have resented the obligation to notify placed on them by the Act, some saying that they should not be compelled to disclose information which they only obtained through being the 1908 20 medical attendant, while others again object on the ground that when the State requires information it should pay for it. The first contention was raised much more loudly when the notification of the infectious diseases was made compulsory, although payment for it was to be made under the Act, and it really is not a serious contention. As to the non-payment of a fee, however, a great deal may be said. A fee ought to be paid for each certificate, for surely it is unfair to demand gratuitous service, and that too from a man whose profession has cost him very many years of preparation for entering on the study of medicine, and after he has done so, at least five years more before he can gain his qualifications. The law is radically unfair, and has no more right to enact the services of the medical profession for nothing than it has to compel solicitors or barristers to give their services without a fee. It is not that doctors care so much about the fee as that they resent being compelled to give information gratuitously, and they naturally ask where will it end ? They are noted above all professional men for their unpaid services in the cause of the public and even private charities, which they give ungrudgingly and with a whole heart in the cause of suffering humanity; and, therefore, they feel deeply hurt, and accordingly resent it, when they are compelled to give certificates notifying births to a public authority for nothing. Table IX. homing the Births (distinguishing Males and Females) and Birth-rate of Islington in 1908, and in the four quarters of the year and of the Conn of London and the Great Towns during the same period; also the met Borough Birth-rates for the years 1898-1907. Quarter. Males. Females. Total. Birth Rates. Islington, 1908. Islington. 1898-07. London, 1908. 76 Great Towni, 1908. 1st. 1,125 1,095 2,220 25 .43 27. 64 26. 9 28. 3 2nd 1,084 1,039 2,123 24. 32 26. 73 26.2 27. 9 3rd 1,100 1,035 2,135 24. 46 26. 60 25. 0 26. 9 4th 1,138 1,049 2,187 23. 27 25.79 23. 6 25.0 The Year 1908 4,447 4,218 8,665 24. 35 26. 69 25. 2 27. 0 1907 4,338 4,193 8,531 24.58 24. 35 25.6 27.0 Increase or decrease + 109 + 25 + 134 -0. 23 -2.34 -0.4 — [1908 21 Table X. Showing the Births o/ Males and Females in each quarter and for the year, 1908, in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. The Borough Males. Females. Total. Males. Females. Tota1. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Qr. 117 105 222 169 118 287 106 82 188 127 150 277 175 184 359 196 210 406 235 246 481 1,125 1,095 2,220 2nd ,, 95 104 199 125 112 237 98 78 176 147 128 275 195 157 352 178 198 376 246 262 508 1,084 1,039 2,123 3rd „ 104 95 199 135 128 263 96 88 184 122 110 232 188 164 352 208 205 413 247 245 492 1,100 1,035 2,135 4th „ 92 104 196 127 113 240 84 96 180 155 128 283 196 157 353 220 210 430 264 241 505 1,138 1,049 2,187 Year 408 408 816 556 471 1,027 384 344 728 551 516 1,067 754 662 1,416 802 823 1,625 992 994 1,986 4,447 4,218 8,665 1908] 22 Showing the Birth-rates for each quarter and for the year 1908. of Islington, of the County of London, and of the 76 Great Towns. Sub-Districts. ISt Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Tufnell 25.46 22.83 22.83 20.88 22.96 Upper Holloway 31.15 25.72 28.55 24.19 27.34 Tollington 20.44 19.13 20.00 18.17 19.41 Lower Holloway 26.50 26.31 22.20 25.14 25.04 Highbury 20.6l 20. 62 20.62 19.20 20.35 Barnsbury 30.18 27.95 30.70 29.69 29.63 Islington, S. East 25.08 26.48 25.65 24.45 25.40 The Borough 25.43 24.32 24.46 23.27 24.35 London 26.9 26.2 25.0 23.6 25.2 76 Great Towns 28.3 27.9 26.9 25.0 27.0 Table XII. Showing the Population, Births, and Birth-rates in Six Decennial Periods, 1841 to 1900, and in 1908. Periods. Mean Population in each Decade. Number of Births in each Period. Birth-rates. Average Yearly Number of Births, corrected on the basis of the population of 1908. 1 2 3 4 5 1841-50 72,767 20,850 28. 65 10,003 1851-60 121,353 41,915 34. 54 12,057 1861-70 181,529 67,520 37. 20 12,984 1871-80 244,884 89,627 36. 60 12,775 1881-90 299,857 97,647 32. 56 11,367 1891-1900 331,868 97.278 29. 31 10,233 1908 349,091 8,665 24 .35 8,665 28 [1908 DEATHS. In 1908 there were 4,679 deaths registered in the Borough, of which 2,348 were those of males, and 2,331 of females. Death-rate—These 4,679 deaths were equal to a mortality of 13.15 in every 1,000 persons living in the Borough, while the death-rate among men was 13.88, and among females 12.48. Contrast with previous records. — It is, indeed, very gratifying to be able to record such a low death-rate in so large, so mixed, and so congested a population; for it proclaims loudly that the general sanitary state of the district must be generally good. Were it not so, there would not be such a good tale to tell, even though as was most certainly the case, the meteorological conditions were most favourable to the preservation of human life, and especially to life during its first year. The death-rate of 13.15 per 1,000 is the lowest recorded in the Borough since civil registration was enforced in 1841, as the figures in Table Y, in Appendix, will prove. Coming down the years, there is no death-rate in this return which even approaches that of last year until 1903 is reached, when it was 14 27 per 1,000, since which year it has been low, but never within 1.25 of the rate of 1908. This may not seem much of a difference between death-rates, but when translated into figures it means 436 lives. How great the saving of lives was, when comparison is made with those periods in which the death-rates were higher, may be learned from the fact that if the death-rate had been the same as in the decennial period 1841-5 there would have been 673 more deaths recorded last year; if the same as in 1851-60 748 more; if the same as in 1861-70 860 more; if the same as in 1871-80 712 more; if the same as in 1881-90 649 more; and if the same as in 1891-1900 618 more deaths. These facts ought to be pondered on, and they are indeed worthy of serious thought, because they show what battalions of human beings are being saved year after year by steady sanitary administration, and in a lesser degree by education, among the classes, although not so much among the working classes as one could wish or suppose, notwithstanding the rate-aided or rate-supported schools. There is no question that the better conditions which prevail among the working classes have worked for good with them, for higher wages have enabled 1908] 24 them to procure better clothes, better food, and better housing than in the olden days, when shoeless boys and girls were the rule, just as now they are the exception. Even during the winter which has passed one could not but notice that the crowds of men who were out of work and who demonstrated in processions in Islington and elsewhere in London were as a rule well clothed. These facts show that the Englishman is generally better off than the workmen of Continental countries, although there too the position of the working-classes has been much improved. Indeed, nearly everywhere the conditions under whirh they live have improved because their welfare has become the concern of the State; and it is well that it should be so, for after all they are a State's first asset, and this being so it is right that the State should see that the houses which they occupy are habitable and healthy, that the food which they eat is good, wholesome, nutritous, and pure, and that the conditions under which they work are as favourable as can be reasonably desired. In Islington for many years—certainly since 1892—these have been the aims of the Medical Officer of Health and the officers of the Public Health Department, whose work has been invariably well supported by the members of the Council—(although the recent refusal to grant Health Visitors was an error of judgment, which to a certainty will some day be atoned for). This is of course as it should be, for the work of every sanitary authority must ultimately be gauged by the results of its endeavours to keep the people healthy. It would be well that sanitary authorities should keep this view continually before them. It is true that it happens that the results to be obtained by the wise expenditure of money are not, as a rule indeed hardly ever, seen at once, because the effect of all sanitary measures is only perceived after the lapse of time, sometimes years, and not immediately. It is, therefore, well for the Council to recollect this truth when considering the advice given by their responsible officers. The present healthy state of affairs in Islington is mainly due to the general policy of the Public Health Department that was adopted in 1892 and 1893, and which was subsequently followed more or less by nearly every health authority in London, and not to the adoption of any recent measures. The foundation of the Public Health Administration that was laid down by the old Vestry of St. Mary, Islington, was very good, and we now see the superstructure in the more healthy lives of the people. Still there are defects in the bridge of life which stretches from the cradle to the grave, but these defects can be remedied to a large extent by means that are available at a small cost. Many years ago 25 [1908 Addison in the Spectator (No. 159, September 1st, 1711), gave to the world that incomparable story of " The Vision of Mirzah," wherein this bridge of life is so graphically and truthfully described. The story is as follows:-—• "'Examine now,' said he, ' this sea that is bounded with darkness at both ends, and tell me what thou discoverest in it.' ' I see a bridge,' said I, ' standing in the midst of the tide.' ' The bridge thou seest,' said he, ' is humane life; consider it attentatively.' Upon a more leisurely survey of it I found that it consisted of threescore and ten entire arches, with several broken arches, which, added to those that were entire, made up the number about an hundred. As I was counting the arches the Genius told me that this bridge consisted at first of a thousand arches; but that a great flood swept away the rest, and left the bridge in the ruinous condition I now beheld it. ' But tell me further,' said he, ' what thou discoverest on it ?' 'I see multitudes of people passing over it,' said I, ' and a black cloud hanging on each end of it.' As I looked more attentively I saw several of the passengers dropping through the bridge, into the great tide that flowed underneath it; and upon further examination, perceived there were innumerable trap-doors that lay concealed in the bridge, which the passengers no sooner trod upon, but they fell through them into the tide and immediately disappeared. These hidden pit-falls were set very thick at the entrance of the bridge, so that throngs of people no sooner broke through the cloud, but many of them fell into them. They grew thinner towards the middle, but multiplied and lay closer together towards the end of the arches that were entire. " I passed some time in the contemplation of this wonderful structure, and the great variety of objects which it presented. My heart was filled with a deep melancholy to see several dropping unexpectedly in the midst of mirth and jollity, and catching at every thing that stood by them to save themselves. Some were looking up towards the heavens in a thoughtful posture, and in the midst of a speculation stumbled and fell out of sight. Multitudes were very busy in the pursuit of bubbles that glittered in their eyes and danced before them, but often when they thought themselves within the reach of them their footing failed and down they sunk. In this confusion of objects, I observed some with scymetars in their hands, and others with urinals, who ran to and fro upon the bridge, thrusting several persons on trap-doors which did not seem to lie in their way, and which they might have escaped had they not been thus forced upon them. The Genius c 1908] 26 seeing me indulge myself in this melancholy prospect, told me I had dwelt long enough upon it: 'Take thine eyes off the bridge,' said he, 'and tell me if thou yet seest anything thou dost not comprehend.' Upon looking up, ' What mean,' said I, ' those great flights of birds that are perpetually hovering over the bridge, and settling upon it from time to time? I see vultures, harpyes, ravens, cormorants; and among many other feathered creatures several little winged boys, that perch in great numbers upon the middle arches.' ' These,' said the Genius, 'are envy, avarice, superstition, despair, love, with the. like cares and passions that infest human life.' " I here fetched a deep sigh. ' Alas,' said I, ' man was made in vain! How is he given away to misery and mortality, tortured in life, and swallowed up in death ! '" How true and graphic a representation of human life this is, especially in its very early stages, for here we see that the trapdoors and pitfalls on the bridge were very thickly set at its commencement, or just where we know that infants encounter those great ills and dangers which chiefly arise through the ignorance and neglect of people who have the rearing of them. It is not necessary to follow the story right through ; it is sufficient to say that the pitfalls and trapdoors grow less tcwards middle age, but as life draws to a close they again become more numerous and more frequent. It is, however, the duty of sanitary authorities wherever they see those trapdoors and pitfalls to remove them, and so enable the people to pass along in safety, and without fear of coming to an untimely end. This is a sacred obligation ! It is the reason of their existence ! The Mortality of the Borough contrasted with that of other places.—When we compare the Islington death-rate of 1315 per 1,000 of its inhabitants with that of other places, it is found to be satisfactory, for in England and Wales the deaths were 14.7 per 1,000 ; in the 76 great towns 14.9 per 1,000, and in the 142 smaller towns 14.0 per 1,000, while in the rural districts, viz., England and Wales, less the 218 towns, it was 14 7 per T000. It is also slightly below the average rate (13.8 per 1,000) in the County of London. It would be a matter of congratulation if the death-rate of Islington were to continue as low as it is now, especially when it is remembered what a diverse population lives within its boundaries. It is hardly, however, to be expected that such will be the case, for no one can close his eyes to the fact that the days of Islington as a residential district, by which is meant a district occupied by the higher classes of society, have nearly come to a close. 27 [1908 One has only to see what has happened, and is happening, in Highbury to appreciate the fact. Indeed the present state of Upper Street, which for years was the principal business thoroughfare of the district, is its confirmation, for the wealthier class of people having gone farther afield to live, the business people who catered for them have to a very great extent lost their customers, and so their trade has diminished. Ages at Death.—These are fully set out in Table XVIII., in which it is seen that compared with the preceding ten years there has been a decrease in the number of deaths registered at all ages, except amongst people 75 years old and upwards. The decrease in the deaths amongst children under 1 year old as compared with the average was 339, while between 1 and 5 years it was 221, so that altogether there was a decrease of 560 deaths amongst children under 5 years of age. Between 5 and 15 years old the deaths showed a decrease of only 4, having fallen from 165 to 161. Between 15 and 25 years of age they decreased from an average of 203 to 170, thus discovering a saving of 33 lives. Between 25 and 35 there was a decrease of 56, the number registered being 257 as compared with an average 313. The next period of life, 35 to 45 years, exhibited a saving of 22 lives, the number of deaths registered being 408 as comas compared with an average of 430. In the age period, 45 to 55 years, 471 deaths were registered, or 64 less than in the preceding 10 years. From 55 to 65 years of age, 597 deaths were registered as against 621 in the preceding years; while between 65 and 75 there were 637 deaths in contrast with 650 in the preceding decade. When, however, the return for the age period of 75 to 85 years of age is studied, it is found that 510 deaths were registered in 1908, or 46 more than the average (464) of the preceding 10 years. Again, among persons 85 years old and upwards there was an increase of 22 deaths, the number being 148, as contrasted with 126 in the decade 1898-1907. Mortality in Sub-Registration Districts.—The mortality in the seven sub-registration districts into which Islington is divided is fully set out in Table XVI., which also gives the deaths and death-rates for the preceding 7 years. In this table it is seen that the death-rate in each of the sub-registration districts was below the average of the preceding seven years. Thus in Tufnell it was 11.96, as against 14.11 per thousand; in Upper Holloway 12.91, 1908] 28 as contrasted with 15.23; inTollington 10.56, as compared with 12.72; in Lower Holloway 13.40, as against 15.79; in Highbury 11.72, as compared with 12 40; in Barnsbury 16.14, as contrasted with 17.43; and in Islington South East 14.08, as contrasted with 15.40. From these figures we see that the healthiest district during the year was Tollington, which was followed in order by Highbury, Tufnell, Upper Holloway, Lower Holloway, Islington South.East, and Barnsbury. It is noticeable that Highbury, which usually occupies the first place for salubrity, had in the year under consideration to take second place to Tollington, which during the preceding seven years had held the second position. Mortality in the Wards.—The deaths and death.rates of the several wards are set out in Table XV., which gives particulars for each quarter, as well as for the year, where it is seen that Tollington Ward, with a death. rate of 10.56, exhibits the lowest mortality. It is followed by Mildmay (10.78), Tufnell (11.96), Highbury (12.73), Upper Holloway (12.91), Canon. bury (13.20), Lower Holloway (13.40), St. Mary's (13.82), St. Peter's (14.21), Thornhill (15.95), and Barnsbury (16.45). m None of these rates can be considered high, notwithstanding the difference that is exhibited between some of them—that between Tollington and Barnsbury being as much as 5.89 per 1,000. The social position of the inhabitants, as well as their occupations, will, however, account for this. SEASONAL MORTALITY. It is a singular fact that, with the exception of the third quarter, the death.rates in the first, second, and fourth quarters of the year were the lowest ever registered in each of them. In the first quarter the deaths numbered 1,387, or 218 less than the corrected average of the preceding 10 years, and represented an annual death. rate of 15.89 per 1,000, as compared with a mean decennial rate of 18.39. It was the lowest rate with one exception ever recorded in the Borough at any similar period of the year. In 1905 the death.rate was 15.35. In the second quarter 1,010 deaths were registered, a number which is 251 below the corrected average of the second quarter 1898.1907, and were equal to an annual death.rate of 11.57 per 1,000, as against a decennial rate of 14.45 per 1,000. This death.rate has the distinction of being the lowest ever recorded in Islington during the second quarter of the year. 29 [1908 The third quarter was also particularly healthy, as with one exception the death.rate (11.27 per 1,000) was below any that had been previously known in the Borough, as contrasted with a mean decennial rate of 14.23 per 1,000. The deaths numbered 984, or 258 below the decennial average. The fourth quarter was also very healthy, the deaths numbering 1,298, or 129 less than the corrected average of the preceding 10 years, while the death.rate reached only 13.81 per 1,000 inhabitants, as compared with a mean decennial rate of 16.35. The death.rate was the lowest rate that had hitherto been recorded in Islington during the fourth quarter. Full particulars as to the causes of death have been published in the Medical Officer of Health's reports for these several periods of the year, so that there is no occasion to further dwell on them. Table XIII. Showing the Estimated Populations, together with the Deaths† and Death rates from All Causes, at Nine Age.periods of life among Males, Females, and Persons. Males. Females. Persons. Ages. Population. Deaths. Death. Rates. Population. Deaths. DeathRates. Population. Deaths. DeathRates. 0—5 19,351 750 38. 75 18,912 570 30.14 38,263 1,320 34. 50 5—15 32,810 71 2.16 32,916 90 2.73 65,726 161 2. 45 15—25 33,393 76 2. 27 37,417 94 2.51 70,810 170 2.40 25—35 30,590 140 4.58 34,210 117 3.42 64,800 257 3 .96 35—45 22,040 231 10.48 24,301 177 7.28 46,341 408 8. 80 45—55 15,417 264 17. 12 17,663 207 11.72 33,080 471 14. 23 55—65 9,680 307 31. 72 11,785 290 24.60 21,465 597 27.81 65-75 4,391 283 64 .45 6,513 354 54. 36 10,904 637 58. 42 75 and upwards 1,490 226 151.68 2,924 432 147.74 4,414 658 149. 07 All ages 169,162 2,348 13. 88 186,641 2,331 12.48 355,803 4,679 13. 15 * This population is estimated for the registration year of 53 weeks. The deaths of 568 persons who had come from other districts of London for treatment in the Public Institutions of Islington are excluded from these returns, while the deaths of 717 residents who had died outside the district are included. 1908] 80 Table XIV. Showing the Deaths and Death Rates from All Causes in the several Sub-Registration Districts. SUB-DISTRICTS. Males. Females. Totals. Death Rates. Tufnell 188 237 425 11.96 Upper Holloway 241 244 485 12.91 Tollington 199 197 396 10.56 Lower Holloway 318 253 571 13.40 Highbury 389 427 816 II.72 Barnsbury 460 425 885 16.14 South-East Islington 553 548 I,IOI 14.08 The Borough 2,348 2,331 4.679 13.15 Previous year 1907 2,554 2,525 5,079 14.63 [1908 81 Table XV. Showing the Deaths and Death-rates from All Causes in the Wards during the Four Quarters of 1908. Wards. First Quartet. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 128 14.68 99 11.35 100 11.47 98 10.44 425 11.96 Upper Holloway 142 15.41 119 12.91 98 10.63 126 12.70 485 12.91 Tollington 114 12.40 86 9.35 82 8.91 114 11.51 396 10.56 Lower Holloway 171 16.36 115 11.00 114 10.90 171 15.19 571 13.40 Highbury 142 16.13 100 11.36 I02 II.59 113 11.92 457 12.73 Mildmay 93 14.75 63 9.99 58 9.20 63 9.28 277 10.78 Thornhill 153 18.25 91 10.85 III 13.24 190 21.05 545 15.95 Barnsbury 87 17.16 74 14.60 65 12.82 114 20.88 340 I6.45 St. Mary's 90 20.53 47 10.72 50 11.40 60 12.71 247 13.82 Canonbury 138 16.25 110 12.95 85 10.01 124 13.56 457 13.20 St. Peter's 129 15.60 106 12.82 119 14.39 125 14.04 479 14.21 The Borough 1,387 15.89 1,010 II.57 984 11.27 1,298 13.81 4,679 I3.15 N.B.—The heavy figures show the healthiest Ward in the several periods to which they refer. 1908] 32 TABLE XVI. Mortality in the Sub-Districts in each of the Seven Years, 1902-8. DEATHS. DEATH-RATES. 1902. 1903. 1904. 1905. 1906. 1907. 1908 Totals. 1902-8. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Mean Rate. 1902-8. Tufnell 491 440 571 483 432 482 425 3-324 I4.84 13.40 17.18 14.36 12.70 13.99 11.96 I4.11 Upper Holloway 605 535 523 550 542 559 485 3,799 17.23 I5.36 I4.85 15.44 1505 15.34 12.91 15.23 Tollington 527 437 475 428 425 480 396 3,168 15.03 I2.57 13.51 12.04 11.82 13.20 10.56 12.72 Lower Holloway 714 618 693 644 721 644 571 4,605 16.88 14.87 16.66 15.46 17.30 15.42 13.40 15.79 Highbury 945 796 775 837 779 816 816 5,764 14.37 12.22 11.79 I2.6I 11.63 12.07 11.72 12.40 Barnshury 1,040 899 963 897 967 949 885 6,600 18.77 16.56 17.77 16.58 17.90 17.60 16.14 17.43 Islington, S. East I,3I3 1,114 1,236 I,Il6 1,184 1,149 1,101 8,213 17.03 14.70 16.27 14.65 15.51 15.01 14.08 15.40 The Borough ... 5,635 4,839 5,236 4,955 5,050 5,079 4,679 35,473 16.39 14.26 15.35 14.44 14.64 14.63 13.15 14.77 33 [1908 Table XVII. Showmg the Deaths and Death-Rates of Islington in 1908, and in the four quarters of the year, of London and the Great Towns during the same period ; also the mean Borough Death-Rates for the years 1898-07. Quarter. Males Females. Total. Dbath Rates. Islington, 1908. Islington, 1898-07. London, 1908. 76 Great Towns, 1908. First 679 708 1,387 15. 89 18. 39 17 .0 17.9 Second 515 495 1,010 11. 57 14.45 12. 7 13. 7 Third 504 480 984 11. 27 14.23 11.9 13. 3 Fourth 650 648 1,298 13. 81 16. 35 13.7 14.8 The Year 1908 2,348 2,331 4,679 13.15 15.86 13. 8 14. 9 1907 2,554 2,525 5,079 14. 63 13.15 14. 6 15. 4 Increase or decrease —206 -194 -400 -1.48 -2. 71 -0.8 -0. 5 34 1908] Table XVIII. Showing the Ages at Death during the Years 1898—1907 and in 1908. Years. AGES. Totals. 0—1 1—5 All under 5 yrs. 5—15 15—25 25—35 35—45 45—55 55—65 65—75 75—85 85 upwards All above 5 yrs. 1898 1,504 924 2,428 161 196 292 435 497 560 585 444 107 3,277 5,705 1899 1,548 767 2,315 212 248 349 486 610 700 712 54° 121 3,978 6,293 1900 1,344 612 1,956 183 233 339 480 605 664 678 469 114 3,765 5,721 1901 1,290 638 1,928 176 210 315 444 511 631 592 451 103 3,433 5,361 1902 1,219 687 1,906 198 222 339 470 571 664 656 468 141 3,729 5,635 I903 1,136 538 1,674 139 201 299 39o 491 533 577 423 112 3,165 4,839 1904 1,140 603 1,743 165 197 295 439 521 603 666 496 111 3,493 5,236 1905 1,074 565 1,639 116 188 318 380 527 590 648 396 153 3.316 4,955 1906 1,083 589 1,672 141 167 273 377 528 611 654 490 137 3,378 5,050 1907 996 545 1,541 162 167 310 398 492 659 73o 463 157 3,538 5,079 Mean. 1,233 647 1,880 165 203 313 430 535 621 650 464 126 3,507 5,387 1908 894 426 1,320 161 170 257 408 471 597 637 510 148 3,359 4,679 Increase or Decrease -339 — 221 -560 -4 -33 -56 — 22 —64 -24 —13 +46 + 22 — 148 — 708 85 [1908 Table XIX. Showing the Deaths and Death-rates from All Causes in the Four Quarters and in the Sub-districts, together with the Death-rates of the Borough during the same periods. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-east Islington. The Borough. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. First Quarter 128 14.68 142 15.41 114 12. 40 171 16. 36 251 14.88 240 17. 84 338 17.62 1,387 15.89 Second Quarter 99 11.35 119 12. 91 86 9.35 115 11.00 187 10.95 165 12.26 239 12. 46 1,010 11 .57 Third Quarter 100 11.47 98 10.63 82 8. 91 114 10. 90 173 10.13 176 13.08 241 12.56 984 11.27 Fourth Quarter 98 10.44 126 12. 70 114 11.51 171 15.19 202 10. 99 304 20.99 283 13. 70 1,298 13. 81 The Year 425 11.96 485 12. 91 396 10.56 571 13. 40 816 11.72 885 16. 14 1,101 14.08 4,679 13.15 N.B.—The heavy figures show which was the healthiest sub-district in the quarters to which they refer. 1908] 36 Table XX. Showing the Deaths and Death-Rates from All Causes for each Quarter since 1888. (The Lowest Death Rates are printed in heavy type.) QUARTERS. Years. First. Second. Third. Fourth. Year. Deaths Death Rates Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Kates. 1888 1.629 21.01 1,163 15 .05 1,072 13. 88 1,333 17. 25 5,197 16. 82 1889 1,440 18.42 1,186 15.17 1,101 14. 07 1,308 16. 73 5,035 16. 10 1890 1,789 22.60 1,359 17.16 1,282 16. 20 1,722 20. 20 6,152 19. 43 1891 1,698 21. 22 1,725 21. 56 1,299 16.23 1,604 20.05 6,326 19. 77 1892 2,193 27. 13 1,260 15. 57 1,231 15. 22 1,391 17. 20 6,075 18.78 1893 1,597 19. 53 1,485 18. 16 1,558 19.06 1,751 21. 41 6,391 19. 55 1894 1,613 19.52 1,284 15. 54 1,131 13.68 1,235 14. 94 5,263 15. 92 1895 1,936 23. 18 1,210 14.48 1,292 15. 47 1,322 15.83 5,760 17.24 1896 1,664 19. 71 1,382 16. 37 1,336 15.82 1,502 17.79 5,884 17.42 1897 1,421 16.85 1,081 12. 82 1,335 15. 83 1,558 18.48 5,395 16. 00 1898 1,744 20. 71 1,246 14. 80 1,439 17 .09 1,276 15.15 5,705 16.94 1899 1,681 19 .,99 1,281 15.23 1,572 18.70 1,759 20.92 6,293 18.71 1900 1,819 21. 66 1,390 16. 55 1.221 14.54 1,291 15. 37 5,721 17. 03 1901 1,411 16. 83 1,253 14. 94 1,216 14.50 1,481 17. 66 5,361 15. 98 1902 1,796 21. 30 1,220 14. 47 1,149 13. 62 1,470 16.19 5,635 16. 39 1903 1,393 16. 31 1,226 14.46 1,031 12.16 1,199 14.14 4,839 14.27 1904 1,436 16. 84 1,106 12.97 1,284 15. 06 1,410 16.53 5,236 15. 35 1905 1,316 15. 35 1,178 13. 73 1,076 12.55 1,385 16.15 4,955 14.44 1906 1,391 16 .12 1,151 13.34 1,163 13. 48 1,345 15 .59 5,050 14. 64 1907 1,640 18. 90 1,224 14. 11 939 10. 82 1,276 14. 70 5,079 14 .63 Corrected Mean 20 years 1,712 19. 62 1,334 15 .29 1,300 14. 88 1,503 17. 22 5,849 16.75 1908 1,387 15. 89 1,010 11. 57 984 11. 27 1,298 13.81 4,679 13. 15 Increase or Decrease -325 -3 73 -324 -3. 72 -3.16 -3.61 -205 -3 .41 -1170 —3. 60 87 [1908 Table XXI. Showing the Deaths and Death-rates from eleven Classified Diseases in the Sub-Districts and in the Borough. Classified Diseases. Tufnell Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. The Borough. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Kates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Miasmatic 23 0.65 32 0.85 25 0.66 47 1.10 46 0.66 79 1 .44 74 0.94 326 0.91 Diarrhoeal 7 019 9 0.24 7 0 .18 23 0.54 17 0.24 29 0.53 25 0. 32 117 0. 33 Constitutional 95 2. 67 111 2.95 85 2.27 137 3.21 193 2.77 171 3. 12 256 3. 27 1,048 2.94 Developmental 40 1. 12 33 0. 88 31 0.32 56 1.31 63 0 .90 77 1. 40 98 1.25 398 1. 12 Nervous 28 0.79 23 0.61 22 0. 58 27 0.63 58 0. 83 52 0.95 60 0.76 270 0.76 Circulation 55 1.55 77 2.05 50 1 .33 62 1.45 125 1.80 118 2.15 132 1.69 619 1.74 Respiration 87 2. 45 96 256 82 2. 19 103 2.42 156 2.24 176 3. 21 227 2 .90 927 2. 60 Digestive Organs 26 0. 73 37 0 .98 27 0.72 37 0. 87 53 0. 76 61 1.11 70 0.89 311 0. 87 Urinary System 17 0.48 20 0.03 18 0.48 24 0.56 32 0 .46 29 0.53 40 0.51 180 0. 50 Violence 9 0.25 19 0. 50 14 0.37 20 0. 47 26 0. 37 35 0. 64 46 0. 59 169 0.47 Ill.defined 17 0. 48 20 0.53 15 0 .40 17 0. 39 22 0. 31 27 0.49 29 0.37 147 0.41 The heavy figures denote that these death.rates were the highest experienced in the several districts during the year from the diseases mentioned. 1908] 38 Table XXII. Showing the Deaths (arranged in Classes) from All Causes, in the Four Quarters. Classified Causes of Death. Quarters. Year. 1st. 2nd. 3rd. 4th. I. Specific or Febrile Causes 143 87 129 149 508 1. Miasmatic Diseases 114 68 48 96 326 2. Diarrhæal ,, 12 3 72 30 117 3. Malarial ,, . . . . . . . . . . 4. Zoogenous ,, 1 . . . . . . 1 5. Venereal ,, 7 4 2 7 20 6. Septic ,, 9 12 7 16 44 II. Parasitic Diseases . . 1 1 2 4 III. Dietic 5 10 7 4 26 IV. Constitutional Diseases 258 250 248 292 1,048 V. Developmental 115 85 71 127 398 VI. Local 777 510 453 639 2,379 1. Diseases of Nervous System 81 70 61 58 270 2. ,, Organs of Special Sense 4 4 1 2 11 3. ,, Circulatory System 163 129 148 179 619 4. „ Respiratory „ 396 191 90 250 927 5. ,, Digestive „ 66 70 86 89 311 6. ,, Lymphatic „ 3 3 1 4 11 7. ,, Urinary ,, 48 31 51 50 180 8. ,, Reproductive ,, 7 7 13 3 30 9.,, Bones and Joints ,, 7 3 . . 2 12 10. ,, Integumentary System .. 2 2 2 2 8 VII. Violence 49 39 40 41 169 1. Accident or Negligence 42 23 29 30 124 2. Homicide 2 1 4 . . 7 3. Suicide 5 15 7 11 38 4. Execution . . . . •• . . . . VIII. Ill-defined Causes 40 28 35 44 147 All Causes 1,387 1,010 984 1,298 4,679 Note—The heavy figures denote that the diseases to which they are applied were most fatal in the Quarter to which they refer. 89 [1908 Table XXIII. Showing the Recorded and Corrected Death Rates per 1,000 persons living in the County of London and in the Metropolitan Boroughs, arranged in their order of Corrected Death-Rates. Borough. Standard Death Rate. * Factor for Correction for Sex and Age Distribution. † Crude or Recorded Death Rate 1908. Corrected Death Rate, 1908. Comparative Mortality Figure,| 1908. England and Wales 18.194 1.0000 14.69 14.69 1,000 London 17.31 1.0511 13.82 14.53 989 Hampstead 16.13 1.1280 8.48 9.57 651 Lewisham 17.46 1.0420 10.98 11.44 779 Woolwich 17.02 1.0690 11.36 12.14 826 Wandsworth 17.25 1.0547 11.56 12.19 830 Greenwich 17.82 1.0210 12.59 12.85 875 Stoke Newington 17.43 1.0438 12.33 12.87 876 Fulham 17.39 1.0462 12.36 12.93 880 Battersea 16.96 1.728 12.19 13.08 890 Camberwell 17.54 1.373 12.66 13.13 894 Paddington 17.04 1.677 12.37 13.21 899 Islington 17.51 1.391 13.15 13.66 930 Hackney 17.46 1.420 13.15 13.70 933 r.ambeth 17.63 1.320 13.28 13.70 933 Kensington 16.88 1.778 12.87 13.87 944 City of Westminster 16.22 1.217 12.64 14.18 965 Heptford 17.31 1.511 13.75 14.45 984 Hammersmith 17.47 1.414 13.95 14.53 989 Chelsea 17.56 1.361 14.50 15.02 1,022 St Marylebone 17.08 1.652 14.20 15.13 1,030 St Pancras 17.40 1.456 14.72 15.39 1,048 Poplar 17.64 1.314 15.85 16.35 1,113 Southwark 17.41 1.450 16.31 17.04 1,160 Stepney 17.41 1.450 16.39 17.13 1,166 Bethnal Green 18.01 1.102 17.08 17.25 1,174 Holborn 16.90 1.766 16.37 17.62 1,199 Shoreditch 17.34 1.493 17.43 18.29 1,245 Bermondsey 17.76 1.244 18.75 19.21 1,308 Finsbury 17.57 1.355 18.61 19.27 1,312 City of London 16.55 1.0993 17.68 19.44 1,323 * The Standard Death Rate signifies the death rate at all ages calculated on the hypothesis that the rates at each of the twelve-age periods in each town were the same as in England and Wales during the ten years 1891-1901; the death rate at all ages in England and Wales during that period having been 18.19 per 1,000. † The Factor for Correction is the figure by which the Crude or Recorded Death Rate should be multiplied in order to correct for variations of sex and age distribution. ‡ The Corrected Death Rate is the Crude or Recorded Death Rate after correction has been made for variations of age and sex distribution, and may be obtained by multiplying the latter by the Factor for Correction. §The Comparative Mortality Figure represents the Corrected Death Rate in each Borough compared with the Recorded Death Rate at all ages in England and Wales in 1908 taken as 1,000, 40 1908] Table XXIV. Showing the Death-rates from All Causes in the several under-mentioned places during the Four Quarters and during the Year. Places. First Quarter. Second Quarte Third Quarter. Fourth Quarter. The Year 1908. England and Wales 17.7 13.8 12.8 14.5 14.7 76 Great Towns 17.9 13.7 13.3 14.8 14.9 142 Smaller Towns 17.1 12.9 12.1 14.0 14.0 England and Wales less) the 218 Towns 17.8 14.1 12.4 14.3 14.7 County of London 17.0 12.7 11.9 13.7 13.8 Bristol 17.8 12.5 11.3 12.6 13.6 Birmingham 19.8 14.8 14.5 14.6 15.9 Liverpool 24.2 17.3 17.2 18.1 19.2 Manchester 21.1 16.5 17.3 18.0 18.2 Leeds 17.5 14.0 14.6 15.1 15.3 Sheffield 19.0 14.0 13.7 16.6 15.8 The Encircling Boroughs 17.6 12.9 12.0 14.8 14.4 St. Pancras 19.0 14.0 11.5 14.4 14.7 Stoke Newington 17.4 10.8 8.8 12.3 12.3 Hackney 16.7 11.7 11.3 12.9 13.2 Hornsey 9.8 9.1 6.7 7.6 8.3 Finsbury 22.0 15.7 17.6 19.1 18.6 Shoreditch 20.7 15.6 16.3 17.1 17.4 Islington 15.89 11.57 11.27 13.81 13.15 41 [1908 INFANTILE MORTALITY. The infantile mortality, that is the proportion of deaths of children under one year old to the number of births registered, during the year was the most favourable recorded in Islington since the date of civil registration, for it is found that the total number of these deaths was 894 among 8,665 births, representing an annual mortality of 103 per 1,000 of those births. The nearest approach to this rate was in 1907, when 966 deaths occurred, representing an infantile mortality rate of 117 per 1,000 births. Thus the last two years have been fortunate in showing the lowest mortality among infants which the Borough has hitherto experienced. The infant mortality was fairly low in each quarter; thus in the first quarter there were 247 deaths and the rate was equal to 111 per 1,000 births; in the second quarter the return was still more favourable, for the deaths numbered only 171 and the rate was as low as 80 per 1,000 births, which is the lowest rate hitherto recorded at this period of the year. There have been, however, comparatively low death-rates, for that of 1889 was only 94, of 1897, 90, of 1904, 94, and of 1906, 90. As a rule, this period of the year is the most favourable to infant life, because there are no extremes of heat or cold, nor are there wide differences between the day and the night temperatures. In the third quarter 204 deaths were registered, which represent a rate of 95 per 1,000 births, which, although not a record for this time of the year, yet it was only less favourable than that experienced in 1907, when there were 166 deaths, which gave a proportion of 79 per 1,000 births. Nothing approaching these figures has hitherto been attained. The fourth quarter also exhibited a low mortality, for the 272 deaths registered represent a mortality of 124 per 1,000 births. This rate has only been lower twice, viz., in 1894 and in 1885, when it was 123. Thus it is seen that whether the figures for the year are examined for each quarter or for the year they are good. It need hardly be said that these low rates which Islington enjoyed were as a rule equally enjoyed by other places, for it appears from the Registrar General's returns that the mortality among infants was also very low in England and Wales, being in the proportion of 121 deaths to every 1,000 births, a rate which was the lowest on record with the exception of that of 1907, when it amounted to 118. The large towns also enjoyed a low infantile mortality, the rate being 124, as compared with 127 per 1,000 in 1907 and a mean proportion in the preceding ten years of 147. D 42 1908] The 142 smaller towns also were fortunate in their infant mortality, for in them it was as low as 110 per 1,000 births, as compared with 122, 154, 132 and 138 in the preceding four years. In the Rural Districts, too, as one might expect, the mortality was also small, the deaths being at the rate of 110 per 1,000 births. From these figures it is clear that the Islington mortality was due to no special effort in the Borough itself, but rather to conditions which prevailed almost universally throughout the country. Consequently we have to look to the meteorology of the year to find the real cause of fhe low mortality. That there is a very close relationship between the two is acknowledged by every inquirer into the causes of deaths among children in the early weeks or months of their lives, and this was shown very conclusively by the Registrar-General in the comments he made in his annual summary for 1907 on the infantile mortality of London. The fact is that the low death rates among infants have been due to meteorological and telluric conditions, and not to anything that has been done in Islington for the prevention of infantile mortality. Islington, like other places, has shared the benefits which the climatic conditions have afforded. The Registrar-General discusses this matter as follows:— "Between the periods 1841-50 and 1891-1900 the crude death-rate "at all ages had fallen in London by over 20 per cent., but no such "corresponding reduction could be recorded in the proportion of deaths "of children under one year of age, the ratio to total births having been "fairly constant in each decennium. It will be seen, however, that since "the beginning of this century the rate of infantile* mortality has, with "fluctuations, shown an appreciable decline. In the year 1907 the deaths "of infants under one year of age belonging to London were in the pro"portion of 116 per 1,000 births, as compared with 131 in the year "immediately preceding, and with 147 the average proportion in the ten "years 1897-1906. The rate in 1907 was lower than that in any other "year on record; this was mainly due to the showery and exceedingly "cool summer experienced in that year. If the proportions in the several "quarters are compared with the respective decennial averages it will * In discussing the same subject with respect to England and Wales the Registrar General writes in his Annual Report for 1907, p. xxxviii:— "It will be seen, however, that since the beginning of this century the rate of infantile "mortality has, with fluctuations, shown an appreciable decline. It is a fair assumption that "this may, in part, be due to the increasing attention the subject of the waste of infant life has "received from all classes of the community ; but at the same time it should be pointed out "that the country has recently experienced a series of seasons favourable to infant life; for "example, the showery and exceedingly cool summer in the year under review checked the rise "in the mortality from diarrhœal diseases that usually occurs in the third quarter of the year in "a remarkable manner," 48 [1908 "at once be apparent how very largely the saving of infant life was due "to the reduced mortality experienced in the third quarter of the year; "for while the mortality in the first quarter was 4 per 1,000 above the "average, and only 10 and 12 per 1,000 below the average in the second "and fourth quarters, it was no less than 107 per 1,000 below the average "in the third quarter." d 2 Year. Deaths of children under 1 year to 1,000 births. Meteorology at Greenwich. Third quarter of each year. Complete Year. ist Quarter 2nd Quarter. 3rd Quarter 4th Quarter. Mean Temperature of earth at depth of 3 ft. 2 ins. Amount of Rainfall. Degrees. Inches. 1897 158 127 111 242 151 62.2 6.3 1898 166 140 126 259 137 62.0 2.5 1899 166 129 113 277 150 64.0 4.3 1900 158 138 124 219 154 61.3 4.6 1901 148 126 112 203 152 62.0 5.1 1902 140 132 119 149 155 59.6 5.7 1903 130 127 102 139 152 60.2 12.3 1904 145 133 107 208 128 61.4 4.8 1905 130 114 103 171 130 61.6 5.8 1906 131 115 97 187 122 62.0 3.8 Average in 10 years, 1897-1906. 147 128 111 205 143 61.6 5.5 1907 116 132 101 98 131 59.2 3.5 "From the foregoing statement it will be observed that the greatest "variations in the rates of infantile mortality occur in the third quarter "of the year, and that these wide fluctuations are coincident with changes "in the summer temperature and rainfall. In order to further exem"plify the effect of climatic conditions on infant life the tabular state"ment below has been prepared showing for the past 38 years the rates "in the third or summer quarter of each year, together with the mean 44 1908] "temperature and the amount of rainfall in that quarter. By grouping "the highest and lowest rates, their relation to climatic conditions is "clearly shown; the former correspond to years in which the summers "were comparatively hot and dry, and the latter to years in which the "earth temperature was low and rainfall excessive." London : Infantile Mortality, Temperature, and Rainfall in the Third Quarter of the Years 1870-1907. Year. Deaths of Infants under one year to 1,000 Births in the third Quarter. Obervations at Greenwich. Year. Deaths of Infants under one year to 1,000 Births in the third Quarter. Observations at Greenwich. Mean Temperature of earth at depth of 3 ft. 2 ins. Amount of Rainfall. Mean Temperature of earth at depth of 3 ft. 2 ins. Amount of Rainfall. 1870 223 Degrees. 61.5 Inches. 57 1889 183 Degrees. 61*9 Inches. 5-6 1871 237 62.8 812 1890 195 6O-4 7.7 1872 223 63.0 6.5 1891 183 60*2 7'9 1873 225 62.4 7.6 1892 170 6o*6 6*6 1874 192 62.2 6.2 1893 207 631 5*9 1875 194 61.7 10.3 1894 163 607 7*5 1876 212 62.6 5.3 1895 220 623 6'5 1877 169 61.6 6.4 1896 228 62*2 87 1878 214 63.1 6.5 1897 242 62*2 6'3 1879 139 59.4 11.7 1898 259 62*0 2'5 1880 212 62.0 8.8 1899 277 64*0 4*3 l88l 191 61.3 8.2 1900 219 61-3 4*6 1882 165 60.3 6.0 19OI 203 62'0 5*1 1883 177 61.0 6.5 1902 149 59"6 57 1884 223 63.1 4.5 1903 139 6o'2 12-3 1885 187 61.5 5.6 1904 208 614 4*8 1886 220 62.3 4.9 1905 171 616 5-8 1887 230 63.0 5.9 1906 187 62*0 3-8 1888 169 59.3 11.2 I9°7 98 59"2 3'5 45 ri908 SUMMARY. Deaths of children under one year to 1,000 Births in the Third Quarter of the year. Observations at Greenwich. Mean Temperature of earth at depth of 3 ft. 2 ins. Mean Rainfall. Proportions ranging from 98 to 165 (6 years) Average in 6 years 142 Degrees. 599 Inches. 7.8 ” ” 169 to 219 (20 years) Average in 20 years 192 61.5 6.6 ” ” 220 to 277 (12 years) Average in 12 years 234 62.6 6.0 "The foregoing figures indicate that in six of the 38 years under "review, the meteorological conditions in the third quarter of the year, "viz., low temperature and high rainfall were conducive to comparatively "low rates of infantile mortality, while the high temperature and low "rainfall that prevailed in the third quarter of 12 of the years was the "main cause of the greatly increased loss of infant life." The infantile mortality rate in Islington during the last six decennial periods has varied very little. Thus from 1846 to 1855 it was 147; from 1856 to 1865, 144; from 1866 to 1875, 153; from 1876 to 1885, 144; from 1886 to 1895, 146; and from 1896 to 1905, 140. It is quite true that for the last three or four years there has been a remarkable decline in that mortality, but this was equally the case throughout the kingdom, and there is no reason whatsoever to suppose, as some people who do not approve of health visitors would fain have us think, that it will be permanent, or has been due to the good sanitary conditions existing in the Borough. It, therefore, behoves us not to be lulled into any false security by delusive mortality rates. A table has been prepared which shows the diseases from which children under 12 months old have died during the last 11 years, and here we find that such diseases as diarrhoea, tuberculous peritonitis or tabes mesenterica, accidents or negligence, measles, whooping cough, rickets, and some minor ailments caused a very considerable proportion of the mortality, and yet all of these are preventable deaths. Then there are also deaths due to partly 46 19081 preventable diseases such as atrophy, marasmus and wasting debility, bronchitis and pneumonia; while finally there is that class of diseases which are grouped as non-preventable, such as premature births and congenital defects, although they too in a very large measure can be prevented by the proper instruction of the mothers before the births of their offspring. It is not proposed to discuss these matters now, for this has already been very fully done in the Medical Officer of Health's report on the " Prevention of Infantile Mortality," which was presented to, and considered by, the Council in the early part of 1908. Favourable though the meteorological conditions of the year were, it is unsatisfactory to find that 21.46 infants out of every thousand born in the year died before they were a week old, a rate which, notwithstanding all the favourable conditions, was slightly above the mean rate of the preceding three years, when it was 21.35. If infants had continued to die in this proportion, none would have been living at the end of 327 days At the end of the first month of life, it is found that out of every 1,000 infants born 35.77 had died, and at the end of three months 56'55 ; or in other words considerably more than one half of the infantile mortality took place in the first three months of life, a state of affairs which to a very large measure is due to causes which might be prevented if the mothers were properly instructed. It is no use blinking the fact, for everyone who has the least knowledge of the subject says so, that the instruction of mothers is an absolute necessity if anything is to be done to reduce this terrible mortality, and all the vapourings of irresponsible persons cannot alter it. The question of proper and suitable health visitors is one that cannot be for ever burked, and although the Medical Officer of Health may not deem it his duty to endeavour to force his advice on the Council yet he feels assured that the Council of themselves will at no distant date see how absolutely necessary it is to appoint them. INFANTILE MORTALITY IN THE SUB-DISTRICTS. One need only study the infantile mortality in the sub-districts to quickly arrive at the conclusion that want of knowledge and social conditions are a very important factor in the causation of the deaths of infants. In the figures given below this is very apparent, for there it is noticeable that in those districts where the people are well-to-do and prosperous, and, therefore, presumably educated, the mortality is lowest, while in the low class districts, where also presumably the people are badly educated and more or less ignorant, the mortality is highest. Thus it is found that in Upper Holloway during the last seven years the infantile mortality rate has been only 98 per thousand, whereas in Lower Holloway, which includes that district 47 [1908 situate between York and Caledonian Roads, the rate has been 148 per thousand births, and so it is found also that the mortality in the other districts has been affected according to the social standing of the residents. These facts alone support the argument that if the Council would save infant lives they must do so by appointing persons to instruct the ignorant as to the rearing of children. The following table shows the deaths and infantile mortality rates in each district during 1908:— Sub-Districts. Deaths. Deaths per 1,000 Births. 1908. 1907. Tufnell 66 81 127 Upper Holloway 76 74 88 Tollington 85 117 132 Lower Holloway 134 125 148 Highbury 143 101 107 Barnsbury 193 119 123 South-East Islington 197 99 104 The Borough 894 103 117 TABLE XXV. Showing the Deaths amongst Infants per 1,000 Births during the years 1902-1908 and also the mean mortality rates for the same period. Sub-Districts. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Mean 1902 8. Tufnell 123 112 141 127 122 127 81 119 Upper Holloway 103 138 92 101 105 88 74 98 Tollington 144 105 128 117 127 132 117 127 Lower Holloway 156 159 161 151 155 148 125 148 Highbury 114 178 98 117 95 107 101 108 Barnsbury 151 210 142 124 138 123 119 132 South East Islington 130 263 134 121 129 104 99 121 132 126 128 123 125 117 103 122 TABLE XXVI. Showing the Ages at Death of Children under one year of age and the Deaths at the several periods per 1,000 Births during years 1905-1908. Ages at Death. Deaths. Deaths per 1,000 Births. 1905. 1906. 1907. 1908. Total 4 years 1905. 1906. 1907. 1908. Total 4 years. Under 1 week 185 182 187 186 740 21.13 21.01 21.91 21.46 21.38 1—2 weeks 61 42 58 52 213 6.96 4.85 6.80 6.00 6.15 2—3 ,, 54 49 51 33 187 6.17 5.66 5.98 3.81 5.40 3—4 ,, 36 * 35 34 39 144 4 .11 4.04 3.98 4.50 4.16 Total under a month 336 308 330 310 1,284 38.37 35.56 38.67 35.77 37.09 1—2 months 124 120 105 97 446 14.16 13.85 12.30 11.20 12.88 2—3 „ 91 108 84 83 366 10.39 12.17 9.84 9.58 10.58 Total 1—3 months 215 228 189 180 812 24.55 26.32 22.14 20.78 23.46 Total under 3 months 551 536 519 490 2,096 62.92 61.88 60.81 56.55 60.55 3-4 months 88 96 63 48 295 10.05 11.08 7.38 5.54 8.52 4—5 ,, 65 67 58 55 245 7.42 7.74 6.80 6.35 7.08 5—6 ,, 43 67 48 48 206 4.91 7.74 5.63 5.54 5.95 Total 3—6 months 196 230 169 151 746 22.38 26.56 19.81 17.43 21.55 6—7 months 62 56 55 37 210 7.08 6.47 6.44 4.27 6.06 7—8 „ 48 55 44 43 190 5.48 6.35 5.16 4.96 5.49 8-9 „ 54 51 68 46 219 6.17 5.89 7.97 5.31 6.33 Total 6—9 months 164 162 167 126 619 18.73 18.71 19.57 14.54 17.88 9—10 months 55 51 45 39 190 6.28 5.89 5.27 4.50 5.49 10—11 ,, 52 54 51 39 196 5.94 6.24 5.98 4.50 5.66 11—12 „ 56 50 45 49 200 6.39 5.77 5.27 5.66 5.78 Total 9—12 months 163 155 141 127 586 18.61 17.90 16.52 14.76 16.93 Total under 1 year 1,074 1,083 996 894 4,047 122..64 125.05 116. 71 103.28 116.91 49 [1908 Table XXVII. Showing the Deaths of Infants under a year old, the Infantile Mortality Rate in each Quarter and in each Year, since 1885. Years. QUARTERS. ANNUAL Deaths & Mortality. First. Second. Third. Fourth. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1 000 Births. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births. Deaths under 1 year. Deaths per 1,000 Births. 1885 322 121 299 128 460 195 306 123 1 387 144 1886 370 144 268 111 577 237 302 126 1,517 154 1887 288 117 323 132 580 239 366 153 1.557 160 1888 326 132 270 115 359 152 316 132 1,271 133 1889 421 164 162 94 376 164 302 130 1,261 132 1890 356 144 326 142 422 177 384 170 1,488 158 1886-90 1,761 141 1,349 113 2,314 195 1,670 142 7,094 147 1891 338 129 349 144 397 165 397 169 1,481 151 1892 425 171 295 122 384 164 313 136 1.417 148 1893 403 161 393 156 508 212 391 166 1,595 163 1894 313 125 267 113 363 154 286 123 1,229 129 1895 353 134 315 128 427 172 321 138 1,416 143 1891.95 1,832 144 1,619 133 2,079 173 1,708 139 7,138 145 1896 373 151 318 130 449 196 350 128 1,490 150 1897 296 115 216 90 446 183 380 156 1 338 136 1898 362 151 282 122 561 227 299 132 1,504 159 1899 308 123 256 105 622 256 362 157 1,548 160 1900 326 132 291 127 419 175 308 147 1,344 145 1896-00 1,665 134 1,363 115 2,497 208 1,699 143 7,224 150 1901 304 124 255 113 397 172 334 147 1,290 139 1902 311 131 236 109 316 136 356 150 1,219 132 1903 329 145 243 107 262 118 302 136 1,136 126 1904 238 104 215 94 424 192 263 124 1,140 128 1905 226 101 250 109 318 152 280 131 1,074 123 1901-05 1,408 121 1,199 107 1,717 154 1,535 138 5,859 130 1906 271 120 203 90 344 164 265 129 1,083 125 1907 319 145 221 102 166 79 290 140 996 117 1908 247 111 171 80 204 95 272 124 894 103 Vote. The lowest infantile mortality rates in the periods of the year to which they refer are printed in heavy type. 50 1908] In England and Wales, in the seven greatest towns, and in the boroughs surrounding Islington, the infantile mortality rates were as follows:— England and Wales 121 per 1,000 births Rural Districts 110 „ 76 Great Towns 128 „ 142 Smaller Towns 124 „ London 113 „ Birmingham 144 „ Liverpool 141 „ Manchester 151 „ Leeds 137 „ Bristol 126 „ Sheffield 140 „ The Encircling Boroughs. Hornsey 62 „ Stoke Newington 92 „ Hackney 115 „ Shoreditch 139 „ Finsbury 133 „ St. Pancras 107 „ The Encircling Boroughs 115 „ Islington 103 51 [1908 Table XXVIII. Showing the Chief Causes of Infantile Mortality in the twelve years, 1896-1907, and in 190S. Cause of Death. Years. VIean 12 years. 1908 D fference. 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 i. Common Infections Diseases. Small-pox .. 1 .. .. .. 1 4 .. .. .. .. .. 1 .. - 1 Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 67 12 65 27 42 37 24 29 51 27 36 27 37 24 - 13 Scarlet Fever 2 1 2 .. 2 2 1 1 1 .. 1 .. 1 3 + 2 Diphtheria (including Membranous Croup 10 6 6 3 5 7 1 4 2 2 3 1 4 4 .. Whooping Cough 103 58 67 66 68 38 76 63 30 51 30 53 59 29 - 30 ii Diarrhœal Diseases. Diarrhoea, all forms 125 138 220 208 148 143 72 83 200 149 171 73 144 80 - 64 Enteritis, Muco-enteritis, Gastro-enteritis 62 65 105 159 67 70 43 46 20 53 92 49 69 52 - 17 Gastritis, intestinal Catarrah 10 8 9 13 21 21 23 22 18 15 14 9 15 7 - 8 iii. Wasting Diseases. Premature Birth 169 174 191 187 176 169 194 174 178 163 144 164 173 167 - 6 Congenital Defects 40 39 30 21 36 48 33 47 43 48 59 47 41 51 + 10 Injury at Birth .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. Want of Breast-milk, Starvation 7 3 2 2 1 5 2 7 6 4 5 8 4 4 .. Atrophy, Debility, Marasmus 242 256 244 285 221 188 192 183 177 138 134 137 200 138 - 62 iv. Tuberculous Diseases. Tuberculous Meningitis 28 23 29 30 25 24 20 20 10 19 20 17 22 13 - 9 Tuberculous Peritonitis Tabes Mesenterica 64 55 48 30 25 26 25 20 20 24 17 17 31 14 - 17 Other Tuberculous Diseases 22 20 20 27 28 19 23 30 16 12 12 23 21 13 - 8 Erysipelas 5 2 .. 6 3 2 3 4 3 1 3 3 3 4 + 1 v. Other Causes. Syphilis 6 17 12 7 17 10 11 10 11 13 9 5 11 13 + 2 Rickets 5 6 4 8 2 5 3 1 4 3 5 .. 4 2 - 2 Meningitis (not Tuberculous) 21 27 25 62 19 23 16 18 10 19 18 10 18 13 - 5 Convulsions 74 60 46 62 57 68 69 47 47 38 24 16 51 15 - 36 Bronchitis 141 129 129 124 119 104 116 90 78 77 82 83 106 39 - 67 Laryngitis 5 4 5 2 4 5 2 4 1 3 .. 1 3 .. - 3 Pneumonia 129 86 87 112 118 123 134 109 101 107 108 153 113 106 - 7 Suffocation, overlying 51 39 48 45 43 39 46 15 25 14 22 23 34 23 - 11 Other Causes 102 109 110 108 97 113 86 108 88 94 79 77 98 80 - 18 1,490 1,338 1,504 1,548 1,344 1,290 1,219 1,136 1,140 1,074 1,083 996 1,263 894 - 369 52 1908] MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES. Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fevers (that is to say Typhus, Enteric and Continued) and Diarrhceal Diseases. Deaths.—The Medical Officer of Health in 1906 was able to congratulate the Council on the low mortality from these diseases. Again in 1907 it was his privilege to report to them that the return was the lowest since 1885, and he is now more than pleased to be able to state that the present record is, so far as he can ascertain, the lowest which has hitherto obtained in Islington. The total number of deaths was only 358, or 433 below the average for the 23 years 1885-1907 after correction for increase of the population. Death-rate.—The 358 deaths represent the low rate of 101 per 1,000 inhabitants, which is below the death-rate of England and Wales (1.29), the 76 Great Towns (1.59), the 142 Smaller Towns (T28). It is, however, slightly above (0 03) that of the Rural Districts (0'99). The record is all the more gratifying as it shows a distinct reduction in the deaths from each of the several diseases. 53 [1908 Table XXIX. Showing the Deaths from the principal Epidemic Diseases for the Twenty-three years 1885-1907 and in 1908. Years. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and Undefined Fevers. Diarrhœal Diseases. Totals. Death-Rate. 1885 129 294 36 167 210 3 63 — 197 1099 3.69 1886 3 63 26 72 214 2 60 — 320 760 2.52 1887 — 335 59 46 240 2 45 — 309 1036 3.39 1888 — 147 64 50 231 1 59 — 162 714 2.31 1889 — 177 40 62 86 — 61 — 178 604 2.01 1890 — 202 65 81 204 — 39 — 180 771 2.44 1891 — 224 50 *178 255 1 32 — 159 899 2.81 1892 3 179 53 170 161 — 41 1 189 797 2.47 1893 2 119 94 200 181 1 48 2 237 884 2.70 1894 3 199 69 218 188 — 36 — 95 808 2.44 1895 1 135 66 144 81 1 30 3 189 650 1.94 1896 1 288 57 257 234 — 46 2 153 1038 3.07 1897 1 97 61 131 130 — 44 — 174 638 1.89 1898 — 325 26 93 168 1 36 1 233 933 2.77 1899 — 155 33 128 160 — 47 — 258 781 2.32 1900 1 159 24 106 142 — 46 2 180 660 1.96 1901 8 151 30 134 85 — 47 1 172 628 1.87 1902 53 114 40 104 152 — 45 1 99 608 1.80 1903 — 120 24 43 152 — 22 1 109 471 1.39 1904 1 181 35 28 83 — 18 — 260 606 1.78 1905 1 123 37 34 111 — 17 — 206 529 1.54 1906 — 187 37 32 74 — 19 — 213 562 1.63 1907 — 130 24 42 120 — 13 — 103 432 1.24 1908 — 78 30 60 55 — 18 — 117 358 1.01 54 190 Table XXX. Showing the Corrected Mean Number of Deaths from the principal Epidemic Diseases, 1885-1907, and in 1908. Diseases. Corrected Average Number of Deaths 1885-1907. 1908. Decrease. Small Pox 9 .. - 9 Measles 189 78 - 121 Scarlet Fever 49 30 - 19 Diphtheria 116 60 - 56 Whooping Cough 169 55 - 114 Typhus Fever 1 .. - 1 Enteric Fever 42 18 - 24 Continued & 1ll-defined Fevers 1 .. - 1 Diarrhoea 205 117 - 88 The above Diseases 781 358 - 433 The following statement shows the relative position occupied by Islington with respect to the Epidemic Diseases in the country and in the neighbouring metropolitan boroughs:— Epidemic death-rates. 1.29 per 1,000 inhabitants. 1.59 ,, ,, 1.28 ,, ,, 0.98 ,, ,, 1.06 ,, ,, 0-82 ,, ,, 1.52 ,, ,, 0.57 ,, ,, 2.09 ,, ,, 209 „ „ 1.40 ,, ,, 1.04 ,, ,, 1.07 ,, ,, 1.60 ,, ,, 2.43 ,, ,, 1.29 ,, ,, 1.35 ,, ,, 1.01 England and Wales 76 Great Towns 142 Smaller Towns Rural Districts The Encircling Boroughs St. Pancras Stoke Newington Hackney Hornsey Finsbury .Shoreditch The Encircling Boroughs County of London West London District North „ ,, Central „ „ East „ „ South „ ,, County of London Islington 55 [1908 Epidemic death-rates. West Ham 2.39 per 1,000 inhabitants. Bristol 1.16 ,, ,, Birmingham 1.86 ,, ,, Nottingham 1.25 ,, ,, Liverpool 2.19 ,, ,, Manchester 2.25 ,, ,, Salford 3.04 ,, ,, Bradford 1.36 ,, ,, Leeds 1.49 ,, ,, Sheffield 1.85 ,, ,, Hull 2.19 Edinburgh 106 ,, ,, Glasgow 2.74 Dublin 1.68 Islington 101 ,, ,, The number of the deaths in, and the epidemic death-rate of, each subregistration district were as follows:— Deaths. Epidemic Death-rates. Tufnell 19 0.53 Upper Holloway 25 0.67 Tollington 25 0.66 Lower Holloway 01 1.43 Highbury 47 0.67 Barnsbury 97 1.76 Islington, South-East 84 1.07 358 1.01 Table XXXI. Deaths from each of the principal Epidemic Diseases during the year 1908, inclusive of the Deaths of Borough Patients in Hospitals outside the Borough. SUBREGISTRATION DISTRICTS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhœa. TOTALS. Tufnell ... 4 4 2 2 ... ... 7 19 Upper Holloway ... ... 1 9 6 ... ... 9 25 Tollington ... 4 2 2 9 ... 1 7 25 Lower Holloway ... 14 3 10 5 ... 6 23 61 Highbury ... 7 4 7 9 ... 3 17 47 Barnsbury ... 36 9 11 9 ... 3 29 97 S. East Islington ... 1 7 19 15 ... 5 25 84 The Borough ... 78 30 60 55 18 117 358 Preceding year, 1907 ... 130 24 42 120 ... 13 103 432 57 [1908 Table XXXII. Death-rates from each of the principal Epidemic Diseases during the Year 1908, inclusive of the Deaths of Borough Patients in Hospitals outside the Borough. REGISTRATION DISTRICTS. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhoea. Total Death-Rates. Tufnell ... O.11 0.11 0.06 0.06 ... ... 019 0.53 Upper Holloway ... ... 0.03 0.24 0.16 ... ... 0.24 0.67 Tollington ... 0.11 0.05 0.05 0.24 ... 0.03 0.18 0.66 Lower Holloway ... 0.33 0.07 0.23 0.12 ... 0.14 0.54 1.43 Highbury ... O.lO 0.06 0.10 0.13 ... 0.04 0.24 0.67 Barnsbury ... 0.66 0.16 0.20 0.16 ... 0.05 0.53 1.76 S. East Islington ... 0.17 0.09 0.24 0.19 ... 0.06 0.32 1.07 The Borough ... 0.22 0..8 0.17 0.16 ... 0.05 0.33 1.01 Preceding year, 1907 ... 0.38 0.07 0.12 0.34 ... 0.04 0.29 1.24 58 1908] Table XXXIII. Showing the Deaths and Death-rates from the Principal Epidemic Diseases in the Wards during the Four Quarters of 1908. wards. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates . Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates Deaths. Deathrates. Tufnell 5 0.57 2 0.23 10 1.14 2 0.21 19 0.53 Upper Holloway 5 0.54 4 0.43 9 0.97 7 0.70 25 0.67 Tollington 5 0.54 7 0.76 9 0.97 4 0.40 25 0.66 Lower Holloway 11 1.05 7 0.67 24 2.29 19 1.69 61 1.43 Highbury 10 1.13 1 0.11 10 1.14 6 0.63 27 0.75 Mildmay — — 7 1.11 5 0.79 3 0.44 15 0.58 Thornhill 9 1.07 4 0.47 18 2.15 38 4.21 69 2.02 Barnsbury 3 0.59 3 0.59 8 1.58 14 2.56 28 1.35 St. Mary's 7 1.59 1 0.23 5 1.14 5 1.06 18 1.00 Canonbury 9 1.06 6 070 5 0.58 10 1.09 30 0.86 St. Peter's 9 1.09 8 0.96 14 1.69 10 1.12 41 1.21 Totals 73 0.84 50 0.57 117 1.34 118 1.25 358 1.01 59 [1908 Table XXXIV. Showing the Deaths from each of the Principal Epidemic Diseases in the several Wards during the Year 1908. WARDS. Small Pox. Measles Scarlet Fever. Diphtheria Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhœa. Total Epidemic Deaths. Tufnell ... 4 4 2 2 — — — 7 19 Upper Holloway ... ... 1 9 6 — — — 9 25 Tollington ... 4 2 2 9 — 1 — 7 25 Lower Holloway ... 14 3 10 5 — 6 — 23 6l Highbury ... 2 1 4 4 — 2 — 14 27 Mildmay ... 4 2 2 4 — — — 3 15 Thornhill ... 29 2 8 7 — 3 — 20 69 Barnsbury ... 7 7 3 2 — — — 9 28 St. Mary's ... 4 — 4 — 1 — 5 18 Canonbury ... 4 7 7 5 — 2 — 5 30 St. Peter s ... 6 1 9 7 — 3 — 15 41 Totals ... 78 30 60 55 — 18 — 117 358 60 1908] Table XXXV. Showing the Death-rates of the Wards from, each of the Principal Epidemic Diseases during the Year 1908. [wards. Small Pox. Measles, Scarlet Fever Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Continued and Ill-defined Fever. Diarrhœa. Death-rate from Epidemic Diseases. Tufnell — 0.11 0.1l 0.06 0.06 — — — 0.19 0.53 Upper Holloway — — 0.03 0.24 0.16 — — — 0.24 0.67 Tollington — 0.1l 0.05 0.05 0.24 — 0.03 — 0.l8 0.66 Lower Holloway — 0.33 0.07 0.23 0.12 — 0.14 — 0.54 1.43 Highbury — 0.06 0.03 0.11 0.11 — 0.06 — 0.39 075 Mildmay — 0.15 0.08 0.08 0.15 — — — 0.12 0.58 Thornhill — 0.85 0.06 0.23 0'20 — 0.09 — 0.59 2.02 Barnsbury — 0.34 0.34 0.14 0.10 — — — 0.43 1.35 St. Mary's — 0.22 — 0.22 0.22 — 0.06 — 0.28 1.00 Canonbury — 0.12 020 0.20 0.14 — 0.06 — 0.14 0.86 St. Peter's — 0.18 0.03 0.27 0.21 — 0.09 — 0.44 1.22 Total — 0.22 0.08 0.17 0.16 — 0.05 — 0.33 1.01 61 [1908 SMALL POX. No death from this disease was registered in the Borough. MEASLES. Measles was the registered cause of 78 deaths, as compared with 130 in the preceding year and with 180 on the corrected average for the 20 years 1888-1907. There has thus been a very large decrease in the mortality. The deaths varied very considerably in the different sub-registration districts ; for while there was none registered in Upper Holloway, and only 4 each in Tufnell and Tollington, there were 7 in Highbury, 13 in South-east Islington, 14 in Lower Holloway, and 36 in Barnsbury. In the first quarter 19 deaths were registered, or 35 below the corrected average for 10 years for that period of the year. In the second quarter they fell to 12, or 47 below the corrected average for that quarter, and in the third there was a still further decline to 7 deaths, or 19 below the corrected average. In the fourth quarter, however, the deaths numbered 40, or 10 above the corrected average of the corresponding periods of the previous years. From these statements it is seen that while the disease had gradually declined from the beginning of the year, yet it showed a decided increase towards its close, which increase was maintained during the earlier quarters of the current year (1909). It will be noticed that although there were more deaths among the cases reported in the fourth quarter, yet the known cases in the third quarter exceeded those of the fourth by 11. It may be noted here that there came to the knowledge of the Medical Officer of Health 1,095 cases of measles in the public elementary schools, of which 137 occurred in the first quarter, 253 in the second, 358 in the third, and 347 in the fourth, all of which were made known by the teachers of the schools. 62 1908] In consequence of the presence of measles, class rooms were either closed or the children who had never had measles excluded from them, in the following schools:— 1st Quarter. Arlington Square L.C.C. School. Yerbury Road L.C.C. School. 2nd Quarter. Montem Street L.C.C. School. St. Thomas' School, Everilda Street. Upper Hornsey Road L.C.C. School. Blackstock Road L.C.C. School. St. Jude's School. Ecclesbourne Road L.C.C. School 3rd Quarter. St. Paul's School, Dorset Street. Grafton Road L.C.C. School. Caledonian Road L.C.C. School. 4th Quarter. Montem Street L.C.C. School. Gifford Street L.C.C School. Thornhill Road L.C.C. School. Richard Street L.C.C. School. St. James' L.C.C. School. Age at Death.—Of the 78 deaths from measles 24 had not reached the end of their first year of life, and 50 were between 1 and 5 years old; the remaining 4 were below 15 years of age. Additional particulars, as to the deaths in the sub-districts and in the quarters are given in the following Tables. 63 [1908 Table XXXVI. Showing the Deaths from Measles in the Sub Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2 .. 2 .. 4 Upper Holloway .. .. .. .. .. Tollington 3 1 .. .. 4 Lower Holloway 3 1 2 8 14 Highbury 2 3 2 .. 7 Barnsbury 2 2 .. 32 36 Islington, South East 7 5 1 .. 13 The Borough 19 12 7 40 78 Table XXXVII. Showing the Death-rates from Measles of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4(h Quarter. Whole Year. Tufnell 0.23 .. 0.23 .. 0.11 Upper Holloway .. .. .. .. .. Tollington 0.32 0.11 .. .. 0.11 Lower Holloway 0.29 0.09 0.19 0.71 0.33 Highbury 0.12 0.17 0.12 .. 0.10 Barnsbury 0.15 0.15 .. 2.21 0.66 Islington, South East 0.36 0.26 0.05 .. 0.17 The Borough 0.21 0.14 0.08 0.43 0.22 64 1908 Table XXXVIII. Showing the Death-Rates of the Encircling Boroughs from Measles in the Four Quarters of 1908. Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. St. Pancras 0.42 0.10 0.07 0.17 0.19 Stoke Newington 0.15 0.37 0.22 .. 0.18 Hackney 0.34 0.72 0.03 0.17 0.31 Hornsey 0.35 0.35 .. 0.04 0.15 Finsbury 0.25 0.79 0.21 0.54 0.45 Shoreditch 0.56 0.97 0.14 0.10 0.44 The above Districts 0.37 0.51 0.09 0.19 0.29 Islington 0.21 0.14 0.08 0.43 0.22 Table XXXIX. Showing the Secondary Causes of the Deaths from Measles. Secondary Diseases. Quarters. The Year 1908. 1 2 3 4 Males. Females. Totals. Pneumonia 12 9 2 24 23 24 47 Bronchitis 5 2 2 5 6 8 14 Spinal Disease 1 .. .. .. 1 .. 1 Convulsions .. 1 2 4 4 3 7 Syncope .. .. 1 .. 1 .. 1 Whooping Cough .. .. .. 1 1 .. 1 Meningitis .. .. .. 1 .. 1 1 Laryngitis .. .. .. 1 .. 1 1 Hyper-pyrexia .. .. .. 1 1 .. 1 Stomatitis .. .. .. 1 1 .. 1 Total Secondary Diseases 18 12 7 38 38 37 75 Deaths where no secondary disease was entered 1 .. .. 2 2 1 3 Total Deaths 19 12 7 40 40 38 78 65 1908 Table XL. Showing the Deaths from Measles during each Week of 1908. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Week. Deaths. Week. Deaths. Week Deaths. Week. Deaths. 1 5 14 2 27 .. 40 .. 2 1 15 .. 28 1 41 .. 3 1 16 1 29 .. 42 2 4 .. 17 .. 30 1 43 .. 5 1 18 .. 31 .. 44 1 6 1 19 1 32 2 45 .. 7 1 20 .. 33 .. 46 1 8 1 21 .. 34 1 47 2 9 1 22 .. 35 1 48 4 10 3 23 .. 36 1 49 1 11 .. 24 1 37 .. 50 6 12 2 25 1 38 .. 51 4 13 2 26 1 39 .. 52 9 53 10 13 weeks 19 13 weeks 12 13 weeks 7 14 weeks 40 66 1908 Table XLI. Showing the deaths front Measles in the Quarters, 1898-07 and 1908. Years. 1st Quarter. 2nd Quarter 3rd Quarter 4th Quarter Whole Year. 1898 183 107 23 12 325 1899 45 53 26 31 155 1900 64 75 15 5 159 1901 7 17 27 100 151 1902 53 29 12 20 114 1903 35 64 17 4 120 1904 20 75 56 30 181 1905 26 17 20 60 123 1906 93 75 11 8 187 1907 4 56 44 26 130 Corrected average number of deaths 54 59 26 30 169 1908. 19 12 7 40 78 Increase or Decrease -35 -47 -19 +10 -91 SCARLET FEVER. Although the return from Scarlet Fever is 18 below the corrected annual average for the past '20 years, yet it is not as good as some of the past records, for whereas 30 deaths were registered during 1908, yet in 1886 and in 1898 only 28 deaths occurred, and in 1900, 1903 and 1907 only 24 deaths were recorded. Nevertheless the 30 deaths registered in the past year must be considered a satisfactory return. Of late years there has been a remarkable decrease in the deaths from Scarlet Fever; indeed in former times they were three or four times more numerous than the average of the last few years. Thus from 1851-1860 they averaged 119 per annum; from 1861-1870 227; from 1871-1880 142; from 1881-1890 69; and from 1891-1900 53. It is, therefore, seen that there has been a steady fall in the number of deaths since the decade 1871-1880. Three factors have contributed to this remarkable improvement. First, without doubt, it is due to better sanitation; secondly, to the large number of patients now isolated in hospitals, whereby the disease has been prevented from spreading; and thirdly the disease has assumed a less fatal form than that which characterized it between 1851 and 1870. 67 1908 Other particulars with respect to its seasonal prevalence and to its extent in the sub-registration districts are to be found in Tables XLII. and XLIII. Table XLII. Showing the Deaths from Scarlet Fever in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 2 .. 2 .. 4 Upper Holloway .. .. .. 1 1 Tollington .. 2 .. .. 2 Lower Holloway 1 1 1 .. 3 Highbury 1 1 .. 2 4 Barnsbury 3 1 3 2 9 Islington, South East 4 1 .. 2 7 The Borough 11 6 6 7 30 Table XLIII. Showing the Death-rates from Scarlet Fever of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.23 .. 0.23 .. 0.11 Upper Holloway .. .. .. 0.10 0.03 Tollington .. 0.22 .. .. 0.05 Lower Holloway 0.09 0.09 0.09 .. 0.07 Highbury 0.06 0.06 .. 0.11 0.06 Barnsbury 0.22 0.07 0.22 0.14 0.16 Islington, South East 0.21 0.05 .. 0.10 0.09 The Borough 0.13 0.07 0.07 0.07 0.08 DIPHTHERIA. There were 60 deaths ascribed to this disease as against an annual average of 118 in the preceding 20 years. This is a very considerable decrease. The deaths are, however, 18 above the return of the preceding year, and nearly double the return (32) of 1906, which was preceded in 1905 and 1904 by very low returns, the deaths numbering only 34 and 28 respectively. 68 1908; Although the return is higher than usual, yet when we look to the period 1891-1902 it is seen that it is very low by comparison, for in that time the smallest number of deaths registered was 93, whereas the average number was 155, or 95 above the present return. There can be no doubt that this great decrease in the mortality is chiefly due to the treatment of the disease with anti-toxin serum. Table XLIV. Showing the Deaths from Diphtheria in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 .. 1 .. 2 Upper Holloway 4 2 2 1 9 Tollington .. 1 .. 1 2 Lower Holloway 1 2 3 4 10 Highbury 3 2 1 1 7 Barnsbury 2 2 1 6 11 Islington, South East 5 2 2 10 19 The Borough 16 11 10 23 60 Table XLV. Showing the Death-rates from Diphtheria of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.11 .. 0.11 .. 0.06 Upper Holloway 0.43 0.22 0.22 0.10 0.24 Tollington .. 0.11 .. 0.10 0.05 Lower Holloway 0.09 0.19 0.29 0.36 0.23 Highbury 0.17 0.12 0.06 0.05 0.10 Barnsbury 0.15 0.15 0.07 0.41 0.20 Islington, South East 0.26 0.10 0.10 0.48 0.24 The Borough 0.18 0.13 0.11 0.25 0.17 69 1908 WHOOPING COUGH. Whooping Cough exhibited the lowest return (55 deaths) recorded during the last 20 years. It is 103 below the corrected average, and compares satisfactorily with the average quinquennial periods, which were as follows:— 1886-1890 195 per annum. 1891-1895 173 „ 1896-1900 166 „ 1901-1905 117 ,, Age at Death.— Of the 55 deaths, only 1 of the patients had passed the age of five years, while 29 had not reached the age of 12 months and the remaining 25 had passed their first year, but had not reached their 5th. Table XLVI. Showing the Deaths from Whooping Cough in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell . . 2 .. .. 2 Upper Holloway 1 •• 4 1 6 Tollington •• 3 5 1 9 Lower Holloway 2 2 .. 1 5 Highbury 1 2 4 2 9 Barnsbury 3 1 4 1 9 Islington, South East 4 5 3 3 15 The Borough 11 15 20 9 55 Table XLVII. Showing the Death-rates from Whooping Cough of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. 0.23 . . .. 0.06 Upper Holloway 0.11 •• 0.43 0.10 0.16 Tollington •• 0.32 0.54 0.10 0.24 Lower Holloway 0.19 0.19 .. 0.09 0.12 Highbury 0.06 0.12 0.23 0.11 0.13 Barnsbury 0.22 0.07 0.30 0.07 0.16 Islington, South East 0.21 0.26 0.16 0.14 0.19 The Borough 0.13 0.17 0.23 0.09 0.16 70 1908 ENTERIC FEVER. Eighteen deaths were registered, or 21 less than the corrected average of the preceding 20 years. This disease, like other zymotics, has shown a steady decrease, for during the quinquennium 1886-1890 the deaths averaged 53 per annum ; during the 1891-1895 quinquennium 37 per annum; during the 1896-1900 quinquennium 44 per annum; and during the 1901-1905 quinquennium 30 per annum, and in the last three years 16 per annum. Thus it is seen that there has been a very substantial reduction in the mortality. Table XLVIII Showing the Deaths from Enteric Fever in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. .. .. Upper Holloway .. .. .. .. .. Tollington .. .. .. 1 1 Lower Holloway 2 .. .. 4 6 Highbury 2 1 .. .. 3 Barnsbury .. 1 .. 2 3 Islington, South East .. 1 2 2 5 The Borough 4 3 2 9 18 Table XLIX. Showing the Death-rates from Enteric Fever of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. .. .. Upper Holloway .. .. .. .. .. Tollington .. .. .. 0.10 0.03 Lower Holloway 0.19 .. .. 0.36 0.14 Highbury 0.12 0.06 .. .. 0.04 Barnsbury .. 0.07 .. 0.14 0.05 Islington, South East .. 0.05 0.10 0.10 0.06 The Borough 0.05 0.03 0.02 0.09 0.05 71 1908 TYPHUS FEVER. No death was recorded during the year, which was the tenth in succession in which there has been none. In the last twenty-four years only 12 deaths altogether have been registered, and these were distributed over eight years, thus leaving Islington for sixteen years absolutely free from the disease. Vide Table XXIX for a statement of the mortality since 1885. CONTINUED FEVER. Nil return. DIARRHGEAL DISEASES. The return from Diarrhœa, like the returns from the other epidemic diseases, has been satisfactory, only 117 deaths having been registered during the year, as compared with a corrected annual average for 20 years of 189. They thus showed a decrease of 72 on that period. When the present return is compared with the quinquennial periods, it is more clearly seen how satisfactory it is. Thus in 1886-1890 the deaths averaged 230 per annum ; 1891-1895, 173; 1896-1900, 230; 1901-1905, 169; and in the three years 1906-1908, 177. Although the return is so good, it is not, however, so good as that of 1907. when 103 deaths were registered, or of 1902, when 99 were registered, or of 1894, when there were 95. Nevertheless it was exceedingly good. In the first quarter of the year 12 deaths were registered, or 30 above the average of the preceding 20 years in that period of the year. In the second quarter only 3 deaths were registered, as compared with an average of 15 in the corresponding quarter of the period just mentioned. In the third quarter 72 deaths were known, as compared with an average of 164 in the preceding 20 similar quarters, and in the fourth quarter 30 deaths were registered, as compared with an average of 23. It is interesting to note that of the 117 deaths no less than 80 occurred amongst infants under 12 months old, and of these 19 died before they had reached the end of their third month; 8 died while in their third month; 8 in their fourth month; 8 in their fifth month; 8 in their sixth month; 12 in their seventh month; 3 in their eighth month; 4 in their ninth month; 1 in their tenth month, and 9 in their eleventh month. 72 1908 It may be pointed out that of these 80 deaths 33 occurred in the third quarter, or 41.2 per cent. of the total deaths from diarrhoea in that period. This is of course the period of the year when, owing to certain meteorological and terrestrial conditions, which have often been discussed in these reports, diarrhoea is most prevalent and fatal. Many of the deaths, as the Medical Officer of Health has frequently pointed out, are due to the improper feeding of children, especially infants, who are too often given foods which they are absolutely unable to digest, and which consequently cause disturbances of the bowels, that on too many occasions ends in fatal diarrhoea. In order to prevent infants being fed with unsuitable food, a series of instructions are now issued to the mother of every newly born child, so that she may feed her child in a suitable manner, The following are the instructions referred to:— Directions for the Prevention ot Summer Diarrhoea. 1.—Diarrhœa is generally very prevalent among infants during the summer months, July, August, and September, and very many die from it, in great suffering. 2.—It is usually caused by wrong feeding among bottle fed children. 3.—Breast suckled infants rarely die from it. It is therefore the duty of mothers to suckle their infants, unless they are forbidden by their medical attendant. 4.—If the infant is fed from a bottle, use one without a tube. The boat shaped bottle with a teat is the best. Two of them should be kept for use, so that one can always be clean and ready for use. 5.—Bottles with long tubes are always a great danger to the health of the baby because the tubes can never be effectively cleansed. 6.—An absolutely clean bottle must be used at every feed. Dirty bottles are the cause of much sickness and many deaths. 7.—After each feed thoroughly cleanse the bottle and teat in hot water and soda, and kept it in cold water in a cool place until again required for use. Finally rinse out the bottle and the teat with hot water before again using it. 8.—The cows' milk that is used must be quite fresh. Old milk in hot weather is usually sour milk, and should never be used. It is almost fatal to infants. 73 1908 9.—Milk should always be kept covered, and in a cool place. It should also be protected from flies, which conyey fatal germs as well as dust on their feet. The germs thrive in the milk, increasing rapidly, and when consumed by baby frequently cause fatal diarrhoea. 10.—In preparing the infant's food do not make more than enough for one feed, and if the baby does not use it all, destroy what is left in the bottle. Old feeds should never be used. 11.—Infants should not be allowed to crawl on the floors unless these are scrupulously clean, because they (the infants) may inhale the dust which often contains the germs of disease. Also the bodies and clothing of the infants should be kept perfectly clean. 12.—Rooms and yards must be kept very clean, while animal, vegetable and waste foods should be quickly removed and placed in a covered dust bin. Slops should be emptied down the water closet, which should be well flushed. These precautions are essential to keep away flies, because they breed and feed among refuse. The rooms should be well ventilated by open windows and doors. 13.—When infants are attacked with summer diarrhcea medical advice should be obtained immediately, because the disease is rapidly fatal to them. While waiting for the Doctor give warm water that has been freshly boiled and sweetened with sugar, and cease to give the baby milk. 14.—Summer diarrhcea is infectious, and the infection is contained in the discharges from the bowels. It is necessary, therefore, to disinfect all the baby's soiled clothing by boiling; and also to wash the hands after changing the baby. Soiled napkins should not be left lying about, especially where flies can gain access to them, for these pests soon find them out, feed on them, and then fly away conveying the disease to the milk which may be consumed by other infants. Note.—Where this disease occurs disinfectants will be supplied to adults free of charge upon application being made to the Public Health Department. A. E. HARRIS, Medical Officer of Health. Town Hall, Islington, N. F 74 1908 Table L. Showing the Deaths from Diarrhoea in the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter 2nd Quarter 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. 5 2 7 Upper Holloway .. 2 3 4 9 Tollington 2 .. 4 1 7 Lower Holloway 2 1 18 2 23 Highbury 2 .. 9 6 17 Barnsbury 2 .. 18 9 29 Islington, South East 4 .. 15 6 25 The Borough 12 3 72 30 117 Table LI. Showing the Death-rates from Diarrhoea of the Sub-Districts for each Quarter. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. 0.57 0.21 0.19 Upper Holloway .. 0.22 0.32 0.40 0.24 Tollington 0.22 .. 0.43 0.10 0.18 Lower Holloway 0.19 0.09 1.73 1.17 0.54 Highbury 0.12 .. 0.52 0.32 0.24 Barnsbury 0.15 .. 1.34 0.62 0.53 Islington, South East 0.21 .. 0.78 0.29 0.32 The Borough 0.14 0.03 0.83 0.32 0.33 75 1908 Table LII. Showing the Deaths from Diarrhceal Diseases together with those classed under Enteritis and its sub-headings, arranged in quarterly periods, and at three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals Diarrhoea Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Under 1 year 10 10 20 2 9 11 53 19 72 15 20 35 80 58 138 1 to 5 years 1 4 5 ... 6 6 12 10 22 10 5 15 23 25 48 Over 5 years 1 4 5 1 5 6 7 4 11 5 5 10 14 18 32 Totals 12 18 30 3 20 23 72 33 105 30 30 60 117 101 218 Note.—In this Table the deaths under Enteritis include only those which are not epidemic or zymotic. F 2 76 1908 TABLE LIII. Showing the Diarrhoeal Deaths including Epidemic Enteritis in the Third Quarter, 1908. 908 Deaths. Death-Rate. Meteorology. Temperature of | the air. Temp. of the earth. Rainfall. Week Ending. Tuf. U.H. Toll. L.H. H. B. S.E. Total. Tuf. U.H. Toll. L.H. H. B. S.E. Total. Mean temperature of air in degrees. Departure from mean temperature of 50 years Temperature of the earth 3 feet below surface. Rainfall in inches. No. of days on which rain fell. July 4th .. .. 1 1 .. .. 2 4 .. .. 1.41 1.24 .. .. 1.36 059 o 63.5 o + 19 o 60.24 0.54 1 „ 11th 1 .. .. .. 1 .. .. 2 1.49 .. .. .. 0.76 .. .. 0.29 61.5 -0.9 61.34 0.35 4 ,, 18th .. .. 1 .. .. .. .. 1 .. .. 1.41 .. .. .. .. 0.14 58.9 - 4.4 60.97 2.76 7 ,, 25th .. .. 1 1 .. 2 .. .. 1.41 .. .. 0.96 .. 0.29 62.4 -0.6 60.47 0 01 1 1 .. 3 1 1 1 2 9 0.37 .. 1.06 0.31 0.19 0.24 0.34 0 33 61.6 -1.0 60.75 3.66 13 August 1st .. .. .. .. 1 .. 1 .. .. .. .. .. 0.96 .. 0.14 64.3 + 2.0 62.15 0.00 .. ,, 8th .. .. .. 2 .. 1 .. 3 .. .. .. 2.49 .. 0.96 .. 0.44 62.1 -0.0 62.65 0.07 2 „ 15th 1 .. .. 1 1 2 1 6 1.49 .. .. 1.24 0.76 1.93 0.68 0.89 58 8 -3.6 62.18 0 22 2 „ 22nd .. .. .. 4 1 1 3 9 .. .. .. 4.99 0.76 0.96 2.04 1.34 59.2 - 2.5 61.26 0.61 3 1 .. .. 7 2 5 4 19 0.37 .. .. 2.18 0.38 1.20 0.68 0.71 61.1 -1.0 62.06 0.90 7 Aug. 29th .. .. .. 1 1 2 3 7 .. .. .. 1.24 0.76 1.93 2.04 1.04 58.9 -1.8 60.88 1.99 7 Sept. 5th 1 1 .. 1 1 5 3 12 1.49 1.41 .. 1.24 0.76 4.84 2.04 1.79 53.2 -6.6 59.51 1.35 6 ,, 12th l 1 1 5 2 2 1 12 1.49 1.41 1.41 4.99 1.52 1.93 0.68 1.79 54.5 -4.1 58.02 0.03 3 ,, 19th .. 1 .. 3 2 1 2 9 .. 1.41 .. 3.74 1.52 0.96 1.36 1.34 56.5 -0.8 57.11 0.11 3 „ 26th l .. .. 1 .. .. 2 4 1.49 .. .. 1.24 .. .. 1.36 0.59 57.3 + 1.8 57.86 0.11 4 3 3 1 10 6 10 11 44 0.89 0.84 0.28 2.49 0.91 1.93 1.49 1.31 56.1 -2.3 58.68 3.59 23 3rd Quarter 5 3 4 18 9 16 17 72 0.57 0.33 0.43 1.72 0.53 1.19 0.88 0.82 59.6 -1.4 60.49 8.15 43 77 1908 Table LIV. Showing the Mean Temperature of the Air and the Earth, and the Rainfall, for each week of the Third Quarter, 1908, together with those of the corresponding periods in 1907. and also the Deaths from Diarrhoea in the same periods. Weeks of Quarter. Mean Air Temperature. Earth Temperature at 3 feet. Rainfall in inches. Diarrhœal Deaths. 1907. 1908. Difference between 1907 and 1908. 1907. 1908. Difference between 1907 and 1908. 1907. 1908. 1907. 1908 Difference. 0 0 0 0 0 0 July 4 53.7 63.5 + 8.8 56.7 60.2 + 3.5 0.16 0.54 .. 4 + 4 ,, 11 56.3 61.5 + 5.2 57.0 61.3 + 4.3 0.22 0.35 .. 2 + 2 „ 18 62.7 58.9 - 3.8 58.5 60.9 + 2.4 0.00 2.76 3 I -2 25 59.5 62.4 + 2.9 59.6 60.5 + 0.9 0.51 0.01 1 2 + 1 July 58.3 61.6 + 3.3 57.9 60.7 + 2.8 0.89 3.66 4 9 + 5 Aug. 1 59.7 64.3 + 4.6 60.1 62.1 + 2.0 0.40 0.00 3 1 - 2 ,, 8 62.3 62.1 - 0.2 60.3 62.6 + 2.3 0.18 0.07 1 3 + 2 ,, 15 61.5 58.8 - 2.7 60.8 62.2 + 1.4 0.71 0.22 3 6 + 3 ,, 22 57.0 59.2 + 2.2 60.2 61.2 + 1.0 0.96 0.61 1 9 + 8 Aug. 60.1 61.1 + 1.0 60.3 62.0 + 1.7 2.25 0.90 8 19 + 11 Aug. 29 61.1 58.9 - 2.2 59.6 60.9 + 1.3 0.16 1.99 .. 7 + 7 Sept. 5 56.8 53.2 - 3.6 59.4 59.5 + 0.1 0 .44 1.35 7 12 + 5 .. 12 58.6 54.5 - 4.1 59.4 58.0 - 1.4 0.00 0.03 3 12 + 9 „ 19 56.8 56.5 - 0.3 58.7 57.1 - 1.6 0.00 0.11 4 9 + 5 „ 26 58.4 57.3 - 1.1 58.1 57.8 - 0.3 0.03 0.11 4 4 — Sept. 58.3 56.1 - 2.2 59.1 58.7 -0.4 0.63 3.59 18 44 + 26 3rd Qr. 58.9 59.6 + 0.7 59.1 60.5 + 1.4 3.77 8.15 30 72 + 42 In this table the heavy figures denote that the temperatures, rainfall or deaths, were higher in the year to which they refer than in that with which they are contrasted. They are printed in this manner in order that comparison may be more readily made. 78 1908 TABLE LV. Shewing the Deaths occurring in Islington and in the several Encircling Boroughs from All Causes, from the principal Epidemic Diseases, and from Phthisis in the year 1908. THE ENCIRCLING BOROUGHS. Estimated Populations, 1908. Total Deaths from all Causes. Total Epidemic Deaths. Deaths from principal Epidemic Diseases. Deaths from Phthisis. Deaths of infants under 1 year of age. Deaths under 1 year to 1,000 Births. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fevers. Diarrhoea. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 St. Pancras 237,075 3,547 255 — 46 20 22 69 — 10 88 363 635 107 Stoke Newington 54,015 677 45 — 10 5 1 6 — 4 — 19 59 100 92 Hackney 235,253 3,145 365 — 75 31 45 44 — 7 — 163 292 64I 115 Hornsey 92,713 783 54 — 14 3 7 12 — 2 — 16 50 94 62 Finsbury 96,007 1,816 205 — 44 13 16 25 — 12 — 95 210 405 133 Shoreditch 115,227 2,042 245 — 51 29 13 24 — 11 — 117 234 521 139 The above Boroughs. 830,290 12,010 1,169 — 240 101 104 180 — 46 — 498 1,208 2,396 115 Islington 349,091 4,679 358 — 78 30 60 55 — 18 — 117 432 894 103 79 1908 Table LVI. Showing the Death Rates of Islington and of the several Encircling Boroughs from All Causes, from the principal Epidemic Diseases, and from Phthisis in the year 1908. THE ENCIRCLING BOROUGHS. Estimated Populations, 1908. Total Deathrates from All Causes. Total Epidemic Death-rates. Death-rate from principal Epidemic Diseases. Death-rates from Phthisis. Deaths under 1 year to 1,000 Births. Small Pox Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Undefined Fevers Diarrhoea. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 St. Pancras 237,075 14.7 1.06 • • • 0.19 o.o8 0.09 0.29 • • • 0.04 • • • 0.37 1.15 107 Stoke Newington 54,0155 12.3 0.82 • • • 0.18 0.09 0.02 0.11 • • • 0.07 • • • 0'35 1.07 92 Hackney 235,253 13.2 1.52 • • • 0.31 0.13 0.19 0.18 • • • 0.03 • • • 0.68 1.22 115 Hornsey 92,713 8.3 0.57 • • • 0.15 0.03 0.07 0.13 • • • 0.02 • • • 0.17 0.54 62 Finsbury 96,007 18.6 2.09 • • • 0.45 0.13 0.16 0.26 • • • 0.12 • • • 0.97 2.15 133 Shoreditch 115,227 17.4 2.09 • • • 0.44 0.25 0.11 0.20 • • • 0.09 • • • 1.00 2.00 139 The above Boroughs 830,290 14.4 1.40 • • •... 0.29 0.I2 0.12 0.22 •• •• 0.05 • • • 0.60 1.45 115 Islington 349,091 13.15 1.01 • • • 0.22 0.08 0.17 0.16 ... 0.05 • • • 033 1-21 103 80 1908 Table LVII. Showing the Death-rates from All Causes, from the principal Epidemic Diseases, together with the Infantile Mortality, in the Country, in the Populous Towns, in Towns whose Populations exceed 300,000 inhabitants, in the Encircling Boroughs, and in Islington. All Causes. Principal Epidemic Diseases (Cols. 3-9). Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhœa. Deaths under 1 Year to 1,000 Births. Cols. 1. 2. 3. 4. 5. 6. 7. 8 9. 10. England and Wales 14.7 1.29 0.00 0.22 0.08 0.15 0.27 0.07 0.50 121 76 Great Towns 14.9 1.59 0.00 0.31 0.10 0.16 0.29 0.08 0.65 128 142 Smaller Towns 14.0 1.26 .. 0.20 0.06 0.15 0.25 0.08 0.52 124 England and Wales less the 218 Towns . 14.7 0.99 0.00 0.13 0.06 0.15 0.25 0.07 0.33 110 London 13.8 1.35 .. 0.31 0.11 0.15 0.20 0.05 0.53 113 Bristol 13.6 1.16 .. 0.26 0.03 0.17 0.34 0.02 0.34 126 Birmingham 15.9 1.86 .. 0.11 0.13 0.19 0.54 0.09 0.80 144 Liverpool 19.2 2.19 .. 0.34 0.28 0.17 0.45 0.11 0.84 141 Manchester 18.2 2.25 .. 0.56 0.15 0.18 0.33 0.11 0.92 151 Leeds 15.3 1.49 0.37 0.03 0.09 0.28 0.05 0.67 137 Sheffield 15 8 1.85 .. 0.23 0.08 0.08 0.53 0.06 0.87 140 St. Pancras 14.7 1.06 .. 0,19 0,08 0,09 0,29 0,04 0.37 107 Stoke Newington 12.3 0.82 .. 0.18 0.09 0.02 0.11 0.07 0.35 92 Hackney 13.2 1.52 .. 0.31 0.13 0.19 0.18 0.03 0.68 115 Hornsey 8.3 0.57 .. 0.15 0.03 0.07 0.13 0.02 0.17 62 Finsbury 18.6 2.09 .. 0.45 0.13 0.16 0.26 0.12 0.97 133 Shoreditch 17.4 2.09 .. 0.44 0.25 0.11 0.20 0.09 1.00 139 Encircling Boroughs 14.4 1.40 .. 0.29 0.12 0.12 0.22 0.05 0.60 115 Islington 13.1 1.01 .. 0.22 0.08 0.17 0.16 0.05 0.33 103 81 1908 INFLUENZA. Since 1890 influenza has been more or less present every year in this country, and in Islington there has been a similar experience. In going back to the records of the Borough, it is found that in the several quinquennial periods since 1855 the deaths were respectively 18, 12, 10, 2, 2, 2, 40, 718, 42 and 271. Thus we see that in earlier years the disease was very little known, and indeed, to find a time when it was a scourge in England we must go back to 1728 and 1803, during which periods it was severely epidemic. Influenza has been defined as a specific fever, epidemic and often pandemic, of sudden onset and short duration, attended with loss of appetite and very great prostration, associated often with more or less severe catarrh, neuralgic pains, or gastro-intestinal disturbance, and especially liable to be complicated by severe respiratory affections to which the mortality of the disease is chiefly due. A short history of the disease has been given in a previous report and, therefore, it is not necessary now to say anything further about it. In Islington since 1898 there have been on an average 75 deaths per annum, the maximum number being registered in 1900, when 149 deaths occurred, while in the preceding year they numbered 126. In the past year there were 81 deaths. The disease is most fatal to elderly persons, especially those who are 45 and upwards. This is well seen in the following statement, which shows the mortality at the several periods of life during the ten years preceding 1908 and also in that year. Ages. 1898. 1899. 1900. 1901. I902. 1903. 1904. 1905. 1906. 1907. Average. 1898-1907. 1908. 0-5 8 6 3 4 4 3 4 4 4 5 4 3 5-10 2 2 3 1 — 1 — 1 1 1 1 — 10-15 — — — — — 1 — — 15-25 4 4 9 — 3 2 3 — 4 3 3 5 25-35 4 12 7 2 7 3 2 3 5 10 5 3 35-45 5 17 16 5 13 5 7, 5 4 19 10 8 45-55 9 15 18 5 14 9 7 7 10 5 10 14 55-65 15 28 28 12 6 8 6 9 13 6 13 16 65-75 11 24 36 12 17 6 11 12 16 12 16 14 75-85 6 14 25 5 15 3 7 12 8 12 11 14 85 and upwards 1 4 4 — 4 — 1 1 2 1 2 4 65 126 149 46 83 40 48 54 67 75 75 81 82 1908 It has usually been most fatal in the first and fourth quarters of the year, in other words, in the periods of low temperatures Thus it is found that on an average there have been 42 deaths during the years 1898-1907 in the first quarters, 14 in the second, 4 in the third and 17 in the fourth. Last year, however, the greatest number of deaths occurred in the first quarter, viz., 52, while in the fourth quarter they numbered only 6 as against 20 in the second quarter. From the figures given in the table which immediately follows, it is seen that whereas the deaths in the first quarter were 10 above the average, those in the fourth quarter were 11 below it. It is interesting to note that the chief complication of influenza noticed during the year was pneumonia, which was registered as a secondary cause in 35, or 44 per cent, of the cases, while bronchitis was the secondary factor in 19, or 24 per cent. Heart disease was a secondary cause in 11, or 14 per cent, of the deaths. Table LVIII. Showing the Deaths from Influenza in the Quarters of the Year 1908, together with those of the corresponding periods 1898-07. Years. Quarters. Totals. First. Second. Third. Fourth. 1898 41 13 4 7 65 1899 52 25 4 45 126 1900 122 17 3 7 149 1901 18 13 4 11 46 1902 45 15 5 18 83 1903 30 3 1 6 40 1904 12 5 2 29 48 1905 26 16 3 9 54 1906 13 21 7 26 67 1897 48 12 4 11 75 Corrected Averages 42 14 4 17 77 1908 52 20 3 6 81 Increase or Decrease +10 + 6 -1 -11 +4 83 [1908 Table LIX. Showing the Secondary Causes of Death from Influenza in the Four Quarters of the Year 1908. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. Totals for Year. Quarters. Quarters. Quarters. Quarters. Quarters Quarters. Quarters. 1st. '2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th 1st 2nd. 3rd ' 4th i 1st. 2nd 3rd 4th. 1st. 2nd. 3rd. 4th 1st. 2nd. 3rd. 4th Pneumonia 3 2 .. .. 4 3 .. .. 1 .. .. .. 2 .. .. 1 7 1 .. 1 2 1 1 .. 3 2 .. 1 35 Bronchitis .. 1 .. .. 4 .. .. .. 1 1 .. .. 2 .. .. .. 3 .. .. .. 2 1 .. 1 1 2 .. .. 19 Hyperpyrexia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 Tuberculosis .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 2 Heart Disease, etc. 2 .. .. .. 1 1 .. .. 1 1 .. .. .. 1 1 .. .. .. .. .. .. .. .. .. 3 .. .. .. 11 Cerebral Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Meningitis .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diarrhcea .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Tabes Dorsalis .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Apoplexy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Senile Decay 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 3 Lumbago 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Jaundice .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 All Secondary Causes 7 3 .. .. 11 4 •• 1 4 3 .. .. 5 1 1 1 12 2 .. 1 4 3 1 2 7 4 1 1 79 No Secondary Causes 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 2 Totals 8 3 .. •• 11 4 •• 1 4 3 .. .. 5 1 1 1 12 2 .. 1 4 3 1 2 8 4 1 1 81 84 1908 APPENDICITIS. Appendicitis was the cause of 25 deaths during the year, of which 14 were males, and 11 were females, as compared with an average of 25 in the preceding 6 years. Since 1902 the deaths have been as follows:— Deaths. s . 1902 20 1906 20 1903 32 1907 19 1904 27 1908 25 1905 29 so that altogether 172 deaths have occurred in 7 years. The ages at death are given in the following statement:— The subsequent tabular statement has been prepared to show the ages at which people died from the disease. Ages. 1902. 1903. 1904. 1905. 1906. 1907. 1908. Totals. 0-5 — 1 — 1 — 1 2 5 5-10 2 4 2 4 3 — 7 22 10-15 7 3 5 1 2 7 1 26 15-20 1 4 3 6 3 3 3 23 20-25 1 7 2 3 1 2 3 19 25-35 3 5 8 3 2 2 2 25 35-45 2 3 2 4 5 — 4 20 45-55 3 2 1 4 1 1 2 14 55-65 — 1 3 2 2 3 1 12 65-75 1 2 1 1 1 — — 6 75-85 — — — — — — — — 85 and upwards — — — — — — — — 20 32 27 29 20 19 25 172 From this table a few small calculations show that during the last seven years; 3 per cent, of these deaths occurred at the age period 0-5 13 5-10 15 10-15 ' 13 15-20 11 20-25 15 25-35 12 35-45 8 45-55 7 55-65 3 65-75 100 All ages 85 1908 SEPTIC DISEASES. In this class are included Erysipelas, Pyaemia, Septicaemia and so-called Puerperal Fever, which collectively, caused 44 deaths, as contrasted with 52 in the preceding year. Erysipeslas.—Erysipelas was the registered cause of 14 deaths, which was exactly the corrected average of the preceding 10 years. 1897 11 1898 8 1899 16 1900 17 1901 15 1902 13 1903 9 1904 23 1905 12 1906 16 1907 13 1908 14 Of the deaths 4 were under 12 months old, while 10 were over that age. There were 7 deaths in the public institutions. Table LX. Deaths from Erysipelas in the Sub-Districts during the Year 1908. Deaths. Death Rates. Tufnell ... — per 1,000 inhabitants. Upper Holloway ... „ „ Tollington 3 0.08 „ Lower Holloway 2 0.05 „ „ Highbury 3 0.04 „ „ Barnsbury 3 0.05 „ „ Islington, South-East 3 0.04 „ „ The Borough 14 0.04 „ Puerperal Septic Diseases. These diseases of women who have been recently confined include Puerperal Pyaemia, Septicœmia, Septicœmia, Septic Intoxication and the vague disease Puerperal Fever. They caused only 4 deaths, as against a corrected average of 10 in the 10 years 1898-1907, and a 86 1908; death rate of 0.46 per 1000 births, as compared with a decennial rate of 1.07. This is an exceedingly good return, as it shows a decrease of 60 per cent, on the average of the preceding 10 years. The following is a statement of the disease for the last decennial period:— Years Deaths. Deaths per 1,000 births. 1898 7 0.74 1899 14 1.45 1900 6 0.65 1901 15 1.62 1902 12 1.30 I903 9 1.00 1904 14 1.57 1905 6 0.68 1906 11 1.27 I907 8 0-94 Corrected average 10 1.07 1908 4 046 Table LXI. Showing the Deaths from Puerperal Fever in the Sub Districts for each Quarter and the Year 1908. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 .. .. .. 1 Upper Holloway .. •• •• •• •• Tollington .. .. •• 1 1 Lower Holloway .. 1 • • 1 2 Highbury .. •• .. .. .. Barnsbury .. •• •• •• •• Islington, South East •• •• •• The Borough 1 1 •• 2 4 87 1908 TABLE LXII. Showing the Deaths from Puerperal Fever per 1,000 Births in the Sub-Districts for each Quarter and the Year 1908. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 4.50 .. .. .. 1.22 Upper Holloway .. • • •• .. .. Tollington .. .. •• 5.55 1.37 Lower Holloway .. 3.63 .. 3.53 1.87 Highbury. .. .. .. .. .. Barnsbury .. .. .. • • .. Islington, South East .. •• •• •• •• The Borough 0.45 0.47 .. 0.91 0.46 CONSTITUTIONAL DISEASES. In this group Cancer, Tuberculous Diseases, Rheumatic Fever, Rheumatism, Rickets, Diabetes, Gout and a few other diseases, as set out in Table LXIX., are included. Cancer and other Malignant Diseases.—During 1908 367 deaths were registered, as compared with a corrected average of 304 in the 17 years 1891-1907, and they were in the proportion of 10.31 deaths per 10,000 of the population as against 8.7 in the period 1891-1907. There has thus been an increase of 63 in the number of deaths and of 1.61 in the rate. The return is larger than any to be found in the above mentioned years. At the same time it must not be forgotton that there has been an additional week, in which 7 deaths were entered, in the registration year, 1908. Years Deaths Deaths per 10,000 Pop. Years Deaths Deaths per 10,000 Pop. 1891 2l8 6.8 1902 326 9.5 1892 219 6.8 1903 350 10.3 1893 238 7.3 1904- 323 9.5 1894 239 7.2 1905 328 9.5 1895 266- 7.9 1906 363 10.5 1896 29I 8.5 1907 348 10.0 1897 - 304 90 Corrected Average 304 87 1898 283 8.4 1899 - 270 8.0 1900 303 9.0 1908 367 10.31 1901 289 8.6 88 1908 An examination of the register shows that of the 367 deaths, 112 occurred between 55 and 65 years of age, while 93 took place between 65 and 75, and 63 between 45 and 55. It is not until the age of 35 is passed that the deaths begin to occur in any considerable numbers, as the subsequent table shows. The ages at death during the last ten years were as follows:— Ages. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. Average. 1898-1907. 1908. 0. 5 3 — 1 — 3 4 1 2 1 1 2 1 5.15 1 1 2 1 3 3 2 1 3 3 2 2 15-25 4 2 3 2 5 7 5 3 3 3 4 8 25-35 8 8 6 8 8 5 10 11 7 6 8 6 35-45 28 19 32 33 29 43 43 22 35 39 32 41 45-55 67 63 79 63 75 75 61 74 90 64 71 63 55-65 70 85 92 76 103 95 84 95 110 95 90 112 65-75 66 72 58 75 70 83 90 92 74 102 78 93 75-85 32 18 27 27 27 34 22 25 38 27 28 39 85&UP wards 4 2 3 4 3 1 5 3 2 8 3 2 283 270 303 289 326 350 323 328 363 348 318 367 The Medical Officer of Health would direct particular attention to Table LXIV., wherein the death-rates from Cancer at seven age periods are given, as well for males as females. Therein it will be noticed that whereas in the age period 35-45 the deaths among 10,000 males living at that age was 4.99, amongst females they were considerably more than double this rate, being 12.34 per 10,000; between 45 and 55 the rate was 18.81 amongst males, and 19.25 amongst females. The difference in the rate increased very considerably between 55 and 65, when the proportion was 48.55 amongst males, as against 55.15 per 10,000 amongst females. At the next age period, however, the greatest mortality occurred amongst males, viz. 97.94 per 10.000, and 76.77 amongst females. This disproportion is again increased when 75 years of age is reached, when it is seen that, while there have been 127.52 deaths per 10,000 males, there were only 75.25 amongst females. 89 [1908 This disease is one which for many years has attracted very great and serious public attention; and well it might, for of the women living at the age of 35 years 1 out of every 9 dies from it. The general opinion is that cancer is increasing, and consequently its cure and prevention have become matters of the very utmost importance. In writing on this subject recently, Dr. James Ewing, Professor of Pathology in Cornell University Medical College, and President of the American Society for Cancer Research, asks this question: "What is the Medical Profession doing for Cancer?" and then proceeds to answer it in a pamphlet, kindly forwarded to the Medical Officer of Health by the Secretary of the Medical Society of the State of New York. " One of the most complete answers to this question is contained in the elaborate work of Wolf, ' Die Lehre von der Krebskrankheit Wiesbaden,' 1907. In this work the history of cancer research is traced in brief detad from the beginning of legendary medicine down to A.D. 1900. In it one finds that the problem of cancer has occupied continuously a prominent place in the medicine of all civilized countries. In it one finds all possible theories as to the cause and nature of cancer, expressed in terms of contemporaneous science ; and one finds a painfully complete account of the natural history of cancer. In these pages one fact is perhaps most prominent, viz., that many of the greatest minds in medicine have in every age directed their attention to this subject, and that in recent times, since the introduction of the microscope, great progress has been made in the knowledge of the cancer process, through the labours of Virchow, Lebert, Waldeyer, His, Remak, Cohnheim and many others. Another fact stands prominent in this history, that, with the great advances in the knowledge of the cancer process, the power of the physician to control cancer has made practically no essential progress. To-day, as in the Middle Ages, early and complete removal by the knife is the weapon of defence against this disease. "In general, the results of the surgical treatment of cancer have been unsatisfactory. In a few types of the disease very early and wide removal of the tumor may effect a cure, yet only a small percentage of cancers can be thus attacked, and in the great majority of cases either the growth is inoperable when first discovered, or operation is promptly followed by return of the disease. Moreover, the persons who recover after operation are often left physically deformed and usually in mental G 90 1908] terror of the frequent recurrence. As a palliative measure, there is no doubt that surgery has relieved an immense burden of human suffering, that its early employment should be consistently urged, and that its results are among the greatest achievements of practical medicine, but surgery is in no proper sense a cure for cancer. At best it mechanically removes the disease from immediate consideration. Hence the prospect of a rational cure of cancer has always been acknowledged as one of the most hopeless outlooks in medical science. "What is the reason why medical science has always branded this field as barren territory ? It is because the method of study by means of animal experimentation was not thought applicable to the subject of cancer. Diphtheria has been conquered, because we can reproduce the disease in animals, study the process under controllable conditions, and test for its cure the antitoxic agents prepared according to the accepted theories of the laboratory. None of these methods was thought applicable to the study of cancer, because it did not seem to be transferable from man to animal, and the disease had not been produced experimentally. "But a new era has opened in the investigation of cancer, and this time it bears closely upon the rational cure of the disease. At last the experimental method has been made available for this work. It has been found that certain cancers of mice, rats, and dogs, may be transferred to animals of the same species. By Hanau in Germany, Moreau in France, Loeb in America, and Jensen in Denmark, after much difficulty and doubt for the experimenters themselves and from their medical colleagues, it has been fully proven (1901-2) that certain genuine cancers of mice and rats may be leadily transferred from one animal to another and studied under the exact conditions of a laboratory experiment. The significance of these discoveries has been at once appreciated so that in all civilized countries elaborate preparations have been made, under government support, to study cancer chiefly by the experimental method. We are giving full rein 1.0 these cancers in lower animals. The best soil for their propagation, the best conditions and nutriment for their growth, are being carefully searched out and liberally provided. The conditions unfavorable for growth and the action of agents inhibiting their progress are also being determined in minute detail, so that in half a decade a great many new facts about the growth and control of cancer in lower animals have been elicited and an extensive new literature has accumulated. 91 [1908 "But the practical man may ask—what good are all these new facts and all this new literature ? As was recently asked of the director of a cancer laboratory—how many cases of human cancer have you cured ? "It may be suggested that it is rather early to ask this question. Five years is a short period in medical history. It took nearly ten years to perfect the antitoxin treatment of diphtheria, which was a comparatively simple problem. However, attention may be drawn to the following concrete results of the new era of experimental cancer research, with the suggestion that they be compared, from the standpoint of rational therapeutics, with the results of the thousand years immediately preceding. "1. It has been shown that the conditions permitting the growth of cancer cells are adjusted with extreme delicacy, far more so than those controlling the growth of bacteria. Haaland's cancer grew well in Berlin mice, but at first would nardly grow at all in Copenhagen mice uf exactly the same species—tne slight variations in the food rendered the animals immune. It is at once apparent that a very slight variation in the nutrition of the tissues may suffice to limit the growth of human cancers, although previously no one had dared to nope for such a thing. "2. The new facts ascertained about the growth of experimental cancer have rendered it very improbable that the cause of cancer is a readily transmissible parasite. They have thus narrowed immensely the field of research, and largely set at rest the fear that this disease must be treated as an infectious process, or that the cancer patient, like the consumptive, is a menace to his neighbours. "3. Cancer strains passed through animals acquire increased powers of growth. By vaccinating an animal with a slowly growing tumor, vaccination being followed by recovery, it has been possible to render the animal immune to the most malignant forms of cancer. Thus has been laid the basis of a preventative treatment of cancer. "4. It has been found possible to render animals immune to cancer by injection of extracts of many normal organs. This work has opened up a new and hopeful field of search for a cure of established cancer and for the control of recurrences after operation. "5. In dogs malignant tumors in advanced stages have in several consecutive cases been cured by bleeding the animal and transfusing into its veins the blood of dogs previously rendered immune to this tumor. G 2 92 1908] "These are a few of the so-called" practical ' results of the past five years' work with experimental cancers. They are selected under protest as, superficially, the most important, but they are only a few among a large number of new facts, any one of which may at any time prove to be the real clue to the final successful attack on the cure of human cancer. "Even to the layman it must be apparent that these facts were obtainable in no other way than by the experimental method; that they constitute genuine progress into the dark domain of the principles of cancer growth and cancer immunity; and that these principles must be mastered before the cure of cancer in man can be devised or even attempted. How far off the cure of human cancer may be, no one can say, but it is certain that the outlook, from the deep gloom pervading scientific circles in 1900, has, by the introduction of the experimental method, been transformed into a prospsct full of suggestion and hope. According to Ehrlich, the leader in German cancer research, the beginning of the end of the cancer problem is in sight. How long that end may be delayed will depend much on the attitude of the public toward the experimental method in medical and biological research. Since the systematic employment of animal experimentation in cancer research has been endorsed by the leading scientific bodies in every civilized nation, those who are engaged in this work in America look forward with confidence to the hearty and continuous moral support of every intelligent person." Thus we see that there is hope that, before long, there will be found some cure for the most malignant and hopeless disease human beings are subject to. 98 [1908 Table LXIII. Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the Year 1908. Quarters. Tufnell. Upper Holloway. Tollington. Lower Hoi oway. Highbury. Barnsbury. Islington, South-East. The Borough. 1st 5 9 7 10 16 13 20 80 2nd 13 9 9 9 24 14 22 100 3rd 2 16 9 9 14 10 26 86 4th 13 11 11 12 15 14 25 101 The Year 33 45 36 40 69 51 93 367 Table LXIV. Deaths and Death-rates from Cancer at seven age periods. Males. Females. Persons. Ages. Deaths. Deaths per 10,000 living at the age. Deaths. Deaths per 10,000 living at the age. Deaths. Deaths per 10,000 living at the age. O.25 4 0.47 7 0.78 11 0.63 25.35 4 1.31 2 0.58 6 0.92 35.45 11 4.99 30 12.34 41 8.85 45.55 29 18.8I 34 19.25 63 19.04 55.65 47 48.55 65 55.15 112 52.18 65.75 43 97.94 50 76.77 93 85.29 75 & up- 19 127.52 22 75.25 41 92.89 All Ages 157 9.28 210 11.25 367 10.31 94 1908] Table LXV. Mortality from Cancer or Malignant Disease during the Year 1908. ORGANS AFFECTED. Sex. Age at Death. Males. Females. Totals. 0—5 -16 -26 —35 —45 —65 -65 -75 -75 upwards. Diseases of Nervous System Brain M. .. .. .. .. .. .. .. .. .. .. .. 2 F. .. .. .. .. 1 1 .. .. .. .. 2 Organs of Special Sense— Nose M. .. .. .. .. .. .. .. .. 1 1 .. l F. .. .. .. .. .. .. .. .. .. .. .. Diseases of Heart, etc — M. .. 1 2 .. .. 1 .. .. .. 4 .. 8 F. .. .. 3 1 .. .. .. .. .. .. 4 Respiratory System— Larynx M. .. .. .. .. 1 1 .. .. .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Epiglottis M. .. .. .. .. .. 1 .. .. .. 1 .. 1 F, .. .. .. .. .. .. .. .. .. .. .. Lung M. .. .. 1 .. .. 1 2 .. .. 4 .. 7 f. .. 1 .. .. .. 1 1 .. .. .. 3 Digestive System — Rectum M .. .. .. .. .. 3 6 5 3 17 .. 37 F. .. .. 1 .. 2 1 9 5 2 .. 20 Pylorus M .. .. .. .. .. .. .. 1 .. 1 .. 5 F. .. .. .. .. .. .. 2 1 1 .. .. Pancreas M .. .. .. .. .. .. 1 3 .. 4 .. 4 F. Liver M .. .. .. 1 1 2 2 3 2 11 .. 31 F. .. .. .. .. .. 5 4 7 4 .. .. Ventriculi M .. .. .. .. .. .. .. .. .. .. .. 1 F .. .. .. .. .. .. 1 .. .. .. .. Œsophagus M. .. .. .. .. 2 4 4 3 3 16 .. 20 F .. .. .. .. 2 .. .. 2 .. .. .. Stomach M. .. .. .. .. 1 2 3 7 2 15 .. 38 F .. .. .. .. 2 3 10 5 3 .. .. Peritoneum M. .. .. .. .. .. 1 .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Gall Bladder M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. 1 .. .. .. .. Duodenum M .. .. .. .. .. .. 1 .. .. 1 .. 1 F .. .. .. .. .. .. .. .. .. .. .. Abdomen M. .. .. .. .. .. .. 3 1 .. 4 .. 5 F. .. .. .. .. .. .. .. .. 1 .. .. Colon M. .. .. .. 1 .. .. 2 5 1 9 .. 19 F. 3 5 2 Jaw M. .. .. .. .. 1 .. 2 .. 2 5 .. 5 F .. .. .. .. .. .. .. .. .. .. .. Intestines (parts not specified) M. .. .. .. .. .. 1 2 2 2 7 .. 17 F. .. .. .. .. 1 1 3 4 1 .. .. Cheek M. .. .. .. .. .. 1 1 .. .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Tongue M .. .. .. 1 1 2 6 2 1 13 .. 13 F. .. .. .. .. .. .. .. .. .. .. .. Cœcum M. .. .. .. .. .. .. .. 1 .. 1 .. 3 F .. .. .. .. .. .. 2 .. .. .. 2 Face M. .. .. .. .. .. .. .. .. .. .. .. 1 F. 1 .. .. .. .. .. .. .. .. .. 1 95 [1908 Table LXV.—continued. ORGANS AFFECTED. Sex. Age at Death. Males. Females. Totals. —5 —15 —25 -35 —45 -55 —65 —75 —76 upwards. Digestive System—continued. Pharynx M. .. .. .. .. .. 2 2 .. .. 4 .. 4 F. .. .. .. .. .. .. .. .. .. .. .. Mouth M. .. .. .. .. .. 1 .. 1 .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Lymphatic System— Groin M. .. .. .. .. .. .. .. .. i i .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Glands of neck M .. .. .. .. 1 .. 1 2 .. 4 .. 4 F .. .. .. .. .. .. .. .. .. .. .. Mediastinal Glands M. .. .. .. .. .. .. 1 .. .. 1 .. 2 F. .. .. .. .. .. .. 1 .. .. .. 1 Inguinial Gland M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. 1 .. .. .. 1 Urinary System— Kidney M. .. .. .. .. .. 3 .. .. .. 3 .. 4 F. .. .. .. .. .. .. 1 .. .. .. 1 Bladder M. .. .. .. .. .. 2 3 2 .. 7 .. 9 F. .. .. .. .. 1 .. .. .. 1 .. 2 Prostate M. .. .. .. .. .. .. 2 2 I 5 .. 5 F. .. .. .. .. .. .. .. .. .. .. .. Generative System— Breast F. .. .. .. .. 8 9 13 10 2 .. 42 42 Uterus F. .. .. .. .. 11 10 11 9 4 .. 45 45 Ovary F. .. .. 1 .. .. 1 1 .. .. .. 3 3 Vulva F. .. .. .. .. .. 2 .. 1 .. .. 3 3 Penis M .. .. .. .. 1 .. .. 1 .. 2 .. 2 Testis M. .. .. .. 1 .. .. .. .. .. 1 .. 1 Organs of Locomotion— Neck M. .. .. .. .. .. .. 3 .. .. 3 .. 3 F .. .. .. .. .. .. .. .. .. .. .. Bones and Joints — Tibia M. .. .. .. .. .. .. .. 1 .. 1 .. 2 F. .. .. .. 1 .. .. .. .. .. .. 1 Thorax M. .. .. .. .. 1 .. .. .. .. 1 .. 2 F .. .. .. .. .. .. .. .. 1 .. 1 Femur M. .. .. .. .. .. .. .. 1 .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Skull M. .. .. .. .. 1 .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Unspecified M. .. .. .. .. .. 1 .. .. .. 1 .. 5 F. .. .. .. .. 2 .. 1 1 .. .. 4 Total Males and Females for Year M. .. 1 3 4 11 29 47 43 19 .. .. 157 F. 1 1 5 2 80 34 (55 50 22 .. .. 210 Total Deaths 1 2 8 6 41 63 112 93 41 157 210 367 96 1908] Tubercular Diseases.—Tuberculosis of the Lungs or Phthisis, Tuberculosis of the Brain or Tubercular Meningitis, Tuberculosis of the Larynx, Tuberculosis of the Abdomen or Tabes Mesenterica, and General Tuberculosis. These diseases collectively caused 604 deaths, which were equal to a deathrate of 1G9 per 1,000, as compared with (373 deaths, and a mean rate of 1.93, in the preceding decennium. Phthisis or Tuberculosis of the Lungs.—This disease caused43'2 deaths, which were equivalent to a death rate of 1.21 per thousand of the population. It is satisfactory to note that they were 101 below the corrected average of the preceding 14 years, and that the death-rate was 0.32 below the mean death-rate of the same years. They represented also 9.23 per 1,000 deaths from all causes, as compared with a mean rate of 9 49 per 1,000 in the years 1894-1907. Thus we see that the mortality shows a satisfactory decrease. In the subsequent return it will be seen that during the last 8 years, that is to say, since 1900, there has been a steady, although irregular, fall in the deaths registered from phthisis. It is of course impossible to say with accuracy what the cause of this decline is, but there can be little doubt that the agitation respecting the prevention of phthisis in recent years and the information that the puplic generally now possess about it have been considerable factors in bringing about the present state of affairs. There is no little hope that this improvement will continue, for undoubtedly the notification of phthisis by the Poor Law Officials will have a good effect, which may be slow at first, in still further reducing the mortality, for if phthisis can be controlled, even in a small degree, among the pauper class, amidst whom it mainly has its origin and flourishes best, it is more than probable that fewer cases will be found among those in a better position in life. The outlook, therefore, for a lessened mortality from this disease is most hopeful. 97 [1908 The record of the disease since 1894 may be seen in the following return:— Years. Deaths Phthisis. Death rates per 1,000 inhabitants. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Cause? per 1,000 inhabitants. 1894 539 1.63 10.24 15.9 1895 568 1.70 9.86 17.2 1896 530 1.54 9.01 17.4 1897 520 1.54 9.64 16.0 1898 527 1.56 9.24 16.9 1899 583 1.73 9.26 18.7 1900 602 1.79 10.52 17.0 1901 545 1.02 I0'16 i5'9 1902 515 I.50 9.14 I6.4 1903 492 1.45 10.16 i4.3 1904 533 1.56 10.18 15.3 1905 438 1.28 8.84 14.4 1906 411 1.19 8.14 14.6 1907 436 1.26 8.58 14.6 Corrected average 533 1.53 9.49 16.1 1908 432 1.21 9.23 131 Ages at death.—Phthisis is most fatal to persons who have just reached the full stage of manhood, that is to say who are between the ages of 25 and 55, at which period we find that 274 deaths, or 63.4 per cent, of all the deaths from the disease, were registered. The mortality between 0.5 years represented 3.9 per cent. of all the deaths from phthisis; between 5 and 15, 3.5 per cent.; 15 to 25, 12.7 per cent.; 25.35, 22 0 per cent.; 35.45, 24.3 per cent.; 45.55, 171 per cent.; 55.65, 10.9 per cent.; 65.75, 3.9 per cent., and 75.85, 1.6 per cent. These figures show that the greatest fatality occurs between the ages of 35 and 45 years, which is, of course, the heyday of life. It is therefore, all the more necessary that every effort should be made to prevent the spread of a disease which carries off so many of the breadwinners. 98 1908] The following return gives the deaths and deaths per thousand persons living at each age:— Age periods. Deaths. Deaths per 1,000 persons living at each age. Age periods. Deaths. Deaths per 1,000 persons living at each age. 0-5 17 0-44 55-65 47 2.19 5-15 15 0-23 65-75 17 I.56 15-25 55 0.77 75-85 7 0.16 25-35 95 1-47 Total 432 1.21 35-45 105 2.28 45-55 74 2.24 Table LXVI. Showing the Deaths from Phthisis in the Sub-Districts during the Four Quarters of the Year 1908 Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Borough 1st 8 12 5 20 22 15 30 112 2nd 5 12 7 9 14 18 25 90 3rd 9 10 8 10 16 21 30 104 4th 9 11 14 13 20 24 35 126 The Year 31 45 34 52 72 78 120 432 Tabes Mesenterica, which is popularly known as consumption of the bowels, was the registered cause of 45 deaths, representing a death-rate of 0.13 per 1,000 of the population. No less than 28 of these deaths were under 5 years of age, of which one half had not reached the end of their first year. 27 of the deaths were of the male sex, and 18 of the female. Tubercular Meningitis and Hydrocephalus caused 63 deaths,, of which 31 were among males and 32 among females. 13 of the deceased were under a year old, 39 between 1 and 5, and 11 over 5 years. The death-rate was equal to 018 per 1,000 of the inhabitants. Tuberculosis of the Larynx.—To this disease was ascribed the deaths of 4 persons, 3 of whom were males and one female. All of them were over 5 years of age. General Tuberculosis or Scrofula was responsible for 40 deaths, 21 males, and 19 females, and they represented a death-rate of 0.11 per 1,000 of the inhabitants. Eight of the deceased had not reached their 12th month, 19 were between that age and 5 years, and 13 were over 5 years. Other Forms of Tuberculosis caused 20 deaths, of which 2 were under 5 years. 99 1908] Table LXVII. Showing the Deaths from the Tubercular Diseases during 1908. Diseases. Ages. Sex. Districts. Totals Deaths. Death Rates. 0—1 1-5 Over 5 M. F. Tuf. U.H Toll. L.H. H. B. S.e. 0—5 5-15 All Ages. Phthisis 5 12 415 248 184 31 45 34 52 72 78 I20 432 0.44 0.23 1.21 Tabes Mesenterica 14 14 17 27 18 5 2 3 9 10 8 8 45 073 0.10 0.13 Tubercular Meningitis 13 39 11 31 32 9 11 3 13 7 8 12 63 1.36 0.10 0.18 Tuberculosis of the Larynx — — 4 3 I — — — 3 1 - — 4 — — 0.01 General Tuberculosis 8 19 13 21 19 I 3 3 6 11 8 8 40 0.71 0.03 0.11 Other Forms of Tuberculosis — 2 18 14 6 2 3 3 1 1 5 5 20 0.05 0.06 0.05 All Tubercular Diseases 40 86 478 344 260 48 64 46 84 102 107 153 604 3.29 0.53 1.69 100 1908] Table LXVIII. Mortality from Tuberculosis of the Lung (including Phthisis) and other Forms of Tuberculosis. Years. Number of Deaths. Death Rates. Tuberculosis of Lung (including Phthisis.) Other forms of Tuberculosis. Tuberculosis of Lung (including Phthisis). Other forms of Tuberculosis. Males (all ages). Females (all ages). Males (all ages). Females (all ages). Children (under 5). Males (all ages). Females (all ages). Males (all ages). Females (all ages). Children (under 5). 1898 322 205 89 70 137 2.02 1.15 0.56 0.39 3.36 1899 359 224 76 70 119 2.26 1.26 0.48 0.39 2.89 1900 385 217 57 51 88 2.42 1.22 0.36 0.29 2.12 1901 325 220 82 50 99 2.04 1.25 0.51 0.28 2.74 1902 308 207 84 73 120 1.92 1.17 0.52 0.41 3.31 1903 291 201 80 60 103 1.80 1.13 0.49 0.34 2.82 1904 315 218 83 66 104 1.94 1.22 0.51 0.37 2.84 I905 243 195 74 68 107 1.49 0.08 0.45 0.38 2.90 1906 252 159 88 79 112 1.54 o.88 0.54 0.44 3.02 1907 260 176 83 89 110 1.58 0.97 0.45 0.49 2.95 Average 306 202 79 67 110 1.90 1.13 0.49 0.38 2.89 1908 248 184 96 76 109 1.53 0.99 0.59 0.41 2.85 101 1908] TABLE LXIX. Showing the Deaths from the several Constitutional Diseases during the Years 1898-07, als» the Corrected Mean Number of Deaths for these Years, together with the Deaths in 1908. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. Corrected Means 189807. 1908. Increase or Decrease Rheumatic Fever 22 26 16 9 17 16 13 18 15 11 17 9 - 8 Rheumatism 12 8 10 12 15 21 21 11 19 13 14 14 — Gout 7 4 7 7 11 6 11 7 6 13 8 7 - 1 Rickets 19 25 13 19 17 9 11 11 11 5 14 5 - 9 Cancer 283 270 303 289 326 350 323 328 363 348 327 367 + 40 Tabes Mesenterica 65 50 36 38 43 40 40 39 35 26 42 45 + 3 Tubercular Meningitis 87 89 69 80 77 71 74 63 80 74 78 63 -15 Phthisis 527 583 602 545 515 492 533 438 411 436 522 432 -90 Other Tubercular and Scrofulous Diseases 7 7 3 14 37 29 35 40 52 72 31 64 + 33 Purpura 1 4 2 2 2 1 1 2 1 3 2 3 + 1 Anaemia. Chlorosis, Leucocythsemia 11 11 12 9 7 8 14 15 16 15 12 14 + 2 Diabetes 18 20 28 33 28 26 35 28 32 21 28 21 - 7 Other Diseases .. 3 3 5 2 1 5 7 1 4 3 4 + 1 Totals 1,059 1,100 1,104 1,062 1,097 1,070 1.116 1,007 1,042 1,041 1,098 1.048 -50 DISEASES OF THE RESPIRATORY ORGANS. Under this heading are included Acute Bronchitis, Bronchitis, Pneumonia, Broncho-Pneumonia, Pleurisy and Asthma, which in the aggregate caused 927 deaths, or 19.8 per cent. of the deaths from all causes, and represented a death-rate of 2.61 per 1,000. Acute Bronchitis caused 132 deaths, 57 males and 75 females, of whom 52 had not reached the end of their fifth year, while 80 were over that age. 39 were under twelve months old. Of these deaths 8 occurred in public institutions. Chronic Bronchitis was the registered cause of 298 deaths, of which 69 took place in public institutions within the Borough. With two exceptions the deceased had all reached their 25th year. It was particularly fatal after the 102 1908] 45th year had been reached, for the returns show that between the ages of 45 and 55, 22 deaths occurred; between 55-65, 67 deaths; between 65-75, 98 deaths; between 75-85, 76 deaths, and above 85 years 20. Pneumonia.—426 deaths were registered from pneumonia, or 131 less than in the preceding year. They were equal to a death-rate of 1 20 per 1,000 of the population. 64 of the deaths occurred in public institutions. The decrease in the mortality must no doubt be attributed to the mildness of the year, which of course had a very considerable effect on infantile mortality. Thus there were only 106 deaths under 1 year of age, as against 153 in the preceding year, and 82 between 1 and 5 years, as contrasted with 125 in 1907. Similar reductions are noticeable at the other ages. Pleurisy caused 27 deaths, all of which with two exceptions had reached the fifth year of life, for 2 were under 5, 1 under 15; 2 were betweed 15 and 25; 3 were between 25 and 35; 7 were between 35 and 55, and 12 between 55 and 85. Asthma and Emphysema caused 19 deaths, 10 males and 9 females. Other Diseases of the Respiratory System were responsible for 17 deaths. The following particulars are of interest respecting the deaths of infants under one year old:— Acute Bronchitis. Pneumonia. Total. 1st quarter - 15 39 54 2nd „ 4 22 26 3rd „ 1 14 15 4th „ 19 31 5o 39 106 145 ALCOHOLISM. Compared with the preceding year, the deaths from alcoholism showed a decrease of 11, the number registered being 17, as compared with 28. During the preceding 7 years there had been an average of 26 deaths from this cause. The return, although satisfactory. is not as low as that of 1906, when only 16 deaths were recorded. The decrease seems to have occurred amongst the chronic cases, for only 14 were registered as against 24 in the preceding year. 103 [1908 The number of deaths during each year since 1901 is as follows:— Acute. Chronic. Total. Males. Females. 1901 - 27 27 7 20 1902 9 29 38 20 18 1903 3 23 26 13 13 1904 4 18 22 12 10 1905 4 21 25 9 16 1906 3 13 l6 5 11 1907 4 24 28 10 18 1898 3 14 17 8 9 199 84 115 These figures, however, do not nearly and for obvious reasons represent the full tale of deaths due to alcoholism. As Dr. Newsholme puts it, " the doctor in attendance hands the death certificate to the nearest relative of the deceased, and he is careful not to hurt that relative's feelings," and he therefore, certifies the death as due to some secondary cause, and there are plenty to choose from, to which the habitual use of alcohol had given rise, such as gastric catarrh, chronic dyspepsia, congestion or cirrhosis of the liver, Bright's disease, inflammation of the lungs, and many other diseases which too surely waylay the chronic drinker in his mad career. There are also several other diseases to which he falls a ready victim should they attack him, the chief of which is phthisis. Indeed, so well is this fact now known that the International Congress on Tuberculosis which met at Paris in 1905, passed a resolution strongly emphasising the importance of connecting the fight against tuberculosis with the struggle against alcoholism. Let it never be forgotten that persons who indulge largely in drink are predisposed to tuberculosis, and that their children also possess a lessened power of resistance to this disease, though the parents had never been attacked with it, and are "frequently attacked with hip joint disease, joint swellings, glandular swellings, 'consumption of the bowels ' and of the lungs." From these facts it can be well understood how difficult it is to enumerate with certainty the deaths due to alcohol. The effects of alcohol on the human system has been much debated, with the result that people are now taking a more intelligent interest in the question, which is undoubtedly of moment from a health point of view, and consequently there is a decrease in the amount of drink consumed in this country. 104 1908] VENEREAL DISEASES. These included Syphilis and Gonorrhoea, which collectively caused 20 deaths, as against 16 in the preceding year. The increase occurred among children under 12 months old, 13 of whom perished, as compared with 5 in 1907 and 9 in 1906. The thought that these deaths of little children were entirely due to the depraved habits of their parents naturally causes food for reflection, particularly when it is recollected that what goes on in Islington also occurs throughout the United Kingdom, for the Registrar General's returns show that in 1907 645 male children and 492 female children under 12 months old died in England and Wales from these terrible diseases, and that 682 male children, inclusive of those already stated, died under 5 years of age, together with 522 females. In London, 133 male children under 5 years old, of whom 125 were under 1 year, and 118 females under 5 years, of whom 114 were under 1 year, were brought to a premature grave from the same cause. The particulars for Islington during the last 8 years are given in the following table:— Under 1 year. 1 — 5 years. Adults. Total. 1901 10 1 6 17 1902 11 — 10 21 1903 10 1 8 19 1904 12 2 6 20 1905 13 — 5 18 1906 9 I 6 16 1907 5 - 11 16 1908 13 I 6 20 DIABETES MELLITUS. This disease, as its name signifies, is marked by an excessive amount of urine, containing an excess of sugar habitually discharged from the system. It is attended by thirst, increased appetite, and, as it progresses, emaciation and loss of strength. It sometimes occurs in a temporary form with certain nervous diseases, and sometimes with congestion of the liver. It is usually chronic and fatal, although when it attacks elderly people its course may continue for some years. 105 [1908 During the year it caused 21 deaths, 10 being males and 11 females, of whom 16 were between 45 and 75 years of age. During the last 10 years it has resulted in the death of 254 persons, or an average of 25 per annum. It is unfortunately one of those diseases for which science has found no special cure, but it is also one about which constant investigations are being made. The disease was apparently known so far back as the seventh century, when Susruta, a physician who lived in India, recognised a disease in which the urine tasted sweet. A thousand years later the sweet taste of diabetic urine was described by Thomas Wilson, and after the lapse of another 100 years (1775), Dobson showed that the sweet taste was due to sugar. The great French physiologist, Claude Bernard, made a special study of it, in the course of which he discovered that an animal could convert sugar which had been taken into its body as food into the form of starch called glycogen, and retain it in its liver, and that then this glycogen could be converted into sugar as the tissue needed it. Other pathololigsts had noticed abnormalities of the pancreas (a gland which discharges its secretion into the intestine) in connection with diabetes, but when death ensued, after this gland was examined no evidence of disease could be found, even under the microscope, for, unfortunately, the microscope does not always indicate a change of function. Von Mering and Minkowski at a later period demonstrated the relationship between the pancreas and diabetes by removing the pancreas from dogs, when the disease followed. It was found that these dogs could not oxidise sugar accumulated in the blood, and consequently they eliminated it in the urine. Minkowski also found that if a small piece of the pancreas was left in the body, diabetes either did not occur, or was less severe than after the removal of the whole gland, and in addition he discovered that if the pancreas was removed completelv, the severe type of the disease was set up, but that if he theft transplanted a piece of an active pancreas into the abdominal cavity of the sick dog, the diabetes was diminished as long as the piece of gland remained functional. He also made further experiments which proved most satisfactorily the connection between disease of the pancreas and diabetes or glycosuria. Up to the present no cure for diabetes has been found, as stated above, but there is every hope that science may some day discover a remedy. The following table shows the deaths that have occurred in Islington during the last 11 years, together with the age and sex of the deceased. 106 1908] Table LXX. Showing the Deaths from Diabetes Mellitus at ten age periods during the years 1898-1907, and in 1908. Ages at Death. Years. Total 10 years. 1908 1898 1899 1900 1901 1902 1903 1904 1905 1900 1907 0-5 1 - - - - - - - - - 1 — 5-15 — — — — 1 1 — — — 1 3 — 15-25 — — 2 2 — 1 3 1 1 1 11 — 25-35 2 1 1 3 2 2 2 3 3 1 20 1 35-45 3 1 2 1 7 2 3 2 3 1 25 2 45-55 5 2 7 5 4 2 5 4 3 2 39 4 55-65 5 — 7 10 9 8 11 6 7 7 70 7 65-75 2 1 7 8 2 7 9 11 14 5 66 5 75-85 — — 2 3 3 3 1 1 1 2 16 1 85 upwards — — — 1 — — 1 — — 1 3 1 All Ages 18 5 28 33 28 26 35 28 32 21 254 21 Males 9 3 11 20 12 11 19 15 13 11 124 1O Females 9 2 17 13 16 15 16 13 19 10 130 ll DEATHS 1N PUBLIC INSTITUTIONS. The number of deaths in local institutions was 1,565, as compared with 1,675 in the preceding year, and of these 550 were non-residents who were undergoing hospital treatment in the Borough. There were, moreover, 684 Islingtonians who died in extra-borough institutions, thus bringing up the number of residents who died in institutions within and without the Borough to 1,699, or 36.3 per cent. of the deaths from all causes during the year. Within the Borough.—1,015 inhabitants died in the local institutions, in addition to which there died 550 persons who had come into the Borough for medical treatment in the local institutions. 750 persons belonging to the Borough died in the workhouses, and 120 in the Great Northern Central Hospital. 107 [1908 Without the Borough.—There were 684 Islingtonians, as compared with an average of 617 in the preceding 10 years, who died in institutions outside the Borough. With the exception of the year 1902, this is the largest number hitherto recorded, as may be seen by the subsequent table. The institutions in which they died, together with the number of deaths, are fully set out in Table LXXIV, which shows the deaths of the inhabitants in public and charitable institutions situated without the Borough. It may, be said, however, that the largest number were registered from St. Bartholomew's Hospital, where 90 died. This was followed in order by the Childrens' Hospital, Great Ormond Street, where 63 died; by the University College Hospital, where 48 died, and by the North-Eastern Hospital, where 44 died. Accidental and sudden deaths without the Borough.-23 deaths of this character occurred in the several metropolitan districts. They are tabulated at the foot of Table LXXIV. Table LXXI. Showing the Deaths of Inhabitants in Local Institutions and Institutions outside the Borough, also the deaths of Non-Inhabitants in Local Institutions during the years 1898-07 and in 1908. Years. Total Deaths in Local Institutions cols. 3 and 4). Inhabitants of Islington in Local Institutions. NonInhabitants of Islington in Local Institutions. Inhabitants in Islington Infirmary. Inhabitants of Islington in G.N.C. Hospital. Inhabitants of Islington in Institutions outside the Borough. Total Deaths of Inhabitants in all Institutions (cols. 3 and 7). Proportion per 100 deaths from all causes (col. 8). I 2 3 4 5 6 7 8 9 1898 1.365 820 545 656 95 517 1,337 23.4 1899 1,672 993 679 772 136 593 1,586 25.2 1900 1,564 990 574 779 124 553 1.543 26.9 1901 1,394 903 491 603 124 630 1,533 28.6 1902 1.531 909 622 587 130 737 1,646 29.2 1903 1,467 912 555 654 122 627 1,539 31.8 1904 1,619 987 632 719 132 589 1.576 30.1 1905 1,526 962 564 680 126 619 1,581 31.9 1906 1,574 955 619 717 106 648 1,603 31.5 1907 6,675 1,082 593 760 130 656 1,738 34.2 Average 1,538 951 587 693 122 617 1,568 29.1 1908 1,565 1,015 550 750 120 684 1,699 36.3 H 2 108 1908] Table LXXII. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated within the Borough distributed to their respective Sub-registration Districts; also the Deaths of Non-Inhabitants in the same Institutions during the Year 1908. PUBLIC INSTITUTION. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. Total Inhabitants. NonInhabitants. Islington Infirmary 90 96 72 87 107 129 169 750 16 Islington Workhouses 5 14 14 15 18 26 19 111 6 Workhouse Schools - - - - — — - — — Gt. Northern Hospital l6 23 25 15 27 5 9 120 91 Holborn Infirmary - - - - 1 — — 1 354 Aged Pilgrims' Asylum — 1 - - — 1 — 2 6 St. Pelagia's Creche - - - - - - - - 20 Aged Blind Home - - - - - - - - 7 Medical and Surgical Home - - - - - - - - - Children's Nursing Home - - - - - - - - - St. John's Nursing Institute - — - - - - - - - Kingsdown Orphanage - - - - - - - - - Shoreditch Workhouse - - - - - - - - - Whittington College - - - - - - - - - Tufnell Park Nursing Institution 2 I 1 - - 4 1 St. Andrew's Nursing Home — - - — - — — 1 H.M. Prison, Holloway - - - - - - - - 7 H.M. Prison, Pentonville - - - - - - - - 6 Drovers' Almshouses - - - - - - - - London Fever Hospital - - - - - 2 — 2 18 Memorial Cottage Hospital — - - 1 8 2 8 19 2 Invalid Home, Aubert Park — - - - — — — — 1 Invalid Home, Highbury Terrace I - - - - - - 1 3 Bookbinders' Asylum - - - - - - 1 1 1 Metropolitan Benefit Societies' Asylum — I - - - - - 1 3 Bricklayers' and Tilers' Almshouses - 1 1 1 Dyers' Almshouses - - - - - - - - 1 Pennefatlier Memorial Home - - - - - - - - — Clothworkers' Almshouses — - - — — — — — — Alexandra Nursing Home, Turle Road _ 1 1 - - - - 2 3 Highbury Nursing Home - - - - - - - - 2 Totals 114 136 112 119 163 165 206 1,015 550* *There were also 18 deaths at places not mentioned in this list. 109 [1908 Table LXXIII. Showing the Deaths of Inhabitants of Islington in Public Institutions and in other places situated outside the Borough distributed to their respective Sub-Registration Districts during the Year 1908. Sub-Registration Districts. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Whole Year. Males. Females. Total. Males. Females. Total. | Males. Females. Total. Males. Females. Total. Males. Females. Total. Tufnell 6 10 16 5 s 10 6 7 13 3 6 9 20 28 48 Upper Holloway 10 8 18 10 4 14 9 4 13 6 11 17 35 27 62 Tollington 4 4 8 6 3 9 4 5 9 6 3 9 20 15 35 Lower Holloway 13 10 23 12 13 25 19 5 24 13 16 29 57 44 101 Highbury 22 10 32 20 12 32 18 10 28 14 11 25 74 43 117 Barnsbury 18 15 33 21 11 32 17 15 32 34 19 53 90 60 150 South-East Islington 28 19 47 34 21 55 25 21 46 25 31 56 112 92 204 Borough 101 76 177 108 69 177 98 67 165 101 97 198 408 309 717 110 1908] Table LXXIV. Showing the Daaths of Inhabitants in Public and Charitable Institutions situated without tho, Borough, during the Year 1908. Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter Year. Middlesex Hospital 3 7 6 3 19 Friedenheim (Home of Peace). N.W. 3 2 5 10 North Western Fever Hospital 10 6 5 4 25 University College Hospital 13 11 10 14 48 Eastern Fever Hospital 1 1 .. 1 3 Children's Hospital, Gt. Ormond Street 19 11 19 14 63 Banstead Asylum 5 3 4 5 17 Manor Asylum (Epsom) 1 .. .. .. 1 Darenth Asylum .. 1 1 1 3 Hanwell Asylum 8 2 * * 6 16 New Hospital for Women (Euston Road) .. 2 .. 4 6 Metropolitan Hospital 2 8 7 4 21 German Hospital 4 2 3 4 13 St. Bartholomew's Hospital 28 18 19 25 90 Royal Chest Hospital 3 8 5 2 18 King's College Hospital 1 3 3 6 13 Guy's Hospital .. 2 .. 1 3 Colney Hatch Asylum 1 7 9 3 20 North Eastern Fever Hospital 9 6 7 22 44 Leavesden Asylum .. 1 .. 3 4 St. Thomas's Hospital .. 1 1 1 3 Cane Hill Asylum 2 .. .. 1 3 City of London Chest Hospital .. .. .. Royal Free Hospital 9 10 5 10 34 London Temperance Hospital 2 1 3 7 13 Cancer Hospital (Chelsea) .. 2 1 3 6 London County Asylum (Dartford) 3 2 3 1 9 London Hospital 2 7 2 2 13 St. Anne's House, Stoke Newington 1 1 1 .. 3 Mildmay Hospital 1 .. .. 2 3 Homæpathic Hospital, Gt. Ormond Street 1 .. 3 1 5 Claybury Asylum 6 6 3 21 Children's Hospital (Paddington Green) .. 1 • • 1 2 St. George's Hospital .. .. 1 .. 1 Hackney Infirmary 2 . . .. .. 3 Queen Charlotte Hospital .. .. .. l 1 St. Pancras Infirmary 1 5 3 5 14 St. Pancras Workhouse .. 2 .. .. 2 Peckham House Asylum 1 .. .. l 2 Chelsea Hospital for Women .. .. .. l 1 West London Hospital .. 1 1 .. 2 City of London Lying-in Hospital 3 1 1 4 9 Marylebone Infirmary l .. .. .. 1 Wesminster Hospital .. 2 1 1 4 Hospital of St. John and St. Elizabeth 1 .. .. I 2 St. Mary's Hospital l .. .. .. 1 Tooting Bee Asylum l .. 1 2 4 Charing Cross Hospital l 1 1 I 4 Bethlem House .. .. .. l 1 Evelina Hospital .. 1 .. .. 1 National Hospital, Queen's Square, W,C. .. 2 .. .. 2 Bethnal House Asylum 1 1 .. .. 2 St. Luke's House, Pembridge Square, S.W. l 1 2 1 5 St. Barnabas Home, 9, Lloyd Street, W.C. l .. .. .. 1 Children's Hospital, Bethnal Green l 1 .. .. 2 Chest Hospital Bethnal Green .. .. .. 1 1 Holborn Workhouse, Hoxton 3 1 2 2 8 Caterham Asylum l .. 1 .. 2 Hostel of God l .. .. .. 1 Shoreditch Infirmary 3 2 3 .. 8 Horton Asylum 2 .. .. 1 3 Ill [1908 Table LXXIV—continued. Institutions. 1st Quarter. 2nd Quaner. 3rd Quarter. 4th Quarter. Year. Heart Hospital, Soho Square .. .. .. 1 1 St. Peter's Hospital .. .. 1 .. 1 Wandsworth Asylum .. .. 1 .. 1 Long Grove Asylum 4 .. 4 1 12 Belmont Asylum 1 .. .. .. 1 Hospital for Women, Soho 1 .. .. .. 1 Cheyne Hospital 1 .. 1 .. 2 Epileptic Colony, Epsom 1 .. .. .. 1 Victoria Hospital, Chelsea .. 2 .. .. 2 Queen's Hospital, Bethnal Green .. 1 2 1 4 St. Luke's House, Old Street, E.C. .. 1 .. • • 1 Lock Hospital .. 1 .. .. 1 Home of Compassion, Paddington .. .. 1 .. 1 British Home and Hospital for Incurables .. .. 1 .. 1 Infant's Hospital .. .. 1 1 2 Royal Hospital, Waterloo Road .. .. .. .. 1 1 Mount Vernon Hospital .. .. .. .. 1 1 Royal Hospital for Women and Children .. 1 1 .. 2 Home Hospital, 16, Fitzroy Square .. 1 .. .. 1 Hampstead Home Hospital .. 1 .. .. 1 Central London Throat and Ear Hospital .. 2 .. .. 2 Italian Hospital .. .. 1 .. 1 Throat Hospital, Golden Square .. .. 1 .. 1 Royal Hospital for Incurables .. .. .. 1 1 Samaritan Free Hospital .. .. .. 1 1 169 167 154 194 634 Accidental and other Deaths :— At Salisbury House, London Wall, E.C. 1 .. .. .. At 7, Glenton Road, Lee 1 .. .. .. In Gower Street, W.C. 1 .. .. .. 1 At 51, Castle Street, Marylebone 1 .. .. .. ] At No. 1 Pond, Parliament Hill 1 1 .. .. 2 At 165, Adelaide Road, Hampstead 1 .. .. .. 1 In River Thames, Hammersmith 1 .. .. .. 1 At Farringdon Street Station, Metropolitan Railway 1 .. .. .. 1 At 34, Cawley Road, South Hackney On Police Ambulance in Gray's Inn Road .. 1 .. .. 1 .. 1 .. .. I At 69, Lincoln's Inn Fields, W.C. .. 1 .. .. I At 13, Kirkwood Road, N.W. .. 1 .. .. 1 In Stable at rear of 512, Oxford Street .. 1 .. .. 1 At 3 & 5, Crown Court, Old Broad Street, E.C .. 1 .. .. 1 Bathing Pond, Hampstead Heath .. 1 .. .. 1 At 46, Amhurst Park, Stamford Hill .. 1 .. .. 1 In Underground Lavatory, Farringdon Street .. 1 .. .. 1 At 3, Hatton Yard, Holborn.. .. .. 1 .. I In Public Lavatory, St George's Road, S.E. .. .. 1 .. 1 At 296, Dalston Lane, N.E. .. .. 1 .. 1 At Potato Market, York Road .. .. 1 .. 1 At 23, Devonshire Street, Marylebone .. .. 1 .. 1 At 11, Hurley Road, Kensington .. .. 1 .. 1 At 6, The Terrace, St. Pancras .. .. 1 .. 1 In Green Lanes, opposite Manor House Tavern .. .. 1 .. 1 At 5, Gloucester Street, Holborn .. .. 1 .. 1 At 65, Cow Cross Street, Holborn .. .. 1 .. 1 At 12, Dorset Mews, Marylebone .. .. 1 .. 1 In Gray's Inn Road, W.C .. .. .. 1 1 On siding at Midland Road Locomotive Department, King's Cross .. .. .. 1 1 On London and North Western Railway at Maida Vale Station .. .. .. 1 1 In No. 2 Pond, Parliament Hill .. .. .. 1 1 Total Deaths 177 177 165 198 717 112 1908] Table LXXV. Showing the Deaths of Inhabitants and Non-Inhabitants in Public and Charitable Institutions situated within the Borough during the Four Quarters and in the Year 1908. PUBLIC INSTITUTIONS. Inhabitants. Non-Inhabitants. Totals. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. 1st qr. 2nd qr. 3rd qr. 4th qr. Year. 1st qr. 2nd qr. 3rd qr. 4th qr. Year, Islington Infirmary 208 185 151 206 750 9 3 1 3 16 217 188 152 209 766 Islington Workhouses and Schools 31 20 33 27 111 3 1 2 # m 6 34 21 35 27 117 Great Northern Central Hospital 32 31 26 31 120 27 20 23 21 si 59 51 4!) 52 91 1 Holborn Infirmary .. 1 .. .. 1 115 74 64 101 354 115 75 64 101 355 St. John's Nursing Institute .. .. .. .. .. .. .. . . .. .. .. .. .. .. Tufnell Park Nursing Institute .. 1 .. 3 4 .. .. .. 1 1 .. 1 .. 4 5 London Fever Hospital .. 1 1 .. 2 8 3 3 4 18 8 4 4 4 20 Aged Pilgrims' Asylum 1 1 .. .. 2 3 1 .. 2 6 4 2 .. 2 8 St Pelagia's Creche. .. .. .. .. .. 2 3 3 12 20 2 3 3 12 20 Memorial Cottage Hospital 3 6 3 7 19 2 .. .. .. 2 5 6 3 7 21 Alexandra Nursing Home, Turle Road 1 .. .. 1 2 2 1 .. .. 3 3 1 .. 1 5 Aged Blind Home .. .. .. .. .. 3 2 1 1 7 3 2 1 1 7 Medical and Surgical Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Invalid uome, Aubert Park .. .. .. .. .. .. .. .. 1 1 .. .. .. 1 1 H M. Prison, Holloway .. .. .. .. .. 3 1 1 2 7 3 .. 1 2 7 H.M. Prison, Pentonville ... .. .. .. .. 1 .. 1 4 6 1 .. 1 4 6 Children's Nursing Home .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Kingsdown Orphanage .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nursing Home, Turle Road .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whittington College .. .. .. .. .. .. .. .. .. .. .. .. .. .. Metropltn. Benefit Societies' Asylum .. .. .. .. 1 3 .. .. .. 3 3 1 .. .. 4 Winifred House .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Shored] tch Workhouse .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drover's Almshouses .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bookbinder's Asylum 1 .. .. .. 1 1 .. .. .. 1 2 .. .. .. 2 Invalid Home, Highbury Terrace .. .. 1 .. 1 2 .. .. 1 3 2 .. 1 1 4 Dyers' Almshouses .. .. .. .. .. .. 1 .. .. 1 .. 1 .. .. 1 Highbury Nursing Home .. .. .. .. .. 1 .. 1 .. 2 1 .. 1 .. 2 Bricklayer's and Tiler's Almshouses 1 .. .. .. 1 .. .. .. 1 1 1 .. .. 1 2 Clothworkers' Almhouses .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. St. Andrew's Nursing Home .. .. .. .. •• .. .. .. 1 1 .. .. .. 1 1 Totals 278 247 215 275 1015 185 110 100 155 550 463 357 315 430 1565 113 [1908 INQUESTS AND MORTUARY. During the year 563 bodies were received into the Mortuary, as compared with an average of 696 in the preceding 10 years. This is the smallest number recorded in these years. The daily average number of bodies received into the mortuary was 1*5, as compared with 1.7 in 1907. In 396 cases inquests were held, as contrasted with an average of 434 in the years 1898-1907. Bodies received into Mortuary. Iaquests. 1898 712 402 1899 807 469 1900 754 475 1901 693 431 1902 745 458 1903 681 393 1904 660 424 1905 625 419 1906 642 433 1907 644 441 Average 696 434 1908 563 396 The following table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1907 and 1908. 1907. No. of bodies received. Daily Average. No. of Inquests held. 1908. No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 176 1.9 127 1st Quarter 166 1.9 121 2nd „ 163 1.8 106 2nd „ 111 1.2 80 3rd „ 134 1.4 84 3rd „ 140 1.5 92 4th 171 1.8 124 4th „ 146 1.6 103 Total for Year 644 1.7 441 Total for Year 563 1.5 396 • " V- PART III. THE NOTIFICATION, ISOLATION, FATALITY, AND PREVENTION OF INFECTIOUS DISEASES. INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS AND ON BUSINESS PREMISES, TOGETHER WITH THE OCCUPATIONS OF THE PERSONS ATTACKED. 1908] 116 THE NOTIFICATION OF INFECTIOUS DISEASES. Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric or Typhoid Fever, Erysipelas, Continued Fever, Relapsing Fever, and Cholera. The above infections are those which are usually known as the notifiable infectious diseases, which are reported to the London Public Health Authorities under Section 55 of the Public Health (London) Act, 1891. During 1908 there were 2,289 cases notified, or 180 below the corrected average of the preceding 10 years. They are, however, 226 above the number notified in 1907. These cases represent an attack-rate of 6.43 per 1,000 of the population, as compared with a mean rate of 6.94 during the years 1898-1907. It is satisfactory to note that, with the exception of Scarlet Fever, all the diseases were below the corrected average of the preceding decennium. The figures in the return given below show that since 1902 there has been a steady fall in the attack-rate, which is probably more marked in the case of Enteric Fever, an ailment which is most amenable to sanitary circumstances, than in any of the other diseases. This return gives the number of the cases together with the attack rate in each year since 1891, when these diseases were first systematically notified. It might be stated that in the early days of notification many cases were not reported. This, however, can hardly be averred now, as the failure to notify is a rare occurrence in Islington. Years Cases. Attack-rates. 1891 2,059 = 6.43 per 1,000 inhabitants. 1892 3,318 = 10.26 „ „ 1893 4,853 = 14.84 „ „ 1894 3,121 = 9.44 „ „ 1895 2,839 = 8.50 „ „ 1896 3,824 = 11.32 „ „ 1897 2,906 = 8.62 „ „ 1898 2,418 = 7.18 ,, „ 1899 2,943 = 8.75 „ „ 1900 2,276 = 6.78 „ „ 1901 2,852 = 8.50 „ „ 1902 3,164 = 9.20 „ „ 1903 1,707 = 5.03 „ „ 1904 1,941 = 5.69 „ „ 1905 1,928 = 5.62 „ „ 1906 2,275 = 6.59 „ „ 1907 2,063 = 5.94 „ „ 1908 2,289 = 6.43 „ „ 117 [1908 When these cases are split up into quinquennial periods, the decrease in their number is very noticeable, for in the quinquennium 1891-1895 they numbered 10,189; in the quinquennium 1896-1900 14,367, and in the quinquennium 1901-1905 11,592. Thus there has been a decrease between the first and last periods of no less than 4,597 cases. When compared with the neighbouring districts, the attack-rate of the borough is satisfactory, for in St. Pancras it was 6.18; in Finsbury 7.44; in Hackney 8.31, and in Shoreditch 8.94. As might have been expected, the rate was lower in the residential districts of Hornsey and Stoke Newington, where it was respectively 4.15 and 5.59 per 1,000 inhabitants. Cases. Attack-Rates. St. Pancras 1,490 6.18 Stoke Newington 307 5.59 Hackney 1,982 8.31 Hornsey 386 4.15 Finsbury 727 7.44 Shoreditch 1,048 8.94 The Encircling Boroughs 5,940 7.14 County of London 35,968 7.36 Islington 2,289 6.43 Sub-Registration Districts.—The 2,289 cases were distributed to these districts as shown below. Cases. Attack-rates. Tufnell 231 6.50 Upper Holloway 2 73 7.27 Tollington 248 6.6i Lower Holloway 350 8.21 Highbury 345 4.96 Barnsbury 371 6.76 Islington South East 471 6.02 Total 2,289 6.43 It will be noticed in this return that, so far as the notifiable infectious diseases are concerned, the healthiest part of the Borough was Highbury, where only 349 cases were notified, and produced an attack-rate of 4'96 per 1,000 of the inhabitants; and that then there followed in order, Islington South-East, with a rate of 6 02; Tufnell, 6.50; Tollington, 6.61; Barnsbury, 6.76 ; Upper Holloway, 7.27, and Lower Holloway, 8.21 per 1,000. In Lower Holloway the cause of the higher attack-rate was due to the greater incidence in proportion to population of Enteric Fever and Diphtheria, while in Upper Holloway Diphtheria was unusually prevalent. 1908] 118 Wards.—The following is a statement as to the cases and the attack rates in the several periods. Cases. Attack Rates. Tufnell 231 6.50 per 1,000 inhabitants. Upper Holloway 273 7.27 „ „ Tollington 248 6.61 „ „ Lower Holloway 350 8.21 „ „ Highbury 194 5.40 „ „ Mildmay 126 4.90 „ „ Thornhill 222 6.50 „ „ Barnsbury 149 7.21 „ „ St. Mary 119 6.66 „ „ Canonbury 173 5.00 „ „ St. Peter 204 6.05 „ „ 2,289 6.43 „ „ In the Quarters.—In the first quarter the number of cases notified was 515, which were equal to an annual attack-rate of 5.90 per 1,000 of the inhabitants. They were 4 above the corrected average (511) which obtained in the first quarters of the preceding ten years. In the same period in the County of London the attack-rate was 7.68 per 1,000, and in the Encircling Boroughs 3.78. In the second quarter the number of cases notified was 422, which were equal to an annual attack-rate of 4.83 per 1,000 inhabitants. They were 93 below the corrected average (515) of the preceding 10 years. In the County of London in the same period the attack-rate was 5.94 per 1,000, and in the Encircling Boroughs 5.64. In the third quarter 595 cases, equal to an annual attack-rate of 6.25 per 1,000 inhabitants per annum, were notified. They were 43 below the corrected average (638) of the corresponding third quarters of the preceding 10 years. In the County of London the attack-rate was 7 04 per 1,000 and in the Encircling Boroughs 6.74. In the fourth quarter there were 759 cases reported, which produced an annual attack-rate of 8 05 per 1,000 inhabitants. The cases were 58 below the corrected average which had obtained in the fourth quarters of the preceding 10 years. In the County of London the attack-rate was 8.66 per 1,000 inhabitants, while in the Encircling Boroughs it was 8.79. 119 [1908 Fatality from the Infectious Diseases.—By fatality is meant the percentage of deaths among the notified cases of the infectious diseases. During the year 12.6 cases occurred among the 2,289 reported cases, so that the fatality was 5.5 per cent. This is a somewhat higher ratio than that reported in 1907, when it was 4.8 per cent., which was the lowest that had occurred since 1891. The fatality now reported is, however, satisfactory, and indeed, has only been better on two occasions, viz., in 1906 and 1907. As the fatality among each of the several diseases will be discussed under its proper heading, it is unnecessary to do so here. Tt is sufficient to give the return for the last 18 years. Years. Cases. Deaths. Fatality. 1891 2,059 258 12.5 1892 3,318 291 8.7 1893 4,858 383 7.9 1894 3,121 339 10.8 1895 2,839 266 9.3 1896 3,824 390 10.2 1897 2,906 258 8.8 1898 2,418 173 7.1 1899 2,243 238 8.1 1900 2,276 202 8.8 1901 3,167 268 8.4 1903 1,707 108 6.3 1904 1,941 119 6.1 1905 1,928 107 5.5 1906 2,275 115 5.0 1907 2,063 100 4.8 1908 2,289 126 5.5 Total 48,779 3,991 8.2 Hospital Isolation.—Out of the '2,289 cases of the notifiable infectious diseases, 1842, or 80.4 per cent., were isolated in hospitals, and of this number 1,734 had been removed to the institutions of the Metropolitan Asylums Board. SMALL POX. No case was notified during the year, nor, indeed, has any occurred since 1906, when 1 was reported. The known cases of this disease in the borough since 1891 have been as follows:—276 in the quinquennium 1891-1895; 58 in that of 1896-1900, and 355 in 1901-1905. The particulars for each year are given in Table K in the Appendix. 1908] 120 SCARLET FEVER. This disease was the cause of 1,409 illnesses, as compared with a corrected average of 1,296 in the preceding 10 years ; they were thus 113 in excess. A study of the accompanying chart shows that Scarlet Fever at the beginning of the year was above the average of the corresponding weeks of the preceding ten years, and that it kept in this position until the second week in March, when it fell below it, only, however, to be again in excess in the following week. Afterwards it remained in this position until the first week in June, when there was a considerable decrease in the cases notified. This decrease continued until the second week in July, when the cases once more passed the average number for that week, and ultimately, in the fourth week of that month, they were as many as 38, or 12 cases above the average for that week. Although the number of cases varied considerably from week to week, yet they remained above the average until the first week in October, when they fell from 49 in the last week of September to 38, or 3 below the average for the corresponding weeks of the year. They then continued below the average until the first week in November, when once more they were in excess, and with the exception of the last week of the month, they may be said to have continued to be excessive until the close of the year. The 1,409 cases that were notified were equal to an annual attack-rate of 3.96 per 1,000 inhabitants, as compared with an annual mean rate of 6.94 in the 10 years 1898-1907. In the County of London 22,072 cases occurred and the attack-rate was 4.53 per 1,000, and in the Encircling Districts 4.43. Of the notifications, 278 were reported in the first quarter, 267 in the second, 410 in the third, and 454 in the fourth, the attack-rates being respectively 319, 3 07, 4.70, and 4.83 per 1,000 inhabitants. The incidence of Scarlet Fever was distributed almost equally throughout the borough, although undoubtedly Highbury and South-East Islington had fewer cases in proportion to their population. The attack-rates for each of the Sub-registration districts were, Tufnell, 4.45; Upper Holloway, 4.31; Tollington, 4.45; Lower Holloway, 4.79; Highbury, 3 05; Barnsbury, 418, and Islington South-East, 3.54 per 1,000 of their inhabitants. Hospital Isolation.—1,274 cases out of 1,409 were removed to hospital for treatment, which represents 90 4 per cent. of the cases, as compared with 94.4 per cent., the highest percentage on record, in the preceding year. Of these 1,274 cases, 1,212 were isolated in the Metropolitan Asylums Board hospitals. Showing the rise and fall of Scarlet Fever for each week in 1908, and the averages for the corresponding weeks in the ten years 1898—1907. Red Lines=Weekly Notifications. Green Lines=Ten Years' Average 121 [1908 Fatality. There were 26 deaths among the reported cases, so that the fatality was equal to 21 per cent. Cause of Scarlet Fever.—It is very difficult to state definitely what is the cause of Scarlet Fever, but all observers are agreed that it is undoubtedly due to some organism. Thus Eddington ascribed it to a bacillus, and Frankel and Freudenburg to a diplococcus, a view which Klein also supports. On the other hand, the investigations by Crookshanks and others seem to disprove this. Dr. Class of Chicago holds that it is due, not to a streptococcus, but to a microbe resembling a gonococcus. The Local Government Board's view of the matter is probably that contained in the 30th report of their Medical Officer, (Dr. W. H. Power) in which he summarises the researches made on behalf of the Board by Dr. Mervin Gordon as follows:— "Dr. Gordon infers, as a result of these and further parallel observations, that the graver manifestations are due not to a single, but to a twofold agency; that the infectious malady, Scarlatina, is to be referred to Streptococcus Scarlatinae, whereas the dangerous phases of this disease, and especially its fatal tendency, frequently result from supplementary invasion of the blood and tissues of the patient by Streptococcus pyogenes. Thus he ascertained that Streptococcus scarlatinae is the micro-organism which is uniformly present and predominant in the mucous secretion of the tonsils of ordinary milk scarlatina; that in the nasal discharge of the disease this micro-organism is exceptionally, and in the ear discharge only rarely, to be detected; and that in the blood and organs of fatal cases, where its presence in abundance might have been anticipated, Streptococcus scarlatinae is by no means universally found. On the other hand, Streptococcus pyogenes was found by him to be seldom absent from scarlatina at any stage of the disease. Frequently it was present, in association with Streptococcus scarlatinae, in the tonsillar mucus of even uncomplicated benign cases at a very early stage of their attack; and in the nasal and aural discharges of the disease it abounded, to the exclusion almost of other micro-organisms. Finally, in the blood and organs of fatal scarlatina, Dr. Gordon found Streptococcus pyogenes commonly present—in circumstances, indeed, and under conditions, in the majority of cases, highly suggestive that death had resulted by the agency, not of Streptococcus scarlatinae, but of this other and septicaemic micro-organisms." The infection of the disease is probably taken into the system through the inspired air, but instead of passing into the lungs, gains access to the I 1908] 122 digestive tract. It is generally supposed to reside in the throat, nasal discharges, and the skin. It can be transmitted either directly from the patient or indirectly by articles which he has used during his illness, or by his clothing and bedding; also that it may be transmitted to a distance by means of letters or articles which the patient had handled. The duration of the infectiousness of the patient varies very considerably, sometimes lasting for months, but rarely less than five or six weeks; indeed, it is not safe to consider any patient absolutely free from infection for less than the last mentioned period. It sometimes happens that, despite the most careful disinfection, the disease may crop up again after the lapse of many months, though of course this is rare, especially when the walls of the infected rooms have been stripped, the ceilings whitened, the bedding and clothing disinfected by steam, and the floors thoroughly washed with disinfectants. The following are the directions given for the prevention of this disease in Islington:— DIRECTIONS FOR PREVENTING THE SPREAD OF SCARLET FEVER, ALSO KNOWN AS SCARLATINA. SCARLET FEVER. Scarlet Fever is one of the most, if not the most, infectious of the infectious diseases. It possesses, like Small Pox and Measles, the power to spread by infection from person to person. The infection is present in the early days of the disease, and until it has run its complete course. It may be contracted from the sick by the healthy. It may be conveyed by clothing or by any article, even by cups, saucers, plates, etc., taken form the sick room that have not been disinfected. Secretions from the mouth, throat, ears and nose, the peelings of the skin, probably the urine, convey the infection. It attacks persons of all ages, but particularly children under five years of age. It is fatal to about 17 in every 100 of the children under 5 years attacked, and to 4 in every 100 persons above this age. It generally appears under one week after the person has been exposed to its infection, but it may appear in a few hours. Usually the time is three days. 123 [1908 Precautions at Home. In Islington the deaths from Scarlet Fever average 52 every year. 1.—Isolate the patient in a room (exposed to sunlight, if possible) from the other inmates of the house, and allow no person to enter it except the nurse and the doctor. 2.—When possible all persons who have not previously had the disease should be sent out of the house to reside elsewhere. 3.—Hang up a sheet outside the door of the sick room, and keep it constantly wet with a disinfectant. 4.—Have the patient's room properly warmed and ventilated, but without draughts. Admit fresh air by opening the upper window sash. Keep the fire-place and chimneys open, using a small fire, when possible, to promote ventilation. Allow air to pass freely through the other part of the house by means of open windows and doors. 5.—Remove from the room intended for the isolation of the patient all unnecessary furniture, carpets, curtains and other articles likely to retain infection. 6.—Remove no articles, used in the room for the patient, or in the preparation of the food of the patient, from the room once he or she has occupied it without previously disinfecting them. 7.—All cups, glasses, spoons, pans, etc., used by the patient, should be first washed in disinfectants and afterwards in boiling water before used by any other person. 8.—Receive all discharges from the patient into a disinfectant. Add disinfectants plentifully to the discharges before emptying them into the closet. 9.—Pour daily into every sink, closet, or privy, a quantity of disinfectants. 10.—Persons attending on the sick should wear garments made of cotton, or other washable material. Woollen dresses should not be worn as they readily convey infection. The attendants should wash their hands, using a disinfectant, after waiting on the sick person and before eating. They should not unnecessarily communicate with the other inmates of the house. I 2 1908] 124 11.—No article of food should be kept in the sick room, nor consumed by any person in the room except the patient, and what he does not partake of should be destroyed by fire. 12.—Under no circumstances should the dairyman's milkcan be brought into the sick room or even handled by the nurse, lest it should become infected, and so possibly infect other cans with which it is brought into contact at the dairy. 13.—All bed and body linen used by the sick person should be at once steeped for a few hours in a disinfectant, and afterwards BOILED in water. 14.—Instead of Handkerchiefs, small pieces of rag should be used, and then these should be burned. 15.—When recovering, and if the body of the patient is peeling, camphorated or carbolised oil should be rubbed over the sick person every day. 16.—The sick person must not be allowed to mix with the rest of the family until the peeling has entirely ceased, and until the discharges from the ears, nose, or throat have disappeared. 17.—When the patient has been declared by his medical attendant to be well, send to the Medical Officer of Health for the room and its contents to be disinfected. 18.—Children in the same family or in the same house must on no account be allowed to attend Day School or Sunday School until the patient has recovered from his illness and until one week has elapsed after the disinfection has been carried out. In Case of Death. 1.—The body should not be removed into another room, as thereby it may spread the infection through the house. It is still infectious. 2.—No articles of bedding or clothing should be removed from the room until it has been disinfected, after which they should be taken to the Council's disinfection chambers for the purpose of being disinfected by steam. 3.—In washing the body, Carbolic Acid (a dessert-spoonful to the gallon of water) should be used. 125 [1908 4.—The body should be put into the coffin as soon as possible, with a disinfectant. Carbolic Powder may be used sprinkled freely underneath and over the corpse, or rags soaked in strong Carbolic Acid may be laid beneath it and over it (beneath the clothing). The coffin should be screwed down and the body buried within 48 hours. Table LXXVI. Showing the Sickness from Scarlet Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter, 2nd Quarter, 3rd Quarter. 4th Quarter, Whole Year. Tufnel 40 47 42 29 158 Upper Holloway 24 31 38 69 162 Tollington 31 24 38 74 167 Lower Holloway 36 29 76 63 204 Highbury 40 31 57 84 212 Barnsbury 32 37 81 79 229 Islington, South East 75 68 78 56 277 The Borough 278 267 410 454 1,409 Table LXXVII. Showing the Attack-Rates of Scarlet Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 4.59 5.39 4.82 3.09 4.45 Upper Holloway 2.60 3.36 4.13 6.96 4.31 Tollington 3.37 2.61 4.13 7.47 4.45 Lower Holloway 3.44 2.77 7.27 5.60 4.79 Highbury 2.34 1.82 3.34 4.57 3.05 Barnsbury 2.38 2.83 6.02 5.45 4.18 Islington, South East 3.91 3.55 4.07 2.71 3.54 The Borough 3.19 3.07 4.70 4.83 3.96 1908] 126 Table LXXVIII. Showing the Fatality from Scarlet Fever. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter 3rd Quarter. 4th Quarter. Whole Year. Tufnell 5.0 •• 4.7 •• 2.5 Upper Holloway •• •• •• 1.4 0.6 Tollington •• 8.3 •• •• 1.2 Lower Holloway 2.8 3.4 1.3 •• 1.5 Highbury 2.5 3.2 •• 2.4 1.9 Barnsbury 9.3 2.7 3.7 2.5 3.9 Islington, South East 5.3 1.5 •• 3.6 2.5 The Borough 3.9 2.2 1.4 1.5 2.1 DIPHTHERIA. Under this heading, in which is included Membranous Croup, 530 cases were notified, as compared with 481 in the preceding year, and with a decennial average of 601, on which there was thus a decrease of 71 cases. Although this is so, yet the record is the least satisfactory since 1902, when 877 cases were notified. The attack-rate for the year was equal to 1.49 per 1,000 inhabitants, while in the County of London it was 1.64. In the first quarter of the year the disease was above the decennial average in six of its weeks; in each week of the second quarter it was below the average, while in the third quarter the average for the corresponding weeks was only exceeded on four occasions. In the fourth quarter, it was exceeded on eight occasions. Thus we see that the greatest incidence of the disease occurred in the last mentioned period, when the attack-rate was 2 01 per 1,000, as compared with 1.6 in the first quarter, 0.92 in the second, and 1.30 in the third. The record of the disease from year to year is given in Table K in the Appendix, but it may be of interest to note that in the quinquennium 1891-1895 the cases numbered 3,828; in that of 1896-1900 3,704; and in that of 1901-1905 2,942. During the last three years they were respectively 439, 481, and 530. Fatality.—It is a noticeable and unsatisfactory part of the record of this disease that the fatality was higher than that of any other year since 1902, for there were 60 deaths out of the 530 cases notified, or 11-3 per cent. This compares very unfavourably with that of the preceding year, when only 3.7 per cent. of the cases died, while in 1906 the fatality was 7.3, in 1905 9.7, 1904 81, and 1903 9.4. Showing the rise and fall of Diphtheria for each week in 1908, and the averages for the corresponding weeks in the ten years 1898—1907. Red Lines=Weekly Notifications. Green Lines=Ten Years' Average. 127 [1908 Notwithstanding this fact, however, it compares most favourably with that of the early years before the notification of the disease came into force, and indeed after that time, when the number of fatal cases was often as high as 20 per cent. When the figures are examined, it is found that, although the deaths occurring in hospitals rose from 8.9 per cent. to 9.6 per cent., yet the fatality amongst those treated at home increased from 7.8 per cent. to 18.9 per cent. It is difficult to understand why this large increase occurred, unless it was due to the method of treatment, because as a rule the more virulent cases are removed to hospital, while those of a mild nature are kept at home. Years. Cases. Deaths. Fatality. 1891 756 178 23.5 1892 738 170 23.0 1893 865 200 22.6 1894 867 218 25.1 1895 582 257 18.0 1898 544 93 17.1 1899 705 128 18.2 1900 633 106 16.7 1901 911 134 14.7 1902 455 43 9.4 1904 347 28 8.1 1905 351 34 9.7 1906 439 32 7.3 1907 481 42 3.7 1908 530 60 11.3 Table LXXIX. Showing the Sickness from Diphtheria in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 14 5 10 16 45 Upper Holloway 30 9 17 22 78 Tollington 16 6 10 20 52 Lower Holloway 27 12 15 28 82 Highbury 16 22 17 24 79 Barnsbury 18 15 15 26 74 Islington, South East 24 13 30 53 120 The Borough 145 82 114 139 530 *(Inclusive of Membranous Croup.) 1908] 128 Table LXXX. homing the Attack-Rates of Diphtheria (inclusive of Membranous Croup) in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter Whole Year. Tufnell 1.61 0.57 1.15 1.70 1.27 Upper Holloway 3.26 0.98 1.85 2.22 2.07 Tollington 1.74 0.65 1.09 2.02 1.39 Lower Holloway 2.58 1.15 1.44 2.49 1.92 Highbury 0.94 1.29 1.00 1.31 1.13 Barnsbury 1.34 1.04 1.12 1.80 1.35 Islington, South East 1.25 0.68 1.56 2.57 1.73 The Borough 1.66 0.92 1.30 2.01 1.49 Table LXXXI. Showing the Fatality from Diphtheria, including Membranous Croup. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 7.1 .. 10.0 .. 4.4 Upper Holloway 13.3 22.2 11.8 4.5 11.5 Tollington .. 16.6 .. 5.0 3.8 Lower Holloway 3.7 16.6 20.0 14.3 12.2 Highbury 18.7 9.1 5.9 4.2 8.8 Barnsbury 11.1 13.3 6.6 23.1 14.9 Islington, South East 20.8 15.4 6.6 18.9 15.8 The Borough 11.0 13.4 8.7 12.2 11.3 129 [1908 Table LXXXII. Showing the Cases and Deaths from Diphtheria and Membranous Croup, together with the Fatality and the Departure from the \Mean Fatality during the ten years 1898-1907, and 1908. Year. Cases. Deaths. Fatality. Diphtheria. Membranous Croup. Total of Diphtheria and Membranous Croup. Diphtheria. Membranous Croup. Total of Diphtheria and Membranous Croup. Deaths to 100 cases of Diphtheria and Membranous Croup. Departure from Average Fatality of 10 years.* 1898 531 13 544 90 3 93 171 – 4.5 1899 688 17 705 120 8 128 18 2 – 3.5 1900 624 9 633 100 6 106 16 7 – 4.9 1901 902 9 911 124 10 134 14-7 – 6.9 1902 871 7 878 101 3 104 11 8 – 8.8 1903 452 3 455 41 2 43 9-4 – 10.0 1904 347 .. 347 27 1 28 81 – 10.3 1905 351 .. 351 33 1 34 9 7 – 7.3 1906 437 2 439 30 .. 32 7 3 – 8.6 1907 480 1 481 41 1 42 8-7 – 5.2 1898-07 5,683 61 5,744 707 37 744 12-9 – 7.0 1908 522 8 530 59 1 60 11 3 – 1.6 * The last column shows the departure from the average fatality of the ten years preceding the year indicated. Table LXXXIII. Showing the Cases, Deaths and Fatality from Diphtheria at Home and in Hospital. Quarter. Cases Nursed at Home. Cases Nursed at Hospital. Cases. 1 Deaths. 2 Percentage Fatality. 3 Cases. 4 Deaths. 5 Percentage Fatality. 6 1st 30 6 20.0 115 10 8.7 2nd 15 2 13.3 67 9 13.4 3rd 24 3 12.5 90 7 7.8 4th 26 7 26.9 163 16 9.8 Year 95 18 18.9 435 42 9.6 Note—In comparing columns 3 and 6 it must not be forgotten that it is only the mildest cases which as a rule are retained at home. The worst cases are invariably hurried to hospital. 1908] 180 Table LXXXIV. Showing the Fatality from Diphtheria0 at each year of life up to 15 years of age, and at each decennial period after that age. Ages. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. The Year. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. Cases. Deaths. Deaths to 100 Cases. 0—1 3 1 33 3 1 33 2 ... ... 5 2 40 13 4 30 1— 2 9 1 11 8 2 25 7 2 28 8 3 37 32 8 25 2— 3 14 1 7 14 3 21 6 1 17 11 2 18 45 7 15 3— 4 14 2 14 7 3 44 15 1 6 24 3 13 60 9 15 4—5 15 1 7 11 ... ... 12 ... ... 23 1 4 61 2 3 5—6 16 6 37 5 • •• ... 16 1 6 28 5 17 65 12 18 6—7 11 ... ... 2 ... ... 10 1 10 19 2 10 42 3 7 7—8 10 1 10 3 ... ... 10 1 10 19 2 10 42 4 9 8— 9 5 ... ... 2 1 50 6 1 17 13 2 15 26 4 15 9—10 9 1 11 2 ... ... 5 ... ... 6 ... ... 22 1 4 10—11 4 ... ... 3 ... ... 4 1 25 6 ... 17 17 2 12 11—12 5 ... ... 3 1 33 3 ... ... 2 ... ... 13 1 8 12—13 1 1 100 3 ... ... 2 ... ... 2 ... ... 8 1 12 13—14 5 1 20 2 ... ... 1 ... ... 2 ... ... 10 1 10 14—15 3 ... ... 2 ... ... 3 1 33 1 ... ... 9 1 11 15—25 13 ... ... 6 ... ... 7 ... ... 11 ... ... 37 ... ... 35—35 6 ... ... 5 ... ... 4 ... 3 ... ... 18 ... ... 35—45 2 ... ... ... ... ... 1 ... ... 5 ... ... 8 ... ... 45—55 ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... 55—65 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... 65 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 145 16 11 82 11 13 114 10 9 189 23 12 53o 60 11 * Inclusive of Membranous Croup. Showing the rise and fall of Enteric Fever for each week in 1908 and the averages for the corresponding weeks in the ten years 1898—1907. Red Lines=Weekly Notifications. Green Lines=Ten Years' Average. 131 [1908 ENTERIC FEVER. The return of only 97 cases is exceedingly satisfactory, as it is no less than 111 below the corrected average for the preceding 10 years. In the County of London 1,357 cases occurred. The record of this disease is given in Table K in the Appendix, and shows that in the quinquennium 1891-1895 1,088 cases occurred in the borough, in the following five years, 1896-1900, 1334; been a very regular decline in the number of cases notified, for the records show that in that year 281 cases occurred. Year by year these have decreased and in the third quinquennium, 1901-1905, 894. Ever since 1901, in which year 281 cases occurred, there has been a very regular decline in the number of cases notified, until at last the low returns of 1907 and 1908 were reached. The attack-rate was 0.27 per 1,000 inhabitants, while in the County of London it was 0.28. Fatality.—The returns show that 18 deaths occurred amongst the notified cases, or 18.5 per cent., as compared with 141 per cent. in 1907, 12.7 per cent. in 1906, and 17 0 per cent. in 1905. Table LXXXV. Showing the Cases of Enteric Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year Tufnell 1 .. 1 .. 2 Upper Holloway 1 1 5 3 10 Tollington .. .. 1 2 3 Lower Holloway 7 1 6 17 31 Highbury .. 6 3 3 15 Barnsbury .. 2 4 10 16 Islington, South East 2 4 7 7 20 The Borough 14 14 27 42 97 1908] 132 Table LXXXVI. Showing the Attack-Rates of Enteric Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 0.11 .. 0.12 .. 0.06 Upper Holloway 0.11 0.11 0.54 0.30 0.27 Tollington .. .. 0.11 0.20 0.08 Lower Holloway 0.67 0.10 0.57 1.51 0.73 Highbury 0.18 0.35 0.17 0.16 0.22 Barnsbury .. 0.15 0.30 0.69 0.29 Islington, South East 0.10 0.20 0.36 0.34 0.26 The Borough 0.16 0.16 0.31 0.45 0.27 Table LXXXVII. Showing the Fatality from Enteric Fever. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter Whole Year. Tufnell .. .. .. .. .. Upper Holloway .. .. .. .. .. Tollington .. .. .. 50.0 33.3 Lower Holloway 28.6 .. .. 23.5 19.3 Highbury 66.6 16.6 .. .. 20.0 Barnsbury .. 50.0 .. 20.0 18.7 Islington, South East •• 25.0 28.6 28.6 25.0 The Borough 28.6 21.4 7.4 21.4 18.5 TYPHUS FEVER. No case of this disease was returned, and indeed in the past 10 years only 5 cases altogether were known. In the County of London 4 cases occurred. Showing the rise and fall of Erysipelas for each week in 1908 and the averages for the corresponding weeks in the ten years 1898—1907. Red Lines=Weekly Notifications. Green Lines=Ten Years' Average. 188 [1908 ERYSIPELAS. Two hundred and thirty-five cases were reported, as contrasted with 299 during the 10 years 1898-1907, so that the year's return shows a decrease of 64. The cases were equal to an attack-rate of 0-66 per 1,000, as compared with 0 84 in the decennial period just mentioned, and with 0-86 in the County of London. Fatality.—14 deaths were registered among the 235 cases, so that the fatality was 6-2 per cent. Table LXXXVIII. Showing the Sickness from Erysipelas in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year.[/##] Tufnell 6 8 7 3 24 Upper Holloway 7 6 3 6 22 Tollington 9 5 8 3 25 Lower Holloway 10 4 4 10 28 Highbury 13 6 6 11 36 Barnsbury 15 11 4 19 49 Islington, South East 15 15 6 15 51 The Borough 75 55 38 67 235 Table LXXXIX. Showing the Attack-Rates of Erysipelas in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year.[/##] Tufnell 0.69 0.92 0.80 0.32 0.66 Upper Holloway 0.76 0.65 0.33 0.61 0.59 Tollington 0.98 0.54 0.87 0.31 0.67 Lower Holloway 0.96 0.38 0.38 0.88 0.66 Highbury 0.76 0.35 0.35 0.59 0.52 Barnsbury 1.12 0.82 0.30 1.31 0.89 Islington, South East 0.78 0.78 0.31 0.73 0.65 The Borough 0.86 0.63 0.43 0.71 0.66 184 1908] Table XC. Showing the Fatality from Erysipelas. (Deaths to 100 cases of Sickness). Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell .. .. .. .. .. Upper Holloway •• •• .. .. .. Tollington .. 40.0 • • 33.3 12.0 Lower Holloway .. 25.0 .. 10.0 7.1 Highbury 15.4 .. .. 9.1 8.3 Barnsbury .. 9.1 25.0 5.2 6.1 Islington,South East .. 6.6 .. 13.3 5.9 The Borough 2.6 9.1 2.6 8.9 6.2 PUERPERAL FEVER. Seventeen cases were reported, which is the lowest return since 1900, when 16 cases were notified. It is satisfactory to note that they are 7 below the corrected average of the preceding 10 years. They were in the proportion of 1.96 per 1,000 births, as compared with 2.57 in the preceding decade. Fatality.—4 deaths, or 23.5 per cent., occurred among the reported cases. This is the lowest percentage since the notification of the disease became compulsory. During the 18 years, it has been on one occasion as high as 5G per cent., and on at least two occasions it has reached 54-5 per cent., while it invariably exceeded 35 per cent. Table XCI. Showing the Sickness from Puerperal Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. lst Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 1 .. 1 .. 2 Upper Holloway .. .. .. .. .. Tollington .. .. .. 1 1 Lower Holloway .. 2 1 2 5 Highbury 1 1 1 .. 3 Barnsbury 1 1 1 3 Islington, South East •• 1 1 1 3 The Borough 3 4 5 5 17 185 [1908 Table XCII. Showing the Attack-Rates of Puerperal Fever per i,oco registered Births in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 4.50 •• 503 •• 2.45 Upper Hollo way .. •• •• •• •• •• Tollington .. •• •• •• 5.56 1.37 Lower Hollo way •• 7.27 4.31 7.07 4.69 Highbury 2.79 2.84 2.84 •• 212 Barnsbury 2-46 •• 2.42 2.33 1.85 Islington, South East •• 1.97 2.03 1.98 1.51 The Borough 1.35 1.88 2.34 2.29 1.96 Table XCIII. Showing the Fatality from Puerperal Fever. Deaths to 100 cases of Sickness. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Whole Year. Tufnell 100.0 .. .. .. 50.0 Upper Holloway .. .. .. .. .. Tollington .. .. .. 100.0 100.0 Lower Holloway .. 50.0 .. 50.0 40.0 Highbury .. •• .. .. .. Barnsbury .. .. .. .. .. Islington. South East .. .. .. .. •• The Borough 33.3 25.0 .. 40.0 23.5 186 1908] CONTINUED FEVER. One case was notified, and it was treated at home. Table XCIV. Showing the number of Cases of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1898-1907 and in 1908. DISEASES. YEARS. Corrected a/erage number of cases. — Increase or Decrease. 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1898-07. 1908 Small Pox ... 3 2 50 276 9 17 3† 1 ... 38 ... -38 Scarlet Fever 1336 1494 1074 1286 1372 865 1146 1198 1386 1216 1296 1409 + 113 Diphtheria 531 688 624 902 871 452 347 351 437 480 595 522 - 73 Membranous Croup 13 17 9 9 7 3 ... ... 2 1 6 8 +2 Enteric Fever 237 353 259 281 257 130 126 100 149 92 208 97 — 111 Typhus Fever 2 ... 1 2 ... ... 1 ... 1 ... 1 ... 1 Erysipelas 279 350 285 285 357 227 280 252 274 252 299 235 -64 Puerperal Fever 19 33 16 34 J9 19 24 24 24 21 24 17 —7 Continued Fever 1 2 6 3 5 2 ... ... 1 1 2 1 — I Relapsinn Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... 3* ... ... ... ... ... ... ... ... ... ... ... Totals 2418 2943 2276 2852 3164 1707 1941 1928 2275 2063 2469 2289 — l80 * English Cholera. † 1 Case returned after a few days not Small Pox. 187 [1908 Table XCV. Showing the Attack.Rates of the several Notifiable Infectious Diseases during the Ten Years 1898.1907 and in 1908. DISEASES. YEARS. Mean Attack Rates. Attack Rate. Increase or Decrease 1898. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 1898.07. 1908. Small Pox 0.00 0.00 0.00 0.15 0.80 0.03 0.05 0.01 0.00 0.00 0. 11 ... -0.11 Scarlet Fever 3.97 4.44 3.20 3.84 3.99 2.55 3.36 3.49 4.02 3.50 3.64 3.96 + 0.32 Diphtheria 1.58 2.05 1.86 2.69 2.53 1.33 1.02 1.02 27 x,39 1.67 1.47 —0.20 Membranous Croup 0.04 0.05 0.03 0.03 0.02 0.01 ... ... 0.00 0.00 0.02 0.02 ... Enteric Fever 0.70 1.05 0.77 0.84 0.75 0.38 0.37 0.29 0.43 0.26 0.59 0.27 —0.32 Typhus Fever 0.00 0.00 0.00 0.00 0.00 0.00 ... 0.00 ... 0.00 ... ... Erysipelas 0.83 1.04 0.85 0.85 1.04 067 0.82 0.74 0.80 0.73 0.84 0.66 —0.18 Puerperal Fever 2.86 3.42 1.73 3.67 2.06 2.11 2.70 2.74 2.79 2.46 2.57 1.96 -0.61 Continued Fever 0.00 0.00 0.02 0.00 0.01 0.00 ... ... 0.00 ... 0.00 ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... 0 00 ... ... ... ... ... ... ... ... 0.00 ... ... Totals 718 8.75 6.78 8.50 9.20 5.03 5.69 5.62 6.59 5.94 6.94 6.43 .0.51 . These figures are calculated as per 1,000 Registered Births. K 138 1908] TABLE XCVI. Shewing the number of Cases of Infectious Diseases notified in the Sub-Registration Districts during 1908. Sub-Registration District. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals. Attack-Rate per 1,000 of the Population. Tufnell ... 158 45 ... 2 ... 24 2 ... ... ... 231 6.50 Upper Holloway ... 162 76 2 10 ... 22 ... 1 ... ... 273 7.27 Tollington ... 167 52 ... 3 ... 25 1 ... ... ... 248 6.61 Low of Holloway ... 204 79 3 31 ... 28 5 ... ... ... 350 8.21 Highbury ... 212 78 1 15 ... 36 3 ... ... ... 345 4.96 Barnsbury ... 229 73 1 l6 ... 49 3 ... ... ... 371 6.76 Islington South East ... 277 TI9 1 20 ... 5i 3 ... ... ... 471 6.02 The Borough ... 1409 522 8 97 ... 235 17 1 ... ... 2289 6.43 (All Duplicates have been deducted). 139 [1908 K 2 TABLE XCVI1. Showing the Attack.rates of Infectious Diseases notified, in the Sub.Registration Districts during 1908. Sub.Registration Districts. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal. Fever. Continued Fever. Relapsing Fever Cholera. Attack.Rate per 1,000 of the Population. Tufnell ... 4.45 1.27 ... o.o6 ... o.66 2.45 ... ... ... 6.50 Under Holloway ... 4.31 2.02 0.05 0.27 ... 0.59 ... 0.03 ... ... 7.27 Tollington ... 4.45 1.39 ... o.o8 ... 0.67 1.37 • • • ... ... 6.61 Lower Holloway ... 4.79 1.85 0.07 0.73 ... 0.66 4.69 ... ... ... 8.21 Highbury ... 3.05 1.12 0.01 0.22 ... 0.52 2.12 ... ... ... 4.96 Barnsbury ... 4.18 1.33 0.02 0.29 ... 0.89 1.85 ... ... ... 6.76 Islington, South East ... 3.54 1.52 0.01 0.26 ... 0.65 1.51 ... ... ... 6.02 The Borough ... 3.96 1.47 0.02 0.27 ... 0.66 1.96 0.00 ... ... 6.43 Per 1,000 Registered Births 140 1908] TABLE XCVIII Showing the number of Cases of Infectious Disease notified, in the Wards during the year 1908. (N.B.—Duplicate notification have been deducted). WARDS. Estimated Population. 1908. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membrous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals. Cases Notified per 1,000 of Population. 1 2 3 1 4 5 6 7 8 9 10 II 12 13 14 15[/### Tufnell 34,863 ... 158 45 ... 2 ... 24 2 ... ... ... 231 6.50 Upper Holloway 36,847 ... 162 76 2 10 ... 22 ... 1 ... ... 273 7.27 Tollington 30,788 ... 167 52 ... 3 ... 25 1 ... ... ... 248 6.61 Lower Holloway 41,807 ... 204 79 3 31 ... 28 5 ... ... ... 350 8.21 Highbury 35,207 ... 119 45 1 9 ... 18 2 ... ... ... 194 5.40 Mildmay 25,211 ... 79 26 ... 2 ... 18 1 ... ... ... 126 4.90 Thornhill 33,526 ... 135 49 1 10 ... 26 1 ... ... ... 222 6.50 Barnsbury 20,271 ... 94 24 ... 6 ... 23 2 ... ... ... 149 7.21 St. Mary's 17,533 ... 78 19 ... 8 ... 13 1 ... ... ... 119 6.66 Canonbury 33,969 ... 88 60 ... 11 ... 14 ... ... ... ... 173 5.00 St. Peter's 33,069 ... 125 47 1 5 ... 24 2 ... ... ... 204 6.05 Totals 349,091 ... 1409 522 8 97 ... 235 17 1 ... ... 2289 6.43 1906 1 1386 437 2 149 1 274 24 1 ... ... 2275 6.59 1907 12l6 480 1 92 ... 252 ... ... ... ... 2063 5.94 141 [1908 Table XCIX. Showing the Attack.Rates of the Notifiable Infectious Diseases notified in the Wards during the Year 1908. WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas Puerperal Fever.. Continued Fever. Relapsing Fever. Cholera. Total Attack. Rates. Tufnell ... 4.45 1.27 ... 0.06 ... 0.66 0.06 ... ... ... 6.50 Upper Holloway ... 4.31 2.02 0.05 0.27 ... 0.59 ... 0.03 ... ... 7.27 Tollington ... 4.45 1.39 ... 0.08 ... 0.67 0.02 ... ... ... 6.61 Lower Holloway ... 4.79 1.85 0.07 0.73 ... 0.66 0.12 ... ... . . . 8.21 Highbury ... 3.32 1.25 0.03 0.25 ... 0.50 0.05 ... ... . . . 5.40 Mildmay ... 3.08 1.01 ... 0.08 ... 0.70 0.04 ... ... . . . 4.90 Thornhill ... 3.95 1.44 0.03 0.29 ... 0.76 0.03 ... ... . . . 6.50 Barnsbury ... 4.55 1.16 ... 0.29 ... 1.ll 0.10 ... ... . . . 7.21 St. Mary.s ... 4.37 1.06 ... 0.45 ... 0.73 0.05 ... ... . . . 6.66 Canonbury ... 2.54 1.73 ... 0.32 ... 0.41 ... ... ... . . . 5.00 St. Peter.s ... 3.71 1.40 0.03 0.15 ... 0.71 0.06 ... ... . . . 6.05 Totals ... 3.96 1.47 0.02 0.27 ... 0.66 0.05 0.00 ... ... 6.43 * Per 1,000 of the Population. 142 [806T Table C. Showing the Number of Cases of Infectious Diseases which were investigated by the District Sanitary Inspectors during the Year 1908. Sanitary Inspectors. Number of the Sanitary District. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cerebro Spinal Fever. Total. Mr. Cook 1 ... 127 34 ... 2 ... 20 1 ... ... 2 186 „ Bicknell 2 ... 163 76 2 10 ... 23 ... I ... ... 275 ,, Bagshaw 3 ... 69 22 ... I ... 9 1 ... ... ... 102 ,, Bacon 4 ... 133 37 ... 7 ... 19 ... ... ... ... 196 ,, Flood 5 ... 77 22 1 3 ... 14 I ... ... ... 118 „ Horsman 6 ... 117 45 1 6 ... 17 5 ... ... 1 192 „ Fortune 7 ... 67 29 1 4 ... 11 1 ... ... ... 113 ,, Metcalf 8 ... 71 22 ... 2 ... 11 1 ... ... ... 107 „ Irving 9 ... 148 56 1 27 ... 18 2 ... ... 1 253 ,, Watson 10 ... 69 51 ... 6 ... 17 ... ... ... ... 143 ,, Burrell 11 ... 112 35 ... 7 ... 18 2 ... ... ... 174 „ Agar 12 ... 83 31 1 7 ... 28 1 ... ... ... 151 „ Jordan 13 ... 101 30 ... 10 ... 15 1 ... ... ... 157 ,, Callow 14 ... 72 32 1 5 ... 15 1 ... ... 1 127 Totals ... 1,409 522 8 97 ... 235 17 1 ... 5 2,294 148 [1908 Table CI. Showing the Cases of Infectious Disease which were notified in the several Months during the Year 1908. N.B.—(Duplicate Notifications have been deducted.) Month. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total each month. January ... 99 57 1 6 ... 30 1 ... ... ... 194 February ... 88 44 1 2 ... 19 1 ... ... ... 155 March ... 91 42 ... 6 ... 26 1 ... ... ... 166 April ... 8o 29 2 7 ... 17 1 ... ... ... 136 May ... 108 23 ... 1 ... 17 1 ... ... ... 150 June ... 79 27 1 6 ... 21 2 ... ... ... 136 July ... 121 33 ... 8 ... 8 2 ... ... ... 172 August ... 99 35 ... 7 ... 11 1 ... ... ... 153 September ... 190 44 2 12 ... 19 2 1 ... ... 270 October ... 137 73 ... 12 ... 14 1 ... ... ... 237 November ... 136 52 ... 16 ... 15 ... ... ... ... 219 December ... 181 63 1 14 ... 38 4 ... ... ... 301 Total ... 1,409 522 8 97 ... 235 17 1 ... ... 2,289 144 1908] Table CII. Showing the Cases of Infectious Disease notified during the Year 1908 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1908. Small Pox. Scarlet Fever or Scarlatina. Diphtheria (including Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Cases. St. Pancras 237,075 2 952 308 6l 1 158 8 ... ... ... 1,490 Stoke Newington 54,015 ... 202 65 11 ... 25 4 ... ... ... 307 Hackney 235,253 1 1,276 389 66 ... 238 12 ... ... ... 1,982 Hornsey 92,713 ... 239 96 9 ... 39 3 ... ... ... 386 Finsbury 96,007 ... 409 170 49 ... 95 4 ... ... ... 727 Shoreditch 115,227 ... 600 2IO 105 ... 127 6 ... ... ... 1,048 The Encircling Boroughs 830,290 3 3,678 1,238 301 1 682 37 ... ... ... 5.940 Islington 349,091 ... 1,409 530 97 ... 235 17 1 ... ... 2,289 145 [1908 Table CIII. Showing the Attack-Rates per 1,000 inhabitants of the Infectious Diseases notified during the Year 1908 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1908. Small Pox. Scarlet Fever or Scarlatina. Diptheria (including Membranous) Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever.* Continued Fever. Relapsing Fever. Cholera. Total Attack-Rates. 1 2 3 4 5 6 7 8 9 10 11 12 13 St. Pancras 237,075 0.01 3.95 1.28 0.25 0.00 0.66 0.03 ... ... ... 6.18 Stoke Newington 54,015 ... 3.68 1.18 0.20 ... 0.46 0.07 ... ... ... 5.59 Hackney 235,253 0.01 5.34 1.63 0.28 ... 1.00 0.05 ... ... ... 8.31 Hornsey 92,713 ... 2.57 1.03 0.10 ... 0.42 0.03 ... ... ... 4.15 Finsbury 96,007 ... 4.19 1.74 0.50 ... 0.97 0.04 ... ... ... 7.44 Shoreditch 115,227 ... 5.12 1.79 0.90 ... 1.08 0.05 ... ... ... 8.94 The Encircling Borough 830,290 0.00 4.43 1.49 0.36 ... 0.82 0.04 ... ... ... 7.14 Islington 349.091 ... 3.96 1.49 0.27 ... 0.66 0.05 0.00 ... ... 6.43 Increase or Decrease ... ... —0.47 ... —0.09 ... —0.16 +0.01 ... ... ... —0.71 * Per 1,000 of the population. 146 1908J Table CIV. Showing the Cases of Infectious Disease notified in the several Metropolitan Boroughs during the year 1908. Cities and Boroughs. Estimated population in the middle of 1908. Notified Cases of Infectious Disease. Small Pox. Scarlet Fever. Diphtheria.* Typhus Fever. Enteric Fever. Other continued Fevers. Puerperal Fever. Erysipelas. Cerebro-spinal Meningitis. Total. london 4 795,757 4 22,070 8,002 4 1,357 13 228 4202 85 35,965 West Districts. Paddington 150,923 .. 682 150 .. 31 1 6 105 1 976 Kensington 182,752 .. 453 238 .. 42 1 11 132 1 878 Hammersmith 134,012 .. 394 204 .. 31 .. 6 69 1 705 Fulham 171,562 .. 596 400 .. 39 .. 17 127 4 1,183 Chelsea 75,049 .. 174 141 .. 17 .. 3 52 .. 387 City of Westminster 170,545 1 627 187 .. 41 .. 6 81 3 946 North Districts. St. Marylebone 126,867 .. 411 119 .. 34 1 8 126 2 701 Hampstead 92.654 .. 280 64 .. 25 1 6 33 .. 409 St Pancras 217,075 2 952 308 1 61 .. 8 158 5 1,495 Islington 349 091 .. 1,409 530 .. 97 1 17 235 7 2,296 Stoke Newington 54.015 .. 202 65 .. 11 .. 4 25 2 309 Hackney 235,253 1 1,276 389 .. 66 .. 12 238 7 1,989 Central Districts. Holborn 54,466 .. 194 50 .. 25 .. 2 46 .. 317 Finsbury 96.007 .. 409 170 .. 49 .. 4 95 3 730 City of London 19,252 .. 53 29 .. 7 .. 1 9 .. 99 East Districts. Shoreditch 115,227 .. 600 210 .. 105 .. 6 127 6 1054 Bethnal Green 131,066 .. 1,010 278 83 .. 6 246 2 1625 Stepney 310,706 .. 2,358 658 3 98 2 9 423 2 3553 Poplar 171,516 .. 1,280 315 .. 61 .. 14 191 5 1,866 South Districts. Southwark 210,442 .. 775 270 .. 48 .. 15 234 6 1,348 Bermondsey 127.910 .. 641 252 .. 58 .. 9 168 3 1,131 Lambeth 321,344 .. 1,454 345 .. 66 3 10 225 14 2,117 Battersea 183,873 .. 1,152 366 .. 41 .. 7 150 3 1,719 Wandsworth 289,506 .. 1,261 591 .. 61 .. 13 209 5 2,140 Camberwell 280,022 .. l,054 398 .. 36 .. 10 233 2 1,733 Deptford 117.539 .. 723 208 .. 28 .. 4 171 .. 1,134 Greenwich 109,110 .. 428 223 .. 35 .. 2 106 .. 794 Lewisham 156,627 .. 620 471 .. 34 3 6 91 .. 1225 Woolwich 131,346 .. 601 368 .. 20 .. 6 91 1 1087 Port of London .. .. 1 5 .. 7 .. .. 6 .. 19 * Including Membranous Croup. 147 [1908 Table CV. Showing the Attack-Rates of the Infectious Diseases notified in the. several Metropolitan Cities and Boroughs during the year 1908. Cities and Boroughs. Small Pox. Scarlet Fever. Diphtheria. * Typhus Fever. Enteric Fever Other Continued Fevers. Puerperal Fever. Erysipelas. Cerebro-Spinal Meningitis. Total Attack-Rate. County ot London 0.00 4.53 1.64 0.00 0.28 0.00 0.05 0.86 .. 7.36 West Districts. Paddington .. 4.45 0.98 .. 0.20 0.01 0.04 0.68 .. 6.36 Kensington .. 2.44 1.28 .. 0.23 0.01 0.06 0.71 .. 4.73 Hammersmith .. 3.12 1.62 .. 0.25 .. 0.05 0.55 .. 5.59 Fulham .. 3.42 2.29 .. 0.22 .. 0.10 0.73 .. 6.76 Chelsea .. 2.28 1.85 .. 0.22 .. 0.04 0.68 .. 5.07 City of Westminster 0.01 3.61 1.08 .. 0.24 .. 0.03 0.47 .. 5.44 North Districts. St. Marylebone .. 3.19 0.92 .. 0.26 0.01 0.06 0.98 .. 5.42 Hampstead .. 2.97 0.68 .. 0.27 0.01 0.06 0.35 .. 4.34 St. Pancras 0.01 3.95 1.28 0.00 0.25 .. 0.03 0.66 .. 6.18 Islington .. 3.96 1.49 .. 0.27 0.00 0.05 0.66 .. 6.43 Stoke Newington.. .. 3.68 1.18 .. 0.20 .. 0.07 0.46 .. 5.59 Hackney 0.01 5.34 1.63 .. 0.28 .. 0.05 1.00 .. 8.31 Central District, Holborn .. 3.51 0.90 .. 0.45 .. 0.04 0.83 .. 5.73 Finsbury .. .. 4.19 1.74 .. 0.50 .. 0.04 0.97 .. 7.44 City of London .. 2.71 1.48 .. 0.36 .. 0.05 0.46 .. 5.06 East Districts Shore Jitch .. 5.12 1.79 .. 0.90 .. 0.05 1.08 .. 8.94 Bethnal Green .. 7.58 2.09 .. 0.62 .. 0.05 1.85 .. 12.19 Stepney .. 7.45 2.08 0.01 0.31 0.01 0.03 1.34 .. 11.23 Poplar .. 7.34 1.81 .. 0.35 .. 0.08 1.10 • • 10.68 South Districts. South wark .. 3.62 1.26 .. 0.22 .. 0.07 1.09 .. 6.26 Bermondsey .. 4.93 1.94 .. 0.45 .. 0.07 1.29 .. 8.68 Lambeth .. 4.45 1.06 .. 0.20 0.01 0.03 0.69 .. 6.44 Battersea .. 6.16 1.96 .. 0.22 .. 0.04 0.80 .. 9.18 Wandsworth .. 4.28 2.01 .. 0.21 .. 0.04 0.71 .. 7.25 Camberwell .. 3.70 1.40 .. 0.13 .. 0.04 0.82 .. 6.09 Deptford .. 6.05 1.74 .. 0.23 .. 0.03 1.43 .. 9.48 Greenwich .. 3.86 2.01 .. 0.32 .. 0.02 0.96 .. 7.17 Lewisham .. 3.90 2.96 .. 0.21 0.02 0.04 0.57 7.70 Woolwich .. 4.50 2.76 .. 0.15 .. 0.04 0.68 .. 8.13 Port of London ? ? ? .. ? •• •• ? .. ? * Including Membranous Croup. 148 1903] EPIDEMIC CEREBRO SPINAL MENINGITIS. This disease, which has been notified in Islington since March, 1907, under an Order of the London County Council, which had been approved by the Local Government Board, was notified in 7 instances, and resulted in 4 deaths. The fatality was therefore 57.1 per cent. The cases were as follows:— Cases. Deaths. 1st quarter 2 1 2nd „ 2 1 3rd „ — — 4th „ 3 2 7 4 VOLUNTARY NOTIFICATION OF PHTHISIS. Fifty-nine cases were notified by medical practitioners, of which 27 occurred in their private practice, and 32 in their public practice. In addition to these, the Relieving Officers notified 50 cases among paupers, so that 109 cases came under the observation of the Medical Officer of Health during the year. In 1905 123 such cases were known, in 1906 126, in 1907 137, so that in four years 495 cases were known. In each instance instructions were left either with the patients themselves or with their parents or guardians. Years. Medical Practitioners Relieving Officers. Totals. Private Practice. Public Practice. 1905 68 13 42 123 1906 30 34 62 126 1907 40 28 69 137 1908 27 32 50 109 Four years 165 107 223 495 If the patients were removed to hospital, disinfection of the rooms was generally effected; at all events the Public Health Department made an offer to the persons in charge of the home to disinfect the rooms and clothing. 149 [1908 A similar course was pursued when information was gleaned from the weekly returns that a death had occurred in any family. As a rule these offers were accepted. Altogether 361 rooms, in 281 houses were disinfected. The following are the particulars:— Houses. Rooms. 1st quarter 75 100 2nd „ 65 95 3rd „ 75 90 4th „ 66 76 Total 281 361 These figures contrast with those of the preceding two years as follows:— Houses. Rooms. 1905 283 380 1906 258 369 1907 296 411 1908 281 361 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS ORDER, 1908. In the month of December the notification of Pulmonary Tuberculosis by Poor Law Officers was made compulsory. The Order was issued by the Local Government Board in pursuance of section 130 of the Public Health (London) Act, 1875, as amended and extended by the Public Health (London) Act, 1891, and the Public Health Act, 189G, to provide for the notification to the Medical Officers of Health of Sanitary Authorities of cases of that disease occurring among the inmates of Poor Law Institutions or among persons under the care of the District Medical Officers. The Order provides that the Medical Officer of all Poor Law Institutions and the District Medical Officers shall post to the Medical Officer of Health for the sanitary district information as to the cases, and that they shall be paid one shilling for each notification, and sixpence for each subsequent re-notification of the same case. The Order came into effect on January 1st, 1909, and is certain to prove very useful. INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. As usual, inquiry was made at the home of every case of infectious disease that was notified, with a view, among other matters, of ascertaining the school at which the patient attended, as well as the school or schools attended by any children living in the house who were of school age. 150 1908] These inquiries showed that out of the 2,289 cases of infectious disease, 1,058 occurred among scholars attending the public elementary schools, as compared with 998 in 1900, and 836 in 1907, and with an average of 947 in the preceding 10 years. The proportion of the infected children attending the schools to the total number of cases was 46.2 per cent. Altogether as many as 3,728 children were excluded from school because one or other of the notifiable infections had occurred in the house in which they resided. Eight hundred and nine scholars were attacked with scarlet fever, and 2,659 children were kept at home in consequence. 230 scholars contracted Diphtheria, and 934 children were excluded from school. 19 scholars contracted Enteric Fever, and 135 scholars had to remain at home. The following return shows that the number of cases of Scarlet Fever among scholars was 174 above the average for the preceding 10 years, while Diphtheria showed a decrease of 21, and Enteric Fever a decrease of 25. Other diseases showed a decrease of 16. A return has been prepared showing the number of scholars attacked with each disease during the preceding 10 years. It is as follows:— Table CVI. Infectious Diseases in the Public Elementary Schools. Year. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Diseases. Total Scholars. Proportion to every 100 cases notified. 1898 .. 640 206 37 8 891 36.9 1899 .. 725 290 61 11 1087 36.9 1900 1 542 283 67 13 906 39.8 1901 •• 669 438 72 32 1211 42.5 1902 14 664 405 64 34 1181 37.3 1903 .. 507 216 35 16 774 45.3 1904 .. 571 138 28 20 757 39.0 1905 .. 640 138 31 23 832 43.2 1906 .. 785 177 33 3 998 43.9 1907 .. 608 216 11 1 836 40.5 Ten years Average 1 635 251 44 16 947 38.3 1908 .. 809 230 19 .. 1,058 46.2 151 [1908 Table CVII. Showing the cases of Notifiable Infectious Diseases occurring in Public Elementary Schools during the Year 1908. NAME OF SCHOOL. Scholars attacked. Scholars excluded from School who lived in houses in which infected children resided. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Fevers. Total. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Other Fevers. Total. Yerbury Road .. 23 5 .. .. 28 .. 81 24 .. .. 105 St. John's, Holloway Road .. 18 5 .. .. 24 .. 29 5 .. .. 34 St. Joseph's, Highgate Hill .. 11 .. .. .. 11 .. 28 1 .. .. 29 Hargrave Park .. 11 4 .. .. 15 .. 111 33 .. .. 141 Burleigh Road .. 16 5 .. .. 21 .. 93 14 1 .. 108 St. Mark's, Grove Road .. 3 6 .. .. 9 .. 19 19 .. .. 38 Cottenham Road .. 5 4 .. .. 9 .. 45 26 1 .. 72 Grafton Road .. 29 9 .. .. 39 .. 75 37 l .. 113 Duncombe Road .. 60 6 .. .. 66 .. 154 31 .. .. 185 Whittington, Highga.e Hill .. 15 1 .. .. 16 .. 51 8 1 .. 60 Montem Street .. 33 10 .. .. 44 .. 92 32 4 .. 128 St. Barnabas, Hornsey Road .. 10 2 .. .. 12 .. 18 6 l .. 25 Forster, Hornsey Road .. 10 3 .. .. 13 .. 43 11 2 .. 56 Poole's Park .. 15 4 .. .. 19 .. 62 12 .. .. 74 Hornsey Road (Upper) .. 38 14 1 .. 53 .. 98 44 1 .. 143 Hungerfcrd Road .. 19 4 .. .. 23 .. 54 10 2 .. 66 Brecknock, York Road .. 13 1 .. .. 14 .. 34 5 .. .. 39 Pakeman Street .. 15 7 .. .. 22 .. 43 27 .. .. 70 St. James', George's Road .. 4 2 .. .. 6 .. 25 11 .. .. 36 Catholic School, Eden Grove .. 5 1 .. .. 6 .. 20 9 .. .. 29 Caledonian Road .. 12 4 1 .. 17 .. 42 13 6 .. 61 Westbourne Road .. 27 5 1 .. 33 .. 101 49 2 .. 152 St. Mary Magdalene, Liverpool Road .. 7 2 .. .. 9 .. 22 13 1 .. 36 Blackstock Road .. 9 2 .. .. 11 .. 34 11 4 .. 49 Gillespie Road .. 8 3 .. .. 11 .. 34 11 .. .. 45 Drayton Park (Wesleyan) .. 9 .. .. .. 9 .. 17 2 .. .. 19 St. John's, Conewood Street .. 2 4 .. .. 6 .. 11 2 .. .. 13 St. Jude's, King Henry's Walk .. 10 1 .. .. 11 .. 16 2 2 .. 20 Newington Green .. 21 2 1 .. 24 .. 41 4 3 .. 48 Ambler Road .. 12 4 .. .. 16 .. 32 19 1 .. 52 York Road .. 17 8 .. .. 25 .. 67 41 .. .. 108 Gifford Street .. 15 3 .. .. 18 .. 78 34 14 .. 126 St. Thomas, Everilda Street .. 7 .. .. .. 7 .. 20 2 .. .. 22 St. Clement's Cumberland Street .. 14 8 .. .. 22 .. 45 10 2 .. 57 Blundell Street .. 25 7 5 .. 37 .. 116 39 45 .. 200 St. Paul's, Dorset Street .. 7 1 .. .. 8 .. 27 8 .. .. 35 Ecclesbourne Road .. 14 24 2 .. 40 .. 35 43 5 .. 83 Tottenham Road.. .. 6 .. .. .. 6 .. 31 7 .. .. 38 Queen's Head Street .. 24 2 .. .. 26 .. 63 28 4 .. 95 Popham Road (Angler's Gardens) .. 6 1 .. .. 7 .. 22 10 .. .. 32 St. Philip's, Arlington Square .. 11 3 .. .. 14 .. 24 7 .. .. 31 Shepperton Road .. 21 3 .. .. 24 .. 62 12 1 .. 75 Rotherfield Street .. 5 2 2 .. 9 .. 21 14 1 .. 36 St. Bartholomew, Shepperton Road .. .. .. .. .. 2 .. .. .. 2 Buckingham Street .. 26 5 .. .. 31 .. 58 35 5 .. 98 Winchester Street .. 6 3 1 .. 10 .. 22 20 5 .. 47 All Saints', Muriel Street .. 3 .. .. .. 3 .. 5 9 4 .. 18 Vittoria Place .. 9 1 .. .. 10 .. 55 18 .. .. 73 Holy Trinity, Cloudesley Street .. 5 2 1 .. 8 .. 25 7 5 .. 37 Richard Street .. 25 7 .. .. 32 .. 75 16 3 .. 94 Station Road .. 12 4 .. .. 16 .. 41 18 1 .. 60 Thornhill Road .. 45 5 .. .. 50 .. 97 14 2 .. 113 Barnsbury Park .. 3 .. .. .. 3 .. 7 2 2 .. 11 St. Matthew's, City Road .. 4 .. .. .. 4 .. 15 .. .. .. 15 St. John's, Duncan Terrace .. 3 1 .. .. 4 .. 17 5 .. .. 22 Hanover Street .. 10 14 .. .. 24 .. 45 25 .. .. 70 Canonbury Road .. 11 3 1 .. 15 .. 31 7 3 .. 41 St. Mary's, Cross Street .. 5 3 .. .. 8 .. 28 12 .. .. 40 German School, St. Peter Street .. .. .. .. .. .. .. .. .. .. .. Total 809 230 19 .. 1058 .. 2659 934 135 .. 3728 152 1908] NON-NOTIFIABLE INFECTIOUS DISEASES. In 4,359 instances infectious diseases which are not notifiable under the Public Health (London) Act, 1891, were reported to the Medical Officer of Health by the teachers of the several public elementary schools. They show a decrease of 1,470 on the return of the preceding year. This large decrease is probably due to the fact that measles was not so prevalent as in 1907. It is exceedingly satisfactory to find that under the London County Council the head teachers are now notifying cases in much larger numbers than they did under the late School Board for London, and that the increase in the notifications has been very perceptible since 1904. These notifications are exceedingly valuable, not only from a public health point of view, but as regards the schools themselves, and therefore, when they are received, every effort is made to prevent the disease both at the homes and in the schools. During the year 1,095 cases of measles were known in the several schools, as compared with 2,065 in the preceding year; while of chicken pox 624 cases were reported, as against 981 in 1907. Whooping cough showed a decrease, for, whereas 831 cases were known in the preceding year, there were only 385 in 1908. On the other hand, the cases of contagious diseases, such as scabies, ringworm and the like, numbered 2,254, as contrasted with 1,952 in 1907. Perhaps it is ungenerous to find fault when so many cases are notified by the teachers, but it would be a great improvement if earlier information respecting them could be sent to the Medical Officer of Health than sometimes occurs. The explanation given is that the fault does not lie with the teachers, who send the information as soon as they get it, but rather with the attendance officers who find it difficult to call on all the absentees quickly when many are reported to them at one time. Of course, allowance has to be made for this, but it would be very satisfactory if an improvement could be effected. The particulars for the last ten years are as follows:— 1899 829 1904 2,425 1900 3,066 1905 3,397 1901 3,395 1906 4,135 1902 2,307 1907 5,829 1903 2,298 1908 4359 158 [1908 Table CVIII. Showing the Infectious Diseases notified during the year 1908 by the Teachers of Public Elementary Schools under the provisions of Regulation 148, sec. iv., of the London County Council Schools Code. School. M easier. Chicken Pox. Whooping Cough. Other Disease s. Totals. All Saints' .. .. .. .. .. Ambler Road 1 2 1 24 28 Amwell Street .. .. .. 1 1 Burleigh Road 3 17 1 20 41 Brecknock .. .. .. .. .. Blackstock Road 26 5 1 15 47 Barnsbury Park .. .. .. 11 1 Blundell Street 10 18 2 164 194 Buckingham Street 73 7 9 92 181 Cottenham Road 16 10 25 25 76 Canonbury Road 83 27 27 48 185 Catholic School, Eden Grove .. 4 .. 6 10 Caledonian Road 53 29 .. 81 163 Chapel of Ease 2 .. 1 13 16 Duncombe Road 9 29 8 166 212 Drayton Park 3 32 21 29 85 Ecclesbourne Road 65 52 2 39 158 Englefield Road .. 1 .. 1 2 Forster, Hornsey Road 2 .. 2 18 22 Grafton Road 21 26 13 44 104 Gillespie Road 2 7 12 45 66 Gifford Street 54 29 22 93 198 Hargrave Park .. 2 1 48 51 Hungerford Road 6 9 .. 19 34 Holy Trinity 18 3 .. 5 25 Hanover Street 32 20 14 41 110 Hugh Myddleton .. .. .. 1 1 Montem Street 102 38 42 98 280 Newington Green 10 1 1 36 48 Poole's Park 21 8 28 74 131 Pakeman Street 14 26 .. 48 88 Popham Road 1 8 1 2 12 Queen's Head Street 1 4 13 76 94 Risinghill Street 1 .. .. .. 1 Rotherfield Street 16 20 1 60 97 Richard Street 21 26 14 54 115 Shepperton Road 1 3 2 53 59 Station Road 26 5 6 70 107 St. John's, Holloway Road 33 .. .. 10 43 St. Joseph's .. .. .. 4 4 St. Mark's, Grove Road 2 2 .. 8 12 St Paul's, Blenheim Road .. .. .. .. .. St. Barnabas 2 10 6 72 90 St. Ann's .. .. .. .. .. St. James ' 19 .. .. 2 21 St. John's, Conewood Street .. .. .. 9 9 St. Jude's 43 5 13 9 70 St. Thomas' 34 14 7 20 75 St. Clement's .. .. .. 10 10 St. Paul's, Dorset Street 8 1 .. 1 10 St. Bartholomew's .. .. .. .. St. Philip's 47 1 1 18 67 St. Matthew's, Rotherfield Street .. .. .. .. .. St. Matthew's, City Road 1 .. 1 10 12 St. John's, Duncan Terrace 1 .. .. 17 18 St. Mary's 1 1 8 7 17 Tottenham Road 7 6 11 13 37 Thornhill Road 18 3 .. 33 54 Upper Hornsey Road 55 12 21 86 171 Vittoria Place 7 3 4 55 69 Whittington 2 23 4 15 44 Westbourne Road 7 39 17 100 163 Winchester Street 25 9 3 24 61 Yerbury Road 45 24 2 93 164 York Road 45 3 17 26 91 Total 1,095 624 385 2,255 4 359 154 1908] ISOLATION OF INFECTIOUS DISEASES. It is satisfactory to find that out of the 2,289 cases of infectious diseases, as many as 1,842, or 80.4 per cent., were isolated in hospitals. This is the largest proportion hitherto recorded, as may be seen by the following figures. 1896 48.4 per cent. 1902 71-9 per cent. 1897 55.7 „ 1903 72.6 „ 1898 58.4 1904 75.5 „ 1899 64.6 „ 1905 76.1 „ 1900 68.2 „ 1906 77.1 „ 1901 69.6 „ 1907 80.0 „ 1908 - 80-4 Of the total number of cases removed, 1,734, or 76 per cent., were admitted to the Metropolitan Asylums Board Hospitals. Scarlet Fever.—Out of the 1409 cases which were notified, 1,274 were isolated in hospitals, of whom 1,212 were removed to one or other of the Metropolitan Asylums Board's hospitals. Thus 90.4 per cent. of the cases of this disease were removed from their homes for isolation and treatment, while 65-8 per cent. were treated in the Metropolitan Asylums Board's institutions. Diphtheria.—Out of the 530 cases notified, 435, or 82 per cent., were isolated in hospital, while 95, or 18 per cent., were retained at home. Enteric Fever.—Of the 97 cases of this disease, 73, or 75.2 per cent., were taken to hospitals, while 24.8 remained at home. Erysipelas.—Of the 235 cases known, 57, or 24.3 per cent., were removed to hospital, while 178 stayed in their homes. Puerperal Fever.—Out of the 17 cases of this disease, 3, or 17.7 per cent. were treated in a public institution. 155 [1908 Table CIX. Summary of Infectious Sickness and cf the Deaths arising therefrom, distinguishing the Cases treated at Home and in Hospitals; and showing the percentages of notified Cases removed to Hospitals, together with the Fatality among cases treated at Home and in Hospitals during the year 1908. Notified Cases Treated. Percentages of Notified Cases Treated. Deaths Occurring. Percentages of Deaths Occurring. In Hospitals. At Home. Total. In Hospital. At Home. In Hospital. At Home. Total. In Hospital. At Home. Total. Small Pox .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever 1,274 135 1,409 90.4 9.6 26 4 30 2.0 2.9 2.1 Diphtheria 435 95 530 82.0 18.0 42 18 60 9.6 18.9 11.3 Enteric (Typhoid Fever) 173 24 97 75.2 24.8 13 5 18 17.8 20.8 18.5 Typhus Fever .. .. .. .. .. .. .. •• • • Erysipelas 57 178 235 24.3 75.7 7 7 14 12.3 3.9 6.2 Puerperal Fever 3 14 17 17.7 82.3 3 1 4 100.0 7.1 23.5 Continued Fever .. 1 1 100.0 v .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. Cholera Total 1,842 447 2,289 80.4 19.6 91 35 126 4.9 7.8 5.5 i56 i908 Table CX. Showing the number of Gases of infectious Disease removed from islington to the Metropolitan Asylums Board's Hospitals for treatment and isolation during i908. Metropolitan Asylums Board's Hospitals. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Typhus Fever. Other Diseases. Total Admissions. Total Deaths. Eastern .. i0 i4 3 .. 6 33 2 North Eastern .. 757 i92 28 .. i0i i,078 44 North Western .. 444 i07 9 .. 60 620 24 Western .. .. i .. .. .. i .. South Western .. i .. .. .. .. i .. The Grove .. .. .. .. .. .. .. .. South Eastern .. .. .. .. .. i i .. Convalescent Hospital .. .. .. .. .. .. .. .. Small Pox .. .. .. .. .. .. .. .. Totals .. i,2i2 3i4 .. .. i68 i 734 70 iNFECTiOUS DiSEASES iN BUSiNESS PREMiSES. it has frequently been pointed out in these reports that there are no returns which show so clearly and emphasize so strongly the utility of the notification of diseases of an infectious character as those which give a list of the trades and businesses that are conducted on premises wherein they have occurred. in looking down the annexed table, in which the full particulars are given, it will be noticed that Scarlet Fever was found in ii houses wherein bootmakers conducted their businesses; in i0 wherein dressmaking was conducted; in 8 wherein hairdressing was carried on; in 5 schools; in 3 tailors' establishments; in 3 sweet shops; in G grocers' premises, and in numerous other places. it can easily be understood that if precautions were not taken in such businesses as the above, such a disease as this would in all probability be spread broadcast among the public. in nearly every case the patients were removed to hospital and the premises disinfected, while in those instances in which they were allowed to remain at home, they were so isolated that it was impossible for the infection to be conveyed to the parts of the premises on which the trade was being carried on. in a few instances it became necessary to threaten the stoppage of the business under section i09 of the Factory and Workshops Act, if the patients were not removed to hospital, but fortunately such refusals were not persisted in, and therefore it was not necessary to invoke the powers given in that section. The return set out in Table CXi. shows that i63 cases of Scarlet Fever, 54 of Diphtheria, i2 of Enteric Fever, and 36 Erysipelas were noted on business premises. 157 i908 Table CXI. List of Trades and Businesses carried on in Houses wherein infectious Diseases have occurred during 1908. trades and businesses. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Artificial Florists ... 1 1 ... ... ... 1 ... ... 3 Auctioneers ... ... 1 ... ... ... ... ... ... 1 Baker ... 2 ... ... ... ... ... ... ... 2 Bootmakers ... 11 1 ... ... ... 4 ... ... 16 Boarding House ... 5 ... ... ... ... ... ... ... 6 Blouse Making ... 1 ... ... ... ... ... ... ... 1 Builder ... 4 2 ... ... ... 1 ... ... 7 Beerhouse ... 1 ... ... ... ... ... ... ... 1 Banks ... 1 ... ... ... ... ... ... ... 1 Butchers ... 3 1 ... ... ... ... ... ... 4 Baby Millinery ... ... 1 ... ... ... ... ... ... 1 Bookbinding ... ... 1 ... ... ... ... ... ... 1 Blind Making ... ... 1 ... ... ... ... ... ... 1 Common Lodging House ... 1 1 ... ... ... 4 ... ... 6 Clothiers ... 2 1 ... ... ... ... ... ... 3 Club ... 1 ... ... ... ... ... ... ... 1 Cabinet Makers ... 1 ... ... ... ... ... ... ... 1 Coffee House ... 1 1 ... 1 ... ... ... ... 3 Chair Caning ... 1 ... ... ... ... ... ... ... 1 Confectioners ... 3 2 ... ... ... ... ... ... 5 Cab Proprietors ... 1 ... ... ... ... ... ... ... 1 Cats Meat ... ... 1 ... ... ... ... ... ... 1 Dentist ... 1 1 ... ... ... ... ... ... 2 Dairy ... 3 ... ... ... ...... ... ... ... 3 Dressmaking ... 10 2 ... ... ... 2 ... ... 14 Decorator ... 1 ... ... ... ... ... ... ... 1 Drapers ... ... ... ... ... ... 2 ... ... 2 Estate Agents ... 2 ... ... ... ... ... ... ... 2 Engineers ... ... 1 ... ... ... ... ... 2 Fire Station ... 2 ... ... ... ... ... ... ... 2 Fruiterers ... 1 ... ... ... ... ... ... ... 1 Feather Cleaning ... 2 ... ... ... ... ... ... 2 F urriers ... 3 ... ... ... ... ... ... ... 3 Furniture Dealers ... 3 3 ... ... ... ... ... ... 6 Fishmongers ... 4 ... ... ... ... ... ... 5 Fried Fish Shop 3 1 ... ... ... ... ... ... 4 Feather Curling ... 1 ... ... ... ... ... ... ... 1 French Polishing ... 1 ... ... ... ... ... ... ... 1 Funeral Furnishers ... ... 1 ... ... ... ... ... ... 1 General Dealers ... 3 7 ... ... ... 2 ... ... 12 Grocers ... 6 ... ... ... ... 3 ... ... 9 Greengrocers ... 3 ... ... ... ... ... ... ... 3 Glass Case Makers ... 1 ... ... ... ... ... ... 2 Gardeners ... ... 1 ... ... ... ... ... ... 1 Glass Cutters ... ... ... ... ... ... ... ... 1 Hatters ... 2 ... ... ... ... ... ... ... 2 Hairdressers ... 8 1 ... ... ... ... ... ... 10 158 1908 Table CXI.—continued. TRADES AND BUSINESSES. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. . Ham and Beef Shop ... 1 ... ... ... ... ... ... ... 1 Hawkers' Goods ... 1 ... ... ... ... ... ... ... 1 Hotel ... 1 ... ... ... ... ... ... ... 1 Laundry ... 4 3 ... 1 ... 1 ... ... 9 Laundry Receiving Office ... 2 ... ... ... ... ... ... ... 2 Lath Rending ... ... ... ... ... ... 1 ... ... 1 Music Dealers ... 1 ... ... ... ... ... ... ... 1 Mangling ... 1 1 ... ... ... ... ... ... 2 Milk Shop ... 4 ... ... 1 ... 1 ... ... 6 Millinery ... 2 ... ... ... ... ... ... ... 2 Mantle Makers ... 1 ... ... ... ... ... ... ... 1 Motor Works ... ... 1 ... ... ... ... ... ... 1 Medical Practitioners ... ... 1 ... ... ... ... ... ... 1 Newsagent ... ... ... ... ... ... 1 ... ... 1 Nursing Home ... ... ... ... 1 ... ... ... ... 1 Offices ... 1 ... ... ... ... 1 ... ... 2 Oil and Color Merchants ... 1 ... ... ... ... ... ... ... 1 Off License ... 1 2 ... ... ... ... ... ... 3 Public House ... 8 ... ... 2 ... 1 ... ... 11 Pinaforte Warehouse ... 1 ... ... 1 ... ... ... ... 2 Provisions ... 2 2 ... ... ... ... ... ... 4 Paper Bag Making ... 1 ... ... ... ... ... ... ... 1 Printers ... 1 1 ... ... ... ... ... ... 2 Refreshment Rooms ... ... ... ... ... ... 1 ... ... 1 School ... 5 ... ... ... ... ... ... ... 5 Stables ... 2 ... ... ... ... ... ... ... 2 Sweetstuff Shop ... 3 1 ... ... ... 1 ... ... 5 Stewed Eel Shop ... 1 ... ... ... ... ... ... ... 1 Surgery ... 1 1 ... ... ... ... ... ... 2 Scale Makers ... 1 ... ... ... ... ... ... ... 1 Surplice Making ... 1 ... ... ... ... ... ... ... 1 Stationers ... 1 ... ... ... ... 1 ... ... 2 Sweep ... 1 1 ... ... ... ... ... ... 2 Stonemason ... ... 1 ... ... ... ... ... ... 1 Shirt Making ... ... ... ... ... ... 1 ... ... 1 Tailor ... 3 2 ... 1 ... 1 ... ... 7 Tobacconist ... 2 ... ... ... ... ... ... ... 2 Toilet Set Making ... ... 1 ... ... ... ... ... ... 1 Umbrella Making ... 2 ... ... ... ... ... ... ... 2 Watchmaking ... 3 ... ... ... ... ... ... ... 3 Wine and Spirit Merchant ... 2 ... ... ... ... ... ... ... 2 Wire Workers ... 2 ... ... ... ... ... ... ... 2 Wardrobe Dealers ... 1 ... ... ... ... 1 ... ... 2 Washing ... ... 2 ... ... ... ... ... ... 2 Wood Carving ... ... 1 ... ... ... ... ... ... 1 Wood Chopping ... ... ... ... 1 ... 1 ... ... 2 Walking Stick Makers ... ... ... ... 1 ... ... ... ... 1 Totals ... 165 54 ... 12 ... 36 ... ... 267 159 1908 OCCUPATIONS OF PERSONS ATTACKED WITH INFECTIOUS DISEASE. in Table CXII. is given a list of the occupations of the persons who were attacked with infectious diseases. Of the 1025 Scarlet Fever patients, it was found that 880 were children attending schools either within or without the Borough. Of persons in actual employment the largest number of cases occurred among married women looking after their own homes, of whom 17 appeared to have been attacked; the next in order were clerks, who were notified in i0 cases; these were followed by nurses, among whom 7 cases occurred; while dressmakers and teachers came next with 5 cases each. With respect to Diphtheria, 259 cases occurred among school children, while 8 mothers of families were attacked, 5 clerks, 5 servants, and several others as set out in the above-mentioned table. Enteric Fever was most prevalent amongst scholars, of whom 17 were attacked, followed again by housewives, of whom 10 were attacked, who were followed in turn by 4 labourers, 4 clerks, 3 printers, and 3 shop assistants. The other cases are set out in the following table:— 160 1908 Table CXII. Showing the Occupations of Patients suffering from the several notifiable Infectious Diseases during the year 1908. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Cerebro-Spina' Fever. Total. Apprentice ... 3 1 ... ... ... ... ... ... ... 4 Artiste ... ... 1 ... ... ... ... ... ... ... 1 Accountant ... ... ... ... 1 ... ... ... ... ... 1 Barman ... 2 ... ... ... ... ... ... ... ... 2 Book Keeper ... 1 ... ... ... ... ... ... ... ... 1 Bricklayer ... 1 ... ... ... ... 2 ... ... ... 3 Brass Finisher ... 1 ... ... ... ... ... ... ... ... 1 Bookfolder ... 3 ... ... 1 ... ... ... ... ... 4 Barmaid ... 1 1 ... 3 ... 1 ... ... ... 6 Brushmaker ... 1 ... ... ... ... ... ... ... ... 1 Blousemaker ... 1 ... ... ... ... 1 ... ... ... 2 Biscuit Icing ... ... 1 ... ... ... ... ... ... ... 1 Bookbinder ... ... 1 ... ... ... 1 ... ... ... 2 Boarding House Keeper ... ... ... ... ... ... 1 ... ... ... 1 Bailiff ... ... ... ... 1 ... ... ... ... ... 1 Clerk ... 1 5 ... 4 ... 7 ... ... ... 26 Carpenter ... 1 ... ... ... ... 1 ... ... ... 2 Charwoman ... 2 ... ... 1 ... 9 ... ... ... 12 Compositor ... 4 ... ... ... ... ... ... ... ... 4 Corset Maker ... 1 ... ... ... ... ... ... ... ... 1 Cabinet Maker ... 1 ... ... 1 ... 1 ... ... ... 3 Coal Porter ... 1 ... ... ... ... 1 ... ... ... 2 Collar Maker ... 1 ... ... ... ... ... ... ... ... 1 Cashier ... 1 ... ... ... ... ... ... ... ... 1 Confectioner ... ... 1 ... 1 ... ... ... ... ... 2 Capsule Maker ... ... ... ... ... ... 1 ... ... ... 1 Coachman ... ... ... ... 1 ... 2 ... ... ... 3 Civil Servant ... ... ... ... ... ... 1 ... ... ... 1 Costermonger ... ... ... ... ... ... 1 ... ... ... 1 Carman ... ... ... ... ... ... 5 ... ... ... 5 Collier ... ... ... ... ... ... 1 ... ... ... 1 Corn Chandler ... ... ... ... ... ... 1 ... ... ... 1 Cab Driver ... ... ... ... ... ... 2 ... ... ... 2 Camera Maker ... ... ... ... 1 ... ... ... ... ... 1 Cellerman ... ... ... ... 1 ... ... ... ... ... 1 Dressmaker ... 5 ... ... ... ... 4 ... ... ... 9 Driller (Steel Pen) ... 1 ... ... ... ... ... ... ... ... 1 Dentist ... ... 1 ... ... ... ... ... ... ... 1 Dustman ... ... ... ... ... ... 1 ... ... ... 1 Dyer ... ... ... ... ... ... 1 ... ... ... 1 Errand Boy ... 1 1 ... 1 ... 1 ... ... ... 4 Engineer ... 1 ... ... ... ... 2 ... ... ... 3 Electro Typer ... ... ... ... 1 ... ... ... ... ... 1 Feather Curler ... 1 ... ... ... ... ... ... ... ... 1 Factory Hand ... 3 1 ... 1 ... ... ... ... ... 5 Fish Salesman ... 1 ... ... 1 ... ... ... ... ... 2 Florist ... 1 ... ... ... ... ... ... ... ... 1 Fancy Leather Worker ... 1 ... ... ... ... ... ... ... ... 1 French Polisher ... ... ... ... ... ... 2 ... ... ... 2 161 1908 Table CXII.—continued. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Cerebro-Spinal Fever. Total. Fruiterer ... ... ... ... ... ... 1 ... ... ... 1 Fur Sewing ... ... ... ... ... ... 1 ... ... ... 1 Fancy Goods ... ... ... ... ... ... 1 ... ... ... 1 Gold Polisher ... 1 ... ... ... ... ... ... ... ... 1 Glass Blower ... 1 ... ... 1 ... 1 ... ... ... 3 Gas Charger (G.N.R.) ... 1 ... ... ... ... ... ... ... ... 1 Gas Fitter ... ... ... ... ... ... 1 ... ... ... 1 Goods Collector ... ... ... ... ... ... 1 ... ... ... 1 General Dealer ... ... ... ... ... ... 1 ... ... ... 1 Gilder ... ... ... ... ... ... 1 ... ... ... 1 Horsekeeper ... 2 2 ... 1 ... 1 ... ... ... 6 Housewife ... 17 8 ... 10 ... 30 17 ... ... 82 Hosier ... 1 ... ... ... ... ... ... ... ... 1 Housekeeper ... ... ... ... ... ... 2 ... ... ... 2 India Rubber Dealer ... 1 ... ... ... ... ... ... ... ... 1 Ironer ... ... ... ... ... ... 1 ... ... ... 2 Iron Plate Worker ... ... ... ... ... ... 2 ... ... ... 2 Independent ... ... ... ... 1 ... 1 ... ... ... 2 Jewel-Case Maker ... ... ... ... ... ... 1 ... ... ... 1 Jewellery Polisher ... ... ... ... 1 ... ... ... ... ... 1 Jeweller ... ... ... ... 1 ... ... ... ... ... 1 Lavatory Attendant ... 1 ... ... ... ... ... ... ... ... 1 Laundress ... 1 ... ... 1 ... 2 ... ... ... 5 Leather Worker ... 1 ... ... ... ... ... ... ... ... 1 Laundry Office Assistant ... 1 ... ... ... ... ... ... ... ... 1 Labourer ... ... ... ... 4 ... 8 ... ... ... 12 Lath Render ... ... ... ... ... ... 1 ... ... ... 1 Laundryman ... ... ... ... ... ... 1 ... ... ... 1 Mantle Maker ... 1 ... ... 1 ... ... ... ... ... 2 Mother's Help ... 1 ... ... ... ... ... ... ... ... 1 Milk Carrier ... 1 ... ... 1 ... 1 ... ... ... 3 Machinist ... 4 2 ... ... ... ... ... ... ... 6 Milliner ... 3 2 ... ... ... 1 ... ... ... 6 Motor Winder ... 1 ... ... ... ... ... ... ... ... 1 Medical Practitioner ... 1 ... ... ... ... 1 ... ... ... 2 Marble Mason ... ... ... ... ... ... 1 ... ... ... 1 Mail Driver ... ... ... ... ... ... 1 ... ... ... 1 Mathematical Instrument Maker ... ... ... ... ... ... 1 ... ... ... 1 Nurse ... 7 ... ... 1 ... 3 ... ... ... 11 Needlewoman ... ... ... ... ... ... 2 ... ... ... 2 Office Boy ... 2 1 ... ... ... ... ... ... ... 3 Pawnbroker's Assistant ... 1 ... ... ... ... ... ... ... ... 1 Plasterer ... 1 ... ... ... ... ... ... ... ... 1 Porter ... 1 ... ... ... ... ... ... ... ... 1 Pianoforte Key Maker ... 1 ... ... ... ... ... ... ... ... 1 Packer ... 3 ... ... ... ... ... ... ... ... 3 Printer ... 2 2 ... 3 ... 3 ... ... ... 10 Pupil Teacher ... 1 ... ... ... ... ... ... ... ... 1 Pianoforte Tuner ... 1 ... ... ... ... ... ... ... ... 1 ,, Maker ... 1 ... ... ... ... ... ... ... ... 1 162 1908 Table CXII.—continued. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Cerebro-Spinal Fever. Total. Pattern Mounter ... ... 1 ... ... ... ... ... ... ... 1 Police Constable ... ... ... ... 1 ... 1 ... ... ... 2 Painter ... ... ... ... ... ... 3 ... ... ... 3 Plumber ... ... ... ... ... ... 1 ... ... ... 1 Publican ... ... ... ... ... ... ... ... ... ... 1 Relief Stamper ... ... ... ... ... ... 1 ... ... ... 1 Railway Servant ... ... ... ... ... ... 4 ... ... ... 4 Restaurant Assistant ... ... ... ... ... ... 1 ... ... ... 1 ,, Keeper ... ... ... ... ... ... 1 ... ... ... 1 Scholar ... 880 259 ... 17 ... 9 ... ... 2 1167 Sorter ... 1 ... ... ... ... ... ... ... ... 1 Servant ... 4 5 ... 2 ... 3 ... ... ... 14 Shop Assistant ... 4 2 ... 3 ... 2 ... ... ... 11 Storekeeper ... 2 ... ... ... ... ... ... ... ... 2 Stationer ... 1 ... ... ... ... ... ... ... ... 1 Shoe Maker ... 1 ... ... ... ... ... ... ... ... 1 Sorter ... ... 1 ... ... ... ... ... ... ... i Screwmaker ... ... ... ... ... ... 1 ... ... ... 1 Smith ... ... ... ... ... ... 1 ... ... ... 1 Silversmith ... ... ... ... ... ... 2 ... ... ... 2 Sugar Refiner ... ... ... ... ... ... 1 ... ... ... 1 Steward ... ... ... ... 1 ... ... ... ... ... 1 Stableman ... ... ... ... 1 ... ... ... ... ... 1 Tobacconist ... 1 ... ... ... ... ... ... ... ... 1 Tin Smith ... 1 ... ... ... ... ... ... ... ... 1 Teacher ... 5 1 ... ... ... ... ... ... ... 1 Tie Maker ... 1 ... ... ... ... ... ... ... ... 1 Trimming Maker ... ... 1 ... ... ... ... ... ... ... 1 Thermometer Maker ... ... 1 ... ... ... ... ... ... ... 1 Tram Conductor ... ... 1 ... ... ... ... ... ... ... 1 Ticket Writer ... ... ... ... ... ... 2 ... ... ... 2 ,, Examiner ... ... ... ... ... ... 1 ... ... ... 1 Type Foundry Hand ... ... ... ... ... ... 1 ... ... ... 1 Tinplate Worker ... ... ... ... ... ... 1 ... ... ... 1 Timekeeper ... ... ... ... ... ... 1 ... ... ... 1 Tin Box Maker ... ... ... ... 1 ... ... ... ... ... 1 Traveller ... ... ... ... 1 ... ... ... ... ... 1 Upholsterer ... ... ... ... ... ... 2 ... ... ... 2 Violin String Maker ... 1 ... ... 1 ... ... ... ... ... 2 Van Boy ... 2 ... ... 1 ... 1 ... ... ... 4 Warehouseman ... 3 ... ... ... ... 1 ... ... ... 4 Washerwoman ... 2 ... ... ... ... ... ... ... ... 2 Waitress ... 1 1 ... ... ... ... ... ... ... 2 Walking Stick Maker ... 2 ... ... ... ... ... ... ... ... 2 Wax Figure Modeller ... 1 ... ... ... ... ... ... ... ... 1 White Lead Worker ... ... ... ... ... ... 1 ... ... ... 1 Wine Merchant ... ... ... ... ... ... 1 ... ... ... 1 Waiter ... ... ... ... ... ... 1 ... ... ... 1 Total ... 1025 306 ... 76 ... 166 17 ... 2 1592 163 1908 INFECTiOUS DISEASE IN THE STREETS. The following table shows the streets in which the several cases of infectious diseases occurred during the year, and as at the time of writing this report a great deal has been said about the condition of Campbell Road, it may be noted that there were only 7 cases of infectious diseases notified from it, namely, 3 of Scarlet Fever, 3 of Diphtheria, and 1 of Erysipelas. This number is, of course, very small, especially in view of the character of the inhabitants of the road. it is a notable fact, too, that each case occurred in a different house, which is strong evidence that no delay occurred in r moving it to hospital. A similar remark may be made with respect to Queensland Road, which next to Campbell Road is the worst in the district, where only 3 cases of infectious disease, 1 being Scarlet Fever and 2 Diphtheria, occurred, and each in separate houses Another point about the infectious character of the cases occurring in these streets is that none of the diseases which are usually associated with insanitation prevailed. Thus for instance, Enteric Fever was entirely absent, while only 1 case of Erysipelas was known. These results are probably due to the fact that the houses are well drained and provided with ample W. C. accomodation. 164 1908 Table CXIII. Showing the Streets in which the several cases of Infectious Disease occurred during 1908. The large figures denote the number of cases and the small figures the number of infected houses. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Menib. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Alfred Street ... 44 ... ... ... ... ... ... ... 44 Arvon Road ... 11 ... ... ... ... ... ... ... 11 Arthur Road ... 22 ... ... ... ... 22 ... ... 44 Ann Street ... 21 ... ... ... ... ... ... ... 21 Alwyne Villas, Canonbury ... ... ... ... ... ... 11 ... ... 11 Aberdeen Road ... 22 ... ... ... ... ... ... ... 22 Andover Road ... 76 22 ... ... ... 11 ... ... 109 Arundel Grove ... 54 ... ... ... ... ... ... 54 Alsen Road ... 55 22 ... ... ... ... ... ... 77 Ashbrook Road ... 41 11 ... ... ... ... ... ... 55 Avenell Road ... ... 11 ... ... ... ... ... ... 11 Albion Grove ... 54 11 ... ... ... ... ... ... 65 Arlington Street ... 22 ... ... ... ... 11 ... ... 38 Aberdeen Mews, Aberdeen Road ... 11 ... ... ... ... ... ... 11 Athelstane Road ... ... ... ... ... ... 22 ... ... 22 Aberdeen Park ... ... 11 ... ... ... 11 ... ... 22 Alwyne Square ... 21 ... ... ... ... ... ... ... 21 Aruudel Mews, Arundel Square ... ... 11 ... ... ... ... ... ... 11 All Saints Street ... ... 21 ... ... ... ... ... ... 21 Albany Cottages, Popham Street ... 21 ... ... ... ... ... ... ... 21 Astey's Row ... 11 ... ... ... ... 11 ... ... 22 Albion Street ... 22 11 ... ... ... 11 ... ... 44 Albert Street ... 21 11 ... 11 ... ... ... ... 48 Ambler Road ... 11 ... ... ... ... ... ... ... 11 Alexander Road ... 11 22 ... ... ... ... ... ... 38 Anatola Road ... ... 11 ... ... ... ... ... ... 11 Ashburton Grove ... 22 11 ... ... ... ... ... ... 33 Arthur Mews, Caledonian Road ... 11 ... ... ... ... ... ... ... 11 Arundel Square ... 21 ... ... ... ... ... ... ... 21 Almington Street ... 22 11 ... ... ... ... ... ... 33 Anchor Dwellings, Brewery Road ... 31 ... ... ... ... 11 ... ... 42 Aberdeen Place ... 11 ... ... ... ... ... ... 11 Arlington Square ... 68 ... ... ... ... 11 ... ... 74 Ashley Road ... 11 ... ... ... ... ... ... ... 11 Almorah Road ... 11 11 ... 11 ... ... ... ... 33 Aubert Paik ... 22 ... ... 11 ... 11 ... ... 44 165 1908 Table CXIII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Anson Road ... 31 11 ... ... ... ... ... ... 42 Arundel Place ... 11 ... ... ... ... ... ... ... 11 Ashrnount Road ... 11 ... ... ... ... ... ... ... 11 Annette Road ... 11 ... ... ... ... 11 ... ... 22 Ardilaun Road ... ... 11 ... ... ... ... ... ... 11 Alma Grove ... 33 ... ... ... ... ... ... ... 33 Archway Road ... 21 ... ... ... ... ... ... ... 21 Alma Terrace ... ... ... ... ... ... 11 ... ... 11 Bickerton Road ... 43 ... ... ... ... 11 ... ... 54 Blundell Street ... 66 33 ... 44 ... 22 ... ... 1515 Bruce Buildings, Caledonian Road ... 11 11 ... 11 ... ... ... ... 32 Brooksby Street ... 11 11 ... ... ... ... ... ... 22 Brand Street ... 11 ... ... ... ... ... ... ... 11 Brunswick Road ... 53 22 ... ... ... ... ... ... 75 Bamsbury Road ... 33 ... ... ... ... 22 ... ... 55 Balls Pond Place ... 11 ... ... 11 ... ... ... ... 22 Blenheim Road ... 11 22 ... ... ... ... ... ... 33 Beacon Hill ... ... ... ... 11 ... ... ... ... 11 Bratton Street ... 11 ... ... ... ... 11 ... ... 22 Bamsbury Street ... 105 38 ... ... ... 11 ... ... 148 Brookside Road ... 11 11 ... ... ... ... ... ... 22 Bride Street ... 66 53 ... 11 ... ... 11 ... 1311 Baxter Road ... 11 ... ... ... ... 11 ... ... 22 Battledean Road ... 32 ... ... ... ... ... 11 ... 48 Balls Pond Road ... 22 11 ... ... ... ... ... ... 33 Baalbec Road ... 11 11 ... ... ... ... ... ... 22 Baldwin Terrace ... 22 11 ... ... ... ... ... ... 33 Blythwood Road ... ... 11 ... ... ... ... ... ... 11 Brewery Road ... 107 ... ... ... ... 11 ... ... 11 Brunswick Street ... 32 ... ... ... ... 11 ... ... 43 Boothby Road ... 11 11 ... ... ... ... ... ... 22 Beaconsfield Buildings, York Road ... 33 11 ... 11 ... 22 ... ... 77 Barbara Street ... 55 ... ... 11 ... 11 ... ... 77 Brecknock Road ... 33 ... ... ... ... ... ... ... 33 Bismarck Road ... 11 ... ... 11 ... ... ... ... 22 Bingfield Street ... 54 11 ... ... ... 11 ... ... 76 Britannia Row ... 53 22 ... ... ... 11 ... ... 86 Brookfield House, Halton Road ... 11 11 ... ... ... ... ... ... 22 Balfour Road ... 11 ... ... ... ... ... ... ... 11 Barnsbury Terrace ... ... ... ... ... ... 11 ... ... 11 Bemerton Street ... 88 33 ... 11 ... ... ... ... 121 Bryan Street ... 33 11 ... ... ... ... ... ... 44 166 1908 Table CXIII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Barnsbury Mews ... ... 11 ... ... ... ... ... ... 11 Belitha Villas ... 22 ... ... 11 ... ... ... ... 33 Bryantwood Road ... ... ... ... 21 ... ... ... ... 21 Boxworth Grove ... 11 ... ... ... ... ... ... ... 11 Barnsbury Grove ... 21 ... ... ... ... ... ... ... 21 Blackstock Road ... 22 22 ... ... ... 11 ... ... 55 Baring Street ... 32 ... ... ... ... ... ... ... 32 Barford Street ... 11 11 ... ... ... ... ... ... 22 Beaumont Road ... 11 ... ... ... ... ... ... ... 11 Balmoral Grove ... 22 ... ... ... ... ... ... ... 22 Benwell Road ... 11 ... ... 22 ... ... ... ... 33 Birnam Road ... 33 62 ... ... ... 11 ... ... 106 Bryett Road ... 11 ... ... ... ... ... ... ... 11 Burns Buildings, Caledonian Road ... 11 ... ... ... ... ... ... ... 11 Cornelia Street ... ... 22 ... ... ... ... ... ... 22 Cromwell Road ... 22 11 ... ... ... 33 ... ... 66 Caledonian Road ... 2316 11 ... 11 ... 22 ... ... 2720 Canon Street ... ... ... ... ... ... 11 ... ... 11 Copenhagen Street ... 138 33 ... ... ... 22 ... ... 1813 Corbyn Street ... 22 11 ... ... ... ... ... ... 33 Cornwallis Road Wobkhouse ... ... ... ... ... ... 2 ... ... 2 College Street ... 11 ... ... ... ... ... ... ... 11 Church Lane ... ... 11 ... ... ... ... ... ... 11 Canonbury Road ... 11 ... ... ... ... ... ... ... 11 Cardigan Street ... 21 21 ... ... ... 11 ... ... 53 Cross Street ... 11 ... ... ... ... 32 ... ... 43 Canning Road ... 32 11 ... ... ... ... ... ... 43 Crescent Street ... 31 ... ... ... ... ... ... ... 31 Cornwallis Road ... 43 44 ... ... ... ... ... ... 87 Charlotte Street ... 11 11 ... ... ... ... ... ... 22 Corinne Road ... 22 11 ... ... ... ... ... ... 33 Colebrooke Row ... 43 11 ... ... ... 11 ... ... 65 Campdale Road ... ... 11 ... ... ... ... ... ... 11 Calverley Grove ... 52 11 ... ... ... ... ... ... 63 Church Grove ... 22 ... ... ... ... ... ... ... 22 Camden Road ... 11 11 ... ... ... 11 ... ... 33 Compton Avenue ... 11 11 ... ... ... ... ... ... 22 Calabria Road ... 33 11 ... ... ... ... ... ... 43 Canonbury Villas ... ... ... ... 11 ... ... ... ... 11 Campbell Road ... 33 33 ... ... ... 11 ... ... 77 Cottenham Road ... 21 22 ... ... ... ... ... ... 48 Crayford Road ... 22 33 ... ... ... 11 ... ... 66 Caledonian Crescent ... ... 22 ... ... ... ... ... ... 22 167 1908 Table CXIII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Carleton Road ... 22 ... ... ... ... 11 ... ... 33 Cornwall Cottages, Eden Grove ... ... 21 ... ... ... ... ... ... 21 Church Road ... ... 64 ... ... ... 11 ... ... 75 Clarence Street ... 22 11 ... ... ... ... ... 33 Canonbury Avenue ... 44 33 ... ... ... ... ... ... 76 Cathcart Hill ... 31 11 ... ... ... ... ... 42 Charlesworth Street ... 74 11 ... ... ... ... ... ... 85 Cloudesley Mansions ... 32 ... ... ... ... ... ... ... 32 Cloudesley Road ... 33 44 ... 11 ... 22 ... ... 109 City Arms Buildings, North Road ... 33 ... ... ... ... ... ... ... 33 Chatterton Road ... 33 33 ... ... ... ... ... ... 65 Clarence Terrace ... 11 11 ... ... ... ... ... ... 22 Clayton Street ... 11 ... ... ... ... ... ... ... 11 Camden Dwellings, York Road ... 11 11 ... ... ... ... ... ... 22 Charlton Crescent ... 11 ... ... ... ... ... ... ... 11 Compton Terrace ... ... ... ... ... 11 ... ... 22 City Garden Row ... 11 11 ... ... ... 11 ... ... 32 Charles Street ... 22 ... ... ... ... ... 11 ... 38 Carlton House, Stanmore Street ... 21 ... ... ... ... ... ... ... 21 Clevelaud Road ... ... ... ... ... ... 11 ... ... 11 Cressida Road ... 32 ... ... ... ... ... ... ... 32 Celia Road ... 11 11 ... ... ... ... ... ... 22 Caledonia Street ... 22 ... ... ... ... ... ... ... 22 City Road ... 11 ... ... ... ... ... ... ... 11 Cutlers Terrace, Balls Pond Road ... 22 11 ... ... ... ... ... ... 32 Canal Terrace ... ... 11 ... 11 ... ... ... ... 22 Charteris Road ... 55 11 ... ... ... ... ... ... 76 Crouch Hill ... ... 22 ... ... ... ... ... ... 22 Cloudesley Square ... ... ... ... 11 ... 11 ... ... 22 Corporation Street ... 11 11 ... ... ... ... ... ... 22 Crinan Street ... 32 ... ... ... ... ... ... ... 32 Canterbury Road ... 33 ... ... ... ... 11 ... ... 44 Conewood Street ... 22 ... ... ... ... ... ... ... 22 Canonbury Park, North ... 11 ... ... ... ... ... ... ... 11 Courtney Road ... 11 ... ... ... ... ... ... ... 11 Cornwall Cottages, Popham Street ... 22 ... ... ... ... ... ... ... 22 Crossley Street ... 22 21 ... ... ... ... ... ... 43 Charlotte Terrace ... 32 ... ... ... ... ... ... ... 32 Corinth Road ... ... ... ... ... ... 22 ... ... 22 Crane Grove ... ... 11 ... ... ... ... ... ... 11 168 1908 Table CXi ii.—continued,. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Clephaue Road ... ... 22 ... ... ... ... ... ... 22 Cumberland Street ... 11 11 ... ... ... ... ... ... 22 Cloudesley Street ... 11 ... ... ... ... ... ... ... 11 Collier Street ... 11 ... ... ... ... ... ... ... 11 Canonbury Park, South ... ... 11 ... ... ... ... ... ... 11 Canonbury Lane ... 11 ... ... ... ... ... ... ... 11 Chalfont Road ... 11 ... ... ... ... ... ... ... 11 Corsica Street ... ... ... ... ... ... 11 ... ... 11 Crown Mansions, Liverpool Road ... 22 ... ... ... ... ... ... ... 22 Clarence Cottage, Thomas Street ... 11 ... ... ... ... ... ... ... 11 Cloudesley Place ... 11 ... ... ... ... ... ... ... 11 Cardozo Road ... 11 ... ... ... ... ... ... ... 11 Carmarthen Street ... ... 11 ... ... ... ... ... ... 11 Dresden Road ... 11 ... ... ... ... 11 ... ... 22 Dunoombe Road ... 1410 43 ... ... ... ... ... ... 1813 Drayton Park ... 53 11 ... ... ... ... ... ... 64 Davenant Road ... 32 54 ... ... ... ... ... ... 85 Dunford Road ... ... 11 ... ... ... ... 11 ... 22 Dame Street ... 33 ... ... ... ... ... ... ... 33 Durham Road ... 55 22 ... ... ... 11 ... ... 88 Dalmeney Road ... ... 11 ... ... ... ... ... ... 11 Duncan Street ... 11 ... ... ... ... ... ... ... 11 Denmark Road ... 32 31 ... ... ... ... ... ... 63 Downham Road ... 22 11 ... ... ... ... ... ... 33 Dagmar Terrace ... 42 ... ... ... ... ... ... ... 42 Duncan Terrace ... 33 11 ... ... ... 11 ... ... 55 Dorinda Street ... 11 ... ... ... ... ... ... ... 11 Dagmar Cottage, Dagmar Terrace ... 21 ... ... ... ... ... ... ... 21 Denmark Terrace ... 22 ... ... ... ... ... ... ... 22 Devonshire Road ... 33 ... ... 11 ... ... ... 11 54 Dennis Street ... 11 11 ... ... ... ... ... ... 22 Despard Road ... 31 11 ... ... ... ... ... ... 42 Denmark Street ... 11 ... ... ... ... ... ... ... 11 Douglas Road ... 11 ... ... ... ... ... ... ... 11 Dean Street ... 11 ... ... ... ... ... ... ... 11 Devonshire Street ... ... 11 ... ... ... ... ... ... 11 Denmark Grove ... 11 ... ... ... ... ... ... ... 11 Dorset Street ... ... 11 ... ... ... ... ... ... 11 Evershot Road ... 22 ... ... ... ... ... ... ... 22 Elton Street ... 22 11 ... ... ... ... ... ... 33 Elmore Street ... 11 33 ... ... ... ... ... ... 44 169 1908 Table CXII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Elliott's Gardens ... 11 ... ... ... ... ... ... ... 11 Elthorne Road ... 109 ... ... ... ... ... ... ... 109 Essex Road ... 77 54 ... ... ... 11 11 ... 1412 Eden. Grove ... 66 22 ... ... ... 11 ... ... 99 Ebury Street ... 31 ... ... ... ... ... ... ... 31 Englefield Road ... ... 32 ... ... ... ... ... ... 32 Edward Square ... 22 ... 11 11 ... ... ... ... 44 East Street ... ... ... ... 11 ... ... ... ... 11 Ellington Street ... 11 11 ... ... ... 11 ... ... 32 Elwood Street ... 22 22 ... ... ... 11 ... ... 54 Edinburgh Cottages, Popham Street ... 11 11 ... ... ... ... ... ... 22 Ebenezer Buildings, Rotherfield Street ... 11 ... ... ... ... ... ... ... 11 Ella Road ... ... 11 ... ... ... ... ... ... 11 Elpliinstone Street ... ... 11 ... ... ... ... ... ... 11 Enkel Street ... 11 ... ... ... ... ... ... ... 11 Ellenborough Road ... 11 ... ... ... ... ... ... ... 11 Ecclesbourne Road ... ... 11 ... ... ... ... ... ... 11 Edinburgh Place ... ... ... ... 11 ... ... ... ... 11 Everilda Street ... 11 ... ... ... ... ... ... ... 11 Frederick Street ... 33 89 ... 11 ... ... 11 ... 1311 Fonthill Road ... 104 11 ... ... ... 11 ... ... 126 Florence Street ... 11 11 ... ... ... ... ... ... 22 Freeling Street ... 22 65 ... ... ... 11 ... ... 98 Frome Street ... 52 ... ... ... ... ... ... ... 52 Fakenham Street ... 11 ... ... ... ... ... ... ... 11 Fairbridge Road ... 86 22 ... 11 ... ... ... ... 119 Fieldway Crescent ... 11 ... ... ... ... ... ... ... 11 Francis Street ... ... ... ... ... ... 11 ... ... 11 Furlong Road ... ... 11 ... 11 ... ... ... ... 22 Fortnam Road ... 22 11 ... ... ... ... ... ... 33 Ferntower Road ... 32 11 ... ... ... ... ... ... 42 Francis Terrace ... ... ... ... ... ... 11 ... ... 11 Foxham Road ... 22 ... ... ... ... ... ... ... 22 Fairmead Road ... 11 ... ... ... ... ... ... ... 11 Freegrove Road ... 22 ... ... ... ... ... ... ... 22 Framfield Road ... ... ... ... ... ... 11 ... ... 11 Grange Road ... ... ... ... ... ... 11 ... ... 11 Grosvenor Road ... 32 ... ... ... 33 ... ... 64 George's Road ... 55 11 ... ... ... 22 ... ... 88 Gladstone Street ... 11 22 ... ... ... ... ... ... 33 Goodinge Road ... 22 22 ... ... ... ... ... ... 44 Grove Street ... ... 41 ... ... ... ... ... ... 41 M 170 1908 Table CXIII.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Grove Road ... 106 44 ... 11 ... 22 ... ... 1712 Gresley Road ... 21 ... ... ... ... ... ... ... 21 Grafton Road ... 32 22 ... ... ... 11 ... ... 65 Grenville Road ... 95 ... ... ... ... ... ... ... 95 Gerrard Street ... 55 11 ... ... ... ... ... ... 66 Gifford Street ... 33 ... ... 21 ... 11 ... ... 65 Gibson Square ... 22 ... ... ... ... ... ... ... 22 Gloucester Road ... 22 ... ... ... ... 11 ... ... 33 Grovedale Road ... 11 ... ... ... ... 11 ... ... 22 Grantbridge Street ... 32 ... ... ... ... ... ... ... 32 George Street ... 11 ... ... 11 ... ... ... ... 22 Gatcombe Road ... 11 ... ... ... ... ... ... ... 11 Graham Street ... ... 11 ... ... ... 11 ... ... 22 Gillespie Road ... 84 ... ... ... ... ... ... ... 84 Gainford Street ... ... 11 ... ... ... ... ... ... 11 George's Yard, Blundell Street ... 11 ... ... ... ... ... ... ... 11 Girdlestone Road ... 21 ... ... ... ... ... ... ... 21 Grace Street ... 11 ... ... ... ... ... ... ... 11 Goods Yard, Tulnell Park ... 11 ... ... ... ... ... ... ... 11 Grosvenor Street ... ... 11 ... ... ... ... ... ... 11 H.M.P Pentonville ... ... ... ... 2 ... 1 ... ... 3 Halse Street ... 22 ... ... ... ... 33 ... ... 55 Hornsey Street ... 125 11 ... ... ... ... ... ... 135 Hornsey Road ... 148 43 11 22 ... 22 ... ... 2315 Hungerford Road ... 22 11 ... ... ... ... ... ... 33 Hargrave Road ... 31 ... ... ... ... ... ... ... 31 Highbury Quadrant ... 22 58 ... ... ... ... ... ... 75 Halliford Street ... 33 11 ... ... ... ... ... ... 44 Hampden Road ... 33 ... ... ... ... 11 ... ... 44 Hemingford Road ... 85 22 ... ... ... ... ... ... 106 Hillmarton Road ... 21 11 ... ... ... ... ... ... 32 Highbury Mansions, Upper Street ... 11 ... ... ... ... ... ... ... 11 Highbury New Park ... 11 22 ... 11 ... 11 ... ... 54 Hercules Road ... 32 32 ... ... ... ... ... ... 63 Hartham Road ... 11 21 ... 11 ... ... ... ... 43 Halton Road ... 43 11 ... ... ... 11 ... ... 65 Hanley Road ... 43 11 ... ... ... 11 ... ... 75 Holloway Road ... 99 43 1 ... ... 33 ... ... / 1716 Hargrave Park ... 44 ... ... ... ... 11 ... ... 55 Hope Street ... 11 ... ... ... ... ... ... ... 11 Hercules Place ... 21 ... ... ... ... ... ... ... 21 Highbury Park ... 11 11 ... ... ... ... ... ... 22 Hamilton Mews, Highbury Park ... ... ... ... 11 ... ... ... ... 11 171 1908 Table CXIII.—continued. name OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Hanover Street ... 22 22 ii 5' Hugo Road ... 5° 5' Hale Street ... ii ii 2* High Street ... 2i ... 2i Hilton Road ... ii ii 2* Highbury Hill ... 22 2a Hilldrop Crescent ... ii ii Huddleston Road ... ' 6" 22 ... 89 Horsell Road ... ii ii Hargrave Mansions, Holloway Road ... 3a 3a Hornsey Rise Gardens ... . ii ii Hanley House, Hanley Road ... 2' ... 2i Hornsey Rise ... ii ii ... 2a Hazellville Road ... ii ii ii ... 3' Havelock Street ... 5a 3a ii ... 9° Harberton Road ... li ii Highbury Park Mews ... ii ... ... ii Harvist Road ... ' 54 ... 54 Hydes Place East ... ii ... ... ... ii Hatley Road ... 33 ii 4* Highbury Terrace ... ... ii ... ii H.M. Prison, Holloway ... i ... i High Street ... ii ii Huntingdon Street ... 63 ii ... 7' Hardinge Street ... 22 ii 3' Hertslet Road ... ii ii Hamilton Road ... ii ... ii Herrick Road ... ii ... il Half Moon Crescent ... ii ii 2a Hornsey Lane ... ii ii ... 2s Hatchard Road ... ii ... ... ... ii Highbury Grange ... ii ii Henry Place ... ... ii ii Highbury Crescent ... ii 3i ... 4a Islington Workhouse Schools ... 29 ... 29 Islington Infirmary ... 2 5 7 Isledon Road ... 33 22 ... 5° Ingleby Road ... 2i ii ... ... 3a Junction Road ... i38 2' ... ii i6" Jackson Road ... ii ii • •• 2i James Street ... ii ii Kelvin Road ... 5* 5* King Henry Street ... ii 22 3" M 2 i72 i908] Table CXiii.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Kingsdown Road s5 2* ii 88 King Edward Street ii 32 A8 Kiver Road ■j 2} 2i Kingsbury Road ii ii Ti ~8 Knox Buildings, Caledonian Road ii j T i ivinlock Street... ii oj Lofting Road ... i38 ii i4° Loraine Road ... £i6 2i at n6 Liverpool Road io7 66 si 7 24.i9 Langdon Road ii J J ii i Lyon Street ... 4s li c* London Fever Hospital 7 2 J Lennox Road ... / ti 9 r4 Liverpool Buildings, Liverpool Road T tl _ i D . i8 Little Cumming Street i Z i i il i4" Ti Leconfield Road ii rl 22 Lesly Street ... 54 ii ii ii 87 Luard Street ... 22 Q 8 London Street jl 3 T i Loraiue Place ... ii ... i ti Lampeter Street 44 i Ai Linton Street i ii4 4 Lady Margaret Road ... T" 22 3 7 Leigh Road ii Ti Lowman Road Ti i t i Lavina Grove i jl i ti Little Cross Street ii Ti i ~2 Landseer Road i2 ii i 08 Lucerne Road ii 3 ii Liberia Road ... ji Ti Lambton Road ii Ti i 02 Lonsdale Square 2i i* i 2 -2 Loraink Mansions, Holloway Road ii j _ i Liverpool Street ii i Ti Marlborough Road 22 66 jl i* i t^iO Mayton Street ^4 2' il i u 85 Marquess Road V 3' Moray Road j A4 J Ji u r5 Mildmay Street ii D yl Matthias Road 22 Ti i , 4 Magdala Road 5" • • • i ii 4 6" i73 [i908 Table CXiii.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. i Totals. Morton lioad ... 3s 3 s 66 Mulkern Road ii ii ii ... 3s Monnery Road ii ii Mildmay Road 56 ii 66 Maygood Street 2a 2a 44 .in uriel Street ii il 2a Milton Grove ... 32 ii ii 2a 78 Monsell Road ... 2a ii ii 44 Myrtle Street ... .. • ii ii Myddleton Buildings High Street ... xi ii Middlesex Street ii ... ii Market Street 3s 2i 59 Mayville Grove jl ... ii Miranda Road... ii ... 3a Mildmay Park... jl ii Mayville Street jl ... ... ii Milner Square jl ii Madras Place ... jl ii 2i Milner Street ... jl ii Moreland Street ... ii ii Mildmay Grove jl ii ii 38 Monte Christo Mansions, Newington Green ... ,i ii Montpelier Road ... ii li Mitford Road j] 4i 5a Martineau Road jl ii Mildmay Avenue 6' 3i ii ... io4 Maud Terrace ... jl ... ii Medina Road ... ii ii Manor Gardens jl • • • ii Mercers Road ii ii Morgan Mansions jl ii Montem Street ' ii ii Nailour Street 8s 6i ii i5" Newington Green Road jl ii 2i Norfolk Road ... 66 48 ii ii0 Newington Green 5' ii ... 64 Norfolk Street... 54 ii ... 66 Napier Terrace ii ii North Road ... 2s ii ii 44 New North Road 3' ii 4* Northampton Street ... 2i ii ... 32 Newhall Street 2a ii 3* i74 i908] Table CXiii.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Northdown Street 2a 2a Noel Street 43 4" Northampton Grove ... 22 2a Nicholay Road ii ii ... 2a North London Cottages, Market Street ... 2i 2i New Wharf Road ii ii Nelson Place . . ii ... ii Northolme Road 7} 2J Urpinglev Road 2a 7i 9* Oxford Terrace ii ii Oakley Road ... ii "ii 2i Offord Street ... io7 3» i3'° Orchard Street 2i 2i Oxford Road ... 3s 3J 6s Outram Street 44 3i 7s Ockendon Road ii ii Ormond Road 52 ii 5 s Pembroke Street T ii ii io9 Paradise Road .. ii ... ii Palmerstone Road 53 3' ii 2a ii9 Prebend Street ii 2a 2a V Peabody Buildings, Greenman street 2a ii ii 44 Pleasant Place, Halton Road 33 3" Prah Road 3s li ... 44 Petherton Road 2" ii 3' Pemberton Terrace ... 2a 4' ii V Popham Street ii ii 2* Penn Road Villas ii ... ii Payne Street ... "4i ii ii 6" Pemberton Gardens ... i72 ii ... i8* Providence Row ii ii 2a Poole's Park ... 5s ii ii 7s Parolles Road ... io6 ... io« Popham Road 8s ii 94 Packington Street 6' 3s ii io7 Plimsoll Road 32 ii 4' Parkhurst Road 23 2a Palmerston Buildings, City Garden Row 38 ii ii 54 Parkfield Street ... ... 73 ... ii 8' Poynings Road ii ii Prospect Cottages, Prospect Row ii ... ii i75 [i908 Table CXiii.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. • Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. i ' Pulteney Street ii ii 22 Palmer Place ... jl ii Pleasant Buildings, York Road 2i ii ii 43 Pickering Street Buildings... li ii Park Street jl ii Poet's Road "ii ii Pleasant Grove ii Pulteney Terrace ii ii Quinn Buildings, Popliam St. 6* ii 7' Queensbury Street il 32 4' Queen's Head Street ji ii Queen's Cottages, Popham Street 22 ii 22 5* Queen's Square 2i 2l Queen Margaret's Grove 3s ii 4* Queensland Road ... ii 22 3' Queen's Arms Buildings 54 54 Romilly Road ... 32 ii ... 4s Roden Street ... ii 44 ii ii 7" Rotherfield Street 33 3s 22 8" Ringcroft Street ii li 2a Rhodes Street... 43 22 22 88 Russell Road ... 33 ii 44 Roman Road ... 8" 6e i4" Randall's Road ii ii 2a Rupert Road ... 4i ii 55 River Street ... ... ii ii Richmond Road 56 22 7' Rydon Street ... ' ii ii Rheidol Terrace "ii ii 2J Rice Place ii' i» Raynor Place ... il ii Rufford Street ii ii Riversdale Road ii i' Regina Road ... . •. ii ii 22 Remington Street ii ... i* Stanley Road ... ii ... 33 44 Southgate Road ... 23 ii 22 54 St. John's Road i49 44 23i2 Sheen Grove ... 22 ii 3s Sussex Road ... 54 22 ii ii 9* St. Paul Street ii ii 22 Stanmore Street 22 22 ii ... 5' St. John's Road Workhouse... 2 ... i i i H i76 i909] Table CXiii.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. i Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. ' Puerperal Fever. Continued Fever. Totals. St. Paul's Road 38 ii ii <;5 Stroud Green Road ii j ji Seven Sisters' Road ... 6s ii ii 8® St. Thomas' Road 5* 22 7 7 Scholefield Road ii 38 / A* St. James Street 2i 22 ii r* Sonderburg Road ii J ii Salisbury Road 3® 2' s" St. Jude Street 2a ii J Shepperton Road i0® ii ii J i2fl Sonning Street 5* ii 6* St. Clement's Street ... 48 ji c* Sudeley Street... ii i* Sun Row, Newhall Street ii jl St. John's Park j i jl St. Mark's Villas, Moray Road ii il Stone Street ... ii Ti St. James Road 64 ,B i A' South Street ... ii ii 9 o2 Suffolk Place ... jl 4 Sutterton Street A' ii jl Stonefield Street 22 jl 9 Story Street ii 3' 3 A} Shaftesbury Road l8 T O8 St. John's College, Aubert Park .. a ■J Sunnyside Road ii J ii St. Jude's Cottages, St. Jude Street ii Station Road ... ii T J St. John's Villas j.. 2a i Spencer Street... ii JL J i Shelburne Road 4» St. Thomas Street t i2 4a Scotts Buildings, Caledonian Road ii St. Peter Street ii 2i jl Sherborne Street ii ii 48 2i Stock Orchard Crescent 2i ii Surr Street ii 3 T i Spring Street ... ii i jl Sparsholt Road 0b Tollington Road 4' ii j Tufnell Park Road ... 5s ii 5 6« i77 [i908 Table CXi ii.—continued. NAME OF STREF.T. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever Erysipelas Puerperal Fever. Continued Fevtr. Totals Tabley Road ... 22 22 ii i.5 Tythertou Road 2* 2' Twyford Street 32 ii 4s Tollington Place ii 2i 3a Tremlett Grove "ii ii 2* Tibbertou Square li li Trinder Road ... "ii ii Tborpedale Road i2i 44 i68 Tollington Park ii 2 2 ii 4i Thane Villas... 22 ii ii 4* Thomhill Square ii ii Trinity Street ... ... ii ii Tiber Street ... ii ii 22 Tyndale Terrace ii -• ii Thornbill Road ii ii Thornhill Crescent ii ... ii Theberton Street li ii Torrens Buildings, City Road ii ... il 22 Thornhill Houses, Thornhill Road ii ii Upper Street ... 56 22 22 qfl Upper Park Street 22 2i Union Street ii ii 22 Union Square ... ii li 22 Vorley Road 55 22 7' Victor Road 6' ii 7' Vittoria Street 32 ii ... 4' Viucent Terrace ii ii 22 VictoriaP lace... ii ... ii Victoria Road .. 3" 22 "ii 6s Windsor Road .. 22 44 6" Woodville Road li "ii 2a Wall Street ... ... . . 42 ii ... ii (■' Whitehall Park ii 22 ii 44 Windsor Street 22 3a " ii 65 Warren der Road ii 2i 3' Wray Crescent 32 2i c8 Wessex Buildings ii6 3i H7 Westbourne Road 8' ii jl io8 Wellington Road 22 44 ... 65 Whewell Road... ii 22 3" Wilton Square... ii ii jl 3' Winchester Street ii 39 4* Wolsey Road ... 22 22 i78 i908] Table CXi ii.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Totals. Wynford Road ii 2a 3s Wyatt Road ... ii ii 23 Wallace Buildings, Caledonian Road ii ii Wallace Road ... ii ii Wedmore Gardens 4* ... J ... 4' Warner Street 6" 2i 87 Wolsey Grove ... ii ii Ward Road ii ii •.. 2a William Street, St. Peter's Street 2a 2a Whistler Street 6* . , . ii jl 8" Woodville Grove 22 2a Witley Road ... ii ii VVharfdale Road 22 ii 3' William Street, Wynfor Road ii ii Witherington Road ... ii ii ... 2a Williamson Street , l ii Weymouth Villas, Moray Road ii li 2i Whitehall Mansions, Whitehall Park ii ii York Road io8 ii ii "3s i5" Yerbury Road ... 56 22 ii 8" Yonge Park ii ii i7& ■i908 BACTERiOLOGiCAL EXAMiNATiONS. During the year 5-i5 specimens were examined for the purpose of diagnosing Diphtheria, Enteric Fever and Phthisis for the medical profession who practise in islington. This was the largest number hitherto examined in one year, the preceding largest return having been 47i in i907. Of these specimens 28i related to Diphtheria, 59 to Enteric Fever, and 205 to Phthisis. Diphtheria.—The 28i specimens forwarded for examination was the largest number hitherto received. in 93 instances positive results were obtained, and in i88 negative. Enteric Fever.—The specimens of the blood of 59 patients were examined, of which 34 resulted in the diagnosis of the disease, and 25 gave negative results. Phthisis.—The sputum of 205 patients was examined, in 69 of which tubercle bacilli were recognised. The above examinations, made on behalf of the Council by the Lister institute, bring up the number of specimens examined since i898 to 3,674, of which i,507 were made for the diagnosis of Diphtheria, 780 for Enteric Fever, and i,387 for Phthisis. The following Tables show the results of the examinations that been made:— Diseases. Total Examinations. i Positive Results. Negative Results. Percentage of Positive Results. Diphtheria i,507 585 922 38 8 Enteric Fever .. 780 349 43i 447 Phthisis i,387 5 882 36 4 Total 3, ,235 i80 i908] Table CXiV. Showing the result of the Bacteriological Examinations made joy the Diagnosis of Diphtheria, Enteric Fever and Phthisis, i898-i908. Diphtheria. Enteric Fevf.r. Phthisis. Periods. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined, j Totals. j i898 (6 months) .. ii 20 3i 3i i7 48 79 i899 47 50 97 25 •5i 76 30 43 79 252 i900 43 62 i05 33 45 78 35 44 79 262 i90i 80 90 i70 66 46 ii2 28 43 7i 353 i902 52 70 i22 45 69 ii4 39 83 i22 358 i903 i4 64 78 i5 54 69 40 96 i36 283 i904 28 58 86 i4 39 53 46 89 i35 274 i905 6i 86 i47 34 22 56 87 i3i 2i8 42i i906 68 99 i67 27 29 56 57 96 i53 376 i907 88 i35 223 25 34 59 68 i2i i89 47i i908 93 i88 28i 34 25 59 69 i36 205 545 Totals (for i0J years) .. 585 922 i507 349 43i 780 505 882 i387 3674 VACCiNATiON. The vaccination returns show that 5,907 children were successfully vaccinated during the last completed year (i907), or 284 less than the successful vaccinations in i906. Perhaps the best way to understand the return is by referring to Table CXV. which gives a return for each year since i880 of the vaccinations per i00 births, less the infants who have died unvaccinated, where it will be found that the percentage of these vaccinations has fallen from 79-9 in i906 to 76 9 in i907. On the other hand, by referring to Table CXV. it will be seen that the number of exemption certificates has risen from i23 in i906 to 259 in i907, or an increase of ii0 per cent.; and it will be noticed in Table CXV. that the 259 exemptions in i907 have increased to 304 in the first six months of i908. 181 [1908 These figures would seem to indicate that anti-vaccinators are not inactive in this borough, and probably the same may be said of other places, where likely enough similar unfavourable statistics will be returned. The truth is the anti-vaccinators are always active, preaching their pernicious doctrines whenever they can find an audience, and spreading their heresies by means of pamphlets, letters to the press, and addresses to working men. Indeed, it has recently been suggested by one of the members of the National Anti-vaccination League that they should extend their agitation to the serum treatment of diseases. Indeed, this gentleman has proposed the legal prohibition of vaccination and the intentional introduction of any disease product into any living animal, either for prophylactic or curative or experimental or for any other purposes. One would suppose that their madness could hardly extend further, but unfortunately, it is found that this same gentleman has suggested the repeal of the Vaccination Acts, except Clause 32 of the Act of 18G7 prohibiting the inoculation of Small Pox. The exact words of this section are as follows:— "Any person who shall after the passing of this Act produce or attempt to produce in any person by inoculation with variolous matter, or by wilful exposure to variolous matter or to any matter, article, or thing impregnated with variolous matter, or wilfully by any other means whatsoever produce the disease of Small Pox in any person, shall be guilty of an offence, and shall be liable to be proceeded against summarily, and upon conviction to be imprisoned for any term not exceeding one month." He will have neither vaccination nor inoculation. Perish the people by Small Pox ! Now, inoculation in its day was certainly most valuable, and no doubt would have been practised largely even now, notwithstanding its great drawbacks, were it not that Jenner, with his great discovery of vaccination, completely ousted it from its position. Inoculation came from the East, and on its introduction into England was met with opposition by some persons, and indeed one clergyman preached a sermon in St. Andrew's Church, Holborn in 1722 from the following text:— " So went Satan forth from the presence of the Lord and smote Job with sore boils from the sole of his foot unto his crown," arguing that these boils were Small Pox, and that therefore Satan was the first inoculator, and consequently that inoculation is a "diabolical operation," tending "to anticipate and banish providence out of the world," and also "to promote the increase of vice and immorality." 182 1908] The method of inoculation practised in Eastern Europe is described in one of Lady Mary Wortley Montague's letters written from Adrianoplein 1717, and as reference to it is frequently made by every writer on the History of Vaccination, the greater part of the extract is here appended:— "Apropos of distempers, I am going to tell you a thing that I am sure will make you wish yourself here. The small-pox, so fatal, and so general amongst us, is here entirely harmless by the invention of ingrafting, which is the term they give it. There is a set of old women who make it their business to perform the operation every autumn, in the month of September, when the great heat is abated. People send to one another to know if any of their family has a mind to have the Small Pox ; they make parties for this purpose, and when they are met (commonly fifteen or sixteen together) the old woman comes with a nutshell full of the matter of the best kind of Small Pox, and asks what veins you please to have opened. She immediately rips open that you offer to her with a large needle (which gives you no more pain than a common scratch) and puts into the vein as much venom as can lie upon the head of her needle, and after binds up the wound with a hollow bit of shell; and in this manner opens four of five veins. The Grecians have commonly the superstition of opening one in the middle of the forehead, in each arm, and on the breast, to mark the sign of the cross, but this has a very ill effect, all these wounds leaving little scars, and is not done by those that are not superstitious, who choose to have them in the legs, or that part of the arm that is concealed. The children or young patients play together the rest of the day, and are in perfect health to the eighth. Then the fever begins to seize them, and they keep their beds two days, very seldom three. They have very rarely above twenty or thirty in their faces, which never mark; and in eight days 'time they are as well as before their illness. Where they are wounded, there remain running sores during the distemper, which I don't doubt is a great relief to it. Every year thousands undergo this operation ; and the French Ambassador says pleasantly that they take the Small Pox here by way of diversion, as they take the waters in other countries. There is no example of any one that has died in it; and you may believe I am well satisfied of the safety of this experiment, since I intend to try it on my dear little son." In a later letter to her husband she writes:— " The boy was engrafted last Tuesday, and is at this time singing and playing, and very impatient for his supper. I pray God my next may give as good an account of him. . . I cannot engraft the girl; her nurse has not had the Small Pox." 188 [1908 The last line of this letter gives the real reason why inoculation was prohibited in England when vaccination was introduced The persons inoculated were a danger to everyone with whom they came into contact who had not previously contracted Small Pox or who had not been inoculated, for they were suffering from the disease themselves. Vaccinated persons on the contrary are no danger to the community, although they themselves became immune from the disease, which immunity lasted for a considerable time. Can anything show more clearly the madness of these anti-vaccinators than the suggestion to sweep away not only inoculation, which nobody now desires, but vaccination, which has done, and is doing so much for the prevention of Small Pox throughout the world ? Do they desire to have the nation return to those days and conditions so well described in an old book on Domestic Medicine,* written by Dr. W. Buchan, written so long ago as 1769 in Edinburgh? This is what he says:— "This disease is so general that few escape it at one time of life or another. It is the most contagious malady in these parts; and has for upwards of a thousand years proved the scourge of Europe. The smallpox generally appear towards the spring. They are very frequent in summer, less so in autumn, and least of all in the winter. Children are most liable to this disease. . . The small-pox are generally caught by infection. Since the disease was brought into Europe, the infection has never been wholly extinguished, and is so generally known that a minute description of it is unnecessary." Dr. Buchan then goes on to speak of— " The inexpressible terrors that perpetually harass persons who never had the disease, in so much that where the small-pox is epidemical, entire villages are depopulated, markets ruined, and the face of distress spread over the whole country. From this terror it arises that justice is frequently postponed or discouraged at sessions or assizes where small-pox rages. Witnesses and juries dare not appear; and by reason of the necessary absence of some gentlemen, our honourable and useful judges are not attended with that reverence due to their office and merit. With regard to the soldiery, it is stated that the miseries attending these poor creatures when attacked by small-pox on a march is inconceivable; without attendance, without lodgings, without any accommodation; so that one of three commonly perishes. *This book had an enormous sale and was found in nearly every household. The M. O. H. recollects it on his grandfather's bookshelves. It was the first medical book he ever saw. He is indebted for the extract to the "Medical Officer." 184 1908] " Such as have not had the small-pox in the early period of life are not only rendered unhappy but likewise in a great measure unfit for sustaining many of the most useful and important offices. Few people would choose even to hire a servant who had not had the small-pox, far less to purchase a slave who had the chance of dying of this disease. How could a physician or surgeon who had never had the small-pox attend others under that malady? Thus, besides the continual fears and anxiety which haunt those persons who have not had small-pox, we might show numberless inconveniences which arise from it. For example: How deplorable is the situation of females who arrive at mature age without having had small-pox? A woman with child seldom survives this disease. And if an infant happens to be seized with the small-pox upon the mother's breast who had not had the disease herself, the scene must be distressing. If she continues to suckle the child, it is at the peril of her own life; and if she weans it in all probability it will perish. How often is the affectionate mother forced to leave her house and abandon her children at the very time when her care is most necessary? But should parental affection get the better of her fears, the consequences will often prove fatal. I have known the tender mother and her infant child laid in the same grave, both untimely victims to this dreadful malady." Let us hope that the United Kingdom will never see such days as these again, but rather look forward to a time when this country will be as well protected as Germany is to-day, for there Small Pox is so rare that they have no longer any use for Small Pox hospitals. If, however, the number of persons who are exempted under the "conscience" clause of the Act daily become more numerous, it will more than ever be incumbent, indeed, a sacred obligation,on those who believe in the power of vaccination to prevent Small Pox to see that not only they themselves, but their children, are duly vaccinated, and, after the lapse of a number of years, re-vaccinated. If the records and statistics of Small Pox in connection with vaccination are studied by inquirers, as they were by the Royal Commissioners, they will find that they show beyond a shadow of doubt that vaccination is an almost certain protection against Small-Pox. If this be so, it may be asked, how is it that anti-vaccinators have not been convinced by the statistics? It is a difficult question to answer, but perhaps a teply is best given by an incident that the late Dr. James Grey Glover, so well-known in Islington during the last generation, and who was an ardent advocate of vaccination, related to me a few months before his death. He was arguing the question of vaccination one evening during the course of a dinner with a well-known anti-vaccinator, and when he put it to him that the statistics 185 [1908 from the Metropolitan Asylums Board Hospitals were overwhelmingly in favour of the efficacy of vaccination, the other shook his head, whereupon Dr. Glover asked him with surprise, "Do you not believe them?" to which he replied, "No." "Then am I to understand that you mean to say that these statistics are cooked?" said the doctor; to which the anti-vaccinator replied, " Yes, certainly." When men will go to this length, it is apparent they must be in a very tight corner, and that they will not be convinced, preferring to slander a body of able men, whose only desire was to throw light on the subject of vaccination Such a slander can only be described as despicable. If a man who by his birth and education should be a gentleman, is capable of making such a statement as that mentioned, what can be expected from those humble followers among the working classes who have never had any education, and who, not having had a chance of studying the other side of the question, make rash statements as to the value of the greatest preventative of one of the most terrible diseases the world has ever known. It is sometimes asked if anti-vaccinators are ever converted. They are, when the force of circumstances is too strong for them, or when seeing means believing, as the following instances show. The writer many years ago, when in charge of the Small Pox Hospitals in the Borough of Sunderland, had under his care a man who was a very strong anti-vaccinator. He was well-known to the public, and was a leader among the labouring classes of the borough. His attack was comparatively mild, for, fortunately for him, he had been vaccinated when he was young, and consequently his attack was slight, and he soon became sufficiently convalescent to be able to observe the other patients in the ward in which he had been placed. It was not long before he commenced to talk about Small Pox and vaccination, and also to note the different types of the disease that were under treatment in his ward. This led him to make inquiries as to the state of vaccination of these people, and soon he was enabled to say pretty positively, when new patients were brought into the ward, whether they had previously been vaccinated or not, with the result that before he left the institution he became a very confirmed believer in the power of vaccination. As he said, " I cannot close my eyes to the fact that the disease in nearly every case in which the patient was unvaccinated, was of a very virulent character, while among the vaccinated it was as a rule of a very mild type." It is only by such an experience that one can ever hope to convert the anti-vaccinator, who, like every other " anti," is steeped in prejudice against his pet aversion. Another case is also of great, if melancholy interest. It is only one, but the first,of many experiences which the Medical Officerof Health could relate. In the early part of the year 1873 he entertained in his father's house one evening, at a time when Small Pox was very prevalent, in the City of Cork, N 186 1908] a number of medical students, together with a friend engaged in mercantile pursuits, and naturally the subject of vaccination was discussed. One of those present had recently obtained his medical qualifications, and he offered there and then to vaccinate the party. All accepted the offer, with the exception of the gentleman named, who stated that he had never been vaccinated, because his father did not believe it was a preventative, and that it would annoy him very much if he were vaccinated then. Some 9 or 10 days later all the party went to the theatre together, and sitting next to the writer, and three persons removed from the gentleman mentioned, was a woman who without doubt had recently come from a bed of Small Pox, for her face gave positive evidence that she had had a very bad attack. In seven or eight days the unvaccinated member of the party began to sicken, and within three weeks he was dead from malignant Small Pox. At his funeral there followed a grief-stricken father, who within nine months was also laid beside his only son, his heart broken by the knowledge of the fact, which he freely confessed, that his boy, who was a splendid type of muscular Christianity, would have then been living were it not for his folly. It is much to be regretted that facts respecting vaccination are not distributed broadcast throughout the country just as the pamphlets of the antivaccinators are. Perhaps one reason for this is that the administration of the Vaccination Acts is in the hands of the Boards of Guardians, who have really no direct interest in the prevention of Small Pox, and also perhaps because there is hardly a Board on which there are not anti-vaccinators. Vaccination it a national question, and facts respecting its power to prevent Small Pox should be made known in pamphlet form to every person to whom a child has been born. They could easily be given to parents or guardians at the registration of a child's birth. In this way anti-vaccinators would be met on their own ground and the public at large be given some opportunity of judging as to the truth of their statements. Years. Vaccinations per 100 births, less infants who died unvaccinated. Years. Vaccinations per 100 births, less infants who died unvaccinated. 1880 89.8 1894 84.0 1881 90.8 1895 70.9 1882 91.1 1896 73.9 1883 90.4 1897 73.3 1884 90.5 1898 64.9 1885 90.6 1899 66.4 1886 90.8 1900 67.9 1887 90.4 1901 75.8 1888 88.4 1902 80.0 1889 89.0 1903 8l.2 1890 89.3 1904 82.3 1891 87.4 1905 80.5 1892 85.5 1906 79.9 1893 85.0 1907 76.9 187 [1908 Table CXV. Showing the State of Vaccination in Islington, 1880-1906, also in London and England and Wales, 1880-1906. Years. No. of Births. Successfully Vaccinated. Insusceptible to Vaccination. Died Unvaccinated. No. of exemption certificates. Postponed by medical certificate. *Remaining. Cases (cols. 6, 7, & 8), not finally vaccinated per' 100 births.† Ditto in London. Ditto in Rest of England. 1 2 3 4 5 6 7 8 9 10 11 1880 9,931 8,123 26 885 Not granted for years previous to 1897. 118 779 9.0 7.0 4.5 1881 9,993 8,339 21 812 89 730 8.2 5.7 4.3 1882 10.000 9,360 22 819 155 644 8.0 6.6 4.5 1883 9,950 8.192 25 890 194 644 8.4 6.5 4.9 1884 9,892 8,121 47 924 191 601 8.0 6.8 5.3 1885 9,083 7,874 41 991 157 617 8.0 7.0 5.5 1886 9,844 7,914 39 1,091 148 622 7.8 7.8 6.1 1887 9,732 7,769 44 1,133 171 615 8.1 9.0 6.7 1888 9,620 7,522 39 1,112 219 728 9.8 10.3 8.2 1889 9,638 7.581 22 1,120 198 717 9.5 11.6 9.6 1890 9,239 7,250 19 1,117 122 731 9.2 13.9 10.9 1891 9,823 7,584 33 1,145 131 930 10.8 16.4 12.9 1892 9,626 7,221 28 1,182 127 1,048 12.2 18.4 14.3 1893 9,757 7,251 38 1,222 132 1,114 12.7 18.2 15.7 1894 9,574 7,151 39 1,067 101 1,216 13.7 20.6 19.0 1895 9,959 7,079 50 975 237 1,618 18.7 24.9 19.9 1896 9,752 6,575 46 854 223 2,054 23.4 26.4 22.3 1897 9,878 6,539 30 954 14 220 2,121 23.8 29.1 21.6 1898 9,478 5,422 44 1,068 103 251 2 590 31.1 34.4 26.6 1899 9,631 5,698 81 1,048 101 333 2,370 29.1 28.7 20.8 1900 9,316 5,777 30 812 127 298 2,272 28.9 26.8 19.9 1901 9,266 6,382 29 852 106 107 1,790 21.6 25.2 17.3 1902 o,055 6,593 39 818 73 98 1,434 17.7 22.1 15.2 1903 8,959 6,673 23 739 103 62 1,359 17.0 21.7 14.7 1904 8,956 6,774 26 729 89 50 1,288 15.9 20.2 14.5 1905 8,603 6,360 28 709 110 66 1,330 17.5 20.1 14.8 1906 8,534 6,260 22 696 123 100 1,333 18.2 22.7 16.8 1907 8,372 5,976 15 609 259 65 1,448 21.2 Not available. Not available. 1908 (6 m'ths) 4,237 2,745 13 272 304 66 837 28.5 * The figures in Column 8 are obtained by adding together the numbers given in Columns 3, 4, 5, 6 and 7 and deducting the total from the number in Column 2. † The figures in Column 9 are percentage statements, obtained by adding together the numbers given in Columns 6, 7 and 8 and applying them to the numbers in Column 2. 188 1908] Table CXVI. Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the year 1907. REGISTRATION SUB-DISTRICTS. Number of Births registered in 1907. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Exemption Certificates received. Died Unvaccinated. Postponement by Medical Certificate. Removed to other Districts. Removed to places Unknown. Number of Children remaining Unvaccinated, or not accounted for in Report Book Total Number of Certificates of Primary Vaccination at All Ages received during year 1908. 1 2 3 4 5 6 7 8 9 10 11 Tufnell 741 513 3 ... 31 61 10 18 101 4 3,031 Upper Holloway 1,017 753 6 ... 22 69 5 12 139 11 Tollington 743 530 1 ... 26 69 5 14 91 7 Highbury 1,266 940 ... ... 50 89 8 23 136 20 Lower Holloway 1,078 776 2 ... 24 95 17 10 136 18 3,178 Barnsbury 1,673 1,183 1 ... 51 112 5 7 286 28 Islington, South East 1,854 1,281 2 ... 55 114 15 15 323 49 The Borough 8,372 5,976 15 ... 259 609 65 99 1,212 137 6,209 189 [1908 Table CXVII. Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the period, January to June, 1908. REGISTRATION SUB-DISTRICT. Number of Births registered from 1st January to 30th June, 1908. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Exemption Certificates received. Died Unvaccinated. Postponement by Medical Certificate. Removed to other districts. Removed to places unknown. Number of children remaining unvaccinated or not accounted for in Report Book. Number of Exemption Certificates received during the year 1908. 1 2 3 4 5 6 7 8 9 10 11 Tufnell 420 270 2 ... 44 28 7 10 44 15 338 Upper Holloway 523 358 4 ... 33 40 6 5 67 10 Tollington 362 250 1 ... 26 32 6 6 28 13 Highbury 692 467 2 ... 68 39 5 8 72 31 Lower Holloway 533 362 ... ... 25 34 11 6 57 38 303 Barnsbury 753 476 1 ... 48 43 14 9 136 26 Islington, South East 954 562 3 ... 60 56 17 10 153 93 The Borough 4,237 2,745 13 ... 304 272 66 54 557 226 641 190 1908] DISINFECTION. The year 1908 has been a busy one with respect to disinfection in its various branches. Under this heading is included the cleansing, spraying, and stripping of rooms, schools, and class rooms, as well as the disinfection of infected and verminous articles of clothing ; and household bedding, etc. Disinfection of Rooms.—There were 2,533 rooms, as compared with 2,402 in 1907, disinfected. As a rule formaldehyde, either in its gaseous form or as a spirit was used. In a few cases, however, sulphurous acid gas was employed, especially where vermin was present. The Cleaning and Stripping of Rooms.—818 rooms, as contrasted with 760 in the previous year, were cleansed, sprayed or stripped, the largest amount of work being done in the fourth quarter of the year. The following are the particulars:— 1907 1908 1st. Quarter 182 184 2nd „ 241 179 3rd „ 168 162 4th ,, 169 293 It may be noted that people as a rule are very willing to have their rooms disinfected, and indeed at times are clamorous to have more done in the way of stripping the walls than the Public Health Department deems necessary or indeed, can call on the owners to execute. Disinfection of Schools —The class rooms in 28 public elementary schools, including the Guardians' School, Hornsey Road, were disinfected after Measles, Scarlet Fever or Diphtheria, while one room was disinfected because of its verminous condition. The following statement shows the class rooms disinfected, as well as the diseases owing to whose presence in them this disinfection became necessary. 1st Quarter. Arlington Square L.C.C. School, Infants' Department (Measles). Guardians' Schools, Hornsey Road, Boys' Dormitories, Schoolrooms, and Probationers' Wards (Scarlet Fever). Home and Colonial College, Highbury Hill (Scarlet Fever). Yerbury Road L.C.C. School, Infants (Measles). 191 [i90H 2nd Quarter Forster L.C.C. School (Verminous). Tollington College (Chicken Pox). Montem Street L.C.C. School (Measles). St. Thomas' School, Everilda Street (Measles). Upper Hornsey Road L.C.C. School (Measles). Blackstock Road L.C.C. School (Measles). St. Jude's School (Measles). Ecclesbourne Road L.C.C. School (Measles). 3rd Quarter Yerbury Road L.C.C. School (Scarlet Fever). York Road L.C.C. School (Srarlet Fever). St. Paul's School, Dorset Street (Measles). Grafton Road L.C.C. School (Measles). Caledonian Road L.C.C. School (Measles). 4th Quarter Guardians' Schools, Dormitories, (Scarlet Fever). Montem Street L.C.C. Schools (Measles). Upper Hornsey Road L.C.C. School (Scarlet Fever). Ecclesbourne Road L.C.C. School (Diphtheria). Hanover Street L.C.C. School (Diphtheria). St. Clement's, Cumberland Street (Diphtheria). Gilford Street L.C.C. School (Measles). Thornhill Road L.C.C. School (Measles). Richard Street L.C.C. School (Measles). St. James' L.C.C. School (Measles). St .Aloysius School (Scarlet Fever). Table CXVIII. Showing the Disinfection of Rooms by Formaldehyde Gas after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1908. Sanitary Inspectors' Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1908. 1907 1st Q'rter 56 66 19 44 33 47 21 45 46 38 54 22 30 58 579 486 2nd do. 47 27 42 21 21 25 31 52 26 52 25 18 37 479 606 3rd do. 47 72 26 45 37 57 29 25 58 50 49 57 42 36 63c 592 4th do. 36 103 55 72 57 67 52 28 97 53 52 78 57 38 845 718 Year 186 296 127 203 148 192 127 129 253 167 207 182 147 169 2533 !402 192 1908] Table CXIX. Showing the Cleansing, Spraying or Stripping of Rooms after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1908. Sanitary Inspectors Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1908. 1907 1st Q'rter 10 17 7 25 20 10 2 12 16 10 15 8 9 23 184 182 2nd do. 40 14 8 13 25 6 5 4 22 9 9 8 5 11 179 241 3rd do. 16 26 9 6 9 6 3 10 12 4 15 12 18 17 162 168 4th do. 36 27 22 43 13 2 15 3 43 30 15 15 10 19 293 169 Year .. 102 83 46 87 67 24 25 29 93 53 54 43 42 70 818 760 Disinfecting Station.—The work done at the Disinfecting Station was greater, with the exception of the year 1896, than at any other period since its erection, no less than 62,455 large articles being disinfected, of which number 36,016 had been exposed to infectious disease. These articles are set out in the following table:— TABLE CXX. Summary of the chief articles of Clothing, Bedding, &c., disinfected during the year 1908, and also in the preceding year 1907. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1908 1907. Beds 6l5 511 735 936 2,797 2,345 Blankets 1,092 882 1,070 1,461 4,505 3,852 Bolsters 517 473 626 721 2,337 1,947 Carpets 124 127 152 198 601 359 Chair Bed Cushions 77 47 82 131 337 383 Mattresses 334 300 499 457 1,590 1,466 Palliasses 352 336 412 415 1,515 1,315 Pillows 1,152 1,011 1,367 1,746 5,276 4,406 Quilts 593 529 708 952 2,782 2,509 Sheets 1,117 959 1,300 1,693 5,069 4.413 Other Articles 1,942 1,670 2,432 3,163 9,207 7,088 Totals 7,915 6,845 9,383 11,873 36,016 30,083 193 [1908 The other articles, 26,439 in number, consisted of soldiers' tunics, overcoats, and some other garments which were disinfected for a firm of clothing contractors in the borough, who when exporting them are required to send with them a certificate from the Medical Officer of Health stating that they had been disinfected to his satisfaction. The following statement gives a description of the clothing that was disinfected and the number of articles:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4 th Quarter. Year. Soldiers' Tunics 2,200 8,425 952 500 12,077 Soldiers' Overcoats 2,975 3,642 89 4,617 11,323 Dustcoats 125 50 ... ... 175 Black Jackets ... 816 ... 250 1,066 Other Articles 102 460 ... 1,236 1,798 5,402 13,393 1,041 6,603 26,439 The following is a record of the work performed by the Steam Disinfectors during the past fourteen years:— 1895 17,240 articles 1896 42,258 ,, 1897 28,302 „ 1898 20,172 ,, 1899 25-378 „ 1900 19,136 ,, 1901 27,050 ,, 1902 36,772 ,, 1903 23,748 ,, 1904 21,868 „ 1905 25,463 ,, 1906 28,629 ,, 1907 30,083 ,, 1908 62,455 „ Total for fourteen years 408,554 „ 194 1908] Disinfectants distributed and used.—The following statement gives the quantity of disinfectants distributed by the Sanitary Authority, and used in disinfecting and cleansing rooms:— How disposed of. Carbolic Powder. Disinfecting Fluid. Formaldehyde. Powder. Solution Tons. cwts Gallons. cwt. qr lb. Gallons. To Householders .. 3 5 720 — — Disinfection of Premised — — 1 2 0 20 SHELTER HOUSE. The Shelter House was used for various purposes during the year, amongst which were the following:— 1st. To house persons whose homes were undergoing disinfection. 2nd. To cleanse verminous persons in its slipper baths under the provisions of the Verminous Persons Act. 3rd. To bathe verminous school children. 4th. To bathe and cleanse midwives after attendance on cases of Puerperal Fever. Only three families, consisting altogether of 13 persons, used the Shelter House while their homes were being disinfected. As many as 1,202 children attending the London County Council Schools were bathed and cleansed and their clothing disinfected. Many of the children attended more than once, and are included in the return given below. Eight persons (men) were cleansed under the Verminous Persons Act, 1897 Sixteen midwives were disinfected after attendance on cases of Puerperal Fever. Persons using Shelter House pending the disinfection of their homes. Dale of Admittance. Address. Number in Family. Cause 1908. 16th Jan. 70, Orpingley Road 2 Diphtheria. ,, ,, ,, ,, 10 ,, 30th Oct. 34, St. Thomas' Road 1 Scarlet Fever. 195 [1908 Verminous persons cleared at the Shelter House under the " Cleansing of Persons Act, 1897." Date of Admittance. Address. Number of Persons. Cause. 1908. 31st Jan. 8a, Hornsey Street 1 Verminous. 18th April Unknown 1 Do. 29th May Unknown 1 Do. 29th June 8, Flowers Mews 1 Do. 28th Sept. 18, Howard Road 1 Do. 29th Sept. 8, Flowers Mews 1 Do. 27th Oct. Unknown 1 Do. 28th Nov. 8, Flowers Mews 1 Do. School Children Cleansed and Bathed.—During the year 1,202 children attending the London County Schools were bathed and cleansed by the woman attendant, and their clothes disinfected. Midwives attending Disinfecting Station for the purpose of disinfection after cases of Puerparal Fever. Date of Admittance. Name. Address. 30th December, 1907 Wilde, Mrs. 77, Offord Road 3rd April - 1908 Barron, Mrs. 22, Sutterton Street 18th May Saville, Nurse 9, Bardolph Road 25th May Welder, Mrs. 107, St. James' Road 6th June Miller, Mrs. 82, Church Road nth June Webb, Nurse 227, Essex Road 15th June Langley, Mrs. 59, Arthur Road 4th August Ventura, Mrs. 38, Devonshire Road 31st August Wilde, Mrs. 77, Offord Road 2nd September O'Neil, Mrs. 39a, Essex Road 23rd September Sprague, Mrs. 32, Copenhagen Street 28th September Wilde, Mrs. 77, Offord Road 9th November Kendal, Mrs. 29, Sutterton Street 20th November Rogers, Mrs. 101, St. James' Road 24th November Kendal, Mrs. 29, Sutterton Street 1st December Webb, Nurse 227, Essex Road PART IV. SANITATION, ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901. INSPECTION OF WORKSHOPS, WORKPLACES, LAUNDRIES AND BAKEHOUSES. HOUSES LET IN LODGINGS. DISTRICT INSPECTIONS. STATE OF PAUPERISM. COMMON LODGING HOUSES. DUST REMOVAL, 198 1908] FACTORY AND WORKSHOP ADMINISTRATION. The Medical Officer of Health is obliged, by the Factory and Workshops Act, to report annually as to the manner in which the Act is administered in the district over which he has charge. By it also all local authorities are compelled to keep registers of workshops, and to transmit copies of the annual reports of their Medical Officer of Health on the subject to the Secretary of State; in addition to which, in London copies must be forwarded to the Local Government Board and the London County Council. As year by year passes, the work under the Factory and Workshop Act, 1901, grows, so that, whereas at one time it was thought that two inspectors, a male and female, would be sufficient to execute it, it is now found that three barely suffice. Inspectors.—Three Inspectors one male and two females, are engaged in carrying out the work entailed on the Council under the Act. It is the duty of the male inspector to inspect all factories and workshops where men are employed, and of one female inspector to visit factories and workshops, including laundries, where women are employed, and of the other female inspector to inspect the homes of homeworkers and the kitchens of restaurants and places where food is prepared. Inspections and Visits.—The number of inspections and visits paid was 11,565, as compared with 10,727 in the preceding year, and 6,980 in 1906. The particulars of these inspections are as follows:—Factories (including factory laundries), 434; workshops (including workshop laundries), 2,008; workplaces other than outworkers' premises, 248; bakehouses, 572; kitchens of restaurants, 800; outworkers' premises, 995; miscellaneous re-inspections and calls, 6,508; total, 11,565. Notices Served —Arising out of these inspections, 704 intimation notices and 17 statutory notices were served for various purposes. These notices related to 1,942 defects, of which 1,773 had been remedied at the close of the year. In addition, 79 notices were served with respect to outworkers' rooms which were found in an unwholesome state. Registers.—4,257 workshops are at present on the registers. This number includes 533 workshops where men are employed, 821 workplaces where 199 [1908 women are employed, 132 laundries, 255 bakehouses, 685 kitchens of restaurants and eating houses, or of places where food is prepared, and 1,831 outworkers' premises. Perhaps if the figures for 1907 and 1908 be placed in parallel columns, the contrast between the two years will be better appreciated. The changes in the registers by additions and subtractions may be seen in the following statement:— Workshops and Workplaces. 1907. 1908. Workshops on Register. Workrooms on Register. Number added during Year. Number removed during Year. Total number of Workshops on Register. Total Number of Workrooms on Register. Workshops where Men are employed 528 824 58 53 533 832 Workshops where Women are employed 826 1,650 194 199 821 1,615 Laundries 134 18 20 132 Bakehouses 256 266 — 1 255 265 Restaurant Kitchens 452 593 250 17 685 939 Outworkers' Premises 1,989 1,989 — 158 1,831 1,831 Total 4,185 5,322 520 448 4,257 5,482 Sanitation.—1,942 sanitary defects were discovered ,of which 719 related to want of cleanliness, 12 to want of ventilation, 8 to overcrowding, 72 to insnfficient, or want of, drainage to the floors, and 520 to other nuisances. In 38 instances dustbins were wanting, in 12 the w.c. accommodation was insufficient, in 375 it was foul, in 17G was unsuitable or defective, and in 10 the sexes had not been provided with separate accommodation. Of these sanitary defects, 1,773 had been remedied at the close of the year. In addition to these, nuisances were found in 141 instances in the homes of outworkers, while in 38 infectious diseases were reported. As showing the volume of work that has been done in factories, workshops, and workplaces since 1896, it may be said that 13,333 more or less serious nuisances, in addition to very many of minor importance, have been discovered and remedied. Their nature is set out in the following table, which has now been prepared for a number of years. 200 1908]  1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 Total Overcrowding 26 12 15 14 22 14 4 13 4 13 30 9 8 184 Ventilation 14 13 2 5 4 3 5 8 11 4 8 31 12 120 Dirty Premises 311 195 109 99 217 218 231 423 630 412 448 970 719 4,982 Drains 554 458 375 313 216 177 90 50 19 15 4 19 261 2,551 W.C.'s 420 325 341 355 411 375 154 161 165 151 190 620 573 4,241 Water supplies 79 41 35 20 19 13 83 54 18 38 17 23 45 485 Surface drains 79 109 87 51 78 81 2 53 40 34 39 45 72 770 Cleanliness.—In 719 instances, premises were found in an uncleanly state. Of these 607 had been remedied before the close of the year. The numbers in the preceding years had been respectively 970, 448, and 412. Effluvium Nuisances.—No nuisance of this kind was reported. Ventilation.—Twelve cases of insufficient ventilation were discovered, which, in addition to three standing over from the previous year, were remedied. Overcrowding.—Overcrowding was discovered in 8 instances, and these were at once abated. Only 9 cases were known in 1907, as compared with 30 in 190G, and 13 in 1905. Want of Drainage of Floors.—In 72 instances nuisances of this character were discovered, and as usual were mostly confined to laundries. Sanitary Accommodation.—The state of the sanitary accommodation in various workplaces received special attention, with the result that it was found that separate accommodation had not been provided in 10 instances. There was insufficient accommodation in 12 cases, w.c. pans were foul in 375 cases, and defective in 176. Bakehouses.—In no instance was an underground bakehouse found to be illegally occupied, nor indeed, were there any offences against the Act with respect to these places. The general condition of the bakehouses is very much superior to what it was when the Factory and Workshop Act came into force. 201 [1908 The Chief Inspector has, as usual, made his annual inspection of these places, and his report is herewith submitted. Town Hall, Upper Street, N. 21st March, 1908. Dear Sir, I have recently completed my annual inspection of the bakehouses in the Borough. There are 116 above ground, and 139 below ground. 10 of the former and 6 of the latter were not in use at the time of inspection. It is very gratifying to be able to report that in no instance did I find a dirty bakehouse, the majority were clean and the remainder were either being cleansed or about to be. The supervision, which is of a regular character, together with the co-operation cf the Master Bakers' Association, has been largely responsible for this satisfactory state of affairs. The occupiers have also shown a desire to readily comply with the suggestions which have been made to them from time to time, as for instance, by providing coal receptacles instead of allowing the coal to be placed on the floor of the bakehouse, and by repairing walls, floors and ceilings almost immediately the necessity has arisen, rather than allow them to become dilapidated. Although I did not find clothes being washed in any of the bakehouses, they were, in several cases, being aired, but at my request they were at once removed from the bakehouse. I have referred to this matter on previous occasions, but I am afraid that the temptation to air or dry clothes in a bakehouse is too great to expect that the occupiers will altogether discontinue the practice, notwithstanding that they are always written to asking them to do so. I am, Yours faithfully, JAMES R. LEGGATT, Superintendent and Chief Sanitary Inspector. Dr. A. E. Harris, Medical Oj/icer of Health, Town Hall, Islington, N. O 202 1908] LIST OF BAKEHOUSES. Upper Holloway District. Bakehouses above ground. 16, Brecknock Road 19, Archway Road 29, Highgate Hill 75, Elthorne Road 44, Cheverton Road 634, Holloway Road 103, Elthorne Road (Factory) 12, Hercules Road 57, Elthorne Road 60, Grove Road 582, Holloway Road 29, Cottenham Road 90, Grove Road no, Marlborough Road 62, Cottenham Road 103, Fairbridge Road 127, Marlborough Road 484, Hornsey Road 166, Fairbridge Road 346, Hornsey Road 163, Seven Sisters Road 67, Durham Road 104, Andover Road. 88, Audover Road 25, Lennox Road 49, Campbell Road 47, Palmerston Road 81, Fonthill Road 114, Fonthill Road 125, Hanley Road 144, Tollington Park 51, Stroud Green Road 131, Stroud Green Road 5, Tollington Park (Factory) 626, Holloway Road 420, Hornsey Road 81, Junction Road 669, Holloway Road Certified Underground Bakehouses. 54, ArchwayRoad 26, Blenheim Road 33, Bedford Tearace 144, Elthorne Road 10, Campdale Road 487, Hornsey Road 87, Hazellville Road 27, Hornsey Riss 676, Holloway Road 264, Hornsey Road 575, Holloway Road 167, Junction Road 239, Junction Road 7, Junction Road 104, Junction Road 32, Milton Grove 57, Marlborough Road 212, Tufnell Park Road 1, Stapleton Hall Road 59, Junction Road 84, Yerbury Road 31, Salisbury Road 47, Landseer Road 3, Cardwell Terrace 84, Ashbrook Road 203 [1908 Bakehouses not in use. 5, Andover Road (Underground) 33, Milton Grove (underground) Crisp & Co., Seven Sisters Road 23, Girdlestone Road (underground) (above ground) 58, Hazellville Road (above ground) 599, Holloway Road (underground) 53, Poole's Park ,, 102, Highgate Hill (above ground) Lower Holloway District. Bakehouses above ground. 69, Holloway Road 85, Holloway Road 251, Holloway Road 261, Holloway Road 463, Liverpool Road 106, St. James' Road 72, Rhodes Street 25, Cornelia Street 421a, Caledonian Road V.V. Bakery, Brewery Road (Factory) Kemp's Bakery, Brewery Road Bakery, Fakenham Street (Factory) 16, Westbourne Road (Factory) 254. York Road ia, St. James' Road Certified Underground Bakehouses. 5, Crossley Terrace 37, Charlesworth Street 118, Roman Road 480, Caledonian Road 78, Goodinge Road 376, York Road 415, Caledonian Road 70, George's Road 132, St. James' Road 32, St. James' Road (Factory) 107, Roman Road Bakehouses not in use. 46, Roman Road (Underground) 92, Wellington Road (Underground) 16, Sherringham Road „ 214, York Road ,, 25, Wellington Road „ 1, Frederick Street „ Highbury District. Bakehouses above ground. 112a, Drayton Park (Factory) 123, Newington Green Road 232, Holloway Road 132, Holloway Road 56, Hornsey Road 154, Hornsey Road 100, Hornsey Road 48, Seven Sisters Road 370, Holloway Road (Factory) 10, Blackstock Road 190, Seven Sisters Road 225, Blackstock Road 258, Seven Sisters Road 226, St. Paul's Road 202, Blackstock Road 53, Boleyn Road 3, Highbury Park O 2 204 1908] Certified Underground Bakehouses. 64, Drayton Park 146, Blackstock Road 246, Hornsey Road 98, Gillespie Road 128, Blackstock Road 77, Newington Green Road 156, Blackstock Road 57, King Henry's Walk 42, Newington Green Road Salvation Army Bakery, Hawthorne 52, Balls Pond Road Street (Factory) 132, Hollo way Road 13, Highbury Place 66, Blackstock Road Bakehouses not in use. 182, Drayton Park (Underground) 2, Queen's Square (Underground) 25, Lowman Road „ 77, Boleyn Road „ 98, Balls Pond Road ,, 16, St. Jude Street (Above ground) 1, Mildmay Park „ 17, Annette Road ,, 84, Mildmay Park ,, Barnsbury District. Bakehouses above ground. 112, Copenhagen Street 129, Barnsbury Road 59, Caledonian Road 36, Caledonian Road 199, Caledonian Road 170, Caledonian Road 32, Bingfield Street (Factory) 275, Caledonian Road 185, Copenhagen Street 12, Bemerton Street 44, Outram Street 213, Copenhagen Street 57, Copenhagen Street 40, Cloudesley Road Certified Underground Bakehouses. 44, Bingfield Street 96, Caledonian Road 21, Barnsbury Road 72, Bemerton Street 60, Bingfield Street 68, Barnsbury Road 370, Caledonian Road 100, Bemerton Street 299, Caledonian Road 76, Caledonian Road 27, Dennis Street 159, Caledonian Road 26, Half Moon Crescent 179, Hemingford Road 1 and 3, Richmond Road 44, Northdown Street 6, Wharfdale Road 52, Stanmore Street 12, Randall's Road 62, Winchester Street 21, Caledonian Road Bakehouses not in use. 29, Offord Road (Underground) 62, Barnsbury Street (Underground) 120, York Road ,, 205, Copenhagen Street ,, 181, Copenhagen Street (Underground) 279, Liverpool Road ,, 269, Liverpool Road ,, 86, Thornhill Road „ 123, Offord Road ,, 334, Caledonian Road ,, 19, Brooksby Street (Above ground) 29, Hemingford Road „ 205 [1908 South-East District. Bakehouses above ground. 76, Baxter Road 137, Upper Street 361, New North Road 229, Balls Pond Road 38, Coleman Street 226, Essex Road 50, Popham Road 313, New North Road 40, Cross Street 20, Popham Road 69, St. Peter Street 172, Essex Road 8, Danbury Street 126, Packington Street 5, Charlton Place (Factory) 52, City Garden Row 129, Upper Street 230, Upper Street Certified Underground Bakehouses. 24, Alfred Street 257, Balls Pond Road 14, Charlton Crescent 350, Essex Road 398, Essex Road 114, Essex Road 68, Essex Road 102, Essex Road 6, High Street 262, Liverpool Road 126, Liverpool Road 16, Rheidol Terrace 33, Park Street 1, Shepperton Road 32, Shepperton Road Oxford House, Sherborne Street 51, Southgate Road 102, Upper Street 1, Theberton Street West 57, Essex Road 55, Clephane Road 50, Arlington Street 121, Packington Street 14, Upper Street 192 New North Road 263, New North Road 1, Cross Street Bakehouses not in use. 28, Baxter Road (underground) 51, Windsor Street (above ground) 30, Canonbury Street „ 76, St. Paul's Street (underground) 202, Essex Road „ 24, Church Street „ 32, Parkfield Street „ 289, City Road „ 38, High Street „ 2, High Street ,, 44, High Street ,, 29, Camden Street ,, 3, St. Paul's Street „ 67, Essex Road ,, 322, Essex Road (above ground) 84, St. Peter Street (above ground) 9, Islington Green „ 107, Upper Street „ 53. Queensbury Street „ 298, New North Road „ 206 190 Outworkers.—There were 1,831 outworkers' premises on the register, as compared with 1,989 in the preceding year. On the list received from employers in Islington, 4,444 were entered, in addition to which 2,715 were received from other Councils. From the local lists 1,431 addresses were forwarded to other Councils. Restaurants and Kitchens where Food is prepared.— 685 restaurant kitchens and places where food is prepared, containing 939 rooms, are on the register, as compared with 452, containing 593 rooms, in the receding year. It will thus be seen that very considerable additions (250) have been made to the register while only 17 were removed from it. It is very satisfactory to be able to say that a great improvement is evidenced in these places and that, although many of the proprietors resent interference yet on the whole, they have fallen in with the ideas of the Inspector, and made the necessary alterations or improvements. Looking back, one cannot but wonder how it came about that not only here but throughout the country, these kitchens, until quite recently, had never received adequate supervision from the local authorities. Workshops notified to H.M. Inspector.—Under the provisions of Section 133 of the Factory and Workshop Act, it is required that the Medical Officer of Health, when he becomes aware that any woman, young child or person is employed in a workshop, shall forthwith send notice to H.M. Inspector of Factories. 159 workshops were reported during the year in accordance with this section. 207 1908 Workplaces notified to Home Office, 1908. Trade. Number of Workshops. Protected Persons Employed, Females. Male Young Persons. Total. Dress Making 47 82 — 82 Blouse Making 16 67 — 67 Laundry 8 27 — 27 Millinery 7 24 — 24 Tailoring 7 12 — 12 Tie Making 5 11 — 11 Fur Sewing 6 21 — 21 Underclothing Making 4 3 — 3 Wardrobe Alterations 3 1 — 1 Mantle Making 3 5 — 5 Underskirt Milking 3 3 — 3 Costume Making 3 34 — 34 Vest Making 2 2 — 2 Engineering 2 — 2 2 Camisole Making 2 9 — 9 Skirt Making 2 4 — 4 Rag Sorting 2 3 — 3 Artificial Flower Making 2 3 — 3 Children's Frock Making 2 5 — 5 Kitchen Jacket Making 1 1 — 1 Trouser Making 1 1 — 1 Button Making 1 10 — 10 Infant's Millinery 1 8 — 8 Leather Goods Making 1 3 — 3 Shirt Making 1 5 — 5 Outfitting 1 2 — 2 Teagown Making 1 2 — 2 Surplice Making 1 9 — 9 Jewel Case Making 1 3 — 3 Boys' Suit Making 1 11 — 11 Fancy Needlework 1 2 — 2 Robe Embroidery 1 1 — 1 Fancy Ornament Making 1 4 — 4 Oil and Varnish Work 1 4 — 4 Ladies Tailoring 1 2 — 2 Wholesale Dress Making 1 6 — 6 Metal Cream Making 1 10 — 10 Tennis Ball Making 1 1 — 1 Post Card Painting 1 1 — 1 Ticket Fastening 1 1 — 1 Evening Cloak Making 1 1 — 1 Wood Chopping 1 1 — 1 Scientific Instrument Making 1 — 2 2 Photographic Work 1 4 — 4 Book Making 1 6 2 8 Pianoforte Making 1 — 1 1 Frame Making 1 — 1 1 Gelatine Manufacture 1 — 3 3 Cycle Making 2 — 2 2 Wheelwright 1 — 1 1 Brush Making 1 — 1 1 Total 159 415 15 430 To elucidate this list it may be said that in many cases the addresses of workshops have been notified to the Home Office before any workpeople were actually found at work. Thus the number of employees given in the list does not fully represent the number of protected persons affected by the notification. 208 1908 SECRETARY OF STATE'S RETURN on the administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES, AND HOMEWORK. 1.—INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. (1) (2) (3) (4) Factories (Including Factory Laundries) 434 63 Nil Workshops (Including Workshop Laundries) 2,008 242 ,, Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 1,620 337 ,, Miscellaneous Re-inspections 6,508 — — Total 10,570 642 Nil 2 -DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:— Want of cleanliness 719 607 Nil Nil Want of ventilation 12 15 „ „ Overcrowding 8 8 „ „ Want of drainage of floors 72 75 „ „ Other nusiances 558 517 „ „ Sanitary Accommodation insufficient 12 11 „ „ unsuitable or defective 551 535 „ „ not separate for sexes 10 5 „ „ Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) Nil Nil „ „ Breach of Special sanitary requirements for bake houses (ss. 97 to 100) „ „ „ „ Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) „ „ „ „ Total 1,94 1,773 Nil Nil * Including those speci6ed in sections 2, 3, 7 and 8, of the Factory and Workshop Act sa rediable under the Public Health Acts. 209 [1908 3.- HOME WORK NATURE OF WORK * outworkers' lists, section 107. Inspections of Outworkers' Premises. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises (Secs. 109. 110). Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances Orders made (S. 110). Prosecutions (Sections 109, 110). Sending twice in the year. Sending once in the year. Received from other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers.† Lists. Outworkers. Contractors Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— 14‡ (1) making, &c 648 530 3,934 314 260 1,944 2,507 1,392 203 .. .. 682 88 42 .. 31 .. .. (2) cleaning and washing 4 4 4 2 2 2 4 .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Artificial Flowers 12 .. 204 6 .. 88 104 25 3 .. .. 89 18 8 .. 2 .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and Upholstery 6 .. 25 3 .. 14 5 .. 2 .. .. 4 1 .. .. .. .. .. Fur pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, &c 2 .. 4 1 .. 2 11 .. 1 .. .. 11 1 1 .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper Bags and Boxes 24 .. 181 12 .. 81 26 14 3 .. .. 48 24 12 .. 4 .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brush making .. .. 69 .. .. 32 49 .. .. .. .. 26 8 2 .. 1 .. .. Racquet and Tennis Balls.. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed Toys .. .. 10 .. .. 5 2 .. .. .. .. 2 .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Electro Plate .. .. 7 .. .. 3 4 .. .. .. .. 4 1 .. .. .. .. .. Cables and Chains 2 .. 6 1 .. 3 3 .. .. .. .. 3 .. .. .. .. .. .. Anchors and Grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cart Gear .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, Latches and Keys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 698 534 4,444 339 262 2,174 2,715 1,431 212 .. .. 869 141 79 .. 38 .. .. * When an occupier gives out work of more than one of the classes specified in column 1, ana subdivides his list in such a way as to show the number of workers in each class of work, the list is included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers are assigned in columns 3 and 4 (or 6 and 7) into their respective classes. ‡ 14 Wearing Apparel and 2 Boxmakers for drinking water supply (L.C.C. General Powers Act). Note.—50 addresses of Artificial Florists, 7 of Electro Plate Workers, 60 of Paper Bag Makers, 69 of Brushmakers, and 10 of Stuffed Toy Makers are included in other lists. 210 1908 4—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the )ear. Number. (1) (2) Important classes of workshops, such as workshop bakehouses may be enumerated here. Workshops where men are employed 533 Workshops where women are employed 821 Laundries 132 Restaurant kitchens 685 Bakehouses 255 Total Number of Workshops on Register 2,426 5.—OTHER MATTERS, Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 159 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5). Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector. 1 Other Nil. Underground Bakehouses (s. 101):— Certificates granted during the year Nil. In use at the end of the year 99 211 [1908 Miss BROWN'S REPORT. Town Hall, Islington, To the Medical Officer of Health, February 15th, 1909. Sir, I beg to submit to you a report of the work done by me during the year 1908 in connection with the workplaces in Islington where women are employed. During the year I have made 1,206 inspections of premises and 2,114 calls and re-inspections. The inspections and re-inspections are as follows:— Inspections of Factories (including steam laundries)) 206 Inspections of Workshops (including workshop laundries) 1,000 Miscellaneous re-inspections and calls 2,114 Total 3,320 Register of Factories.—There were on the register of Factories at the end of the year 179 factories, 26 having been added, and 8 removed during the year. The following is a list of Factories and Steam-Laundries on the register. Industry. Number. Industry. Number. Factory Laundry 44 Beer bottling 1 Printing 17 Musical sundries making 1 Book binding 8 Publishing 1 Box making 11 Wood cutting 1 Confectionery making 5 Corset making 2 Wire mattress making 5 Outdoors games making 1 Cigar making 4 Pill making 1 Dyeing and cleaning 4 Furniture cream making 1 Stationery 3 Toy making 1 Blouse making 3 Baking flour making 1 Costume making 3 Compressed beef tinning 1 Mantle making 3 Curtain making 1 Blind making 2 Surgical leather work 1 Chemists' sundries packing 2 Wicker work 1 Aerated water making 2 Leather work 1 Cabinet making 2 Outfitting 1 Millinery 2 Marquetry work 1 Brushmaking 2 Slate works 1 Chemists' sundries making 2 White lead works 1 Cake and biscuit making 2 Surgical appliance making 1 Fur sewing 2 Chocolate making 1 Electrical engineering 2 Underclothing making 1 Glass letter making 1 Mangling 1 Iron work 1 Frame making 1 Toothbrush making 1 Sack making 1 Piano string making 1 Sauce making 1 Syphon making 1 Button making 1 Meat preserving 1 Bottle works 1 Seed packing 1 Pickle making 1 Apron making 1 Pattern card making 1 Skirt making 1 Library bureau 1 Mirror making 1 Shoe accessories making 1 Boot upper making 1 Photographic mount making 1 Capsule making 1 Arc lamp making 1 Brewery 1 Washing-powder making 1 Total 179 212 1908 There is a slight increase in the number of Factories during the year, which is in a measure due to the fact that some workshops have installed machinery, though in some cases the amount of machinery introduced scarcely appears of sufficient consequence to demand a change of administration. In one case where the premises had been inspected as a workshop for some time, it was discovered that one machine used by one girl, a member of the family, who was partially crippled, was moved by a small motor, thus making the place a Factory. Being in a corner it had escaped observation on previous occasions or perhaps had not been in use. General Conditions.—As noticed last year the improved conditions of the sanitary accommodation in Factories seems to be maintained. Some employers appear anxious to do their best in the way of keeping conveniences, mess-rooms, lavatory basins and all fittings in a proper condition, but complain that it is almost impossible to do so owing to the careless behaviour of the employees. In certain factories notices are put up calling the attention of the employees to the fact that the arrangements provided must be treated in a proper manner, and threatening dismissal in case of disobedience. In spite of this, those in charge often find it difficult to keep up the required standard of cleanliness and order. Speaking generally, this matter is not so noticeable in the case of workshops where there is more direct supervision. Register of Workshops.—There is again a diminution in the number of workshops during the year, due probable to the general state of trade, which has again been most unsatisfactory. At the end of the year there were 821 workshops and 132 laundries on the register. There were added during the year 194 workshops and 18 laundries, while 199 workshops and 20 laundries have been removed. The workplaces left on the register comprised 1,615 workrooms. As is usual, the second quarter of the year showed the greatest increase in the number of workshops, and the fourth quarter the least. The following is a list of trades carried on in the various workshops. Nature of business. Number of Workshops. Number of Workrooms. Dressmaking 251 319 Laundries 133 352 Millinery 81 170 Fur sewing 56 78 Tie making 42 47 Tailoring 41 53 Mantle making 33 50 Blouse making 33 74 Waistcoat making 14 16 Skirt making 14 21 Underclothing making 14 17 Leather goods making 13 37 Artificial flower making 11 30 Children's frock making 10 17 Box making 9 23 Rag sorting 8 16 Photographic work 7 29 Corset making 7 7 Feather curling 6 9 218 1908 Nature of business. Number of Workshops. Number of Workrooms. Fancy goods making 5 9 Shirt making 5 10 Confectionery making 4 9 Trunk making 4 5 Bonnet and hat shape making 4 4 Costume alterations 4 5 Dressing gown making 4 4 Pinafore and apron making 4 4 Paper sorting 4 7 Underskirt making 3 4 Jet and bead work 3 3 Cabinet making 3 3 Fur printing 3 4 Frilling making 3 5 Waterproofing 3 4 Umbrella making 3 3 Fancy Needlework 3 3 Collar making 2 3 Artist's brush making 2 3 Embroidery 2 3 Firewood cutting 3 5 Wig making 2 3 Boot upper making 2 5 Pelisse making 2 2 Drug packing 2 2 Jewell case making 2 2 Baby-linen making 2 3 Ink making 2 2 Hair work 2 3 Postcard painting 2 4 Belt making 2 2 Brace making 2 3 Lace work 2 3 Chiffon tucking 2 2 Upholstery 2 3 Boot Polish making 2 2 Pickling 1 1 Glass painting 1 1 Dolls' hair curling 1 1 Stamp sorting 1 1 Trousers making 1 1 Curry powder making 1 1 Perambulator hood making 1 1 Glove cleaning 1 1 Pyjamas making 1 1 Trimming making 1 1 214 1908 Nature of business. Number of Workshops. Number of Workrooms Fancy glass work 1 1 Cutting sorting 1 1 Basinette making 1 3 Doll trimming 1 1 Naval cap making 1 5 Bath glove making 1 1 Frame making 1 1 Fancy ornament making 1 1 Purse making 1 5 Tent making 1 1 Motor cap making 1 1 Hassock making 1 1 Surplice making 1 2 Tennis ball making 1 1 Boot and shoe making 1 1 Japanning 1 1 Camera bellows making 1 1 Perfumery making 1 1 Needlecase making 1 1 Bathing dress making 1 1 Aerated water makers' sundries making 1 1 Dyeing and cleaning 1 1 Candle shade making 1 1 Valentine making 1 1 Back supports making 1 1 Camisole making 1 1 Oil and varnish work 1 1 Surgical furniture making 1 1 Cushion making 1 1 Bottle washing 1 2 Surgical instrument making 1 1 Balloon making 1 1 Swandown sewing 1 1 Cork cutting 1 1 Ticket writing 1 3 Turkish delight making 1 1 Blind making 1 1 Ticket fastening 1 2 Kitchen jacket making 1 1 Toy soldier making 1 5 Wooden toy making 1 1 Wax figure making 1 3 Stationery 1 2 Chemists' sundries 1 2 Funeral furnishing 1 1 Limelight cylinder making 1 1 215 1908 Nature of business. Number of Workshops. Number of Workrooms. Surgical appliances making 1 4 Chimney-cleansing Imp making 1 1 Electrical engineering 1 1 Mattress making 1 1 Fur muff making 1 2 Scientific instrument making 1 l Evening cloak making 1 l Musical string making 1 2 Sausage skin making 1 2 Hosiery making 1 l Glass etching 1 l Wreath case making 1 2 Gold beaters skin preparing 1 4 Total 953 1615 Workshops—General Remarks.—During the year the names and addresses of 144 workplaces where women are employed have been forwarded to the Home Office in compliance with Section 133 of the Factory Act. These are premises where the required Abstract is not affixed, or if affixed, where it was found on inquiry that the premises had not been visited by H.M. Inspector. The inquiry in this case is made because sometimes the occupiers of workshops buy abstracts and affix them, and then consider that their responsibility ends there. This is probably due to an imperfect knowledge of the law. A small percentage of the places notified were Factories, and although there is no obligation under the Act to notify such, these also were forwarded as a matter of courtesy, and are included in the accompanying list on p. 207. The local inspectors have more opportunity of ascertaining the existence of new workplaces than H.M. Inspectors, as the area visited by them is more circumscribed. Every effort is made, as already pointed out, to find new workshops, and it is probable that almost all are found. It is, however, possible that an occasional one may escape attention for some time, as in the case of one found recently, where it was stated that employment to a certain extent had been going on for seven years. There were no outward signs of a workplace or anything to differentiate it from an ordinary dwelling, until for the first time a dressmaker's bill was put in the window, which attracted immediate attention. Most of the workshops are found by watching the advertisements for employees. Advertising is looked upon by some occupiers as a direct and legitimate mode of notifying to the (local inspector the existence of a workshop. Latterly, however, it has been noticed that sometimes no address is given and application is to be made at the office of the paper. This is possibly with a view to conceal employment, though, generally speaking, workshop occupiers do not resent inspection, and are also wilding to volunteer all manner of information about the work, the processes and methods of work, the rate of pay, etc. This information, though not directly connected with the work of inspection, yet is interesting, as illustrating conditions of industry which are in a way bound up with it. There is still a general outcry about the low rate of pay given to outworkers, and it is to be hoped that the recommendations made to Government by the Select Committee on Home Work may be carried into effect at an early date by the establishment of wages 216 1908 boards in certain trades. Workers doubt the possibility of such a thing being done, but that it can be done has been proved in our Colonies with a fair measure of success. These recommendations, however, as some industrial experts have pointed out, do not seem sufficiently far-reaching, as they stop short of factory workers, who, being congregated and combined, would considerably strengthen the position. Apropos of a remark made in last year's report with regard to the want of skilled workers in various industries, and the regrettable decline of the apprenticeship system, it is of interest to note that within the last year a Skilled Employment Committee has been established in Islington. This Committee, composed of voluntary workers, has already done good work in the way of placing boys and girls in suitable employment where a skilled trade may be thoroughly learned. This may in a small measure help to solve the unemployment problem, as, at present, a certain amount of work has to be sent abroad, as it cannot be properly done in this country. As regards forwarding lists of Outworkers twice a year, some employers have commented on the fact that in February and August, when the lists must be forwarded, work is not as a rule very busy, and that if (lists are forwarded then, these lists do not represent the full complement of workers, as fresh employees may be taken on later, in the busy season. This matter appears worthy of attention. The difficulty could perhaps be obviated by requiring employers to forward names and addresses of all outworkers employed since the previous lists were sent in. Cleanliness.—During the year 181 instances of workrooms found in a dirty condition, either in whole or in part, have been dealt with. Of these, 163 were cleansed under my supervision before the end of the year. Some of these refer merely to the want of domestic cleanliness of workrooms. Most of the workshops on the register are satisfactory in this respect. In many of them the floors are scrubbed once a week and swept daily, which, without exactly indicating an ideal condition, yet appears sufficient for all practical purposes. The workers in some cases have certain parts of the floor allotted to them to cleanse, and are responsible for their own sections. It is satisfactory to notice that some occupiers of workshops and laundries cleanse their walls annually as a matter of routine, without waiting to be asked. Overcrowding.—Overcrowding was found in 7 workrooms during the year. The number of employees was in each case reduced on notice being given. The small number of cases dealt with has been probably due, as before, to trade depression, and a corresponding decrease in the demand for manufactured goods. The seasonal rush of work which leads to overcrowding has been conspicuous by its absence. As regards the space allowed for each person, it almost appears an oversight in the Factory Act that a certain amount of floor space is not made necessary, as in schools and elsewhere. Under the present arrangements, in those workrooms which are pretty lofty, the workers are sometimes crowded together to a certain extent, without being exactly overcrowded within the meaning of the Factory Act. This appears anything but desirable, considering the exhalations from the bodies of the workers and the impurities of the human breath. Ventilation.—In two workrooms structurally insufficiently ventilated, additional means of ventilation have been provided. As before, the subject of ventilation remains one of the most troublesome of the matters to be dealt with. It is no uncommon thing for a workroom to be provided with sufficient means of ventilation, and yet to be badly ventilated, through carelessness or wilfulness on the part of the workers or employers. During the winter, in 217 [1908 some workrooms the air is extremely vitiated. This is attributable not only to neglect to use the existing means of ventilation—the windows being kept closed to exclude cold air and fogs—but also to the fact that gas fumes are present, given off from the burners used for lighting and heating. Some workrooms are apparently heated entirely by the burning of gas jets. In this way the required reasonable temperature is maintained, without any corresponding means of removing impurities caused by the process. The question of how a workroom is heated is not a sanitary provision within the meaning of the Factory Act, and consequently cannot be dealt with directly by the local inspector. Some trades also, such as artificial flower making or box making, require gas to heat the tools or the materials used in the process of manufacture. In many cases, too, the windows are not even opened at meal-times, as some employees have their meals in the workrooms. It almost appears desirable that a certain amount of ventilation, as well as means of ventilation, should be required by law, thus definitely settling the matter, and removing the necessity for persuasion, which may have no lasting effect. On the other hand, it is encouraging to note that this matter of bad ventilation is not by any means universal, some workrooms being extremely well ventilated, both during working hours and meal-times. In two workrooms lately it was noticed that the doors had been taken away, while in another the door was fixed in such a way that it could not be closed. In another workshop again, some panes of glass had been taken out entirely, thus providing a constant supply of fresh air. These arrangements indicate an improvement, though of course they have the disadvantage of producing a draught, which perhaps is the lesser evil. Sanitary Accommodation.—During the year 3 instances of insufficient accommodation, 127 of closets in a dirty condition, 53 of closets unsuitable or defective, and 4 instances of accommodation not separate for sexes were found. Of these, 121 have been cfleansed and 53 repaired under my supervision, the other instances, with accompanying defects on the same premises, being dealt with by Inspector West. Miscellaneous Defects.—Other defects, such as defective floors, dustbins, cisterns, etc., were found to the number of 150. Of these, 123 had been remedied before the end of the year. Any defects found on inspected premises which did not directly concern the workplace have been referred to the District Inspectors, and have been dealt with by them, together with any instances of defective or unventilated drains. Workroom Cards.—During the year 310 workroom cards have been distributed, specifying the cubic contents of each room, and stating the number of employees allowed during ordinary working hours and during overtime. Notices.—During the year, 87 intimation notices have been served (77 in connection with workshops, and 10 in connection with factories), and 3 Statutory notices. As before, most of the nuisances have been remedied after a verbal notice has been given, so that a written notice has not been found necessary. Complaints from Home Office.—One complaint was received from the Home Office re cleansing the walls of a workshop, concerning which we had previously received no Notice of Occupation. The work was found done, and the fact duly notified to H.M. Inspector. I remain, Sir, Your obedient servant, JOSEPHINE J. BROWN, (Sanitary Inspector of Workshops.) P 218 1908 MRS. YOUNG'S REPORT. Town Hali., Upper Street, N. 22nd April, 1909. To the Medical Officer of Health. Sir,—Herewith I beg to submit to you a report of the work done during the year 1908, in reference to restaurant kitchens and outworkers' premises. During that period 3,788 calls and inspections have been made as follows: — Inspections of Restaurant Kitchens, etc. 800 Re-inspections and calls 815 Inspections of Homeworkers' Premises 869 Re-inspections and calls 1,304 3,788 387 intimation notices were served to cover 715 defects, including those on the homeworkers' premises. Twelve statutory and 31 intimation Courtesy notices were forwarded; 212 letters to employers failing to send lists of outworkers; 254 workroom cards were delivered, specifying cubic space of workroom; 296 cards to homeworkers, containing instructions in case of infectious disease occurring on premises where work is done. Restaurant Kitchens.—The total number registered at the end of the year 1908 was 685 kitchens, with 939 workrooms. At the beginning of the year there were 452 kitchens, with 593 workrooms. During the period under report 17 of these premises were closed, and 250 kitchens, with 346 workrooms added to the register. The following is a brief summary of the general conditions (satisfactory or otherwise) found on inspection. Satisfactory. Unsatisfactory. Total. Restaurants 52 19 71 Do., attached to Public Houses 72 6 78 Coffee and Dining Rooms 156 54 210 Tea Rooms 60 7 67 Fried Fish shops 72 32 104 Ham and Beef, Tripe, etc., shops 31 15 46 Stewed Eel shops 12 5 17 Oyster bars 1 1 2 Provision shops, selling cooked meat 143 62 205 599 201 800 219 1908 716 sanitary defects were found, and 592 were remedied, as below: — Found. Remedied. Dirty walls, or ceilings, or floors 243 145 Dirty and dilapidated walls and ceilings 80 66 Defective floors 16 16 Want of proper and sufficient ventilation 8 9 Drinking water cistern requiring cleansing or cover 18 17 Want of bins for offal or house refuse 139 120 Unpaved or defectively paved yards 19 20 Want of impervious wall where fish is cleansed 8 8 Defective flushing cistern 30 29 Drainage defects 13 9 Foul or defective sanitary accommodation 30 27 Miscellaneous defects 96 115 Want of domestic water supply on upper floors 16 11 716 592 141 of the above sanitary defects were found on the homeworkers' premises, of these 88 were remedied, and are duly included in the schedule herewith. Found. Cleansed. Utensils in dirty condition 171 93 Dirty or insanitary storage of food 223 116 The following tables show the comparative general conditions relative to the basement, ground floor, and upper storey kitchens, when inspected in 1907; with the result of the improved conditions found in 1908. Satisfactory. Unsatisfactory. 1907— Basement 41 47 Ground floor 288 143 Upper storeys 63 11 392 201 1908— Basement 80 54 Ground floor 339 99 Upper storeys 73 6 492 159 It is noticeable that the basement kitchens are still the most unsatisfactory in proportion to their numbers, though the improvements effected in them have resulted in bringing 60 per cent. up to the average conditions of cleanliness, etc. The remainder are structurally unsatisfactory, that is, they have not the light nor ventilation necessary to places where food is prepared or stored. As I pointed out in my previous report, the openings made to admit air and light from the pavements generally admit very much more dirt and road detritis than P 2 220 1908 anything else. The storage of bones, refuse, and fat, which, in the best regulated premises is a difficult problem, becomes in basement kitchens a constant nuisance. Where there is no yard the kitchen has to be used to store food (including milk), refuse, etc., while the heat generated in the processes of cooking renders this storage doubly offensive. The abolition of basement kitchens appears to be the only means of removing this evil, and is really as necessary as was the abolition of basement bakehouses. It is forbidden (and rightly) that clothing should be made in insanitary places, but it is of far greater importance that the preparation of food should be prohibited in these places; and artificial lighting, and half-yearly limewashing cannot make sanitary (for this purpose) any room or place through which it is impossible for a current of fresh air to pass, and in which the atmosphere is still further vitiated by the conditions I have already mentioned. There is a decided improvement in the other kitchens, viz., those on the ground floors and upper floors. The unsatisfactory kitchens registered in the year 1907 have been reduced by at least 20 per cent. in the year 1908. But the question of refuse disposal is still a difficult one, and I would again respectfullly urge the necessity of a (gratuitous) bi-weekly clearance of refuse from all places where food is prepared. It is probable that a great deal of sickness is caused by the foul odours arising from these accumulations, especial in the poorer districts. There are, in Islington, over 2,250 persons employed in kitchens, exclusive of those kitchens attached to public houses. Of these, over 1,200 are women. The standard of cleanliness among the kitchen employees is not a high one; but the employers seldom provide any accommodation for them, and it is usual to find that the kitchen sink is their only accessible wash basin. In Section 8 of the L.C.C. General Powers Act (1908) it is laid down that" due cleanliness shall be observed by persons engaged in such places." It is regrettable that the Act makes no order which shall compel the employer to provide suitable means for the attainment of the personal cleanliness desired. . Outworkers' Premises.—The total numbers of names and addresses of outworkers received during the year is as follows: — From employers in Islington 2,263 From the Medical Officer of Health for other Boroughs ... 2,715 4978 These figures represent the total number of the two half-yearly returns, viz., those made in February and August, in compliance with Section 107 Factory and Workshop Act (1901). The number of outworkers residing in the Borough at the end of the year 1908 was 1,831, a decrease of 158 under the corresponding period in 1907 ; but as there is an increase of 90 in the numbers sent away to other districts, the returns for the two years show but little discrepancy in the totals, the difference being only 78. Total number of outworkers' addresses received in 1907 5,056 „ „ „ 1908 4,978 78 Thirty-eight cases of infectious disease occurred on premises where work is done. In all these disinfection was carried out and the patient removed to hospital where necessary, under the supervision of the District Inspector. 221 [1908 Upon reporting these cases to you, you caused a number of cards to be printed, for distribution among the homeworkers, warning them "that if any infectious disease should occur on the premises where homework is done, the homeworker must not return the work to the factory until the Medical Officer of Health has been informed, or the Workshop Inspector has called, after which, if necessary, the work will be disinfected, free of cost." These cards have been dully left with the homeworkers. when visited The nature of the work done and the number of persons engaged in each trade, is shown below: — Making, repairing, etc., of wearing apparel 2,208 Artificial flower making 88 Furniture and Upholstery 14 Paper bags and boxes 81 Brush making 32 Stuffed toys 5 Electro plate 3 Umbrellas 2 Chain making 3 2,436 One hundred and forty-one statutory defects were found, and 79 intimation notices served to remedy them; the nuisances consisted principally of dirty walls and ceilings, etc., and are scheduled in the list of nuisances found, shown in the earlier part of the report. In 16 instances notice was served upon the owner of the premises to provide a domestic water supply on the upper floors (L.C.C. General Powers Act, 1908). This section of the Act has proved useful in helping to better the conditions under which homework is carried on. The time and labour necessary to carry water from the basement to the top of a three-storey house is a matter of considerable importance and material cost to the homeworkers, with the result that in such cases, the use of water for all purposes has been reduced to a minimum. But where the domestic water supply has been carried upstairs in conformity with the Act, a marked improvement in the general cleanliness of the premises has followed. As I reported to you in 1908, the conditions under which homework is carried on in Islington are fairly satisfactory. The systematic inspection of these places has brought some of the most untidy and dirty workrooms to the average cleanliness, as the occupiers understand that this is indispensable if they wish to continue working at home. But of 869 inspected, only 99 were reported unsatisfactory for this cause. During the period under report 212 letters of reminder were sent to employers failing to send lists of their outworkers. I remain, Sir, Yours obediently, (Mrs.) A. CATHERINE YOUNG, (Inspector of Workshops). 222 1908 INSPECTOR WEST'S REPORT. Town Hall, Upper Street, Islington, N. 31th March, 1909. To the medical officer of health. Sir,—I have pleasure in again submitting my report to you for the year ending the 2nd January, 1909. During that time I have made 4,457 visits to the various places of business, consisting of factories, workshops and workplaces in the Borough, having made 2,182 inspections and 2,275 re-inspections. The visits to the various trades carried on in them were as follows:—228 factories, 1,008 workshops, 248 workplaces, 572 bakehouses, 126 outworkers' premises, and 2,275 miscellaneous. Artificial florists 3 Fancy brooch maker 1 Automatic machine maker, etc. 1 Feather dressers 2 Beer bottlers 1 File cutter 1 Bakehouses 255 Fish cleaner 1 Builders 10 Fish curers 2 Blacksmiths 9 French polisher 1 Basket makers 2 Flooring maker (Patent) 1 Blind makers 3 Fancy goods maker 2 Brush makers 5 Gun makers 2 Bamboo cabinet makers 4 Glazier 1 Balloon maker 1 Glove maker 1 Baking powder maker 1 Gold paint maker 1 Boot polish makers 2 Gilder (card edge) 1 Book maker 1 Glass workers 2 Brace maker 1 Hat shapes makers 3 Confectioners 8 Hair work 1 Cycle makers 12 Japanners 1 Cabinet makers 32 Leather goods 8 Condiment makers 1 Ladder maker 1 Coppersmiths 1 Lath renders 2 Camera bellows maker 1 Limelight works 1 Cardboard box makers 6 Lamp makers 2 Cap makers 2 Laundries 2 Clay pipe maker 1 Marquetry workers 3 Cork cutter 1 Marking ink 1 Cattle food drugs maker 1 Mineral water sundries 1 Coopers 3 Marble masons 3 Cloth shrinkers 1 Metal workers 2 Corset maker 1 Brass instrument maker 1 Carpenters 2 Motor works 11 Coach painters 2 Mount maker 1 Dairy can maker 1 Mop maker 1 Dye maker 1 Musical string makers 2 Engineers 12 Mantle makers 3 Exhibition stall maker 1 Naturalist 1 Embroidery maker 1 Overmantels 1 Farriers 30 Optician 1 Furriers 47 Organ builders 2 223 1908 Pianoforte makers 41 Surgical appliance makers 2 Provision dealers 2 Stationers, etc. 1 Plaster block maker 1 Trunk maker 10 Pickle bottlers 1 Tailors 70 Plumbers, etc. 3 Tarpaulin makers, etc. 1 Picture frame makers 6 Tinsmiths 2 Perambulator makers 2 Turkish delight maker 1 Photographers, etc. 7 Ticket writers 4 Picture post card maker 1 Tea sifters 2 Paper sorting 1 Toy makers 3 Rag sorters 7 Umbrella makers 2 Rubber merchants 3 Umbrella and stick mounters 2 Scale makers 2 Upholsterers 12 Shoemakers 138 Wheelwrights 39 Stove makers 2 Wood choppers 8 Scientific instruments 6 Watchmakers, etc 11 Shop fitters 1 Wire workers 2 Scene painter 1 Wood letter maker 1 Sign writers 2 Wreath case maker 1 Soap makers 1 Wax figure maker 1 Sun-dial maker 1 Harness maker 7 Sealing wax maker 1 - Saddle tree maker 1 Total 954 Sanitary improvements.—During the year I have served 232 notices for the abatement of nuisances, 293 workshops have been cleansed and lime-whited, 9 w.c.'s have been provided for men at various workshops, whilst 509 other improvements were carried out under my supervision. Also 43 workroom cards were distributed showing the cubic capacity and the number of employees allowed to work in each workroom. 29 water supplies were also provided. Bakehouses.—I have paid 572 visits to bakehouses, and am pleased to find the improvement is still kept up in respect to their cleanliness, although at times there is a tendency to use the bakehouse to dry or air the linen; when found, I have reported to you, and caused letters to be sent remonstrating with the occupiers for doing so. I may also mention that on my last visit 200 bakehouses were in use, and 55 empty or not in use. I have also reported through you to H.M. Inspector of Factories, as required by Section 27 of the Public Health Act, 1891, the addresses of 15 workshops where young persons under the age of 18 years were employed, and where the abstract of the Factory Act was not affixed. Register.—During the year, 58 workshops, containing 108 workrooms, have been measured and added to the Register, whilst 53 workshops, containing 93 workrooms, have been removed. I may also mention that 91 workshops, containing 179 workrooms, have been notified by Miss Brown to me as employing both sexes, so that at the present time there are 954 workshops, containing 1,455 workrooms, and 65 outworkers' premises now on the register. I am, Sir, Your obedient servant, GEORGE WEST, Sanitary Inspector of Workshops, etc. 224 1908 INSPECTION OF HOUSES LET IN LODGINGS. As explained in the Report of the Medical Officer of Health for 1907, there is no provision in the by-laws for the keeping of a register because every house, which is let in lodgings or is occupied by the members of more than one family, and which does not come within the scope of the exemption clauses, is subject to them. There is, however, a number of houses, altogether some 900, which are systematically inspected and visited, either because they are neglected by their owners, or by reason of the class of tenants, such as those occupying houses in Campbell Road and Queensland Road, occupying them. These houses are regularly inspected by two Inspectors (Messrs. Ward and Hancock), who together made 10,782 inspections and visits to them, and served 1,120 intimation notices and 159 statutory notices on the persons responsible for abating the 2,662 nuisances which were discovered. It must be noted that in the first quarter Inspector Bridel inspected the northern district, at the end of which time he was succeeded by Inspector Ward, who had been performing the duties of an Inspector under the Sale of Food and Drugs Acts, and who in turn was succeeded by Inspector Burrell, while Inspector Bridel undertook the duty in the district vacated by the last-named Inspector. Nuisances Abated.—Altogether 2,662 nuisances were abated, and in abating them the following work became necessary:— Drains constructed 25 „ repaired 21 „ traps supplied to 135 W.C.'s., extra provided 10 ,, amended 51 „ water supply provided 154 Dustbins provided 87 ,, repaired 6 Surface drains of yard constructed or relaid 28 Water supply.—Cisterns (new) provided 7 ,, Cisterns, repairs and cleansed 27 Water supply provided 219 Houses repaired 83 „ cleansed or limewashed 386 ,, ventilated 16 Overcrowding abated 61 Verminous rooms disinfected, &c. 2 225 1908 HOUSES LET IN LODGINGS. Table CXXI. Summary of Sanitary Work carried out under Inspectors Bridel, Ward and Hancock in Houses Let in Lodgings during the year 1908 InspBridel. Inspector Ward. Inspector Hancock. Totals. 1st Quarter 2nd Quarter. 3rd Quarter 4th Quarter. Year. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Number of Houses inspected 298 65 84 104 551 308 316 265 242 1,131 1.682 Re-inspections, Calls made, etc. 1,300 637 743 971 3,651 1,263 1,308 1,258 1,620 5,449 9,100 Total inspections, etc. 1,598 702 827 1,075 4,202 1,571 1,624 1,523 1,862 6580 1,0782 Notices Served. Intimation 146 225 39 42 452 172 149 170 177 668 1,120 Statutory 19 3 .. .. 22 23 11 30 73 137 159 Nuisances Abated. Drains— Constructed 8 2 1 .. 11 1 11 4 7 14 25 Improved or repaired 5 1 5 11 3 4 1 2 10 21 Traps fixed 13 4 2 19 1 7 59 49 116 135 Cesspools— Abolished .. .. .. .. .. .. .. .. .. .. .. Cleansed or disinfected .. 5 .. .. 5 .. .. .. .. .. 5 Water Closets— Pan, trap and water supply furnished 4 2 .. .. 6 .. .. .. .. .. 6 Pan and trap only furnished 7 13 4 4 28 .. 5 7 5 17 45 Water supply furnished 18 4 23 21 66 30 16 23 19 88 154 Extra closets provided 3 .. 1 1 5 1 2 .. 2 5 10 Dust Bins — Provided 18 .. .. 12 30 11 22 9 15 57 87 Repaired 3 .. 2 .. 5 .. .. 1 .. 1 6 Surface Drains and Pavement of Yards— Constructed 2 1 .. .. 3 1 .. .. .. 1 4 Relaid or amended 8 2 2 .. 15 1 .. 1 7 9 24 Domestic Water Supply— New cisterns provided 2 5 .. .. 7 .. .. .. .. .. 7 Cisterns repaired and cleansed 4 3 8 5 20 2 .. 3 2 7 27 Water supply provided 3 4 14 24 45 6 5 76 87 174 219 Other Improvements— Houses generally repaired 7 9 22 11 49 4 .. 28 2 34 83 „ etc., cleansed or limewashed 4 4 19 11 38 .. 211 133 4 348 386 „ ventilated 1 3 .. .. 4 .. .. 6 6 12 16 Overcrowding abated 5 .. 1 4 10 11 11 11 18 51 61 Illegal use of underground rooms for sleeping discontinued .. 12 .. .. 12 2 .. 1 1 4 16 Other Improvements or Nuisances abated 250 20 69 86 425 264 156 197 281 898 1,323 Verminous Rooms Disinfected .. .. .. .. .. .. 2 .. .. 2 2 Total Nuisances Abated 365 89 171 189 814 338 443 560 507 1,848 2,662 No. of Premises affected 186 34 65 90 375 177 346 266 226 1,015 1,390 226 1908 DISTRICT INSPECTION. There are 14 inspectors engaged on the work of district inspection, and on them also devolves the duty of making inquiries respecting infectious diseases, which it may be mentioned has become enormously heavy owing to the very great number of cases of measles, whooping cough and chicken pox which are now reported by the teachers of the London County Council's Schools, and which formerly were only notified in much smaller numbers. They have also to inquire respecting the failures to notify births, and to make inquiries respectinp pulmonary phthisis, besides making many inquiries respecting various matters which usually crop up in all large communities. Inspections and Visits.—8,270 houses were inspected; and these inspections entailed 64,066 further visits to superintend the necessary works, or to see that the nuisances had been abated. House to House Inspections.—1,202 house to house inspections were made, as compared with 1,696 in 1907. These inspections are required by Section 1 of the Public Health (London) Act 1891, and section 30 of the Housing of the Working Classes Act 1890. Important though such work undoubtedly is, yet it can only be carried out as the exigencies of the other work of the inspectors allow. It is difficult to foresee what will happen if the Town Planning Bill becomes law, for it contains the requirement that every house must be inspected quinquennially. In Islington such a gigantic work as this could only be undertaken by a staff of special inspectors. Synopsis of the Inspectors' Work —The following statement gives a brief synopsis of the district inspectors' work:— House to house inspections 1,202 Other inspections of dwelling houses 7,c68 Re-inspections and calls made 64,066 Visits of inquiry re notifiable infectious diseases 2,289 „ school cases of „ 4.359 Butchers' shops, stalls, etc. (Saturday nights) 4,908 Ice cream shops and factories 348 Dairies and milkshops 3,303 Stables and yards 4,022 Manure depots 118 Workshops re drains 261 Certificates under the Customs and Inland Revenue Acts 83 Water certificates for newly erected houses or flats 74 Visits re samples of foods and drugs, under the Sale of Food and Drugs Acts 300 Smoke observations 618 227 1908 Notices Served.—There were 3,686 intimation notices served by the inspectors with respect to nuisances, of which 3,521 were delivered personally and 165 by post. In 427 instances it became necessary, as the intimations had not been attended to, to report to the Public Health Committee, who ordered statutory notices to be served, of which 131 were delivered personally and 296 by registered letter post. Improvements Effected.—The subjoined list of the principal nuisances abated speaks for itself as to the character and utility of the work that has been carried out. It contrasts favourably with the record of previous years:— Houses. Dirty 773 Damp 225 Out of repair 254 Water Closets. Foul 567 Without water supply 294 With deficient water supply 272 Improperly constructed 546 Defective - 412 Stopped - 124 Improperly situated 27 Insufficient external ventilation 61 Insufficient in number 81 Soil Pipes. Defective 176 Unventilated 160 Improperly ventilated 157 Yards. Improperly paved 563 Dirty 78 Undrained 22 Drains. Foul 52 Defective 882 Choked or stopped 236 Unventilated 231 Cesspools. Abolished 8 Overcrowding. Abated 70 Underground Rooms. Abolished for sleeping 31 Other Nuisances 4,638 Total Nuisances 10,940 228 1908 Cesspools —These relics of a bygone sanitation in London are still discovered occasionally in the borough, although in decreasing numbers. During the year 10 were found, of which 8 were abolished, while two were cleansed and disinfected. In 1907, 28 came under observation. Overcrowding.—70 cases, as compared with 84 in 1907, were found and abated. It is not always possible to get the correct number of persons in a family among the very poor, who know quite well when they are too many for a particular room, and therefore they not infrequently give incorrect figures to the inspector. Of late years, however, the landlords have to a much larger extent than formerly come to the assistance of the inspectors, for they find it to their interest not to have more persons in their houses than there are w.c.'s provided for them, i.e., 1 w.c. for every 12 persons, lest they should be required to provide the additional accommodation. Nevertheless, overcrowding does occur, but happily in fewer instances. If, however, inspection were to be relaxed it would speedily reappear, for there are unfortunately some owners of property who care more for their own pockets than for the health of the people who rent their rooms. Underground Rooms.—31 rooms, in comparison with 22 in the preceding year, were discontinued as sleeping places. Houses Closed.—It was not necessary to close any houses. Manure Depots.—These places were kept under observation by the visits of the inspectors on 118 occasions. Complaints have been received occasionally from the London County Council School Yerbury Road as to a nuisance from the manure railway siding close at hand, but in each instance an immediate visit failed to substantiate the complaint. Manure railway sidings are not drawing-rooms, but if ever there was a manure railway siding free from offence, it is the one in question. It is years ago since any real cause for complaint was given at this place. The cleanliness of these sidings is a matter of concern more than ever now, lest by allowing deposits of manure to accumulate, or to remain for any length of time, they should become the breeding place of flies, who are now known to be the active carriers of the forms of such diseases as Enteric or Typhoid Fever and Diarrhoea. Regent's Canal.—The canal was kept in a fairly good state. No complaints were received concerning it. 229 [1908 Smoke Nuisances. —Observations for smoke nuisances were made to the extent of 618 with respect to the following factories and workshops:— Mayfield Laundry Co., 93, Gillespie Road. Great Northern Railway Electric Light Works, Albert Place. Poulton and Noel, Brewery Road. Bellchambers' Glass Works, Ronalds Road. Taylor and Sons, Fonthill Road. Lorimer and Co., Britannia Row. Hobb, Hart and Co., Arlington Street, N. Thorley's, Ltd., 4 and 6, All Saint's Street. Messrs. Grover, Shepperton Road. Tibberton Square Baths. Geo. Kemp, Ltd., Brewery Road. Westinghouse Brake Co., Ltd., 82, York Road. 57, Essex Road. Legal proceedings were taken in one instance and an order was obtained for the abatement of the nuisance, a fine of £5 and 2s. costs being inflicted. Water Certificates.—These are issued under section 48 of the Public Health (London) Act 1891, and after examinations of the fittings had been made, 21 certificates were issued by the Public Health Committee acting as the Sanitary Authority. Water Supply.—Water supplies which had been cut off or which had not previously existed were provided in 531 cases. In addition 30 new cisterns were fitted, and 583 old ones were repaired or cleansed. Water Supply to Tenement Houses.—The supply of water to the upper stories of tenement houses is enforceable under Section 78 of the London County Council (General Powers) Act 1907. This power is not generally known to property owners, and, therefore, when the demand has been made, it has been met frequently by a direct refusal, or a demand for further information. It has so far had a mixed reception, some owners entirely concurring with the enactment, while others, protesting against it, have only complied with it under compulsion. At one time a grave fear as to the possibility of enforcing the section arose in consequence of a doubt in your Solicitor's mind as to the exact meaning of the section which is set out in the following report that the Medical Officer of Health made to the Public Health Committee on December 7th. 1908. 230 1908 To the Chairman and Members of the Public Health Committee. Gentlemen,— WATER SUPPLY TO TENEMENT HOUSES. I am very sorry to have to report that we appear to have arrived at an impasse with respect to enforcing the provisions of the London County Council (General Powers) Act 1907, respecting the supply of water to the upper storeys of houses let in lodgings or apartments, and I have to report that, acting on your Solicitor's advice, I have refrained from issuing further summonses. This has been done in consequence of the receipt of the following letter from your Solicitor:— 23, Leadenhall Street, E.C. 25th November, 1908. Dear Dr. Harris,— London County Council (General Powers) Act 1907, as to the supply of water in tenement houses. The case of the Council v. Andrew, which was down for hearing to-day, but has been adjourned, was a summons for non-compliance with a Statutory Notice respecting 17, Church Street, for abating a nuisance existing by reason of the house being a tenement house with three tenants, with a room in the basement unlet, and being without a proper water supply, inasmuch as the only water provided was in the basement scullery. This case was based upon section 78 of the London County Council (General Powers) Act 1907, and raises the question what is the true construction of that section which deals with a supply of water to tenement houses. The section is a long and complicated one, but if carefully considered, I am afraid its provisions are clearly against your wish. The first paragraph provides that a tenement house shall be deemed to be without a proper and sufficient water supply unless there shall be provided on the storey or one of the storeys in which the rooms or lodgings in the separate occupation of each family occupying such house are situate a sufficient provision for the supply of water for domestic purposes. That paragraph, although uncertain at first sight, is fairly clear when fully considered. The difficulty arises in the provision by which this part of the section is followed, which, omitting the words not material to Mr. A—s' case, is as follows:— "provided that with respect to any building existing and in use as a "tenement house at the passing of the Act the section shall not apply "where the only storey or storeys on which a proper supply of water 231 1908 "is not provided is or are a storey or storeys to which a supply of "water for domestic purposes is not at the passing of the Act being "furnished by the Metropolitan Water Board by agreement—" You will see that this proviso is inapplicable to houses first used as a tenement house after the passing of the Act, but with respect to a house previously so used, the section is not to supply where the only storeys with a sufficient water supply are storeys to which water at the date of the Act was being furnished by agreement, that is, turning the sentence round the other way, the section is only to apply to houses which at the date of the passing of the Act were being supplied with water for domestic purposes " by agreement" with the Metropolitan Water Board. I imagine there is scarcely a tenement house in London to which water is supplied by agreement, and the consequence appears to me to be that the Act will be inoperative as regards tenement houses existing at the passing of the Act, and as a further consequence, the summons against Mr. A. will probably fail. You will remember that I pointed out to you the probable construction of this clause some weeks ago. I should have contended, with a very reasonable hope of success, that if the Act had not been passed, a house such as Andrews' for four families with only a water supply in the basement, was a house without a proper and sufficient water supply under the 48th section of the Act of 1891, but the Act of 1907 seems to cut down what otherwise would have been the construction of section 48, and renders it less effectual than it otherwise would have been. I can hardly believe that the London County Council appreciated the effect of this section of their Act, or that their intention could have been to render section 48 of the Act of 1891 less effectual than it otherwise would have been, except as regards houses first used as tenement houses after the passing of the Act of 1907, and I suggest, therfore that you should communicate with the Clerk to the London County Council or with the Medical Officer, pointing out what appears to be the construction of the section, enquiring whether this was what was intended, and if not, what steps they propose to take to remedy the apparent defect. As regards tenement houses generally, I am of opinion that it would be useless to issue summonses for deficient water supply to the various floors of tenement houses in use as such at the passing of the Act of 1907. Will you kindly consider the question and let me know. Yours faithfully, (Signed) ARTHUR M. BRAMALL. 1908] 232 I have written to Mr. Tanner, the Solicitor to the London County Council, on the subject, and enclosed him a copy of your Solicitor's letter, but have not yet received a reply. As this is a matter of the most vital importance, affecting as it does, the health and cleanliness of the people, I think you ought at once to bring the matter before the London County Council, so that they may if possible amend the Act next year in such a manner as will carry out what was undoubtedly their original intention, namely, to provide means of enforcing the owners of tenement houses to afford a supply of water to upper storeys of houses. The above portion of this report was written on Friday last, but on the following day I received a reply from Mr. Tanner, the Solicitor to the London County Council, which is as follows:— London County Council, Spring Gardens, S.W. 4th December, 1908 Dear Dr. Harris,— Water Supply in Tenement Houses. I have your letter of the 27th ultimo with copy of Mr. Bramall's letter to you of the 25th ultimo. In my view the correct interpretation of Section 78 of the London County Council (General Powers) Act 1907 is that the word " and " in the ninth line of the first proviso to that section must be read as connecting (i.) and (ii.) in the proviso and that they must be read together, and that what is meant is that the section shall not apply where the storey referred to in (B) is at a height exceeding the high service height, and such storey was not at the date of the Act supplied with water by agreement. You will see from this therefore that I do not adopt the view taken by Mr. Bramall of the effect of the section in question. It appears to me this construction does no violence to the words of the proviso, and obviates the section being, as Mr. Bramall says, inoperative. Yours faithfully, EDMUND TANNER, Dr. A. E. Harris, Solicitor. Medical Officer of Health, Islington. I am Your faithful servant, A. E. HARRIS, Town Hall, Medical Officer of Health. Upper Street, Islington, N. 7th December, 1908. 233 [1908 What followed is best told in a further report of the Medical Officer of Health to the Public Health Committee, dated January 4th, 1909. To the Chairman and Members of the Public Health Committee. Gentlemen, Water Supplies to Tenement Houses. Further report as to the legal position of the Council in connection therewith, and a letter from the Solicitor to the L.C.C. I have to report that I submitted the letter from the Solicitor to the London County Council which I read at the last meeting of the Committee to your Solicitor, with the result that while he did not agree with the meaning as expressed by words in the section which the Solicitor to the London County Council placed on them, he nevertheless thought that under the circumstances we might proceed with summonses taken out under that section. It so happened that just before the meaning of the section had been questioned, a summons had been issued against a Mr.A— for not having a sufficient water supply to a house owned by him, and this was down for hearing at the Clerkenwell Police Court on the 30th December last. Mr. Bramall took the opportunity of explaining to the sitting Magistrate, Mr. Dickenson, the peculiar manner in which the section was worded, but nevertheless the Magistrate came to the conclusion that it was self-evident that the meaning of the section was that which the London County Council placed on it, as otherwise it would be nonsense to have passed it. I presume therefore that it is now your desire that the outstanding notices should be enforced by summonses if necessary. Will you kindly give me your instructions? I am, Your faithful servant, A. E. HARRIS, Medical Officer of Health. Town Hall, Islington, 4th January, 1909. After the magistrate's opinion as to the meaning of the clause was obtained notices were again served on the owners of houses let in lodgings or occupied by members of more than one family (of the working class) where such houses were without a supply of water on one of the upper storeys. 9 1908] 234 During the year 562 tenement or lodging houses were furnished with a water supply to an upper storey, and 236 preliminary notices had been served, and 125 notices by order of the Public Health Committee. Public House Urinals in Streets.—Complaints respecting these places are frequently received, and consequently they are regularly visited by the Inspectors. As a rule it is found that the persons complaining live in their immediate neighbourhood and object to them more on the ground that they are morally offensive than that they are insanitary, and also because it sometimes happens that people under the influence of drink use the walls of houses in their immediate neighbourhood. It is much to be regretted that all public houses do not provide urinal accommodation within the premises, as they are compelled to do in some provincial towns. To enforce similar provisions in London would mean that in innumerable instances the buildings would have to be entirely re-constructed. 235 [1908 Table CXXII. Showing summary of Sanitary Work from Inspectors' reports for the Year 1908. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 71 34 70 78 28 175 141 58 42 82 229 87 33 74 1202 Number of houses inspected 406 480 458 606 404 665 383 398 418 662 576 566 545 501 7068 Re-inspections, Calls made, etc 4498 4160 3517 4506 3937 3806 5580 4931 3830 4572 5065 5061 4483 6120 64066 Total Visits Visits to Ice Cream Factories 17 15 24 54 6 11 26 23 31 39 27 34 30 11 348 ,, Dairies and Milkshops 224 166 119 339 147 152 299 183 341 169 351 411 241 161 3303 „ Stables and Yards 125 101 573 645 558 662 254 48 146 135 92 176 346 161 4022 ,, Manure Depôts 72 .. 12 20 8 1 2 .. .. 1 2 .. .. .. 118 ,, Workshops, with respect to drains .. .. .. 1 .. 43 18 .. 1 9 .. 171 .. 18 261 ,, Under Customs and land Revenue Acts 6 .. 5 5 .. .. 24 .. .. .. .. 42 1 .. 83 ,, re Water Certificates 2 .. 12 1 .. 44 1 .. .. 11 3 .. .. .. 74 ,, Under Sale of Food and Drugs Acts 36 24 27 .. 22 39 9 12 18 17 20 31 16 29 300 Smoke observations 5 19 1 91 192 20 31 5 15 87 58 92 1 1 618 Saturday night inspections 222 297 162 380 339 243 237 438 385 713 543 480 243 226 4908 All Inspections, visits, etc 5684 5296 4980 6726 5641 5861 7005 6096 5227 6497 6966 7151 5939 7302 86371 Notices Served. Intimation — Personally 251 202 176 306 156 128 251 180 237 256 474 293 239 362 3521 By Post 1 1 .. 4 3 27 54 13 3 4 11 18 .. 26 165 Statutory— Personally 8 9 .. 2 5 11 10 3 7 12 9 31 13 11 131 By Post 11 10 2 12 23 14 33 20 14 26 27 63 11 30 296 Improvements. Drains— Constructed.. 79 71 48 44 43 40 97 99 34 75 17 67 53 88 855 Improved or repaired 30 26 19 27 19 69 26 10 27 38 64 38 50 48 491 Traps fixed 420 355 293 184 203 177 553 428 170 348 98 320 259 386 4194 Cesspools— Abolished 2 .. .. .. .. .. .. .. .. .. 3 2 1 8 Cleansed or disinfected .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 2 Water Closets— Pan, trap and water supply furnished 53 35 7 7 15 11 17 10 26 27 .. 25 39 20 292 Pan and trap only furnished 97 96 96 75 53 54 148 136 43 72 61 95 63 124 1213 Water supply furnished 27 29 13 32 29 26 19 12 31 53 130 52 47 68 568 Dust Bins- Provided 148 62 47 66 35 43 84 78 50 83 87 65 66 82 996 Repaired .. 1 8 .. 6 .. 1 .. 7 2 16 .. 4 6 51 Surface Drains and Pavements of Yards— Constructed 7 1 5 15 3 17 37 24 9 20 22 26 13 20 219 Relaid 89 101 81 119 70 54 167 98 99 67 89 122 161 161 1478 Domestic Water Supply— New Cisterns provided 1 2 3 1 1 1 .. 1 1 2 1 11 2 3 30 Cisterns repaired and cleansed 44 19 23 49 30 108 32 4 21 34 58 74 39 48 583 Water Supply provided 56 24 19 45 26 9 7 24 48 67 53 64 53 36 531 Other Improvements— Houses generally repaired 6 14 5 41 17 38 11 9 26 9 45 64 22 33 340 „ etc., cleansed or limewashed 48 36 75 105 65 96 51 34 153 35 286 222 155 148 1509 ,, ventilated 1 9 3 6 21 2 19 8 4 7 21 10 21 132 Overcrowding abated 1 3 3 5 4 2 1 4 5 12 12 8 10 70 Illegal use of underground Rooms for sleeping discontinued .. 1 4 1 .. 5 1 1 5 2 3 7 1 .. 31 Other Improvements, or Nuisances abated 257 254 179 236 130 470 226 172 152 331 559 801 292 579 4638 Rooms Disinfected 175 230 133 152 185 84 101 126 207 181 156 197 114 139 2180 Total Improvements 1539 1371 1064 1210 930 1327 1582 1286 1121 1455 1764 2288 1453 2021 20411 Total Premises Improved 502 400 312 478 299 456 149 322 466 476 643 529 479 521 6332 2 Table CXXIII. Giving a Summary of the Nuisances discovered by the District Sanitary Inspectors during the Four Quarters and for the Year 1908, for the abatement of which notices were served. NUISANCES. QUARTERS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. 1. The house or part ol the house in a dirty condition 147 234 230 162 773 2. „ ,, in a damp condition 62 63 59 41 225 3. ,, in a dilapidated condition 38 77 93 46 254 4. The inlet of surface drain improperly trapped 52 46 51 60 209 5. The water-closet so foul as to be a nuisance 175 145 43 104 567 6. „ ,, without a water supply 117 66 70 41 294 7 ,, ,, with a deficient supply of water 65 74 56 77 272 8. ,, ,, improperly constructed so as to be a nuisance 155 151 135 105 546 9. „ „ so defective as to be a nuisance 104 113 100 95 412 10. ,, ,, stopped 40 39 22 23 124 11. ,, ,, placed in an improper position 8 5 7 7 27 12. Insufficient external ventilation to water-closets 14 9 15 23 61 13. Insufficient water-closet accommodation 15 21 24 21 81 14. The soil pipe defective 42 43 45 46 176 15. „ unventilated 35 43 51 31 160 16. ,, improperly ventilated 55 39 27 36 157 17. The yard in a condition injurious to health by reason of the want of proper paving 134 155 120 154 563 18. The yard dirty 18 27 13 20 78 19. ,, undrained 3 5 4 10 22 20. A gully trap improperly placed within the house 69 68 38 47 222 21. The waste pipe of sink directly connected with the drain 28 33 36 23 120 22. 11 „ improperly trapped 10 10 16 6 42 23. ,, ,, untrapped 181 195 164 166 706 24. ,, of lavatory directly connected with the drain 4 8 5 2 19 25. „ „ improperly trapped 3 1 .. 2 6 26. ,, ,, untrapped 44 45 29 26 144 27. „ of bath directly connected with the drain 4 9 5 4 22 28. ,, ,, improperly trapped 1 .. 1 1 3 29. „ „ untrapped 42 47 38 32 159 30. The water cistern so foul as to be a nuisance 50 105 83 85 323 31. „ „ being without a close fitting cover .. 80 130 108 92 410 32. ,, „ being placed in an improper position 43 26 30 39 138 33. , ,, defective 7 9 10 6 32 [8061 236 TABLE CXX1II.—continued. NUISANCES. QUARTERS. 1st 2nd 3rd 4th The Quarter. Quarter. Quarter. Quarter. Year. 34. An accumulation or deposit of refuse injurious to health, by reason of the want of a proper dustbin or ashpit 51 107 69 67 294 35. The dustbin or ashpit defective 120 145 177 211 653 36. ,, „ placed in an improper position The drain foul 1 2 5 8 37. 6 30 8 8 52 38. ,, defective 261 232 183 206 882 39 ,, choked or stopped 54 70 56 56 236 40. ,, unventilated 58 72 53 48 231 41. The rain-water pipe in direct communication with the drain 59 45 54 41 199 42. ,, ,, in direct communication with the soil-pipe 15 15 1 6 37 43. „ lt defective The water supply used for domestic purposes connected with the cistern 51 76 61 48 236 44. which is used for flushing the W.C. 2 15 2 19 45. The house without a proper water supply 88 97 107 87 379 46. The roof defective 47 57 121 67 292 47. The guttering defective 49 55 35 28 167 48. The area improperly paved 10 17 10 10 47 49. dirty 2 16 3 6 27 50. ,, undrained 2 1 1 2 6 51. The paving of the washhouse defective 40 43 28 23 134 52. The back addition walls defective .. .. .. .. .. 53. The want of a proper manure receptacle 5 5 4 6 20 54. The bakehouse walls dirty .. .. .. .. .. 55. An animad kept in suoh a manner as to be a nuisance 12 19 24 22 77 56. The house or part of a house so overcrowded as to be injurious or dangerous to the health of the inmates 30 37 35 43 145 57. An underground room occupied as a dwelling contrary to the provisions of the Act 9 16 13 10 48 58. A tent, van, shed or similar structure used for human habitation which is in such a state as to be injurious or dangerous to the health of the inmates .. .. 1 .. 1 59. The space below floor in the basement or ground floor being unventilated 7 5 6 9 27 60. The space below floor in the basement or ground floor being improperly or insufficiently ventilated 13 28 16 23 80 All Nuisances 2837 3,179 2,911 2,667 11,594 237 806l] 1908] 238 Table CXXIV. Giving a Summary of the Sanitary Work performed by the District Inspectors in 1908 Inspections. QUARTERS. The First. Second. Third. Fourth. Year. House to House Inspections 513 399 141 149 1,202 Number of Houses Inspected 1,689 1,636 1,804 1,939 7,068 Re-inspections, Calls made, &c. 17,617 17,123 12,737 16,589 64,066 Total Visits 19 819 19,158 14,682 18,677 72,336 Visits to Ice Cream Factories 14 263 70 1 348 Do. Dairies and Milkshops 581 613 897 1,212 3,303 Do. Stables and Yards .. 1,239 1,009 880 894 4,022 Do. Manure Depots 39 31 24 24 118 Do. Workshops, with respect to Drains 240 8 13 261 Do. Under Customs and Inland Revenue Acts 72 11 83 Do. re Water Certificates 3 1 4 66 74 D0 under the Sale of Food and Drugs Acts 299 1 .. .. 300 Do. Shops and Stalls on Saturday Nights 46 4,691 86 85 4,908 Smoke Observations 190 219 131 78 618 All Inspections, Visits, &c. 22,542 25 994 16,798 21,037 86,371 REMOVAL OF DUST. The following statement is of interest, as showing the improvement that has been effected in the removal of dust since 1891 :— Applications to Remove Dust. Applications to Remove Dust. 1891 10,138 19OO 234 1892 9,964 19OI 157 1893 4,986 1902 198 1894 4,5°6 1903 152 1895 4,596 I9°4 116 1896 4,245 1905 89 1897 312 1906 58 1898 303 19°7 55 1899 262 1908 64 Dust Receptacles Provided.—During the year 1,083 dust receptacles were provided, while 57 were repaired. Table CXXV. Summary of Applications for the Removal of Dust during the Year 1908. Ward. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Number of Assessments Michaelmas, 1908. Number of Applications to every 100 Assessments. I I 3 2 2 8 4,893 0.163 2 -— -— 2 2 4 4,661 0.086 3 I 1 2 I 5 4,509 0'lII 4 4 1 - - 5 5,449 0 092 5 1 2 2 3 8 5,726 0.139 6 2 3 3 4 12 4,088 0293 7 I 1 - 1 3 4,°4I 0.074 8 I 2 1 - 4 2,732 0146 9 — 3 2 3 8 2,686 0.298 I0 I — 3 1 5 3,539 0.141 II — — 1 1 2 4,622 0043 Totals 12 16 18 18 64 46,946 0.136 239 [1908 1908] 240 STATE OF PAUPERISM. For many years there has been embodied in the annual report of the Medical Officer of Health a short statement as to pauperism, as shown by the Poor Law returns in the borough. At first sight it may not be apparent that there is any connection between public health work and pauperism, or between a Sanitary Authority and a Board of Guardians. Nevertheless there is, for as a matter of fact the public health service of this country is administered by these two authorities, the duty of the former authority being the prevention of illness through the adoption of sanitary and other measures, and that of the latter the supply of physicians, medicines, food and nursing to those who are ill, and without means, to assist them to recover ; also the provision of food to the destitute and needy to prevent them becoming ill, or dying, through starvation. The two authorities are, therefore, allied, the one being the complement of the other. It is for this reason that the proposal to place the administration of Poor Law work in the hands of sanitary authorities has been made in one of the reports of the Royal Commission on the Poor Laws. Paupers Relieved.—The returns show that on an average 10,349 paupers have been relieved weekly throughout the year, as compared with 9,599 in 1907 and 9,069 in 1906. For the first time the weekly average has reached five figures. The figures show that 750 more persons were in receipt of weekly relief than in 1907, during which year the number relieved was 530 per week more than in 1900. These are very unsatisfactory figures for they indicate that there has been a scarcity of employment in Islington. The average number of paupers relieved in each year since 1898 has been as follows:— 1898 6,635 per week relieved. 1899 6,854 ,, 1900 6,956 ,, 1901 7,327 ,, 1902 7,668 ,, 1903 8,004 ,, 1904 8,086 ,, 1905 9,224 ,, 1906 9,069 ,, 1907 9,599 ,, Average 7,942 ,, 1908 10,349 ,, Indoor Paupers.—The average number of indoor paupers (inclusive of children) relieved during each week was 4,558, or 297 in excess of the average which obtained in 1907, and as contrasted with a weekly average of 3,728 in the decennial period 1898-1907. Outdoor Paupers.—These averaged 5,791 per week, as contrasted with 5,338 in 1907, and with 4,'214 in the preceding ten years. Of the outdoor paupers 3,752 were adults and 2,039 were children under 16 years of age. 241 ("1908 Vagrants.—The weekly average number relieved was only 13, as against 75 in 1907, and 30 in the ten years 1898-1907. Children Boarded Out—These numbered on an average 125 per week, or 10 less than the average of the preceding year. The number was, however, the same as the average number boarded out in the decennium 1898-1907. Table CXXV. Showing the State of Pauperism in the Borough during the year 1898-1907 and 1908. Average number Relieved during each week. Years. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals Outdoor. Totals. All paupers relieved, cols. 2 & 5. Vagrants Relieved. Children Boarded out. Deathrates. Adults. Children 1 2 3 4 5 6 7 8 9 1898 3,168 2,224 1,243 3,467 6,635 27 116 16 94 1899 3,351 2,237 1,266 3,503 6,854 16 131 18.71 1900 3,397 2,288 1.271 3,559 6,956 7 100 17. 03 1901 3,522 2,444 1,361 3,805 7,327 12 130 1598 1902 3,594 2,662 1,412 4,074 7,668 10 125 16. 71 1903 3,879 2,739 1,386 4,125 8,004 17 127 14.27 1904 3,622 3,069 1,395 4,464 8,086 65 122 15.35 1905 4,295 3,302 1,627 4,929 9,224 58 126 14. 44 1906 4,189 3,335 1,545 4,880 9,069 12 134 14 64 1907 4,261 3,556 1,782 5.338 9,599 75 135 14.63 Average 3,728 2,785 1,429 4,214 7,942 30 125 1586 1908 4.558 3,752 2,039 5,791 10,349 13 125 13. 15 Table CXXVI. Showing the State of Pauperism in the Borough during tue year 1908 Average number Relieved during each week. Quarters. Indoor Paupers, Adults and Children. Outdoor Paupers. Vagrants Relieved. Children Boarded out. Death rates. Adults. Children under 16. Totals. corresponding periods 1907 1 2 3 4 5 6 7 8 9 1st Qr. 4,625 3,782 1,957 10,364 9,920 5 128 15 89 2nd ,, 4.416 3,566 1,742 9,724 9,255 7 125 11 57 3rd ,, 4 417 3,626 1,862 9,905 9,231 17 123 11 27 4th „ 4.773 4,033 2,597 11,403 9,991 22 123 13. 81 TheYear 4,558 3,752 2,039 10,349 9,599 13 125 13 15 1908] 242 COMMON LODGING HOUSES. These places are controlled by the London County Council under by-laws which give powers of inspection both by day and night. They are licensed annually, and therefore their keepers or owners are more amenable to control, and obey the by-laws more carefully than do the owners of any other class of lodgings. They number 49 in Islington, of which 39 are licensed for men, 8 for women, and 2 for married couples. Table CXXVII. Showing the Addresses of the Common Lodging-Houses in the Borough. (Under the Control of the London County Council). Situation of Premises. Authorized No. of Lodgers. Sex of Lodgers. M = Men. W = Women. MC = Married Couples. Name of Licensee. 36, Ball's Pond Road 28 M. Alfred Edward Hurworth. 14, 16, Barnsbury Street 51 M. Ellen Maples. 18, 20 & 22, Barnsbury Street 91 M. ,, 47a, Campbell Road 71 M. Wm. Jno. Cragg. 35, Campbell Road 27 W. ,, 37 & 39, Campbell Road 61 M. ,, 10 & 12, Campbell Road 52 M. Hugh Hersey. 180, Caledonian Road 51 M. Mrs. Finetta Jefcoate. 55, Colebrooke Row 71 W. Dave Levy 155, Englefield Road 64 M. Wm. Jno. Cragg. 1 & 3, Eden Grove 107 M Lewis Henry Levy. 87, Essex Road 52 M. Jas. Shuttleworth, Jun. 89, Essex Road.. 35 M. ,, 8, Flower's Mews 72 M. Mrs. Finetta Jefcoate. 102, 104 & 106, George's Road 51 W. Robert Wm. Maples. 68, George's Road 38 W. Ellen Maples. 1, Gordon Place, Highgate Hill 5 M. George Willis. 2, Gordon Place 5 M. ,, 3, Gordon Place 5 M. ,, 4, Gordon Place 10 M. ,, 5, Gordon Place 10 M. ,, 6, Gordon Place 9 M. ,, 7, Gordon Place 9 M. ,, 13, Gordon Place 9 M. 87, Highgate Hill 16 M. ,, 29, Halton Road, and la, Allen Street 59 M. Chas. Jas. Vincent Somerville. 29, Hornsey Road 88 M. Sidney Allen. 8a, Hornsey Street 48 M Colin F. Campbell. 10, Milton Place 22 M. Lewis Henry Levy. 4 & 6, Queensland Road 34 M. Margaret Jones. 8 & 10, Queensland Road 18 M.C. ,, 23 & 25, Queensland Road 28 W. „ 160 & 162, St. James'Road 76 M. Wm. John McGrath 235a, Upper Street 37 M. Hugh Hersey. 92, York Road 29 M. Hugh Hersey. 128, York Road 22 M. Albert a. Bingham 243 [1908 ARTISANS AND OTHER DWELLINGS. There are 397 blocks of dwellings, containing 4,621 separate flats or tenements, in the Borough. These vary considerably in the class of persons occupying them, some of whom are only labourers while others are clerks, well paid mechanics, and middle class people. A list of these buildings has been prepared, and is now presented. WARD. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Tufnell. Wessex Buildings Wedmore Street 3 225 „ *Lincoln House Dartmouth Park Hill 1 6 „ *Suffolk House „ „ 1 6 „ *Durham House „ „ 1 3 „ *Carlisle House „.„ 1 6 „ *No. 46 and 48, Dartmouth Park Hill „ „ 2 12 „ *Nos. 8, 9, 10, 11 and 12, Wyndham Mansions Wyndham Crescent 1 30 „ *Nos. 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28 and 29, Cathcart Hill J unction Road 1 78 „ *Roydon Mansions „ 1 3 „ *Manor Mansions .. Holloway Road 2 10 „ *Hargrave Mansions Hargrave Road 10 60 „ *St. John's Park Mansions Pemberton Gardens 8 64 „ *Nos. 18 and 21, Pemberton Gardens Holloway Road 2 5 „ *Fulford Mansions Fairmead Road 2 14 „ *10, St. John's Park Holloway Road 1 3 „ *47, Hargrave Park Junction Road 1 3 „ *Nos. 49 to 67, Hargrave Park „ „ 10 30 Upper Holloway *Albermarle Mansions Holloway Road 3 24 „ Whitehall Mansions Archway Road 1 30 „ Elthorne House Elthorne Road 1 6 „ *Elthorne Mansions „ „ 1 12 *Nos. 34, 36, 38, 40, and 42, Dresden Road Dresden Road 5 15 „ *Nos. 27, 29, and 31, Cheverton Road Cheverton Road 3 9 „ Nos. 221 to 259, Hornsey Road Hornsey Road 38 114 „ Nos. 269 to 283, Hornsey Road 8 16 „ *473, Hornsey Road „ „ 1 3 Tollington Nos. 83 and 85, Alsen Road „ „ 2 8 „ *Turle Mansions Wray Crescent 1 11 „ *St. Mark's Mansions Tollington Park 4 16 „ *Tollington Park, Nos. 14, 16,20,22,24,26,28 and 30 „ „ 8 16 „ *Albert Mansions .. Crouch Hill 1 12 *Brambledown Mansions.. „ 1 12 „ *Hanley House Hanley Road 1 9 „ *Grenville Road, Nos. 28, 30, 32, 34, 36 and 38 Hornsey Road 6 12 Lower Holloway Queen's Arms Buildings North Road 1 63 „ City Arms Buildings North Road 1 63 19081 244 ARTISANS AND OTHER DWELLINGS—continued. WARD. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Lower Holloway Camden Dwellings York Road 1 44 North London Cottages Market Road 1 8 „ "Crown Mansions Liverpool Road 2 24 „ Crown Mansions Paradise Passage, Liverpool Road 1 10 „ St. James's Mansions St. James's Road 1 6 „ Pleasant Buildings York Road 3 27 „ Edinburgh Place Brewery Road 2 45 „ Aberdeen Place Brewery Road 2 35 „ Anchor Dwellings „ 2 15 „ *Nos. 24, 34 & 33, Arundel Square Offord Road 3 12 *Loraine Mansions Widdenham Road 12 96 „ *Morgan Mansions Holloway Road 8 64 „ L.C.C. Dwellings Caledonian Road Burns 1 30 Scott 1 30 Wallace 1 70 Knox 1 66 Bruce 1 76 Highbury Lome Buildings Benwell Road 4 26 „ Holloway House Hornsey Road 1 6 ,, Highbury House „ 1 6 „ Hatton House „ 1 6 ,, Drayton House „ 1 6 „ Ingram House „ 1 6 „ 23, Hornsey Road „ 1 3 ,, 25, Hornsey Road ,, 1 3 „ 27, Hornsey Road „ 1 3 „ *York House Highbury Crescent 1 24 „ *Thane Mansions Thane Villas 1 10 „ *Walton House Thane Villas 1 10 „ *Wilmington House Highbury Crescent 1 8 „ *Nos. 1 and 2, Fieldway Houses Fieldway Crescent 2 16 „ *17, Highbury Crescent „ 1 8 *Nos. 1 to 16, Aberdeen Court Aberdeen Park 2 16 „ *Nos. 1 to 6 Durham House Fieldway Crescent 1 6 „ * „ 1 to 6 Westmoreland House „ „ 1 6 „. *Nos. 1 to 6 Highbury Gardens Highbury Crescent 1 6 „ *15, Highbury Crescent ,, „ 1 4 „ "16, „ 1 4 „ '55, Highbury Park Highbury Park 1 10 „ 'Nos. 1 to 3, Hamilton Road „ „ 1 3 „ 60, Holloway Road Holloway Road 1 3 Thornhill Beaconsfield Buildings .. East Street . 3 475 Clarence Terrace Rufford Street 1 53 Carlton House Stanmore Street 1 15 Pembroke House „ 1 15 Barnsbury „ Cloudesley Mansions Cloudesley Place 1 12 Stonefield Mansions Cloudesley Square 1 12 „ Oatlands House Upper Park Street 1 12 Ashley House „ 1 12 Halliford House „ 1 12 „ Thanet House „ 2 15 245 [1908 ARTISANS AND OTHER DWELLINGS—continued. ward. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Barnsbury Thornhill Houses Thornhill Road 5 84 „ Arvon House Offord Road 1 10 „ Buckland House „ 1 10 „ 33a & 33b, Thornhill Road Thornhill Road 1 2 „ Colne House Offord Road 1 8 „ Bures House ,, 1 8 „ Liverpool Buildings Liverpool Road 26 276 „ 371, Liverpool Road „ 1 4 „ 1 and 2, Heathcote House Barnsbury Square 1 2 St. Mary's Albert Mansions Liverpool Road 1 8 „ Essex House Essex Road 1 13 „ Anson House „ 1 8 „ Thatched House Buildings 1 8 „ Bampton House Pleasant Place 1 10 „ Catton House „ 1 10 „ Tiverton House „ 1 10 „ Dawlish House „ 1 10 „ Fowler House Halton Road 1 10 „ Arundel House „ 1 10 „ Brcokfield House „ „ 1 4 „ Worcester House Astey's Row 1 10 „ Lincoln House Astev's Row 1 10 „ Carleton House Cross Street 1 6 „ Devonshire House ,, 1 10 „ Dagmar House Dagmar Terrace 1 16 „ Tufnell House Pleasant Place 1 10 „ Nos. 9 to 23 (inclusive), Pleasant Place Essex Road 14 42 „ Nos. 1, 2, 3, 4, 5, Carleton Terrace Halton Road 5 15 „ No. 7, Astey's Row Essex Road 1 4 „ Nos. 1,2,3, Clarence Houses „ 1 4 „ York House „ 1 4 Canonbury Canonbury Avenue Canonbury Road 17 148 „ Ebenezer Buildings Rotherfield Street 5 36 „ 1 to 6, Wallace Gardens Wallaco Road 1 6 St. Peter's Palmerston Buildings City Garden Row 3 72 „ Torren's Buildings Torren's Street 6 83 „ Myddleton Buildings High Street 5 80 „ Albany Cottages Popham Street 1 98 „ Cornwall Cottages „ 1 94 „ Edinburgh Cottages „ 1 86 ,, Queen's Cottages „ 1 86 „ Quinn Buildings „ 13 240 „ Peabody Buildings Greenman Street 10 294 „ Dibden Street Buildings Dibden Street 4 32 ,, Pickering Street Buildings Pickering Street 11 83 „ Nos. 10a, 11a, 12a, 13a, Norfolk Street Essex Road 2 6 „ Nos. 16, 17 to 30, Norfolk Street „ „ 15 30 „ Nos. 141 to 147, Shepperton Road New North Road 4 12 397 4,621 * These flat tenements are occupied by the better middle class people. PART V. FOOD. INSPECTION OF FOOD AND THE PLACES WHERE FOOD IS PREPARED. THE ADULTERATION OF FOOD AND THE ADMINISTRATION OF THE ADULTERATION ACTS. WATER SUPPLY. 1908] 248 INSPECTION OF FOOD. The inspection of food, especially of meat foods, is an important duty of all sanitary authorities, which in Islington is undertaken by a special food inspector, who, a butcher by trade, possesses the necessary qualifications for the duty. The district inspectors, some of whom hold the special food certificate of the Sanitary Institute, are also expected to seize and prevent the sale of unsound food of all descriptions which they may come across, while in the case of diseased meat they are at once to call the attention of the Medical Officer of Health or the Food Inspector to it, for reasons detailed in the last Annual Report (p. 246). Unsound Food.—The amount of food surrendered or seized and condemned during the year amounted to 5 tons 17 cwt., 1 qr. 22 lbs., as compared with 2 tons 1 cwt. 0 qr. 9 lbs. in 1907, and with 2 tons 1 cwt. 1 qr. 2 lbs. in 1906. The increase in the amount condemned was due chiefly to the seizure of 2 tons 3 cwt. of unsound tinned foods which were found in a canning works at King's Cross. This seizure was the subject of legal proceedings, during which the defendents showed that they did not intend to sell the food for human consumption, and therefore the summons was dismissed, but no costs were allowed. Inspection of Street Markets.—These are inspected regularly by the Meat Inspector, and on Saturday nights they are also inspected by seven of the fourteen district inspectors, each being responsible for two districts. Unsound Fish.—Occasionally costers bring fish to the Town Hall for examination when, on opening the trunks or boxes in which they are packed, they have found the contents to be unsound. They are then given a certificate stating the hour at which it was examined and the state it was in, so as to enable them to obtain the return of the money which they had paid for the fish, which is of course removed to the manure depot or to the crematory at the disinfecting station for destruction. The food destroyed during the year was as follows:— ist Quarter. tons cwts. qrs. lbs. Diseased meat and organs from slaughterhouses 9 3 io Unsound fish surrendered i i 18 Unsound fruit, &c., surrendered i 3 16 Diseased meat from shops, etc. o 1 8 Unsound meat and rabbits from shops o i 12 Unsound tinned fruits, etc., seized 2 3 o 0 Total Tons 2 16 3 8 249 [908 Warranty with Cattle.— One of the questions which during the year greatly exercised the minds not only of the meat trade, but of farmers, was the question of a warranty being given with cattle when sold. Hitherto, when an animal was discovered after slaughter to be unfit for human food, r 2nd Quarter. tons cwts. qrs. lbs.[/$$$] Diseased meat and organs from slaughterhouses 6 I 4 Diseased bovine kidneys from shop o o 4 Unsound meat from shops, etc. 5 I 8 Unsound fish from shops and stalls 3 3 12 Unsound fruits and vegetables from shops and stalls 1 o II Tinned and bottled fruits, etc., surrendered 15 1 5 Total Ton 1 II 3 16 3rd Quarter. tons cwts. qrs. lbs. Diseased meat and organs from slaughterhouses 8 o 23 Meat and organs otherwise unsound o 2 25 Diseased meat from other premises o O 26 (seized) 0 0 13 Two geese unsound by decomposition (seized) o o 16 Fish unsound by decomposition (surrendered) o 3 4 Eggs unsound by decomposition (surrendered) o 2 0 Unsound fruit (seized) 1 2 18 Unsound fruit (surrendered) 8 O 15 Total Ton 1 o 3 0 4th Quarter. cwts. qrs. lbs. Diseased and unsound meat and organs from terhouses 4 2 27 Diseased and unsound meat and organs from shops, etc. 2 3 I Unsound fruit from shops I 13 Unsound shrimps from shops 0 13 Total cwts. 7 3 26 1908] 250 whether surrendered to or seized by the sanitary authority, the whole of the loss fell upon the butcher who bought it, while the farmer who either raised it or fattened it sustained no loss. As a matter of trade, the question has no interest for health authorities, except in the sense that they cannot close their eyes to the fact that where a man stands to lose the price of an animal, that is to say between £18 and £30 according to its weight, and when he is to receive no compensation for its destruction, a great temptation is placed before him to sell the meat surreptitiously; for it is undoubtedly a hardship on him that he alone should bear not only a heavy pecuniary loss, but possibly in addition the risk of having to explain in a court of justice why he had a diseased carcase on his premises, in course of preparation for sale. And yet it may happen that neither he, nor indeed a veterinary surgeon, could tell while the animal was alive that it was diseased. In looks, when alive, it might have appeared to be quite healthy, and yet when dead the carcase might disclose a state of generalized tuberculosis. Now, while the butcher has not a fair opportunity of examination, the farmer has, for he can, if he chooses to do so, have his animals tested with the tuberculin test to ascertain if they are suffering from tuberculosis, a disease which has caused serious loss to butchers. The farmers say that the butchers can protect themselves by insuring against loss, while the butchers with equal reason, say to them: " you can do the same, and also protect us from loss with a warranty." The proper way to arrive at a solution of this question is to inquire by whose neglect, default,or sufferance the herds of this country are as tuberculous as they are known to be ? When one considers it in this light, it appears to the writer that in the first instance it is due to the breeders of the cattle, who either through ignorance or neglect, allowed their animals to become so generally infected by failing to adopt preventive measures; and in the second instance, to the various Governments, who have failed to pass legislation for the eradication or prevention of tuberculosis among cattle. The question is now a national one, and if farmers, whether breeders or feeders, are not to be ruined in the stamping out process, for stamped out the disease must be, the purse of the taxpayer must be opened by the Chancellor of the Exchequer. The policy of drift has gone on for years. It is time in the paramount interest of the health of the people that it should cease. Meanwhile it would be well that breeders made certain that the cattle from which they breed are free from tuberculosis, and so make a beginning. The English pedigree breeds are of world wide fame, and among them there are surely to be found healthy animals in sufficient numbers to start anew breeds of 251 1908 thoroughly sound cattle, which it will be then necessary to protect from infection. Half measures will be, as they always are, a failure, and therefore it is necessary that the animals to be bred from in the future must be free from taint or blemish, or even predisposition to tuberculosis, especially in view of the fact that not only is this freedom from tuberculosis a necessity to ensure sound meat, but also uninfected milk. The importance of the question is thus greatly enhanced, for it would not be too much to say that for one person who has contracted tuberculosis through eating infected meat, which is invariably lightly or well cooked, a thousand persons, mostly children, have contracted it through drinking infected milk, which is almost as invariably uncooked, and so the germs of the disease are consumed in a vigorous state. The body politic has too long and wilfully shut its eyes to the condition of the English herds, and it is therefore blameworthy. It must now open them as well as its purse. Slaughter Houses.— There are on the register 34 slaughter houses, or 3 less than in 1907. The proprietors of these did not apply for a renewal of the licenses, and therefore they lapsed. Seven of the slaughter houses are licensed for the killing of small cattle only, while one is licensed for small cattle only and not more than three beasts a week. Another is licensed for killing small cattle only and for the purposes of his own shop. In two instances the hours are specified during which animals may be received, with the additional proviso in one case that not more than five large animals shall be killed per week, while in the other case the killing is limited to the requirements of the licensee's shop. In the returns which were obtained from the butchers, it is seen that there has been a steady decrease in the number of oxen killed in the slaughter houses; thus from 1904 to 1908 they have been respectively 2,360, 2,195, 2,172, 2,146 and 1,941, so that 416 fewer oxen were slaughtered during 1908 than in 1904. This is due to the larger amount of killed and dressed meat now purchased by butchers, some of whom undoubtedly do not desire to run the risk of loss should the animals on being killed, prove to be diseased. When they purchase the carcase they see what they are getting, and, therefore, their risk, if any, is only small. No cows were killed. This trade, which at one time assumed large proportions in the borough slaughterhouses, is now practically dead, having been driven, and rightly driven, away by the rigid inspection the animals received. R 2 1908] 252 A great number were found to be tuberculous, and indeed, there were only a few in which some of their organs were not diseased. Their constant seizure has forced their owners to seek other slaughtering places, but whether in London or not it is impossible to say. Calves also were slaughtered in lesser numbers, only 86 being killed during the year, as compared with 142 in 1907. Sheep alone showed an increase, and of these 28,476 were slaughtered, as against 24,380 in 1907. The numbers are not, however, as great as in 1904, 1905 or 1900, when there were killed respectively 32,973; 30,686 and 30,668. In this class of trade, too, more dead meat, whether English or foreign, is purchased than formerly. Pigs were never killed in large numbers in Islington slaughterhouses, and consequently it is no surprise to find that only 4 were dealt with, which, however, is an increase of 2 on the return for 1907. The following figures from the returns for 1904, 1905, 1906 and 1907 are interesting, and fully bear out the statement that has just been made:— Animals killed. 1904. 1905. 1906. 1907. 1908. Oxen 2,360 2,195 2,172 2,146 1,941 Cows 4 17 — 4 — Calves 154 127 143 142 86 Sheep 32,973 30,686 30,668 24,380 28,476 Pigs 25 48 II 2 4 35,516 33,073 32,994 26,674 30,507 Altogether 2,008 visits were made by the Meat Inspector to the slaughterhouses, which he reports were generally conducted in a satisfactory manner, and that the quality of the meat was of the best. 253 [1908 LICENSED SLAUGHTER-HOUSES. Registered No. Name of Licensee Situation of Premises. Condition of Licence. 119 Gayes, W J. D. 4, Athelstane Mews 120 Cockerill, A. E. 34, Balls Pond Road To kill small cattle only and not more than three beasts a week. 121 Clarke, Jno. 259, Balls Pond Road 122 Sharman, W. J 53, Barnsbury Street To kill small cattle only and for purposes of own shop. 124 Hack. Thomas 10, Bingfield Street .. Small cattle only. 125 Guyer, Aubrey 18, Brecknock Road Small cattle only. 126 Webber, George 41, Caledonian Road 129 Luxton, John Carter's Yard, 170, Essex Rd. 130 Selman, W. G (Between) 185-7, Church Road 132 Toop, William (Rear of) 1, Clayton Street. 134 Mobbs, Jas. Hy. 219, Copenhagen Street Small cattle only. 135 Sparrey, Thomas 62, Essex Road Cattle admitted only between 11 p.m. and. 7 a.m , and not more than five large animals to be killed per week. 131 Austin,W.Hanks 410, Essex Road 136 Hammond, F 6, George's Road t 137 Jenkins, Charles 12, Hazelville Road, Hornsey Road 138 Wadsworth.A.B 32, High Street 139 Webber, Wm 81, Highgate Hill 140 Stone, Sidney 234, Holloway Road 141 Wilde, Fredk 498, Holloway Road 142 Watson, Harriet 576, Holloway Road 143 Tuck, Wallace 152, Hornsey Road 144 Worboys, Richd 410, Hornsey Road 145 Webber, Jno 9, Junction Road, Upper Holloway 146 Buckingham, J 393, Liverpool Road 147 Gregory, Arthur T. 81, Newington Green Road Small cattle only. 151 Newbury, Louisa 102, Roman Road 152 Eteen, R. E. 49, St. Peter Street Small cattle only. 154 Stone, A. 194, Seven Sisters Road 155 Farmer, Chas. J. 280, Seven Sisters Road 157 Fothergill, H. 79, Stroud Green Road Cattle received upon the premises only between 7 p.m. and 8 a.m., and killing limited to requirements of own shop. 158 Richardson, J. 149, Upper Street Small cattle only 159 Luxton, John (E. side of) Wycombe Mews 160 Lidstone (Ltd ) 398, York Road 156 Farley, E. J 53, Southgate Road Small cattle only Total 34 Slaoghter-Houses. 1908] 254 Butcher Shops and Places where Food is sold.—The Inspector also made 13,148 visits to these places, during which various food stuffs as set out in Table B of his report, were seized or surrendered. Cowhouses.—There are now only 7 cowhouses in the borough. They have gradually grown fewer in number, as may be seen from the following figures:— Years. Cowhouses. Years. Cowhouses. 1892 31 1901 13 1893 31 1902 13 1894 25 I903 13 1895 19 1904 10 1896 19 1905 9 1897 19 1906 9 1898 15 1907 7 1899 14 1908 7 1900 13 Apparently it pays dairymen better to purchase the milk from farmers or from wholesale milk dealers than to keep cows in the borough. At all events, whatever be the cause, the number of cows now kept is very small. Indeed, although the seven cowsheds are licensed for 172 animals, they have housed, on an average, not more than 50. As the Inspector well points out, this is a matter for regret, because far greater precautions are taken against the contamination of milk in them than in most country districts, and also because the animals are better housed, while they are also better groomed. The cowsheds were visited on 81 occasions. Only once had the Inspector to complain of the state of the cows. When the Medical Officer of Health made his annual visit to the cowsheds he was able to report to the Public Health Committee on October 2Gth that they were all in a very good condition. List of Licensed Cowhousbs in the Borough of Islington. Registered No. Name of Licensee. Situation of Premises. No. of Cows licensed to hold. 107 Williams, Joseph 108, Elmore Street Shed No. 1 =28 108 Jones, Elizabeth 3, Frome Street 18 111 Jones, Samuel 24, Hercules Place, Holloway 12 112 Wright, Henry 11, Matilda Street 15 113 Edwards, James 1, Northampton Street 19 114 Jones, Edward 88, Roman Road 16 115 Arnold, George 233, Seven Sisters Road 64 Total 7 Cow-Houses. 255 [1908 INSPECTOR WILKINSON'S REPORT. Public Health Department, Town Hall, Upper Street, N. April 30th, 1909. To the Medical Officer of Health. Dear Sir,—I have pleasure in submitting the following report bearing on my duties for the year 1908. Inspection of Slaughterhouses.—There were at the commencement of the year 37 licensed slaughterhouses within the borough, but three of these were not renewed at the annual licensing Sessions of the London County Council in October last, there being no applications owing to the premises being vacant, and no application for renewal of any one of these has since been made. The premises in question are situated respectively at the rear of 174, Caledonian Road, 52, Packington Street, and 317, New North Road. The conduct of the slaughterhouses generally has been very satisfactory during a total of 2,008 visits, and any requests for repairs to structural defects or better observance of the by-laws have been readily complied with. The number of animals slaughtered was as follows:— Oxen Calves Sheep and lambs Pigs Total. 1,941 86 28,476 4 30,507 That of the previous year being as under, viz.:— Oxen Cows Calves Sheep and lambs Pigs Total 2,146 4 142 24,380 2 26,674 The quality of the animals slaughtered has been generally of the best, and, as will be seen by a perusal of the following table, only two whole carcases and the fore-quarters of a third were surrendered on account of tuberculosis, which is not much more than 1 per 1,000 slaughtered, and that has been about the average loss to the trade so far as the Islington private slaughter houses are concerned during the past five years. This in itself is proof that the quality of the animals purchased, so far as outward appearances show, is of the best, as the doss concerned on that account does not equal 6d. per head of the cattle slaughtered. It is therefore somewhat singular that the very animal— which was made a test case last year as to the liability of the farmer when an animal bought at full market value proved to be so diseased as to be unfit for the purpose for which it was intended, and which has since resulted in the National Federation of Meat Traders resolving in future to demand a warranty with each animal purchased—should have been one of so few found in the Islington private slaughter houses. Other animals found to be affected with the same disease were ondy so in a very slight degree, or strictly localised in extent, as shown in the following table. A summary of parasitic organs and also other abnormal conditions will also be found in the same table. 256 1908] TABLE A. No of Cases Description of Animals. Extent of Disease or Affection. Nature of Affection. How disposed of. 1 Cow Carcase and all organs Tuberculosis (generalised) (per Insp. Bagshaw) Carcase and all organs surrendered and destroyed 1 Ox do. do. Generalised Tuber- culosis (per Insp. Burrell) do. do. 1 do. Heart and one lung (slightly) Tuberculosis Affected organs destroyed 1 do. Lungs and fore quarters do. Fore quarters and organs affected surrendered and destroyed 1 do. Throat, gland and lungs do. (slight) Affected organs surrendered and destroyed 2 Oxen Lungs do. do. do. do. 1 Ox Lungs and costal pleura do. do do. do. 1 do. Lungs and Liver Tuberculosis do do. 1 do. Lungs and mediastinal glands do do. do. 1 Heifer Costal pleura Tubercular pleurisy Affected parts surrendered and destroyed 1 do. Lungs and submaxillary glands Tuberculosis Affected organs, &c., surrendered and destroyed Liver Parasitic (Dis. Hep.) 1 Bull Lungs Tuberculosis do. do. 1 Ox Liver, lungs. tripe, and certain trimmings do. do. do. 4 Sheep Carcase and all organs Found dead or slaughtered in a moribund condition Carcases and organs surrendered and destroyed 1 do. do. Bruised and moribund (per Insp. Irving) do. do. 1 do. One loin Decomposition Affected parts surrendered and destroyed 1 do. Lung and portion of carcase adjacent Abnormal growth, primarily due to an accident do. do. 1 do. Entire carcase Dropsy Surrendered and destroyed 1 do. One neck and one breast Chronic pleurisy do. do. 1 do. Parts of carcase Bruised Parts surrendered and destroyed 1 do. Lung and portion of carcase Pleurisy (acute) Organs and parts surrendered and destroyed 1 Ox Tripe, reed, roll and head .. Decomposition .. Affected organs destroyed 1 do. Lumbar fat and tissues Rupture of blood vessel Affected parts destroyed 1 do. Heart Pericarditis (chronic) Affected organ destroyed 1 do. Tongue Actinomycosis do. do. 1 do. Head do. do. do. 16 Oxen Liver Abscess do. do. 20 do. do. Parasitic (Dis. Hep.) do. do. 3 Sheep do. Parasitic (Dis. Hep.) do. do. 17 do. do. Parasitic (Ech. Vet.) do. do. 8 do. Liver and lungs Parasitic (Ech. Vet.) do. do. 1 do. Lungs Parasitic (Ech. Vet.) do. do. 7 do. Various (slight) Various do. do. 257 [1908 Shop Inspection.— This includes the inspection of butchers' shops, fish shops, fruit shops, sausage factories, and other premises where foodstuffs are sold or prepared for sale, as well as stalls, barrows, etc., from which perishable foods are sold. The approximate number of shops within the Borough is as follows, viz.: — Butchers and provision dealers 250, fishmongers and fish fryers 116, greengrocers and fruiterers 200. There are also 9 places where food-stuffs are prepared for sale, principally from meat substances (sausage factories, etc.), where no retail business is transacted, and also usually about 7 butchers' stalls, 6 fish stalls or barrows, and some 30 greengrocers and fruit stalls, but the number of these fluctuate considerably. To these a total of 13,148 visits have been made during the year, and the foodstuffs generally have been of a satisfactory quality; but of necessity there must be a certain percentage of unsoundness in all perishable foods, due to varying atmospheric conditions and from the particulars of Table "B" appended, it wild be seen that the defects found were due rather to decomposition than to disease or other inferiority. Twelve summonses under Section 47 Public Health (London) Act 1891 were taken out during the year, and in eleven of these, convictions were obtained, with varying fines and costs, which totalled £37 18s. 6d. The particulars will be found in Table "B" below. The remaining case was that in which a large quantity of tinned foodstuffs were found on the premises of a canning company in a blown and unsound condition, but on the case coming before the Magistrate, at the Clerkenwell Police Court, he found that they were not intended for human consumption, and dismissed the summons. Further particulars of unsound foods dealt with will also be found in Table "B," a large quantity of which was examined by the request of the respective owners. If, then, we deduct the weight of the latter, together with the unsound tinned foods previously named, and also that of meat and organs voluntarily surrendered in slaughter houses from the total amount of unsound foodstuffs dealt with, as shown at the end of this report, I am sure you will agree that the amount intercepted which was apparently intended to be sold for human food was only very small in comparison to the amount of foodstuffs required to feed a population of nearly 350,000 inhabitants for one year, and that this is some proof of the effectiveness of constant special supervision of the food supply. 258 19081 TABLE B. Description of Food. Nature of Unsoundness. Conditions under which it was found. How disposed of. Weight in lbs. Observations. Various canned foods Blown Tins On wholesale Canning Co.'s premises Conveyed to Council's destructor 4,816 Legal proceedings taken. Summons dismissed by Mr. Bros, who held that they were not intended for food Herrings Decomposition Exposed for sale Do. do. do. 336 (a) Seized. Legal proceedings taken. Defendant fined 40s. and 2s. costs. Beef and Pork Do. In ice safe Do. do. do. 427 Do. do. Defendant fined £5 and £2 2s. costs. Pork Chops Do. Exposed for sale Do. do. do. 2 Do. do. Defendant fined 40s. and 2s. costs Oranges Do. Do. do. Do. do. do. 12 (b) Do. do. Defendant fined 40s and 23s. costs. Apples Do. Do. do Do. do. do. 4 Do. do. Defendant fined 60s and 23s. costs. Black Currants Do. Do do. Do. do. do. 180 (c) Do. do. Defendant fined 20s. and 10s 6d. costs. Lamb and Beef Do. Partly exposed for sale Do. do. do. 32 Do. do. Defendant fined £3 and 24s. costs. Sheeps Hearts and other meat Do. Exposed for sale Do. do. do. 9 (d) Do. do. Defendant fined £4 and 24s costs. Pears Do. Do. do. Do. do. do. 6 Do. do. Defendant fined £3 and 23s costs. Two Geese Do. Do. do. Do. do. do. 16 Do. do. Defendant fined £2 and 2s. costs. Pears Do. Do. do. Do. do. do. 21 (b) Do. do. Defendant fined 20s. and 2s. costs. (a) Inspector Bridel. (b) Inspector Fortune. (c) Inspector Hancock. (d) Inspector Flood. 259 [1908 TABLE B.— continued. Description of Food. Nature of Unsoundness. Conditions under which it was found. How disposed of. Weight in lbs. vations. Sausages Turned sour Exp sed for sale Conveyed to Council's destructor 1 Seized. Letter of caution sent by order of Public Health Committee. Shrimps Partly decomposed At rear of fish shop (after a complaint) Deposited with house refuse 13 (a and e) Do. do. Various Tinned and Bottled Fruits, &c. Blown and broken down Examined by request Conveyed to destructor 1,685 Surrender accepted under Sec. 47 (8) Public Health (London) Act, 1891. Tinned Fruits, &c. Blown Set aside at Canning Factory Destroyed on boiler furnace 28 Surrender accepted and destroyed in Inspector's presence Damsons Partly decomposed Fruiterers' shop Conveyed to destructor 20 Seized and conveyed to Police Court. Magistrate's order to destroy refused on the grounds that the whole of the fruit was not unsound. Owner subsequently agreed to surrender. Various Fruits, &c. Do. Various Destructor and refuse shoot 1,230 Various surrenders accepted by different Inspectors. Oxen Livers Parasitic (Dis. Hep.) Do. Destructor and owner's premises 257 Chiefly examined by request and surrender accepted. Fish Decomposition Submitted Deposited with fish offal 280 Eight cases of surrender, in five of which condemned notes were given. Pig's Head Tuberculosis Examined by request Conveyed to destructor 12 Surrender accepted. Ox's Head Actinomycosis At Tripe Works, &c. Destroyed on furnace fire 24 Do. do. Various Meat Decomposing On Butcher's premises Destroyed 24 Surrender accepted and particulars reported to Medical Officer of Health. a) Inspector Bridel. (e) Inspector Bicknell. 260 19081 TABLE B.— continued. Description of Food. Nature of Unsoundness. Conditions under which it was found. How disposed of. Weight in lbs. Observations. Foreign Rabbits Decomposing Submitted Destroyed 16 Surrender accepted. Pork (Dutch) Decomposition Sausage Factory (examined by request) Council's destructor 68 Affected portions of carcase surrendered and condemnation note given. Beef Parings Partial decomposition Sausage Factory (Trimmed from large pieces) Treated with carbolic and deposited with waste bones, &c. 70 Trimmings from pieces of beef in a stale condition, but not decidedly unsound. Cautioned. Pigs Heads Decomposition Sausage, &c. Factory (by request) Council's destructor 25 Found on delivery to be unsound. Inspector called in and surrender accepted. Bovine Kidneys Chronic Nephritis By request Do. do. 4 Inspector requested to examine and surrender accepted. Cooked Meat Decomposing Preserving Works Destroyed on fire 4 Although salted and cooked, turned bad in weak brine solution. Cautioned. Eggs Do. Brought to Town Hall Council's destructor 56 Brought by dairyman to Town Hall. Surrender accepted. Boar's Head Diseased Gland Examined by request Do. do. 26 Inspector called to Meat Preserving Works. Surrender accepted. Leg of Beef Due to fracture during life Do. do. Do. do. 17 Part of a consignment from Smithfield Market set aside. Surrender accepted. Smoked Sausages Mouldy Do. do. Do. do. 34 Inspector's attention called to them on a visit. Surrender accepted. 261 [1908 Cowsheds.— There are still 7 cowsheds on the register, although in three of them no cows have been kept during the year. The total accommodation licensed is for 172 cows, whereas the average number kept during the year did not reach 50, and there is not much probability of the number being increased. This in some respects is a matter for regret, as my experience shows that far greater precautions are taken against the contamination of the milk produced in the London cowsheds than obtains in most country districts, both in the better housing of the cattle, better grooming, and better sanitary precautions in the milking and handling of the milk prior to distribution. During the year 81 visits were paid to the cowsheds, and generally speaking, the observations were satisfactory. In one instance, however, complaint had to be made of the dirty condition of some cows, and the licensee took the necessary steps to ensure an improvement, and again I have to make the same excuse for the London cowkeeper (which bears out my foregoing statement regarding the insanitary conditions under which the cows are often kept in rural districts) that has previously been made in these reports, that in nearly every case where there are grounds for complaint in this direction it is in respect to cows which have been recently obtained from some country district. Only in one instance was disease of the udder noted by your inspector, and in this case I found that lactation had ceased, and was also informed that it had already come under the observation of the Veterinary Inspector to the London County Council. Other minor defects, to floors, etc., on being pointed out, received due attention. The Offensive Trade Establishments— comprising 3 tripe dressers, 2 gut scrapers. 1 knacker's yard, and 1 tallow melter, have received a total of 103 visits, and have been satisfactorily conducted. The talllow melting business, of which complaints have previously been rather frequent, has been discontinued since June last, and the premises are still unoccupied. The knacker's yard is at present being reconstructed at the rear of the old premises on a most elaborate and up-to-date closed chamber principle, which will be ready for occupation shortly. The following is a summary of foodstuffs destroyed during the year, particulars of which appear in tables "A" and "B." tons. cwts. qrs. lbs. Diseased meat and organs, as per table "A" 1 9 3 5 Unsound fooda, as per table "B" 4 7 2 17 Tons 5 17 1 22 I am, Sir, Yours obediently, H. WILKINSON, Meat Inspector, etc. Milkshops and Dairies.— There were on the register 29 dairies and 528 milkshops, to which 3,303 visits were paid by the district inspectors. In addition they were all inspected by the Chief Inspector, Mr. J. R. Leggatt, towards the end of the year, who reported on them as follows:— 262 1908] Public Health Department, Town Hall, Upper Street, N. 15th December, 1908. Dear Sir,— I beg to report that I have just completed my annual inspection of the Dairies and Milkshops within the borough, there being 29 of the former and 528 of the latter. I have directed my attention to the measures in use and to the sterilization of the milk cans. With respect to the measures, I found that in only a few cases the handles were in one piece, and that the remainder had a space at the back which permitted sediment such as rust, verdigris, &c., to accumulate. In every instance I have written to the dairymen and purveyors of milk on the subject and they have readily carried out my suggestions, and very shortly the whole of the measures in use in the shops and milk rounds will have been soldered, which will, I trust, prevent any deposit such as I have mentioned in future. I have now to refer to the sterilization of the milk cans. To avoid the methods adopted last year, and alluded to in my report, I am pleased to say that I have persuaded those responsible for the scalding or steaming of the utensils used in the sale of milk, where there have been no steam jets, to provide a strong metal cage or tray in which to place the cans, and then to put the whole into a copper of boiling water, thus ensuring their thorough sterilization. This suggestion has, I am glad to say, been put into effect, and will bring about a much needed improvement. There still remains the question of milk being sold in unsuitable premises, and I have given you a list of places which, in my opinion, should be dealt with under the recent powers obtained by the London County Council through their General Powers Act. In conclusion I would like to slate that I found that the general condition of the Dairies and Milkshops was much more satisfactory. I am, Yours respectful, JAMES R. LEGGATT, Superintendent and Chief Sanitary Inspector. The powers under the London County Council (General Powers) Act 1908, to which he refers are contained in the 8th section. The matter is at present engaging the serious attention of the Medical Officer of Health, who will report on it to the Public Health Committee at an early date. 263 [1908 Bakehouses.— These have been dealt with in Part 4 of this report in connection with the administration of the Factory and Workshops Act, in which the Medical Officer of Health is required to report specifically, vide p. 200 Kitchens of Restaurants and Eating Houses.— These have also been dealt with in Part 4 of this report. Places where Ice Creams are made.— There are now 230 places of this kind in the borough, and to them the Inspectors made 348 visits. They have been kept in a pood state. They are for the most part owned by Italians, among whom the provisions of the London County Council General Powers Act, 1902, translated into their own language, have been distributed. ADULTERATION OF FOOD AND DRUGS. Not the least work of the Public Health Department is to obtain samples of foods and drugs for analysis by the Public Analyst for the detection of the adulteration. During the last eighteen years 15,449 samples have been examined, of which 1,692, or nearly 11 (actually 10.95) per cent were adulterated or sold contrary to the provisions of the Adulteration Acts. Table CXXVIII. Showing the Number of Samples of Foods and Drugs Analysed with the Result of the Analyses for the Year 1908 and the preceding Seventeen Years. Years. No. of Samples Examined. Genuine. Adulterated. Per cent. Adulterated. l891 368 345 23 6.2 1892 367 302 65 17.7 1893 378 327 51 13.5 1894 390 342 48 12.3 1895 772 673 99 12.8 1896 755 661 94 12.4 1897 863 765 98 11.3 1898 875 784 91 10.5 1899 899 820 79 8.8 1900 885 774 111 12.5 1901 942 800 142 15.1 1902 932 796 136 14.6 1903 1,016 898 118 11.6 1904 1,204 1,101 103 8.5 I905 1,200 1,101 99 8.2 1906 1,190 1,079 111 9.3 1907 1,213 1,131 82 6.7 1908 1,200 1,058 142 11.8 Totals 15,449 13,757 1,692 10.95 264 1908] The samples examined during these years were very varied, and included 8 different kinds of dairy produce and oleaginous foods, 47 different kinds of groceries, 9 different kinds of alcoholic beverages, and 59 different kinds of drugs. The results of the analyses are very interesting, because they show that only a comparatively small number of articles are adulterated. Thus, of oleaginous foods it was found that only 1 sample of dripping out of 64 examined was adulterated, and 2 samples of lard out of 135. Of groceries, out of 85 samples of bread examined, none was adulterated, while the same has to be said of 6 chicories, 6 cinnamons, 109 corn-flours, 10 honeys, 31 jams, 15 lime juices, 8 meat extracts, 10 preserved mushrooms, 30 pea flours, 3 tinned or bottled peas, 73 black peppers, 33 pickles, 14 salad oils, 6 soda waters, 14 sugars (other than demerara), and 50 teas. Again, there was only 1 sample adulterated in 80 white peppers examined, in 62 arrowroots, in 65 ground gingers and in 41 sweets and confections. Also only 2 samples were adulterated in 10 golden syrups, in 142 mustards, and 34 yeasts. Of the alcoholic beverages, out of 41 beers, ales, and porters, none was adulterated, while the same must be said of 5 samples of wine. Among the 59 different kinds of drugs, of which 719 were examined, no less than 613 were returned as genuine. There is a long list of different drugs, 31 in number, of which none was adulterated, while only 1 sample of acetic acid out of 22 examined was returned as not genuine, while the same return was made with respect to 17 castor oils. The full list of all the articles examined, together with the number of each returned as adulterated, not up to standard, or sold contrary to the provisions of the Adulteration Acts, is as below:— MILKS AND OLEAGINOUS FOODS. No. of Samples Analysed. No. of Samples Adulterated. Percentage of Adulteration Butter 2,305 260 11.2 Cheese 387 3 1.4 Cream 7 — — Dripping 64 1 1.5 Lard 135 2 1.4 Margarine 655 185 28.2 Milk 7.919 849 10.7 Skimmed Milk 11 2 18.1 11,483 1,302 11.3 265 [1908 GROCERIES. Articles. No. of Samples Analysed. No. of Samples Adulterated. Percentage of Adulteration. Almond Rock 1 1 100.0 Arrowroot 62 1 1.6 Baking Powder 68 1 - Bread and Butter 53 10 18.8 Bread 85 - - Chicory 6 — - Cinnamon 6 — - Cocoa 121 23 19.0 Coffee 341 67 19.6 Cornflower 3 - - Egg Powder 1 — - Flour 109 — - Ginger (ground) 65 1 1.5 Golden Syrup 10 2 20.0 Honey 10 — — Jam (Raspberry) 15 — — Jam (Plum) 5 — — Jam (Black Currant) 7 — — Jam (Strawberry) 4 — — Lemonade Crystals 1 — — Lime Juice 15 — — Lithia Water 1 — — Meat Extract 8 — — Meat Tablets 6 3 33.3 Tinned Mushrooms 10 - - Mustard 142 2 1.4 Olive Oil 72 6 8.3 Pea Flour 30 — - Peas (tinned) 3 — — Black Pepper 73 — — White Pepper 80 1 1.2 Pickles 33 — — Pork Sausages 8 — — Potash Water 3 — — Rice 1 — — Saffron 12 3 25.0 Sage 3 - — Salad Oil 14 — — Soda Water 6 — — Sugar 7 — — Demerara Sugar 85 48 56.4 Moist Sugar 7 - — Black Tea 35 — — Green Tea 15 — — Vinegar 84 10 11.9 Yeast 34 2 5.8 Sweets 41 1 2.4 1,804 181 10.0 266 1908] ALCOHOLIC BEVERAGES. Ale 1 — — Beer 38 — — Brandy 74 13 17.5 Gin 114 13 11.4 Porter 2 — - Port Wine 12 — — Rum 68 8 11.7 Whisky 345 58 16.8 Wines 5 — — 659 92 13.9 DRUGS. Samples taken. Adulterated. Percentage. Acetic Acid (diluted) 28 1 4.5 Acetic Acid 4 — - Almond Oil 15 3 20.0 Ammon. Sol. 2 - - Ammon. Tincture of Quinine 3 — - Arnica, Tincture of 3 — — Belladonna Liq. Extract 3 — — Bismuth A. Cit. 3 — — Camphor 8 — - Camp., Comp. Tincture of 6 — — Camphorated Oil 28 2 7.1 Camphor Water 16 — - Camphor, Spirits of 10 — — Castor Oil 17 1 5.8 Citric Acid 6 2 33.3 Cod Liver Oil 48 — - Cream of Tartar 22 9 40.9 Digitalis, Tincture of 2 - - Eucalyptus Oil 27 4 14.8 Gentian Root (ground) 7 2 28.5 Gentian, Tincture of 2 — — Glycerine 55 3 5.4 Gregory Powder 4 2 50.0 Iodide of Potassium 2 — — Iodine, Tincture of 8 2 25.0 Iodine 8 3 37.5 Iron, Tincture Perchlor of 1 1 100.0 Jalap, Tincture of 1 1 100.0 Juniper, Oil of 7 5 71.4 Lime Water 54 8 14.8 Liniments 4 — — Linseed Meal 50 3 6.0 Liquorice Powder 35 2 5.7 Magnesia (Fluid) 5 1 20.0 Magnesia, Cit. 2 — - Milk of Sulphur 1 — - 267 [1908  Samples taken. Adulterated. Percentage. Nitrous Ether 4 1 25.0 Nux Vomica 1 — — Oil of Almonds 1 — — Oil of Turpentine 5 — — Ointment 4 3 75.0 Opium, Tincture of 8 - - Pills (Iron) 23 6 26.0 Prescriptions 24 6 25.0 Quinine Tincture 3 — - Quinine Wine 11 — — Quinine, Sulphate of 8 — — Rhubarb, Tincture of 46 7 15.2 Sal Volatile 6 - - Saltpetre 1 — — Soap Liniment 5 4 80.0 Strych. Hydr. Sol. 2 — — Sulphur, Precipitated 37 — — Squills, Tincture of 2 — — Sweet Spirits of Nitre 27 5 18.5 Tartaric Acid 3 3 100.0 Yellow Wax 7 6 85.7 Zinc Ointment 3 — — 719 96 13.3 Thus it is seen here that there are many articles which it seems almost a waste of time, energy, and money to sample. Nevertheless, some of them if not analysed would soon be adulterated as they had been in former days. It is therefore, very necessary to sample them occasionally, if only to let the manufacturers and chemists see that they have not been forgotten. Samples Analysed in 1908.— During the year 1,200 samples were examined, 1,058 of which the Public Analyst reported as genuine and 142, or 11.8 per cent., as adulterated or sold contrary to the provisions of the Adulteration Acts. Examined. Genuine. Adulterated. Per cent. 1st Quarter 302 280 22 7.3 2nd „ 296 268 28 9.5 3rd „ 301 257 44 14.6 4th ,, 301 253 48 15.9 The Year 1,200 1,058 142 11.8 This is the highest percentage of adulteration attained since 1903, the proportions in the intervening years being 8.5 per cent. (1904), 8.2 (1905), 9.3 (1906) and 6.7 (1907). S 2 268 1908] It will be noticed that as the year progressed the percentage of adulteration increased. This increase was entirely due to the methods adopted by Inspector Burrell, who became the Inspector for the purpose of the Adulteration Acts at the beginning of the third quarter, and who at once, with the entire approval of the Public Health Committee, proceeded to obtain informal samples of milk, butter, margarine, coffee and demerara sugar, which he examined either by simple processes, which are entirely within the competence of any educated man, or by the microscope, in the use of which Mr. Burrell is very highly skilled. If he found that any of these samples were not genuine, he at once proceeded to make purchases under the Acts, while with respect to those which were genuine, no further action was taken. In this way he examined 340 samples of the above mentioned foods, of which 245 were genuine, 28 were protected by a declaration, and 47 did not appear to be genuine. At the end of the year, 36 duplicate samples had been purchased and submitted to the Public Analyst, who afterwards reported against 33. Legal proceedings followed in due course, and penalties and costs to the amount of £71 Gs. 9d. were obtained. The Inspector has written a short account on his work, which is appended to this section of the report. Dairy Produce.— 900 samples were submitted to the Public Analyst of which 86, or 9.5 per cent., were adulterated, as compared with 7.2 per cent. in 1905, 10.2 per cent. in 1906 and 6.5 per cent. in 1907. The samples taken and the results of the analyses are shown in the following table:— Samples. Adulterated. Percentage Adulterated in 1908. Percentage Adulterated in 1907. Percentage Adulterated in 1906. Milk 604 52 8.6 6.6 11.7 Milk (Separated) ... ... ... 33.3 33.3 Cream ... ... ... ... ... Butter 199 19 9.5 6.2 5.5 Margarine 42 15 35.7 13.3 15.4 Cheese 40 ... ... ... ... Lard 15 ... ... ... ... 900 86 9.5 6.5 10.2 269 [1908 Milk.— 597 samples were submitted to the Public Analyst, who reported against 52, or 8.6 per cent., as compared with 6.7 per cent in 1907, and with an average of 10.5 per cent. since 1892. There is no doubt of the fact that the amount of detectable adulteration of milk is now less than at any preceding period, but it is very doubtful if adulteration is actually less. At one time it was the custom to add water in considerable quantities, but there is reason to think that the practice has been superseded by adulteration with separated milk, which amounts to the same thing as depriving the milk of its fat or cream. During the last seven years the analyses of 792 samples of farmers' milks arriving at Finsbury Park Railway Station, show that only 12, or 1.51 per cent., gave a fat content of less than 3 per cent., whereas the analyses of 3,304 samples purchased from milkmen and dairy shops, showed that 251, or 7.6 per cent., had a fat content of less than 3 per cent. From the knowledge of the Medical Officer of Health of the interiors of the milk depots in Islington, he has no hesitation in saying that this difference in the fat content is not to be accounted for by the use of milk separators in the borough, and, therefore, he is forced to the conclusion that it has been accomplished by the addition of separated milk, mainly received from butter factories or creameries, to whole milk. The sophistication is very easily done. All that is required is to know the amount of fat in the farmer's milk, which practically varies very little from day to day, and then to add the amount of separated milk necessary to reduce the fat to 3 per cent., the minimum allowed by the regulations of the Board of Agriculture, if the milk is to be presumed to be genuine. Dishonest traders work down to this minimum, and only recently a man, who to the knowledge of the Medical Officer of Health has been in the trade, and in a large way too, for the last twelve years, and doubtless much longer, stated on oath in course of a prosecution for milk adulteration that it was a general practice of the trade to add separate milk to new milk. The Medical Officer of Health recently heard Counsel seriously contend in the High Court that it was allowable to add separated milk to new milk, provided the fat content was not reduced below 3 per cent. If so, it can only be said that the trade is a most dishonest one. Fortunately, the figures showing the analyses of the milks purchased or procured under the Adulteration Acts are before him, and they prove that the average fat content of 5,050 milks, which included all those that were sophisticated, was about 3.61 per cent. Consequently that man's statement must be very much exaggerated. Nevertheless, the farmers' milks arriving in Islington would admit of about one-twelfth of their weight of separated milk being added to them to reduce them to a percentage of 3.6 per cent of fat. In a recent prosecution it was sworn in 270 1908] evidence that eight quarts of separated milk had been added to a churn of milk, and yet the Public Analyst felt compelled to pass this milk, so far as its fat content was concerned, because it was only just a decimal point below the standard of the Board of Agriculture; and had it not been that someone had added 6 per cent. of water, no prosecution would have occurred, and a serious fraud would have gone unpunished. The Board of Agriculture minimum of 3 0 per cent. is far too low. No milk vendors in London or indeed elsewhere would be satisfed with milk showing such a low percentage of fat No farmers who made butter for commercial purposes would be satisfied with cows that did not gave milk of a higher quality. No butter manufacturers, unless they paid by weight of fat, would purchase such milk. The cows that gave it would hardly pay for their keep. Then why should the public be compelled to pay for a milk fluid which does not contain a proper proportion of fat, when the normal proportion, according to the Islington figures, has been on an average nearly 4 per cent. (actually 3.91) during a period of ten years, and when the analyses of 200,000 milks received in London also averaged 3.9 per cent. Some day this standard must be altered, because it is undoubtedly too low, notwithstanding all that is said to the contrary by interested persons. samples Adulterated Per cent. Examined Adultered. 1st Quarter 153 9 5.9 2nd „ 149 14 9.4 3rd „ 150 22 14.7 4th „ 152 7 4.6 604 52 8.6 These samples were obtained as follows:— On Sundays 160, of which 15, or 9.4, were adulterated. On Weekdays 324, of which 35, or 10.8, were adulterated. At Railway Stations 120, of which 2, or 1.6 were adulterated. These figures indicate that the percentage of adulteration of milk sold on Sundays was slightly less than of that sold on week days. At one time this was not so. Indeed, it was quite the reverse. It is, however, most satisfactory to find that the regular and systematic sampling of milks on Sundays has had a very deterrent effect on vendors, who know that more samples are now obtained in the borough on that day than on any other day of the week. The quality of the milk is also slightly better than that purchased on week days. 271 [1908 The following is a record of the adulteration of milk in Islington since 1892:— MILK ADULTERATION. Samples Analysed. Genuine. Adultrated. Per cent. Adultrated. 1892 171 139 32 18.7 1893 213 173 40 18.7 1894 206 169 37 17.9 1895 413 343 70 16.9 1896 468 418 50 10.6 1897 513 464 49 9.5 1898 543 492 51 9.4 1899 532 477 55 10.3 1900 541 485 56 10.3 1901 632 536 76 12.0 1902 586 528 58 9.9 1903 508 458 50 9.8 1904 600 553 47 7.8 1905 594 549 45 7.6 1906 634 560 74 11.8 1907 597 557 40 6.7 1908 604 552 52 8.6 Totals 8,355 7,473 882 10.5 The Quality of the Milk.— The average quality of the 601 milks was good, as the analyses showed that the average percentage of fat was 3.7, and the average percentage of solids not fat 8.6. It must not be forgotten that these percentages included 52 milks which were returned by 1 he Public Analyst as adulterated, besides many that were just below the standard, but which were too near it to risk proceedings, even if the Courts would grant summonses, for it is only in exceptional cases that they do so, when the percentage of adulteration is less than 5.0. The milks procured at Finsbury Park as they arrived from the farm gave higher percentages of fat than those afterwards purchased from milk purveyors in the borough, namely 3.88 per cent., as compared with 3.52 per cent. for the milks purchased on week days and 3.69 per cent. for milks purchased on Sundays. These percentages are all considerably higher than the official standard, which is 3 per cent. The results of the analyses during the year were as follow:— Obtained No. of Samples. Analysed. Average Percentage of Fat. Average Percentage of Solids, not Fat. Average Percentage of Total Solids On Sundays 160 3.69 8.58 12.27 On Weekdays 324 3.52 8.58 12.10 At Railway Stations 120 3.88 8.73 12.61 Official Standard ... 3.00 8.50 11.50 272 1908] Table CXXIX. Showing the analyses of 6,344 milks examined in Islington during the eleven years 1898-1908, and distinguishing those purchased on Sundays, on Weekdays, and procured at the Railway Stations while in transit from the Farmer to the London Milk Purveyor. Years. Sunday Milks. Week-day Milks. Railway Milks (Farmers). No. of Samples. Per cent. ft non-fatty solids. Per cent. of fat. No. of samples. Per cent. of non-fatty solids. Per cent. of fat. No. of samples. Per cent. of non-fatty solids. Per cent. of fat. 1898 193 8.50 3.50 230 8.56 3.69 120 8.84 4.04 1899 181 8.49 3.50 231 8.53 3.58 120 8.82 4.23 1900 196 8.64 3.62 224 8.55 3.53 121 8.75 3.93 1901 196 8.56 3.64 295 8.60 3.49 141 8.77 3.69 1902 192 8.59 3.60 274 8.64 3.51 90 8.76 3.85 1903 167 8.42 3.86 218 8.47 3.74 120 8.66 3.90 1904 164 8.52 3.78 317 8.48 3.74 120 8.62 3.97 1905 161 8.55 3.68 323 8.51 3.72 112 8.66 3.87 1906 195 8.49 3.58 332 8.52 3.59 110 8.75 3.69 1907 150 8.64 3.63 327 8.65 3.76 120 8.77 3.96 190s 160 8.58 3.69 324 8.58 3.52 120 8.73 3.88 Eleven Years 1,955 8.59 3.64 3,095 8.55 3.62 1,294 8.74 3.91 From these analyses the following averages have been deduced:— Solids not fat. Fat. Total solids. 1,955 Sunday Milks 8.59 3.64 12.23 3,095 Week-day Milk 8.55 3.62 12.17 1,294 Farmers' Milk 8.74 3.91 12.65 Total Milks 8.63 3.72 12.35 The Effect of an Official Standard.— It has been frequently contended that the effect of a minimum standard is to cause the vendors of milk to reduce good milks to as near it as it is possible without incurring the risk of prosecution, so, with a view of discovering how far this is true, the Medical Officer of Health examined the analyses of 4,090 milks made by the Public Analyst, with the following results:— 273 [1908 WEEK DAY MILKS. Samples Examined, 2,115. No. of samples whose fat was below 3 per cent. but above No. Per cent. 2.76 90 4.25 No. of samples whose fat was below 275 87 4.11 Total below 3 per cent. 177 8.36 No. of samples whose solids not fat were below 8.5 per cent. but above 8.25 per cent. 545 25.76 No. of samples whose solids not fat were below 8.24 per cent. 256 12.10 Total below 8.5 per cent. 801 37.86 SUNDAY MILKS. Samples Examined, 1,189. No. of samples whose fat was below 3 per cent. but above No. Per cent. 2.76 40 3.36 No. of samples whose fat was below 2.75 per cent. 34 2.86 Total below 3 per cent. 74 6.22 No. of samples whose solids not fat were below 8.5 per but above 8.25 per cent. 314 26.41 No. of samples whose solids not fat were below 8.24 per cent. 132 11.10 Total below 8.5 per cent. 446 37.51 FARMERS' MILK. Samples Examined, 792. No. of samples whose fat was below 3 per cent. but above No. Per cent. 2.76 7 0.88 No. of samples whose fat was below 2.75 5 0.63 Total below 3 per cent. 12 15.1 No. of samples whose solids not fat were below 8.5 per cent. but above 8.25 per cent. 134 16.92 No. of samples whose solids not fat were below 8.24 22 2.77 Total below 8.5 per cent. 156 19.69 These figures seem to indicate that large quantities of milk were reduced so as to come near the minimum standards, and that in attempting to do so the mixers passed just below them in many instances. It is impossible to set out the separate figures here, but they rather denote, especially in the case of fats, that many of the milks showed fats that were only on the border line, indicating 274 1908] that the milks had been reduced by the addition of separated milk. This is hardly to be wondered at when it is recollected that the average percentage amount of fat in the milk which arrives at Finsbury Park Railway Station from farms is 3.91, which would admit of the addition of one twelfth part by weight of separated milk to a churn of whole milk, and yet satisfy the official minimum standard for fat, and there is no doubt that this is largely done. In fact, during a recent trial a man well-known in the milk trade stated that nearly all the milk dealers added separated milk, and he was not ashamed of it, nor did he think it was any harm. To prevent frauds of this character it seems to be necessary that the law should be so altered as to allow of a prosecution if it could be shown that the milk sold by any vendor gave a percentage of fat less than the average percentage of the milks which he had received into his premises on the date on which the sample was taken, that average being taken as the standard for his milk. It would be well, too, that all separated milks should be conveyed in special churns distinguished by some universal mark, such as a painted coloured band; and also that it should be consigned in the name of the firm, and not, as is frequently done, in another name. It has recently come to light that this is a common practice, which it adopted with a view to prevent the Sanitary Inspector, who examines the churns at the railway station, knowing that the real consignees are using such milk. It should also be made a distinct offence to add separated milk to any whole milk; and dealers in separated milk should be compelled to keep books, which would be open to the Sanitary Authority, showing how it is dealt with. These may seem very drastic proposals, but then it must be remembered that milk is perhaps the most important of all foods. It certainly is for young children, and, therefore its adulteration should be prevented by every possible means. Honest dealers would have nothing to fear. Table CXXX. Giving the particulars of the Milk taken during each quarter of 1908 on Sundays, on Week-days, and at the Railway Stations. 1907. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Quarters. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. Sundays. Week-days. Railway Stations. All Milks. 1st Quarter 40 83 30 153 37 77 30 144 3 6 .. 9 7.5 7.2 .. 5.9 2nd ,, 40 79 30 149 37 68 29 134 2 11 1 14 5.0 13.9 3.3 9.4 3rd ,, 40 80 30 150 34 66 29 129 7 14 1 22 17.5 17.5 3 .3 14.7 4th „ 40 82 30 152 37 78 30 145 3 4 .. 7 7.5 4.9 .. 4.6 The Year 160 324 120 604 145 289 118 552 15 35 2 52 9.4 10.8 1.6 8.6 275 Table CXXXI. Showing the Samples of Milk Analysed, the number found adulterated, with the percentage of Samples adulterated for the fast eleven years. Year. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Sundays Week-days. Ry. Stations. All Milks. Sundays. Week-days. Ry. Stations. All Milks. Sundays. Week days. Ry. Stations. All Milks. Sundays. Week. days. Ry. Stations. All Milks. 1898 193 230 120 543 165 207 120 492 28 23 .. 51 15.0 10.0 .. 9.4 1899 181 231 120 532 154 204 119 477 27 27 1 55 14.9 11.2 0.8 10.3 1900 196 224 121 541 170 194 121 485 26 30 .. 56 13.3 13.4 .. 10.3 1901 196 295 141 632 172 247 137 556 24 48 4 76 12.3 16.3 2.8 12 0 1902 192 274 90 556 172 238 88 498 20 36 2 58 10 4 13.1 2 2 10 4 1903 167 218 120 505 147 190 118 455 20 28 2 50 11.9 12.8 1 7 9.9 1904 164 317 120 601 158 276 120 554 6 41 .. 47 3.6 12.9 .. 7.8 1905 161 323 112 596 151 294 106 551 10 29 6 45 6.2 9 0 5.3 7.5 1906 195 332 110 637 173 281 108 562 22 51 2 75 11.3 15 4 1.8 11.8 1907 150 327 120 597 137 300 120 557 13 27 .. 40 8.7 8.2 .. 6.7 1908 160 324 120 604 145 289 118 552 15 35 2 52 9.4 10.8 1.6 8.6 Totals 1,955 3,095 1,294 6,344 1,744 2,720 1,275 5,739 211 375 19 605 10.8 12.1 1.5 9.5 [1908 276 1908] BUTTER AND MARGARINE. 199 samples of butter were submitted to the Public Analyst, of which 19, or 9.5 per cent., were returned as adulterated, as compared with 6.2 per cent. in 1907, and 5.5 in 1906. Of margarine, 42 samples were purchased, 15, or 35.7 per cent. of which were sold contrary to the provisions of the Margarine Act, as contrasted with 15.4 per cent in 1906, and 13.3 in 1907. It is exceedingly difficult to detect persons who sell margarine as butter, for, as pointed out in previous reports, the offenders are very careful not to substitute margarine until they have made sure that the purchasers are regular customers. It will be seen, therefore, that it entails many purchases by the Inspector or his agent before it is at all likely that he will be handed margarine for the butter he demanded. There is, however, an exception to this rule, and that is if, instead of an adult, a child is sent to make the purchase, when it is almost certain that, if the people are dealing fradulently in margarine, they will palm off that article on him for butter, probably assuming that a child would not be brought to the Police Court to give evidence. In the first six months of last year 98 samples of butter were purchased, of which 5, or 51 per cent., were margarine, while in the second six months, during which Inspector Burrell purchased the samples, out of 101 butters, 14, or 13.9 per cent., were margarine. Again, in the first six months of the year, 7 out of 22 margarines, or 31.8 per cent., were sold contrary to the provisions of the Act, while in the second six months 12 out of 20, or 60.0 per cent., were sold in this manner. These figures clearly denote that very serious frauds are taking place in the butter and margarine trade, and indicate that the time has arrived when some very drastic measures must be taken by the legislature to put an end to them. The English Government have been very slow to adopt strong measures with respect to the substitution of margarine for butter. Nevertheless, it should in some way or other be earmarked so that it might be readily detected by analysts, or that the method which is almost universal in America should be introduced into England, namely, to sell it in its natural, uncoloured condition, so that the public may see what they are buying. This is the practice pursued in 29 of the United States, where also there are other drastic measures enforced. Thus in 6 States the use of margarine in public institutions is forbidden. In 1 State dealers must have a licence, and they must also keep a record of its sales, and also it must not bear the name of any dairy, cattle or words or symbols used in the butter trade. In 2 States it must not bear the words "dairy" or "cream" in connection with it. In another State it must be coloured pink. In 40 States it must be branded in a prescribed way. In 12 States dealers must display a prescribed placard. In 5 States the delivery waggons must be marked. In 10 States the dealers must verbally inform the 277 [1908 purchaser of the nature of the article they have sold. In 11 States the purchaser must be furnished with a prescribed printed notice. In 17 States the proprietors of hotels in which it is used must display a prescribed poster. In 10 States the proprietors of hotels using it must inform their guests of the fact. In 2 States the proprietors must mark the dish in a prescribed manner. In 4 States bakers who use it must display a prescribed placard. And finally, in I State food containing margarine must be labelled in a prescribed manner. It will thus be seen that very strong measures are adopted in the United States to prevent fraudulent dealing in this article. There is no objection to margarine as an article of food, indeed, it is a good food, but clearly when a substance which can be purchased in the ordinary way from 4d. to 8d. per pound is sold to a customer at 1s. and 1s. 2d. per pound, the legislature should do something to protect the purchaser. There is at present a Bill before Parliament dealing with this matter, but as it is a private measure, it is possible that it may not pass; but whether it does or not, the time cannot be far distant when the Government will be compelled in the interests of honest trading to pass a measure containing more stringent powers than the law at present provides. The earmarking or denaturation of margarine, that is to say, the addition of some substance which can be easily detected by analysts to enable them to tell with certainty the amount of it which has been mixed as an adulterant with butter is ordained in several foreign countries. This is of course all to the good, but does not enablethe public to know at sight when margarine is substituted for butter, a practice which is now much more common than formerly. This change has arisen partly because butter and margarine factories are now, under the provisions of the Butter and Margarine Act of 1907, registered and are open to official inspection, and therefore the fraudulent addition of margarine to butter to any large extent is difficult; and chiefly because the substitution of other fats, even more difficult to detect, has superseded its use. An objection, which is not, however, a strong one, to the practice of earmarking is made by some persons on the ground that it is wrong in principle to adulterate a pure article by the addition of another substance, even though it is absolutely harmless, and also that if one trade requires protection in this way others will demand it also. People, however, who argue in this way forget that it is not the trades which require protection so much as the public, who are getting more and more, and in several directions, notably in that of jams, into the hands of the manufacturers, who, having succeeded in passing off their fraudulent goods on an unsuspecting public for a number of years, successfully plead "the custom of the trade" when they are at last brought to book by the Sanitary Authorities for adulteration. In seven countries the denaturation of margarine is compulsory, namely, in Germany, since 1897; in Belgium, since 1900; in Austria and Hungary, 278 1908] since 1901; in Denmark, Sweden and Victoria since 1905. Sesame oil is the earmark required in each country, except Hungary, where dimethylaminoazobenzene is prescribed. In Belgium starch must also be used in addition to the sesame oil, and not only must the margarine be earmarked in Denmark, but it must not be coloured, as already mentioned. The Medical Officer of Health is under the impression that it is also earmarked in France. In several countries also margarine must be kept in vessels or sold in boxes or vessels of a particular shape, as for instance, in Sweden, under the law which came into force on May 1st, 1906, where persons who manufacture or trade in margarine must keep it in vessels which are either quadrangular, or of such an oval form that the length is at least half as much again as the breadth. The vessels must also be branded with the words "Margarine" or "Artificial Fats." In several countries, too, the importation of margarine, whether earmarked or not, is either forbidden or only permitted entry under severe regulations. The addition of Margarine to butter is prohibited in Austria and Germany, and it is restricted in Belgium, Denmark and France. This is also the case in the United Kingdom where, as shown by the above facts (which, so far as the European states are concerned, are mainly culled from publications of the Board of Agriculture and Fisheries, and, so far as America is concerned, from official publications of the United States Government) the consumers of butter are least protected against the fraudulent sale of margarine. The recommendation that margarine should be sold in its uncoloured state was made so long ago as July, 1896, by the Select Committee of the House of Commons who inquired into this question and reported as follows: "While your Committee are reluctant to interfere with any edible commodity, they cannot, in the interests of honest trading, arrive at any conclusion other than to recommend the absolute prohibition of the artificial colouring of margarine to resemble or imitate butter." Unfortunately, this recommendation has not been adopted by any government since then, and so the fraud of substituting margarine for butter has gone on practically unchecked, and the practice is therefore as bad, or even worse, to-day than it was in 1896, when the Select Committee made their recommendations. Much more attention is, however, now paid to food products by the Local Government Board, who have instituted a sub-department to deal with them, and therefore, there is some hope that, at a not very distant date, steps will be taken to ensure the legitimate sale of margarine. The Local Government Board could hardly do better than adopt the above mentioned private Bill, making such amendments in it as they think desirable, in the interests of honest traders, if it should require any in this direction. 279 [1908 Groceries.— 173 samples were submitted to the Public Analyst, of which 36, or 20.8 per cent., were adulterated. The detection of this large amount of adulteration was due chiefly to the methods of the Inspector with respect to the purchase of samples of coffee and demerara sugar, of which the percentage of articles returned as adulterated were respectively 59.2 and 33.3 per cent. The coffee was adulterated with chicory, while that description of beetroot sugar known in the trade as yellow crystals was substituted for the West Indian product. The following are the particulars of the samples analysed:— No. of Samples. No. Adulterated. Percentage Adulterated. Percentage Adulterated in 1907. Coffee 27 16 59.2 4.3 Cocoa 15 1 6.6 — Demerara Sugar 18 6 33.3 — Pepper (White) 6 — — — Mustard 6 — — — Arrowroot 6 — - — Ginger (Ground) 6 — — — Olive Oil 12 5 41.6 — Bread 3 — - — Malt Vinegar 14 4 28.6 — Yeast 6 — — — Dripping 6 — — — Cornflour 6 — — — Jams 18 1 5.5 — Extract of Meat Tablets — — — 50.0 Preserved Spinach 2 2 100.0 — Preserved Peas 2 1 50.0 — Preserved French Beans 2 — — — Ground Mace 3 — — — Ground Cinnamon 3 — — — Ground Allspice 2 — — — Lemon Squash 6 — — — Lobster, Potted 4 - — — 173 36 20.8 2.3 Alcoholic Drinks.—The number of samples submitted to the Public Analyst was 36, of which 3, or 8-3 per cent., were adulterated. 280 1908] These samples were only examined for alcoholic strength. No. of Samples. No. Adulterated. Percentage Adulterated. Whiskey (Scotch) 10 1 10.0 Whiskey (Irish) 10 2 20.0 Rum 8 — — Gin 8 — — Total 36 3 8.3 Drugs.— 91 samples of drugs were examined, of which 17, or 18.7 per cent. were adulterated. In the case of 7 pepsins returned as not up to the standard, summonses were issued, but after consultation with the Public Analyst, the Public Health Committee decided, owing to the unsatisfactory character of the test in the British Pharmacopoeia, to withdraw them, and to direct the attention of the Medical Council to the matter with a request that better and more reliable tests should be substituted for that at present laid down in the Pharmacopoeia. The following is a return of the drugs examined:— Samples. Number adulterated. Percentage adulterated. Percentage adulterated 1907. Tincture of Quinine 4 — — — Ammoniated Tincture of Quinine 10 1 10.0 - Iodine Ointment 2 — — — Liniment of Oidine 2 — — — Liquor Iodi Fort. 2 — — — Tincture of Iodine 1 — — — Iron Pills 7 2 28.6 — Pepsin 7 6 85.7 — Sweet Spirits of Nitre 7 — — — Cream of Tartar 7 1 14.3 — Compound Tincture of Camphor 7 1 14.3 - Prescriptions 7 2 28.6 — Lime Water 14 1 7.1 16.7 Hydrargyrum cum Creta- 7 — — — Fluid Magnesia 7 3 42.8 — Oil of Juniper — — — 100.0 Ground Gentian Root — — — 100.0 Tartaric Acid — — — 100.0 91 17 18.7 14.7 281 [1908 INSPECTOR BURRELL'S REPORT. Public Health Department, Town Hall, Islington, N. 7th April, 1909. To the Medical Officer of Health. Dear Sir,—In compliance with your instructions, I have pleasure in submitting for your consideration the following brief report an summary of the work carried out by me during the latter part of the year 1908. 340 samples in all were qualitatively examined, of which number 245 seemed to be genuine, while 28 were protected by a declaration on the wrapper, and 47 appeared to be adulterated. Of the latter, 36 duplicate samples were purchased, and submitted to the Public Anallyst in the usual wav. when he reported against 33 for prosecution. In the case of 11 samples, the purchase was not proceeded with because the vendors made a declaration as to the exact nature of the article, although when purchases were made on previous occasions, no similar announcements were forthcoming. Legal proceedings followed, and were successful in every instance, the total amount of fines and costs being £71 6s. 9d. COFFEE. Apparently No. No. of samples No. declared by adulterated and of samples apparently printed wrapper sold as Coffee examined. genuine. or verbally. in plain wrapper. 3rd Quarter 57 36 11 10 4th Quarter 36 10 18 8 Total 93 46 29 18 Percentage of adulteration, 19 35. BUTTER. No. No. of samples No. sold No. apparently of samples apparently in Margarine adulterated examined. genuine wrapper. (Margarine). 3rd Quarter 4 — - 4 4th Quarter 88 69 4 15 Total 92 69 4 19 Percentage of adulteration, 20.65. SUGAR. No. No. of samples No. declared by No. apparently of samples apparently wrapper adulterated examined. genuine. or verbally. (dyed Sugar). 4th Quarter 25 14 5 6 Percentage of adulteration, 24. MILKS. No. No. of samples No. of of samples a parently samples apparently examined. genuine. adulterated. 2nd Quarter 112 108 4* 4th Quarter 18 18 — Total 130 126 4 Percentage of adulteration, 3. "The above figures do not include as adulterated those milks which were below the standard to 1 or 2 per cent. of adulteration, but only those of a standard low enough for prosecution. I am, Your obedient servant, T. L. BURRELL. T 282 1908] Table CXXXII. Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1908. Description. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Genuine. Adulterated. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Milk 153 149 150 152 604 144 135 128 145 552 9 14 22 7 52 Butter 48 50 50 51 199 46 47 48 39 180 2 3 2 12 19 Cheese 10 10 10 10 40 10 10 10 10 40 .. .. .. .. .. Dripping .. 6 .. .. 6 .. 6 .. .. 6 .. .. .. .. .. Lard 5 5 5 .. 15 5 5 5 .. 15 .. .. .. .. .. Coffee .. 6 9 6 21 .. 3 1 1 5 .. 3 8 5 16 Cocoa 6 3 .. 6 15 6 3 .. 5 14 .. .. .. 1 1 Pea Flour 6 .. .. .. 6 6 .. .. .. 6 .. .. .. .. .. Bread 3 .. .. .. 3 3 .. .. .. 3 .. .. .. .. .. White Pepper 6 .. .. .. 6 6 .. .. .. 6 .. .. .. .. .. Mustard 6 .. .. .. 6 6 .. . .. 6 .. .. .. .. .. Ground Ginger .. .. 6 .. 6 .. .. 6 .. 6 .. .. .. .. .. Preserved Peas 2 .. .. .. 2 1 .. .. .. 1 1 .. .. .. 1 Preserved Spinach 2 .. .. .. 2 .. .. .. .. .. 2 .. .. .. 2 Demerara Sugar 6 .. 6 6 18 6 .. 4 2 12 .. .. 2 4 6 French Beans 2 .. .. .. 2 2 .. .. .. 2 .. .. .. .. .. Plum Jam 3 .. .. .. 3 3 .. .. .. 3 .. .. .. .. .. Black Currant Jam 1 .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. Strawberry Jam 1 .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. Raspberry Jam 1 .. .. .. 1 1 .. .. .. 1 .. .. .. .. .. Jams .. .. 6 6 12 .. .. 6 5 11 .. .. .. 1 1 Ground Mace .. 3 .. .. 3 .. 3 .. .. 3 .. .. .. .. .. Ground Cinnamon .. 3 .. .. 3 .. 3 .. .. 3 .. .. .. .. .. Lobster .. 4 .. .. 4 .. 4 .. .. 4 .. .. .. .. .. Arrowroot (St. Vincent) .. 6 .. .. 6 .. 6 .. .. 6 .. .. .. .. .. Vinegar (Malt) .. 6 .. 8 14 .. 3 .. 7 10 .. 3 .. 1 .. Lemon Squash .. 6 .. .. 6 .. 6 .. .. 6 .. .. .. .. .. Ground Allspice .. .. 2 .. 2 .. .. 2 .. 2 .. .. • • .. .. Olive Oil .. .. 6 6 12 .. .. 3 4 7 .. .. 3 2 5 Cornflour .. .. 6 .. 6 .. .. 6 .. 6 .. .. .. .. .. Yeast .. .. 6 .. 6 .. .. 6 .. 6 .. .. .. .. .. Irish Whiskey 2 2 2 4 10 1 2 2 3 8 1 .. .. 1 2 283 [1908 T 2 Table CXXXII.—continued. Description. 1st Quarter. 2nd Quarter. 3rd Quarter. 4tb Quarter. Totals. Genuine. Adulterated. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. Scotch Whiskey 2 2 2 4 10 2 2 2 3 9 • • • • • • 1 1 Rum 2 2 2 2 8 2 2 2 2 8 • • • • • • • • • • Gin 2 2 2 2 8 2 2 2 2 8 • • • • .. • • • • Lime Water • • 7 7 • • 14 • • 7 6 • • 13 • • • • 1 • • 1 Tincture of Quinine 4 • • • • • • 4 4 • • • • • • 4 • • • • • • • • • • Ammoniated Tincture of Quinine 3 • • • • 7 10 3 • • • • 6 9 • • • • • • 1 1 Iodine Ointment 2 • • • • • • 2 2 • • • • • • 2 • • • • • • • • • • Liniment of Iodine 2 • • • • • • 2 2 • • • • • • 2 • • • • • • • • • • Liquor Iodi Fort 2 • • • • • • 2 2 • • • • • • 2 • • • • • • • • • • Tincture of Iodine 1 • • • • • • 1 1 • • • • • • 1 • • • • • • • • • • Iron Pills 7 • • • • • • 7 5 • • • • • • 5 2 • • • • • • 2 Hydrargyrum cum Creta • • 7 • • • • 7 • • 7 • • • • 7 • • • • • • • • • • Fluid Magnesia • • 7 • • • • 7 • • 4 • • • • 4 • • 3 • • • • 3 Compound Tincture of Camphor • • • • 7 • • 7 • • • • 6 • • 6 • • • • 1 • • 1 Prescriptions • • • • 7 • • 7 • • • • 5 • • 5 • • • • 2 • • 2 Pepsin • • • • • • 7 7 • • • • • • 1 1 • • • • • • 6 6 Sweet Spirits of Nitre • • • • • • 7 7 • • • • • • 7 7 • • • • • • • • • • Cream of Tartar • • • • • • 7 7 • • • • •• 6 6 • • • • • • l 1 290 266 291 291 1,158 273 260 250 248 1,031 17 26 41 43 127 MARGARINE ACT. Margarine 12 10 10 10 42 7 8 7 5 27 5 2 3 5 15 284 1908] Public Analyst's Returns, during the Quarters of the Year 1908. ADULTERATED SAMPLES.—First Quarter, 1908. Sample Numbered Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if adulterated, what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. Observations. 130 A. Milk ‡ Inspector 14 per cent. of added water 136 A. Butter do. 90 per cent. of Margarine 139 A. Margarine do. 100 per cent. of Margarine 160 H.C. Milk ‡ do. 8 per cent. of added water 166 H.C. Margarine do. 100 per cent. of Margarine 44 B. Milk ‡ do. 40 per cent. of added water 47 B. „ ‡ do. 13 per cent. of original fat abstracted 52 B. Margarine do. 100 per cent. of Margarine .. 47 W.H.F. Butter do. 70 per cent. of Margarine 131 C.E.H. Milk ‡ do. 12 per cent. of original fat abstracted 135 C.E.H. Preserved Spinach do. 0.03 per cent. of copper 112 M. Preserved Peas do. 0.0035 per cent. of copper 141 I. Milk ‡ do. 1 per cent. of added water and 3 per cent. of original fat abstracted 147 I. „ † do. 12 per cent. of added water 151 I. „† do. 3 per cent. of original fat abstracted 680 W.N. Margarine do. 13 per cent. of butter fat, in the fat 684 W.N. Spinach do. 0.014 per cent. of copper 179 H.C. Irish Whiskey do. 29.4 degrees under proof 188 H.C. Iron Pill do. 32.3 per cent. of Ferrous Carbonate 150 A. B. „ do. 32.0 per cent. of Ferrous Carbonate 204 T.L.B. Margarine do. 100 per cent. of Margarine 74 B. Milk‡ do. 6 per cent. of added water † Traces of Boric Acid and Formalin present. ‡ Boric Acid and Formalin absent. Number of Samples analysed in the Quarter, 302. 285 [1908 ADULTERATED SAMPLES.—Second Quarter, 1908. Sample Numbered Article submitted † or Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if adulterated, what were the nature and extent of the Adulteration. The sum paid in repect of the Analysis. Observations. 184 T.L.B. Milk † Inspector 13 per cent. of original fat abstracted 186 T.L.B. do. † do. 9 per cent. of added water 188 T.L.B. do. † do. 9 per cent. of original fat abstracted 197 T.L.B. Butter do. 55 per cent. of Margarine 226 T.L.B. Milk † do. 10 per cent. of added water 234 T.L.B. Margarine do. 100 per cent. of Margarine 236 T.L.B Milk † do. 6 per cent. of added water 246 T.L.B. Margarine do. 100 per cent. of Margarine 247 T.L.B. Fluid Magnesia do. 63 per cent. of Magnesia deficient 254 T.L.B. do. do. 75 per cent. of Magnesia deficient 620 C/K Butter do. 95 per cent. of Margarine 293 T.L.B. Fluid Magnesia do. 80 per cent. of Magnesia deficient 324 T.L.B. Butter do. 50 per cent. of Margarine 347 T.L.B. Milk † do. 3 per cent. of added water 367 T.L.B. do. † do. 9 per cent. of original fat abstracted 374 T.L.B. Coffee do. 70 per cent. of Chicory 377 T.L.B. do do. 98 per cent. of Chicory 378 T.L.B. do do. 60 per cent. of Chicory 387 T.L.B. Milk † do. 18 per cent. of original fat abstracted 389 T.L.B. Malt Vinegar do. Vinegar other than Malt 390 T.L.B. do. do. Vinegar other than Malt 391 T.L.B. do. do. Vinegar other than Malt 390 T.L.B. Milk † do. 16 per cent. of original fat abstracted 391 T.L.B. do. † do. 36 per cent. original fat abstracted 432 T.L.B. do. † do. 4 per cent. of added water 434 T.L.B. do. † do. 12 per cent. of original fat abstracted 444 T.L.B. do. † do. 11 per cent. of original fat abstracted 449 T.L.B. do.‡ do. 11 per cent. of original fat abstracted † Boric Acid and Formalin absent. Total Number of Samples analysed in the Quarter, 296. 286 1908] ADULTERATED SAMPLES.—Third Quarter, 1908. Sample Numbered Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a local Authority, under Section 13 of Act, and if so, the name of such Authority. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. Observations. 465 T.L.B. Milk * Inspector 10 per cent. of added water 471 T.L.B. do.* do. 8 per cent. of original fat abstracted 491 T.L.B. do.* do. 5 per cent of original fat abstracted 494 T.L.B. do.* do. 4 per cent. added water and 39 per cent. of original fat abstracted .. 495 T.L B. do.* do. 14 per cent. of added water and 7 per cent. of original fat abstracted 499 T.L.B. do. * do. 11 per cent. of added water 510 T.L.B. do.* do. 7 per cent. of added water and 8 per cent. of original fat abstracted 514 T.L.B. do. * do. 17 per cent. of added water 516 T.L.B. do. * do. 12 per cent. of added water 517 T.L.B. do. * do. 4 per cent. of added water 518 T.L.B. do. * do. 8 per cent. of added water 519 T.L.B. do.* do. 7 per cent. of added water and 8 per cent. of original fat abstracted 525 T.L B. do.* do. 14 per cent. of original fat abstracted 531 T.L.B. do. * do. 47 per cent. of original fat abstracted 537 T.L.B. Limewater do. 50 per cent. deficiency in Lime 560 T.L.B. Coffee do. 31 per cent. of Chicory 561 T.L.B. do. do. 70 per cent. of Chicory 563 T.L.B. Milk * do. 14 per cent. of original fat abstracted 605 T.L.B Butter do. 22.6 per cent. of water 618 T.L.B. Milk * do. 10 per cent. of added water 619 T.L.B. do.* do. 8 per cent. of added water 622 T.L.B. do.* do. 7 per cent. of added water 631 T.L.B. do.* do. 18 per cent. of added water 643 T L B. Prescription do. Slight deficiency in Mercuric Chloride * Boric Acid and Formalin absent. 287 [1908 ADULTERATED SAMPLES {Third Quarter, 1908)—continued. Sample Numbered Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so, the name of such Authority. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. Observations. 644 T.L B. Prescription Inspector 48 per cent. deficiency in Iron 640 T.L.B. Margarine do. 100 per cent. Margarine 642 T.L.B „ do. 100 per cent . Margarine 669 T.L.B. „ do. 100 per cent. Margarine 670 T.L.B Butter do. 100 per cent . Margarine 684 T.L.B. Coffee do. 76 per cent. of Chicory 686 T.L.B Milk * do. 4 per cent. added water 690 T.L.B „* do. 4 per cent. added water 696 T.L.B. olive Oil do. 100 per cent. of Mineral Oil 697 T.L.B. „ do. 100 per cent. of Cotton Seed Oil 698 T.L.B. „ do. At least 70 per cent. of Arachis Oil 716 T.L.B. Demerara Sugar do. Dyed Sugar other than Demerara 717 T.L.B. „ do. Dyed Sugar other than Demerara 733 T.L. B. Tincture Camphor Co. do. Benzoic Acid in slight excess 748 T.L.B. Coffee do. 62 per cent. of Chicory 749 T.L.B. „ do. 44 per cent. of Chicory 750 T.L.B. Milk do. 10 per cent added water 755 T.L.B. Coffee do. 50 per cent. of Chicory 756 T.L.B. „ do. 43 per cent. of Chicory 757 T.L B. „ do. 58 per cent. of Chicory * Boric acid and Formalin absent. Number of Samples analysed in the Quarter, 301. 288 1908] ADULTERATED SAMPLES (Fourth Quarter, 1908). Sample Numbered. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act. and if so, the name of such Authority. Result of Analysis. Shewing whether the sample was Genuine or Adulterated, and, if adulterated, what were the nature and extent of the Adulteration. The sum paid in respect of the Analyses. Observations. 778 T.L.B. Milk* Inspector 4 per cent. of added water 802 T.L.B. Pepsin „ 40 per cent. deficient in strength 803 T L B. Butter „ 100 per cent. of Margarine 805 T.L.B. Olive Oil „ 100 per cent. of Cottonseed Oil 807 T.L.B. „ „ At least 75 per cent. of Arachis Oil 811 T.L.B. Cocoa „ 49 per cent. of added sugar and 15 per cent. of added starch 815 T.L.B. Demerara Sugar „ Dyed sugar other than Demerara 816 T.L.B. „ „ „ „ „ „ 821 T.L.B. Butter „ 100 per cent. of Margarine 822 T.L.B. „ „ „ „ 823 T.L.B. „ „ „ „ 824 T.L.B. „ „ „ „ 825 T.L.B. „ * „ „ „ 831 T.L.B. Milk * „ 4 per cent. of added water 832 T.L.B. „* „ „ „ 836 T.L.B. Demerara Sugar „ Dyed sugar other than Demerara 837 T.L.B. Butter „ 100 per cent. of Margarine 845 T.L.B. Ammoniated Tincture of Quinine „ 34 per cent. of the Ammonia deficient 846 T.L.B. Pepsin „ 75 per cent. deficient in strength 847 T.L.B. „ „ 25 per cent. deficient in strength 848 T.L.B. „ „ 75 per cent. deficient in strength 866 T.L.B. Milk* „ 4 per cent. of the original fat abstracted 873 T.L.B. Pepsin „ 79 per cent. deficient in strength 885 T.L.B. Irish Whiskey „ 27.0 degrees under proof 886 T.L.B. Pepsin „ 50 per cent. deficient in strength 917 T.L.B. Margarine „ 100 per cent. of Margarine *Boric Acid and Formalin absent. 289 [1908 ADULTERATED SAMPLES (Fourth Quarter, 1908)—continued. Sample Numbered. Article submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under direction of a Local Authority, under Section 13 of Act, and if so. the name of such Authority. Result of Analysis. Shewing whether the sample was Genuine or Adulterated, and, if Adulterated, wheat were the nature and extent of the Adulteration. The sum paid in respect of the Analyses. Observations. 918 T.L.B. Margarine Inspector 100 per cent. of Margarine 919 T L B. „ „ „ „ „ 924 T.L.B. Milk * „ 19 per cent. of added water 928 T.L.B Scotch Whiskey „ 26.3 degrees under proof 937 T.L.B. Margarine „ 100 per cent. Margarine 941 T.L.B. Milk* „ 4 per cent. of added water 962 T.L.B. Demerara Sugar „ Dyed Sugar other than Demerara 965 T.L.B. Crearn of Tartar „ 0 0175 per cent. of Lead in combination 969 T.L B. Milk * „ 10 per cent. of original fat abstracted 976 T.L.B. Malt Vinegar „ Vinegar other than Malt Vinegar 997 T.L.B. Coffee „ 38 per cent. of Chicory 1016 T.L.B. Butter „ 100 per cent. of Margarine 1029 T.L.B. „ „ 90 per cent. of Margarine 1036 T.L.B Margarine „ 100 per cent. of Margarine 1043 T.L.B. Coffee „ 42 per cent. of Chicory 1044 T.L.B „ „ 75 per cent. of Chicory 1045 T.L.B. „ „ 41 per cent. of Chicory 1046 T.L.B. „ „ 48 per cent. of Chicory 1047 T.L.B. Black Currant Jam „ Raspberry structure present in small amount. 1059 T.L.B. Butter „ 90 per cent. of Margarine 1060 T.L.B. „ „ 90 per cent. of Margarine 1061 T.L.B. „ „ 100 per cent. of Margarine * Boric Acid and Formalin absent. Number of Samples analysed in the Quarter 301. 290 1908] Table CXXXIII. SUMMARY OF PROSECUTIONS.—During year 1908. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties Received. £ s. d. ”Public Health (London) Act, 1891” 55 50 3 2 120 2 6 ” Sale of Food and Drugs Acts, 1875-99 ” 79 73 3 3 234 11 6 ” Margarine Act, 1887 ” 9 8 ... 1 10 19 6 ” Dairies, Cowsheds and Milkshops Order, 1885” 1 1 ... ... 2 12 0 ” Metropolis Local Management Act ” 1 1 ... ... 1 8 0 ” London County Council General Powers Act ” ... ... ... ... ... Total 145 133 6 6 369 13 6 291 [1908 WATER SUPPLY. The following are the particulars as to the water supply of the district receiving water from the New River, as abstracted from the last return of the Metropolitan Water Board. They are a continuation of those which have been given for some years past:— 1900-7 1907-8. Houses Supplied 210,428 212,592 Houses on constant system 198,017 212,524 Houses not on constant system 12,411 68 Percentage of houses on constant system 94.1 99.9 Population supplied 1,379,198 1,393,668 Average daily supply (gallons) 43,472,306 42,509,789 Daily supply—Domestic purposes (gals.) 34,777,845 34,007,831 „ „ -Other purposes (gals.) 8,694,461 8,501,958 Quantity of water supplied during the year (gals.)15,867,392,000 15,558,582,823 Average daily supply per house (gals.) 207.78 200.66 „ „ „ head (gals.) 31.52 30.50 Average daily supply per house for domestic purposes only (gals.) 165.26 160.86 Average daily supply per head (gals.) 25.22 24.40 Average number of persons supplied per house 6.55 6.58 Capacity of subsidence reservoirs 168,100,000 168,100,000 No. of days supply 3.87 3.95 APPENDIX. o VITAL AND SANITARY STATISTICS, 19 08, together with Abstracts for Ten Years, 1898-07. 294 1908] Table A. Showing the Deaths from All Causes in Islington during the Year 1908. Deaths of Non-Residents in Hospitals excluded. Deaths of Residents in Public Institutions are distributed. institutions within Borough. diseases. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. b. S.E. Small Pox (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b)Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Measles 24 50 2 2 .. .. .. .. .. .. .. .. .. 74 4 4 .. 4 14 7 36 13 40 38 78 1 Scarlet Fever 3 15 8 1 1 1 1 .. .. .. .. .. .. 18 12 4 1 2 3 4 9 7 18 12 30 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Epidemic Influenza 2 1 .. .. 2 3 3 8 14 16 14 14 4 3 78 11 16 7 8 15 10 14 35 46 8 12 Whooping Cough 29 25 1 .. .. .. .. .. .. .. .. .. .. 54 1 2 6 9 5 9 9 15 29 26 55 3 Diphtheria 4 26 25 5 .. .. .. .. .. .. .. .. .. 30 30 2 9 2 10 7 11 19 28 32 60 2 Enteric Fever .. .. .. 2 3 2 3 5 3 .. .. .. .. .. 18 .. .. 1 6 3 5 5 9 9 18 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 13 Diarrhœa, Dysentery 56 20 1 .. .. .. .. 1 2 3 2 3 .. 76 12 7 8 5 13 12 24 19 47 41 88 4 Epidemic Enteritis 24 3 1 .. .. .. .. .. .. 1 .. .. .. 27 2 .. 1 2 10 5 5 6 17 12 29 Other Allied Diseases *4 .. .. .. .. .. .. .. .. .. .. .. .. 4 .. .. .. .. 1 1 1 1 2 2 4 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. 1 .. 1 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Syphilis 13 1 .. .. .. .. 1 .. .. .. .. .. 14 1 .. .. 4 1 1 7 2 8 7 15 1 Gonorrhœ .. .. .. .. .. .. .. .. 1 3 1 .. .. .. 5 1 .. 1 .. 1 .. 2 5 .. 5 Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7 Erysipelas 4 .. .. .. .. .. .. 2 3 2 .. 3 .. 4 10 .. .. 3 2 3 3 3 6 8 14 2 Puerperal Fever .. .. .. .. .. 2 1 1 .. .. .. .. .. .. 4 1 .. 1 2 .. .. .. .. 1 4 3 Pyæmia 4 1 .. .. 1 1 1 .. 2 1 .. .. .. 5 6 1 .. 1 1 1 2 5 6 5 11 1 Infective Endocarditis .. .. .. .. .. 1 1 2 .. 1 .. .. .. .. 5 2 .. .. .. 2 .. 1 4 l 5 2 Other Allied Diseases 1 .. .. .. .. 1 .. 1 2 1 3 1 .. 1 9 .. 1 .. 1 6 1 1 4 6 10 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Rheumatic Fever .. .. .. 4 .. 1 .. 3 .. .. 1 .. .. .. 9 .. .. .. 3 1 2 3 4 5 9 Rheumatism of Heart .. .. .. 1 1 .. .. .. .. .. .. .. .. .. 2 1 .. .. 1 .. .. 2 .. 2 7 Tuberculosis of Brain 13 39 6 1 .. 1 3 .. .. .. .. .. .. 52 11 9 11 3 13 7 8 12 31 32 63 2 Tuberculosis of Larynx .. .. .. .. .. .. 2 2 .. .. .. .. .. .. 4 .. .. .. 3 1 .. .. 3 1 4 126 Phthisis 5 12 2 13 16 39 95 105 74 47 17 7 .. 17 115 31 45 54 52 72 78 120 248 184 132 4 Abdominal Tuberculosis 14 14 3 4 .. 2 3 2 1 1 1 .. .. 28 17 5 2 3 9 10 8 8 27 18 45 11 General Tuberculosis 8 19 1 1 1 1 4 1 1 .. .. .. 27 13 1 3 3 6 11 8 8 21 19 40 6 Other forms Tuberculosis .. 2 2 2 2 .. 2 3 2 1 4 .. .. 2 18 2 3 3 1 1 5 5 14 6 20 Other Infectiver Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 1 Actinomycosis .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 1 1 .. .. .. .. .. 1 1 2 Hydatid Diseases .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 1 Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. 1 .. .. 1 .. .. 2 .. .. .. .. .. 4 .. .. .. .. 2 .. 2 2 2 4 1 Acture Alcoholism .. .. .. .. .. .. .. 2 1 .. .. .. .. .. 3 1 .. .. .. 1 1 .. 3 .. 3 2 Chronic Alcoholism .. .. .. .. .. .. 2 5 4 2 1 .. .. .. 14 2 1 .. 1 .. 4 6 5 9 14 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Osteo-arthritis .. 1 .. .. .. .. .. .. 1 1 3 5 1 1 11 3 .. 2 1 4 1 1 4 8 12 Gout .. .. .. .. .. .. .. .. .. 4 2 1 .. .. 7 1 .. .. 3 1 1 1 5 2 7 97 Cancer .. 1 .. 2 2 6 6 41 63 112 93 39 2 1 366 33 45 36 40 69 51 93 157 210 367 2 Diabetes Mellitus .. .. .. .. .. .. 1 2 4 7 5 1 1 .. 21 4 2 .. 2 7 4 2 10 11 21 Purpura Hæmorrhagica .. .. .. 1 .. .. .. 1 .. 1 .. .. .. .. 3 .. .. .. .. 2 1 .. 2 1 3 Hæmophilia 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 1 1 Anæmia 2 2 .. 1 1 .. 2 1 1 2 2 .. .. 4 10 2 .. 1 1 5 3 2 8 6 14 Lymphadenoma. .. .. .. .. .. 2 .. .. 1 .. .. .. .. .. 3 .. .. .. 1 1 .. 1 3 .. 3 Premature Birth 167 .. .. .. .. .. .. .. .. .. .. .. .. 167 .. 15 13 9 27 34 32 37 100 67 167 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Debility at Birth 26 .. .. .... .. .. .. .. .. .. .. .. .. 26 .. 1 .. 1 4 6 5 9 14 12 26 Atelectasis 13 .. .. .. .. .. .. .. .. .. .. .. .. 13 .. 1 .. 2 2 3 1 4 10 3 13 Congenital Defects 38 .. .. .. .. .. .. .. .. .. .. .. .. 38 .. 1 1 3 10 5 10 8 18 20 38 1 Want of Breast Milk 4 .. .. .. .. .. .. .. .. .. .. .. .. 4 .. .. 1 .. 1 1 .. 1 3 1 4 1 Atrophy, Debility, Marasmus 112 7 .. .. .. .. .. .. .. .. .. .. .. 119 .. l6 20 14 13 15 22 19 80 39 119 * Cerebro-Spinal Meningitis. 295 [1908 296 1908] Table a.- -Continued. AGES. iri DISTRICTS. t/) CJ 05 within Boroug DISEASES. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- |7, ' 85- 0) 'O c D <u > O 3 H X 5 "o H a ; J I H. B. L CO 13 rt s 0 b rt O h 2 Other Diseases, Pregnancy and Childbirth Arthritis, Ostitis, Periostitis Other Diseases, Osseous System 1 *2 ? i 1 2 1 1 •• 2 1 1 2 2 1 3 2 5 2 7 1 l 1 2 1 *3 i 5 1 1 6 5 1 4 6 2 10 ? 1 2 1 1 i 1 2 3 Other Diseases, Integumentary System 1 1 1 i 2 1 1 1 1 2 3 Accidents and Negligence. 3 1 2 2 ?, 2 1 1 3 11 1 1 On Railways On Ships, Boats, etc. (not drowning) 1 1 '? 1 1 1 3 i 6 1 2 2 2 1 2 3 1 6 3 1 6 By Weapons and Implements .. 'A 11 1 3 1 1 2 14 8 1 1 1 8 Poisons, Poisonous Vapours Surgical Narcosis Drowning Suffocation, Overlaid in Bed 23 1 2 i 1 1 1 1 i 1 2 24 5 1 2 2 3 2 2 1 2 2 1 4 '5 3 11 2 2 ii 5 2 24 7 4 2 1 1 1 1 3 4 5 6 I 5 6 28 2 3 b 2 7 y 6 20 14 34 2 2 ? 1 ?, 1 3 4 4 1 2 4 3 1 1 i 4 4 3 7 Suicide. 2 3 4 3 2 1 15 3 2 2 2 6 13 2 15 2 By Hanging and Strangulation By Drowning By Shooting By Cut or Stab By Precipitation from Elevated Places By Crushing By other and unspecified Sudden Death, cause not ascer- Ill-defined and unspecified causes •• 1 1 1 1 1 1 1 i l l l b 2 1 1 1. I 1 b 6 3 2 5 1 2 1 1 1 1 "2 1 1 2 1 i 1 2 1 1 1 1 3 3 1 3 1 3 1 2 2 6 3 2 5 1 2 m 2?6 39 32 35 41 140 231 264 307 283 187 39 750 1598 188 241 199 318 389 460 553 2348 370 200 56 34 32 62 117 177 207 290 354 323 109 570 1761 237 244 197 253 427 425 548 2331 192 894 426 95 66 67 103 257 408 471 597 637 510 148 1320 3359 425 485 396 571 816 885 1101 2348 2331 4679 297 [1908 Table B. Showing the Deaths from All Causes registered during the Quarters of the Year 1908 at three periods of life. DISEASES. 1st Quarter. Total. 2nd Quarter Total. 3rd Quarter. Total. 4th Quarter. Total. Total for Year. Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Under 1 1 to 5 Over 5 Small Pox— (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 8 10 1 19 3 8 1 12 1 5 1 7 12 27 1 40 78 Scarlet Fever 2 5 4 11 .. 4 2 6 .. 4 2 6 1 2 4 7 30 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 1 .. 51 52 .. .. 20 20 1 .. 2 3 .. 1 5 6 81 Whooping Cough 4 6 1 11 9 6 .. 15 14 6 .. 20 2 7 .. 9 55 Diphtheria 1 5 10 16 1 8 2 11 .. 4 6 10 2 9 12 23 60 Enteric Fever .. .. 4 4 .. .. 3 3 .. .. 2 2 .. .. .. 9 18 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. Diarrhœa, Dysentery 8 1 1 10 .. .. 1 3 33 11 5 49 13 8 .. 26 88 Epidemic Enteritis 2 .. .. 2 .. .. .. .. 20 1 2 23 2 2 .. 4 29 Other Allied Diseases *1 .. .. 1 .. .. .. 1 .. .. .. .. 2 .. .. 2 4 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis 3 1 .. 4 1 .. 1 2 2 .. .. 2 7 .. .. 7 15 Gonorrhœa .. .. 3 3 .. .. 2 2 .. .. .. .. .. .. .. .. 5 Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. 2 2 3 .. 2 5 .. .. 1 1 1 .. 5 6 14 Puerperal .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. 2 2 4 Pyæmia .. .. 2 2 .. 1 2 3 1 .. 2 3 3 .. .. 3 11 Infective Endocarditis .. .. 1 1 .. .. 2 2 .. .. .. .. .. .. 2 2 5 Other Allied Diseases 1 .. 2 3 .. .. 1 1 .. .. 3 3 .. .. 3 3 10 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. 1 1 .. .. 4 4 .. .. 1 1 .. .. 3 3 9 Rheumatism of Heart .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 1 2 Tuberculosis of Brain 3 10 .. 13 3 9 5 17 5 9 2 16 2 11 4 17 63 Tuberculosis of Larynx .. .. 2 2 .. .. 1 1 .. .. 1 1 .. .. .. .. 4 Phthisis 1 5 106 112 1 2 87 90 2 1 101 104 1 4 121 126 432 Abdominal Tuberculosis 4 4 2 10 1 2 4 7 3 3 7 13 6 5 4 l5 45 General Tuberculosis .. 10 6 16 6 4 1 11 2 3 5 10 .. 2 1 3 40 Other Infective Diseases .. .. 5 5 .. l 4 5 .. .. 6 6 .. 1 3 4 20 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 Actinomycosis .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 2 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Scurvy Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. 1 1 .. .. 1 1 .. .. 1 1 .. .. 1 1 4 Acute Alcoholism .. .. .. .. .. .. 2 2 .. .. 1 1 .. .. .. .. 3 Chronic Alcoholism .. .. 2 2 .. .. 5 5 .. .. 4 4 .. .. 3 3 14 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Osteo-arthritis .. .. 4 4 .. .. .. .. .. .. 2 2 .. 1 5 6 12 Gout .. .. .. .. .. .. 3 3 .. .. .. .. .. .. 4 4 7 Cancer .. 1 79 80 .. .. 100 100 .. .. 86 86 .. .. 101 101 367 Diabetes Mellitus .. .. 8 8 .. .. 4 4 .. .. 4 4 .. .. 5 5 21 Purpura Hæmorrhagica .. .. 1 1 .. .. .. .. .. .. 1 1 .. .. 1 1 3 Hæmophilia .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 Anæmia 1 .. 2 3 .. 1 3 4 .. .. 2 2 1 1 3 5 14 Lymphadenoma .. .. 1 1 .. .. 2 2 .. .. .. .. .. .. .. .. 3 Premature Birth 42 .. .. 42 30 .. .. 30 29 .. .. 29 66 .. .. 66 167 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Debility at Birth 10 .. .. 10 3 .. .. 3 5 .. .. 5 8 .. .. 8 26 Atelectasis 5 .. .. 5 3 .. .. 3 3 .. .. 3 2 .. .. 2 13 Congenital Defects 15 .. .. 15 9 .. .. 9 4 .. .. 4 10 .. .. 10 38 Want of Breast Milk 2 .. .. 2 2 .. .. 2 .. .. .. .. .. .. .. .. 4 Atrophy, Debility, Marasmus 28 1 .. 29 24 1 .. 25 28 2 .. 30 32 3 .. 35 119 * Cerebro-Spinal Meningitis. u 298 1908] Table B.—Continued. DISEASES. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter Total for Year Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Dentition .. 3 .. 3 2 2 .. 4 .. .. .. .. 2 3 .. 5 12 Rickets 1 1 .. 3 1 1 .. 2 .. .. .. .. .. .. 1 1 5 Old Age, Senile Decay .. .. 53 52 .. .. 43 43 .. .. 35 35 .. .. 49 49 180 Convulsions 4 2 1 7 2 .. .. 2 4 2 .. 6 5 .. 1 6 21 Meningitis 3 1 .. 7 6 2 4 12 .. 1 1 .. 4 1 .. 5 26 Encephalitis .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Apoplexy .. .. 13 13 .. .. 7 7 .. .. 11 11 .. .. 10 10 41 Softening of Brain .. .. 8 8 .. .. 9 2 .. .. 5 5 .. .. 3 3 18 Hemiplegia .. .. 6 6 .. .. 11 11 .. .. 7 7 .. .. 4 4 28 General Paralysis of Insane .. .. 9 9 .. .. 6 6 .. .. 9 9 .. .. 5 5 29 Other forms of Insanity .. .. 7 7 .. .. 3 3 .. .. 2 2 .. .. 4 4 16 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebral Tumour .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. 1 1 3 Epilepsy .. .. 7 7 .. .. 3 3 .. .. 3 3 .. .. 5 5 18 Laryngismus Stridulus .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. Locomotor Ataxy .. .. 4 4 .. .. 1 1 .. .. 1 1 .. .. 1 1 7 Paraplegia 1 .. 8 9 .. 1 14 15 .. .. 9 9 .. .. 12 12 45 Other forms, Brain Diseases .. .. 3 3 .. .. 5 5 .. .. 6 6 1 .. 1 2 16 Otitis .. 1 3 4 .. 1 3 4 .. .. 1 1 .. .. 2 2 11 Disease of Nose, Epistaxis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Eye .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pericarditis .. .. 3 3 .. .. 1 1 .. .. .. .. .. .. .. .. 4 Endocarditis .. .. .. .. .. .. .. .. .. .. 3 3 .. .. 1 1 4 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Angina Pectoris .. .. 1 1 .. .. 1 1 .. .. 1 1 .. .. 1 1 4 Aneurism .. .. .. .. .. .. 3 3 .. .. 3 3 .. .. 6 6 12 Senile Gangrene .. .. 3 3 .. .. 2 2 .. .. 2 2 .. .. 3 3 10 Embolism, Thrombosis .. .. 7 7 .. .. 6 6 .. .. 3 3 .. .. 12 12 28 Phlebitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Varicose Veins .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. Other Diseases, Heart and Vessels 2 147 149 .. .. 116 116 .. 1 134 136 1 .. 155 156 557 Laryngitis .. 3 .. 3 .. 1 .. 1 .. .. .. .. .. .. .. .. 4 Croup .. 1 .. 1 .. .. .. .. .. 1 .. 1 .. .. .. .. 2 Other Diseases, Larynx and Trachea .. .. .. .. .. 1 1 2 .. .. .. .. .. .. .. .. 2 Acute Bronchitis 15 8 41 84 4 2 15 21 1 .. 8 9 19 3 16 38 132 Chronic Bronchitis .. .. 145 145 .. .. 55 55 .. .. 23 23 .. 1 74 75 298 Lobar Pneumonia .. .. 15 15 .. .. 7 7 .. 1 6 7 1 .. 9 10 39 Lobular Pneumonia 22 19 20 61 11 13 8 32 5 3 4 12 16 18 18 52 157 Pneumonia 17 17 53 87 11 5 42 58 9 1 19 29 14 5 37 56 230 Emphysema, Asthma .. 1 6 7 .. .. 7 7 .. .. 3 3 .. .. 2 2 19 Pleurisy 1 .. 7 8 .. .. 4 4 .. .. 4 4 .. 1 10 11 27 Other Diseases, Respiratory System .. .. 5 5 .. .. 4 4 .. .. 2 2 .. 1 5 6 17 Diseases of Mouth and Annexa .. 5 .. 1 .. .. 1 1 .. .. .. .. 1 .. .. 1 3 Diseases of Pharynx .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Diseases of CEsophagus .. .. .. .. .. .. .. .. .. .. 2 2 .. 1 .. 1 3 Ulcer of stomach and Duodenum .. .. 8 8 .. .. 3 3 .. .. 5 5 .. .. 7 7 23 Other Diseases of Stomach 3 .. 2 5 1 2 2 5 .. .. 2 2 2 1 1 4 16 Enteritis 7 4 2 13 8 4 3 15 19 10 2 31 18 4 4 26 85 Appendicitis 1 .. 2 3 .. .. 10 10 .. 1 4 5 .. .. 7 7 25 Obstruction of Intestine 4 1 9 14 4 1 2 7 .. 1 14 15 1 .. 6 7 43 Other Diseases of Intestine .. .. .. .. .. .. .. .. .. .. 2 2 .. .. 1 1 3 Cirrhosis of Liver .. .. 9 9 .. .. 9 9 1 .. 15 16 .. .. 20 20 54 Other Diseases of Liver .. .. 2 2 1 .. 5 6 1 .. 3 4 .. .. 6 6 18 Peritonitis .. 1 4 5 .. .. 1 1 .. .. 2 2 .. .. 1 1 9 Other Diseases, Digestive System 1 .. 2 3 6 .. 3 9 .. .. 2 2 2 .. .. 2 16 Diseases, Lymphatic System & Glands 1 .. 2 3 1 1 1 3 .. .. 1 1 .. 1 3 4 11 Acute Nephritis .. .. 6 6 .. .. 2 2 .. 1 2 3 1 .. 3 4 15 Bright's Disease .. .. 32 32 .. .. 27 27 .. .. 36 36 .. .. 34 34 129 Calculus .. .. .. .. .. .. .. .. .. .. 2 2 .. .. 1 1 3 Diseases of Bladder and Prostate .. .. 7 7 .. .. 1 1 .. .. 7 7 .. .. 7 7 22 Other Diseases, Urinary System .. .. 3 3 .. .. 1 1 .. .. 3 3 .. 1 3 4 11 Diseases of Testis and Penis 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Diseases of Ovaries .. .. 2 2 .. .. .. .. .. 1 1 .. .. 2 2 5 Diseases of Uterus and Appendages .. .. 1 1 .. .. 6 6 .. .. 4 4 .. .. 1 1 12 Dis of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Placenta Prævia, Flooding .. .. 1 1 .. .. .. .. .. .. 4 4 .. .. .. .. 5 Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Dis., Pregnancy and Childbirth. 1 .. 1 2 .. .. .. .. .. .. 4 4 .. .. .. .. 6 Arthritis, Ostitis. Periostitis .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 2 Other Diseases. Osseous System 1 1 5 7 1 .. 1 2 .. .. .. .. .. .. 1 1 10 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 299 [1908 Table B.—Continued DISEASES. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Total. Under 1 1 to 5 Over 5 Eczema .. .. .. .. 1 .. .. 1 .. .. .. .. 1 .. .. 1 2 Pemphigus 1 .. .. 1 .. .. 1 1 1 .. .. 1 .. .. .. .. 3 Other Diseases, Integumentary System 1 .. .. 1 .. .. .. .. .. .. 1 1 .. .. 1 1 3 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. .. 3 3 .. .. 3 3 .. 2 5 7 .. 1 1 1 14 On Railways .. .. 2 2 .. .. .. .. .. .. .. .. .. .. 1 1 3 On Ships, Boats, &c. (not drowning) .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 In Building Operations .. .. 1 1 .. .. 3 3 .. .. 1 1 .. .. 1 1 6 By Machinery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Weapons and Implements .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Burns and Scalds 2 4 2 8 1 2 3 6 .. 1 1 2 .. 4 2 6 22 Poisons Poisonus Vapours .. 1 .. 1 .. .. 1 1 .. .. .. .. .. .. .. .. 2 Surgical Narcosis .. .. .. .. .. 1 .. 1 .. .. .. .. .. 1 .. 1 2 Effects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. 1 1 .. .. .. .. .. .. 1 1 .. .. .. .. 2 Suffocation, Overlaid in Bed 11 .. .. 11 4 1 .. 5 2 .. .. 2 6 .. .. 6 24 ,, Otherwise 2 .. 2 4 .. .. .. .. 1 .. .. 1 2 .. .. 2 7 Falls not specified .. .. 11 11 1 1 1 3 2 1 8 11 1 .. 8 9 34 Weather Agencies .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Otherwise, not stated .. .. .. .. 1 .. .. 1 1 1 1 3 .. .. 3 3 7 Homicide 1 .. 1 2 1 .. .. 1 2 .. .. 4 .. .. .. .. .. Suicide. By Poison .. .. 1 1 .. .. 6 6 .. .. 1 1 .. .. 7 7 15 By Asphyxia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Hanging and Strangulation .. .. 1 1 .. .. .. .. .. .. 3 3 .. .. 2 2 6 By Drowning .. .. 1 1 .. .. 3 3 .. .. 1 1 .. .. 1 1 6 By shootin .. .. .. .. .. .. 2 2 .. .. 1 1 .. .. .. .. 3 By Cut or Stab .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. .. .. 2 By Precipitation from Elevated Place .. .. .. .. .. .. 3 3 .. .. 1 1 .. .. 1 1 5 By Crushing .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. 1 1 2 Males 151 74 454 679 96 43 276 515 118 41 345 504 159 68 423 650 2348 Females 96 55 557 708 75 46 374 495 86 36 358 480 113 63 472 648 2331 TOTAL DEATHS 247 9 1011 87 171 89 750 1010 204 77 703 984 272 131 895 1298 4679 300 1908] Table C. Showing the Population, Inhabited Houses, Marriages, Births and Deaths for the year 1908, and 10 years preceding. gross numbers. Year. Estimated Population. No. of Inhabited Houses. Marriages. Registered Births. Number of Deaths. Deaths of Residents in Public Institutions. Total all ages. Under one year. Under five 1 2 3 4 5 6 7 8 9 1908 349091 39,926 2,781 8,665 4,679 894 1,320 1,699 1898 336,727 42,672 3,205 9,453 5,705 1,504 2,428 1,327 1899 336,259 42,973 3,254 9,658 6,293 1,548 2,315 1,586 1900 335,892 42,959 2,968 9,254 5,721 1,344 1,956 1,542 1901 335,325 38,645 2,994 9,264 5,361 1,290 1,928 1,533 1902 337,268 39,766 3,108 9,214 5,635 1,219 1,906 1,646 1903 339,137 39,902 3,053 8,983 4,839 1,136 1.674 1,539 1904 341,044 39,920 2,948 8,890 5,236 1,140 1,743 1,576 1905 342,994 39,910 2,984 8,756 4,955 1,074 1,639 1,581 1906 344,987 39,884 2,964 8,659 5,050 1,083 1,672 1,603 1907 347,017 39,900 2,962 8,531 5,079 996 1,541 1,738 Average of 10 years. 339,665 40,653 3,054 9,066 5,387 1,233 1,880 1,567 Notes.—I. Population of Census, 1901 = 334,991 = 159,290 Males 175,701 Females. 2. Average number of persons in each house at Census, 1901 = 8.6. 3. Area of Parish in acres = 3,091.5. 4. Average number of Persons living on each acre at Census, 1901 = 108 301 [1908 Table D. Showing the Annual Birth and Death rates, Death rates of Children, and Deaths in Public Institutions per 1,000 Total Deaths for the year 1908, and 10 years preceding. Year. Birth-rates per 1,000 of the population. Deathrates per 1,000 of the population. *Corrected Death-rates per 1,000 of the population. Deaths of Children under 1 year per 1,000 of Registered Births. Deaths of Children under 1 year per 1,000 of Total Deaths Deaths of Children under 5 years per 1,000 of Total Deaths. Deaths of Residents in Public Institutions per 1,000 of Total Deaths 1 2 3 4 5 6 7 8 1908 24-35 13 15 13-66 103 191 282 363 1898 28.1 16.9 18.1 159 264 425 233 1899 28.7 18.7 20.0 160 246 368 252 1900 27.5 17.0 18.2 145 235 342 269 1901 27.6 15.9 16.5 139 241 360 286 1902 26.8 16.4 17.0 132 216 338 292 1903 26.5 14.3 14.8 126 235 346 318 1904 26.1 15.3 15.9 128 218 333 301 1905 25.5 14.4 150 123 217 331 319 1906 25.1 14.6 15.2 125 214 331 317 1907 24.6 14.6 15.2 117 196 303 342 Average of 10 years. 266 15.8 16.6 136 228 349 291 * The Death Rates in column 4 are corrected for sex and age distribution for the purpose of contrasting them on an equal basis with those of England. 302 1908] LOCAL GOVERNMENT BOARD RETURN.—Table I. Table E. Metropolitan Borough of Islington. vital statistics of whole district during 1908 and previous years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of NonResidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District Under 1 Year of Age. At all Ages. Number. Rate.* Number. Rate per 1,000 Births registered. Number. Death Rate.* Number. Death Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1898 336,727 9,453 28.1 1,504 159 5.746 17.1 1,327 558 517 5,705 16.9 1899 336,259 9,658 28.7 1,548 160 6,395 19.0 1,586 695 593 6,293 18.7 1900 335,892 9,254 27.5 1,344 145 5,767 17.2 1.542 599 553 5,721 17.0 1901 335,325 9,264 27.6 1,290 139 5,222 15.6 1,394 491 630 5,361 15.9 1902 337,268 9,214 26.8 1,219 132 5,530 16.1I 1,541 632 737 5,635 16.4 1903 339,137 8,983 26.5 1,136 126 4,772 14.1 1.472 560 627 4,839 14.3 1904 341,044 8,890 26.0 1,1!77 132 5.241 15.4 1,619 632 627 5,236 15.3 1905 342,994 8,756 25.5 1,032 118 4,902 14.3 1,528 566 619 4,955 14.4 1906 344,987 8.659 25.1 1,045 120 5,000 14.5 1,589 634 684 5,050 14.6 1907 347,017 8,531 24.6 943 110 4,987 14.4 1,675 593 685 5,079 14.6 Averages for yrs. 1 8 9 8 1907. 339,665 9,066 26.6 1,224 135 5,356 15.8 1,527 596 627 5,387 15.9 1908 349,091 8,665 24.3 827 95 4,530 12.'73 1,566 568 717 4,679 13.15 *Rates in Columns 4, 8 and 13 calculated per 1,000 of estimated population. Note-The deaths included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term " non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institution there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions" taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouse, and lunatic asylums. Area of District in acres (exclusive of area covered by water Total population at all ages, 334,991 3,085 Number of inhabited houses, 38,645 Average number of persons per house, 8.6 At Census of 1901 LOCAL GOVERNMENT BOARD RETURN TABLE II. Metropolitan Borough of Islington.—TABLE F. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1908 AND PREVIOUS YEARS. Names of Localities. 1.—Upper Holloway 2.— South-West. 3.—Highbury. 4.—South-East. Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births registered. Deaths at all Ages Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a b. c. d. a. b. c. d. a. b. c. d. 1890 89,049 2,740 2,059 - 105,290 3,311 2,007 - 58,399 1,452 1.234 - 63,805 1,916 898 - 1891 90,622 2,751 2,176 - 105,644 3,456 2,065 - 59,452 1,639 937 — 64,273 1,956 1,148 - 1892 92,201 2,753 2,158 - 105,999 3,385 1,813 - 60,509 1,542 952 - 64,742 1,872 1,152 - 1893 93,801 2,768 1,702 409 106,359 3,386 2,303 647 61,581 1,601 1,008 219 65,217 1,994 1,378 320 1894 95,411 2,698 1, 458 326 106,359 3,301 1,859 464 62,658 1,608 865 183 65,695 1,895 1,081 256 1895 97,041 2,779 1,564 400 107,088 3,475 2,023 527 63,750 1,621 939 211 66,179 2,004 1,234 278 1896 97,449 2,929 1,603 395 107,457 3,390 2,099 561 66,146 1,709 997 246 66,614 1,893 1,185 288 1897 97,879 2,904 1,48l 347 107,332 3,289 1,855 502 66,283 1,657 886 217 65,703 1,992 1,173 272 1898 98,308 2,793 1,530 414 106,984 3,244 2,050 576 66,417 1,578 931 214 65,018 1,838 1,194 300 1899 98,736 2,792 1,698 407 106,397 3,269 2,184 590 66,520 1,651 1,093 238 64,606 1,946 1,318 313 Averages of Years 1890 to 1899 95,047 2,790 1,742 385 106,527 3,350 2,025 552 63,171 1,605 984 218 65,185 1,930 1,176 289 Upper Holloway. Lower Holloway. Highbury. Barnsbury. South-East. 1900 99,071 2,699 1,635 375 41618 1,170 738 181 62,092 1,551 932 186 55,445 1,782 1,004 265 77,666 2,052 1,412 337 1901 100,099 2,707 1,454 318 41,433 1,179 688 196 59,540 1,463 898 202 54,457 1,788 1,033 253 79,796 2,127 1,88 324 Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. 1902 32,450 745 491 93 34,442 1,131 605 117 34,385 849 527 122 41,486 1,122 714 175 64,519 1,488 945 169 54,368 1,757 1040 266 75,610 2,122 1,313 277 1903 32,838 740 440 83 34,822 1,108 535 138 34,765 850 437 105 41,537 1,126 618 159 65,112 1,460 796 178 54,278 1,648 899 210 75,785 2,051 1,114 263 1904 33,225 799 571 113 35,210 1,066 523 98 35,153 815 475 104 41,589 1,114 693 180 65,717 1423 775 140 54,146 1,672 963 237 75,964 2,001 1,236 268 1905 33,622 758 483 96 35,607 1,067 550 108 35,549 809 428 95 41,642 1,118 644 169 66,336 1,303 837 153 54,091 1,706 897 212 76,147 1,995 1,116 241 1906 34,028 746 432 91 36,012 1,06l 542 111 35,954 747 425 95 41,696 1,118 721 173 66,968 1,348 779 128 53,995 1,697 967 232 76,334 1,960 1,184 253 1907 34,441 745 482 95 36,425 1,023 559 90 36,367 755 480 100 41,751 1,049 644 162 67,612 1,278 816 137 53,897 1,709 949 211 76,524 1,927 1,149 201 1908 34,863 816 425 66 36,847 1,027 485 76 36,788 728 396 85 41,807 1,067 571 134 68,271 1,416 816 143 53,797 1,625 885 193 76,718 1,986 1,101 197 Notes.—(a) The separate localities adopted for this Table are registration sub-districts. (6) Dexc^uded reSidentS OCCUrr,ng in public lnstltutl0ns bey°nd the district are included in sub-columns c of this Table, and those of non-residents registered in public institutions in the district (c) Deaths of residents occurring in public institutions whether within or without the district are allotted to the respective localities, according to the addresses of the deceased. (d) Care is taken that the gross totals of the several columns in this Table respectively equal the corresponding totals for the whole districts in Tables I. and IV.: thus the totals ot sub columns a, b and c agree with the figures for the year m the columns 2 3 and 12 respectivelv of Table I. : the gross total of the sub columns c agree with the total of column 2 in Table IV., and the gross total of sub-columns d with the total of column 3 in Table IV. 5 308 [1908 LOCAL GOVERNMENT BOARD RETURN.—Table IV Table G. Metropolitan Borough of Islington. causes of, and ages at death during year, 1908. Causes of Death Deaths of Residents at subjoined Ages, whether occurring in or beyond the District. Deaths of Residents (at all Ages) belonging to Localities whether occurring in or beyond the District. Total Deaths in Public Institutions in the District, whether Residents or Non-residents. All ages. Under l yr. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East Islington. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 78 24 50 4 .. .. .. 4 .. 4 14 7 36 13 10 Scarlet Fever 30 3 15 9 2 1 .. 4 1 2 3 4 9 7 12 Whooping Cough 55 29 25 1 .. .. 2 6 9 5 9 9 15 19 Diphtheria and Mem branous Croup 60 4 26 30 .. .. .. 2 9 2 10 7 11 19 6 Croup 2 .. 2 .. .. .. .. .. .. .. .. .. 1 1 .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 18 .. .. 2 5 11 .. .. .. 1 6 3 3 5 6 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 8l 2 1 .. 5 41 32 11 16 7 8 15 10 14 6 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 117 80 23 2 .. 7 5 7 9 7 23 17 29 25 30 Enteritis 101 58 25 3 • • 7 8 10 9 13 15 11 20 23 37 Puerperal Fever 4 .. .. .. 2 2 .. 1 .. 1 2 .. .. .. 2 Erysipelas 14 4 .. .. .. 7 3 .. .. 3 2 3 3 3 10 Phthisis (Pulmonary Tuberculosis) 432 5 12 15 55 321 24 31 45 34 52 72 78 120 255 Other Tuberculous Diseases 172 35 74 20 7 31 5 17 19 12 32 30 29 33 48 Cancer, Malignant Disease 367 .. 1 2 8 222 134 33 45 36 40 69 51 93 136 Bronchitis 430 39 14 2 3 133 239 42 44 38 41 76 81 108 133 Pneumonia 426 106 .. 1 16 131 80 38 44 37 53 63 83 108 86 Pleurisy 27 1 1 1 2 13 9 .. 4 1 4 8 6 4 7 Other Diseases of Respiratory Organs 42 .. 7 1 1 23 10 7 4 6 5 9 5 6 15 Alcoholism Cirrhosis of Liver 71 1 .. 1 .. 63 6 5 8 2 10 13 11 22 17 Venereal Diseases 20 13 1 .. .. 5 1 1 .. 5 1 2 7 4 4 Premature Birth 167 167 .. .. .. .. .. 15 13 9 27 34 32 37 2 Diseases and Accidents of Parturition 12 1 .. .. 1 10 •• 2 2 2 1 2 1 2 4 Heart Diseases 619 4 1 10 18 264 322 55 77 50 62 125 118 132 217 Accidents 124 37 21 7 4 35 20 4 12 10 16 21 27 34 43 Suicides 38 .. .. .. 4 30 4 5 7 3 3 4 8 8 13 Homicide 7 4 .. .. .. 2 .. .. .. 1 1 1 .. 4 4 All other causes 1165 277 45 39 37 374 393 129 111 101 135 211 217 261 444 All causes 4679 894 426 161 170 1733 1295 425 485 396 571 8l6 885 1101 1566 1908] 304 Table H. Metropolitan Borough of Islington. INFANTILE MORTALITY DURING THE YEAR 1908. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes. Certified 186 52 33 39 310 97 83 48 55 48 37 43 46 39 39 49 894 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Common Infectious Diseases. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. 1 .. 1 .. 1 .. .. .. 2 3 3 3 5 6 24 Scarlet Fever .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 3 Diphtheria (including Membranous Croup) .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 2 1 4 Diarrhœal Diseases. Whooping Cough .. .. .. .. .. 2 3 2 1 1 4 2 3 4 3 4 29 Diarrhœa, all forms .. .. 2 .. 2 9 8 8 8 8 8 12 3 4 1 9 80 Enteritis, Muco-enteritis, Gastroenteritis .. .. 1 .. 1 4 6 5 10 9 2 1 7 2 3 2 52 Wasting Diseases. Gastritis, Gastro-intestinal Catarrh .. .. .. 1 1 1 .. .. 1 2 .. .. .. .. 1 1 7 Premature Birth 111 17 7 14 149 13 2 1 .. .. .. .. 1 .. 1 .. 167 Congenital Defects 20 10 3 1 34 3 6 1 2 1 .. 2 2 .. .. .. 51 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast-milk, Starvation .. .. .. .. .. 1 .. .. 2 .. 1 .. .. .. .. .. 4 Tuberculous Diseases. Atrophy, Debility, Marasmus 28 10 9 8 55 23 19 14 7 4 4 2 4 2 1 3 138 Tuberculous Meningitis .. .. .. .. .. .. 1 1 3 1 2 .. 3 .. 1 1 13 Tuberculous Peritonitis: Tabes Mesenterica 1 .. .. .. 1 1 4 2 .. 1 .. .. 3 .. 2 .. 14 Other causes. Other Tuberculous Diseases .. .. 1 .. 1 1 2 .. .. 1 2 1 1 2 1 1 13 Erysipelas .. .. .. 2 2 1 .. .. .. 1 .. .. .. .. .. .. 4 Syphilis .. 2 .. .. 2 1 3 .. 2 3 1 .. 1 .. .. .. 13 Rickets .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 2 Meningitis (not Tuberculous) .. .. .. .. .. .. 1 .. 1 .. 1 3 1 2 2 2 13 Convulsions 4 4 .. 1 9 1 .. .. .. .. 2 2 1 .. .. .. 15 Bronchitis .. 2 2 1 5 8 9 2 2 5 1 .. 2 3 .. 2 39 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia 1 2 3 3 9 14 13 10 6 7 2 10 7 10 6 12 106 Suffocation, overlying 4 .. 2 3 9 4 3 .. 1 2 2 1 .. .. .. 1 23 Other Causes 17 5 2 5 29 10 2 2 9 2 2 3 2 7 9 3 80 Totals 186 52 33 39 310 97 83 48 55 48 37 43 46 39 39 49 894 Births in the year legitimate 8,434 illegitimate 231 Deaths from all Causes at all Ages 4,679 Deaths in the year of legitimate infants 847 illegitimate infants 47 Population. Estimated to middle of 1908. 349,091. 305 [1908 Table I. Showing the Births, Deaths, Infantile Mortality, the Deaths from the Principal Epidemic Diseases, and from Influenza Cancer, Phthisis, and Puerperal Fever occurring in the Year 1908, and during the Years 1898-1907. Year. Births. Birth rates. Deaths. Death-rates. Deaths of Infants under 1 year of age. Deaths under 1 year to 1,000 Births. Deaths from the Principal Epidemic Diseases. Total Epidemic Death-rates. Influenza. Cancer. Phthisis. Puerperal Fever Totals. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and undefined Fevers. Diarrhœal Diseases. Deaths. Death-rates. Deaths. Death-rates. Deaths. Death-rates. Deaths. Deaths per 1,000 births. 1898 9,453 28.1 5,705 16.9 1,504 159 933 .. 325 26 93 168 1 36 1 283 2.77 65 0.19 283 0.84 527 1.56 7 0.74 1899 9,658 28.7 6,293 18.7 1,548 160 781 .. 155 33 128 160 .. 47 .. 258 2.32 126 0.37 270 0.80 583 1.73 14 1.45 1900 9,254 27.5 5,721 17.0 1,344 145 660 1 159 24 106 142 .. 46 2 180 1.96 149 0.44 303 0 .90 602 1.79 6 0.65 1901 9,264 27.6 5,361 15.9 1,290 139 628 8 151 30 134 85 .. 47 1 172 1.87 46 0.14 289 0.86 545 1.62 15 1.62 1902 9,214 26.8 5,635 16.4 1,219 132 608 53 114 40 104 152 .. 45 1 99 1.80 83 0.24 326 0.95 515 1.50 12 1.30 1903 8,983 26.5 4,839 14.3 1,136 126 471 .. 120 24 43 152 .. 22 1 109 1.39 40 0.12 350 1.03 492 1.45 9 1.00 1904 8,890 26.1 5,236 15.3 1,140 128 606 1 181 35 28 83 .. 18 .. 260 1.78 48 0.14 323 0.95 533 1.56 14 1.57 1905 8,756 25.5 4,955 14.4 1,074 123 529 1 123 37 34 111 .. 17 .. 206 1.54 54 0.16 328 0.95 438 1.28 6 0.68 1906 8,659 25.1 5,050 14.6 1,083 125 562 .. 187 37 32 74 .. 19 .. 213 1.63 67 0.19 363 1.05 411 1.19 11 1.27 1907 8,531 24.6 5,079 14.6 996 117 432 .. 130 24 42 120 .. 13 .. 103 1.24 75 0.22 348 1.00 436 1.26 8 0.94 Corrected average. 9,318 26.69 5,536 15.86 1,267 136 638 6 169 32 76 129 .. 32 1 193 1.83 77 0.23 327 0.94 522 1.49 10 1.07 1908 8,665 24.35 4,679 13.15 984 103 358 .. 78 30 60 55 .. 18 .. 117 1.01 81 0.23 367 1.03 432 1.21 4 0.46 Departure from Average. -653 -2.34 -857 -271 -283 -33 -280 -6 -91 —2 —16 -74 .. -14 -1 -76 -0. 82 + 4 - + 40 +0.09 -90 —0.28 -6 —0.61 1908] 306 LOCAL GOVERNMENT BOARD RETURN.—Table III. Table J. Cases of Infectious Disease coming to the knowledge of the Medical Officer of Health during the year 1908. Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each locality. At all Ages. At Ages—Years. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 8 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Tufnell. Upper Holloway. Tollington. Lower Holloway Highbury. Barnsbury. South-East. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South-East. Total cases removed to Hospital. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous Croup) 530 13 191 261 36 29 .. 45 78 52 82 79 74 120 27 65 44 66 55 70 108 435 Erysipelas 235 9 6 10 32 156 22 24 22 25 28 36 49 51 9 5 3 8 7 11 14 57 Scarlet Fever 1409 9 338 871 130 59 2 158 162 167 204 212 229 277 140 140 151 184 190 212 257 1,274 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 97 .. 3 21 26 47 .. 2 10 3 31 15 16 20 2 8 3 25 6 14 15 73 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever 1 .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 17 .. .. .. 2 15 .. 2 .. 1 5 3 3 3 .. .. .. 1 1 .. 1 3 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 2289 31 538 1163 227 306 24 231 273 248 350 345 371 471 178 218 201 284 259 307 395 1,842 307 [1908 Table K. Showing cases of Infectious Diseases notified in Islington in the Quinquennial Periods, 1891-05 and in 1906-08 Year. Smallpox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Notifications. 1891 1 728 756 189 2 343 33 6 1 .. 2059 1892 42 1709 738 219 .. 553 52 6 .. 3 3318 1893 118 2880 885 251 1 672 58 7 .. 1 4853 1894 90 1493 867 245 1 395 23 7 .. .. 3121 1895 25 1692 582 184 5 320 22 9 .. .. 2839 1891-5 276 8502 3828 1088 9 2280 167 35 1 4 16,190 1896 50 2031 1091 229 .. 385 30 6 2 .. 3824 1897 3 1577 729 256 .. 312 27 1 .. 1 2906 1898 .. 1336 544 237 2 279 19 1 .. .. 2418 1899 3 1494 705 353 .. 350 33 2 .. 3 2943 1900 2 1074 633 259 1 285 16 6 .. .. 2276 1896-00 58 7512 3702 1334 3 1611 125 16 2 4 14,367 1901 50 1286 911 281 2 285 34 3 .. .. 2852 1902 276 1372 878 257 .. 357 19 5 .. .. 3164 1903 9 865 455 130 .. 227 19 2 .. .. 1707 1904 17 1146 347 126 1 280 24 .. .. .. 1941 1905 3 1198 351 100 .. 252 24 .. .. .. 1928 1901-05 . 355 5867 2942 894 3 1401 120 10 .. .. 11,592 1906 1 1386 439 149 1 274 24 1 .. .. 2275 1907 .. 1216 481 92 .. 252 21 1 .. .. 2063 1908 • • 1409 530 97 .. 235 107 1 .. .. 2289 308 1908] Table L. Showing the Cases of Small Pox that occurred in the several Wards from 1891 to 1908. Year. Tufnell. *Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. .. .. 1 .. .. .. .. .. .. .. 1 1892 .. 12 .. 12 .. 7 .. .. 9 1 1 42 1893 .. 41 .. 28 6 3 14 6 6 5 9 118 1894 17 8 2 5 2 3 10 .. 15 2 26 90 1895 1 6 3 1 1 1 2 4 1 .. 5 25 1896 8 3 25 1 6 5 1 1 .. .. .. 50 1897 1 1 .. .. .. .. .. .. .. 1 .. 3 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. 2 .. .. .. .. .. .. .. 1 3 1900 .. .. .. 1 .. 1 .. .. .. .. .. 2 1901 3 .. .. 11 4 1 13 6 4 4 4 50 1902 9 34 28 32 17 13 25 33 7 16 62 276 1903 3 1 .. 2 .. .. .. .. .. 1 2 9 1904 .. .. .. 1 .. .. 12 .. 2 2 .. 17 1905 .. .. .. .. .. .. 2 .. .. .. 1 3 1906 .. .. .. .. .. 1 .. .. .. .. .. 1 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards. †The figures for 1891-2 are inclusive of Highbury. Table M. Showing the Cases of Scarlet Fever occurred in the several Wards from 1891 to 1908. Year. Tufnell. *Upper Holloway. Tollington. Lower Holloway. Highbury. † Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St.Peter's. Totals. 1891 .. 229 .. 108 .. 99 55 59 27 46 105 728 1892 .. 435 225 .. 313 148 100 94 194 200 1709 1893 .. 790 .. 368 .. 633 355 209 136 201 187 2880 1894 176 235 114 196 152 67 165 116 91 90 91 1493 1895 142 166 220 214 168 117 182 89 108 112 174 1692 1896 181 244 191 169 230 127 150 149 104 191 295 2031 1897 144 153 193 187 137 126 155 91 76 113 202 1577 1898 159 151 152 182 151 102 114 38 58 107 122 1336 1899 100 172 183 178 176 118 117 102 79 98 171 1494 1900 78 85 102 138 152 90 85 66 51 107 120 1074 1901 97 109 129 172 178 83 137 86 61 93 141 1286 1902 140 147 160 187 121 88 187 67 45 94 136 1372 1903 76 78 113 129 130 70 88 42 28 36 75 865 1904 72 76 222 135 127 65 147 84 45 103 70 1146 1905 100 142 112 130 114 42 96 71 97 119 175 1198 1906 139 135 67 204 133 68 121 70 97 155 197 1386 1907 120 78 91 164 125 112 110 92 49 105 170 1216 1908 158 162 167 204 119 79 135 94 78 88 125 1409 * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards. † The figures for 1891-2-3 are inclusive of Highbury. 309 [1908 Table N. Showing the Cases of Diphtheria that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 305 .. 43 .. 112 37 44 44 54 73 712 1892 .. 299 .. 43 .. 95 49 43 54 37 75 695 1893 .. 283 .. 57 .. 140 94 46 55 62 117 855 1894 86 91 177 131 93 40 81 37 45 25 97 843 1815 64 77 50 67 80 21 46 28 21 34 76 564 1896 129 177 84 89 87 46 200 95 29 49 82 1067 1897 71 77 118 66 43 60 81 43 30 52 59 700 1898 44 52 50 36 41 64 54 30 26 92 42 531 1899 148 99 88 56 62 28 28 29 39 52 59 688 1900 61 64 46 62 49 74 47 43 55 38 85 624 1901 83 69 61 104 87 55 96 67 61 60 159 902 1902 128 100 62 165 106 38 73 31 29 55 84 871 1903 43 45 47 120 37 17 34 17 21 36 35 452 1904 28 37 45 37 26 28 49 30 13 25 29 347 1905 38 41 40 23 45 42 34 18 10 38 22 351 1906 25 56 49 60 50 22 47 28 27 35 38 437 1907 35 65 41 55 39 30 64 30 39 35 47 480 1908 45 76 52 79 45 26 49 24 19 60 47 522 Table O. Showing the Cases of Membranous Croup that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 20 .. 2 .. 5 3 1 1 2 10 44 1892 .. 10 .. 3 .. 10 3 1 2 8 6 43 1893 .. 10 .. 5 .. 3 3 3 1 .. 5 30 1894 2 2 .. 5 .. 2 6 1 .. 5 1 24 1895 1 3 .. 3 3 1 1 .. 1 1 4 18 1896 3 3 .. 4 4 1 3 1 1 1 3 24 1897 2 4 2 5 .. .. 1 .. 3 3 3 29 1898 2 4 .. 1 1 .. 4 .. 1 .. .. 13 1899 2 1 1 2 1 1 3 2 1 .. 3 17 1900 2 .. .. 1 1 .. 1 2 .. 1 1 9 1901 1 .. 1 1 .. 2 1 2 .. 1 .. 9 1902 .. 1 .. 3 1 .. 1 1 .. .. .. 7 1903 .. .. .. 1 .. .. 1 .. .. .. 1 3 1904 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. 1 .. .. .. .. 1 .. .. .. .. 2 1907 .. .. .. .. .. .. .. .. 1 .. .. 1 1908 .. 2 .. 3 1 .. 1 .. .. .. 1 8 310 1908] Table P. Showing the Cases of Typhoid Fever that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's Canonbury. St. Peter's. Totals. 1891 .. 61 .. 25 .. 33 31 15 8 5 11 189 1892 .. 78 .. 19 .. 49 25 16 7 12 13 219 1893 .. 88 .. 19 .. 56 17 17 9 24 21 251 1894 24 23 18 32 25 23 19 21 9 21 30 245 1895 21 16 12 25 26 22 10 9 9 14 20 184 1896 17 22 19 35 30 15 40 10 9 12 20 229 1897 25 25 43 34 25 27 20 18 10 11 18 256 1898 22 34 24 30 26 21 18 16 10 15 21 237 1899 39 40 94 24 49 17 31 17 15 16 11 353 1900 14 37 42 25 23 27 34 15 9 13 20 259 1901 32 42 19 39 22 28 15 14 14 27 29 281 1902 29 22 18 32 23 12 37 25 11 20 28 257 1903 9 13 14 11 13 13 21 7 4 13 12 130 1904 13 10 10 16 6 20 23 3 2 8 15 126 1905 3 12 9 13 9 14 7 10 4 5 14 100 1906 7 22 27 18 16 2 14 16 2 2 23 149 1907 9 10 10 10 15 6 11 2 6 6 7 92 1908 2 10 3 31 9 2 10 6 8 11 5 97 Table Q. Showing Cases of Typhus Fever that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway* Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St Peter's. Totals. 1891 .. .. .. .. .. .. .. 1 .. .. 1 2 1892 .. .. .. .. .. .. .. .. .. .. .. .. 1893 .. 1 .. .. .. .. .. .. .. .. .. 1 1894 .. .. .. 1 .. .. .. .. .. .. .. 1 1895 3 .. .. .. .. .. .. 2 .. .. .. 5 1896 .. .. .. .. .. .. .. .. .. .. .. .. 1897 .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. 1 .. .. .. .. .. .. 1 .. 2 1899 .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. 1 .. .. .. .. .. .. 1 1901 .. .. .. .. .. .. 1 1 .. .. .. 2 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 1904 1 .. .. .. .. .. .. .. .. .. .. 1 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. 1 .. .. .. .. .. .. 1 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. 311 [1908 Table R. Showing the Cases of Erysipelas that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 139 .. 23 .. 42 30 28 13 23 45 343 1892 .. 194 .. 46 .. 80 35 39 44 39 73 550 1893 .. 244 .. 70 .. 75 63 51 49 41 79 672 1894 34 85 23 59 29 19 43 19 20 26 38 395 1895 29 62 23 38 36 24 26 21 16 12 33 320 1896 54 65 20 51 35 30 22 29 18 22 39 385 1897 24 66 21 38 25 26 19 15 16 19 43 312 1898 23 60 20 31 22 16 15 17 13 22 40 279 1899 15 70 36 47 25 12 39 23 22 19 42 350 1900 31 45 25 30 24 13 29 16 15 20 37 285 1901 24 52 30 16 18 14 37 10 15 25 44 285 1902 33 47 34 41 30 18 33 19 13 51 38 357 1903 23 28 22 25 16 10 25 10 12 31 25 227 1904 36 19 30 29 23 19 30 15 16 38 25 280 1905 26 18 22 36 25 16 29 17 19 16 28 252 1906 20 26 14 27 28 23 41 26 13 16 40 274 1907 26 20 21 35 17 18 33 22 13 18 29 252 1908 24 22 25 28 18 18 26 23 13 14 24 235 Table S. Showing the Cases of Puerperal Fever that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 10 .. 9 .. 7 2 1 1 .. 3 33 1892 .. 28 .. 5 .. 7 5 2 2 .. 2 51 1893 3 5 4 7 5 3 3 3 2 .. 3 38 1894 1 3 6 4 3 2 2 1 1 .. .. 23 1895 1 2 1 2 6 2 3 1 1 3 .. 22 1896 3 2 3 5 2 1 5 2 1 3 3 30 1897 5 6 2 4 3 1 4 .. 1 1 .. 27 1898 .. .. 2 2 .. 2 3 2 1 4 3 19 1899 1 7 4 9 1 1 4 3 .. 1 2 33 1900 4 2 1 3 3 .. • • 2 .. 1 .. 16 1901 2 3 4 5 5 2 3 4 .. 3 3 34 1902 2 1 2 1 4 .. 5 .. .. 3 1 19 1903 3 4 1 4 4 1 .. 1 .. .. 1 19 1904 5 4 3 .. 2 1 5 1 1 1 1 24 1905 1 1 3 9 2 1 3 .. .. 2 2 24 1906 2 1 3 4 3 1 5 2 1 1 1 24 1907 3 5 .. 5 .. 2 1 1 2 1 1 21 1908 2 .. 1 5 2 1 1 2 1 .. 2 17 312 1908] Table T. Showing the Cases of Continued Fever that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 1 .. 2 .. .. 3 .. .. .. .. 6 1892 .. 2 .. .. .. 3 .. .. .. 1 .. 6 1893 1 .. .. .. 1 .. 1 .. 1 1 2 7 1894 .. .. 2 1 3 .. .. .. .. 1 .. 7 1895 .. 4 1 .. 1 3 .. .. .. .. .. 9 1896 1 2 .. .. .. 1 1 1 .. .. .. 6 1897 .. .. .. .. .. .. .. .. .. .. 1 1 1898 .. .. .. .. .. .. .. .. .. 1 .. 1 1899 .. .. .. .. .. .. 1 .. .. .. 1 2 1900 .. .. .. 3 .. 2 .. .. .. 1 .. 6 1901 .. .. .. 1 .. .. 1 .. .. .. 1 3 1902 .. .. .. .. .. .. 5 .. .. .. .. 5 1903 1 .. .. .. .. .. .. .. .. 1 .. 2 1904 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. 1 .. .. .. .. 1 1907 .. .. .. .. .. 1 .. .. .. .. .. 1 1908 .. 1 .. .. .. .. .. .. .. .. .. 1 Table U. Showing the Cases of Relapsing Fever thai occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. 1 .. .. .. .. .. .. .. .. .. 1 1892 .. .. .. .. .. .. .. .. .. .. .. .. 1893 .. .. .. .. .. .. .. .. .. .. .. .. 1894 .. .. .. .. .. .. .. .. .. .. .. .. 1895 .. .. .. .. .. .. .. .. .. .. .. .. 1896 .. .. .. 1 .. .. .. .. 1 .. .. 2 1897 .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. .. 1901 .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 1904 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. .. .. .. .. .. .. 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. 313 [1908 Table V. Showing the Cases of Cholera that occurred in the several Wards from 1891 to 1908. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. 1891 .. .. .. .. .. .. .. .. .. .. .. .. 1892 .. .. .. .. .. .. .. .. .. .. *3 3 1893 .. .. .. .. .. .. 1 .. .. .. .. 1 1894 .. .. .. .. .. .. .. .. .. .. .. .. 1895 .. .. .. .. .. .. .. .. .. .. .. .. 1896 .. .. .. .. .. .. .. .. .. .. .. .. 1897 .. .. .. .. .. .. 1 .. .. .. .. 1 1898 .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. 2 1 .. .. .. .. .. .. .. .. 3 1900 .. .. .. .. .. .. .. .. .. .. .. .. 1901 .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. 1904 .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. .. .. .. .. .. .. 1907 .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. * Asiatic Cholera. Table W. Illegitimate Births registered in Islington during the years 1841-1908. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. Years. Births. 1841 * 1851 100 1861 184 1871 280 1881 380 1891 265 1901 228 1842 33 1852 100 1862 207 1872 346 1882 353 1892 298 1902 248 1843 * 1853 95 1863 224 1873 335 1883 370 1893 267 1903 242 1844 * 1854 125 1864 248 1874 344 1884 341 1894 290 1904 273 1845 43 1855 126 1865 291 1875 363 1885 327 1895 286 1905 227 1846 53 1856 149 1866 272 1876 361 1886 331 1896 242 1906 244 1847 64 1857 151 1867 306 1877 337 1887 350 1897 269 1907 230 1848 85 1858 140 1868 317 1878 303 1888 345 1898 262 1908 231 1849 74 1859 174 1869 284 1879 401 1889 350 1899 279 1850 97 1860 175 1870 318 1880 359 1890 328 1900 261 7 yrs. 449 1851 to 1860 1335 1861 to 1870 2651 1871 to 1880 3429 1881 to 1890 3475 1891 to 1900 2719 1901 to 1908 1923 * The births in these years could not be ascertained. V 314 1908] TABLE X. Showing the Births and Birth Rates of Islington from 1841 to 1908. Years. Births. Birth Rates. Years. Births. Birth Rates. Years. Births. Birth Rates. Years. Births. Birth Rates. 1841 1446 25.58 1861 5530 35.31 1881 9894 34.87 1901 9264 27.62 1842* 1508 25.28 1862 5619 34.76 1882 9991 34.79 1902* 9214 26.80 1843 1627 25.86 1863 6094 36.51 1883 9940 34.19 1903 8983 26.48 1844 1804 27.18 1864 6349 36.84 1884* 9872 33.54 1904 8890 26.06 1845 1838 26.20 1865 6743 37.90 1885 9667 32.45 1905 8756 25.52 1846 2152 29.13 1866* 6983 38.02 1886 9849 32.66 1906 8659 25.10 1847 2318 29.75 1867 7391 38.97 1887 9740 31.92 1907 8531 24.58 1848* 2529 30.76 1868 7608 38.86 1888 9609 31.10 1908* 8665 24.35 1849 2613 30.13 1869 7529 37.24 1889 9628 30.79 1850 3015 32.96 1870 7674 36.77 1890* 9230 29.16 1841-50 20850 28.65 1861-70 67520 37.20 1881-90 97420 32.49 1901-08 70962 25.93 1851 3033 31.46 1871 7671 35.73 1891 9797 30.61 1852 3462 34.19 1872* 8048 36.36 1892 9743 30.12 1853 3701 34.81 1873 8398 36.89 1893 9749 29.81 1854* 3964 35.50 1874 8697 37.16 1894 9678 29.28 1855 4148 35.37 1875 9068 37.67 1895 10183 30.48 1856 4306 34.97 1876 9225 37.26 1896* 9921 29.38 1857 4512 34.89 1877 9380 36.85 1897 9842 29.19 1858 4560 33.57 1878* 9488 36.28 1898 9453 28.07 1859 5011 35.13 1879 9714 36.08 1899 9658 28.71 1860* 5218 34.84 1880 9928 35.86 1900 9254 27.55 1851-60 41915 34.54 1871-80 89627 36.60 1891-1900 97278 23.31 * These years contained 53 weeks. 315 [1908 TABLE Y. Showing the Deaths and Death Rates of Islington from 1841 to 1908. Years. Deaths. Death Rates. Years. Deaths. Death Rates. Years. Deaths Death Rates. Years. Deaths. Death Rates. 1841 1013 17.91 1861 3123 19.94 1881 5617 19.79 1901 5361 15.98 1842 1101 18.46 1862 3496 21.62 1882 5643 19.65 1902 5365 16.71 1843 1115 17.72 1863 4340 26.00 1883 5561 19.12 1903 4839 14.27 1844 1294 19.94 1864 4594 26.65 1884 5515 18.74 1904 5236 15.35 1845 1258 17.96 1865 4617 25.94 1885 5740 19.27 1905 4955 14.44 1846 1383 18.72 1866 5154 28.06 1886 5434 18.02 1906 5050 14.64 1847 1624 20.83 1867 4509 24.55 1887 5699 18.67 1907 5079 14.63 1848 1745 21.22 1868 4886 24.95 1888 5197 16.82 1908 4679 13.15 1849 1891 21.80 1869 4937 24.42 1889 5035 16.10 1850 1609 17.58 1870 5078 24.33 1890 6152 19.43 1841-50 14033 19.28 1861-70 44734 24.64 1881-90 55782 18.60 1901-08 40834 4.92 1851 2082 21.59 1871 5048 23.44 1891 6326 19.77 1852 2086 20.60 1872 4196 18.95 1892 6075 18.78 1853 2395 22.52 1873 4156 18.25 1893 6391 19.55 1854 2800 25.07 1874 4816 20.57 1894 5263 15.92 1855 2680 22.85 1875 4833 20.07 1895 5760 17.24 1856 2677 21.74 1876 4969 20.07 1896 5884 17.42 1857 3586 20.00 1877 5111 20.07 1897 5395 16.00 1858 2777 20.44 1878 5376 20.53 1898 5705 16.94 1859 2898 20.32 1879 5456 20.27 1899 6293 18.71 1860 3028 21.21 1880 5716 20.65 1900 5721 17.03 1851-60 26009 21.43 1871-80 49977 20.40 1891-1900 58813 17.72 V 2 316 1908] TABLE Z. Infantile Mortality Returns, extracted from the Annual Reports of the Registrar General, 1841-1855, and from the Annual Reports of the Medical Officer of Health of Islington, 1856-1908. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. Years. Deaths under 1 year old. Deaths per 1,000 Births. 1841 190 131 1861 748 135 1881 1,400 140 1901 1,290 139 1842* 224 149 1862 725 130 1882 1,403 140 1902* 1,219 132 1843 — — 1863 906 147 1883 1,312 133 1903 1,136 126 1844 - — 1864 969 153 1884* 1,506 150 1904 1,140 128 1845 267 164 1865 1,088 161 1885 1,387 144 1905 1,074 123 1846 330 153 1866* 1,170 169 1886 1,510 154 1906 1,083 125 1847 348 150 1867 1,119 152 1887 1,549 159 1907 996 117 1848* 386 152 1868 1,266 164 1888 1,262 132 1908* 894 103 1849 441 168 1869 1,234 165 1889 1,242 130 1850 360 119 1870 1,135 149 1890* 1,484 158 1841-50 (8 years) 2,546 146 1861-70 10,360 153 1881-90 14,055 144 1901-08 8,832 124 1851 457 151 1871 1,179 154 1891 1,481 152 1852 457 132 1872* 1,200 150 1892 1,417 145 1853 571 154 1873 1,172 138 1893 1,595 164 1854* 604 152 1874 1,278 147 1894 1,229 127 1855 605 146 1875 1,306 145 1895 1,416 139 1856 612 142 1876 1,397 152 1896* 1,490 150 1857 642 140 1877 1,302 140 1897 1,338 136 1858 648 142 1878* 1,453 154 1898 1,504 159 1859 665 133 1879 1,340 135 1899 1,548 160 1860* 747 144 1880 1,517 154 1900 1,344 145 1851-60 6,008 143 1871-80 13,144 147 1891-00 14,362 148 * These years contained 53 weeks. 317 [1908 TABLE AA. Showing some of the Work of the Public Health Department. Years. Number of cases of Notifiable Infectious Diseases, inclusive of Phthisis. Number of cases of Non-notifiable Diseases notified by the Public Elementary Schools. Number of acknowledgments of Infectious Diseases to Medical Men, &c. Number of Letters received. Number of Letters written. Number of letters sent to Head Teachers of Schools after disinfection of Pupils homes. Number of Visits made by Sanitary Inspectors to houses. Number of Visits made to Workshops and Factories. Visits made by Food Inspector Number of Houses wherein Nuisances were abated. Number of Houses wherein Drainage Work has been carried out. Number of Disinfections. Number of Intimation Notices served. Number of Infectious Diseases no ified to School Teachers. Number of Statutory Notices served. 1891 2059 .. 2059 .. 1330 .. 45059 17 .. 3382 177 1487 .. .. .. 1892 3478 .. 3478 .. 1617 .. 58786 57 .. 5001 293 2624 .. .. .. 1893 5187 .. 5187 2140 2050 .. 51861 34 .. .. 888 4197 .. .. .. 1894 3338 .. 3338 7444 2931 .. 75969 124 .. .. 1129 3202 6412 .. .. 1895 3086 .. 3086 8409 3756 151 72382 40 .. 6309 1672 3039 6231 .. .. 1896 4149 .. 4149 8218 4600 147 67801 5996 .. 7077 1690 4540 4862 .. 232 1897 3133 .. 3133 9062 4722 324 69098 6761 .. 6674 1728 3859 5586 .. 573 1898 2571 .. 2571 8344 4039 978 70540 6882 .. 6011 1683 3391 5878 .. 608 1899 3164 829 3164 7160 3562 1650 64551 7233 4501 5505 1341 4051 4544 .. 471 1900 2442 3066 2442 6084 3311 1517 60936 7411 6086 5673 1095 3515 4432 .. 316 1901 3054 3395 3054 6486 3718 1690 58407 7371 -* 4461 843 3304 3955 .. 328 1902 3447 2307 3447 6872 5247 2092 63701 8060 4000 5827 1426 4464 4363 .. 275 1903 2215 2298 2215 6131 4409 1255 72140 7846 4889 6756 1711 2157 5153 .. 372 1904 2068 2425 2068 5738 3565 1319 68182 7463 4690 5411 1201 2587 5464 .. 451 1905 2189 3397 2189 5829 3518 1497 76418 7914 4955 7061 1132 2945 5157 .. 630 1906 2550 4135 2550 5911 3438 1774 83168 698O 6968 6004 1043 3220 5847 .. 669 1907 2335 5829 2335 6131 3358 1648 81628 10727 9938 6038 1259 3162 5624 .. 518 1908 2483 4359 2483 6318 4469 1914 86371 11565 13148 6332 1346 3351 5757 1943 789 * Meat Inspector left Borough service for an appointment under City Corporation, and the appointment was vacant some time. 318 1908] Table Ab. BATHS AND WASHHOUSES. Table showing the Number of Persons using the Swimming Baths Private Baths, and the Washhouses during 1908. Swimming Baths. Bathers. Caledonian Road. Hornsey Road. Essex Road. Total. Public. 1st class Males 12,286 43,960 15,864 72,110 Females 652 13,086 2,314 16,052 2nd class Males 25,921 28,364 21,778 76,063 Females 2,529 6,104 4,734 13,367 Schools. 1st class Boys ... 4,921 537 5,458 Girls ... 3,091 ... 3,091 2nd class Boys 43,955 46,323 56,841 147,119 Girls 24,654 23,101 23,966 71,721 Totals 109,997 168,950 126,034 404,981 Private (Slipper Baths.) 1st class Males 15,711 30,431 18,057 64,199 Females 1,170 4,050 1,996 7,216 2nd class Males 50,867 48,364 54,236 153,467 Females 15,214 20,960 23,512 59,686 Totals. 82,962 103,805 97,801 284,568 Washhouses. Washers 31,236 27,677 44,415 103,328 Total Persons using the Establishments. Total persons using each establishment in 1908 224,195 300,432 268,250 792,877 319 LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1908. PREMISES. Number of Places— Number of inspections, 1908. Number of Notices. 1908. Number of Prosecutions 1908. On Register at end of 1907. Added in 1908. Removed in 1908. On Register at end of 1908. Milk premises 532 41 ... 573 3303 493 1 Cowsheds 7 ... ... 7 81 ... ... Slaughter-houses 37 ... 3 34 2008 ... ... Other offensive trade premise 7 ... ... 7 103 ... ... Ice cream premises 230 ... ... 230 348 29 ... Registered houses let in lodgings ‡... ... ... ... 10,782 (a)* 61 (a)* ••• (b)† 1218 (b)†5 * (a) For overcrowding. †(b) For other conditions. ‡ No Register now] pt under new By-Laws. Total number of intimation notices served for all purposes 5757 Overcrowding, 1908. Number of dwelling rooms overcrowded 131 Number remedied 131 Number of prosecutions — Underground rooms— Illegal occupation dealt with during year 47 Number of rooms closed 47 Insanitary houses— Number closed under the Public Health (London) Act, 1891 — Number closed under the Housing of the Working Classes Act - Number of premises cleansed under Sec. 20 of the L.C.C. (General Powers) Act, 1904 115 1908] 320 Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 37 Revenue Acts— Number of houses for which applications were received during year 10 Number of tenements comprised therein 90 Number of tenements for which certificates were (a) granted 41 (b) refused 49 (c) deferred nil Number of prosecutions under By-laws under Public Health Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive matter ning out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health 1 (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. — (f) As to cesspools and privies, removal and disposal of refuse, etc. — (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. 8 (i) With respect to sufficiency of water supply to water closets 1 (j) With respect to drainage, etc. (Metropolis Management Act, section 202) — (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) 1 Mortuaries— Total number of bodies removed 563 Total number of infectious bodies removed 3