ISL 61 1913. FIFTY-EIGHTH 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. 1914. MEMBERS OF THE PUBLIC HEALTH COMMlTTEE. (November, 1912, to November, 1913.) Mayor. Alderman GEORGE SAMUEL ELLIOTT, J.P. Aldermen. CHARLES CROLE-REES* ROBERT STEPHENS CUFFLIN RICHARD JOHN BRIDGELAND Councillors. Ward 1. ROBERT JAMES GANN 1. REUBEN LOOMES 2. HAROLD E. BUTCHER 2. THOMAS B. MADGETT 3. WILLIAM J. SMITH 4. ROSA ESSEX 5. THOS. LUKE HARWOOD 6. WM. MASON BRADBEAR Ward 7. JAMES GRIFFITHS 7. ALEXANDER C. COLEMAN 7. Dr. JAMES E. JACKSON 9. WM. THORESBY COOKSEY, J P. 10. HENRY MILLS, J.P. 11. Dr. SARAH KATE K. HASLAM 11. Dr JOHN J. A. SHERRY, J.P. Chairman Councillor THOMAS LUKE HARWOOD Vice-Chairman Councillor WM. J. SMITH * Died 23rd March, 1913, and was succeeded by Alderman Richard John Bridgeland. OFFICERS OF THE Public health Department Medical Officer of Health. ALFRED EDWIN HARRIS, L.R.C.S., L.R.C.P.Edin. Public Analyst. FRANK LITHERLAND TEED, D.Sc., F.I.C., F.C.S. Solicitor. ARTHUR MELLOR BRAMALL. 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 S-c., in which Females are employed. MARIAN GWYNETH PARKER DAVIES, Cert. Sanit Insp. Ex. Bd. EMILY GROVES MOYNIHAN-NYM AN, Cert. Sanit. Insp. Ex. Bd Inspectors of Houses let in Lodgings. STANLEY PELTON MARKS, Cert. Sanit. Insp. Ex. Bd. THOMAS HENRY HANCOCK, Cert. Sanit. Insp. Ex. Bd. Inspector appointed under the Sale of Food and Drugs ActsTOM 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 GEORGE JAMES BRIDEL. Cert. Sanit. Insp. Ex. Bd. ,, 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 ROBERT WILSON, Cert. Sanit. Insp. Ex. Bd. ,, 12 EDWIN ERNEST WILLIS, Cert. Sanit. Insp. Ex. Bd. ,, 13 THOMAS WALLACE AGAR, Cert. Sanit Inst. ,, 14 HARRY CALLOW, Cert. Sanit. Inst. Engineer in charge of Steam Disinfectors. BEAUMONT SHAW. Caretaker of Shelter House. Mrs. SHAW. Nurse at Disinfecting Station. RITA EDMONDS. Mortuary Keeper. SAMUEL MAXWELL. Distributor of Disinfectants. JOHN REDDY. Disinfectors. JOHN WRIGHT and THOMAS DIXON. Clerical Staff. Chief Clerk GEORGE HAROLD KING Second Clerk HENRY ANGEL. Third Clerk EDWARD ALBERT ABBOTT. Fourth Clerk WALTER JOSEPH WOLFE. Fifth Clerk WILLIAM GEORGE BUNCH. Sixth Clerk ARTHUR ROBERT WITTRICK. Seventh Clerk CLEMENT MARSTONE WHEBLE Junior Clerk NORMAN CLARENCE TURRELL Messenger. ALBERT EDWARD BOOKER. iv. INDEX. Page Adulteration of Food 280 Ages at Death 30, 34,35 Alcoholism 98 Analyst's quarterly reports 309-317 Annual Birth and Death rates, and Death-rates of Children 333 Appendicitis 79 Area of Borough 12 Artizans' and other Dwellings 258 Bacteriological Diagnoses 202 Bakehouses 221-226 Baths and Washhouses 347 Births 19 „ in Decennial periods from 1841 335 „ notification of 23 Butcher's Shops and Shops where food is sold 275 Butchers' open window stalls 275 Butter and Margarine 302 Cancer 82-90 Cleansing of Verminous School Children 214 Common Lodging Houses 257 Constitutional Diseases 81-97 Continued Fever 68 Cow Houses 271-273, 278 Deaths 29 „ from Classified Causes 41, 42 „ at different age periods 30, 34, 35 in the Quarters 38-40 „ ,, Sub-Districts 32 „ ,, Wards 36 „ „ Encircling Boroughs 73, 74 „ from Epidemic Diseases 54-72 Deaths registered from all causes during the Year 326 Deaths registered from all causes in each Quarter 329 Deaths in Decennial periods from 1841 337 Deaths in Public Institutions 103-113 Death-rates of Populous Towns 75 Density of Borough 10 Diabetes Mellitus 96 Diarrhoea 68 Diphtheria 65 ,, Fatality from 128.132 „ Notification of 128 Diphtheria and Croup 131 Disinfectants distributed and used 213 Disinfecting Station 210 Disinfection Work 209 District Inspectors Work 244 Dust, removal of 253 Enteric Fever 67 „ Notification of 133 „ Fatality from 133 Epidemic Diseases 54-72 ,, Cerebro-Spinal Meningitis 159 Erysipelas, Notification 135-136 ,, Fatality from 135 V. Page Factories and Workshops 218 Fatality from infectious Diseases 119, 180 Food, Adulteration of 280 ,, Informal sampling of 292 Food Inspection 263 Hospital Isolation of Infectious Diseases 120, 181 Houses Let in Lodgings 242 Housing, Town Planning, &c., Act, 1909. Administration of 261 Illegitimate Births 22 „ „ in Decennial periods from 1841 336 Infantile Mortality 45-54 „ „ in Decennial periods from 1841 338 Infectious Diseases on Business Premises 185 „ ,, in Streets 188 „ „ in Schools 170, 178 „ ,, (Non-notifiable) in Schools 173, 174 Infectious Sickness in the several Wards from 1891 340-345 „ „ in Quinquennial periods from 1891 339 Informal Sampling of Foods 292 Influenza 76 Inspection of Food 263 „ Kitchens of Restaurants 227 „ Slaughter Houses and Cow Houses 267-270, 272 Houses let in Lodgings 242 Inquests 114 Isolation of Infectious Diseases 120, 179 Local Government Board Returns 348-351 London County Council Return of Sanitary Work 352, 353 Margarine Act 302 Marriages 16 Measles 61 „ Notification of 173 ,, Children excluded from Schools 175 Meat Inspection 263 Midwives attending Disinfecting Station 214 Milkshops, Registration of 279 Milk, Quality of 294 Milkshops and Dairies 279 Mortality in Sub-Registration Districts 32 Mortuary and Coroner's Court 114 Notification of Infectious Diseases 116, 140, 141 ,, „ in Registration Sub-Districts 117,142, 143 „ „ „ „ in the Sanitary Inspectors' Districts 146 „ „ „ in the Wards 118, 144, 145 „ „ „ „ during the several Months 147 „ „ „ „ in the Encircling Boroughs 148, 149 „ „ ,, „ in Metropolitan Boroughs 150, 151 „ ,, Phthisis 161 „ ,, Births Act 23 Non-notifiable Infectious Diseases in Schools 173, 174 Occupation of persons attacked with Infectious Disease 181 Offensive Trades 279 Ophthalmia Neonatorum 101 Outworkers' Premises 226 230 Pauperism 255 vi. Page Persons to an Acre 11 Phthisis 91, 161 „ Notification of 161 Places where Food is prepared 227 Pneumonia 98 Population—Estimated in 1913 3, 9 ,, Age distribution of 6 „ in Sub-Districts 10 ,, and Density of Wards 11 „ Birth Places of Persons living in Borough 8 Population, Inhabited Houses, Marriages, Births, and Deaths 332 Prosecutions, Summary of 323 Puerperal Septic Diseases 80 Puerperal Fever 80 „ „ Notification of 137-139 „ „ Fatality from 137 Polio-myelitis Acute 152 Pulmonary Tuberculosis 91-95, 161 Registered Lodging Houses 242 Respiratory Diseases 97 Restaurant Kitchens 227 Samples analysed in 1913 291 Sanitary Inspectors' Work 244-252 Scarlet Fever 64 ,, Notification of 121, 127 „ Fatality from 125 Seasonal Mortality 31 Septic Diseases 80 Shelter House 213 Slaughter Houses 267 Small Pox 61 „ Notification of 121 Smoke Nuisances 248 Street Markets 249 Streets where Infectious Diseases occurred 188 Summary of Sanitary Work in fourteen Districts 249 ,, ,, Applications for Removal of Dust 253 Trades carried on in Houses where Infectious Diseases have occurred 185 Tubercular Diseases 91, 161 Tuberculosis, Pulmonary, Notification of 161-169 Typhus Fever 68, 135 Unsound Food 263 Unsound Fish 267 Vaccination 203 Venereal Diseases 99 Verminous Persons 213 ,, Children, Cleansing of 214 Water Certificates 249 Water Supply 324 „ to Tenement Houses 243, 249 Whooping Cough 67 Workshops and Factories, Inspection of 218 Work of Public Health Department, Summary of 346 REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1913. To The Worshipful The Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. Mr. Mayor, Aldermen and Councillors, In compliance with the Order of the Local Government Board, I have pleasure in submitting to you the fifty-eighth annual report of the Medical Officer of Health, which deals with the health and sanitary slate of the borough during 1913, and in congratulating you that both continue to be good. Last year I drew special attention to the increase of cancer, which I regret to inform you still continues not only in Islington but throughout the United Kingdom ; and I have thought it advisable to dwell at some length on the subject in this report. It is satisfactory to find, on the other hand, that the deaths from Pulmonary Consumption continue to decrease, and, I trust, when the two Tuberculosis Dispensaries now authorised by you have been established, that they will cause a still further decline in the mortality, and also tend to stop the spread of the disease itself. For the greater part of the year the Public Health Committee occupied themselves with the question of Tuberculosis, its cause, prevention and cure; and ultimately recommended to you a scheme to establish a municipal dispensary on clearly defined and well tried lines; and indeed, this scheme had obtained the provisional approval of the Local Government Board before it was presented to you. U nfortunately it did not meet with your approbation, and the matter was referred to a Special Committee, who have since viii. brought forward a scheme for two dispensaries, which you have accepted. It now only awaits the sanction of the Local Government Board and the London County Council to enable you to complete the arrangements with the two hospitals, which have undertaken to perform the necessary work, and to commence operations forthwith. I sincerely trust that these dispensaries will prove to be a real blessing to the persons who may be attacked with this dire disease, as well as to the community at large. I desire once more to thank the Chairman, Councillor Harwood, and members of the Public Health Committee, for the care and patience with which they have considered the many reports submitted by me from time to time, as well as for the courtesy they have extended towards myself. I cannot conclude without drawing attention to the willing manner in which the staff of the Public Health Department, from the Superintendent (Mr. J. R. Leggatt) downwards, have endeavoured to discharge the ever increasing duties which the legislation of the last few years has imposed on them. I have the honour to be, Your obedient servant, Medical Officer of Health. 31st July, 1914. ix. SUMMARY of Vital Statistics, 1913. Population (Enumerated at Census) ... ... ... 327>4°3 persons „ (Estimated at middle of year) 1913 ... 325,585 persons Estimated decrease on population, 1911 ... ... ... ...1,818 persons Mean Population, ten years (1902-1911) ... ... ... 329,863 persons Area ... ... ... ... ... ... ■ 3>°92 acres Density ... ... ... ... ... ••• 105 persons per acre Marriages ... ... ... ... ... ... ... 2,984 Persons married ... ... ... ... ... ... 5>s68 Persons married rate ... ... ... ... 17*98 per 1,000 inhabitants Births Males 4,317 Females 4,042 Persons 8,339 Birthrate ... ... ... .... ... 25*19 per 1,000 inhabitants Deaths from All Causes Males 2,542 Females 2,486 Persons 5,028 Death rate ... ... ... ... ... 15*15 per 1,000 inhabitants Deaths from Principal Epidemic Diseases Males 162 Females 160 322 persons Death rate ... ... ... ... ... 0*97 per 1,000 inhabitants Infantile Deaths under 1 year Males 517 Females 381 Total 898 Infantile mortality rate ... .. ... ... ... 107 per 1,000 births Excess of Births over Deaths t. ... ... ... 3,331 PART I. THE POPULATIONS, AREAS AND DENSITIES OF THE SUB-REGISTRATION DISTRICTS, THE WARDS AND THE BOROUGH. B 3 1913 REPORT OF THE Medical Officer of Health FOR THE YEAR 1913. POPULATION OF THE BOROUGH, THE SUB-REGISTRATION DISTRICTS THEIR AREAS AND DENSITIES. Population.—The number of people living in any sanitary area is the factor most required for correctly gauging the measure of its health, and for comparing it with other areas; for on it are calculated the death-rates by which these comparisons are made. It is, therefore, of the utmost consequence that the enumerated or the estimated populations should be accurate. Unfortunately in the case of Islington considerable doubt has crept in as to its accuracy since the Census of 1911. That the enumeration showed a decrease then was not altogether unexpected by the Medical Officer of Health, who in common with others interested in the question, had noticed that the number of empty houses had increased towards the close of the intercensal period. No one was, therefore, surprised when the census of 1911 showed a decrease of 7,568 persons. Population in 1901 334,991 Population in 1911 327,423 Decrease 7,568 b 2 4 1913 It is true that this decrease amounted to only 2.8 per cent., but nevertheless it showed for the first time that a check had been placed on the growth of this large and populous borough, which for so many years had held the foremost position in the great metropolis of the world. Since the enumeration in April, 1911, the Registrar-General has estimated its population at the middle of each year as follows:— 1911 327,585 1912 326,398 849 decrease on 1911 1913 325,585 1,818 ,, ,, 1914 324,764 1914 ,, ,, Thus from mid 1911 to mid 1914 (the current year) there is an estimated decrease of 2,639 persons. Unfortunately it is by no means certain that the population is decreasing at the present time. The concensus of opinion is to the contrary. House agents and others interested in property hold an opposite view, and such facts and figures as the Medical Officer of Health has ascertained support it. Thus at Lady Day, 1911, there were 47,491 rateable hereditaments (houses, workshops, stables, etc.) of which 2,396 were unoccupied, whereas at Lady Day, 1914, there were 47,738 hereditaments, ot which only 1,458 were unoccupied, which is a decrease of 938 unoccupied premises. During these three years there was also an increase of 1,185 rateable hereditaments—new property, etc. Again it appears from the weekly returns made by the sub-inspectors of the dust removal department that at the begining of 1913 there were 1,200 empty houses, while during the first three months of 1914 they have varied from 736 to 695. These figures indicate a decrease of about 500 unoccupied houses in one year. But the occupation of unlet houses has been increasing steadily since the end ot 1910, when undoubtedly the period of slump that had prevailed during a few preceding years came to an end, and a brighter period began. Mr. Charles Findlater, of the Town Clerk's Department, has informed the Medical Officer of Health that the registers for the year ended 15th July, 1913, show that 783 ratepayers removed from other parts of the County of London into Islington as ratepayers, and that a number also came into the borough from lodgings elsewhere or became lodgers on entering the borough, and that a further number came in from districts outside the County of London, e.g., Hornsey, Tottenham, and other places coterminus with the County, who, however, would not be qualified for registration until they had resided here for twelve months. From these figures he thinks it fair to 5 1913 assume that at least 1,200 families removed into Islington during 1913, and that they represented a population of some 5,000 or 6,000 persons. It is, he thinks, difficult to estimate the number of human beings who migrate during the year, but from what knowledge we possess, they do not, by a long way, equal the number entering the borough. The census returns for 1901 and 1911 show that the number of families living in Islington were respectively 79,129 and 79,902; that is, with a less population there is a greater number of families, which can be accounted for by the fact that houses are now let out and converted into flats, and that the families occupying these hereditaments consist mainly of married couples without children or single occupiers. Taking the number of families, in round numbers, as 80,000, and the inhabited houses as 40,000, and allowing 4.098 persons, the number ascertained at the census, to each family, he arrives at the following estimated population:— Empty houses, Lady Day, 1911 2,396 1914 1,458 Decrease 938 Of this 938 decrease he assumes that at least 600 houses contain two families, and allowing 4,098 persons to each family, he gets 4,917 persons. Population 1911 327,403 Estimated increase 4,917 332,320 which is his estimate of the population at Lady Day, 1914. These figures of Mr. Findlater are worthy of consideration, especially as they are borne out by the observations of the sanitary inspectors, who constantly report on the increasing difficulty that people, especially the working classes, meet with in their endeavours to obtain rooms. This incertitude as to the size of population of the most populous metropolitan borough, makes it most necessary that a numerical census of the population should be taken at least quinquenially of the County of London. 6 1913 Such a census was made once, in 1896, but not since, although it was generally understood at that time, that one would be taken in the future. Meanwhile it is necessary to accept the estimate of the Registrar General, and to calculate the populations of the sub-districts of the borough by his methods. Based on his estimate of the total population of the borough, that of each of the sub-districts has been calculated as follows:— Sub-district. Population. Tufnell 33,902 Upper Holloway 37,894 Tollington 29,807 Lower Holloway 38,861 Highbury 57.289 Barnsbury 52,665 South-East Islington 75,167 The Borough 325,585 Of these seven districts three are credited with an increase in their population since the census. Thus Tufnell is estimated to have increased by 376, Upper Holloway by 778, and South-East Islington by 3,392. On the other hand, four districts are supposed to have decreased, Tollington by 802, Lower Holloway by 501, Highbury by 4,715, and Barnsbury by 346. Age Distribution of the Population.—The manner in which the population is distributed according to the ages of the people is undergoing a gradual change. Calculations made by the Medical Officer of Health clearly indicate that this change is in a direction which will adversely affect the death rate; in other words, the population is gradually becoming older. In every thousand persons living in 1881, 537 were under 25 years of age; 374 were between 25 and 55, and 89 were 55 and over. In 1891 the figures were 524 under 25 years of age; 383 were between 25 and 55; and 93 over 55. In 1901 492 were under 25 years of age; 405 between 25 and 55; and 103 were over 55. In 1911 they had altered still further, for only 461 were under 25; while 417 were between 25 and 55, and 122 over 55. 7 1913 These figures may be better appreciated in tabular form Age periods 1881. 1891. 1901. 1911. Under 25 years old 537 524 492 461 Between 25 and 55 374 383 405 417 Over 55 89 93 103 122 1,000 1,000 1,000 1,000 What these figures mean is that in the interval between 1881 and 1911 the proportion of population under 25 years of age—that is to say its younger and most active members—has decreased 14.2 per cent. while the number of persons in mature life, that is between 25 and 55, has increased 11.5 per cent.: and the number of those who are advancing into old age, or who have arrived at it, has increased by 37 per cent. It does noc need much demonstration to prove that such changes must seriously affect the mortality, for it goes without saying that the older a person grows the nearer he approaches death. It would, therefore, be well when comparing the present death returns of the boroughs with past years to recollect these changes, which happily have been countered to a great extent by active sanitary administration. For a similar reason when contrasting one County, Town, or District with another, the manner in which the ages of their populations are distributed must be taken into account, for considerable differences occur among them. The following tabular statement shows how the populations of England and Wales, the English Urban Districts, London and Islington, compared at the last census:— Age Period. England and Wales. Urban Districts. London. Islington. Under 25 years of age 487 488 482 461 Between 25 & 55 397 403 378 417 Over 55 years 116 109 140 122 A further statement respecting the age distribution of all these populations is given in Tables V. and VI. Sexes of the Population. -The total estimated population, 325,585, of the borough consists of 155,032 males and 170,553 females, so that the males are in the proportion of 100 to every 110 females. Further, and full particulars are given in Table I. which follows. 8 1913 Birth Places of Persons living in the Borough.—During the year a census return was issued which gave the particulars respecting the birth places of persons resident in Islington, and which shows that 17,447 or 5.3 per cent. were born in countries other than England and Wales. The particulars are given in the following statement:— Countries of which the Residents ark Native. Males. Females. Totals. England and Wales 146,442 163,514 309,956 Scotland 1,690 1,394 3,084 Ireland 1,439 1,557 2,996 Isle of Man and Channel Islands 141 172 313 British Colonies 615 578 1,193 Europe— Gibraltar 26 15 41 Malta and Gozo 20 17 37 Asia— Indian Empire 179 203 382 Ceylon 14 9 23 Other Colonies in Asia 5 5 10 Africa— South African Colonies 83 66 149 West African Colonies 9 7 16 Other African Colonies 3 6 9 America— Canada 78 83 161 Newfoundland 3 6 9 West Indies 37 29 66 British Guiana, &c 9 3 12 Australasia— Australian Commonwealth 116 108 224 New Zealand 32 19 51 Other Australasian Colonies 1 1 Colony or Dependency not stated 1 1 2 Foreign Countries— 3,903 2,165 6,068 British Subjects 194 337 531 Naturalised British Subjects 302 164 466 Foreigners 3,407 1,664 5,071 At Sea— 42 45 87 Birthplace not stated 1,629 2,077 3,706 9 1913 Table I. Showing the Estimated Number of Persons living in Islington at the middle of 1913, at Nine Age Periods, and distinguishing Males and Females, together vith the Number of Persons at Census 1911. Ages. Males. Females. Persons. Persons at Census 1911. Increase or Decrease. 0—5 16,928 16,607 33,535 33,711 —176 5—15 29,085 28,980 58,065 58,373 -308 15—25 27,860 30,702 58,562 58,905 -343 25—35 27,330 30,382 57,712 58,032 -320 35—45 21,248 23,692 44,940 45,207 -267 45—55 15,534 17,631 33,165 33,371 -206 55—65 10,113 12,015 22,128 22,237 -109 65—75 5,394 7,448 12,842 12,905 -63 75 and upwards 1,540 3,096 4,636 4,662 -26 All ages 155,032 170,553 325,585 327,403 -1,818 10 1913; Table II. Showing the Areas, Densities, and Estimated Populations oj the Sub-registration Districts at the middle of the year 1913. Sub-Districts. Area in Acres Estimated Acres to a person, 1913. Estimated Persons to an Acre, 1913. Estimated Population Mid-year 1913. Population at Census 1911. Increase or Decrease on Census. Tufnell 411 0.0121 82 33,902 33,526 +376 Upper Holloway 299 0.0079 127 37,894 37,116 +778 Tollington 315 0.0105 95 29,807 30,609 -802 Lower Holloway 415 0.0107 94 38,861 39,362 -501 *Highbury 799 0.0130 77 57,289 62,004 -4,715 Barnsbury 310 0.0059 170 52,665 53,011 -346 *South-East Islington 543 0.0076 130 75,167 71,775 +3,392 The Borough 3,092 0.0095 105 325,585 327,403 —1,818 * By order of the Registrar-General, that part of Canonbury Ward, hitherto included in Highbury Sub-District, was transferred to Islington South East on 1st June, 1913, and their respective populations have been corrected accordingly. 11 1913 Table III. Showing the Areas, Densities and Estimated Populations of the Wards at the middle of the year 1913, together with the Populations at Census 1911 WARDS. Area in Acres. Estimated Persons to an Acre, or Density of Population, 1913. Estimated Population Mid-year, 1913. Population at Census 1911. Increase or Decrease. No. 1—Tufnell 411 82 33,902 33,526 + 376 2—Upper Holloway 299 127 37,894 37,116 +778 3—Tollington 315 95 29,807 30,609 -802 4—Lower Holloway 415 94 38,861 39,362 -501 5—Highbury 417 80 33,572 33,805 -233 6—Mildmay 337 70 23,717 23,923 -206 7—Thornhill 172 181 31,093 31,5!2 -419 8—Barnsbury 137 157 21,572 21,499 4-73 9—St. Mary's 148 114 16,828 16,908 -80 10—Canonbury 286 100 28,692 28,921 -229 11—St. Peter's 155 191 29,647 30,222 -575 The Borough 3,092 105 325,585 327,403 -1,818 12 1913 Area.—Islington contains 3,092 acres, of which 292 are parks, open spaces, water, railways, or markets, so that only 2,800 acres are available for houses, roads and streets. Water, such as the Regent's Canal, and the New River, covers 17.2 acres, railways 196.9 acres, markets 14.9 acres, and parks and open spaces 62.8 acres, so that altogether 291.8 acres are unavailable for housing the people. This is not a very great area, although distributed as it is throughout the borough, it provides very satisfactory lungs for it. Table IV. shows how this space is distributed:— Table IV. Sub-Districts. Gross Area (Acres). Water. Railways. Markets. Parks and Open Spaces. Total Unavailable Space. Net Area. 1 2 3 4 5 6 7 8 Tufnell ... 417 7.4 20.8 ... 6.2 34.4 382.6 Upper Holloway 290 ... 7.3 ... ... 7.3 282.7 Tollington 320 ... 20.8 ... ... 21.9 298.1 Lower Holloway 413 ... 33.0 14.9 11.0 58.9 354.1 Highbury 798 ... 76.1 ... 32.4 108.5 689.5 Barnsbury 309 5.1 22.0 ... 4.7 31.8 277.2 South-East Islington 545 4.7 15.8 ... 8.5 29.0 516.0 The Borough 3.092 17.2 196.9 14.9 62.8 291.8 2,800.2 13 1913 Table V. Showing the Number of People living at Nine Groups of Ages in every Thousand of the Population in 1881, 1891, 1901, and 1911. Census Years. age periods of life. 0—5 —15 —25 —35 —45 —55 —65 —75 75 and upwards. 1881 133 206 198 172 122 80 52 27 10 1891 118 206 200 172 124 87 54 28 11 1901 108 185 199 182 130 93 60 31 12 1911 103 178 180 177 138 102 68 40 14 Table VI. Showing the number of Persons in the several Places mentioned living at Nine Groups of Ages in every thousand of their populations, according to the Census 1911. DISTRICTS. -5 -15 -25 -35 -45 -55 —65 —75 75 and Upwards. England and Wales 107 200 180 165 134 98 64 38 14 Urban Districts 107 198 183 170 136 97 62 35 12 Rural 105 205 172 149 128 101 71 48 21 London 103 185 184 176 139 101 63 36 13 Islington 103 178 180 177 138 102 68 40 14 PART II. MARRIAGES, BIRTHS AND DEATHS. 16 1913 MARRIAGES During the year there were 5,968 persons united in marriage, as contrasted with 6,182 in the previous year; and the marriage rate was 17.98, as against 18.94 in 1912. It is, therefore, nearly 1.0 per 1,000 of the population less than in the latter year. Although this is so, yet an examination of the returns for the last seventy-two years reveals the fact that in only fifteen has the rate been higher than that now recorded. This is gratifying, for it shows that the period through which the borough is passing is not a lean one, but, on the contrary, rather indicates that trade is good; for bad trade has a very depressing effect on the matrimonial market. "Marriage Returns," as the greatest of our vital statisticians (Dr. Wm. Farr) wrote so long ago as 1847, " point out periods of prosperity little less distinctly than the funds measure the hopes and fears of the money market. If one is the barometer of credit, the other is the barometer of prosperity, present in part, but future, expected, anticipated in still greater part." And again, having discussed the effect on marriages, of war, the grain crops, the establishment of new, and the extension of old, employments, epidemics of speculation, and of sanguine politics created by a great leader, he adds, "in fine the great fluctuation in the marriages of England are the results of peace after war, abundance after dearth, high wages after want of employment, speculation after languid enterprize, confidence after distress, national triumphs after national disasters." And so we find it still, as also that what is true of a nation is true of a smaller community. Prosperity, even though it last but a year, has its effects and often induces thoughtless men and women to marry when they ought rather to consider if the prosperity were going to continue or to prove merely a wave which was followed by a depression, and not a full sweeping tide, or at least such a tide as would enable them to meet with confidence the backwash when it comes, as come it will. The higher marriage rates of the last two years indicate that the flow has been steady, and that these were the times to marry. The marriage rate in 1913 showed that one woman was married for every 57-2 women living in the borough, and one man to every 51.9 men, or putting it another way, as regards females the marriage rate among those of a marriageable age, that is over 15 years, was 23.9 per 1,000, and among males, of whom very few, however, marry before 21, 27.4 per 1,000. In the following Table it will be noticed how the marriage rates fluctuated according to the period of the year; the best period being apparently the third quarter, and the worst the second. Probably the reason why the third quarter holds the premier position is that during it persons usually take their 17 1913 annual holiday, and, therefore, it would be from a business point of view the most suitable for marriage, which usually entails a short or long absence from work, according to the means and business pre-occupations of the persons marrying. Showing the number nj Persons Married and the Marriage Rates in each quarter of 1913 and in 1912. Quarters No. persons married. Persons married per 1,000 inhabitants. 1913. 1912. 1913 1912. First 1,214 946 14.91 11.59 Second 1,250 1,554 15.35 19.04 Third 1.954 1,886 24.01 23.11 Fourth 1,550 1,796 17.68 22.01 The Year 5,968 6,182 17.98 18.94 C 18 1913 Table VII. Shewing the Marriages and Marriage Rates of Islington from 1841 to 1913. The marriage rates for the year in which they were above that of 1913 are printed in heavy type. Years. Marriages. Marriage Rates. Years. Marriages. Marriage Rates. Years. Marriages. Marriage Rates. Years. Marriages. Marriage Rates. 1841 533 18.86 1861 1,236 15.79 1881 2,306 16.25 1901 2,994 17.88 1842 458 15.36 1862 1,399 17.31 1882 2,367 16.48 1902 3,108 18.26 1843 489 15.54 1863 1,400 16.77 1883 2,370 16.30 1903 3,053 18.32 1844 524 15.79 1864 1,630 18.92 1884 2,393 15.95 1904 2,948 17.73 1845 632 18.05 1865 1,759 19.77 1885 2,278 15.92 1905 2,984 17.99 1846 640 17.32 1866 1,805 19.65 1886 2,176 14.43 1906 2,964 17.91 1847 657 16.86 1867 1,710 18.35 1887 2,241 14.69 1907 2,962 17.94 1848 661 16.08 1868 1,766 18.04 1888 2,270 14.69 1908 2,781 16.56 1849 695 16.02 1869 1,665 16.47 1889 2,436 15.57 1909 2,769 16.84 1850 820 17.92 1870 1,794 17.20 1890 2,485 15.40 1910 2,870 17.50 1841-50 6,109 16.79 1861-70 16,194 17.84 1881-90 23,322 15.55 1901-10 29,433 17.76 1851 895 18.56 1871 1,744 16-20 1891 2,741 17.13 1911 2,843 17.37 1852 982 19.40 1872 1,952 17.63 1892 2,783 17.21 1912 3,091 18.94 1853 1,025 19.28 1873 1,998 17.55 1893 2,653 16.23 1913 2,984 17.98 1854 1,054 18.88 1874 2,080 17.77 1894 2,694 16.30 1855 1,000 17.06 1875 2,162 17.96 1895 2,680 16.04 1856 1,098 17.83 1876 2,187 17.67 1896 2,969 17.25 1857 1,108 17.13 1877 2,188 17.19 1897 3,000 17.80 1858 1,152 16.96 1878 2,191 16.74 1898 3,205 19.04 1859 1,280 17.95 1879 2,195 16.31 1899 3,254 19.35 1860 1,307 17.45 1880 2,192 15.83 1900 2,968 17.67 1851-60 10,901 17.96 1871-80 20,889 17.06 1891-1900 28,947 17.44 19 1913 BIRTHS. There were 8,359 births registered, of which 4,317 were males, and 4,042 females. All these children, although borne by mothers belonging to Islington, were not, however, born here, for 229 were delivered at the Lyingin Hospital, Finsbury, and 139, which were afterwards notified to the Medical Officer of Health by the Registrar-General, occurred in various other places. This practice of the Registrar-General has now continued for three years, with the result that the particulars as to the births are more accurate than hitherto, as formerly their gross number was only obtainable. The new information was the outcome of the Notification of Births Act. It should be noticed that the number of births at the Workhouse Infirmary was 101, or 68 less than in the previous year, and 70 less than the average of the preceding five years. This decrease is no doubt due to the maternity benefit now granted to lying-in women under the National Insurance Act, which has enabled them to obtain the necessary medical attention in their own homes. The total births represented a rate of 24.77 per 1,000 of the population, as contrasted with 25.83 in the preceding ten years. A glance at Table F. in the Appendix will show that these rates are very much lower than those experienced in former years in the borough, when at times the birth-rate reached nearly the level of the great industrial towns, in which it is usually higher than in other places. Thus, during the ten years 1861-70 it averaged 37.20 per 1,000, and in 1866, 1867 and 1868 was respectively 38.02, 38.97, and 38.86. The rate for 1867 was the high-water mark for the borough. There can be little doubt that the ordinary family in this country is gradually decreasing in size, and that whereas formerly large families were very general, smaller ones more usually prevail now. It is difficult to prove this statistically, but, fortunately, new material contained in the Scottish Census enabled Dr. Crawford Dunlop to make an investigation which throws a most interesting light on the subject. Delay in marriage is, of course, a contributory cause, the influence of which he was able to prove, and was enormously greater when it occurred in the case of a woman than of a man. Indeed, he showed that a delay of three years on the part of a wife aged 20 to 25 years old reduces the size of the family approximately by one child, but that it requires a delay of something like forty years on the part of the husband to effect the same reduction. He found when he compared the C 2 20 1913 average Scottish family with the corresponding figures for similar marriages twenty years earlier that the decrease in size was universal, and that for all ages under 36, 32 excepted, it amounted to more than one child per marriage. Thus while in 1866 the wife who had married at 20 had on an average a family of eight or nine children, in 1886 she was the mother of seven or eight children, and so on. A Table, given below, appended to Dr. Dunlop's paper, bears out the contention that the shrinkage in the size of the Scottish family is not entirely due to later marriages alone, because the marriages at a later age to-day show a relatively diminished number of children when contrasted with similar marriages twenty years before. Age of Wife at Marriage. Date. Average Family. Date Average Family. 27 1873 5.85 1893 1.67 28 1874 5.08 1894 1.11 29 1875 4.91 1895 1.38 30 1876 4.57 1896 1.35 31 1877 4.35 1897 1.48 32 1878 3.48 1898 0.82 33 1879 3.76 1899 1.36 34 1880 3.44 1900 1.25 35 1881 2.80 1901 1.11 36 1882 2.40 1902 0.72 These figures are very remarkable, and are a distinct warning, if anything approaching such a family shrinkage is occurring in other parts of the United Kingdom, that no effort would be too great or too far reaching which would prevent the loss of the lives of the infants that have been born to the nation, and that such prevention should be a national duty. Money is required for the purpose, and it should be forthcoming in large proportions from the Imperial Treasury. Local Authorities year by year are feeling more and more the burden of modern health legislation, which has for its object the preservation of infant life and the proper care and nurture of young children; and the time has now arrived when they can afford to accomplish little more unless they are enabled to do so by liberal grants by Parliament in aid of the specific purposes for which they are required. The money will be well spent, for if ever money can buy life and health it can do so to a very large extent in the case of infants and young children, and so enable them to fight against the ailments of youth, and to grow up with bright cheeks, strong frames, and sturdy limbs. Contrast this with the children we see every day in our schools 21 [1913 and streets, with their too white cheeks, their too slender limbs, their too slow gait and shrinking habits. These are the children who have passed through pains and early miseries; frail, helpless creatures, and often too helpless and too frail to be useful inmates of this active world. The Spartans of old ensured that such children should not encumber the nation, for, according to their laws, every infant soon after it was born was brought to an official, who judged whether it was. to be allowed to live or not. If the child was weak and puny it was taken from the mother and carried to a hill, where it was allowed to die; but if it was healthy and strong it was permitted to live, and was afterwards cared for by the State. But modern civilization has discovered a better method than this for ensuring a healthy race, which is to teach future and present mothers of the race how to care for themselves when pregnant; how to care for themselves after their child is born, and how to care and feed their infants. More than fifty years ago Florence Nightingale wrote in her "Notes on Nursing for the Working Classes" : "Every woman in England has, at one time or another in her life, charge of the personal health of somebody, whether child or invalid, in other words, every woman must become a nurse. The knowing what are the laws of life and death for men, and what the laws of health for houses (and houses are healthy or unhealthy, mainly according to the knowledge or ignorance of the woman), are not these matters of sufficient importance and difficulty to require learning by experience and careful inquiry, just as much as any other art? They do not come by inspiration to the loving heart. Terrible is the injury that has followed from such wild notions." Florence Nightingale has not taught in vain, for although the result of her teachings have been of slow growth, still that growth has been continuous, so that to-day they are universally accepted. Teach the mothers of the race what they should do for their infants, and the race will in time be strong and healthy. A strong indication that the interest in such teaching in this country has taken deep root is shown by the fact that Her Majesty the Queen recently gave her patronage to and attended a theatrical performance in aid of the funds of certain Metropolitan " Schools for Mothers," whose most useful work has thereby received the hall mark not only of Her Majesty"s approval, but of all thinking persons. Nursing evidently does not appear a trivial matter to the Queen, and Her Majesty is right, for, as Charles Kingsley wrote: "Nations are gathered out of nurseries." It is very pleasing to note that the Government are at last awakening from their long sleep as to the importance o'f saving the lives of the children of 22 1913] the country, and of raising a strong and healthy race, for only just recently (June 26th, 1914) Lord Haldane, the Lord Chancellor, made an arresting speech on the subject. It should be read, for it indicates that our rulers now recognise the necessity of action on this great question for which Medical Officers of Health, who are only anxious for the health and vigour of the nation, have pleaded for many years. The only regret of the Medical Officer of Health of this Borough (who has so often advocated similar action in addresses, papers, lectures, and official reports for the last 36 years, and who knows no politics in his work) is that this new policy comes clothed in a strongly political garb. This, however, will soon be forgotten, as that of the opposite party in introducing the Public Health Act, 1875, has long been, when the good results, which must accrue from it, are seen. It is clear that the Lord Chancellor thoroughly grasps his subject, for he says:—"Now I want to come to what our problem is. In some respects it is a serious one. The birth-rate is diminishing. That may not be altogether an evil —it may mean a general desire to bring up children in a way they were not brought up in before—but it is a difficulty which the most highly-civilized nations have to reckon with. While we cannot hope to increase the birth-rate, and while I am not sure that I should very much wish to do so, there is one thing we can do, and that is to secure compensation. I have studied these things pretty closely, and what has concerned me, I think, more than anything else is the enormous proportion of children who die in the first .12 months of life, and who never come into the world at all, although under proper conditions they would be living and healthy. The statistics are frightful. In the first 12 months of child life the death-rate is 128 per thousand. But that is not so bad as the rate relating to children who might come into the world and yet die before they are born, which is perhaps not less than 150 per thousand. If you could only reduce these even partially you would have compensated for all our difficulties as regards the birth-rate and would have made good the assurance we desire to have about the future generation. Can it be done? The purpose of my right hon. friend's Budget is directed, perhaps, more than anything else, to solving this problem." Illegitimate Births. These births numbered 297, or 36 less0 than in the preceding year, and represented 3.55 per cent, of the total births, a proportion which is somewhat less than in 1912, but more than the average of the twenty years 1891-1910, in which it was 2.77 per cent. 23 [1913 The following statement shows the illegitimacy in the borough since 1841:— Periods. Illegitimate Births. Total Births. Illegitimate Births per 1,000 Registered Births. 1841.50 641* 20,850 3.07 1851.60 1.335 41,915 3.18 1861.70 2,651 67,520 3.92 1871.80 3,429 89,627 3.82 1881.90 3.475 97,420 3.57 1891.1900 2,719 97,278 2.79 1901.1910 2,413 87,361 2.76 *This is an estimated figure, as the returns for only seven years are available. Table G of the Appendix gives a return of the illegitimate births for each year since 1841. The Notification of Births.—7,215 notifications of births, representing 86-7 per cent, of the total births, were forwarded to the Medical Officer of Health under~the provisions of the Notification of Births Act, 1907, which enacts that every birth shall be notified within thirty-six hours of its occurrence. There were, however, 1,114 failures to comply with the Act, or 13-3 per cent, of the gross number of births. In the preceding years the figures were as follows: — Births. Notifications. Failures to notify. Per cent, notified. Per cent, of Failures to notify. 1908 (From July 16th) 3.967 3,211 756 80*9 19-1 1909 8,198 6.983 1.215 85-2 14-8 I9IO 8,201 7.407 794 90-3 97 igil 8,113 7.232 881 bg*i 10 9 1912 8,211 7.238 973 88-i II*9 1913 8.359 7.245 1,114 86-3 I3'3 Here it is seen that the percentage of failures to notify has gradually increased during the last four years from 9-7 per cent, in 1910 to 13-3 in 1913. Of the 7,245 notifications, 1,070 were supplied by medical practitioners. 3,351 were supplied by midwives. 2,824 were supplied by parents and others. 24 1913] Of the 1,114 failures to notify to the Medical Officer of Health, it has been ascertained on inquiry that: In 742 instances the mother was attended by a doctor. In 72 instances the mother was attended by a midwife. In 33 instances the father was not at home within 6 hours of the birth. In 267 instances no information could be obtained for the reasons which follow:— Information refused. Wrong address on certificates. Futile calls. Removal from the house since birth of child. Death of child before registration. The following statement shows by whom the notifications were made since the Act came into operation:— By Medical Practitioners. By Midwives. By Parents and other Persons. Total Notifications. 1908 (From July 16th) 483 974 1,754 3,211 1909 988 2,312 3,683 6,983 1910 1,011 3,271 3,125 7,407 1911 1,048 3,412 2,772 7,232 1912 1,059 3,412 2,767 7,238 1913 1,070 3,351 2,824 7,245 25 [1913 TABLE VIII. Showing the number of Births registered in the Sub-Registration Districts, 1902-1913. Sub-District. 1902 1903 1904 1905 1906 1907 I908 1909 I9IO 1911 &£:1912 1913 Tufnell 745 740 799 758 746 745 816 759 741 763 749 787 Upper Holloway Tollington 1,131 1,108 1,066 1,067 1,061 1,023 1,027 993 985 945 1,021 897 849 850 815 809 747 755 728 7°5 724 739 660 752 Lower loway Highbury 1,122 1,126 1,114 1,118 1,118 1,094 1,067 1,084 1,050 986 1,027 1,077 1,488 1,460 1.423 1,303 1,348 1,278 1,416 1,301 1,271 1.349 1,211 1,245 Barnsbury 1,757 1,648 1,672 1,706 1,679 1,709 1,625 i,493 1,4545 1,498 1,519 1,544 Islington South-East 2,122 2,051 2,001 1,995 1,960 1,927 1,986 1,863 1,885 1.793 1,864 1,9l8 Borough 9,214 8,983 8,890 8,756 8,659 8,531 8,665 8,198 8,201 7,973* 8,051* 8,220* *Not including "Transferable Births" forwarded by Registrar-General, whose mothers' place of residence cannot be located. 26 1913] Table IX. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1913, and in the four quarters of the year and of the County of London and the Great Towns during the same period; also in the year 1912; together with the mean Borough Birth-rates for the years 1903-1912. Quarter. Males. Females. Total. Birth Hates. Islington, 1913. Islington 1903-12. London, 1913 96 Great Towns, 1913 First 1,077 968 2,045 25.12 26.42 25.7 25.4 Second 1,106 1,026 2,132 26.19 26.00 25.2 25.9 Third 1,040 961 2,001 24.58 25.29 24.7 25.3 Fourth 1,022 1,020 2,042 23.29 24.88 23.7 24.1 The Year 1913 4,245 3,975 8,220* 24.77 25.83 24.5 25.1 191.2 4,199 3,852 8,051 24.67 24.77 24.7 24.9 Increase or decrease +46 +123 +169 +0.10 -1.06 -0.2 -0.2 *In addition to these 8,220 births the Registrar-General transferred 139 to Islington. The total births are therefore 8,359 = 25.19 per 1,000 inhabitants. 27 [1913 Table X. Showing the Births of Males and Females in each quarter and for the year, 1913, and in the several Sub-registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington South-East. The Borough Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. 1st Qr. 90 87 177 139 111 250 85 87 172 157 115 272 187 146 333 182 188 370 237 234 471 1,077 968 2,045 2nd „ 111 100 211 112 104 216 108 83 191 141 147 288 161 160 321 215 199 414 258 233 491 1,106 1,026 2,132 3rd „ 103 94 197 121 103 224 99 102 201 128 123 251 145 142 287 187 178 365 257 219 476 1,040 961 2,001 4th „ 98 104 202 97 110 207 87 101 188 129 137 266 166 138 304 204 191 395 241 239 480 1,022 1,020 2,042 Year 402 385 787 469 428 897 379 373 752 555 522 1,077 659 586 1,245 788 756 1,544 993 925 1,918 4,245 3,975 8,220* *Vide note to Table VIII. 28 1913] Table XI. Showing the Birth-rates for each quarter and for the year 1913. of the several Sub-registration Districts and of the Borough. Sub-Districts 1St Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Tufnell 20.88 24.90 23.24 22.13 22.77 Upper Holloway 26.38 22.80 23.64 20.29 23.22 Tollington 23.08 25.63 26.97 23.42 24.75 Lower Holloway 27.99 29.64 25.83 25.43 27.19 Highbury 21.64 22.41 20.04 19.71 21.31 Barnsbury 28.10 31.45 27.72 27.86 28.76 Islington, S. East 26.57 26.13 25.33 23.72 25.03 The Borough 25.12 26.19 24.58 23.29 24.77 Table XII. Showing the Population, Births, and Birth-rates in Seven Decennial Periods, 1841 to 1910, and in 1913. Periods. 1 Mean Population in each Decade. 2 Number of Births in each Period. 3 Birth-rates. 4 Average Yearly Number of Births, corrected on the basis of the population of 1913. 5 1841-50 72,767 20,850 28.65 9,327 1851-60 121,353 41,915 34.54 11,246 1861-70 181,529 67,520 37.20 12,107 1871-80 244,884 89,627 36.60 11,918 1881-90 299,857 97,420 32.49 10,578 1891-1900 331,868 97,278 29.31 9,544 1901-10 331,434 87.361 26.36 8,582 1913 325,585 8,359 25.19 8,359 29 [1913 DEATHS. The mortality returns gave 5,028 deaths as properly belonging to the borough of Islington, which means they include many deaths which until two years ago were credited to the localities in which the persons died, and wherein they had resided for some time. Indeed, in some instances inquiries, made at the supposed former addresses of some of the deceased persons, and even in their neighbourhood, failed to elicit any information respecting them. Nevertheless the Somerset House officials insisted on their inclusion in the Islington returns, because the deceased had given their addresses here at the time of their entry into the institution wherein they had died, which, in some cases, occurred many years ago. The returns also include the deaths of all persons who had died in public institutions outside the borough, to which they had gone for treatment or to die Thus it is apparent that the mortality returns are something more than exact. The 5,028 deaths were equal to a death-rate of 15.15 per 1,000 of the estimated population, which is 0.81 per 1,000 higher than the rate of the preceding year. It contrasts also with a death-rate of 14.2 for the County of London, with 13.4 for England and Wales, and with a mean rate of 14.7 for the boroughs which encircle Islington. It was pointed out in the earlier part of this report, as well as in several reports of previous years, that the manner in which the ages of the population are distributed has a considerable influence on the deathrate, as has also the distribution of the sexes. The Registrar-General has, therefore, prepared factors by which these recorded death-rates can be standardized so as to make the death-rates of various places comparable with that of England and Wales, which is the basis of his calculation, and with each other. These he calls "factors for correction," and that for Islington is 0.9749; and therefore the "corrected" death rate for Islington is 14.77. It is, therefore, possible to compare one borough with another with some exactitude, and this is the result. Corrected death rate St. Pancras 15.15 Hornsey 9.64 Stoke Newington 12.93 Hackney 13.41 Shoreditch 19.21 Finshury 18.09 Islington 14.77 30 1913] Ages at Death.—The returns showing the ages of the persons who have died have been examined to ascertain the periods of life at which the deaths were in excess of those of last year, with the result that it is found that among children under five years of age there was an increase in the mortality in 1913 of 215, of which 188 were infants under a year old; in that between 5 and 15 it was 26; between 15 and 25, 23; between 35 and 45, 29; between 45 and 55, 59; between 65 and 75, 24; between 75 and 85, 4; and above 85 it was 14. There were, therefore, 8 age-periods at which the deaths showed a joint increase of 394, and two at which they exhibited a decrease of 48, namely, between 25 and 35 of 18, and between 55 and 65 of 30, leaving a net increase of 346. Age Periods. 1912. 1913. Difference. Age Periods. 1912. 1913. Difference. 0-1 710 898 +188 45-55 518 577 +59 1-5 423 450 +27 55-65 645 615 -30 Under 5 1,133 1,348 +215 65-75 754 778 +24 5-15 140 166 + 26 75-85 563 567 +4 15-25 158 181 +23 85 and upwards 153 167 +14 25-35 271 253 -18 35-45 347 376 +29 Total 4,682 5,028 +346 In this statement the largest increases are seen to have occurred at the earliest periods of life. The year 1912 was, however, the most favourable which the borough has experienced in its long history, and it was not to be expected that its good fortune would continue, and consequently these increased deaths are only of passing moment. When, however, the figures for the year under discussion are compared with those of the preceding ten years, 1903-1912, it is found that the deaths of infants were 71 below the average, and of young children (1-5 years) 74 below it, making a total of 145. In the following statement a contrast is made between the deaths in 1913 and the average numbers for the years 1903-1912. Age periods. Average 1903-12. 1913. Difference. Age priods. Average 1902-12. 1913. Difference. 0-1 969 898 -71 45-55 506 577 +71 1-5 524 450 -74 55-65 605 615 +10 Under 5 1.493 1348 -145 65-75 668 778 +110 5-15 146 166 +20 75-85 486 567 +81 15-25 170 l8l +11 85 and upwards 144 167 +23 25-35 276 253 -23 35-45 388 376 —12 Total 4,882 5,028 +146 CHART. Showing the Mean Weekly Death-Rate from ALL CAUSES for each week of the twenty years 1894-1913, together with the Death-Rate for each week in 1913. 31 A further tabulated statement, prepared by the Medical Officer of Health is given below and distinguishes at once the classified diseases from which there was an increased mortality when compared with preceding years. It indicates that they are those over which the sanitary authority possesses little or no control. Indeed, zymotic diseases, against which we are constantly lighting, exhibit the very gratifying decrease of 148 on the average of the preceding ten years. Classified Diseases. 1913. Average of 1903-12. 1912. Difference from 1903-12. Difference from 1912. Zymotics 322 470 296 —148 +26 Respiratory 958 964 980 —6 —22 Venereal 19 20 17 —1 +2 Septic 42 47 43 —5 —1 Parasitic 1 1 — 0 +1 Dietic 17 27 19 —10 —2 Constitutional 1,032 1,031 1,023 +1 +9 Developmental 468 410 396 +58 +72 Nervous System 376 308 260 +68 +116 Special Sense Organs 20 12 4 +8 +16 Circulatory System 733 679 754 +54 —21 Digestive „ 362 309 290 +53 +72 Lymphatic „ 10 10 6 0 +4 Urinary „ 213 167 166 +46 +47 Reproductive „ 26 26 25 0 +1 Bones and Joints 6 12 10 —6 —4 Integumentary 14 8 5 +6 +9 Violence 195 194 227 +1 —32 Ill-defined Causes 149 146 120 +3 +29 SEASONAL MORTALITY. In the first quarter of the year the deaths numbered 1,495, and were equal to an annual death-rate of 18.36 per 1,000 of the inhabitants. This deathrate contrasts with an average rate of 16.94 in the first quarters of the ten preceding years, and with 19.35 in the years 1886-1912. There was an increase in the number of deaths of young infants as compared with the preceding ten years, as well as a considerable increase among persons of 65 years old and upwards. Indeed, these deaths amounted to as many as 79. For further particulars, reference should be made to the quarterly reports of the Medical Officer of Health, which deal fully with this matter. 1913] 32 The slight disparity in the total deaths and death-rates in the Quarterly Reports and those given here is due to the addition of the " transferable " deaths forwarded by the Registrar-General, after these reports had been published. In the second quarter 1,207 deaths were known, and equalled an annual death-rate of 14.83 per 1,000, as contrasted with 12.96 in 1912, and a decennial rate of 13.5. See also the second quarterly report of the Medical Officer of Health. In the third quarter, 993 deaths were registered, and were equal to a rate of 12.20 per 1,000 of the population, as contrasted with a mean decennial rate for this quarter of the year of 12.75, and with 14.74 in the 27 years 1886-1912. This quarter, as usual, was the healthiest of the year. It was remarkable for the large decline in diarrhœal diseases among children, as well as from miasmatic diseases. In the fourth quarter, 1,333 deaths were entered in the registers, representing an annual death-rate of 15.20 per 1,000 inhabitants. This rate was slightly below that of the decennium 1903-1912, when it was 15.75, and with the mean rate of 17.05 in the preceding 27 years. Full particulars are given in the Medical Officer of Health's fourth quarterly report. The deaths and death-rates of the several quarters are shown in the following statement:— Deaths. Death rates. 1903-12. 1886-1912. First Quarter 1,495 18.36 16.94 19.35 Second „ 1.207 14.83 13.50 15.01 Third „ 993 12.20 12.75 14.74 Fourth „ 1.333 15.20 15.75 17.05 DEATHS IN THE REGISTRATION SUB-DISTRICTS. The death-rates in the sub-registration districts varied,, as might be expected, according to the status in life of their inhabitants. Thus in the residential district of Highbury the death-rate was only 13-89, whereas in the working class district of Barnsbury it was 16-88 per 1,000. Tufnell.—(Estimated population, 33,902.) 494 deaths were registered, as contrasted with 390 in the preceding year, and with an average of 429 in the septennial period 1906-1912; and the death-rate was 14.30, as compared respectively with 11.56 and 12.90 in the years mentioned. 33 [1913 Upper Holloway.—(Estimated population, 37,894.) 587 deaths were known, or 8 less than in 1912, but they were 34 more than the average of the seven years 1906-1912. the figures for which were respectively 579 and 553. The death-rate for the year was 15.20 per 1,000 of the population, as against 15-41 in 1912, and a mean rate of 15-11 from 190G to 1912. Tollington.—(Estimated population, 29,807.) The 464 deaths registered in this area showed an increase of 70 over the return for 1912, and of 46 over that for the scptennium 1906-1912, and they represented a death-rate of 15-27 per 1,000, which may be contrasted with 13 06 in 1912 and with 13 40 in the seven years immediately preceding. Lower Holloway.—(Estimated population, 38,861.) For several years the mortality returns have run very evenly in this populous sub-district, and they now only show an increase of 7 as compared with the preceding year, while they are 8 below the septennial average. The deaths numbered 620, while in 1912 they were 613, and in the seven years averaged 613. They represented a death-rate of 15.65 per 1,000, as against 15 68 in 1912, and 15.81 in the years 1906-1912. Highbury.—(Estimated population, 57,289.) This district is usually the most healthy in the borough, and in 1913 was no exception to the rule, for the deaths, which numbered 811, were equal to a death-rate of 13 89 per 1,000 inhabitants, which was the lowest returned by any of the districts. It is, however, higher than that recorded in 1912, when it was 13.0. The mean septennial rate was 12.66. Barnsbury.—(Estimated population, 52,665.) 906 deaths were registered, as compared with 820 in 19T2, and an average of 885 in the years 1906-1912, and represented a death-rate of 16.88 per 1,000, as contrasted with 15 52 in 1912 and a mean septennial death-rate of 16.61. Islington South-East.—(Estimated population, 75,167.) This is the largest area of the borough, and is more populous than many well-known towns in England. Here the returns showed that 1,146 deaths were registered during the year, as contrasted with 1,083 in the preceding year, and with an average of 1,126 in the seven years 1906-1912. The resulting death-rate represented 14.96 per 1,000 of the population, as contrasted with 15.19 in 1912 and 15.55 in the septennial period. It will be noticed that although the deaths were more than those registered in 1912, yet the resulting deathrate was less. This is due to the fact that part of Canonbury Ward, hitherto D 34 1913] included in Highbury Sub-District, was transferred to Islington South-East on 1st June, 1913, and their respective populations have been corrected accordingly. At the census, however, this district showed a decreased population, and, therefore, every year, in estimating the number of persons living there, an addition is now made to the population. Table XIII. Showing the Estimated Poplations,* 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 17,258 747 43.30 16,927 601 35.50 34,180 1,348 39.44 5—15 29 644 80 2.70 29,537 86 2.9l 59,181 166 2.80 15—25 28,397 74 2.60 31,291 107 3.42 59,688 181 3.03 25—35 27,855 131 4.70 30,967 122 3.94 58,822 253 4.30 35—45 21,657 195 9.00 24,147 181 7.49 45,804 376 8.20 45—55 15,833 313 19.77 17.970 264 14.69 33,803 577 17.07 55—65 10,307 335 32.50 12,247 280 22.86 22,554 615 27.27 65—75 5,498 389 70.75 7,591 389 51.24 13,089 778 59.44 75 and upwards 1,569 278 177.19 3,156 456 144.49 4,725 734 155.37 All ages 158,013 2,542 16.08 173,833 2,486 14.30 331,846 5,028 15.15 *These populations are estimated for the registration year of 53 weeks. †The deaths of 605 persons who had come from other districts of London for treatment in the Public Institutions, etc., of Islington are excluded from these returns, while the deaths of 936 residents who had died in Institutions, &c., outside the district are included. 35 [1913 Table XIV Showing the Ages at Death during the Years 1903—1912 and in 1913. Years. AGES. Totals. 0—1 1—5 All under 5yrs. 5—15 15—25 25—35 35—45 45—55 55—65 65—75 75—85 85 upwards All above 5 yrs. 1903 1,136 538 1,674 139 201 299 390 491 533 577 423 112 3,165 4,839 1904 1,1410 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 1,541 162 167 310 398 492 659 730 463 157 3,538 5,079 1908 894 426 1,320 161 170 257 408 471 597 637 510 148 3,359 4,679 1909 841 560 1,401 140 144 271 415 539 600 692 544 172 3,517 4,918 1910 777 515 1,292 150 146 235 341 479 607 636 495 142 3,231 4,523 1911 1,040 478 1,518 151 163 234 388 494 603 681 483 151 3,348 4,866 1912 710 423 1,133 140 158 271 347 518 645 754 563 153 3,549 4,682 Mean. 969 524 1,493 146 170 276 388 506 605 668 486 144 3,389 4,882 1913 898 450 1,348 166 181 253 376 577 615 778 567 167 3,680 5,028 Increase or Decrease -71 -74 -145 +20 +11 —23 —12 +71 +10 +110 +81 +23 +291 +146 D 2 36 1913] Table XV. Showing the Deaths and Death-Rates from All Causes in the Wards during the Four Quarters of 1913. Wards. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Dathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 150 17.70 113 13.33 92 10.85 139 15.23 494 14.30 Upper Holloway 180 19.00 147 15.52 116 12.24 144 14.11 587 15.20 Tollington 144 19.32 116 15.56 83 11.13 121 15.08 464 15.27 Lower Holloway 179 18.42 143 14.72 129 13.28 169 16.15 620 15.65 Highbury 127 15.13 123 14.65 94 11.20 123 13.60 467 13.65 Mildmay 92 15.51 74 12.48 55 9.27 95 14.88 316 13.07 Thornhill 172 22.12 141 18.14 124 15.95 148 17.68 585 18.46 Barnsbury 97 17.99 78 14.46 65 12.05 81 13.95 321 14.60 St. Mary's 82 19.49 52 12.36 52 12.36 57 12.58 243 14.17 Canonbury 128 17.84 93 12.97 91 12.68 117 15.14 429 14.67 St. Peter's 144 19.42 127 17.13 92 12.41 139 17.41 502 16.61 The Borough 1,495 18.36 1,207 14.83 993 12.20 1.333 15.20 5,028 15.15 N.B.—The heavy figures show the healthiest Ward in the several periods to which they refer. TABLE XVI. Showing the Deaths and Death Bates together with the mean Mortality of the Sub-Districts for the Seven Years, 1906-12 and during the Year, 1913. DEATHS. DEATH-RATES. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Average 1906-12 1913 1906. 1907. 1908. 1909. 1910. 1911. 1912. Average 1906-12. 1913 Tufnell 432 482 425 440 424 408 390 429 494 13.17 14.62 12.59 13.23 12.69 12.15 11.56 12.90 14.30 Upper Holloway 542 559 485 558 535 6l0 579 553 587 15.20 15.54 13.12 15.25 14.50 16.39 15.41 15.11 15.20 Tollington 425 480 396 430 392 412 394 418 464 13.21 15.07 12.32 13.79 12.70 13.49 13.06 13.40 15.27 Lower Holloway 721 644 571 617 599 631 613 628 620 17.87 16.04 14.03 15.53 15.16 16.05 15.68 15.8l 15.65 Highbury 779 816 816 793 759 760 803 789 811 12.39 13.02 12.81 1273 12.21 12.27 13.00 12.66 13.89 Barnsbury 967 949 885 872 802 902 820 885 906 18.00 17.72 16.25 16.37 I5.09 17.02 15.52 16.61 16.88 Islington, S. East 1,184 1,149 1,101 1,208 1,012 1,143 1,083 1,126 1,146 16.11 15.71 14.84 16.68 14.04 15.94 15.19 15.55 14.96 The Borough 5,050 5,079 4,679 4,918 4,523 4,866 4,682 4,828 5,028 15.25 15.37 13.93 14.96 13.79 14.87 14.34 14.68 15.15 38 1913] Table XVII. Showing the Deaths and Death-Rates of Islington in 1913, and in the four quarters of the year, and of the County of London and the Great Towns during the same period, the mean Borough Death-Rates for the years 1903.12, and the deaths and death-rates in the year 1912. Quarter. Males Females. Total. Death Rates. Islington, 1913. Islington, 1903-12. London, 1913. 96 Great Towns, 1913. First 754 741 1,495 18.36 16.94 17.5 16.9 Second 620 587 1,207 14.83 13.50 13.3 13.5 Third 497 496 993 12.20 12.75 11.8 12.7 Fourth 671 662 1,333 15.20 15.75 14.1 14.2 The Year 1913 2542 2,486 5,028 15.15 14.80 14.2 14.3 1912 2,420 2,262 4,682 14.34 15.15 13.6 13.8 Increase or Decrease +122 +224 +346 +081 +0.35 —0.6 —0.5 39 [1913 Table XVIII. 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. Islington. South-east. The Borough. Deaths. Death Kates. Deaths. Death Kates. Deaths. Death Kates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates First Quarter 150 17.70 180 19.00 144 19 .32 179 18.42 239 16.69 269 20.43 334 17.77 1,495 18.36 Second Quarter 113 13.33 147 15.52 116 15 .56 143 14.72 205 14.31 219 16.63 264 14.04 1,207 14.83 Third Quarter 92 10.85 116 12.24 83 11.13 129 13.28 149 10.40 1811 14.35 235 12.50 993 12.20 Fourth Quarter 139 15.23 144 14.11 121 15.08 169 16.15 218 14.13 229 16.15 313 15.46 1,333 15.20 The Year 494 14.30 587 15.20 464 15.27 620 15.65 811 13.89 906 16.88 11.46 14.96 5,028 15.15 N.B.—The heavy figures show which was the healthiest sub-district in the quarters to which they refer. 40 1913] Table XIX. Showing the Deaths and Death-Rates from All Causes for each Quarter since 1888. (The Lowest Death Rate in etch quarter since 1888 is printed in heavy type.) Years. QUARTERS. First. Second. Third. Fourth. Year. Deaths Death Rates Deaths Death Rates. Deaths Death Rates. Deaths Death Rates. Deaths Death Kates. 1888 1,629 21.09 1,163 15.05 1,072 13.88 1,333 17.26 5,197 16.82 1889 1,440 18.42 1,186 15.17 1,101 14.08 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 21.42 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 16.52 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 16.86 1,253 14. 97 1,216 14.50 1,481 17.69 5,361 15.98 1902 1,796 21.50 1,220 14 .61 1,149 13.76 1,470 16.35 5,635 16.55 1903 1,383 16.59 1,226 14.71 1,031 12.37 1,199 14.39 4,839 14.52 1904 1,436 17.27 1,106 13.30 1,284 15.44 1,410 16.96 5,236 15.74 1905 1,316 15.86 1,178 14.20 1,076 12.97 1,385 16.70 4,955 14.93 1906 1,391 16.80 1,151 13.90 1,163 14.05 1,345 16.25 5,050 15.26 1907 1,640 19.86 1,224 14.82 939 11.37 1,276 15.45 5,079 15.38 1908 1,387 16.83 1,010 12.26 984 11.94 1,298 14.63 4,679 13.93 1909 1,676 20.39 1,136 13.82 903 10.98 1,203 14.63 4,918 14.96 1910 1,237 15.08 974 11.88 882 10.75 1,430 17.44 4,523 13.79 1911 1,402 17.13 1,064 13.00 1,215 15.21 1,155 14.11 4,866 14.87 1912 1,324 16.22 1,058 12.96 1 009 12.36 1,291 15.82 4.682 14.34 Corrected Mean 25 years 1,568 19.27 1,213 14.90 1.178 14.47 1,386 17.02 5,345 16.25 1913 1,495 18.36 1,207 14.83 993 12.20 1,333 15.20 5,028 15.15 Increase or Decrease -73 -0.91 —6 —0.07 —185 —2.27 —53 —1.82 —317 —1.10 41 [1913 Table XX. 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. Bainsbury Islington. South East. 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. Miasmatic 23 0.66 41 1.06 34 1.12 45 1.14 42 0.72 39 0.72 60 0.78 284 0.85 Diarrhœal 9 0.26 13 0.33 3 0.09 25 0.63 13 0.22 19 0.35 17 0.22 99 0.29 Constitutional 105 3.04 97 2.51 93 3.06 137 3.46 183 3.13 199 3.71 218 2.84 1,032 3.11 Developmental 47 1.36 57 1.48 54 1.78 48 1.21 64 1.10 84 1.56 114 1.49 468 1.41 Nervous 35 1.01 52 1.35 40 1.32 37 0.93 68 1.16 66 1.23 78 1.02 376 1.13 Circulation 79 2.28 89 2.30 70 2.30 75 1.89 131 2.24 111 2.07 178 2.32 733 2.21 Respiration 84 2.43 110 2.85 79 2.60 114 2.88 161 2.76 174 3.24 236 3.08 958 2.89 Digestive Organs 49 1.42 49 1.27 37 1.22 35 0.88 48 0.82 71 1.32 73 0.95 362 1.09 Urinary System 24 0.69 27 0.70 17 0.56 27 0.68 32 0.55 40 0.74 46 0.60 213 0.64 Violence 12 0.35 22 0.57 9 0.03 26 0.65 26 0.44 42 0.78 58 0.76 195 0.59 Ill-defined 14 0.40 20 0.52 14 0.04 29 0.73 19 0.32 31 0.58 22 0.28 149 0.45 The heavy figures denote that these death-rates were the highest experienced in the several districts during the year from the diseases mentioned. 42 1913] Table XXI. 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 149 129 85 85 448 1. Miasmatic Diseases 113 115 25 31 284 2. Diarrhœal „ 5 5 49 40 99 3. Malarial „ .. .. .. .. .. 4. Zoogenous „ 3 1 .. .. 4 5. Venereal „ 8 5 1 5 19 6. Septic „ 20 3 10 9 42 II. Parasitic Diseases .. 1 .. .. 1 III. Dietic .. 4 5 8 17 IV. Constitutional Diseases 248 235 251 298 1,032 V. Developmental 130 119 101 118 468 VI. Local 869 623 476 750 2,718 1. Diseases of Nervous System 89 87 89 111 376 2 „ Organs of Special Sense 6 2 6 6 20 3. „ Circulatory System 240 163 128 202 733 4. „ Respiratory 403 209 98 248 958 5. „ Digestive „ 69 84 101 108 362 6. „ Lymphatic „ 5 2 2 1 10 7. „ Urinary „ 50 63 39 61 213 8. „ Reproductive „ 3 7 8 8 26 9. „ Bones and Joints . . 4 .. 2 6 10. „ Integumentary System 4 2 5 3 14 VII. Violence 51 56 46 42 195 1. Accident or Negligence 43 45 34 35 157 2 Homicide 2 .. .. 1 3 3. Suicide 6 11 12 5 34 4. Execution .. .. •• 1 1 VIII. Ill-defined Causes 48 40 29 32 149 All Causes 1,495 1,207 993 1,333 5,028 Note—The heavy figures denote that the diseases to which they are applied were most fatal in the Quarter to which they refer. 43 [1913 Table XXII. Showing the Death-rates from All Causes in the several undermentioned places during the Four Quarters and the Year. Places First Quarter. Second Quarter Third Quarter. Fourth Quarter. The Year 1913. England and Wales 16.1 13.2 12.2 13.2 13.7 96 Great Towns 16.9 13.5 12.7 14.2 14.3 145 Smaller Towns 15.0 12.2 11.6 12.4 12.8 England and Wales less the 241 Towns 15.5 13.2 11.7 12.2 13.1 County of London 17.5 13.3 11.8 14.1 14.2 Bristol 15.5 12.2 11.1 11.9 12.7 Birmingham 16.6 13.3 14.1 14.8 14.7 Liverpool 20.5 16.6 16.7 18.0 18.0 Manchester 17.7 14.7 14.6 15.3 15.6 Leeds 17.9 15.4 14.5 13.9 15.4 Sheffield 18.2 14.4 14.4 16.0 15.7 The Encircling Boroughs 17.9 13.7 12.4 14.7 14.7 St. Pancras 18.5 14.9 12.8 14.9 15.2 Stoke Newington 16.4 13.0 10.5 14.4 13.6 Hackney 16.7 12.4 11.0 13.4 13.4 Hornsey 10.9 9.7 7.8 9.3 9.4 Finsbury 21.4 17.3 16.6 17.8 18.3 Shoreditch 23.7 15.0 16.2 19.3 18.6 Islington 18.36 14.83 12.20 15.20 15.15 44 1913] INFANTILE MORTALITY. There were 898 deaths among infants under one year of age, and as there were 8,359 born into the borough, the infantile mortality was at the rate of 107 per 1,000 births. This rate is good for Islington, as it has been less on only two previous occasions: in 1910 when it was 95, and in 1912 when it was 86. The returns for preceding years up to 1885 show that the infant mortality has averaged 136 per 1,000 births, and that since 1901 there has been a slow but sure decline in it. Thus from 1886 to 1890 it averaged 147; from 1891 to 1895, 145; 1896 to 1900, 150; from 1901 to 1905, 130; from 1906 to 1910, 109; while from 1901 the separate figures for each year have been: — 1901—139 1906—125 1911—128 1902—132 1907—117 1912—86 1903—126 1908—103 1913—107 1904—128 1909—103 1905—123 — 1910—95 Good though the rates of the past two years are for the borough, yet they are not good enough, because they could without doubt be lessened considerably if special efforts were made to effect a reduction. Islington possesses many natural advantages which tend to a low mortality among infants, for it has more roomy houses, wide streets, squares, and open spaces than are usually to be found either in London or in provincial towns. Hence the mortality should be low; yet in St. Pancras last year it was only 92, in Hornsey 60, and in Stoke Newington 82. The rate in St. Pancras is to be noted, for although it was higher there than in the preceding year, yet it followed a low rate in 1912. This was anticipated because of the special efforts that have of late years been made there to dispel maternal ignorance, which causes so many deaths among infants, by the employment of those agencies which are now widely recognised as necessary when dealing with this problem. Much has been said in the past by the Medical Officer of Health on this subject, and he does not propose to dwell further on it now, although he hopes that the example of other communities may in time induce his Borough to adopt similar measures to those employed by them There is no doubt that to their ill-feeding is due far too much of the sickness and mortality among infants. Indeed, from the particulars as to the feeding of infants who have died here from diarrhoeal diseases, given in Table XXV., is deduced the fact that only 17.5 per cent, of the infants under three months 45 [1913 old were fed on their mother's breast alone, while 75.6 per cent, of the mothers whose infants had died were in good health, and, therefore, it is to be supposed were capable of suckling their children. It is a calamity that so many young infants should be reared artificially, for at their age they, with a few exceptions, should have had the breast and the breast alone, whereas the figures show that 82.5 per cent, had been fed on artificial foods. In the following statement is shown the ages at which infants died from all causes in Islington, during the past 8 years, the number at each age, and the percentage which these numbers bear to the total infant deaths. Ages of Infants. No. of Deaths. Percentage of Deaths. Under a week old 1,429 died, or 19.7 per cent, of the infant deaths 1 to 2 weeks„ 391„ 5.4„ „ 2 to 3„ „ 306,, 4.3„ „ 3 to 4„ „ 262„ 3.6„ „ Total under a month 2,388„ 33.0„ „ 1 to 3 months 1,402„ 19.3„ „ Total under 3 months 3,790„ 52.3„ „ 3 to 6 months 1,342„ 18.5„ „ 6 to 9 „ 1,068„ 14.8„ „ 9 to 12 „ 1,039„ 14.4„ „ Total 3 to 12 months 3,449„ 47.7„ „ Total 7,239„ 100.0„ „ These figures, especially those relating to the earlier weeks of existence, need no comment, for any person who seriously studies them can arrive at no other conclusion than that they indicate an enormous waste of life. It is shocking to think that practically 20 per cent, of the deaths are those of infants under a week old, and that 33 per cent, had not attained their first month. 46 1913] TABLE XXIII. Showing the Deaths among Infants per 1,000 Births during the year 1913, and also the mortality rates for the years 1903-12. Sub-Districts. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Mean 1903-12. 1913. Increase or decrease on mean. Tufnell 112 141 127 122 127 81 107 78 85 61 104 108 —4 Upper Hollo 125 92 101 105 88 74 77 88 115 85 95 119 +24 way Tollington 124 128 11 127 132 117 96 88 131 88 115 104 —11 Lower Hollo 141 161 151 155 148 125 101 108 162 94 135 121 —14 way Highbury 122 98 117 95 107 101 93 82 104 80 100 89 —11 Barnsbury 127 142 '124 138 123 119 111 111 162 98 125 128 +3 Islington South East 128 134 121 129 104 99 117 94 128 94 115 98 —17 The Borough 126 128 123 125 117 103 103 95 128 86 113 107 —6 47 [1913 TABLE XXIV. Showing the Mortality per 1,000 Births among Infants under one year of age in the three years 1901-03 ; in the ten years 1903-12 ; and in 1913 from certain specified causes. Causes of Death Mean rate of 3 years 1901-2-3 per 1,000 Births. 1913. Mean rate 10 years 1903-12 per 1,000 Births. Premature Birth and Congenital Defects 24.25 21.41 23.35 Bronchitis and Pneumonia 25.67 20.10 20.42 Atrophy and Marasmus 20.54 17.95 15.96 Diarrhœal Diseases (all forms) 19.01 8.14 20.89 Convulsions 6.66 2.15 3.05 Whooping Cough 6.44 2.63 4.58 Measles 3.27 1.91 3.52 Phthisis 1.85 0.24 0.70 Other forms of Tuberculosis 5.68 0.27 4.81 Diohtheria 0.43 0.36 0.35 Total of above 113.80 77.16 97.63 All other causes 18.91 30.26 16.08 Total 132.71 107.42 113.71 48 1913] TABLE XXV. Particulars of Investigations into the Deaths of Infants from Diarrhœa during the six years 1908-13. Ages of Infants in three monthly periods. Total under twelve months. Total for 6 years. 0—3. 3—6. 6—9. 9—12. 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908—13 Food of Infants. Breast milk only 3 .. 1 6 .. 3 2 1 2 2 2 .. .. 3 4 .. 1 1 1 1 7 .. .. 6 2 7 19 2 6 42 Cows' milk only 9 3 1 11 .. 2 14 5 3 20 3 4 11 6 3 18 .. 4 .. 1 2 11 1 2 34 15 9 60 4 1? 134 Condensed milk only 2 1 .. 8 .. 2 1 4 .. 18 .. 1 3 2 .. 9 .. .. .. 2 2 5 .. 1 6 9 2 40 .. 4 61 Artificial foods only .. 1 .. .. .. 1 .. .. .. 3 .. 1 3 .. .. 5 .. .. .. .. .. 5 .. .. 3 1 .. 13 .. 2 19 Breast & cows' milk 3 .. .. 3 1 1 1 .. 3 5 .. 1 2 1 .. 1 .. .. .. .. 1 5 .. .. 6 1 4 14 1 2 28 „ condensed milk 1 .. .. 4 .. .. .. .. .. 4 1 1 .. .. .. 4 .. .. .. 1 .. 2 .. .. 1 1 .. 14 1 1 18 „ artificial foods .. .. .. .. .. 2 1 .. 1 6 2 1 1 .. 2 .. .. .. 1 .. 6 1 .. 2 2 1 14 3 2 24 Mixed foods .. .. .. .. 1 .. 1 .. .. .. 1 2 .. 1 .. 8 .. .. 3 .. .. 2 .. 2 4 1 .. 10 2 4 21 Not stated .. .. .. 3 .. 1 .. .. .. 6 .. 1 1 1 4 .. .. .. .. 1 4 .. •• 1 1 2 17 • • 1 22 18 5 2 35 2 12 20 10 9 64 9 12 21 12 7 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 State of Mother's Health. Good health 16 4 1 24 1 10 11 5 7 34 6 8 13 9 5 34 .. 5 3 5 4 35 .. 5 43 93 17 127 7 28 245 Moderate 1 1 .. 3 .. .. 4 1 1 9 2 2 4 2 1 10 .. .. 1 .. 1 6 1 .. 10 4 3 28 3 2 50 Bad 1 .. 1 5 1 1 5 4 1 14 1 2 3 .. 1 5 .. .. .. 1 1 3 1 .. 9 5 4 27 3 3 51 Not stated .. .. .. 3 •• 1 .. .. .. 7 .. •• 1 1 .. 6 .. .. .. .. 1 3 .. .. 1 1 1 19 .. 1 23 18 5 2 35 2 12 20 10 9 64 9 12 21 12 .. 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 Mother s State as to Occupation. No occupation 15 4 .. 27 2 7 16 7 .. 43 5 9 15 6 1 36 .. 4 .. 5 .. 34 2 3 4 22 1 140 9 28 241 Occupied at work 3 1 .. 5 .. 4 4 3 8 15 4 3 5 5 5 15 .. 1 4 1 6 10 .. 2 16 10 19 45 4 10 104 Not stated .. .. 2 3 .. 1 •• •• 1 6 .. •• 1 1 1 4 .. .. .. .. 1 3 .. .. 1 1 5 16 .. 1 24 18 5 2 35 2 12 20 10 9 64 9 12 21 12 .. 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 Method of Feeding. Breast 3 .. 1 6 .. 3 2 1 2 2 2 2 .. .. 3 4 .. 1 1 1 1 7 .. .. 6 2 7 19 2 6 42 Bottle with tube 7 2 .. 2 .. .. 9 5 3 4 .. 1 13 7 2 5 .. .. .. 4 3 6 .. .. 29 18 8 17 .. 1 73 Bottle (boat shape) without tube 7 2 1 22 2 7 8 4 4 49 6 8 6 3 1 37 .. 4 .. 1 2 25 1 4 21 10 8 133 9 23 204 Spoon 1 1 .. 2 .. 1 .. .. .. 3 .. 1 1 .. .. 2 .. .. 2 .. .. 1 .. 1 4 1 .. 8 .. 3 16 Otherwise .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. 2 .. .. 1 .. .. 2 .. .. 2 1 .. 4 .. .. 7 Not stated .. .. .. 3 •• 1 .. .. .. 6 1 1 1 1 5 .. .. .. .. 1 6 1 .. 1 1 2 20 2 1 27 18 5 2 35 2 12 20 10 9 64 9 12 21 12 7 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 49 [ 1913 Table XXV.—continued, Ages of Infants in three monthly periods. Total under twelve months. Total for 6 years. 0—3. 3—6. 6—9. 9—12. 11108 1909 1900 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 1909 1910 1911 1912 1913 1908 12 Method used to cleanse Feeding Apparatus. Scalding water 2 .. .. 6 .. 2 3 3 2 15 2 4 5 3 .. 9 .. 1 .. 1 1 5 .. .. 10 7 3 35 2 7 64 Hot 4 .. .. 1 1 4 1 3 .. 2 1 2 3 1 1 2 .. 1 .. 1 .. 1 .. 2 8 5 1 6 2 9 31 Hot water and soda.. 3 2 .. 12 .. 1 9 2 2 21 1 3 6 2 2 20 .. 2 .. 2 1 15 .. 1 18 8 5 68 1 7 107 Cold water .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. 1 1 .. 3 Rrush and hot water 3 2 1 4 1 .. 4 1 2 14 1 .. 4 4 .. 8 .. .. .. 1 3 9 1 1 11 8 6 35 3 1 64 Otherwise .. 1 .. .. .. .. 1 .. .. 1 .. .. .. 1 .. 2 .. .. .. .. .. .. .. .. 1 2 .. 3 .. .. 6 Not stated (including 42 at breast) 6 .. 1 12 .. 5 2 1 3 11 3 3 2 1 4 13 .. 1 4 1 2 17 1 1 14 3 10 53 4 .. 94 18 5 2 35 2 12 20 10 9 64 9 12 21 12 7 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 No. of Rooms occupied by Family. 1 room 3 .. .. 6 1 2 .. 1 3 18 2 3 2 4 .. 3 .. .. .. 2 1 7 .. .. 11 7 4 34 3 5 64 2 rooms 6 2 1 16 .. 3 8 .. 2 16 3 6 8 5 2 22 .. .. .. 2 2 19 1 2 23 15 7 73 4 15 137 3 ,, 7 2 .. 3 1 3 3 1 3 8 2 2 5 2 5 16 .. .. .. 2 2 12 1 3 15 7 10 39 4 8 83 4 ,, .. .. 1 6 .. 2 .. .. .. 10 2 .. 2 .. .. 4 .. 1 .. .. 1 5 .. .. 3 .. 2 25 2 3 35 5 ,, or more 2 1 .. 1 .. 1 1 2 1 6 .. 1 1 .. .. 5 .. .. .. .. .. .. .. .. 4 3 1 12 .. 2 22 Not stated .. .. .. .. .. .. 3 .. .. .. .. .. 2 .. .. 1 .. .. 1 .. .. 3 .. .. 6 .. .. 4 .. .. 10 Unknown .. .. .. 3 .. 1 .. .. .. 6 .. .. 1 1 .. 4 .. .. .. .. 1 1 .. .. 1 1 1 14 .. 1 18 18 5 2 35 2 12 20 10 9 64 9 12 21 12 7 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 State of Rooms as to Cleanliness. Clean 13 5 2 28 2 9 15 8 7 52 8 12 16 6 5 44 .. 5 2 3 6 36 1 4 46 22 20 160 11 30 289 Dirty 4 .. .. 1 .. 2 3 1 1 4 .. .. 3 3 .. 3 .. .. 2 2 .. 5 1 1 12 6 1 13 1 3 36 Unwholesome .. .. .. 2 .. .. 1 .. 1 2 1 .. .. .. 1 2 .. .. .. 1 .. 3 .. .. 1 1 2 9 1 .. 14 Not stated 1 .. .. 1 .. .. 1 1 .. .. .. .. 1 2 1 2 .. .. .. .. .. 2 .. .. 3 3 1 5 .. .. 12 Unknown .. .. .. 3 .. 1 .. .. .. 6 .. .. 1 1 .. 4 .. .. .. 1 1 .. .. 1 1 1 14 .. 1 18 18 5 2 35 2 12 20 10 9 64 9 12 21 12 7 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 Prevalence of Flies. (Numerous 2 .. .. 14 .. 1 3 4 2 30 .. .. 5 1 1 30 .. .. .. .. .. 25 .. .. 10 6 3 99 .. 1 119 ! Moderate .. .. .. 3 .. .. .. 1 .. 4 .. 1 4 1 .. 3 .. .. .. .. 1 2 .. 3 4 2 1 12 .. 4 23 Few 2 3 1 12 2 1 6 3 2 17 3 5 3 5 2 11 .. 2 .. .. 2 15 1 2 11 13 7 55 6 10 102 1 None noted 14 2 1 6 .. 10 11 2 5 13 6 6 9 5 4 11 .. 3 4 3 4 5 1 .. 38 12 14 35 7 19 125 18 5 2 35 2 12 20 10 9 64 9 12 21 12 7 55 .. 5 4 6 7 47 2 5 63 33 25 201 13 34 369 50 1913] XXVI. Summary of Investigations into the Deaths of Infants from Diarrhoea during the six years 1908-13. Ages of Infants in three monthly periods. Total under twelve months. 0—3. 3—6. 6—9. 9—12. Food of Infants. f Breast milk only 13 11 8 10 42 Cows' milk only 26 49 42 17 134 Condensed milk only 13 24 14 10 61 Artificial foods only 2 4 8 5 19 Hreast and cows' milk 8 10 4 6 28 condensed milk 5 6 4 3 18 artificial foods 2 10 4 8 24 Mixed foods 1 4 9 7 21 ^ Not stated 4 6 7 5 22 74 124 100 71 369 State of Mother's Health. Good health 56 71 66 52 245 Moderate 5 19 17 9 50 Bad 9 '27 9 6 51 Not stated 4 7 8 4 23 74 124 100 71 369 Mother's state as to occupation. No occupation 55 80 62 44 241 Occupied at work 13 37 31 23 10J Not stated . 6 7 7 4 24 74 124 100 71 369 Method of Feeding. / Breast 13 11 8 10 42 Bottle with tube 11 22 27 13 73 Bottle (boat shape) without tube 41 79 51 33 204 Spoon . 5 4 3 4 16 Otherwise .. 1 3 3 7 t Not stated 4 7 8 8 27 74 124 100 71 369 Method used to cleanse Feeding Apparatus. Scalding water 10 29 18 7 64 Hot 10 9 8 4 31 Hot water and soda 18 38 32 19 107 Cold water .. 1 2 .. 3 Brush and hot water 11 22 16 15 64 Otherwise 1 2 3 .. 6 Not stated (including 42 at breast) 24 23 21 26 94 74 124 100 71 369 No. of Rooms Occupied by the Family. 1 room 12 32 9 11 64 2 rooms 28 41 41 27 137 3 ,, 16 19 28 20 83 4 ,, 9 12 7 7 35 5 ,, or more 5 11 6 .. 22 Not stated 3 3 4 10 Unknown 4 6 6 2 18 74 124 100 71 369 State of Rooms as to Cleanliness. / Clean 59 102 76 52 289 Dirty 7 q 9 11 36 2 3 4 14 Not staled 2 2 6 2 12 Unknown 4 6 6 2 18 74 124 100 71 369 Prevalence of Flies. Numerous 17 39 37 26 119 Moderate 3 6 8 6 23 Few 21 36 23 22 102 None noted 33 43 32 17 125 74 124 100 71 369 51 [1913 TABLE XXVII. 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 1906-1913. Ages at Death Deaths. Deaths per 1,000 Births 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. Total 8 years 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. Total 8 yars Under 1 week 182 187 186 156 163 170 190 195 1,429 21.01 21.91 21.46 19.02 19.87 20.96 23.14 23.33 21.35 1—2 weeks 42 58 52 52 45 52 41 49 391 4.85 6.80 6.00 6.34 5.49 6.41 4.99 5.86 5.84 2-3 „ 49 51 33 26 41 34 25 47 306 5.66 5.98 3.81 3.17 5.00 4.19 3.05 5.62 4.57 3—4,, 35 34 39 35 29 37 24 29 262 4.04 3.98 4.50 4.27 3.54 4.56 2.92 3.47 3.91 Total under a month 308 330 310 269 278 293 280 320 2,388 35.56 38.67 35.77 32.80 33.90 36.12 34.10 38.28 35.67 1—3 months 228 189 180 147 131 207 133 187 1,402 26.32 22.14 20.78 17.92 15.97 25.51 16.20 22.37 20.94 Total under 3 months 536 519 490 416 409 500 413 507 3,790 61.88 60.81 56.55 50.72 49.87 61.63 50.30 60.65 56.61 3 — 6 months 230 169 151 148 144 201 121 178 1,342 26.56 19.81 17.43 180.5 17.56 24.78 14.73 21.30 20.05 6—9 months 162 167 126 144 106 171 81 111 l,0t'8 18.71 19.57 14.54 17.57 12.92 21.08 9.86 13.27 15.95 9—12 months 155 141 127 133 118 168 95 102 1.039 17.90 16.52 14.76 16.22 14.38 20.70 11.56 12.20 15.52 Total under 1 year 1,083 996 894 841 777 1,040 710 898 7,239 125.05 116.71 103.28 102.56 94.73 128.19 86.45 107.42 108.13 E 2 19131 52 Table XXVIII. 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 1.387 113 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 1.271 132 1889 421 164 162 94 376 164 302 130 1,261 131 1890 356 144 326 142 422 177 384 170 1.488 161 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 1 417 145 1893 403 161 393 156 508 212 391 166 1,595 164 1894 313 125 267 113 363 154 286 123 1,229 127 1895 353 134 315 128 427 172 321 138 1.416 139 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 90 344 164 205 129 1,083 125 1907 319 145 221 102 166 79 290 140 996 117 l908 247 111 171 80 204 95 272 124 894 103 1909 233 106 221 109 180 90 207 104 841 103 1910 219 103 159 76 138 67 261 134 777 95 1906-10 1,289 117 975 91 1 032 99 1,296 126 4,591 109 1911 243 115 192 97 410 206 195 102 1,040 128 1912 189 87 169 86 165 81 187 98 710 86 1913 275 134 192 90 205 102 226 110 898 107 Note:—The lowest infantile mortality rates in the periods of the year to which they refer are printed in heavy type. 53 [1913 Table XXIX. Showing the Chief Causes of Infantile Mortality in the fourteen years, 1899 1912 and in 1913. Cause of Death Years M ean 14 years. 1913 Difference. 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 i. Common Infectious Diseases. Small-pox .. .. 1 4 .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. Measles 27 42 37 24 29 51 27 36 27 24 31 21 28 29 31 16 - 15 Scarlet Fever .. 2 2 1 1 1 .. 1 .. 3 1 .. .. .. 1 2 + 1 Diphtheria (including Membranous Croup 3 5 7 1 4 2 2 3 1 4 1 1 2 6 3 4 + 1 Whooping Cough 66 68 38 76 63 30 51 30 53 29 36 61 31 17 46 22 -24 Diarrhoea, all forms 208 148 143 72 83 200 149 1 71 73 80 46 33 229 23 118 68 -50 ii Diarrhaeal Diseases. Enteritis, Muco-enteritis, Gastro-enteritis 159 67 70 43 46 20 53 92 49 52 26 38 73 49 60 99 + 39 Gastritis, Gastro intestinal Catarrh 13 21 21 23 22 18 15 14 9 7 23 15 9 8 15 14 - 1 iii. Wasting Diseases. Premature Birth 187 176 169 194 174 178 163 144 164 167 136 121 149 128 161 139 -22 Congenital Defects 21 36 48 33 47 43 48 59 47 51 52 46 35 34 43 40 3 Injury at Birth .. .. .. .. 1 .. .. .. .. .. .. 1 4 3 1 2 +1 Want of Breast-milk, Starvation 2 1 5 2 7 6 4 5 8 4 4 .. 14 5 5 6 + 1 Atrophy, Debility, Marasmus 285 221 188 192 183 177 138 134 137 138 133 94 117 114 101 144 - 17 iv. Tuberculous Diseases Tuberculous Meningitis 30 25 24 20 20 10 19 20 17 13 18 24 19 15 20 9 -11 Tuberculous Peritonitis Tabes Mesenterica 30 25 26 25 20 20 24 17 17 14 20 14 11 8 19 7 - 12 Other Tuberculous Diseases 27 28 19 23 30 16 12 12 23 13 8 8 16 5 17 5 - 12 v Other Causes. Erysipelas 6 3 2 3 4 3 1 3 3 4 4 3 .. .. 3 1 -2 Syphilis 7 17 10 11 10 11 13 9 5 13 10 8 4 8 10 12 + 2 Rickets 8 2 5 3 1 4 3 5 .. 2 1 .. 6 1 3 2 -1 Meningitis (not 7 ubeiculous) 16 19 23 16 18 10 19 18 10 13 11 14 10 5 14 8 -6 Convulsions 62 57 68 69 47 47 38 24 16 15 14 22 17 17 37 18 -19 Bronchitis 124 119 104 116 90 78 77 82 83 39 55 50 51 41 79 59 -20 Laryngitis 2 4 5 2 4 1 3 .. 1 .. 1 .. 1 1 2 .. — 2 Pneumonia 112 118 123 134 109 101 107 103 153 106 106 110 101 97 113 109 -4 Suffocation, overlying 45 43 39 46 15 25 14 22 23 23 27 26 21 23 28 32 +4 Other Causes 108 97 113 86 108 88 94 79 77 80 77 64 91 73 88 80 - 8 1,548 1,344 1,290 1,219 1,136 1,140 1,074 1,083 996 894 841 777 1,040 710 1,078 898 -180 54 1913] In Engalnd and Wales, in the ninety-six great towns, in the severi greatest towns, and in the six boroughs surrounding Islington, the infantile mortality was as follows:— England and Wales 109 per 1,000 births 96 Great Towns 117 ,, 145 Smaller Towns . 112 „ Rural Districts 96 ,, London 105 ,, Birmingham 129 ,, Liverpool 131 ,, Manchester 127 ,, Leeds 133 ,, Bristol 96 „ Sheffield 128 „ The Encircling Boroughs. Hornsey 60 „ Stoke Newington 82 „ Hackney 99 ,, Shoreditch 155 ,, Finsbury 138 ,, St. Pancras 92 ,, The Encircling Boroughs 109 ,, Islington 107 ,, MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fevers (Typhus, Enteric and Continued) and Diarrhoeal Diseases. Altogether 322 deaths from these diseases were registered, and they represented an annual death-rate of 0-97 per 1,000 of the population, as against 296 deaths, and a death-rate of 0-90 in 1912. The decrease in these deaths is very noticeable, for since the quinquennium 1896-1900 their numbers have regularly, year by year, become less, but somewhat like an ebb tide which, while it gradually recedes, yet at times sends up one or more waves which reach farther up the shore than those which have preceded them, only, howevei, to be followed by others still lower. In these five years the annual average was 810 per annum, but in the succeeding five years (1901-1905) it was only 568, which was followed in the years 1906-1910 by one of 439. In the next three years it fell to 407. This is a good record, and one on which the Borough is to be congratulated. 56 [1913 So that the decrease in recent years may be more readily appreciated, the deaths since 1901 have been put on a common basis. Thus if the 628 deaths in that year are taken as 100, and the deaths in twelve succeeding years are expressed in terms of 100, the relative deaths are as follows: — 1901—100 1906—89 1911—96 1902—07 1907—69 1912—47 1903—75 1908—57 1913—51 1904—96 1909—67 — 1905—84 1910—68 Average—77 Thus the deaths in 1913 were 49 per cent, fewer than in 1901, and 26 per cent. below the average of the thirteen years 1901-13. The mortality in these years has been above the average on six occasions and below it on seven, six of which have been in the last eight years. The full figures for each year since 1885 are given in Table XXX. 56 1913] Table XXX. Showing the Deaths from the principal Epidemic Diseases for the Twenty-eight years 1885-1912 and in 1913, together with Death-rates for the total deaths. Years. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric Fever. Simple and Undefined Fevers. Diarrhceal Diseases. Total Death-Rate. 1885 129 294 36 167 210 3 63 —— 197 1099 3.69 1886 8 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 fl78 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 1 283 933 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 1.82 1903 — 120 24 43 152 — 22 1 109 471 1.41 1904 1 181 35 28 83 — 18 —— 260 606 1.82 1905 1 123 37 34 111 — 17 —— 206 529 1.59 1906 —— 187 37 32 74 —— 19 —— 213 562 1.70 1907 —— 130 24 42 120 — 13 —— 103 432 1.31 1908 —— 78 30 60 55 —— 18 —— 117 358 1.09 1909 — 197 25 31 86 — 12 —— 67 418 1.27 1910 — 166 11 34 124 — 17 —— 76 428 1.30 1911 — 124 20 53 71 — 12 —— 324 604 1.84 1912 — 151 9 38 54 — 8 —— 36 296 0.90 1913 — 101 19 37 62 — 4 —— 99 322 O.97 † From this date Membranous Croup was included. 57 11913 Table XXXI. Showing the Corrected Mean Number «/ Deaths from the Principal Epidemic Diseases 1885-1912 and m 1913. Diseases. Corrected Average Number of Deaths 1885 1912. 1913. Decrease. Small pox 7 .. 7 Measles 172 101 71 Scarlet Fever 41 19 22 Diphtheria 98 37 61 Whooping Cough 145 62 83 Typhus Fever .. .. .. Enteric Fever 34 4 30 Continued & Ill-defined Fevers 1 .. 1 Diarrhœa 180 99 81 The above Diseases 678 322 356 58 1913] Table XXXII. Deaths and Death-Rates from each of the principal Epidemic Diseases during the year 1913 inclusive of the Deaths of Borough Patients in Hospitals outside the Borough. SUBREGISTRATION. DISTRICTS. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhœa. TOTALS. Deaths. Deathrates. Deaths. Dtathrates. Deaths. Deathrates Deaths. Deathrates Deaths Dtatbrates Deaths. Deathrates Deaths. Deathrates. Deaths Deathrates. Tufnell 2 0.06 ... ... 7 0.20 3 0.09 1 0.03 5 0.14 9 0.26 27 0.78 Upper Holloway ... ... ... ... 20 0.51 2 0.05 8 0.21 5 0.13 13 0.34 48 1.24 Tollington ... ... ... ... 17 0.56 3 0.10 6 0.19 3 0.10 3 0.10 32 1.05 Lower Holloway ... ... ... ... 15 0.38 4 0.10 13 0.33 6 0.15 25 0.63 63 1.59 Highbury 1 0.02 ... ... 10 0.17 1 0.02 13 0.22 4 0.07 13 0.22 42 0.72 Barnsbury ... ... ... ... 17 0.32 ... ... 11 0.20 3 0.06 19 0.35 50 0.93 Islington S. East 1 0.01 ... ... 15 0.20 6 0.08 10 0.13 11 0.14 17 0.22 50 0.78 The Borough 4 0.01 ... ... 101 0.31 19 0.06 62 0.19 37 0.11 99 0.29 322 0.97 Preceding year, 1912. 8 0.02 ... ... 151 0.46 9 0.03 54 0.16 38 0.12 36 0.11 296 0.90 59 [1913 Table XXXIII. Showing the Deaths and Death-rates from the Principal Epidemic Diseases in the Wards during the Four Quarters of 1913 WARDS. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrate-. Deaths Deathrates. Deaths Deathrates. Tufnell 8 0.94 7 0.82 5 0.59 7 0.76 27 0.78 Upper Holloway 14 1.47 15 1.58 9 0.95 10 0.98 48 1.24 Tollington 10 1.34 19 2.55 2 0.27 1 0.12 32 1.05 Lower Holloway 15 1.54 17 1.75 15 1.54 16 1.53 63 1.59 Highbury 4 0.47 9 1.07 11 1.31 4 0.44 28 0.81 Mildmay 8 1.35 2 0.34 ... ... 3 0.47 13 0.53 Tliornhill 11 1.41 10 1.29 13 1.67 7 0.83 41 1.29 Barnsbury 5 0.93 2 0.37 1 0.18 1 0.17 9 0.40 St. Mary's 4 0.95 — — 2 0.47 3 0.66 9 0.52 Canonbury 8 1.11 7 0.97 7 0.97 2 0.26 24 0.82 St. Peter's 6 0.81 11 1.48 4 0.54 7 0.87 28 0.92 Totals 93 1.14 99 1.21 69 0.85 61 0.69 322 0.97 60 1913] Table XXXIV. Showing the Deaths and Death-rates from each of the Principal Epidemic Diseases in the several Wards during the Year 1913. WARDS. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea. Totals. Deaths. Death rates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates Deaths Deathrates. Deaths. Death rates. Deaths. Deathrates. Tufnell 2 0.06 ... ... 7 0.20 3 0.09 1 0.03 5 0.14 9 0.26 27 0.78 Upper Holloway ... ... ... ... 20 0.51 2 0.05 8 0.21 5 0.13 13 0.34 48 1.24 Tollington ... ... ... ... 17 0.56 3 0.10 6 0.19 3 0.10 3 0.10 32 1.05 Lower Holloway ... ... ... ... 15 0.38 4 0.10 13 0.33 6 0.15 25 0.63 63 1.59 Highbury ... ... ... ... 5 0.14 1 0.03 7 0.20 3 0.09 12 0.35 28 0.81 Mildmay 1 0.04 ... ... 5 0.21 ... ... 5 0.21 1 0.04 1 0.04 13 0.54 Thornhill ... ... ... ... 13 0.41 ... ... 9 0.28 2 0.06 17 0.54 41 1.29 Barnsbury ... ... ... ... 4 0.18 ... ... 2 0.09 1 0.04 2 0.09 9 0.40 St. Mary's ... ... ... ... 3 0.17 ... ... 1 0.06 1 0.06 4 0.23 9 0.52 Canonbury 1 0.03 ... ... 8 0.27 4 0.14 3 0.10 2 0.07 6 0.21 24 0.82 St. Peter's ... ... ... ... 4 0.13 2 0.07 7 0.23 8 0.26 7 0.23 28 0.92 The Borough 4 0.01 ... ... 101 0.31 19 0.06 62 0.19 37 0.11 99 0.29 3.22 0.97 61 ri m a SMALL POX. No death was registered from Small Pox during the year nor was a case of the disease notified. t MEASLES. 101 deaths were registered, or 50 less than in 1912, and 23 less than in 1911. Nevertheless the toll of lives is a heavy one, and ought to have been much lighter, for many of the deaths were undoubtedly due to causes which might with reasonable care and forethought have been prevented. The deathrate, which was equal to 0-31 per 1,000 of the population, contrasts with a mean rate of 0-27 in the boroughs encircling Islington, and is lower than that of Finsbury, but almost identical with that of Hackney. The Medical Officer of Health desires to draw special attention to Table XXXVII., which gives the secondary causes of the deaths, but which were really the true diseases from which the children, who had been attacked with measles, died. Table XXXV. Showing the Deaths and Death-rates from Measles in the Sub Districts for each Quarter and the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deathrates. Deaths. Deathrates Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 2 0.24 5 0.59 .. .. .. .. 7 0.20 Upper Holloway 9 0.95 11 1.16 .. .. .. .. 20 0.51 Tollington 5 0.67 11 1.48 1 0.13 .. .. 17 0.56 Lower Holloway 8 0.82 7 0.72 .. .. .. .. 15 0.38 Highbury 4 0.26 6 0.42 .. .. .. .. 10 0.17 Barnsbury 13 0.99 4 0.30 .. .. .. .. 17 0.32 Islington, South East 8 0.45 5 0.27 2 0.11 .. .. 15 0.20 The Borough 49 0.60 49 0.60 3 0.04 .. .. 101 0.31 62 1913] Table XXXVI. Showing the Death-Rates of the Encircling Boroughs from Measles in the Four Quarters of 1913. Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. St. Pancras 0.47 0.26 0.02 0.02 0.19 Stoke Newington 0.48 0.40 •• •• 0.21 Hackney 0.86 0.27 0.09 .. 0.30 Hornsey 0.37 0.18 •• •• 0.13 Finsbury 1.23 0.19 •• .. 0.35 Shoreditch 1.43 0.37 .. 0.10 0.47 The above Districts 0.79 0.27 0.03 1.19 0.27 Islington 0.60 0.60 0.04 .. 0.31 Table XXXVII. Showing the Secondary Causes of tlu Deaths from Measles. Secondary Causes. Quarters. The Year 1913. 1 2 3 4 Males. Females. Totals. Pneumonia 41 38 1 .. 40 40 80 Bronchitis 3 2 .. .. 2 3 5 Convulsions .. 2 .. .. 1 1 2 Tubercular Peritonitis 1 .. .. .. 1 .. 1 Tubercular Meningitis 1 .. .. .. .. 1 1 Pulmonary Tuberculosis .. .. 1 .. 1 •• 1 Enteritis .. 2 .. .. .. 2 2 Influenza .. 1 .. .. 1 .. 1 Caccrum Oris 1 1 .. .. 2 .. 2 Whooping Cough .. •• 2 1 .. 1 2 3 Total Secondary Causes 47 48 3 .. 49 49 98 Deaths where no secondary cause was entered 2 1 .. •• 1 2 3 Total Deaths 49 49 3 •• 50 51 101 63 11913 Table XXXVIII. Showing the Deaths front Measles during each Week of 1913. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Week. Deaths Week. Deaths. Week. Deaths Week. Deaths. 1 4 14 8 27 ... 40 ... 2 3 2 2 15 16 8 5 28 29 3 41 42 ... 4 5 17 3 30 ... 43 ... 5 1 18 2 31 ... 44 ... 6 1 19 2 32 ... 45 ... 7 4 20 4 33 ... 46 ... 8 4 21 4 34 ... 47 ... 9 7 22 2 35 ... 48 ... 10 4 23 3 36 ... 49 ... 11 6 24 2 37 ... 50 ... 12 4 25 3 38 ... 51 ... 13 5 26 3 39 ... 52 ... 13 weeks 49 13 weeks 49 13 weeks 3 13 weeks ... 64 1913] Table XXXIX. Showing the deaths from Measles in the Quarters, 1903-12 and 1913. Years. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter- Whole Year 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 1908 19 12 7 40 78 1909 89 94 10 4 197 1910 1 8 21 136 166 1911 83 33 5 3 124 1912 24 29 29 69 151 Corrected average number of deaths 39 45 22 37 143 1913. 49 49 3 .. 101 Increase or Decrease +10 + 4 -19 -37 -42 SCARLET FEVER. The deaths from Scarlet Fever have been few in recent years, and since 1907 have not exceeded 30. In 1910 there were only 11 deaths, and in 1912 only 9. These figures were, however, altogether exceptional and cannot be expected to recur. The number of deaths now to be reported is 19, representing a rate of 0.06 per 1,000. The districts in which they occurred are set out in Table XL., wherein it will be noticed that no death was registered in Barnsbury, and only 1 in Highbury. 65 [1913 Showing the Deaths and Death-rates from Scarlet Fever in the Sub-Districts for each Quarter and the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deathrates. Deaths. Deat' rates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Death- rates. Tufnell 2 0.24 .. .. .. .. 1 0.11 3 0.09 Upper Holloway .. .. .. .. 2 0.21 •• .. 2 0.05 Tollington 2 0.27 1 0.13 •• .. •• .. 3 0.10 Lower Holloway 2 0.21 .. •• .. .. 2 0.19 4 010 Highbury 1 0.06 .. • • .. •• .. .. 1 0.02 Barnsbury • • .. .•• .. •• •• •• .. .. •• Islington, South East .. .. 2 0.10 3 0.16 1 0.05 6 0.08 The Borough 7 0.09 3 0.04 5 0.06 4 0.05 19 0.06 DIPHTHERIA. The 37 deaths which were registered were equal to a death-rate of Oil per 1,000 of the population. These contrast with 38 in the preceding year. The deaths are few if compared with those which obtained in years gone by. Indeed, since 1902 there has been a notable drop, for whereas they then numbered 104, they have never been more than 60 in any year since, while the average in the quinquennial period 1906-1910 has been only 40. In 1906, 1907, 1909, 1910, 1912 and 1913 the deaths did not exceed 42, and varied from 31 to 38. These figures are, however, far different from those which obtained from 1891 to 1895, when the average was 182 per annum, and from 1896 to 1900, when it was 143, after which time there was a fall in 1901-1905 to 69. These low figures continued into the next quinquennium, when the deaths averaged 40. Considering how fatal Diphtheria is, especially in young life, it is very gratifying to find such a marked decline in the fatality. F 66 1913] Its history, so far as the records of Islington show, is given in the following statement, which sets out the number of deaths in each quinquennial period as well as the average number for each year in those periods. Years. Total Deaths. Annual Deiths. Average 1861—1865 194 39 1866—1870 137 27 1871—1875 115 23 1876—1880 165 33 1881—1885 418 84 1886—1890 311 62 1891—1895 910 182 1896—1900 715 143 1901—1905 343 69 1906—1910 199 40 Table XLI, Showing the Deaths and, Death-rates from Diphtheria in the Sub-Districts or each Quarter and the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Death, rates. Deaths. Deathrates. Tufnell 2 0.24 1 0.12 1 0.12 1 0.11 5 0.14 Upper Holloway 2 0.21 .. 1 0.11 2 0.19 5 0.13 Tollington 1 0.13 2 0.27 .. .. .. .. 3 0.10 Lower Holloway 2 0.21 1 0.10 .. .. 3 0.29 6 0.15 Highbury .. .. 2 0.14 1 0.07 1 0.06 4 0.07 Barnsbury 1 0.07 .. .. •• .. 2 0.14 3 0.06 Islington, South East 4 0.22 5 0.27 1 0 .05 1 0.05 11 0.14 The Borough 12 0.15 11 0.13 4 0.05 10 0.11 37 0.11 67 [1913 WHOOPING COUGH. The returns gave 62 deaths, which were equal to a death-rate of 019 per 1,000 of the population, as contrasted with 54 in the preceding year and an average of 92 in the preceding ten years. Table XLII. Showing the Deaths ani Death-rates from Whooping Cough in the Sub-Districts for each Quarter and the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Death-. Deathrates. Deaths. Deathrates Tnfnell .. .. 1 0.12 .. .. .. .. 1 0.03 Upper Holloway 2 0.21 3 0.32 .. .. 3 0.29 8 0.21 Tollington 2 0.27 3 0.40 1 0.13 .. .. 6 0.19 Lower Holloway 2 0.21 7 0.72 2 0.20 2 0.19 13 0.33 Highbury 7 0.46 3 0.21 2 0.14 1 0.06 13 0.22 Barn-bury .. .. 8 0.61 3 0.23 .. .. 11 0.20 Islington, South East 3 0.17 6 0.32 .. •• 1 0.05 10 0.13 The Borough 16 0.19 31 0.38 8 0.10 7 0.08 62 0.19 ENTERIC FEVER. The return of deaths from Enteric Fever was the lowest on record, only 4 being known, as contrasted with 8 in the preceding year, and with 12 in 1911. How different these figures are from those of former years. Thus, from 1886 to 1890, inclusive, there were 264 deaths registered, or an average of 53 per annum; from 1891 to 1895, 187, or an average of 37; from 1896 to 1900, 219, or an average of 44; from 1901 to 1905, 149, or an average of 30. Then a sudden drop of nearly 50 per cent, occurred, for in the quinquennium 1906-1910 only 79 deaths were returned, or an average of 16 per annum. This is a very notable record, and indicates the enormous strides that have been made in the public health of the community. A still more extraordinary fact with respect to the mortality last year is that no death was registered in the 2nd, 3rd or 4th quarters, all the deaths having occurred in the first, nor did any occur in the sub-districts of Upper Holloway, Tollington, Lower Holloway or Barnsbury. F 2 68 1913] Table XLIII. Showing the Deaths and Death-rates from Enteric Fever in the Sub-Districts for each Quarter and the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Deaths. Deathrates. Tufnell 2 0.24 .. .. .. .. .. .. 2 0.06 Upper Holloway • • .. .. .. .. .. .. .. •• •• Tollington .. .. .. .. .. .. .. .. .. •• Lower Holloway .. .. .. .. .. .. .. .. .. •• Highbury 1 0.06 .. .. .. .. .. .. 1 0.02 Barnsbury •• .. .. .. .. .. .. .. .. .. Islington, South East 1 0.06 .. .. .. .. .. .. 1 0.01 The Borough 4 0.05 .. .. .. .. .. .. 4 0.01 TYPHUS FEVER Nil return. CONTINUED AND ILL-DEFINED FEVERS. Nil return. DIARRHCEAL DISEASES. These include Diarrhoea, Dysentery, Choleriac Diarrhoea, Zymotic Enteritis, Epidemic Enteritis, Infective Enteritis, Enteric Catarrh, Gastro-intestinal Catarrh and Gastro-enteric Catarrh. The deaths from these diseases conjointly numbered 268, as contrasted with 134 in 1912, and 461 in 1911. The deaths were equal to a death-rate of 0-81 per 1,000 of the population. 99 deaths were ascribed to true diarrhoea, which is an increase of 63 on the preceding year. The deaths from dirarhoeal diseases during last year are shown in Table XLVII., where it should be noted that 210 out of the total number of those from diarrhoeal diseases occurred among children under two years old, and represented a mortality of 25 12 per 1,000 births. 69 [1913 Table XL1V. Showing the Deaths from Diarrhoeal Diseases together with those classed under Enteritis and its Sub-headings during four Quarters of the ten ye ns 1904-13. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Under 1 year 8 5 13 2 10 12 181 17 198 9 6 15 200 38 238 1 to 5 years 3 1 4 3 2 5 40 1 41 1 2 3 47 6 53 Over 5 years 3 5 8 1 6 7 9 9 18 — 10 10 13 30 43 1904 14 11 25 6 18 24 230 27 257 10 18 28 260 74 334 Under 1 year 4 10 14 9 10 19 119 20 139 17 28 45 149 68 217 1 to 5 years — 3 3 3 1 4 29 6 35 2 4 6 34 14 48 Over 5 years 4 8 12 2 6 8 11 5 16 6 8 14 23 27 50 1905 8 21 29 14 17 31 159 31 190 25 40 65 206 109 315 Under 1 year 6 7 13 7 16 23 134 49 183 24 34 58 171 106 277 1 to 5 years 3 2 5 2 3 5 20 8 28 2 10 12 27 23 50 Over 5 years — 9 9 1 13 14 13 8 21 1 1 2 15 31 46 1906 9 18 27 10 32 42 167 65 232 27 45 72 213 160 373 Under 1 year 7 15 22 8 12 20 22 8 30 36 23 59 73 58 131 1 to 5 years 1 5 6 3 — 3 5 4 9 7 5 12 16 14 30 Over 5 years 3 9 12 2 6 8 3 7 10 6 8 14 14 30 44 1907 11 29 40 13 18 31 30 19 49 46 36 85 103 102 205 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 1908 12 18 30 3 20 23 72 33 105 30 30 60 117 101 218 Under 1 year 3 6 9 3 9 12 31 14 45 9 20 29 46 49 95 1 to 5 years 1 4 5 1 3 4 10 5 15 —— 2 2 12 14 26 Over 5 years 4 4 8 2 9 11 — 9 9 3 8 11 9 30 39 1909 8 14 22 6 21 27 41 28 69 12 30 42 67 93 160 70 1913] Table XLIV (Continued). Ages 1 st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhœa Enteritis, etc. Total Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Diarrhoea. Enteritis, etc. Total. Under 1 year 2 7 9 4 14 18 13 9 22 14 23 37 33 53 86 1 to 5 years 5 1 6 1 — 1 11 1 12 14 7 21 31 9 40 Over 5 years 2 6 8 2 4 6 4 3 7 4 6 10 12 19 31 1910 9 14 23 7 18 25 28 13 41 32 36 68 76 81 157 Under 1 year 4 11 15 7 .. 18 201 46 247 15 14 29 227 82 309 1 to 5 years 2 2 4 1 3 4 47 10 57 5 4 9 55 19 74 Over 5 years 4 8 12 2 8 10 26 12 38 10 8 18 42 36 78 1911 10 21 31 10 22 32 274 68 342 30 26 56 324 137 461 Under 1 year 5 10 15 3 13 16 13 19 32 2 15 17 23 57 80 1 to 5 years — 3 3 — 1 1 3 1 4 1 8 9 4 13 17 Over 5 years — 7 7 2 7 9 5 5 10 2 9 11 9 28 37 1912 5 20 25 5 21 26 21 25 46 5 32 37 36 98 134 U nder 1 year 5 21 26 2 13 15 34 44 78 27 34 61 68 113 181 1 to 5 years — 3 3 — 5 5 13 12 25 7 13 20 20 33 53 Over 5 years — 5 5 3 6 9 2 6 8 6 6 12 11 23 34 1913 5 29 34 5 24 29 49 | 62 111 40 53 93 99 169 266 An examination of the figures from 1885 onwards shows that the average number of deaths in each of the quinquennial periods were as follows:— 1886—1890 230 1901 1905 169 1891 1895 173 1906-1910 115 1896—1900 209 71 Table XLV. Showing the Deaths from Diarrhœal Diseases together with those classed under Enteritis and its sub-headings, arranged in quarterly periods, and at tlnee 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. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Under 1 year 5 21 26 2 13 15 34 44 78 27 34 6l 68 113 181 1 to 5 years ... 3 3 ... 5 5 13 12 25 7 13 20 20 33 53 Over 5 years ... 5 5 3 6 9 2 6 8 6 6 12 11 23 34 Totals 5 29 34 5 24 29 49 62 111 40 53 93 99 169 268 Note.—In this Table the deaths under Enteritis include only those which are not epidemic or zymotic. [1913 72 1913] TABLE XLVI. Showing the Diarrhoeal Deaths including those from Epidemic Enteritis in the Third Quarter, 1913. 1913. Deaths. Meteorology. Temperature of the air. Temp, of the earth. Rainfall. Week Ending. Tuf. U.H. Toll. L.H. H. B. S E. Total. Mean temperature of air in degrees. Departure from mean temperature of 65 years Temperature of the earth 3 feet below surface. Rainfall in inches. No. of days on which rain fell. o o o July 6th.. .. .. .. .. .. .. .. .. 59.9 -1.9 59.82 021 4 ,,12th .. .. .. 1 .. 1 .. 2 57.2 -5.4 59.40 1 33 4 „ 19th 1 .. .. .. .. .. .. 1 60.0 -3.3 59.61 0-52 6 ,, 26 th .. .. .. .. .. .. .. .. 57.7 -5.2 59.45 0 05 1 1 .. •• 1 .. 1 .. 3 58.7 -3.9 59. 57 2 11 15 August 2nd .. 1 .. .. .. 1 .. 2 59.5 -2.8 59.73 0 00 1 „ 9th .. .. .. .. .. 1 .. 1 57.1 -5.1 60.24 009 2 ,, 16th .. 1 .. 2 2 .. 1 6 60.7 -1.7 60.10 014 4 ,, 23rd .. .. .. 1 .. .. l 2 60.9 -0.6 60.58 0-36 2 •• 2 •• 3 2 2 2 11 59.5 -2.5 60.16 059 9 August 30th .. .. .. .. .. .. 1 1 62.8 + 2.3 60.62 0.51 4 Sept. 6th 1 .. .. 2 1 2 .. 6 59.1 -0.5 60.63 1.43 5 13th 2 .. .. 1 .. 2 1 6 58.0 -0.4 59.96 0.06 2 20th .. 3 .. 4 3 .. 2 12 54.9 -2.2 59.03 0.60 7 .. 27th .. 1 .. 2 2 4 1 10 60.2 +4.8 58.46 0.13 2 3 4 .. 9 6 8 5 35 59.0 +0.8 59.74 2.73 20 3rd Quarter 4 6 •• 13 8 11 7 49 59.1 -1.8 59.82 5.43 44 78 [1913 Table XLVII. Showing the Deaths occurring in Islington and in the several Encircling Boroughs from All Causes, from the principal Epidemic Diseases, and from Pulmonary Tuberculosis in the year 1913. THE ENCIRCLING BOROUGHS. Estimated Populations, 1913. Total Deaths from all Causes. Total Epidemic Deaths. Deaths from principal Epidemic Diseases. Pulmonary Tuberculosis. Deaths of infants under 1 year of age Enteric Fever. ' Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea and Enteritis (under 2 yr's) 1 2 3 4 5 6 7 8 9 io iL 12 13 St. Pancras 214,330 3,321 214 6 ... 41 6 31 l6 114 327 508 Stoke Newington 50,518 698 42 2 ... 11 1 6 6 16 48 94 Hackney 223,353 3,037 258 4 ... 68 11 23 11 141 26l 549 Hornsey 87,596 838 39 3 ... 12 ... 8 4 12 40 85 Finsbury 84,679 1,576 171 ... ... 30 4 31 9 97 173 352 Shoreditch 109,654 2,068 306 1 ... 52 3 29 14 207 200 546 The above Boroughc 770,130 11,538 1,030 16 ... 214 25 128 60 587 1,049 2,134 Islington 325,585 5,028 322 4 ... 101 19 62 37 210 420 898 74 1913J XLVIII, Showing the Death Rates of Islington and of the several Encircling Boroughs from All Causes, from the principal Epidemic Diseases, and from Pulmonary Tuberculosis in the yew 1913. THE ENCIRCLING BOROUGHS. Estimated Populations, 1913. Total Deathrates from All Causes. Death-rates per 1,000 p rsons living. Rate per 1,000 Births. Enteiic Fever. Small Pox Measles. Scar et Fever. Whooping Cough. Diphtheria Pulmonary Tuberculosis. Diarrhoea and Enteritis (under 2 yrs.) Deaths under i year. 1 2 3 4 5 6 7 8 9 10 11 12 St. Pancras 2I4>330 15.2 0.03 ... 0.19 0.03 0.14 0.07 1.50 20-68 92 Stoke Newington 50,518 13.6 0.04 ... 0.21 0.02 0.12 0.12 0.93 13.99 82 Hackney 223,353 13.4 0.02 ... 0.30 0.05 0.10 0.04 1.15 25.53 99 Hornsey 87,596 9.4 0.03 ... 0.13 ... 0.09 0.04 0.44 8.53 60 Finsbury 84,679 18.8 ... ... 0.35 0.05 0.36 0.10 2.01 38.08 138 Shoreditch 109,654 I8.6 0.01 ... 1.47 0.03 0.26 0.13 1.79 58.92 155 The above Boroughs 770,130 14.7 0.02 ... 0.27 0.03 0.16 0.07 1.34 29.88 109 Islington 325,585 15.15 0.01 ... 0.31 0.06 0.19 0.11 1.26 25.12 107 75 [1913 Table XL1X. 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. Per 1,000 Persons Living. Rate per 1,000 Births. All Causes. Enteric Fever. Small-Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea and ' Enteritis (under 2 years). Deaths under 1 Year. Cols. 1 2. 3. 4. 5. 6. 7. 8. 9. England and Wales 13.7 0 04 0. 00 0.28 0.06 0.14 0.12 23.41 109 96 Great Towns 14.3 0.04 0.00 0.34 0.07 0.17 0.13 29.33 117 145 Smaller Towns 12.8 0.05 0.00 0.30 0.05 0.13 0.11 24.73 112 England and Wales less the > 241 Towns 13.1 0.04 0.00 0.20 0.05 0.12 0.11 14.39 96 London 14.2 0.02 .. 0.34 0.04 0.17 0.09 275 105 Bristol 12.7 0.01 .. 0.13 0.01 0.14 0.08 18.9 96 Birmingham 14.7 0.02 .. 0.45 0.20 0.18 0.19 35.3 129 Liverpool 18.0 0.04 0.00 0.41 0.07 0.31 0 .09 38.1 134 Manchester 15.6 0 .06 .. 0.35 0.12 0.19 0.13 32.2 127 Leeds 15.4 0 .04 .. 0.23 0.03 0.20 0.18 30.2 134 Sheffield 15.7 0.04 .. 0.77 0.16 0.14 0.12 30.5 128 St Pancras 15.2 0.03 .. 0.19 0. 03 0.14 0.07 20.68 92 Stoke Newington .. 13.6 0.04 .. 0.21 0.02 0.12 0.12 13.99 82 Hackney 13.4 0 .02 .. 0.30 0.05 0.10 0.05 25.53 99 Hornsey 9.4 0. 03 .. 0.13 ... 0.09 0.04 8.53 60 Finsbury 18.3 .. .. 0.35 0 .05 0.36 0.10 38.08 138 Shoreditch 18.6 0.01 .. 0.47 0.03 0.26 0.13 58.92 155 Encircling Boroughs 14.7 0.02 .. 0.27 0.03 0.16 0.17 29.88 109 Islington 15.1 0.01 .. 0.31 0.06 0.19 0.11 25.12 107 76 1913] INFLUENZA. Influenza caused 58 deaths, which is 30 more than in 1912, but 9 less than the average of the preceding fourteen years, as shown in the following statement : — Average. i8go- Ages. 1899. 1900. 1901. 1902. 1903. 1904. 1905. 1906 1907 1908. 1909 1910 1911 1912 1912. 1913 0-5 - 6 3 4 4 3 4 4 4 5 3 1 2 3 1 3 5 5-10 -2 3 1 — 1 — 1 1 1 — 1 — — — 1 — 10-15 - - - - — — — — 1 — — — — — 15-25 - 4 9 -— 3 2 3 — 4 3 5 2 2 I 2 3 2 25-35 - 12 7 2 7 3 2 3 5 10 3 4 2 4 1 5 4 35-45 - 17 16 5 13 5 7 5 4 19 8 8 3 2 5 8 8 45-55 - 15 18 5 14 9 7 7 10 5 14 10 5 6 X 9 17 55-65 - 28 28 12 6 8 6 9 13 6 16 9 5 3 4 11 5 65-75 - 24 36 12 17 6 11 12 16 12 14 20 5 10 7 15 7 75-85 - 14 25 5 15 3 7 12 8 12 14 11 8 7 5 10 9 85 and up- 4 4 — 4 — 1 1 2 1 4 4 4 1 2 2 1 wards — - - - - - - - - - - — —- - - 126 149 46 83 40 48 54 67 75 81 70 36 37 28 67 98 Here we see that from year to year the mortality has been of an irregular up and down character, with, however, a downward tendency. As usual, secondary causes have been very apparent, for a reference to Table LI. shows that in only a single instance was there none, while pneumonia was a complication in 38 instances, bronchitis in 8, heart disease in 3, pleurisy in 2, and enteritis in 2, while meningitis, hemiplegia, and senile decay had each one death to its credit. In 19 cases the deceased were under 45 years of age, and in 39 they were over that age; 17 were between 45 and 55,5 between 55 and 65, and 17 were 65 and upwards. The record of cases since 1856 are given below in quinquennial periods Quinquennia. Deaths. Average number of Deaths per annum. 1856-60 18 3.6 1861-65 12 2.4 1866-70 10 2.0 1871-75 2 0.4 1876-80 2 0.4 1881-85 2 0.4 1886-90 40 8.0 1891-95 718 143.6 1896-00 420 84.0 1901-05 271 54.2 1906-10 329 65.8 77 [1918 Table L. Showing the Deaths from Influenza in the Quarters of the Year 1913, together with the corrected averages of the corresponding periods 1903-1912. Years. Quarters. * Totals First. Second. Third. Fourth. 1903 30 3 1 6 40 1904 12 5 2 29 48 1905 26 16 3 9 54 1906 13 21 7 26 67 1907 48 12 4 11 75 1908 52 20 3 6 81 1909 36 19 4 11 70 1910 21 6 2 7 36 1911 18 9 1 9 37 1912 14 4 2 8 28 Corrected Averages 26 11 3 12 52 1913 25 18 5 10 58 Increase or Decrease -1 +7 + 2 -2 + 6 78 19131 Table LI Showing the Secondary Causes of Death from Influenza in the Four Quarters of the Year 1913. Tufnell. Upper Holloway. Tollington, Lower Holloway. Highbury. Barnsbury. Islington, S~uth-East. 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. 1st. 2nd. 3rd. 4th. 1st. 2nd. 3rd. 4th 1st. 2nd. 3rd. 4 th. Pneumonia 1 2 .. 1 2 2 .. .. 1 1 .. .. 2 2 1 3 3 1 1 .. 2 .. 1 6 3 2 1 38 Bronchitis .. .. .. .. .. 1 .. .. 1 .. .. .. 1 .. .. .. 1 .. .. .. 1 1 .. .. 2 .. .. .. 8 Heart Disease, etc. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 3 Pleurisy .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Peritonitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 Enteritis .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Hemiplegia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 Senile Decay.. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 All Secondary Causes 2 2 .. 1 2 3 .. 1 4 1 .. .. 3 3 .. 1 5 3 3 1 1 3 .. 2 8 3 2 3 57 No Secondary Causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 Totals 2 2 •• 1 2 3 .. 1 4 1 .. .. 3 3 .. 1 5 3 3 2 1 3 .. 2 8 3 2 3 58 79 1913 APPENDICITIS. This disease caused 24 deaths, which is the normal number for the Borough, although 11 more than were registered in 1912. It is a singular fact that almost 42 per cent, of the deaths now reported occurred between the ages of five and twenty, although, strangely enough, during five years of this period, that is to say between the ages of 10 and 15, none were known, and that during the preceding ten years the average percentage of deaths between the same years has been almost identical, namely 37-5. The ages at which people died from the disease is shown in the following statement:— Ages. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910 1911. 1912. A verage 1903-12 1913. 0- 5 1 — 1 — 1 2 2 3 — 1 1 2 5-10 4 2 4 3 — 7 7 2 3 1 3 5 10-15 3 5 1 2 7 1 2 3 2 — 3 — 15-20 4 3 6 3 3 3 3 4 4 — 3 5 20-25 7 2 3 1 2 3 1 5 2 4 3 2 25-35 5 8 3 2 2 2 1 1 4 1 3 2 35-45 3 2 4 5 — 4 4 2 3 1 3 2 45-55 2 1 4 1 1 2 1 5 4 2 3 55-65 1 3 2 2 3 1 2 — 3 1 2 — 65-75 2 1 1 1 — — 2 2 1 — 1 2 75-85 — — — — — — — — 2 — — 1 85 and upwards — — — — — — — — — — — — 32 27 29 20 19 25 25 27 24 13 24 24 The following statement shows the percentage of the deaths which occurred last year at the several age periods. 8.3 per cent. of the deaths during 1913 occurred at the age period 0- 5 20.9 ,, ,, ,, ,, 5-10 — ,, ,, ,, ,, 10-15 20.9 ,, ,, ,, ,, 15-20 8.3 ,, ,, ,, ,, 20-25 8.3 ,, ,, ,, ,, 25-35 8.3 ,, ,, ,, ,, 35-45 12.5 ,, ,, ,, ,, 45-55 — ,, ,, ,, ,, 55-65 8.3 ,, ,, ,, ,, 65-75 4.2 ,, ,, ,, ,, 75-85 100 ,, ,, ,, ,, All ages 80 1913 SEPTIC DISEASES. These include Erysipelas, Pyaemia, Septicaemia, and Puerperal Septic Infections, and in the aggregate caused 42 deaths, which is 1 less than the return for 1912, 10 less than that of 1911, and 4 less than the average mortality of the ten years 1901-1910. Erysipelas.—Nine deaths were attributed to it, and although the return is 6 above that for 1912, it is 11 less than the average (20) of the years 1897-1912. Between 1891 and 1901 the average was 39 per annum, which fell in the next decade (1901-1910) to 26. In 1911 there were 12 entries, and in 1912 5. Table LII. Deaths from Erysipelas in the Sub-Districts during the Year 1913. Deaths. Death Rates. Tufnell 1 0.03 per 1,000 inhabitants. Upper Holloway 2 0.05 ,, ,, Tollington 1 0.03 ,, ,, Lower Holloway ... ... ,, ,, Highbury ... ... ,, ,, Barnsbury 2 0.04 ,, ,, Islington, South-East 3 0.04 ,, ,, The Borough 9 0.03 „ ,, 81 1913 The returns for the last eleven years are given below:— Years. Deaths. Deaths per 1,000 births. 1903 9 1.00 1904 14 1.57 1905 6 0.68 1906 11 1.27 1907 8 0.94 1908 4 0.46 1909 7 0.85 1910 8 0.97 1911 7 0.87 1912 2 0.24 Corrected average 8 0.95 1913 7 0.84 LIII. Showing the Deaths from Puerperal Fever per 1,000 Births in the Sub-Districts for each Quarter and the Year 1913. Sub-districts. 1st Quarter. 2ud Quarter. 3rd Quarter. 4th Quarter. Year. Deaths. Deaths per 1,000 Births. Deaths. Deaths per 1,000 Births. Deaths. Deaths per 1,000 Births. Deaths Deaths per 1,000 Births Deaths. Deaths per 1,000 Births. Tufnell .. .. .. .. 1 5.07 1 4.95 2 2.54 Upper Holloway .. .. .. .. .. .. .. .. .. .. Tollington 1 5.81 .. .. .. .. .. .. 1 1.33 Lower Holloway 1 3.68 .. .. .. .. .. .. 1 0.93 Highbury .. .. .. .. .. .. .. .. .. .. Barnsbury 1 2.70 .. .. .. .. .. .. 1 0.65 Islington, South East 2 4.24 .. .. .. .. .. .. 2 1.04 The Borough 5 2.44 .. .. 1 0.50 1 0.49 7 0.84 CONSTITUTIONAL DISEASES. Under this heading are included Cancer and Tuberculosis, as well as Rheumatic Fever, Rheumatism, Rickets, Diabetes, Gout, Anaemia, Gangrene and Purpura. Two of these, Cancer and Tuberculosis, are among the most important and fatal which afflict mankind. G 82 1913 All these diseases conjointly were responsible for 1,032 death, or slightly over twenty per cent, of all the deaths registered in the year. The statistics lor the last twenty-tv/o years show that they pursue a very even course, causing on an average 1,033 deaths annually, which represent a mean death-rate of 317 per 1,000 of the population. This statement is borne out by the following figures: — 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 Deaths 1,064 1,037 I.093 997 1,114 1,122 1,084 1,067 1,115 1,119 1,180 Death-rates. 3.32 3.21 3.18 3.02 3.33 3.26 3.21 3.17 3.32 3.33 3.22 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 Average 1913 Deaths. 1,101 1,070 1,116 1,007 1,042 1,041 1,048 1,032 989 943 1,023 1.033 1,032 Death-rates. 3.23 3.21 3.36 3.03 3.15 3.15 3.12 3.14 3.01 2.88 3.13 3.17 3.11 CANCER. For many years past (since 1891) the Medical Officer of Health has given a statement as to the mortality from Cancer with a view of attracting special attention to its continuous increase; and he has also from time to time added Tables which gave very full particulars of the ages of the patients and the parts of their bodies which were affected. He would be glad if he could give some indication of its decline, but, unfortunately, he cannot, for its mortality continues to increase, so that the death-rate which was only 0.68 per 1,000, representing 218 deaths in 1891, was in 1913 1.22 per 1,000, representing 404 deaths. Thus, in twenty-three years the mortality has risen 85.3 per cent., an increase to which no other disease can approach. Furthermore, the increase is common to both sexes, although greater among males than females; for among the former the mortality has risen 131 per cent, since 1891, and among the latter 61.8 per cent. Nevertheless, it still remains greater among females. The particulars are given once more. They distinguish the males from the females, and include the total number of persons who have died, as well as the resulting death-rates. 83 1913 Year. 1891 1892 1893 1894 1895 1891-95 1896 1897 1898 1899 1900 1896-00 1901 1902 1903 1904 1905 1901-05 1906 1907 1908 1909 1910 1906-10 1911 1912 1913 Males. 74 70 82 78 96 400 104 112 106 104 115 541 103 133 155 147 138 676 154 177 157 146 158 792 143 160 171 Females. 144 149 156 161 170 780 187 192 177 166 188 910 186 193 195 176 190 940 209 171 210 207 203 1000 186 222 233 Persons. 218 219 238 239 266 1180 291 304 283 270 303 1451 289 326 350 323 328 1616 363 348 367 353 361 1792 329 382 404 Death-rate. 0.68 0.68 0.73 0.72 0.79 0.72 0.85 0.90 0.84 0.80 0.90 0.86 0.86 0.96 1.05 0.97 0.99 0.96 1.10 1.05 1.09 1.07 1.10 1.08 1.00 1.17 1.22 Ages at Death.—One death was registered under five years, none between 5 and 15; 7 between 15 and 25, 13 between 25 and 35, 31 between 35 and 45; 83 between 45 and 55; 99 between 55 and 65; 115 between 65 and 75; 49 between 75 and 85, and 6 above 85 years. The deaths and the death-rates at seven age periods among males and females are set out in Table LV. G 2 84 1913 Ages. 1903 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Average. 1903.1912. 1913. 0- 5 4 1 2 1 1 1 — 2 1 1 1 1 5-15 3 2 1 3 3 2 3 1 3 2 2 — 15-25 7 5 3 3 3 8 3 5 4 4 4 7 25-35 5 10 11 7 6 6 10 6 5 7 7 13 35-45 43 43 22 35 39 41 27 40 32 25 35 31 45-55 75 61 74 90 64 63 79 72 67 71 72 83 55-65 95 84 95 110 95 112 96 100 92 130 101 99 65-75 83 90 92 74 102 93 94 85 87 86 89 115 75-85 34 22 25 38 27 39 34 47 31 51 35 49 85&upwards 1 5 3 2 8 2 7 3 7 5 4 6 350 323 328 363 348 367 353 361 329 382 350 404 Table LIV. Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the Year 1913. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough. 1st 9 11 11 11 20 11 20 93 2nd 7 9 6 11 18 12 12 75 3rd 16 7 10 14 10 32 27 126 4th 9 10 7 11 29 18 26 110 The Year 41 37 34 47 87 73 85 404 Death-rate per 1,000 of the population 1.19 0.96 1.12 1.19 1.49 1.36 1.11 1.22 85 1913 Table LV. Deaths and, Death-rates from Cancer or Malignant Disease at seven Age Periods. Ages. Males. Females. Persons. 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. 0-25 6 0.79 2 0.26 8 0.52 25-35 3 1.08 10 3.23 13 2.21 35-45 8 3.69 23 9.52 31 6.77 45-55 36 22.73 47 26.15 83 24.55 55-65 51 49.48 48 39.20 99 43.89 65-75 51 92.76 64 84.30 115 87.86 75 & upwards 16 101.98 39 123.59 55 116.41 All Ages 171 10.82 233 13.40 404 12.20 In the Table given below, particulars of the ages at death during the last twenty-one years, as well as the average for each age are given, and here we find that at each age period, with the exception of two—0-15 and between 35 and 45--there was an incerase in the mortality when compared with the average. Thus, between 45 and 55 it amounted to 13 deaths; between 55 and 65 to 11; between 65 and 75 to 38; (between 75 and 85 to 19; and over 85 years to 3 Below 45 years of age the total increase was 5, while above that age it was 84. 86 1913 Table LVI. Deaths from Cancer during the twenty years 1893-1912, and in 1913, at ten age periods. Ages. Years. Under 5 Under 15 Under 25 Under 35 Under 45 Under 55 Under 65 Under 75 Under 85 85 upwards Total 1893 2 1 1 9 21 56 53 69 24 2 238 1894 2 1 2 9 26 52 67 59 20 1 239 1895 2 1 5 15 30 66 68 51 26 2 266 1896 1 2 3 13 30 86 68 63 21 4 291 1897 1 3 7 12 37 71 79 67 25 2 304 1898 3 1 4 8 28 67 70 66 32 4 283 1899 .. 1 2 8 19 63 85 72 18 2 270 1900 1 2 3 6 32 79 92 58 27 3 303 1901 .. 1 2 8 33 63 76 75 27 4 289 1902 3 3 5 8 29 75 103 70 27 3 326 1903 4 3 7 5 43 75 95 83 34 1 350 1904 1 2 5 10 43 61 84 90 22 5 323 1905 2 1 3 11 22 74 95 92 25 3 328 1906 1 3 3 7 35 90 110 74 38 2 363 1907 1 3 3 6 39 64 95 102 27 8 248 1908 1 2 8 6 41 63 112 93 39 2 367 1909 .. 3 3 10 27 79 96 94 34 7 353 1910 2 1 5 6 40 72 100 85 47 3 361 1911 1 3 4 5 32 67 92 87 31 7 329 1912 1 2 4 7 25 71 130 86 51 5 382 Average 1 2 4 8 32 70 88 77 30 3 315 1913 1 .. 7 13 31 83 99 115 49 6 404 Difference .. - 2 + 3 + 5 - 1 + 13 + 11 +38 + 19 + 3 + 89 CHART. Showing the Increase of Deaths from CANCER and the Decrease of Deaths from TUBERCULOSIS since 1893. Cancer Deaths = BLACK. Tuberculosis Deaths = BLUE. 87 1913 Cancer and Tuberculosis together caused 939 deaths last year, or 18.6 per cent, of the deaths from all causes, but whereas the deaths from Tuberculosis are decreasing year by year, those from cancer are increasing (see the chart facing this page), and it promises before long to cause an even greater mortality. Modern sanitation, by teaching the cult of pure air and the open window, as well as of cleanliness in everything, has been greatly assisted by bacteriological science in preventing and reducing the mortality from tuberculosis, but up to the present time neither has done anything to prevent, retard or reduce that from cancer. Many theories as to the cause of this disease have been advanced, but none up to now rest on sure bases. Latterly the theory of "cancer-houses" has been advanced, by which is meant that old houses in which, in the past, cases of cancer have occurred, become infected and impart the disease to persons occupying them. There does not seem any sufficient warrant for coming to this conclusion. Some years ago the Medical Officer of Health made an inquiry in a small way, but he could discover no evidence that would enable him to form the opinion that old houses infect their residents. As a matter of fact, few families escape the disease, and there are few persons who have not had friends or relatives who have died from it, so that it is clear that there can be few old houses in which cases have not occurred from time to time. Dr. E. F. Bashford, Director of the Imperial Cancer Research Fund, in a recent lecture at the Royal Sanitary Institute, said that he was frequently asked whether an ancient family mansion should not be burned down because of the occurrence of cancer in successive members of the family; that he was frequently consulted regarding the anxieties of persons who wish to occupy a house in which a patient has died of cancer, and that he invariably replied that he should have no objection to occupying a so-called cancer-house himself, giving his reasons. Cancer was so frequently a cause of death that one woman out of seven, and one man out of ten above the age of 35 died of it. Aggregations of cases of cancer were bound to occur frequently in the same area whether it was a large or merely a small house, or even a single room. Cancer-houses, then, in Dr. Bashford's opinion, are not to be considered seriously as a source of the spread of cancer Indeed, there is little doubt in the mind of the Medical Officer of Health that the cause or causes must be looked for in other directions. These are continuously and laboriously sought for, but whatever they may be they have not up to now been found. The Cancer Research Fund is, however, doing good work in this direction, and it is to be hoped that its labours may be rewarded speedily with success, for the increase of the disease is causing great anxiety to every person who has watched its gradual but continuous 88 1913 growth. Mr. C. E. Green, F.R.S.E., in a work, " The Cancer Problem: A Statistical Study," recently published, points out that the Registrar-General's Reports show that it is more prevalent in some districts than in others; that it is to be found in some trades and not in others; that it is almost unknown among tanners and paper makers who work daily in lime; and that it occurs more frequently among those brought into contact with sulphur fumes. Mr. Green shows, also, that while the disease is extremely prevalent when coal is burned, its absence is noticeable where peat is consumed. From this he infers that a fuel rich in sulphur is responsible for the prevalence of the disease; and he noticed that in one district, where a special peat containing sulphur was burned, cancer was found. He points out also that where the houses of the people built on sloping sites, owing to smoke accumulating, the death-rate is high, but that where there is a free draught the incidence falls. He points out that in the Strand area the roof lines of the houses are very irregular, thereby preventing smoke from passing away quickly, and that in Stepney they are level; and that this may account for the fact that in the Strand area, Cancer causes one out of every seven deaths from all causes, and in Stepney only one in fifty-four. This smoke theory is a striking thing, and deserves consideration, for if correct, as "The Times" says, it furnishes yet another argument for the necessity of efficient smoke consumption. It is quite probable that the idea is not so far fetched as might at first appear, because it must not be forgotten that Cancer is associated with the pitch and tar industries. Organs or Parts Attacked.—These varied widely among men and women. Thus the larynx was the seat of the disease in 8 instances among men and in 1 among women, the tongue in 14 instances among men, in none among women; the oesophagus, in 15 among men, and in 1 among women. Although men suffered so disproportionately from the disease in some of the parts attacked, yet it must not be forgotten that women suffer and die in large numbers from cancer of the various organs, which together are called the generative system. Thus the breast was the seat of the disease in the case of 39 deaths; the uterus in 46, the ovaries in 3. Table LVII. is interesting and instructive, for it gives- a full statement of the various parts of the body affected with the disease, as well as the sex and age of the persons who died. 89 1913 Table LVII. Mortality from Cancer or Malignant Disease during the Year 1913. ORGANS AFFECTED. Age at Death. Males. Females. Totals.  Sex. 0—5 —15 —25 —35 —45 —55 —65 —75 —75 upwards. Diseases of Nervous System Brain M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. 1 .. .. .. .. 1 Organs of Special Sense— Nose M. .. .. .. .. .. .. .. 1 .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Respiratory System— Larynx M. .. .. .. .. .. 1 3 3 1 8 .. 9 F. .. .. .. .. 1 .. .. .. .. .. 1 Lung M. .. .. .. .. .. 2 2 1 .. 5 .. 8 F. .. .. .. 2 .. .. 1 .. .. .. 3 Throat M. .. .. .. .. .. .. 1 .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Pleura M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. .. .. .. .. 1 Chest M. .. .. .. .. .. 1 .. .. .. 1 .. 2 F. .. .. .. .. .. l .. .. .. .. .. Digestive System— Stomach M. .. .. .. 1 2 4 7 10 1 25 .. 56 F. .. .. .. .. 2 5 12 9 3 .. 31 Liver M. .. .. .. .. .. 3 2 2 3 10 .. 35 F. .. .. .. .. 2 2 6 5 10 .. 25 Pylorus M. .. .. .. .. 1 2 1 2 .. 6 .. 11 F. .. .. .. .. 1 2 2 .. .. .. 5 Intestines (parts not specified) - M. .. .. .. .. .. 1 2 5 1 9 .. 19 F. .. .. .. .. .. 4 .. 3 2 .. 10 Œsophagus M. .. .. .. .. .. 5 6 4 .. 15 .. 16 F. .. .. .. .. .. .. .. 1 .. .. 1 Colon M. .. .. .. 1 1 .. 2 3 .. 7 .. 18 F. .. .. .. .. 1 .. 1 7 2 .. 11 Rectum M. .. .. .. .. 1 4 4 5 3 17 .. 33 F. .. .. .. 1 1 2 4 4 4 .. 16 Cæcum M. .. .. .. .. .. .. .. .. .. .. 5 F. .. .. .. .. .. 1 1 1 2 .. 5 Abdomen M. .. .. .. .. .. .. 2 l .. 3 .. 4 F. .. .. .. .. .. .. .. l .. .. 1 Peritoneum M. .. .. .. .. .. .. .. .. .. .. .. 2 F. .. .. .. .. .. 1 .. .. 1 .. 2 Duodenum M. .. .. .. .. .. l 1 .. .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Gall Bladder M. .. .. .. .. .. .. .. .. .. .. .. 6 F. .. .. .. .. .. .. .. 4 1 .. 6 Jaw M. .. .. .. .. .. .. 1 1 .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Tongue M. .. .. .. .. .. 7 4 3 .. 14 .. 14 F. .. .. .. .. .. .. .. .. .. .. .. Tonsils M. .. .. .. .. .. 1 1 .. .. 2 .. 3 F. .. .. .. .. 1 .. .. .. .. .. 1 Pancreas M. .. .. .. .. l .. .. .. .. 1 .. 7 F. .. .. .. .. .. .. 2 3 .. .. 6 Face M. .. .. .. .. .. .. .. .. 1 1 .. 2 F. .. .. .. .. .. .. .. .. l .. 1 90 1913 Table LVII.—continued. ORGANS AFFECTED. Age at Death. Males. Females. Totals. Sex. —6 — 15 —25 —36 —45 —55 —65 —76 —76 upwards. Digestive System—continued. Pharynx M. .. .. 1 .. .. .. 1 2 .. 4 .. 5 F. .. .. .. .. .. .. 1 .. .. .. 1 Mouth M. .. .. .. .. .. .. .. .. i 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Lymphatic System— Glands of Neck M. .. .. .. .. .. .. .. 2 .. 2 .. 2 F. .. .. .. .. .. .. .. .. .. .. .. Thyroid Gland M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. 1 .. .. .. 1 Mediastinum M. 1 .. .. .. .. 1 .. 1 .. 3 .. 5 F. .. .. .. .. .. 1 1 .. .. .. 2 Axilliary Gland M. .. .. 1 .. .. .. .. .. .. 1 .. 1 F. .. .. .. .. .. .. .. .. .. .. .. Parotid Gland M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. 1 .. .. .. .. .. .. 1 Glands (frontal fissure) M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. 1 .. .. .. .. 1 Urinary System— Kidney M. .. .. .. 2 1 .. 1 1 1 6 .. 6 F. .. .. .. .. .. .. .. .. .. .. .. Bladder M. .. .. .. .. .. 1 2 2 .. 5 .. 7 F. .. .. .. .. .. 1 .. .. 1 .. 2 Prostate M. .. .. .. .. .. .. 1 .. 2 3 .. 3 F. .. .. .. .. .. .. .. .. .. .. .. Generative System— Breast M. .. .. .. .. .. .. 1 .. .. 1 .. 40 F. .. .. .. 1 6 6 6 13 7 .. 39 Uterus F. .. .. .. 3 6 12 10 11 4 .. 46 46 Ovary F, .. .. .. .. .. 3 .. .. .. .. 3 3 Pelvis F. .. .. .. .. .. .. .. 1 .. .. 1 1 Testis M. .. .. 1 .. .. 1 .. .. .. 2 .. 2 Organs of Locomotion— Neck M. .. .. .. .. .. .. 1 .. .. 1 .. 2 F. .. .. .. .. .. .. .. .. 1 .. 1 Bones and Joints— Spine M. .. .. 1 .. .. 1 1 1 .. 4 .. 4 F. .. .. .. .. .. .. .. .. .. .. Femur M. .. .. 1 .. 1 .. 1 .. .. 3 .. 3 F. .. .. .. .. .. .. .. .. .. .. .. Ribs M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. 1 .. .. .. .. .. 1 Skull M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. .. .. .. .. .. 1 .. .. 1 Frontal Bone M. .. .. .. .. .. .. .. .. .. .. .. 1 F. .. .. 1 .. .. .. .. .. .. .. 1 Unspecified M. .. .. .. .. .. .. 3 1 1 5 .. 9 F. .. .. 1 .. 1 2 .. .. .. .. 4 Total Males and Females for Year M. 1 .. 5 3 8 36 51 51 16 .. .. 171 F. .. .. 2 10 23 47 48 64 39 .. .. 233 Total Deaths 1 .. 7 13 31 83 | 99 115 55 171 233 404 91 1913 TUBERCULOSIS. Pulmonary Phthisis, Tabes Mesenterica, Tuberculous Meningitis, Tuberculosis of the Larynx, General Tuberculosis, and other form of Tuberculosis, such as Lupus, Tuberculous Caries, and Pott's Disease. These diseases in combination caused 535 deaths, as contrasted with a decennial average of 587, while the death-rate was 1.61 per 1,000 of the estimated population, as contrasted with a decennial death-rate of 1.77. Thus, there was a decrease of 52 on the average number of deaths, and of 0.16 on the mean death-rate. The number of deaths from tuberculosis has been gradually decreasing since 1893, which the Medical Officer of Health has shown graphically on the chart facing p. 87 of this report, and although now and again the deaths exhibit a peak, yet these peaks as the years pass become lower and lower, so that there is every hope, if proper energetic and sustained efforts be now made, that before another generation passes awav the disease will no longer demand such a heavy toll from the ranks of our people, as it has done in the past. The actual number of deaths from tuberculosis in each year has been as follows: — since 1891 Year. Deaths. Death Kates. Year. Deaths. Death Rates. l891 717 2.24 1903 632 1.90 1892 677 2.09 1904 682 2.05 1893 758 2.32 1905 580 1.75 1894 673 2.04 1906 578 1.74 1895 763 2.28 1907 608 1.84 1896 730 2.I6 1908 604 1.83 1897 689 2.04 1909 582 1.77 1898 686 2.04 1910 539 1.64 1899 729 2.17 1911 512 1.56 1900 710 2.11 1912 553 1.69 1901 677 2.02 Average 652 1.97 1902 672 2.01 1913 535 1.61 Pulmonary Phthisis.—The chief factor in causing this (tuberculosis) mortality was, of course, pulmonary phthisis, to which 420 deaths were ascribed, or 78'5 per cent, of all deaths from tubercular diseases. They also represented 8-35 per cent, of the deaths from all causes during the year. 92 1913 The serious character of this disease has been fully recognised for many years, but it was only at a comparatively recent period that any real efforts have been made in the United Kingdom to fight it. These efforts are alluded to in that part of this report which deals with the notification of tuberculosis. Pulmonary Phthisis. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. Years. Deaths. Death rates per 1,000 inhabitants. 1891 544 1.70 8.60 19.8 1892 504 1.56 8.30 18.8 1893 560 1.71 8.76 19.5 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 1.62 10.16 15.9 1902 515 1.51 9.14 16.5 1903 492 1.48 10.16 14.5 1904 533 1.60 10.18 15.7 1905 438 1.32 8.84 14.9 1906 411 1.24 8.14 15.3 1907 436 1.32 8.58 15.4 1908 432 1.29 9.23 13.9 1909 424 1.29 8.62 14.9 1910 390 1.19 8.62 13.8 1911 379 1.16 7.88 14.9 1912 427 1.31 9.12 14.3 Corrected average 22 years 486 1.47 9.o1 16.3 1913 420 1.26 8.35 15.1 The following return shows the deaths at each age period:— Age periods. Deaths. Age periods. Deaths. 0- 5 13 55-65 47 5-15 13 65-75 15 15-25 60 75-85 6 25-35 8l 35-45 108 Total 420 45-55 77 CHART. Showing Deaths from ALL Forms of TUBERCULOSIS per 100 Deaths from ALL DISEASES at each age. 1903, 1912, and 1913. M = 1913. M = 1903—1912 93 1913 Table LVIII. Showing the Deaths from Phthisis in the Sub-Districts during the Four Quarters of the Year 1913. Quarters Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough 1st 6 8 7 25 15 25 25 11 2nd 11 9 9 14 14 18 21 96 3rd 9 14 7 11 9 17 14 81 4th 14 12 16 14 17 29 30 132 The Year 40 43 39 64 55 89 90 420 Abdominal Tuberculosis caused 30 deaths, of which 16 occurred among children under five years of age. Ten deaths occurred among males and 20 among females. The death-rate was 0 09 per 1,000. Tuberculosis of the Larynx.—This was the cause of 7 deaths, and produced a death-rate of 0 02 per 1,000. Tubercular Meningitis.—Fifty-eight deaths were reported from it, representing a death-rate of 017 per 1,000. These deaths are 9 less than in the preceding ten years. Of the 58 deaths, 31 were males and 27 females; while 37 were children under five years, and 21 over that age; indeed, all with five exceptions were under fifteen. General Tuberculosis.—The deaths of 18 persons were ascribed to it, of whom 8 had not reached their fifth year. The deaths were five less than in 1912, and produced a death-rate of 0 00 per 1,000. Other forms of Tuberculosis caused 9 deaths, 7 males and 2 females, and with two exceptions they were those of persons above five years of age. 94 1913] Table LIX. Showing the Deaths from the Tubercular Diseases during 1913. Diseases. Ages. Sex Districts. Totals Deaths. Death Rates per 1000 Population 0—1 1—5 Over a M. F. Tuf. U.H Toll. L.H H. B. S.E. 0—5 5-15 All Ages. Phthisis 2 11 400 242 171 39 43 37 63 55 86 90 413 0.38 0.22 1.25 Tuberculosis of the Larynx — — 7 7 — 1 — 2 I — 3 — 7 — — 0.02 Tubercular Meningitis 9 28 21 31 27 4 3 7 7 7 17 13 58 1.08 0.27 0.17 Abdominal Tuberculosis 7 9 14 10 20 5 4 2 4 5 6 4 30 0.47 0.07 0.09 General Tuberculosis 1 7 10 8 10 1 — 2 2 2 6 5 18 0.23 0.05 0.05 Other Forms of Tuberculosis 2 — 7 7 2 1 2 2 1 1 — 2 9 0.06 0.03 0.03 All Tubercular Diseases 21 55 459 305 230 51 52 52 78 70 118 114 535 2.22 0.64 1.61 95 1913 Table LX. Mortality from Tuberculosis of the Lungs (including Phthisis) and other Forms of Tuberculosis. Years. Number of Deaths. Death Rates. Tuberculosis of the Lungs (inc'uding Phthisis). Other forms of Tuberculosis. Tuberculosis of the Lungs (including Phthisis). Other forms of Tuberculosis. Males (all ages). Females (all ages). Persons (all ages). Males (all ages). Females | (all ages). | (Persons (all ages). Children (under 5). | Males 1 fall agesl. Females , (all ages). ! Persons (all ages). Males (all aces). Females (all ages). Persons (all ages). Children (under 5). 1903 291 201 492 80 60 140 103 1.80 1.13 1.48 0.49 0.34 0.42 2.82 1904 315 218 533 83 66 149 104 1.94 1.22 1.60 0.51 0.37 0.45 2.84 1905 243 195 438 74 68 142 107 1.49 1.08 1.32 0.45 0.38 0.43 2.90 1906 252 159 411 88 79 167 112 1.54 0.88 1.24 0.54 0.44 0.50 3.02 1907 260 176 436 83 89 172 110 1.58 0.97 1.32 0.45 0.49 0.52 2.95 1908 248 184 432 96 76 172 109 1.53 0.99 1.31 0.59 0.41 0.52 2.85 1909 255 169 424 80 78 158 116 1.68 0.92 1.29 0.48 0.42 0.48 3.07 1910 234 1???6 390 89 60 149 93 1.39 0.84 1.19 0.53 0.32 0.45 2.45 1911 223 156 379 71 62 133 80 1.43 0.91 1.16 0.45 0.36 0.40 2.37 1912 255 172 427 72 54 125 72 1.64 1.00 1.31 0.46 0.31 0.38 2.14 Average 257 179 436 82 69 151 100 1.59 0.99 1.32 0.49 0.38 0.45 2.74 1913 249 171 420 56 59 115 63 1 58 0 98 1-27 0 35 0 38 0 34 1 84 Increase or Decrease on Average - 8 - 8 - 16 - 26 - 10 - 36 - 37 -0.01 -0.01 -0.05 -0.14 -0.05 -0.1l -0.90 96 1913 DIABETES MELLITUS. Thirty-five deaths were registered, which is an increase of six on the return of the" preceding year, and also seven above the average of the preceding 10 years. The disease is of importance in middle and later life, for in ten years, between the ages of 35 and 75, it caused an annual average of 22 deaths, or 78 per cent, of the deaths from it at all ages. The deaths were equally distributed among the sexes, namely, 18 among males, and 17 among females. Table LXI. Showing the Deaths from Diabetes Mellitus at ten age periods during the years 1903-1912, and in 1913. Ages at Death. Years. Mean 10 years.  1903 1904 1905 1900 1907 1908 1909 1910 1911 1912 0-5 — — — — — — — — — — — 1 5-15 1 — — — 1 — — 1 — — — 2 15-25 1 3 1 1 1 — 4 3 1 1 1 2 25-35 2 2 3 3 1 1 2 1 1 3 2 5 35-45 2 3 2 3 1 2 1 3 3 4 2 2 45-55 2 5 4 3 2 4 10 7 4 2 4 7 55-65 8 11 6 7 7 7 8 7 9 10 8 4 65-75 7 9 11 14 5 5 5 10 8 7 8 11 75-85 3 1 1 1 2 1 3 2 1 2 2 1 85 upwards — 1 — — 1 1 3 — — — 1 — All Ages 26 35 28 32 21 21 36 34 27 29 28 35 Males 11 19 15 13 11 10 22 20 13 19 15 18 Females 15 16 13 19 10 11 14 14 14 10 13 17 97 1913 TABLE LXII. Showing the Deaths from the several Constitutional Diseases during the Years 1903-1912, also the Corrected Mean Number of Deaths for these Years, together with the Deaths in 1913. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. Corrected Means 1903 1912. 1913 Increase or Decrease. Rheumatic Fever 16 13 18 15 11 9 10 15 10 15 13 11 - 2 Rheumatism 21 21 11 19 13 14 28 15 18 20 18 15 - 3 Gout 6 11 7 6 13 7 4 2 5 3 6 2 - 4 Rickets 9 11 11 11 5 5 3 4 10 1 7 4 - 3 Cancer 350 323 328 363 348 367 353 361 332 382 346 404 + 58 Abdominal Tuberculosis 40 40 39 35 26 45 41 36 33 20 34 30 - 4 Tuberculosis Tubercular Meningitis 71 74 63 80 74 63 72 72 50 67 68 58 -10 Phthisis 492 533 438 411 436 432 424 390 387 427 431 420 -11 Other Tubercular and t Scrofulous Diseases 29 35 40 52 72 64 45 41 51 39 46 28 -18 Purpura 1 1 2 1 3 3 .. 1 2 2 2 3 + 1 Anaemia, Chlorosis, Leucocythæmia 8 14 15 16 15 14 13 16 22 11 14 18 + 4 Diabetes 26 35 28 32 21 21 36 34 27 29 29 35 + 6 Other Diseases 1 5 7 1 4 4 3 2 10 7 4 4 — Totals 1,070 1,116 1,007 1,042 1,041 1,048 1,032 989 957 1,023 1,018 1,032 + 14 DISEASES OF THE RESPIRATORY SYSTEM. These include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, and together caused 999 deaths, or 19 more than in the preceding year, and represented a death-rate of 3.01 per 1,000 of the population. They formed 19.9 per cent. of all the deaths registered in the borough during the year. Acute Bronchitis.—To it were ascribed 149 deaths, of which 81 occurred among males and 68 among females. The deaths are 15 below the return for 1912. They include 59 deaths of infants under twelve months old, and 21 deaths in the Public Institutions of the Borough. H 98 1913] Chronic Bronchitis.—As many as 343 deaths were registered as compared with 307 in the preceding year and 247 in 1911. 183 deaths were those of males and 160 of females. Pneumonia—This very serious ailment caused the deaths of 419 persons, of whom 236 were males and 183 females, which were 20 above the number registered in 1912. It was very fatal to infants under one year old, causing no less than 109 deaths, and to young children aged between one and five years causing 102 deaths. It also resulted in 11 deaths among children between 5 and 10 years of age. 92 deaths occurred in the Public Institutions as contrasted with 81 in the preceding year, the majority of whom, as usual, came from the Workhouse Infirmaries. Pleurisy.—16 deaths were attributed to it, three being children under 5 years old. Three deaths were registered in public institutions. Asthma and Emphysema.—To these diseases were ascribed the deaths of 15 persons, all of whom were adults. Other Diseases of the Respiratory System.—16 deaths were attributed to them, as compared with 20 in 1912. Deaths among Infants—As it is interesting to note the deaths among infants, they are given herewith:— Acute Bronchitis. Pneumonia. Total. 1st quarter 28 58 86 2nd „ 7 13 20 3rd „ 4 7 11 4th „ 20 31 51 59 109 168 ALCOHOLISM. The mortality from alcoholism is not in it self an important item, for in thirteen years the deaths have averaged about 19 per annum. They are, however, of real importance as an indication, however small, of the drinking habits of the people, and of those alcoholic excesses which lead to so many other diseases. In the returns for the year only 10 deaths are entered from it. The tabular statement, given below, shows that the deaths have fallen from 28 in 1907 to 10 in 1913; and the gratifying part of the decrease is that it CHART. Showing the Mean Weekly Number of Deaths from PNEUMONIA during each week of the seventeen years 1896-1912 and in 1913. Seventeen years average = Heavy black line. Deaths 1913 = Dotted line. 99 1913 has been almost continuous, both among men and women. Among the diseases which may be reasonably attributed to the immoderate use of alcohol are some affecting the liver and kidneys, cancer of the stomach and aesophagus, cerebral hæmorrhage and thrombosis, gastric catarrh, hæmaturia, deafness, congenital deafness in children, insanity, paralysis and other nervine complaints, and it also affects the embryonic child in the womb. It, too, is the cause of innumerable accidents and crimes, as well as of pauperism. Hence, although the direct mortality ascribed to alcoholism is small, yet its effects are many and wide-spread. 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 l6 1906 3 13 16 5 11 1907 4 24 28 10 18 1908 3 14 17 8 9 1909 4 14 18 12 6 1910 3 8 11 6 5 1911 - 4 4 2 2 1912 3 8 11 5 6 *9*3 2 8 10 5 5 253 114 139 VENEREAL DISEASES. The two diseases of most interest under this heading are Syphilis and Gonorrhoea, which conjointly caused 19 deaths during the year. Of these, 12 were infants under a year old, while seven were adults. It is, therefore, apparent that they are diseases which can be conveyed to the progeny, either in the case of syphilis while the child is still in its mother's womb, or by infection conveyed to it after birth. Gonorrhoea is the frequent cause of the ophthalmia of infants, and is the chief source of blindness among them; and it was to counteract such a result that Ophthalmia Neonatorum was made compulsorily notifiable by the Ophthalmia Neonatorum Order of the Local Government Board. This Order, it is well to note, is doing exceedingly good work in this country, and H 2 100 1913 as the Medical Officer of the Local Government Board states, is greatly reducing the risk of neglect of treatment of this serious condition. It is to be regretted that the public are not fully aware of the serious extent to which syphilis in particular affects the national health; for if they were, it is only reasonable to suppose that they would take a deeper interest in the question of its cure and prevention than they do. Syphilis is supposed to have been introduced into Europe by the adventurers who accompanied Christopher Columbus on his voyage of discovery on their return in 1493 from America; but whether this statement be correct or not, the disease does not appear to have been known until the close of the 15th century. At all events, it is certain that in 1494 syphilis ravaged Spain, and extended to France and Germany in 1495; to Holland and Greeoe in 1496; to England and Scotland in 1497, and to Russia and Hungary in 1499, since which time it has been endemic in Europe. It is difficult to state with exactitude the number of deaths from this disease that occur annually in this country, because as a writer (Dr. R. W. Johnstone) on the subject puts it in a report to the Local Government Board : " few medical men are so callous as not to try to spare the memory of the dead and the feelings of the relatives by attributing the death to some of the contributary causes which always exist. In consequence, syphilis is rarely certified as the cause of death." The Registrar-General, in his Annual Report for 1912, dwells at more length on this subject, and he states that: " The deaths tabulated from the registers as due to syphilis clearly afford no measure of the absolute amount of mortality properly ascribable to the disease. This is inevitable under the present system by which the causes of death are certified, an open certificate being handed by the certifying practitioner to the relatives of the deceased, and subsequently included in a register open to inspection by any member of the public on payment of a small fee. The practitioner is obviously strongly tempted, in fact almost obliged, in many cases under this system to avoid mention on the certificate of the syphilitic nature of the disease he is returning as the cause of death. Indeed, the fact that such concealment is commonly practised is frequently illustrated both by the correspondence with medical men who have issued purposely indefinite certificates, and by efforts made in certain cases to embody in the wording of the certificate a hint as to the true cause of death not likely to be understood by 101 1913 relatives- Considerations of his sort apply far less to institutional than to private practice, and so it is to be expected that the proportion of deaths returned from institutions should be higher in the case of syphilis than of mortality in general. " The proportion of the deaths from syphilis returned by institutions is double that of deaths in general, and in the case of adults more than half the total deaths ascribed to syphilis are returned from institutions. It is much more likely that this is due to greater under statement of these deaths in private practice than to exceptional resort to institutions by sufferers from syphilis." The returns of deaths from syphilis, issued by the Registrar-General, show that whereas in 1875 their number was 2,138—equal to a death-rate of 89 per million of the population—in 1910 they numbered 1,639—equal to a death-rate of 46 0 per million. Thus, on the surface there appears to have been a decrease of 23 per cent. These figures are, however, fallacious, for such diseases as locomotor ataxia, general paralysis of the insane, aneurysm, and other diseases known to be induced by syphilis, show no similar diminution. It is singular, however, that the number of intending recruits refused admission to the army on account of syphilis, per 10,000 offering themselves for enlistment, has declined from 158 in 1870 to 19 in 1911, which would seem to show that syphilis is becoming less prevalent. The reduction is explained, the Army Surgeons say, by the fact that candidates for the army now know that they will be rejected if they present themselves whilst suffering from active signs of the disease, and, therefore, they avoid doing so. The fact, also, is to be taken into consideration that a form of syphilis known as soft chancre was proved to be due to a different cause from syphilis, and was probably neglected in the return which showed the cause of the rejection of candidates on account of other non-syphilitic disease of the genital organs. It is not proposed to follow this disease through its various ramifications, but rather to study it from a public health point of view. As already stated, locomotor ataxia and general paralysis of the insane are looked upon as being entirely dependent upon syphilis; indeed, to these two diseases Dr. Mott attributes about 40 per cent. of the male deaths at the London County Council Claybury Asylum. 102 1913 According to Dr. Hutchinson, the whole arterial and capilliary system is affected in the secondary stage of syphilis, and in many instances receives some permanent damage, and hence the suspicion that 20-80 per cent, of aneurysms have been considered to be due to syphilis is correct, and also that arterio-sclerosis, aortic insufficiency, endarteritis and many affections of the heart and large blood vessels owe their origin to these diseases. Then there is the effect of the disease on procreation, for it is well known that sterility, marasmus, abortion, still-births, deaths of infants from convulsions, marasmus, meningitis, hydrocephalus, are not infrequently the outcome of conception by syphilitic parents. But there is also the fact that children who, though they may appear to be healthy at birth, yet in later life develop hereditary syphilis, which does not manifest itself until some years after birth. A disease of the eyes, known as interstitial keratitis, characterized with deep deposits in the substance of the cornea, which assumes a hazy and a ground glass appearance, deafness, and lesions of bone, skin and viscera are also some of the evils which follow in the wake of syphilis. The main source of the spread of the disease need not be discussed, because that source is well known. There is, however, a more numerous and a more dangerous class than the acknowledged prostitutes—the class generally referred to as clandestine prostitutes. Of this class Sir Alfred Keogh, in speaking on the Police Regulation of Vice, said, " She will always avoid their mesh, and it is to her that the greatest amount of the disease is due." That the clandestine prostitute flourishes may be inferred from the figures referring to Bremen submitted by Weidanz at the Berlin Congress of 1912, which showed that from 1901 to 1909 they varied annually, and that the numbers ranged from one prostitute to every 37 clandestine prostitutes, to one to every 155 clandestine prostitutes. The disease is also spread by males, who, either through ignorance, or recklessness, or deliberation, infect women. The latter class of men are, fortunately, very few in number, and only commit such a crime in a spirit of revenge and at rare intervals. There is no doubt that the concealment of the disease is mainly due to shame, which prevents the sufferers from resorting to their medical advisers until the disease has taken a strong hold of them, preferring to rush to some herbalist or quack for advice. Indeed, the Medical Officer of Health has in his mind the case of a man, at one time a medical 103 [1913 student, considerably addicted to drink, who lived in a northern seaport town, where he eked out an existence by selling prescriptions to sailors suffering from venereal diseases, of which he had no special knowledge. The result, of course, was very bad for those who took his advice. The question of the notification of syphilis has been frequently mooted, but the concensus of opinion among medical officers of health and those whose opinion is best and worth having is that the time has not yet arrived for it; because, as stated in a recent report of the Local Government Board, " The stigma of suffering from a venereal disease is so great, and the desire for concealment, with its consequent resort to quacks and self-treatment so marked, that until a more reasonable attitude towards the whole subject has penetrated to the popular rnind, notification would be likely to increase the number of concealments." Besides, it does not bear thinking that the name of an innocent married woman, infected by her husband, should be made known to any officials, however worthy they may be, or however secret they may keep the information. Under 1 year. 1—5 years. Adults. Total 1902 11 — 10 21 1903 10 I 8 19 1904 12 2 6 20 1905 13 — 5 18 1906 9 I 6 l6 1907 5 — 11 l6 1908 13 I 6 20 1909 10 — 5 15 1910 8 — 7 15 1911 6 — 7 13 1912 8 2 7 17 1902-12 105 7 78 190 1913 12 — 7 19 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—1,938 persons died in the Public Institutions located in Islington, of whom 1,361 belonged to this Borough, the remaining 577 having come here for treatment or relief. Among the latter were 395 persons who died in the Holborn Infirmary, and 82 in the Great Northern Central Hospital, 17 in the Islington Infirmary, 8 in the Islington Workhouses, 5 in the London Fever Hospital, 9 in St. Pelagia's Creche, 8 in the Memorial Cottage Hospital, and 8 in the Aged Blind Home. 1913] 104 Of the 1,361 deaths of inhabitants, 980 occurred in the Islington Infirmary, 231 in the Islington Workhouses and Schools, and 115 in the Great Northern Central Hospital. The proportion which the 1,361 deaths bore to the Borough mortality was 271 per cent. Without the Borough.—844 deaths of persons belonging to Islington were registered as occurring in Public Institutions in districts of London outside the Borough. They included, among others, 49 in the North-Eastern Fever Hospital, 60 in the Children's Hospital, Great Ormond Street, 98 in St. Bartholomew's Hospital, 47 in the Colney Hatch Asylum, 54 in the Royal Free Hospital, 54 in the University College Hospital, and 21 in Claybury Asylum. These 844 deaths represented 16.8 per cent. of all the deaths registered in the year. Within and without the Borough.—The deaths of Islingtonians in Public Institutions numbered 2,205, and were equal to 43.8 per cent. of the total deaths registered during the year. Fatal accidents or sudden deaths outside the Borough.— Ninety-two inhabitants died from accidental deaths, or suddenly, in places outside Islington. 105 [1913 Table LXIII. Showing the Deaths of Inhabitants in Local Institutions and in Institutions outside the Borough, also the Deaths of Non.Inhabitants in Local Institutions during the ten years 1903.1912 and in 1913. Years Total Deaths in Local Institutions (cols. 3 and 4). Inhabitants of Islington in Local Institutions. Non. Inhabitants 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. &). 1 2 3 4 5 6 7 8 9 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 1,675 1,082 593 760 130 656 1,738 34.2 1908 1,565 1,015 550 750 120 684 1,699 36.3 1909 1,672 1,055 617 755 113 735 1,790 36.4 1910 1,683 1,120 563 839 97 681 1,801 39.8 1911 1,804 1,181 623 817 113 760 1,941 39.9 1912 1,693 1,184 509 846 I27 760 1,944 41.5 Average 1,627 1,045 582 754 118 676 1,721 35.2 1913 1,938 1,361 577 980 116 844 2,205 438 1913] 106 Table LXIV. Showing the Deaths of Inhabitants in Public ami 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 1913. PUBLIC INSTITUTION. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. Total Inhabitants. NonInhabitants. Islington Infirmary 86 137 94 124 117 209 213 980 17 Islington Workhouses 13 37 22 39 39 31 50 231 8 Guardians Schools — — — — — — — — — Gt. Northern Hospital 24 24 16 9 24 11 7 115 32 Holborn Infirmary — — 1 — — 3 1 5 395 Aged Pilgrims' Asylum — — — — — — — — 3 St. Pelagia's Creche — — — — — — — — 29 Aged Blind Home — — 1 — — — — 1 8 Whittington College — — — — — — — — 1 Cranford Nursing Home, Warltersville Road — — — — — — — — 1 Tower House Nursing Home, — — — — — — — — Warltersville Road — — — — — — — — 2 Alexandra Nursing Home, Turle Road 1 — — 1 — — 2 4 Nightingale Nursing Home, Hanley Road — — 1 — — — 1 2 2 H.M. Prison, Holloway 3 — — — — — — 3 6 H.M. Prison, Pentonville — — — 2 — — 1 3 7 Drovers' Almshouses — — — 1 — — — 1 — London Fever Hospital — — — — — — 2 2 5 Memorial Cottage Hospital — — — — — — 3 3 8 Invalid Home, Aubert Park — — — — — — — — 4 Invalid Home, Highbury Terrace — — — — — — — — 3 Highbury Nursing Home — — — — 3 — 1 4 6 Bookbinders' Asylum — — — — 2 — — 2 1 Metropolitan Benefit Societies' Asylum — 1 — — 3 — — 4 3 Bricklayers' and Tilers' Almshouses — — — — 2 — — 2 — Dyers' Almshouses — — — — — — — — 1 Clothworkers' Almshouses — — — — — — — — 1 Totals 127 199 135 175 191 254 280 1,361 577 •Also 28 at other places not in above list. 107 [1913 Table LXV. 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 1913. 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 9 19 28 9 9 18 9 7 16 11 12 23 38 47 85 Upper Holloway 12 22 34 11 15 26 13 14 27 12 11 23 48 62 110 Tollington 6 5 11 9 13 22 7 8 15 8 9 17 30 35 65 Lower Holloway 17 14 31 12 14 26 13 9 22 12 10 22 54 47 101 Highbury 15 16 31 21 19 40 17 17 34 13 20 38 71 72 143 Barnsbury 36 25 61 28 17 45 12 18 30 20 23 43 96 83 179 Islington, South-East 29 31 60 35 30 65 34 28 62 44 22 66 142 111 253 Borough 124 132 256 125 117 242 105 101 206 125 107 232 479 457 936 1913] 108 Table LXVI. Showing the Deaths of Inhabitants in Public and Charitable Institutions situated without the Borough, also Accidental Deaths in Outlying Places during the Year 1913. Public Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Middlesex Hospital 5 7 3 10 25 Friedenheim (Home of Peace), N.W. 3 1 1 5 10 North-Western Fever Hospital 20 l6 6 .. 47 University College Hospital 11 20 11 12 54 Eastern Fever Hospital 4 5 .. 2 11 Children's Hospital, Gt. Ormond Street 12 19 13 16 60 Banstead Asylum 5 4 6 .. 12 Manor Asylum (Epsom) .. .. 1 .. 1 Hanwell Asylum 8 2 5 .. 21 St. Mary Hospital 1 1 .. .. 6 Hospital of St. John and St. Elizabeth .. •• 1 .. 2 Hospital for Women (Euston Road) .. .. 1 .. 6 Metropolitan Hospital 3 4 3 .. 15 German Hospital 6 2 3 .. 13 St. Bartholomew's Hospital 22 21 27 28 98 Royal Chest Hospital 2 1 1 5 9 King's College Hospital .. 3 .. .. 3 Guy's Hospital 2 .. 2 1 5 Colney Hatch Asylum 10 9 13 15 47 North-Eastern Fever Hospital 14 21 9 5 49 Leavesden 7 2 3 3 15 St. Thomas's Hospital 1 •• 1 1 3 Cane Hill Asylum 2 .. 1 1 4 Royal Free Hospital 14 15 9 16 54 London Temperance Hospital 3 2 4 5 14 Cancer Hospital (Chelsea) 1 .. .. 1 2 London County Asylum (Dartford) 1 1 1 3 6 London Hospital 1 2 2 1 6 Mildmay Hospital 2 2 2 2 8 Westminster Hospital .. 1 .. 1 2 Homoeopathic Hospital, Gt. Ormond Street 2 1 .. .. 3 Claybury Asylum 10 2 5 1 21 St. George's Hospital 1 •• 1 1 3 Hackney Infirmary 1 •• .. .. 2 Middlesex Asylum (Wandsworth) 1 •• 1 .. 2 Queen Charlotte Hospital 1 •• .. .. 1 French Hospital .. .. 1 .. 1 St. Pancras Workhouse .. 1 1 .. 2 St. Pancras Infirmary 1 .. .. 2 3 Brompton Hospital .. 1 .. 2 6 City of London Lying-in Hospital 6 2 1 1 10 Charing Cross Hospital 1 .. .. .. 1 Hampstead Home Hospital 3 3 .. .. 6 Hostel of God (Clapham) 1 1 .. .. 2 Northern Fever Hospital .. 2 1 2 5 St. Luke's House (14, Pembridge Square, W.C.) 3 .. 2 1 6 Central London Throat and Ear Hospital .. 1 .. .. 1 St, Mark's Hospital .. .. 1 .. 1 Holborn Workhouse, Hoxton 5 1 .. 3 9 St. Giles' Infirmary .. .. 1 .. 1 Chest Hospital IBethnal Green) 2 .. .. .. 2 Shoreditch Infirmary 2 2 4 3 11 Horton Asylum 1 .. 2 2 5 109 [1913 Table LXVI.—continued. Public Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Chelsea Hospital for Women 1 .. .. .. 1 Royal London Ophthalmic Hospital .. .. 1 .. 1 Tooting Bec Asylum 2 4 l 3 10 Long Grove Asylum 4 1 l 1 7 Royal Hospital, Waterloo Road 1 3 .. .. 4 Queen's Hospital 2 1 1 5 9 East London Hospital 1 2 4 1 8 Lock Hospital 1 .. .. .. 1 St. Peter's Hospital (Covent Garden) 1 .. .. .. 1 Caterham Asylum 4 2 l 1 8 Marylebone Infirmary 1 1 .. .. 2 Queen Mary's Hospital, Carshalton 1 .. 3 1 5 Strand Workhouse, Edmonton 1 .. .. .. 1 Park Hospital 2 1 2 1 6 Sick Asylum, Cleveland Street 2 .. .. .. 2 Nursing Home, 6, Alexandra Road, Stoke Newington 1 4 .. .. 5 Southwark Infirmary 1 .. 1 l 3 Mount Vernon Hospital 1 .. 1 2 4 St. Scholastica's Retreat, Lower Clapton 1 .. .. .. 1 St. Barnabas' Home, 9, Lloyd Square, W.C. 1 1 1 .. 3 Darenth Industrial Colony .. 3 .. .. 3 Battersea General Hospital .. l .. .. 1 Fountain Temporary Asylum .. l .. .. 1 Down's Sanatorium, Sutton .. 2 1 4 7 St. Luke's Hospital .. l .. .. 1 Westminster Infirmary (Hendon) .. l .. .. 1 " Ravenswood " Nursing Home, Highgate Road, N.W. .. l .. .. 1 City of Westminster Workhouse, Edmonton .. l .. .. 1 West End Hospital Welbeck Street .. l .. .. 1 Infant's Hospital, Vincent Square .. .. 3 .. 3 Alexander Hospital, Queen's Square .. .. 1 .. 1 Evelina Hospital .. .. 1 2 3 Western Fever Hospital .. .. .. 1 1 Babies' Home, Shoreditch .. .. .. 1 1 Nightingale Hospital .. .. .. 1 1 Southern Hospital, Dartford .. .. .. 1 1 Whitechapel Union Workhouse .. .. .. 1 1 Seamen's Hospital .. .. .. 1 1 230 210 167 208 815 1913] 110 Table LXVI.—continued. Public Institutions. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Accidental and other Deaths :— At Euston Station 1 .. .. .. 1 At 3, New Yard, Gt. Queen Street, St. Giles, W 1 .. .. .. 1 At 7, The Terrac, St. Pancras 2 1 .. 2 5 In Kingsland Road, Hackney 1 .. .. .. 1 In tramcar in Goswell Road 1 .. .. .. 1 In Farringdon Road, Clerkenwell 1 .. .. .. 1 At 86, Brook Street, Mayfair 1 .. .. .. 1 At 7, Fenchurch Street, E.C. 1 .. .. .. 1 At 21, Albion Road, Hampstead 1 .. .. .. 1 In Gt. Ormond Street, W.C. .. 1 .. .. 1 On Ambulance nr. St. Bartholmew's Hospital .. 1 .. 1 2 South Metropolitan Gas Works, Greenwich .. 1 .. .. 1 At 18, Southwold Road, Upper Clapton .. 1 .. .. 1 At 108, Louiseville Road, Streatham .. 1 .. .. 1 In River Thames nr. Temple Steps .. 1 .. .. 1 At 11, Copthall Court, E.C. .. 1 .. .. 1 In Motor 'Bus, Southampton Street, Clerkenwe .. 1 .. .. 1 At 105, Mint Street, S.E. .. 1 .. .. 1 At No. 4, Road, King's Cross Station, G.N.R. .. 1 .. .. 1 At 76, Jeffrey's Road, Clapham Road .. .. 1 .. 1 In Gray's Inn Road, St. Pancras .. .. 1 .. 1 At 25, Sanford Lane, Stoke Newington .. .. 1 .. 1 In New River, Woodberry Down Bridge .. .. 1 .. 1 In No. 3 Pond, Hampstead Heath .. .. 1 .. 1 At 4, Cambridge Lodge Villas, Mare Street, E. .. .. 1 .. 1 At 58, Benyon Road, Hackney .. .. 1 .. 1 At 241, Gt. College Street, St. Pancras .. .. 1 .. 1 At 28, Digby Road, Stoke Newington .. .. 1 .. 1 At " Lynton," The Avenue, Grove Park, S.E. .. .. 1 .. 1 In Hanway Street, St. Marylebone .. .. 1 .. 1 At 12, St. James' Road, Brixton .. .. 1 .. 1 In River Thames off Riley Street, Chelsea .. .. 1 .. 1 In Arlington Street, outside Sadler's Wells Theatre .. .. .. 1 1 In Victoria Park, near Cricket Pavilion, Hackney .. .. .. 1 1 At 20, Gate Street, St. Giles, W C. .. .. .. 1 1 On the way to Charing Cross Hospital .. .. .. 1 1 On East Heath, Hampstead .. .. .. 1 1 In Sutton Street, E.C. .. .. .. 1 1 In workshop at rear of 23, Meredith Street, E.C. .. .. .. 1 1 At the entrance of Heddon Street, Westminster .. .. .. 1 1 On foreshore of river Thames, Bermondsey .. .. .. 1 1 In River Lea, near Lea Bridge .. .. .. 1 1 At 61, Weymouth Street, Marylebone .. .. .. 1 1 Total Deaths 240 221 180 222 863 111 [191-3 Table LXVII. Showing the Transferable Deaths of Inhabitants in Outlying Public Institutions and other Places during the Year 1913. (Forwarded by the Registrar General.) PUBLIC INSTITUTIONS. 1st Quaiter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Lunatic Asylum, Kingston, Portsmouth 1 .. 1 Brighton Borough County Asylum, Wivelsfield 1 .. 1 Peterborough Infirmary 1 .. 1 Prince of Wales General Hospital, Tottenham ] 1 .. 2 Children's Convalescent Home, Beaconsfield 1 .. 1 Enfield Union Workhouse 1 .. 1 Fisherton House Asylum, Salisbury 1 .. 1 Cottage Hospital, Acton 1 .. 1 City Asylum, Nottingham 1 .. 1 Firs Home, Bournemouth 1 .. 1 Edmonton Union Workhouse 1 1 2 Nottingham Workhouse Infirmary 1 .. 1 Yarmouth Infirmary 1 .. 1 Royal Sussex County Hospital 1 .. 1 Holloway Sanatorium, Virginia Water 1 .. 1 Union Infirmary, Isleworth i .. 1 The Hospital, Newton Abbott I .. 1 Sleaford County Asylum I .. 1 Berkshire Asylum I .. 1 The Hospital, Redhill l .. 1 Children's Hospital, Gt. Ormond Street, W.C. i .. 1 Workhouse Infirmary, Eastbourne l .. 1 Seamen's Hospital, West Ham l .. 1 North London Institute, 5, Alexandra Road, N.E. l .. 1 Makings Farm Sanatorium, Nayland 1 1 Mount Vernon Hospital, Ruislip 1 1 Bury St. Edmund's Workhouse Infirmary 1 1 Accidental and other Deaths:— At '26, York Road, Kingson-on-Thames 1 .. .. .. 1 At 143, Langham Road, Tottenham 1 .. .. .. 1 In River Lea, near Craven Park Road, Tottenham 1 .. .. .. 1 At 58, Cromwell Avenue, Hornsey 1 1 .. .. 2 At Midland Railway, near Milestone Bridge, St. Alban's 1 .. .. 1 At 34, Wellington Square, Hastings 1 .. .. .. 1 At 67, Barnsole Road, Gillingham 1 .. .. .. 1 In Reservoir at Clacton-on-Sea 1 .. .. .. 1 At Nag's Head Inn, Wyle Cop, Shrewsbury 1 .. .. .. 1 At St. Cleather, Freeland Road, Clacton .. 1 .. .. 1 At 28, Picardy Street, Belvedere, Erith .. 1 .. .. 1 In River Thames at lhe Hollows, Brentford .. 1 .. .. 1 At 60, Ethelbert Road, Margate .. 1 .. .. 1 At 20, Warwick Road, Worthing .. .. .. 1 At 5, Gordon Terrace, Heyles Owry Road, Newport .. 1 .. .. 1 At Hollanden House, Burlington Road, Ipswich .. 1 .. 1 At 5, Woodbridge Road, Moseley, Birmingham .. 1 .. .. 1 At Shurnhold, Melksham .. 1 .. .. 1 At "Ariston," 9, Rokesby Avenue, Hornsey .. 1 .. .. 1 At 9, Crescent Road, Hornsey .. 1 .. .. 1 At " Heimath," Crouch End Hill, Hornsey .. 1 .. .. 1 At East Cliff House, Margate .. .. 1 .. 1 At Hollow Pond, Epping Forest, Leyton .. .. l .. 1 1913] 112 Table LXVII.—continued. PUBLIC INSTITUTIONS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. At Rose Cottage Broad Street, Guildford • • • • 1 • • 1 At 10, Bouverie Road, Folkestone • • • • 1 • • 1 At Hopper Huts, Fairbrook Farm, Faversham • • • • 1 • • 1 At 28, George Street, Brighton • • • • 1 • • 1 At High Road, Whetstone • • • • 1 • • 1 At Speen, Princes Risborough, Wycombe • • • • 1 • • 1 On Midland Railway, Southend • • • • 1 • • 1 At Dolphin Hotel, The Quay, Penzance • • • • 1 • • 1 At 14, Victoria Mansions, Chambers Lane, Willesden • • • • 1 • • 1 At 18, Rutland Road, Aldrington, Hove • • • • 1 • • 1 At 16, Rodwell Avenue, Weymouth • • • • 1 • • 1 At 11, Broadlands Road, Hornsey • • • • 1 • • 1 At Wood Green, between Lordship Lane and Hospital • • • • 1 • • 1 At Brislingtcn House, Brislington, Keynsham • • • • 1 • • 1 On Towpath, River Thames, Barnes • • • • • • 1 1 At Ely Villas, Arundel Road, Brighton • • • • • • 1 1 At 3, St. Paul's Square, Portsmouth • • • • • • 1 1 At Shrivenham, Faringdon • • • • • • 1 1 At 467, Seven Sisters' Road, Tottenham • • • • • • 1 1 At 2a, Hillside Villas, Stonebridge, Willesden • • • • • • 1 1 Totals 16 21 26 10 73 113 [1913 i Table LXVIII. 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 1913. 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 280 207 206 287 980 5 3 2 7 17 285 210 208 294 997 Islington Workhouses and Schools 59 70 44 58 231 3 1 2 2 8 62 71 46 60 239 Great Northern Central Hospital 25 26 34 30 115 31 12 15 24 82 56 38 49 54 197 Holborn Infirmary 2 1 1 1 5 110 85 103 97 395 112 86 104 98 400 St. John's Nursing Institute • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • London Fever Hospital • • 1 1 • • 2 1 2 2 • • 5 1 3 3 • • 7 Aged Pilgrims' Asylum • • • • • • • • • • 1 1 • • 1 3 1 1 • • 1 3 St. Pelagia's Creche. • • • • • • • • • • 5 2 • • 2 9 5 2 • • 2 9 Memorial Cottage Hospital 1 • • 1 • • 3 1 2 2 3 8 2 2 3 4 11 Alexandra Nursing Home, Turle Road • • 2 • • • • 2 1 1 1 1 4 1 3 1 1 6 Aged Blind Home • • • • 1 • • 1 4 3 1 • • 8 4 3 2 • • 9 Cranford Nursing Home • • • • • • • • • • • • • • • • 1 1 • • • • • • 1 1 Invalid Home, Aubert Park • • • • • • • • • • 2 1 1 • • 4 2 1 1 • • 4 H.M. Prison, Holloway • • 2 • • 1 3 3 2 • • 1 6 3 4 • • 2 9 H.M. Prison, Pentonville 1 • • 1 1 3 2 1 3 l 7 3 1 4 2 10 Children's Nursing Home • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Kingsdown Orphanage • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Whittington College • • • • • • • • • • • • • • 1 • • 1 • • • • 1 • • 1 Metropltn. Benefit Societies' Asylum • • 1 3 • • 4 • • 1 1 1 3 • • 2 4 1 7 Shoreditch Workhouse • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • • Drovers' Almshouses • • 1 • • • • 1 • • • • • • • • • • 1 • • • • 1 Bookbinders' Asylum • • 2 • • • • 2 • • • • • • 1 1 1 2 • • 1 3 Invalid Home, Highbury Terrace • • • • • • • • • • 1 • • • • 2 3 • • • • • • 2 3 Dyers' Almshouses • • • • • • • • • • • • • • • • 1 1 6 • • • • 1 1 Highbury Nursing Home 2 • • 1 1 4 4 2 • • • • 6 2 • • 1 1 10 Bricklayers' and Tilers' Almshouses 2 • • • • • • 2 • • • • • • • • • • 2 • • • • • • 2 Cloth workers'Almshouses • • • • 1 • • 1 1 • • • • • • 1 1 • • 1 • • 2 Tower House Nursing Home • • • • • • • • • • 1 • • • • 1 2 1 • • • • 1 2 Nightingale Nursing Home, Hanley Road • • 1 1 • • 2 • • • • 1 1 2 • • 1 2 1 4 Totals 372 314 295 380 1361 176 119 135 147 577 548 433 430 527 1938 1913] 114 INQUESTS AND MORTUARY. During the year 575 bodies were received into the Mortuary, as compared with an average of 629 in the preceding 10 years. The daily average number of bodies received was 1.6 as compared with 1.7 in 1912. In 384 cases inquests were held, as contrasted with an average of 416 in the years 1903-1912. Bodies received into Mortuary. Inquests. 1903 681 393 1904 660 424 1905 625 419 1906 642 433 1907 644 441 1908 563 396 1909 592 407 1910 609 385 1911 646 425 1912 634 443 Average 629 416 1913 575 384 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1912 and 1913. 1912. No. of bodies received. Daily Average. No. of Inquests held. 1913. No. of bodies received. Daily Average. No. ot Inquests held. 1st Quarter 173 1.9 117 1st Quarter 166 1.8 110 2nd „ 147 1.6 94 2nd „ 146 1.6 101 3rd ,, 144 1.5 112 3rd „ 134 1.4 82 4th „ 170 1.8 120 4th „ 129 1.4 91 Total for Year 634 1.7 443 Total for Year 575 1.6 384 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. DISINFECTION. CLEANSING OF VERMINOUS CHILDKEN. I 2 1913] 116 NOTIFICATION OF INFECTIOUS DISEASES Under the Provisions of the Public Health (London) Act, 1891. Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric or Typhoid Fever, Typhus Fever Erysipelas, Continued Fever, Relapsing Fever and Cholera. There were 2,171 cases of these diseases which are notifiable under the Public Health (London) Act, 1891 : for it must be recollected that there are other infectious diseases, such as Tuberculosis, Ophthalmia Neonatorum, Acute Poliomyelitis, and Cerebro-Spinal Fever, which are notifiable either under Orders of the Local Government Board or under Orders of the London County Council with the approval of that Board. The cases are 594 more than were notified in 1912, and although less than the average of the preceding 21 years, yet are 272 in excess of that of the preceding ten years. The chief causes of the increase are to be found in the returns from Scarlet Fever and Diphtheria, which showed respective increases of 238 and 91. The increase in the number of cases of these diseases was not, however, peculiar to Islington, but was common to the County of London. The figures for each of the infectious diseases and the average of each during the ten years 1903-1912, together with the departure from it, were as follows: — 1913. Average 10 years. Increase or decrease. Small Pox — 4 - 4 Scarlet Fever 1,317 1,079 + 238 Diphtheria 546 455 + 91 Membranous Croup - 4 3 + 1 Enteric Fever 50 99 - 49 Typhus „ — — — Erysipelas 226 240 - 14 Puerperal Fever 28 19 + 9 2,171 1899 + 272 The behaviour of each disease is discussed under its appropriate heading further on in the report. CHART. Showing the number of cases of Notifiable INFECTIOUS DISEASES and the Fatality from them since 1892. Thick Line represents the cases of Infectious Diseases. Dotted Line represents the Fatality. 117 [1913 The returns for the preceding 21 years are given in the following statement : — Years Cases. Attack-rates per 1,000 inhabitants. Years. Cases. Attack-rates per 1,000 inhabitants. 1892 3,318 10.26 1903 1,707 5.12 1893 4,853 - 14.84 1904 1,941 5.84 1894 3,121 9.44 1905 1,928 5.81 1895 2,839 8.50 1906 2,275 6.87 1896 3,824 11.32 1907 2,063 6.25 1897 2,906 8. 62 1908 2,289 6.82 1898 2,418 7.18 1909 2,049 6.23 1899 2,943 - 8.75 1910 1,525 4.65 1900 2,276 6.78 1911 1,759 5.37 I901 2,852 8.52 1912 1,577 4.83 I902 3,164 9.29 1892-1912 53,627 770 1913 2,171 6.54 Sub-Registration Districts. —The incidence of the infectious diseasesvaried greatly in the several sub-registration areas, for while the attack rate was as high as 8 07 per 1,000 of the population in Tollington, and 8.05 in Islington South East, it was as low as 4.28 per 1,000 in Barnsbury and 4.82 in Lower Holloway. This is the second consecutive year in which the attack rate has been very low in Barnsbury. The cases and attack-rates for each sub-district are given in the following statement:— Cases. Attack-rates. Tufnell - 256 7.41 Upper Holloway 296 7.66 Tollington 245 8.07 Lower Holloway 191 4.82 Highbury 328 5.62 Barnsbury 238 4.28 Islington South East 617 8.05 Total 2,171 6.56 1913] 118 Wards.—The cases referred to the several wards were as follows:— Tufnell Cases. Attack Rates. 256 7.41 per 1,000 inhabitants. Upper Holloway 296 7.66 ,, „ Tollington - 245 8.07 ,, „ Lower Holloway 191 4.82 ,, „ Highbury - 181 5.29 ,, „ Mildmay 147 6.08 „ „ Thornhill - 127 4.00 ,, „ Barnsbury - 111 5.04 ,, „ St. Mary 127 7.41 ,, „ Canonbury - 178 6.08 ,, „ St. Peter 312 10.32 ,, „ Total - 2,171 6.54 Seasonal Attacks —In the earlier quarters of the year the infectious diseases were below the average of the corresponding quarters of the preceding ten years, but in the third and fourth quarters they were in excess of by 30 and 376 respectively. Similar increases were noticed throughout the metropolis. First Quarter.—The 327 cases notified were equal to an attack-rate of 4 02 per 1,000, and contrasted with a decennial average of 107 cases, so that the return showed a decrease of 80. Second Quarter.-—There were 357 cases notified, or 42 fewer than the average for the decennial period. They represent an attack-rate of 4 39 per 1,000 inhabitants. Third Quarter —530 cases were known, which is 30 above the average that obtained in the corresponding quarters of the 10 years, 1903-1912. They were equal to an annual attack-rate of 6 51 per 1,000 of the population. Fourth Quarter.—957 cases were notified, as contrasted with a decennial average of 581. There has, therefore, been an increase of 376 attacks. These cases represent an attack-irate of 10.92 per .1,000 of the population. The following statement gives the particulars for each quarter:— Quarters. Cases. Attack-rates. Decennial average. Increase or decrease. First 327 4.02 407 —80 Second 357 4.39 399 —42 Third 530 6.51 500 +30 Fourth 957 10.92 581 +376 119 [1913 FATALITY FROM THE INFECTIOUS DISEASES. By "fatality" is meant the percentage proportion of deaths to attacks— thus, if there were 100 attacks and 5 deaths the fatality would be 5 per cent. It has been shown in the preceding pages that there was a considerable increase in the number of cases, yet, extraordinary to relate, the fatality has never been so low, while the actual number of deaths has been less on only one occasion—in 1912. The fact is that the diseases were generally of a very mild type, and consequently there were fewer deaths. Indeed, this was the consensus of the opinion of the medical practitioners of the Borough, many of whom frequently declared to the Medical Officer of Health that often they had had difficulty in arriving at a correct diagnosis, especially in cases of scarlet fever, and were at times unable to arrive at a conclusion with respect to it until desquamation had commenced. The succeeding tabular statement shows plainly that there has been a gradual reduction of the fatality from the chief infectious diseases during the last twenty-three years:— Years Cases. Deaths. Fatality. 1891 2,059 258 12.5 1892 3,318 291 8.7 1893 4,853 383 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 2,943 238 8.1 1900 2,276 202 8.8 1901 2,852 250 8.7 1902 3,164 268 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 1909 2,049 87 4.2 1910 1,525 79 5.2 1911 1,759 104 5.9 1912 1,577 62 3.9 1913 2,171 76 3.5 Total 57,857 4,399 7.6 1913] 120 By splitting up these figures into lustrums the enormous decrease of these diseases is at once apparent. Periods. Cases. Deaths. Fatality Number. Average. Number. Average. 1891-95 16,190 3,238 1,537 307 9.49 1896-1900 14,367 2,873 1,261 252 8.78 1901-1905 11,592 2,318 852 170 7.35 1906-10 10,201 2,040 507 121 4.96 1911-13 (3 years) 5,507 1,835 242 81 4.39 These figures are worth pondering over, for they indicate that not only have the actual cases decreased from an average of 3,238 in the five years 1891-5 to an average of 1,835 in the three years 1911-1913, or 43.4 per cent., but that the deaths have decreased to even a greater degree, namely, from an average of 307 to 81, or 73.6 per cent., which are truly wonderful figures. In period after period, too, the decreases have been continuous, which is a proof that they are no casual occurrences, but the result of factors which have been continuously at work, the chief of which are the amelioration of the conditions under which the people live, and education, for undoubtedly it has a great influence for good on the habits of the people, and the conduct of their homes. Hospital Isolation.—Although on several occasions the cases isolated in hospital have exceeded the number of those removed during the year, yet never before has the percentage of the cases so isolated been so high, for it reached 85.9. We have seen that 2,171 cases were notified, of which 1,866 were isolated to prevent the spread of infection or for treatment. One great reason for this increase is that the Education Authority is now more strict than ever in preventing the attendance at the public schools of children who have infectious illness in their homes or in the houses in which they reside. But it is not the Education Authority's Officials alone who put on pressure to have the children isolated, but also the people with children, and sometimes without, who live in the house with the person or persons who have been attacked. Indeed, occasionally an unpleasant wrangle arises between the families, and, of course, complaint is made in such cases that the Public Health Department has been negligent, whereas the truth is that its officials have been strenuously endeavouring to obtain the consent of the parents or guardians for the patient's removal so as to avoid recourse to Police Court proceedings to obtain a Magistrate's 121 [1913 Order to compel them to consent. Such procedure is always distasteful, for it is not a nice task to drag away with force a sick child from its parents, whose only fault is usually an intense love for it. Fortunately such proceedings are rare, and it is many years since the Medical Officer of Health has had to resort to them. Patience, perseverence, and good temper generally succeed where threats of legal compulsion utterly fail. The following tabular statement has been prepared to show the growth of the percentage number of cases treated in the various public institutions connected with the Borough : — Year. Cases treated in Hospital. Percentage of cases treated. Year. Cases treated in Hospital. Percentage of cases treated. 1896 1,862 48.4 1905 1,466 76.1 1897 1,620 55.7 1906 1,755 77.1 1898 1,413 58.4 1907 1,651 80.0 1899 1,901 64.6 1908 1,842 80.4 1900 1,552 68.2 1909 1,705 83.2 1901 1,987 69.6 1910 1,247 81.8 1902 2,276 71.9 1911 1,416 80.5 1903 1,241 72.6 1912 1,577 84.1 1904 1,467 75.5 1913 1,866 85.9 SMALL POX. No case of this disease occurred in the Borough, although four were notified in the County of London, namely, one in St. Marylebone, two in Poplar, and one in Southwark. SCARLET FEVER. There were 1,317 cases notified, which, with two exceptions, is the highest figure reached since 1906, when 1,386 were recorded, and in 1908, when 1,409 were notified. They occurred in 1,046 houses, and in numbers as given in the following statement, which shows that 1,046 houses were infected, as contrasted with 806 in 1912, and 650 in 1911. Of these 1,046 infected houses, 884 had only one case of scarlet fever in each of them, 109 had two cases, 43 had three, 6 had four, 1 had six, 1 had seven, 1 had nine, and 1 had ten. 1913] 122 Number of cases of Scarlet Fever occurring in one house. No. of cases. 1 case in one house. 2 cases in one house. 3 cases in one house. 4 cases in one house. 5 cases in one house. 6 cases in one house. 7 cases in one house. 8 cases in one house. 9 cases in one house. 10 cases in one house. No. of houses infected. No. of houses infected. /1910 499 65 12 5 3 — — — — — 584 1911 546 80 19 3 1 — — 1 — — 650 1912 592 156 45 8 5 — — — — — 806 U913 884 109 43 6 — 1 1 — 1 1 1046 No. of cases occurring in Public Institutions. Cases. 5 Public Institutions Infected Islington Infirmary London Fever Hospital 4 St. John's Road Workhouse 3 Receiving Homes, Hornsey Rise 16 Kingsdown Orphanage 2 30 If the figures in this Table (excluding the Public Institutions) be translated into percentages, the contrast with the preceding years will be best understood, for it shows the percentages of the houses responsible for 1, 2, 3, or more cases in the four years. 1910 1911 1912 1913 Houses in which 1 case occurred 85-45 84-02 73-4 84-5 „ „ 2 cases „ 11-13 12-30 19-4 10-4 »» »» 3 ,, ,, 2-05 2-92 5-6 4-1 4 99 99 ^ 99 99 0-86 0-46 10 0-6 * 99 99 U 99 99 0-51 0-15 0-6 — >9 9} 0 ,, ,, — — — 7 >) >) 1 >> ,» — — — o-i ,, ,, 8 ,» »> — 0-15 — — q 99 99 ° >9 99 — — — o-i », 99 10 ,, )) — — — o-l 100-00 100-00 100-0 100-00 Showing the cases of SCARLET FEVER notified in each week in 1913, and the averages for the corresponding weeks in the ten years 1903-1912. RED LINES = Weekly Notification*. GREEN LINE8 = Ten years' average. 123 [1913 The cases now notified were also 238 above the average of the preceding ten years, and were equal to an attack rate of 3.97 per 1,000 of the population, as compared with a mean decennial rate of 3.29. High though this rate undoubtedly is, it is only slightly above the aggregate attack rate of the County of London, 3.81 per 1,000, throughout which the disease was unusually prevalent. Indeed, some of the metropolitan boroughs felt its incidence much more heavily than did Islington, for it will be noticed in Table LXXXIX. that in no less than ten was the rate higher than in Islington, and in six it was between 4.0 and 5.0 per 1,000, while in four others it was even higher than the last figure. And just as the attack-rates varied in the several parts of the county, so, also, did they vary throughout the country, where they averaged 3.57 per 1,000 of the population. Indeed, in some of the great towns its incidence was excessively high, for in Birmingham and South Shields it reached the very unusual proportion of 10.19 and 10.16 cases in every 1,000 of their inhabitants, while in many other towns the rates greatly exceeded those of Islington and of the County of London; all of which goes to prove that scarlet fever was unusually prevalent everywhere, or, in other words, that 1913 was a scarlet fever year. In the Sub-Districts —Just as the incidence of the disease varied in London and throughout the country, so, too, did it vary locally, for while the cases represented an attack rate of only 2.12 per 1;000 in Barnsbury, they were equal to a rate of 5.33 in Tollington. That part of Islington north of Camden and Seven Sisters' Roads had the largest number of cases in proportion to their populations, as the following figures show: — Tufnell 179 cases = 5"i8 per 1,000 Upper Holloway 193 „ = 5.00 ,, Tollington 162 „ = 5.33 ,, The south-east of the Borough was also severely attacked, for in Islington South-east sub-registration district there were 376 cases, which represent an attack-rate of 4 91 per 1,000. In the other sub-districts the incidence was much lighter, as shown by the following returns :— Lower Holloway 100 cases = 2.53 per 1,000 Highbury 189 „ = 3.24 Barnsbury 118 „ = 2.12 1913] 124 The disease was not unusually prevalent in the first half of the year, for in January, February and March the cases numbered only 55, 41 and 52 respectively, as contrasted with 55, 45, and 28 in 1912; while in April, May and June there were 46, 49 and 68 respectively, as against 45, 55 and 55 in 1912, yet in July they numbered 85; in August 71, and in September 173, as contrasted with 66, -39 and 121 in the same months of the previous year, while in October they were 197, in November 234, and in December 246, compared with 119, 99 and 84 in the corresponding months of 1912. may be better seen in a tabular form: — The comparison be better seen in a tabular form: — 1913. 1912. Difference. January 55 55 — February 41 45 - 4 March 52 28 + 24 1st Quarter 148 128 + 20 April 46 45 + 1 May 49 55 - 6 June 68 55 + 13 2nd Quarter 163 155 8 July 85 66 + 19 August 71 39 + 32 September 173 121 + 52 3rd Quarter 329 226 + 103 October 197 119 + 78 November 234 99 + 135 December 246 84 + 162 4th Quarter 677 302 + 375 Here, then, we see that the conditions were about normal in the first half of the year—and it must not be forgotten that in 1912, with which year comparison is made, was itself a sub-normal year—and that the increase in the number of cases only became serious in its second half. It is also to be noticed that the increase was gradual in the last seven months. First, it was 126 [1913 13 in June, towards the end of which the epidemic may be said to have commenced, then 19 in July, 32 in August, 52 in September, 78 in October, 135 in November, and, finally, .162 in December, when it had not finished its course, as it has continued since then. Fatality.—Numerous though the cases were, yet the disease caused only 19 deaths, or 10 more than in 1912, although there were 506 more cases, and the fatality only 1.4 per centum of the persons attacked. In former years the percentage of deaths was much higher; thus : — From 1891 to 1900 it was — 3.3 „ 1901 to 1910 „ 2.4 „ 1911 to 1912 ,, 1.6 It is very apparent, then, that the disease is of a very much milder type than it used to be in former years. But it has only become so gradually. This subject has been discussed very fully in former reports of the Medical Officer of Health, particularly in that for 1909, where he showed that very few cases of the severe form of the disease known as scarlatina anginosa and scarlatina maligna were now seen; and he would direct reference to that report and also to his report for 1910 for further particulars. Hospital Isolation —Of the 1,317 cases which were notified, as many as 1,230, or 93.4 per cent., were removed to a hospital—usually one belonging to the Metropolitan Asylums Board—for isolation and treatment. This is a very high percentage, and means that practically all the cases occurring in tenements and the majority of those living in separate houses have been removed. Were it otherwise, there would have been a complete upset in the educational arrangements, for the Education Authority will not permit—and rightly so—any children to attend school from infected houses, which, in the case of this disease, would mean that these scholars would be absent from school, on an average, for at least six weeks, which would entail not only the loss of education to the children, but a pecuniary loss to the ratepayers, because the staff of teachers would not then be doing to the full the work for which they were engaged. It is plain, therefore, that what the ratepayers lose in one direction they gain, or nearly so. in another. 1913] 126 Table LXIX. Showing the Sickness, Attack-rate and Fatality front Scarlet Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 8rd Quarter. 4th Quarter. Year. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrats. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Tufnell 27 3.19 7.4 14 1.65 .. 47 5.54 .. 91 9.97 11 179 5.18 1.7 Upper Holloway 9 0.95 .. 34 3.59 .. 48 5.07 4.2 102 10.00 .. 193 5.00 1.0 Tollington 35 4.70 6.0 30 4.03 3.3 20 2.68 .. 77 9.60 .. 162 5.33 1.8 Lower Holloway 17 1.75 11.8 21 2.16 .. 21 2.16 .. 41 3 .92 4.9 100 2.53 4.0 Highbury 22 1.43 4.5 23 1.50 .. 40 2.60 .. 104 6.74 .. 189 3.24 0.5 Barnsbury 12 0.91 .. 11 1.87 .. 26 1.98 .. 62 4.37 .. 118 2.12 .. Islington, South East 26 1.47 .. 23 1.30 8.7 127 7.17 2 .3 200 9.88 0.5 376 4.91 1.6 The Borough 148 1.82 4.7 163 2.00 1.8 329 4.04 1.5 677 7.72 0.6 1317 3.97 1.4 127 [1913 Table LXX. Showing Cases, Deaths and Fatality of Scarlet Fever in age periods 0.5 and over 5 years. Fatality means percentage of Deaths to Cases. Ages. 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 Mean. 1893. 1912 1913 0—1 Cases 38 18 15 19 18 15 13 16 13 11 7 13 20 11 6 9 14 2 5 10 13 14 Deaths 4 2 3 2 1 2 — 2 2 1 1 — i — 3 1 — — — 1 2 Fatality 10.5 11.1 20.0 10.5 5.6 13.3 — 12.5 15.4 — 14.3 7.7 — 91 — 33.3 7.1 —— — —. 7.7 14.3 1.2 Cases 98 60 56 55 57 51 39 36 43 51 31 47 31 32 38 47 30 16 23 35 44 42 Deaths 14 9 5 5 7 4 1 3 4 7 1 6 5 2 2 5 4 1 2 1 4 2 Fatality 14.3 15.0 9.0 9.1 12.3 7.8 2.6 8.3 9.3 13.7 3.2 12.8 16.1 6.2 5.3 10.6 13 3 6.2 8.7 2.8 9.1 4.9 2—3 Cases 125 83 98 132 102 79 102 64 75 95 54 62 88 94 61 82 82 53 60 42 82 58 Deaths 14 13 12 12 5 3 7 4 4 6 4 5 6 10 4 3 3 1 4 3 6 4 Fatality 11.2 15.6 12.2 9.1 4.9 3.8 6.9 6.2 5.3 6 3 7.4 8.1 6.8 10.6 6.6 3.7 3.7 1.9 6.6 7.1 7.3 6.9 3—4 Cases 165 110 126 150 155 102 124 78 105 110 71 108 105 137 107 89 102 72 62 65 107 78 Deaths 14 10 11 8 9 7 6 2 5 7 5 6 11 8 4 2 4 4 3 — 6 3 Fatality 8.5 91 8.7 5.3 5.8 69 4.8 2.6 4.8 6.4 7.0 5.5 1.5 5.8 3.7 2.2 3.9 5.5 4.8 — 5.6 3.8 4—5 Cases 229 156 178 183 162 137 152 103 104 161 78 106 125 129 128 125 137 71 90 80 132 135 Deaths 10 14 8 6 12 2 5 4 3 8 2 8 6 2 4 4 8 1 3 — 6 2 Fatality 4.4 9.0 4.5 3.3 7.4 1.5 3.3 3. 9 2.9 4.7 7.6 7.6 4.8 1.6 3.1 3.2 5.8 1.4 3.3 — 4.5 1.4 Total under 5 Years. ! Cases 655 427 473 539 494 384 430 297 340 428 241 336 369 403 340 352 365 214 240 232 378 327 Deaths 56 48 39 33 34 18 19 15 18 28 13 26 28 23 14 17 20 7 12 4 23 13 Fatality 8.6 11.2 8.2 6.1 6.9 4.5 4.4 5.1 5 3 6.5 5.4 7.7 7.6 5.7 4.1 48 5.5 3.3 5.0 1.7 6.1 3.9 Over 5 Years. Cases 2,225 1.066 1,219 1,492 1,083 952 1,064 777 946 944 624 810 829 983 876 1,057 920 516 564 579 976 990 Deaths 38 21 27 24 27 8 14 9 12 12 11 9 9 14 10 13 5 4 8 5 14 6 Fatality 1.7 1.9 2.2 1.6 2.5 0.1 1.3 1.2 1.3 1.3 1. 8 1.1 1.1 1.4 101 1.2 0.5 0.7 1.4 0.8 1.4 0.6 Totals Cases 2,880 1,493 1,692 2,031 1,577 1,336 1,494 1,074 1,286 1,372 865 1,146 1,198 1,386 1,216 1,409 1,285 730 804 811 1,354 1,317 Deaths 94 69 66 57 61 26 33 24 30 40 24 35 37 37 24 30 25 11 20 9 37 19 Fatality... 3.3 46 3.9 2.8 3 8 1.9 2.2 2.2 2.3 2.9 2.7 30 3.1 2.7 1.9 2.1 1.9 1.5 2.5 1.1 2.7 1.4 1913] 128 DIPHTHERIA. Under the heading of Diphtheria is also included Membranous Croup, and together they caused 550 cases, which is 34 more than were notified in the preceding year. They also compare with a decennial average of 458, so that they were 92 in excess of it. The cases represent an attack rate of 1.65 per thousand of the inhabitants, which is exactly the rate of the County of London. It is, however, 0.26 above the mean rate of the Borough during the years 1903-12. In the subsequent statement particulars are given as to the behaviour of the disease in England and Wales, in the County of London and in the County Boroughs of England during the year. Cases. Attack-rate. England and Wales 130,626 1.39 London 7,654 1.65 78 English County Boroughs 17,263 1.49 St. Pancras 438 2.01 Stoke Newington 84 1.63 Hackney 331 1.45 Hornsey 117 1.31 Finsbury 107 1.24 Shoreditch 185 1.66 The Encircling Boroughs 1,262 1.61 Hospital Isolation.—512 of the notified cases, or 931 per cent., were removed to hospital for treatment and isolation, and of these, 403 were treated in the Institutions of the Metropolitan Asylums Board. Fatality.—The 37 deaths were equal to a fatality rate of 6.7 per cent., which is 1.8 below the mean fatality of the preceding ten years. It is gratifying to note that the fatality from diphtherial continues to decrease. This subject has been dealt with fully in previous reports. 129 [1913 Houses Infected.—Enquiry elicited the fact that the 550 cases were notified from 473 houses, and that in 427 houses only one case was known, in 34 houses there were two cases, in 8 houses three cases, in 2 houses four cases, in 1 house five cases, and in 1 house eight cases. Ten cases occurred in Public Institutions, as seen in the subsequent tabulated statement. As nearly all of these cases were removed to hospital, it is clear that the spread of the disease to others must have been very largely prevented. For instance, it is hardly possible for 427 cases to remain in 427 separate houses for several weeks without spreading the disease to other children in the house. Number of cases of Diphtheria occurring in one house. 1 case in house. 2 cases in bouse. 3 cases 4 cases in house. iu house. 5 cases in house. 8 cases in house. No. of houses infected No. of cases in 1913. 427 34 8 2 1 1 473 550 Number of cases occurring in Public Institutions. Cases. Receiving Homes, Hornsey Rise 4 Islington Infirmary 2 London Fever Hospital 4 10 130 Table LXXI. Showing the Sickness, Attack-rate and Fatality from Diphtheria* in the Sub-Districts for each Quarter and, for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 8rd Quarter. 4th Quarter. Year. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Tufnell 15 1.77 13.3 11 1.30 91 11 1. 30 91 14 1.53 71 51 1.48 9.8 Upper Holloway 13 1.37 15.4 13 1.37 •• 13 1.37 7.7 22 2.16 9.1 61 1.57 8.2 Tollington 3 0.40 33.3 21 2.82 9.5 11 1.47 •• 16 1.99 •• 51 1.68 5.9 Lower Holloway 13 1.34 15.4 13 1.34 7.7 21 2.16 • • 15 1.43 20.0 62 1.56 9.7 Highbury 20 1.30 • • 27 1.75 7.4 22 1.43 4.6 30 1.95 3.3 99 1.70 4.0 Barnsbury 14 1.00 7.1 15 1.14 .. 14 1.06 .. 21 1.48 9.5 64 1.15 4.7 Islington, South East 32 1.81 12.5 35 1.97 14.3 42 2.37 2.4 53 2.62 1.9 162 2.11 6.8 The Borough 110 1.35 10.9 135 1.66 8.1 134 1.65 3.0 171 1.95 5.8 550 1.66 6.1 •(Including Membranous Croup.) 131 [1913 Table LXXII. 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 1903 1912, and 1913. 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.*[] 1903 452 3 455 41 2 43 9.4 - 10.0 1904 347 .. 347 27 1 28 8.1 - 10.3 1905 351 .. 351 33 1 34 9.7 - 7.3 1906 437 2 439 30 2 32 7.3 - 8.6 1907 480 1 481 41 1 42 8.7 - 5.2 1908 522 8 530 59 1 60 11.3 - 1.6 1909 425 5 430 30 1 31 7.2 - 5.2 1910 463 8 471 34 — 34 7.2 - 4.1 1911 590 3 593 53 — 58 8.9 - 1.3 1912 512 4 516 38 — 38 7.3 - 2.0 1903-12 4,579 34 4,613 386 9 395 8.5 — 1913 546 4 550 37 — 37 6.7 - 1.8 * The last column shows the departure from the average fatality of the ten years preceding the year indicated. Table LXXIII. Showing the Cases, Deaths and Fatality from Diphtheria at Home and in Hospitals. Quarter. Cases Nursed at Home. Cases Nursed at Hospitals. Cases. Deaths. Percentage Fatality Cases. Deaths. Percentage Fatality. 1 2 3 4 5 6 1st 7 1 14.3 103 11 10.7 2nd 9 — — 126 11 3.7 3rd 6 — — 128 4 3.1 4th 16 — — 155 10 6.4 Year 38 1 2.6 512 36 7.0 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. 132 1913] Table LXXIV. 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— i 1 i ioo 3 ... ... 4 ... ... 2 2 IOO 10 3 30 1— 2 8 3 37 4 2 50 7 ... ... 6 1 17 25 6 24 2—3 6 4 66 10 1 10 10 ... ... 11 ... 37 5 13 3—4 11 1 9 14 2 14 17 1 6 26 2 8 68 6 9 4—5 9 1 11 10 ... ... 11 1 9 10 1 io 40 3 7 5—6 14 2 14 20 4 20 16 ... ... 18 1 6 68 7 10 6—7 8 ... ... 12 ... ... 7 1 14 15 2 J3 42 3 7 7—8 9 ... ... 7 1 14 4 ... ... 10 1 10 30 2 7 8—9 6 ... ... 7 ... ... 4 1 25 14 ... 31 1 3 9—10 10 ... ... 8 ... ... ... 6 ... ... 10 ... 34 ... ... 10—11 3 ... ... 4 ... ... 7 ... ... 4 ... 18 ... ... 11—12 1 ... ... 4 ... ... ... 5 ... ... 11 ... 21 ... ... 12—13 2 ... ... 6 1 17 4 ... ... 7 ... 19 1 5 13—H » 2 ... ... 7 ... ... 3 ... ... 2 ... 14 ... ... 14—J5 ... ... ... 2 ... ... 3 ... ... 2 ... 7 ... ... 15—25 10 ... ... 11 ... 14 ... ... 16 ... 51 ... ... 25—35 8 ... ... 1 ... ... 6 ... ... 4 ... i9 ... ... 35—45 1 ... ... 4 ... ... 4 ... ... 1 ... 10 ... ... 45—55 1 ... ... 1 ... ... ... ... ... 2 ... 4 ... ... 55—65 ... ... ... ... ... ... 2 ... ... ... ... 2 ... ... 65 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals no 12 11 135 11 8 134 4 3 171 10 6 550 37 7 * Inclusive of Membranous Croup. Showing the cases of ENTERIC FEVER notified in each week in 1913, and the averages for the corresponding weeks in the ten years 1903-1912. A\0NTH. OANUARY FEBRUARY MARCH. APRIL. MAY. JUNE. U U LY. AUGUST. SEPTEMBER. OCTOBER. NOVEMBER. DECEME i E R. Week 10 5 0 1 2 3 4 5 6 •7 8 9 10 II 12 13 14 15 16 17 18 19 20 21 * ?? 23 24 25 5 f" ?7 % 28 M 50 51 3^33 34 55 36 37 3839 +0 4-1 42j43 44 45 46|47 48^49 50 51 52 * 5i * RED LINES = Weekly Notifications GREEN LINES = Ten year*' averages. 133 (1913 ENTERIC FEVER. Enteric Fever was responsible for 50 cases of sickness, and represented an attack rate of 0'15 as contrasted with a similar rate in 1912, and a mean rate of 0-30 in the preceding ten years; consequently the rate was 50 per cent, below the average that has obtained in the Borough for some time past. It contrasts favourably with the rate in England and Wales, where it was 0.22, with that of the County of London, where it was 017, and with the 78 Great Towns of the country, where it was 0.25. There is hardly anything so satisfactory in the vital statistics of the Borough as the continuous fall in both the death rate and the attack rate from this formidable disease; and it speaks well for the improved conditions that obtain in Islington, and, indeed, in the County of London, where also there has been a decrease. Encircling Boroughs. Cases Attack-rates St. Pancras 41 0.19 Stoke Newington 9 0.17 Hackney 39 0.17 Hornsey 11 0.12 Finsbury 15 0.17 Shoreditch 15 0.13 130 0.17 Islington 50 0.15 Hospital Isolation.—Thirty-nine cases were removed to hospital, or 78 per cent, of those known to have occurred. This is a slightly lower percentage than that of the preceding year, when it was 79-6 per cent. Fatality*—In the 50 cases there were 4 deaths, so that the fatality rate was 8.0, which is a very small percentage when compared with many of the rates that have occurred in past years. 134 h"4 CO J—1 CO TABLE LXXV. Showing the Sickness, Attack-rate and Fatality from Enteric Feyer in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 8rd Quarter. 4th Quarter. Year. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases, Attackrate. Fatality Tufnell 4 0.47 50.0 1 0.12 .. 1 0.12 .. 1 0.1l .. 7 0.20 28.6 Upper Holloway 1 0.10 .. • • .. .. 2 0.21 .. 2 0.19 .. 5 0.13 • • Tollington .. .. .. 1 0.13 .. • • .. .. 1 0.12 .. 2 0.07 .. Lower Holloway 2 0.21 .. 1 0.10 .. 1 0.10 .. 4 0.38 .. 8 0.20 .. Highbury 3 0.20 33.3 2 0.13 .. 5 0.33 .. 1 0.06 .. 11 0.19 9.1 Barnsbury 1 0.07 .. .. .. .. .. .. .. 5 0 .35 .. 6 0.11 .. Islington, South East 8 0.17 33.3 1 0.06 .. 1 0.05 .. 6 0.30 .. 11 0.14 9.1 The Borough 14 0.17 28.6 6 0.07 .. 10 0.12 .. 20 0.23 .. 50 0.15 8.0 136 [1913 TYPHUS FEVER. No case was known. ERYSIPELAS. To Erysipelas was ascribed 226 cases of illness, which represented an attack rate of 0.68 per thousand of the inhabitants. The cases are 14 below the average of the preceding 10 years, while the rate is 015 below the mean rate of 1903-12. The cases are considerably in excess of those that were known in 1912, when only 185 were notified, which was the lowest number ever recorded in the Borough. Indeed, the figures were such as one could not well expect to occur again. Hospital Isolation. —Of the 226 cases notified, 62 were treated in hospital, so that 27.4 per cent, were isolated. Fatality.—The 9 deaths represented a fatality rate of 4 0 per cent., which is 1.3 higher than that of the preceding year. 136 h-4 CO H- co Table LXXVI. Showing the Sickness, Attack-rate and Fatality from Erysipelas in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality, Cases. Attackrate. Fatality, Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Tufnell 4 0.47 25.0 1 0.12 .. 6 0.71 .. 4 0.44 .. 15 0.43 6.6 Upper Holloway 5 0.53 .. 10 1.06 .. 6 0.63 .. 15 1.47 13.3 36 0.93 5.5 Tollington 4 0.54 .. 9 1.21 .. 5 0.67 20.0 10 1.25 .. 28 0.92 3.6 Lower Holloway 3 0.31 .. 6 0.62 .. 2 0.21 .. 5 0.48 .. 16 0.40 •• Highbury 6 0.39 .. 4 0.26 .. 3 0.19 .. 13 0.84 .. 26 0.44 •• Barnsbury 8 0.61 12.5 8 0.61 .. 11 0.84 .. 17 1.20 5.9 44 0.79 4.5 Islington, South East 15 0.85 13.3 10 0.56 .. 17 0.96 5.9 19 0.94 .. 61 0.80 4.9 The Borough 45 0.55 8.9 48 0.59 .. 50 0.61 4.0 83 0.95 3.6 226 0.68 4.0 137 1913 PUERPERAL FEVER. Twenty-eight cases were registered, as contrasted with 16 in the preceding year, and an average of 19 in the 10 years 1903-12. It is regrettable to find that this sickness, peculiar to women, should have shown an excess of 9 on the decennial average. The disease is, however, one with which the Sanitary Authority can do very little, as its prevention depends more on the cleanliness and care of the patient, both on her own part and of those in attendance on her, than is the case in any other complaint. Frequently, also, it arises from accidental causes at the time of the infant's birth, which no forethought can prevent. Schools for Mothers are doing useful work in many of the great towns in instructing women, who are with child, what to do before and after they are confined to ward off any untoward sickness. Hospital Isolation.—As many as 23 of the patients were treated in hospital, leaving only 5 to be looked after in their own homes. This is a larger number than has previously been treated in public institutions, and represented 82.1 per cent, of the total number of cases. Last year the percentage was only 56.2. It is thus apparent that these patients received every attention that medical science could afford them. Fatality.—It is regrettable to find that 7 deaths occurred among the patients, representing a fatality rate of 25 0. 138 Table LXXVII. Showing the Sickness, Attack-rate* and Fatality from Puerperal Fever in the Sub-Districts for each Quarter and for the Year. Sub-Districts. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality. Cases. Attackrate. Fatality, Cases. Attackrate. Fatality. Tufnell .. .. .. .. .. .. 2 10.1 50.0 2 9.9 50.0 4 5.08 50.0 Upper Holloway 1 4.0 •• •• .. .. •• • • .. • • .. .. 1 1.11 .. Tollington 1 5.8 100.0 •• •• .. 1 5.0 .. .. .. .. 2 2.66 50.0 Lower Holloway 2 7.3 50.0 1 3.5 .. 1 3.9 .. 1 3.7 .. 5 4.64 20.0 Highbury 1 3.0 .. 1 3.1 .. •• .. .. 1 3.3 .. 3 2.41 .. Barnsbury 3 8.1 33.3 2 4.8 .. 1 2.7 .. .. • • .. 6 3.89 16.6 Islington, South East 2 4.2 100.0 1 2.0 .. 2 4.2 .. 2 4.2 .. 7 3.65 28.6 The Borough 10 4.9 50.0 5 2.3 •• 7 3.5 14.3 6 2.9 16.6 28 3.41 25.0 * Per 1,000 Registered Births. 139 [1913  Tufnell. Upper Hollo way. Tollington. Lower Holloway. Highbury. | Barnsbury. Islington, Soutb-Rast.l The Borough. Cases notified by Doctor 4 I 2 5 3 6 7 28 Patient delivered by Doctor 1 1 2 2 2 5 4 *17 „ „ by Midwife 3 — — 3 — — 3 *9 Cases inquired into 4 I 2 5 3 6 7 28 „ treated in Hospital . 3 — 2 5 3 4 6 23 „ treated at home 1 I — — — 2 1 5 * There were also 2 cases of Miscarriage—1 in Highbury and 1 in Ehrnsbury. The following statement gives the number of the cases and deaths, together with the fatality rate during the last 23 years:— Years. Cases. Deaths Fatality. 1891 33 8 24.2 1892 51 23 45.1 1893 38 13 34.2 1894 23 8 34.8 1895 22 12 54.5 1896 30 11 36.7 1897 27 10 37.0 1898 19 7 36.8 1899 33 14 42.4 1900 16 6 37.5 1901 34 15 44.1 1902 22 12 54.5 1903 19 9 47.3 1904 25 14 56.0 1905 24 6 25.0 1906 25 11 44.0 1907 21 8 38.1 1908 17 4 23.5 1909 14 7 50.0 1910 20 8 40.0 1911 14 7 60.0 1912 16 2 12.5 1913 28 7 25.0 SUMMARY IN QUINQUENNIAL PERIODS. []###Years. Cases. Deaths. Fatality. 1891—1895 167 64 88.3 1896—1900 125 48 38.4 1901—1905 124 56 45.1 1906—1910 97 38 39.1 140 1913] Table LXXVIII. Showing the number of Cases of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1903-12 and in 1913. diseases. years. Corrected average number of eases. — Increase or Decrtase. 1903. 1904. 1905. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1903-1912. 1913[\###] Small Pox 9 17 3† 1 ... ... 3 1 ... ... 4 ... —4 Scarlet Fever 865 1146 1198 1386 1216 1409 1285 730 804 811 1079 1317 +238 Diphtheria 452 347 351 437 480 522 425 463 590 512 455 546 +91 Membranous Croup 3 ... ... 2 1 8 5 8 3 4 3 4 + 1 Enteric Fever 130 126 100 149 92 97 95 89 73 49 99 50 —49 Typhus Fever ... 1 ... 1 ... ... 1 1 ... ... ... ... ... Erysipelas 227 280 252 274 252 235 221 212 275 185 240 226 — 14 Puerperal Fever 19 24 24 24 21 17 14 20 14 16 19 28 +9 Continued Fever 2 ... ... 1 1 1 ... 1 ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... •• ... ... ... ... ... ... Totals 1707 1941 1928 2275 2063 2289 2049 1525 1759 1577 1899 2171 + 272 † 1 Case returned after a few days not Small Pox. % 141 [1913 Table LXXIX. Showing the Attack-Rates of the several Notifiable Infectious Diseases during the Ten Years 1903-12 and in 1913. diseases. years. Mean Attack Rates. Attack Rate. Increase or Decrease 1903. 1904. 1935. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1903-1912 1913. Small Pox 0.03 0.05 0.01 0.00 ... ... 0.01 0.00 ... ... 0.01 ... —0.01 Scarlet Fever 2.60 3.45 3.6l 4.18 3.68 4.20 3.91 2.22 2.46 2.49 3.29 3.97 + 0.68 Diphtheria 1.36 1.04 1.06 1.32 1.45 1.64 1.29 1.41 1.80 1.57 1.39 1.65 + 0.26 Membranous Croup 00.1 ... ... o.oo 0.00 .02 0.01 0.03 0.01 0.01 0.01 0.01 ... Enteric Fever 0.39 0.38 0.30 0.45 0.28 0.9 0.29 0.27 0.22 0.15 0.30 0.15 —0.15 Typhus Fever ... 0.00 ... 0.00 ... ... 0.00 0.00 ... ... 0.00 ... ... Erysipelas o.68 0.84 0.76 0.83 0.76 0.70 0.67 0.84 0.84 o.57 0.30 0.68 —0.05 •Puerperal Fever 2.11 2.70 274 2.79 2.46 1.96 1.71 2.44 1.76 0.95 2.26 3.41 + 1.15 Continued Fever o'oo ... ... 0.00 0.00 0.00 ... 0.00 ... ... 0.00 ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... • •• Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 5.12 5-84 5-8I 6-87 6-25 6-82 6 23 4-65 5'37 4'®3 579 6.55 +0.75 * These figures are calculated as per 1,000 Registered Births, 142 191 3] TABLE LXXX. Showing the number of Cases of Infectious Diseases notified in the Sub-Registration Districts during 1913. 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. Tnfnell ... 179 50 1 7 ... 15 4 ... ... ... 256 7.41 Upper Holloway ... 193 60 1 5 ... 36 1 ... ... ... 296 7.66 Tollington ... 162 51 ... 2 ... 28 2 ... ... ... 245 8.07 Lower Holloway ... 100 61 1 8 ... 16 5 ... ... ... 191 4.82 Highbury ... 189 99 ... 11 ... 26 3 ... ... ... 328 5.62 Barnsbury ... 118 63 1 6 ... 44 6 ... ... ... 238 4.28 Islington South East ... 376 162 ... 11 ... 61 7 ... ... ... 617 8.05 The Borough ... 1,317 546 4 50 ... 226 28 ... ... ... 2171 6.54 (All Duplicates have been deducted) 143 [1913 TABLE LXXXI. Showing the AttacK-rates of Infectious Diseases notified in the Sub-Registration Districts during 1913. 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. Attacli-Rate per 1,000 of the Population. Tufnell ... 5.I8 1.45 0.03 0.20 ... 0.43 5.08 ... ... ... 7.41 Upper Holloway ... 5.oo 1.55 0.02 0.13 ... 0.93 1.11 ... ... ... 7.66 Tollington ... 5.33 1.68 ... 0.07 ... 0.92 2.66 ... ... ... 8.07 Lower Holloway ... 2.53 1.54 0.02 0.20 ... 0.40 4.64 ... ... ... 4.82 Highbury ... 3.24 1.70 ... 0.19 ... 0.44 2.41 ... ... ... 5.62 Barnsbury ... 2.12 1.13 0.02 0.11 ... 0.79 3.88 ... ... ... 4.28 Islington, South East ... 4.91 2.11 ... 0.14 ... 0.8o 3.65 ... ... ... 8.05 The Borough ... 3.97 1.65 0.01 0.15 ... o-68 3.41 ... ... ... 6.54 * Per 1,000 Registered Births. 144 1913] TABLE LXXXII. Showing the number of Cases of Infectious Disease notified in the Wards during the year 1913- (N.B.—Duplicate notifications have been deducted). WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous 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 4 5 6 7 8 9 10 11 12 13 14 Tufnell ... 179 50 1 7 ... 15 4 ... ... ... 256 7.41 Upper Holloway ... 193 60 1 5 ... 36 1 ... ... ... 296 7.66 Tollington ... 162 51 ... 2 ... 28 2 ... ... ... 245 8.07 Lower Holloway ... 100 61 1 8 ... 16 5 ... ... ... 191 4.82 Highbury ... 99 63 ... 2 ... 15 2 ... ... ... 181 5.29 Mildmay ... 90 36 ... 9 ... 11 1 ... ... ... 147 6.08 Thornhill ... 56 39 ... 2 ... 27 2 ... ... ... 127 4.00 Barnsbury ... 62 24 1 4 ... 17 4 ... ... ... 111 5.04 St. Mary's ... 72 38 ... 4 ... 13 ... ... ... ... 127 7.41 Canonbury ... 92 58 ... 3 ... 22 3 ... ... ... 178 6.o8 St. Peter's ... 212 66 ... 4 ... 20 4 ... ... ... 312 10.32 Totals ... 1317 546 4 5o ... 226 28 ... ... ... 2171 6.54 1911 ... 804 590 3 73 ... 275 14 ... ... ... 1759 5.37 1912 811 512 4 49 185 16 ... ... ... 15 77 4.83 145 [191.3 Table LXXXIII. Showing the Attack-Rates of the Notifiable Infectious Diseases notified in the Wards during the Year 1913. WARDS. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever.* Continued Fever. Relapsing Fever. Cholera. Total AttackRates. Tufnell ... 5.I8 1.45 0.03 0.20 ... 0.43 0.12 ... "... ... 7.41 Upper Holloway ... 5.00 1.55 0.02 0.13 ... 0.93 0.02 ... ... ... 7.66 Tollington - ... 5 .33 1.68 ... 0.07 ... 0.92 0.07 ... ... ... 8.07 Lower Holloway ... 2.53 1.54 0.02 0.20 ... 0.40 0.I3 ... ... ... 4.82 Highbury ... 2.89 1.84 ... 0.06 ... 0.44 0.06 ... ... ... 5.29 Mildmay ... 3.72 1.49 ... 0.37 ... o.46 0.04 ... ... ... 6.08 Thornhill ... 1.77 1.23 0.03 0.06 ... 0.85 0.06 ... ... ... 4.00 Barnsbury ... 2.82 1.09 ... o.18 ... 0.77 0.18 ... ... ... 5.04 St. Mary's ... 4.20 2.22 ... 0.23 ... 0.76 ... ... ... ... 7.41 Canonbury ... 3.15 1.98 ... 0.10 ... 0.75 0.10 ... ... ... 6.08 St. Peter's ... 7.02 2.18 ... 0.13 ... o.86 0.13 ... ... ... 10.32 Totals ... 3.97 1.65 0.01 0.15 ... o.68 0.08 ... ... ... 6.54 * Per 1,000 population. 146 1913] Table LXXXIV. Showing the Number of Cases of Infectious Diseases which were investigated by the District Sanitary Inspectors during the Year 1913. Sanitary Inspectors. Number of thr 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 I ... 135 36 1 3 ... 16 3 ... ... ... 194 „ Bicknell 2 ... 192 61 1 5 ... 34 1 ... ... ... 294 „ Bagshaw 3 ... 86 22 ... 1 ... 12 ... ... ... ... 121 „ Bridel 4 ... 105 39 ... 1 ... 22 2 ... ... ... 169 „ Flood 5 ... 59 30 1 6 ... 3 2 ... ... ... 101 „ Horsman 6 ... 77 34 ... 3 ... 9 2 ... ... ... 125 „ Fortune 7 ... 47 45 ... 4 ... 6 2 ... ... ... 104 ,, Metcalf 8 ... 73 27 ... 7 ... 7 ... ... ... ... 114 „ Irving 9 ... 47 37 ... 1 ... 27 3 ... ... ... 115 ,, Watson 10 ... 61 47 ... 4 ... 18 3 ... ... ... 133 „ Jeffery 11 ... 148 58 ... 3 ... 21 4 ... ... ... 234 ,, Canham 12 ... 48 34 1 4 ... 21 3 ... ... ... 111 ,, Agar 13 ... 88 31 ... 5 ... 10 2 ... ... ... 136 „ Callow 14 ... 151 45 ... 3 ... 20 1 ... ... ... 220 Totals . ... 1,317 546 4 5o ... 226 28 ... ... ... 2,171 147 [1913 Table LXXXV. Showing the Cases of Infectious Disease which were notified in the several Months during the Year 1913. 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 ... 55 30 ... 8 ... 10 2 ... ... ... 105 February ... 4i 34 1 2 ... 16 1 ... ... ... 95 March ... 52 42 3 4 ... 19 7 ... ... ... 127 April ... 46 31 ... 1 ... 17 ... ... ... ... 95 May ... 49 37 ... 1 ... 16 2 ... ... ... 105 June ... 68 67 ... 4 ... 15 3 ... ... ... 157 July ... 85 34 ... 3 ... 11 5 ... ... ... 138 August ... 7i 30 ... 1 ... 15 2 ... ... ... 119 September ... 173 70 ... 6 ... 24 ... ... ... ... 273 October ... 197 53 ... 7 ... 30 ... ... ... ... 287 November ... 234 42 ... 3 ... 19 2 ... ... ... 300 December ... 246 76 ... 10 ... 34 4 ... ... ... 370 Total ... 1,317 546 4 50 ... 226 28 ... ... 2,171 148 1913] Table LXXXVI. Showing the Cases of Infectious Disease notified, during the Year 1913 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1913. Small Pox. Scarlet Fever or Scarlatina. Diphtheria (including Membranous Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fevers. Relapsing Fever. Cholera. Total Cases. St. Pancras 214,330 ... 565 438 41 ... 215 11 I .... ... 1,271 Stoke Newington 50,5!8 ... 109 84 9 ... 35 2 ... ... ... 239 Hackney 223,353 ...... 821 331 39 ... 184 19 I ... ...... 1,395 Hornsey 87,596 ... 212 117 11 ... 27 2 ... ... 369 Finsbury 8+,679 ...... 274 107 15 ... 125 14 .. ... ... 535 Shoreditch 109,654 ... 354 185 15 ... 159 9 1 ... ... 723 The Encircling Boroughs 770,130 ... 2,335 1,262 130 ... 745 57 3 ... ...... 4,532 Islington 325,585 ... 1,317 550 50 ... 226 28 ... ... ...... 2,171 149 [1913 Table LXXXVII. Sho ving the Attack-Rates per 1,000 inhabitants of the Infectious Diseases notified during the Year 1913 in Islington and in the Encircling Boroughs. The Encircling Boroughs. Estimated Populations, 1913. Small Pox. Scarlet Fever or Scarlatina. Diphtheria (including Membranous) Croup. Enteric (Typhoid) Fever. Typhus Fever. Erysipelas. Puerperal Fever.' Continued Fevers. Relapsing Fever. Cholera. Total Attack-Rates. 1 2 3 4 5 6 7 8 9 10 11 12 13 St. Pancras 214,330 ... 2.59 2.01 0.19 ... 0.98 0.05 0.00 ... ... 5.82 Stoke Newington 50,518 ... 2.12 1.63 0.17 ... 0.68 0.04 0.00 ... ... 4.64 Hackney 223,353 ... 3.6l 1.45 0.17 ... 0.81 0.08 ... ... ... 6.13 Hornsey 87,596 ... 2.38 1.31 0.I2 ... 0.30 0.02 ... ... ... 4.13 Finsbury 84,679 ... 3.I8 1.24 0.17 ... 1.45 0.16 ... ... ... 6.20 Shoreditch 109,654 ... 3.i7 1.66 0.13 ... 1.42 o.o8 0.01 ... ... 6.47 The Encircling 770,130 ... 2.97 1.61 0.17 ... 0.95 0.07 0.00 ... ... 5.77 Borough Islington 325,585 ... 3.97 1.66 0.15 ... 0.68 0.08 ... ... ... 6.54 I ncrease or Decrease ... ... + 1.00 + 0.05 — 0"02 ... — 0.27 + 0.0I ... ... ... +0.77 * Per 1,000 of the population. 150 1913] Table LXXXVIII. Showing the Cases of Infectious Diseases notified in the several Metropolitan Cities and Boroughs during the year 1913. This Table is supplita by the Medical Officer of Health of the County of London to the Registrar-General. Cities and Boroughs. Estimated population in the midale of 1913. Notified Cases of Infectious Diseasfs. Small Pox Scarlet Fever. Diphtheria.* Tryphus Fever. Enteric Fever. Other continued Fevers. Puerperal Fever. Erysipelas. Cerebro-spinal meningitis. Other Notifiable Infectious Diseases. Totals. Columns 1 to 8. 1 2 3 4 5 6 7 8 9 10 LONDON 4.518,191 4 17,554 7,653 4 758 15 349 4,146 92 791 30,483 West Districts. Paddington 142,210 .. 487 304 .. 25 .. 8 112 .. 24 936 Kensington 171,284 .. 558 145 .. 28 .. 13 112 3 21 856 Hammersmith 123,745 .. 537 138 .. 13 .. 8 101 .. 24 797 Fulham 157,117 .. 767 270 .. 34 .. 19 121 5 22 1,211 Chelsea 64,598 .. 206 61 .. 7 .. 8 35 .. 6 317 City of Westminster 223,353 .. 379 192 .. 29 .. 6 75 .. 20 681 North Districts. St. Marylebone 114,532 1 417 130 .. 19 .. 4 78 3 10 649 Hampstead 86,346 .. 208 128 .. 15 .. 1 33 .. 15 385 St. Pancras 214,330 .. 565 438 .. 41 1 11 215 5 33 1,271 Islington 325,585 .. 1,317 550 .. 50 .. 28 226 8 59 2,171 Stoke Newington 50,518 .. 109 84 .. 9 .. 2 35 1 6 239 Hackney 223,353 .. 821 331 .. 39 l 19 184 8 46 1,395 Central Districts. Holborn 46,949 .. 132 60 .. 7 .. 1 29 .. 5 229 Finsbury 84,679 .. 274 107 .. 15 .. 14 125 5 9 535 City of London 17,916 •• 47 30 • • 6 .. 8 .. 3 91 East Districts. Shoreditch 109,654 .. 354 185 .. 15 1 9 159 4 30 723 Bethnal Green 127,824 .. 411 223 .. 23 .. 13 265 1 22 935 Stepney 475,300 .. 820 471 2 68 1 34 364 10 40 1,760 Poplar 160,913 2 754 345 •• 40 l 26 173 5 51 1,341 South Districts. South wark 188,487 1 880 327 1 39 2 15 260 6 55 1,525 Bermondsey 124,739 .. 731 243 1 27 1 14 130 3 27 1,147 Lambeth 297,139 .. 1,397 408 .. 39 2 2o 219 7 7 3 2,090 Battersea 167,464 .. 949 288 .. 20 2 10 123 3 36 1,392 Wandsworth 330,395 .. 1,007 447 .. 52 2 32 206 9 51 1,746 Camberwell 261,805 .. 1,155 403 .. 23 1 12 257 6 36 1,851 Deptford 109,280 .. 625 245 .. 17 .. 1 232 .. 20 1,120 Greenwich 96,015 .. 330 267 .. 8 .. 5 112 .. 17 722 Lewisham 168,822 .. 670 431 .. 34 .. 3 84 .. 16 1,222 Woolwich 122,382 .. 645 402 .. 14 •• 8 72 .. 14 1,141 Port of London •• 2 2 .. 2 •• 1 •• .. 5 * Including Membranous Croup. 151 [1913 Table LXXXIX. Showing the Attack-Rates of the Infectious Diseases notified in the several Metropolitan Cities and Boroughs during the year 1913. Cities and Boroughs. Small Pox. Scarlet Fever. Diphtheria. * Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cerebro-Spinal Meningitis. Dtlier Notifiable Infectious Diseases. Attack-Kates per 1,000. Cols. 1 to 8. 1 2 3 4 5 6 7 8 9 10 County of London 0.00 3.81 1.66 .. 0.17 .. 0.08 0.90 0.02 0.17 6.62 West Districts. Paddington .. 3.36 2.10 .. 0.17 .. 0.05 0.77 .. 0.17 6.46 Kensington .. 3.20 0.83 .. 0.16 .. 0.07 0.64 0.02 0.12 4.90 Hammersmith .. 4.26 1.10 .. 0.10 .. 0.06 0.80 .. 0.19 6.32 Fulham .. 4.79 1.69 .. 0.21 .. 0.12 0.75 0.03 0.14 7.56 Chelsea .. 3.13 0.93 .. 0.11 .. 0.12 0.53 .. 0.09 4.81 City of Westminster .. 1.67 0.84 .. 0.13 .. 0.03 0.33 .. 0.08 9 North Districts. St. Marylebone 0.01 3.57 1.11 .. 0.16 .. 0.03 0.67 0.03 0.09 5.56 Hampstead .. 2.36 1.45 .. 0.17 .. 0.01 0.38 .. 0.17 4.37 St. Pancras .. 1.59 2.01 .. 0.19 0.00 0.05 0.98 0.02 0.15 5.82 Islington .. 3.97 1.66 .. 0.15 .. 0.08 0.68 0.02 0.18 6 54 Stoke Newington .. 2.12 1.63 .. 0.17 .. 0.04 0.68 0.02 0.12 4.64 Hackney .. 3.61 1.45 .. 0.17 0.00 0.08 0.81 0.03 0.20 6.13 Central Districts. Holborn .. 2.76 1.25 .. 0.15 .. 0.02 0.61 .. 0.10 4.09 Finsbury .. 3.18 1.24 .. 0.17 .. 0.16 1.45 0.06 0.10 6.20 City of London .. 2.57 1.64 •• 0.33 .. .. 0.44 .. 0.16 4.98 East Districts Shoreditch .. 3.17 1.66 .. 0.13 0.01 0.08 1.42 0.03 0.27 6.47 Bethnal Green .. 3.15 1.71 .. 0.13 .. 0.10 2.03 0.01 0.17 7.17 Stepney .. 2.2 1.68 0.01 0.24 0.00 0.12 1.30 0.04 0.14 6.27 Poplar 0.01 4.0 2.10 .. 0.25 0.00 0.16 1.06 0.03 0.31 8.17 South Districts. Southwark 0.01 4.8 1.70 0.01 0.20 0.01 0.08 1.35 0.03 0.28 7.94 Bermondsey .. 5.5 1.91 0.01 0.21 0.01 0.11 1.02 0.03 0.21 9.02 Lambeth .. 4.1 1.35 .. 0.13 0.00 0.08 0.72 0.02 0.21 6.90 Battersea .. 5.6 1.69 .. 0.12 0.01 0.06 0.72 0.01 0.21 8.15 Wandsworth .. 2.9 1.33 .. 0.15 001 0.09 0.61 0.03 0.15 5.18 Camberwell .. 4.3 1.51 .. 0.09 0.00 0.04 0.96 0.02 0.14 6.94 Deptford .. 5.61 2.20 .. 0.15 .. 0.01 2.08 .. 0.18 10.05 Greenwich .. 3.37 2.73 .. 0.08 .. 0.05 0.14 .. 0.17 7.38 Lewisham .. 3.89 2.51 .. 0.19 .. 0.02 0.49 .. 0.09 7.10 Woolwich .. 5.17 3.22 .. 0.11 .. 0.07 0.58 .. 0.11 9.15 * Including Membranous Croup. 152 1913] OTHER NOTIFIABLE DISEASES. Acute Poliomyelitis, Cerebrospinal Meningitis, 0 phthalmia Neonatorum, Tuberculosis, Plague and Cholera. Acute Poliomyelitis. Although only 19 cases, representing an attack rate of 0.06 per 1,000 inhabitants, were notified during the year, yet the disease is of very great importance, because of the serious results which follow in its train, and, therefore, it is now discussed fully, more particularly as laymen know very little about it, and, indeed, it was only in recent years that physicians understood anything about its methods of spreading and its causation. Before proceeding to give particulars respecting the Islington cases, it may be well to say something about its symptoms, etiology or causation, its mode of spreading, the person whom it attacks, and the means by which it gains access to the human body. Symptoms of Poliomyelitis.—Acute poliomyelitis is also known as spinal infantile paralysis, notwithstanding that it sometimes attacks adult persons, as it did in one instance in Islington. The period of incubation lasts at least five days, and usually does not extend beyond ten days, while its average duration is about a week. It may evolve in two stages, separated by a period of days or even weeks, according to Kling and Livaditi, during which the patients appear to be well, but are capable of conveying the infection. The attacks generally commence with a slight fever, which may be intermittent or continuous, while at the same time the frequency of the pulse is increased, and occasionally a rash makes its appearance. There is usually also a feeling of drowsiness and malaise. Sometimes the respiratory tract is involved, and less frequently the alimentary canal. Commonly there is headache and sometimes vomiting; and there may be catarrh of the nose and throat. The head may be retracted, due to rigidity of the muscles of the neck, while those of the spine may be similarly affected. Considerable impatience may be exhibited by the patient, as well as a desire to be let alone, together with a distaste of- fondling, due to the fact that a slight touch often causes pain, which is increased by even a slight movement. Excessive sweating has also been observed. Paralysis most frequently attacks the lower limbs, and next in order the muscles of the shoulders. The buttock muscles very seldom escape paralysis—perhaps once in every three or four cases—and the 153 [1913 abdominal muscles are not infrequently involved. "In short," as Romer puts it, "any and every muscle may be affected," but the great characteritsic of the disease is motor paralysis, that is of the muscles of movement. These various paralyses lead to most abnormal twistings and contractions of the limbs and body, so that they are often painful to look at. Unfortunately these abnormalities are mostly frequent and permanent, and, therefore, cripple the patients for life. Etiology or Causation.—The cause of the disease is undoubtedly some living virus, but whatever it may be, it is clear from the experiments of Romer that hitherto it has been impossible to isolate microbes which could be easily stained and cultivated, and which could be said to be the active agents. The researches of Wickham led to the same result; while those of Landsteiner, and Krause and Meincke, throughout an epidemic in Westphalia, failed to indicate bacteria which could be regarded as playing a part in the etiology of the disease. Experiments prove that if the virus be a bacterium, then it is so minute as to pass through Berkefeld, Chamberland and Puckall filters, which are known to keep back ordinary bacteria. Ultra-microscopy does not elucidate the matter, although it seems to have detected very small, oval, slightly illuminated, motionless bodies, which, however, were not constant enough to enable Romer, with Joseph and Siebert, to aver positively that they were connected with the disease, or that they were the causative agent. It would be of interest to give an account of the various experiments on monkeys and rabbits that were made in search of the virus for this disease, but this is hardly the place to do so. At present it is sufficient to say that so far the search for the bacterium of poliomyelitis has had negative results, but this is not to say that the disease is not caused by one. Romer, however, asserts that his own researches have convinced him that poliomyelitis was not caused by bacteria, but that the virus, like that of rabies, showed a selective preference for the cerebral nervous system, and, also, as proved by his intracerebral injection of virus into monkeys, that he was able at once to produce a disease in them which clinically and pathologically was identical with poliomyelitis in man; and that he was also able to transmit the disease from one monkey to another, which proved, he alleges, that the virus which caused the changes in the brain and spinal cord was living and not merely a toxin. 154 1913] How the Virus Gains Access to the Human Body.—The most probable portals are the mouth, throat, and the respiratory and alimentary tracts, from which the virus, having first pierced the mucous membrane, passes into the lymphatics, which convey it to the spinal cord and nervous centres. Romer, in discussing this point, says: " Many things point to the virus remaining for a long time in the mucous membrane of the mouth and throat of infected individuals. One might think of the infection by the saliva in speaking, coughing, sneezing, or in more direct contact. Unfortunately, there is no proof that the virus is contained in the saliva." And he goes on to say: "Considering how little we really know about the pathogenesis of the disease, any attempt to explain how infection occurs under the conditions of an epidemic must be fraught with almost insuperable difficulties." Since Romer penned these remarks, Kling, Wernsdett and Petterson have succeeded in producing the disease in monkeys by using saliva and intestinal contents, while Newstadter and Thro have done the same thing by the use of dust from the sick room. Nevertheless, a difficulty arises as to how epidemics spread, which is only, after all, a similar one to that which has long since arisen as to epidemics of Scarlet Fever. How the Disease is Spread.—It is generally agreed that the chief method of transmission of the disease is the direct one; that is to say, from human being to human being, although the "carrier" must not necessarily be the sick person. This was Wickman's theory of transmission by human contacts, which is brought about by typical cases, but especially by the abortive forms which usually form the majority, and which may easily pass unrecognised, and, consequently unisolated. Kling and Livaditi found that the hypothesis of the transmission of disease by means of water, milk, dust, flies, bugs and mosquitoes was not confirmed either by experimental results or epidemiological data; that patients are infectious during the incubation period; and that man appears to be the sole depository of the virus. Persons Whom the Disease Attacks. Children, as already stated, are most frequently attacked, although adults are sometimes sufferers. Thus out of 153 cases in Cornwall and Devonshire reported on by Reece, 121, or 79 per cent., were under ten years old, and that all, with one exception, were under forty. The following statement, prepared by the Medical Officer of Health from his figures, gives the percentage of cases of four decades of life: — 165 [1913 1st decade 79.1 per cent. 2nd „ 12.5 „ 3rd „ 7.8 „ 4th „ 0.6 „ 100.0 These figures do not quite tally with those of Miiller, given below, although they show that by far the greater proportion of patients are under ten years. Reece. Miiller. 1st decade - - 79.1 per cent. - 96 per cent. 2nd „ - - 12.5 „ - 2 3rd „ - - 7.8 „ 2 When Recce's figures arc further examined in quinquennial periods, it is found that the larger proportion of cases occurs in the first five years of life. 1st five years - - - 47.0 per cent. 2nd „ - - 32.0 „ 3rd „ - - 9.1 „ 4th„ - - 3.2 „ 5th „ - - 1.9 „ 6th „ - - 1.9 „ 7th „ - - 1.3 „ 8th „ - - 1.9 „ These figures may be considered sufficient to prove that the disease is practically confined to early life, and particularly to its first decade. Seasonal Prevalence.—The disease seems to prevail in the late summer and early autumn, which Wickman has very clearly shown in the report of his investigations into a Swedish epidemic in 1905. when he found that in the early months of the year it was practically negligible, and that not until May was its curve of real consequence, that it then gradually rose until it reached its highest point in August, from which time it decreased until the close of the year. In the Hesse-Nassau epidemic of 1909, however, the curve did not reach its maximum until October, from which time it rapidly decreased to December, when it reached its minimum. Wickman's observations are supported by an Australian epidemic, in which the disease was most prevalent during March and April, which there correspond to our summer. 156 1913] The Islington Cases. Having now some insight into the epidemiology of Acute Poliomyelitis, attention may be directed to the occurrence of the disease in Islington during the year. Altogether 19 cases of acute poliomyelitis have been notified up to the end of the year, but there has been no death. They are as follows:— No. Date. Age. Sex. Address. I January 29 8 years F Upper Street 2 February 1 2 „ M Cottenham Road 3 March 26 2 „ M Thorpedale Road 4 July 29 3 „ M Fairbridge Road 5 August 9 3 days F Benwell Road 6 „ 12 1 year M Edinburgh Cottages 7 „ 22 2 years M Milton Grove 8 September 2 10 „ F Caledonian Road 9 „ „ 10 months M Hornsey Street IO „ „ 3 „ F Outram Street II „ 15 2 „ M Woodville Road 12 „ 19 6 „ M Dame Street 13 October 14 18 years F Canonbury Park North 14 „ 15 4 „ F Sunnyside Road 15 „ 18 2½ „ M Landseer Road 16 „ 23 9 „ F Essex Road 17 „ 28 1 year F Edward Square 7 months 18 November 26 6 years M Birnam Road December 2 45 „ M Havelock Street The clinical aspects of each of these cases were obtained from the Medical attendant. Recent inquiries with respect to the condition of these patients show that their present state is as follows: — 1. Child walks a little lame, but otherwise her health is good. 2. Child still suffering from paralysis, but continues to attend St. Bartholomew's Hospital. 157 [1913 3. Dead.* Vaccinated at 6 months old. Paralysis of right side, stated to have occurred immediately afterwards. Four months prior to death was removed to Great Northern Hospital for infantile paralysis and remained therein for two months, when he was transferred to the Islington Infirmary, where he remained two months, and was then removed to the North-Eastern Hospital, St. Anne's Road, Tottenham, suffering from Measles," where he died. The death certificate gives " Measles, Scarlet Fever, Pyaemia " as the cause of death. 4. Patient was removed to Hospital for Sick Children, Great Ormond Street, and recovered. 5. Patient still under treatment at Great Ormond Street Hospital for slight paralysis of right leg. General health good. G. Left leg paralysed, and is still an out-patient of St. Batholomew's Hospital. 7. Patient much better, but is subject to fits of screaming and staring. Attends Great Ormond Street Hospital. 8. Patient is still an inmate of Great Northern Central Hospital, but is able to run about the ward. 9. Recovered. 10. Patient still in North-Eastern Hospital. General health better, but cannot walk. The Superintendent of the North-Eastern Hospital thinks the case is probably not poliomyelitis. 11. Still under treatment for paralysis in German Hospital, N.E. 12. It is hoped that there will be no permanent paralysis. Patient still in hospital. 13. Patient out of danger, but under treatment in National Hospital. Paralysis of the lower limbs and right arm. 14. Both legs affected. Under treatment in St. Bartholomew's Hospital. 15. Right lower leg affected. In Great Ormond Street Hospital. 16. Whole of upper extremity affected. In Great Northern Hospital. 17. Muscles of left thigh affected. Removed to Metropolitan Asylums Board Hospital. 18. Left leg paralysed. Removed to Great Northern Hospital. 19. Patient died* Post-mortem revealed death from myasthenia gravis. An examination of the addresses of the patients suffering from poliomyelitis shows that the cases were widely scattered over the Borough, and that in no instance did they live near each other. They seem to be sporadic and not epidemic. But it would not be well to dogmatise on mere appearances until more is known of the manner in which this disease is spread. * It will be noticed in these two cases that the deaths were not attributed to Poliomyelitis. 158 1913] It has been noticed by Gatsberg, who investigated the first epidemic in Norway (July to October, 1899) that the infection of poliomyelitis spreads along the line of traffic. This may 'be so in rural districts, although the statement is hardly borne out in a large community like Islington, for nearly all the cases have occurred in streets which are not on the main lines of traffic, although possibly some of them are more or less adjacent to them. It has also been found that attacks usually occur in groups; but, again, in Islington this can hardly be said to have been the case, unless those in Milton Grove, Landseer Road, Cottenham Road, Thorpedale Road, Fairbridge Road, may be said to be grouped together, yet the distance from one to the other is in no case, with one exception, less than a quarter of a mile, while in one instance there is a railway cutting between two of them, viz., between that at Fairbridge Road and Cottenham Road. It is possible, however, that there may have been some central source, but it could not be ascertained. Sanitary Circumstances.—As a rule, the premises in which the cases of poliomyelitis occurred were in a fair sanitary state, although in one or two homes the conditions might have been better; and in only two instances were vermin noticed to be present. Infection.—It is a noticeable fact that in no instance has more than one case of the disease occurred in the same family, or, indeed, in the same house, although in several homes there were young children living in the family whom one might reasonably have expected to have been attacked if the disease were very virulent. Steps Taken to Verify the Diagnosis.—No special steps were taken to verify the diagnoses by the examination of the cerebro-spinal fluid, owing to the great difficulty in obtaining it; but inasmuch as all the cases of poliomyelitis except one were treated as indoor or outdoor patients at a hospital, it was assumed that the diagnoses were correct, and all the more readily because, as already stated, the attendant physicians very kindly filled in the inquiry forms so far as they related to the clinical aspect of the cases. In any circumstance the examination of the cerebro-spinal fluid of the patients could at best only give negative results. Measures Adopted for Checking the Spread of the Disease.—In every instance, when a notification was received, an Inspector called on the parents 159 [1913 or guardians of the patient, who were made aware of the infectious nature of poliomyelitis, and an offer to have the premises disinfected was made. This offer was in most instances accepted, although in one or two cases it was refused. Disinfection was, however, only left optional to them in the early part of the year, for latterly it has been insisted that the rooms occupied by the patient, as well as the bedding and clothing, should be disinfected. This was effected by fumigation or spraying the rooms with formaldehyde, and by removing the bedding to the disinfecting station, where it was passed through a Goddard, Massey and Warner steam disinfector. The latter precaution has been adopted more for the purpose of bringing home to the minds of the people the infectious nature of the disease than because it was considered necessary, for so far as the Medical Officer of Health can discover, its virus is easily destroyed, and probably would not require such a process. He bases this opinion on the fact that Romer states that he exposed an active emulsion to formalin vapour, and found that the virulence of the emulsion was destroyed. Perhaps it is not astonishing to find that many people in whose family the disease has occurred cannot be brought to look on it as infectious when even now some medical men do not deem these precautions to be necessary, stating that it is nothing more than what was known formerly as infantile paralysis, about which no fuss was ever made. This opinion is now nearly dead, and the profession as a whole view these cases in a serious light, and are anxious to assist the Medical Officer of Health in adopting any precautions that lie may deem desirable. Epidemic Cerebro-spinal Meningitis. This disease, which was fully discussed in the Medical Officer of Health's Annual Report for 1907, is also known as " Spotted Fever," and to it were credited 8 cases, two of which were subsequently proved not to have been diagnosed correctly, and the attack rate was equal to 0.02 per 1,000 of the population. The return is five below that for each of the preceding six years. Three of the attacked died. In England and Wales the rate was 0.01; in London 0.02; in the County Boroughs 0 01, and in the Rural Districts 0.01. The disease has been notifiable since 1907, since which time, to the end of 1913, 77 persons have been reported, of whom 44 have died Thus the fatality was 57.1 per cent., which is an appalling figure. Fortunately the cases of this disease are not numerous. 160 1913] The following are the particulars as to the ages, sex, and addresses of the patients notified: — Case. Date. Age. Sex. Address. A February 13 10 years F 8b Beaconsfield Buildings B February 24 2¾ „ M 24 Queens Head Street C April 10 8 months M 34 Offord Street D May 5 4 years M 14 Noel Street 8 months E May 30 7 weeks M 22 Ellenborough Road F June 21 12 years M 4 Barnsbury Mews G June 30 23 „ F 5 Church Street H Dec. 8 9 „ M 1 Thornhill Grove Recent inquiries have also elicited the following facts with respect to these notifications:— A. This case is stated by the Medical Superintendent of the NorthEastern Hospital, Tottenham, to have been one of pleurisy, and not of cerebro-spinal meningitis. B. Is now apparently in good health. C. Dead. D. Dead. E. Family removed from address in Islington, and no information can be obtained as to present whereabouts. F. Dead. Patient had been removed to Islington Infirmary. G. Dead. The certificate of death shows on post-mortem examination " Malignant Endocarditis." H. Left sided paralysis with right side facial (partial). Patients A. and G. are to be excluded, as they had not suffered from the disease, and are not included in the following summary. The record of the disease since it became notifiable in 1907 is shown below: — 1907. 1908. 1909. 1910. 1911. 1912. 1913. Total Cases. Total Deaths 1907-13. 1st quarter — 2 2 3 4 1 1 14 8 2nd „ 3 2 3 7 4 6 3 29 13 3rd „ 5 — 2 1 3 3 1 15 11 4th „ 3 3 3 4 2 3 1 19 12 11 7 10 15 13 13 6 77 42 161 [1913 Ophthalmia Neonatorum. (Purulent Diseases of the Eyes of Newly-born Children.) This disease of the eyes of infants was notified in 38 instances, and in every case where the circumstances of the parents were such as to indicate that they could not afford to employ a nurse, an arrangement was made with the Matron of the North London Nursing Association whereby she very kindly supplied one, who visited the case once or even twice a day, when necessary, to bathe the eyes. The cases notified represented an attack rate of 4.54 per 1,000 births. Tufnell Upper Holloway, Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East, The Borough. Cases notified by Doctor 1 .. 4 10 4 15 4 38 ” ” by Midwife .. .. .. .. .. .. .. .. Cases inquired into 1 . 4 10 4 15 4 38 ,, treated in Hospital 1 .. 2 9 4 6 1 j 23 „ treated at Home .. .. 2 1 .. 9 3 ! 15 ,, attended by Nurse .. .. 2 2 2 6 2 j 14 Tuberculosis. This disease in its varying forms became compulsorily notifiable on the first day of February, and since that time 1,504 cases have become known to the Medical Officer of Health, in addition to which 179 cases of pulmonary phthisis were notified under Orders made prior to the present Order of the Local Government Board coming into force. Altogether 1,683 cases of tuberculosis were notified during the year which were equal to an attack rate of 5.07 per 1,000 of the population, compared with 6.56 in London, 3.43 in England (excluding London), and 2.94 in Wales. The incidence of the combined forms of the disease varied considerably, ranging from 3.90 per 1,000 of its population in Highbury and 3.99 in Tufnell, to 6 00 in South East Islington and 6.22 in Barnsbury, while the attack rates in the other sub-districts were 4.05 in Tollington, 4.92 in Upper Holloway, M 162 1913] and 5.30 in Lower Holloway. The major part of the notifications related to persons suffering from phthisis, of which there were 1,303, as against 380 notifications of other forms of tuberculosis. The following statement gives the particulars for each Sub-registration District. Sub-Regif tration Districts. Pulnonary Phthisis. Other Forms of Tuberculosis Grand Totals. Males Females. Total. Attack Kate Males. Femeles. Total. Attack Rate. Males & Females Attack Rates Tufnell 58 48 106 3.07 18 14 32 0.92 138 3.99 Upper Holloway 98 61 159 4.12 17 14 31 0.80 190 4.92 Tollington 48 37 85 2.80 23 15 38 1.25 123 4.05 Lower Holloway 97 63 160 4.04 29 21 50 1.26 210 5.30 Highbury 105 70 175 3.00 29 24 53 0.90 228 3.90 Barnsbury 150 102 252 4.69 44 38 82 1.53 334 6.22 South East Islington 220 146 366 4.77 46 48 94 1.23 460 6.00 776 527 1303 3.93 206 174 380 1.14 1683 5.07 It is wortny of observation that the two districts in which the incidence of the disease was heaviest are also the two in which a greater number of people live on each of their acres (vide Table II.). The better way to understand rightly where the disease was most prevalent is to study the small map which faces this page. It has been produced from a photograph of a large map on which black and white pins were fixed as near as possible to the positions of the house in which the teases of tuberculosis occurred. The black pins represent the cases of pulmonary phthisis and the white those of other forms of the disease. Here it is seen at a glance that the dark patches are exactly those parts of the Borough where the working classes for the most part live. And where they live the houses are usually old, and the older the houses are, the greater the number of families are to be fourd living in them ; and the greater the number of families, the poorer are the people; and the poorer the people, the greater the insufficiency of clothing, and the greater the lack of air and light, because the ill-fitting windows are screened to keep out the draughts; and the greater the lack of air and light, the greater the 163 [1913 uncleanliness of the rooms and the impurity of the air. And when to this uncleanliness and impurity of the air are added the insufficiency of food, it is at once apparent that there must be a lack of that vitality among the people, who live under these conditions, which is so necessary to ward off disease. Hence it is no wonder that tuberculosis, which flourishes in uncleanliness, impure air, and darkness, attacks those who lack vitality to resist its invading germs. The very poor are ever the worst sufferers, and, apart from all feelings of humanity and sympathy, which everyone should have for them, they should be medically looked after as well as instructed how to avoid passing the disease on to others; for it must not be forgotten that the great mass of consumptives in this country have contracted the disease from the sputum of consumptives. Hence the universal warfare waged to-day throughout the world against this disease, which has so long been a scourge to Great Britain and Ireland. Islington is beginning to do its part in this fight, and it is pleasing to know that before long two Tuberculosis Dispensaries will be at the service of the people who most require them. One of these dispensaries will find its home within the Borough at the Great Northern Central Hospital, and the other without the Borough at the City Road Chest Hospital. It is common knowledge that the Medical Officer of Health would have preferred dispensaries under the complete control and management of the Council, but the Council have thought otherwise. It is not for him to gainsay their will, but on the contrary, it shall be be his duty as well as his pleasure to utilize the dispensaries to their fullest extent for the cure and prevention of this terrible malady, which year by year disables, cripples, pauperizes, or kills some thousands of our population, and generally at the most important period of their life—at full manhood. This is well seen in a Table which has been prepared to show the ages of persons who were notified during the year, and wherein it is found that In every hundred 0.8 ” ” ” 5.7 ” ” ” 18 ” ” ” 15.8 „ „ „ 40.3 ” ” ” 1.4 were under 1 year of age. „ aged 1 to 5 „ „ 5 to 15 56.1 ” ” 15 to 25 ” ” 25 to 45 „ „ 45 to 65 „ „ 65 and upwards M 2 164 19131] More than half the patients were between the ages of 15 and 45, or just at that time of life in which adolescence is ceasing and full maturity is approaching, or has arrived, and when men and women are at their best. There is no occasion to dwell further on these facts because they have been discussed in several reports of the Medical Officer of Health. The Table from which the above figures are taken is appended. Table XC. the periods of life at which tuberculosis attacked the persons notified during 1913 Tubercular Diseases. Sex. cases notified in whole district. At all ages. At Ages—Years. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Phthisis (including Tuberculosis of Larynx.) M. 776 2 9 72 102 388 190 13 f. 527 1 7 54 105 252 99 9 Tubercular Meningitis M. 13 1 10 2 f. 14 1 10 2 1 Tabes Mesenterica M. 17 3 8 4 1 1 f. 15 2 — 6 3 3 1 General Tubercolosis M. 2 1 1 f. 3 2 1 Other forms of Tubercolosis M. 174 1 29 89 23 25 6 1 f. 142 2 20 74 30 12 4 — All Tubercular Diseases M. 982 7 57 167 126 414 197 14 f. 701 6 39 136 139 265 106 10 Totals 1683 13 96 303 265 679 303 24 Percentages at each life period to total cases 100 0.8 57 18.0 15.8 40.3 18.0 1.4 165 [1913 Occupations of the Persons Attacked.—It was not possible to obtain particulars respecting every case, but among those whose employment was ascertained the following were noted:— Army pensioner 1 Cellar man 1 Artificial florist 3 Cardboard box cutter 1 Agent 3 Cattle driver 1 Accountant 2 Cabinet maker 3 Awl block finisher 1 Coachman 1 Aluminium moulder 1 Carpet cutter 1 Box maker 5 Chaff cutter 1 Baker 5 Carpenter 4 Bootmaker 6 Clock maker 2 Bottle stopper maker 1 Christmas card maker 1 Blouse maker 1 Cap maker 1 Bookfolder 1 Costermonger 4 Bookbinder 7 Coal porter 2 Brush maker 3 Colour grinder 1 Brass finisher 3 Coffee stall keeper 1 Buffet attendant 1 Cloth worker 1 Brewery hand 1 Cycle maker 2 Bricklayer 1 Cab washer 1 'Bus conductor 5 Coach trimmer 1 Book-keeper 1 Collector 1 Billiard marker 1 Chauffeur 6 Book-keeper 2 Domestic servant 31 Butcher 1 Decorator 3 Brace maker 1 Dressmaker 11 Barman 1 Dry battery maker 1 Charwoman 13 Doorkeeper 1 Clerk 64 Dustman 1 Carmen 18 Dealer 3 Civil servant 1 Engineer's labourer 1 Coal porter 3 Envelope folder 1 Collier 1 Errand boy 2 Cloth worker 2 Engineer 8 Compositor 5 Engine fitter 2 Confectioner 5 Emery cloth maker 1 Customs officer 5 Electrician 5 166 1913] Occupations of the Persons attacked.—continued. Engine driver 1 Laundry manager 1 Engraver 2 Labourer 57 Electro-typist 1 Labeller 1 Factory hand 3 Lamplighter 1 Fishmonger 4 Locksmith 1 Flusher 1 Lamp trimmer 1 Flower seller 2 Lavatory attendant 1 Fashion designer 1 Liftman 1 Fitter 3 Laundry inspector 1 Feather dresser 2 Mechanic 4 French polisher 4 Machinist 11 Fish curer 1 Metal roller 2 Fish fryer 1 Milliner 2 Furrier 2 Musician 3 Fruiterer 1 Milk carrier 2 Fur sewer 1 Music agent 2 Gardener 3 Miner 1 General dealer 2 Music teacher 1 Gilder 1 Messenger 1 Gas fitter 2 Mattress maker 1 Glass bottle maker 1 Newsboy 1 Glass worker 1 Nurse 4 Grocer 1 Newsagent 4 Housewife 126 Ostler 1 Handyman 1 Office cleaner 1 Housekeeper 4 Optician 1 Horsekeeper 7 Piano tuner 1 Hawker 6 Porter 21 Hat packer 1 Packer 13 Hairdresser 2 Printer 17 Hammerman 1 Painter 17 Ironmonger 1 Plasterer 4 Joiner 2 Perfumer 1 Key stamper 1 Pipe polisher 1 Knife grinder 1 Post office official 14 Leather dresser 1 Post office sorter 1 Laundress 8 Printer's assistant 1 Leather worker 6 Pianoforte maker 6 167 [1913 Occupations of the Persons attacked.—continued. Policeman 1 Slaughterman 1 Publican 5 Stoker 1 Pattern maker 1 Storekeeper 1 Pattern card maker 1 Stone mason 1 Picture frame maker 1 Shirt cutter 1 Potman 2 Solicitor 1 Pocket book maker 1 Sweet packer 1 Portmanteau maker 1 Silversmith 1 Packing case maker 1 Surgical instrument maker 2 Provision dealer 1 Skin dresser 1 Polisher 3 Sempstress 4 Police constable 2 Telegraphist 2 Plumber 1 Telephone operator 2 Refreshment house keeper 1 Tram conductor 4 Rag sorter 2 Typist 2 Road sweeper 1 Tool grinder 1 Railway employee 5 Theatre attendant 2 Railway carriage cleaner 1 Tailor 6 Rivetter 1 Tailor's assistant 1 Syphon fitter 1 Tailor's cutter 2 School children 158 Traveller 3 School cleaner 1 Thread spinner 1 Shoeblack 1 Tinman 2 Stick mounter 1 Tin box maker 3 Shirt ironer 1 Ticket inspector 2 Shop assistant 18 Ticket writer 2 Scientific instrument maker 1 Typewriter mechanic 1 Ship's steward 1 Tramway worker 2 Scaifolder 2 Tie maker 2 Sword maker 1 Toy maker 2 Saddler 1 Train conducter (Tube) 1 Sawyer 1 Telegraph messenger 1 Syphon maker 2 Upholster 3 School teacher 1 Van guard 1 Sign writer 1 Veterinary surgeon 1 Stone grinder 1 Vellum sewer 1 Stationer's cutter 1 Waitress 4 Soldier 2 Wood carver 1 168 1913] Occupations of the Persons attacked.—continued. Watchmaker 1 Window cleaner 1 Woodcutter 4 Wire worker 1 Warehouseman 9 Wood sawyer 1 Waiter 2 Zinc worker 1 This is an interesting Table which shows that those trades in which the employees were exposed to severe weather conditions or to close confinement suffered most. It bears close study. Institutional Treatment. Some 589 persons, so far as could be ascertained, were admitted to about 30 different institutions for treatment, among which were:— The Islington Infirmary. Mount Vernon Hospital, Hampstead. City Road Chest Hospital. Victoria Park Hospital. Maltings Farm Sanatorium, Suffolk. Eversfield Chest Hospital, Hastings. Royal National Sanatorium, Ventnor. Benenden Sanatorium, Kent. Royal Sea-bathing Hospital, Margate. Brompton Hospital. Northern Hospital Sanatorium, Winchmore Hill. Table XCI. TUBERCULOSIS. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. The Year. Males. Females. Total. Males. Females, Total. Male s. Females. Total. Males. Females. Total. Males. Females. Total. Phthisis 246 175 421 224 135 359 161 100 261 145 117 262 776 527 1303 Tubercular Meningitis. 5 1 6 5 4 9 1 5 6 2 4 6 13 14 27 Tabes Mesenterica 6 5 11 3 1 4 2 3 5 6 6 12 17 15 32 General Tuberculosis- 1 — 1 1 1 2 — 1 1 — 1 1 2 3 5 Other Forms of Tuberculosis 82 73 155 45 37 82 29 16 45 18 16 34 174 142 316 340 254 594 278 178 456 193 125 318 171 144 315 982 701 1683 169 [1913 Table XCII. Showing the Notified Cases of Tuberculosis in the Wards During 1913. Wards. Pulmonary Phthisis. Other Forms of Tuberculosis. Grand Totals. Tuberculosis Rates per 1,000 of Population. Males. Females. Total. Males. Females. Totals. Tufnell 58 48 106 18 14 32 138 3.99 Upper Holloway 98 61 159 17 14 31 190 4.92 Tollington 48 37 85 23 15 38 123 4.05 Lower Holloway 97 63 160 29 21 50 210 5.30 Highbury 53 48 101 18 18 36 137 4.00 Mildmay 52 22 74 11 6 17 91 3.76 Thornhill 92 63 155 25 20 45 200 6.31 Barnsbury 58 39 97 19 18 37 134 6.09 St. Mary's 43 27 70 13 3 16 86 5.01 Canonbury 66 47 113 19 22 41 154 5.26 St. Peter's 111 72 183 14 23 37 220 7.28 Totals 776 527 1,303 206 174 380 1,683 5.07 Disinfection of Houses and Rooms after Phthisis. The following are the particulars for the year: — Houses. Rooms. 1st quarter 118 1,67 2nd „ 103 163 3rd „ 105 147 4th „ 210 264 Total 536 741 The figures for the year contrast with those of the preceding eight years, as follows : — Houses. Rooms. 1905 283 380 1906 258 369 1907 296 411 1908 281 361 1909 514 672 1910 481 645 1911 426 579 1912 554 798 1913 536 741 170 1913] THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. There were 1,013 cases of those infectious diseases which are compulsorily notifiable under the Public Health (London) Act, 1891 among the scholars in attendance at the public elementary schools of the Borough, and they represented 46.6 per cent. of all the cases which occurred during the year, as contrasted with 40.5 per cent. in 1912. The figures for the year also contrast with an average of 812 in the preceding 10 years, and a percentage of 37.4 of the total cases. Scarlet Fever.—758 of the notifications of Scarlet Fever occurred among scholars, as contrasted with a decennial average of 588, so that there was an increase of 170. Diphtheria was accountable for 252 cases among scholars, as compared with 197 in the 10 years, 1903.12; consequently there was an increase of 55 cases. Enteric Fever.— This disease attacked only 3 scholars, which is the lowest number hitherto recorded. The annual average has been 21, but during the last five years the number has gradually diminished. A full statement as to the number of scholars attacked by these notifiable infectious diseases, together-with the number of scholars excluded, are given in Table XCIV. 171 [1913 Table XCIII. Showing the Scholars attacked by the Notifiable Infectious Diseases in the Public Elementary Schools. Year. By Small Pox. By Scarlet Fever. By Diphtheria. By Enteric Fever. By Other Diseases. Total Scholars attacked. Proportion to every 100 cases notified. 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 1908 .. 809 230 19 •• 1058 46.2 1909 .. 737 184 16 1 938 45.8 1910 .. 369 197 13 •• 579 38.0 1911 .. 424 272 14 •• 710 40.4 1912 .. 430 201 7 •• 638 40.5 Ten years' Average .. 588 197 21 6 812 37.4 1913 .. 758 252 3 •• 1013 46.6 Increase or Decrease on Average .. +170 +55 -18 -6 +201 +9.2 172 19131 Table XCIV. Showing the cases of Notifiable Infectious Diseases occurring in Public Elementary Schools during the Year 1913. Sub-Districts. 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. tufnell Burghtey Road •• 24 5 •• •• 29 •• 89 15 •• •• 104 Hargrave Park •• 11 3 •• •• 14 •• 115 14 •• •• 129 St. John's, Holloway Road •• 8 5 •• •• 13 •• 15 4 •• •• 19 St. Joseph's, Highgate Hill •• 2 4 •• •• 6 •• 11 18 •• •• 29 upper holloway Cottenham Road •• 18 6 •• •• 24 •• 133 69 •• •• 202 Duncombe Road •• 79 7 •• •• 86 •• 148 38 •• •• 186 Grafton Road •• 21 7 •• •• 28 •• 48 14 •• •• 62 St. Mark's, Mitford Road •• 6 4 •• •• 10 •• 16 18 •• •• 34 Whittington, Highgate Hill •• 8 3 •• •• 11 •• 13 7 •• •• 20 Yerbury Road •• 47 5 •• •• 52 •• 128 33 •• •• 161 tollington Montem Street •• 36 4 •• •• 40 •• 96 14 1 •• 111 Poole's Park (Lennox Road) •• 15 3 •• •• 18 •• 43 9 •• •• 52 Upper Hornsey Road •• 23 15 •• •• 38 •• 85 59 •• •• 144 holloway Blundell Street •• 4 4 •• •• 8 •• 11 29 •• •• 40 "Brecknock," York Road •• 3 1 •• •• 4 •• 22 18 •• •• 40 Caledonian Road •• 3 2 •• •• 5 •• 24 10 •• •• 34 Catholic School, Eden Grove •• 3 1 •• •• 4 •• 9 10 •• •• 19 Chapel of Ease, Liverpool Road •• 8 2 •• •• 10 •• 25 11 •• •• 36 Hungerford Road •• 5 5 •• •• 10 •• 14 16 •• •• 30 St. Clement's, Cumberland Street •• 2 4 •• •• 6 •• 8 2 •• •• 10 St. James', George's Road •• 3 1 •• •• 5 •• 12 3 •• •• 15 Westbourne Road •• 13 7 •• •• 20 •• 48 16 •• •• 64 highbury Ambler R oad •• 6 12 •• •• 18 •• 14 39 •• •• 53 Blackstock Road •• 12 •• •• •• 12 •• 51 14 •• •• 65 Drayton Park •• 5 2 •• •• 7 •• 6 3 •• •• 9 "Forster," Hornsey Road •• 8 1 •• •• 9 •• 26 13 •• •• 39 Gillespie Road •• 6 10 •• •• 16 •• 20 22 •• •• 42 Highbury Hill High School •• 1 •• •• •• 1 •• 1 •• •• •• 1 Newington Green •• 10 4 •• •• 14 •• 25 17 •• •• 42 Pakeman Street •• 17 3 •• •• 20 •• 54 8 •• •• 62 St. John's, Conewood Street •• 2 4 •• •• 6 •• 4 5 •• •• 9 St. Jude's, Mildmay Park •• 26 2 •• •• 28 •• 49 9 •• •• 58 St. Matthias (Hackney) •• . . •• •• •• •• •• •• i •• •• 1 Shelburne Road •• 4 7 •• •• 11 •• 17 15 •• •• 33 barnsbury All Saints', Muriel Street •• 4 •• •• •• 4 •• 19 3 •• •• 22 Barnsbury Park •• 29 6 •• •• 35 •• 40 12 •• •• 52 Buckingham Street •• 9 1 •• •• 10 •• 18 26 •• •• 44 Cloudesley, Cloudesley Street •• 5 •• •• •• 5 •• 10 3 •• •• 13 Gifford Street •• 3 6 •• •• 9 •• 13 17 •• •• 30 Richard Street •• 6 •• •• •• 6 •• 22 11 •• •• 33 Risinghill Street •• 1 2 •• •• 3 •• 8 5 •• •• 13 St. Thomas, Everilda Street •• 1 1 •• •• 2 •• 2 6 •• •• 8 Thornhill Road •• 23 4 •• •• 28 •• 54 15 •• •• 70 Vittoria Place •• 4 1 •• •• 5 •• 14 13 •• •• 27 Winchester Street •• 9 3 •• •• 12 •• 22 18 •• •• 40 York Road •• 3 3 •• •• 6 •• 13 18 •• •• 31 south east Canonbury Road •• 27 16 •• •• 43 •• •• 32 •• •• 92 Ecclesbourne Road •• 13 18 •• •• 31 •• 32 40 •• •• 72 Hanover Street •• 38 4 •• •• 42 •• 97 '22 •• •• 119 Popham Road •• 21 10 •• •• 31 •• 68 23 3 •• 94 Queen's Head Street •• 56 6 •• •• 63 •• 108 27 2 •• 137 Rotherfield Street •• 21 6 •• •• 27 •• 61 13 •• •• 74 St. John's, Duncan Terrace •• 3 3 •• •• 6 •• 13 o •• •• 18 St. Matthew's, City Road .. .. •• 8 1 •• •• 9 •• 16 2 •• •• 18 St. Mary's, Cross Street •• 7 5 •• •• 12 •• 16 15 •• •• 31 St. Paul's, Dorset Street •• 2 3 •• •• 5 •• 4 14 •• •• 18 Shepperton Road •• 8 3 •• •• 11 •• 28 li •• •• 39 Station Road •• 8 5 •• •• 13 •• 20 5 •• •• 25 Tottenham Road •• 9 2 •• •• 11 •• 32 10 •• •• 42 White Lion Street •• 1 •• •• •• 1 •• 3 2 •• •• 5 Total •• 758 252 3 •• 1013 •• 2173 941 8 •• 3122 173 [1913 NON-NOTIFIABLE INFECTIOUS DISEASES AMONG THE CHILDREN ATTENDING THE PUBLIC ELEMENTARY SCHOOLS. These reached the high figure of 5,333 cases, which is the largest number, with two exceptions, hitherto notified by the teachers of the schools. They compare with 5,986 in 1912, and with an average of 4,395 in the 10 years 1903-1912, and are, therefore, 938 in excess of it. It need hardly be noted that inquiries into these cases largely increase the work of the Public Health Department. Measles.—1,272 cases were notified, as against 1,377 in 1912 and with 1,698 in 1911, and with a decennial average of 1,443. Chicken Pox.—Compared with the preceding year, the 731 notified cases showed a decrease of 429, although they were 104 above the average of the preceding 10 years. Whooping Cough.—578 case were reported, or 107 less than the average of the years 1903-1912. They are also 316 below the return for 1912. 174 1913] Table XCV. Non-notifiable Diseases among Children attending the Public Elementary Schools. Year. Measles. Chicken Pox Whooping Cough. Other Diseases. Totals. 1903 1,049 206 277 766 2,298 1904 355 182 1,293 595 2,425 1905 999 637 732 1,011 3,379 1906 1,935 425 300 1,475 4,135 1907 2,065 981 831 1,952 5,829 1908 1,095 624 385 2,255 4,359 1909 1,667 491 708 1,739 4,605 1910 2,194 985 892 2,006 6,077 1911 1,698 585 533 2,060 4,876 1912 1.377 1,156 894 2,541 5,968 Totals 10 years 14.434 6,272 6,845 16,400 43,951 Average 1.443 627 685 1,640 4,395 1913 1,272 731 578 2,752 5,333 Increase or Decrease on Average -171 + 104 — 107 + 1,112 +938 175 [1913 Statement showing number of Children excluded from various Schools on account of Measles in their Homes. Note.—I. = Infants' Department; B. = Boys'; J.B. = Junior Boys'; G. = Girls'; J. G. — Junior Girls; Mxd. = Mixed; J.M. = Junior Mixed; S.M. = Senior Mixed; M.D. - Mentally Deficient; P.D. = Physically Deficient; Spec. = Spjc ial School. Name of School. Dept. 1st Qr 2nd Qr. 3rd Qr. 4th Qr. Total in Dept. Total for School. Ambler Road I. 20 1 3 ... 24 31 B. 3 ... ... ... 3 G. ... 4 ... ... 4 All Saints I. 1 ... ... ... 1 1 Angler's Gdns., Popham Road I. 5 ... ... 1 6 7 G. ... 1 ... ... 1 Barnsbury Park I. 4 3 1 ... 8 9 B. ... 1 ... ... ... Blackstock Road I. ... 17 ... ... 17 24 G. ... 7 ... ... 7 Blundell Street I. 11 17 ... ... 28 30 G. ... 2 ... ... 2 Buckingham Street 10 11 12 ... 33 33 Burghley Road I. 20 1 ... ... 21 25 J.M 1 ... ... ... 1 B. 3 ... ... ... 3 Caledonian Road I. 2 2 ... ... 4 4 Canonbury Road I. 24 1 1 ... 26 27 B. 1 ... ... ... 1 Cloudesley Street I. ... 2 ... ... 2 2 Cottenham Road I. 15 6 3 ... 241 25 B. ... 1 ... ... 1 Drayton Park ... 4 ... ... 4 4 Duncombe Road I. 38 18 ... 3 61 92 B. 13 8 ... ... 21 G ... 10 ... ... 10 Ecclesbourne Road I. 12 ... ... ... 121 13 B. 1 ... ... ... 1 Forster I. 15 ... 3 ... 18 19 B. 1 ... ... ... 1 Gifford Street I. 8 8 ... ... 16 17 G. 1 ... ... ... 1 Gillespie Road I. 10 1 ... ... 11 12 G. ... 1 ... ... 1 176 1913] Name of School. Dept. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Total in Dept. Total for School. Grafton Road I ... 5 ... ... 5 8 G. ... 1 1 1 3 Hanover Street I 3 1 ... 1 5 6 G. 1 ... ... ... 1 Hargrave Park I. 9 11 ... ... 20 23 B. 1 2 ... ... 3 Hungerford Road I. 6 ... ... ... 6 6 Montem Street I. 10 23 ... ... 33 37 G. 1 ... ... ... 1 B. 2 ... ... ... 2 Mxd. ... 1 ... ... 1 Newington Green I. 1 ... ... ... 1 1 Pakeman Street I. 3 6 1 ... 10 10 Poole's Park I. 5 18 ... ... 23 26 B. ... 1 ... ... 1 G. ... 2 ... ... 2 Queen's Head Street I. ... 2 ... ... 2 2 Richard Street I. 6 2 ... ... 7 7 Rotherfield Street I. 21 3 2 1 27 32 G. 3 1 ... 1 5 St. Clement's I. ... 1 ... ... 1 1 St. James' I. 4 4 ... ... 8 8 St. John's, Conewood Street I. 3 ... ... ... 3 3 ,, Duncan Place I 1 ... ... ... 1 1 ,, Pemberton Garders I. 4 1 ... ... 5 5 St. Jude's I. 1 2 ... ... 3 5 B. 1 1 ... ... 2 St. Mark's I. 2 12 ... ... 14 14 St, Mary Magdalene I. 3 ... ... ... 3 3 St. Mary's, Fowler Road I. 1 ... ... ... 1 1 St. Matthew's 4 ... ... 1 5 5 St. Paul's, Dorset Street I. 4 ... ... ... 4 4 Shelburne Road I. 6 ... ... ... 6 7 Mxd ... ... 1 ... 1 Shepperton Road I. 10 1 ... 2 13 13 177 [1913 Name of School. Dept. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Total in Dept. Total for School. St. Thomas' I. 2 ... 1 ... 3 3 Station Road I. 12 ... ... 1 13 13 Thornhill Road G. ... 1 ... ... 1 1 Tottenham Road I. 3 2 ... ... 5 5 Upper Hornsey Road I. 11 38 ... 1 50 65 B. ... 5 ... ... 5 G. 1 7 1 ... 9 Spec. ... 1 ... ... 1 Vittoria Place I. 10 5 ... ... 15 15 Westbourne Road I. 38 7 ... ... 45 45 Whittington I. 1 15 ... 1 17 17 Yerbury Road I 4 36 6 46 48 B ... 2 ... ... 2 York Road I. 7 9 1 1 18 18 423 356 39 15 833 833 SUMMARY. Department 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Total. Infants 389 296 36 13 734 Mixed ... 1 1 ... 2 Junior Mixed 1 ... ... ... 1 Boys 26 21 ... ... 47 Girls 7 37 2 2 48 Special ... 1 ... ... 1 435 356 39 15 833 178 1913] Table XCVI. Showing the cases of Infectious Diseases notified during the year 1918 by the Teachers of Public Elementary Schools under the provisions of the London County Council Schools Code. Sub-Districts. School. Measles. Chicken Pox. Whooping Cough. Other Diseases. Totals. TUFNELL Burehley Road 85 22 28 68 203 Hargrave Park 31 12 9 16 68 St. John's, Holloway Road 68 6 3 13 90 St. Joseph's, Highgate Hill 11 .. 3 6 20 UPPER HOLLOWAY Cottenham Road 30 8 2 20 60 Duncombe Road 74 21 14 116 225 Grafton Road 27 15 22 26 90 St. Mark's, Mitford Road 25 7 .. 7 39 “Whittington,” Highgate Hill 19 23 31 8 81 Yerbury Road 24 21 25 82 152 TOLLINGTON Montem Street 57 22 13 67 159 Poole's Park, Lennox Road 39 9 4 47 99 Upper Hornsey Road 62 34 5 119 220 LOWER HOLLOWAY Blundell Street 38 22 12 149 221 “Brecknock,” York Road 1 1 3 14 19 Caledonian Road .. 1 .. 14 15 Catholic School, Eden Grove 2 .. 1 7 10 Chapel of Ease, Liverpool Road. 1 3 20 27 51 Hungerford Road 7 .... 2 30 39 St. Clement's, Cumberland Street 4 .. .. 1 5 St. James', George's Road 5 5 3 31 44 Westbourne Road 61 16 36 50 163 HIGHBURY ' Ambler Road 47 5 .. 43 95 Blackstock Road 32 8 .. 49 89 Drayton Park 31 1 6 49 87 “Forster,” Hornsey Road 17 10 9 114 150 Gillespie Road 27 21 3 69 120 Highbury Hill High School .. .. .. 4 4 Newington Green 5 2 3 36 46 Pakeman Street 16 13 7 25 61 St. John's, Conewood Street 14 17 .. 14 45 St. Jude's, Mildmay Park 8 5 9 24 46 St. Matthias, Hackney • • .. .. 1 1 Shelburne Road .. 26 23 25 74 BARNSBURY All Saints', Muriel Street 2 .. 6 5 13 Barnsbury Park 43 24 4 94 165 Buckingham Street 28 7 45 55 135 Cloudesley, Cloudesley S:reet 7 17 29 59 112 Gifford Street 21 12 14 131 178 Richard Street 4 24 19 47 94 Risinghill Street 4 .. .. 3 7 St. Thomas', Everilda Street 16 7 5 19 47 Thornhill Road 1 3 2 31 37 Vittoria Place 2 8 14 59 83 Winchester Street 2 •• .. 3 5 York Road 24 9 13 46 92 SOUTH-EAST Canonbury Road 74 119 11 110 314 Ecclesbourne Road 31 12 57 40 140 Hanover Street 8 11 21 72 112 Popham Road 6 27 9 95 137 Queen's Head Street 12 20 2 135 169 Rotherfield Street 51 14 14 157 236 St John's, Duncan Terrace 1 •• •• 13 14 St. Matthew's, City Road 13 .. .. 5 18 St. Mary's, Cross Street 1 10 •• 23 34 St. Paul's, Dorset Street 13 l 1 30 45 Shepperton Road 2 17 11 67 97 Station Road 31 32 5 73 141 Tottenham Road 7 1 .. 8 16 White Lion Street .. .. .. 1 1 Total 1,272 731 578 2,752 5,333 179 [1913 ISOLATION OF INFECTIOUS DISEASES. The proportion of cases isolated during the year was larger than at any time in the history of the Borough, for 1.866 cases out of the '2,171 notified under the Public Health (London) Act, 1891, were isolated in hospital, or 85*9 per cent, of all the cases. The following statement gives the percentages for each year from 1896, from which it will be seen that the percentage has gradually increased from 48.4 in 1896, to 77.1 in 1906, and to 84.1 in 1912. 1896 48.4 per cent. 1897 55.7 „ 1898 58.4 „ 1899 64.6 „ 1900 68.2 „ 1901 69.6 „ 1902 71.9 „ 1903 72.6 „ 1904 75.5 „ J9°5 76.1 percent. 1906 77.1 „ 1907 80.0 „ 1908 80.4 „ 1909 83.2 „ 1910 81.6 „ 1911 80.5 „ 1912 84.1 „ 1913 859 „ Particulars respecting each disease have been given under their various headings in that part of the report relating to the notification of infections diseases, but they are tabulated below for easy reference:— Disease. Cases. Removed to Hospital. Percentage removed to Hospital. Scarlet Fever 1,317 1,230 93.4 Diphtheria 550 512 93.1 Enteric Fever 50 39 78.0 Erysipelas 226 62 27.4 Puerperal Fever 28 23 82. 1 Total 2,171 1,866 85.9 N 2 180 1913] Table XCVII. Summary of Infectious Sickness and of the Deaths arising therefrom, distinguishing the Gases 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 1913. Notified Cases Treated. Percentages of Notified Cases Treated. Deaths Occurring. Percentages of Deaths Occurring. In Hospital. At Home. Total. In Hospital. At Home. In Hospital. At Home. Total. In Hospital. At Home. Total. Small Pox .. .. .. .. ,, .. .. .. .. .. .. Scarlet Fever 1,230 87 1,317 93.4 6 6 19 19 1.5 .. 1.4 Diphtheria 512 38 550 93.1 69 36 1 37 7.0 2.6 6.7 Enteric (Typhoid Fever) 39 11 50 78.0 22 0 1 3 4 2.5 27.3 8.0 Typhus Fever •• •• •• •• •• •• •• •• •• •• •• Erysipelas 62 164 226 27.4 72 6 5 4 9 8.0 2.4 4.0 Puerperal Fever 23 5 28 82.1 17 9 6 1 7 26.1 20.0 25.0 Continued Fever .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever •• •• •• •• •• • • .. .. .. •• •• Cholera •• •• •• •• •• •• •• •• •• •• •• Total. 1,866 305 2,171 85.9 14.1 67 9 76 3 .6 2.9 3.5 181 [1913 Table XCVIII. Showing the Cases of Infectious Disease removed to the Metropolitan Asylums Board's Hospitals for treatment and isolation during 1913. Metropolitan Asylums Board's Hospitals. Small Pox. Scarlet Fever. diphtheria. Enteric Fever. Typhus Fever. ♦Other Diseases. Total Admissions. Total Deaths. Eastern .. 64 8 1 .. 91 164 10 North Eastern .. 787 44 .. .. 348 1,179 48 North Western .. 179 342 .. .. 236 775 47 Western .. 5 7 .. .. 3 15 1 South Western .. 2 .. .. .. .. 2 .. The Grove .. .. .. .. .. .. .. .. Brook Hospital .. 1 .. .. .. 4 7 .. South Eastern .. 3 .. .. .. 3 6 .. Convalescent Hospital .. .. .. .. .. .. .. 1 Small Pox .. •• •• .. .. • • •• •• Totals .. 1,041 403 19 •• 685 2,148 107 *Including cases of Measles, Whooping Cough, Puerperal Fever, Cerebro-Spinal Fever and Polio-Myelitis. OCCUPATIONS OF PERSONS ATTACKED WITH INFECTIOUS DISEASES. The majority of the persons attacked with the notifiable infectious diseases are children under 15 years of age, and the patients are for the most part in attendance at school. Nevertheless, Table XCIX. shows very clearly that many of the persons attacked while pursuing their occupations might easily have carried the disease to their co-workers, or to the articles that they made or sold, which in turn might convey the infection to the persons wearing or using them. 1913] 182 Table XCIX. Showing the Occupations of Patients suffering from the several notifiable Infectious Diseases during the year 1913. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Total. Agent ... ... ... ... ... ... 1 ... ... 1 Accumulator Maker ... ... ... ... ... ... 1 ... ... 1 Artiste ... 1 ... ... ... ... ... ... ... 1 Accountant ... ... ... ... 1 ... ... ... ... 1 Bookbinder ... 1 ... ... ... ... ... ... ... 1 Blouse Maker ... ... ... ... ... ... 1 ... ... 1 Barmaid ... 1 ... ... ... ... ... ... ... 1 Butcher ... 1 ... ... ... ... 3 ... ... 4 Box Maker ... ... ... ... ... ... 1 ... ... 2 Bookfolder ... 1 ... ... ... ... ... ... ... 1 Belt Maker ... 1 ... ... ... ... ... ... ... 1 Bottler ... ... ... ... ... ... 1 ... ... 1 Bottle Washer ... 1 ... ... ... ... ... ... ... 1 Bricklayer ... 1 ... ... ... ... ... ... ... 1 Butter Blender ... ... 1 ... ... ... ... ... ... 1 Baker ... ... 1 ... ... ... 1 ... ... 2 Boot Maker ... ... 1 ... ... ... 1 ... ... 2 Bottle Manufacturer ... ... ... ... 1 ... ... ... ... 1 Bookseller ... ... ... ... ... ... 1 ... ... 1 Clerk ... 19 2 ... 5 ... 3 ... ... 29 Carpenter ... ... ... ... 1 ... ... ... ... 1 Charwoman ... 1 1 ... ... ... 4 ... ... 6 Canvasser ... 1 ... ... ... ... ... ... ... 1 Cook ... 1 1 ... ... ... 1 ... ... 3 Cycle Repairer ... 1 ... ... ... ... ... ... ... 1 Case Maker ... 1 ... ... ... ... ... ... ... 1 Contractor ... ... ... ... ... ... 1 ... ... 1 Carman ... 1 ... ... ... ... 3 ... ... 4 Conductor ... ... ... ... ... ... 2 ... ... 2 Cab Driver ... ... ... ... ... ... 4 ... ... 4 Chemist Assistant ... 2 ... ... ... ... ... ... ... 1 Coachbuilder ... 1 ... ... ... ... ... ... ... 1 Cashier ... ... 1 ... 1 ... ... ... ... 2 Chorus Girl ... ... 1 ... ... ... ... ... ... 1 Cooper ... ... ... ... 1 ... ... ... ... 1 Constable ... ... ... ... ... ... 1 ... ... 1 Caddie ... ... ... ... ... ... 1 ... ... 1 Cabinet Maker ... ... ... ... ... ... 2 ... ... 2 Dressmaker ... 4 1 ... 1 ... 2 ... ... 8 Draper's Assistant ... 2 ... ... ... ... ... ... ... 2 Draughtsman ... 2 ... ... ... ... ... ... ... 2 Engineer ... 3 2 ... 2 ... 4 ... ... 11 Errand Boy ... 4 ... ... ... ... ... ... ... 4 183 [1913 Table XCIX.—continued. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Total. Electrician's Assistant ... ... 1 ... ... ... ... ... ... ... 1 Engraver ... ... 1 ... ... ... ... ... ... ... 1 Embosser ... ... ... 1 ... ... ... ... ... ... 1 Fishmonger ... ... 1 ... ... ... ... ... ... ... 1 Furniture Dealer ... ... 1 ... ... ... ... ... ... ... 1 Furrier ... ... 1 1 ... ... ... 1 ... ... 3 Factory Hand ... ... 1 ... ... ... ... 1 ... ... 6 Fancy Leather Worker ... ... ... 1 ... ... ... 1 ... .. 2 French Polisher ... ... ... 1 ... ... ... ... ... ... 1 Foreman ... ... ... ... ... 1 ... 1 ... ... 2 Frame Maker ... ... ... ... ... ... ... 1 ... ... 1 Governess ... ... 1 ... ... ... ... ... ... ... 1 Gold Blocker ... ... ... ... ... ... ... 1 ... ... 1 Housewife ... ... ... 1 ... 3 ... 11 ... ... 18 Hairdressing ... ... ... 1 ... ... ... ... ... ... 1 Hawker ... ... ... 1 ... 1 ... 2 ... ... 4 Horsekeeper ... ... 1 ... ... ... ... 1 ... ... 2 Iron Founder ... ... ... ... ... ... ... ... ... ... 1 Ironer ... ... 1 1 ... ... ... 3 ... ... 5 Insurance Agent ... ... ... ... ... 1 ... ... ... ... 1 Ironmonger ... •• ... ... ... ... ... 1 ... ... 1 Ice Cream Vendor ... ... ... ... ... .. ... 1 ... ... 1 Laundry Hand ... ... 1 ... ... ... 3 ... ... 4 Lampshade Maker ... ... 1 ... ... ... ... ... ... ... 1 Leatherwork ... ... ... ... ... ... ... ... ... ... 1 Linotype ... ... ... 1 ... ... ... ... ... ... 1 Labourer ... ... ... ... ... 1 ... 10 ... ... 13 Locksmith ... ... ... I ... ... ... ... ... ... 1 Milliner ... ... ... ... ... 1 ... 1 ... ... 3 Mantle Maker ... ... ... ... ... ... ... ... ... ... 1 Machine Minder ... ... ... ... ... ... ... ... ... ... 1 Machinist ... ... ... ... ... 1 ... 1 ... ... 3 Manager ... ... 1 ... ... ... ... ... ... ... 1 Milkman 8 ... ... ... 2 ... ... 4 Messenger ... ... j ... ... ... i ... 3 Mechanic ... ... ... ... ... ... ... 2 ... 2 Meat Preserver ... ... ... ... ... ... i ... i Navvy ... ... 1 ... ... ... ... ... ... ... i Nurse ... ... ... ... ... ... ... 2 ... ... 16 Newsagent ... ... ... ... ... 1 ... 1 ... ... 2 Nurseryman ... ... ... ... ... ... ... 1 ... ... i Needlewomen ... ... ... ... ... ... ... 1 ... ... 1 Organ Tuner ... ... ... ... ... ... ... 1 ... ... i Printer ... ... ... ... ... ... ... i ... ... 5 Painter ... ... 1 ... ... ... ... ... ... ... 1 Postal Official ... ... 5 ... ... ... ... 2 ... ... 10 Pianoforte Maker ... ... 3 1 ... ... ... ... ... ... 4 1913] 184 Table XCIX —continued. Occupations. Small Pox. Scarlet Fever. Diphtheria. Memb. Croup. Typhoid Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Total. Porter ... 3 1 ... ... ... 2 ... ... 6 Piano Tuner ... 1 ... ... ... ... ... ... ... 1 Packer ... 1 1 ... ... ... 2 ... ... ... Packing Case Maker ... ... 1 ... ... ... ... ... ... 1 Plasterer ... ... ... ... 1 ... 2 ... ... 3 Pantry Boy ... ... ... ... 1 ... ... ... ... 1 Process Worker ... ... ... ... ... ... 1 ... ... 1 Plumber ... ... ... ... ... ... 1 ... ... 1 Potman ... ... ... ... ... ... 1 ... ... 1 Pointsman ... ... 1 ... ... ... ••• ... ... 1 Railway Official ... 1 1 ... 1 ... 1 ... ... 4 Robe Maker ... ... 1 ... ... ... ... ... ... 1 Road Sweeper ... ... ... ... ... ... 1 ... ... 1 Rag Sorter ... ... ... ... ... ... 1 ... ... 1 Scholars ... 847 268 ... 3 ... 14 ... ... 1132 Servants ... 10 8 ... 1 ... 5 ... ... 24 Sequin Work ... 1 ... ... .... ... ... ... ... 1 Syphon Making ... 1 ... ... ... ... ... ... ... 1 Shop Assistant ... 3 1 ... 1 ... ... ... ... 6 Stenographer ... 1 ... ... ... ... ... ... ... 1 Soldier ... 1 ... ... ... ... ... ... ... 1 Silk Mercer ... ... 1 ... ... ... ... ... ... 1 Salesman ... ... 2 ... ... ... ... ... ... 3 Sawyer ... ... 1 ... ... ... ... ... ... 1 Steward ... ... ... ... 1 ... ... ... ... 1 Shirt Maker ... ... ... ... ... ... ... ... ... 1 Tailoress ... 1 1 ... ... ... ... ... ... 3 Typist ... 3 ... ... ... ... ... ... ... 3 Telegraphist ... 2 ... ... ... ... ... ... ... 2 Teacher ... 2 2 ... 2 ... ... ... ... 6 Tie Maker ... 1 .. ... ... ... ... ... ... 2 Tram Driver ... ... 1 ... ... ... ... ... ... 1 Traveller ... ... 1 ... 1 ... ... ... ... 3 Toy Painter ... ... 1 ... ... ... ... ... ... 1 Underclothes Making ... ... 1 ... ... ... ... ... ... 1 Upholsterer ... ... ... ... I ... ... ... ... 1 Umbrella Maker ... ... ... ... 1 ... ... ... ... 1 Van Boy ... 1 ... ... ... ... ... ... ... 3 Veterinary Surgeon ... ... ... ... I ... ... ... ... 1 Wax Model Maker ... 1 ... ... ... ... ... ... ... 1 Wreath Making ... 1 ... ... ... ... ... ... ... 1 Waitress ... ... 1 ... ... ... 1 ... ... 2 Warehouseman ... ... 2 ... ... ... 1 ... ... 3 Watchman ... ... ... ... ... ... 1 ... ... 1 Total ... 978 337 ... 38 ... 136 ... ... 1489 185 [1913 TRADES AND BUSINESSES CARRIED ON IN THE HOMES OF PATIENTS. The list of trades and businesses carried on in the homes of the patients or in the houses in which they resided which is given below, proves very conclusively that the spread of infectious diseases through the goods made in the homes, or in the case of tenements, in the houses wherein they reside, is very possible. From this list it is seen that Scarlet Fever occurred in 155 houses in which a business was conducted or work done; also Diphtheria in 66, Enteric Fever in 6, and Erysipelas in 27. In every instance the most careful inquiry was made as to the possibility of the disease being bspread by the articles sold or made on the premises, and in the case of Scarlet Fever, the work especially if it were connected with wearing apparel, was at once stopped, either until the patient (if kept at home; had recovered, or, if removed to hospital, until the house had been disinfected, and the period of the incubation of the disease had passed, and, where necessary, the goods, if wearing apparel, had been disinfected. In these cases, too, the individual firms to whom they belonged were communicated with. 1913] 186 Table C. List of Trades and Businesses curried on in Houses wherein Infectious Diseases have occurred during 1913. TRADES AND BUSINESSES. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Meiub. Croup. Enteric Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. Total. Accountants ... 1 ... ... ... ... ... ... ... 1 Artificial Flowers ... ... 2 ... ... ... ... ... ... 2 Beer House ... 1 1 ... ... ... ... ... ... 2 Bootmakers ... 10 2 ... 1 ... 3 ... ... 16 Box Making ... 3 ... ... ... ... ... ... ... 3 Blouse Making ... 2 ... ... ... ... ... ... ... 2 Builders ... 3 4 ... ... ... ... ... ... 7 Bakers ... 3 2 ... ... ... ... ... ... 5 Butchers ... 3 2 ... ... ... ... ... ... 5 Bag Making ... 1 ... ... ... ... ... ... ... 1 Blind Making ... 1 ... ... ... ... ... ... ... 1 Bon-bon Making ... 1 ... ... ... ... ... ... ... 1 Boarding House ... 1 ... ... 2 ... ... ... ... 3 Brush Making ... ... 2 ... 1 ... l ... ... 4 Coffee Shop ... 5 ... ... ... ... ... ... ... 5 Cripple Home ... 1 ... ... ... ... ... ... ... 1 Clothiers ... 2 ... ... ... ... ... ... ... 2 Confectionery ... 4 1 ... ... ... ... ... ... 5 Cycle Shop ... 2 ... ... ... ... ... ... ... 2 Conjuring Apparatus ... 1 ... ... ... ... ... ... ... 1 Continental Provisions ... 1 ... ... ... ... ... ... ... 1 Chemists ... 1 ... ... ... ... ... ... ... 1 Cornchandlers ... ... 1 ... ... ... ... ... ... 1 Common Lodging House ... ... 1 ... ... ... ... ... ... 1 Carpentry ... ... 1 ... ... ... 1 ... 2 Drapers ... 4 2 ... 1 ... 1 ... ... 8 Dressmaking ... 7 6 ... 1 ... 3 ... ... 17 Dentists ... 2 ... ... ... ... ... ... ... 2 Dyeing ... ... ... ... ... ... 1 ... ... 1 Engineering ... ... 1 ... ... ... ... ... ... 1 Fancy Leather Works ... 1 ... ... ... ... ... ... ... 1 Furriers ... 2 1 ... ... ... ... ... ... 3 Fruiterers ... 1 1 ... ... ... ... ... ... 2 Fishmongers ... 2 ... ... ... ... ... ... ... 2 Furniture Dealers ... 4 1 ... ... ... ... ... ... 5 Grocers ... 1 1 ... ... ... ... ... ... 2 General Shop ... 5 3 ... ... ... 5 ... ... 13 Greengrocers ... 1 4 ... ... ... ... ... ... 5 Glazier ... ... ... ... ... ... ... ... ... 1 Hospital ... 1 ... ... ... ... ... ... ... 1 Hairdressing ... 7 1 ... ... ... ... ... ... 8 Hardware ... 1 ... ... ... ... ... ... ... 1 Jewellers ... ... ... ... ... ... 1 ... ... 1 Laundry ... 10 2 ... ... ... 2 ... ... 14 Milkshops ... 4 1 ... ... ... ... ... ... 5 187 [1913 Table C.—continued. TRADES AND BUSINESSES. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Memb. Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Cholera. J Total. Mantle Making 2 3 ... ... ... 1 ... ... 6 Milliners ... 1 ... ... ... ... ... ... ... 1 Muffin Making ... 1 ... ... ... ... ... ... ... 1 Musical Instruments 1 ... ... ... ... ... ... 1 Mangling ... ... 1 ... ... ... ... ... ... 1 Marine Store ... ... 1 ... ... ... ... ... ... 1 Mathematical Instruments ... ... 1 ... ... ... ... ... ... 1 Newsagents ... 1 1 ... ... ... 2 ... ... 4 Needlework ... 1 ... ... ... ... ... ... ... 1 Off Licence ... 3 ... ... ... ... ... ... ... 3 Oil Shop ... 22 1 ... ... ... ... ... ... 1 Provision Dealers ... ... 1 ... ... ... ... ... ... 5 Public House ... 4 1 ... ... ... 2 ... ... 7 Printing ... 2 1 ... ... ... ... ... ... 3 Photo Cabinet Making ... 1 ... ... ... ... ... ... ... 1 Receiving Homes ... 14 5 ... ... ... ... ... ... 19 Rubber Goods ... 1 ... ... ... ... ... ... ... 1 Restaurant ... ... 1 ... ... ... 1 ... ... 2 School ... ... ... ... ... ... ... ... ... 2 Stationers ... 1 1 ... ... ... ... ... ... 2 Stable ... 1 1 ... ... ... ... ... ... 2 Surgical Instruments ... 1 ... ... ... ... ... ... ... 1 Surgery ... ... 1 ... ... ... ... ... ... 1 Tailors ... ... ... ... ... ... 1 ... ... 4 Tobacconists ... ... ... ... ... ... ... ... ... 2 Tyre Making ... 1 ... ... ... ... ... ... ... 1 Tinplate Works ... 1 ... ... ... ... 1 ... ... 2 Thermometer Making ... ... ... ... ... ... ... ... ... 1 Tie Making ... ... 1 ... ... ... ... ... ... 1 Undertakers ... 1 ... ... ... ... ... ... ... 1 Wood Chopping ... 1 ... ... ... ... ... ... ... 1 Wardrobe Dealers ... ... ... ... ... ... 1 ... ... 4 Watchmakers ... 1 ... ... ... ... ... ... ... 1 Weaver ... ... 1 ... ... ... ... ... ... 1 Totals 155 66 ... 6 ... 27 ... ... 254 1913] 188 Table CI. Showing the Streets in which the several cases of Infectious Disease occurred during 1913. The large figure denotes the number of cases and the small figure the number of infected houses. name of street. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. j Erysipelas. Puerperal Fever. Cerebro-Spinai Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Ashburton Grove ... 44 ... ... ... ... ... ... ... 44 Ambler Road ... l1 11 ... ... ... ... ... ... 24 Anson Road ... l1 11 22 ... ... ... ... ... 44 Albion Street ... ... 22 ... ... ... ... ... ... 22 Almorah Boad ... 33 11 ... ... ... ... ... ... 44 Avenell Road ... 32 33 ... ... 11 ... ... ... 76 Alsen Road ... 33 ... ... 22 ... ... ... ... 55 Alwyne Square ... 22 11 ... ... ... ... ... ... 33 Albert Street ... ... 22 ... 11 11 ... ... ... 44 Anneeley Road ... ... 11 ... ... ... ... ... ... 11 Alma Grove ... ... ... ... 11 ... ... ... ... 11 Aslibrook Road ... 53 22 ... ... ... ... ... ... 75 Alexander Road ... 74 33 ... ... ... ... ... ... 107 Anatola Road ... 11 ... ... ... ... ... ... l1 Andover Road ... 75 135 ... 11 ... ... ... ... 219 Archway Road ... 11 11 ... 11 ... ... ... ... 33 Athelstane Road ... 32 ... ... ... ... ... ... ... 32 Almington Street ... 32 11 ... 11 ... ... ... ... 54 Aberdeen Park ... ... 22 11 ... ... ... ... ... 32 Arundel Square ... 108 11 ... ... ... ... ... ... 118 Arundel Grove ... 11 ... ... ... ... ... 11 ... 22 Astey's Row ... 11 11 ... ... ... ... ... ... 22 Albert Place ... 11 ... ... ... ... ... ... ... 11 Archibald Road ... 21 ... ... ... ... ... ... ... 21 Albany Cottages, Popham Street ... 86 11 ... ... ... ... ... ... 96 Arlington Street ... 75 ... ... ... ... ... ... ... 75 Arthur Road ... 22 ... ... ... ... ... ... ... 22 Allen Street ... 11 ... ... ... ... ... ... ... 11 Alfred Street ... 33 ... ... 11 ... ... ... ... 44 Andover Street ... 11 ... ... ... ... ... ... ... 11 Arundel Place ... ... 11 ... ... ... ... ... ... 11 Arlington Square ... 22 ... ... ... ... ... ... ... 22 Adelaide Square ... ... 11 ... ... ... ... ... ... 11 Alwyne Road ... 11 ... ... ... ... ... ... ... 11 Albion Grove ... 11 ... ... ... ... ... ... ... 11 Albany Place ... ... ... ... 11 ... ... ... ... 11 Annette Road ... 11 ... ... ... ... ... ... ... 11 189 [1913 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Aberdeen Mews ... ... 11 ... ... ... ... ... ... 11 Alwyne Villas ... 11 ... ... ... ... ... ... ... 11 Aubert Park ... 11 ... ... ... ... ... ... ... 11 Baxter Road ... 64 11 ... 23 ... ... 21 ... 116 Beaumont Road ... 4 ... ... ... ... ... ... ... 46 Baalbec Road ... ... ... 11 ... ... ... ... ... 111 Brecknock Road ... 54 48 11 ... ... ... ... ... 106 Bedford Terrace ... 22 11 ... ... ... ... ... ... 5 Bemerton Street ... 11 33 ... 48 ... ... 11 ... 9 Boleyn Road ... 48 22 ... ... ... ... 11 ... 75 Brooksby Street ... ... 22 11 ... ... ... ... ... 33 Beaconsfield Buildings ... 3' ... ... 11 ... ... 23 ... 88 Brookside Road ... 11 2a ... ... ... ... ... ... 33 Blackstock Road ... 11 44 ... 11 ... ... ... ... 66 Barnsbury Grove ... 11 ... ... ... ... ... ... ... 76 Birnam Road ... 22 22 ... 11 ... ... ... ... 65 Bracey Street ... 65 ... ... ... ... ... ... ... 22 Bryett Road ... 22 ... ... ... ... ... ... ... 33 Bryan Street ... 11 11 11 ... ... ... ... ... 33 Balls Pond Road ... ... 22 ... ... ... ... ... ... 22 Benwell Road ... 11 ... ... 22 ... ... ... 11 44 Beversbrook Road ... 11 ... ... ... ... ... ... ... 11 Brewery Road ... 11 11 ... 21 ... ... ... ... 43 Bevan Street ... ... 22 11 ... ... ... ... ... 33 Burns Buildings, Caledonian Road ... 11 ... ... 11 ... ... ... ... 22 Britannia Row ... 2 11 ... ... ... ... ... ... 33 Blenheim Road ... 33 44 ... 22 ... ... ... ... 99 Bride Street ... 22 ... ... ... ... ... ... ... 22 Brunswick Road ... ... 11 ... ... ... ... ... ... 11 Barnsbury Road ... 33 11 ... 11 11 ... 11 ... 77 Baring Street ... 22 ... ... 11 ... ... 22 ... 32 Blundell Street ... 22 ... 11 ... ... ... ... ... 55 Boxworth Grove ... 11 ... ... ... ... ... ... ... 11 Barnsbury Mews ... ... 11 ... ... ... ... 11 ... ... 11 Bishops Grove ... ... ... ... ... ... ... ... 11 Bruce Buildings ... 11 44 ... ... ... ... ... ... 54 Balls Pond Place ... 21 ... ... ... ... ... ... ... 21 Beresford Road ... 11 ... ... ... ... ... ... ... 11 Bismarck Road ... 22 ... ... ... ... ... ... ... 22 Bardolph Road ... 11 ... ... 11 ... ... ... ... ... ... 11 Balfour Road ... ... ... ... ... ... ... ... 11 Barbara Street ... 22 32 ... ... ... ... ... ... 54 Buckland House, Offord Road ... 11 ... ... ... ... ... ... ... 11 1913] 190 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Bryantwood Road ... 33 ... ... ... ... ... ... ... 33 Bickerton Road ... 11 11 ... ... ... ... ... ... 22 Bures House, Offord Road ... ... 11 ... ... ... ... ... ... 11 Belper Street ... 22 ... ... ... ... ... ... ... 21 Barnsbury Park ... 11 ... ... ... ... ... ... ... 11 Brunswick Street ... ... 11 11 ... ... ... ... ... 22 Battledean Road ... ... ... 11 ... ... ... ... 11 Bovey Place ... 11 ... ... ... ... ... ... ... 11 Broad Yard, Essex Road ... 11 ... ... ... ... ... ... ... 11 Barford Street ... ... ... ... 11 ... ... ... ... 11 Bingfield Street ... ... 11 ... ... ... ... ... ... 11 Barnsbury Street ... 11 ... ... 11 ... ... ... ... 22 Caledonian Road ... 1110 43 ... 44 ... ... 11 11 2119 Copenhagen Street ... 55 11 ... 55 ... ... 11 ... 1212 Canonbury Road ... 44 11 ... ... ... ... ... ... 55 Cromartie Road ... 65 ... ... ... ... ... ... ... 63 Charlesworth Street ... ... ... ... 11 11 ... ... ... 22 Corinne Road ... 45 22 ... ... 11 ... ... ... 75 Campbell Road ... 11 22 ... 45 ... ... 22 ... 98 Crossley Street ... 35 ... ... 22 ... ... ... ... 55 Charlotte Street ... ... 11 ... . . . ... ... ... ... 11 Cumberland Street ... ... l1 ... 11 ... ... ... ... 22 Cromwell Road ... 85 11 ... 11 ... ... ... ... 102 Canonbury Square ... 5:l 32 ... ... ... ... ... ... 85 Crayford Road ... 22 11 ... ... ... ... ... ... 33 Cleveland Road ... ... 22 11 11 ... ... ... ... 44 Canning Road ... 38 22 ... ... ... ... ... ... 54 Cottenham Road ... 64 44 ... 33 ... ... ... 11 1410 Calverley Grove ... 148 22 ... 11 ... ... ... ... 1710 Canonbury Street ... 11 11 ... ... ... ... ... ... 22 Carlsbad Street ... 11 11 ... ... ... ... 11 ... 33 Corbyn Street ... 35 ... ... 22 ... ... 11 ... 66 Cloudesley Street ... ... 11 ... ... ... ... ... ... 11 Compton Road ... 11 ... ... 11 ... ... ... ... 22 Cornwall Cottages, Popham ... ... ... ... ... ... ... ... ... ... Street ... 87 97 ... ... ... ... ... ... 1714 Colebrooke Row ... 32 33 11 ... ... ... ... ... 74 Corsica Street ... ... ... ... 11 ... ... ... ... 11 Charlton Crescent ... 11 11 ... ... ... ... ... ... 22 Church Road ... ... 48 ... ... ... ... ... ... 48 Cloudesley Road ... 33 22 ... 11 11 ... ... ... 77 Cruden Street ... 54 ... ... ... ... ... ... ... 54 Cathcart Hill ... 22 ... ... ... ... ... ... ... 22 Campdale Road ... 11 ... ... ... ... ... ... ... 11 191 [1913 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Camden Road ... 11 11 ... ... ... ... ... ... 22 Cornwallis Road ... 44 11 ... 44 ... ... ... ... 92 22 Charteris Road ... ... ... ... 11 11 ... ... ... Corinth Road ... ... 11 ... ... ... ... ... ... 11 11 Crane Grove ... ... ... 11 ... ... ... ... ... Chalfont Road ... 11 22 ... ... ... ... ... ... 33 Cheverton Road ... 22 ... 84 ... ... ... ... ... ... 810 11 Canonbury Avenue ... 86 ... 22 ... ... ... ... Cloudesley Square ... ... ... ... 11 ... ... ... 11 ... 11 Cardale Street ... ... ... ... ... ... ... ... 11 Chatterton Road ... ... 42 ... ... ... ... ... ... 42 22 Corporation Street ... ... 11 ... 11 ... ... ... ... Cornelia Street ... 31 ... ... ... ... ... ... ... 31 Canterbury Road ... 33 22 ... ... ... ... ... ... 55 Camden Dwellings, York Road ... ... 22 ... 11 ... ... ... ... 33 College Street ... ... 32 ... ... ... ... ... ... 32 Clifton Terrace ... ... 21 11 ... ... ... ... ... 11 Crouch Hill ... 11 ... 22 ... ... ... ... ... ... 22 Compton Avenue ... ... ... ... ... ... ... ... Church Street ... 11 ... ... 11 ... ... ... ... 33 Carleton Terrrace ... 11 ... ... ... ... ... ... ... 11 65 City Garden Row ... 54 ... ... ... ... ... 11 ... Charles Street, Holloway ... 22 ... ... ... ... ... ... ... 22 Crown Mansions, Holloway Road ... ... 11 ... ... ... ... ... ... 11 College Gardens, Carelton Road ... 11 ... ... ... ... ... ... ... 11 City Mansions. North Road ... 11 ... ... ... ... ... 11 ... 22 Cross Street ... 53 ... ... ... ... ... ... ... 58 Cottenham Terrace ... 21 ... ... 11 ... ... ... ... 31 Camden Passage ... l1 ... ... ... ... ... ... ... 68 Clephane Road ... 21 ... ... ... 11 ... ... ... 32 Clarence Street ... 52 11 ... ... ... ... ... ... 63 Conewood Street ... 32 ... ... ... ... ... ... ... 32 Cromwell Road ... 41 ... ... ... ... ... ... ... 44 Church Grove ... 21 ... ... ... ... ... ... ... 21 Camden Street ... 21 ... ... ... ... ... ... ... 21 Carelton Road ... 11 ... ... ... ... ... ... ... 11 Canonbury Lane ... 11 ... ... ... ... ... ... ... 11 Church Lane ... ... 11 ... ... ... ... ... ... 11 Cloudesley Mansions ... ... 11 ... ... ... ... ... ... 11 Cutlers Terrace ... 11 ... ... ... ... ... ... ... 11 Canonbury Park, North ... ... ... ... ... ... ... ... 11 11 Caledonia Street ... 11 ... ... ... ... ... ... ... 11 1913] 192 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Carlton House, Stanmore Street ... ... ... ... ... ... ... 11 ... 11 Canonbury Park South ... 11 ... ... ... ... ... ... ... 11 Calabria Road ... 11 11 ... ... ... ... ... ... 23 Canonbury Villas ... 11 ... ... ... ... ... ... ... 11 Cressida Road ... 22 ... ... ... ... ... ... ... 22 Compton Road ... 11 .. ... ... ... ... ... ... 11 Dennis Street ... 33 33 ... 11 ... ... 11 ... 88 Dagmar Terrace ... 11 22 ... ... ... ... ... ... 33 Drayton Park ... 33 ... ... ... ... ... ... ... 33 Dresden Road ... 3s 11 11 ... ... ... ... ... 56 Dartmouth Park Hill ... 43 ... ... 11 ... ... ... ... 54 Durham Road ... 54 11 ... ... ... ... ... ... 65 Devonshire Road ... 55 ... 11 11 ... ... ... ... 77 Denmark Terrace ... 11 11 ... ... ... ... ... ... 22 Dorset Street ... ... ... ... 11 ... ... ... ... 11 Duncombe Road ... 42 ... ... 11 ... ... ... ... 53 Dunford Road ... 32 33 ... ... ... ... ... ... 65 Delhi Street ... 36 ... ... ... ... ... ... ... 33 Dorinda Street ... 33 ... ... ... ... ... ... ... 33 Denmark Street ... ... 11 ... ... ... ... ... ... 11 Despaxd Road ... 11 11 ... ... ... ... ... ... 22 Dean Street ... 11 22 ... ... ... ... ... ... 32 Denmark Grove ... ... 11 ... 22 ... ... ... ... 33 Devonshire Street ... 11 11 ... ... ... ... ... ... 22 Duncan Terrace ... 11 11 ... ... ... ... ... ... 22 Danbury Street ... 95 ... ... ... ... ... ... ... 95 Dame Street ... 22 ... ... ... ... ... ... 11 33 Dibden Street ... 11 11 ... ... ... ... ... ... 22 Davenant Road ... 11 ... ... ... ... ... ... ... 11 Denmark Road ... ... ... ... 11 ... ... ... ... 11 Downham Road ... 11 ... 11 ... ... ... ... ... 22 Devonshire House, Cross Street ... 11 ... ... ... ... ... ... ... 11 Duncan Street ... 11 ... ... ... ... ... ... ... 11 Dalmeny Road ... 11 ... ... ... ... ... ... ... 11 Edinburgh Cottages, Popham Street ... 11 32 ... ... ... ... ... 11 54 Elton Place ... 52 ... ... ... ... ... ... ... 52 Elton Street ... ... 11 ... ... ... ... ... ... 11 Elmore Street ... 11 53 ... ... 11 ... ... ... 75 Evershot Road ... 11 ... ... 11 ... ... ... ... 22 Elthorne Road ... 1614 33 11 11 11 ... ... ... 2219 Enkel Street ... 11 ... ... ... ... ... ... ... 11 193 [1913 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Englefield Boad ... 11 ... ... ... ... ... ... ... 11 Elden Grove ... 31 11 ... ... ... ... ... ... 43 Essex Road ... I211 11 ... 22 ... ... 11 11 1715 Ellington Street ... 52 ... 11 ... 11 ... ... ... 74 Elwood Street ... ... 62 ... ... ... ... ... ... 63 Ellenborough Road ... ... ... ... ... ... 11 ... ... 11 Edward Square ... 11 22 ... ... ... ... ... 11 43 Edward's Cottages, Canonbury Road ... 11 ... ... ... ... ... ... ... 11 Elliott's Gardens ... 11 ... ... ... ... ... ... ... 11 East Street ... ... ... ... 11 ... ... ... ... 11 Ebenezer Buildings, Botherfield Street ... ... 11 ... ... ... ... ... ... 11 Everleigh Street ... 11 ... ... ... ... ... ... ... 11 Fullbrook Road ... 45 ... ... ... ... ... ... ... 43 Foxliam Road ... 64 ... ... ... ... ... ... ... 64 Fonthill Road ... 117 33 ... ... ... ... ... ... 1410 Fairbridge Road ... 9' 11 ... 33 ... ... ... 11 1411 Fowler Road ... ... 31 ... ... ... ... ... ... 31 Fortnam Road ... 32 11 ... ... ... ... ... ... 43 Frederick Street ... 11 22 ... ... ... ... 22 ... 54 Francis Street ... 11 ... ... ... ... ... ... ... 11 Francis Terrace ... ... 11 ... ... ... ... ... ... 11 Fairmead Road ... 22 ... 11 11 11 ... ... ... 55 Freegrove Road ... ... 11 ... ... ... ... ... ... 11 Florence Street ... ... 11 11 ... ... ... ... ... 22 Framfield Road ... 11 ... ... ... ... ... ... ... 11 Ferntower Road ... 22 ... ... 11 ... ... ... ... 33 Freeling Street ... 11 ... ... ... ... ... ... ... 11 Fordhams Grove ... 21 ... ... ... ... ... ... ... 21 Frome Street ... 11 11 ... ... ... ... ... ... 22 Fife Terrace ... 11 ... ... ... ... ... ... ... 11 Goodinge Road ... 64 22 11 11 ... ... ... ... 106 Goodwin Street ... 11 ... ... ... ... ... ... ... 11 Grove Road ... 54 22 ... 22 ... ... ... ... 98 Gibson Square ... 22 11 ... ... ... ... ... ... 38 Grosvenor Street ... 75 ... ... ... ... ... ... ... 75 Grautbridge Street ... 11 11 ... 11 ... ... ... ... 35 Gloucester Road ... 22 ... ... 11 ... ... ... ... 33 Gifford Street ... ... 44 ... 21 ... ... 21 ... 86 Gillespie Road ... 22 23 ... ... ... ... ... ... 44 Great Northern Hospital ... 11 ... ... ... ... ... ... ... 11 Grafton Road ... 22 ... ... ... ... ... ... ... 22 Green Lanes ... ... 11 ... ... ... ... ... ... 11 1913] 194 Table CI.—continued. name of street. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Grace Street ... ... 11 ... ... ... ... ... ... 11 Greenman Street ... ... ... ... 11 ... ... ... ... 11 Grenville Road ... 54 31 ... 11 ... ... ... ... 96 Gerrard Street ... 33 ... ... ... ... ... ... ... 33 Graham Street ... 11 ... ... ... 11 ... ... ... 22 Grovedale Road ... 22 ... ... ... ... ... ... ... 22 Gladstone Street ... ... 11 ... ... ... ... ... ... 11 Grosvenor Road ... 31 ... 11 ... ... ... ... ... 42 George's Yard ... 11 ... ... ... ... ... ... ... 11 George's Road ... ... 11 ... 11 ... ... ... ... 22 Girdlestone Road ... ... ... ... 32 ... ... ... ... 32 Gatcombe Road ... 31 ... ... ... ... ... ... ... 31 Goldsmith Place ... 33 ... ... ... ... ... ... ... 33 Gladsmuir Road ... ... 11 ... ... ... ... ... ... 11 Huddleston Road ... 178 11 11 ... ... ... ... ... 199 Hanover Streat ... 44 22 ... 22 ... ... ... ... 87 Halton Road ... 65 11 11 11 ... ... ... ... 97 Hartham Road ... 22 ... 11 ... ... ... ... ... 33 Hornsey Rise ... 143 53 ... 22 ... ... ... ... 216 Hertslet Road ... 85 ... ... 11 ... ... ... ... 96 Hollingsworth Street ... 53 ... ... 11 ... ... ... ... 64 Hanley Road ... 75 33 11 22 ... ... ... ... 1310 Hawthorne Street ... 21 ... ... 11 ... ... ... ... 32 Hilldrop Crescent ... ... 22 ... ... ... ... ... ... 22 Hornsey Road ... 2318 129 ... 33 ... ... ... ... 3820 Hatchard Road ... ... 22 ... ... ... ... ... ... 22 Hartnoll Street ... ... 11 ... ... ... ... ... ... 11 Havelock Street ... 22 11 ... 11 ... ... ... 11 56 Hungerford Road ... 11 ... ... ... 11 ... ... ... 22 Heathville Road ... ... 11 ... ... ... ... ... ... 11 Hercules Road ... ... ... ... 11 ... ... ... ... 11 Haverstock Street ... 11 ... ... 21 ... ... ... ... 21 Holloway Road ... 1111 11 ... 22 ... ... ... ... 1414 Highbury New Park ... 11 ... 22 ... ... ... ... ... 33 Hemingford Road ... 86 ... ... 11 ... ... ... ... 97 Herrick Road ... 11 ... ... ... ... ... ... ... 11 Highbury Hill ... 33 11 ... 21 ... ... ... ... 65 Hillmarton Road ... ... 32 ... ... ... ... ... ... 32 Highgate Hill ... ... 11 11 ... ... ... ... ... 22 87 Hargrave Park ... 22 54 ... ... ... ... ... ... Hargrave Road ... ... 33 ... ... ... ... ... ... 33 H.M.P. Pentonville ... ... ... ... 11 ... ... ... ... 11 Highbury Park ... ... ... ... 11 ... ... ... ... 11 195 [1913 Table CI.—continued. NAME OF STREET Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Halliford House, Upper Park Street ... 22 ... ... ... ... ... ... ... 22 Hazellville Road ... 96 32 ... ... ... ... ... ... 128 Hampden Road ... 77 22 ... ... ... ... ... ... 99 Hurlock Street ... ... 11 ... ... ... ... ... ... 11 Henry Place ... ... ... ... ... ... ... 11 ... 11 Hatley Road ... 22 ... ... 11 ... ... ... ... 33 Highbury Quadrant ... 11 11 ... ... ... ... ... ... 22 Hornsey Street ... 33 11 ... ... ... ... 11 11 64 Harberton Road ... 22 ... ... ... ... ... ... ... 22 Halliford Street ... 11 ... ... 11 ... ... ... ... 22 Highbury Crescent ... ... 11 11 ... ... ... ... ... 22 Half Moon Crescent ... 32 ... ... ... ... ... ... ... 32 Halse Street ... ... ... ... 11 ... ... 11 ... 22 Hercules Place ... ... 11 ... ... ... ... ... ... 11 Hydes Place ... ... ... ... 11 ... ... ... ... 11 Harvist Road ... 11 11 ... ... ... ... •• ... 22 Haverstock Street ... 11 ... ... ... ... ... ... ... 11 Hargrave Mansions ... I1 ... ... ... ... ... ... ... 11 Hydes Place West ... ... 22 ... ... ... ... ... ... 22 Hugo Road ... 11 ... ... ... ... ... ... ... 11 Holborn Infirmary ... ... ... ... 11 ... ... ... ... 11 Highwood Road ... 11 ... ... ... ... ... ... ... 11 Hornsey Lane ... 21 ... ... ... ... ... ... ... 21 Highbury Terrace ... ... 11 ... ... ... ... ... ... 11 Hardinge Street ... 21 ... ... ... ... ... ... ... 21 Highbury Place ... 11 ... ... ... ... ... ... ... 11 Highbury Grove ... ... 11 ... ... ... ... ... ... 11 Islington Infirmary ... 5 2 ... 11 ... ... ... ... 81 Isledon Road ... 11 11 ... 11 ... ... ... ... 33 Ingleby Road ... 11 ... ... ... ... ... ... ... 11 Islington Green ... 43 ... ... ... ... ... ... ... 43 Islington Workhouse,: t. John's Road ... 31 ... ... 21 ... ... ... ... 51 Junction Road ... 87 11 ... 22 ... ... ... ... l19 Jackson Road ... 11 33 ... ... ... ... ... ... 44 Kingsdown Road ... 55 22 ... 11 ... ... ... ... 88 Kiver Road ... ... 22 ... ... ... ... ... ... 22 Knox Buildings, Caledonian road ... 21 ... ... ... ... ... ... ... 21 King Henry's Walk ... 42 11 11 22 ... ... 11 ... 97 King Edward's Buildings ... ... 11 ... 11 ... ... 11 ... 33 Kingsbury Road ... 11 33 ... ... ... ... ... ... 44 King Henry Street ... 62 ... ... ... ... ... ... ... 62 O 2 1913] 196 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Keen's Yard, St. Paul's Road ... ... 11 ... ... ... ... ... ... 11 Linton Street ... 43 11 11 ... ... ... ... ... 65 Liverpool Road ... 77 65 11 ... ... ... ... ... 1418 London Fever Hospital ... 4 4 ... ... ... ... ... ... 81 Lady Margaret Road ... 11 22 ... ... ... ... ... ... 32 Loraine Road ... 11 11 ... • •• ... ... ... ... 21 Lavina Grove ... 11 44 ... ... ... ... ... ... 54 Lofting Road ... 76 22 ... ... ... ... ... ... 98 Langdon Road ... 33 11 ... 11 ... ... ... ... 55 Lonsdale Square ... 22 ... ... 11 ... ... 11 ... 44 Leconfield Road ... 64 11 ... ... •• ... ... ... 75 Lennox Road ... 53 11 ... ... ... ... ... ... 64 Lesly Street ... 22 ... 11 ... ... ... ... ... 33 Loraine Mansions ... 11 ... ... ... ... ... ... ... 11 Lyon Street ... 21 ... ... 11 ... ... ... ... 32 Landseer Road ... 33 32 ... ... ... ... ... 11 76 London Street ... ... 11 ... ... ... ... ... ... 11 Liverpool Street ... 11 ... ... ... ... ... ... ... 11 Lidyard Road ... ... ... 11 ... ... ... ... ... 11 Little Cross Street ... ... ... ... 11 ... ... ... ... 11 Lysander Grove ... 11 ... ... ... ... ... ... ... 11 Lucerne Road ... 21 ... ... ... ... ... ... ... 21 Legard Road ... ... 11 ... ... ... ... ... ... 11 Lowman Road ... ... 11 ... ... ... ... ... ... 11 Liverpool Buildings ... 11 ... ... ... ... ... ... ... 11 Leigh Road ... ... 11 ... ... ... ... ... ... 11 Marriott Road ... 22 ... ... 11 ... ... ... ... 33 Moray Road ... 44 11 ... ... ... ... ... ... 55 Moreland Street ... 11 ... ... ... ... ... ... ... 11 Mayville Street ... 11 ... ... ... ... ... 11 ... 22 Magdala Road ... 11 ... ... ... ... ... ... ... 11 Mildmay Grove ... 44 22 ... 11 ... ... ... ... 77 Mildmay Park ... 21 11 ... ... ... ... ... ... 32 Madras Place ... 11 21 ... ... ... ... ... ... 32 Milkern Road ... 65 11 ... ... ... ... ... ... 76 Muriel Street ... 22 ... ... ... ... ... ... ... 22 Monsell Road ... 11 22 ... ... ... ... ... ... 33 Mildmay Road ... 3s ... ... 11 ... ... ... ... 44 Matthias Road ... 11 ... 11 11 ... ... ... ... 33 Marcellus Road ... ... 11 ... 11 ... ... ... ... 22 Mitford Road ... 22 ... ... ... ... ... ... ... 22 Montpelier Road ... 11 ... ... ... ... ... ... ... 22 Montem Street ... 11 ... ... ... ... ... ... ... 11 Morton Road • 56 22 ... ... ... ... ... ... 76 197 [1913 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Medina Road ... 11 ... ... ... ... ... ... ... 11 Milton Grove ... ... 11 ... 11 ... ... ... 11 33 Mildmay Street ... 22 43 ... ... ... ... ... ... 65 Mayton Street ... 42 11 ... ... ... ... ... ... 53 Marlboro' Road ... 119 ... ... 11 ... ... ... ... 1210 Mildmay Avenue ... 21 22 ... ... ... ... ... ... 43 Monnery Road ... 22 ... ... ... ... ... ... ... 22 Melgund Road ... 21 ... ... ... ... ... ... ... 21 Maygood Street ... ... 11 ... ... ... ... 11 ... 21 Mayville Grove ... 11 ... ... ... ... ... ... ... 11 Mountfort Terrace ... ... 11 ... ... ... ... ... ... 11 Mercers Road ... 44 ... ... ... ... ... ... ... 44 Myddleton Buildings, High Street ... 44 ... ... ... ... ... ... ... 44 Marquess Road ... 11 ... ... ... ... ... ... ... 11 Mentone Road ... 11 ... ... ... ... ... ... ... 11 Milner Square ... 11 ... ... 11 ... ... ... ... 22 Market Street ... 11 ... ... ... ... ... ... ... 11 Moon Street ... 11 ... ... ... ... ... ... ... 11 North Avenue ... 11 ... ... ... ... ... ... ... 11 Newington Green ... 22 ... ... ... ... ... ... ... 22 Nelson Terrace ... 11 11 ... 11 ... ... ... ... 33 New North Road ... 84 ... ... 23 ... ... ... ... 106 Newington Green Road ... 11 44 ... ... ... ... ... ... 54 Northdown Street ... ... 11 ... 11 ... ... 11 ... 33 Norfolk Road ... ... 21 ... 11 ... ... ... ... 31 Noel Street ... 85 ... ... • ... 11 ... ... 96 Northampton Street ... 3s 22 ... ... ... ... ... ... 55 Nicholay Road ... 108 11 ... ... ... ... ... ... 118 Norfolk Street ... 22 11 ... 11 ... ... ... ... 41 Newhall Street ... ... 11 ... ... ... ... ... ... 11 New Wharf Road ... ... 11 ... ... ... ... ... ... 11 Nailour Street ... ... 23 ... ... ... ... ... ... 22 Northwall Quarters, Roman Road ... ... 11 ... ... ... ... ... ... 11 Northampton Grove ... 21 ... ... ... ... ... ... ... 21 Nelson Place ... ... ... ... 11 ... ... ... ... 11 North Cottages Canonbury Road ... 11 ... ... ... ... ... ... ... 11 Offord Road ... 66 21 11 11 11 11 ... ... 1211 Oakley Road ... ... ... ... 11 ... ... ... ... 11 Orpingley Road ... ... ... ... ... ... • • • ... ... 55 Outram Street ... 21 ... ., ... ... ... ... 11 32 Oakley Crescent ... ... ... ... 11 ... ... ... ... 11 1913] 198 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Orchard Street ... ... ... ... 11 ... ... ... ... 11 Offord Street ... 11 ... ... ... ... ... ... ... 11 Oxford Road ... 22 42 ... ... ... ... ... ... 64 Ockenden Road ... ... 11 ... ... ... ... ... ... 11 Plimsoll Road ... 33 44 ... ... ... ••• ... ... 77 Petherton Road ... 22 22 22 ... ... ... ... ... 66 Pickering Street ... 42 5s ... 11 ... ... ... ... 107 Popham Road ... 11 22 ... ... ... ... ... ... 33 Peabody Buildings, Greenman Street ... 1310 33 ... 11 ... ... ... ... 1713 Packington Street ... 129 ... ... 22 11 ... ... ... 1512 Paddington Street ... 11 ... ... ... ... ... ... ... 11 Pulteney Street ... 11 ... ... 11 ... ... ... ... 21 Parkhurst Road ... 11 ... ... ... ... ... ... ... 11 Pemberton Terrace ... 11 ... ... ... ... ... ... ... 11 Pleasant Buildings York Road ... ... 11 ... ... ... ... ... ... 11 Playford Road ... 98 11 ... 11 ... ... ... ... 1110 Providence Row ... 21 ... ... ... ... ... ... ... 21 Poole's Park ... 11 ... ... 11 ... ... ... ... 22 Pembroke Street ... ... 22 ... 22 ... ... ... ... 41 Prospect Row ... 11 22 ... 11 ... ... ... ... 44 Prebend Street ... 33 11 ... ... ... ... ... ... 44 Poynings Road ... 22 11 ... ... ... ... ... ... 33 Penn Road ... ... 22 ... ... ... ... ... ... 22 Prospero Road ... ... ... ... 11 ... ... ... ... 11 Palmerston Buildings ... 22 11 ... ... ... ... ... ... 33 Payne Street ... ... ... ... 22 ... ... ... ... 22 Pleasant Place ... 11 ... ... ... ... ... ... ... 11 Park Street ... 31 ... 11 ... ... ... ... ... 42 Pulteney Terrace ... 11 ... ... ... ... ... ... ... 11 Pauntley Street ... ... 31 ... ... ... ... ... ... 31 Parolles Road ... 22 ... ... ... ... ... ... ... 22 Pyrland Road ... ... 11 ... ... ... ... ... ... 11 Pemberton Gardens ... 91 ... ... ... ... ... ... ... 91 Prab Road ... 11 ... ... ... ... ... ... ... 11 Poets Road ... 11 ... . . . ... ... ... ... ... 11 Queen's Mansions, North Road ... 11 ... ... ... ... ... ... ... 11 Queen's Head Street ... 44 11 ... 11 ... 11 ... ... 77 Quinn Buildings ... 11 139 11 22 ... ... ... ... 1712 Queen's Place ... 22 ... ... ... ... ... ... ... 22 Queen's Cottages, Popham Street ... 21 11 ... ... ... ... ... ... 32 Queensbury Street ... 11 11 ... 11 ... ... ... ... 33 Queensland Road ... 22 ... ... 11 ... ... ... ... 33 Queen's Square ... 2 ... ... ... ... ... ... ... 21 199 [1913 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spina) Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Queen Margaret's Grove ... 85 ... ... ... ... ... ... ... 85 Russell Road ... 21 11 ... ... ... ... ... ... 32 Riversdale Road ... 74 33 ... ... ... ... ... ... 107 Rotherfield Street ... 44 l1 ... 2 2 ... ... ... ... 77 Roman Road ... 22 54 ... ... ... ... ... ... 76 Rheidol Terrace ... 32 ... ... ... 11 ... ... ... 42 Roseleigh Avenue ... ... 31 ... ... ... ... ... ... 31 Rhodes Street ... ... ... ... ... 11 ... ... ... 11 Rupert Road ... 43 32 ... 11 ... ... ... ... 86 Ronald's Road ... 44 ... ... ... ... ... ... ... 41 Richmond Road ... 22 ... ... ... 11 ... 11 ... 44 Roden Street ... 22 11 ... 11 ... ... ... ... 41 Romilly Road ... ... 11 ... ... ... ... ... ... 11 Regina Road ... 62 11 ... 11 ... ... ... ... 81 Rothery Street ... 21 ... ... ... ... ... ... ... 21 Remington Street ... 32 ... ... 11 ... ... ... ... 43 Raynor Place ... 11 ... ... ... ... ... ... ... 11 Rocliffe Street ... 2l ... ... ... ... ... ... ... 21 Rufford Street ... 11 31 ... ... ... ... ... ... 42 Randalls Road ... ... 11 ... ... ... ... ... ... 11 Railway Street ... ... ... 11 ... ... ... ... ... 11 St. George's Avenue ... 22 21 ... ... ... ... ... ... 4 St. James Road ... 32 41 ... 11 ... ... ... ... 87 St. Clement's Street ... 32 ... ... ... ... ... ... ... 32 Shepperton Road ... 76 22 ... 11 ... ... ... ... 108 Spencer Street ... ... 22 ... ... ... ... ... ... 22 Sherborne Street ... 22 ... 11 ... ... ... ... ... 33 South Street ... 22 11 ... 11 11 ... ... ... 41 St. John's Park Mansions ... 11 ... ... ... ... ... ... ... 11 Sonning Street ... 22 ... ... ... ... ... ... ... 22 Stanmore Street ... 11 ... ... 11 ... ... ... ... 22 Shelburne Road ... 11 ... ... ... ... ... ... ... 11 Salisbury Road ... 21 11 ... 11 ... ... ... ... 43 Sam Lewis' Buildings, Liverpool Road ... 1310 44 ... 11 ... ... ... ... 1813 Stanley Road ... 22 ... ... ... 11 ... ... ... 32 Sotheby Road ... 22 22 ... 11 ... ... ... ... 55 Sussex Road ... 11 33 ... 22 ... ... ... ... 66 Spencer Road ... 11 ... ... 11 ... ... ... ... 22 Sutterton Street ... ... 22 ... ... ... ... ... ... 22 Scholefield Road ... 22 ... ... 11 ... ... ... ... 33 Seven Sisters' Road ... 65 55 ... ... ... ... ... ... 119 Shaftesbury Road ... 22 11 ... 11 ... ... ... ... 41 St. Paul's Road ... 33 ... ... ... ... ... ... ... 33 StaVordale Road ... 22 ••• ... ... ... ... ... ... 22 1913] 200 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria & Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. St. Thomas' Road ... 66 22 ... ... ... ... ... ... 88 Sparsholt Road ... 44 ... ... ... ... ... ... ... 44 St. John's Villas, Upper Holloway ... 75 ... ... 11 ... ... ... ... 86 St. Peter's Street ... 98 11 ... 11 ... ... ... ... 117 Stonefield Street ... ... ... ... 11 ... ... ... ... l1 Studd Street ... ... ... ... 11 ... ... ... ... 11 Southgate Road ... 11 32 ... ... ... ... ... ... 43 St. Paul's Street ... 68 11 ... ... ... ... ... ... 71 Station Road ... ... 11 ... ... ... ... ... ... 11 St. Jude Street ... 43 22 ... ... ... ... ... ... 65 Sheen Grove ... ... ... ... 11 ... ... ... ... 11 Stanley Terrace ... 11 ... ... ... ... ... ... ... 11 Stock Orchard Street ... ... 11 ... ... ... ... ... ... 11 Sunnyside Road ... ... ... ... ... ... ... ... 11 11 St. John's Park ... 11 ... ... ... ... ... ... ... 11 St. John's Road ... 22 ... ... ... ... ... ... ... 22 Sudeley Street ... ... ... ... 11 ... ... ... ... 11 St. Mary's Road ... 11 ... ... ... ... ... ... ... 11 Stroud Green Road ... 33 ... ... ... ... ... ... ... 33 Stock Orchard Crescent ... 11 ... ... ... ... ... ... ... 11 St. Paul's Place ... ... ... ... 11 ... ... ... ... 11 Thane Villas, Seven Sisters Road ... ... 11 ... ... ... ... ... ... 11 Thorpedale Road ... 33 11 ... 11 ... ... 11 11 76 Torrens Buildings, City Road ... 32 ... ... ... ... ... ... ... 32 Tremlett Grove ... 21 21 ... ... ... ... ... ... 42 Tabley Road ... 22 ... ... ... ... ... ... ... 33 Trinder Road ... l1 ... ... ... ... ... ... ... 11 Tibberton Square ... 42 ... ... ... ... ... ... ... 42 Tufnell Park Road ... 125 22 ... ... 11 ... ... ... 158 Theberton Street ... 31 11 ... 11 ... ... ... ... 53 Tavistock Terrace ... 11 ... ... ... ... ... ... ... 11 Tollington Park ... 87 11 ... 11 ... ... ... ... 109 Thornhill Grove ... ... 11 ... ... ... 11 ... ... 22 Tytherton Road ... 22 ... ... ... ... ... ... ... 22 Tiber Street ... 11 11 ... ... ... ... ... ... 22 Thornhill Road ... 33 ... ... ... ... ... ... ... 3s Thornhill Square ... 33 ... ... ... ... ... ... ... 44 Thornhill Crescent ... 11 ... ... 11 ... ... ... ... 22 Twyford Street ... 11 22 ... ... ... ... ... ... 32 Tollington Road ... 11 22 ... 11 ... ... ... ... 44 Tyndale Place ... ... ... ... 11 ... ... ... ... 11 Tenby Place ... 11 ... ... ... ... ... ... ... 11 Theberton Street ... ... ... 11 ... ... ... ... ... 11 Tyndale Terrace ... ... 11 ... ... ... ... ... ... 11 201 [1913 Table CI.—continued. NAME OF STREET. Small Pox. Scarlet Fever. Diphtheria Memb. Croup. Enteric Fever. Erysipelas. Puerperal Fever. Cerebro-Spinal Fever. Ophthalmia Neonatorum. Polio-Myelitis. Totals. Tiverton House, Pleasant Place ... 11 ... ... ... ... ... ... ... 11 Upper Street ... 65 11 ... 11 ... ... ... 11 96 Upper Hornsey Rise ... 11 ... ... ... ... ... ... ... 11 Upper Park Street ... 44 11 ... ... ... ... ... ... 55 Union Square ... ... ... ... ... 11 ... ... ... 11 Victoria Road ... ... 1 ... ... ... ... ... ... 11 Victoria Place ... 11 ... ... ... ... ... ... ... 11 Victor Road ... 22 11 ... ... ... ... ... ... 38 Vittoria Street ... 11 ... ... ... ... ... ... ... 11 Vorley Road ... 11 ... ... 22 11 ... ... ... 44 Vincent Terrace ... 32 ... ... ... ... ... ... ... 32 Whistler Street ... 11 22 ... ... ... ... ... ... 33 Witherington Road ... 11 11 11 11 11 ... ... ... 44 Wallace Buildings ... ... 22 ... ... ... ... ... ... 32 Ward Road ... 21 ... 11 ... ... ... ... ... 32 Westbourne Road ... 76 11 ... ... 11 ... ... ... 98 Warner Street ... 33 ... ... ... ... ... ... ... 33 Waterloo Street ... ... ... ... 11 ... ... ... ... 11 Wray Crescent ... 11 11 ... ... ... ... ... ... 41 Wellington Road ... 22 11 11 ... ... ... ... ... 44 Wells Terrace ... 22 ... ... ... ... ... ... ... 22 Winchester Street ... 11 11 ... ... ... ... ... ... 22 Wedmore Gardens ... 11 ... ... ... ... ... ... ... 11 Wyatt Road ... ... 11 ... ... ... ... ... ... 11 Widdenham Road ... ... 11 ... ... ... ... ... ... 11 Windsor Street ... 22 11 ... 44 ... ... ... ... 77 Wall Street ... ... ... ... 11 ... ... ... ... 11 Wilton Square ... 11 ... ... ... 11 ... ... ... 22 Wynford Road ... 22 ... ... 11 ... ... ... ... 33 Wessex Buildings ... 1612 11 ... ... ... ... ... 11 1813 Whitehall Park ... ... 22 11 ... ... ... ... ... 3 Woodville Road ... ... ... ... 11 ... ... ... 11 22 Wedmore Street ... 22 ... ... ... ... ... ... ... 22 William Street ... ... 11 ... ... ... ... ... ... 11 Windsor Road ... 21 ... ... 11 ... ... ... ... 32 Williamson Street ... 11 ... ... ... ... ... ... ... 11 Yerbury Road ... 68 33 ... ... ... ... ... ... 96 York Road ... 33 33 ... 11 ... ... 11 ... 88 Yonge Park ... 22 ... ... ... ... ... ... ... 22 Zoffany Street ... 11 ... ... ... ... ... ... ... 11 1913] 202 BACTERIOLOGICAL EXAMINATIONS. These examinations, gratuitously made for the medical profession, again increased in number, for which the Insurance Act was mainly responsible by bringing a larger numbed of suspected cases of pulmonary phthisis under observation. Diphtheritic specimens also showed an increase. These examinations have now been made for nearly 16 years, during which time 8,028 specimens have been submitted by the practitioners of Islington and reported on by the Lister Institute, whose bacteriologists continue to perform their work in a most admirable manner. In the case of 3,708 specimens the suspected disease was Diphtheria, in 1,050 Enteric Fever, and in 3,270 Phthisis. Diphtheria—581 swabs of mucus taken from the throats of patients suspected to be suffering from Diphtheria, were examined, as contrasted with 435 in 1912. 163 positive results were obtained; and the cases were afterwards duly notified by the practitioners. Enteric Fever.—52 specimens of blood were examined, 24 being positive and 28 negative. Phthisis—729 specimens of sputum were examined, which is an increase of 417 on the record of 1912. This increase was without doubt due to two causes, the first being the compulsory notification of the disease under the Public Health (Tuberculosis) Regulations, 1911, and the second to the advent of the National Insurance Act. Of the 729 specimens, 183 gave positive results, and 546 negative. The following Tables give the results of the examinations that have been made during the last 15½ years. Diseases. Total Examinations. Positive Results. Negative Results. Percentage of Positive Results. Diphtheria 3,708 1,231 2,477 33.2 Enteric Fever 1,050 467 583 44.5 Phthisis 3,278 996 2,274 30.5 Total 8,028 2,594 5,334 33.6 203 [1913 Table CII. Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Phthisis, 1898-1913. Periods. Diphtheria. Enteric Fever.. Phthisis. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Totals. 1898 (6 months) 11 20 31 31 17 48 .. .. .. 79 1899 47 50 97 25 51 76 36 43 79 252 1900 43 62 105 33 45 78 35 44 79 262 1901 80 90 170 66 46 112 28 43 71 353 1902 52 70 122 45 69 114 39 83 122 358 1903 14 64 78 15 54 69 40 96 136 283 1904 28 58 86 14 39 53 46 89 135 274 1905 61 86 147 34 22 56 87 131 218 421 1906 68 99 167 27 29 56 57 96 153 376 1907 88 135 223 25 34 59 68 121 189 471 1908 93 188 281 34 25 59 69 136 205 545 1909 64 236 300 20 35 55 60 162 222 577 1910 125 276 401 32 29' 61 63 157 220 682 1911 157 327 484 19 33 52 66 186 252 788 1912 137 298 435 23 27 50 119 341 460 945 1913 163 418 581 24 28 52 183 546 729 1362 Totals (for 15½ years) 1231 2477 3708 467 583 1050 996 2274 3270 8028 VACCINATION, OR THE STATE OF PREPAREDNESS OF THE BOROUGH TO MEET SMALL POX. At no time since 1880 has the percentage of vaccinated children been so low as in 1912, which is the latest year for which full returns are available, and they show that only 54.1 per cent. of the children born during the year (less infants who had died before vaccination was performed) were vaccinated. This is much to be regretted, because the present generation are laying up a store of sorrow for themselves and affliction—probably disfigurement, death, or even what is worse than both, blindness—for their innocent 1913] 204 children. No doubt when an epidemic comes, as come it will some day, the majority of these people, not all of whom are anti-vaccinators, will rush to be vaccinated, as they generally do at such times; although, even then, they frequently put off the operation until the disease has appeared in their homes, or even until the infection has already seized them. The Medical Officer of Health has had a woeful experience during his long professional career of such procrastination, and has known many persons, now dead, who had too long delayed protecting themselves and their children. This matter of vaccination is of vital importance to the nation, and, therefore, it is a sad reflection to think that the men who rule this country should have allowed such lattitude to the people, who have been, and are, sadly mislead by a number of faddists, whom no facts or figures can convince. The German Government are not so foolish! Years. Vaccinations per 100 births, less infants who died unvaccinated. Years. Vaccinations per 100 births, less infants who died unvaccinated. 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 89.8 90.8 91.1 90.4 90.5 90.6 90.8 90.4 88.4 89.0 89.3 87.4 85.5 85.0 84.0 70.9 73.9 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 73.3 64.9 66.4 67.9 75.8 80.0 81-2 82.3 80.5 79.9 76.9 72.4 70.7 66.7 62.3 54.1 In the year 1912, which is the year under consideration, it was found that of the 7,878 children born, 491 died unvaccinated. so that there remained 7,387 who were liable to the operation, and of these only 3,995, or 541 per cent. were vaccinated. Insusceptibility.—15 infants were reported as being insusceptible to vaccination. Died Unvaccinated.—491 infants died before vaccination could be performed. 205 [1913 Certificates of Exemption.—The excessive number of 1,646 certificates of exemption, relating to 22.3 per cent. of the births, were received by the Vaccination Officers. This is an increase of 405 on the return for the preceding year (1911), and of 566 on that for 1910, and 882 on that for 1909. The ensuing Table shows very clearly the large increase in these certificates since 1897, which is the year they were first received as an excuse for the failure of parents to have their infants vaccinated. 1897 1898 1899 1900 1901 1902 1903 1904 14 103 101 127 106 73 103 89 1905 1906 1907 1908 1909 1910 1911 1912 110 123 259 588 824 1,080 1,241 1,646 If these years be divided into quinquennial periods, the exemptions will be possibly more clearly appreciated:— 1897—1901 451 1902—1906 498 1907—1911 3,992 These figures indicate that there has been an increase in the number of these certificates of 785 per cent. between the quinquennial periods of 1897-1901 and 1907-11. The following Table shows how the exemption certificates were distributed throughout the borough and the percentages they bore to the births, less the children who died unvaccinated:— Registration Sub-District. Births, less Infants died unvaccinated. Exemptions. Percentage of Exemption Certificates to Births. Tufnell 710 196 27.6 Upper Holloway 929 169 18.2 Tollington 606 125 20.6 Highbury 1,131 338 29.9 Lower Holloway 940 197 20.9 Barnsbury 1,402 256 18.2 Islington, South-East 1,669 365 21.9 The Borough 7,387 1,646 22.3 1913] 206 Table CIII. Showing the State of Vaccination in Islington, 1880-1913, also in London and in England and Wales, 1880-1910. 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 ii 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 8,360 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 9,683 7,874 41 991 157 617 8.0 7.0 5.5 1886 9,844 7,944 39 1,091 148 622 7.8 7.8 6.1 1887 9,732 7,709 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 19.8 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 1,055 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 8,5:54 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 25.8 20.4 1908 8,317 5,595 31 595 588 89 1,419 25.2 28.8 27.9 1909 8,044 5,332 35 507 824 59 1 ,287 26.9 30.7 32.3 1910 7,989 4,961 21 548 1,080 29 1 350 30.8 36.8 39.7 1911 7,723 4,427 36 619 1,241 32 1,368 34.2 39.9 42.9 1912 7,878 3,995 15 491 1,640 69 1 662 42.9 Not available. Not available. 1913 (6 m'ths) 4,017 1,864 9 299 914 51 880 45.9 *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. 207 [1913 Table CIV. Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the year 1912. REGISTRATION SUB-DISTRICTS. Number of Births registered in 1912. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Statutory Declarations of Conscientious Objection. 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 I9I3. 1 2 3 4 5 6 7 8 9 10 11 Tufnell 748 386 4 ... 196 38 3 36 71 14 1,976 Upper Holloway 1,002 612 2 ... 169 73 1 19 100 26 Tollington 049 374 — ... 125 43 3 3 71 30 Highbury 1,197 594 4 ... 338 66 6 30 118 41 Lower Holloway 1,008 510 — ... 197 68 9 3 139 82 2,020 Barnsbury 1,493 716 1 ... 256 91 15 6 268 140 Islington, South East 1,781 803 4 ... 365 112 32 7 309 149 The Borough 7,878 8,995 15 ... 1,646 491 69 104 1,076 482 3,996 208 1913] Table CV. Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the period, January to June, 1913. REGISTRATION SUB-DISTRICT. Number of Births registered from 1st January to 30th June, 1913. Successfully Vaccinated. Insusceptible of Vaccination. Had Small Pox. Number of Statutory Declarations of Conscientious Objection. 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 Statutory Declarations of Conscientious Objections received during the year 1913 1 2 3 4 5 6 7 8 9 10 11 Tufnell 376 191 1 ... 92 31 3 20 30 8 204 Upper Holloway 454 258 ... ... 99 35 2 5 35 20 203 Tollington 352 183 1 ... 77 19 2 ... 38 32 150 Highbury 633 285 1 ... 178 34 1 14 54 66 354 Lower Holloway 538 255 2 ... 97 43 6 1 67 67 1,060 Barnsbury 755 341 ... ... 130 63 16 5 142 58 Islington, South East 909 351 4 ... 241 74 21 7 121 90 The Borough 4,017 1,864 9 ... 914 299 51 52 487 341 1,971 209 [1913 DISINFECTION. This work grows in importance year by year, for not only are rooms, in which the notifiable infectious diseases have occurred, as well as the infected bedding disinfected, but recently it has become necessary to disinfect the rooms in which patients suffering from pulmonary tuberculosis have lived; while in addition the largely increased number of rooms in a verminous state w hich have come under notice have had to be dealt with. Disinfection of Rooms.—2,84-5 rooms were disinfected, as contrasted with 2,377 in 1912. For this purpose formaldehyde, either in a gaseous form or in solution, is usually employed, although it is sometimes augmented by sulphur dioxide, when it is necessary to kill vermin, for which purpose it has been found most effective. The Cleansing and Spraying of Rooms.-As many as 1,439 rooms, as contrasted with 1,272 in 1912, were cleansed and sprayed. 1912 1913. 1st Quarter 363 355 2nd „ 306 302 3rd „ 267 241 4th „ 336 541 Disinfection of Schools and Institutions. —Class-rooms in 13 of the public elementary schools were disinfected as shown in the list given below; while the dormitories were disinfected in the Receiving Homes, Hornsey Rise. The following statement shows the Class-rooms, etc., disinfected: — 1st Quarter. St. James', George's Road L.C.C. Schools (Diphtheria). St. John's Schools, Pemberton Gardens (Measles). 2nd Quarter. Ecclesboume Road L.C.C. Schools (Whooping Cough). Upper Hornsey Road L.C.C. Schools (Diphtheria). 3rd Quarter. Queen's Head Street L.C.C. Schools (Scarlet Fever). Barnsbury Park L.C.C. Schools (Scarlet Fever). 4th Quarter. Grafton Road L.C.C. Schools (Scarlet Fever). Hanover Street L.C.C. Schools (Scarlet Fever). Duncombe Road L.C.C. Schools (Scarlet Fever). Queen's Head Street L.C.C. Schools (Scarlet Fever). Montem Street L.C.C. Schools (Scarlet Fever). Highbury High Schools (Scarlet Fever). St . Jude's Schools (Scarlet Fever). P 1913] 210 Dormitories were also disinfected in the— Receiving Homes, Hornsey Rise (Measles and Scarlet Fever.) Table CVI. Showing the Disinfection of Rooms by Formaldehyde Gas after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1913. Sanitary Inspectors' Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1913. 1912 1st Q'rter 58 56 32 44 45 47 28 32 45 48 40 40 55 59 629 472 2nd do. 52 68 34 87 19 35 44 11 37 34 28 28 41 27 545 578 3rd do. 71 81 11 39 30 40 18 27 34 39 102 23 44 89 651 575 4th do. 105 135 62 63 31 57 45 63 43 58 120 53 67 118 1020 752 Year 268 340 142 233 125 179 135 133 159 179 290 144 207 293 2845 2377 Table CVI I. Showing the Cleansing and Spraying of Rooms after Infectious Disease, in the Sanitary Inspectors' Districts, during the year 1913. Sanitary Inspectors Districts. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Total 1913. 1912 1st Q'rter 9 12 80 18 58 17 16 25 13 17 13 9 48 2C 355 363 2nd do. 18 24 65 38 40 6 22 11 20 14 14 7 15 8 302 306 3rd do. 11 16 21 26 36 7 9 9 9 10 11 16 21 39 241 267 4th do. 72 40 39 34 28 18 29 50 24 48 54 23 41 11 541 336 Year 110 92 205 116 162 48 67 95 66 89 92 55 125 108 1439 1272 Work at the Disinfecting Station.—The work at the disinfecting station was unusually heavy owing to the disinfection of the clothing of verminous school children, as part of their general cleansing, which was undertaken for the first time. 211 [1913 Altogether 72,368 large articles, not including the verminous children's clothing, were disinfected, as compared with 69,509 in 1912, and 88,999 in 1911. They included, however, 20,786 second-hand garments, consisting mainly of soldiers' overcoats, jackets and tunics, about to be exported, which were for the most part only disinfected to enable the consignors to obtain certificates that the clothing was free from infection, which are required by several foreign and British Dominion Governments before the goods are allowed to be landed in their countries. The actual number of garments, etc., removed from the houses wherein infectious diseases had occurred or verminous persons resided was 51,582, as compared with 37,217 in 1912; with 37,600 in 1911; with 27,168 in 1910; with 37,273 in 1909, and with 36,106 in 1908. These figures do not include the clothing of the children who were cleansed and bathed at the station for the Education Authority. TABLE CVIII. Summary of the chief articles of Clothing, Bedding, &c., disinfected during the year 1913, and also in the preceding year 1912. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1913 1912. Beds 530 534 782 1,184 3,030 2,207 Blankets 1,186 1,095 1,368 2,001 5,650 5,160 Bolsters 466 563 761 1,120 2,910 2,385 Carpets 123 91 189 306 709 327 Chair Bed Cushions 169 115 234 342 860 601 Mattresses 760 605 870 1,322 3,557 2,193 Palliasses 317 193 287 524 1,321 825 Pillows 1,031 1,163 1,593 2,073 5,860 5,461 guilts 616 581 7i5 1,178 3,090 2,411 Sheets 761 953 1,221 1,793 4,728 4,026 Other Articles 3,997 2,744 5,251 7,875 19,867 11,621 Totals 9,956 8,637 13,271 19,718 51,582 37,217 P 2 1913] 212 The nature of the articles disinfected for the clothing contractors is shown below:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Soldiers' Overcoats 2,409 2,640 3,392 3,048 11,489 „ Jackets 850 783 306 431 2,370 „ Tunics 1,584 518 2,324 752 5,178 „ Haversacks ... ... 6 0 ... 600 Trousers 2 29 ... 2 33 Vests 24 24 ... ... 48 Frock Coats ... 433 348 ... 781 Dresses ... ... 78 78 Other Articles 8 52 ... 149 209 4,877 4,479 6,970 4,460 20,786 The following is a record of the work performed by the Steam Disinfectors during the past nineteen 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 „ 1909 68,860 ,, 1910 83,786 „ 1911 88,999 „ 1912 69,509 „ 1913 72,368 „ Total for nineteen years 792,076 „ 213 [1913 Disinfectants distributed and used The following statement given the quantity of disinfectants distributed by the Sanitary Authority, or 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 9 740 — — Disinfection of Premises.. — — 1 2 0 50 Cost = £81 19s. 8d. Persons using Shelter House pending the disinjection of their homes. Date of Admittance. Address. Number in Family Cause. 1913. April 12 63, St. James' Road 1 Diphtheria November 13 45, Playford Road 6 Scarlet Fever Verminous persons cleanscd at the Shelter House under the "Cleansing of Persons Act, 1897." Date of Admittance. Address. Number of Persons. Cause. 1913 3rd Jan. 29, Hornsey Road 1 Verminous. 17th Feb. 22, Cloudesley Road 1 Do. 13th March 87, Essex Road 1 Do. 9th April 33, Marcellus Road 1 Do. 28th „ 37, Campbell Road 1 Do. 5th May Halton House, Halton Road 1 Do. 22nd „ 1, Eden Grove 1 Do. 10th June 85, Caledonian Road 1 Do. 3rd J uly 10, Campbell Road 1 Do. 6th Aug. 29, Halton Road 1 Do. 6th Sept. 8a, Hornsey Street 2 Do. 1st Oct. 301, Holloway Road 2 Do. 18th Dec. 11, Stanhope Gardens 1 Do 1913] 214 Midwives attending Shelter House for the purpose of disinfection after attendance on cases of Puerperal Fever. Date of Attendance. Name. Address. 1913 3rd March Mrs. W. 21, Grantbridge Street. 26th „ Miss H. 96, Bingfield Street. 8th May Nurse L. 33, Ringcroft Street 27th „ Nurse H. 95, Fairbridge Road. 27th June Nurse H. 96, Bingfield Street. 28th „ Mrs. 0. 30, Denmark Grove. 5th July Miss L. 31, Crossley Street. 10th „ Mrs. B. 47, Queensbury Street. 6th Aug. Miss B. 40, Leverton Street. 16th „ Mrs. A. 35, Charteris Road. 14th Nov. Nurse V. 8, Tabley Road. 26th „ Nurse B. 64, Mayton Street. Cleansing of Verminous School Children.—This work was carried out during the year under an agreement with the London County Council, whereby the Council undertook the duty of cleansing such children as were from time to time sent to the Shelter House from the London County Council Schools. To enable the Council to execute the work efficiently it became necessary to erect a special plant, consisting of a boiler and disinfecting apparatus, the contract for which was given to Messrs. Goddard, Massey & Warner, of Nottingham, who had erected the two large disinfecting machines, which have been in constant use since 1895, and are still quite sound. The Council were, therefore, in a position to perform the work thoroughly, and the Medical Officer of Health understands it has given entire satisfaction to the Education Authority. The new disinfecting apparatus has enabled the Engineer to disinfect the children's clothing at a steam pressure of 20 lbs., equal to a temperature of 260 degrees Fahrenheit, and to dry them during the time the heads and bodies of the children themselves are undergoing a thorough cleansing at the hands of the nurse whom the Council appointed for the work. The arrangement between the London County Council and the Borough Council came into force in the early part of the year, by which the latter body received 2s. for each set of baths given during a calendar month. 215 ' [1913 The total amount thus received was £121 2s. 0d., being the sum payable for the 1,211 sets of baths given. These baths were as under:— 393 children received 1 bath each set. 139 do. do. 2 baths do. 498 do. do. 3 do. 107 do. do. 4 do. 68 do. do. 5 do. 6 do. do. 6 do. *1,211 do. do. 2,969 baths. * (Note.—43 of these sets were commenced in 1913 and completed in the current year.) A few baths were given to children residing in other Boroughs, but attending schools in Islington, as under:— St. Pancras 75 Stoke Newington 45 Hackney 7 Shored itch 4 131 Separate baths. The average daily attendance of children at the baths throughout the year was 14, ranging from 2 to -30 per day. In many instances children were found in such a verminous condition as to necessitate their being given at least two, sometimes five and even six sets of baths, which ranged from two to as many as 20 separate baths; the actual figures beii.g 204 children who were given 522 sets of baths. Deducting these 522 sets of baths from the total number of sets given (1,211) it is seen that 689 children were given one set of baths only and if to these are added the 204 children mentioned above we get the actual total of 893 children dealt with. At the outset of this work it was estimated, on information supplied by the London County Council, that there were 3,600 school children who were to be found in a more or less verminous condition during the year, but only 50 per cent, of this number, viz., 1,800, was taken as a basis. 1913] 216 Below is given a Table comparing the estimated with the actual figures. Comparison of the Receipts and Expenditure from January 27th to December, 1913 (11 months), with the Estimate! Receipts and Expenditure. Estimated for 12 months. Estimated for 11 months (based on Column 1.) Actual figures for 11 months. 1 2 3 Number of Children 1,800 1,650 893 £ s. d. £ s. d. £ s. d. Wages and Material 100 0 0 91 13 4 87 6 4 Amount received from L.C.C. 180 0 0 165 0 0 121 2 0 At the request of the Medical Officer of Health of the London County Council the homes of 892 children were visited and carefully examined for verminous condition, and in 84 cases notices were served on the parents of the children, and in 58 cases on owners of the houses, with respect to verminous clothes and rooms; in 39 cases bedding and clothing removed for disinfection, and in three cases for destruction. Copies of these 892 reports were duly forwarded to the London County Council Educatio n Department. In 38 cases the London County Council instituted legal proceedings under Section 122 of the Children Act, 1908, and the prosecutions resulted in fines varying from Is. to 10s., as follows : — Amount of fine 1/- 2/6 3/- 4/- 5/- 6/- 7/6 8/- 10/- Number of cases 1 2 1 3 17 3 3 3 5 In the majority of the prosecutions costs were also granted. PART IV SANITATION. ADMINISTRATION OF THE FACTORY ANI) WORKSHOP ACT, igoi. INSPECTION OF WORKSHOPS, WORKPLACES, LAUNDRIES AND BAKEHOUSES. HOUSES LET IN LODGINGS. DISTRICT INSPECTIONS. STATE OF PAUPERISM. COMMON LODGING HOUSES. DUST REMOVAL. 1913] 218 FACTORY AND WORKSHOP ADMINISTRATION. In compliance with the requirements of the Factory and Workshops Act, it is the duty of the Medical Officer of Health to submit an annual report on the manner in which its provisions are carried out in his district, and accordingly he herewith submits his report. Inspectors.—Three inspectors, one man and two women, are employed on this work. The man and one woman are engaged in inspecting factories and workshops where men and women are employed; and the second woman inspector visits the homes of outworkers and also inspects the kitchens of restaurants and places where food is cooked. Inspections and Yisits.—The total number of inspections, and visits to the several places under the charge of the above-mentioned inspectors was 11,230, as contrasted with 10,655 made during the preceding year. The particulars of these are as follows:— Factories, including Factory Laundries 615 Workshops, including Workshop Laundries 2,561 Workplaces other than Outworkers' Homes 209 Bakehouses 460 Kitchens and Restaurants 320 Outworkers' Homes 1,068 Miscellaneous re-inspections and calls 5,997 11,230 Notices served.—These inspections resulted in the detection of 990 sanitary defects, and entailed the service of 176 intimations and 7 statutory notices, of which 25 were served on the owners of factories, 100 on the owners of workshops, and 18 on the owners of workplaces other than outworkers' premises. In addition to these, 35 notices were served for the abatement of 92 nuisances on outworkers' premises. 219 [1913 Registers—There were 5,040 workshops on the register at the close of the year. These included 510 workshops where men were employed, 806 workplaces where women were employed, 96 laundries, 237 bakehouses, 687 kitchens of restaurants and eating houses, or places where food is prepared, and 2,704 outworkers' premises. The various workshops and workplaces are tabulated as below-.— Workshops and Workplaces. 1912. 1913. 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 496 710 55 41 510 730 Workshops where Women are employed 811 1,524 102 107 806 1,502 Laundries 100 — 4 96 1 Bakehouses 241 251 — 4 237 247 Restaurant Kitchens 730 1,013 3 50 687 931 Outworkers' Premises 2,802 2,802 721 611 2,704 2,704 Total 5,180 6,300 881 817 5,040 6,114 Sanitation.—Of the 990 sanitary defects discovered, 256 related to uncleanliness; 30 to want of ventilation; 17 to overcrowding; 34 to insufficient or entire want of drainage to the floors; and 142 to various other nuisances. In 28 cases there were no dustbins, or they were defective; in 39 the w.c. accommodation was insufficient; in 292 cases it was foul, in 120 it was unsuitable or defective; and in 12 instances separate accommodation was required for the sexes. In 20 a water supply was required. Of these sanitary defects, 948 had been remedied at the close of the year. In addition to the above nuisances, 92 were discovered in the homes of outworkers, from which also 75 cases of infectious disease have been reported. This year's work of the Workshops Inspectors brings the total number of major nuisances dealt with by them since 1898 up to 18,867, and as these were of a more or less serious character, it is self-evident that they are doing a very good work in the Borough. The following Table shows the nature of some of the work dealt with since 1896. 1913] 220  1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 I9IO 1911 1912 1913 Total Overcrowding 26 12 15 14 22 14 4 13 4 13 30 9 8 9 24 14 14 17 262 Ventilation 14 13 2 5 4 3 5 8 11 4 8 31 12 29 20 23 33 30 255 Dirty Premises 311 195 109 99 217 218 231 423 630 412 448 970 719 425 5°5 449 476 256 7,093 Drains 554 458 375 313 216 177 90 50 19 15 4 19 261 61 * * * * 2,612 W.C.'s 420 325 341 355 411 375 154 161 165 151 190 620 573 677 522 471 517 463 6,891 Water supplies 79 41 35 20 19 13 83 54 18 38 17 23 45 40 46 53 l6 20 660 Surface drains 79 I09 87 51 78 81 2 53 40 34 39 45 72 99 Il6 47 28 34 1,094 *Now included in District Inspector's summary. Cleanliness.—The reports of the Inspectors show that 256 premises were found in an uncleanly state, and that 273, which included some places remaining over from 1912, were remedied. In the five preceding years the numbers have been as follows 1907, 505; 190S, 425, 1909, 719; 1910, 970; 1911, 448; and 1912, 492. These figures are conclusive as to the greater cleanliness now to be found in the workshops and workplaces of the borough. Effluvium Nuisances —None were discovered. Ventilation.—Thirty cases of insufficient ventilation were discovered, of which 26 had been remedied before the end of the year. Overcrowding.—In 17 instances overcrowding was discovered, and was remedied in each case. This offence has never been serious in the Borough, as in 18 years only 79 cases have been discovered. Generally it only occurs when business is very brisk, when extra hands are temporarily taken on. The particulars for each year since 1896 may be seen in the tabular statement given above. Want of Drainage of Floors—34 cases, invariably in laundries, were discovered where the fioprs were not so drained as to prevent the water standing on them. Notices were duly served, which in 30 instances had been complied with before the year had closed. Sanitary Accommodation.—In only 12 workshops was separate accommodation for the sexes required, and with three exceptions it had been provided before the end of the year. 221 [1913 In 39 cases the number of w.c.'s was not sufficient, and before the year closed 30 had been provided. Uncleanliness of the closet pans was discovered in 262 cases, and these were duly cleansed, while 124 that were unsuitable or defective were removed. Bakehouses —There are now on the register 237, of which 187 are in actual use. This shows a great decrease since 1S97, when there were 268 on the register and all were worked. The legislation prohibiting the occupation of uncertified Bakehouses is the principal cause of the reduction, although it is also partly due to the erection of numerous factory bakehouses in London, which have to an extent ousted the small bakers. The Chief Inspector, Mr. J. R. Leggatt, visited those at present occupied, and has presented the following report on their state : — Town Hall, Upper Street, Islington, N. 21 st June, 1913 To the Medical 0/licer of Health, Islington. Dear Sir, I have pleasure in stating that as a result of my annual inspection of the bakehouses within the borough (187), I found them to be in a satisfactory condition. For the first time for many years I did not find any wearing apparel being aired or dried in the bakehouses. This to me is very gratifying, as I have had to frequently refer to this objectionable practice in previous reports. It would, there fore, appear that the occupiers of bakehouses have at last realized what a bakehouse is intended for. The bakehouses have been regularly visited by Mr. West, Workshops Inspector, during the year. I am, Yours faithfully, JAMES R. LEGGATT, Superintendent of the Public Health Department, and Chief Sanitary Inspector. 1913] 222 LIST OF BAKEHOUSES. Upper Holloway District. Bakehouses above ground. 104, Andover Road 58, Hazellville Road 88, Andover Road 12, Hercules Road 19, Archway Road (Factory) 582, Holloway Road 16, Brecknock Road 626, Holloway Road 62, Cottenham Road 679, Holloway Road 29, Cottenham Road 484, Hornsey Road 49, Campbell Road 346, Hornsey Road 130, Devonshire Road 420, Hornsey Road 103, Ekhorne Road (Factory) 29, Highgate Hill 57, Elthorne Road 81, Junction Road 75, Elthorne Road 127, Marlborough Road 166, Fairbridge Road no, Marlborough Road 103, Fairbridge Road 163, Seven Sisters Road 81, Fonthill Road 131, Stroud Green Road 114, Fonthill Road 51, Stroud Green Road 90, Grove Road 144, Tollington Park 60, Grove Road 5, Tollington Park (Factory) Certified underground Bakehouses. 54, Archway Road 239, Junction Road (Factory) 84, Ashbrook Road 167, Junction Road 33, Bedford Terrace 104, Junction Road 10, Campdale Road 59, Junction Road 3, Card well Terrace 7, Junction Road 144, Elthorne Road 47, Landseer Road 87, Hazellville Road 32, Milton Grove 676, Holloway Road 31, Salisbury Road 575, Holloway Road 1, Stapleton Hall Road 487, Hornsey Road 212, Tufnell Park Road 264, Hornsey Road 84, Yerbury Road 27, Hornsey Rise 223 [1913 Bakehouses not in use. 14, Cheverton Road (aboveground) 67, Durham Road (aboveground) 23, Girdlestone Road (underground) 599, Holloway Road (underground) 25, Lennox Road (aboveground) 57, Marlborough Road „ 125, Hanley Road „ 53, Poole's Park (aboveground) 26, Blenheim Road (underground) 634, Holloway Road „ Lower Holloway District. Bakehouses aboveground. V.V. Bakery, Brewery Road (Factory) 85, Holloway Road Kemp's Bakery, Brewery Road 69, Holloway Road (Factory) 463, Liverpool Road 421a, Caledonian Road 106, St. James' Road 25, Cornelia Street 16, Westbourne Road (Factory) 261, Holloway Road (Factory) 254, York Road 251, Holloway Road Certified underground Bakehouses. 415, Caledonian Road 78, Goodinge Road 480, Caledonian Road 107, Roman Road 37, Charlesworth Street 118, Roman Road 5, Crossley Terrace 32, St. James' Road (Factory) 1, Frederick Street 132, St. James' Road „ 70, George's Road 376, York Road Bakehouses not in use. 46 Roman Road (underground) | 92, Wellington Road (underground) 25, Wellington Road „ Highbury District. Bakehouses aboveground. 17, Annette Road (Factory* 56, Hornsey Road 53, Boleyn Road 100, Hornsey Road 10, Blackstock Road 154, Hornsey Road 112a, Drayton Park (Factory) 123, Newington Green Road 3, Highbury Park 190, Seven Sisters Road 232, Holloway Road 258, Seven Sisters Road 370, Holloway Road (Factory) 48, Seven Sisters Road 202, Blackstock Road 226, St. Paul's Road 1913] 224 Certified underground Bakehouses. 52, Balls Pond Road Hawthorne Street Salvation Army 156, Biackstock Road Bakery (Factory) 146, Biackstock Road (Factoiy) 132, Holloway Road 128, Biackstock Road 246, Hornsey Road 66, Biackstock Road 57, King Henry's Walk 64, Drayton Park 1, Mildmay Park 98, Gillespie Road 42, Newington Green Road 13, Highbury Place 77, Newington Green Road (Factory) Bakehouses not in use. 98, Balls Pond Road (underground) 225, Biackstock Road (abovegiounc 77, Boleyn Road (underground) 25, Low man Road (underground) 182, Drayton Park „ 2, Queen's Square ,, Barnsbury District. Bakehouses aboveground. 129, Barnsbury Road 199, Caledonian Road 2, Bemerton Street 40, Cloudesley Road 32, Bingfield Street (Factory) 213, Copenhagen Street 36, Caledonian Road 185, Copenhagen Street 170, Caledonian Road 112, Copenhagen Street 275. Caledonian Road 57, Copenhagen Street 59. Caledonian Road Certified underground Bakehouses. 21, Barnsbury Road 370, Caledonian Road 68, Barnsbury Road 27, Dennis Street 100, Bemerton Street 26, Half Moon Crescent 72, Bemerton Street 179, Hemingford Road 60, Bingfield Street 44, Northdown Street 44, Bingfield Street 12, Randall's Road 76, Caledonian Road 1 and 3, Richmond Roa< 96, Caledonian Road 52, Stanmore Street 159, Caledonian Road 6, Wharfdale Road 299, Caledonian Road 62, Winchester Street 225 [1913 Bakehouses not in use. 62, Barnsbury Street (underground) 29, Hemingford Road (underground) 19, Brooksby Street (aboveground) 279, Liverpool Road „ 334, Caledonian Road (underground) 123, Offord Road „ 21, Caledonian Road „ 29, Offord Road „ 205, Copenhagen Street ,, 86, Thornhill Road ,, 181, Copenhagen Street ,, 120, York Road „ South-East District. Bakehouses aboveground. 76, Baxter Road 361, New North Road 229, Balls Pond Road 313, New North Road 5, Charlton Place (Factory) 126, Packington Street 52, City Garden Row 20, Popham Road 38, Coleman Street 50, Popham Road 40, Cross Street 69, St. Peter Street 8, Danbury Street 84, St. Peter Street 226, Essex Road 137, Upper Street 172, Essex Road 51, Windsor Street Certified underground Bakehouses. 24, Alfred Street 192 New North Road 257, Balls Pond Road 263, New North Road 14, Charlton Crescent 121, Packington Street 1, Cross Street 32, Park Street 57 Essex Road 16, Rheidol Terrace 68, Essex Road 32, Shepperton Road 102, Essex Road 1, Shepperton Road 114, Essex Road Oxford House, Sherborne Street 350, Essex Road 51, Southgate Road 398, Essex Road 1, Theberton Street West 126, Liverpool Road 14, Upper Street 262, Liverpool Road 102, Upper Street O 1913] 226 Bakehouses not in use. 28, Baxter Road (underground) 44, High Street (underground) 29, Camden Street ,, 38, High Street ,, 30, Canonbury Street ,, 2, High Street ,, 24, Church Street ,, 9, Islington Green (aboveground) 289, City Road „ 32, Parkfield Street (underground) 202, Essex Road ,, 76, St. Paul's Street ,, 322, Essex Road (aboveground) 3, St. Paul's Street ,, 67, Essex Road (underground) 107, Upper Street (aboveground) 50, Arlington Street „ 55, Clephane Road (underground) 129, Upper Street (aboveground) Outworkers' Premises.—There were 2,704 outworkers' premises registered, or 98 less than in the preceding year, when there was an increase of 300 as compared with 1911. The lists received from the employers in Islington contained the names and addresses of 1,384 outworkers, in addition to which lists, received from the Medical Officers of Health of other boroughs situated within and without tht: County of London, contained similar information respecting 2,899 outworkers. From the lists forwarded by local tradesmen, which for the most part are obtained only after personal applications had been made for them, the names of 613 pe'sons living outside Islington were abstracted and forwarded to the Medical Officers of Health of other boroughs. The failure of numerous employers to forward lists of their outworkers lias caused very great inconvenience, and thrown much additional work on the inspector, on whom devolves the duty of inspecting these homes, keeping the records, and forwarding the names of the employees found on the local lists of sanitary authorities. The law on this subject is very explicit, and requires all persons who employ outworkers to send in their lists twice a year, in February and in August; but of recent years the failures to comply with it have largely increased. The refusal or failure to send these lists is a punishable offence, which the Medical Officer of Health has hitherto passed over, believing that a warning would be sufficient; but since such failures have become so numerous, and are repeated again and again by the same persons, he will be left no alternative in the future than to advise the sanitary authority to prosecute the offenders. 227 [1913 The inspection of the homes of outworkers is very important, and during the year was the means of discovering that these people were making wearing apparel in 36 unwholesome homes, artificial flowers in 15, and paper boxes or paper bags in 41. In 75 infected premises outworkers were engaged at work, in 40 of which they were making wearing apparel, in 15 cases artificial flowers, and in '20 cases paper boxes or paper bags. Thus it is plain that these employers' lists of outworkers are of real public utility. Restaurants and kitchens where food is prepared.—There are now on the register 687 of these places, containing 93.1 separate rooms, and of these 320 inspections were made. There is a great deal of work yet to be done in connection with them, for it is not a nice reflection to find that, out of 67 hotel and restaurant kitchens inspected, 21 were not in a satisfactory state, while 21 out of 103 coffee and dining rooms were in a similar condition. The examination of 48 refreshment rooms showed that 15 were unsatisfactory, and that of 37 fried fish shops inspected, 12 did not meet with the inspector's approval; while of 54 provision dealers, 20 were not as cleanly as they should have been. A detailed statement of the work of the Inspector (Mrs. Nyman), who visits these places, is given in her report. 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. 120 workshop- were reported during the year in accordance with this section. Q 2 1913] 228 Workshops notified to Home Office, 1913. Trade. Number of Workshops. Protected Persons Employed. Females. Male Young Persons. Total. Dress Making 25 94 .. 94 Mantle Making 12 49 .. 49 Millinery 12 65 .. 65 Tie Making 12 36 .. 36 Tailoring 7 14 1 15 Blouse Making 5 46 .. 46 Feather Dressing 4 27 .. 27 Cabinet Making 3 2 1 3 Children's Frock Making 3 10 .. 10 Corset Making 3 3 .. 3 Engineering 3 2 1 3 Furrier 3 4 .. 4 Artificial Florists 2 8 .. 8 Embroidery 2 22 .. 22 Laundry 2 16 .. 16 Skirt Making 2 6 .. 6 Trunk Making 2 2 2 4 Box Making 1 .. .. .. Button Making 1 .. .. Camera Making 1 .. 4 4 Card Painting 1 5 1 6 Condiment Making 1 3 .. d Cork Stopper 1 .. 8 8 Fancy Lace Goods Making 1 4 .. 4 Fancy Leather Goods Making 1 4 .. 4 Fancy Neckwear Making 1 5 .. 5 Gold Chain Making 1 1 .. i Hat Shape Making 1 15 .. 15 Jewel Case Making 1 3 .. 3 Kite Making 1 1 .. 1 Lamp Making 1 .. 2 2 Paper Sorting 1 2 .. 2 Pelisse Making 1 4 .. 4 Perfume Making 1 21 5 26 Piano Making 1 .. 1 1 Publishing 1 .. 2 2 Shoe Making 1 .. 1 1 Surgical Appliances Making 1 .. .. .. Surgical Dresssing Making 1 .. 2 2 Theatrical Costume Making 1 2 .. 2 Ticket Writing 1 .. 2 2 Toy Making 1 8 .. 8 1 1 .. 1 WigMaking 1 .. 1 1 Total 129 485 34 519 229 [1913 SECRETARY OF STATE'S RETURNS 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. Prosecutions. (1) (2) (3) (4) Factories (Including Factory Laundries) 615 25 Nil Workshops (Including Workshop Laundries) 2,561 100 „ Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 989 18 „ Miscellaneous Re-inspections 5,997 .. .. Total 10,162 143 Nil 2. —DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number cf Prosecutions Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:—* Want of cleanliness 256 273f Nil Nil Want of ventilation 30 26 „ „ Overcrowding 17 17 „ „ Want of drainage of floors 34 30 „ „ Other nuisances 170 161 „ „ Sanitary Accommodation insufficient 39 30 „ „ unsuitable or defective 412 385 „ „ not separate for sexes 12 3 „ „ water supply provided 20 17 „ „ Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) Nil Nil „ „ Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) „ „ „ „„ Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) „ „ „ „ Total 990 948 Nil Nil *Including those specified in sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. †Including some remaining over from 1912. 1913] 230 230 8.—HOME WORK. NATURE OF WORK. * Outworkers' Lists, Section 107 Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises. (Secs. 109, 110). Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served under Public Health (London) Act, 1891. 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. Lists, † Outworkers.f Lists. Outworkers. Contractors Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Annarel— »v caiiu^ /ljJUaici (1) making, &c. 128 12 1,032 80 2 150 24 .. .. 36 28 .. 40 .. .. (2) cleaning and washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets* .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Curtains and furniture hangings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and upholstery 4 .. 4 2 .. 2 .. .. .. .. .. .. .. .. .. Electro-plate .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brass and brass articles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fur pulling 6 4 30 4 .. 6 .. .. .. .. .. .. .. .. .. Cables and chains .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anchors and grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cart gear .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, latches and keys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, Sc. 2 .. 4 1 .. 1 .. .. .. .. .. .. .. .. .. Artificial Flowers 8 .. 60 4 .. .. .. .. .. 15 2 .. 15 .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Racquet and Tennis Balls .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. Paper, etc., Boxes, Paper Bags 8 4 50 2 1 20 .. .. .. 41 5 .. 20 .. .. Brush making .. .. .. 1 .. 2 .. .. .. .. .. .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed toys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chocolates and Sweetmeats .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cosaques, Christmas Crackers, Christmas Stockings, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Textile weaving .. .. .. .. .. .. .. .. .. .. .. .. .. .. Total 156 20 1,180 94 3 181 24 Nil Nil 92§ 35 Nil 75 Nil Nil *When an occupier gives out work of more than one of the classes specified in oolumn 1, and 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. ‡The figures required in colums 2, 3 and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. §Ninety-two instances of unwholesome premises because of unsatisfactory domestic conditions. 2-31 [1913 4— REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. (1) (2) Workshops where men are employed 510 Workshops where women are employed 806 Laundries 96 Bakehouses 237 Restaurant kitchens 687 Total Number of Workshops on Register 2,336 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 Is. 133, 1901) 155 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, 1901). Notified by H.M. Inspector 16 Reports (of action taken) sent to H.M. Inspector. 14 Other Nil. Underground Bakehouses (s. 101):— Certificates granted during the year Nil. In use at the end of the year 94 INSPECTOR'S WEST'S REPORT. Town Hall, Upper Street, Islington, N., 20th March, 1914. To the Medical Officer of Health. Sir, I have pleasure in submitting my report to you for the year ending the 3rd January, 1914, during which time the following inspections and visits have been made, viz.: — Inspection of Factories 380 ,, ,, Workshops 1,154 ,, ,, Workplaces 183 ,, ,, Bakehouses 460 ,, „ Outworkers'Premises 123 Miscellaneous Re-inspections and calls 1,709 Total 4,009 1913] 232 The following is a list of workshops on the register: — No. of Workshops. No. of Workshops Artificial flower making 6 Feather dressers 4 Automatic machine makers 3 Fire escape maker 1 Bakers 237 F ile cutter 1 Builders 9 Fish cleaner 1 Blacksmiths 7 Fish curers 2 Basket maker 1 French polishers 2 Blind makers 4 Fancy goods makers 2 Brush makers 8 Gun maker 1 Bamboo cane makers 2 Glove maker 1 Balloon maker 1 Glass engravers 2 Billiard table maker 1 Glass worker 1 Boot polish makers 2 Gold paint maker 1 Bust makers 3 Glass cutter 1 Bedding maker 1 Harness maker 8 Box makers 2 Hat shape makers 5 Brass finishers 1 Hair workers 2 Brass instrument makers 1 Iron plate worker 1 Confectioners 6 Imitation marble works 1 Cycle makers 16 Japanner 1 Cabinet makers 33 Jewel case makers 2 Coppersmith 1 Leather goods makers 8 Camera makers 2 Ladder makers, 2 Cardbox-box makers 5 Limelight works 1 Cap maker 1 Lamp makers 4 Clay pipe maker 1 Laundries 1 Cork cutter 1 Marquetaire maker 2 Cattle food maker 1 Marking ink maker 1 Coopers 2 Marble masons 3 Cloth shrinker 1 Metal workers 2 Carpenters 2 Mineral water sundries 1 Coach painter 1 Musical string makers 2 Carpet maker 1 Mica goods maker 1 Chemist sundries 1 Motor works 8 Condiment maker 1 Mantle makers 6 Dairy can maker 1 Machine ruler 1 Dentist 1 Organ works 1 Engineers 8 Pianoforte makers 41 Exhibition stall fitters 6 Plaster block make 1 Embroidery maker 1 Plumbers 4 Enamel ler 1 Perambulator makers 2 Engraver 1 Picture frame makers 10 F arriers 25 Photographers 5 Furriers 45 Paper sorters 2 Fancy brooch maker 1 Pea packer 1 233 [1913  No. of Workshops. No. of hops Pipe maker 1 Tinsmiths 4 Rag sorters 7 Ticket writers 8 Rubber merchants 2 Tea sifter 1 Scale makers 3 Toy makers 3 Shoemakers 111 Undertakers 3 Scientific instrument makers 4 Umbrella maker 1 Shop fitters 3 Umbrella and stick maker 1 Stick mounters 2 Upholsterers 9 Scene painter 1 Wood choppers 2 Sign writers 4 Watchmakers, etc. 13 Soap makers 1 Whalebone cutter 1 Sealing wax maker 1 Work-basket fitter 1 Saddle tree maker 1 Wire workers 3 Surgical appliance makers 3 Wood letter maker 1 Stationer 1 Wreath case makers 2 Sack maker 1 Wax-figure maker 1 Trunk makers 10 Wheelwrights 30 Tailors 62 - Tarpaulin and tent maker 1 Total 910 Sanitary Improvements.—During the year 85 notices have been served for the abatement of nuisances, 192 workshops have been cleansed and limewhited, 28 W.C.'s have been provided (12 for males and 16 for females) at various factories and workshops; 192 W.C.'s, which were in a foul condition, have been cleansed; 54 W.C.'s, which were defective, have been amended; 17 water supplies have been provided; also 141 other improvements were carried out under my supervision; 20 workroom cards were distributed., showing the cubic capacity and the number of employees allowed in each workroom. Five drains which were found to be stopped or in a defective condition, were transferred to the various district inspectors. Bakehouses.—During the year 460 inspections were made to the bakehouses, besides a number of other calls to same, to see if they were kept clean, and free from any clothes being dried or aired in them, but I am pleased to state, they were kept in a very satisfactory condition, and the occupiers generally do their utmost to meet our requirements, and give as little trouble as possible. At the end of the year there were 93 bakehouses in use above ground,94 below ground, and 50 not in use, making a total of 237, a decrease of 4 from the previous year. I have notified through you to H.M. Inspector of Factories the names and addresses of 49 factories and workshops in the Borough, where young persons under the age of 18 years, were employed, and where the abstract of the Factory Act was not affixed, also 4 new factories have been reported in accordance with the Home Office Memorandum of March, 1912. During the year 71 workshops have been added to the Register, whilst 57 have been removed, so that at the present time there are 910 workshops, containing 1,338 workrooms, and 69 outworkers' premises now on the register. I may here state that there is a net increase of 14 workshops, to that of the preceding year. I am, Sir, Your obedient servant, GEORGE WEST. Sanitary Inspector of Workshops, etc. 1913] 234 Miss DAVIES' REPORT. Town Hall, Upper Street,, N. April 241h, 1914. To the Medical Officer of Health. Sir, I beg to submit to you the following report of my work during the year 1913. The following inspections and visits have been made during that period:— Inspections of Factories 235 Inspections of Workshops 1,407 Inspections of Workplaces 10 Miscellaneous re-inspections and visits 2,190 Total 3,842 Factories.—There were on the register at the end of the year 210 factories employing women, 24 having been added during that period, and 8 removed. The following is a list of the factories (including steam laundries) on the register:— Industry. Number Number of women employed. Laundry work 45 1,804 Printing 18 187 Box-making 14 483 Book-binding 10 220 Confectionery 10 488 Blouse making 7 270 Dressmaking 6 480 Dyeing and cleaning 5 59 Toy-making 3 296 Chemists sundries making 4 202 Electrical engineering 4 137 Meat preserving 4 104 Packing 4 14 Brush making 3 223 Furrier 3 46 Mantles 3 167 Millinery 3 498 Bottling 2 71 Cigarette making 2 41 French polishing 2 26 Mattress making 2 17 Mineral waters, making 2 33 Photo mount making 2 30 Apron making 1 36 Blind making 1 7 Boot upper making 1 13 Bottle washing 1 16 Button making 1 30 235 [191 Industry. Number. Number of women employed. Cabinet making 1 100 Camera making 1 4 Capsule making 1 280 Children's frock making 1 20 Collar and cuff making 1 6 Corset making 1 7 Cotton wool pressing 1 8 Electric lamp making 1 40 Embroidery 1 10 Engineering 1 50 Fancy leather goods making 1 25 Food preparing 1 34 Glass letter making 1 1 Glass work 1 0 Juvenile outfitting 1 40 Leather work 1 56 Lock and safe making 1 9 Mangling 1 1 Manufacturing stationery 1 30 Music roll making 1 8 Outdoor game requisites making 1 32 Overmantle making 1 3 Patent seal making 1 36 Pattern card making 1 60 Perambulator hood making 1 17 Perforating 1 2 Piano making 1 6 Piano string making 1 3 Pickling 1 10 Picture frame making 1 10 Pill making 1 3 Sack making 1 10 Sauce making 1 70 Seed packing 1 6 Shop fitting 1 2 Stay making 1 23 Surgical appliances making 1 4 Syphon making 1 230 Table stationery making 1 30 Tooth brush making 1 8 Underclothing making 1 313 Underskirt making 1 40 Vinegar making 1 30 Washing powder making 1 6 White lead works 1 6 Total 210 7,686 1913] 2-36 The following is a list of the trades carried on in the various workshops :— Nature of Business. Number of Workshops. Number of Workrooms. Number of Women employed Dressmaking 225 300 1168 Laundry 96 224 377 Millinery 76 152 597 Fur work 59 93 165 Tailoring 54 65 144 Mantle making 45 B6 271 Tie making 42 50 160 Blouse making 28 62 208 Underclothing making 17 22 64 Artificial flower making 11 33 121 Embroidery 10 15 107 Rag picking 10 13 50 Packing 9 17 41 Fancy leather goods making 8 13 39 Feather dressing 8 31 88 Children's frock making 7 15 38 Corset making 7 12 37 Shirt making 7 8 36 Box making 6 13 53 Fancy goods making 6 12 21 Wig making 6 8 12 Photogpaphic work 5 13 10 Trouser making 5 6 14 Artists' brush making 4 9 37 Boot upper making 4 5 17 Dressmakers' stand making 4 8 31 Glass work 4 4 24 Paper sorting 4 6 19 Trunk making 4 10 19 Apron making 3 3 16 Card painting 3 3 8 Confectionery 3 4 4 Fancy lace goods making 3 3 Hat-shape making 3 5 12 Jewel box making 3 3 5 Mantle alterations 3 3 3 Opera cloak making 3 5 17 Perambulator hood making 3 9 15 Sequin Work 3 4 23 Skirt making 3 3 4 Umbrella covering 3 3 3 Wood chopping 3 3 4 Baby linen making 2 3 15 Boot polish making 2 3 4 Bottle washing 2 3 9 Cambric bow making 2 3 17 237 [1913 Nature of Business. Number of Workshops. Number of Workrooms Number of Women employed. Dressing-gown making 2 3 13 Exhibition stall fitting 2 2 2 Fancy shade making 2 2 8 Frilling making 2 2 3 Hassock making 2 2 3 Ink making 2 3 4 Surgical instrument making 2 3 2 Tea gown making 2 5 11 Toy making 2 7 8 Waistcoat making 2 2 4 Waterproof making 2 3 61 Wreath case making 2 4 5 Back support making 1 1 3 Balloon making 1 2 4 Blind making 1 1 0 Box lining 1 7 13 Brace making 1 2 3 Button making 1 1 1 Cabinet making 1 2 2 Camera bellows making 1 2 0 Cap making 1 1 3 Carpet planning 1 1 8 Chemists sundries making 1 1 3 Collar and cuff making 1 1 1 Comb mounting 1 4 8 Cork Cutting 1 2 2 Dolls' hair making 1 7 12 Dough weighing 1 1 1 Engineering 1 1 1 Fancy glass work 1 1 2 Fancy neckwear 1 2 5 Framing 1 1 1 French polishing 1 1 3 Fruit preserving 1 1 35 Funeral fnrnishing 1 1 3 Fur lining 1 1 2 Gold beater's skin making 1 4 5 Gold chain making 1 1 2 Grease proofing 1 2 1 Housemaids' cap and apron making 1 1 9 Housemaids' dress making 1 3 23 Imitation fur work 1 1 0 Imitation marble making 1 5 9 Japanning 1 1 1 Jewellers' case making 1 1 2 Kite making 1 1 1 Lace curtain making 1 2 12 1913] 238 Nature of Business. Number of Workshops. Number of Workrooms. Number of Women employed Leather work 1 1 1 Limelight making 1 1 1 Manufacturing stationers 1 1 0 Mica goods making 1 2 3 Music string preparing 1 2 28 Ornament making 1 1 7 Pelisse making 1 1 3 Perfume making 1 1 2 Piano key cover making 1 1 0 Pickling 1 1 7 Picture frame making 1 1 3 Pincushion making 1 1 7 Purse making 1 4 20 Sign writing 1 8 1 Sausage skin making 1 4 35 Sun-bonnet making 1 1 1 Surgical appliance making 1 1 4 Surgical furniture making 1 1 1 Surplice making 1 2 9 Syphon sundries making 1 2 3 Tarpaulin making 1 1 1 Theatrical outfitting 1 1 2 Underskirt making 1 1 2 Wax figure making 1 1 2 Total 902 1502 4585 There has been a net increase of 16 in the number of factories on the register,, and a net increase of 602 in the number of women employed in them. The workshops show a net decrease of 9, and there were 184 women less employed in them. Thus the number of premises under my observation has increased by 7, and the number of women by 418, the additional labour being employed in factories. An almost unaccountable slump in certain trades, particularly the fur and mantle trades, during the fourth quarter of the year, is probably the primary cause of the decrease in workshops. The insufficiency of women workers in the district is becoming acute. For instance, one firm formerly employing 150 women, has recently adapted its factory to a warehouse, and is now compelled to have the goods made in a provincial town, as it was found impossible to obtain the necessary amount of lalbour here, although they offered more advantageous terms than many employers. There are factories in the borough where work is waiting for practically any number of efficient machinists, and many employers have told me that they have had to refuse work as they cannot obtain sufficient assistance. The demand for women workers has resulted in a slight rise in the wages paid to the beginners. This, unfortunately, leads in some ways to bad results, as if the employer has to pay an apprentice a relatively high wage, he cannot afford to teach her the trade throughout, but will keep her to one section of it., wfiere she can soon be of value to hitn. and she has no opportunity of becoming efficiently trained in all sections of her work, and so fails to fit 239 [1913 herself for any responsible post. The wages paid to skilled workwomen are,, on the whole, still far too low, the Minimum Wage Act has improved the conditions of those working at the scheduled trades, but much remains to be done. The personal cleanliness of many of the employees is not as satisfactory as it might be, and in those trades where it is most necessary it is often most lacking. Some employers dismiss any girl found to be in a verminous condition, but this, unfortunately, is not compulsory, nor as the law stands at present does it remedy the evil, as the woman easily finds work where the employer is not so careful. It might be possible to make it compulsory upon the employer to notify any such case, so that the sufferer could receive attention at a cleansing station, and her home be dealt with by the Sanitary Authority. Mess Rooms are gradually being provided, but the increase in lavatory accommodation is extremely slow. Nuisances.—The following table shows the number of defects found and remedied during the year: — Nature of nuisance. Found. Remedied. Want of cleanliness 60 61 Want of ventilation 13 13 Overcrowding 17 17 Want of drainage of floors — 1 Dustbins wanting or defective 10 10 Sanitary accommodation insufficient 2 2 Sanitary accommodation foul 74 70 Sanitary accommodation unsuitable cr defective 65 66 Sanitary accommodation not separate for the sexes 1 — Other nuisances 38 38 Total 280 278 Notices.—In respect to the above nuisances, 55 Intimation Notices were served, 8 in connection with factories, and 47 in connection with workrooms. In no case was it necessary to serve a Statutory Notice, the work in each instance being done within a reasonable time of the receipt of the Intimation Notice. Workshop Cards.—The number of Workroom Cards distributed was 213. These cards specify the cubic space of each room, and the number of persons who may be employed in it during i r inary working hours and during overtime (if allowed). Workshops notified to the Home Office.—In accordance with the requirements of the Public Health (London) Act (Sec. 27) the addresses of 106 workshops employing women were notified to the Home Office. These were premises whose occupiers had failed to send in any notice of occupation to H.M. Inspector, or in which the abstract of the Factory and Workshop Acts was not affixed. Notices of 8 new factories were also forwarded to the Home Office. H.M. Inspector notified 5 matters which were remediable under the Public Health Acts, but not under the Factory and Workshops Act. These nuisances were abated, and the necessary reports sent to H.M. Inspector. I remain. Sir, Your obedient servant, M. GWYNETH DAVIESS Sanitary Inspector of Workshops, etc. 1913] 240 Mrs. NYMAN'S REPORT. Town Hall, Upper Street, N. 18tk May, 1914 To the Medical Officer of Healtk. Dear Sir,— I herewith submit to you a report of the work done by me during the year, 1913:— Inspections made: Hotels and Restaurant Kitchens 320 Outworkers' premises 945 Domestic Workshops 16 Re-inspections and calls 2,098 3,376 Notices Served: Intimation notices 38 Intimation courtesy notices 5 Statutory notices — 43 Registers: Workshops. Workrooms. Hotels and Restaurant Kitchens Beginning of the year 734 1017 Added during the year 3 6 Closed 50 92 Total number now registered 687 931 Outworkers': Registered at beginning of year 2,514 Added during year 721 Less removals 600 2,635 Nuisances found and Remedied in Outworkers' Premises: Found. Remedied. Want of cleanliness 62 53 „ ventilation — — „ or defective bins 12 12 Other nuisances S 2 Sanitary accommodation Insufficient — — Unsuitable or defective 13 12 Not separate for sexes — — 92 79 241 [1913 The conditions found were as follows:— Hotel and Restaurant Kitchens: Saris- Unsatisfactory. factory. Hotels and Restaurants 67 21 Coffee and Dining Rooms 103 21 Refreshment Rooms 48 15 Fried Fish Shops 37 12 Pork Butchers Provision Shops 54 20 309 89 Found. Remedied. Unsatisfactory storage conditions 14 14 Dirty utensils 6 5 Nuisances Found: Found. Remedied. Want of cleanliness28 20 ,, ventilation 3 2 „ or defective bins 5 5 Other nuisances 15 15 Insufficient Sanitary accommodation Unsuitable or defective 3 3 Not separate for sexes 1 1 55 46 Outworkers.— The number of names and addresses received during the period under report is as follows :— From employers in the Borough of Islington 1,384 From employers in other districts (per the Medical Officer of Health) 2,899 4,283 Insanitary Premises (Outworkers): Intimation notices for statutory defects 35 Unsatisfactory domestic conditions 91 126 Infectious Diseases (Outworkers) : Notifications 75 Disinfection of workrooms and work 71 Letters, etc. : To employers re failure to supply lists 24 Notifications of outworkers to other districts 613 637 I am, Sir, Your obedient Servant, EMILY G. M. NYMAN, Sanitary Inspector of Workshops, etc. R 1913] 242 INSPECTION OF HOUSES LET IN LODGINGS. There are houses in every town which frequently change their tenants. They are mostly inhabited by the working classes, are usually occupied by two or more families, and are let at smaller rents than similar accommodation would command in better class houses and districts. The leases of many of these houses in Islington are approaching their expiration, when they will revert to the ground landlords; and consequently such houses are neglected by their owners, and frequently are badly used by the tenants, who sometimes are not very particular as to the damage they do to their homes. Therefore they require constant supervision, which work is undertaken by two specially appointed inspectors, and during the year devolved on Inspectors Hancock and WatsonThe latter, however, only acted until July 17th, when he was relieved at his own request by Inspector Marks, who had been appointed to fill a vacancy on the inspectorial staff. During the year, 1,848 houses were inspected, to which 10,312 visits were subsequently made, so that the total visits to them numbered 12,160. These inspections entailed the service of 1,325 notices, and 195 statutory notices to obtain the abatement of the 6,283 sanitary defects or nuisances which were discovered and which are set out below. Synopsis of Inspectors' Work.—In abating the nuisances the following work became necessary:— Drains constructed 2 „ reconstructed 18 „ repaired 74 „ traps supplied to 104 W.C.'s, extra provided 11 „ pan and trap only provided 35 „ water supply provided 138 Dustbins provided 160 „ repaired 17 Yards paved or re-paved 78 Water supply—cisterns (new) provided 7 „ cisterns, repaired and cleansed 40 Water supply provided 149 Rooms cleansed and limewashed 2463 Walls and passages repaired, cleansed or limewashed 1568 Floor space ventilated 21 Floors repaired 95 Overcrowding abated 98 Verminous rooms disinfected, etc. 48 Roofs repaired 159 Other improvements or nuisances abated 998 243 [1913 HOUSES LET IN LODGINGS. Table CIX. Summary of Sanitary Work carried out under Inspectors Hancock, Watson and Marks in Houses Let in Lodgings during the year 1913. Inspector Hancock. Inspector Watson. Inspector Marks.* Total. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. 1st Quarter 2nd Quarter. 3rd Quarter. 3rd Quarter. 4th Quarter. Year. Number of Houses inspected 210 264 206 227 907 209 383 92 91 166 941 1.848 Re-inspections, Calls made, etc. 1,464 1,441 1,190 1,474 5.569 1,057 1,431 492 489 1,274 4,743 10,312 Total inspections and calls 1,674 1,705 1.396 1,701 6,476 1,266 1,814 584 580 1,440 5,684 12,160 Notices Served. Intimation Personally 76 66 89 101 332 29 9 5 57 98 198 530 By Post 52 48 70 57 227 140 106 59 12 56 373 000 Statutory Personally 7 15 26 9 57 2 2 . . 1 4 9 66 By Post 16 11 33 11 71 31 12 1 . . 14 58 129 Improvements. Drains— Constructed 2 2 2 Re-constructed 2 1 . . 2 5 . . 2 4 1 6 13 18 Repaired 2 . . 1 4 7 8 35 7 4 5 59 66 Ventilated . . . . . . 1 1 3 1 3 . . . . 7 8 Gully and other Traps fixed is 8 2 16 41 7 9 23 . . 24 63 104 Urinals— Water supplied—cleansed . . . . . . . . . . . . . . . . . . . . . . . . Cesspools— Abolished . . . . . . . . . . . . . . . . . . . . . . . . Water Closets— W.C. erected with pan, trap and . . . . . . . . . . . . . . . . . . . . . . . . water supply . . . . 1 . . 1 3 . . . . 2 5 10 11 Pan and trap only provided 5 1 6 3 15 4 9 3 3 1 20 35 Water supply provided .. 6 12 19 12 49 31 36 5 8 9 89 138 Ventilated . . . . . . . . . . . . . . . . 8 2 10 10 Position altered . . . . . . . . . . . . . . . . . . 3 3 3 Dust Bins — Provided 18 9 23 23 73 29 10 13 2 33 87 160 Repaired 1 . . . . . . 1 1 . . . . . . 15 16 17 Areas— Constructed . . 2 . . . . 2 . . . . . . . . 2 2 4 YardsPaved 3 1 . . . . 4 4 . . 1 . . 2 7 11 Re-paved 6 . . . . 4 10 16 30 4 2 5 57 67 Sinks Provided 10 5 6 15 36 12 13 4 1 3 33 69 Domestic Water Supply— Cisterns provided . . . . . . . . . . . . 5 . . . . 2 7 7 Cisterns repaired and cleansed 3 8 6 4 21 io 6 2 1 19 40 Water supply provided to dwelling house . . 2 1 3 . . . . . . 1 1 2 5 Water supply provided for tenement house 22 18 20 19 79 30 17 14 1 3 05 144 Other Improvements— Rooms cleansed or limewashed 64 238 371 109 842 181 587 101 318 434 1,621 2 463 Walls and passages repaired, cleansed and whitewashed 18 145 140 26 329 116 657 96 214 156 1.239 1,508 Floor space ventilated 3 . . . . 1 4 2 8 7 . . . . 17 21 Floors repaired 7 28 13 11 59 18 6 5 7 36 95 Roofs repaired 11 11 14 11 47 35 32 7 12 26 112 159 Overcrowding abated 9 8 10 20 47 21 23 2 2 3 51 98 Illegal use of underground rooms for sleeping discontinued . . 1 . . . . 1 . . . . . . . . 1 1 2 Other Improvements or Nuisances abated 112 83 98 137 430 170 82 45 57 126 480 910 Rooms Disinfected 7 7 11 4 29 . . 3 12 4 . . 19 48 Total Improvements 324 648 742 422 2,136 685 1,583 359 646 874 4,147 6,283 Total Premises Improved.. 114 224 235 183 756 165 282 105 122 281 955 1,711 * Inspector Marks was appointed Inspector of Houses let in Lodgings on 17th July, 1913, when Inspector Watson took over District 10. R 2 1913] 244 DISTRICT INSPECTORS' WORK The work performed by these inspectors, of whom there are fourteen, is of a varied character, and is increasing year by year, as Public Health legislation increases. Their principal duties are set out in the following statement: 1. To make a house to house inspection of their district as requited by the Housing and Town Planning Act, 1909. 2. To inquire into complaints made to the Sanitary Authority. 3. To supervise the work required to be done for the abatement of the nuisances which they have discovered. 4. To inspect ice cream factories. 5. To inspect dairies and milkshops. 6. To inspect stables, yards, manure pits, passages, courts and vacant plots of land. 7. To inspect urinals attached to public-houses. 8. To inspect houses for which certificates are required under the Customs and Inland Revenue Acts. 9. To inspect premises for which water certificates are required. 10. To make observations of smoke nuisances. 11. To inspect the shops, stalls and markets where food is sold on Saturday evenings and Sunday mornings. 12. To inquire respecting infectious diseases notified under the Public Health (London) Act, 1891, and under Orders of the Local Government Board. 13. To make inquiries respecting the infectious diseases (measles, etc.) notified by the teachers of the Public Elementary Schools. 14. To make inquiries as to the cause of failures to notify births under the Notification of Births Act, 1907. 15. To inspect the homes of verminous children notified by the London County Council as required by that body. 16. To make inquiry respecting persons notified under the luberculosis Order, 1913. 17. To supervise the disinfection of rooms, schools, etc., after the occurrance of an infectious disease in them. 245 [1913 This is a long taie of work, which, to do thoroughly, would require a considerable increase in the staff ; nevertheless, as much of it is done as can possibly be expected. There are certain inquiries or visits which must be made day by day, that is to say, those relating to the cases of infectious diseases that are notified by the medical profession, as well as those which are notified by the teachers of the schools and by other persons ; as must also, in most instances, the homes of the verminous school children. Much of this work could, and ought, to be done by women, who are in every way more suitable for it, and some day will be done by them in conjunction with other work relating to young life, which is certain to devolve on the sanitary authorities of this country, and for the proper performance of which it is expected they will get relief from imperial funds. At all events, as things are in Islington, and it is no exceptional place, it is not possible to make house to house inspections to the extent the Housing and Town Planning Act authorises, and which the Local Government Board anticipate should be done. The Medical Officer of Health has no fault to find with the amount of work performed by District Inspectors, but he cannot close his eyes to the fact that they cannot do all the work devolving on them, especially that relating to house to house inspection as required by the Housing and Town Planning Act, 1910. Altogether 6'2,447 inspections, visits, and calls were made by the inspectors in connection with the various branches of their work and these related to 6,356 separate premises. The inspections included 83 to ice cream shops or places where it is made ; 1,043 to dairies and milkshops ; 370 to stables ; 1,114 to yards ; 84 to manure depots ; 185 to vacant land, passages. and courts ; 562 to public house urinals ; 37 to houses for which applications for Customs and Inland Revenue Act certificates were made ; and 45 to houses for which water certificates were required. The details of the work performed in each inspector's district is set out in Table CX. House to House Inspections.—These showed a decrease of 178 on the return for 1912. This was, however, through no fault of the staff, whose time, as already explained, was fully occupied in other directions, which demanded their daily attention. Altogether 732 inspections were made, as contrasted with 910 in the preceding year, and with 701 in 1912. It has 1913] 246 been pointed out in previous reports that work of this class has for many years been a feature of the Public Health Department, and, indeed, in this respect it has probably the best record in London. This is shown by the following statement, which is not now published for the first time. The following is the statement alluded to in the preceding paragraph: — House to House House to House Years. Inspections. Years. Inspections. 1899 387 1907 1,696 1900 883 1908 1,202 1901 821 1909 783 1902 807 1910 934 1903 1,999 1911 701 1904 1,903 1912 910 1905 1,725 1913 732 1906 '2,088 Total 17,571 These figures show that since 1899, 17,571 houses have been inspected systematically, that is from house to house; and they represent 47-7 per cent, of all the houses in the Borough, as ascertained at the census. This is a good record, but, good though it be, it does not meet the requirements of recent legislation. Synopsis of the Inspectors' Work. The following statement gives a brief synopsis of the district inspector's work in 1913 : — House to house inspections 732 Other inspections of dwelling houses 5,624 Re-inspections and calls made 52,277 Visits of inquiry re notifiable infectious diseases 2,171 „ school cases of ,, 5,333 Butchers' shops, stalls, etc. (Saturday nights) 199 Ice cream shops and factories 83 Dairies and Milkshop 1,043 Stables and yards 1,484 Manure depots 84 Certificates under the Customs and Inland Revenue Acts 37 Water certificates for newly erected houses or flats 45 Smoke observations 92 247 [1913 Notices Served.—There were 2,399 intimation notices served by the inspectors with respect to nuisances, of which, 1,277 were delivered personally and 1,122 by post. In 265 instances it became necessary, as the intimations had not been attended to, to report the nuisances to the Public Health Committee, who ordered statutory notices to be served, of which 53 were delivered personally and 212 by registered letter post. Nuisances Discovered.—The subjoined statement shows some of the principal nuisances discovered, and, as it speaks lor itself, both as to the character and utility of the work that has been carried out, requires no comment. It contrasts favourably with the records of previous years : — Houses. Dirty 1,078 Damp 412 Out of repair 464 Water Closets. Foul 323 Without water supply 95 With deficient water supply 251 Improperly constructed 247 Defective 216 Stopped 80 Improperly situated 24 Insufficient external ventilation 62 Insufficient in number 63 Soil Pipes. Defective 49 Unventilated 47 Improperly ventilated 27 Yards. Improperly paved 547 Dirty 73 Undrained 35 Drains. Foul 22 Defective 459 i Chocked or stopped 239 Unventilated 114 Overcrowding 109 Underground Rooms 44 Other Nuisances 4,177 Total Nuisances 9,257 1913] 248 Smoke Nuisances—Black smoke having been observed issuing from the chimneys of the undermentioned premises, notices were served on the owners of the businesses requiring its abatement. Pianoforte Works, Corporation Street. 21 Lyon Street. Mayfield Laundry, Gillespie Road. Several other chimneys were also observed to give forth black smoke, but a call on the owner, or a letter, was sufficient to cause the abatement of the nuisances. SYNOPSIS OF THE DISTRICT INSPECTORS' SANITARY WORK FROM 1891 to 1913 (23 years). Houses inspected and visited 1,255,312 Drains constructed 20,763 „ improved and repaired 20,627 „ traps fixed 105,083 Water closets, pan, trap, etc., supplied 21,748 „ pan and trap only, supplied 22,164 „ water only, supplied 9,755 Soil pipe, defective, renewed or remedied 4,268 „ insufficiently ventilated, fully ventilated 3,669 „ unventilated, ventilation supplied 6,048 Dust bins, provided 21,233 „ repaired 4,066 Surface drainage, constructed 12,066 „ relaid 26,116 Water supply, new cisterns provided 4,340 „ cisterns repaired and cleansed 13,067 „ new supply 8,779 Houses generally repaired 12,902 „ cleansed 24,836 „ ventilated 14,002 Other improvements 152,101 Total improvements 507,663 249 [1913 Table CX. Showing summary of Sanitary Work from Inspectors' reports for the Year 1913. DISTRICTS. Totals. 1 2 b 4 5 6 7 8 9 10 11 13 14 House to House Inspections 193 11 97 48 4 6 172 44 7 31 47 1 19 52 732 Other premises inspected 419 556 252 516 210 258 336 435 441 319 574 398 419 491 5624 Re-inspections, Calls made, etc. 3673 3785 3752 3941 2880 2467 4027 4313 3545 3262 3724 3419 4467 5022 52277 Ice Cream Factories inspected 6 2 18 .. 1 .. 22 8 1 15 7 . . . . 3 83 Dairies and Milkshops „ 105 43 94 114 102 31 98 41 129 70 65 41 51 59 1043 Stables ,, 38 11 15 23 124 34 19 6 29 11 5 . . 36 19 370 Yards ,, 26 65 302 86 71 151 95 4 57 36 21 22 116 62 1114 Manure Dep6ts ,, 82 . . . . . . . . 1 . . . . . . . . . . . . 1 . . 84 Vacant land, Passages and Courts inspected 44 4 18 4 . . 9 14 . . . . 34 1 2 41 14 185 Urinals attached to P.H.'s inspected 20 32 41 41 172 64 44 6 2 80 26 12 3 19 562 Premises (re Certificate Customs and Inland Revenue Acts) inspected . . 2 . . 4 4 11 . . 1 1 . . 13 .. . . 1 37 Premises (re Water Certificates) inspected . . 5 . . . . . . 19 1 . . 20 . . . . . . . . . . 45 Visits re Sale of Food and Drugs Acts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Smoke observations 1 23 1 1 2 8 2 6 6 6 23 5 2 92 Shops, Stalls and Markets (Saturday evening) 16 15 13 12 11 13 15 17 17 14 19 10 14 13 199 Total Inspections and calls 4623 4554 4603 4795 3580 3066 4851 4877 4255 3878 4508 39285172 5757 62447 Notices Served. Intimation—Personally 163 11 66 152 51 11 105 36 81 101 120 75 77 226 1277 By Post 9 12 4G 182 . . . . 257 231 19 7 17 36 79 228 1122 Statutory—Personally 2 . . 1 10 . . 2 . . . . 7 3 5 2 5 14 53 By Post 13 i5 2 35 9 11 19 9 10 13 24 14 49 212 Improvements. Drains— . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Constructed 5 1 3 2 . . 4 . . 2 3 . . 5 . . 1 27 Re-constructed 12 44 26 39 18 12 27 36 16 31 12 19 57 25 374 Repaired 21 14 21 25 8 4 27 12 34 28 16 14 33 37 294 Ventilated 6 33 6 34 16 7 15 19 9 27 6 9 40 21 248 Gully and other traps fixed 94 230 57 219 114 34 186 152 75 153 34 113 214 162 1837 Urinals—Water supplied, cleansed 2 1 8 5 3 3 4 1 8 3 8 1 12 59 Cesspools—Abolished . . 1 . . . . . . . . . . . . . . . . . . . . . . . . .1 Water Closets— W.C. erected with pan, trap and water supply 1 6 . . 7 5 1 . . 1 2 2 . . 2 1 1 36 Pan and trap only provided 29 64 15 64 30 15 55 48 28 67 28 57 67 60 627 Water supply provided 19 29 18 21 22 4 31 7 21 26 33 19 24 68 342 Ventilated 5 3 3 3 2 3 6 14 2 11 22 74 Position altered . . . . . . . . . . . . 1 . . 1 1 . . . . . . , , 3 Dust Bins—Provided 124 89 52 102 59 12 117 138 87 104 88 68 49 144 1233 Repaired 2 . . 6 1 3 . . 6 . . 2 . . 4 . . . . 4 28 Areas—constructed 1 . . 1 . . . . . . . . . . 1 6 . . 9 Yards—Paved 6 2 . . 14 . . 8 62 24 19 5 2 2 12 9 178 Re paved 63 73 22 99 30 7 100 27 61 80 44 93 67 95 861 Sinks—provided 8 12 8 42 5 2 15 8 16 23 17 20 25 27 228 Domestic Water Supply— Cisterns provided 1 . . . . 1 . . 2 2 1 . . . . . . . . . . . . 7 Cisterns repaired and cleansed 25 12 50 39 7 8 68 8 i7 23 31 i4 14 '48 364 Water Supply provided to ling house 8 9 5 9 5 1 6 41 11 24 3 5 7 6 140 Water supply provided to tenement house 12 10 2 18 3 2 6 2 29 28 14 13 4 32 175 Other Improvements— Rooms cleansed and limewashed 262 69 146 209 75 54 309 113 186 112 310 223 131 340 2569 Walls and passages repaired, cleansed and limewashed 90 21 41 83 7 6 27 36 36 67 82 54 43 165 758 Floor space ventilated 6 5 9 32 . . 10 55 21 3 23 12 21 19 25 241 Floors repaired 15 11 12 41 7 6 12 16 24 32 26 49 43 45 339 Roofs repaired 43 37 13 73 6 9 71 25 36 31 35 29 21 47 476 Overcrowding abated 4 1 . . 6 . . 1 9 . . 2 6 2 7 6 14 58 Illegal use of underground Rooms for sleeping discontinued . . . . . . 1 . . . . . . 3 3 2 2 . . . . 8 19 Other Improvements, or Nuisances abated 132 123 79 229 43 48 114 81 111 133 118 186 171 357 1924 Rooms Disinfected 276 207 308 236 214 37 89 103 92 165 144 42 256 214 2383 Total Improvements 1271 1107 923 1656 684 294 1426 928 924 1249 1066 1073 1322 1989 15912 Total Premises Improved 598 41G 396 603 277 95 463 363 349 426 523 309 421 628 5867 250 Table CXI. Giving a Summary of the Nuisances discovered by the District Sanitary Inspectors during the Four Quarters and for the Year 1913, 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 of the house in a dirty condition 279 326 245 228 1,078 2. ,, in a damp condition 171 90 72 79 412 3. „ in a dilapidated condition 131 125 115 93 464 4. The inlet of surface drain improperly trapped 7 12 14 12 45 5. The water-closet so foul as to be a nuisance 75 89 87 72 323 6. ,, ,, without a water supply 20 26 34 15 95 7. ,, ,, with a deficient supply of water 51 75 67 58 251 8. ,, ,, improperly constructed so as to be a nuisance 61 75 63 48 247 9. „ ,, so defective as to be a nuisance 49 58 52 57 216 10. „ ,, stopped 18 24 17 21 80 11. ,, ,, placed in an improper position 2 10 4 8 24 12. Insufficient external ventilation to water-closets 22 11 15 14 62 13. Insufficient water-closet accommodation 10 20 14 19 63 14. The soil pipe defective 12 10 7 20 49 15. „ unventilated 9 12 16 10 47 16. „ improperly ventilated 6 8 7 6 27 17. The yard in a condition injurious to health by reason of the want of proper paving 204 124 103 116 547 18. The yard dirty 29 15 15 14 78 19. ,, undrained 10 9 4 12 35 20. A gully trap improperly placed within the house 32 26 23 27 108 21. The waste pipe of sink directly connected with the drain 6 9 13 3 31 22. ,, ,, improperly trapped 1 3 6 4 14 23. ,, ,, untrapped 134 127 83 104 448 24. „ of lavatory directly connected with the drain .. 3 .. 1 4 25. ,, ,, improperly trapped 1 .. 1 1 3 26. ,, ,, untrapped 3 *9 9 8 29 27. „ of bath directly connected with the drain 1 2 3 2 8 28. ,, ,, improperly trapped .. .. .. .. , , 29. ,, ,, untrapped ,, 5 11 5 6 27 30. The water cistern so foul as to be a nuisance 71 65 56 60 252 31. ,, „ being without a close fitting cover 101 82 70 67 320 32. ,, ,, being placed in an improper position 22 12 15 24 73 33. ,, defective 14 6 3 5 28 192 TABLE CXI.—continued. NUISANCES. QUARTERS. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. 34. An accumulation or deposit of refuse injurious to health, by reason of the want of a proper dustbin or ashpit 41 38 65 83 227 35. The dustbin or ashpit defective 280 27 o 324 1,109 36. ,, „ placed in an improper position .. • • 1 1 •• 2 37. The drain foul 5 3 6 8 22 38. ,, defective 133 117 88 121 459 39 ,, choked or stopped 61 52 61 65 239 40. „ unventilated 26 43 26 19 114 41. The rain-water pipe in direct communication with the drain 12 21 17 13 63 42 ,, ,, in direct communication with the soil-pipe.. 3 11 2 5 43. „ ,, defective 55 42 40 178 44. The water supply used for domestic purposes connected with the cistern which is used for flushing the W.C. 69 1 1 .. 2 45. The house without a proper water supply 60 61 60 250 46. The roof defective 82 83 102 98 365 47. The guttering defective 52 38 39 64 193 48. The area improperly paved .. 17 6 11 7 41 49. „ dirty 8 6 4 5 23 50. „ undrained 1 7 1 1 10 51. The paving of the washhouse defective 21 21 18 11 71 52. The back addition walls defective .. .. .. .. 53. The want of a proper manure receptacle 1 2 .. 2 5 54. The bakehouse walls dirty .. .. .. .. .. 55. An animal kept in such a manner as to be a nuisance 16 11 i2 17 56 56. The house or part of a house so overcrowded as to be injurious or dangerous to the health of the inmates .. 21 32 30 26 109 57. An underground room occupied as a dwelling contrary to the provisions of the Act , 11 16 5 12 44 58. A tent, van, shed or similar structure used for human hr.bitation which is in such a state as to be injurious or dangerous to the health of the inmates .. .. .. .. .. 59. The space below floor in the basement or ground floor being unventilated 7 11 16 5 39 60. The space below floor in the basement or ground floor being improperly or insufficiently ventilated 50 32 35 31 148 All Nuisances 2,534 2,392 2,103 2,228 9,257 1913] 252 Table CXII. giving a Summary of the Sanitary Work performed by the District Inspectors in 1913. Inspections. QUARTERS. The Year. First. Second. Third. Fourth. House to House Inspections 286 236 140 70 732 Number of Houses Inspected 1,154 1,297 1,392 1,781 5,624 Re-inspections, Calls made, &c. 14,048 14,236 10,187 13,806 52,277 Total Visits 15,488 15,769 11,719 15,657 58,633 Visits to Ice Cream Factories . . 54 29 . . 83 Do. Dairies and Milkshops 253 287 258 245 1,043 Do. Stables and Yards 460 396 329 299 1,484 Do. Manure Depǒts 24 23 16 21 84 Do. Vacant Land Passages and Courts 54 41 29 61 185 Do. Urinals attached to P.H.'s 135 151 118 158 562 Do. Under Customs and Inland Revenue Acts 26 . . . . 11 37 Do. re Water Certificates 2 4 9 30 45 Do. Shops and Stalls on Saturday Nights 47 49 50 53 199 Do. Sale of Food and Drugs Act . . . . . 00. . . . . Smoke Observations 26 31 26 9 92 All Inspections, Visits, &c. 16,515 16,805 12,583 16,544 62,447 253 [1913 REMOVAL OF DUST. The removal of dust or household refuse and sweepings is a very important item in the work which is necessary to be done to assure healthy homes for the people, and, therefore, in modern days every sanitary authority looks upon it as of the utmost moment. Indeed, of late years very strong opinions have been expressed by sanitarians, with whom the Medical Officer of Health is in entire agreement, that it should not be allowed to accumulate in a house for more than three or four days, in other words that it should be removed twice in every week. Of course, in some houses where the refuse, especially that made in the kitchen, is day by day destroyed, such removal would be a work of supererogation ; but frequent and sometimes daily removals are necessary from some places, particularly from restaurants or places where food is prepared. The Horse and Dep6t Department has of late years made very considerable advances in this respect, and, on the whole, it must be said that it gets through the work in a satisfactory manner. Indeed, this is clearly indicated in the returns for the year wherein the Medical Officer of Health finds that the number of applications to have dust removed from premises numbered only 32, which is the lowest record hitherto known in Islington. How different this is to that which obtained 20 years ago when (in 1893) they numbered 4,986, and prior to that were as high as 10,138. This is truly a marvellous change. The particulars for each year since 1891 are as follows:— Applications to Remove Dust. Applications to Remove Dust. 1891 10.138 1903 152 1892 9,964 1904 Il6 1893 4,986 1905 89 1894 4.506 1906 58 1895 4.596 1907 55 1896 4.245 1908 64 1897 312 1909 67 1898 303 1910 44 1899 262 1911 52 1900 234 1912 47 1901 157 1913 32 1902 198 Dust Keceptacles Provided.—During the year 1,393 dust receptacles were provided, while 45 were repaired. 1913] 254 Table CXIII. Summary of Applications for the Removal of Dust during the Year 1913. Ward. 1st Quarter.) 2nd Quarter 3rd Quarter. 4th Quarter. Year. Number of Assessments Michaelmas, 1913. Number of Applications to every 100 Assessments. I 1 — 3 1 5 4.95i 0.101 2 — 1 2 — 3 4,833 0.062 3 — — 3 — 3 4,5*7 0.066 4 1 — 1 — 2 5,513 0.036 5 1 — — 2 3 5,74i 0.052 6 2 3 2 2 9 4,145 0.217 7 — 1 1 — 2 4,033 0.049 8 — — — i 1 2,735 o.037 9 — 1 1 — 2 2,987 0.067 10 — — 1 — 1 3,56I 0.028 11 — — 1 — 1 4,601 0.022 Totals 5 6 15 6 32 47,6i7 0.067 255 [1913 STATE OF PAUPERISM IN THE BOROUGH. The number of paupers relieved weekly in the Borough continues to decrease, for in 1913 they averaged 9,399 as contrasted with 10,131 in 1912; with 9,553 in 1911; and with 10,773 in 1910. They are still above the average (8,862) of the years 1899-1912, the particulars of which are as follows :— The following statement shows the average number of people in each week of the last 14 years: — 1899 6,854 Per week relieved. 1900 6,956 1901 7,327 1902 7,668 1903 8,004 1904 8,086 „ 1905 9,224 „ 1906 9,069 1907 9.599 1908 10,349 1909 10,476 1910 10,773 1911 9.553 1912 10,131 Average 8,862 „ 1913 9,399 1913] 256 Table CXIV. Showing the State of Pauperism in the Borough during the year 1903-1912 and 1913. Years. Average number Relieved during each week. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals Outdoor. Totals. All paupers relieved, cols. 2 & 5. Vagrants Relieved. Children Boarded out. Deathrates. Adults. Children under 16. 1 2 3 4 5 6 7 8 9 1903 3,879 2,739 1,386 4,125 8,004 17 127 1452 1904 3,622 3,069 1,395 4,464 8,086 65 122 15 74 1905 4,295 3,302 1,627 4,929 9,224 58 126 14.93 1906 4,189 3,335 1,545 4,880 9,069 12 134 15.26 1907 4,261 3,556 1,782 5,338 9,599 75 135 15.38 1908 4,558 3,752 2,039 5,791 10,349 13 125 13.93 1909 4,864 3,649 1,963 5,612 10,476 Wards closed 107 14.96 1910 5,017 3,721 2,035 5,755 10,773 ,, 106 13.79 1911 4,974 2,573 2,006 4,579 9,553 No Wards 102 14.87 1912 5,030 2,937 2,164 5,101 10,131 • > 99 14.34 Average 4,469 3,263 1,794 5,057 9,526 24 118 14.80 1913 4,780 2,768 1,851 4 619 9,399 No Wards 100 15 15 257 [1913 COMMON LODGING HOUSES. These houses are controlled by the London County Council under bylaws which give that body 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 46 in Islington, of which 36 are licensed for men, 8 for women, and 2 for married couples. Table CXVI. 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 27 M. Wm. Norman. 14, 16, Barnsbury Street 51 M. Ellen Maples. 18. 20 & 22, Barnsbury Street 91 M. ,, 35, Campbell Road 27 W. Wm. John Cragg 37 & 39, Campbell Road 6L M. ,, 10 & 12, Campbell Road 52 M. Hugh Hersey. 180, Caledonian Road 51 M. Mrs. Finetta Jefcoate. 13 & 14, Duncan Terrace 63 W. B. Jaffa. 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. 104 & 106, George's Road 30 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. ,, 29, Halton Road, and la, Allen Street 52 M. Mrs. Mary Jane Somerville. 29, Hornsey Road 88 M. Sidney Allen. 8a, Hornsey Street 48 M. Rev. Wilson Carlile. 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 67 M. Arthur Willie Horsley 235a, Upper Street 37 M. Hugh Hersey. 128, York Road 20 M. Hugh Hersey. 1913] 268 ARTISANS' AND OTHER DWELLINGS. These include houses and blocks of houses in which the artizan classes mostly reside, although some are occupied by clerks and persons employed in non-manual labour. During the year only one block was added to those already in the Borough in which there are now some 443 dwellings, containing 5,117 separate flats or tenementa Two years ago the Medical Officer of Health drew attention to the fact that some of the older buildings were not so fully occupied as in former days, partly because of their structure, partly because of their deterioration, and partly because their sanitary accommodation was not so good as that which the more modern erections contained ; and also because there is less light and less household conveniences, such as food cupboards, in them. No.of No. of WARD. Name of Dwellings. Where situated. Blocks 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, 20, 27, 28 and 29, Cathcart Hill Junction 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, 21 and 26, Pemberton Gardens Holloway Road 3 7 ,, 'Fulford Mansions.. Fairmead Road 2 14 „ *10, St. John's Park Holloway Road 1 3 ,, *47, Hargrave Pa'k 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, ton Poad Cheverton Road 3 9 „ Nos. 221 to 259, Hornsey Road Hornsey Road 38 114 ,, Nos. 269 to 283, Hornsey Road ,, ,, 8 10 ,, *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 „ Camden Dwellings York Road 1 44 ,, 60, George's Road Holloway Road 1 8 * These flat tenements are occupied by the better middle-class people. 259 [1913 ARTISANS AND OTHER DWELLING S—continued. WARD. Name of Dwellings Where situated. No. of Blocks. No. of separate Dwellings. Lower Hollo way 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 38 160 „ •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 „ 2-5, 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 Highbury 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 „ •3 Highbury Hill Highbury 1 5 „ *15, Highbury Crescent Highbury 1 4 „ *16, „ 1 4 „ *55. Highbury Park Highbury 1 10 „ *61, Highbury Park „ 1 5 „ •Nos. 1 to 3, Hamilton Road „ 1 3 „ 60, Holloway Road Holloway 1 3 „ *Newington Green Mansions Newington Green 1 43 „ *Manhattan Mansions Holloway Road 1 32 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 2 12 Stonefield Mansions Cloudesley Square 1 12 „ Oatlands House Upper Park Street 1 12 „ Ashley House „ 1 12 * These flat tenements are occupied by the belter middle class p#ople s 2 1913] 260 ARTISANS AND OTHER DWELLINGS—continued. ward. Name of Dwellings. Where situated. No. of Blocks. No. of separate Dwellings. Barnsbury Halliford House Upper Park Street 1 12 „ Thanet House „ „ 1 15 „ Thornhill Houses Thornhill Road 5 84 „ Arvon House Offord Road 1 10 „ Buckland House Barnsbury 1 10 „ 33a & 33b, Thornhill Road 1 2 „ Colne House Offord Road 1 8 „ Bures House „ „ Barnsbury 1 8 „ 371, Liverpool Road 1 4 „ 1 and 2, Heathcote House Barnsbury Square 1 2 St. Mary's Albert Mansions Liverpool Road 1 8 „ Liverpool Buildings Liverpool Road 26 276 „ Essex House Essex Road.. 1 13 „ Anson House „ „ 1 8 „ Thatched House Buildings „ „ Pleasant Place 1 8 „ Bampton House 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 Astey'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 Avenue Canonbury Road 17 148 „ Lewis'Trust Buildings Liverpool Road 6 323 Canonbury Ebenezer Buildings Rotherfield Street 5 36 „ *1 to 6, Wallace Gardens Wallace Road 3 6 „ *7 to 15 Wallace Gardens „ 5 9 „ •Canonbury Mansions Canonbury Place 1 5 St. Peter's Palmerston Buildings City Garden Row 3 72 „ Torren's Buildings Torren's Street 6 83 „ Myddelton 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, to 30, Norfolk Street „ „ „ 15 30 „ Nos. 141 to 147. Shepperton Road New North Road 4 12 443 5,117 * These flat tenements are occupied by the better middle-class people. 261 [1913 ADMINISTRATION OF THE HOUSING, TOWN PLANNING, Etc., ACT, 1909. In a general Order made under Section 17 (1) of this Act, the duties of the local authorities and their officers are duly set forth, and as these duties are very important, it is necessary that the Council should have the Regulation before them. They are to be found in the Report of the Medical Officer of Health for 1911, page 287. Particulars as to houses dealt with under the Housing and Town Planning Act 1909, Sec. 17. Property. Closing Order made. Closing Order determined. Demolition Order made. Demolition completed by Owner 1910 1910. 48 Queensland Rd. 18th November 19ih Jan. 1912 1st March, 1912 50 „ „ „ „ 52 „ „ „ „ 54 „ „ „ 10 Henshall Street „ 9th June 1911 12 „ „ „ 14 „ „ „ 16 „ „ „ 27 Orchard Street „ 9th June 1911 29 „ „ 1911. 1911. 1 Rice Place 2nd February 17th Nov. 1911 2 „ „ „ 3 „ „ „ 4 „ „ „ 5 „ „ „ 6 „ „ „ 7 „ „ „ 8 „ „ „ 1 Bratton Street „ 6th Oct. 1911 3 „ „ 17th Nov. 1911 5 „ „ 6th Oct. 1911 7 „ „ 17th Nov. 1911 9 „ „ „ 11 „ „ „ 13 „ „ 6th Oct. 1911 15 „ „ „ 8 Hope Place „ 17th Nov. 1911 1912 1912. 1, 2, 3, 4, 5, 6&7 Elliott's Place 19th January — 4th October, 1912 April, 1913 I. 2, 3 Providence Row 4th October — — February, 1913 242 PentonvilleRd. „ — — — 244a „ „ — — — 1913. 3, 4 & 5, Queen's Head Cottages 6th June — 3rd April, 1914 37, Colebrooke Row No order made — October 1913. Acquired by 38 „ „ — L.CC. for 40 „ „ — tion of School *41 „ „ (Premises put into habitable condition by owner. 25, Poole's Park.. 6th June 27 „ „ 29 „ „ 31 „, ‡ 31, Dorinda Street No order made ‡ 33 „ „ ‡ 35 „ „ 1, Sherborne Mews „ 6th June 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 1913] 264 INSPECTION OF FOOD. This duty is undertaken by Inspector Wilkinson, who has long held the certificate of an Inspector of Meat. His work during the year has, as usual, resulted in preventing the sale of much unsound or diseased meat which might otherwise have found its way to the public. For some years past the quantity of food dealt with by him, and which was subsequently destroyed, has ranged annually from two to four tons, but this by no means represents the amount of undesirable food stuffs that would have been foisted on the public if there had been no inspector. A signal example of this is the manner in which the slaughter of cows has been driven from the Borough, where in 1900 668 were killed for human food, and in 1910, 1911, 1912 and 1913 none. The trade in these used-up and emaciated animals, so far as Islington is concerned, has gone, and, let it be hoped, never to return. This is due chiefly to the rigid inspection that was made of the carcases by the Meat Inspectors, Mr. Wilkinson and, to a certain extent, his predecessor, Mr. Young. The consignees of these animals found that, owing to the close inspection the cows were subjected to, which resulted in so many of the carcases being wholly or in part condemned, it did not pay them to send such animals to Islington to be slaughtered. Unsound Food.—The total weight of the unsound food dealt with by the inspector was 3 tons 9 cwt. 2 qrs. 13 lbs., as contrasted with 2 tons 5 cwt. 2 qrs. 5 lbs. in 1912. The chief item was meat and butchers' offal, of which 1 ton 11 cwt. 2 qrs. 13 lbs. were destroyed. The other articles of food surrendered or seized consisted of fish, vegetables, fruit, eggs, condensed milk, meat and fish pasties, to which the inspector makes special allusion in his report. The seizure of ox tongues, infected with foot and mouth disease, is so unusual an occurrence that it is well the facts, as reported to the Public Health Committee, should be placed on permanent record here. To the Chairman and Members of the Public Health Committee. Mr. Chairman, Alderman and Councillors, Surrender of Ox Tongues. I have to report that on the 24th February last a further quantity of ox tongues were surrendered by a packing firm to Inspector Wilkinson, 265 [1913 with whom they had first communicdted. It appears that the mucous membranes were, like those of the other tongues reported to you at the meeting on the 24th February, blistered, and discoloured in parts. In the present instance Inspector Wilkinson, to whom credit is due, noticed that there was also a brown or chocolate discolouration on the flesh underneath the blisters? and he therefore brought a number of the tongues to me for examination. On seeing them I came to the conclusion, after a careful inspection, that the blisters were pathological and not the result of freezing. I, therefore, had them sent to Dr. Macfadden, the Medical Inspector for Foods at the Local Government Board, with a request that he might get them examined; and he thereupon forwarded them to the Royal Veterinary College, where the Veterinary Surgeons, having examined them, arrived at the conclusion that these blisters and pathological marks were caused by foot and mouth disease. They thereupon communicated with the Board of Agriculture. Some of you will recollect that some three or four years ago a consignment of tongues from America showed certain marks of blistering, and that at that time I communicated with the United States officials, including Dr. Wray, their expert on animal foods in London, who informed me that such blisters were frequently to be found on frozen tongues. As the experts at the Veterinary College were in agreement with this opinion, the tongues were, of course, passed as fit for human consumption. In the present case, however,—although to anyone casually observing them the blisters appeared similar to those on the American tongues,—there was the brown staining, already alluded to, on some of them, and as I have already stated, it was this discolouration, together with a cicitrization around some of the blisters which induced me to send them to the Local Government Board for further examination. The Board of Agriculture seem deeply interested in the matter, and are making the very fullest inquiries, the result of which will, no doubt, be communicated to me later. If their suspicion that this is foot and mouth disease should prove to be correct, your officials will have revealed a mode of entry of this disease into the country which has hitherto been unsuspected. 1913] 266 I trust that my efforts in this matter may be the means of throwing some light on the mysterious cases of this disease in England, which have recently occurred. I am, Your faithful servant, A. E. HARRIS, Medical Officer of Health. Town Hall, Islington, n. 10th March, 1913. The subsequent information received by the Medical Officer of Health showed that the Veterinary Surgeons of the Royal College and those of the Board of Agriculture were in agreement that the blisters and pathological marks on the tongue were really ulcers, the result of foot and mouth disease. This hitherto unsuspected source of the introduction of this terrible disease into England was a great surprise to Veterinarians, as it pointed to another possible way by which infection might be conveyed into this country, viz., by the packing cases in which the tongues arrived from abroad and which when empty become scattered throughout the country. In this particular instance the tongues had come from Siberia. It is no surprise, therefore, to find that the Board of Agriculture and Fisheries immediately issued the following order :— ORDER OF THE BOARD OF AGRICULTURE AND FISHERIES. Dated 15th April, 1913. IMPORTATION (RAW TONGUES) ORDER OF 1913. The Board of Agriculture and Fisheries, by virtue and in exercise of the powers vested in them under the Diseases of Animils Acts, 1894 to 1911, any of every other power enabling them in this behalf, do order, and it is hereby ordered as follows : DISINFECTION IN CONNECTION WITH IMPORTATION OF RAW TONGUES. 1. Any box or other receptacle and any packing material in which raw bovine tongues shall be brought to Great Britain from any country out of the United Kingdom which is not mentioned in the schedule to this Order shall, after the tongues have been removed therefrom, forthwith be destroyed by fire by the owner of the tongues at the time of removal, and shall not be permitted to come in contact with any animal. 267 [1913 SHORT TITLE. 2. This Order may be cited as the Importation (Raw Tongues) Order of 1913. In witness whereof the Board of Agriculture and Fisheries have hereunto set their Official Seal this fifteenth day of April, nineteen hundred and thirteen- (Signed) SYDNEY OLIVIER, L.S. Secretary. SCHEDULE. United States of America. Union of South Africa. Commonwealth of Australia. Channel Islands. Dominion of Canada. Isle of Man. The following were the foodstuffs which were seized or surrendered and destroyed: — Tons. cwts. qrs. lbs. Meat and offal in slaughterhouses 0 14 0 5 „ butchers' shops 0 17 2 8 Fish 0 13 1 0 Vegetables and fruits 1 3 2 4 Eggs 0 0 0 10 Condensed milk 0 0 1 0 Meat and Fish Paste 0 0 3 14 Tons 3 9 2 13 In the preceding year 2 tons 5 cwt. 2 qrs. 5 lbs. were seized or surrendered. The quantity dealt with in the 12 years during which Mr. Wilkinson has been an inspector was els follows : — Tons. cwts. qrs lbs. Tons. cwts. qrs. lbs. 1902 3 17 3 16 1909 2 4 3 18 1903 3 5 3 4 1910 4 1 1 25 1904 5 8 3 17 1911 4 13 3 7 1905 1 11 1 4 1912 2 5 2 5 1906 2 1 1 2 1913 3 9 2 13 1907 2 1 0 9 1902-13 40 9 0 2 1908 5 7 1 22 Average 3 14 1 12 1913] 268 The following list shows the articles destroyed in year:— each quarter of the 1st Quarter. Tons cuts. qrs. lbs. Diseased meat and organs from slaughterhouses — 5 0 8 Unsound fish surrendered — 2 3 0 Unsound fruit and vegetables surrendered 1 2 2 1 Diseased and unsound meat, &c., from shops . 0 10 3 4 Total 2 1 0 13 2nd Quarter. Diseased meat and organs from slaughterhouses — 2 0 11 Diseased meat and organs from shops — 6 2 22 Unsound fish from shops and stalls — 2 2 4 Unsound fruit from stalls — — 2 18 Total — 11 3 27 3rd Quarter. Diseased meat and organs from slaughterhouses — 2 3 14 Unsound fish from shops and stalls — 5 2 3 Unsound fruit from shops — — — 21 Total — 8 2 10 4th Quarter. Diseased meat and organs from slaughterhouses — 4 0 0 Diseased meat and organs from shops — — — 10 Unsound fish from shops — 2 1 21 Unsound fruit from shops and stalls — — — 20 Unsound eggs from baker's shop — — — 10 Unsound condensed milk — — 1 0 Unsound meat and fish paste — — 3 14 Total — 7 3 19 Total for the Year 3 9 2 13 Slaughterhouses —There are now only 27 slaughterhouses in the borough, which, on inspection, were found to have been well kept, although in one or two instances there has been some laxity in complying with the bylaws relating to limewashing. Slaughterhouses are becoming a diminishing 269 [1913 quantity, for whereas there were 62 in the borough in 1893, there were only 27 in 1913. Consequently and naturally, there has been a diminution in the number of animals killed. The reduction since 1900, the first complete year for which figures are available, has also been large, for whereas in that year there were 57,267 animals slaughtered, only 31,305 were killed in 1913. Sheep and Oxen. Cows. Calves. Lambs. Pigs. Total. 1900 3,019 668 356 52,760 464 57,267 1913 937 — 25 30,343 — 31,305 Decrease 2,082 668 331 22,417 464 25,962 These decreases are very substantial, and clearly indicate, since meat is eaten more than ever, that there must be a much larger trade now in what is known as "dead meat" than in former years. It must be recollected also that in past years there were some butchers who, having large slaughterhouses, killed for persons outside the borough ; indeed, one of these, whose premises are situate at Roman Road, who did a very large trade of this character, has now ceased to do so. Year. Oxen. Cows. Calves. Sheep Pigs. Total. Lambs. 1899* 2,436* 402* 436* 43,252* 903* 47,429* 1900 3,019 668 356 52,760 464 57,267 1901‡ .1,507‡ 440‡ 195‡ 23,324‡ 125‡ 25,595‡ 1902 2,996 498 195 41,024 72 44,785 1903 2,445 173 141 38,090 46 40,895 1904 2,360 4 154 32,973 25 35,516 1905 2,195 17 127 30,686 48 33,073 1906 2,172 — 143 30,668 11 32,994 1907 2,146 4 142 24,380 2 26,374 1908 1,941 — 86 28,476 4 30,507 1909 1,763 6 100 36,4811 — 38,350 1910 1,691 — 91 36,176 — 37,958 1911 1,448 — 73 38,009§ — 39,530 1912 1,085 — 40 29,310 — 30,435 1913 937 — 25 30,343 — 31,305 * These returns are for 9 months ‡ The returns are for 6 months. § Includes 8 goats. ‡ Includes 2 goats. 1913] 270 Last year the Medical Officer of Health mentioned the meat trade with special reference to the decreased importation of live animals and meat, and the possibility of the foreign supply being curtailed. Since then the meat problem has become more acute, for the world's consumption increases more rapidly than the supplies. Indeed, a great authority recently declared that it is unlikely that the development which may be expected in the world's stock farms will succeed in reducing prices to the comfortable level of 20 years ago. The great influence at work to increase the value and scarcity of meat in this country has been the new fiscal policy of the United States, which permits the free import of refrigerated meats, which is tantamount to saying that the Argentine supplies are being drawn to them. Once upon a time the United States fed Europe very largely; now they draw meat from so far afield as Australia; and, indeed, during last year consignments of packed meats have been sent to New York from our own borough. The fact is that owing to enormous immigration and to bad and wasteful farming, the United States have become a meat consuming country, and have ceased to be productive in their supply How great this has been is well pointed out in an article in "The Times," where it says that: "As recently as 1907 the imports of cattle and beef to Great Britain were estimated at 231,599 tons ; last year they had dropped to 3,316 tons. In estimating such figures some allowance is usually made for the artificial fluctuations introduced by the operations of trusts or combines; but although these interests can temporarily dam or divert a stream of natural tendency, they cannot permanently control it. The main fact is that in most of the chief countries of the world increasing prosperity and the spread of new modes of civilization are making mankind carnivorous. There is no sign that the luxury of increased flesh food will be forgone by a large proportion of those who have once acquired it, and the competition for the supply of meat will steadily tend to drive up its price." This competition for the meat supplies of the world may be a blessing in disguise for the greatest of our industries, agriculture, because the scarcity of foreign cattle must of necessity create a greater demand for British cattle, the breeders of which could then demand a higher price than was hitherto obtainable. There is, however, another aspect of this question which is of importance to sanitary authorities, viz.,the substitution of foreign for British beef; indeed, for a considerable time past the practice has been growing for butchers to substitute 271 [1913 (especially) Argentine meat for the home product, and several butchers have been prosecuted both here and in the provinces for the offence. If butchers desire to sell Argentine meat, by all means let them do so, for it is a good, wholesome, nutritious article, which no person need be afraid to eat, but let them sell it for what it is, and at its proper price. LICENSED SLAUGHTER-HOUSES. Registered No. Name of Licensee. Situation ol Premises. Condition of Licence. 119 Gayes, W. J. D. 4, Athelstane Mews 121 Clarke, Jno. 259, Balls Pond Road 122 Wood, Edward 53, Barnsbury Street To kill small cattle only arid for purposes of own shop. 124 Hack, Thomas 40, Bingfield Street Small cattle only. 125 Guyer, Aubrey 18, Brecknock Road Small cattle only. 129 Luxton, John Carter's Yard, 170, Essex Rd. 130 Allday, Fredk (Between) 185-7, Church Road 132 Toop, Frederick John (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. 136 Hammond, F. 6, George's Road 138 Chalk & Cox 32, High Street 139 Webber, John 81, Highgate Hill 140 Stone, Sidney 234, Holloway Road 141 Horsey, Arthur W. 498, Holloway Road 142 Watson, R. C. 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, Mary Ann 280, Seven Sisters Road 158 Richardson,J. 149, Upper Street Small cattle only. 159 Luxton, John (E. side of) Wycombe Mews 160 Lidstone (Ltd) 398, York Road Total 28 Slaughterhouses. 272 1913] Cowhouses.—There are now only 5 cowhouses on the register in Islington, whereas in 1892 there were 31. The few that exist received 53 visits from the inspector, and were found to be in a satisfactory state. It is noteworthy that one of the largest and best cowhouses in London, situated near Finsbury Park, passed from the register during the year. At one time this cowhouse used to accommodate 50 or 60 cows, which were noted for their quality, and, indeed, were a pleasant sight to anyone interested in cattle. Now that is all gone, and Islington has lost one of its glories. The passing of the London cowsheds is not a matter for entire rejoicing, for although in theory it is very heartening for consumers of milk to know that the animals have been fed on splendid grass land and kept in open fields, yet if they were to see the insanitary conditions in which these cows are fre quently housed and milked, and the dirty condition of their flanks and udders, they would not be quite so pleased. The Medical Officer of Health has no hesitation in stating that however indifferent the cowsheds of the borough may be, considered in the light of modern requirements, there are existing to this day hundreds in country places that are a disgrace to the sanitary authorities in whose districts they are situated. Until closer supervision over our cowsheds in rural areas is exercised, the Medical Officer of Health for one will not rejoice at the disappearance of cowsheds from London, where he believes there are still to be found as good byres as there are to be seen anywhere in the kingdom. The following statement gives the number of cowhouses licensed in the Borough in each year since 1892:— Years. Cowhouses Years. Cowhouses. 1892 31 1903 13 1893 31 1904 10 1894 25 1905 9 1895 19 1906 9 1896 19 1907 7 1897 19 1908 7 1898 15 1909 7 1899 14 1910 5 1900 13 1911 5 1901 13 1912 5 1902 13 1913 5 273 [1913 List of Licensed Cowhouses in the Borough of Islington. Regis tered No. Name of Licensee. Situation of Premises. No. of Cows licensed to hold. 108 Jones, Elizabeth 3, Frome Street 18 111 White. George 24, Hercules Place, Holloway 12 112 Wright, Henry 11, Matilda Street 15 114 Jones, Edward 88, Roman Road 16 115 Arnold, Gecrge 233, Seven Sisters Road 32 Total 5 Cowhoosbs. INSPECTOR WILKINSON'S REPORT. Public Health Department, Town Hall, Upper Street, N. May 8th. 1914. To the Medical Officer of Health. Dear Sir,— I have pleasure in submitting the following report bearing on the duties of the Inspector of Meat and other Foods for the year 1913. Slaughterhouse Inspection.—There were 28 slaughterhouses on the register at the commencement of the year, but as the licence of one situate at the rear of 234 Holloway Road, was allowed to lapse, the number at the end of the year was 27, to which 1,579 visits were paid. With a few exceptions they have been well conducted. Non-observance of the byelaw as to periodical limewashing where the premises were not in constant use being the chief exception. The number of animals slaughtered in them was as follows, viz.:— Oxen. Calves. Sheep and Lambs. Pigs. Total. 937 25 30,343 0 31,305 These figures compare with those for the year 1912, as follows:— Oxen. Calves. Sheep and Lambs. Pigs. Total. 1,085 40 29,310 0 30,435 T 274 1913] These animals genarally were of the highest quality and remarkably free from disease, only 4 cases of tuberculosis being detected in the 937 bovines slaughtered; in three of these the disease was of a strictly localised character as shown in the subsequent table. The remaining case, however, was more serious my attention being called to the liver and other internal organs of an exceeding good ox, of the value of over £27. I found that the whole of these organs were the seat of considerable tubercular disease, which was especially marked in the liver, and in the mesenteric, mediastinal and pharyngeal glands, as well as in the lungs. This was a most singular case, for although the disease was so well marked in the organs, not a single superficial lesion was visible on the very well nourished carcase. On further examination, guided by the condition of the above mentioned organs, considerable portions of the carcase were also found to be affected, and after the whole carcase had been cut up and the various deep-seated glands examined by Professor Woolridge of the Royal Veterinary College (who appeared on behalf of the owner of the carcase through the London Butcher's Trade Society) and myself, it was decided to submit the whole to your personal inspection, with the result that considerable portions of the carcase and the whole of the internal organs were ultimately surrendered for destruction. It is here worthy of note that in the year 190D (the first complete year in which the records have been kept by a specially appointed meat inspector), 132 animals were found more or less affected with tuberculosis, as compared with 4 for the year 1913. Mention should be made of a strangely diseased ewe sheep to which your inspector's attention was called. The carcase and organs of the abdominal region were extensively diseased in a most peculiar form, the leisions in some respects being very similar to those of tuberculosis, although on a more careful examination of the substance and formation of the nodules certain well marked differences showed them to have no connection with that disease. Owing to the fact that your inspector had never before met with any similar case during more than 30 years' experience in the slaughterhouse, and after consulting you it was decided to submit the carcase and organs—which had been surrendered for destruction—for special examination at the laboratory of the Royal Veterinary College, after obtaining suitable photographs of its diseased condition. It is, however, disappointing to know that after a prolonged investigation the College were unable to make any definite statement as to the nature of the disease although it would appear that the research had been mainly devoted to an endeavour to find the tubercle bacillus, with a negative result. Other abnormal cases will be found in table "A" which follows:— 275 [1913 TABLE A. No. of Cases Description of Animal Affected. Nature of Disease or Affection. Extent of Disease. How disposed of. 3 Sheep Found dead or in a moribund condition Carcase and al1 organs Council's Destructor 1 do. Parasitic disease ? (See special mention in report) do. do. do. 1 do. Pleurisy and abscess Necks, breasts and pluck do. do. 1 Ox Tuberculosis (See special paragraph) Parts of carcase and all organs do. do. 2 Oxen Tuberculosis Head and tongue (throat glands) do. do. 1 Ox do. Lungs (localised) do. do. 1 do. Actinomycosis Head do. do. 1 do. do. Head and Tongue do. do. 36 Bovines (Oxen or Heifers) Parasitic (Dis. Hep.) Liver (whole or Part) do. do. (chiefly.) 22 Sheep do. do. do. do. 1 Ox Hydatid disease do. do. do. 28 Sheep Parasites (Various) do. do. do. 2 do. do. do. and lungs do. do. 8 Oxen Abscess Liver and small portions adjacent do. do. Shops,, etc., Inspection of.—The number of shops, etc., where foodstuffs are sold varies somewhat from time to time, but may be approximated for the year as follows:— Butchers' Provision Dealers, etc., 237, Meat and Rabbit stalls 5, Sausage factories and l'ood-preserving works 9, Fish shops 105, Fish stalls 6, Fruit shops 212, and about 20 Fruit stalls. To these a total of 12,558 visits were recorded, apportioned as under,, viz.:— Butchers, Provision Dealers, etc., Shops 6,230 visits. Sausage Factories, etc. 197 ,, Butcher and Provision Stalls 417 „ Fish Shops 1,658 „ „ Stalls 416 ,, Fruit Shops 2,668 ,, ,, Stalls 972 „ Total 12,558 visits. The quality and condition of foodstuffs in general coming under those observations were on the whole again very satisfactory, a detailed list of unsound foods dealt with, which were in nearly every case, voluntarily submitted for inspection, and ultimately surrendered for destruction, will be found in the succeeding table "b." T 2 276 1913] TABLE B. Number of similar cases. Description of Food. Nature of Unsoundness. Conditions under which found. How disposed of. Weight in lbs. Observations. 3 Ox tongues Peeling membrane Examined by request Council's destructor 608 See special remarks in this report (a) 1 Pig's head and piece of pork Tuberculosis Exposed for sale do. do. 14 ,, ,, ,, (b) 3 Parts of pigs do. examined by request do. do. 664 ,, ,, ,, (c) 1 Dressed beef tripe Decomposition do. do. Ashburton Grove Shoot 672 Imperfect preservation in cold air stores, surrendered and destroyed. 17 Fish (various) do. do. do. do. do. 1484 *See footnote to this table. 1 10 sacks of beans do. Surrendered to Inspector Bridel Council's destructor 2016 Surrender accepted, found on premises during ordinary visit. 4 Tomatoes and fruit do. Examined by request do. do. 505 do. do. 1 5 boxes of tomatoes do. Seized by Inspector Jeffery do. do. 105 Public Health Committee decide to caution the offender. 1 Fruit (pears) do. Exposed for sale do. do. 10 do. do. 1 90 fowls' eggs do. Examined by request Ashburton Grove Shoot 10 Surrendered by a baker and confectioner. 1 Meat and fish pastes do. Returned goods Council's destructor 98 Surrendered, see special note in report (a) 1 Ox's liver Parasitic Offal dealer's do. do. 10 Livers had been partially, but not sufficiently trimmed. 1 Condensed milk Blown tins Wholesale Dairy Premises do. do. 28 Seized, legal proceedings taken, tee further explantion in report (e) *One lot per Medical Officer of Health, two lots per Chief Inspector Leggatt, one lot of cockles per Inspector Bridel, and one lot of crab fish per Inspector Bicknell, all examined by request and surrendered for destruction. 277 [1913 (а) On two occasions your inspector's attention was called to consignments of frozen imported ox tongues at a Meat Packing Factory, where in all 301 of the said tongues were found to have peeled patches of the mucous membrane, in many of which it was most difficult to understand the cause, although throughout a suspicion was felt of the probability of its being due to Foot and Mouth Disease. In the second consignment, however, I was able to select certain specimens which showed lesions identical with those of that disease, which were submitted to you, and on your instruction forwarded to the Chief Food Inspector of the Local Government Board, who forwarded them to the Royal Veterinary College, where the Foot and Mouth Disease was recognised, and a communication made to the Board of Agriculture, who forthwith sent Veterinary Inspector Berry of that department to enquire into all the facts of the case. The whole of the tongues mentioned were surrendered and conveyed to the Council's Destructor. This has led to increased vigilance on the part of the Port Sanitary and Smithfield Market Inspectors in handling consignments of tongues from foreign ports, and certain restrictions on the disposal of the packing litter and cases of consignments from scheduled foreign countries have since been issued by the Board of Agriculture. In spite of the increased vigilance of the Smithfield Market Inspectors, in some way or another a further lot of 24 ox tongues subsequently escaped their notice and were arrested at the same factory and surrendered for destruction owing to a similar affection. Specimens of these were submitted to Veterinary Inspector Young of the City Corporation, and he agreed that the affection was such as ought to have attracted the attention of any inspector, and concluded that the particular cases in which they were packed had escaped examination, and undertook to make full enquiries at the Cold Stores in the City from whence the tongues had been drawn. (b) A pig's head and one piece of pork were found exposed for sale containing sections of a markedly tuberculous gland. The facts of the case were reported through you to the Public Health Committee, who resqlved, under all the circumstances, not to prosecute, but to send a letter of caution to the butcher concerned. (c) In one instance from information received I found two quarters of a tuberculous pig hanging in a carrier's van in a carrier's yard in Market Road, which had been rejected by a firm of food packers in the district, and from what transpired were evidently in course of return to the wholesale firm in Charterhouse Street, Finsbury. You will remember the circumstances were reported to you and submitted to tht Council's Solicitor, who held that the meat was not liable to be seized. After telephonic communication with Inspector Green of Finsbury, and also with the salesman who had sold the said pork, the latter undertook, on your suggestion, to surrender the meat for destruction, this course being adopted, and the meat ultimately destroyed at the Council's disinfecting station. Two other lots of diseased pork (tuberculosis) were found, the head and shoulders of a sow pig, and the carcase ex-head of a boar pig, in both cases having certain lymphatic glands diseased, which are not in the ordinary course of inspection available until the carcase is cut up. They were surrendered for destruction, and the Smithfield Market Inspectors notified of the facts although no blame appeared to rest with them under all the circumstances. (d) The meat and fish pastes here referred to had been sold some two years previously, and exported to one of the Colonies, in small glass jars with the usual guarantee as to soundness—which it would appear has no time limit—and had become more or less 278 1913] unsound or stale, with the result that they were now rejected by the Colonial vendors, and ior want of a better method of checking the bad or doubtful part of such goods, through a reliable agent or public authority wherever the goods may be (at home or abroad), the objectionable system of returning unsatisfactory foodstuffs still exists. Thus the goods now under consideration, which were not very decidedly unsound, although they were sufficiently doubtful to render them unfit for purposes of human consumption, were returned from Australia to London, where they were stopped by the Port of London Authority, and subsequently liberated on the understanding that they were to be destroyed, and this department was accordingly notified some days prior to the goods arriving in this district, when they were surrendered for destruction. (e) On one occasion, on your instruction, I visited the premises of a wholesale dairy company, where two 14 lb. tins of unsound condensed milk were found in a basement room along with 64 tins of the same size containing in the aggregate 8 cwts. of condensed milk, which was evidently intended for dilution and mixing with fresh milk. The two blown tins were seized (after the whole of the other tins had been carefully examined), and subsequently an order for their destruction was given by a Metropolitan Magistrate sitting at Clerkenwell Police Court. You presented the facts to the Public Health Committee, who ordered a prosecution, and at the hearing of the summonses the Magistrate decided not to convict on the evidence before him, but said there had been gross negligence on the part of defendants, and ordered them to pay £2 2s. costs. In concluding my remarks on food inspection let me once more draw your attention to the amount of various foodstuffs which are regularly contaminated by exposure to dust, flies, etc., through open windows or on the pavement in front of shops, in the hope that by constant agitation, some means may be found of stopping the practice, either by persuasion or compulsion. In addition to meat, bacon and other provisions which are usually more or less subjected to cooking processes, that may possibly lessen the dangerous effects of the contamination, there are other articles similarly exposed which are consumed without any cooking, dressings or cleansing, such as ripe fruits, cheap sweets, biscuits, etc., exposed to clouds of dust often, and which are very largely consumed by young children, the effects of which cannot easily be calculated. The following is a summary of foodstuffs destroyed, viz.:— Tons. cwts. qrs. lbs. From Slaughterhouses as per Table A — 14 0 5 From Shops, Factories, etc., as per Table B 2 I5 2 8 Total 3 9 2 13 Cowsheds.—There were 5 cowsheds on the register until the licensing meeting of the L.C.C. in October last, when the renewal of the licence of one situate at Arnold's Dairy, Seven Sisters Road, was adjourned indefinitely owing to no cows having been kept for a considerable time. Structural alterations reducing the accommodation from 12 cows to 6 were also carried out at the cowshed in Hercules Place, during which time no cows were kept. Repairs to roof and stall floors have been carried out at 11. Matilda Street cowshed, where not more than 2 cows have been kept at any time during the year„ and for a period 279 [1913 none were kept. A total of 53 visits were paid, when with few exceptions they were found satisfactory. On two occasions, however, attention was drawn to foul udders, flanks, etc., which were bound to contaminate the milk. The necessity for the above repairs to roof and floors, and in one instance suspicion of advanced tuberculosis in a cow, including the udder, was reported to the L.C.C. The cow in question was not, however, giving milk at the time, but in the usual course the attention of the County Council's Veterinary Inspector was called to it, and although from enquiries made later, it did not appear that the Veterinary Inspector upheld my suspicions of tuberculosis, yet about a fortnight later the cow died in the shed, and was removed to the knacker's yard. Some difficulty occurred on two or three occasion:, in gaining admission to this shed owing to the door being locked and the key not being available. The licensee was informed that unless facilities for inspection were duly afforded the renewal of the licence would be opposed, and this had the desired effect. Offensive Trades.—Comprising 3 tripe boilers, 2 gutscrapers and the knacker's yard, received 87 visits during the year, with satisfactory results, neither have any complaints of bad smells in the neighbourhood been received,, as on some previous occasions. One of the premises (tripe boilers) situate at Pleasant Grove, has been seldom used during the year, probably just sufficient to ensure its existence. i am, Sir, Yours obediently, H. WILKINSON, Inspector of Meat and Other Foods. Milkshops and Dairies.—At the end of the year there were 493 milkshops and dairies on the register, to which 1,043 visits were paid by the district inspectors. The state of the law with respect to these places in London is very unsatisfactory, because, as the Public Health Committee are advised by the Council's solicitor, it is not necessary for a purveyor of milk to register unless the sale of milk forms a substantial part of his business. In a letter, dated some time ago, the solicitor wrote: "I think that a purveyor of milk means a man who as the Lord Chief Justice said, sells retail to refreshment establishments and wholesale to other milk dealers. If this be correct, then it is not necessary for a person who sells milk by retail to be registered unless the trade is so large, as, for instance, the Aylesbury Dairy Company, that they really could be looked upon as purveyors of milk." The London County Council (General Powers) Act, 1908, Section 5 provides as follows:— "Notwithstanding anything contained in the Dairies, Cowsheds and Milkshops Order of 1885, or in any subsequent order, any sanitary authority may remove from the register kept by them of persons from time to time carrying on in their district the trade of cow-keepers, dairymen or purveyors 280 1913] of milk, or may refuse to enter upon such register the name of any person carrying on or proposing to carry on the trade of a dairyman or purveyor of milk upon premises which are, in the opinion of such sanitary authority, for any reason unsuitable for the sale of milk therein. Provided that for the purposes of this section premises shall not be deemed to be unsuitable for the sale of milk therein on any ground inconsistent with the provisions or requirements of any order or regulation made under any enactment for the time being in force and applicable to such premises." In this case the Public Health Committee are advised that this section is only operative where the premises themselves are in such a state as to be likely to contaminate the milk. It is true that the original Bill was drafted with the object of preventing the sale of milk in a shop where goods were sold which were likely to contaminate the milk. The London County Council was appealed to on the subject, and the Medical Officer of Health received a letter from their solicitor stating that the meaning of the section was one that should be decided in the High Court. It is not likely that any sanitary authority will lightly undertake such a task, for the fact that the London County Council's legal adviser seems to be doubtful of the power which the section confers on it would be sufficient proof to most minds that it did not carry out the intentions of the framers of the measure. THE ADULTERATION OF FOODS AND DRUGS. From the earliest ages men have ever been found who, for the purpose ot gain, did not scruple to adulterate the food of the people or substitute an inferior article for the one required. There are numerous references to adulteration in the classics, and Pliny tells us that flour could not be obtained in a state of purity even by wealthy persons, for it was mixed with white clay. In ancient Athens and Rome wine was adulterated with colouring and flavouring agents, and to such an extent was it carried on that special inspectors were appointed to look after it. It would be interesting, but it would occupy too much space, to follow the course of adulteration in ancient times, but it would be useful, however, to understand something of the history of adulteration in this country. As early as the days of King John proclamation was made a legal obligation of Assize as regards bread, so that its proper weight and quality might be assured. In the reign of Henry III. which followed, a statute was 281 [1913 passed entitled "The Pillory and Tumbrell," for the expressed purpose of protecting the public from the dishonest practice of bakers, vintners, brewers, butchers and others. This enactment is remarkable in that it is the first in which the adulteration of human food is specially noticed and prohibited, and it is well to find that it was enforced with more or less vigour until the reign of Queen Anne (1709). The Liber Albus tells us that it was strongly enforced in the days of Edward the First, for it relates If any default should be found in the bread of a baker in the City, the first time let him be drawn on a hurdle from the Guildhall to his own home through the great street where thereby most people assemble, and through the great streets which are most followed, with the faulty loaf hanging from his neck; if a second time he shall be found committing the same offence, let him be drawn through the great street of Cheepe in the manner aforesaid to the pillory and remain there at least one hour in the day; and the third time that such fault shall be found, he shall be drawn, and the oven shall be pulled down and the baker made to forswear the trade for ever." Somewhere between 1350 and 1400 that amazing book, "Piers Plowman," attributed to William Langland, throws some light on the practices that were so prevalent, for he writes:—* Women that bake and brew They are the people They harm the poor and secretly and oft They grow rich on their retail They buy houses If they sold honestly nor buy their tenures. Butchers and Cooks, that harm the poor, Who can but buy in pennyworths, They poison them; With what the poor should eat, They become landlords, they would not build so high, It is curious to find in this long-ago book, one of the first in the English language, that the requirements of the poor were much as they are now; lower rents, unadulterated and good food, and warm clothing. That their food was not of a very luxurious character is apparent from another passage in it, where one learns that they require "milk and meal to satisfy the babes that continually cry for food" and that "bread and thin ale" are for themselves a banquet; that "cold flesh and cold fish are like roast venison"; a farthingsworth of mussels, a farthingsworth of cockles were a feast for them on Fridays or Fast Days." In another place he speaks of their dinner of peascods, beans and baken apples; onions and salads and cherries and bread with beans in it, and halfpenny ale. *These lines are taken from Burrell's modernized English version and are to be read across the page. 282 1913] It was the practice in those days for bakers of Stratford (which appears to have had some celebrity for its cheap bread) to come to the City to sell bread to the poor which was "two ounces in the penny wheat loaf heavier than the penny wheat loaf baked in the city." And Stow tells us in his "Survey of London," published in 1598, that he has "read that in the 4th year of Edward II., Richard Reffeham being Mayor, a baker named John of Stratforde, for making bread less than the assize, was with a fool's hood on his head, and loaves of bread about his neck, drawn on a hurdle through the streets of this city." One wonders if the said John was the same man whom Piers Plowman makes one of his many characters in his book say "they grumble when my cakes come not to town with baked bread from Stratford." If so he received his deserts for not selling his bread according to the assize. Stow also writes: "I read also in the 20th of Henry VIII., Sir James Spencer being Mayor, six bakers of Stratford were amerced in the Guildhall of London for baking under the size appointed." These Stratford bakers appear to have ceased selling bread in London about 1568. The assize of 1634 was very drastic, for it enacted that "If any person or persons who by any false wayes or meanes sell any meale unto the Kinge's subjects, either by mixing it deceitfully or selling any musty or corrupted meale, which may be to the hurte or infection of man's body, or use any false weight, or any deceitful wayes or meanes, and so deceive the subject, for the first offence he shall be grievously punished, the second he shall loose his meale, for the third he shall suffer the judgment of the pillory, and the fourth time he shall forsweare the town wherein he dwelleth." Vintners, spicers, grocers, butchers, regrators, and others were subject to like punishments, as it was thought that the pillory, by appealing to the sense of shame, was far more deterrent of such crimes than fine or imprisonment. In other parts of England also punishments for offences are recorded, as, for instance, a knavish Tavener of the City of Chester was taken round the town in a cart in which the refuse of the privies has been collected. Ale tasters were appointed in various places, whose duty it was to look after the quality of the ale, which was the universal drink of the country, much as tea is to-day, and to test it. Their mode of testing was novel, for "the tester spilled some on the wooden seat and then sat on the wet place 283 [19l3 in his leathern breeches and the stickiness of the residue obtained by evaporation afforded the evidence of purity or otiierwise of the ale, for if sugar had been added, he adhered to the bench, and the ale was therefore looked on as adulterated, while pure malt beer was not considered to yield an adhesive extract.'" A long interval then elapsed before any further English legislation is found, and it was not until 1725 that an act relating to the adulteration of tea was passed, which to prevent dealers in or manufacturers or dyers of tea adulterating it with terra-japonica or with any drug or drugs, or mixing it with any leaves other than the leaves of tea, or with any ingredients whatsoever, on pain of forfeiting the tea so adulterated or mixed, and of a penalty one hundred pounds. The next enactment was passed in 1780-31 and again related to tea. It recited that "several ill-disposed persons had freqiently dyed, fabricated, or manufactorued very great quantities of sloe leaves, liquorice leaves and the leaves of tea that has been before used, or the leaves of other trees, shrubs or plants in imitation of tea, and do likewise mix, color, stain and dye such leaves with terra-japonica, sugar, molasses, clay, logwood, and with other ingredients, and do sell and vend the same as true and real tea to the prejudice of the health of His Majesty's subjects, the diminution of revenue, and to the ruin of the fair trader." The Act provided a penalty of ten pounds for every pound of adulterated tea found in possession of any persons. This Act, like many Acts relating to adulteration, was passed more to protect the revenue than the health of His Majesty's subjects, or to prevent the ruin of the fair trader. Loss of revenue has in past times been the almost invariable lever used to induce Governments to stop adulteration. The health of the people and the ruin of the fair trader were nothing as compared with the loss of revenue; for of course this must be protected, no matter what happened to the consumer. The penalties under the Act do not, however, appear to have had a deterrent effect, for in 1766-7 a further Act was passed increasing the penalty to imprisonment for not less than six or more than twelve months. Prior to the passing of these Acts one was enacted respecting coffee in 1718, because "divers ill-disposed persons" had "at the time of or soon after the roasting of coffee made use of water, grease, butter, or such like materials which greatly increased it in weight," for which offence there was a penalty of £20. In 1803 another Act preventing the addition of burned, scorched or 284 1913] roasted peas, beans or parsnips to coffee was passed. Then fourteen years later there was legislation to prevent brewers, dealers, or retailers of beer or porter possessing or mixing with worts or beer, liquor extract or other preparations other than ground or unground brown malt, for the purpose of darkening their colour, and it also ordained that no molasses, honey, liquorice, vitriol, quassia, coculus indiae, grains of paradise, guinea pepper, or opium, or an extract of these or any articles or preparation whatsoever should be used as substitute. In this case the penalty was £200 for the brewer and £500 for the druggist who sold to him any colouring matter or malt substitute. From this period onwards adulteration in England seems to have been rampant, and if it attracted any notice very little was said about it until 1820, when F. C. Accum, F.L.S., a well-known chemist and technologist, published his "Treatise on Adulteration of Food and Culinary Poisons," which attracted very marked attention to the subject, which was followed ten years later (1830) by a volume with the sensational title, "Deadly Adulteration and Slow Poisoning unmasked, or Disease and Death in the Pot and the Bottle, in which the blood empoisoning and life destroying adulterations of wines, spirits, beer, bread, flour, tea, sugar, spices, cheesmongery, pastry, confectionery, medicines, etc., etc., are laid open," and published anonymously by John Dingwall Williams, who wrote under the pseudonym "An Enemy of Fraud and Villany." A biblical quotation in the preface of Accum's book attracted immediate attention, "There is death in the pot" (2 Kings iv. 40), as did also the following paragraph:— "Devoted to disease by baker, butcher, grocer, wine merchant, spirit dealer, cheesemonger, pastry cook and confectioner, we call in a physician to our assistance. But here again the pernicious system of fraud, as it has given the blow, steps in to defeat the remedy. The unprincipled dealer in drugs and medicines exerts a most potent and diabolical ingenuity in sophisticating the most potent and necessary drugs—peruvian bark, rhubarb, ipecacuanha, magnesia, calomel, castor oil, spirits of hartshorn, and almost every other medicinal commodity and chemical preparation used in pharmacy." As regards the quotation, "There is death in the pot," the Medical Officer of Health recollects its common use when a boy of ten, that is, some 40 years after the book was published. These books, as well as other publications by Henry (1836), Mitchell (1848), and Normandy (1850), had this great merit, that they prepared people for the far-reaching investigations of Dr. Arthur Hill Hassall, who, in 1850, after examining samples of coffee sold in 285 [1913 London, entered into an arrangement with Thomas Wakley, the proprietor of "The Lancet," to make a series of reports, afterwards known throughout the world as the "Reports of 'The Lancet' Analytical Sanitary Commission" on the composition of food, drugs and beverages then sold in London. For the purpose of these examinations he made thousands of analyses, the publication of which had very far-reaching effects, and marked an epoch in the annals of public hygiene in this country, and, indeed, attracted an enormous amount of attention everywhere, so that even on the continent interest was aroused. Although he used all the usual scientific methods known at the time for his analyses, yet he depended most on the use of the microscope, which up to then had been very little used for examining adulterations in foods and medicines. "The Lancet," to its honour, be it said, undeterred by the fear of prosecutions, boldly published the names and addresses of the persons who had sold the adulterated foods and drugs, and the natural result was that the leading organs of public opinion, such as "The Times" and "The Quarterly Review," took up the question and by their efforts compelled the appointment of a Parliamentary Select Committee, to whom Dr. Hassall, Dr. Henry Letheby and others gave startling evidence. The result of the report of that Committee was that in 1860 the first real Act of Parliament against the adulteration of food and drugs was enacted, and it was the precursor of all the Food Adulteration Acts which have since been passed. The disclosures made to the Select Committee were truly alarming, for not only was it shown that foods and drugs were adulterated, but that the ingredients with which they were adulterated were themselves adulterated. For instance, anatto, which is so often used to cloak the quality of milk, was itself adulterated with chalk, wheat flour, rye flour, salt and soap, with turmeric, Venetian red and red lead; and again, chicory, so often used to adulterate coffee, was mixed with roasted wheat, rye flour, burned beans, farina, sawdust, carrots, mangle-wurtzel, torrified ground rice, toasted biscuit oak bark tan, croats (exhausted tan), baked horse liver, litmus and Naples yellow. It is not proposed to give the long list of adulterations which the Medical Officer of Health has extracted from the Parliamentary Committee's report, but he may mention those of one or two of the best known articles of food. Thus tea was found to be mixed with exhausted tea leaves dressed with gum, leaves of sycamore, horse chestnut and plum, which were broken up and mixed with gum; that lie tea—itself a mixture made up of tea dust, gum, and sand, and faced with Prussian blue or indigo and china clay—was expressly 286 1913] manufactured for adulteration of tea; also that the leaves of the beech, plane, elrn, poplar, willow, fancy oak, hawthorn and sloe, and were coloured with plumbago or blacklead, gum, indigo, or Prussian blue, tumeric, Chinese yellow, Chinese clay, soapstone or French chalk, rose pink, Dutch pink, vegetable red and yellow dyes, cream yellow, Venetian red, carbonate of copper, arsenite of copper, chromate and bi-chromate of potash and carbonate of lime and magnesia. Milk was mixed with water, anatto, flour, starch, treacle, sheep's brains and chalk. And flour with alum, hydrated sulphate of lime, rye, Indian grain, rice, pea and bean flours, the ground and dressed hulls of wheat, barley and oats, bone earth and plaster of Paris, also with powdered flints, probably the result of grinding. And confectionery was coloured with dangerous or even poisonous substances; thus red sweets were dyed with vermilion, red lead or sulphate of mercury; yellow sweets with chromate of lead and gamboge; brown sweets with umber and sienna; blue sweets with Prussian blue and ultramarine; purple sweets with Prussian blue and cochineal; green sweets with Brunswick green (a mixture of chromate of lead and Prussian blue); while others were coloured Scheeles green or arsenite of copper and carbonate of copper; and in the sugar coatings of cakes, white lead was discovered. It is no wonder in view of adulterations such as these, which were common alike to the food of the poor and of the rich, that "The Times" in its leading article on July 25th, 1855, exclaimed, "Death is not only in the pot, it is everywhere; not only in our food and our drink, but in the very medicines which should cure our diseases." Nevertheless, so far as can be ascertained it does not appear that any of the great English boroughs sought local parliamentary powers to check the growing evil, although in the early "fifties" the citizens of Cork obtained authority under a local Act of Parliament to protect themselves against adulteration, whose provisions enabled them to appoint a "Market Jury," who had power to seize adulterated goods, and who did good work, as told by Sir John Gordon, then Mayor of the City, and an Apothecary, to the Select Committee. Among other things he narrated how on one occasion they seized, on its arrival from England, a large consignment of flour which looked like ground wood, but which was really "the hulls of wheat, barley and oats, but so well dressed as to have all the appearance of fine flour." It was used to adulterate flour, which was afterwards sold at 10½d. the 7 lbs., but immediately the seizure was made the flour dealer raised his price to one shilling. 287 [1913 It was not, however, until 1860 that the first general Adulteration Act was passed, which was followed twelve years later (1872) by the Act which enabled counties and boroughs to appoint public analysts. Since that time many Acts of Parliament and Orders made under them, relating to the Adulteration of Focds and Drugs have been passed by the Legislature, as may be seen by the following list of those now in force. Adulteration of Coffee Act, 1718. Adulteration of Tea and Coffee Act, 1724. Adulteration of Tea Act, 1730. Do. do. 1776. Bread Act, 1836. Sale of Food and Drugs Act, 1875. Sale of Food and Drugs Act Amendment Act, 1879. Margarine Act, 1887. Sale of Food and Drugs Act, 1899. Butter and Margarine Act, 1907. Order as to Registration of Margarine Factories, 1887. Do. do. do. 1900. Order as to Registration of Butter Factories, etc., 1907. Sale of Milk Regulations, 1901. Sale of Butter Regulations, 1902. Milk (Sale of) Regulations, 1912. Milk and Cream Regulations, 1912. Notwithstanding these enactments adulteration is still practised largely, although it is of a different character from that of the olden days; and it consists either of substitution (as in the case of margarine for butter), or the addition of chemicals to improve the appearance of the food (as in the case of confectionery and bottled vegetables), or to preserve it (as in the case of sausages and non-alcoholic wines). There is no longer to be found the gross and often crude adulterations which the two previous generations knew so well. The Medical Officer of Health has collected from the pages of one journal, published during 1913, particulars as to the nature of the adulteration of food and drugs as revealed in the Police Courts of England last year. They are as follows:— 288 1913] Articles. Nature of Adulteration. Almonds, Oil of Peach kernel oil. Baking Powder Sulphate of calcium. Arsenic. Barley Meal Sand. Beans, Bottled Sulphate of copper. Brandy Water. Grain spirit. Butter Water, Foreign fats, Margarine, Milk, Milk powdei, Boric acid, Sodium fluoride. Cheese Fat deficiency. Crushed Linseed Exhausted linseed (i.e., deprived of its oil). Cream Boric acid. Demerara Sugar Dyed cane and beet sugar. Dripping Cotton seed oil. Water. Flour Sulphate oi lime, Potassium persulphate. Gin Water. Glycerine Sugar. Golden Syrup Glucose. Honey Sucrose. Jam, Apricot Apple pulp. ,, Blackcurrant Apple pulp, Gooseberry pulp. ,, Plum Apple pulp. „ Raspberry Apple pulp. Jelly, Black Currant Salicylic acid. ,, Red Currant Gooseberry jelly. ,, Table Salicylic acid. Lard Cotton seed oil, Stearin (beef and mutton). Water. Milk Water, separated or skimmed milk, Formaldehyde, Benzoic acid. Mustard Starch. Olive Oil Arachis oil. Pearl Barley Rice. Pepper Rice flour, Talc. Potted meats and fish Boric acid. Rice Powdered talc. Rum Water. Saffron Mineral matter. Vinegar, Malt Non-malt vinegars, Water. Wine, Raisin Salicylic acid. „ Black Cuirant Salicylic acid. Whiskey Water. For the most part these adulterations are harmless substitutions or the addition of preservatives to keep the goods sound, and cannot be said to be seriously injurious to health, for modern legislation has had a blighting effect on dangerous adulteration, but for all that if Public Analysts who examine, and the Inspectors who take, the samples were to disappear there is small doubt that it would soon become rampant again. 289 [1913 Dairy products are now more adulterated than any other foods, but even their adulteration are only to be discovered, as a rule, in poor neighbourhoods, where it is practised by vendors of low class. The adulteration of drugs is almost unknown, for drugs are now generally prepared by large wholesale manufacturers who make them in large quantities and sell them to chemists. If these manufacturers were now to sell adulterated articles—which they would only do so as to sell them cheaply—they would soon be discovered, because other manufacturers, finding themselves undersold, would at once examine samples, and quickly expose the fraud. Confectionery, which was once coloured with very dangerous, even poisonous chemicals, is now treated with harmless and sometimes beautiful dyes which were unknown fifty years ago, so that they are much more attractive than formerly. Occasionally, such an indigestible substance as paraffin wax is found in them, while the substitution of glucose for cane sugar, which alone was formerly used, is not uncommon. This substitution is also very usual in jams, but the trade allege that it is used only to prevent crystallization, which, they say, would otherwise occur. This, however, is nonsense, for every one knows that in former days the home-made jams kept well, as do those made by certain manufacturers whose names have been household words for years. Some jam manufacturers also add apple juice and pulp to their products, for the purpose, they say, of improving it. It is probable, however, that this addition has been made with a fraudulent intent, and is a practice introduced from the United States. Now that the fraud has been detected they sometime place small labels on their products to indicate that it has been added for the purpose of improving the article; and this enables them to escape penalties. Labelling food-stuffs has become far too common, and, indeed, if the practice is allowed to develop much more it will be difficult to obtain pure articles of food. It is quite time that legislation stepped in to put an end to it, or to only allow it in very exceptional circumstances. Our food-stuffs also require to be defined or standardized, so that our traders may know what it is they are required to sell and the buyers know what they expect to get. Substitution is practised far too largely, and it is quite time it was ended. It is not alleged that the substituted articles are injurious to health, usually they are not. But frequently the same charge is made for them as for the genuine articles, and, therefore, the buyers are robbed to the extent of their difference in price, just as much as if the money had been stolen from their pockets. The shameless manner in which poor people are sometimes robbed in the matter of butter is U 290 1913] notorious. It is true the vendors generally comply with the law by wrapping the article in a paper with the word "margarine" stamped on it in letters of a certain size; but even this law has been practically evaded by some cunning traders who stamp the word on the bottom of the bag in which the article is wrapped so that when the purchase rests on the counter the word is not seen; and, indeed, the customer may never notice the stamp, or only see it on arrival at home, if even then. And yet the full price for butter had been paid. Private sampling in Islington has revealed that certain traders in poor neighbourhoods are continually palming off margarine for butter, at the same time charging the price of butter for the article. The efforts of our Inspector to detect these culprits are constant, and it is a satisfaction to know that more than one has had to leave the Borough because of his efforts. Indeed, during the year, two of these dishonest traders, one of them a well-known man, living in the same road not far from each other, were convicted for fraudulently selling margarine for butter, with the result that the man above mentioned has now left the neighbourhood, and when it became known another trader, who had often complained of their dishonest dealings, found that his trade went up ten pounds a week. There is no reason why margarine should not be sold to-day for what it is—a good, wholesome nutritious article of diet. Labelling should be abolished, and if it is to be earmarked at all it should be sold uncoloured, although this is not recommended. It is a distinct article of food, and its manufacture on a large scale is generally conducted with scrupulous cleanliness, There is a wonderful difference between what it is now and what it was when it was first made in Paris during the dark days of its siege by the Germans. No person imagined then that its manufacture would become a staple industry. This is one of the romances of trade, and, indeed, the story of its growth, improvement and popularity forms a most interesting and instructive chapter in the history of the foods of the nations. Sago and tapioca are not labelled, although so much alike, nor are several other articles which resemble each other. Why, then, should margarine be? Let the article be sold for w hat it is, and let those who substitute it for butter bear the penalty that the law exacts; but at the same time let that penalty be a fixed and deterrent one, and not left to the discretion of a magistrate or a bench of justices, all of whom very frequently inflict the most inadequate penalties on the offenders against the law as it exists to-day. It might be even enacted that the offenders might be let off for a first offence, with a warning that if he came before the Court again the full penalty would be inflicted, which being a heavy one would make him consider many times before he again engaged in his dishonest trade. And on the other hand, let the Board of Agriculture and 291 [1913 the Local Government Board, if labelling he no longer insisted on, see that the law is administered by the Sanitary Authorities, and also that private sampling be practised, against which dishonest traders find it difficult to fight, as it is to-day in all the great communities and in Islington. Then, and not till then, will this substitution of margarine for butter cease to be practised to the great pecuniary loss of farmers, of poor people, and of honest traders who are by far the more numerous class. Labelling cream to show the amount of preservatives it contains has recently been introduced in Orders made by the Local Government Board, and while it may be very necessary in this case, so as to prevent this food being given to infants by their mothers or nurses, it is a practice that is to be deprecated as regards foods in general, for the fact cannot be blinked that preservatives are very frequently added for the purpose of enabling producers to sell meats and other articles of diet which were fast approaching the time when they would naturally decompose, or to prevent decomposition owing to the insanitary conditions under which they were prepared. The Medical Officer of Health is strongly of opinion, therefore, that no permission to use labels to show that preservatives had been added to the food should be given unless the Medical Officer of Health of the district could certify from personal examination that the premises in which the food had been prepared were in a thoroughly sanitary state; and in any case the use of preservatives in food of any description should only be permitted in the most exceptional cases and under exceptional circumstances. Let us now consider the state of adulteration in Islington during the year under consideration. Adulteration in the Borough in 1913. 1,215 samples were submitted to the Public Analyst for his judgment, of which 113 or 9.3 per cent, were adulterated or reported against as not complying with the law. This percentage contrasts with 11 per cent., which was the average of the 22 years 1891-1912. During this period the adulteration has been as high as 17.7 per cent, and as low as 6.2. As a rule, however, from 1892 to to 1903 it was high, and percentages above 10 were not uncommon. These percentages do not always represent the true rate of adulteration in the borough, because a great deal depends on the methods adopted by the several Inspectors. There can be no doubt, for instance, that if the methods that U 2 1913] 292 were adopted in 1892, when 17.7 per cent. of the articles examined were found to be sophisticated, were applied to last year, there would have been a much lower percentage than 9.3 which were detected. Informal sampling is now very largely practised, and as these samples are not counted in the return for the year, but only the samples taken officially, the percentage appears to be higher than it really is. By private sampling one is enabled to accomplish two things: first, the fair and honest tradesman is not worried during his business hours by Inspectors carrying out their duties under the Act; and, secondly, it enables the Inspector to come down on those tradesman who are sophisticating the articles which they sell. It has also shown that the adulteration of milk and the substitution of margarine for butter are confined to a small and limited circle of dealers, some of whom live entirely on fraud, while the great bulk of the tradesmen in the borough are straightforward, upright, honest people. It is on the former class, therefore, that the Inspector naturally concentrates his efforts, and it is gratifying to know that in this he has been very successful. This is well shown in the Table at the end of his report, which is given on page 322. Informal sampling has been very successful, especially in the case of milk, because the Inspector can make his arrangements with his agent to buy a number of samples at milkshops or from milkmen on their rounds, and on their receipt at the Town Hall to quickly examine them by means of a Gerber Rotary Machine; and afterwards, in the case of adulterated samples, to purchase official samples from the same people before they had sold out their morning or afternoon supplies, as the case may be. Informal sampling has enabled the Inspector to obtain 1,883 samples during last year, as contrasted with 1,213 in 1907, the year before he commenced this work, which is an increase of 64 per cent. The number of prosecutions also rose from 53 to 82, or 65 per cent., and the penalties increased from £106 18s. 6d. to £314 19s. 6d., or 194 per cent.* Such figures as these are encouraging, and show that apart from unmasking fraudulent dealers, the work of this branch of the public health department very much more than recoups the Council for its expense. •The actual amount of the penalties and costs since 1908 to 1913 (inclusive) has been £1,554 13s. 7d. 293 [1913 Table CXVII. Showing the Number of Samples of Foods and Drugs Analysed, with the Result of the Analyses for the Year 1913 and for the preceding Twenty-two 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 411 350 61 14.8 1895 825 697 128 15.5 1896 825 699 126 15.3 1897 863 765 98 11.3 1898 875 784 91 10.4 1899 899 820 79 8.8 1900 925 798 127 13.7 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 1905 1,200 1,1O1 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 1909 1,201 1,060 141 11.7 1910 1,204 1,076 128 10.6 1911 1,200 1,105 95 7.9 1912 1,207 1,110 97 8.0 Totals 20,445 18,202 2,243 11.0 1913 1,215 1,102 113 9.3 The Public Analyst, in his several quarterly reports during the year, reported against the articles examined as follows:— Examined. Genuine. Adulterated. Per cent. 1st Quarter 267 238 29 10.9 2nd „ 332 305 27 8.1 3rd „ 300 280 20 6.7 4th „ 316 279 37 11.7 The Year 1,215 1,102 113 9.3 294 1913] Milk, Butter and Oleaginous Foods.—915 samples were examined, of which 92, or 10 per cent., were adulterated, as contrasted with 7.2 in 1912, and 8.4 in 1911. Since 1905 the percentages of these foods found to be adulterated were as follows:— 1905 7.2 per cent 1910 10.2 per cent. 1906 10.2 „ 1911 8.4 ,, 1907 6.5 ,, 1912 7.2 ,, 1908 9.5 ,, 1913 10.0 ,, 1909 8.7 ,,  Samples. Adulterated. Percentage Adulttrated in 1913. Percentage Adulterated in 1912. Percentage Adulterated in 1911. Milk 597 45 7.5 5.4 9.8 Cream ... ... ... ... ... Milk (Separated) 3 ... ... ... ... Butter 214 26 12.1 3.5 5.0 Butter (milk blended) 1 ... ... ... ... Margarine 40 21 52.5 62.5 17.5 Cheese 40 ... ... ... ... Lard 20 ... ... ... ... 915 92 10.0 7.2 8.4 Milk.—The record of milk adulteration in Islington is given in a Table on page, 298 which shows that the average has been 9.9 per cent. This figure is based on the analyses of 10,788 samples, which were purchased in the streets from roundsmen, and at shops, or procured at railway stations when the milk was in course of transit. In 1913 600 samples of milk were submitted to the Public Analyst, of which 45, or 7.5 per cent., were certified as adulterated. This figure is higher than in 1912, when the analyses showed only 5.4 per cent. 295 [1913 As the percentage of adulteration varied according as the samples were taken on weekdays, Sundays, and at railway stations, the facts respecting them will be of interest. Milks Purchased on Sundays.—162 samples were purchased, of which 11, or 6.8 per cent., were adulterated, as contrasted with 8.7 per cent. in 1911 and 6.9 per cent. in 1910. Since it became known some years ago that the sampling of milk was as actively pursued on Sundays as on other days, the percentage amount of adulteration has fallen. Up to the end of 1902 it had only been done in an irregular way, and as a consequence the percentage of adulteration was high, but since then it has decreased, so that last year it was only 6-8 per cent., as compared with 15 per cent. in 1898 (vide Table CXXI.). Milks Purchased on Week-days.—318 samples were submitted to the Public Analyst, of which 30, or 9.4 per cent., were found to be adulterated. This contrasted with 4.9 in 1912, when the amount of adulteration was unusually low; indeed it was the smallest percentage hitherto known in the borough, in which it has averaged 11.2 per cent. since 1898 (vide Table CXXI.) Milks Procured at Railway Stations.—120 samples were procured and examined by the Public Analyst, who returned 4, or 3.3 per cent., as adulterated. This percentage is in excess of that of the preceding year, when it was 2.5. It is to be accounted for by the fact that the adulterated milks were specially taken for a milk purveyor who suspected that a farmer was supplying him with an inferior milk. It may, however, be taken as a fact that the farmers supply good milks to their local customers, as will presently be shown. The quality of the milk sold in the borough was very good. The Medical Officer of Health has taken the trouble to examine the certificates of the 600 milks reported on by the Public Analyst, and he has given the results in the Table CXVIII. which follows, which shows the fat contents of these milks. He finds that out of the 600 samples reported on, only 35 contained less than 3 per cent. of fat, which is the minimum standard laid down by the Government, while 225, or 37.50 per cent. showed from 3.0 to 3.4 per cent, of fat. These would be considered fairly good milks; indeed, anything over 3.25 is now looked on as a fair average milk. But he also finds, and this is the best part of the record, that 340 samples contained over 3.5 per cent, of lat, and are, therefore, very good milks. 296 1913] Now we are sometimes told that the farmers do not send milk of high quality to the metropolis. The Medical Officer of Health, however, finds that this is an altogether fallacious statement, for out of 120 samples that were procured at the railway stations in course of transit, 89, or 74.16 per cent., contained above 3.4 of fat; in other words, that the milk delivered by the farmers was of a very high quality. An examination of the records respecting these farmers' milks further showed that 43.4 per cent. contained from 3.5 to 3.9 per cent. of fat, while 32.5 per cent, contained from 4.0 to 4.9 per cent. of fat, which means that 75.8 per cent. were high-class milks. There can be no longer any doubt, therefore, that the milks delivered in Islington from the country are ofa very high quality; and, indeed, the Medical Officer of Health finds also that the analyses of the milks sold in the street—and it is to be recollected that these milks include the adulterated samples—show that the quality is good, for out of 318 samples analysed, only 26, or 8.18 per cent., contained under 3.0 per cent. of fat; that 125, or 39.30 per cent., contained 3.0 and under 3.5 per cent, of fat; while 167, or 52.52 per cent., contained over 3.5 per cent. of fat. Again the milks sold on Sundays were found to be particularly good, for only 7, or 4.32 per cent., were found to contain less than 3 per cent., while 71, or 43.83 per cent., contained 3.0 and under 3.5 per cent. of fat, and 84, or 51.85 per cent., contained over 3.5 per cent, of fat. These figures, therefore, show two things: first, that the farmers send really good milk to Islington, and that the milk which is generally sold in the borough, whether on weekdays or Sundays, is of good quality. 1 his should be reassuring information for those persons who are constantly bewailing the quality of the milk; while it should also be very gratifying to the farmers, who are frequently made the scape-goats of interested persons. 297 [1913 TABLE CXVIII. Showing tin Percentage of Fat in the samples of Milk submitted to the Public Analyst during 1913, distinguishing those obtained on Weekdays, on Sundays and at Railway Stations. FAT CONTENT. MILKS purchased on Week Days. MILKS purchased on Sundays. MILKS purchased at Railway Station. ALL MILKS. Under 1 per cent. No. % of Total No. % of Total No. % of Total Total Nos. % of Total 2 0.63 .. .. .. .. 2 0.33 Containing 1.0 .. .. .. .. .. .. .. .. 1.1 .. .. .. .. .. .. .. .. 1.2 .. .. .. .. .. .. .. .. 1.3 .. .. .. .. .. .. .. .. 1.4 .. .. .. .. .. .. .. .. 1.5 .. .. .. .. .. .. .. .. 1.6 .. .. .. .. .. .. .. .. 1.7 .. .. .. .. 1 0.83 l 0.17 1.8 1 0.31 .. .. .. .. 1 0.17 1.9 .. •• .. •• .. .. •• •• Containing 2.0 per cent. 1 0.31 1 0.62 .. .. 2 0.33 2.1 1 0.31 .. .. .. .. 1 0.17 2.2 .. .. .. .. .. .. .. .. 2.3 .. .. .. .. .. .. .. .. 2.4 .. .. .. .. .. .. .. .. 2.5 2 0.63 .. .. .. .. 2 0.33 2.6 2 0.63 1 0.62 .. .. 3 0.50 2.7 5 1.57 2 1.23 1 0.83 8 1.33 2.8 3 0.94 1 0.62 .. .. 4 0.67 2.9 9 2.83 2 1.23 .. .. 11 1.83 Containing 3.0 per cent. 13 4.09 9 5.56 2 1.67 24 4.00 3.1 29 9.12 17 10.49 5 4.17 51 8.50 3.2 20 6.29 15 9.26 2 1.67 37 6.16 3.3 34 10.69 10 6.17 9 7.50 53 8.83 3.4 29 9.12 20 12.35 11 9.16 60 10.00 3.5 35 11.01 17 10.49 12 8.33 62 10.33 3.6 26 8.18 16 9.87 12 10.00 54 9.00 3.7 20 6.30 12 7.41 8 6.67 40 6.67 3.8 25 7.86 10 6.17 9 7.50 44 7.33 3.9 19 5.98 6 3.70 13 10.83 38 6.33 Containing 4.0 per cent. 16 5.03 9 5.56 9 7.50 34 5.67 4.1 10 3.15 2 1.23 8 6.67 20 3.33 4.2 3 0.94 4 2.47 5 4.17 12 2.00 4.3 2 0.63 3 1.85 2 1.67 7 1.17 4.4 2 0.63 .. .. 1 0.83 3 0.50 4.5 4 1.26 .. .. 2 1.67 6 1.00 4.6 2 0.63 .. .. .. .. 2 0.33 4.7 1 0.31 .. .. 4 3.33 5 0.83 4.8 1 0.31 1 0.62 2 1.67 4 0.67 4.9 .. •• •• .. 1 0.83 1 0.17 Containing 5.0 per cent. .. .. 1 0.62 2 1.67 3 0.50 5.1 .. .. .. .. .. .. .. .. 5.2 .. .. .. .. .. .. .. .. 5.3 .. .. .. .. .. .. .. .. 5.4 .. .. .. .. 1 0.83 1 0.17 5.5 .. .. .. .. .. .. .. .. 5.6 .. .. 1 0.62 .. .. 1 .17 5.7 .. .. .. .. .. .. .. .. 5.8 .. .. 1 0.62 .. .. 1 0.17 5.9 .. .. .. .. .. .. .. .. Containing 6.0 per cent. .. .. .. .. .. .. .. .. 6.3 .. .. 1 0.62 .. .. l 0.17 7.3 1 0.31 .. .. ..0 .. 1 0.17 318 100.00 162 100.00 120 100.00 600 100.00 298 1913] The following statement is a synopsis of the figures shown in the previous Table. Fat Content. Week Days. Sundays. Railway Station. Total. Under 3 per cent. 26 % 7 % 2 % 35 % 8.18 4.32 1.67 5.83 3 per cent. and under 3.5 per cent. 125 39.30 71 43.83 29 24.17 225 37.50 Over 3.5 per cent. 167 52.52 84 51.85 89 74.16 340 56.67 Totals 318 100.00 162 100.00 120 100.00 600 100.00 The number of milks returned as adulterated by the Public Analyst is given in the following tabular statement:— MILK ADULTERATION. Samples Analysed Genuine. Adulterated Per cent. Adulterated. 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 632 556 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 1909 605 563 42 6.9 1910 621 563 58 9.3 1911 601 542 59 9.8 1912 606 573 33 5.4 Totals 10,788 9.714 1,074 9.9 1913 600 555 45 7.5 299 [1913 The quality of these various milks in L913 are given in the following tabular statement:— Obtained. No of Samples Analysed. Average Percentage of Fat. Average Percentage of Solids, not Fat. Avtiago Percentage of Total Solids. On Sundays 162 3.56 8.74 12.30 On Week-days 318 3.52 8.72 12.24 At Railway Stations 120 3.80 8.92 12.72 Official Minimum Standard — 3.00 8.50 11.50 Table CXIX. Showing the analyses of 9,377 milks examined in Islington during the fifteen years 1898-1912 and 1913, and distinguishing those purchased on Sundays, on Weekdays, and procured at the Railw.iy 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, ot 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 1908 160 8.58 3.69 324 8.58 3.52 120 8.73 3.88 1909 159 8.66 3.67 326 8.85 3.62 120 8.74 3.86 1910 160 8.57 3.55 336 8.50 3.44 125 8.76 3.74 1911 160 8.57 3.63 320 8.54 3.65 121 8.71 3.92 1912 160 8.70 3.67 326 8.76 3.61 120 8.84 3.86 Total Fifteen Years 2,594 8.56 3.64 4,403 8.58 3.61 1,780 8.74 3.89 1913 162 8.74 3.56 318 8.72 3.52 120 8.92 3.80 300 1913] From these analyses the following averages for the years 1898-1913 have been deduced:— Solids not fat. Fat Total solids. 2,756 Sunday Milks 8.57 3.63 12.20 4,721 Week-day Milks 8.59 3.61 12.20 1,900 Farmers' Milks 8.76 3.89 12.65 9,377 Total Milks 8.62 3.67 12.29 Table CXX. Giving the particulars of the Milk taken during each quarter of 1913 on Sundays, on Week-days, and at the Railway Stations. 1913. 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 77 30 147 36 69 30 135 4 8 .. 12 10.0 10.4 .. 8.1 2nd „ 42 81 30 153 39 70 29 138 3 11 1 15 7.1 13.6 3.3 9.8 3rd „ 40 80 30 150 39 74 29 142 1 6 1 8 2.5 7.5 3.3 5.3 4th „ 40 80 30 150 37 75 28 140 3 5 2 10 7.5 6.2 6.6 6.6 The Year 162 318 120 600 151 288 116 555 11 30 4 45 6.8 9.4 3.3 7.5 301 [1913 Table CXXI. Showing the Samples of Milk Analysed, the number found adulterated, with the percentage of Samples adulterated for the past sixteen years. Year. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Sundays Week-days. Ry Statiors 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 2s 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 196 295 141 632 172 247 137 550 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 1909 159 326 120 605 145 304 114 563 14 22 6 42 8.9 6.7 5.0 6.9 1910 160 336 125 621 146 292 125 563 14 44 .. 58 8.7 13.1 .. 9.3 1911 160 320 121 601 149 277 116 542 11 43 5 59 6.9 13.4 4.1 9.8 1912 160 326 120 606 146 310 117 573 14 16 3 33 8.7 4.9 2.5 .4 1913 162 318 120 600 151 288 116 555 11 30 4 45 6.8 9.4 3.3 7.5 Totals 2,756 4 721 1,900 9,377 2,481 4,191 1,863 8,535 275 530 37 842 9.9 11.2 1.9 8.9 302 1913] Butter and Margarine.—255 samples were purchased and submitted to the Public Analyst, of which 215 were butter and 40 margarine. Of the butters 26, or 12T per cent., were adulterated, and of the margarines 21, or 52.5 per cent., were sold contrary to the Margarine Act. Last year it was pointed out that the sale of margarine for butter still obtained to a considerable extent, although the practice was confined to tradesmen of a low grade selling in the poorer neighbourhoods. Towards the close of the year, in fulfilment of an arrangement made some two years previously with the representative of the Irish Board of Agriculture, and with the cognisance of the Public Health Committee, a special effort was made to discover and punish the persons who fraudulently sold margarine for Irish butter. The Irish Board were of course only interested in that article, but, as a matter of fact, the persons who sold margarine to their inspectors turned out to be the persons whom the Public Health Department knew to be selling—and in many instances had prosecuted for the offence—margarine for butter. It does not matter to them whether the article asked for be Irish, Brittany, Dutch, Australian or any other butter, because they would in any case have sold margarine. For some time past the sale of margarine for butter has assumed a serious aspect in Islington, because certain tradesmen persistently substitute margarine for butter on every possible occasion. It has already been explained in these annual reports that fraud of this character is only to be detected by the employment of agents who become customers at the particular shop where the fraud is carried on; and that these agents must not only purchase butter, but other groceries, such as tea, sugar, eggs, bacon, etc., as well, because it is only when they are well known to the vendors that margarine is foisted on them. There is one exception, however, to this practice of the vendors, which is that they invariably sell margarine for butter to young children when sent to buy butter, because they know perfectly well that no child would be put into the witness box to give evidence against them. During the months of October and November the agents of the Irish Board of Agriculture, unknown to the Public Health Department, were busily engaged sampling the various shops in which butter is sold in Islington, with the result that they discovered some 76 persons who persistently sold margarine for butter. The Head Official of the Board in London then called on the Medical Officer of Health and requested him to be good enough to arrange for the Inspector to obtain official samples, employing their Irish agents as his 303 [1913 own. The result was that sixteen persons were detected and summonses were issued against them. At the hearing of the summonses a great deal of odium was sought to be cast on the method adopted in obtaining the informal samples prior to the official ones being taken, which, it may be said, is on all fours with that which has been pursued in Islington for several years past, with this exception, that the Council's agents have never dressed themselves, or smudged their face and hands, so as to represent workmen returning from their work, as did those employed by the Irish Board. One cannot see why this should be called trickery. The agents who purchased the samples, went to the shop in the garb of working men, thus representing the very class of persons who were habitually and systematically defrauded by these shopkeepers. Again in no instance was a prosecution undertaken unless the defendant had persistently sold margarine for butter to these agents, because it might have so happened, where only one sample was obtained, that margarine was given for butter through an oversight or a mere accident. No such plea could be set up in these instances, nor, indeed, in any case in which the Islington Borough Council have recently prosecuted, because the official sample has only been taken when the defendant has been found to be deliberately substituting margarine for butter, and on the result of the analysis of this sample a prosecution depended. So that this matter may be clearly understood in the case of these Irish prosecutions, it must be stated that some of the defendants had sold margarine for butter on several occasions, previous to the purchase of the official sample This is seen in the following statement, which gives the number of samples taken before an official sample was obtained and the number of times margarine was substituted. It also shows the result of the prosecution, together with the number of previous convictions against the defendants. 304 1913] Defendant. Address. No. of Informal Purchases. No. of times Margarine was substituted for Butter. Result of Prosecution. No. of previous convictions. i No. of previous convictions against persons formerly occupying these premises. A. St. James Road 18 14 Fined £2 and £3 15s. 6d, costs 4 4 B. Caledonian Road 12 8 Fined £5 2 2 C. do. 18 15 Fined £5 .. 1 D. do. 10 4 Fined £5 .. 1 E. Copenhagen Street 12 9 Fined £3 .. Nil. F. Copenhagen Street 10 4 Fined £5 2 2 G. Hornsey Road 9 8 Fined £4 and £1 1s. cos's .. Nil. H. Hornsey Road 10 9 Fined £2 and £1 1s. costs 1 1 I. Roman Road 14 12 Fined £5 .. Nil. K. Half Moon Crescent 3 2 fined £3 1 6 L. Balls Pond Road 9 7 Fined £1 and £1 1s. costs 1 1 M. Balls Pond Road 10 5 Fined £5 and £1 1s costs .. 1 N. Essex Road 9 7 (including 3 Mixtures) Fined £10 4 4 o. Brewery Road 10 9 Fined £3 .. 4 P. Essex Road 8 4 Fined £2 1s. and £3 5s costs 7 7 Q. Offord Road 5 3 Fined £2 and 12s. 6d. costs .. Nil. 305 [1913 Several of these people are old offenders, and, indeed, one of them had seven previous convictions against him. It is much to be regretted that among them, and, indeed, one of the worst, was a man who should have set an example for honest and fair trading to others, for he was a member of the Borough Council, from which he has now retired. This was not his first offence, for he had been convicted on four previous occasions. After the prosecutions had concluded, Mr. R. L. Bowen Colthurst wrote on behalf of the Irish Board of Agriculture thanking the Borough Council for the kindness and courtesy shown to himself personaly and to the other officers of the Board; and also paid a very high tribute to the attention and acuteness which Mr. Burrell had shown in helping matters to a satisfactory conclusion. Cheese.—40 samples were submitted to the public analyst, who reported that they were not adulterated. Lard.—All the samples, 20 in number, were found to be genuine. Groceries.—185 samples of various foods usually purchasable at an ordinary grocer's shop were examined, and of these 14, or 7.6 per cent., were found to be adulterated. The names of the samples and their analyses are set out in the Table annexed. No. cf Samples. No. Adulterated. Percentage Adulterated. Percentage Adulterated in 1912. Coffee 28 5 18.0 50.0 Cocoa 28 1 3.6 — Demerara Sugar 7 4 57.1 — Pepper 10 — — — Mustard 11 — — 3.8 Golden Syrup 14 1 7.1 9.1 Black Current Jam 1 — — — Raspberry Jam 6 — — — Arrowroot — — — 7.1 Sauces 7 1 14.3 — Malt Vinegar 14 1 7.1 31.6 Milk Chocolate - — — 100.0 Bread 7 — — — Self-Raising Flour 7 — — — Flour 7 — — — Dripping 14 — — — Rice 7 — — — Ground Ginger 5 — — — Crushed Linseed 5 1 20.0 — Honey 7 — — — 185 14 7.6 13.8 w 306 19131 Alcoholic Drinks.—60 samples were examined by the Public Analyst, of which 2, or 3 3 per cent., were adulterated. No. of Samples. No. Adulterated. Percentage Adulterated. Whiskey (Scotch) 12 — — Whiskey (Irish) 12 — — Rum 12 — — Gin 12 1 8.3 Brandy 12 1 8.3 Total 60 2 3.3 Drugs.—55 samples of drugs were examined, and of these 5, or 9.1 per cent., were returned as adulterated. This percentage is in excess of that of last year, when 6.6 per cent were returned as sophisticated by the Public Analyst. The following is a list of the articles examined. No. of Samples. No. Adulterated Percentage Adulterated Camphorated Oil 5 — — Blaud's Pills 5 1 20.0 Paregoric 5 2 40.0 Compound Liquorice Powder 5 1 20.0 Lime Water 5 — — Cod Liver Oil 5 — — Olive Oil 5 1 20.0 Tartaric Acid 5 — — Glycerine 5 — — Oil of Turpentine 5 — — Citric Acid 5 — — 55 5 9.1 307 [1913 w 2 Table CXXII. Showing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1913. 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 145 153 149 150 597 133 138 141 140 552 12 15 8 10 45 Milk Separated 2 .. 1 3 2 .. 1 .. 3 .. .. .. .. .. Butter 47 51 50 66 214 44 49 47 48 188 3 2 3 18 26 Butter (Milk Blended) 1 .. .. .. 1 1 , , .. 1 .. .. .. .. .. Cheese .. 20 10 10 40 .. 20 10 10 40 .. .. .. .. .. Lard 5 5 5 5 20 5 5 5 5 20 .. .. .. .. Dripping 7 .. 7 .. 14 7 .. 7 .. 14 .. .. .. .. .. Coffee 7 7 7 7 28 5 5 6 7 23 2 2 1 .. 5 Cocoa .. 14 7 7 28 .. 14 6 7 27 .. .. 1 .. 1 Mustard 5 .. 3 3 11 5 .. 3 3 11 .. .. .. .. .. Pepper .. 3 .. 7 10 .. 3 .. 7 10 .. .. .. .. .. Golden Syrup 7 7 .. 14 6 .. 7 .. 13 1 .. .. .. 1 Demerara Sugar 2 5 .. .. 7 .. 3 .. .. 3 2 2 .. .. 4 Vinegar (Malt) .. 7 7 .. 14 .. 7 6 .. 13 .. .. 1 .. 1 Bread .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Flour .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Rum 3 3 3 3 12 3 3 3 3 12 .. .. .. .. .. Gin 3 3 3 3 12 2 3 3 3 11 1 .. .. .. 1 Irish Whiskey 3 3 3 3 12 3 3 3 3 12 .. .. .. .. .. Scotch Whiskey 2 4 3 3 12 2 4 3 3 12 .. .. .. .. .. Brandy 3 3 3 3 12 2 3 3 3 11 1 .. .. .. 1 Rice .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Ground Ginger .. 5 .. .. 5 .. 5 .. .. 5 .. .. .. .. .. Self-raising Flour .. .. 7 .. 7 .. .. 7 .. 7 .. .. .. .. .. Crushed Linseed .. .. 5 .. 5 .. .. 4 .. 4 .. .. 1 .. 1 Honey .. .. .. 7 7 .. .. .. 7 7 .. .. .. .. .. Raspberry Jam .. .. .. 6 6 .. .. .. 6 6 .. .. .. .. .. Black Currant Jam .. .. • • 1 1 .. .. .. 1 1 .. .. .. .. .. * Examined for strength only. 308 1913] Table CXXII.—continued. 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. Sauces .. .. .. 7 7 .. .. .. 6 6 .. .. .. 1 1 Cod Liver Oil .. .. .. 5 5 .. .. .. 5 5 .. .. .. .. Olive Oil .. .. .. 5 5 .. .. .. 4 4 .. .. .. 1 1 Paregoric .. .. .. 5 5 .. .. .. 3 3 .. .. .. 2 2 Camphorated Oil 5 .. .. .. 5 5 .. .. .. 5 .. .. .. .. .. Tartaric Acid 5 .. .. .. 5 5 .. .. .. 5 .. .. .. .. .. Blaud's Pills .. 5 .. .. .. 5 4 .. .. .. 4 1 .. .. .. 1 Glycerine .. 5 .. .. 5 .. 5 .. .. 5 .. .. .. .. .. Oil of Turpentine .. 5 .. .. 5 .. 5 .. .. 5 .. .. .. .. .. Compound Liquorice Powder .. 6 .. .. 5 .. 4 .. .. 4 .. 1 .. .. 1 Lime Water .. .. 5 .. 5 .. .. 5 .. 5 .. .. .. .. .. Citric Acid .. .. 5 .. 5 .. .. 5 .. 5 .. .. .. .. .. 257 322 290 30g 1,175 234 300 275 .274 1,083 23 22 15 32 92 MARGARINE ACT. Margarine 10 10 10 10 40 4 5 5 5 19 6 5 5 5 21 309 [1913 Abstracts from the Public Analyst's Returns, together with the proceedings taken during the Quarters of the. Year 1913. ADULTERATED SAMPLES. —First Quarter, 1913. Sample marked. 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. Action taken, with result of prosecution. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. T.L.B. 935 Coffee Inspector 34 per cent' of Chicory Fined £5 and £1 12s. 6d. costs, or 14 days in default. 940 Blaud's Pills do 17 per cent. Ferrous Carbonate deficient No proceedings taken. 966 Demerara Sugar do Dyed Sugar other than Demerara Fined £2 and £1 12s. 6d. costi, or 14 days in default. 967 do. do. do do. do. Fined £2 and £1 12s. 6d. costs, or 14 days in default. 985 Milk do Nearly 4 per cent, of added water Cautioned by letter. 994 998 do do 21 per cent, of added water, and 9 per cent, of the original fat abstracted No proceedings, this being the return of a duplicate sample of 998 T.L.B. purchased for safety. do do 21 per cent, of added water, and 8 per cent, of the original fat abstracted Summons withdrawn, warranty established. 1,004 do do 6 per cent, of added water Fined £100 and £5 5s. costs, or 3 months in default. 1,005 do do 9 do. do. Fined £10 and £2 2s. costs, or 1 month in default. 1,020 Brandy do. 27 8 degrees under proof Ordered to pay £2 2s. costs. 1,028 Golden Syrup do 70 per cent, of Glucose Syrup Fined £1 and £1 13s. costs, or 14 days in default. 1,039 Milk do 14 per cent, of added water Fined £3 and 12s. 6d. costs. 1,047 Butter do. 38 do. of Margarine Fined £5 and £113s. costs, or 21 days in default. * Boric Acid and Formalin absent. 310 1913] ADULTERATED SAMPLES (First Quarter, 1913)—continued. Sample marked. 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. Action taken, with result of prosecution. T.L.B. 1,058 Gin Inspector 40*3 degrees under proof, Ordered to pay £2 2s. costs. 1,0-59 Coffee do 30 per cent, of Chicory Ordered to pay 12s. 6d. costs. 1,069 Milk do 4 do. of added water Cautioned by letter. 1,070 * do do 6 do. deficiency in fat Dismissed on warranty. 1 * do do 10 do. of added water Ordered to pay 12s. 6d. costs. 2 * do do- 20 do. of added water Fined £1 and 12s. 6d. costs. 13 do do 6 do. of original fat abstracted No conviction but defendant cautioned by Magistrate. 15 Margarine do 100 do. of margarine Ordered to pay 12s. 6d. costs. 16 do. do 100 do. do. Fined 10s. and £1 3s. costs. 30 Milk do 7 per cent, deficiency in fat Summons withdrawn, warranty established. 33 Margarine do 100 do. of Margarine Fined £1 and 12s. 6d. costs. 34 do. do 100 do. do. Fined £2 and 2s. costs. 35 do. do 100 do. do. Summons not served. Premises closed. 36 do. do 100 do. do. Fined £2 and 2s. costs. 45 Butter do 55 do. do. Fined £1 and 12s. 6d. costs. 69 do do 90 do. do. Fined £1 and 12s. 6d. costs. * Boric Acid and Formalin absent. Total number of samples analysed during the Quarter 267. Number of samples adulterated 29. 311 [1913 ADULTERATED SAMPLES.—Second Quarter, 1913. Sample marked. 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. Action taken, with result of prosecution. Showing whether the sample was Genuine or Adulterated, and, if adulterated, what were the nature and extent of the Adulteration. T.L.B. 113 Demerara Sugar Inspector Dyed Cane Sugar other than Demerara Sugar No prosecution. 116 do. do. do do. do. do. No prosecution. 120 *Milk do 3 per cent, of original fat abstracted No prosecution. 193 * do do 3 per cent, of added water and 36 per cent, of the original fat abstracted Fined £1 and 12s. 6d. costs. 196 * do do 11 per cent, of added water Summons dismissed on ground of warranty. 219 * do do 11 do. do. Summons dismissed on ground of warranty. 234 * do do 31 per cent, of the original fat abstracted Fined £2 and 12s. 6d. costs. 258 Butter do 100 per cent, of Margarine Fined £5 and 12s. 6d. costs. 263 †Milk do 0'0027 per cent, of Formaldehyde ... Summons dismissed as Magistrate was satisfied that defendant had no knowledge of the presence of Formaldehyde. 303 Compound Liquorice Powder do 3 per cent, of Maize Starch No prosecution. 309 Margarine do 100 per cent, of Margarine Fined 5s. and 12s. 6d. costs. 313 Coffee do 45 per cent, of Chicory Fined £7 and 12s. 6d. costs. 314 do do 32 do. do. Fined £2 and 12s. 6d. costs. 320 •Milk do 19 per cent, of added water Summons not served — Defendant absconded. 321 do do 19 per cent. of added water Summons not served — Defendant absconded. * All free from Boric Acid and Formalin. † Boric Acid absent. 312 1913] ADULTERATED SAMPLES (Second, Quarter, 1913)—continued. Sample marked. 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. Action taken, with result of prosecution. T.L.B. 324 *Milk Inspector 9 per cent, of original fat abstracted Fined £1 and £1 1s. costs. 332 * do do 8 per cent, of added water Fined £1 and £1 1s. costs. 333 * do do 8 per cent, of original fat abstracted Fined £1 and £1 1s. costs. 340 Butter do 100 per cent, of Margarine Fined £2 and 12s. 6d costs. 341 Margarine do. 100 per cent, of Margarine—the fat of the sample contained 55 per cent, of butter fat Fined £2 and 12s. 6d. costs. 355 •Milk do 40 per cent, of original fat abstracted Fined £4 and 14s. 6d. costs. 382 • do do 5 per cent, of added water Cautioned by letter. 392 * do do 14 per cent, of original fat abstracted Fined £5 and lis. 6d. costs. 406 Margarine do 100 per cent, of Margarine Cautioned by letter. 407 do. do 100 do. do. Cautioned by letter. 408 do. do 100 do. do. To pay 12s. 6d. costs. 432 *Milk do 12 per cent, of original fat abstracted Fined £2 and £1 3s. costs. * All free from Boric Acid and Formalin. Total number of Samples analysed during the Quarter, 332. Number adulterated 27. 313 [1913 ADULTERATED SAMPLES {Third Quarter, 1913). 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. Result of Analysis. Showing whether the sample was Genuine or Adulterated, and, if Adulterated, what were the nature and extent of the Adulteration. Action taken, with result of prosecution. TLB. 34 Butter Inspector 100 per cent, of Margarine Fined £4 and 12s. 6d. costs. 51 „ „ 100 ,, ,, Ordered to pay 12s 6d. costs. 53 *Milk „ 9 per cent, of the original fat abstracted Fined 7s. 6d. and 12s. 6d. costs. 62 * „ „ 4 per cent, of added water Cautioned by letter. 63 * „ „ 13 „ of the original fat abstracted Ordered to pay 12s. 6d. costs. 83 Crushed Linseed „ 24 per cent, of the original oil deficient and not recently prepared Cautioned by letter. 100 Butter „ 100 per cent, of Margarine Fined £30 and 12s. 6d. costs of 1 month in default of distress. 126 Cocoa „ Coloured with oxide of iron No proceedings. 131 Margarine „ 100 per cent, of Margarine Margarine wrapper not labelled. Fined £1 and 12s. 6d. costs. 135 •Milk „ 7 per cent, of the original fat abstracted Ordered to pay 13s. 6d. costs. 157 Margarine „ 100 per cent, of Margarine Cautioned by letter. 158 " „ „ 100 ,, „ Margarine wrapper not labelled. Fined 10s. and 12s. 6d. costs. 159 „ „ 100 „ „ Margarine wrapper not labelled. Fined 10s. and 12s. 6d costs. 197 „ „ 100 „ „ Cautioned by letter. 214 *Milk „ 8 per cent, of original fat abstracted Summons dismissed on ground of warranty. 217 „ 4 per cent of added water and 2 per cent, of the original fat abstracted Cautioned by letter. 261 Coffee „ 27 per cent, of Chicory Fined 5s. and £1 13s. 6d. costs. 270 Malt Vinegar „ Vinegar other than Malt Fined £1 and £1 13s. 6d. costs. 278 •Milk „ 2 per cent, of added water Cautioned by letter. 284 * „ 4 „ ,, Cautioned by letter. * Free from Boric Acid and Formalin. Total number of Samples analysed during the Quarter 300. Number adulterated 20. 314 )13] 3rd Quarter 1913. The following 27 samples of Cream were submitted under the Public Health (Milk and Cream) Regulations, 1912. Sample marked. Sample labelled. Milk Fat Per cent. Boric Acid. Per cent. Other Preservatives and Thickeners. Whether in conformity with the Regulations or not. T.L.B. 1§ No label 54.8 Absent Absent Yes 2§ „•> 53.7 ,, „ „ 3§ „ 53.3 o.44 „ No 4§ Not exceeding 0.5 per cent. Boric Acid 54.3 0.17 „»„ Yes 5§ No label 54.5 Absent „ 6§ Not exceeding 0.5 per cent. Boric Acid 47.'7 0.32 „ „ 7§ 8§ No label Not exceeding 0.5 per cent. Boric Acid 60.2 57.7 Absent 0.11 „ „ 9§ No label .. 58.4 Absent „ 10§ „ 53.2 „1 „ „ 11§ Not exceeding 0 5 per cent. Boric Acid 48.6 0.35 „ „ 12§ No label 21.1 Absent „„ „ 13 „ 35.7 0.34 „ No 14 „ 47.9 0.22 „ „ 15 „ 53.3 0.13 „ „ 69§ „ 47.2 0.37 „ „ 70§ ,, 46.3 0.28 „ „ 7i§ Not exceding 0.5 per cent. Boric Acid 56.3 Absent „ Yes 72§ 51.2 0.49 „ 73§ No label 48.9 0.46 „ No 74§ „ 45.2 Absent „ Yes 1§ „ 48.3 0.37 „ No 2§ 59.'3 o.68 „ „ 3§ :> 60.5 Absent „ Yes 4§ Not exceeding 0.5 per cent. Boric Acid 56.4 „ „ 5§ „ 53.4 .0.70 „ „ 6§ „„ 47.7 0.44 „ „ § Taken informally. 315 [1913 ADULTERATED SAMPLES (Fourth Quarter, 1913). Sample Marked. 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. Action taken, with result of prosecution. T.L.B. 320 Butter.. Inspector 100 per cent, of Margarine Fined £5 and £1 3s. costs. 321 *ilk do. 4 per cent, of added water Cautioned by letter. 322 * do. do. 4 „ Cautioned by letter. 376 Olive Oil do 20 per cent, of Earthnut Oil Ordered to pay 12s. 6d. costs. 427 Margarine do 100 per cent. of Margarine Margarine wrapper not labelled. Fined £1 and 12s. 6d. costs. 428 do. do 100 „ Margarine wrapper not labelled. Ordered to pay 12s. 6d. costs. 462 Milk do 7 per cent, of added water Fined £2 and 12s. 6d. costs. 464 do. do 2 Cautioned by letter. 467 Margarine do. 100 per cent, of Margarine Margarine wrapper not labelled. Ordered to pay 12s. 6d. costs. 487 do do 100„ Margarine wrapper not labelled. Fined £2 and 12s. 6d. costs. 501 Sauce do. Copper equal to 0*48 grains of crystallized Sulphate of Copper per pound Cautioned by letter. 518 *Milk do= 5 per cent, of added water Cautioned by letter. 521 „ do 4 „ Fined £1 and £1 1s. costs. 522 „ do 7 Fined £1 and £1 1s. costs. 546 Butter do 100 per cent, of Margarine Margarine sold as Irish Butter. Fined £3. 548 „ do 100 „ „ Margarine sold as Irish Butter. Fined £5. *49 „ do 100„ Summons not served as Defendant absconded. * Boric Acid and Formalin absent in all cases. 316 1913] ADULTERATED SAMPLES.—(Fourth Quarter, 1913)—continued. Sample Marked. Article submitted for Analysis. State whether the sample was submitted to the Anilyst 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. Action taken, with result of prosecution. TLB. 550 Butter Inspector 100 per cent, of Margarine .. Margarine sold as Irish Butter. Fined £1 and £1 1s. costs. 551 do. do. 100 do. do. Do. Fined £2 and £1 1s. costs. 552 do 100 do. do. Do. Fined £3. 553 do. do. 100 do. do. Do. Fined £10. 554 do do. 100 do. do. Do. Fined £5. 555 do do 25 do. do. An admixture of Margarine and Butter sold as Irish Butter. Fined £5. 566 do do 50 do. do. Do. do. Fined £3 557 do do 100 do. do. Margarine sold as Irish Butter. Fined £3. 558 do do 100 do. do. Do. Summons not served as defendant absconded. 559 do do 75 do. do. Do. Fined £5 and £1 1s. costs. 560 do do 100 do. do. Do. Fined £2 and 10s. 6d. costs. 561 do do 100 do. do. Do. Fined £2 and 10s. 6d. costs. 562 Margarine do The fat contained 30 per cent, of Butter fat Summons withdrawn. (Conviction obtained fo- sample 555.) 563 Butter do 100 per cent, of Margarine Margarine sold as Irish Butter. Fined £2 and 12s. 6d. costs. 564 do. do 100 do. do. Do. do. Fined £5. 565 *Milk do 2 per cent, of added water No action taken. 611 * do do 1 •• * Boric Acid and Formalin absent in all cases. 317 [1913 ADULTERATED SAMPLES (Fourth Quarter, 1913)—continued. Sample marked. 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. Action taken, with result of prosecution. T.I.B. 636 *Milk Inspector 2 per cent. of fat deficient No action taken. 639 Paregoric do. Made with Alcohol of about 80 per cent. instead of with Alcohol of 60 per cent, strength do. 640 do do. 0.18 per cent of Salycylic Acid Cautioned by letter. * Bone Acid and Formalin absent in all cases. Total number of samples analysed during the Quarter 316. Number of samples adulterated .. .. .. ..37. The following 16 samples were submitted under the Public Health (Milk and Cream) Regulations, 1912. Number of Samples. Article submitted for Analysis. Sample submitted to Analyst by Officer under direction of Local Authority. Result of Analysis. 2§ Cream Inspector Conformed with the Regulations. 3§ do do Did not conform with the Regulations. 6S Preserved Cream do. Conformed with the Regulations. 2 Cream do. Conformed with the Regulations. 2 do. .. .. do. Did not conform with the Regulations. 1 Condensed Milk do. Conformed with the Regulations § These samples were taken without the formalities prescribed. 318 1913] INFORMAL SAMPLING OF FOOD. As usual Inspector Burrell has informally sampled several of the more common foods, and from a report which he has submitted to me it is seen that it has resulted in the discovery of several delinquents who might otherwise have escaped detection. His work is now so well known to the Council that there is no occas ion for me to dwell on it further. His report for the year is as follows:— Public Health Department, Town Hall, Islington, N. IIth February, 1914. To A. E. Harris, Esq., Medical Officer of Health, Dear Sir, As directed by you, and for the information of the Public Health Committee, I have pleasure in submitting for your consideration the following report on the testing of informal samples for the year ending 31st December, 1913. The purchase of samples under the Regulations as to Preservatives in Milk and Cream, made under the Public Health (Regulations as to Food) Bill, have during the past year made a very considerable addition to my already heavy duties, and although I have succeeded in keeping the testing work at nearly the same level as for 1912, this has only been accomplished by executing a greater portion of the work at the expense of my private time. As in previous years, a very considerable percentage of the Defendants to the summonses issued as a result of this work are habitual offenders. In one such case I found it expedient to employ two agents, who between them paid fourteen visits to the premises, before we ventured to purchase an official sample. That such precautions were necessary I may mention that one of the agents was suspected, and after receiving Margarine twice, was served with Butter during his remaining visits. Of the fourteen samples thus purchased, six were genuine and eight adulterated. Ultimately the Defendant in this case was fined 40s., and this after two previous convictions, a sequel which explains the existence of the habitual offender. That the public is defrauded in such instances is only one side of the question; there is another, and a most important one, and that is the effect it has on the honest tradesman. During the past few years I have received a number of complaints from tradesmen, the complaint usually being to the effect that the complainant while trying to carry on a legitimate business is seriously handicapped by another 319 [1913 tradesman in the vicinity who, while advertising to sell similar commodities at a considerably cheaper rate, is actually selling an adulterated article and thus securing a greater percentage of profit than the honest tradesman. That some of these complaints arise from a feeling of trade jealousy I have discovered to be a fact; but my investigations have led me to the conclusion that the greater number are well founded. Perhaps the following instance will illustrate the matter better than anything else I could say upon the subject. A is a tradesman who has for some years engaged in the provision trade, and so far as informal sampling, and the purchase of official samples show, he has carried on a legitimate business. On either side of him, at a short distance, B and C are also engaged in the provision business, and as a decoy cut the prices of several leading commodities to a vanishing point, but substitute Margarine for Butter. In order to keep his trade together, A has to meet the competition, but continues to sell pure butter, the result being (so he assured me) that he was recently carrying on business at a loss. A number of previous convictions prove that B and C have been engaged in a fraudulent business for several years, and I have no doubt whatever that were they to attempt to trade in a legitimate manner at their present prices, they would soon have to close their shops. Indeed, I have noticed in one instance, that when the usual methods are suspended, as they are during the pending of a prosecution, there is a considerable diminution of stock. It so happened that B and C have been in this condition during the past few weeks, and A assured me that his takings went up £10 the first week they were so situated, and to substantiate this statement offered to produce his takings book. The fines paid, the old order of things is soon resumed and will continue to be until such time as a crushing penalty is incurred, an event that may take years to happen, seeing that B in the case above mentioned was fined £3 on the occasion of his filth conviction. In spite of the many difficulties, however, informal sampling has in the past few years brought Nemesis to not a few of the worst offenders, who have since migrated to the unknown. During the year I tested and examined 668 samples, of which 543 were found to be genuine, 36 were sold either with a declaration given verbally or imprinted upon the wrapper, while 89, or 13.3 per cent, were adulterated, the latter including repetition samples purchased at the same premises over varying periods, and samples purchased by young children. In 40 instances the informal sampling was concluded by the purchase of an official sample, the latter being submitted to the Public Analyst in the usual manner, who reported against 36 for prosecution, and 1 sample of Coffee, 1 sample 320 1913] of Milk and 2 samples of Butter as genuine. Of the coffee and milk doubtless a change had been effected between the purchase of the preliminary and official samples, while in the case of the two butter samples, by a curious coincidence, Inspectors acting under the direction of the Board of Agriculture for Ireland were ' engaged in purchasing informal samples at ihe same time, and on comparing notes we have come to the conclusion that our joint operations may have been answerable for a sudden reversion to Butter, where for some time we had been given Margarine. In one case, however, a further sample has been purchased when Margarine was again sold as Butter, and the vendor has since disappeared, doubtless to save himself from what would have been his eighth appearance at Court. In two instances the sellers were cautioned, and in the other 34 cases summonses were issued, while of the proceedings which followed, 32 were successful, 1 summons remains in abeyance, the defendant having absconded, and 1 summons against a vendor for selling milk containing formalin was dismissed. In addition to the above prosecutions, two summonses were issued against milk vendors " for refusing to sell." it having been discovered by testing samples procured from their customers that they were engaged in a system of fraudulent trading. The number of prosecutions therefore was 36, or 43.9 per cent of the total number of prosecutions under the Sale of Food and Drugs Acts for the year, while the fines and costs from the same source amounted to £124 ns. 6d. For a period covering about six weeks during the fourth quarter, four Inspectors, acting under the instructions of the Board of Agriculture for Ireland, made a most extensive investigation within the Borough, their object being to discover persons who were selling Margarine when asked for Irish Butter. The figures showing their total number of purchases are not available, but as the whole Borough seems to have been thoroughly tested, it is not too much to suppose that some hundreds of samples were examined. Seeing that the conditions under which the samples were purchased were such as to assure the highest possible results, it is gratifying to know that only 17 cases of fraud were detected, and [still more so that the persons responsible were not new to us. Acting under your instructions, and with the assistance of the Inspectors above mentioned, I purchased official samples from each of the persons under suspicion. The samples were submitted to the Public Analyst, and in due course he reported against 16, in consequence of which summonses were issued, and the results of the prosecutions will be duly reported. I have not included the above 17 samples in my returns by reason that the whole figures were not available, and if added would have given a false value to the 321 [1913 percentages. They must be considered with the test sampling work, however, and their inclusion will give an amended total of 684 samples. The several foods examined were as follows:— Milk.—As in previous years, the milk samples have been obtained for the most part from dairies and milkshops, and more particularly from those vendors whom we have reason to regard with suspicion. A number of samples were also procured from the customers of certain vendors, and in two cases, as already stated, convictions were obtained against vendors thus discovered to be engaged in fraudulent practices, while in another prosecution, the knowledge gained by informal testing enabled us to break down a defence of warranty. During the year 184 samples were tested, of which number 14, or 7-6 per cent, were found to be adulterated, not including those samples adulterated to an extent of less than 4 per cent. Margarine.—Of the 192 samples examined, 172 were found to be sold in conformity with the Act, while 20, or 10.4 per cent, were delivered to the purchaser in an unstamped wrapper, and were accordingly classed as adulterated. Coffee.—Fifty-eight samples of coffee were tested, of which number, 37 were found to be genuine; 14 were sold either with a verbal declaration, or enclosed in a package bearing an inscription to the effect that the contents were sold as an admixture of Coffee and Chicory, or more frequently Chicory and Coffee, and 7 or 12 per cent, were adulterated. Demerara Sugar.—42 samples were tested, 24 of which were genuine, 15 were sold in wrappers having the words "Yellow Crystals," or with a verbal declaration to that effect, while 3 or 7.1 per cent, were adulterated. Butter—The major portion of the Butter Samples were purchased from those shopkeepers against whom there had been previous convictions. 142 samples were tested, 98 being genuine, and 44 or 30.98 per cent, adulterated. This high rate of adulteration is explained by the fact that repetition samples and samples purchased by children have been included. The samples purchased with the assistance of the Inspectors of the Board of Agriculture for Ireland have not been included with the above. Spirits (Gin).—12 samples were tested as to strength, n were found to be genuine, and 1 or 8 3 per cent, adulterated. X 322 1913] Scotch whiskey.—Six samples were similarly tested and found to be genuine. Malt Vinegar.—12 samples were tested, six of which were sold with a declaration to the effect that they were "Wood Vinegar," while six were found to be genuine. Olive Oil.—Of the eight samples tested, seven were genuine, and one was sold with a declaration to the effect that it was " Nut Oil." Cocoas.—12 samples were tested and found to be genuine. For purposes of comparison I insert the following Table. showing the results of the test work since its conception in 1908 :— ALL SAMPLES. Year. No. of Samples. Declared. Adulterated. Percentage of Adulteration. 1908 340 38 47 13.8 1909 471 96 88 18.7 1910 633 81 73 11.5 1911 663 10 68 10.2 1912 783 49 67 8.7 1913 668 36 89 13.3 3.558 310 432 12.1 I am, Your obedient Servant, (Signed) TOM L. BURRELL, Food and Drugs Inspector. 323 [1913 * Warranties successfully pleaded in 4 instances. The other 3 cases were dismissed on their merits, 4Dismissed on point of law. § Work executed prior to hearing of summonses. ‡ 3 of these were alternative summonses. The other 3 were withdrawn on warranties being successfully pleaded. Defendant absconded. Table CXXIII. SUMMARY OF PROSECUTIONS.—During year 1913. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties Received. "Public Health (London) Act, 1891 " 24 19 1 + 4§ £ 57 s. 8 d. 6 "Sale of Food and Drugs Acts, 1875-99" 64 51 7* 6‡ 290 4 0 "Margarine Act, 1887 " 18 17 ... 10 24 15 6 " London County Council By-laws" 2 I ... 1£ 7 0 Total 108 88 8 12 372 15 0 324 1913] 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:— 1911-12 1912-13 Houses Supplied 219,165 220,021 Houses on constant system 220,021 220,021 Houses not on constant system Nil Nil Percentage of houses on constant system 1000.0 100.0 Population supplied 1,434,771 1,335.402 Average daily supply (gallons) 47.665,300 45,516,000 Quantity of water supplied during the year (gals.) 17,445,510,000 16,613,548,000 Average daily supply per house (gals.) 217.49 206.30 „ ,, head (gals.) 33.22 34.10 Average number of persons supplied per house 6.55 6.05 Capacity of subsidence reservoirs 99,200,000 99,200,000 APPENDIX. VITAL AND SANITARY STATISTICS, 1913. together with the PRESCRIBED RETURNS OF THE LOCAL GOVERNMENT BOARD AND Abstracts for Previous Years. 326 1913] Table A. Showing the Deaths from All Causes in Islington during the Year 1913., Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. Deaths in Institutions within Borough. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals 0- 1- 5- 10- 15- 20- 25- 35- 15- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.e. Small Pox (a) vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Measles 16 80 4 1 .. .. .. .. .. .. .. .. .. 96 5 7 20 17 15 10 17 15 80 51 101 Scarlet Fever 2 11 5 .. .. .. 1 .. .. .. .. .. .. 13 6 3 2 3 4 1 .. 6 14 5 19 Typhus fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Epidemic Influenza 1 4 .. .. .. 2 4 8 17 5 7 9 1 5 53 5 6 5 7 13 6 16 7.6 32, 58 1 Whooping Cough 22 35 5 .. .. .. .. .. .. .. .. .. .. 67 5 1 8 6 13 13 11 10 33 29 62 1 Diphtheria 3 20 13 1 .. .. .. .. .. .. .. .. .. 23 14 5 5 3 6 4 3 11 13 ?A 37 Enteric Fever .. .. .. .. .. .. .. 2 2 .. .. .. .. .. 4 2 .. .. .. 1 .. 1 3 1 4 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Diarrhoea, Dysentery 40 10 .. .. 1 .. 1 2 2 .. 2 1 1 50 10 5 9 6 13 8 11 11 31 29 60 9 epidemic Enterities 28 10 .. .. .. .. .. .. .. .. .. 1 .. 38 1 4 4 12 5 8 6 18 21 39 Other Allied Diseases 11 11 .. 1 .. .. .. .. .. .. .. .. .. 2 1 .. .. .. .. .. 2 1 3 .. 3 Hydrophobla .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Tetanus 3 .. .. 1 .. .. .. .. .. .. .. .. .. 3 1 .. .. .. 1 1 .. 2 4 .. 4 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Syphilis 12 .. .. .. .. .. .. .. 4 1 .. .. .. 12 5 3 .. .. 5 2 3 4 11 6 17 1 Gonorrhoea .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 .. .. .. .. 1 .. 1 2 .. 2 Phagedena .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 .. 1 6 Erysipelas 1 1 .. .. .. .. .. 2 1 .. 4 .. .. 2 7 1 2 1 .. .. 2 3 4 5 9 3 Puerperal Fever .. .. .. .. .. 2 4 1 .. .. .. .. .. .. 7 2 .. 1 1 .. 1 2 7 7 4 Pyaemia 3 .. .. 1 2 .. .. .. 1 1 .. l .. 3 6 .. .. .. 1 2 3 3 6 3 9 Infective Endocarditis 1 .. .. .. .. 2 1 3 .. .. .. .. .. 1 6 .. 2 1 1 2 1 4 3 7 6 Other Allied Diseases) .. .. .. .. .. .. .. .. 5 2 2 .. .. .. 9 .. 1 2 3 1 2 6 3 9 Malarial fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. 3 1 2 .. 4 .. 1 .. .. .. .. .. 11 .. 1 3 2 2 1 2 .. 8 11 Rheumatism of Heart .. .. .. 1 2 .. 1 .. .. .. .. .. .. .. 4 1 .. .. .. .. 2 1 .. 4 4 11 Tuberculosis of Brain 9 28 13 3 4 .. 1 .. .. .. .. .. .. 37 21 4 3 7 7 7 17 13 31 27 58 5 Tuberculosis of Larynx .. .. .. .. .. .. .. 3 3 1 .. .. .. 7 1 .. ? 1 .. 3 .. 7 .. 7 134 Phthisis 2 11 4 9 23 37 81 105 74 46 15 5 1 13 400 39 43 37 63 55 26 90 242 171 113 7 Abdominal Tuberculosis 7 9 2 2 1 2 1 1 4 1 .. .. .. 16 14 5 4 2 4 5 6 4 20 90 30 4 General Tuberculosis 1 7 3 .. .. 2 4 .. 1 .. .. .. .. 8 10 1 .. 2 2 2 6 5 8 10 18 2 Other forms Tuberculosis 2 .. .. 2 1 1 2 1 .. .. .. .. .. 2 7 1 2 2 1 1 .. 2 7 9 9 Other Infective Diseases .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 1 Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Actinomycosis .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 1 1 Hydatid diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Food Acute Alcoholism .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 .. .. .. .. .. .. 2 1 .. .. Chronic Alcoholism .. .. .. .. .. .. .. 1 4 2 1 .. .. .. 8 1 3 2 1 4 4 8 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. Other chronic poisontings .. .. .. .. .. .. .. .. .. .. .. .. 1 Osteo-arthritis .. .. .. .. .. .. .. .. 1 4 4 2 .. .. .. 1 2 1 1 3 .. 3 4 7 11 Gout .. .. .. .. .. .. .. .. .. 1 1 .. .. 2 .. .. .. 2 .. .. 2 .. 2 116 Cancer .. 1 .. .. .. 4 13 31 83 99 115 49 .. 1 403 41 37 34 47 87 73 8b 171 233 104 Diabetes Mellitus 1 .. .. 2 2 .. 5 2 7 4 11 1 6 l 34 8 3 2 1 10 4 7 18 17 35 Purpura Hemorrhagica 1 .. .. .. .. .. .. 1 .. .. 1 .. .. 1 2 1 .. .. 1 1 .. .. 1 2 3 Haemophillia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anaemia .. .. .. .. 1 7 2 7 4 1 .. .. .. 18 2 .. 1 2 8 1 4 10 8 18 Lymphadenoma .. 1 .. .. .. .. 1 .. 2 .. .. .. .. 1 3 .. .. .. 2 1 .. 1 3 1 4 1 Premature Birth 139 .. .. .. .. .. .. .. .. .. .. .. .. 139 .. 14 12 15 14 19 33 32 73 66 139 Injury at Birth 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. 1 .. 1 1 2 Debility at Birth 2b .. .. .. .. .. .. .. .. .. .. .. .. 25 .. 2 2 1 4 6 3 7 19 6 25 Atelectasis 16 .. .. .. .. .. .. .. .. .. .. .. .. 16 .. .. 1 2 3 2 5 3 9 7 16 1 Congenital Defects 40 1 .. .. .. .. .. .. .. .. .. .. 41 .. 8 6 6 3 1 7 10 19 22 41 Want of Breast Milk 6 1 .. .. .. .. .. .. .. .. .. .. .. 7 .. 1 1 .... 1 2 1 1 4 7 Atrophy, Debility, Marasmus 119 4 .. .. .. .. .. .. .. .. .. .. 123 .. 12 18 13 25 13 28 14 76 47 123 * Cerebro-Spinal Meningitis. † Post B. Meningitis. 327 1913 Table A.—Continued. Deaths in Institutions within Borough. DISEASES. AGES. Under 5. Over 5. DISTRICTS. Males. Females. Total 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.e. 1 Dentition 4 2 •• •• •• •• •• •• •• •• •• •• •• 6 •• •• •• 1 1 •• 2 2 4 2 6 Rickets 2 2 •• •• •• •• •• •• •• •• •• •• •• 4 •• •• 1 •• 1 1 1 2 2 4 Old Age, Senile Decay •• •• •• •• •• •• •• •• •• 4 58 130 78 21 270 24 38 31 27 42 69 98 172 270 Convulsions 18 3 •• 1 •• •• •• 1 •• •• •• •• •• 16 2 1 6 •• 3 3 7 17 6 23 Meningitis 8 8 1 •• 2 •• •• 2 1 •• •• •• •• •• 6 2 2 1 2 7 1 9 13 22 Encephalitis •• •• •• •• •• 1 1 1 •• •• •• •• •• 3 3 1 •• 18 1 25 •• 1 2 3 1 Apopelxy 2 1 •• •• 1 •• 3 5 18 33 46 25 8 •• 139 13 17 2 10 1 3 35 62 80 142 Softening of Brain •• •• •• •• •• •• •• •• 2 5 4 2 1 •• 14 2 1 •• 2 6 5 4 6 8 14 Hemiplegia •• •• •• •• •• •• •• •• 2 7 7 5 •• •• 21 2 1 •• 3 5 5 5 11 10 21 General Paralysis of the Insame •• •• •• •• •• •• 3 12 14 7 •• 1 •• •• 37 5 8 3 3 7 2 8 29 8 37 Other forms of Insanity •• •• •• •• 1 •• 1 5 1 4 4 3 2 •• 21 •• 4 1 •• •• 4 9 12 21 Chorea •• •• •• •• •• •• 1 •• •• 1 • • •• •• •• 2 •• •• 2 •• 1 3 •• 5 1 2 Cerebral Tumour •• 1 2 1 1 1 •• 2 3 1 1 •• •• 1 12 •• 4 2 1 3 8 2 14 8 13 Epilepsy 1 •• 1 1 1 2 4 1 9 3 3 2 •• 1 27 4 2 •• 9 •• 1 1 14 28 Laryngismus Stridulus 1 1 •• •• •• •• •• •• •• •• 1 •• •• 2 1 •• 1 1 •• 3 2 2 8 2 3 Locomotor Ataxy •• •• •• •• •• •• •• •• 5 3 1 •• •• •• 9 •• •• 2 •• 6 6 4 16 1 9 Paraplegia •• •• 1 •• 1 •• 1 33 5 4 8 2 •• •• 25 5 2 1 1 1 3 3 4 9 25 Other forms, Brain Diseases •• 1 •• •• 1 •• •• 3 4 2 1 1 •• 1 12 •• 4 1 1 1 2 5 7 9 13 Otitts 1 2 4 2 4 2 •• 1 •• •• •• •• •• 3 13 1 1 3 3 •• •• 1 1 9 16 Disease of Nose, Epistaxis 1 •• 1 •• 1 •• •• •• •• •• •• •• •• 1 2 •• 1 •• 1 •• •• 1 1 2 3 Disease of Eye •• •• •• •• •• •• •• 1 •• •• •• •• •• •• 1 •• •• •• •• 1 2 1 •• •• 1 Pericarditis 1 1 •• •• •• 1 1 •• 1 •• •• •• •• 2 3 1 •• •• •• 1 4 2 7 5 5 2 Endocarditis •• •• 2 1 1 1 1 1 4 1 2 •• •• •• 14 1 •5 1 •• •• •• •• •• 7 14 Hypertrophy of Heart •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 4 1 2 7 •• •• Angina Pectoris •• •• •• •• •• •• •• •• 1 3 5 1 •• •• 10 2 •• 1 •• 4 4 2 13 3 10 2 Aneurism •• •• •• •• •• •• •• 2 2 6 3 •• 1 •• 14 1 •• 1 2 4 1 •• 3 2 14 6 Senile Gangrene •• •• •• •• •• •• •• •• •• 2 5 1 1 •• 9 2 2 •• •• 7 5 5 11 18 9 9 Embolism, Thrombosis •• •• •• 1 •• •• 1 2 5 6 6 7 1 •• 29 1 4 3 4 •• •• •• •• •• 29 Phlebitis •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Varicose Veins •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 192 Other Diseases, Heart and Vessels 4 1 4 9 8 16 28 53 96 128 171 106 28 5 647 71 78 64 69 110 94 166 264 388 652 1 Laryngitis •• 3 •• •• •• •• 1 •• •• •• •• •• •• 3 1 1 •• 1 •• 1 •• 1 1 3 4 Croup 1 •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• •• •• •• •• •• •• •• •• •• Othet Diseases, Larynx and Trachea •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 21 Acute Bronchitits 59 16 2 •• 1 •• 1 3 8 14 25 14 6 75 74 9 16 16 19 30 25 34 81 68 149 130 Chronic bronchitis •• 1 1 •• •• •• 3 10 24 61 116 108 19 1 342 29 42 22 38 55 71 86 183 160 343 25 Lobar Pneumonia 1 4 3 •• 1 1 5 6 12 11 5 3 1 5 48 4 10 3 7 7 11 11 34 19 53 46 Lobular Pneumonia 82 69 3 •• •• 1 1 1 8 10 14 7 •••• 151 45 16 20 20 28 32 41 39 101 95 196 21 Pneumonia 26 29 5 4 4 2 15 11 25 19 21 6 3 55 115 21 15 14 17 29 20 54 101 69 170 7 Emphysema, Asthma •• •• •• •• •• •• 2 2 3 1 2 4 1 •• 15 1 3 1 2 1 2 5 11 4 15 3 1 2 •• •• •• 1 1 2 1 5 3 •• •• 3 13 3 3 •• 1 5 2 2 12 4 16 Other Diseases, Respiratory System •• •• 1 1 •• •• 1 1 1 2 1 2 1 •• 11 •• 1 2 2 1 2 3 5 6 11 Diseases of Mouth and Annexa 1 2 •• •• •• •• •• •• 1 •• •• •• •• 3 1 •• 1 1 1 •• •• 1 2 2 4 Disesase of Pharynx •• 3 1 •• •• •• •• •• 1 •• •• •• •• 3 2 •• •• •• •• 4 •• 1 4 1 5 Diseases of Œsophagus •• •• 1 •• •• •• •• •• •• •• •• •• •• •• 1 •• •• •• •• •• •• 1 1 •• 1 2 Ulcer of Stomach and Duodenum •• •• •• •• •• •• 3 4 6 5 3 1 •• •• 22 1 2 2 •• 1 6 10 18 4 22 1 Other Diseases of Stomach 14 4 •• •• •• •• •• 2 2 •• 4 2 •• 18 10 5 7 2 3 1 4 6 15 13 28 81 Enteritis 99 29 2 •• •• •• 3 •• 1 2 2 2 1 128 13 19 19 12 14 10 38 29 78 63 141 1 Appendivitis •• 2 5 •• 5 2 2 2 3 •• 2 1 •• 2 22 3 3 3 1 7 2 5 8 16 24 Obstruction of Intestine 6 3 1 •• •• •• 4 2 2 9 7 5 •• 9 30 6 5 8 4 9 3 4 16 23 39 Other Diseases of Intestine 4 2 •• •• •• 1 •• •• •• •• 2 2 •• 6 5 •• •• 3 2 1 2 3 7 19 11 13 Cirrhosis of Liver •• •• •• •• •• •• 1 7 16 10 7 3 •• •• 44 8 8 4 4 5 10 5 25 7 44 Other Diseases of Liver •• 1 •• •• 1 •• •• 1 •• 5 3 4 •• 1 14 2 2 1 3 4 •• 3 8 6 15 3 Peritonitis 1 •• 2 1 •• •• 1 1 •• •• 2 1 •• 1 8 1 2 •• 1 4 •• 1 3 6 9 Other Diseases, Digestive System 5 •• •• •• 1 •• •• 1 2 3 •• 1 •• 5 8 4 •• •• 1 2 4 2 7 8 13 Diseases, Lymphatic System and Glands •• •• •• 1 1 •• •• 3 3 •• 2 •• •• •• 10 1 •• 1 •• 1 2 5 2 10 10 3 Acute Nephritis •• 2 1 1 •• •• •• 4 33 3 2 3 •• 2 17 2 3 2 2 3 3 4 9 75 19 36 Bright's Disease •• •• •• 2 •• 1 1 19 1 40 32 22 1 •• 151 20 21 12 18 13 31 36 76 1 151 Calculas •• •• •• •• •• •• 1 1 •• 1 2 1 •• •• 7 •• •• 1 1 2 1 2 6 2 7 Diseases of Bladder and Prostate •• •• •• •• •• •• 1 12 3 11 7 3 •• 26 2 3 2 2 11 4 2 24 4 26 Other Diseases, Urinary System 3 •• •• •• •• •• 2 2 1 •• 2 •• •• 3 7 •• •• •• 4 3 1 2 6 •• 10 Disease of Testis and Penis •• •• •• •• •• •• •• •• 1 •• •• •• •• •• 1 •• •• •• •• •• 1 •• 1 1 1 Disease Of Ovaries •• •• •• •• •• •• •• •• 1 •• •• •• •• •• 1 •• •• •• •• •• 1 •• •• 5 1 Diseases of Uterus and Appendages •• •• •• •• •• 1 1 1 1 •• •• •• •• 5 •• •• 1 •• •• •• 4 •• 5 Diseases of Vagina and External Genitals •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Diseases of Breast •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• •• 1 Abortion, Miscarriage •• •• •• •• •• 1 •• •• •• •• •• •• •• •• 1 •• •• •• •• •• •• •• •• 1 1 Puerperal Mania •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 1 •• •• •• Puerperal Convulsions •• •• •• •• •• 1 •• •• •• •• •• •• •• •• 1 •• •• •• •• •• •• 1 •• 1 1 1 Placenta Prævia, Flooding •• •• •• •• •• 1 9 •• 1 •• •• •• •• 11 •• 2 2 1 2 3 1 •• 11 11 328 1913] Table A.—Continued. Deaths in 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. Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other diseases, Pregnancy and Childbirth .. .. .. .. .. 1 4 1 .. .. .. .. .. .. 6 1 .. .. 1 2 1 1 .. 6 6 Arthritis, Ostitis, Periostitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other diseases osseous system 1 .. .. 1 1 .. 1 1 .. .. .. .. .. 2 4 .. .. 2 .. 1 3 .. 3 3 6 Ulcer, Bedsore .. .. .. .. .. .. .. 2 .. .. .. 1 .. .. 3 .. .. .. 1 .. 1 1 3 .. 3 Eczema 1 1 .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 .. 2 .. 2 Pemphigus 5 .. .. .. .. .. .. .. .. .. .. .. .. 5 .. .. .. 1 1 1 .. 2 2 3 5 Other Diseases, Integumentary system 1 1 1 1 1 3 1 1 .. 1 .. 1 2 2 4 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. 2 7 2 4 .. 4 3 2 3 5 4 .. 2 34 6 4 2 4 4 5 11 29 7 36 On Railways .. .. .. .. 1 2 .. .. .. 1 .. 4 .. .. 1 .. 2 1 .. 4 .. 4 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 In Building Operations .. .. .. .. .. .. .. 3 2 .. .. .. .. .. 7 .. .. .. 1 .. 3 3 / .. 7 By Machinery .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 2.. .. .... .... .... 1 .... 1 1 1 2 By Weapons and Implements .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 2 1 .. .. .. .. .. 1 2 .. 2 Burns and Scalds 2 1U .. 1 .. .. 1 2 .. .. 2 .. .. 12 6 .. 6 .. 2 2 4 4 11 7 18 Poisons, Poisonous Vapours .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 .. .. .. .. 1 .. 1 2 .. 2 surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Effcts of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions By Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. .. .. 1 1 .. 1 1 l 2 .. .. .. 1 7 .. 1 .. .. .. 3 4 5 3 8 Suffocation, Overland in Bed .. .. .. .. .. .. .. .. .. .. .. .. .. 32 .. 2 2 1 4 4 9 10 12 20 32 „ Otherwise 3 .. .. 1 .. .. 1 .. 2 .. 1 .. .. 6 6 .. 1 .. 2 1 4 1 4 5 9 Falls not specified 2 4 2 .. .. .. i 3 2 3 4 7 2 6 24 2 3 4 5 5 5 6 10 20 30 Weather Agencies .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 .. .. .. .. .. 1 .. 1 Otherwise, not stated .. .. 1 .. .. .. .. 1 1 1 .. .. .. 1 4 .. .. .. 1 2 2 3 2 5 Homicide 1 1 .. 1 .. .. .. .. .. .. .. .. .. 2 1 .. .. .. 2 .. 1 .. .. 3 3 Suicide. 1 By Poison .. .. .. .. 1 .. 2 2 2 3 1 .. .. .. 11 1 1 .. 3 2 .. 4 9 2 11 By Asphyxia .. .. .. .. .. .. .. .. 1 1 1 .. .. .. 3 1 1 .. .. .. 1 3 .. 3 by Hanging and Strangulation .. .. .. .. 1 1 .. 2 1 .. .. .. .. 6 .. 1 .. 5 .. .. 2 6 .. 6 by Drowning .. .. .. .. .. .. .. 2 3 .. .. .. .. .. 6 .. .. .. 1 1 2 2 4 2 6 By shooting .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 .. 1 .. .. 1 .. .. 2 .. 2 by Cut or Stab .. .. .. .. .. .. 1 1 1 1 .. .. .. .. 4 .. .. .. .. .. 3 1 4 .. 4 By Precipitaion from Elevated Places .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 By Crushing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By other and unspecified methods .. .. .. .. .. .. l .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Execution .. .. .. .. .. .. i .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Sudden Death, Cause not tained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill defined and unspecified causes .. .. .. .. .. .. .. .. .. l .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Males 517 230 56 24 40 34 131 195 313 335 389 229 49 747 1795 246 283 234 317 394 477 59 .. .. 2542 Females 381 220 52 34 49 58 122 181 264 280 389 338 118 601 1885 248 304 230 303 417 429 555 .. .. 2486 969 TOTAL DEATHS 898 450 108 58 89 92 253 376 577 618 178 867 167 1348 3680 494 587 464 620 811 906 1146 2542 2486 5028 329 [1913 Table B. Showing the Deaths from All Causes registered during the Quarters of the Year 1913 at three periods of life. DISEASES. 1st Quarter. Total. 2nd Quarter. Total. 3rd Quarter. Total. 4 th 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 ft Small Pox- fa:) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 4 41 4 49 11 37 1 49 1 2 .. 3 .. .. .. .. 101 Scarlet Fever 2 3 2 7 .. 3 .. 3 .. 3 2 5 .. 2 .. 4 19 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. 1 24 25 .. .. 18 18 .. 1 4 5 1 2 7 10 58 Whooping Cough 5 11 .. 16 .. 16 5 31 5 3 .. 8 2 5 .. 7 62 Diphtheria 1 9 2 12 .. 5 6 11 .. 2 2 4 2 4 .. 10 37 Enteric fever .. .. 4 4 .. .. .. .. .. .. .. .. .. .. .. .. 4 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhoea, Dysentery 3 .. .. 3 .. .. 3 5 24 6 1 31 11 4 6 21 60 Epidemic Enteritis 2 .. .. 2 .. .. .. .. 10 7 1 18 16 3 .. 19 39 Other A llied Diseases .. .. .. .. 1† 1† 1* 3 .. .. .. .. .. .. .. .. 3 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 2 .. 1 3 1 .. .. 1 .. .. .. .. .. .. .. .. 4 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox syphilis 6 .. 2 8 3 .. 2 5 .. .. 1 1 3 .. .. 3 17 Gonorrhoea .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 2 2 Phagedena .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 erysipelas 1 .. 3 4 .. .. .. .. .. .. 2 2 .. 1 2 3 9 Puerperal Fever .. .. 5 5 .. .. .. .. .. .. 1 1 .. .. 1 1 7 Pyaemia 2 .. .. 2 1 .. .. 1 .. .. 3 3 .. .. 3 3 9 Infective Endocarditis 1 .. 3 4 .. .. 1 1 .. .. 2 2 .. .. .. .. 7 Other Allied Diseases .. .. 4 4 .. .. 1 1 .. .. 2 2 .. .. 2 2 9 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatic Fever .. .. 2 2 .. .. 2 2 .. .. 4 4 .. .. 3 3 11 Rheumatism of Heart .. .. .. .. .. .. .. .. .. 3 3 .. .. 1 1 4 Tuberculosis of Brain 2 6 7 15 1 10 4 15 3 5 3 11 3 7 7 17 58 Tuberculosis of Larynx .. .. 2 2 .. .. 3 3 .. .. 1 1 .. .. 1 1 7 Phthisis 1 .. 106 109 1 6 86 93 .. 3 77 80 .. .. 131 131 413 Abdominal Tuberculosis 2 .. 3 5 2 2 5 9 1 4 3 8 2 3 3 8 30 General Tuberculosis .. 1 2 3 1 3 4 8 .. 1 1 2 .. 2 3 5 18 Other Forms Tuberculosis .. .. 2 2 1 .. 1 2 1 .. 2 3 .. .. 2 2 9 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Actinomycosts .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 1 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Altered Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute alcoholism .. .. .. .. .. .. .. .. .. .. 2 2 .. .. .. .. 2 Chronic Alcoholism .. .. .. .. .. .. 1 1 .. .. 1 1 .. .. .. 6 8 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo-arthritis .. .. 4 4 .. .. 3 3 .. .. 2 2 .. .. 2 2 11 Gout .. .. .. .. .. .. 1 1 .. .. .. .. .. .. 1 1 2 Cancer .. .. 93 93 .. .. 75 75 .. 1 125 126 .. .. 110 110 404 Diabetes Mellitus .. .. 9 9 .. .. 12 12 .. .. 7 7 1 .. 6 7 35 Purpura Hæmorrhagica .. .. 1 1 1 .. .. 1 .. .. 1 1 .. .. .. .. 3 Haemophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anaemia .. .. 2 2 .. .. 6 6 .. .. 2 2 .. .. 8 8 18 Lymphadenoma .. .. .. .. .. .. 3 3 .. .. .. .. .. 1 .. 1 4 Premature Birth 34 .. .. 34 35 .. .. 35 35 .. .. 35 35 .. .. 35 139 Injury at Birth 1 .. .. 1 1 .. .. 1 .. .. .. .. .. .. .. .. 2 Debility at Birth 12 .. .. 12 5 .. .. 5 6 .. .. 6 2 .. .. 2 25 Atelectasis 7 .. .. 7 3 .. .. 3 4 .. .. 4 2 .. .. 2 16 Congenital Defects 12 .. .. 12 11 .. .. 11 11 .. .. 11 6 1 .. 7 41 Want of Breast Milk .. .. .. .. 3 .. .. 3 1 1 .. 2 2 .. .. 2 7 Atrophy, Debility, Marasmus 32 3 .. 35 35 .. .. 35 22 1 .. 23 30 .. .. 30 123 * Cerebro-Spinal Meningitis. †Post B. Meningitis, 330 1913] Table B.—Continued. 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 Denition 2 .. .. 2 1 2 .. 3 .. .. .. .. 1 .. .. 1 6 Rickets 1 .. .. 1 1 1 .. 2 .. 1 .. 1 .. .. .. .. 4 Old age, Senile Decay .. .. 76 76 .. .. 69 69 .. .. .. 51 .. .. 74 74 270 convulsions 6 2, .. 8 4 .. 1 5 5 1 1 7 3 .. .. 3 23 Meningitis 2 3 .. 5 2 1 3 6 1 1 2 4 3 3 1 7 22 euciphalitis .. .. .. .. .. .. 2 2 .. .. 1 1 .. .. .. .. 3 Apoplexy .. 1 34 35 1 .. 38 39 1 .. .. 31 .. .. 37 37 142 Softening of Brain .. .. 3 3 .. .. 3 3 .. .. 6 6 .. .. 2 2 14 Hemiplegia .. .. 5 5 .. .. 5 5 .. .. 5 5 .. .. 6 6 21 General Paralysis of Insane .. .. 12 12 .... .. 3 3 .. .. 11 11 .. .. 11 11 37 Other forms of Insanity .. .. 3 3 .. .. 4 4 .. .. 7 7 .. .. 7 7 21 Chorea .. .. 1 1 .. .. .. .. .. .. 1 1 .. .. .. .. 2 Cerebral Tumour .. .. .. .. .. .. 3 3 .. 1 2 3 .. .. 7 7 13 epilepsy .. .. 6 6 .. .. 9 9 1 .. 4 5 .. .. 8 8 28 Laryngismus Stridulus .. .. .. 1 .. 1 .. 1 .. .. 1 1 .. .. .. .. 3 Locomotor Ataxy 1 .. 1 1 .. .. 3 3 .. .. 2 2 .. .. 3 3 9 Paraplegia .. .. 7 7 .. .. 2 2 .. .. 5 5 .. .. 11 11 25 Other forms, Brain diseases .. .. 2 2 .. .. 2 2 .. .. .. .. 1 8 9 13 Otitis .. .. 4 4 1 .. 1 2 .. 1 4 5 .. 1 .. 5 16 Disease of Nose, Epistaxis 1 .. 1 2 .. .. .. .. .. .. 1 1 .. .. .. .. 3 disease of eye .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Pericarditis 1 1 1 3 .. .. .. .. .. .. .. .. .. 2 2 5 Endocarditis .. .. 8 8 .. .. 1 1 .. .. .. .. .. 5 5 14 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Angina Pectoris .. .. 2 2 .. .. 1 1 .. .. 5 5 .. .. 2 2 10 Aneurism .. .. 7 7 .. .. 1 1 .. .. .. .. .. 6 6 14 Senile Gangrene .. .. 3 3 .. .. 3 3 .. .. 1 1 .. .. 2 2 9 embolism, Thrombosis .. .. 7 7 .. .. 14 14 .. .. 3 3 .. .. 5 5 29 Phlebitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Varicose viens .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Heart and Vessels .. .. .. .. .. .. .. 143 .. .. 119 119 1. 1 178 180 652 Laryngitis 2 .. 208 210 1 .. 142 1 .. .. .. .. 1 1 2 4 Croup .. 1 .. 1 .. 1 .. .. .. .. .. .. .. .. 1 Other diseases, Larynx and Trachea 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. Acute Bronchitis .. .. .. .. .. .. 16 26 4 5 2 12 20 3 21 44 149 Chronic Bronchitis 28 4 35 67 7 3 82 83 .. .. 30 30 .. .. 80 80 343 Lobar Pneumonia .. .. 150 150 .. .. 15 15 .. 1 8 9 .. .. 14 14 b3 Labulor Pneumonia 1 3 11 15 11 16 9 36 7 .. 5 21 25 16 10 51 196 Pneumonia 39 28 21 88 2 4 30 25 .. .. 15 17 6 14 30 50 170 Emphysema , Asthma 18 9 40 67 .. .. 4 4 .. .. 4 4 .. .. 1 1 15 Pleurisy .. .. 6 6 .. .. 4 6 .. .. 1 1 1 .. 3 4 16 Other diseases, Respiratory system .. .. 6 3 .. 2 2 2 .. .. 4 4 .. .. 2 2 11 Diseases of Mouth and Annexa .. .. 3 3 .. .. .. 1 1 .. 1 .. .. 1 1 4 Diseases of Pharynx .. 1 .. 1 .. 1 1 1 .. .. .. .. 1 1 2 5 diseases of Esophagus .. 2 .. 2 .. .. .. .. .. .. .. .. .. I 1 1 Ulcer of Stomach and Duodenum .. .. .. .. .. .. 8 8 .. .. 5 5 .. .. 7 7 22 Other diseases of Stomach .. .. 2 2 5 .. 4 9 4 2, 1 7 3 1 3 7 28 Enteritis 2 1 2 5 8 5 52 15 40 10 5 56 32 12 3 47 141 Appendicitis .19 2 3 24 .. 2 7 9 .. .. 4 4 .. .. 7 7 24 Obstruction of Intestine .. .. 4 4 2 2 8 12 1 .. 6 7 1 .. 13 14 39 Other diseases of Intestine 2 1 3 6 .. .. 1 1 3 .. 3 8 1 .. 1 11 Cirrhosis of Liver .. .. 1 1 .. .. 12 12 .. .. 6 6 .. .. 13 13 44 Other diseases of Liver .. .. 13 13 .. .. 7 7 .. .. 3 3 .. 1 ? 3 15 Peritonitis .. .. 2 2 .. .. 2 2 .. .. 2 2 .. .. 1 1 9 Other diseses, Digestive system 1 .. 3 4 .. .. 2 4 2 .. 1 3 1 .. 2 3 13 Diseases, Lymphatic System & Glands .. .. 3 3 2 .. 2 2 .. .. 2 2 .. .. 1 1 10 Acute Nephritis .. .. 5 5 .. .. 5 5 .. .. 2 2 .. 1 6 7 19 Bright's Disease .. 1 4 5 .. .. 3 43 .. .. 34 34 .. .. 41 41 151 Calculus .. .. 33 33 .. .. 1 1 .. .. .. .. .. 5 5 7 Diseases of Bladder and Prostate .. .. 1 1 .. .. 12 12 .. .. 2 2 .. .. 5 5 26 Other Diseases, Urinary System .. .. 7 7 .. .. 1 2 .. .. 1 1 1 .. 2 3 10 Diseases of Testies and Penis 1 .. 3 4 1 .. .. .. .. .. .. .... .. .. 1 diseases of Ovaries .. .. 1 1 .. .. 1 1 .. .. .. .... .. .. 1 Diseases of Uterus and appendages .. .. .. .. .. .. 1 1 .. .. 1 1 .... .. 3 3 3 Dis. of vagina and External Genitals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Puerperal Mania .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Placenta Praevia, Flooding .. .. 1 1 .. .. 4 4 .. .. 5 5 .. .... 1 1 11 Puerperal Thrombosis .. .... 1 1 .. .. .. .. .. .. .. .. .. Other Dis., Pregnancy and childbirth .. .. .. .. .. .. 1 1 .. .. 2 2 .. .. 3 3 6 Arthritis, Ostitis, Periostits .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases Osseous System .. .. .. .. 1 .. 3 4 .. .. .. .. 1 1 2 6 Ulcer, Bedsore .... .. 2 2 .. .. .. .. .. .. 1 1 .. .. .. .. 3 Table B.—Continued DISEASES. 1st Quarter Total. 2nd Quarter. Total. 3rd Quarter. Total. 4th Quarter. Total. Total. 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 Eczema 1 .. .. 1 .. .. .. .. .. 1 .. 1 .. .. .. .. 2 Perphigus .. .. .. .. 1 .. .. 1 3 .. .. 3 1 .. .. 1 5 Other Diseases, Integumentary System .. .. 1 1 1 .. .. 1 .. .. .. .. .. .. 2 2 4 Accidents and Negligence. In mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Vehicular Traffic .. .. 4 4 .. 2 12 14 .. .. 8 8 .. .. 5 5 36 On Railways .. .. 2 2 .. .. 1 1 .. .. .. .. .. .. 1 1 4 On Ships, Boats, &c. (not drowning) .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 In Building Operations .. .. .. .. .. .. 1 1 .. .. 3 3 .. .. 3 3 7 By Machinery .. .. 1 1 .. .. 1 1 .. .. .. .. .. .. .. .. 2 By Weapons and Implements .. .. .. .. .. .. 1 1 .. .. 1 1 .... .. .. 2 Burns and Scalds 1 2 4 7 1 4 .. 5 .. 2 1 3 .. .. 1 3 18 Poisons Poisonons Vapours .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 1 2 Surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Effect of Electric shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosins by Chemicals .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Drowning .. 1 2 3 .. .. 3 4 .. .. .. 1 .. .. 1 1 8 Suffocation, Overlaid in Bed 11 .. .. 11 8 .. .. 8 8 .. .. 8 5 .. .. 5 32 ,, Otherwise .. .. 2 2 1 .. 1 2 .. .. 1 .. 2 .. 2 4 9 Falls not specified .. 1 5 6 1 .. 7 8 .. 2 4 6 1 .. 8 10 30 Weather Agencies .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 Otherwise, not stated 1 .. 1 2 .. .. 1 1 .. .. .. .. .. .. 2 2 5 Homicide 1 .. 1 2 .. .. .. .. .. .. .. .. .. 1 .. 1 3 Suicide. By Poison .. .. 1 .. .. .. 6 6 .. .. 2 2 .. .. 2 2 11 By Asphyxia .. .. 1 1 .. .. .. .. .. .. .. 2. .. .. .. .. 3 By hanging and Strangulation .. .. 2 2 .. .. 2 2 .. .. 1 1 .. .. 1 1 6 By Drawing .. .. 1 1 .. .. 1 1 .. .. 3 3 .. .. 1 .. 6 By shooting .. .. 1 1 .. .. .. .. .. .. 1 1 .. .. .. .. 2 By cut or stab .. .. .. .. .. .. 2 2 .. .. 2 2 .. .. .. .. 4 By Precipitation rom Elevated Places .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 By Crushing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 1 Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 Males 167 74 313 754 116 71 433 620 105 38 354 497 129 47 495 671 2542 Females 108 67 566 741 76 60 451 587 100 44 352 496 97 49 516 662 2486 TOTAL DEATHS 275 141 1079 1495 192 131 884 1207 205 82 706 993 226 96 1011 1333 5028 331 [1913 1913] 332 Table C. Showing the Population, Inhabited Houses, Marriages, Births and Deaths for the year 1913, and 10 years preceding. gross numbers. Year. Estimated Population. No. of Inhabited Houses (estimated). 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 1913 325585 39,888 2,984 8,359 5,028 898 1,348 2.205 1903 333.273 39,902 3,053 8,983 4,839 1,136 1,674 1,539 1904 332,512 39,920 2,948 8,890 5,236 1,140 1,743 1,576 1905 331,753 39.910 2,984 8,756 4,955 1,074 1,639 1,581 1906 330,996 39,884 2,964 8,659 5,050 1,083 1,672 1,603 1907 330,241 39,900 2,962 8,531 5,079 996 1,541 1,738 1908 329,487 39,926 2,781 8,665 4,679 894 1,320 1,699 1909 328,735 39,982 2,769 8,198 4,918 841 1,401 1,788 1910 327,985 39,949 2,870 8,201 4,523 777 1,292 1,801 1911 327,247 36,778 2,843 8,113 4,866 1,040 1,508 1,941 1912 326,398 39,908 3,091 8,211 4,682 710 1,133 1,944 Average of 10 years. 329,863 39,606 2,926 8,521 4,883 969 1,492 1,721 333 [1913 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 1913, 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 ot Total Deaths. 1 2 3 4 5 6 7 8 1913 25.19 15.15 14.77 107 179 268 423 1903 26.9 14.5 14.1 126 235 346 318 1904 26.7 15.7 15. 3 128 218 333 301 1905 26.4 14.9 14.5 123 217 331 319 1906 26.2 15.2 14.8 125 214 331 317 1907 25.8 15.4 15.0 117 196 303 342 1908 25.8 i3.9 13.5 103 191 282 363 1909 24.9 14.9 14.5 103 171 285 363 1910 25. 0 13.8 13.4 95 170 286 398 1911 24.8 14.9 i4.5 128 214 310 399 1912 25.1 14.3 13.9 86 152 242 415 Average of 10 years. 25.8 14.8 i4.3 114 198 305 352 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. Table E. 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 1913, and during the Ten Years preceding. Year. Births. Birth-rates. Deaths. Death-rates. Deaths of Infants under 1 year of age. Deaths under 1 year per 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. Diarrhoeal Diseases. Deaths. Death-rates. Deaths. Death-rates. Deaths. Death-rates. Deaths. Deaths per 1,000 births. 1903 8.983 26.9 4,839 14.5 1,136 126 471 •• 120 24 43 152 •• 22 1 109 1.41 40 o. 12 350 1.05 492 1.48 9 1.00 1904 8,890 26.7 5,236 15.7 1,140 128 606 1 181 35 28 83 •• 18 •• 260 1.82 48 0.14 323 0.97 533 1.60 14 1.57 1905 8,756 26.4 4,955 14.9 1,074 123 529 1 123 37 34 111 •• 37 •• 206 1.59 54 o.16 328 0.99 438 1.32 6 0.68 1906 8,659 26.2 5,050 15.2 1,083 125 562 •• 187 37 32 74 •• 19 •• 213 1.70 67 0.20 363 I.IO 411 1.24 11 1.27 1907 8.531 25.8 5,079 15.4 996 117 432 •• 130 24 42 120 •• 13 •• 103 1•31 75 0.23 348 1.05 436 1.32 8 0.94 1908 8.665 25.8 4,679 13.9 894 103 358 •• 78 30 60 55 •• 18 •• 117 1.07 81 0.24 367 1 .09 432 1.29 4 0.46 1909 8,198 24.9 4,918 14.9 841 103 418 •• 197 25 31 86 •• 12 •• 67 1.27 70 0.21 353 1.07 424 1.29 7 0.85 1910 8,201 25.0 4,523 13.8 777 95 428 •• 166 11 34 124 •• 17 •• 76 1.30 36 O.11 361 I.IO 390 1.19 8 0. 97 1911 8,113 24.8 4,866 14.9 1,040 128 603 •• 124 20 53 70 •• 12 •• 324 1.84 37 O.1l 329 I .00 381 1.16 7 0.86 1912 8,211 25.1 4,682 14.3 710 86 296 •• 151 9 38 54 •• 8 •• 36 0.90 28 O.O8 382 1.17 427 1.31 2 0.24 Corrected average. 8,410 25.83 4,820 14.80 956 114 464 •• 144 25 38 92 •• 16 •• 149 1.42 53 o.16 345 1.06 430 1.32 8 0.95 1913 8,359 25.19 5,028 15.15 898 107 322 •• 101 19 37 62 •• 4 •• 99 0 .97 58 0 .17 404 1 22 420 1.26 7 1.84 Departure from Average. -51 -0,64 + 208 +0.35 -58 -7 -142 •• -43 -6 — 1 -30 •• —12 •• -50 -0.45 + 5 + 0.01 + 59 +0-16 — 10 — 0.06 — 1 — O-11 1913 384 335 [1913 TABLE F. Showing the Births and Birth Rates of Islington from 1841 to 1913. 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 27. 06 1843 1627 25.86 1863 6094 36.51 1883 9940 34.19 1903 8983 26.-95 1844 1804 27.18 1864 6349 36.84 1884* 9872 33.54 1904 8890 26.73 1845 1838 26.20 1865 6743 37.90 1885 9667 32 .45 1905 8756 26.39 1846 2152 29.13 1866* 6983 38.02 1886 9849 32.66 1906 8659 26.16 1847 2318 29.75 1867 7391 38.97 1887 9740 31.92 1907 8531 25.83 1848* 2529 30.76 1868 7608 38.86 1888 9609 31 .10 1908* 8665 25.80 1849 2613 30 13 1869 7529 37. 24 1889 9628 30.79 1909 8198 24.93 1850 3015 32.96 1870 7674 36.77 1890* 9230 29.16 1910 8201 25.01 1841-50 20850 28.65 1861.70 67520 37.20 1881-90 97420 32 .49 1901-10 87361 26.36 1851 3033 31.46 1871 7671 35.73 1891 9797 30.61 1911 8113 24.79 1852 3462 3419 1872* 8048 36 36 1892 9743 30.12 1912 8211 25.15 1853 3701 34.81 1873 8398 3689 1893 9749 29.81 1913* 8359 25 19 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* 9498 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 29 .31 * These years contained 53 weeks. 1913] 336 Table G. Showing the Illegitimate Births in Islington from 1841 to 1913. . Births. Years. Births. Years. Births. Years Birihs. Years. Births. Years. Births j Years Birth Years. Births. 1841 * 1851 100 1861 184 1871 280 1881 380 1891 265 1901 228 1911 248 1842 33 1852 100 1862 207 1872 346 1882 353 1892 298 1902 248 1912 333 1843 * 1853 95 1863 224 1873 335 1883 370 1893 267 1903 242 1913 297 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 1909 250 1850 97 1860 175 1870 318 1880 359 1890 328 1900 261 1910 240 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 1910 2413 * The births in these years cannot be ascertained. [1913 TABLE H. Showing the Deaths and Death Rates of Islington from 1841 to 1913. Years. Deaths. Death Rates. Years. Deaths. Death Rates. Years. Deaths. Death Rates. Years. Deaths. Death Rates. 1841 1013 17. 91 186 1 3123 19.94 1881 5617 19.79 1901 5361 15.98 1842* 1101 18.46 1862 3496 21.62 1882 5643 19.65 1902* 5635 16.55 1843 1115 17 .72 1863 4340 26 .00 1883 5561 19.12 1903 4839 14.52 1844 1294 19.49 1864 4-594 26 .65 1884* 5515 18.74 1904 5236 15.74 1845 1258 17.96 1865 4617 25.94 1885 5740 19.27 1905 4955 14. 93 1846 1383 18. 72 1866* 5154 28.06 1886 5434 18.02 1906 5050 15.26 1847 1624 20.83 1867 4509 24.55 1887 5699 18.67 1907 5079 15.38 1848* 1745 21.22 1868 4886 24. 95 1888 5197 16.82 1908* 4079 13.93 1849 1891 21. 80 1869 4937 24 .42 1889 5035 16.10 1909 4918 14 96 1850 1609 17.58 1870 5078 24.33 1890* 6152 19.43 1910 4523 13.79 1841-50 14033 19. 28 1861-70 44734 24.64 1881-90 55593 18.55 1901- 10 50275 15.17 1851 2082 21.59 1871 5048 23. 44 1891 6326 19.77 1911 4866 14.88 1852 2086 20.60 1872* 4196 18 .95 1892 6075 18.78 1912 4682 14. 34 1853 2395 22.52 1873 4156 18 .25 1893 6391 19. 55 1913* 5028 15. 15 1854* 2800 25. 07 1874 4810 20 .57 1894 5263 15.92 1855 2080 22. 85 1875 4833 20.07 1895 5760 17 .24 1856 2677 21.74 1876 4969 20. 07 1896* 5884 17.42 1857 2586 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 I860* 3028 21 .21 1880 5716 20.65 1900 5721 17.03 1851-60 26009 21.43 1871-80 49677 20.28 1891-1900 58813 17. 72 * These years conlain 53 weeks Z 387 1913] TABLE I. Infantile Mortality Returns, extracted from the Annual Reports of the Registrar-General, 1841-55, and frtrn the Annual Reports of the Medical Officer of Health of Islington, 1856 to 1913. Year's. 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 i 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 1,387 143 1905 1,074 123 1846 330 153 1866* 1,170 169 1886 1,51'7 154 1906 1,083 125 1847 348 150 1867 1,119 152 1887 1,557 160 1907 996 117 1848* 386 152 1868 1,266 164 1888 1,271 132 1908* 894 103 1849 441 168 1869 1,234 165 1889 1,261 131 1909 841 103 1S50 360 119 1870 1,135 149 1890* 1,488 161 1910 777 95 1841-50 (8 years) 2,546 146 1861-70 10,360 153 1881-90 14,102 145 1901-10 10,450 120 1851 457 151 1871 1,179 154 1891 1,481 151 1911 1,040 128 1852 457 132 1872* 1,200 150 1892 1,14'7 145 1912 710 86 1853 571 154 1873 1,172 138 1893 1,595 164 1913* 898 107 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. 338 339 [1913 Table J. Showing the Cases of Infectious Diseases in Islington in Quinquennial Periods, 1891—1910 and in 1913. Year. Smallpox. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Notifications. Attack rates per 1,000 Population. 1891 1 728 756 189 2 343 33 6 1 .. 2059 6 43 1892 42 1709 738 219 .. 550 51 6 .. 3 3318 10.26 1893 118 2880 885 251 1 672 38 7 .. 1 4853 14.84 1894 90 1493 867 245 1 395 23 7 .. .. 3121 9.44 1895 25 1692 582 184 5 320 22 9 .. .. 2839 8.50 1891-5 276 8502 3828 1088 9 2280 167 35 1 4 16,190 9.90 1896 50 2031 1091 229 .. 385 30 6 2 .. 3824 11 .32 1897 3 '577 729 256 .. 312 27 1 .. 1 2906 862 1898 .. 1336 544 237 2 279 19 1 .. .. 2418 7.18 1899 3 1494 705 353 .. 350 33 2 .. 3 2943 8. 75 1900 2 1074 633 259 1 285 16 6 .. .. 2276 6.78 1896-00 58 7512 3702 1334 3 1611 125 16 2 4 14.367 8.53 1901 50 1286 911 281 2 285 34 3 .. .. 2852 8.51 1902 276 1372 878 257 .. 357 19 5 .. .. 3164 9. 29 1903 9 865 455 130 .. 227 19 2 .. .. 1707 5.12 1904 17 1146 347 126 1 280 24 .. .. .. 1941 5.84 1905 3 1198 35i 100 .. 252 24 .. .. .. 1928 5.81 1901-05. 355 5867 2942 894 3 1401 120 10 .. .. 11,592 6.96 1906 1 1386 439 149 1 274 24 1 .. .. 2275 6.87 1907 .. 1216 481 92 .. 252 21 1 .. .. 2063 6. 25 1908 .. 1409 530 97 .. 235 17 1 .. .. 2289 6.82 1909 3 1285 430 95 1 221 14 .. .. .. 2049 6. 23 1910 1 730 471 89 1 212 20 1 .. .. 1525 4 .65 1906-10 5 6026 2351 522 3 1194 96 4 .. .. 10201 6.19 1911 .. 804 593 .. .. 275 14 .. .. .. 1759 5.37 1912 .. 811 516 49 .. 185 16 .. .. .. 1577 4.83 1913 .. 1317 550 50 .. 226 28 .. .. .. 2171 6.54 z 2 1913] 340 Table K. Showing the Cases of Small Pox that occurred in the several Wards from 1891 to 1913. Year. Tufnell. * Upper Holloway. Tollington. Lower Holloway. Highbury. r 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 i 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 I902 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 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. 3 .. .. .. .. .. .. .. .. 3 1910 .. .. 1 .. .. .. .. .. .. .. .. 1 1911 .. .. .. .. .. .. .. .. .. .. .. .. 1912 .. .. .. .. .. .. .. .. .. .. .. .. 1913 .. .. .. .. .. .. .. .. ... .. .. .. * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards, t The figures for 1891-2 are inclusive of Highbury. Table L. Showing the Cases of Scarlet Fever that occurred in the several Wards from 1891 to 1913. Year. Tufnell. *Upper Holloway. 1 1 j Tollington. Lower Holloway. Highbury. t 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 1909 155 149 126 206 149 94 81 110 51 84 80 1285 1910 83 121 76 91 53 49 72 45 32 45 63 730 1911 60 69 69 "3 40 47 138 63 61 79 65 804 1912 91 81 83 141 100 45 6O 35 38 79 64 811 1913 179 193 162 100 99 90 56 62 72 92 212 1317 * The figures for 1891-2-3 are inclusive of Tufnell and Tollington Wards, f The figures for 1891-2-3 are inclusive of Highbury. 341 [1913 Table M. Showing the Cases of Diphtheria that occurred in the several Wards from 1891 to 1913. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway- Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Can»nbury. 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 1895 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 3° 64 30 39 35 47 480 1908 45 76 52 79 45 26 49 24 19 60 47 522 1909 52 63 28 49 34 24 46 34 18 27 50 425 1910 48 92 62 31 18 22 87 20 22 21 40 463 1911 54 99 95 56 41 22 67 35 40 27 54 590 1912 46 82 61 55 39 18 48 29 30 57 47 512 1913 50 60 51 61 63 36 39 24 38 58 66 546 Table N. Showing the Cases of Membranous Croup that occurred in the several Wards from 1891 to 1913. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill, Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals 1891 .. 20 .. 2 .. 5 1 1 2 10 44 1892 .. 10 .. 3 .. 10 3 1 .. 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 29 1898 .. 4 .. 1 1 .. 4 .. .. i .. .. 13 1899 2 1 1 2 1 1 3 2 1 .. 3 17 1900 2 .. .. 1 1 .. 1 2 .. 1 1 9 1901 1 .. i 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 .. .. .. .. .. .. .. .. i .. .. 1 1908 .. 2 .. 3 1 .. 1 .. .. .. 1 8 1909 1 2 i .. .. .. .. 1 .. .. .. 5 1910 1 2 i .. 1 .. .. 1 2 .. .. .. .. 8 1911 1 .. .. 1 .. .. 1 .. .. .. .. 3 1912 .. .. .. 1 2 .. .. .. .. 1 .. .. 4 1913 1 1 .. 1 .. .. 1 .. .. .. 4 342 Table O. Showing the Cases of Typhoid Fever that occurred in the several Wards from 1891 to 1913. 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 7 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 1909 4 13 2 14 10 7 16 7 6 14 2 95 19I0 7 13 5 13 4 5 13 13 4 8 4 89 1911 7 8 7 3 4 9 6 9 7 5 8 73 1912 5 3 2 3 6 4 4 2 7 5 8 49 1913 7 5 2 8 2 9 2 4 4 3 4 50 Table P. Showing Cases of Typhus Fever occurred in the several Wards from 1891 to 1913. 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 .. i .. .. .. .. .. .. .. .. .. .. 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 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. .. .. .. .. .. .. 1 .. .. 1 1910 .. .. .. .. .. .. .. 1 .. .. .. 1 1911 .. .. .. .. .. .. .. .. .. .. .. .. 1912 .. .. .. .. .. .. .. .. .. .. .. .. 1913 .. .. .. .. .. .. .. .. .. .. .. .. 1913] 343 [1913 Table Q. Showing the Cases of Erysipelas that occurred in the several Wards from 1891 to 1913. 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 19 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 3° 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 1909 23 22 23 26 22 19 17 18 14 14 23 22 [ 1910 19 17 24 33 19 5 22 16 22 21 14 112 1911 31 34 33 27 9 13 26 22 18 28 34 275 1912 12 13 15 19 16 14 23 14 15 26 18 185 1913 15 36 28 16 15 11 27 17 13 22 26 226 Table R. Showing the Cases of Puerperal Fever that occurred in the several Wards from 1891 to 1913. 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 i 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 .. 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 .. 1 4 4 1 •• 1 .. .. 1 19 1904 5 .. 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 .. 2 1 1 2 1 1 21 1908 2 .. 1 5 2 1 1 2 1 .. 2 17 1909. 2 .. 3 2 2 1 1 i 1 1 14 1910 2 .. 1 3 2 1 3 1 1 1 1 20 1911 2 1 1 4 1 .. 3 .. .. 2 .. 14 1912 2 1 .. 1 2 .. 5 .. .. 2 3 16 1913 4 1 2 5 2 1 2 4 .. 3 4 28 1913] 344 Table S. Showing the Cases of Continued Fever that occurred in the several Wards from 1891 to 1913. 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 .. .. .. .. .. .. 7 1895 .. 4 l .. 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 .. .. .. .. .. 1907 .. .. .. .. .. .. 1 .. .. .. .. .. 1 1908 .. 1 .. .. .. .. .. .. .. .. .. 1 1909 .. .. .. .. .. .. .. .. .. .. .. .. 1910 .. .. 1 .. .. .. .. .. .. .. .. .. 1911 .. .. .. .. .. .. .. .. .. .. .. .. 1912 .. .. .. .. .. .. .. .. .. .. .. .. 1913 .. .. .. .. .. .. .. .. .. .. .. .. Table T. Showing the Cases of Relapsing Fever thai occurred in the several Wards from 1891 to 1913. Year. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Mildmay. Thornhill. Barnsbury. St. Mary's. Canonbury. St. Peter's. Totals. l891 .. 1 .. .. .. .. .. .. .. .. .. 1 1892 .. .. .. .. .. .. .. .. .. .. .. .. .. 1893 .. .. .. .. .. .. .. .. .. .. .. .. .. 1894 .. .. .. .. .. .. .. .. .. .. .. .. 1895 .. .. .. .. .. .. .. .. .. .. .. .. 1896 .. .. .. .. 1 .. .. ... .. 1 .. .. 2 1897 .. .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. .. .. 1901 .. .. .. .. .. .. .. .. .. .. .. .. .. 1902 .. .. .. .. .. .. .. .. .. .. .. .. .. 1903 .. .. .. .. .. .. .. .. .. .. .. .. .. 1904 .. .. .. .. .. .. .. .. .. .. .. .. .. 1905 .. .. .. .. .. .. .. .. .. .. .. .. .. 1906 .. .. .. .. .. .. .. .. .. .. .. .. 1907 .. .. .. .. .. .. .. .. .. .. .. .. .. 1908 .. .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. .. .. .. .. .. .. .. .. .. .. .. 1910 .. .. .. .. .. .. .. .. .. .. .. .. .. 1911 .. .. .. .. .. .. .. .. .. .. .. .. .. 1912 .. .. .. .. .. .. .. .. .. .. .. .. .. 1913 • • .. .. .. .. .. .. .. • • .. .. .. 345 Table U. Showing the Cases of Cholera that occurred in the several Wards from 1891 to 1913. 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 .. .. .. .. .. .. .. .. .. .. .. .. 1909 .. .. .. .. .. .. .. .. .. .. .. .. 1910 .. .. .. .. .. .. .. .. .. .. 1911 .. .. .. .. .. .. .. .. .. .. .. .. 1912 .. .. .. .. .. .. .. .. .. .. .. .. 1913 .. .. .. .. .. .. .. .. .. .. .. .. •Asiatic Cholera [1913 Table V. Showing some of the Work of the Public Health Department. Years. Number of cases of Notifiable Infectious Diseases, inclusive of Phthisis. 1 1 Number of cases of Non-notifiable Diseases notified by the Public Elementary Schools. Number of Infectious Diseases notified to School Teachers. Number of acknowledgments of Infectious Diseases to Medical Men, &c. Number of Letters received. Number of Letters written. Number of letters sent to County Council 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 Statutory Notices served. 1891 2059 .. .. 2059 .. 1330 .. 45059 117 .. 3382 177 1487 .. .. 1892 3478 • • .. 3478 .. 1617 .. 5S786 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 716c 3562 1650 64551 7233 4501 5505 1341 4051 4544 471 1900 2442 3066 .. 2442 6084 3311 '5!7 60936 7411 6086 5673 1095 35'5 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 2 75 1903 2215 2298 .. 2215 6131 4409 1255 72140 7846 4889 6756 1711 2157 5'53 372 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 6980 6968 6004 1043 3220 5847 669 1907 2335 5829 .. 2335 6131 3358 1648 81628 10727 9938 6038 1259 3162 5624 518 1908 2483 4359 1943 2483 6318 4469 1914 86371 11565 13148 6332 1346 3351 5757 789 1909 3228 4605 1924 3228 5880 4197 1852 76416 11476 11093 7276 990 3281 5304 709 1910 2860 6077 1249 2860 6433 4229 1208 77445 11004 11280 6919 1078 2870 5443 716 1911 2291 4876 1530 2291 6636 4421 1441 74683 9892 12011 7130 965 3517 5118 707 1912 4083 5968 1351 4083 5989 457° 1466 76562 10018 12893 7156 1133 3649 5093 631 1913 3675 5333 1763 3675 5622 4125 1571 74607 11230 "558 7578 1037 4284 4812 659 1913] Meat Inspector left Borough service for an appointment under City Corporation, and the appointment was vacant some time. 346 t 347 [1913 Table W. BATHS AND WASHHOUSES. Private (Slipper Baths.) Males 1st class Females 15,049 32,994 17,623 65,666 1,651 6,007 2,789 10,447 Males 2nd class Females 47,698 55,507 57,235 160,440 19,968 29,246 25,847 75,O6I Totals 84,366 123,754 103,494 311,614 Washhouses. Washers 29,015 27,392 40,421 96,828 Total Persons using the Establishments. Total admissions at each establishment in 1913 211,140 323,353 266,197 800,690 Table showing the Number of Persons using the Swimming Baths, Private Baths, and the Washhouses during 1913. Swimming Baths. Bathers. Caledonian Road Hornsey Road Essex Road. Total. Public. (Males 1st class 1 I Females 9,862 40,084 17,164 67,110 1,016 16,482 1,915 19,413 (Males 2nd class -1 1 Females ... 19,193 23,093 19,993 62,279 5,287 7,524 4,331 17,142 Schools. | Boys 1st class (Girls ... 3,312 359 3,671 3 4,348 ... 4,351 Boys 2nd class Girls 38,904 46,602 52,474 137,980 23,494 30,762 26,046 80,302 Totals 97,759 172,207 122,282 392,248 LOCAL GOVERNMENT BOARD RETURN.—TABLE I. Metropolitan Borough of Islington. VITAL STATISTICS OF WHOLE DISTRICT DURING 1913 AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. I Nett Deaths belonging to the District. Uncorrected Number. Nett. Of Non-Residents registered in the District. Of Residents not registered in the District. Under 1 Year of Age At all Ages. Number. Rate. Number.! 1 Rate. Number.† Rate per 1.000 nett Births. Number.! Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1908 329,487 8,665 - 25.8 4,530 13.7 568 717 894 103 4,679 13.9 1909 328,735 8,198 — 24.9 4,782 14 .5 634 770 841 103 4,918 14.9 1910 327,985 8,201 — 25.0 4,376 13.3 563 710 777 95 4,523 13.8 1911 327,247 7,729 8,113 24 .8 4,643 14.2 640 863 1,040 128 4,866 14.9 1912 326,398 8,051 8,211 25 .1 4.343 13.3 509 861 710 86 4,682 14. 3 1913 325,585 8,220 8,359 25 .2* 4.697 14.1* 605 936 898 107 5,028 15.1* * These rates have been calculated on estimated population for the registration year of 53 weeks Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. The rates are calculated per 1000 of the estimated gross population. t In Column 6 are included the whole of the deaths registered during the year as having actually occurred within the district. In Column 12 is entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column g. Deaths in Column 10 are similarly corrected by subtraction of the deaths under i, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. J " Transferable Deaths " are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, eg., casuals, are not included in Columns 8 or 9, except in certain instances under 3 (b) below. In Column 8 the number of transferable deaths of "non-residents" are deducted, and in Column 9 the number of deaths of "residents" registered outside the district are added in calculating the nett death-rate of the district. The following special cases arise as to Transferable Deaths:— (1) Persons dying in Institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) are regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such Institution to another, the death is transferable to the district of residence at the time of admission to the first Institution. (2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement are referred to the district of fixed or usual residence 0f the parent. (3) Deaths from Violence are referred (a) to the district of residence, under the general rule; (6) ii this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known; and (d) failing this, to the district where the body was found. 1913] 348 Area of District in acres (land and ■ 3,092 inland water) ... Total population at all ages, 327,403 1 Number of inhabited houses, 36,778 L Average number of persons per house, 8 9 i At Census of 1911. (cf. Census, Vol. V.) LOCAL GOVERNMENT BOARD RETURN.—Table II. Cases of Infectious Disease notified during the year 1913 in the Metropolitan Borough of Islington. [Notifiable Disease. Cases Notified in Whole District. Total Cases Notified in each Registration Sdb-District. Total cases removed to Hospital. At Ages—Years. 1 2 3 4 5 6 7 At all Ages Under 1. 1 to 5. 5 to 15 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Tufnell. Upper Holloway Tollington. Lower Holloway Highbury. j Barnsbury Islington South-Eas Small-pox .. .. • • .. .. .. .. .. .. .. •• •• .. .. .. .. Cholera (C) Plague (P) .. .. .. •• .. .. .. •• .. •• .. •• .. .. •• .. Diphtheria (including Membranous Croup) 550 10 171 284 51 28 6 .. 51 61 51 62 99 64 162 512 Erysipelas 226 6 8 16 28 63 83 22 15 36 28 16 26 44 61 62 Scarlet Fever 1317 14 3i3 852 95 38 5 .. 179 193 162 100 189 118 376 1230 Typhus Fever •• .. .. .. .. .. .. .. .. .. •• .. •• •• .. •• Enteric Fever 59 .. 3 3 17 20 7 .. 7 5 2 8 .. 6 11 39 Relapsing Fever (R) Continued Fever (C) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 28 .. .. .. [2 16 .. .. 4 1 2 5 3 6 7 23 Cerebro-spinal Meningitis 8 2 2 3 1 .. .. .. .. 1 .. .. .. 4 3 5 Poliomyelitis 19 2 11 4 1 .. 1 .. 1 3 3 1 2 4 5 15 Pulmonary Tuberculosis 1124 3 17 109 182 557 238 18| 137 189 125 205 223 338 456 .. Other forms of Tuberculosis 559 9 80 188 83 125 68 6 Ophthalmia Neonatorum .. 38 38 .. .. .. •• .. .. 1 .. 4 10 4 15 4 .. Totals 3919 84 605 1459 470 847 408 46 395 489 377 407 567 599 1085 1886 Isolation Hospital or Hospitals, Sanatoria, &c.—Metropolitan Asylums Board Hospitals. 340 O LOCAL GOVERNMENT BOARD RETURN—Table III. Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING YEAR, 1913. Causes of Death. Nat Deaths at the subjoined Ages of " Residents " whether occurring within or without the District. 1 otal Deaths whether of _ " Residents" or " NonM residents" in Institutions in the District. All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 16 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 and upwards. I 2 3 4 5 6 7 8 9 10 .,, (Certified All causes jUncertified 5028 898 260 190 166 181 629 1192 1512 1574 •• •• •• •• •• •• •• • • •• •• Enteric Fever 4 •• •• •• •• •• 2 2 •• •• Small-pox •• •• •• •• •• •• •• •• •• •• Measles 101 l6 47 33 5 •• •• •• •• 13 Scarlet Fever 19 2 2 9 5 •• 1 •• •• 2 Whooping Cough 62 22 21 14 5 •• •• •• •• 1 Diphtheria and Croup 38 4 8 13 13 •• •• •• •• 2 Influenza 58 1 1 3 •• 2 12 22 17 9 Erysipelas 9 1 1 •• •• .. 2 1 4 6 Phthisis (Pulir onary Tuberculosis) 420 2 8 3 13 60 189 124 21 242 Tuberculous Meningitis 58 9 12 16 l6 4 I •• •• 24 Other T uberculous Diseases 58 10 4 12 9 7 9 7 •• 22 Cancer, Malignant Disease 404 .. 1 •• •• 7 44 182 170 177 Rheumatic Fever 11 •• •• •• 4 2 4 1 •• •• Meningitis 25 9 2 7 3 2 2 .. •• 3 Organic Heart Disease 571 2 •• 1 11 22 71 195 269 272 Bronchitis 492 59 12 5 3 1 17 107 288 204 Pneumonia (all forms) 419 109 74 28 15 9 39 85 60 149 Other Diseases of Respiratory Organs 46 1 3 2 2 1 10 13 14 17 Diarrlicea and Enteritis. 240 167 43 7 1 1 6 5 10 124 Appendicitis and Typhlitis 24 •• •• 2 5 7 4 3 3 6 Cirrhosis of Liver 44 •• •• •• •• •• 8 25 11 17 Alcoholism 10 •• •• •• •• •• 2 7 1 1 Nephritis and Bright's Diseases 170 •• 1 1 4 1 24 79 60 62 Puerperal Fever 7 •• •• •• •• 2 5 •• •• 4 Other accidents and diseases of Pregnancy and Parturition 22 •• •• •• •• 5 16 1 •• 9 Congenital Debility and Malformation, including Premature Birth 335 329 4 2 •• •• •• •• •• 15 Violent Deaths, excluding Suicide 161 41 5 13 *7 9 27 22 27 41 Suicide 34 •• •• •• 1 2 11 16 4 8 Other Defined Diseases 1185 114 11 19 34 37 123 294 553 144 Diseases ill-defined or unknown 1 •• •• •• •• •• •• 1 •• •• 5028 898 260 190 166 181 629 I 192 1512 '574 Sob-Entries — included in above figures:— Cerebro-spinal Meningitis Poliomyelitis 3 •• •• 1 1 ,, «• •• . • 1913] 350 351 LOCAL GOVERNMENT BOARD RETURN.—Table IV. Metropolitan Borough of Islington. INFANTILE MORTALITY DURING THE YEAR 1913. Nett Deaths from stated Causes at Various Ages under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under One Month 4 Weeks and under 3 Months 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. J Certified 195 49 47 29 320 187 178 1ll 102 898 ( Uncertified .. .. .. .. .. .. .. .. .. .. / Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox.. .. .. .. .. .. .. .. .. .. .. J Measles .. .. .. .. .. .. 1 4 11 16 | Scarlet Fever .. .. .. .. .. .. .. 1 1 2 1 Whooping Cough .. .. .. 1 i 2 3 6 .. 8 22 Diphtheria and Croup .. .. .. .. .. .. 1 .. 2 4 Erysipelas .. .. .. .. .. 1 .. .. .. 1 Tuberculous Meningitis .. .. .. .. .. .. 1 2 3 3 9 ■ Abdominal Tuberculosis .. .. .. .. .. 3 3 1 .. 7 Other Tuberculous Diseases .. .. .. .. .. 1 2 .. 2 5 Meningitis (not Tuberculous) .. .. .. .. .. 1 4 2 1 8 Convulsions 5 .. 2 1 8 3 1 3 3 18 Laryngitis .. .. .. .. .. .. .. .. ... .. Bronchitis 1 3 8 .. l5 16 I5 10 3 59 Pneumonia (all forms) 1 2 .. 4 10 24 28 23 24 109 I Diarrhoea .. .. .. .. .. 20 23 14 11 68 [ Enteritis .. .. 2 .. 2 21 32 22 22 99 Gastritis .. .. .... .. 6 2 2 .. 10 Syphilis .. 1 2 2 5 4 3 .. .. 12 Rickets .. .. .. .... .. .. 1 1 2 Suffocation, overlying 11 .. .. .. 11 14 7 .. .. 32 Injury at Birth 2 .. .. .. 2 .. .. .. .. 2 Atelectasis .. 14 .. .. .. 14 2 .. .. .. 16 ( Congenital Malformations 22 5 3 1 31 6 1 1 1 40 j Premature Birth 91 10 8 10 129 8 2 .. .. 139 v Atrophy, Debility and Marasmus S8 11 8 7 64 44 28 9 5 150 Other Causes 10 7 10 .. 27 9 7 11 4 68 Totals .. 195 49 47 29 320 187 178 111 102 898 Nett Births in the year | legitimate .. 8,062 1 Nett Deaths in the year of f legitimate infants .. 817 ( illegitimate .. 297 J { illegitimate infants .. 81 [1913 1913] 352 LONDON COUNTY COUNCIL RETURN. Borough oj Islington. PROCEEDINGS DURING 1913. PREMISES. Number of Places— Number of inspections, 1913. Number of Notices. 1913. Number of Prosecutions 1913. On Register at end of 1912. Added in 1913 Removed in 1913. On Register at end ot 1913. Milk premises 582 7 29 560 1043 63 Nil Cowsheds 5 ... ... 5 53 Nil ,, Slaughter-houses 28 Nil Nil 28 1579 ,, ,, Other offensive trade premises 6 ,, ,, 6 91 ,, ,, Ice cream premises 224 42 27 239 83 22 ,, Registered houses let in lodgings ... ... ... ... 12160 (a)* 98 (a)* ,,. (6)† 1227 (b) †| 20 * (a) For overcrowding. f (6) For other conditions. J No Register now kept under new By-Laws. Total number of intimation notices served for all purposes 4812 Overcrowding, 1913. Number of dwelling rooms overcrowded 156 Number remedied 156 Number of prosecutions Nil Un dergroun d rooms— Illegal occupation dealt with during year 21 Number of rooms closed ... ... 21 Number of prosecutions ... ... Nil Insanitary houses— Number closed under the Public Health (London) Act, 1891 ... Nil Number closed under the Housing of the Working Classes Acts... 15 Number of premises cleansed under Sec. 20 of the L.C.C. (General Powers) Act, 1904 233 353 [1913 Shelters provided under see. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 7 Revenue Acts— Number of houses for which applications were received during year 8 Number of tenements comprised therein 31 Number of tenements for which certificates were (a) granted 24 (6) refused 7 (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. Nil (b) For prevention of nuisance arising from offensive matter ning out of any manufactory, etc. Nil (c) For the prevention of keeping of animals in such a manner as to be injurious to health Nil (d) As to paving of yards, etc., of dwelling houses 1 (1e) In connection with the removal of offensive matter, etc. Nil (/) As to cesspools and privies, removal and disposal of refuse, etc. Nil (g) For securing the cleanliness of tanks, cisterns, etc. Nil (h) With respect to water closets, earth closets, etc. 4 (i) With respect to sufficiency of water supply to water closets 1 (j) With respect to drainage, etc. (Metropolis Management Act, section 202) Nil (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendment (By-laws) Act, 1899) 1 Number of prosecutions under L.C.C. General Powers Act, 1907— (I) With respect to Water Supply to Tenement Houses ... Nil Mortuaries— Total number of bodies removed 575 Total number of infectious bodies removed Nil A a