1SL 63 1917. SIXTY-SECOND 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. 1918. iii. INDEX. Paqe. Adulteration of Food 32 Bacteriological Examinations 21 Births 1 ,, Illegitimate 1 ,, Notification of 2 „ Stillborn 2 Cancer 10 Cleansing of Verminous School Children 23 Constitutional Diseases 10 Cow Houses 31 Deaths from All Causes during the year 2, 37 „ „ Epidemic Diseases 9 ,, ,, Respiratory Diseases 12 ,, in Public Institutions 8 Defence of Realms Act, 1914-17, Food Regulations 33 Disinfectants distributed and used 22 Disinfecting Station 22 Disinfection Work 21 District Inspectors' Work 28 Dust, removal of 30 Epidemic Diseases 9 ,, Cerebro-Spinal Meningitis 15 Factories and Workshops Administration 24 Fatality from Notifiable Infectious Diseases 15 Food, Adulteration of 32 Food Inspection 30 Hospital Isolation of Infectious Diseases 15 Infant Mortality 3 Infant Welfare Work 5-8 Infectious Diseases in Schools 20 „ „ (Non-notifiable) in Schools 20 Influenza 9 Inspection of Food 30 „ Kitchens of Restaurants 24 „ Slaughter Houses and Cow Houses 30, 31 Inquests 13 Isolation of Infectious Diseases 15 Local Government Board Returns 40, 41 London County Council Return of Sanitary Work 42, 43 Marriages 1 Measles, Notification of 14 Meat Inspection 30 iv. Page Milk and Cream Regulations 1912 33 Milk Adulteration 32 Milkshops and Dairies 32 Mortuary and Coroner's Court 13 Notification of Infectious Diseases 13 „ „ Tuberculosis 16 ,, ,, Births Act 2 Non-notifiable Infectious Diseases in Schools 20 Offensive Trades 31 Ophthalmia Neonatorum 16 Outworkers' Premises 24-27 Other Notifiable Diseases 15 Phthisis 11-16 ,, Notification of 16 Places where Food is prepared 31 Population—Estimated in 1917 1 Prosecutions, Summary of 36 Puerperal Septic Diseases 10 Polio-myelitis Acute 15 Pulmonary Phthisis 11-16 Respiratory Diseases 12 Samples analysed in 1917 34, 35 Sanitary Inspectors' Work 28 Septic Diseases 10 Shelter House 23 Slaughter Houses 30 Smoke Nuisances 29 Tubercular Diseases 11 Tuberculosis Dispensaries 18 Tuberculosis, Pulmonary, Notification of 16 Unsound Food 30 Vaccination 21 Venereal Diseases 13 Verminous Children, Cleansing of 23 Verminous Premises 29 Voluntary Maternity and Child Welfare Centres 6 Workshops and Factories. Inspection of 24 Welfare Work by Health Visitors 5 1 [1917 REPORT OF THE Medical Officer of Health FOR THE YEAR 1917. Population.—The population of the Borough in the year 1917 has been divided into two categories by the Registrar-General—the estimated civil population, upon which is calculated the death rate of the persons dying in the Borough, and the estimated total population for the calculation of the birth rate. This includes, and that excludes, the military population. Total population (inclusive of military) 331,185 Civil „ (exclusive of military) 297,102 MARRIAGES. Marriages.—The number of persons married was 5,378, which is 782 less than the number married in the preceding year. The marriage rate, which was 16.23 per 1,000 inhabitants, was the lowest rate hitherto recorded in the Borough. BIRTHS. The births registered during 1917 numbered 5,837, as contrasted with 8,359 in the year before the war and with 8,177 in 1914, the year in which the war broke out. The birth rate represents 17.62 per 1,000 of the population, and is only 214 per 1,000 higher than the death rate. The birth rate in 1913 was 25T9, in 1914 it was 25.12 per 1,000 inhabitants. Illegitimate Births.—297 illegitimate births were registered, and were equal to 5.09 per cent, of the total registered births. This number was 8 more than in the previous year, and were I'll per cent, of the registered births more than in 1916. 1917] 2 Notification of Births Act, 1907.—4,880 births were notified, or 83 per cent, of the total number of the total number of births that were registered during the year. The births were notified as follows:— Notified by— Still Births. Live Births. Total. Doctors 18 446 464 Certificated Midwives 84 2,613 2,697 Parents and other persons 26 1,693 1,719 128 4,752 4,880 DEATHS. The deaths numbered 1,000, and the death rate was 15-48, or 013 above that of the preceding year (15 35), and was 0-4 more than the average of the previous 10 years. The Deaths from All Causes in the Sub-registration Districts were as follows :— Sub-Districts. Quarters. The Year. 1 2 3 4 Tufnell 146 106 70 106 428 Upper Holloway 197 137 86 118 538 Tollington 141 114 61 99 415 Lower Holloway 210 137 102 125 574 Highbury 224 150 171 173 718 Barnsbury 252 179 140 212 783 Islington (South-East) 391 266 197 290 1,144 The Borough 1,561 1,089 827 1,123 4,600 3 [1017 INFANT MORTALITY. 505 deaths occurred amongst infants under 12 months old, or 279 below the decennial average of 844. These deaths represented an infant mortality rate of 97 per 1,000 infants born, which is 7 per 1,000 below the mean annual record of the preceding 10 years. This is satisfactory as compared with past returns, but a great deal has yet to be done to lower a rate which in the opinion of many authorities should not be more than 40 per 1,000. It is hoped that the efforts of the agencies now in force and the passing of an Act of Parliament giving power to local authorities to establish Maternity Centres and similar institutions for the prevention of infant mortality, and to give pecuniary support to similar voluntary institutions, will in the course of a fewyears effect the reduction which is so much to be desired. Infantile Mortality during each of the Ten Years 1903-17. Deaths at various Ages under One Year oj Age. Years. Under 1 week. Weeks. Total under 4 weeks. Months. Total Deaths under 1 year. 1-2 2-3 3-4 4 weeks and under 3 months. 3-6 6-9 9-12 1908 186 52 33 39 310 180 151 126 127 894 1909 156 52 26 35 269 147 148 144 133 841 1910 163 45 41 29 278 131 144 106 118 777 1911 170 52 34 37 293 207 201 171 168 1040 1912 190 41 25 24 280 133 121 81 95 710 1913 195 49 47 29 320 187 178 111 102 898 1914 179 40 39 33 291 159 181 118 100 849 1915 155 49 35 31 270 142 152 125 116 805 1916 129 32 27 21 209 128 116 92 89 634 1917 93 38 23 7 161 106 108 99 91 565 Totals 1616 450 330 285 2681 1520 1500 1173 1139 8013 The mortality in the registration sub-districts ranged from 66 per 1,000 births in Upper Holloway to 121 in Lower Holloway. 1917] 4 Showing the Deaths among Infants per 1,000 Births during the year 1917, and also the mortality rates for the years 1907-16. Sub-Districts. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915. 1916. Mean 10 years. 1917. Increase or decrease on mean. Tufnell 127 81 107 78 85 61 108 93 65 84 89 99 +10 Upper Holloway 88 74 77 88 115 85 1T9 86 118 67 92 66 — 26 Tollington 132 117 96 88 131 88 104 92 135 93 108 104 - 4 Lower Holloway 148 125 101 108 162 94 121 134 118 107 122 121 — 1 Highbury 107 101 93 82 104 80 89 93 109 74 93 82 —11 Barnsbury 123 119 hi hi 162 98 128 119 107 103 1118 114 - 4 Islington South East 104 99 117 94 128 94 98 105 108 91 104 89 -15 The Borough 117 103 103 95 128 86 107 104 107 87 104 97 - 7 5 [1917 In London the infant mortality rate was 103 per 1,000 births, while in the six boroughs encircling Islington it was 106 per 1,000. The rate for England and Wales was 97 per 1,000 births. The following Table shows the diseases that proved most fatal in the first year of child life, together with the mortality rates per 1,000 births. Showing the Mortality per 1,000 Births among Infants under one year of age in the three years 1901-03; in the ten years 1907-16; and in 1917 from certain specified causes. Causes of Death. Mean rate of 3 years 1901-2-3 per 1,000 Births. 1917. Mean rate 10 years 1907-16 per 1,000 Births. Premature Birth and Congenital Defects 24.25 18.33 22.03 Bronchitis and Pneumonia 25.67 21.41 19.45 Atrophy and Marasmus 20.54 16.10 14.65 Diarrhœal Diseases (all forms) 10.81 4.46 9.48 Convulsions 6.66 1.20 1.99 Whooping Cough 6.44 2.91 4.43 Measles 3.27 5.66 2.83 Phthisis 1.85 0.86 0.49 Other forms of Tuberculosis 5.68 3.43 3.81 Diphtheria 0.43 •• 0.37 Total of above 105.60 74.36 79.53 All other causes 27.11 22.44 24.37 Total 132.71 96.80 103.90 WELFARE WORK BY HEALTH VISITORS. For the purpose of carrying out this work, the borough was divided into two districts, i.e., the part of Islington north of the Great Northern Railway, which is called the Northern District, and that south of the railway, which is known as the Southern District. To each a Health Visitbr is appointed. The work performed by the two Health Visitors, during the year 1917, is set out in the following summary:- 1917] 6 Northern District. Southern District. Total. Investigations. Calls. Investigations. Calls. Investigation. Calls. Measles (notifications) 1784 607 1018 544 2802 1151 Ophthalmia Neonatorum (notifications) 19 31 22 44 41 75 Diarrhoea and Dysentery (infant deaths) 5 7 20 45 25 52 Scarlet Fever - 1 1 ... ... 1 1 Births (notified) 41 274 29 48 70 322 Do. (not notified) 5 3 ... ... 5 3 Complaints {re Welfare of Infants) 5 4 11 ... 16 4 Other investigations 4 36 35 13 39 49 Visits to Welfare Centres ... 28 14 ... 14 28 Do. to Schools ... 14 3 ... 3 14 Totals 1864 1005 1152 694 3016 1699 7 [1917 North Islington Maternity and Child Welfare Centre. Number of Expectant Mothers 162 ,, Attendances 506 ,, Consultations held 50 Number of Babies attending (all ages) 1,021 ,, „ (under 1 year) 794 ,, Attendances 6,518 ,, Consultations held 288 Number of Attendances of Morning Callers 1,553 Number of Sewing Classes 81 „ Attendances 667 Number of Health Talks 24 „ Attendances 1,032 Number of Visits—Professional 5,413 ,, ,, —Voluntary 872 Number of Deaths—Infant 34 —Other 15 Infant Mortality (based on Cases) 42.9 South Islington Maternity and Child Welfare Centre. Ante-Natal Cases. Number of Mothers 67 Full Term Births 36 Premature Births 2 Still Births 1 Miscarriages — Not yet confined 17 False Pregnancy 5 Left the neighbourhood before confinement 6 Number of Attendances 100 Referred to Hospital for Treatment 9 Home Visits 79 Post-Natal Cases. Number of Mothers 90 Number of Attendances 146 Referred to Hospitals— Medical 9 Surgical 14 Given Convalescent Treatment 7 1917] 8 Record of Children. Children on Books 31st March, 1917 759 New Children during the year 525 Children on Books 31st March, 1918 1,281 Ceased to attend before 31st March, 1917 158 „ „ since ,, 373 531 In attendance at the present time 753 Analysis of Attendances. Children under 1 year 427 Do. over 1 year 380 Weighing and Consultations 5,118 Weighings only 1,147 West Islington Maternity and Child Welfare Centre. Patients. Children under 1 year 341 Do. over 1 year 382 Mothers, nursing 99 Do., expectant 37 Consultations 138 New Patients 600 Attendances of Patients 4,513 Home Visits, Supt. 1,700 Do. Assist. 3,555 Do. Voluntary 77 Weighings only 1,412 Dressings, etc. 736 Massage 551 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—2,145 persons died in the Public Institutions located in Islington, of whom only 1,383 belonged to this borough, the remaining 762 having come here for treatment or relief. Among the latter were 560 persons who died in the Holborn Infirmary and 83 who died in the Great Northern Central Hospital. Of the 1,383 deaths of inhabitants, 952 occurred in the Islington Infirmary, 296 in the Islington Workhouses, and 93 in the Great Northern Central Hospital. The proportion which the 1,383 deaths in these public institutions bore to the borough mortality was 30.1 per cent. 9 [1917 Without the Borough.—848 deaths of persons belonging to Islington were registered as occurring in Public Institutions in districts of London outside the borough. They included, among others, 25 in the NorthWestern Fever Hospital, 56 in the Children's Hospital, Great Ormond Street, 82 in St. Bartholomew's Hospital, 62 in the Colney Hatch Asylum, 43 in the Royal Free Hospital, 31 in the University College Hospital, 51 in the North-Eastern Fever Hospital, 19 in the Middlesex Hospital, and 52 in the Claybury Asylum. These 848 deaths represented 18.4 per cent, of all the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians numbered 2,231, and were equal to 48.5 per cent, of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— Sixty-nine inhabitants died from accidental deaths, or suddenly, in places outside Islington. Deaths from the principal Epidemic Diseases.—291 persons died from these diseases; and their deaths represented a death-rate of 0.97 per 1,000 of the civil population, as contrasted with a decennial average of 401 deaths anda death-rate of 1.23 per 1,000. It is the lowest death-rate from these diseases hitherto recorded in the Borough. In London there were 4,815 deaths from the same diseases, representing a death rate of 1.20 per 1,000 of the civil population, while in the Boroughs encircling Islington the death rate was 1.34. The following is the record of the various diseases:— Disease Deaths. Death rate. Enteric Fever 4 0.01 per 1,000 Measles H9 0.50 Scarlet Fever 4 0.01 Whooping Cough 45 0.15 Diphtheria 33 0.11 Diarrhoea 56 0.19 Total 291 0.97 INFLUENZA. Influenza caused 36 deaths, and were the same in number as in 1916. They represent an annual death rate of 0.12 per 1,000 of the civil population as contrasted with a mean decennial rate of 0.16 per 1,000, 1917] 10 SEPTIC DISEASES. Of these diseases Erysipelas and Puerpera' Septicemia are the chief. Erysipelas.—Eight deaths occurred from it, which is 2 above the number of 1916, and 3 less than the average of the ten years 1907-16. Puerperal Diseases.—These were Puerperal Pyaemia, Septicæmia, Septic Intoxication and Puerperal Fever, and they caused 6 deaths, which is 3 below the return of 1916, and 1 less than the average of the preceding ten years. CONSTITUTIONAL DISEASES. The chief of these diseases are Cancer, Tuberculosis, Rheumatism, Diabetes, Gout, Gangrene and Purpura. They were collectively responsible for 1,114 deaths, as contrasted with an average of 1,040 in the preceding ten years. The death rate represented 375 per 1,000, as contrasted with a decennial average of 3.18. Cancer.—The ravages from Cancer slowly and steadily increase. There were 432 deaths registered from it during the year, as contrasted with an average of 372 in the previous decennial period. These 432 deaths represented a death rate of 1.45 per 1,000 of the inhabitants, which is the highest rate that has been registered in Islington. Despite the efforts of the medical profession no cure has yet been discovered for it. 194 deaths occurred among males and 238 among females. It will be noticed in the following tabular statement how fell the disease becomes as age advances:— Ages. 1907. 1908. 1909 1910. 1911 1912. 1913 1914 1915 1916. Average. 1907-1916 5. 1917 5 1 1 — 2 1 1 1 — — — 1 2 5-15 3 2 3 1 3 2 — 2 1 3 2 2 15-25 3 8 3 5 4 4 7 2 2 — 4 5 25-35 6 6 10 6 5 7 13 11 7 4 7 8 35-45 39 41 27 40 32 25 31 37 24 30 33 31 45-55 64 63 79 72 67 71 83 69 75 86 73 73 55-65 95 112 96 100 92 130 99 121 120 124 109 131 65-75 102 93 94 85 87 86 115 96 105 114 98 120 75-85 27 39 34 47 3i 5i 49 40 39 48 40 55 85&up- wards 8 2 7 3 7 5 '6 6 4 3 5 5 348 367 353 361 329 382 404 384 377 412 372 432 lesiqai bas ,noiJjsluqoq Iivio srfi to 000,1 i 11 [1917 TUBERCULOSIS. The group of diseases which are known as Tuberculosis together caused 596 deaths and were 32 above the average of the last decennium, and were also 83 above the number registered in 1916. The death-rate resulting from them was equal to 2 01 per 1,000 of the civil population, and represented 12-9 per cent, of the deaths from all causes during the year. Pulmonary Phthisis.—This disease, which is the principal one of the group, and caused 485 deaths, as contrasted with the decennial average of 432, while the death-rate was 1.53 per 1,000 of the civil population, as against the decennial rate of 1.33 per 1,000, which figures are an increase of 53 on the number of deaths and 0.30 on the mean death-rate. In 1913 the death-rate from Phthisis was T26 per 1,000 of the population. It then rose to 1.42 in 1914, increased to 1.57 in 1915, fell to 1.48 in 1916, and in 1917 rose to l-63, which is the highest rate recorded during 10 years. Years Pulmonary Deaths Phthisis. Death rates per 1,000 inhabitants. Proportion of Deaths from Phthisis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. 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 1913 420 1.26 8.35 I5.1 1914 46I 1.42 9.33 15.2 1915 496 1.57 8.98 17.4 1916 458 1.48 9.64 15.3 Average 10 years 432 1.33 8.83 15.0 1917 485 1.63 10.54 15 5 The following return gives the deaths at each age period:— Age periods. Deaths. o- 5 18 5-15 14 15-25 79 25-35 109 35-45 102 45-55 108 Age periods. Deaths. 55-65 34 65-75 21 75 upwards — Total 485 12 19171 Other Tubercular Diseases.—In addition to the deaths from Phthisis there were 111 from other tubercular diseases, namely:— Tabes Mesenterica 22 deaths. Tubercular Meningitis 65 „ General Tuberculosis 13 ,, Other forms of Tuberculosis 11 „ These brought up the total number of deaths from tubercular diseases to 596, which are equal to an annual death-rate of 2'01 per 1,000 of the civil population. Their distribution among the sub-registration districts was as follows:— Phthisis. Tabes Mesenterica Tubercular Meningitis. General Tuberculosis. Other forms of Tuberculosis. Totals. Tufnell - - - 34 5 1 2 — 42 Upper Holloway- 64 1 5 1 1 72 Tollington- - - 51 2 4 — 2 59 Lower Holloway - 51 2 12 1 1 67 Highbury - - - 70 4 11 1 1 87 Barnsbury - - - 87 2 12 1 1 103 Islington South-East - 128 6 20 7 5 166 The Borough - 485 22 65 13 11 596 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. These diseases, which include Chrome and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 887 deaths, or 119 less than in 1916. They were equal to a death-rate of 2'99 per 1,000 of the civil population, and represented 19-3 per cent, of the total deaths registered in the borough. Acute Bronchitis.—There were 132 deaths as compared with 146 in the previous year. 61 occurred among males, and 71 among females. 33 deaths of infants under 12 months were registered. Chronic Bronchitis—Three hundred and ten deaths were ascribed to it, 164 being males and 146 females. This return is 58 below that for 1916t Pneumonia (All forms).— Three hundred and ninety-five deaths were registered, of which 230 were males and 165 females. They are 50 above the number who died in 1916. It was very fatal to infants under a year old, among whom it caused 92 deaths, while between the ages of 1 and 5 years 89 died from it. Above 5 years of age the deaths numbered 214, - 13 [1917 As many as 74 deaths occurred in Public Institutions, chiefly the Workhouse Infirmaries. Pleurisy.—From this disease 19 deaths were registered, of which 4 were under five years old. Only 6 deaths occurred in Public Institutions. Asthma and Emphysema.—Seventeen deaths were recorded from these diseases, 15 of which were those of adults. Other Diseases of the Respiratory System.—Fourteen deaths were registered from them, as contrasted with 18 in 1916. VENEREAL DISEASES. Fifteen deaths were ascribed to these diseases, which equalled the return for 1916. They were 3 below the mean of the preceding ten years 1907-16. The annual average number of deaths recorded during ten years from these diseases at three groups of ages has been as follows:—Under 1 year 10 deaths, 1-5 years 1 death, and over 5 jears 7 deaths, making an average total of 18 per annum. INQUESTS AND MORTUARY. During the year 479 bodies were received into the Mortuary, as compared with an average of 592 in the preceding 10 years. The return is the lowest known for forty years. The daily average number of bodies received was 1'3 as compared with 1-4 in 1916. In 359 cases inquests were held, as contrasted with an average of 394 in the ten years 1907-1916. THE NOTIFICATION, ISOLATION, FATALITY, AND PREVENTION OF INFECTIOUS DISEASES. notification of infectious diseases. Under the Provisions of the Public Health (London) Act, 1891. The Principal Diseases Comprise:— Small Pox, Scarlet Fever, Diphtheria, Membranous Croup, Enteric Fever, Typhus Fever, Continued Fever, Erysipelas and Puerperal Fever. The number of cases notified was 1,251, which represent an annual attackrate of 4 21 per 1,000 of the civil population. They were 752 below the average (2,003) which obtained in the preceding ten years 1907-16. This 14 [1917] decline was due to a decrease, when a comparison is made with the average of these years, of 662 cases of Scarlet Fever, of 45 cases of Enteric Fever, of 57 cases of Erysipelas, and of 4 cases of Puerperal Fever. On the other hand Diphtheria showed an increase of 16 cases, when compared with the average. The above rate of 4'21 per 1,000 of the civil population will be further increased to 21*16 per 1,000 when the 5,036 cases of Measles notified under the " Public Health (Measles and German Measles) Regulations, 1915," are included. In London the attack-rate was 412 per 1,000, or 0-01 lower than in Islington, while in the Encircling Boroughs it was 4T3 or O'OB lower than here. Small Pox.—No case was notified in the Borough during the year; neither was any case known since 1910, when one case occurred. Scarlet Fever.—478 cases were notified, and they showed a decrease of 662 or 41 per cent, on the average (1,140) of the ten years 1907-16. The attack-rate was equal to 1.61 per 1,000 of the civil population annually, which is a decrease of 1.90 per 1,000 on the mean rate (3.51) of the preceding ten years. Diphtheria and Membranous Croup were responsible for 561 cases of illness, and were 16 above the average (545) of the preceding ten years. The attack-rate was equal to 189 per 1,000 of the civil population annually, and was 0.21 above the mean rate (1.68) of the decennial period. In London the attack rate was 1.97 per 1,000, and in the Encircling Boroughs 1.96. Enteric Fever was only notified in 23 instances which is 45 below the average (68) that obtained during the ten years 1907-16. The attack-rate was 0'08 per 1,000 annually, or 0T3 per 1,000 below the mean rate (0.21) of the last ten years. In London the rate was 0.11 and in the Encircling Boroughs 0.08 per 1,000 of the civil population. Typhus Fever.—Nil return. Continued Fever.—Nil return. Erysipelas.—173 cases were notified, or 57 below the average (230) of the preceding ten years, the attack-rate being 0'58 per 1,000 of the civil population, as compared with 0.56 in London and 0'60 in the Encircling Boroughs. . i v . nn -\ J 15 [1917] Puerperal Fever. —16 notifications were received, being in the proportion of 2.74 per 1,000 births. The cases were below the average number notified during the ten years 1007-16, but showed an increase of O'll in the proportion of attacks to a thousand births. HOSPITAL ISOLATION OF NOTIFIABLE INFECTIOUS DISEASES. There were 1,099 cases isolated in hospital, or 87.8 per cent, of the 1,251 cases which were notified during the year. Only 12.2 per cent, of the patients were nursed at home. The percentage of cases treated in hospital during the preceding ten years, 1907-16, averaged 84'2. FATALITY FROM NOTIFIABLE INFECTIOUS DISEASES. By " Fatality" is meant the percentage proportion of deaths to attacks of sickness During the year it was found that out of the 1,251 cases notified 55 deaths occurred, or 4.4 per cent., which contracts with an average percentage of 4-8 in the preceding ten years 1907-16. CASES TREATED IN HOSPITAL. Disease. No. Percentage of known cases. Scarlet Fever 462 99.6 Diphtheria 552 98.4 Enteric Fever 20 86.9 Erysipelas 56 32.4 Puerperal Fever 9 56.2 1,099 87.8 OTHER NOTIFIABLE DISEASES. ACDTE POLIOMYELITIS. Six cases were notified during the year, or one half less than the number recorded in 1916. No death from the disease was registered. EPIDLMIC CE RE BRO-SPINAL MENINGITIS. Twenty-seven cases were notified, being a decrease of 12 as contrasted with the return for 1916, and no less than 24 died. It will be noticed that the fatality from this disease was at the rate of 89 per cent, of the cases notified. I6 1917] OPHTHALMIA NEONATORUM. This disease, which is so frequently caused by Gonorrhoeal disease, was responsible for 42 notifications, of which 31 were forwarded by members of the Medical Profession, and 11 by Midwives. As the result of visits by the Health Visitors 28 cases were referred to Hospitals for treatment, while 14 were attended at their homes. Nurses were provided by the Council in 11 cases. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South-East. The Borough. Cases notified by Doctor 5 5 4 .. 5 6 6 31 ,, „ by Midwife * 1 3 3 2 1 1 11 Cases inquired into.. 5 6 7 3 7 7 7 42 „ treated in Hospital .. 3 6 3 .. e 6 6 28 „ treated at Home 2 • • 4 3 2 2 1 14 ,, attended by Nurse .. 1 .. 1 .. l 5 3 11 * One notification was also received from a midwife which had been notified by doctor. TUBERCULOSIS. 1,055 cases of Tubercular Disease were notified, and represent an attackrate of 3"55 per 1,000 of the civil population. This number is an increase of 212 on the return of the preceding year, and on the attack-rate of 0-83. It was also 61 more than in 1915. Pulmonary Phthisis.—897 notifications were received, of which 568 referred to males and 329 to females, and represented an attack-rate of 3.02 per 1,000. The return was an increase of 225 on that of 1916. There can be little doubt that the increase in the number of cases and deaths from the disease have been due to the altered circumstances under which the population is now living in these serious war times. Indeed, 91 of the increase in the number of notifications was accounted for by the detection of the disease in men who were remitted by the military Medical Boards to the Tuberculosis Officers for examination and report. 17 [1917 THE PERIODS OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1917 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 (in-cluding Tuberculosis of Larynx. M. 568 — 4 22 89 321 122 10 F. 329 — 3 25 76 153 63 9 Tubercular Meningitis M. 6 — 2 3 - 1 — — F. 12 2 5 4 1 — — — Tabes Mesenterica . M. 9 — 3 5 — — 1 — F. 12 1 8 2 — 1 — — General Tuberculosis M. 5 2 2 — — 1 — — F. 1 — — 1 — — — — Other forms of Tuberculosis M. 58 1 6 27 14 8 2 1 ' F. 55 — 4 20 15 12 2 2 All Tubercular Diseases M. 646 3 16 57 103 331 125 11 F. 409 3 20 52 92 166 65 11 Totals 1055 6 36 109 195 497 190 22 Percentages at each life period to total cases 100 0 6 3 4 10 3 18-5 47 1 180 2 1 18 [1917] TUBERCULOSIS DISPENSARIES. The work of the Tuberculosis Dispensaries has been exceedingly useful, and during the year 1,345 persons were examined by the Tuberculosis Officers. The patients made 6,570 attendances. The Northern Dispensary, at the Great Northern Central Hospital, Holloway Road, N., was not opened until May, so that it was only working for eight months, while the Southern Dispensary, at the Royal Hospital for Diseases of the Chest, City Road, E.C. was in full operation throughout the year. At the Northern Dispensary there were 628 new cases, and at the Southern 717, while the attendances at the former were 2,279 and at the latter 4,291. The examination of contacts with tuberculous cases showed that 20 were suffering from tuberculosis, 55 were suspect, and 293 were not suffering. The nurses of the Northern Dispensary paid 925 visits, and those of the Southern 1,620, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 112 visits and of the Southern 128 visits to the patients' homes for the purpose of examining their patients. The full particulars for each month of the year are set out in the tabular statement which is attached ;— The full particulars for each month of the year are set out in the tabular statement which is attached ;— 1917. Date. Dispensary. Feb. March. April May. June. 1 July. 1 August. Sept. Oct. Nov Dec. Total. Total. Attendances Northern — — — — 201 324 1 449 350 211 256 273 215 2,279 6,570 Southern 283 253 329 292 434 422 3S9 363 373 386 430 337 4.291 New Cases Including Contacts. Northern — — 107 110 148 77 33 50 67 36 628 1,345 Southern 61 43 48 37 81 100 78 61 51 51 56 43 717 Contacts. Tuberculosis Northern — — — — —1 — — — — 1 1 — 5 20 Southern 1 — i 2 4 2 2 2 1 — — — 15 Suspects Northern — — — — 1 4 2 3 2 — — 1 13 55 Southern 7 5 3 3 5 2 2 3 2 2 3 5 42 Non-Tuberculous Northern — — — — 20 19 12 8 4 8 8 5 84 293 Southern 23 15 21 12 31 23 ii 18 13 15 16 11 209 Nurses' Visits ... Northern — — — 68 116 125 143 127 124 103 119 925 2,545 Southern 157 149 150 120 142 I48 124 142 98 140 126 124 1620 Medical Officer's Visits Northern — 15 29 10 21 10 10 11 6 112 240 Southern 8 10 10 11 13 14 15 12 8 8 9 10 128 20 1917] THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 2,317 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 210 were Scarlet Fever, 248 Diphtheria, 1,828 Measles, and 1 other disease. The number of notifications of the several diseases are given below :— Disease. No. of Notifications. Average of preceding 10 years. Decrease or Increase. Scarlet Fever 240 619 379 Diphtheria 248 243 + 5 Enteric Fever — 10 - 10 *Measles 1,828 — — Other Diseases 1 — + 1 Total 2,317 * N.B.—Measles only became a notifiable disease from 1st January, 1916. Non-Notifiable Diseases.—3,028 cases came to the knowledge of the Medical Officer of Health during the quarter, viz. :—435 cases of Whooping Cough, 586 of Chicken Pox, and 2,007 cases of other diseases. The information respecting these cases was received from the teachers of 57 schools. Exclusion of Scholars from Schools.—1,684 children were excluded from classrooms of various schools owing to the presence of an infectious disease, chiefly Diphtheria, in the houses wherein they lived. Non-notifiable diseases among children attending the Public Elementary Schools :— Disease. Notifications by Teachers. Average of preceding 10 years. Increase or Decrease. Chicken Pox 586 823 -237 Whooping Cough. 435 683 -248 Other Diseases 2,007 2,282 — 275 3,028 3,788 -760 Note.—" Other Diseases " include Mumps, Scabies, Sore Eyes, Itch, &c. 21 [1917 BACTERIOLOGICAL EXAMINATIONS. During the year 921 examinations were made for the medical profession of the sputum and blood of patients lor the detection of Diphtheria, Enteric Fever and Phthisis. This number shows a decrease of 30 on the return for 191G, but was 363 less than that for 1915. The following Tables give the results of the examinations that have been made during the last 19£ years. Diseases. Total Examinations. Positive Results. Negative Results. Percentage of Positive Results. Diphtheria 5,607 1,759 3,848 31 4 Enteric Fever 1,186 520 666 43-8 Phthisis 5,956 1,737 4,219 29 2 Total 12,749 4,016 8,733 315 STATE OF VACCINATION IN ISLINGTON. Of the 6,811 births registered in 1916, the returns of the Vaccination Officers show that only 3,065 infants were successfully vaccinated; while 18 were declared insusceptible to vaccination ; 382 died unvaccinated ; 1,796 certificates of exemption were produced by parents; and 93 cases were postponed under medical authority, thus leaving 1,487 unaccounted for. Certificates of Exemption.—The following tabular statement shows that the increase of these certificates, more especially during the past seven years, is being maintained. 1906 123 1912 1,646 1907 259 1913 1,942 1908 588 1914 2,124 1909 824 1915 1,710 1910 1,080 1916 1,796 ion 1,241 DISINFECTION. Disinfection of Rooms.—1,140 rooms were disinfected, as contrasted with 1,349 in 1916. For this purpose formaldehyde, either in a gaseous form or in solution, was 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. These above figures also include the disinfection of houses and rooms after Phthisis, vide p. 17. 1917] 22 The Cleansing and Spraying of Rooms.-1,628 rooms, as contrasted with 1,749 in 1916, were cleansed and sprayed. Rooms disinfected. Rooms sprayed. 1917. 1916. 1917. 1916. 1st Quarter 302 374 413 457 2nd 233 354 439 448 3rd 240 306 340 465 4th 365 315 436 379 The Year 1,140 1,349 1,628 1,749 The following class-rooms, etc., were disinfected after the occurrence in them of cases of the diseases mentioned:— 1st Quarter. Nil. 2nd Quarter. Guardians' Schools (Measles). 3rd Quarter. Guardians' Schools (Diphtheria). 4th Quarter. Thornhill Road, L.C.C. Schools (Scarlet Fever). Colebrooke School, Duncan Terrace (Scarlet Fever). Work at the Disinfecting Station.—42,237 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 50,064 similar articles disinfected during the previous year. In addition to the above articles 77,621 old or second-hand garments, mostly soldiers' overcoats, jackets and tunics were disinfected for clothing contractors trading in the borough, who paid the Council for the work, amounting to the sum of £91 16s. 10d. Disinfectants distributed and used.—The following statement gives 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 qrs. Gallons. cwt. qr. lbs. Gallons. To Householders 1 4 3 228 — Disinfection of Premises. — — 0 2 0 18 Cost = £33 19s. 4d. 23 [1917 Shelter House.-The Shelter House was occupied by five persons during the disinfection of their homes after infectious diseases. Baths were given to 4 verminous persons, also to 1 person suffering from Scabies. 32 soldiers who had been in contact with an infectious disease were also afforded bathing facilities, and their clothing was disinfected before rejoining their units, whether at home or abroad. Five midwives also used it for disinfection, after attending cases of Puerperal Fever. Yerminous School Children.—During the year 4,001 baths were given to children from the London County Council Schools, who attended the Disinfecting Station, and were cleansed by the nurse whom the Borough Council appointed for the work, while their clothing was undergoing disinfection. The daily attendance ranged from 2 to 30. The agreement entered into between the London County Council and the Borough Council, for the cleansing of verminous children, is a payment of 1s. for each bath ; upon the understanding that the minimum amount to be paid to the Borough Council in respect of such cleansing shall be £100 per annum. The amount paid during the year by the London County Council for the baths given to the children was .£200 1s. 0d. In 4 cases the London County Council instituted legal proceedings under Section 122 of the Children Act, 1908, and the prosecutions resulted in fines and costs amounting to eighteen shillings being inflicted. 1917] 24 FACTORY AND WORKSHOP ADMINISTRATION. In accordance with the Factory and Workshops Act, the Medical Officer of Health, herewith, submits his annual report on the work carried out by the Workshops' Inspectors during the year 1917. Inspections and Visits.—The inspections and visits made by the Inspectors were as under:— Factories, including Factory Laundries 1,128 Workshops, including Workshop Laundries 1,476 Workplaces, other than outworkers' homes 239 Bakehouses 476 Restaurant Kitchens 282 Outworkers' premises 744 Miscellaneous re-inspections and calls 3,092 Total 7,437 Notices served.—In consequence of the 1,098 sanitary defects discovered as the result of the above-mentioned inspections, 160 intimations and 12statutory notices were served. Of these notices 48 were served on the owners of factories, 86 on the owners of workshops, 35 on the owners of restaurant kitchens, and 3 on the owners of Outworkers' premises. In addition to these nuisances, 59 were discovered on Outworkers' premises, necessitating the service of 21 notices. Registers.—There were 1,896 workshops on the Register, as contrasted with 1,949 in 1916, while the total number of workrooms was 2,624 as contrasted with 2,699 in the previous year. 154 workshops were added to the Register while 207 were removed from it. The various workshops and workplaces are tabulated as below:— Workshops and Workplaces. 1916. 1917. 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 427 550 67 107 387 488 Workshops where Women are employed 863 1,358 67 72 858 1,353 Laundries 72 188 5 10 67 183 Bakehouses 237 247 1 .. 238 248 Restaurant Kitchens 350 356 14 18 346 352 Total 1,949 2,699 154 207 1,896 2,624 Outworkers' Premises — 1,413 557 224 — 1,746 25 [1917 Workshops notified to Home Office, 1917. Trade. N umber of Workshops. Protected Employed Persons. Women. Male Young Persons. Total. Toys 4 26 2 28 Mantles 2 12 .. 12 Blouses 2 34 .. 34 Furrier 2 4 .. 4 Robes 2 20 .. 20 Artificial Flowers 1 12 1 13 Brushes 1 24 .. 24 Ties .. .. .. Millinery 2 18 .. 18 Dolls 1 8 1 9 Scientific Instrument Making 1 4 1 5 Army Work— Munitions 4 215 .. 215 Balloon Making 2 56 .. 56 Aeroplane Making 4 628 .. 628 Cigarette Making 1 85 .. 85 Total 29 1,146 5 1,151 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. (1) (2) (3) (4) Factories (Including Factory Laundries) 1,228 48 Nil Workshops (Including Workshop Laundries) 1,852 86 „ Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 521 35 „ Miscellaneous Re-inspections 3,092 .. .. Total 6,693 169 Nil 1917] 26 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:—* Want of cleanliness 298 283 1 Nil Want of ventilation 22 22 2 „ Overcrowding 6 6 1 „ Want of drainage of floors 24 26 Nil „ Other nuisances 264 255 12 „ Sanitary Accommodation insufficient 48 47 Nil „ unsuitable or defective 421 415 )» „ not separate for sexes 14 13 „ Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) .. .. .. .. Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) 1 1 .. .. Other offences (Excluding offences relating to outwork which are included in Part 3 of this report) •• •• •• •• Total 1,098 1,068 16 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. 27 [1917 3. HOME WORK. NATURE OF WORK* Outworkers' Lists, Section 107. Outwork in Unwholesome Premises, Section 108. octwork 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, 1801. 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.† Lists Outworkers. Contractors Workmen Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) W oaring Apparel— a (1) making, &c. 156 90 1,804 10 2 58 155 .. .. 32 11 .. 22 .. .. (2) cleaning and washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Curtains and furniture hangings .. .. .. 1 .. 1 1 .. .. .. .. .. .. .. .. Furniture and upholstery .. .. .. .. .. .. .. .. .. .. .. .. .. .. Electro-plate .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brass and brass articles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fur pulling .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cables and chains .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anchors and grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cart gear .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, latches and keys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Artficial Flowers 10 .. 158 .. .. .. 8 .. .. 19 7 .. .. .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Racquet and Tennis Balls .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper, etc., Boxes, Paper Bags 20 .. 280 .. .. .. 20 .. .. 3 2 .. 8 .. .. Brush making 2 .. 194 .. .. .. 1 .. .. 4 1 .. 3 .. .. Fea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons. Ac. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed toys .. .. .. 1 .. 3 1 .. .. 1 .. .. .. .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chocolates and Sweetmeats .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cosaques, Christmas Crackers, Christmas Stockings, &c .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Textile weaving .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Christmas Stockings 2 .. 22 .. .. .. 2 .. .. .. .. .. .. .. .. Total 190 90 2,458 12 2 62 188 Nil Nil 59 21 Nil 43 Nil Nil *an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list 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 in columns 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 Dames of outworkers in those lists. 1 a 4 Umbrellas, 23 Furniture, and 2 Brass are included in lists of Wearing Apparel Makers. 1917] 28 4—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number. (1) (2) Workshops where men are employed 387 Workshops where women are employed 858 Laundries 67 Bakehouses 238 Restaurant kitchens 346 Total Number of Workshops on Register 1,896 5.—OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 73 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 7 Reports (of action taken) sent to H.M. Inspector. 7 Other (New Factories reported under Home Office Memorandum, 1912) nil Underground Bakehouses (s. 101) in use at the end of the year 166 DISTRICT INSPECTORS' WORK. Owing to the War five Inspectors have joined the Forces ; one Inspector, William Irving, has died, while Mr. George West, after 41 years of valued and very faithful service, has been compelled to retire through the loss of a leg from a constitutional disease and was superannuated. The Inspectorial Staff worked with a shortage of seven men, and their places were not filled owing to the difficulty experienced in getting suitable temporary Inspectors, and the sanitary work of the Borough has suffered in consequence. Indeed, the District Sanitary Inspectors worked with five men short, and therefore the sanitary improvements effected in the Borough were less. Each of the fourteen districts contain in ordinary times on an average 23,000 persons 29 [1917 for the Inspector to look after, but during the. last few years these were reduced to 10 districts, so that each district contained 33,000 persons, so that their tally of work necessarily shows a decrease, although, if each Inspector's work be taken, in each instance there is an increase. It has been impossible to carry out house-to-house inspection. Synopsis of the Inspectors' Work.—The following statement gives a brief synopsis of the district inspector's work in 1917:— House to house inspections 5 Other inspections of dwelling houses 3,646 Re-inspections and calls made 31,097 Visits of inquiry re notifiable infectious diseases 1,251 „ school cases of infectious diseases 4,856 Butchers' shops, stalls, etc. (Saturday nights) 165 Ice cream shops and factories 27 Dairies and Milkshops 948 Stables and yards 2,041 Manure depots 95 Certificates under the Customs and Inland Revenue Acts 21 Water certificates for newly erected houses or flats 1 Smoke observations 33 Notices Served.—There were 1,892 intimation notices served by the inspectors with respect to nuisances, of which 1,939 were delivered personally, and 187 by post. In 234 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. Verminous Premises—Bedding and Clothing.—17 premises were found to be in a verminous condition, and these were cleansed by the owners or occupiers upon receiving the Inspectors' intimations. In 17 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification or destruction. Smoke Nuisances.—Black smoke was observed to be issuing from the chimneys of the undermentioned premises, and consequently notices were served on the owners of the following businesses requiring the abatement of the nuisance:— 121, Holloway Road. Roylance's Laundry, Barnsbury Park. Western's Laundry, Drayton Park. Public Baths, Tibberton Square, Essex Road. 1917] 30 REMOVAL OF DUST. Thirty applications were received during the year for the removal of dust, which is 9 above the number recorded last year. The return is very satisfactory, and demonstrates that the dust collection in the Borough is efficiently performed by the Horse and Depot Department. The applications received for the past ten years were as follows:— 1906 58 1912 47 1907 55 1913 32 1908 64 1914 26 1909 67 1915 28 1910 44 1916 21 1911 52 Dust Receptacles Provided.—During the year 384 dust receptacles were provided, while 9 were repaired after the service of sanitary notices. INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 1,025 visits to the 22 Slaughter Houses now on the register, and that he has ascertained that 34,145 animals were killed therein, namely:— 855 oxen, 46 calves, and 33,244 sheep and lambs. These were mostly found of good quality and free from disease. The food destroyed or otherwise disposed of so as to prevent its use for human food was as follows:— Tons cwts. qrs. lbs. Diseased meat and organs from slaughterhouses 7 1 22 Diseased or unsound meat, etc., from other sources 3 0 10 Fruit, Vegetables, etc. 5 0 2 20 Bread (Ropy) 13 1 20 Cheese 2 1 14 Fish 6 0 0 Total Tons 6 13 0 8 The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 6 ton 13 cwts. 0 qrs. 8 lbs. The diseases which affected animal food are set out in detail on p. 31. 31 [1917 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., 223, meat and rabbit stalls 3, food preparation establishments 15, fish shops 95, fish stalls 5, fruit shops 200, and about 18 fruit stalls and barrows. To these a total of 10,308 visits were made, apportioned as under, viz.:— Butchers, Provision Dealers, etc., Shops 5,073 visits. Food Preparation Establishments 279 „ Butcher and Provision Stalls 335 „ Fish Shops 1,265 ,, ,, Stalls 182 „ Fruit Shops 2,253 „ ,, Stalls 921 „ Total 10,308 visits. Cowhouses.—There are 4 cowhouses, but only two are actually in use in the borough, and these were visited upon 29 occasions. They were generally found to be satisfactory. Offensive Trades.—The 4 tripe boilers, 2 gut scrapers and the knacker's yard received 89 visits during the year. List of diseased or unsound meat and organs discovered in slaughterhouses during the year 1917:— No. of Cases Description of Animal Affected. Nature of Disease or Affection. Extent of Disease. How disposed of. 1 Cow Tuberculosis Carcase and all organs Council's Crematory 1 do. do. Lungs do. do. 7 Oxen Parasitic Liver do. do. 3 do. Abscess do. do. do. 2 do. Decomposition Tripes do. do. 37 Sheep Parasitic Livers do. do. 1 do. do. Liver and lungs do. do. 1 do. do. Lungs do. do. *Cow found slaughtered on unlicensed premises. Prosecution pending. 1917] 32 Milkshops and Dairies,—At the close of the year there were 586 milkshops and dairies on the register, 18 having been added, and 14 removed from it. They received 948 visits from the District Sanitary Inspectors, who served notices for the execution of various sanitary improvements and the cleansing of dirty utensils. THE ADULTERATION OF FOODS AND DRUGS. During the year 1,134 samples of various foods and drugs were obtained by Inspector Burrell and submitted by him to the Public Analysts (Mr. Frank L. Teed, D.Sc., and Mr. E. A. Pinchin, B.Sc.) for examination. Of these 1,050 were genuine, while 84, or 7'4 per cent., were adulterated. This is 2.6 per cent. lower than the percentage of adulteration in the preceding year, and 3 4 per cent. below the average rate during the last 26 years. Prosecutions.—66 summonses were issued under the Sale of Food and Drugs Acts, 54 of which were successfully prosecuted. Altogether penalties and costs to the amount of £238 15s. 6d. were obtained. The Public Analysts, in the quarterly reports during the year, reported on the genuineness of the articles examined as follows:— Examined. Genuine. Adulterated. Per cent. 1st Quarter 282 256 26 9.2 2nd „ 267 235 32 12.0 3rd „ 300 284 16 5.3 4th „ 285 275 10 3.5 The Year 1,134 1,050 84 7.4 Milk.—The qualitative results of the Analyses of the Milk samples, which have now been published for many years, are as follows No. of Samples. Solids not Fat. Fat. Total solids. Milk purchased on Sundays 150 8.63 3.45 12.08 Milk purchased on week-days 322 8.60 3.41 12.01 Milk procured in transit at Finsbury Park Station 120 8.84 3.59 12.43 Official Standard — 8.50 3.00 11.50 The particulars as to the genuineness or otherwise of the samples procured or purchased on Sundays, Week-days, and at Finsbury Park Railway Station are as follows:— 33 [1917  Number taken. Genuine. Adulterated. Percentage Adulterated On Sundays 160 145 15 9.4 On Week-days 312 263 49 15.7 At Railway Stations (Farmers' Milks) 120 118 2 1.7 592 526 66 11.1 Giving the particulars of the Milk taken during each quarter of 1917 on Sundays, Week-days, and at the Railway Stations. 1917. 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 80 30 150 38 62 30 130 2 18 .. 20 5.0 22.5 .. 13.3 2nd ,, 40 72 30 142 34 57 29 120 6 15 1 22 15.0 20.8 3,3 15.5 3rd ,, 40 80 30 150 37 68 29 134 3 12 1 16 7.5 15.0 3.3 10.6 4th „ 40 80 30 150 36 76 30 142 4 4 .. 8 10.0 5.0 .. 5.3 The Year 160 312 120 592 145 263 118 526 15 49 2 66 9.4 15.7 1.7 11.1 MILK AND CREAM REGULATIONS, 1912. No samples of Cream were submitted to the Public Analysts under these Regulations, the use of Cream, for the time, being prohibited. DEFENCE OF THE REALM ACTS, 1914-17. Fifteen samples, comprising Bread, Margarine and Jam, were examined by the Public Analysts under the Regulations, all of which conformed with the Food Control Orders. 1917] 34 Shewing the Samples of Foods and Drugs submitted to the Public Analyst during the year 1917. 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 150 141 150 150 591 130* 119* 134* 142* 525 20* 22* 10* 8* 66 Milk, Separated .. 1 .. 1 .. 1 .. .. 1 .. .. .. .. .. Butter 50 50 57 40 197 48 43 57 39 187 2 7 .. 1 10 Cheese 10 10 10 10 40 10 10 10 10 40 .. .. .. .. .. Lard 5 5 5 5 20 5 5 5 5 20 .. .. .. .. .. Dripping .. 7 .. .. 7 .. 7 .. .. 7 .. .. .. .. .. Ten 3 .. .. .. 3 3 .. .. .. 3 .. .. .. .. .. Coffee .. 7 7 7 21 .. 7 7 7 21 .. .. .. .. .. Cocoa 7 7 7 7 28 7 7 7 7 28 .. .. .. .. .. Mustard 7 .. 7 7 21 6 .. 7 7 20 1 .. .. .. 1 Pepper 3 .. .. 7 10 3 .. .. 7 2 .. .. .. .. .. Golden Syrup .. .. 2 .. 2 .. .. 2 .. 14 .. .. .. .. .. Malt Vinegar .. 7 7 .. 14 .. 7 7 .. 6 .. .. .. .. .. Sauce .. 3 .. 3 6 .. 3 .. 3 14 .. .. .. .. .. Self-raising Flour .. .. 7 7 14 .. .. 7 7* 6 .. .. .. .. .. Honey 3 .. .. 3 6 3 .. .. 3 2 .. .. .. .. .. Pickles .. .. .. 2 2 .. .. .. 2 17 .. .. .. .. .. Olive Oil 5 5 7 .. 17 5 5 7 .. 17 .. .. .. .. .. Ground Ginger 3 .. .. .. 3 3 .. .. .. 3 .. .. .. .. .. Rice 3 .. 7 .. 10 3 .. 7 .. 10 .. .. .. .. .. Arrowroot 7 .. .. .. 7 7 .. .. .. 7 .. .. .. .. .. Black Currant Jam 1 1 2 .. 4 1† 1§ 2‡ .. 4 .. .. .. .. .. Raspberry Jam 1 .. 4 5 10 1† .. 4‡ 5 10 .. .. .. .. .. Apricot Jam .. .. 1 .. 1 .. .. 1‡ .. 1 .. .. .. .. .. Strawberry Jam 1 2 2 .. 5 1† 2§ 2‡ .. 5 .. .. .. .... .. Baking Powder 3 .. .. 7 10 3† .. .. 7 10 .. .. .. .. .. *All free from Boric Acid and Formalin. †All free from Arsenic. *All free from Sulphurous and Salicylic Acids and Arsenic. §All free from preservatives and Arsenic. 35 1917] Samples of Foods and Drugs—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. Flowers of Sulphur 5 .. .. .. 5 5 .. .. .. 5 .. .. .. .. .. Comp Powder of Liquorice 3 .. .. 5 8 3 .. .. 5 8 .. .. .. .. .. Cod Liver Oil 2 .. .. .. 2 2 .. .. .. 2 .. .. .. .. .. Lime Water .. 5 .. .. 5 .. 4 .. .. 4 .. 1 .. .. 1 Quinine Wire .. 5 .. .. 5 .. 5 .. .. 5 .. .. .. .. .. Liquid Paraffin .. .. 7 .. 7 .. .. 7 .. 7 .. .. .. .. .. Prescription .. .. 1 .. 1 .. .. 1 .. 1 .. .. .. .. .. Tartaric Acid .. .. .. 5 5 .. .. .. 4 4 .. .. .. 1 1 Ammon. Tinct. of Quinine .. .. .. 5 5 .. .. .. 5 5 .. .. .. .. .. 272 256 290 275 1,093 249 226 274 265 1,014 23 | 30 16 10 79 MARGARINE ACT. Margarine 10 11 10 10 41 7 9 10 10 36 3 2 .. .. 5 Totals 282 267 300 285 1,134 256 235 284 275 1,050 26 32 16 10 84 36 1917] SUMMARY OF PROSECUTIONS.—During year 1917. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount Penalties Received. £ s. d. “Public Health (London) Act, 1891 ” 5 5 ... ... 6 10 “Sale of Food and Drugs Acts, 1875-99 ” 59 48 7* 4† 224 10 “Margarine Act, 1887 ” 7 6 1† ... 14 5 Total 71 59 8 4 245 5 * Warranty established in six summonses. One case was dismissed owing to witness not having arrived at Court when case was called. † These were alternative summonses. 37 [1917 Table A. Showing the Deaths from All Causes in Islington during the Year 1917. 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- 45- 55- 65- 7b- 85- Tuf. U.h. Toll. L.H. H. B. S.E. Small Pox (a) Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (b) Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (c) No Statement .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 16 Measles 53 110 6 .. .. .. .. .. .. .. .. .. .. 143 6 17 5 18 18 13 43 35 89 60 147 Scarlet Fever 1 2 .. .. 1 .. .. .. .. .. .. .. .. 3 1 1 .. .. 1 .. 2 .. 3 1 4 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 Epidemic Influenza 1 .. .. .. .. .. 2 2 7 8 10 4 2 1 35 6 3 6 6 1 5 9 23 13 36 6 Whooping Cough 17 26 2 .. .. .. .. .. .. .. .. .. .. 43 2 3 5 7 6 8 9 7 19 26 45 1 Diphtheria .. 19 10 3 .. 1 .. .. .. .. .. .. .. 19 14 1 4 3 7 2 7 9 15 18 33 1 Enteric Fever .. .. .. .. 1 .. .. 1 1 .. 1 .. .. .. 4 1 2 .. .. .. .. 1 3 1 4 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Diarhœa, dysentery 12 6 1 .. .. 1 3 2 7 5 2 1 .. 18 22 1 5 2 8 6 8 10 21 19 40 2 Epidemic Enteritis 14 1 .. .. .. .. .. .. .. 1 .. .. .. 15 1 2 1 .. 2 2 8 1 7 9 16 2*1 Other Allied Diseases 1†8 *9 *2 *1 *1 ‡1 .. .. .. .. .. .. .. 17 5 1 1 1 4 8 3 4 14 8 22 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tetanus 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 .. .. .. 1 .. 1 1 2 Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cow Pox .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. Syphillis 9 1 .. .. .. .. 1 .. 2 .. .. .. .. 10 3 1 1 3 .. 1 4 3 9 4 13 Gonorrhœa .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 .. .. .. .. 1 .. 1 2 .. 2 Phagedæna .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. 1 2 3 1 1 .. .. 8 1 2 .. .. 1 1 3 5 3 8 Puerperal Fever .. .. .. .. .. 2 3 1 .. .. .. .. .. .. 6 .. .. 2 .. 1 3 .. .. 6 6 1 Pyæmia .. 1 .. .. .. .. .. 1 .. 1 .. .. .. 1 2 .. 1 .. .. .. .. 2 2 1 3 1 Infective Endocarditis .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. 3 1 .. 1 .. .. 1 .. 2 1 3 1 Other Allied Diseases .. .. .. .. .. .. .. 1 .. .. 2 2 .. .. 5 1 1 1 .. 2 .. .. 3 2 5 Malarial Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Rheumatic Fever .. .. 1 1 1 .. 2 1 1 1 .. .. .. .. 1 .. 1 1 1 2 .. 3 3 5 8 Rheumatism of Heart .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 1 Tuberculosis of Brain 15 31 10 4 3 1 1 .. .. .. .. .. .. 46 19 1 5 4 12 11 12 20 22 43 65 Tuberculosis of Larynx .. .. .. .. .. .. .. .. 2 .. .. .. .. .. 2 .. 1 .. .. .. 1 .. 2 .. 2 1 Phthisis 5 13 3 11 35 44 109 102 106 34 21 .. .. 18 465 34 63 51 51 70 86 128 277 206 483 150 Abdominal Tuberculosis 3 11 .. 2 .. 1 3 1 .. 1 .. .. .. 14 8 5 1 2 2 4 2 6 11 11 22 General Tuberculosis 2 3 3 1 3 .. 1 .. .. .. .. .. .. 5 8 2 1 .. 1 1 1 7 7 6 13 Other forms Tuberculosis .. .. .. 2 1 .. 2 4 1 .. 1 .. .. .. 11 .. 1 2 1 1 1 5 8 6 11 Other Infective Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Thrush .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Actinomycosis .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 Hydatid Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scurvy .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases due to Alteved Food .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Alcoholism .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chronic Alcoholism .. .. .. .. 1 .. 1 .. .. .. 2 .. 1 .. 1 .. .. .. .. 2 2 Chronic Industrial Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Chronic Poisonings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Osteo Arthritis .. .. .. .. .. .. .. 1 3 6 9 3 1 .. 23 3 2 1 3 2 5 7 8 15 23 Gout .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 2 .. 1 1 .. .. .. .. 2 .. 2 Cancer .. 2 1 1 2 3 8 31 73 131 120 55 5 2 430 47 59 41 50 75 60 100 194 238 132 Diabetes Mellitus .. .. .. .. 1 .. 3 1 3 5 8 5 .. .. 26 3 3 1 .. 5 5 9 11 15 26 Purpura Hæmorrhagica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hæmophilia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Anæmia 1 .. .. 3 1 .. .. 2 4 3 5 .. .. 1 18 .. 2 2 6 2 3 4 13 6 19 Lymphadenoma .. .. .. .. .. .. 3 .. .. .. .. .. .. .. 3 2 .. .. .. .. .. 1 1 2 3 Premature Birth 81 .. .. .. .. .. .. .. .. .. .. .. .. 81 .. 8 11 8 6 15 11 22 48 33 81 Injury at Birth 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. .. .. .. 1 1 1 2 Debility at Birth 11 .. .. .. .. .. .. .. .. .. .. .. .. 11 .. 2 .. .. 8 .. .. 1 8 3 11 Atelectasis 9 .. .. .. .. .. .. .. .. .. .. .. .. 9 .. 2 .. 1 .. 2 2 2 6 3 9 Congenital Defects 26 1 .. .. .. .. .. .. .. .. .. .. .. 27 .. 1 1 1 8 3 7 6 17 10 27 Want of Breast Milk 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 .. 1 Atrophy, Debility, Marasmus 83 8 .. .. .. .. .. .. .. .. .. .. .. 91 .. 9 8 7 11 11 17 28 50 41 91 * Cerebro-Spinal Fever (20). ‡ Post Basic Meningitis (1). ‡ Chicken Pox (1). 38 1917] Deaths in Institutions within Borough. DISEASES. AGES. Under 5. 1 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. Dentition 6 2 .. .. .. .. .. .. .. .. .. .. .. 8 .. 1 3 .. 1 1 1 1 4 4 8 Rickets .. 3 1 .. .. .. .. .. .. .. .. .. .. 3 1 1 .. .. .. .. 2 1 1 3 4 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. 1 74 204 88 .. 367 29 45 38 30 64 68 93 153 214 367 Convulsions 7 10 .. .. .. .. .. .. .. .. .. .. .. 17 .. .. 1 2 7 2 3 2 10 7 17 Meningitis 7 2 .. .. .. .. .. .. .. .. .. .. .. 9 3 1 .. 3 .. .. 6 2 5 7 12 Encephalitis .. .. .. .. 1 1 1 .. .. .. 1 .. .. .. 4 .. .. .. .. .. 2 2 1 3 4 Apoplexy .. .. .. .. .. .. .. 2 12 41 49 33 6 .. 143 18 22 16 15 23 18 31 56 87 143 Softening of Brain .. .. .. .. .. .. .. .. 1 .. 3 .. .. .. 4 1 1 .. .. 1 1 .. 1 3 Hemiplegia .. .. .. .. .. .. .. .. 2 4 6 3 1 .. 16 1 2 .. 2 7 1 3 8 8 16 General Paralysis of the Insane .. .. .. .. .. .. 7 14 10 2 .. .. .. .. 34 1 5 5 3 5 5 10 26 8 34 Other forms of Insanity .. .. .. .. .. 2 3 3 3 3 8 7 1 .. 30 5 8 1 2 3 4 7 17 13 30 Chorea .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebral Tumour .. .. .. .. .. .. .. 3 1 .. .. .. .. 1 4 1 .. 1 1 1 1 .. 3 2 5 Epilepsy 1 .. 1 2 .. 4 3 4 8 3 7 2 1 1 35 1 7 5 5 5 6 7 21 15 36 Laryngismus Stridulus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. .. Locomotor Ataxy .. .. .. .. .. .. .. 2 6 4 4 .. .. .. 16 4 .. .. 2 6 3 1 13 3 16 Paraplegia .. .. .. .. .. 2 1 3 3 6 5 5 .. .. 25 .. 5 1 .. 9 6 4 11 14 25 Other forms, Brain Diseases .. .. 1 .. .. 1 1 1 2 .. .. 2 .. .. 8 1 1 2 3 .. .. 1 4 4 8 Otitis 4 1 2 1 .. 2 1 .. .. 1 .. 1 .. 5 8 2 .. 2 2 2 1 4 6 7 13 Disease of Nose, Epistaxis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Disease of Eye .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 Pancarditis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 Endocarditis .. .. .. .. .. .. 1 .. .. 1 3 1 .. .. 8 .. 3 .. .. .. 3 2 6 2 8 Hypertrophy of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Angina Pectoris .. 1 5 2 1 9 1 1 1 3 1 2 J 9 1 Aneurism .. .. .. .. 1 .. .. 4 3 6 1 2 .. .. 17 3 1 1 3 6 1 2 11 6 17 1 Senile Gangrene .. .. .. .. .. .. .. .. .. .. 1 1 1 .. 3 1 .. .. .. .. 1 1 2 1 3 30 Embolism, Thrombosis .. 1 .. .. .. 1 2 6 10 15 14 7 4 1 59 4 3 7 10 15 9 12 31 29 60 Phlebitis .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. 2 2 .. .. .. .. .. .. .. 2 2 Varicose Veins .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 187 Other Diseases, Heart and Vessels 3 1 .. 1 9 7 32 39 64 117 168 122 18 4 577 55 78 46 85 91 86 140 288 293 581 2 Laryngitis 1 5 1 .. .. .. .. .. .. .. .. .. .. 6 1 .. .. 2 .. .. .. 5 5 2 7 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Larynx and .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Bronchitis 33 15 1 .. .. .. .. 4 10 17 22 22 8 48 84 19 23 17 16 10 14 33 61 71 132 117 Chronic Bronchitis 2 2 1 .. .. .. 5 9 27 61 109 81 13 4 306 21 41 16 43 41 65 83 164 146 310 9 Lobar Pneumonia 3 5 2 1 .. 2 7 7 15 9 8 4 .. 8 55 4 8 6 4 13 13 15 35 28 63 47 Lobular Pneumonia 70 67 2 3 .. .. 7 11 9 10 11 7 .. 137 60 20 21 17 36 19 42 42 106 91 197 18 Pneumonia 19 17 5 4 4 1 7 13 21 19 15 7 3 36 99 16 9 4 16 24 19 47 89 4b 135 1 Emphysema, Asthma .. .. .. .. .. .. 1 2 4 5 2 3 .. .. 17 .. 1 1 4 5 2 4 8 9 17 6 Pleurisy 2 2 1 .. .. .. 3 3 1 .. 4 2 .. 4 15 1 3 3 2 4 1 5 12 7 19 2 Other Diseases, Respiratory .. .. .. .. .. .. 1 2 2 2 .. .. .. .. 7 .. .. .. .. 2 1 4 4 3 1 Diseases of Mouth and Annexa .. 2 2 .. .. .. .. 1 .. .. .. .. .. 2 3 .. .. .. 1 1 1 2 1 4 5 Diseases of Pharynx .. 1 .. .. .. .. .. .. .. 1 .. .. .. 1 1 1 .. .. .. .. .. 1 1 1 2 Diseases of Pharynx .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Ulcer of Stomach and Duo- denum .. .. .. .. 1 .. 3 7 4 9 3 2 .. .. 29 2 4 4 4 6 3 6 15 14 29 2 Other Diseases of Stomach 6 1 1 .. 1 .. 2 1 1 4 1 1 .. 7 13 2 1 2 3 4 6 2 12 8 20 22 Enteritis 43 2 2 .. .. .. 1 4 1 3 4 .. .. 55 16 10 7 7 4 6 11 16 39 32 71 4 Appendicitis .. .. 2 4 1 .. 1 1 2 .. .. 1 .. .. 12 .. .. 1 1 5 2 3 8 4 12 Obstruction of Intestine 4 2 .. .. 1 .. .. 2 9 9 14 7 .. 6 43 7 3 4 6 8 6 15 23 26 49 Other Diseases of Intestine .. .. .. .. .. .. .. .. 1 2 .. .. .. .. 3 1 1 .. .. .. .. 1 2 1 3 5 Cirrhosis of Liver .. .. .. .. .. .. .. .. 4 8 6 1 .. .. 19 .. 3 2 2 6 2 4 10 9 19 Other Diseases of Liver .. .. 1 .. .. .. .. .. 4 1 2 2 .. .. 10 .. .. 2 3 2 1 2 4 6 10 Peritonitis .. 1 1 1 1 .. .. 2 3 1 1 .. .. 1 10 .. 2 .. .. 2 4 3 5 6 11 Other Diseases, Digestive System 1 .. .. .. .. .. .. .. 1 .. .. 2 .. 1 3 .. 1 1 .. .. .. 2 2 2 4 Diseases, Lymphatic System and 1 .. 1 .. .. .. 1 .. .. 1 5 .. .. 1 8 1 2 1 .. .. 1 4 4 5 9 2 Acute Nephritis .. 1 1 .. .. .. .. 2 2 2 2 1 l 10 2 .. 1 2 2 3 1 6 5 11 21 Bright's Disease .. .. .. .. 2 .. 4 9 18 29 24 9 2 .. 97 10 10 9 11 20 10 27 54 43 97 Calculus .. .. .. .. .. .. .. 1 .. 1 .. 1 1 1 1 2 2 4 Diseases of Bladder and Prostate .. .. .. .. .. .. .. .. 2 1 6 5 1 .. 15 1 2 1 3 4 .. 4 15 .. 15 Other Diseases, Urinary System .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 2 1 .. .. .. 1 1 .. 2 1 3 Diseases of Testis and Penis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diseases of Ovaries .. .. .. .. .. .. .. 1 .. .. 2 .. .. .. 3 .. 1 1 .. .. .. 1 .. 3 3 Diseases of Uterus and Appendages .. .. .. .. .. .. 1 5 2 .. .. .. .. .. 8 1 .. 1 .. .. 5 1 .. 8 8 Diseases of Vagina and External Genitals .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 1 .. .. 1 1 Diseases of Breast .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Abortion, Miscarriage .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 1 Puerperal Mania .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Placenta Prævia Flooding .. .. .. .. .. 1 1 2 .. .. .. .. .. .. 4 .. .. .. 1 1 1 1 4 4 39 [1917 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- U.H. Toll. L.H. H. B. S.e. Puerperal Thrombosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Pregnancy and Childbirth .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Arthritis, Ostitis, Periostitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Osseous System .. .. 1 .. .. 1 1 .. .. .. 2 .. .. .. 5 1 .. .. .. .. 2 2 .. 5 5 Ulcer, Bedsore .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Eczema 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. 1 Pemphigus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Diseases, Integumentary System 2 1 .. .. .. .. .. 1 .. .. .. 1 .. 3 2 .. .. 1 .. 2 2 .. 3 2 5 Accidents and Negligence. In Mines and Quarries .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9 In Vehicular Traffic .. .. 8 2 1 1 3 3 5 8 2 5 .. .. 38 3 1 3 5 7 9 10 26 12 38 On Railways .. .. .. .. 1 .. 1 1 .. .. 1 .. .. .. 4 .. .. 1 .. 1 1 1 4 .. 4 On Ships, Boats, etc. (not drowning) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. In Building Operations .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. 2 .. .. .. .. 1 1 .. 2 .. 2 By Machinery .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 By Weapons and Implements .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 1 .. .. 1 .. 1 .. .. 1 1 2 11 Burns and Scalds .. 5 1 .. .. .. .. 1 .. .. 3 4 1 5 10 2 2 3 2 2 1 3 4 11 15 Poisons, Poisonous Vapours .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 .. 1 .. 1 .. .. .. 2 .. 2 Surgical Narcosis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Effects of Electric Shock .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Corrosions by Chemicals .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. 1 .. 1 .. 1 Drowning .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 1 .. .. .. 1 .. .. 2 .. 2 Suffocation, Overlaid in Bed 7 .. .. .. .. .. .. .. .. .. .. .. .. 7 .. .. .. 1 1 2 3 4 3 7 ,, Otherwise 2 .. .. .. .. .. .. .. .. .. 1 .. 4 2 .. 1 .. 1 2 2 .. 1 5 6 23 balls not specified 2 .. .. 2 .. .. 2 4 1 6 1 9 1 2 38 6 8 4 1 4 4 13 22 18 40 Weather Agencies .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. 1 1 Otherwise, not stated .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. 2 1 .. .. .. 1 .. .. 2 .. 2 1 Homicide .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 1 Warfare (wounds) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Suicide. 1 By Poison .. .. .. .. .. .. 1 1 .. 1 1 .. .. .. 4 1 1 .. .. .. 1 l 1 3 4 By Asphyxia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Hanering and Strangulation .. .. .. .. .. .. 2 .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 2 1 1 2 By Drowning .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Shooting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Cut or Stab .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 .. 1 1 .. .. .. .. 2 .. 2 1 By Precipitation from Elevated Places .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 1 By Crushing .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 2 .. .. .. .. 1 1 .. 1 1 2 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Execution .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Sudden Death, cause not ascertained .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ill-defined and unspecified causes .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. By Bombs (enemy aircraft) .. 3 1 2 1 5 2 4 2 4 1 .. 3 22 .. 2 .. 4 12 1 6 14 11 25 Males 321 215 37 31 30 38 120 191 298 362 424 260 55 536 1846 229 271 213 329 354 415 571 .. .. 2382 Females 244 195 45 27 46 47 137 147 199 266 377 384 104 439 1779 199 267 202 245 364 368 573 .. .. 2218 888 TOTAL DEATHS 565 410 82 58 76 85 257 338 497 628 801 644 159 975 3625 428 538 415 574 718 783 1144 2382 2218 4600 40 1917] LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING THE CALENDAR YEAR, 1917. Causes of Death Nett Deaths at the subjoined Ages of " Residents" whether occurring within or without the District. Total Deaths whether of “ Residents” or “ Nonresidents" 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 11 All causes Certified 4635 572 224 192 143 165 601 1134 1604 1691 Uncertified .. .. .. .. .. .. .. .. .. .. Enteric Fever 4 .. .. .. .. 1 1 1 1 3 Small-pox .. .. .. .. .. .. .. .. .. Measles 151 33 65 46 7 .. .. .. .. 68 Scarlet Fever 4 1 2 1 .. .. .. 1 Whooping Cough 46 17 18 9 2 .. .. .. 10 Diphtheria and Croup 34 .. 5 15 13 1 .. .. .. 8 Influenza 35 1 .. .. .. .. 4 16 14 12 Erysipelas 8 .. .. .. .. .. 1 5 2 7 Phthisis (Pulmonary Tuberculosis) 490 5 10 3 14 81 214 142 21 275 Tuberculous Meningitis 64 15 14 17 14 3 1 .. .. 16 Other Tuberculous Diseases 47 5 3 12 8 5 11 2 I 22 Cancer, Malignant Disease 436 .. 1 1 1 5 40 207 181 220 Rheumatic Fever 8 .. .. .. 2 1 3 2 .. 2 Meningitis 33 14 3 9 5 2 .. .. .. 4 Organic Heart Disease 490 1 .. .. 3 15 63 161 247 286 Bronchitis 438 35 8 9 2 .. 17 113 254 195 Pneumonia (all forms) 400 95 55 35 18 8 50 86 53 140 Other Diseases of Respiratory Organs 50 3 2 5 2 1 12 14 11 15 Diarrhoea and Enteritis 127 68 16 3 3 1 11 17 8 44 Appendicitis and Typhlitis 12 .. .. .. 6 1 2 2 1 8 Cirrhosis of Liver 19 .. .. .. .. .. .. 12 7 12 Alcoholism 2 .. .. .. .. .. .. 1 1 Nephritis and Bright's Disease 107 .. 1 .. 1 2 15 51 37 43 Puerperal Fever 6 .. .. .. .. 2 4 .. .. 3 Other accidents and diseases of Pregnancy and Parturition 6 .. .. .. .. 1 5 .. .. 3 Congenital Debility and Malformation, including Premature Birth 208 198 10 .. .. .. .. .. .. 19 Violent Deaths, excluding Suicide 150 10 3 8 18 4 26 31 50 73 Suicide 12 1 5 5 1 8 Other Defined Diseases 1248 71 10 18 24 29 116 266 714 194 Diseases ill-defined or unknown .. .. .. .. .. .. .. .. .. .. 4635 572 224 192 143 165 601 1134 1604 1691 Scb-Entries — included in above figures;— Cerebro-spinal Meningitis 20 7 2 6 3 2 .. .. .. 1 Poliomyelitis .. .. .. .. .. .. .. .. .. .. 41 [1917 LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Metropolitan Borough of Islington. INFANTILE MORTALITY DURING THE CALENDAR YEAR 1917. 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 four Weeks. 4 Weeks and under 3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes Certified 94 38 25 7 164 109 111 97 91 572 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. 1 1 Measles .. .. .. .. .. 1 3 7 22 33 Scarlet Fever .. .. .. .. .. 1 1 Whooping Cough .. .. .. .. .. 1 3 7 6 17 Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. 1 2 6 6 15 Abdominal Tuberculosis .. .. .. .. .. 2 .. .. 1 3 Other Tuberculous Diseases .. .. .. .. .. .. 2 2 3 7 Meningitis (not Tuberculous) .. .. .. .. .. 2 4 5 3 14* Convulsions .. .. .. 3 .. 1 2 1 7 Laryngitis 1 .. .. .. I .. .. .. .. 1 Bronchitis .. .. 2 1 3 16 8 3 5 35 Pneumonia (all forms) 1 2 1 1 5 19 23 25 23 95 Diarrhoea .. 1 1 1 3 6 8 6 2 25 Enteritis .. 6 2 1 9 7 14 10 3 43 Gastritis .. .. .. .. 4 2 6 Syphilis 1 .. 4 .. 5 2 1 1 9 Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlying 2 .. .. 1 3 2 2 .. .. 7 Injury at Birth 1 .. .. .. 1 .. .. .. .. 1 Atelectasis 8 .. .. .. 8 .. 1 .. .. 9 Congenital Malformations 13 6 3 .. 22 .. 1 .. .. 26 Premature Birth 50 12 8 .. 70 10 1 1 1 83 Atrophy, Debility and Marasmus 12 5 1 2 20 32 29 12 5 98 Other Causes 5 3 3 .. 11 4 6 11 4 36 Totals 94 38 25 7 164 109 111 97 91 572 Nett Births in the year legitimate 5,540 ) Nett Deaths in the year of legitimate infants 512 illegitimate 297 illegitimate infants Co * Cerebro-Spinal Meningitis (7). 42 1917] LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1917. premises. Number of Places— Number of inspections, 1917. Number of Notices. 1917. Number of Prosecutions 1917. On Register at end of 1916. Added in 1917 Removed in 1917. On Register at end ot 1917. Milk premises 582 18 14 586 948 Nil Nil Cowsheds 4 Nil Nil 4 29 ,, ,, Slaughter-houses 22 Nil Nil 22 1025 ,, ,, Other offensive trade premises 7 Nil Nil 7 89 ,, ,, Ice cream premises 238 11 14 235 27 ,, ,, Registered houses let in lodgings ‡ ... ... ... ... *... *... ,, * Included in District Inspectors' Summary. J No Register now kept under existing By-Laws. Total number of intimation notices served for all purposes 1892 Overcrowding, 1917. Number of dwelling rooms overcrowded 14 Number remedied 14 Number of prosecutions Nil Underground rooms— Illegal occupation dealt with during year 6 Number of rooms closed 6 Number of prosecutions Nil Insanitary houses— Number closed under the Public Health (London) Act, 1891 Ni Number closed under the Housing of the Working Classes Acts Nil Number of premises cleansed under Sec. 20 of the L.C.C. (General Powers) Act, 1904 17 579 43 [1017 Shelters provided under sec. 60 (4) of the Public Health (London) .1 ct, 1891 — Number of persons accommodated during the year 5 Revenue Acts— Number of houses for which applications were received during year 12 Number of tenements comprised therein 26 Number of tenements for which certificates were (a) granted Nil (6) refused 36 (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 running 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 Nil (e) In connection with the removal of offensive matter, etc. Nil (f) 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. Nil (i) With respect to sufficiency of water supply to water closets Nil (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) Nil Number of prosecutions under L.C.C. General Powers Act, 1907— (l) With respect to Water Supply to Tenement Houses Nil Mortuaries— Total number of bodies removed 479 Total number of infectious bodies removed 6