(SL 66 1925 SEVENTIETH ANNUAL REPORT on the Health and Sanitary Condition of the METROPOLITAN Borough of Islington. G. CLARK TROTTER, M.D., D.P.H., F.R.S.E. MEDICAL OFFICER OF HEALTH.e London: Vail & Co., 170, Farringdon Road. E.C. I. ii MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1925, to November, 1926.) Mayor. LOUIS LEWIS. J.P. Aldermen. HERBERT SAMUEL JORDAN REWARD HENRY TOMKINS, J.P. Councillors. Ward 1. LEONARD McCLANE 1. WILLIAM HERBERT GALE 1. HERBERT TICE 2. HENRY PENN 3. WALTER FREDERICK NOKES 3. WILLIAM THOMAS SMITH 5. FREDERICK COPPING 6. WALTER HARPER Ward 6 WILLIAM T. RICKETTS 6. WILLIAM HENRY BURGESS 7. LESLIE BOYNE 8. WILLIAM J. MITCHELL 8. HARRY ISAAC ROLF 10. SARAH JOHNSON 11. LUCY ELLIOT Chairman Councillor JORDAN Vict Chairman Councillor SMITH MEMBERS OF THE MATERNITY AND CHILI) WELFARE COMMITTEE. (November, 1925, to November, 1926.) A lderman. HENRY B. VORLEY, J.P. Councilors. Ward 1. WILLIAM HERBERT GALE 2. JOSEPH ORCHARD 3. GRACE MAY WATSON 4. GEORGE P. JARRETT 4. MATILDA SOUTHGATE, J.P. 5. ALBERT E. PETTET 6. ALBERT H. JACKSON Ward 7. GEORGE RUST 8. WILLIAM J. MITCHELL 9. MARTHA PANNELL 10. SARAH JOHNSON 11. HENRY JOHNSON 11. PHILIP R. BEECH 11. LUCY ELLIOT Members appointed by the Council from outside their own body. Lady ANDREWES, "Windy Gap," Merton Lane, Highgate N 6 Dr. ALICE VANCE KNOX, 15, South Grove, Highgate, N.6 Mrs. COLEMAN, 76, Plimsoll Road, N. 4 Mrs. WATT, 69, Highbury New Park, N.5 Mrs. VORLEY, "Fern Bank," Helly Park, Crouch Hill, N. 4 Dr. KATE PLATT, 59, Queen Anne Street, W. 1 Chairman Councillor MATILDA SOUTHGATE, J.P. Vice-Chairman Councillor GRACE MAY WATSON SUMMARY of Vital Statistics in the Registration Year 1925 population (Enumerated at Census, 1921) 380,737 persons „ Estimated Mid Year 1925 339,200 persons Increase on Census population, 1921 8,163 persons Mean Population, ten years (1915-1924) 320,894 persons Area 3,092 acres Density (Mid-year 1925) 110 persons per acre Births Males 3,397 persons 6,580 Females 3,183 Birth rate 19.40 per 1,000 inhabitants Deaths from All Causes Males 2,127 persons 4,160 Females 2,033 Death rate 12.26 per 1,000 inhabitants Deaths from Principal Epidemic Diseases Males 63 131 persons Females 68 Death rate 0.39 per 1,000 inhabitants Deaths from All Tuberculosis Males 271 438 persons Females 167 Death rate 1.29 per 1,000 inhabitants Deaths from Respiratory Tuberculosis Males 210 382 persons Females 142 Death rate 1.18 per 1,000 inhabitants Infantile deaths under 1 year Males 231 Total 414 Females 183 Infantile mortality rate 63 per 1,000 births Excess of Births over Deaths 2,420 Rateable value of Borough of Islington £1,900,207 Sum represented by a penny rate £7,935 IV Public Health Department, Municipal Offices, Tyndale Place, N.l. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I have the honour to submit the Annual Report on the Health and Sanitary Conditions of the Borough for the year 1925. This is a "Survey Report," having tables and statistics covering the prece ding five years as well as the annual tables as prescribed by the Ministry of Health. The draft Report was submitted to the Public Health Committee in June, 1926. The death rate for 1925 was 12.20. (The lowest recorded death rate, in the Borough records, which date from 1841, was 11.6 in 1923.) The Maternity and Child Welfare Scheme, both organisations, Municipal and Voluntary, have worked in unison. The Infantile Mortality rate—63 per 1,000 births—constitutes a record for Islington. During the year, the Public Health (Meat) Regulations came into force, on the 1st April; a Municipal Tuberculosis Visiting Nurse was specially appointed for home visitation work, to co-operate between the Public Health Department and the two Islington Tuberculosis Dispensaries. I am, Ladies and Gentlemen, Your obedient Servant, G.Glame Trottes Medical Officer of Health. REPORT OF THE Medical Officer of Health FOR THE YEAR 1925. SURVEY REPORT. SPECIAL REPORTS (OTHER THAN THE HEALTH OF THE BOROUGH, AND OUTSTANDING MATTERS BROUGHT BEFORE THE PUBLIC HEALTH OR MATERNITY AND CHILD WELFARE COMMITTEES DURING THE YEAR. SUMMARY. 1. Historic Survey, Health of Islington—Past and Present. See page 2. 2. Tuberculosis Control, Regulations, Treatment and Procedure. pages 34-86. 3. Sanitation of the Borough.—Pages 45-49. 4. Housing.—Pages 49, 60, 71. 5. Factories and Workshops.—Pages 41-44. 6. Meat, Food and Drugs. — (a) Public Health (Meat) Regulations, 1924, page 55. (b) Unsound Food, page 53. (c) Preservatives in Food, page 59, (d) Sophistication of Milk, page 60 (e) Restaurant kitchens, page 54. (j) Prosecutions, fruit, meat and eggs, page 54. 7. Health Visitation Pages 12, 13, 15, 16. 8. Index to Report.—Pages 75-77. 1925] 2 THE HEALTH OF ISLINGTON—PAST AND PRESENT. In this Report, which is a survey report, besides the statistics for 1925, Tables are given for past years, and some special Tables for a period of five years. It is, therefore appropriate to deal briefly with the matter of the past changes which have come over our borough from its existence as a mere village on the line of what is now Essex Road, its extension still rural in the beginning of the eighteenth century when it was largely used as a health resort, its parish government and, finally, its establishment as a Metropolitan Borough. As regards health comparisons, the latter Vestry administration and the Borough administration, as far as health administration is concerned, are on the same lines, the late Medical Officer of Health being the successor of the other Vestry Medical Officers, and our statistics are in continuity. To get an idea of the early conditions one has to refer to old histories. Lewis's "History of Islington," published in 1842, stated that in the year 1708 Islington possessed 325 houses. It was a progressive neighbourhood even in those times, for in 1754" the number was 937; in 1788 it was 1,060; in 1793 it had risen to 1,200, and the number of inhabitants in that year was 6,660. According to the return in 1801 the number of houses in the parish was 1,745, of which 80 were uninhabited. Further details could be gleaned from the Censuses of 1811, 1821, and 1831. Coming to the question of medical supervision, Islington during the period of 1856 to 1871, had, as Medical Officer of Health, Dr. Edward Ballard, M.D. (London), with a staff of one Superintendent-Inspector, two Sanitary Inspectors, and one clerk. Total 5. In 1871, Dr. W. Henry Corfield, M.A., M.D. (Oxon.), was appointed Medical Officer, and had his staff increased by an extra Sanitary Inspector and a Dust Inspector. In 1872, Dr. C. Meymott Tidy, M.B. (London), was appointed Medical Officer, and the staff was increased by two clerks and a messenger, a total of 10. The officers in those days did not have to do a lot of things that during the new legislation were included in the duties of present officers. By 1891, Dr. Tidy's staff had been raised to 15, and this was the staff when Dr. A. E. Harris, L.R.C.P. (Edin.), commenced under the Vestry in 1892. In 1895 there were one Chief Inspector and fourteen Sanitary Inspectors, and new appointments were made of two Workshops Inspectors, one female Inspector for workshops, and one lodging-house Inspector. In 1899, a Meat Inspector was appointed. In 1900 the old Vestry Health Department was taken over by the newly constituted Borough of Islington, Dr. Harris remaining Medical Officer of Health. The next important change was the appearance of a Foods and Drugs Inspector in 1904; in 1916 two Health Visitors were appointed. Among other things special supervision was introduced over the large number of slaughter-houses in Islington. In tracing the supervision of the health and sanitary conditions in the Borough, it will be noted that the Medical Officer of Health's reports only dated from 1856, and it is necessary to go to the Registrar-General for earlier statistics. The period from 1841-1850 showed a death-rate of 19.3 per 1,000 of the population. In the period, 1851-1860, the death-rate was 21.4, and the infantile mortality rate—that is, the number of deaths of infants under one year per 1,000 births 3 [1925 registered, was 143. It was within this period that the first Medical Officer of Helth was appointed by the Vestry. In 18G1-1870 the death-rate was 24.6, and the infant mortality rate to 153. The climax was reached during this period, normaly in the year 1866, with the high death-rate of 28. This was attributable to the epidemic of cholera, and choleric diarrhoea accounted for 245 deaths. There was also a large number of deaths from smallpox, measles, scarlet fever, whooping cough, typhoid, phthisis, and respiratory diseases and heart disease. The rate was added to by diseases of nutrition among infants, bad feeding, and so on. The infant mortality rate was 170 in 1866. It is interesting to recall at this stage seeing the occasional occurrence of smallpox even to-day, some of the smallpox outbreaks of those times. In 1863, there were in Islington 509 cases of smallpox and 108 deaths; in 1866, 670 cases, land 67 deaths; in 1871, no fewer than 1,429 cases and 386 deaths; in 1876, 367 cases and 69 deaths; 1877, 633 cases and 112 deaths; in 1884, 608 and 97 deaths; and in 1855, 659 cases and 125 deaths. During the years 1862-1880 measles and scarlet fever were very prevalent and much more fatal than at the present time, these diseases now being much less virulent. The lessening of the death-rates of diphtheria was largely due to the introduction of the anti-toxin treatment. As regards the removal of house refuse compared with olden times, considerable progress has been made. It is to such matters and to the enforcement of the Public Health enactments that one ascribes the first stage in improvement of health in populous areas. There is, of course, to be added the spread of knowledge in these matters. The removal of house refuse was performed by contractors during the years 1856-1876. The system was that the district was divided into wards and there was a separate contract for a certain number of wards, and the contractor was supposed to remove the dust in that district, and if this were not done complaints were made. In the year 1876, the number of complaining applications for removal reached a total of 36,867. By way of contrast, and to show the efficiency with which the corporation does its work, there were in the year 1925 only 21 applications. The growth of the Public Health Department and its work has been due, more particularly since the formation of the Metropolitan Borough, to the large increases under the Statutes dealing with Public Health Matters, and the subsequent Orders under the Local Government Board, and latterly, the Ministry of Health. Thus the Notification of Infectious Diseases Act came into operation in 1889. There was a great deal of sanitary legislation in 1890. The Customs and Inland Revenue Act, since superseded, required the inspection of houses for exemption from taxation. The Housing of the Working Classes Act, the Working Classes Dwellings Act, the Public Heailth Amendment Act, and the Infectious Diseases Prevention Act were all in that year. It was, however, in 1891, that London obtained a special Health Act consolidating the old sanitary Acts. In 1894, still under the Vestry, the disinfecting chamber was erected; the disinfecting work was formerly done by contract. In 1907-8 the Notification of Births Act gave a fillip to child welfare work. The Borough of Islington stands well to the fore in the assistance received from voluntary organisations in respect of the care of infants. There are four 1925] 4 voluntary infant welfare centres, with three branches. Each centre specialises in a way, inasmuch as special clinics receive prominence. The North Islington Welfare Centre was one of the first in this country to start artificial sunlight treatment as a preventive measure against illness in young children. The artificial sunlight lamp was established in Manor Gardens in September, 1924. The West Islington Welfare Centre established a similar clinic in June, 1925. The dental care of young children has been during the later years a matter which called for energetic action. The old idea that because the decayed tooth is one of the child's first set, and that therefore it is useless to trouble, has with our modern knowledge been largely dissipated, and the centres have taken a leading part in the establishment of dental clinics. This work in the departments mentioned is merely a corollary of the routine work of the Centres as regards the ante-natal care of the mothers and the supervision of the infants, the establishment of proper methods of care in the homes, and kindly advice on all matters appertaining to the rearing of healthy children. The object of the centres is not treatment of disease, which is the province of the family doctor, but the prevention of illness, which can be attained by increasing the resistance of the individual by natural means, for it is now considered an established fact that the healthy person most successfully resists infection. Returning momentarily again to the past, in a description which Sir Walter Besant gives of London in 1210, he says, "Leaving London and walking along the straight line of wall running nearly east and west we look upon the open moor, dotted with ponds, and intersected with streams and ditches. Here, the kennels belonging to the city hunt and to rich citizens from which all day can be heard the barking of dogs. From here stretches west an uncultivated moorland, covered with rank grass and weeds and marsh flowers. The marsh is in itself a regular area, measuring roughly 400 yards from east to west by 300 yards north to south. The few buildings here must be erected upon piles driven into the London clay. There is talk of the construction of a postern opening upon the moor, and of a causeway across the moor which would be a great convenience to people wishing to go to ISLEDON or on a pilgrimage to Our Lady of Muswell Hill." Just as the traffic passes through, it may be, Islington to-day on the way to the Alexandra Palace, so in those days at Islington began the forest which had to be passed on the way to the same place, Muswell Hill, for the religious festival. But what a change in the aspect of the country there now is. The only part of the forest which remains is Kenwood. But. as in the past there was a day population of visitors, excursionists, as it were, on holiday, Islington at the ptesent day, although not in any way to be compared to the City of London in this respect, has a day population as well, for from the Census of 1921 interesting figures reveal the change in character in recent years. The Borough is becoming more and more a factory and workshop area. In the Census year 1921, the persons working in Islington enumerated elsewhere in London and the home counties were 21,071 males and 10,227 females. Thus there were 31,298 workers not living in the borough. The health of the worker, however, whether he may or may not reside where he works, is of very considerable health importance. The ordinary resident basis which it is usual to use as an index to important aspects of the home conditions and 5 [1925 surroundings is rather apt to overshadow the fact that fully half of an individual's time not spent in repose—indeed, it might be said, half of the life of a worker is genrally spent amidst entirely different surroundings from what is called his home. These surroundings—where he works—must leave their imprint upon him Apart from the factory inspection by the Home Office, this is provided for by a Borough male Inspector and two lady Inspectors for workshops. The Public Health Administration of our towns and Counties has made rapid advances with the spread of our special knowledge in prevention of infection and the maintenance of health. This has, however, had undoubted assistance from the advance in education which has enabled the individual to grasp and understand these matters in a way which was not possible two or three generations ago, and the same education which has enabled this knowledge to be acquired also at the same time permits the absorption of the information disseminated by the public press of the day. The effect of both the better education and the influence of the press—for the newspaper is the most widely read literature cannot but have been a great factor in the improvement recorded. To this education I must add the activities now displayed in the education of youthBoys' Brigades, Scouts and Girl Guides. All make for a training of health as well as character. Might I, however, plead for a more active recognition of "Health Week" and the other activities, especially from a civic point of view, and I think if the people of Islington would bear the matter in mind, the example set in the educative organisations I have mentioned could be extended. Our voluntary organisations are always pleading for more extensive interest in their work. I would put in a plea for this health welfare of the citizens. We have not reached the best possible. Our voluntary workers are largely drawn from outside Islington. There is need for more local help. POPULATION. The population of the Borough in 1925, estimated by the Registrar-General, was 339,200 persons, of whom 158,780 were males and 180,120 females. Thus it is shown there was a total increase of 1,800 persons as compared with those of the preceding year, and 8,463 since the last census enumerated in 1921. In the following tables will be found information respecting the sex, age and estimated populations of the several sub-registration districts and wards, together with particulars of their areas and densities. Showing the Areas, Densities and Estimated Populations cf the Subregistration Districts at the Middle of year 1925, also the Populations at the Census 1921. Sub-Districts. Area. Acres. Estimated Acres to a person. Estimated Persons to an Acre. Estimated Population Mid-year 1925. Enumerated Population at Census 1921. Inc ease or Decrease on Census. Tufnell 411 0.0120 83 34,317 33,750 + 567 Upper Holloway 299 0.0093 108 32,180 35,721 -3,541 Tollington 315 0.0100 100 31,399 30,832 + 567 Lower Holloway 406 0.0096 104 42,136 40,139 + 1,997 Highbury 749 0.0121 82 61,700 58,850 + 2,850 Barnsbury 316 0.0056 177 55,987 53,859 + 2,128 South East Islington 596 0.0073 137 81,481 77,586 + 3,895 The Borough 3,092 0.0091 110 339,200 330,737 + 8,463 1925] 6 Shewing the Areas Densities and Estimated Populations of the Wards at the Middle of the year 1925, also the Populations at the Census 1921. WARDS. Area in Acres. Estimated Persons to an Acre or Density of Population. Estimated Population Mid-year, 1925. Enumerated Population Census, 1921 Increase or Decrease on Census. No. 1—Tufnell 411 83 34,317 33,750 + 567 2—Upper Holloway 299 108 32,180 35,721 -3,541 3—Tollington 315 100 31,399 30,832 + 567 4—Lower Holloway 406 104 42,136 40,139 + 1,907 5—Highbury 417 78 32,434 33,417 -983 6—Mildmav 332 88 29,266 25,433 + 3,833 7—Thornhill 178 173 30,741 31,301 -560 8—Barnsbury 138 183 25,246 22,558 + 2,688 9—St. Mary's 150 123 18,519 17,363 + 1,156 10—Canonbury 290 113 32,727 29,997 + 2.730 11—St. Peter's 156 194 30,235 30,226 + 9 The Borough 3,092 110 339,200 330,737 + 8,463 Showing the Estimated Number of Persons living in Islington at the Mid-year 1925, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 14,930 14,578 29,508 5—15 31,213 30,522 61,735 15—25 26,124 31,878 58,002 25—35 25,106 30,524 55,630 35—45 21,714 26,116 47,830 45—55 18,999 20,688 39,687 55—65 12,214 13,904 26,118 65—75 6,445 8,480 14,925 75 and upwards 2,035 3,730 5,765 All ages 158,780 180,420 339,200 MARRIAGES. Marriages, 2788 ; Marriage Rate, 16.4—The number of persons married was 5,570, as contrasted with 5,744 in the preceding year, which is a decrease of 68. The marrige rate was 16.4 per thousand inhabitants, as compared with 17.0 in 1924. The following statement shows the figures for the previous ten years 1915-24. Years. Marriages. Marriage Rate. Years. Marriages. Marriage Rate. 1915 4,252 26.12 1920 3,370 20.05 1916 3,080 18.30 1921 3,141 18.86 1917 2,689 16.23 1922 2,877 17.23 1918 2,971 18.51 1923 2,764 16.42 1919 3,306 19.28 1924 2,872 17.03 BIRTHS. There were 6.580 births registered, of which 3,397 were boys, and 3,183 girls. Of this number, however, 1,118 were born of mothers living in Islington, although they were confined in Lying-in Institutions, and in other homes situated outside the Borough. The annual birth rate was equal to 19.4 per 1,000 of the population, as compared with a mean birth rate of 21.3 in the preceding ten years. r ri92.-, Showing the Births (distinguishing Mules and Femalesand Birth-rates of Islington in 1925, 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 1924 ; together with the mean Borough Birth-rates for the 10 years 1915-1924. Quarter. Males. Females. Total. Birth Rates. Islington, 1925. Islington, 1915-24. London, 1925. 105 Great Towns, 1925. First 876 811 1,087 19.9 22.0 19.1 19.3 Second 904 813 1,717 20.2 21.8 19.3 19.9 Third 852 808 1,660 19.6 20.6 18.5 19.0 Fourth 765 751 1,516 17.9 20.6 16.9 17.6 The Year 1925 3,397 3,183 *6,580 19.4 21.3 18.0 18.8 1924 3,470 3,329 6,799 19.8 19.4 18.7 19.4 Increase or decrease — 73 — 146 -216 -0.4 — 1.9 — 0.7 — 0.6 * These include 1,118 births which occurred in Lying-in Institutions, etc., outside the Borough. N.B.-The total registered births given by the Registrar-General for the Calendar year, 1925, will be found at the foot of table on p. 12. Showing the Births of Malts and Females and the Birth-rates in each quarter and for the year, 1925, and in the several Sub-Registration Districts. Tufnell. Upper Holloway. Tollington. Lower Hollo way. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. 1 Males. Females Total. Birth rates. 1st Quater 79 94 173 20.2 81 68 149 18.5 81 65 146 18.6 110 124 234 22.2 2nd Quater 93 72 165 19.2 82 75 157 19.5 72 82 154 19.6 120 99 219 20.8 3rd Quater 79 89 148 17.2 106 105 211 26.2 58 65 123 15.7 102 94 196 18.6 4th Quater 66 60 126 14.7 90 106 196 24.4 49 54 103 13.1 121 99 220 20.9 Year 317 295 612 17.8 359 354 713 22.2 260 266 526 16.7 453 416 869 20.6 Showing the Births of Males and Females and the Birth-rates in each quarter and for the year 1925, and in the several Sub-Registration Districts.—contd. Highbury. Barnsbury. Islington South-East. The Borough. Males. Females Total Birth rates. Males Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. 1st Quater 145 137 282 18.3 152 136 288 20.6 228 187 415 20.4 876 811 1,687 19.9 2nd Quater 137 151 288 18.7 182 155 337 24.1 218 179 397 19.5 904 813 1,717 20.2 3rd Quater 165 154 319 20.7 151 150 301 21.5 191 171 362 17.8 852 808 1,660 19.6 4thQuater 120 112 232 15.0 136 151 287 20.5 183 169 352 17.3 765 751 1,516 17.9 Year 567 554 1,121 18.2 621 592 1,213 21.7 820 706 1,526 18.7 3,397 3,183 6,580 19.4 Illegitimate Births (196).—The number of illegitimate births, 196, shows an increase of 10 on the return of the year 1924. They are equal to a rate per 100 registered births. A table for former decennial periods was given in the Report for 1921. 8 1925] Notification of Births Act, 1907. —4,928 births were notified, exclusive of 119 still born, or 74.9 per cent. of the total number that was registered during the year. They were notified by doctors, midwives, parents and guardians as follows: Notified by: Doctors. Midwives. Parents and other Persons. Total. Alive. Still born. Alive. Still born. Alive. Still born. Alive. Still born. 1925. 1st Quarter 319 9 682 18 276 6 1,277 33 2nd „ 332 16 725 12 266 4 1,323 32 3rd „. 290 8 610 8 248 8 1,148 24 4th „ 270 8 681 18 229 4 1,180 30 Year 1,211 41 2,698 66 1,019 22 4,92S 119 DEATHS. The deaths numbered 1,1G0, while the death-rate was equal to 12.26 per 1,000 of the population, or 0.02 lower than that of the preceding year (12.28), and was 2.3 less than the average of the previous 10 years. When compared with the mortality of the country, the death-rate is also satisfactory, for it is found that, while the mortality rate in Islington was 12.3 per 1,000, that of England and Wales was 12.2. There is, however, a considerable difference in the distribution of the ages and sexes in the two populations, which of course affects the death-rate, and a correction must be made before an accurate comparison can be arrived at, and then it is found that the standardized death-rate of the Borough becomes 11.5, whilst that of England and Wales is 10.7, so that the local mortality rate is 0.8 above that of the country. When it is recollected that Islington has a large population living under crowded conditions that do not occur in the country as a whole, the death-rate may be considered very creditable. The Deaths and Death-rates from All Causes in the Sub-Registration Districts were as fellows:— Sub-Districts. Quarters. The Year. 1 2 3 4 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates Tufnell 120 14.0 86 10.0 93 10.8 117 13.6 416 12.1 Upper HoIIoway 117 14.5 95 11.8 87 10.8 142 17.6 441 13.7 Tollington 103 13.1 79 10.1 77 9.8 103 13.1 362 11.5 Lower Holloway 156 14.8 102 9 7 90 8.5 150 14.2 498 11.8 Highbury 229 14.8 178 11.5 146 9.5 229 14.8 782 12.7 Barnsbury 192 13.7 154 110 130 9.3 198 14.1 674 12.0 Islington (SouthEast) 295 14.5 216 10.6 204 10.0 272 13.3 987 12.1 The Borough 1,212 14.3 910 10.7 827 9.7 1,211 14.3 4,160 12.3 N.B.—The heavy figures show the healthiest Districts in the several periods to which they refer. 9 [1920 Showing the Deaths and Death Rates of Islington in 1925, 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 10 years 1915 24 and the deaths and death-rates in the year 1924. Quarter. Males. Females. Total. Death Rates. Islington, 1925. Islington, 1915-24. London, 1925. 105 Great Towns, 1925. First 599 613 1,212 14.3 18.6 14.1 14.6 Second 487 423 910 10.7 13.3 10.1 11.4 Third 424 403 827 9.7 10.8 9.1 9.6 Fourth 617 594 1,211 14.3 15.8 13.6 13.4 The Year 1925 2,127 2,033 4,160 12.3 14.6 11.7 12.2 1924 2,096 2,126 4,222 12.3 12.3 121 12.3 Increase or Decrease + 31 — 93 — 62 _ — 2.3 — 0.4 - 0.1 Causes of Death (Classified).—The following table shows the deaths arranged in classes of Disease from All Causes during the ten years 1915-24 and in 1925— Classified Causes of Death . Years. Mean 10 Yrs. Difference. 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 I. Specific or Febrile Causes 618 380 391 1361 579 552 464 639 273 391 565 286 - 279 1. Miasmatic Diseases 451 268 293 1258 466 437 301 546 155 316 449 191 - 258 2. Diarrhoeal 94 56 56 51 36 28 85 29 40 20 49 15 - 34 3. Malarial ,, — — - 2 2 2 - — — — 1 — - 1 4. Zoogenous „ — 3 2 — 1 2 1 — — 2 1 3 + 2 5. Venereal „ 23 15 15 15 13 13 17 17 20 9 16 8 — 8 6. Septic „ 50 38 25 35 61 70 60 47 58 44 49 69 + 20 II. Parasitic Diseases — 1 1 — 1 1 — 3 1 2 1 1 — III. Dietetic 36 3 3 4 2 2 4 7 2 3 7 3 — 4 IV. Constitutional Diseases 1132 1095 1114 1101 973 918 985 935 945 945 1014 1054 + 40 V. Developmental 554 522 486 520 657 556 486 477 377 396 503 404 — 99 VI. Local 2847 2457 2344 2596 2177 2172 2203 2362 2106 2290 2355 2211 - 144 1. Diseases of Nervous System 418 339 351 330 322 341 345 330 294 290 336 291 - 45 2. ,, Organs of Special Sense 17 12 14 10 11 20 13 9 16 14 14 10 - 4 3. „ Circulatory System 722 669 681 691 654 592 651 734 745 822 696 740 + 44 4. ,, Respiratory 1147 1006 887 1156 770 822 717 903 598 797 880 756 - 124 5. ,, Digestive ,, 319 233 243 246 215 224 260 204 259 192 240 225 - 15 6. „ Lymphatic „ 9 10 9 3 1 1 10 14 11 11 8 10 7 - 3 7. „ Urinary „ 182 149 130 137 151 129 168 134 157 136 147 142 - 5 8. „ Reproductive ,, 18 24 18 8 17 20 13 20 10 15 16 20 + 4 a „ Orgs, of Generation 9 12 12 2 7 7 8 5 4 6 7 10 + 3 b „ of Parturition 9 12 6 6 10 13 5 15 6 9 9 10 + 1 9. „ Bones and Joints 8 9 5 9 12 5 3 8 8 10 8 10 + 2 10. „ Integumentary System 7 — 6 6 14 9 19 9 8 6 8 10 + 2 VII. Violence 234 183 159 156 162 179 142 137 151 156 166 169 + 3 1. Accident or Negligence 194 156 122 115 132 140 99 94 105 115 127 124 - 3 2. Homicide 3 4 1 3 2 2 3 3 8 2 3 2 - 1 3. Suicide 37 23 11 27 28 37 40 39 38 39 32 42 + 10 4. Execution — — — — — — — 1 - — — 1 + 1 5. By Bombs (Enemy Aircraft) — — 25 11 — — — — — 4 - - 4 VIII. Ill-Defined Causes 125 1ll 102 103 89 95 84 54 47 39 85 32 - 53 All Causes 5546 4752 4600 5841 4640 4475 4368 4614 3902 4222 4696 4160 — 536 1925] 10 AGES AT DEATH. The following statement gives the ages at which persons died in the Borough, and contrasts them with the returns for the preceding ten years : Ages. Number of Deaths, 1925. Mean Deaths (10 years. 1915-24.) Increase or Decrease on mean. 0-1 year 414 592 — 178 1-5 years 212 390 — 178 Under 5 years 626 982 — 356 5-15 years 98 173 — 75 15-25 „ 182 192 — 10 25-35 „ 198 202 — 64 35-45 „ 279 341 — 62 45-55 „ 463 510 — 47 55-65 „ 671 639 + 32 65-75 818 811 + 7 75-85 643 619 + 24 85 upwards 182 167 + 15 4,160 4,696 — 636 INFANTILE MORTALITY. Infant Deaths, 414; Mortality Rate, 63.—There were 414 deaths among infants under twelve months old during the year, or 178 below the decennial average (592), and they represented an infant mortality rate of 63 per 1,000 infants born. This rate is 20 per 1,000 births below the mean annual record of the preceding ten years, and it is the lowest infant mortality rate recorded in Islington. In the sub-registration districts the infant mortality was as follows : Sub-District. Infant Deaths. Mortality per 1,000 Births. Tufnell 29 47 Upper Holloway 41 57 Tollington 34 65 Lower Holloway 68 78 Highbury 62 54 Barnsbury 91 75 Islington South East 89 58 In London the infant mortality was 68 per 1,000 births, while in the six boroughs encircling Islington it was also 68. The rate for England and Wales was 75 per 1,000 births. The seasonal mortality during the years 1924-5 was as follows: Quarters. Rate per 1,000 Registered Births. 1925. 1924. First 75 90 Second 44 64 Third 50 55 Fourth 84 61 The Year 63 66 11 [1925 Infantile Mortality during each of the Ten Years 1915-24 and 1925. Deaths at various ages under One Year of Age. Years. Under one week. Weeks. Total under four weeks. Months. Total Deaths under one year. Deaths per 1,000 Births. 4 weeks and under 3 mths. 3-6 6-9 9-12 1-2 2-3 3-4 1915 155 49 35 31 270 142 152 125 116 805 107 1916 129 32 27 21 209 128 116 92 89 634 87 1917 93 38 23 7 161 106 108 99 91 565 97 1918 123 31 19 14 187 87 112 78 107 571 110 1919 158 32 22 21 233 95 92 60 45 525 83 1920 142 54 37 22 255 141 120 79 81 676 72 1921 131 34 35 22 222 104 148 96 71 641 81 1922 125 37 29 22 213 80 97 96 93 579 77 1923 128 35 20 11 194 72 104 54 49 473 66 1924 110 33 23 21 187 59 60 65 76 447 66 Mean 10 years 129 38 27 19 213 101 111 84 82 591 84 1925 105 25 20 20 170 70 72 58 44 414 63 Increase or decrease on mean — 24 -13 -7 + 1 — 43 — 31 — 39 — 26 — 38 —177 — 21 Showing the Deaths among Infants per 1,000 Births during the Year 1925. and also the mortality rates for the Years 1915-1924. Sub-Districts. 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 Mean 10 years 1925 Increase or decrease on mean Tufnell 65 84 99 93 50 41 53 83 46 54 67 47 —20 Up. Hollo way 118 67 68 83 79 69 76 59 64 70 75 57 —18 Tollington 135 93 102 135 98 58 83 58 55 60 88 65 —23 Lr. Holloway 118 107 121 130 101 66 93 81 81 85 98 78 —20 Highbury 109 74 83 99 83 67 93 64 61 60 79 54 —25 Barnsbury 107 103 114 122 91 89 87 86 59 77 93 75 —18 Islington, S.E. 108 91 89 107 81 79 77 88 82 55 86 58 —28 The Borough 107 87 97 110 83 72 81 77 66 66 84 63 —21 The following table shows the diseases that proved must 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 ten years 1915-24: and in 1925 from certain specified causes. Causes of death. 1925. Rate per 1,000 Births. Mean rate 10 years 1915-24 per 1,000 Births. Difference. Premature Birth and Congenital Defects 17.2 19.6 — 2.4 Bronchitis and Pneumonia 14.3 17.6 — 3.3 Atrophy and Marasmus 4.7 10.4 — 5.7 Diarrhoeal Disease (all forms) 2.1 4.8 — 2.7 Convulsions 0.6 1.6 — 1.0 Whooping Cough 3.6 3.4 + 0.2 Measles 0.6 3.1 — 2.5 Diphtheria — 0.3 — 0.3 Phthisis 0.8 0.4 + 0.4 Other forms of Tuberculosis 1.1 1.6 — 0.5 Total of above 45.0 62.8 —17.8 All other causes 17.9 20.8 — 2.9 Total 62.9 83.6 —20.7 1925] 12 INFAN1ILE MORTALITY during the Calendar Year 1925. Nett Deaths from stated causes at various Ages under One Year of Age. Cause of Death. Under 1 week Weeks. Total under 4 weeks 4 weeks and under 3 months Months. Total Deaths under 1 year 1-2 2-3 3-4 3-6 6-9 9-12 All Causes. Certified 104 25 20 20 169 70 71 58 44 412 Uncertified — — — — - - - - - Nil Small-pox - - - - - Chicken-pox - - - - - - - - - — Measles — — - - - 2 2 4 Scarlet Fever - - - 2 2 Whooping-Cough — — - - 7 4 9 4 24 Diphtheria, Croup — — - - — — — — — Erysipelas 1 — - - 1 2 — — — 3 Tuberculous Meningitis - 1 _ - 1 - 1 3 2 7 Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - 2 2 1 5 Meningitis (not Tuberculous) 1 - - 1 2 2† 1§ - - 5 Convulsions 3 — - 1 4 — — — — 4 Laryngitis — — - - — — - — — Bronchitis — 1 2 3 4 5 4 1 17 Pneumonia (all forms) 1 2 1 4 8 11 10 19 23 77 Diarrhoea — - — 5 7 2 — 14 Enteritis 2 1 — 3 15 15 9 5 47 Gastritis 2 — 2 — — 1 — 3 Syphilis — — — — — — — — — — Rickets — - — — — — — — — Suffocation, overlying 2 - - - 2 - - - - 2 Injury at birth 4 1 - — 5 — — — — 5 Atelectasis 8 3 - — 11 — — — — 11 Congenital Malformations 16 4 1 4 24 5 3 1 1 34 Premature birth 56 7 8 2 73 6 — — — 70 Atrophy, Debility and Marasmus 7 2 1 2 12 8 9 2 i 32 Other causes 6 3 5 4 18 5** 8 4** 2 37 Totals 104 25 20 20 169 70 71 58 44 412 Nett Births legitimate 6,274 6,546 in the year illegitimate 272 * Influenza (4). † Cerebro-Soinal Meningitis(1) Nett Deaths in legitimate infants 300 the year of illegitimate infants 22 Post-Basic Meningitis (1) MUNICIPAL HEALTH VISITORS WORK. OPHTHALMIA NEONATORUM is an inflammatory disease with purulent discharge occurring in the eyes of infants within three weeks of birth. 94 cases of Ophthalmia Neonatorum were notified as against 77 in 1924. 31 out of the 94 cases of Ophthalmia Neonatorum were attended at birth by mid wives. The cases occurred in the sub-registration districts as follows: Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South East. The Borough Ophthalmia Neonatorum. Cases notified by Doctor 4 12 5 6 8 16 29 80 Cases notified by Certified Midwives 3 7 1 2 1 — — 14 Ophthalmia. Cases reported by L.C.C. 2 2 2 5 6 4 17 38 Cases reported by Health Visitors ... — 1 — - - 2 - 3 13 [1925 Of the 135 cases investigated, both of the infants' eyes were affected in 108 instances, whilst in 10 the right eye was involved and in 17 the left. Treatment.—58 of the 91 Ophthalmia Neonatorum cases were treated at Hospitals; of these, 9 were admitted to St. Margaret's Hospital. 31 of the 91 cases were treated at home by private doctors, while 2 were under the care of certified midwives. Nursing.—28 cases of inflammatory disease of infants' eyes were nursed by the North London Nursing Association for the Council at the cost of £28 3s. (In 1921, 33 cases were nursed at the cost of £38 19s.). Skilled attention decreases the possibility of partial, or complete blindness; so that the cost incurred was in every way money well spent. Results.-—Of the 91 Ophthalmia Neonatorum cases : 88 cases completely clear. 3 cases partial impairment of the left eye, and one of the right eye, while 2 cases are still under treatment. Deaths.—No death was certified as due to Ophthalmia Neonatorum. Ophthalmia.—11 cases of Ophthalmia were reported by the London Cou.ily Council and the Health Visitors, whilst the number of cases in 1921 was 43. PUERPERAL FEVER. Definition.—The Royal College of Physicians' definition of Puerperal Fever is Septicaemia, Pya;mia, Septic Peritonitis, Septic Metritis, and other acute septic inflammation in the pelvis occurring as the direct residt of child-birth. 23 cases were notified in 1925, and 19 during the previous year, being in the proportion of 3.50 per 1,000 births. The notifications were 1 above the average (22) of the preceding 10 years, and showed a decrease of 0.39 in the proportion of attacks to 1,000 births. Cases of Puerperal Fever notified and inquired into during the year 1925. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South East. The Borough Cases notified 2 4 2 2 3 5 5 23 Private Practitioners' Cases 1 1 2 1 2 . 1 3 11 Hospital Cases 1 — 1 1 3 1 7 Certified Midwives' Cases — 3 — — — 1 1 5 Cases inquired into 2 4 2 2 4 5 6 25 Cases treated in Hospital 2 2 2 2 4 4 4 20 Cases treated at Home - 2 — — — 1 3 5 Of the 23 notified cases, 19 were treated in Hospitals; 7 cases being removed to Metropolitan Asylums Board Hospitals; and 12 cases to other London Hospitals. Deaths.—Seven deaths were registered as being due to Puerperal Fever. Two of these, however, were not notified, and are not included in the cases given in above tabular summary. 1925] 14 THE MILK SCHEME FOR NECESSITOUS EXPECTANT AND NURSING MOTHERS AND CHILDREN UNDER FIVE YEARS OF AGE. The sum expended during the year 1925 in the provision of fresh and dried milk for necessitous expectant and nursing mothers and children under five years of age amounted to £3,140 1s. 11d., as against £3,186 19s. 2d. in 1924. The total amount expended since the Order came into operation in 1918 is £42,854 15s. 5d. The total recipients during the year numbered 10,480, and the quantity of milk supplied to them was equal to 248,101 pints (31,012½ gallons). The amended scheme for the distribution of milk adopted by resolution of the Council at their meeting on the 26th October, 1922, is given below : No. in family. Free. Half-cost. 1 13/- after deduction of rent 15/- after deduction of rent 2 10/6 per head after deduction of rent 12/6 per head after deduction of rent 3 8/6 „ „ 10/- „ „ 4 7/6 „ „ 8/6 „ „ 5 7/- „ „ 8/- „ „ 6 6/6 ,, ,, 7/6„ „ 15 [1925 SUMMARY OF VISITS BY HEALTH VISITORS FOR YEAR 1925. District 1 2 3 4 5 6 7 Totals. I. Births, First Visits, Infants under 1 Year ... 573 736 689 877 1,151 915 753 5,694 II. Births, Re-Visits, Infants under 1 Year 793 455 674 614 838 613 552 4,539 III. Visits to Children, between 1st and 2nd Years 639 410 621 584 708 262 441 3,665 IV. Visits to Children, between 2nd and 5th Years 1,497 1,044 1,482 1,417 1,506 1,814 881 9,641 V. Visits re Still Births 17 25 18 23 36 24 13 156 VI. Deaths, Visits, re Infants under 1 Year 10 13 12 1 15 15 4 80 VII. Deaths, Visits, re Children 1 to 5 years 2 4 - - 1 7 VIII. Ante-Natal, Home Visits 99/F 181 94/F 130 111/F 152 134/F 154 83/F 120 109/F 152 93/F 99 723/F 988 IX. Puerperal Fever, Home Visits 5/F 6 4/F 6 F 2 F 3 5/F 10 F 1 4/F 6 24/F 34 Totals 3,718 2,819 3,654 3,683 4,384 3,797 2,749 24,804 X. Attendances at Welfare Centre 28 24 51 48 46 35 48 280 XI. Other Work by Direction 454 624 651 510 189 679 344 3,451 XII. Visits Declined 38 27 31 130 11 58 295 XIII. Visits, House Shut 578 739 455 832 552 1,061 817 5,034 Grand Total of Visits 4,816 4,233 4,842 5,203 5,182 5,572 4,016 33,864 1925] 16 SUMMARY OF VISITS BY HEALTH VISITORS—Continued. District 1 2 3 4 5 6 7 Totals. Analysis of Visits included in I.-IX. relating to (a) Ophthalmia Neonatorum 15/F 46 9/F 22 7/F 15 7/F 15 13/F 23 16/F 19 11/F 22 78/F 162 (b) Epidemic (Summer) Diarrhoea 1/F 4 1 — — 2/F 3 — 3/F 8 (c) Other Digestive Diseases 2 4 1 — — 1 1 9 (d) Pneumonia and Bronchitis 34 12 12 11 53 — 23 145 (e) Rickets 7 18 19 48 48 95 58 293 (f ) Measles and German Measles 2/F 4 5/F 8 F 1 1/F 2 4/F 13 F 1 1/F 4 15/F 33 (g) Whooping Cough 26/F 39 43/F 56 19/F 21 23/F 27 19/F 33 14/F 15 5/F 11 149/F 202 (h) Tuberculous Disease 1 - 1 — 1 — — 3 (i) Convulsions — - — — 1 — — 1 (j) Polio-myelitis — — — — — — — — (k) Premature Birth 4 35 27 33 35 8 29 171 (l) Atrophy, Debility and Marasmus — 3 - 1 8 - 1 13 (m) All other investigations ** 42 68 67 88 54 44 124 487 (n) Routine Visits included in I. to IX. and not cluded in (a) to (n) 3,535 2,592 3,490 3,458 4,112 3,614 2,476 23,277 ***Totals (a) to (n) 3,718 2,819 3,654 3,683 4,384 3,797 2,749 24,804 Total Families Visited 2,318 2,020 2,496 2,430 2,886 2,959 1,951 17,060 **e.g.—Infectious Diseases other than Measles, Whooping Cough, Epidemic Diarrhoea, Polio-myelitis, etc., Syphilis, Rheumatism, Non-notified birth, etc. ***Totals (a) to (n) correspond with Totals I. to IX. F. after figures denotes a " First Visit." WELFARE CENTRE'S DISTRICTS. POPULATION. NORTH. Wards 1, 2, 3. SOUTH. Wards 9, 10, 11 and Part of 6. EAST. Ward 5, and Parts of 4 and 6. WEST. Wards 7, 8, and Part of 4. Total. 1925 (Approximate Estimate) 97,900 97,440 53,920 89,940 339,200 29,508 up to 5 years old. BIRTHS. 1924 1,890 (Actual) 1,625 (Approximate) 1,087 (Approximate) 2,197 (Approximate) 6,799 1925 1,851 (Actual) 1,526 (Approximate) 1,121 (Approximate) 2,082 (Approximate) 6,580 Number on Books 1st April, 1926, i.e., Record Cards of Children to be visited. Exclusive of Record Cards marked ' Attending Centre," and "Above Standard," "Visits declined," and "Visits not necessary" 20,631 17 [1925 REPORT OF WORK OF VOLUNTARY CENTRES. A Tabic is given summarising very briefly the work of the Welfare Centres for the year ending March 21st, 1920. As regards the North Centre, the Committee, with the aid of the Ministry purchased the premises 6, 7, 8 and 9, Manor Gardens. A Quartz lamp for local artificial sunlight treatment was presented to the Centre by Professor Leonard Hobhouse. This forms an additional lamp, for, as mentioned in a previous report, this Centre already possesses an Eidinow Carbon Arc Lamp. As regards the Light Clinic, whenever the weather is suitable children are exposed to the rays of the real sun instead of those of the lamp and their bodies become much browner. The out-of-door treatment, however, has been possible on so few days that no comparison has been feasible in respect of the two treatments. The artificial variety is invaluable in the long periods of sunless days. It is reported that the light treatment has had benefcial effect on the appetites of the children. Their vitality and their contentedness have been improved and, with few exceptions, practically all the children have responded equally well. In addition to the activities during " Health Week," lectures were given during the year under the auspices of the Fathers', Mothers' and Parent's Committees. South Centre. — During the year mentioned, the South Centre purchased a house to be used as a Convalescent cottage for six mothers w ith young babies. This Centre reports that the knowledge of the value of ante-natal work is spreading and the mothers are showing an increasing desire to be treated and cared for during this time. A few cases from this Centre have been sent for artificial light treatment through the good offices of the Almeric Paget Clinic in Britannia Row. East Centre.— Just towards the close of the Centre year this Centre moved into their new premises at 10, Drayton Park. Like the South Centre, cases are sent for artificial sunlight treatment to the Almeric Paget Corps. West Centre. — This Centre sustained a great loss in the untoward death of the founder and physician-in-charge, Dr. Marion Vaughan. During the Centre year, the Alpine Arc Lamp, the gift of the National Sunday League, was installed at this Centre, and we hope to report upon this further when it has been in use a little longer. "HEALTH AND BABY WEEK." The Centres, as I have stated, participated actively in the Islington "Health and Baby Week," which opened in Islington on the 1st October, 1925, the Mayor presiding at a Lantern Lecture "School and the Children" by Miss Henrietta Adler, J.P. The following is the official programme of the Illustrated Lectures and Exhibits from Welfare Centres, etc., held in the Town Hall, Upper Street, N. Friday, 2nd October, 1925. 2.30 p.m. (also each afternoon).—Health and Domestic Hygiene Exhibits. 7.30 p.m.—Illustrated Lecture (Film).—" Care of Milk in the Home." T. S. Smellie, Esq., N.D.D. (Milk Publicity Council). 1925] 18 Saturday, 3rd October. 8. p.m.—Illustrated Lecture (Film).—" A Peep in to the Human Body. Mrs. Clayton (British Social Hygiene Council). 14 to 18 years specially invited. Sunday, 4 th October. 6.30 p.m.—At St. Mary's Parish Church.— Official Sermon by The Vicar and Rural Dean of Islington. Monday, 5th October. 2.30 p.m.—"Care of the Expectant Mother." Dr. A. Vance Knox., 7.30 p.m.—Illustrated Lecture (Lantern).—"Dental Hygiene." Councillor J. T. Hoare. Tuesday, Gth October. 7.30 p.m.—Illustrated Lecture (Film).—"Clean Milk Production." A. D. Allen, Esq., O.B.E. (Milk Publicity Council). Wednesday, 7th October. 8 p.m.—Illustrated Lectures (Film) (adults only).—"Memories." "Economy." Mr. Herbert Jones (British Social Hygiene Council). Thursday, 8th October. 2.30 p.m.—Illustrated Lecture (Lantern).—"Rat Infestation."Chief Sanitary Inspector. 7.30 p.m.—"Ideal Home" (Film). Lantern Lecture.—"Municipal Health Services." Medical Officer of Health. Friday, 9th October. 7.30 p.m.—Lecture.—" Teaching of Health in Schools." Alderman R. Montford, J.P. In the district, at the Welfare Centres, the following propaganda work was carried on:— North Centre. — This Centre was open to visitors from 10 a.m. to 10 p.m. There was a display of clothes and diets suitable for children of different ages up to 5 years. Lectures were given on the following subjects:— "Mothercraft Training for Girls," by Mis. rruelovc. "The Value of Ante-Natal Clinics," by Dr. Vance Knox. (Senior). "Natural Feeding," by Mrs. Truelove. (Junior). "Home Helps," by Miss Davies. "How Fathers can help Infant Welfare Work " (for fathers only), by Mr. Nixon, Chairman of the Fathers' Committee. "Teeth," a lantern lecture, by Mrs. Keen. South Centre, — The Centre was open for inspection and demonstrations on the afternoons of the Gth, 7th and 8th October. A party of about 75 of the mothers attending this Centre and its Branches were taken in small numbers to visit Institutions of special interest to them, such as the Artificial Sunlight installation, Britannia Row, the Maternity and Children Wards of the Royal Northern Hospital, the Women's Department of the Northern Polytechnic, the Hygiene 19 [1925 Exhibition at the Town Hall, etc. A special lecture was given, addressed to parents, on the "Formation of Character." East Centre.— On the 8th October this Centre's Branch at Hurlock Street was open for inspection all day, while on the 9th October the Main Centre (Drayton Park) was open for inspection in the afternoon. On the 10th October, at 8 p.m., in the Hall adjoining 10, Drayton Park, a lecture on " Infant Welfare " was given by Sir Bruce Bruce-Porter, K.B.E., C.M.G., M.D. West Centre.— On the following days lectures were given at 2.30 p.m.: October 6th.-—"Arch of Health," by Miss Margaret Green. October 8th.—"Care of the Teeth," by Miss Margaret Green. October 9th.—"Cooking Demonstration " by " The Pudding Lady." The Centre was open for inspection on Monday and Wednesday, 5th and 7th October. In addition to the above, the Public Health Department arranged for the exhibition of a film "Well-Born," obtained from the Ministry of Health. This could not be fitted into the " Health Week " proper, so was shown on Thursday, the 22nd October, in the hall of the new premises of the East Islington Welfare Centre. The various Departments of the Four Voluntary Centres, with the attendances for 1925, may be summarised thus: North. South. East. west. Total. 1. Ante-Natal Clinics and Ailing Mother Clinics. Number held weekly 3 1 * 1 1 6½ Number of attendances 1,589 807 376 595 3,367 2. Consultations for Children up to 5 Years of Age. Number held weekly 10 8† 7 7 32 Number of attendances 20.044‡ 16,355 11,968 1,7085 65,452 3. Home Visiting. Number of visits made 12,584 10,378 9,222 7,017 39,201 4. Dental Clinics. Number attending 413 148 79 66 706 Number of attendances or arrangements made for attendances 1,177 243 202 133 1,755 5. Morning Callers. Number of attendances 620 387 136 1,213 2,356 6. Massage Clinics. (& Sunlight treatment) Number of cases given massage or sent for massage 57 87 102 30 276 7. Wards. Number of beds 18 - 8 26 Number of patients received 167 - — 127 294 8. Number of Children on Books 1,845 1,519 1,217 1,083 5,664 Two clinics one week ; one following week = 1½ weekly. †Two Ministry of Health Special Consultations per month to be added. ‡ Ordinary, 14031; (Special) Ministry of Health, 146; "Sunlight," 5,640; " Eye," 227 ; Total, 20,044 1925] 20 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough. —2,000 persons died in the Public Institutions located in Islington, of whom 1,364 belonged to this Borough, the remaining 642 having come here for treatment or relief. Of these, 420 died in the Archway House and 115 in the Royal Northern Central Hospital. Of the 1,364 deaths of inhabitants, 962 occurred in the Islington Infirmary, 22f in the Islington Institution, and 128 in the Royal Northern Central Hospital. The proportion which the 1,304 deaths in these Public Institutions bore to the Borough mortality was 32.8 per cent. Without the Borough.— 777 deaths of persons belonging to Islington were registered as occurring in Public Institutions in districts of London outside the Borough and in various provincial towns. They included, among others, 23 in the North-Western Fever Hospital, 38 in the Children's Hospital, Great Ormond Street, 94 in St. Bartholomew's Hospital, 38 in the Colney Hatch Mental Hospital, 49 in the Royal Free Hospital, 49 in the University College Hospital, 25 in the Hanwell Mental Hospital, 26 in the Metropolitan Hospital, and 28 in the Middlesex Hospital. These 777 deaths represented 18.7 per cent, of all the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians numbered 2,141, and were equal to 51.5 per cent, of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— 100 inhabitants died from accidental deaths, or suddenly, in places outside Islington. During the previous year (1924) the total deaths in Local Institutions numbered 1,903, being 1,273 inhabitants of Islington in Local Institutions, plus G30 non-inhabitants of Islington in Local Institutions, the number in Islington Infirmary being 891, the number in the Royal Northern Hospital 133. The deaths of inhabitants of Islington in Institutions outside the Borough were 778; the total deaths in all Institutions, 2,051 ; and the proportion per 100 deaths from all causes, was 48.6. Transferable Deaths.—During the year 63 deaths that had occurred in outlying Institutions and other places outside the Borough were transferred by the Registrar-General to Islington. MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES. Small Pox, Measles, Scarlet Fever, Whooping Cough, Fevers—Typhus, Enteric and Continued—and Diarrhocal Diseases. During the year 131 persons died from these diseases, the death-rate being 0.39 per 1,000 inhabitants, as contrasted with 0.66 in the corresponding period last year, and a decennial average mortality of 285 and a death-rate of 0.89 per 1,000. 21 [1925 In London the death-rate from the epidemic diseases was 0.60, while in the six Boroughs encircling Islington the death-rate was 0.67. Locally the deaths in the Sub-Registration Districts and Wards were as follows:— Showing the Deaths from each of the principal Epidemic Diseases in the several Wards and Sub Registration Districts during the Year 1925. SubRegistration Districts. Wards Enteric Fever. Small Pox. Measles Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea. Totals. Deaths Deaths Deaths Deaths Deaths Deaths Deaths Deaths Tufnell Tufnell - - - 1 1 4 1 7 Up. Holloway Up. Holloway — — 3 - 3 2 1 9 Tollington Tollington 1 - 2 1 5 4 2 15 Lr. Holloway Lr. Holloway 3 - 4 1 5 4 1 18 Highbury Highbury — - 1 2 8 2 — 13 Mildmay — - 1 — 7 1 1 10 Barnsbury Thornhill — - 2 2 7 1 4 16 Barnsbury — - 1 — 4 2 — 7 Islington South East St. Mary's — - 1 — 4 1 1 7 Canonbury — - 4 - 5 - 2 11 St. Peter's — - 3 1 12 — 2 18 The Borough 4 — 22 8 61 21 15 131 Total Death Rates 0.01 — 0.06 0.02 0.20 0.06 0.04 0.39 Showing the Deaths and Death-Rates from the Principal Epidemic Diseases during the ten years 1915.24 and for the Year 1925. 1915 1916 1917 1918 1919 1920 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 5 0.01 9 0.03 4 0.01 7 0.02 5* 0.02 3* 0.01 Small Pox — — — - — - - - 1 0.00 — — Measles 153 0.48 80 0.26 149 0.50 114 0.39 12 0.04 92 0.27 Scarlet Fever 38 0.12 18 0.06 4 0.01 8 0.03 14 0.04 12 0.04 Whooping Cough 103 0.32 60 0.19 45 0.15 147 0.51 17 0.05 70 0.21 Diphtheria 57 0.18 45 0.14 33 0.11 45 0.16 51 0.16 135 0.40 Diarrhoea and Enteritis (under 2 years) 154 20.43 per 1,000 births 117 16.11 per 1,000 births 106 18.16 per 1,000 births 82 15.78 per 1,000 births 85 13.53 per 1,000 births 77 8.19 per 1,000 births 1921 1922 1923 1924 Mean 10 years 1925 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 1 0.00 - - - - 4 0.01 4 0.00 4 0.01 Small Pox - - - - - - - - - - - - Measles 27 0.08 134 0.40 16 0.05 103 0.30 88 0.27 22 0.06 Scarlet Fever 19 0.06 29 0.09 13 0.04 10 0.03 16 0.05 8 0.02 Whooping Cough 43 0.13 98 0.29 38 0.11 57 0.17 68 0.21 61 0.20 Diphtheria 110 0.33 59 0.18 21 0.06 33 0.09 59 0.18 21 0.06 Diarrhoea and Enteritis (under 2 years) 156 19.78 per 1,000 births 71 9.46 per 1,000 births 103 14.51 per 1,000 births 52 7.65 per 1,000 births 100 14.12 per 1,000 births 69 10.54 per 1,000 births * Including 2 Malarial Fever. 1925] 22 Showing the Deaths from Diarrhœal Diseases together with those classed under Enteritis and its Sub-headings, arranged in quarterly periods, and in three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Under 1 year 3 5 8 - 8 8 8 13 21 3 21 24 14 47 61 1 to 5 years 1 1 2 - 2 2 — 3 3 - 3 3 1 9 10 Over 5 years - - - 2 2 — 2 2 — 1 1 - 5 5 Totals 4 6 10 - 12 12 8 18 26 3 25 28 15 61 76 INFLUENZA. During the year Influenza caused 72 deaths, which is a decrease of 32 on the return for the year 1924; and 130 below the average of the preceding ten years 1915-24. The death-rate was equal to 0.21 per 1,000 inhabitants. Showing the Deaths from Influenza in the Quarters of the Year 1925, together with the averages of the corresponding periods, 1915-24. Years. Quarters. Totals. First. Second. Third. Fourth. 1915 52 11 3 5 71 1916 9 7 2 18 36 1917 22 8 1 5 36 1918 14 8 60 849 931 1919 294 35 6 21 356 1920 56 43 7 12 118 1921 33 17 2 41 93 1922 200 10 3 8 221 1923 21 22 7 8 58 1924 70 15 4 15 104 Average 77 18 9 98 202 1925 47 3 1 21 72 Increase or Decrease — 30 —15 — 8 — 77 —130 The following statement gives the ages at death of the persons who suffered from Influenza during the preceding ten years as compared with the return for the year 1925. Ages. 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 Mean l0 yrs 1925 Difference. 0- 5 3 - 1 106 19 10 5 22 5 11 18 6 — 12 5-10 — — - 52 5 3 - 1 - 1 6 2 — 4 10-15 — — - 32 8 3 1 - 2 2 5 - —5 15-25 5 — - 141 48 12 5 11 - 10 23 2 — 21 25-35 4 — 2 252 82 21 9 14 6 7 40 1 — 39 35-45 7 1 2 109 47 18 15 18 4 10 23 3 — 20 45-55 15 6 7 93 48 17 18 42 12 12 27 11 — 16 55-65 12 6 8 69 42 17 13 37 5 19 23 11 — 12 65-75 11 10 10 50 36 13 14 43 16 16 22 19 — 3 75 & upwards 14 13 6 27 21 4 13 33 8 16 15 17 + 2 All Ages 71 36 36 931 356 118 93 221 58 104 202 72 — 130 23 [1925 SEPTIC DISEASES. Erysipelas and Puerperal Septicaemia are the principal diseases of this class. Erysipelas.— 11 deaths were returned from this disease, or 1 less than in the year 1924, and 2 above the average of the preceding ten years, 1915-24. Puerperal Diseases -These comprise Puerperal Pyaemia, Septicaemia, Septic Intoxication and Puerperal Fever, and they caused 8 deaths, which is equal with the return of 1924, and also the average of the ten years 1915-24. The deathrate was equal to 1.21 per 1,000 births. CANCER. Cancer.— There were 534 deaths from this malignant disease during the year, compared with 470 in 1924, and with an average of 429 in the previous decennium. The deaths represent a death-rate of 1.57 per 1,000 of the civil population and is 0.24 above the average rate (1.33) of the last ten years; 269 deaths occurred among males and 265 among females. The following statement shows the ages at death of the persons attacked during the past ten years, and the return for the year 1925. Ages. 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 Mean l0 yrs 1925 Difference. 0- 5 - - 2 - 2 3 2 - 1 1 1 1 - 5-15 1 3 2 — 1 — 1 — — 1 1 2 + 1 15-25 2 — 5 - 4 1 1 4 6 4 3 3 — 25-35 7 4 8 8 5 10 10 8 10 9 8 5 - 3 35-45 24 30 31 27 36 32 34 34 27 38 31 40 + 9 45-55 75 86 73 75 101 74 98 88 88 77 83 93 + 10 55-65 120 124 131 99 120 110 140 124 138 131 124 168 + 44 65-75 105 114 120 126 123 124 131 110 125 149 123 144 + 21 75-85 39 48 55 52 39 43 52 47 68 52 49 71 + 22 85 & upwards 4 3 5 6 7 5 6 6 9 8 6 7 + 1 377 412 432 393 438 402 475 421 472 470 429 534 + 105 Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the year 1925. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 12 11 13 7 19 16 23 101 Second 12 18 15 13 29 22 31 140 Third 17 13 8 11 26 20 33 128 Fourth 21 14 14 19 32 23 42 165 The Year 62 56 50 50 106 81 129 534 TUBERCULOSIS. Tuberculosis caused 438 deaths, which were 51 below the average of the last decennium, and were 39 more than the number registered in 1924. The deathrate resulting from them was equal to 1.29 per 1,000 of the civil population, and represented 10.5 per cent. of the deaths from all causes during the year. Tuberculosis of the Respiratory System (Phthisis or Pulmonary Tuberculosis) caused 382 deaths, as contrasted with the decennial average of 410, while the death-rate was 1.13 per 1,000 of the civil population, as against the 24 1925] decennial rate of 1.27 per 1,000. There was a decrease of 28 on the ten years' average number of deaths, and of 0.14 on the mean death-rate. Tuberculosis (Respiratory System). Proportion of Deaths from Tuberculosis per 100 Deaths from All Causes. Death rates from All Causes per 1,000 inhabitants. Years. Deaths. Death rates per 1,000 inhabitants. 1915 496 1.57 8.98 17.0 1916 458 1.48 9.64 15.3 1917 485 1.63 10.54 15.5 1918 516 1.80 8.83 20.4 1919 388 1.18 8.56 14.1 1920 349 1.04 7.80 13.3 1921 355 1.07 8.13 13.1 1922 378 1.13 8.19 13.8 1923 337 1.00 8.64 11.6 1924 340 0.99 8.05 12.3 Average 10 years 410 1.27 8.73 14.6 1925 382 1.13 9.18 12.3 Difference on Mean - 28 - 0.14 + 0.45 - 2.3 The following return gives the deaths at each age period : Age Periods. Males. Females. Total. 0-5 7 1 8 5-15 5 3 8 15-25 39 45 84 25-35 43 32 75 3o-45 48 23 71 45-55 58 20 78 55-65 32 15 47 65 upwards 9 2 11 Total 241 141 382 Showing the Deaths from Tuberculosis of Respiratory System in the Sub-Districts during the Four Quarters of the Year 1925. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. . bury. ' Islington, South East. The Borough First 7 14 11 10 22 22 31 117 Second 6 10 8 9 11 22 19 84 Third 8 8 7 8 6 11 25 73 Fourth 9 12 5 11 21 23 27 108 The Year 29 44 31 38 60 78 102 382 Showing the Deaths from Tuberculosis during 1925. Form. Ages. Sex. Districts. Total Deaths. 0-1 1-5 over 5 M. F. Tuf. U.H. Toll. L.H. H. B. S.E. Respiratory 5 3 374 241 141 29 44 31 38 60 78 102 382 Meningeal 7 12 9 16 12 1 3 4 6 5 4 5 28 Abdominal — 2 11 5 8 2 3 1 1 3 1 2 13 General — — 5 5 — — — — — 3 1 1 5 Other forms — — 10 5 5 1 3 1 1 1 2 1 10 All Tuberculosis 12 17 409 272 166 33 53 37 46 72 86 111 438 25 [1925 DEATHS FROM THE DISEASES OF THE RESPIRATORY SYSTEM. (Exclusive of Tuberculosis and Influenza). These diseases, which include Chronic and Acute Bronchitis, Pneumonia, Pleurisy and Asthma, caused 756 deaths, or 41 more than in 1924. They were equal to a death-rate of 2.23 per 1,000 of the civil population, and represented 18 per cent. of the total deaths registered in the Borough. Acute Bronchitis —There were 80 deaths as compared with 106 in the previous year. 29 occurred among males, and 51 among females. The deaths of 6 infants under 12 months were registered. Chronic Bronchitis.—240 deaths were ascribed to it, 118 being males and 122 females. This return is 37 less than that for 1924. Pneumonia (All forms).—379 deaths were registered, of which 210 were males and 109 females. They are 24 more than the number who died in 1924. It caused 77 deaths to infants under a year old, while between the ages of 1 and 5 years 57 died from it. Above 5 years of age the deaths numbered 245. 135 deaths occurred in Public Institutions, chiefly the Islington Infirmaries. Pleurisy—Of this disease 12 deaths were registered. 1 death occurred in a Public Institution. Asthma and Emphysema.—Eighteen deaths were recorded from these diseases, all of which were adults. Other Diseases of the Respiratory System.—Twenty-seven deaths were registered, as contrasted with 20 in 1924. VENEREAL DISEASES. Eight deaths were ascribed to these diseases, which is the lowest on record, as compared with 9 in 1924. All of these were males. The mean deaths of the preceding ten years 1915-24, was 10. The annual average number of deaths recorded during ten years from them at three groups of ages has been as follows : Under 1 year, 8 deaths, 1-5 years, 1 death, and over 5 years, 7 deaths, making an average total of 10 per annum. The treatment centres for these diseases are the Royal Northern Hospital, Holloway Road, N., and the Royal Free Hospital, Gray's Inn Road, W.C. DEATHS FROM COAL-GAS POISONING. Thirteen deaths were registered from asphyxia caused by the inhalation of carbon monoxide gas. Fourteen of these deaths were attributable to suicide, while the two remaining deaths were accidental. Of the 10 deaths, 9 were males and 7 females, the ages ranging from 22 to 84 years. 1925] 26 During- the year special inquiries were made and reports furnished to the Ministry of Health on deaths from this cause. ACCIDENTAL DEATHS. The deaths due to accident numbered 124. Of this number 56 were due to vehicular traffic, as against 41 in the previous year. The vehicles causing these deaths may be summarised as follow : Motor Car or Lorry. Bus or Tram. Taxi-cab. Other Vehicles. Total. 32 10 3 11 = 56 It is only fair to say, however, that 21 of these deaths occurred to Islington residents when outside the district. Eleven deaths of non-residents were also killed by vehicles w ithin the Borough. INQUESTS AND MORTUARY. During the year 275 bodies were received into the Mortuary, as compared with an average of 405 in the preceding 10 years. No infectious body was received during the year. The daily average number of bodies received was 0.7 as compared with 0.8 in 1924. In 306 cases inquests were held, as contrasted with an average of 342 in the ten years 1915-24. Bodies received into Mortuary. Inquests. 1915 612 475 1916 507 394 1917 479 359 1918 476 348 1919 429 321 1920 340 312 1921 313 299 1922 316 307 1923 288 279 1924 294 317 Average 405 342 1925 275 306 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1925 and 1924 1925 No. of bodies received. Daily Average. No. of Inquests held. 1924 No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 79 0.8 100 1st Quarter 101 1.0 110 2nd 58 0.6 60 2nd „ 70 0.7 76 3rd „ 65 0.7 65 3rd 44 0.5 55 4th „ 73 0.8 81 4th „ 79 0.8 76 Total for year 275 0.7 306* Total for year 294 0.8 317* *Inclusive of Inquests held by Coroner upon bodies of deceased persons who died in Public Institutions in the borough. 27 [1925 PREVENTION OF INFECTION. Notification, Isolation, Fatality, of Specified Diseases under the Provisions of the Public Health (London) Act, 1891. The Principal Diseases Include : Small Pox, Diphtheria, Scarlet Fever, Enteric Fever, Typhus Fever, Puerperal Fever and Erysipelas. There were 2,194 cases of these diseases which are notifiable under the Public Health (London) Act, 1891. This number does not include other communicable ailments which are now notifiable. The complete list of infectious diseases which are notifiable in Islington are enumerated on page 30. The total cases notified are 109 more than those of the previous year (2,085) and 24 below the average (2,218) of the preceding ten years. There was an increase when contrasted with the decennial averages in the return from Diphtheria, which shows 45 cases in excess, and 1 in the return from Puerperal Fever, while the other diseases all exhibit a decrease, Scarlet Fever accounting for 16 cases, Erysipelas 42 cases, and Enteric Fever 10 cases. The 2,194 cases were equal to an attack-rate of 6.5 per 1,000 of the civil population. The returns for the preceding ten years are given in the following statement Year. Cases. Attack-rates per 1,000 civil population. 1915 2,210 6.98 1916 1,439 4.65 1917 1,251 4.21 1918 1,127 3.93 1919 1,993 6.05 1920 2,853 8.49 1921 4,344 13.05 1922 2,787 8.34 1923 2,096 6.23 1924 2,085 6.06 10 years averagi 3 2,218 6.91 1925 2,194 6.47 Registration Sub-Districts.—The total number of cases notified in these districts was as follows : Total cases notified. Tufnell 161 Upper Holloway 259 Tollington 235 Lower Holloway 229 Highbury 373 Barnsbury 378 Islington South-East 559 Total 2,194 Small Pox.—No case was notified in the Borough during the year. The average number of cases during the preceding ten years was only 0.4. Diphtheria was responsible for 913 cases of illness, which were 43 above the average (870) of the preceding ten years. The attack-rate was equal to 2.69 per 1,000 of the civil population annually, and was 0.02 below the mean rate (2.71) of the decennial period. 1925] 28 In London ihe attack-rate was 2.75 per 1,000, and the six Encircling Boroughs 2.85. Scarlet Fever.—1,139 cases were notified, and they showed a decrease of 1G on the average (1,155) of the ten years 1915-21. The attack-rate was equal to 3.3G per 1,000 of the civil population annually, which is a decrease of 0.21 per 1,000 of the mean rate (3.60) of the preceding ten years. In London the attackrate was 2.90 per 1,000 of the civil population, while in the Encircling Boroughs it was 2.80. Enteric Fever.—Only 10 cases were notified, a decrease of 10 on the average (20) that obtained during the ten years 1915-24. The attack-rate was 0.03 per 1,000 annually, or 0.03 per 1,000 below the mean rate (0.06) of the last ten years. In London the rate was 0.08, and in the Encircling Boroughs 0.05 per 1,000 of the civil population. Typhus Fever.-No case was notified. Puerperal Fever.-See pages 13 and 23. Erysipelas. —109 cases were notified, or 12 below the average 151 of the preceding ten years, the attack-rate being 0.32 per 1,000 of the civil population. FATALITY FROM THE EIGHT PRINCIPAL NOTIFIABLE INFECTIOUS DISEASES. By "Fatality" is meant the percentage proportion of deaths to attacks of sickness. During the year it was found that of the 2,194 cases notified, 51 deaths occurred, or 2.3 per cent., which contrasts with an average percentage of 04.3 in the preceding ten years 1915-24. Years. Cases. Deaths. Fatality. 1915 2,210 118 5.3 1910 1,439 87 6.0 1917 1,251 55 4.4 1918 1,127 67 6.0 1919 1,993 96 4.8 1920 2,853 173 6.0 1921 4,344 146 3.3 1922 2.787 102 3.7 1923 2,096 48 2.3 1924 2,087* 65 3.1 Mean 2,218 96 4.3 1925 2,194 51 2.3 including 2 cases not notified. Hospital Isolation.—Of the 2,194 cases of infectious diseases notified, 2,105 were isolated in hospital, or a percentage of 95.9, while only 4.1 per cent. of the patients, therefore, were nursed at home. This is the highest number on record. 29 [1925 The following tabular statement shows the number of cases treated in the various public institutions : Year. Cases treated in Hospital. Percentage of cases, treated. 1915 1,991 90.1 1916 1,269 90.0 1917 1,099 87.8 1918 982 87.1 1919 1,772 88.9 1920 2,642 92.0 1921 4,117 94.8 1922 2,621 94.0 1923 1,996 95.2 1924 1.975 94.6 1925 2,105 95.9 DISEASES TREATED IN HOSPITAL. Disease. Total cases. Cases isolated. Percentage of known cases. Scarlet Fever 1,139 1,115 97.9 Diphtheria 913 897 98.2 Enteric Fever 10 9 90.0 Erysipelas 109 64 58.7 Puerperal Fever 23 20 87.0 2,194 2,105 95.9 Summary of Infectious Sickness and of Deaths arising therefrom, distinguishing the Cases treated at Home and in Hospitals; and showing the percentage of notified Cases removed to Hospitals, together with the Fatality among cases treated at Home and in Hospitals during the year 1925. Notified Cases Treated. Percentage of Notified Cases Treated. Deaths Occurring. Percentage 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 1,115 24 1,139 97.9 2.1 8 - 8 0.7 — 0.7 Diphtheria Enteric 897 16 913 98.2 1.8 21 - 21 2.3 — 2.3 (Typhoid Fever) 9 1 10 90.0 10.0 3 1 4 33.3 1000 40.0 Typhus Fever .. - - - - - - - - - - - Erysipelas 64 45 109 58.7 41.3 9 1 10 14.0 2.2 9.2 Puerperal Fever 20 3 23 87.0 13.0 7 1 8 35.0 33.3 35.0 Continued Fever - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - Cholera - - - - - - - - - - - Total 2,105 89 2,194 95.9 4.1 48 3 51 2.3 3.4 2.3 30 Showing the number of Cases and Attack Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1915-24 and in 1925. DISEASES. YEARS. Average number of cases, 1915-24 1925 Increase or Decrease 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 Small Pox Cases 2 2 — — — — Rate — — — 0.00 0.00 — — — — — — — — Diphtheria Cases 620 587 556 514 645 1324 1548 1126 889 854 866 911 + 45 Rate 1.96 1.90 1.87 1.80 1.96 3.94 4.65 3.37 2.64 2.48 2.70 2.69 — 0.01 Membranous Croup Cases 4 6 5 4 4 4 5 4 2 2 4 2 — 2 Rate 0.01 0.02 0.02 0.01 0.01 0.01 0.02 0.01 0.00 0.00 0.01 0.00 — 0.01 Scarlet Fever Cases 1332 838 478 432 1084 1307 2622 1496 1080 1077 1155 1139 — 16 Rate 4.21 2.06 1.61 1.51 3.29 3.89 7.87 4.48 3.21 3.13 3.60 3.36 — 0.24 Enteric Fever Cases 28 32 23 30 16 24 10 9 16 14 20 10 — 10 Rate 0.09 0.10 0.08 0.10 0.05 0.07 0.03 0.03 0.05 0.04 0.06 0.03 0.03 Continued Fever Cases — — — 1 .— 3 — — Rate — — — — 0.00 — — — 0.01 — — — Puerperal Fever* Cases 23 21 16 4 29 29 34 20 22 19 22 23 + 1 Rate 3.48 2.89 2.74 0.77 0.46 3.08 4.31 2.68 3.10 2.80 3.11 3.50 + 0.39 Erysipelas Cases 203 155 173 141 212 165 125 132 87 116 151 109 — 42 Rate 0.64 0.50 0.58 0.49 0.64 0.49 0.38 0.39 0.26 0.34 0.47 0.32 — 0.15 Total Cases 2210 1439 1251 1127 1993 2853 4344 2787 2096 2085 2218 2194 — 14 Rate 6.98 4.65 4.21 3.93 6.05 8.49 13.05 8.34 6.23 6.06 6.91 6.47 — 0.44 * Per 1,000 Registered Births. Showing the Cases of the Notifiable Infectious Diseases notified in the SubRegistration Districts and the Wards during the Year 1925. SubRegistration Districts. Wards. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric Typhoid; Fever. Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Tyfnell Tufnell — 73 67 — 1 — 18 2 — — — 161 Up. Holloway Up. Holloway — 126 115 — 1 — 13 4 — — — 259 Tollington Tollington — 138 90 — — — 5 2 — — — 235 Lr. Holloway Lr. Holloway — 99 116 1 1 — 10 2 — — — 229 Highbury Highbury — 165 74 — 4 — 14 1 — — — 258 Mildmay — 71 38 — — — 4 2 — — — 115 Barnsbury Thornhill — 87 107 — 1 — 11 3 — — — 209 Barnsbury — 95 63 — — — 9 2 — — — 169 Islington, S.E. St. Mary's — 62 70 — — — 4 — — — — 136 Canonburv — 103 78 1 2 — 9 3 — — — 196 St. Peter's — 120 93 — — — 12 2 — — — 227 Totals — 1139 911 2 10 — 109 23 — — — 2194 Attack-Rates per 1,000 population — 3.36 2.69 0.00 0.03 — 0.32 0.07 — — — 6.47 OTHER NOTIFIABLE DISEASES. The diseases which are notifiable in Islington include those which have since been added by Order, and the complete list is as follows: Small Pox, Cholera, Diphtheria, Membranous Croup, Erysipelas, the diseases known as Scarlatina or Scarlet Fever, the fevers known by any of the following names: Typhus, Typhoid, Enteric, Relapsing, Continued or Puerperal, and also the following infectious diseases: Anthrax, Acute Encephalitis Lethargica, Acute Polio-Encephalitis, Acute 31 [1925 Poliomyelitis, Acute Primary Pneumonia, Acute Influenzal Pneumonia, Cerebrospinal fever or Epidemic Cerebro-spinal Meningitis, Dysentery, Glanders or Farcy, Hydrophobia or Rabies, Malaria, Ophthalmia Neonatorum, Plague, Trench Fever, and Tuberculosis. Acute Poliomyelitis. Only one case was notified during the year, as compared with 7 in 1924, and 1 case in 1923. 1925 1924 Cases. Deaths. Cases. Deaths. 1st Quarter Nil Nil Nil Nil 2nd „ 1 „ „ „ 3rd „ Nil „ 6 2 4th „ „ „ 1 Nil 1 Nil 7 2 Epidemic Cerebro-Spinal Meningitis. Six cases were notified, and they equalled the notifications of the previous year. During the ten years 1915-24, the cases averaged 18 per annum. A return of attacks of the disease during the past ten years is given in the following statement : 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 Average 10 yrs. 1915-24 1925 Total Deaths, 1915-24. 1st Quarter 12 7 15 7 8 5 3 1 3 — 6 2 41 2nd 13 17 11 4 7 5 3 2 2 — 6 1 48 3rd 11 8 1 1 1 2 — — 2 2 3 2 10 4th 4 7 3 4 — 2 1 — 1 4 3 1 14 Year 40 39 30 16 16 14 7 3 8 6 18 6 113 The deaths during the year numbered 3, and were equal to the very high rate of .50 per cent, of the cases notified. Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations, 1919. During the past 6 years the following cases were notified by medical practitioners to the Medical Officer of Health : 1920 1921 1922 1923 1924 1925 Malaria 17 8 2 2 1 Nil Dysentery 4 — 1 3 Nil Nil Acute Primary Pneumonia 34 47 77 120 119 93 Acute Influenzal Pneumonia 22 25 67 58 65 41 Pneumonia 3 — — — — — Total 80 80 147 183 185 134 1925] 32 Acute Encephalitis Lethargica and Acute Polio-Encephalitis. These diseases became notifiable under an Order of the Local Government Board on the 1st January, 1919, and during the year 17 cases of Acute Encephalitis Lethargica were notified, C of which proved fatal. No case of Acute PolioEncephalitis was known in the Borough. Ophthalmia Neonatorium. Purulent Disease of the Eyes of Newly-born Children. See p. 12. Tuberculosis. During the year 885 cases of Tuberculosis in its different forms were notified. The attack-rate was equal to 2.01 per 1,000 of the civil population. This number shows an increase of 219 on the return of the previous year (666), and of 0.67 per 1,000 on the attack-rate (1.94). It was also 213 above the number in 1923. Respiratory (Pulmonary) Tuberculosis.—696 notifications were received, of which 396 referred to males and 300 to females, and represented an attack-rate of 2.05 per 1,000. The return was an increase of 156 on that of 1924, and 154 on 1923. Showing the Notified Cases of Tuberculosis in the Wards during 1925. Registration Sub-Districts. Wards. Respiratory Tuberculosis. Other Forms of Tuberculosis. Grand Totals Tuberculosis Rate per 1,000 of Population. Males Females Total Males Females Total Tufnell Tufnell 30 25 55 6 6 12 67 1.95 Up. Holloway Up. Holloway 51 33 84 7 6 13 97 3.01 Tollington Tollington 22 32 54 3 13 16 70 2.23 Lr. Holloway Lr. Holloway 41 41 82 8 10 18 100 2.37 Highbury Highbury 32 20 52 7 6 13 65 2.00 Mildmay 25 18 43 5 11 16 59 2.02 Barnsbury Thornhill 35 42 77 16 12 28 105 3.42 Barnsbury 37 19 56 7 5 12 68 2.69 Islington, S.E. St. Mary's 21 26 47 6 5 11 58 3.13 Canonbury 57 14 71 11 6 17 88 2.69 St. Peter's 45 30 75 16 17 33 108 3.57 Totals 396 300 696 92 97 189 885 2.61 The actual number of cases of Respiratory Tuberculosis coming to the knowledge of the Medical Officer of Health in each year since 1915, has been as follows : Year. Cases. Year. Cases. 1915 780 1920 663 1916 672 1921 652 1917 897 1922 570 1918 1,006 1923 542 1919 759 1924 540 Average, 10 years 721 = 2.3 per 1,000 inhabitants. 1925 696 cases = 2.05 per 1,000 inhabitants. 33 [1925 THE PERIOD OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFED DURING 1925. 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 up. Respiratory Tuberculosis M. 396 — 6 16 84 170 109 11 F. 300 — — 17 83 145 50 5 Tubercular Meningitis M. 6 — 2 2 1 — 1 — F. 4 1 3 — — — — — Tabes Mesenterica M. 5 — — 4 1 — — — F. 6 — 2 1 1 2 — — General Tuberculosis M. 1 — — — 1 — — — F. — — — — — — — — Other forms of Tuberculosis M. 80 1 14 26 22 9 8 — F. 87 — 7 36 26 15 2 1 All Tubercular Diseases M. 488 1 22 48 109 179 118 11 F. 397 1 12 54 110 162 52 6 Totals 885 2 34 102 219 341 170 17 Percentages at each life period to total cases 0.23 3.84 11.52 24.75 38.53 19.21 1.92 From the above statement it will be seen how the disease attacked people at the various ages, viz. : In every hundred eases 0.2 were under 1 year of age „ „ 3.8 were aged 1 to 5 years. ,, „ 11.5 were aged 5 to 15 years. Prime „ ,, 24.7} were aged 15 to 25 years of „ ,, 38.5} 82.4 were aged 25 to 45 years Life „ „ 19.2} were aged 45 to 65 years ,, „ 1.9 were aged 65 and upwards. Showing the Notified Cases of Tuberculosis in the Quarters during 1925. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Males Females Total Males Females Total Males Females Total Males Females Total Males Females Total Respiratory Tuberculosis 94 69 163 113 88 201 107 71 178 82 72 154 396 300 696 Tubercular Meningitis 1 1 2 1 1 2 2 2 4 2 — 2 6 4 10 Tabes Mesenterica 1 2 3 2 2 4 1 — 1 1 2 3 5 6 11 General Tuberculosis 1 — 1 — — — — — — — — — 1 ... 1 Other forms of Tuberculosis 17 18 35 23 24 47 20 19 39 20 26 46 80 87 167 Totals 114 90 204 139 115 254 130 92 222 105 100 205 488 397 885 Disinfection of Houses and Rooms after Pulmonary Tuberculosis.—The following statement gives the particulars for the year: Houses. Rooms. 1st quarter 186 238 2nd ,, 136 186 3rd „ 141 205 4th „ 142 176 Total 605 805 34 1925] PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 4th January, 1925, to the 2nd January, 1926, in the Metropolitan Borough of Islington. Age-periods Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and up. Total Primary Notifications. Pulmonary Males — 6 6 10 31 53 84 86 73 36 11 396 577 Females — — 7 10 37 46 92 53 39 11 5 300 433 Non-pulmonary Males 1 16 22 10 19 6 4 5 7 2 92 108 „ „ Females 1 12 13 23 15 12 11 6 — 2 1 96 112 Age-periods Notifications on Form B. Number of Notifications on Form C, Number of Primary Notifications. Total Notifications on Form B. Poor Law Institutions. Sanatoria. Under 5 5 to 10 10 to 15 Total Primary Notifications Pulmonary Males — — — — — 77 247 ,, Females — — — — 64 160 Non-pulmonary Males — — — — — 8 42 „ „ Females — 1 — 1 1 8 53 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1924. These Regulations came into operation on the 1st January, 1925, and necessitated a complete revision of the register of notified cases of tuberculosis then in use. The requirement of a quarterly statement to the County Medical Officer of the actual number of cases of tuberculosis on the register necessitates systematic and constant examination of the records, resulting in the removal from the register of the names of all patients suffering from tuberculosis who have died, left the district, etc. The revision of the register revealed the fact that a fair number of patients had removed out of the Borough, and the following statistical statement shows the known cases of tuberculosis in the Borough at the close of the year. NOTIFICATION OF TUBERCULOSIS. Summary of statistics for the year ending 2nd January, 1926. (Y ear 1925.) Lungs. Other forms. Total. M. F. M. F. Nos. on register at commencement of the year 1925 658 496 172 138 1,464 Notified cases added during the year 1925 396 800 92 97 885 Ca3es coming to the knowledge M.O.H. during the year 1925 123 62 53 49 287 1,177 858 317 284 2,636 Number of cases removed from the register during the year 1925 309 177 63 61 610 Number of cases on register at end of the year 1925 868 681 254 223 2,026 35 [1925 TREATMENT OF TUBERCULOSIS. " PROCEDURE." The "Procedure" of the London County Council regarding' cases of tuberculosis recommended for institutional treatment came into operation on the 1st January, 1924. Formerly all documents regarding patients accepted by the London County Council for institutional treatment w ere dealt with directly between the London County Council and the Tuberculosis Dispensaries; these are now forwarded through the Public Health Department. This "Procedure" entails a large amount of additional clerical work, but it affords a reliable source of informa tion regarding many patients who come to the knowledge of the Medical Officer of Health for the first time, resulting eventually in the case being placed on our register of notified cases. Another important result of documents passing through the Public Health Department is that we receive early intimation of the admission of a patient to a residential institution for treatment, and are thereby enabled to arrange for disinfection of the home at once. Boarding out of children.—In the early part of 1925 the London County Council instituted a scheme for the boarding out of children of advanced tuberculous patients. In several cases advantage was taken of the scheme, but in others it was difficult to induce the parents to give their consent. The question of institutional treatment for advanced cases is one which requires earnest consideration. TUBERCULOSIS DISPENSARIES. The work of the Tuberculosis Dispensaries during the year has been very efficiently performed. It is with great regret that I have to record the death of Dr. A. J. McFarland, the Tuberculosis Officer for the Southern Dispensary and district on the 23rd April, 1925. Dr. McFarland had been Tuberculosis Officer, with his headquarters at this Dispensary since its inception in August, 1916. He will be sadly missed by the staff and patients alike. Many relatives of patients will remember the kindly, sympathetic and personal interest he took in the numerous cases which c?.me under his care. The vacancy has been filled by the appointment of his Senior Assistant, Dr. A. Leitch. During the year 1,199 persons were examined by the Tuberculosis Officers, and the patients made 9,570 attendances. At the Northern Dispensary there were 543 new cases, and at the Southern 656, while the attendances at the former were 3,394 and at the latter 6,176. The examination of contacts with tuberculous cases showed that 53 were suffering from tuberculosis, 39 were suspect, and 419 were not suffering. The nurse at the Northern Dispensary paid 1,086 visits, and the nurse at the Southern 1,949, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 174 visits, and of the Southern 378 visits to the patients' homes for the purpose of examining them. Pneumothorax Treatment was administered to two patients at a cost to the Council of £4 4s. 0d. 36 The number of persons in attendance at the Dispensaries in each year is as follows : TUBERCULOSIS. 1918 1919 1920 1921 North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy New Cases 635 872 585 756 655 760 615 758 Actual number of Attendances 3798 6511 4057 6782 3921 6895 3212 7030 Totals 4433 7383 4642 7538 4576 7655 3827 7788 1922 1923 1924 1925 North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy New Cases 600 581 721 562 502 549 543 656 Actual Number of Attendances 3297 6659 4001 6825 3374 6122 3394 6176 Totals 3897 7240 4722 7387 3876 6671 3937 6832 A summary of the combined dispensaries is given for the following years : Cases. Attendances. Cases. Attendances.[/###/ 1913 1,507 10,309 1923 1,283 10,826 1919 1,341 10,839 1924 1,051 9,496 1920 1,415 10,816 1925 1,199 9,570 1921 1,373 10,242 Totals 10,350 82,054 1922 1,181 9,956 Table showing the number of Tuberculous Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1925. Date. Dispensary Jan. Feb. Mar. Apr. May. June July Aug. Sept. Oct. Nov. Dec. Year. Total. Attendances Northern 264 270 346 256 252 313 292 242 264 307 316 272 3,394 9,570 Southern 566 481 567 474 468 506 590 506 412 526 553 527 6,176 New Cases Including Contacts Northern 38 32 58 49 44 61 44 36 42 48 58 33 543 1,199 Southern 52 51 49 41 53 67 73 69 43 53 61 44 656 Contacts. Tuberculosis Northern — 1 — — — 1 2 1 — 3 1 9 53 Southern 3 6 5 3 3 6 3 6 — 3 5 1 44 Suspect Northern — 1 1 1 3 — 1 2 3 1 — 13 39 Southern 4 4 1 2 2 1 1 4 3 1 2 1 26 Non-Tuberculous 12 10 22 20 12 27 18 9 11 23 21 11 196 419 Southern 22 5 15 4 11 36 30 22 22 16 29 11 223 Nurses'Visits Northern 138 169 117 75 92 92 63 62 73 68 69 68 1,086 3,035 Southern 212 227 190 200 167 151 195 163 20 144 157 123 1,949 Tuberculosis Northern 13 17 16 17 6 13 17 18 11 18 16 12 174 552 Officers' Visits Southern 30 30 30 33 42 29 41 36 21 27 24 35 378 37 [1925 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 1,052 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which G32 were Scarlet Fever and 418 Diphtheria. The number of notifications of the several diseases are given below : Disease. No. of Notifications. Average of preceding 10 years. Increase or Decrease. Small Pox Scarlet Fever 632 674 — 42 Diphtheria 418 399 + 19 Enteric Fever 2 1 + 1 Other Diseases — — - Total 1,052 1,074 - 22 Non-Notifiable Diseases.- 5,555 cases came to the knowledge of the Medical Officer of Health during the year, viz. : 1,793 cases of Measles, 1,261 cases of Chicken Pox, 871 of Whooping Cough, and 1,630 of other diseases. The information respecting these cases was received from the teachers of 60 schools. Exclusion of Scholars from Schools.—3,446 children were excluded from classrooms of various schools owing to the presence of an infectious disease, chiefiy Diphtheria and Scarlet Fever, in the houses wherein they lived. The non-notifiable diseases among children attending the Public Elementary Schools were : Disease. Notifications by Teachers. Average of preceding 10 years. Increase or Decrease. Measles ,793 1,689 + 104 Chicken Pox 1,261 762 + 499 Whooping Cough 871 563 + 308 * Other Diseases 1,630 2,438 — 808 5,555 5,452 + 103 * Note.—" Other Diseases " include Mumps, Scabies, Ophthalmia, Itch, etc. BACTERIOLOGICAL EXAMINATIONS. 2,78G examinations were made for the medical profession of the sputum, of swabs from the throat and of the blood of patients suspected to be suffering from Pulmonary Tuberculosis, Diphtheria and Enteric Fever, respectively. This number is an increase of 479 on that of the preceding year. It is also 1,310 above the decennial average. Of the total examinations, 394 or 14 per cent. gave positive results. Diphtheria.—1,850 specimens were examined for Diphtheria, of which 233, or 12.G percent., were found to contain Diphtheria bacilli. Enteric Fever.—14 specimens of blood were examined, 2 of which gave positive results. Pulmonary Tuberculosis.—922 specimens of sputum were examined, 100, or 17.3 per cent., of which showed that the patients were suffering from this disease. 1925J 38 DIPHTHERIA—PATHOGENICITY TESTS. 1925. No. Submitted for Examination. Negative Result. (Bacilli) Positive Result. (Bpcilli) Non-Virulent. Virulent. 17 16 1 — 1 Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Pulmonary Tuberculosis, 1915-24. Periods. Diphtheria. Enteric Fever. Pulmonary Tuberculosis. Totals. Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined 1915 123 360 483 16 19 35 198 568 766 1,284 1916 127 277 404 10 12 22 135 390 525 951 1917 100 216 316 12 8 20 165 420 585 921 1918 74 171 245 3 21 24 111 358 469 738 1919 116 352 468 5 15 20 92 348 440 928 1920 261 677 938 3 20 23 83 375 458 1,419 1921 238 969 1,207 3 19 22 127 421 548 1,777 1922 291 953 1,244 9 9 139 472 611 1,864 1923 306 1,371 1,677 5 15 20 152 719 871 2,568 1924 180 1,333 1,513 17 17 127 650 777 2,307 Average 10 years 182 668 850 6 15 21 133 472 605 1,476 1925 232 1,618 1,850 2 12 14 160 762 922 2,786 VACCINATION. Of the 5,662 births registered in 1924, the returns of vaccination show that only 2,915 infants were successfully vaccinated, while 15 were found to be insusceptible. There were also 265 who died unvaccinated, and 1,755 statutory declarations of conscientious objection to vaccination were obtained by the parents or guardians; 41 vaccinations were postponed under medical authority, 273 were removed to other districts or places unknown, thus leaving 2,126 unaccounted for. The return of certificates of exemption, therefore, represents 31 per cent. of the registered births. years. Vaccination per 100 births, less infants who died unvaccinated. Years. Vaccination per 100 births, less infants who died unvaccinated. 1915 1916 1917 1918 1919 49.0 47.5 46.7 46.4 46.0 1920 1921 1922 1923 1924 49.3 44.9 46.3 54.8 54.0 Certificates of Exemption.—The following tabular statement shows the increase of these certificates, more especially since 1919; whereas during the last two years they have decreased : 1915 1,710 1920 2,866 1916 1,796 1921 2,506 1917 1,341 1922 2,347 1918 1,027 1923 1,751 1919 1,583 1924 1,755 Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the previous year 1924. Registration Sub-Districts. Number of Births registered in 1924 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 (cols. 3 to 9). Total Number of Certificates of Primary Vaccination at All Ages received during year 1925. Number of Statutory Declarations of Conscientious Objection received during year 1925. 1 2 3 4 5 6 7 8 9 10 11 12 Tufnell 514 290 4 148 25 5 11 18 13 1,654 790 Up. Holloway 552 314 2 — 154 32 — 21 16 13 Tollington 505 258 2 — 141 19 6 14 12 53 Highbury 880 419 3 — 300 34 6 9 46 63 Lr. Hollowav 795 386 — 206 56 5 3 29 110 1,833 1136 Barnsbury 1101 654 1 303 51 3 6 32 51 Islington, S.E. 1315 594 3 — 503 48 16 12 44 95 The Borough 5662 2915 15 — 1755 265 41 76 197 398 3,487 1,926 DISINFECTION. Disinfection of Rooms.— 3,707 rooms were disinfected, as contrasted with 8,497 in 1924. For this purpose formaldehyde was employed, although it was sometimes augmented by sulphur dioxide, when it was necessary to kill vermin, for which purpose it has been found most effective. For the extermination of bugs, however, all the architrave mouldings and skirting boards behind which they breed are removed, and the walls washed with hot lime. Rooms Disinfected. 1925 1924 1st Quarter 915 803 2nd „ 922 825 3rd „ 995 881 4th „ 935 988 The Year 3,767 3,497 The above figures also include the disinfection of houses and rooms after Pulmonary Tuberculosis, vide p. 33. Work at the Disinfecting Station.— 35,076 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 32,129 similar articles disinfected during the previous year. In addition to the above articles, 29,644 second-hand garments and bed blankets were disinfected for clothing contractors trading in the borough, who paid the Council for the work, amounting to the sum of £103 13s. 6d. Altogether, 64,720 articles described in the two paragraphs preceding were disinfected, which bring the number of large articles disinfected since the disinfecting station was established to 2,090,792. 1W5J 40 Summary of the chief article of Clothing, Bedding, etc., disinfected during the year 1925, and also in the preceding year 1924. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarter. The Year 1925 1924 Beds 409 442 560 563 2,034 2,087 Blankets 1,187 1,046 1,195 1,382 4,810 4,051 Bolsters 307 351 492 512 1,722 1,242 Carpets , 5 — 4 3 12 11 Chair Bed Cushions 30 54 33 30 153 77 Mattresses 399 322 389 426 1,536 1,243 Palliasses 4 2 2 8 4 Pillows 1,156 1,071 1,260 1,423 4,910 4,209 Quilts 476 478 574 606 2,134 1,769 Sheets 821 842 1,005 1,098 3,766 3,276 Other Articles 3,117 2,753 2,990 5,131 13,991 14,160 Totals 8,037 7,361 8,504 11,174 35,076 32,129 The nature of the articles disinfected for the clothing contractors is shown below : 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Overcoats 3,284 2,980 3,395 2,671 12,330 Jackets 3,907 1,810 503 1,164 7,504 Blankets 450 — 800 607 1,857 British Warms 1,087 1,012 1,110 1,079 4,288 Tunics — — — 53 53 Other Articles 127 470 2,752 263 3,612 Total 8,915 6,272 8,620 5,837 29,644 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 Solution. Tons. cwts. Gallons. Gallons. To Householders 2 0 220 _S Disinfection of Premises — 80 Cost = £55 Shelter House.— The Shelter House was nut occupied during the year; but baths were given to 23 verminous persons under the " Cleansing of Persons Act," whilst their clothing was disinfected. 10 other persons who had been in contact with cases of infectious diseases also had their clothing disinfected. Three midwives attended for the purpose of disinfection after attendance on cases of Puerperal Fever. Verminous School Children.— During the year 4,841 baths were given to children from the London County Council Schools, who attended the Disinfect- 41 [1925 ing Station, and were cleansed by the nurse whom the Borough Council appointed for the work, while their clothing was undergoing disinfection. Of this number 534 were suffering from Scabies. The daily attendance ranged from 6 to 48. The agreement entered into between the London County Council and the Borough Council from the 1st January, 1021, for the cleansing of verminous children, is a payment at the rate of 2s. for each attendance of each child at Cleansing Station, except when such child is, or is suspected to be, suffering from Scabies, in which case payment by the London County Council will be at the rate of Is. for each bath given. The minimum payment to be paid to the Borough Council in respect of such cleansing shall be not less than £ 100 per annum. The amount paid during the year by the London County Council for the baths given to the children was £457 8s. Proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, in 167 instances during the year, when fines ranging from 3s. to 10s. were inflicted, the total amount being £51 15s. 0d. FACTORY AND WORKSHOP ADMINISTRATION. The Medical Officer of Health submits the annual report on the manner in which the provisions of the Factory and Workshops Act, 1901, were carried out in his district during the year 1925. Inspections and Visits.—The inspections and visits made by the three Inspectors (1 male and 2 female) were as under: {###] Male Inspector. Female Inspectors. Total.{/###] Factories, including Factory Laundries ... 335 393 728 Workshops, including Workshop Laundries 423 . 672 1,095 Workplaces, other than outworkers' homes 417 . 48 465 Bakehouses 301 — 361 Restaurant Kitchens — 488 488 Outworkers' premises — 1,497 1,497 Miscellaneous re-inspections and calls 1,694 3,075 4,769 Totals 3,230 6,173 9,403 Notices Served —In consequence of the 1,376 sanitary defects discovered as the result of the inspections above; 285 intimations and 48 statutory notices were served. Of these notices 71 were served on the owners of factories, 144 on the owners of workshops and workplaces, and 74 on the owners of bakehouses and restaurant kitchens. In addition to these nuisances, 14G were discovered on Outworkers' premises, necessitating the service of 38 notices. Four summonses were taken out with the result that fines and costs amounting to £22 16s. were inflicted. Registers.—There were 2,104 workshops on the Register, as contrasted with 2,048 in 1024, while the total number of workrooms was 3,036, as contrasted with 2,860 in the previous year; 206 workshops were added to the Register, while 103 were removed from it. 1925] 42 The various workshops and workplaces are tabulated as below : {###]Workshops and Workplaces. 1925. Total Workshops on Register. Total Workrooms on Register. Number added during Year. Number removed during Year.{/###] Workshops where Men are employed 055 1,456 114 154 Workshops where Women arc employed 507 784 64 27 Laundries 42 53 Nil Nil Bakehouses 235 244 Nil 1 Kestaurant Kitchens 412 456 28 11 Other Workplaces ... 43 43 Nil Nil Total 2,194 3,036 206 193 Outworkers' Premises 2.868 617 392 Workshops Notified to Home Office, 1925. {###]Trade. Number of Workshops. Protected Employed Persons. Women. Male Young Persons. Total.{/###] Dressmaking 18 80 80 Dress Stands I 3 1 4 Hat Ornaments 1 3 3 Brushes (Artists) 1 20 — 20 Costumes ... 1 5 — 5 Sports Outfits 1 1 — 1 Corrugated Paper 1 7 — 7 Tailoring 6 8 — 8 Lamp Shades 1 fi — 6 Trunk Making 1 3 — 3 Millinery 4 17 — 17 Embroidery 2 10 — 10 Furrier 4 7 1 8 Boudoir Caps 1 5 — 5 Artificial Florist 1 14 — 14 Art Needlework 1 4 4 Mantles 3 10 10 Perambulators 1 2 2 Coathangers 1 3 — 3 Boxes 1 2 2 Shoes 1 2 — 2 Cat Whiskers 1 5 5 Engineer's Pattern Making 1 1 1 Wireless Parts 1 — 2 2 Piano Making 1 — 1 1 Packing Cases 1 — 2 2 Wire Workers 1 — 4 4 Table Making 1 — 1 1 Shoe Trees 1 6 — 6 Total 60 223 13 236 Inspection of Factories, Workshops and Workplaces. {###]Premises. Number of Inspections. WrittenNotices Prosecutions. (1) (2) (3) (4){/###] Factories 72s 71 1 (Including Factory Laundries) Total Workshops 1,095 110 2 Fines (Including Workshop Laundries) and Workplaces 1,314 108 1 Costs, (Other than Outworkers' premises) £22 16s. Miscellaneous Re-Inspections and calls 4,769 — — Total 7,906 289 4 43 [1925 DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. {###]Particulars. Number of Defects. Number of Prosecutions. Found. Referred Remedied, to H.M. | Inspector. (1) (2) (3) (4) (5){/###] Nuisances under the Public Health Ads*— Want of cleanliness 471 456 o 1 Want of ventilation 35 33 — Overcrowding 9 9 — Want of drainage of floors 12 7 — Other nuisances 399 372 2 Sanitary insufficient 25 24 — Accommodation ^unsuitable, foul or defective 419 413 — J not separate for sexes 4 4 1 Offences under the Factory and Workshop Art- Illegal occupation of underground bakehouse (s. 101) — — — Breach of Special sanitary requirements for bakehouses (ss. 97 to 100) — — — Other offences 2 9 Total 1,376 1,320 3 4 * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshops Act, 1901, as remediable under the Public Health Acts. OUTWORKERS' PREMISES. {###] Instances. Noticcs Served. Remedied. Prosecutions.{/###] Outwork in unwholesome premises (s. 108) 124 38 124 Outwork in infected premises (s. 109, 110) 22 — — Total 146 38 124 — OUTWORKERS' LISTS (s. 107) : Lists received from Employers 1,770 Addresses received from Other Councils 1,988 Addresses forwarded to Other Councils 967 Firms failing to send in lists (No. letters sent) 325 OTHER MATTERS. {###] Number.{/###] Matters notified to H.M. Inspector of Factories : Failure to affix Abstract of the Factory and Workshop Act Is. 133, 1901) ... 60 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). j Notified by H.M. Inspector ... 12 Reports (of action taken) sent to H.M Inspector 12 Other (New Factories reported under Home Office Memorandum, 1912) ... Nil Underground Bakehouses (s. 101) in use at the end of the year. 81 ' 1925] 44 OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. {###]Nature of Work. Instances. Notices served. Prosecutions. (1) (2) (3) (4){/###] Wearing Apparel— Making, &c, 73 21 Cleaning and washing . — Household linen — Lace, lace curtains and nets — Curtains and furniture hangings ... — Furniture and upholstery 5 — Electro-plate — — File mailing — — Brass and brass articles — — Fur pulling — — Cables and chains — — Anchors and Grapnels — Cart gear ... — Locks, latches and keys — — Umbrellas, &c. 1 — Artificial flowers 15 4 Nets, other than wire nets — — Tents — — Sacks — — Racquet and tennis balls — — Paper, &c., boxes, paper bags 20 9 Brush making 7 4 Pea picking — — Feather sorting — — Carding, &c., of buttons, &c. — — Stuffed Toys — — Basket making 1 — Chocolates and sweetmeats — — Cosaques, Christmas Crackers, Christmas stockings, &c— 2 — Textile weaving * Total 124 38 Nil 45 DISTRICT INSPECTORS' WORK. The fourteen district inspectors made a total of 57,929 inspections and calls during the year, an increase 22 inspections on the corresponding period of 1921; while 15,192 improvements were effected in 6,635 premises; as against 13,890 improvements in (5,230 premises for the preceding year. Synopsis of Inspectors' Work,—The following statement gives a brief synopsis of the district inspectors' work in 1925 : House to house inspections 2,920 Other inspections of dwelling houses 5,163 Re-inspections and calls made 46 477 Visits of inquiry re notifiable infectious diseases 2,194 Butchers'shops, stalls, etc. (Saturday nights) 50 Ice cream shops and factories 223 Dairies and Milkshops 1,262 Stables and yards 1,179 Manure depots 5 Smoke observations 114 Notices Served—There were 4,822 intimation notices served by the inspectors with respect to nuisances, of which 289 were delivered personally, and 4,033 by post. In 505 instances it became necessary, as the intimations to owners or occupiers of the properties had been ignored, to report the nuisances to the Public Health Committee, who ordered statutory notices to be served. Verminous Premises—Bedding and Clothing.- 68 premises, which were found to be in a verminous condition, were cleansed by the owners or occupiers upon receiving the inspectors' intimations. In 13 instances it was necessary to- remove the bedding and clothing to the Disinfecting Station for purification or destruction. Smoke Nuisances.—51 complaints of smoke issuing from factory chimneys in the borough were investigated, and as a result the Inspectors made 114 observations and 18 written warnings were given, whilst 17 intimation notices served upon the owners of the businesses requiring the abatement of the nuisance. In no case was it found necessary to institute legal proceedings. REMOVAL OF DUST. Twenty-one applications were received during the year for the removal of dust, which is 12 below the number recorded last year. The applications received for the previous ten years were as follows : 1915 28 1920 36 1916 21 1921 21 1917 30 1922 15 1918 11 1923 16 1919 19 1924 33 Dust Receptacles Provided.—During the year 1,500 dust receptacles were provided, while 18 were repaired after the servicc of sanitary notices. 1925] 46 Summary of Sanitary Work from Inspectors' Reports for the year 1925. Districts. Totals 1 2 3 4 5 0 7 8 9 10 11 12 13 14 House to House Inspections 209 202 222 215 139 157 175 81 364 145 266 284 241 220 2920 Other premises inspected 401 253 249 540 264 383 271 481 401 426 392 397 395 310 5163 Re-inspections, Calls made, etc. 2841 1587 3330 3704 4 2612 3761 3406 3885 4213 3006 3974 3931 3427 2800 46477 Ice Cream Factories inspected — 1 40 16 — 26 1 - 44 21 4 43 24 3 223 Dairies and Milkshops 60 57 97 78 21 78 163 103 126 84 97 182 67 49 1262 Stables „ 13 2 8 1 29 3 13 1 10 — - 1 — 5 86 Yards „ 105 13 263 36 213 9 277 10 51 l3 7 5 81 10 1093 Manure Depots „ 1 - — — — — — — 4 — — — - - 5 Vacant land, Passages and Courts inspected 2 1 4 1 73 1 62 3 2 13 1 - 2 7 172 Urinals attached to P.H.'s inspected 5 68 30 18 57 78 - 14 21 2 1 32 22 348 Premises (re Certificate Customs and Inland Revenue Acts) inspected - - - - - - - 4 - - - - - 4 Premises (re Water Certificates) inspected 1 - - 1 — - 8 1 - - - - - - 11 Visits re Sale of Food and Drugs Acts i — — 1 1 Smoke observations 14 2 9 12 3 29 13 - 22 4 6 - - 114 Shops, Stalls and Markets (Saturday evening) 4 - 3 4 3 4 4 4 4 5 4 5 3 3 50 Total Inspections and Calls 3651 2123 4293 4638 3375 4509 4471 4573 5255 3738 4753 4849 4272 3429 57929 Notices Served. Intimation Personally 2 3 6 24 - 15 15 12 132 11 3 3 56 7 289 By Post 200 208 261 330 93 326 274 324 335 354 449 416 251 212 4033 Statutory Personally - 2 — — 2 6 8 1 16 7 - - 4 3 49 By Post 13 9 22 26 13 33 26 27 51 44 48 80 33 31 456 Improvements. Drains— Constructed 1 — 1 — — 1 — 2 3 — — 1 — — 9 Re-constructed 14 5 8 7 6 11 1 11 15 17 3 1 6 11 116 Repaired 27 11 19 35 5 41 18 12 34 24 55 29 16 19 345 Ventilated 14 3 6 5 11 7 7 13 11 12 7 5 — 8 109 Gully and other taps fixed 92 30 44 50 15 58 19 35 46 69 39 4 23 41 565 Urinals— Water supplied, cleansed 1 2 1 3 — 2 6 — 7 5 3 1 7 4 42 Cesspools—Abolished — — — — - — — — — — - — — — — Water Closet— W.C. erected with pan, trap and Water Supply 1 - 1 - - 1 - - 2 1 - - - 2 8 Pan and trap only provided 51 25 24 54 13 28 20 34 34 50 78 14 15 32 472 Water supply provided 30 29 19 67 — 40 30 32 38 24 54 45 32 29 469 Ventilated — 1 1 3 — — 1 ] 1 — 2 1 2 13 Position altered — — 10 — — — 1 - - - - - - 11 Dust Bins 'Provided 86 123 66 177 19 80 171 168 79 110 115 119 99 88 1500 Repaired 1 — 1 2 — 1 2 7 — 3 — 1 — i 18 Areas—Constructed - - - - - - - -- - - - - - - - Yards Paved 2 1 2 3 — 1 1 — 2 — — - 1 13 Repaved 17 21 27 95 11 28 20 17 43 39 36 13 33 18 418 Sinks—Provided 12 6 6 3 3 1 9 3 3 17 11 — 1 8 83 Domestic Water Supply— Cisterns Provided - 2 1 — — - - 1 - - - - - - 4 Cisterns repaired and cleansed 11 26 26 47 3 21 16 1 24 7 11 6 15 13 227 Water supply provided to dwelling house 2 5 4 4 - 3 4 3 1 3 2 1 32 Water supply provided to tenement house 2 1 - 7 3 5 2 1 7 6 6 2 2 6 50 Other improvements— Rooms cleansed & limewashed 104 189 231 525 99 273 222 171 334 273 448 295 247 217 3628 Walls and passages repaired, cleansed and limewashed 43 49 72 185 16 74 71 68 117 117 184 103 84 58' 1241 Floor space ventilated 3 2 — 5 - 5 1 3 9 19 3 2 — 2 54 Floors repaired 16 26 18 59 7 26 18 10 65 17 35 22 24 23 360 Roofs repaired 59 67 55 230 15 91 83 85 100 105 141 120 106 81 1338 Overcrowding abated — — — 5 - 5 1 1 4 — 1 2 — — 19 Illegal use of underground rooms for sleeping discontinued - - - - 1 3 - - 4 Other improvements, or ances abated 100 106 117 293 44 207 139 118 210 155 325 138 165 127 2244 Rooms Disinfected 202 45 167 247 44 58 98 29 137 56 199 111 179 168 1800 Total improvements 951 769 926 2110 316 1067 960 819 1336 1126 1762 1036 1055 959 15192 Total premises improved 476 302 465 807 126 374 452 375 567 390 725 546 554 476 6635 47 [1925 Return of Sanitary Work carried out during five years 1920-24, and in 1925. 1920 1921 1922 1923 1924 Average 1925 House to House Inspections 377 630 1,740 2,535 3,110 1,678 2,920 Other premises inspected 9,055 8,787 5,924 5,284 5,077 6,826 5,163 Re-inspections, Calls made, etc. 48,816 50,573 43,930 46,789 45,994 47,220 46,477 Ice Cream Factories inspected 44 62 95 83 146 86 223 Dairies and Milkshops do. 577 468 710 823 1,030 722 1,262 Stables do. 280 185 101 226 321 222 86 Yards do 738 643 744 1,090 1,391 921 1,093 Manure Depots do. 120 73 14 47 35 58 5 Vacant land, Passages and Courts inspected 93 53 73 123 140 96 172 Urinals attached to P.H.'s inspected 438 343 283 423 412 380 348 Premises (re Certificate Customs and Inland Revenue Acts) inspected 16 21 344 69 12 86 4 Premises (re Water Certificates) inspected 3 178 77 63 10 72 11 Visits re Sale of Food and Drugs Acts ... 1,091 204 — — — 260 1 Smoke observations 64 84 209 215 180 150 114 Shops, Stalls and Markets (Saturday evening) 53 43 48 47 49 48 50 Total Inspections and Calls 61,765 62,347 54,292 57,817 57,907 58,825 57,929 Notices Served. Intimation 'Personally 1,713 876 485 341 316 706 289 By Post 1,690 3,497 3,336 3,148 4,069 3,148 4,033 Statutory "Personally 136 79 125 133 59 110 49 By Post 256 455 514 451 558 447 456 Improvements. Drains— Constructed 8 — 8 6 7 6 9 Re-constructed 110 120 116 132 105 117 116 Repaired 258 334 280 265 321 292 345 Ventilated 94 120 116 137 100 113 109 Gully and other traps fixed 490 576 454 477 435 486 565 Urinals—Water supply, cleansed 31 12 16 20 27 21 42 Cesspools—Abolished — — — — — — — Water closets— W.C. erected with pan, trap, and water supply 17 7 23 25 18 16 8 Pan and trap provided 268 436 398 356 353 362 472 Water supply provided 477 655 433 424 388 475 469 Ventilated 13 13 13 42 12 19 13 Position altered 4 2 5 10 4 5 11 Dust Bins Provided 2,585 1,776 1,030 1,309 1,467 1,634 1,500 Repaired 62 34 9 8 18 26 18 Areas—Constructed 2 — 4 1 8 3 Yards Paved 45 22 16 25 22 26 13 Repaved 469 502 340 324 330 393 418 Sinks—Provided 50 78 89 42 53 62 83 Domestic Water Supply— Cisterns provided 3 1 6 5 4 4 4 Cisterns repaired and cleansed 291 333 259 196 221 260 227 Water supply provided to dwelling house 56 78 62 50 36 56 32 Water supply provided to tenement house 66 56 81 40 59 60 50 Other improvements— Rooms cleansed and limewashed 4,555 5,900 3,860 3,473 3,535 4,265 3,628 Walls and passages repaired, cleansed and limewashed 1,187 1,592 1,136 992 1,090 1,199 1,241 Floor space ventilated 56 83 67 54 33 59 54 Floors repaired 419 568 407 306 354 411 360 Roofs repaired 1,456 1,719 1,366 1,123 1,395 1,412 1,338 Overcrowding abated 4 6 8 15 12 9 19 Illegal use of underground Rooms for sleeping discontinued 3 3 3 6 4 4 4 Other Improvements, or Nuisances abated 1.907 2,564 1,834 1,615 1,838 1,952 2,244 Rooms Disinfected 1,625 1,872 1,734 1,697 1,647 1,715 1,800 Total Improvements 16,611 19,462 14,173 13,175 13-896 15,464 15,192 Total Premises Improved 7,067 7,599 5,866 5,762 6,239 6,507 6,635 19251 48 HOUSES LET IN LODGINGS. There were 1,011 houses under the operation of the bye-laws at the end of the year 1925; 219 inspections were made during the year, followed by 2,122 subsequent re-inspections and calls, so that the total visits amounted to 2,371. These inspections resulted in 364 intimations being served on the persons responsible, which were followed by 80 statutory notices to demand the abatement of the nuisances discovered by the inspector especially engaged upon his work. It was not found necessary to take legal proceedings for non-compliance with the notices served. Altogether, 953 improvements were effected in 293 premises. In addition to figures given above, 1,585 inspections and calls were made by the Inspector in District No. 2 during the District Inspector's absence on sick leave. Synopsis of Inspectors Work:— Improvements. Drains : Constructed - Reconstructed - Repaired 5 Ventilated - Gully and other traps fixed - Water Closets : W. C. erected with pan, trap and water supply 2 Pan and trap only provided 17 Water supply provided 25 Ventilated 1 Position altered - Dust Bins : Provided 97 Repaired - Areas : Constructed - Yards : Paved 1 Repaved 16 Sinks : Provided - Domestic Water Supply : Cisterns provided 2 Cisterns repaired and cleansed 3 Water supply provided to dwelling house - Water supply provided to tenement house 1 Other Improvements: Rooms cleansed and limewashed 278 Walls and passages repaired, cleansed and limewashed 44 Floor space ventilated - Floors repaired 37 Roofs repaired 86 Miscellaneous improvements 338 Total Improvements 953 Total Premises Improved 293 49 [1925 The following statement shows the work performed :— SUMMARY OF WORK FROM INSPECTORS REPORTS DURING THE YEARS 1920-25. 1925 1924 1923 1922 1921 1920 Number of Streets visited 98 91 544 711 669 607 Number of Private Houses visited 133 176 650 1,023 805 045 Number of Shops and Factories visited 14 19 712 1,009 1,034 1,326 Total Premises inspected 147 195 1,362 2,032 1,839 2,271 Found Rat Infested 66 61 787 1,331 1,406 1,355 Found Mice Infested 2 1 66 72 55 196 Defective Drains Repaired (Cause of Rat trouble) 51 60 13 52 45 34 Number of Complaints received 105 118 67 177 175 172 METROPOLITAN BOROUGH OF ISLINGTON. Housing Statistics for the Year, 1925 Number of new houses erected during the year :— (a) Total (including numbers given separately under (b) 8 (b) With State assistance under the Housing Acts : (i) By the Local Authority Nil (ii) By other bodies or persons 8 1. Unfit dwelling-house. Inspection— (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 6,248 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 3,328 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceeding sub-head) found not to be in all respects reasonably fit for human habitation 1,835 2. Remedy of defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers Not recorded 1925] 50 3. Action under Statutory Powers. (a) Proceedings tinder Section 3 of the Housing Act, 1925. (1) Number of dwelling-houses in respect of which notices were served requiring repairs Nil* (2) Number of dwelling-houses which were rendered fit after service of formal notices— (a) By owners Nil* (b) By local authority in default of owners Nil* (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close Nil* (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 4,755 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 3,903 (b) By local authority in default of owners Nil (c) Proceedings under Sections 11, 14 and 15 of the Housing Act, 1925. (1) Number of representations made with a view to the making of Closing Orders Nil (2) Number of dwelling-houses in respect of which Closing Orders were made Nil (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwellinghouses having been rendered fit Nil (4) Number of dwelling-houses in respect of which Demolition Orders were made Nil (5) Number of dwelling houses demolished in pursuance of Demolition Orders Nil GEORGE'S ROAD AND BRAND STREET IMPROVEMENT SCHEME. On the 31st July, 1925, the Ministry of Health issued an Order sanctioning' Improvement Scheme under Part II., Housing Act, 1925; approving the London County Council undertaking the execution of the Scheme (see pp. 43, 44 and 45 of Medical Officer of Health's Annual Report, 1924). *—1.684 houses (under £40 per annum rental) were however inspected under the Public Health Acts, and 1,382 notices were served upon the Owners of these houses, which were subsequently rendered fit for human habitation. 51 [1925 INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS, 1919, 1920, 1923 and 1925. Upon the above Acts coming into operation, whereby at any time or times, not being less than three months after the date of any increase of rent permitted, the tenant or the Sanitary Authority may apply to the County Court for an order suspending such increase, and also any increase under section 2, sub-section 1 (c); on the ground that the house is not in all respects reasonably fit for human habitation or is otherwise not in a reasonable state of repair, or on the Court being satisfied by the production of a certificate of the Sanitary Authority on any such ground as aforesaid is established, and upon being satisfied that the condition of the house is not due to the tenants neglect or default, or breach of express agreement, shall order that the increase be suspended until the Court is satisfied, on the report of the Sanitary Authority or otherwise, that the necessary repairs have been executed. On any application to a Sanitary Authority for a certificate or report under the Act, a fee of one shilling is payable. The certificate of a Sanitary Authority shall specify what works (if any) required to be executed in order to put the house in a reasonable state of repair. The issue of certificates under the above Acts under the authority of the Public Health Committee in most cases throws a large amount of work on the staff of the Public Health Department. The majority of the applicants have little idea of their responsibility when the certificate is actually in their possession, the initial idea being that they have only to pay the statutory fee of one shilling to the Sanitary Authority to secure repairs being done. On the other hand the mere issue of the certificate has resulted in a number of premises being redecorated which otherwise might have remained in a state of disrepair, as the defects could not be dealt with under the Public Health (London) Act, 1891. Number of applications for certificates and reports under the above Acts. Year. House or part of the house not kept in a reasonable state of repair. House or part of the house kept in a reasonable state of repair. Reports re completion of work mentioned in schedule issued with certificate. Certificate not issued. Total. 1920 25 28 — 1 54 1921 269 52 1 5 327 1922 157 25 11 2 195 1923 123 8 15 2 148 1924 117 6 19 — 112 1925 96 5 12 3 116 Totals 787 124 58 13 982 RABIES. On 5th June, 1925, a notification was received from the Ministry of Agriculture and Fisheries of a suspected case of Rabies occurring in a brown-andwhite dog seen by a Police Constable in York Road, on 30th May, 1925, snapping at passers-by and foaming at mouth. Dog was taken to Police Station and there destroyed. A man who assisted Police Constable was bitten on right hand. The 1925] 52 Wound was cauterised by a doctor. The case was investigated by Mr. W. F. Shaw, Veterinary Inspector to the London County Council, who was of opinion the case was not one of Rabies. NUISANCES BY DOGS. Many complaints having been received regarding nuisances by dogs, the matter came under discussion at the Public Health Committee during the year, and the Medical Officer of Health was requested to prepare a poster which would be circulated with a view to seeing if an improvement could be effected. It was felt that there was a difficulty in enforcing bye-laws without assistance from the police, the Borough Council having no power to enforce compliance with a request for a person's name and address. The poster, of which a copy follows, was designed to give an unbiassed and non-exaggerated statement of the position, and to appeal to the common sense of the citizens in the matter. METROPOLITAN BOROUGH OF ISLINGTON. Public Health Department. NUISANCES BY DOGS. The fouling of footways by dogs can be very considerably diminished if proper care is exercised by those in charge. The dog on a lead should be taken to the kerb, and not permitted to excrete upon the public footway. There are grave risks of milk cans at doors, of baskets containing vegetables, etc., and of other food being contaminated. Parasitic worms are common in the dog. The excrement is also carried into the home on boots. Much can obviously be done by those in charge of dogs, for dogs are trained not to foul living rooms and they can be similarly trained to use the gutter. The people of Islington are appealed to, in the interests of Public Health, to help. G. CLARK TROTTER, M.D., Municipal Buildings, Medical Officer of Health. Upper Street, N.l. October, 1925. STATE OF PAUPERISM IN THE BOROUGH. During the year there was a marked decrease in Pauperism, the number of paupers relieved weekly averaged 10,583, as contrasted with 11,792 in 1924, whilst in 1923 the number was 13,914. Appended is a statement furnished by the Clerk to the Islington Guardians : Showing the State of Pauperism in the Borough during the year 1925. Quarters. 1 Average number Relieved during each week. Borough Death rates, 1925. 8 Indoor Paupers, Adults and Children. 2 Outdoor Paupers. Totals. 5 Totals corresponding periods 1924. 6 Children Boarded out. 7 Adults. 3 Children under 16. 4 1st Quarter 2,997 4,774 3,392 11,163 13,204 47 14.3 2nd „ 2 881 4,534 3,147 10,562 11,884 47 10.7 3rd „ 2,836 4,288 2,836 9,960 11,231 42 9.7 4th „ 2,939 4,640 3.071 10,650 10,851 39 14.3 The Year 2,913 4,559 3,111 10,583 11,792 44 12.3 53 [1925 Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 730 visits to the 13 Slaughter Houses now on the register, including one Horse Slaughter House, and that he has ascertained that 11,788 animals were killed therein, namely, 568 oxen and cows, 52 calves, 6,000 sheep and lambs, 14 pigs and 5,154 horses for human consumption, the whole of which were exported. These were apparently of good quality and free from disease, but in 44 cases meat and organs found to be diseased were destroyed (vide table on page 55). The number of private Slaughter Houses in use: In 1920, In January, 1925. In December, 1925. Registered Nil Nil Nil Licensed 18 14 13 Total 18 14 13 The food destroyed or otherwise disposed of (chiefly for pigs' food) so as to prevent its use for human food was as follows: Tons. cwts. qrs. lbs. Diseased meat and organs from slaughter-houses 6 5* Diseased or unsound meat, etc., from other sources — 3 3 7 Fish — 7 2 7 Fruit, Vegetables, etc. 3 10 — 3 Tinned foods (fruit and meat) 1 2 10 Total 4 9 0 10 * Of this quantity 3 qrs. 12 lbs. was Tuberculous. The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 4 tons 9 cwts. 0 qrs. 10 lbs. The diseases which affected animal food are set out in detail on page 55. Shops, etc , Inspection of.-The total 662 shops and places where foodstuffs are sold may be approximated for the year as follows: Butchers', provision dealers', etc., shops, 240; meat, provisions, rabbits, tinned foods, etc., stalls, 19; food preparation establishments, 23; fish shops, 103; fish stalls, 12; fruit shops, 200; and about 65 fruit, etc., stalls and barrows. To these 19,826 visits were paid apportioned as follows: Butchers, Provision Dealers, etc., Shops 7,474 visits* Food Preparation Establishments 839 ,, Butchers, Provision, etc., Stalls 1,609 ,, Fish Shops 1,299 ,, Fish Stalls 794 ,, Fruit Shops 2,546 ,, Fruit Stalls and Barrows 5,265 ,, Total 19,826 ,, LICENSED PREMISES. The procedure adopted in 1924 has continued during the last twelve months with respect to public houses. Upon information being received from the Clerk to the Licensing Justices of the Finsbury Division that premises are about to 1925] 54 change hands or that alteration to a building is contemplated, the Sanitary Inspector visits and inspects the premises. Particular attention is paid to the sanitary conveniences available for the public using the premises, and where luncheons are served suitable accommodation for the women customers has been enquired into. Where such accommodation is not available a suggestion is made to the owners of the premises that separate conveniences are desirable, and in every instance these have been readily provided. There is a growing tendency to make the better-class licensed house more as a restaurant than a mere drinking saloon. During the past year 16 plans have been submitted on behalf of licencees and examined by the Borough Engineer in collaboration with the Medical Officer of Health and approved by the Public Health Committee, which in some cases have voluntarily included separate sanitary conveniences for women. Consequent on the visits by the Sanitary Inspector, 22 notices under the Public Health (London) Act, 1891, were served intimating various nuisances, and the improvements made are included in the summary of the Inspectors' work. Restaurant Kitchens.—The work of inspecting restaurant kitchens is tabulated under Workshops. This work is done by two Women Inspectors. The following is a tabulated statement of the premises examined, and the results. In each case the unsatisfactory conditions were remedied without having to resort to prosecution: Number Inspected. Number found Unsatisfactory. Hotel and Restaurant Kitchens 57 18 Coffee and Dining Rooms 218 49 Refreshment Rooms 95 33 Provisions (Cooked Meats, cooked but not consumer on premises) 118 31 488 131 Prosecutions.—Two summonses were taken out for exposing unsound fruit for sale. A fruiterer was fined £2, with £1 Is. costs, for exposing for sale unsound pears and pineapples; whilst in the other case a costermonger was prosecuted for exposing tangerine oranges unfit, for food. In the latter case, however, a penalty was not pressed, and the magistrate ordered defendant to pay £1 Is. costs. Thirty summonses were taken under the Sale of Food Order, 1921, for exposing for sale imported meat and eggs without the necessary labels. Of this number, 10 referred to imported meat. The total fines amounted to £21 4s., with £8 13s. costs. The remaining 20 summonses were for exposing for sale imported eggs. The total fines and costs in these cases were £30 Is. and £23 10s. 6d., respectively. Cowsheds.—The 4 cowsheds within the Borough received 31 visits, and were found generally satisfactory. 55 [1925 Offensive Trades include 4 tripe dressers, 3 gut scrapers, and the knackers' vard which received a total of 48 visits. The Inspector reports that he found the conduct of the business carried on in them satisfactory. Tabulation of meat and organs diseased as found in slaughter-houses during the year 1925: No. of Cases. Description of Animal Affected. Nature of Disease. Extent of Disease. How disposed of. 1 Ox Tuberculosis Head and Throat Glands Council's Destructor. 1 Heifer Tuberculosis Lungs, Tripe, Trimmings „ „ 1 Heifer Tuberculosis Lungs and Mesentery „ „ 1 Ox Actinomycosis Heat, Tongue and Tripe „ „ Same Ox Acute Congestion Lungs and Liver „ „ 2 Pigs Acute Congestion Lungs „ „ 25 Oxon, or Heifers Parasitic (Dis. Hep.) Liver „ „ 10 „ „ Abscess (simple or multiple Liver „ „ 1 Sheep Parasitic (Dis. Hep.) Liver Destroyed premises 2 Lambs Parasitic (Ech. Vet.) Liver „ „ METROPOLITAN BOROUGH OF ISLINGTON. Public Health Department. The Public Health (Meat) Regulations, 1924*, came into operation on the first day of April, 1925. These Regulations include the following: MEAT means the flesh of cattle, swine, sheep, or goats, including bacon and ham and edible offal and fat, which is sold or intended for sale for human consumption. STALL includes any stall barrow or vehicle from which meat is offered for sale in a street or other open space or in any market place. ROOM includes a shop cellar passage or other space forming the whole or part of a building. STALLS. A person selling meat or exposing or offering meat for sale from any stall- (a) shall keep his name and address legibly painted or inscribed on such stall in some conspicuous position; (b) shall cause such stall (if not placed in an enclosed and covered market place) to be suitably covered over and to be screened at the sides and back thereof in such a manner as to prevent mud, filth or other contaminating substance being splashed or blown from the ground upon any meat on the stall; (c) shall cause every counter, slab, vessel or other article on or in which meat is placed for sale and all knives and other implements used in connection with the meat to be thoroughly cleansed after use and to be kept at all times in a cleanly condition; (d) shall take all such steps as may be reasonably necessary to guard against the contamination of meat by flies; (e) shall not place or cause to be placed any meat on, or within eighteen inches of the ground or floor, unless the meat is placed in a closed cupboard or other adequately protected space not less than nine inches from the ground or floor; (f) shall cause all trimmings, refuse and rubbish to be placed in properly covered receptacles kept for the purpose apart from any meat intended for sale. "Copies of the full Regulations, price 2d., may be obtained on application at the Public Health Department. 1925] 56 SHOPS, STORES, Etc. (1) The occupier of any room in which any meat is sold or exposed for sale or deposited for the purpose of sale or of preparation for sale or with a view to future sale, and any person who knowingly lets any room or suffers any room to he occupied for such purpose shall cause the following provisions to be complied with :— (a) No urinal, water-closet, earth-closet, privy, ashpit or other like sanitary convenience shall be within such room or shall communicate directly therewith, or shall be otherwise so placed that offensive odours therefrom can penetrate to such room; (b) No cistern for supplying water to such room shall be in direct communication with or directly discharge into any such sanitary convenience. (C) No drain or pipe for carrying off faecal or sewage matter shall have any inlet or opening within such room unless it is efficienly trapped. (d) No such room shall be used as a sleeping place, and, so far as may be reasonably necessary to prevent risk of the infection or contamination of any such meat as aforesaid, no sleeping place shall communicate directly with such room. (e) Except in the case of a room used as a cold store, adequate means of ventilation shall be provided. (2) The occupier of any such room shall not cause or suffer any refuse or filth whether solid or liquid to be deposited or to accumulate therein except so far as may be reasonably necessary for the proper carrying on of the trade or business. (3) Such occupier shall cause the walls and ceiling of such room to be whitewashed, cleansed or purified as often as may be necessary to keep them in a proper state. (4) Such occupier and every other person engaged in such room shall observe due cleanliness in regard to such room and all articles, apparatus and utensils therein. (5) The occupier of any such room— (a) shall take all steps as may be reasonably necessary to guard against the tamination of the meat therein by llies and shall cause the meat to be so placed as to prevent mud, filth or other contaminating substance being splashed or blown thereon; (b) shall not permit any gut-scraping, tripe-cleaning or household washing to be carried on therein; (ci) sliali cause every counter, slab, vessel or other article on or in which meat is placed for sale and all knives and other implements used in connection with the meat to be thoroughly cleansed after use and to be kept at all times in a cleanly condition ; (d) shall cause all trimmings, refuse and rubbish to be placed in properly covered receptacles kept for the purpose apart from any meat intended for sale. G. CLARK TROTTER, M.D., Medical Officer of Health. Islington Municipal Offices, Tyndale Place, Upper Street, N.l. April, 1925. Milkshops and Dairies.— At the close of the year there were 568 milkshops and drtiries on the register, 14 having been added to it, while 20 were removed. These received 1,262 visks from the District Sanitary Inspectors, who served 182 notices for the execution of various sanitary improvements and the cleansing rti dirty utensils. 57 [1925 Milk and Dairies (Amendment) Act, 1922. Dairies, Cowsheds and Milkshops Order, 1885, etc. The Chief Sanitary Inspector in conjunction with the District Sanitary Inspectors, inspected the premises in the borough in which milk is stored and retailed other than in sealed bottles, and have examined the utensils in use by the occupiers. In 193 cases letters were addressed to the occupiers intimating unsatisfactory conditions, either of the premises or of the vessels and utensils in use. These unsatisfactory conditions are summarised as follows: Unsatisfactory receptacles 47 ,, storage 17 „ coverings 89 ,, premises 25 Defective measures 43 Premises in which paraffin oil was sold 15 In each of these cases, except four, intimation by letter of the specific unsatisfactory condition, addressed to the responsible person, was sufficient to obtain improvement, but in the four cases where paraffin oil was stored in close proximity to the milk, and no improvement had been made on receipt of the initial communication, recourse was had to the Milk and Dairies (Amendment) Act, 1922, and the occupiers were served with notice to appear before the Public Health Committee, with the result that the purveying of milk or oil ceased from the particular premises. In all the other instances (11) the paraffin oil was removed from the shop, or the sale of milk was discontinued. The unsatisfactory coverings were generally of muslin stretched across a vvoodon or wire hoop, and had for many years been the accepted method of preventing the milk from contamination by dust, but the inspectors frequently found that these were missing from the proper place over the vessels and no protection afforded to the milk. This method is now changed, and metal ventilated covers are provided, except in a few instances where the milk vessel is enclosed in a glass case. There is an increase in the number of shops in which milk is sold in sealed bottles, but as these shops are excluded from the definition of "dairy" under the Dairies, Cowsheds and Milkshops Orders by the Milk and Dairies (Consolidation) Act, 1915, which came into operation on the 1st September of this year, less attention need be paid to them. It is, however, advisable that their situation should be noted so that occasional visits may be paid by the Sanitary Inspectors in order to see that the bottles are kept sealed and not broached for the purpose of selling small quantities of milk, as this action would constitute the premises a " dairy." Some inspection is therefore necessary of these purveyors of milk. Milk and Dairies (Amendment) Act, 1922. Milk (Special Designations) Order, 1923. During the year the following applications were made for licences under the provisions of above Order to enable the persons to sell Specially Designated Milk: 1925] 58 LICENCES GRANTED during 1025. Applications. Designation. Granted. Fees received £ s. d. 3 "Certified" 3 0 15 0 2 "Grade A." (Tuberculin tested) 2 0 10 0 Nil "Grade A" Nil — — — 3 "Pasteurised" 3 3 3 0 (Pasteurisers) 2 (Supplementary) " Pasteurised " 2 0 4 0 10 10 £4 12 0 REPORT OF THE MEDICAL OFFICER OF HEALTH TO THE MINISTRY OF HEALTH UNDER THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 and 1917. During the past year (1925), samples of Milk, Cream and Preserved Cream have been obtained to ascertain the extent to which the provisions of the Regulations are being carried out by the vendors. (1) Milk and Cream NOT Sold as Preserved Cream : Milk. Milk 679 Separated Milk 5 Total number of samples of milk examined for the presence of preservatives 684 Number in which preservative was found to be present Nil Cream. (2) Cream NOT Sold as Preserved Cream 30 Number of which preservative was found to be present 28 Cream Sold as Preserved Cream: (a) Instances in which samples have been submitted for analysis to ascertain if the statement on the label as to preservative were correct— Correct statements made Nil Statements incorrect Nil (b) Determination of Milk Fat in cream sold as preserved cream— Above 35 per cent Nil (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream have not been observed 23 (d) Particulars of each case in which the regulations have not been complied with, and action taken (see p. 59). Note.—A further 61 informal samples were purchased of cream, of these 38 had the orthodox preservatives label, or were pure cream. Taking account of these 61 informal samples, and referring to the official samples, it will be seen that 91 creams were taken. Of these 91 creams, 30 were submitted for analysis; two of which were pure cream. 59 [1920 SUMMARY OF PROCEEDINGS under the Public Health (Milk and Cream) Regulations, 1912 and 1917. Sample No. Offence. Result. 154.g. Cream containing 0-19% Boric Acid Fined 5s. and 10s. 6d. costs. 155.g. „ „ 0-19% „ „ Fined 10s. and 10s. 6d. costs. 157.g. „ „ 0-25% „ „ Summons withdrawn on payment of £2 2s. Od. costs. 161.g. „ „ 0.35% ,, „ Fined £1 Is. Od. to cover 4 summonses. 163.g. „ „ 0.25% ,, „ Ordered to pay 15s. costs. 164.G. „ „ 0.26% „ „ Fined £2 2s. Od. and £2 2s. Od. costs. 170.g. „ „ 0.29% „ „ Summonses (3) withdrawn on payment of £5 5s. Od. costs. 171.G. „ „ 0.29% „ „ Included in above (170.G). 172.G. „ „ 0.25% ,, ,, Included in above (170.G.) 184.g. „ „ 0.28% „ „ Fined 10s. 6d. and £2 2s. Od. costs. 185.G. „ „ 0.29% „ „ Ordered to pay £1 Is. Od. costs. 188.G. „ „ 0.31% „ „ Fined 10s. 6d. and £2 2s. Od. costs. 189.g. „ „ 0.22% „ „ Summons withdrawn on payment of £2 2s. Od. costs. 193.g. „ „ 0.20% „ „ Cautioned re-labelling. 195.g. „ „ 0.11% „ „ Ordered to pay £2 2s. Od. costs. 198.g. „ „ 0.24% „ „ Summons withdrawn on payment of £1 Is. Od. costs. 199.g. „ „ 0.31% „ „ Summons withdrawn on payment of £1 Is. Od. costs. 202.G. „ „ 0.23% „ „ Fined £1 and £2 2s. Od. costs. 209.G. „ „ 0.25% „ „ Included in 161.G. 210.G. „ „ 0.23% „ „ do. 211.G. „ „ 0.28% „ „ do. 212.g. „ „ 0.11% „ „ Cautioned re-labelling. 214.G. „ „ 0.12% „ „ do. 215.g. „ „ 0.22% „ „ do. 217.g. „ „ 0.19% do. 218.g. „ „ 0.15% „ „ Ordered to pay £2 2s. Od. costs. 17.G. „ „ 0.23% „ „ Summons withdrawn on payment of £1 Is. Od. costs. 94.g. „ „ 0.23% „ „ do. do. ADULTERATION OF FOOD AND DRUGS. During- the year the analysis of samples of food and drugs was performed by our Analyst, Mr. Ernest A. Pinchin, B.Sc., who examined 1,373 samples submitted to him by the Food and Drugs Inspector. Of the total articles analysed 1,231 were found to be genuine, whilst 142, or 10.3 per cent., were adulterated. The percentage of adulteration in the four quarters of the year was as follows: Examined. Genuine. Adulterated. Per Cent. 1st Quarter 408 373 35 8.6 2nd „ 362 331 31 8.6 3rd „ 227 184 43 18.9 4th „ 376 343 33 8.8 The Year 1,373 1,231 142 10.3 Prosecutions. — Sixty-nine summonses were issued under the "Sale of Food and Drugs Acts," and 63 of these were successfully prosecuted. The total amount of penalties and costs received was £205 10s. Od. Eleven other cases were heard under the Public Health (Milk and Cream) Regulations, resulting in the defendants being fined £4 8s. 6d., with £15 9s. Od. costs. 1925] 60 Showing the number of Samples of Food and Drugs Analysed, with the result of the Analyses for the Year 1925 and the preceding Ten Years 1915-24. Years. No. of Samples Examined. Genuine Adulterated Per cent. Adulterated. Amount of Penalties and Costs Received. £ s. d. 1915 1,207 1,080 127 10.5 195 18 0 1916 1,139 1,025 114 10.0 150 11 6 1917 1,134 1,050 84 7.4 238 15 6 1918 1,125 1,017 108 9.6 233 7 0 1919 1,229 1,166 63 5.6 158 7 0 1920 1,238 1,192 46 3.7 47 9 6 1921 1,201 1,141 60 4.9 63 5 6 1922 1,209 1,096 113 9.3 198 7 0 1923 1,223 1,147 76 6.2 158 8 6 1924 1,255 1,109 146 11.6 122 4 0 Totals 11,960 11,023 937 7.8 1,566 13 6 1925 1,373 1,231 142 10.3 225 7 6 MILK SOPHISTICATION. The number of samples of milk purchased for analysis was 684, of which 652 were genuine and 32, or 4.7 per cent, were adulterated. Giving the particulars of the Milks taken during each quater of 1925 on Sundays, Week-days, and at the Railway Stations. 1925. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Quarters. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. 1st Quarter 30 100 56 186 28 96 47 171 2 4 9 15 6.0 4.0 16.0 8.1 2nd 30 126 59 215 28 124 54 206 2 2 5 9 6.0 10 8.0 4.2 3rd 30 81 31 142 28 77 31 136 2 4 - 6 60 5.0 — 4.2 4th 18 77 46 141 18 75 46 139 — 2 — 2 - 2.0 — 1.4 The Year 108 384 192 684 102 372 178 652 6 12 14 32 5.5 3.1 7.3 4.7 MILK ADULTERATION. Samples Analysed. Genuine. Adulterated Per cent. Adulterated. l915 605 531 74 12.2 1916 599 506 93 15.5 1917 592 526 66 11.1 1918 634 637 97 15.3 1919 638 579 59 9.2 1920 642 605 37 5.7 1921 644 605 39 6.0 1922 638 576 62 9.7 1923 676 644 32 4.7 1924 681 646 35 5.1 Totals 10 yrs. 6,349 5,755 594 9.3 1925 684 652 32 4.7 61 [1925 Showing the anaylses of 6,349 milks examined in Islington during the 10 years 1915-1924 and 1925, and distinguishing those purchased on Sundays, on Week-days, and procured at the Railway Stations whilst in transit from the Farmer to the London Milk Purveyor. Years. Sunday Milks. Week-day Milks. Railway Milks (Farmers). No. of Samples Per cent, of nonfatty solids. Per cent, of fat. No. of Samples Per cent, of nonfatty solids. Per cent, of fat. No. of Samples Per cent, of nonfatty solids. Per cent, of fat. 1915 165 8.64 3.43 320 8.76 3.49 120 8.86 3.67 1916 160 8.60 3.53 319 8.56 3.43 120 8.83 3.63 1917 150 8.63 3.45 322 3.60 3.41 120 8.84 3.59 1918 136 8.39 3.60 377 8.44 3.53 121 8.61 3.65 1919 166 8.56 3.56 331 8.56 3.61 141 8.67 3.68 1920 162 8.71 3.42 338 8.76 3.52 142 8.86 3.66 1921 151 8.83 3.34 371 8.79 3.37 122 8.91 3.73 1922 120 8.74 3.39 356 8.76 3.34 162 8.75 3.60 1923 120 8.82 3.55 388 9.08 3.63 168 8.90 3.63 1921 120 8.74 3.42 399 8.78 3.48 162 8.87 3.65 Total samples and average constituents (10 years) 1,450 8.67 3.47 3,521 8.71 3.48 1,378 8.81 3.65 1925 108 8.71 3.41 384 8.71 3.37 192 8.79 3.67 Informal Sampling. — This included 8 samples of full cream sweetened Condensed Milk and 6 full cream Dried Milk, all of which were genuine. Milk.—The qualitative result 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 108 8.71 3 41 12.12 Milk purchased on week-days 384 8 71 3.37 12.08 Milk procured in transit at Finsbury Park Station 192 8.79 3.67 12.46 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 Station are as follows: Percentage Number taken. Genuine. Adulterated. Adulterated. On Sundays 108 102 6 5.5 On Week-days 384 372 12 3.1 At Railway Stations 192 178 14 7.3 (Fanners' Milks) 684 652 32 4.7 SAMPLES OF MILK SUBMITTED FOR ANALYSIS UNDER THE MILK AND DAIRIES (AMENDMENT) ACT, 1922. 1925. No. of Samples Samples Coloured Prosecutions for Mixed Milk Result of Prosecutions Successful Dismissed No proceedings 1st Quarter 7 Nil 3 1 2 4 2nd Nil „ Nil „ „ „ 3rd ,, „ „ „ „ „ 4th „ „ „ „ „ „ The Year 7 Nil 3 1 2 4 1925] 62 The Public Analyst, in the quarterly reports during the year, reported on the genuineness of the articles examined as follows :— Showing the Samples of Food and Drugs submitted, to the Public Analyst during the Year 1925. Description. Total Samples Genuine. Adulterated. 1st Or. 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 Milk 184 214 142 139 679 169 205 136 137 647 15 9 6 2 32 Milk (separated) 2 1 — 2 5 2 1 — 2 5 - — — — — Butter 78 53 21 122 274 77 49 19 118 263 1 4 2 4 11 Lard 6 10 4 12 32 6 10 4 12 32 - - - - - Dripping 4 2 2 3 11 4 2 2 3 11 - - - - - Cheese 6 - — - 6 6 — — - 6 - — — — — Cocoa 23 17 2 7 49 23 17 2 7 49 - - - - - Coffee 10 5 1 13 29 10 5 1 13 29 - - - - - Arrowroot 13 6 3 4 26 13 6 3 4 26 - — — — — Pepper 11 13 5 12 41 11 13 5 12 41 - - - - Rice 8 7 2 2 19 8a 7 a 2a 2 a 19 - - - - - Custard Powder 7 — 2 1 10 7b — 2b lb 10 - - - - - Condensed Milk 6 — 2 — 8 6 — 2 — 8 - — — — — Self-Raising Flour 4 1 1 — 6 46 16 lb — 6 - - - - - Dried Milk 4 — — — 4 4 - - — 4 - — — — — Mustard 4 6 - 8 18 3 6 - 8 17 1 — — — 1 Strawberry Jam 3 — - — 3 3c — - - 3 - — — — — Raspberry Jam 3 — — 3 3c - — — 3 - — — — Honey 2 2 - — 4 2d 2d - — 4 - — — — - Chocolate Snowman 1 — - — 1 1 — - — 1 - — — — — Ground Ginger 1 — - — 1 1 - - — 1 - — — — — Curry Powder 1 — - — 1 1e - - — 1 - — — — — Whisky 2 — 1 1 4 1 — 1 1 3 1 — — — 1 Lemonade Powder — 4 - — 4 — 4e — — 4 - — — — — Orange Powder — 1 - — 1 — 1e — — 1 - — — — — Cream — — 28 2 30 — — 2 — 2 - — 26 2 28 Full Cream Dried Milk — — 2 — 2 — — 2 — 2 - — - — — Beef Suet — — — 3 3 — - — 3 3 - — — — — Ground Almonds — — — 2 2 — - — 2 2 - — — — Malt Vinegar — — - 2 2 — — — 2 2 - - - - - Ground Cinnamon — — — 1 1 — —- 1 1 - - - - - Glace Cherries - — — 1 1 — — - 1c 1 - — — — — Sponge Fingers - — — 1 1 — — - 1f 1 - — — — — Cayenne Pepper - — — 1 1 — — - 1 1 - — — — — Raisins - — - 1 1 — — - 1c 1 - — — — — Shredded Suet — — — 1 1 — — - 1 1 - - - - - Ground Caraway Seeds — — — 1 1 — - 1 1 - — — — — Sultanas — — — 1 1 — — - 1c 1 - — — — — Crystallised Fruit — — — 1 1 — — - 1c 1 - — — — — Preserved Ginger - — — 1 1 — — - 1 1 - — — — — Crushed Linseed — — — 1 1 - - - - - - - - 1 1 Brandy — — — 1 1 - — - - - - - - 1 1 Prescription 8 — — 6 14 8 — - 6 14 - — — — — Olive Oil 3 — - 3 — 2 - — 2 - 1 — — 1 Margarine 391 345 218 353 1,307 373 331 184 343 1,231 18 14 34 10 76 17 17 9 23 66 — — — — — 17 17 9 23 66 Totals 408 362 227 376 1,373 373 331 184 343 1,231 35 8.6% 31 8.6% 43 18.9% 33 8'8% 142 10.3% All Milks free from Boric Acid and Formalin. (а) Conformed to the suggested limit of extraneous mineral matter. (б) do. do, of Sulphate of Lime and Arsenic. (c) Free from Preservatives and Arsenic. (d) Free from Preservatives. («) Free from Lead and Arsenic (/) Free from Boric Acid. 63 [1926 Milk Prosecutions. The summary of prosecutions showed that during the year 31 prosecutions were taken, of which number 25 were successful, and 5 were dismissed, while 1 was withdrawn. Summary of Prosecutions during year 1925. Total Prosecutions. Successful. Dismissed. Withdrawn. Amount of Penalties and Costs Received. £ s. d. " Public Health (London) Act, 1891 " 17 17 — — 43 13 0 "Sale of Food and Drugs Acts, 1875-99 " 55 49 4 a b 2 a 187 6 0 " Margarine Act, 1887 " 14 14 — — 18 4 0 "Public Health Milk and Cream Regulations, 1912-17 " 11 11 - - 19 17 6 ' Sale of Food Order, 1921 " 30 26 4 a b — 83 8 6 "Milk & Dairies Amendment Act, 1922" 1 - 1 a - - "Dairies, Cowsheds and Milkshops Order, 1885 " 1 1 - - 2 0 0 " L.C.C. General Powers Act, 1908 " 9 7 - 2 a 29 13 0 " L.C.C. By-Laws " ... 14 8 4 b 2 a 27 6 0 Totals 152 133 13 6 411 8 0 a 12 Alternative summonses. b 7 Dismissed on point of law. PUBLIC HEALTH STAFF. The staff of the Medical Officer of Health is constituted as follows : Chief Sanitary Inspector and Superintendent.—George James Bridel, S.I.E.Bd. *Sanitary Inspectors.—T. W. Agar, H. J. Bicknell, A. Bagshaw, S. P. Marks, E. I. Fortune, J. Metcalf, T. H. Hancock, C. E. Horsman, A. E. Wood, E. G. Holmes, E. J. Nether, F. H. Chuter, H. H. Uren, C. W. Lewis, Harry Dewhurst (Houses let in Lodgings). *Senior Sanitary Inspector. Inspector of Workshops and Bakehouses.— H. J. J. Watson. * Inspectors of Workshops, etc., in which Females are Employed.—Eleanor H. Daniell, Mrs. S. Undery. *Inspector of Meat, etc.—H. Wilkinson. *Inspector of Food and Drugs, etc.—G. S. Green. Disinfecting Station.—A. Lewis (Engineer), W.G.Jollie (Stoker), Mrs. Home (Cleansing Station Attendant), Mrs. Lewis (Caretaker, Shelter House). Disinfectors.— F. Webb, J. Brown, W. Hardwick, W. Woodley, A. Taylor. Motor Van Driver.—G. Cooper. Mortuary Keeper.—S. Maxwell. G4 Clerical Staff.-—G. H. King (First Clerk), H. Angol, A. E. Abbott, W. J. Wolfe, W. G. Bunch, A. R. Wittrick, *C. M. Wheble, A. E. Booker, W. R. Causton, *C. J. Gridland, 1.. VV. Edis. Milk Grants.—*F. C. Green, *A. E. Vanstone, *I)aisy Francis. * Health Visitors.—Miss \-. A. Lainton, R. Palmer, L. Flower, E. Foot, fM1S)A. Mc»rr\ E. Neale, E. O. Oliver. Tuberculosis Visiting Nurse.—Miss E. McGoldrick. Those marked with an asterisk indicates contribution was expected either under the Public Health Acts or by Exchequer Grants. The Medical Officer of Health expresses his thanks to the Town Clerk, C. G. E. Fletcher, Esq., C.B.E. ; the Solicitor; the Borough Engineer: the Public Analyst, A. E. Pinchin, Esq., B.Sc., and to the Heads of other departments, for their courtesy and assistance in various matters. He records with regret the loss of two very esteemed colleagues, Arthur M. Bramall, Esq., Solicitor ; and J. P. Barber, Esq., Borough Engineer ; both dying while in office, Mr. Barber on 22nd April, and Mr. Bramall on 31st August, 1925. He takes this opportunity of expressing his indebtedness to the staff for the efficient work and thorough co-operation which has meant so much in attaining the results reported on. APPENDIX. Vital and Sanitary Statistics, 1925. TOGETHER WITH THE PRESCRIBED RETURNS OF THE MINISTRY OF HEALTH. 1925 66 STATISTICAL APPENDIX Showing Deaths from all Causes in Islington during the Year 1925. Deaths of Non-Residents in Hospitals arc 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- 75- 35- Tuf. U.H. Toll. Iy.H. H. B. S.E. Small Pox - - - - - - - - - - - - - - - - - - - - - - - - - (a) Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - - (b)Unvaccinated - - - - - - - - - - - - - - - - - - - - - - - - - (c) No Statement - - - - - - - - - - - - - - - - - - - - - - - - - 6 Measles 4 17 1 - - - - - - - - - - 21 1 - 3 2 4 2 3 8 10 12 22 Scarlet Fever 2 3 2 1 — — - - - — — — — 5 3 1 — 1 1 2 2 1 4 4 8 Typhus Fever - - - - - - - - - - - - - - - - - - - - - - - 8 Epidermic Influenza 4 2 2 - 1 1 1 3 11 11 19 16 1 6 66 14 9 7 8 10 7 17 32 40 72 9 Whooping Cough 24 35 2 - - - - - - - - - - 59 2 1 3 5 5 15 11 21 32 29 61 1 Diphtheria - 11 8 2 - - - - - - - - - 11 10 4 2 4 4 3 3 1 9 12 21 Enteric Fever — — 1 — — - — — 1 1 1* — — — 4 - — 1 3 — — — 1 3 4 Asiatic Cholera - - - - - - - - - - - - - - - - - - - - - - - - - 4 Diarrhoea, Dysentery 11 - - - - - - - - - - - - 11 — 1 1 2 1 — 1 5 4 7 11 1 Epidermic Enteritis 3 - - - - - - - - - - - - 4 - - - - - 1 3 - 3 1 4 1 Other Allied Diseases 2a 1a - - - - - - - - - - - 3 - 1 — 1 1 - - - 2 1 3 Hydrophobia - - - - - - - - - - - - - - - - - - - - - - - - - Glanders - - - - - - - - - - - - - - - - - - - - - - - - - Tetanus 3 - - - - - - - - - - - - 3 - 1 2 - - - - - 3 - 3 Anthrax - - - - - - - - - - - - - - - - - - - - - - - - - Cow Pox - - - - - - - - - - - - - - - - - - - - - - - - - 1 Syphilis - - - - - - - - 1 1 1 - - - 3 — - 1 — — 1 1 3 - 3 2 Gonorrhoea - - - - - - - - 2 2 1 - - - 5 — — — 1 1 1 2 5 - 5 Phagedaena - - - - - - - - - - - - - - - — - - - - - - - - - 4 Erysipelas 3 1 - - 1 - 1 - 2 - 1 1 1 4 7 1 — 2 2 1 3 2 3 8 11 3 Puerperal Fever - - - - - 1 7 - - - - - - - 8 — — 1 — 3 2 2 - 8 8 11 Pyaemai 1 - 1 - 2 1 2 3 1 4 2 2 — 1 18 2 2 1 2 4 4 4 10 9 19 8 Infective Endocaritis - 1 1 - 1 2 4 3 9 — — — — 1 20 2 3 1 3 4 4 4 5 16 21 8 Other Allied Diseases 2 1 — - 1 — 1 1 — 3 1 — — 3 7 2 2 1 — 2 — 3 3 7 10 Malarial Fever - - - - - - - - - - - — — — — — — — — — — — - - — 1 Rheumatism Fever - - - 3 - - 1 - 1 1 2 - - - 8 1 - - - 2 2 3 3 5 8 Rheumatism of Heart - - 1 - - - 1 2 2 - 1 — — - 7 - 1 - 3 — 1 2 1 6 7 8 Tuberculosis of Brain 7 12 4 1 2 - 1 - 1 - - - - 19 9 1 3 4 6 5 4 5 16 12 28 Tuberculosis of Larynx - - - - - - 1 1 1 - - - - - 3 1 - - 1 - - 1 2 1 3 113 Phthisis 5 3 4 4 29 55 74 70 77 47 10 1 - 8 371 28 44 31 37 60 78 101 238 141 379 6 Abdominal Tuberculosis - 2 - 2 1 - 1 2 2 1 1 1 - 2 11 2 3 1 1 3 1 2 5 8 13 1 Genaral Tuberculosis - - 1 - 1 - - — - 2 1 - — - 5 — — — — 3 1 1 5 - 5 3 Other forms culosis - - - 1 - 1 3 — 2 1 1 1 — — 10 1 3 1 1 1 2 1 5 5 10 Other Infective Diseases - - - - - - - - - - - - - - - - - - - - - - - - - Thrush - - - - - - - - - - - - - - - - - - - - - - - - - Actinomycosis - - - - - 1 - - - - - - - - 1 - - 1 - - - - - 1 1 Hydatid Diseases - - - - - - - - - - - - - - - - - - - - - - - - - Scurvy - - - - - - - - - - - - - - - - - - - - - - - - - Other Diseases due to Altered Food - - - - - - - - - - - - - - - - - - - - - - - - - Acute Alcoholism - - - - - - - 2 - - 1 - - - 3 - - - 2 - - 1 2 1 3 Chronic Alcoholism - - - - - - - - - - - - - - - - - - - - - - - - Chronic Industrial Poisonings - - - - - - - - - - - - - - - - - - - - - - - - - Other Chronic Poisonings - — —- — —- — -— — - - - - - - - - - - - - - - - — Osteo-arthritis - 1 - - - - - 1 1 2 4 6 1 1 15 3 3 1 1 1 4 3 5 11 16 Gout - - - - - - - - - - 2 - - - 2 - - - 1 1 - - 1 1 2 185 Cancer - 1 1 1 1 2 5 40 93 168 144 71 7 1 533 62 56 50 50 106 81 129 269 265 534 Diabetes Mellitus - - — 1 1 — - - - 4 9 1 - - 20 2 - 1 5 7 5 - 7 13 20 Purpura Haemorrhagica 1 - — — — - - - - - - - - 1 - - - - - - 1 - - 1 1 Haemophilia 1 - - - - 1 1 3 3 - - - - 1 - - 1 - - - - - - 1 1 Anaemia 1 - - - - - - - 1 5 5 1 - 1 19 2 3 - 3 7 1 4 4 16 20 Lymphadenoma 1 - - - - - - - 1 - 1 - 1 4 - - - - 2 2 1 2 3 5 Premature Birth 79 — - - - - - - - - - - - 79 - 4 9 4 15 18 12 17 40 39 79 Injury at Birth 5 - - - - - - - - - - - - 5 - 1 1 - 2 1 - - 4 1 5 Debility at Birth 3 — — - — - - - - - - - - 3 - 1 - - 1 1 - - 1 2 3 Atelectasis 11 — — — — - - - - - - - - 11 - - - - 2 2 3 4 6 5 11 Congenital Defects 34 3 - - - - - - - - - - - 37 - 3 3 6 4 6 11 4 19 18 37 Want of Breast Milk — — — — - - - - - - - - - - - - - - - - - - - - - Atrophy, Debility, Marasmus 28 - - - - - - - - - - - - 28 — 1 5 6 5 5 3 3 21 7 28 a Cerebro-Spinal Fever (3). * Paratyphoid. 67 [1925 Continued. Dettth in in Institutions Within Borough DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 05- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.E. Dentition 2 1 - - - - - - - - - - - 3 - - 1 - - 1 - 1 2 1 3 Rickets — 2 — — — — — — — — — — — 2 - - - - - - 2 - 1 1 2 Old Age, Senile Decay — — — — — — — — — 2 42 152 70 — 272 40 30 20 24 61 32 59 109 103 272 Convulsions 4 2 - - - - - - - - - 1 - 6 1 1 - - - 1 l 4 3 4 7 Meningitis 3 6 2 - — — 1 — — — — — — 9 3 - 1 2 - 4 3 2 5 7 12 Encephalitis — 1 - — — — 1 — — 1 — 1 — 1 3 1 - - - - 1 2 1 3 4 Apoplexy 2 — - — 1 — 2 3 6 26 53 43 10 2 144 21 24 14 14 23 19 31 65 81 146 Softening of Brain - — — — — - - - 1 2 1 2 1 — 7 - - - 2 3 1 1 1 6 7 Hemiplegia — 1 - - - - - - - 4 1 4 — 1 9 2 2 1 1 1 2 1 5 5 10 General Paralysis of Insane - - - - 1 1 2 2 6 4 - - - - 16 3 2 1 1 3 3 3 13 3 16 Other forms of Insanity — — — — — — 2 2 1 2 1 — 1 — 9 2 2 - 1 3 - 1 - 2 9 Chorea — — — — — — — — — — — — — - - - - - - - - - - - - Cerebral Tumour — 1 — 1 — 1 2 3 1 7 1 — — 1 16 2 1 1 4 3 3 3 13 4 17 Epilepsy — — — — 1 1 1 3 1 2 4 1 1 — 15 - 2 1 3 2 3 4 7 8 15 Laryngismus Stridulus — 1 — — — — — — — — — — — 1 - - - - - - 1 - 1 - 1 Locomotor Ataxy — — — — — — — — 3 4 5 1 — - 13 1 1 4 - 1 4 2 11 2 13 Paraplegia — — — — 1 — — — 2 5 5 2 — — 15 3 - - 3 3 1 5 8 7 15 Other Forms, Brain Diseases - 1 3b 1 - - lb 4b 2 3 3 1b - 1 18 1 2 - 3 7 4 2 10 9 19 Otitis — 2 — 1 — 2 — 2 — 1 — — — 2 6 - - - 1 3 3 1 3 5 8 Disease of Nose, Epistaxis - - - - - - - - - - - - - - - - - - - - - - - - - Disease of the Eye - - - 1 - - - - - - - 1 - - 2 1 - - - - - 1 1 1 2 2 Pericarditis — — - — 2 1 — — — — — — — - 3 - - 2 - - - 1 2 1 3 2 Endocarditis — 1 — — 2 — 2 — 6 1 1 — 1 1 13 1 1 - - - 3 9 5 9 14 Hypertrophy of Heart — - — — — — — — — — — — - - - - - - - - - - - - - Angina Pectoris — — — — — - — — 1 2 5 2 — — 10 2 1 - - 2 - 5 8 2 10 4 Aneurism - - - - - - 1 — 3 3 2 2 1 — 12 1 3 - 2 4 1 1 5 7 12 5 Senile Gangrene - - - - - - - - - - 6 3 2 — 11 - 1 1 1 2 3 3 5 6 11 28 Embolism, Thrombosis - - - - - - 3 3 6 12 20 11 : — 57 9 6 1 11 10 8 12 24 33 57 2 Phlebitis — — - — — — — — 2 1 2 — — - 5 1 - - 2 2 - - 3 2 5 Varicose Veins — — — — — — — 1 — — — — - - 1 - - - - l - - 1 - 1 157 Other Diseases, Heart and Vessels 1 1 1 5 7 6 17 30 73 123 194 132 37 2 625 62 73 50 64 130 89 159 299 328 627 1 Laryngitis — 1 — — — — — — — — — — — 1 — - - - - - - 1 1 - 1 Croup — 1 — — — — — — — — — — — 1 - 1 - - - - - - 1 - 1 Other Diseases, Laryn and Trachea - - - - - - - - — - - - - - - - - - - - - - - - - 13 Acute Bronchitis 6 7 — — — 1 — 3 5 11 23 21 3 13 67 6 8 4 10 18 15 1 29 51 80 59 Chronic Bronchitis 11 1 — — — - 1 4 11 50 80 65 17 12 228 12 21 17 29 44 50 67 18 122 240 24 Lobar Pneumonia 2 5 1 1 1 1 10 14 17 16 21 7 1 7 90 11 12 10 9 14 15 26 58 39 97 105 Lobular Pneumonia 68 47 6 1 2 1 2 5 20 22 30 29 6 115 124 21 17 25 38 35 44 59 127 112 239 6 Pneumonia 7 5 3 — 1 — 1 3 5 7 9 2 — 12 31 3 3 5 5 7 12 8 25 18 43 3 Emphysema Asthma — — — — — — — 2 3 8 5 — — - 18 - 1 4 2 5 1 5 14 4 18 1 Pleurisy — — — — — 1 3 1 2 1 3 1 — - 12 2 1 1 3 - 5 7 5 12 8 Other Diseases, Respiratory System 2 - - - 1 1 3 5 4 3 6 - - 2 23 1 5 - 6 4 4 5 19 6 25 Diseases of Mouth and Anenxa - - - - 1 1 - - 1 - - - - - 3 - 1 - - 1 1 - 3 - 3 Diseases of Pharynx - - - - - - - - - - - - - - - - - - - - - - - - - Diseases of (Esophagus - - - - - - - - - 1 - - - - 1 - - - - 1 - - 1 - 1 2 Ulcer of Stomach and Duodenum - - - - - 1 4 11 10 6 5 1 - - 38 4 5 4 3 6 4 12 30 8 38 Other Diseases of the Stomach 3 - - - - - - - 1 - 1 - 2 3 4 - 1 - 2 1 - 3 2 5 7 23 Enteritis 47 9 — 2 — — 1 — — — 2 — — 50 5 5 5 6 10 5 18 12 39 22 61 6 Appendictis — — 1 4 4 3 1 4 1 6 1 1 1 — 27 4 6 3 3 5 3 3 16 11 27 1 Obstruction of Intestines 6 3 - 1 1 - 2 4 4 7 6 8 1 9 34 8 3 4 12 5 4 7 24 19 43 Other Diseases of Intestines - - - - - - - 1 - - 2 1 - - 4 1 - 1 1 - 1 - 2 2 4 4 Cirrhosis of Liver — — — 1 — — 1 1 3 5 2 2 - - 15 5 1 1 - 2 2 4 10 5 15 Other Diseases if Liver 1 — — — — 1 — 1 — 5 1 - - 1 8 1 - 1 2 2 2 1 2 7 9 1 Peritonitis 1 — 1 1 — 1 2 - 1 — 3 - - 1 9 1 2 - 1 1 1 4 2 8 10 Other Diseases, Digestive System - - - - - - - 1 1 2 - - - - 4 1 1 1 - l - - - 4 4 Diseases, Lymphatic System and Glands 1 1 - - - - 1 2 1 1 - - - 2 5 - 1 1 1 2 1 1 4 3 7 Acute Nephritis 1 — — — — — — — — — — — - 1 - - - - - 1 - - - 1 1 22 Bright's Disease — — — 1 1 3 4 9 9 17 19 15 1 - 79 8 7 6 10 17 14 17 30 43 79 Calculus — — — — — — 1 1 1 1 - - 1 - 5 1 1 1 1 - - 1 1 4 5 1 Diseases of Bladder and Prostate - - - - - - 1 - 5 8 10 13 2 - 39 6 3 4 3 9 4 10 34 5 39 Other Diseases, Urinary System - - - - - 1 - 1 5 2 4 3 1 - 18 3 5 1 2 3 2 2 9 9 18 Diseases of Testis and Penis - - - - - - - - - - - - - - - - - - - - - - - - - 1 Diseases of Ovaries - - - - - 1 - - 1 1 3 - - - 6 1 1 2 - 1 - 1 - 6 6 Diseases of Uterus and Appendages - - - - - - 1 2 1 - - - - - 4 - - - - 1 - 3 - 4 4 Diseases of Vagina and _ External Genitals - - - - - - - - - - - - - - - - - - - - - - - - - Diseases of Breast - - - - - - - - - - - - - - - - - - - - - - - - - 1 Abortion, Miscarriage - - - - - - 1 - - - - - - - 1 - - 1 - - - - - 1 1 Puerperal Mania - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Convulsions - - - - - 2 1 - - - - - - - 3 2 - 1 - - - - - 3 3 Piaccuta Previa, Flooding — - — — - - 1 1 — — — — — — 2 - - - 1 1 - - - 2 2 b Encephalitis Lethargica (6). 1925] 68 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- G5- 75- 85- Tuf. U.H. Toll. L.H H. B. S.E. Puerperal Thrombosis - - - - - - - - - - - - - - - - - - - - - - - - - 3 Other Diseases, Pregnancy and Childbirth - - - - - 1 2 1 - — — — — — 4 1 — 1 — — 2 — — 4 4 Arthritis, Ostitis, Periostitis - - - - - - - - - - - - - - - - - - - - - - - - - Other Diseases, Osseous System - - 2 - 2 3 1 — — 1 1 — - — 10 1 — 3 — 1 2 3 5 5 10 Ulcer, Bedsore 1 — - — — — — — — — — 1 — 1 1 - - - 2 - - - - 2 2 Eczema - - - - - - - - - - - - - - - - - - - - - - - - - Pemphigus 1 — — — — — — — - 1 — — — 1 1 — - - 1 1 - - - 2 2 Other Diseases, Integumentary System 2 - - - - - 2 - - - 2 - - 2 4 1 — 1 — 1 — 3 3 3 6 Accidents and Negligence. In Mines and Quarries — — — — — - - - - - - - — - - - - - - - - - - - - 15 In Vehicular Traffic — 6 6 3 3 1 3 5 6 10 5 6 2 6 50 1 5 4 14 11 7 14 37 19 56 On Railways — — — — — — 1 - 1 i — - — — 3 — 1 — 2 - - - 2 1 3 On Ships, Boats, etc. (not drowning) - - - - - - - - - - - - - - - - - - - - - - - - - 1 In Building Operation — — — — 1 — - - - 1 1 - — - 3 - 1 - 1 - 1 - 3 - 3 By Machinery - - - - - - - - - - - - - - - - - - - - - - - - - By Weapons and Implements - - - - - - - 1 1 - - - - - 2 - - - - - - 2 2 — 2 5 Burns and Scalds 1 3 — — — — — — 1 — 1 — — 4 2 1 - 1 - - 1 1 3 3 6 1 3 Poisons, Poisonous Vapours — 1 — — — — — 1 1 1 — 2 — 1 5 — 2 - 1 - 2 1 6 - 6 Surgical Narcosis — 2 — — - - - 1 - 2 - - — 2 3 1 - 2 1 - - 1 2 3 5 Effects of Electric Shock - - - - - - - - - 1 - - - - 1 - - - - - 1 - 1 - 1 Corrosions by Chemicals - - - - - - - - - - - - - - - - - - - - - - - - - Drowning - - - 1 - - - - - - 1 - - - 2 - - - - 1 - 1 2 - 2 Suffocation, Overlaid in Bed 2 - - - - - - - - - — - - 2 — — 1 - — - 1 - — 2 2 1 Suffocation, Otherwise 4 2 — — — — 1 — — - — 1 — 6 2 1 1 - 1 2 2 1 3 5 8 9 Falls, not specified — 1 — — — — 1 1 4 3 8 3 2 1 22 — 1 4 4 5 3 6 8 15 23 Weather Agencies — — — — — — - — — — — — — — — - — — - - - - - - - 1 Otherwise, nut stated — 1 — 1 — 1 1 1 — — 1 — — 1 2 — — — - 4 1 1 5 1 6 Homicide Suicide. 1 - - - - 1 - - - 1 - - - 1 2 - - - - 2 - 1 1 2 3 3 By Poison - - - - - - 2 2 5 4 5 4 - - 22 2 1 - 3 4 6 6 11 11 22 By Asphyxia — — — — — — — — — - — - — — — — — - - - — — — - - By Hanging and Strangulation - - - - - - - 1 1 1 1 — — — 5 - — 1 1 - 2 1 3 2 5 By Drowning — - — - - - 2 - - - 1 - - - 3 2 - - - 1 - - 2 1 3 By Shooting - - - - - - - - - - - - - - - - - - - - - - - - - 2 By Cut or Stab — — — — — — - - 2 1 — — — — 3 - 1 1 1 - - - 3 - 3 2 By Precipitation from Elevated Places - - - - - - - 1 1 1 1 — - — 4 — — — — 2 - 2 2 2 4 By Crushing — — — — — 1 — — 1 1 2 - — — 5 2 — — 1 1 — 1 4 1 5 By other and unspecified methods - - - - - - - - - - - - - - - - - - - - - - - - - Execution - - - - 1 - - - - - - - - - 1 - - - 1 - - - 1 - 1 Sudden Death, cause not ascertained - - - - - - - - - - - - - - - - - - - - - - - - - Ill-defined and unspecified causes - - - - - - - - - 1 - - - - 1 - - - - 1 - - 1 — l Males 231 107 34 22 43 52 100 160 253 377 410 281 57 338 1789 207 216 172 260 392 355 525 — - 2127 Females 183 105 21 21 33 54 98 119 210 294 408 362 125 288 1745 209 225 190 238 390 319 462 — — 2033 912 TOTAL DEATHS 414 212 55 43 76 105 198 279 463 671 818 643 182 626 3534 416 441 362 498 782 674 987 2127 2033 4160 69 [1925 Metropolitan Borough of Islington. CAUSES OF, AND AGES AT DEATH DURING THE CALENDAR YEAR 1925. Causes of Death. Nett Deaths at the subjoined Ages of "Resident" whether occurring within or without the District. All ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 yrs. 15 and under 25 yrs. 25 and under 45 yrs. 45 and under 65 yrs. 65 and upwards Total Deaths whhether of dents" or " NonResidents " in istitutions in the District 1 2 3 4 5 6 7 8 9 10 11 All Causes Certified 4127 412 116 95 97 181 470 1122 1634 - Uncertified 1 - — - - - — — 1 — Enteric Fever 4 - - - 1 - - 2 1 - Small Pox - - — - — — — — — — Measles 22 4 13 4 1 — — — — 7 Scarlet Fever 8 2 2 1 3 — — — — 1 Whooping Cough 61 24 16 19 2 — — — — 14 Diphtheria and Croup 21 - 5 7 9 — — — — 3 Influenza 71 4 1 1 2 2 4 21 36 20 Erysipelas 10 3 1 — - 1 1 1 3 5 Phthisis (Pulmonary Tuberculosis) 371 5 2 2 7 82 143 119 11 224 Tuberculous Meningitis 27 7 2 10 4 2 1 1 — 15 Other Tuberculous Diseases 27 - - 2 4 3 7 7 4 17 Cancer, malignant disease 530 — 1 — 2 3 43 260 221 284 Rheumatic Fever 11 — - — 3 — 3 2 3 1 Meningitis 13 5 2 5 1 - — — — 2 Organic Heart Disease 649 1 - 3 4 15 56 218 352 263 Bronchitis 325 17 6 2 - 1 9 79 211 137 Pneumonia (all forms) 379 77 39 18 13 6 33 90 103 167 Other diseases of respiratory organs 55 1 1 - - 3 15 20 15 16 Diarrhoea and Enteritis 76 61 8 2 2 — 1 — 2 35 Appendicitis and Typhlitis 26 - — — 4 7 5 6 4 12 Cirrhosis of Liver 15 — — — 1 1 2 7 4 7 Alcoholism 3 - - - - - 2 — 1 — Nephritis and Bright's Disease 80 1 - - 1 4 14 26 34 34 Puerperal Fever 7 - - - - - 7 — — 3 Other accidents and diseases of Pregnancy and Parturition 10 - - - - 3 7 - - 6 Congenital Debility and Malformation, including Premature Birth 148 145 3 - - - - - - 18 Violent Deaths, excluding Suicide 127 8 6 11 10 8 16 35 33 61 Suicide 39 — - - — 3 10 17 9 12 Other Defined Diseases 1013 47 8 8 †23 37 †91 211 588 215 Diseases Ill-defined or unknown — — — — — — — — — — Totals 4128 412 116 95 97 181 470 1122 1635 1579 Sub-Entries.—Included in above figures: *Cerebro-spinal Meningitis 2 2 — — — - — — — 1 †Encephalitis Lethargica 5 — — — 1 — 3 — 1 — ‡Paratyphoid 1 - - - - - - - 1 - 1925] 70 Showing Birth-Rates, Death-Rates, and Analysis of Mortality of Islington during the Five Calendar Years 1920-1924, and the rates for the year 1925. RATE PER THOUSAND POPULATION. Years 1920 1921* 1922 1923 1924 Mean 5 years 1925 Difference Estimated Popuation 335,907 333,000 333,900 336,000 337,400 334,761 339,200 +4,439 Total Births 28.2 23.5 22.6 21.1 19.9 23.1 19.3 —3.8 Total Deaths 13.3 130 13.7 11.5 12.2 12.7 12.3 —0.4 Deaths from— Enteric Fever 0.00 0.00 - — 0.01 0.00 0.01 +0.01 Small Pox — — — — — — — — Measles 0.28 0.08 0.39 0.05 0.30 0.22 0.06 —0.16 Scarlet Fever 0.04 0.06 0.09 0.04 0.03 0.05 002 —0.03 Whooping Cough 0.21 0.13 0.29 0.11 0.17 0.18 0.20 +0.02 Diphtheria 0.40 0.33 0.18 0.07 0.09 0.22 0.06 —0.16 All the above Diseases 0.93 0.60 0.95 0.27 0.60 0.67 0.35 —0.32 Deaths from— Influenza 0.35 0.28 0.64 0.17 0.31 0.35 0.21 —0.14 Tuberculosis (All Forms) 1.27 1.21 1.24 1.12 1.14 1.20 1.29 +0.09 Pulmonary 1.04 1.05 1.08 0.97 0.97 1.03 1.13 +0.10 Non.Pulmonary 0.23 0.16 0.16 0.15 0.17 0.17 0.16 —0.01 Cancer 1.19 1.42 1.25 1.40 1.36 1.33 1.57 +0.24 Dis. of the Respiratory System 2.44 2.14 2.72 1.76 2.29 2.28 2.23 —0.05 Dis. of the Circulatory System 1.30 1.55 1.79 1.89 1.93 1.70 2.18 +0.48 Violence 0.53 0.40 0.42 0.42 0.44 0.44 0.49 +0.05 RATE PER THOUSAND BIRTHS. Deaths of infants under 1 year 72 81 77 67 65 73 63 —10 Deaths from Diarrhoea and Enteritis (under 2 years). 7.49 19.58 9.40 14.47 7.31 11.51 10.54 —0.97 * Census Year. Showing Sickness Rates per 1,000 Population of Infectious Diseases Notified during the Five years 1920.24; and in 1925, also Deaths in same periods. 1920 1921 1922 1923 1924 Mean 5 yrs. 1925 Difference. Mean Deaths 1920-24 Deaths 1925 Enteric Fever 0.07 0.03 0.03 0.05 0.04 0.04 0 03 -0.01 1 4 Small Pox — — — — — — — — — — Scarlet Fever 3.89 7.87 4.48 3.21 3.13 4.53 3.36 —1.17 8 8 Diphtheria 3.95 4.67 3.38 2.64 2.48 3.44 2.69 —0.75 36 21 Erysipelas 0.49 0.38 0.39 0.26 0.34 0.37 0.32 —0. 05 4 10 Acute Enceph. Lethargica 0.02 0.03 0.01 0.03 0.12 0.05 0.04 —0.01 2 6 ,, Polio.myelitis 0.02 0.01 — 0.00 0.02 0.01 000 —0.01 0.8 — ,, Polioencephalitis — — — 0.00 0.00 0.00 — — — — Cerebro Spinal Fever 0.04 0.02 0.01 0.02 0.02 0.02 0.01 —0.01 3 3 Ophthalmia Neonatorum 0.42 0.40 0.38 0.20 0.23 0.33 0.27 —0.06 0.4 — Acute Primary Pneumonia 0.10 0.14 0.23 0.36 0.35 0.24 0.27 +0.03 — — „ Influenzal Pneumonia 0.07 0.07 0.20 0.17 0.19 0.14 0.12 —0.02 — — Malaria 0.05 0.02 0.00 0.00 0.00 0.02 — —0.02 0.4 — Dysentery 0.01 — 0.00 0.01 — 0.00 — — — — Rate Per 1,000 Births. Puerperal Fever 3.08 4.31 1 2.68 3.10 3.05 3.23 3.50 +0.27 4 7 71 [1925 LONDON COUNTY COUNCIL RETURN. Borough of Islington. PROCEEDINGS DURING 1925. Premises. Number of Places. Number of Inspections 1925 Number of Notices 1925 Number of Prosecutions 1925 On Register at end of 1924 Added in 1925 Removed in 1925 On Register at end of 1925 Milk Premises 574 14 20 568 1,262 182 Nil Cowsheds 4 — — 4 31 Nil ,, Slaughter-Houses 14 — 1 13 730 ,, ,, Other Offensive Trade Premises 17 - - *17 48 ,, ,, Ice Cream Premises 238 — — 238 223 17 4 Registered Houses Let in Lodgings 1,012 - 1 1,011 2,371 394 Nil * Including 8 Fur Skin Dressers and 1 Fat Melter. Total number of intimation notices served for all purposes 4,371 Insanitary houses— Number closed under the Public Health (London) Act, 1891 Nil Number of premises cleansed under Section 20 of the L.C.C. (General Powers) Act, 1904 68 Housing of the Working Clauses— Number of houses inspected 1,684 Number of representations by householders Nil Number of representations by Medical Officer Nil Number of houses included in such representations Nil Number of houses remedied without Closing Orders Nil Number of Demolition Orders Nil Number of houses dealt with under Section 15 of the Housing-, Town Planning-, etc., Act, 1909 Nil Number of Closing- Orders Nil Number of houses included in such Closing Orders Nil Number of Closing Orders determined Nil Number of houses demolished—(a) in pursuance of Orders Nil (b) voluntarily Nil Obstructive buildings— Number of representations under Section 38 of the Housing Act, 1890 Nil Number of representations still under consideration Nil Number of buildings demolished Nil Number of houses repaired under Section 3 of the Housing Act, 1925 Nil Number of houses repaired by local authorities Nil Number of houses closed on notice by owner that they could not be made fit Nil Total number of houses in the Borough about 45,000 Number of houses for the working classes— (a) Erected during year (Flats) Nil (b) In course of erection (Flats) Nil Number of houses occupied by the working classes about 28,000 1925] 72 Smoke nuisances— Number of observations 114 Number of warnings (letters sent) 18 Number of notices 17 Number of nuisances and complaints 51 Number of summonses Nil Underground Rooms— Number illegally occupied 4 Number closed or illegal occupation discontinued 4 Overcrowding— Number of rooms overcrowded 19 Number remedied 10 Prosecutions Nil Cleansing— Number of adults cleansed 20 Number of children cleansed 4,841 Cleansing— Number of rooms or premises cleansed 3,835 Water supply to tenement houses— Premises supplied 50 Prosecutions Nil Sale of Food— Number of premises used other than ice cream premises, milk shops and cowsheds 662 Number of inspections 19,826 Ophthalmia neonatorum regulations— Number of Notifications received during the year from certified mid- wives 14 Sanitary officers— Number of Sanitary Inspectors (Whole time) Male, 18 Female 2 ,, ,, (Part time) Male, Nil Female Nil Chief Sanitary Inspector (Whole time) 1 Number of Health Visitors Whole time, 7 Part time Nil ,, Tuberculosis Visiting Nurses (Whole time) 1 Disinfection Shelter provided under Sec. 60 (4) of the Public Health (Lpndon) Act, 1891— Number of persons accommodated during the year 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 73 [1925 (e) In connection with the removal of offensive matter, etc. 12 (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 (fe) 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-— (I) With respect to water supply to tenement houses Nil Mortuaries— Total number of bodies removed 275 Total number of infectious bodies removed Nil 75 INDEX Page Accidental Deaths 26 Acreage 5, 6 Adulteration of Food 59 63 Ages at Death 10 Area 5-6 Bacteriological Examinations 37 Births 6 „ Illegitimate 7 „ Notification of 8 „ Stillborn 8 Cancer 23 Chicken Pox 37 Cleansing of Verminous School Children 40 Coal gas Poisoning 25 Colouring matter in Milk 61 Consumption (see Tuberculosis) 23,32, 38 Cow Sheds 55 Deaths from all causes during the year 8, 66 Deaths from Epidemic Diseases 20 „ „ Respiratory Diseases 25 „ in Public Institutions 20 „ from Classified Causes 9 Density 5,6 Diphtheria 27, 38 Diseases Treated in Hospital 28 Disinfectants distributed and used 40 Disinfecting Station 39 Disinfection Work 33, 39 District Inspectors' Work 45-47 Dogs, Nuisances by 52 Drugs 62 Dust, removal of 45 Dysentery 31 Education Propaganda 17-19 Eggs, labelling of 54 Encephalitis Lethargica 32 Enteric Fever (Typhoid) 28, 38 Epidemic Diseases 20 „ Cerebro-Spinal Meningitis 31 Erysipelas 23, 28 Factories and Workshops Administration 41 Fatality from Notifiable Infectious Diseases 28 Food, Adulteration of, Inspection of, Unsound 53-59 Food Order 54 Gas (Coal) Poisoning 25 George's Road and Brand Street Improvement Scheme 50 Health of Islington—Past and Present 2 Health Visitation 15 76 Page Health and Baby Week 17 Hospital Isolation of Infectious Diseases 28 Housing 49, 50, 71 Houses Let in Lodgings 48, 71 Ice Cream 71 Infantile Mortality 10, 12 Infant Welfare Work 15 Infection, Prevention of 27 Infectious Diseases in Schools 37 „ „ (Non-Notifiable) in Schools 37 Influenza 22 Inspection of Food 53 „ „ Houses 45-49 „ „ Kitchens of Restaurants 41, 54 ,, Slaughter Houses and Cow Houses 53, 54 ,, „ Workshops 41 Institutions 20 Increase of Rent (Rescrictions) Acts 51 Inquests 26 Isolation of Infectious Diseases 28 Licensed Premises 53 London County Council Return of Sanitary Work 71 Malaria 31 Malignant Diseases 23 Marriages 6 Maternity and Child Welfare Committee ii Maternity and Child Welfare Work 12, 13, 15, 16 Measles, Notifications by School Teachers 37 Meat Inspection 53 Meat Regulations, 1924 55 Meat, labelling of 54 Ministry of Health Returns 12, 69, 70 Milk Scheme 14 „ Adulteration 60 „ Shops and Dairies 56, 71 „ and Cream Regulations 58 Mortuary and Coroner's Court 26 Notification of Infectious Diseases 27 „ „ Tuberculosis 32 „ ,, Births Act 8 Non notifiable Infectious Diseases in Schools 37 Nuisances by Dogs 52 Offensive Trades 55, 71 Ophthalmia Neonatorum 12 Outworkers' Premises 43 Other Notifiable Diseases 30 Pauperism 52 Pathogenicity Tests (Diphtheria) 38 Phthisis 23, 32, 38 ,, Notification of 32 Places where Food is Prepared 41 Pneumonia 25,31 Pneumothorax treatment 35 Population at the Census, 1921 5, 6 „ estimated, 1925 5, 6 Preservatives 62 Prevention of Infection 27 Prosecutions, Summary of 63 77 Page Public Health Committee ii „ „ Milk and Cream Regulations 58 „ Staff 63 Puerperal Diseases 13, 23 Polio-Myelitis, Acute 31 Pulmonary Tuberculosis 23, 32, 3S Rabies 51 Rats and Mice (Destruction) Act, 1919 48 Rateable Value iii Rent and Mortgage Interest (Restrictions) Acts 51 Respiratory Diseases 25 „ Tuberculosis 23,32,38 Restaurant Kitchens 41, 54 Samples Analysed in 1925 62 Sanitary Inspectors' Work 45 Schools 37 Septic Diseases 23 Shelter House 40 Slaughterhouses 53 Smoke Nuisances 45 Sophistication of Milk 60 Statistics 65 Street Accidents 26 Typhoid Fever (see Enteric) 28, 38 Tuberculous Diseases 23, 32, 38 Treatment of Tuberculosis—Procedure 35 Tuberculosis Dispensaries 35 „ Notification of 32 Deaths from 23 „ (Public Health) Regulations, 1912 34 „ ,, Regulations, 1924 34 Unsound Food 53 Vaccination 38 Venereal Diseases 25 Verminous Children, Disinfestation of 40 „ Premises 45 Voluntary Maternity and Child Welfare Centres 16, 17, 18 Workshops and Factories, Inspection of 41 Welfare Work by Health Visitors 12, 13, 15,16