AC 4361 1SL 69 1929 SEVENTY-FOURTH 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. London: Vail & Co., Printers, 170, Farringdon Road, E.C. 1. 1929 SEVENTY-FOURTH 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 HEIALTH. London": Vail & Co., Printers, 170, Farringdon Road, E.C. 1. ii MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1929, to November, 1930.) Mayor. Alderman WILLIAM EDWIN MANCHESTER, J.P. A ldermen. HERBERT SAMUEL JORDAN FRANK LEYDEN SARGENT WALTER FREDERICK NOKES EDWARD HENRY TOMKINS, J.P. Councillors. WILLIAM AWCOCK, J.P. WALTER HARPER WALTER BLOUNT ARTHUR JAS. KENT JOHN BRUCE WILLIAM J. MITCHELL CHAKLES BUNDOCK HENRY PENN MIRIAM P. COLEMAN WILLIAM T. RICKETTS FREDERICK C. COOKSEY EDWARD A. WILLIS WILLIAM H. GALE Chairman Aldekman JORDAN Vice Chairman Councillor BUNDOCK MEMBERS OF THE MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1929, to November, 1930.) Aldermen. GEORGE HENRY BULL ALBERT EDWARD PETTET Councillors. JESSIE L. BLYTHE WILLIAM H. GALE CHARLES BUNDOCK ALBERT H. JACKSON WILLIAM H. BURGESS Mrs. MAUD MANCHESTER FLORENCE CLARKE WILLIAM J. MITCHELL MIRIAM P. COLEMAN WM. P. H. SPR1NZ FREDERICK M. COLLIS BLODWEN I. STEVENSON ROSA ESSEX MARGARET SUMMERS Members appointed by the Council from outside their own body. Lady ANDREWS, "Windy Gap," Merton Lane, Highgate, N.6 Dr. ALICE VANCE KNOX, 15, South Grove, Highgate, N.6 Dr. ELEANOR PULLEINE, 5, Hamilton Terrace, N.W. 8. Mrs. WATT, 60, Highbury New Park, N.5 Chairman Councillor SPRINZ Vice-Chairman : Councillor Mrs. M. A MANCHESTER iii SUMMARY of Vital Statistics in the Registration Year 1929. Population (Enumerated at Census, 1921) 330,737 persons ,, Estimated Mid Year 1929 319,800 persons Decrease on Census population, 1921 10,937 persons Mean Population, ten years (1919-1928) 333,724 persons Area 3,092 acres Density (Mid-year 1929) 103 persons per acre Births Males 2,778 J persons 5,509 Females 2,781 Birth rate 17 2 per 1,000 inhabitants Deaths from All Causes Males 2 414 persons 4,748 Females 2,334 Death rate 14.8 per 1,000 inhabitants Deaths from Principal Epidemic Diseases Males 98 | 194 persons Females 96 Death rate 0.78 per 1,000 inhabitants Deaths from All Tuberculosis Males 208 345 persons Females 137 Death rate 1.08 per 1,000 inhabitants Deaths from Respiratory Tuberculosis Males 192 314 persons Females 122 Death rate 0.98 per 1,000 inhabitants Infantile Deaths under 1 year Males 227 Total 403 Females 176 Infantile mortality rate 73 per 1,000 births Excess of Births over Deaths 761 Rateable value of Borough of Islington £2,018,406 Sum represented by a penny rate £8,870 iv Public Health Department, Municipal Buildings, Upper Street, N.l. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the report on the Health and Sanitary Condition of the Borough for the year 1929. The death-rate for 1929 was 14.8 per 1,000 inhabitants, as against 12.8 the previous year. The Infantile Mortality Rate was 73. The rate in the previous year, 1928, was 64. The rise in the rates is due to the epidemic prevalence of Influenza and Whooping Cough, also an increase in the respiratory diseases. Influenza deaths numbered 207, as against 41 in the previous year; Whooping Cough numbered 126 as against 21 in the previous year; and deaths from respiratory diseases were double those of the previous year. The rise due to these causes was not confined to Islington but was fairly general. Of particular interest, I would refer to the number of cases of Smallpox. The disease was of the mild type, but this is a disease which, as I have stated before, is apt to linger owing to the large proportion of the population not vaccinated or revaccinated. This year also the work of the Voluntary Centres is reviewed up to the 31st March, 1930. With these associations coming under the provisions of the Local Government Act, 1929, our reports in future will end with the calendar year. In the work of the Centres as reviewed, their statistics were adversely affected, as ours; that is, the death-rate was raised by the epidemic outbreaks. I feel that it is most appropriate here to refer to the sad losses the Council and the department have sustained during the year by the passing of valued officers. First in February our esteemed Town Clerk, Mr. C. G. E. Fletcher, whose work and personal attributes marked him out among his colleagues ; then in August, Mr. H. J. Bicknell, one of our old and esteemed Sanitary Inspectors. In December no less than three deaths occurred, Mr. G. H. King, the Chief Clerk of the Public Health Department, an outstanding man in his particular work, after forty-seven years in the department; Mr. A. E. Pinchin, the Public Analyst, and Mr. W. Woodley, one of our disinfecting staff. All these changes in one year have affected the department seriously. 1 have to thank the Superintendent and members of my staff, and the Chiefs of other departments, for their hearty co-operation during the year, and not least the Charman and members of the Council and Committees for the help and interest in the work. Your obedient servant, Eglarstiotles Medical Officer of Health REPORT OF THE Medical Officer of Health FOR THE YEAR 1929. 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. Diseases, Infectious, etc., pages 30-38. Occurrence of Smallpox, pages 30—32. Whooping Cough, pages iv, 24, 48. 2. Prevalence of Influenza, pages 24—25. Tuberculosis, pages 26—27, 38—44, Venereal Diseases, page 28. 3. Provision of Medicines, etc.—Insulin, page 37. Diphtheria Antitoxin, page 32. 4. Meat, Food and Drugs.—(a) Unsound food prosecution, page 68. (b) Labelling of Meat, pages 69—70. (c) "Cream Cakes and Pastries, pages 73—74. (d) Restaurant Kitchens, page 69. (e) Unsatisfactory Churns, page 74. (f) Mercurial poisoning, page 68. 5. Workshops, etc., pages 52—55. Housing, pages 61—67, 6. Sewer Emanations, pages 60—61. Scavenging, pages 55 -56, 7. Health Visitation and work of Voluntary Centres, Artificial Sunlight , etc., pages 18—22. Maternal Mortality, pages 10 - 12. 8. Legal Proceedings, pages 85—89 9. Index to Report, pages 93—96. 1929] 2 POPULATION. The number of the population at mid-year 1929, is estimated at 319,800 persons. There was, therefore, a decrease in the population of 10,937, when compared with the number of inhabitants ascertained at the census in 1921. The following tables give the distribution of the population in the several sub-registration districts and wards, together with particulars of their areas and densities. Showing the Areas, Densities and Estimated Populations of the Subregistration Districts at the Middle of year 1929, also the Populations at the Census 1921. Sub-Districts. Area. Acres. Estimated Persons to an Acre. 1929. Estimated Population Mid-year 1929. Enumerated Population at Census 1921. Tufnell 411 79 32,352 33,750 Upper Holloway 299 101 30,340 35,721 Tollington 315 94 29,606 30,832 Lower Holloway 406 98 39,727 40,139 Highbury 749 78 58,174 58,850 Barnsbury 316 167 52,785 53,859 South East Islington 596 129 76,816 77,586 The Borough 3,092 103 319,800 330,737 Showing the Areas Densities and Estimated Populations of the Wards at the Middle of the year 1929, also the Populations at the Census 1921. WARDS. Area in Acres. Estimated Persons to an Acre or Density of Population. Estimated Population Mid-year, 1929. Enumerated Population Census, 1921 No. 1—Tufnell 411 79 32,352 33,750 2—Upper Holloway 299 101 30,340 35,721 3—Tollington 315 94 29,606 30,832 4—Lower Holloway 406 98 39,727 40,139 5—Highbury 417 73 30,581 33,417 6—Mildmav 332 83 27,593 25,433 7—Thornhill 178 163 28,980 31,301 8—Barnsbury 138 172 23,805 22,558 9—St. Mary's 150 116 17,462 17,363 10—Canonbury 290 106 30,844 29,997 11—St. Peter's 156 183 28,510 30,226 The Borough 3,092 103 319,800 330,737 Showing the Estimated Number of Persons living in Islington at the Mid-year 1929, at Nine Age Periods, and distinguishing Males and Females. Ages. Males. Females. Persons. 0—5 14,067 13,733 27,800 5—15 29,420 28,780 58,200 15—25 24,625 30,075 54,700 25—35 23,670 28,780 52,450 35—45 20,470 24,630 45,100 45—55 17,909 19,511 37,420 55—65 11,510 13,110 24,620 65—75 6,077 7,993 14,070 75 and upwards 1,916 3,524 5,440 All ages 149,664 170,136 319,800 3 [1929 MARRIAGES. Marriages, 2,967 ; Marriage Rate, 18.56.—There were 5,934 persons married or 2,967 marriages, in 1929, and the marriage rate, that is to say, the number of persons married per 1,000 of the population was 18.56. Compared with the previous year these figures show an increase of 168 in the number of persons married, or of 84 marriages; and of 0.76 per 1,000 in the rate. The following statement shows the figures for the previous ten years 1929-28. Years. Marriages. Marriage Rate. Years. Marriages. Marriage Rate. 1919 3,306 19.28 1924 2,872 17.03 1920 3,370 20.05 1925 2,788 16.44 1921 3,141 18.86 1926 2,749 16.21 1922 2.877 17.23 1927 2,844 17.01 1923 2,764 16.42 1928 2,883 17.80 BIRTHS. During the year there was 5,509 live births registered, of which 2,778 were boys and 2,731 girls. Of this number, however, 1,101 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 17.2 per 1,000 of the population, as compared with a mean birth-rate of 20.9 in the preceding ten years. It was the lowest birth-rate since the year 1918, when it was 16.2. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1929, 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 1928; together with the mean Borough Birth-rates for the 10 years 1919-1928. Quarter. Males. Females. Total. Birth Rates. Islington, 1929. Islington, 1919-20. London, 1929. 107 Great Towns, 1929. First 696 695 1 391 17.4 21.7 16.5 16.7 Second 726 794 1,520 19.0 21.2 17.2 17.5 Third 721 677 1,398 17.5 20.6 16.4 16.9 Fourth 635 565 1,200 15.0 20.1 15.1 15.5 The Year 1929 2,778 2,731 5,509 17.2 20.9 16.3 16.6 1928 2,945 2,845 5,790 17.8 20.6 16.9 15.9 Increase or decrease — 167 — 114 — 281 — 0.6 + 0.3 — 0.6 + 0.7 N.B.—The total registered births given by the Registrar-General for the Calendar year, 1929. will be found at the foot of table on p. 9. Showing the Births of Males and Females and the Birth-rates in each quarter and for the year, 1929, and in the several Sub-Registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Males. Females 1 Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. 1st Quarter 46 77 123 15.2 87 99 186 24.5 60 42 10° 13.8 88 74 162 16.3 2nd 62 82 144 17.8 103 97 200 26.4 70 67 137 18.5 72 101 173 17.4 3rd 62 62 124 15.3 q9 79 171 22.5 56 51 107 14.4 83 80 163 16.4 4th 64 50 114 14.1 90 85 175 23.1 48 44 92 12.4 76 65 141 14.2 Year 234 271 505 15.6 372 360 732 24.1 234 204 438 14.8 319 320 639 16.1 1929] 4 Showing the Births of Males and Few ales and the Birth-rates in each quarter and for the year 1929, 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 Quarter 119 101 220 15.1 150 133 283 21.4 146 169 315 16.4 696 695 1,391 17.4 2nd „ 140 140 280 ] 9.3 110 141 251 19.0 169 166 335 17.4 726 794 1,520 19.0 3rd 118 111 229 15.7 134 127 261 19.8 176 167 343 17.9 721 677 1,398 17.5 4th 95 87 182 12.5 113 99 212 16.1 149 135 284 14.8 635 565 1,200 15.0 Year 472 439 911 15.6 507 500 1,007 19.1 640 637 1,277 16.6 2,778 2,731 5,509 17.2 Illegitimate Births (207). The illegitimate births numbered 207 and show a decrease of 42 on the return of the year 1928. They were equal to a rate of 3.7 per cent, of the total registered births. Notification of Births Act, 1907. 4.206 live births were notified (exclusive of 96 stillborn), or 76 per cent, of the total number that was registered during the year. Notified by : Doctors. Midwives. Parents and other Persons. Total. Alive. Still bom. Alive. Still born. Alive. Still born. Alive. Still born. 1929. 1st Quarter 194 4 625 14 286 9 1,105 27 2nd 210 5 633 9 277 5 1,120 19 3rd 159 7 615 11 254 9 1,028 20 4th 153 9 558 15 242 6 953 30 Year 716 25 2,431 49 1,059 22 4,206 96† REGISTERED STILL-BIRTHS. Certified by Doctor. Certified by Midwife. By Other Persons. Total. Registered. Per 1,000 of Total Births (including still-born) Period. 1929. 1st Quarter 29 7 4 40 27.9 2nd 20 3 1 24 15.5 3rd 16 3 — 19 13.4 4th 30 5 — 35 28.3 Year 95 18 5 128 21.0 † Of the total number (118) registered still-births, 22 were not notified under the Notification of Births Act, 1907; therefore, the total still-births coming to the knowledge of the Medical Officer of Health during the year was 140 (i.e., 118 + 22) or 24.8 per 1,000 total births (including still-born). 5 [1929 DEATHS. The deaths registered during the year numbered 4,748 (exclusive of stillbirths), while the death-rate was equal to 14.8 per 1,000 of the estimated population, or 2.0 above that of the previous year (12.8), and 2.0 above the mean of the preceding ten years; whilst the death-rate of England and Wales was 13.4 and the 107 Great Towns 13.7. The Deaths and Death-rates from All Causes in the Sub-Registration Districts were as follows:— 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 219 27.1 83 10.3 81 10.0 78 9.6 461 14.25 Upper Holloway 226 29.8 89 11.7 78 10.3 86 11.3 479 15.79 Tollington 200 27 .0 88 11.9 64 8.6 97 13.1 449 15.17 Lower Holloway 256 25.8 111 11.2 96 9.7 103 10.4 566 14.25 Highbury 334 23.0 180 12.4 109 7.5 183 12.6 806 13.85 Barnsbury 395 29.9 143 10.8 135 10.2 161 12.2 834 15 80 Islington (South- East) 503 26.2 233 12.1 191 9.9 226 11.8 1,153 15.01 The Borough 2,133 26.7 927 11.6 754 9.4 934 11.7 4,748 14.85 Showing the Deaths and Death Rates of Islington in 1929, 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 1919-1 £'28, and the deaths and death-rates in the year 1928. Quarter. Males. Females Total. Death Rates. Islington, 1929. Islington, 1919-28. London, 1929. 107 Great Towns. 1929. First 1,061 1,072 2,133 26.7 16.8 24.1 22.7 Second 492 435 927 11.6 11.5 11.4 11.8 Third 388 366 754 9.4 9.6 8.9 9.3 Fourth 473 461 934 11.7 13.3 11.1 11.3 The Year 1929 2,414 2,334 4,748 14.8 12 .8 13.8 13.7 1928 2,076 2,085 4,161 12.8 13.5 11.6 11.6 Increase or Decrease +338 +249 + 587 + 20 - 0.7 + 22 + 2.1 1929] 6 Causes ot Death (Classified).— The following table shows the deaths arranged in classes of Disease from All Causes during the ten years 1919-28 and in 1929. Classified Causes of Death. Years. Mean 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 10 Yrs. 1929 Difference. I. Specific or Febrile Causes 579 552 464 639 273 391 286 285 355 371 419 482 + 63 1. Miasmatic Diseases 466 437 301 546 155 316 191 204 266 258 314 394 + 80 2. Diarrhoeal ,, 36 28 85 29 40 20 15 29 19 25 33 13 — 20 3. Malarial „ 2 2 - - - - - - - - - - - - 4. Zoogenous „ 1 2 1 — — 2 3 - — 3 1 — — 1 5. Venereal „ 13 13 17 17 20 9 8 5 12 19 13 22 + 9 6. Septic „ 61 70 60 47 58 44 69 47 58 66 58 53 — 5 II. Parasitic Diseases 1 1 — 3 1 2 1 1 — 2 1 1 - - III. Dietetic 2 2 4 7 2 3 3 2 4 3 3 5 + 2 IV. Constitutional Diseases 973 918 985 935 945 945 1054 882 878 950 947 907 — 40 V. Developmental 657 556 486 477 377 396 404 467 289 248 436 256 — 180 VI. Local 2177 2172 2203 2362 2106 2290 2211 2255 2415 2363 2255 2887 + 632 1. Diseases of Nervous System 322 341 345 330 294 290 291 307 213 212 294 228 66 2. „ Organs of Special 10 Sense 11 20 13 9 16 14 16 16 11 14 11 — 3 3. ,, Circulatory System 654 592 651 734 745 822 740 802 929 1073 774 1226 + 452 4. „ Respiratory „ 770 822 717 903 598 797 756 709 835 653 756 960 + 204 5. „ Digestive „ 215 224 260 204 259 192 225 223 203 205 221 229 + 8 6. „ Lymphatic ,, 11 10 14 11 11 8 7 19 10 8 11 13 + 2 7. „ Urinary „ 151 129 168 134 157 136 142 142 179 167 150 172 + 22 8. „ Reproductive ,, 17 20 13 20 10 15 20 19 19 27 18 21 + 3 a ,, Orgs, of Generation 7 7 8 5 4 6 10 3 12 7 9 + 2 b „ of Parturition 10 13 5 15 6 9 10 16 12 15 11 12 + 1 9. ,, Bones and Joints 12 5 3 8 8 10 10 11 8 4 8 5 3 10. Integumentary System 14 9 19 9 8 6 10 7 3 3 9 1 — 8 VII. Violence 162 179 142 137 151 156 169 169 168 199 163 205 + 42 1. Accident or Negligence 132 140 99 94 105 115 124 124 136 156 123 149 + 26 2. Homicide 2 2 3 3 8 2 2 3 — 8 3 2 — 1 3. Suicide 28 37 40 39 38 39 42 42 32 35 37 54 + 17 4. Execution — — — 1 — — 1 — — — — — - - 5. By Bombs (Enemy Aircraft) - - - - - - - - - - - - - - VIII. Ill-Defined Causes 89 95 84 54 47 39 32 29 15 25 51 26 — 25 All Causes 4640 4475 4368 4614 3902 42224160 4090 4124 4161 4275 4275 + 473 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, 1929. Mean Deaths (10 years, 1919-28.) Increase or Decrease on mean. 0-1 year 403 488 — 85 1-5 years 239 273 — 34 Under 5 years 642 761 — 119 5-15 years 96 133 — 37 15-25 „ 159 163 4 25-35 „ 193 205 — 12 35-45 „ 290 298 — 8 45-55 „ 513 465 + 48 55-65 „ 805 633 + 172 65-75 „ 938 805 + 133 75 85 „ 877 636 + 241 85 upwards 235 176 + 59 All Ages. 4,748 4,275 + 473 7 [1929 There was a decrease of 119 deaths in the number of deaths under 5 years of age when compared with the average deaths at those ages during the preceding ten years ; whilst the number of registered deaths at the several age periods up to between 5-45 years, were also below the decennial average. The deaths of aged people between the age period 65 years and upwards showed an increase of 363 in the number of deaths when contrasted with the previous year 1928, and were 433 above the ten years' average (1919-28). INFANTILE MORTALITY. Infant Deaths, 403 ; Mortality Rate, 73.—The deaths ot 403 infants under twelve months' old \Vere registered during the year, or 85 below the decennial average (488), and they were equal to the infantile rate of 73 per 1,000 births. The lowest rate on record, however, is 53 per thousand births in the year 1927. The rate was 4 per 1,000 births above the mean annual record of the preceding ten years, and is 9 per 1,000 above the rate of last year (1928). In the quarters the mortality ranged from 111 per 1,000 births in the first quarter, 62 in the second, 50 in the third, and 76 in the fourth. In the sub-registration districts the infant mortality was as follows:— Sub-District. Infant Deaths. Mortality per 1,000 Births. Tufnell 38 75 Upper Holloway 31 42 Tollington 31 71 Lower Holloway 61 95 Highbury 55 60 Barnsbury 88 87 Islington South Hast 99 78 In London the infantile mortality was 70 per 1,000 births, while in the six boroughs encircling Islington it was 67. The rate for England and Wales was 74 per 1,000 births. Infantile Mortality during each of the Ten Years 1919-28 and 1929. 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 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 61 64 76 447 66 1925 105 25 20 20 170 70 72 58 44 414 63 1926 98 19 16 10 143 63 96 56 69 427 66 1927 90 19 13 9 131 56 38 53 324 53 1928 108 10 14 9 141 60 73 58 42 374 64 Mean 10 years 119 30 23 17 189 79 92 66 62 488 69 1929 103 18 15 11 147 64 68 73 51 403 73 Increase or decrease on mean — 16 -12 — 8 -6 — 42 — 15 — 24 + 7 -11 — 85 + 4 I929] 8 Showing the Deaths among Infants per 1,000 Births during the Year 1929. and also the mortality rates for the Years 1919-1928. Sub-Districts. 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 Mean 10 years 1929 Increase or decrease on mean Tufnell 50 41 53 83 46 54 47 64 52 65 55 75 + 20 Up. Holloway 79 69 76 59 64 70 57 30 31 44 58 42 —16 Tollington 98 58 83 58 55 60 65 92 63 85 72 71 — 1 Lr. Holloway 101 66 93 81 81 85 78 82 74 77 82 95 + 13 Highbury 83 67 93 64 61 60 54 48 52 47 63 60 — 3 Barnsbury 91 89 87 86 59 77 75 90 59 75 79 87 + 8 Islington, S.E. 81 79 77 88 82 55 58 64 49 67 70 78 + 8 The Borough 83 72 81 77 66 66 63 66 53 64 69 73 + 4 The following table shows the diseases that proved most fatal in the first year of child life, together with the mortality rates per 1,000 births. Showing the Mortality per 1,000 Births among Infants under one year of age in the ten yearsl919-28 : and in 1929 from certain specified causes. Causes of death. 1929. Rate per 1,000 Births. Mean rate 10 years 1919-28 per 1,000 Births. Difference. Premature Birth and Congenital Defects 17.1 19. 5 — 2.4 Bronchitis and Pneumonia 17.6 15.2 + 2.4 Atrophy and Marasmus 4.0 6.4 — 2.4 Diarrhoeal Disease (all forms) 2.3 4.6 — 2.3 Convulsions 0.5 1.1 — 0.6 Whooping Cough 8.3 2.9 + 5.4 Measles 0.4 2.4 — 2.0 Diphtheria 0.5 0.3 + 0.2 Phthisis 0.4 0.3 + 0.1 Other forms of Tuberculosis 0.4 0.8 — 0.4 Total of above 51.5 53.5 — 2.0 All other causes 21.6 16.3 + 5.3 Total 73.1 69 8 + 3.3 9 [1929 INFANTILE MORTALITY during the Calendar Year 1929. Nett Deaths from stated causes at various Ages under One Year of Age. Cause of Death. Under 1 week Weeks. Total under 4 4 weeks Months. Total Deaths under 1-2 2-3 3-4 weeks 3 months 3-6 6-9 9-12 1 year All Certified - - - - - - - - - - Causes. Uncertified - - - - - - - - - - /Small-pox — - - - - - - - - - Chicken-pox — - - - - - - - - - Measles — - - - - - - - 2 2 Scarlet Fever — — — — — — - — — Whooping-Cough — — — 2 2 4 7 20 13 46 Diphtheria, Croup 1 — — — 1 — — 1 1 3 Erysipelas - - - - - - - - - - Tuberculous Men- ingitis — — — — — 1 — — 1 Abdominal culosis - - - - - - - 1 — 1 Other Tuberculous Diseases - - - - - - 1 1 — 2 Meningitis (not Tuberculous) - - - — — 2 3a 5 1 11 Convulsions - — — 1 1 — 1 i — 3 Laryngitis - - - - - - - - - - Bronchitis - - - - - 7 5 1 2 15 Pneumonia (all forms) 2 6 4 3 15 11 16 19 21 82 Diarrhoea — — — — — 3 4 2 4 13 Enteritis — 1 ] 1 3 15 2 11 4 55 Gastritis — — — — — — — — — — Syphilis — — — — — — 1 — — 1 Rickets - - - - - - - - - - Suffocation, overlying - - - - - - - - - - Injury at birth 4 — — — 4 — - — — 4 Atelectasis 8 — — — 8 — — — — 8 Congenital mations 16 4 2 1 23 6 1 1 _ 31 Premature birth 59 2 1 — 62 1 — — — 63 Atrophy, Debility and Marasmus 7 3 1 2 13 8 1 - — 22 Other causes 6 2 6 1 15 7b 5 10 3§ 40 Totals 103 18 15 11 147 64 68 73 51 403 1929] 10 REPORT ON MATERNITY AND CHILD WELFARE WORK. Municipal Health Visitors. OPHTHALMIA NEONATORUM AND OPHTHALMIA. Ophthalmia Neonatorum is an inflammatory disease with purulent discharge occurring in the eyes if infants within three weeks of birth. 69 cases of Ophthalmia Neonatorum were notified, compared with 78 cases last year. 75 cases of Ophthalmia were reported by the London County Council and Health Visitors as against 61 cases during the previous year. 29 out of the 69 cases of Ophthalmia Neonatorum were attended at birth by midwives. The cases occurred in the sub-registration districts as follows:— Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. South East. The Borough Ophthalmia Neonatorum. 5 4 5 10 7 22 16 69 Cases notified by Doctor 2 3 5 6 2 6 3 27 Ophthalmia. Cases reported by L.C.C. 5 9 6 8 2 14 27 71 Cases reported by Health Visitors 2 — 1 1 — — 4 Of the 69 cases investigated, both of the infants' eyes were affected in 60 instances, whilst in 8 the right eye was involved, and in 1 the left. Treatment.—10 of the 69 Ophthalmia Neonatorum cases were admitted to St. Margaret's Hospital, 28 being treated at other hospitals. 31 cases were treated at home by private Doctors. 35 cases of inflammatory disease of infants' eyes were nursed by the North London Nursing Association for the Council at a cost of £38 6s. In 1928 36 cases were nursed at the cost of £34 2s. Results.—Of the 69 Ophthalmia Neonatorum cases, vision was impaired in one case only. There were two fatal cases during the year. Ophthalmia Neonatorum Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths. Notified, Treated. At home. In hospital. 69 59 10 66 1 Nil 2 MATERNAL DEATHS. The number of women dying in, or in consequence of, child-birth during the year 1929 was 27, or 4.9 per 1,000 registered births. Of this number 14 occurred from Sepsis (Puerperal Septicaemia); whilst 13 died from other diseases of childbirth. The deaths for the preceding year numbered 25 and were equal to the proportion of 4.3 per 1,000 births. 11 [1929 MATERNAL DEATHS, 1929. 1923. Month. Cause of Death. Ages at Death. Totals. 15 25 25 35 35 45 45 upwd. Total. From Puerperal Sepsis. From other Diseases of Childbirth. Jan. Puerperal Septicaemia • • 1 •• 1 1 •• Feb. Eclampsia .. 1 .. .. 1 • • 1 ,, Puerperal Septicaemia .. .. 1 .. 1 1 .. ,, Broncho - Pneumonia, prolonged labour, Forceps delivery 1 .. .. .. 1 .. 1 Mar Abortion—Embolism .. 1 .. .. 1 .. 1 ,, Ante Partum Haemorrhage, Placenta Praevia .. .. 1 .. 1 .. 1 Peritonitis following Septic Abortion .. 1 .. 1 1 .. General Peritonitis, Puerperal Septicaemia .. 1 .. .. 1 1 .. General Peritonitis—Abortion, Septic Uterus 1 1 1 .. Chronic Nephritis of Pregnaacy 1 •• •• .. 1 •• 1 1st Qr. 1 2 5 3 •• 10 5 5 April Septicaemia Pericarditis, Septic Abortion 1 .. .. .. 1 1 .. Post Partem Haemorrhage. Twin .. .. 1 .. 1 .. 1 May Placenta Praevia, Ulcerated Foetus .. .. .. 1 .. 1 .. 1 " Toxic vomiting of Pregnancy, Abortion 1 .. .. .. 1 .. 1 June Post Partem Hæmorrhage .. .. 1 .. 1 •• 1 2nd Qr. 2 •• 3 .. 5 1 4 July Puerperal Septicaemia, Placenta .. .. 1 .. 1 1 .. Aug. Puerperal Septicaemia .. 1 .. 1 1 .. „ Precipitate labour .. .. .. 1 .. 1 1 .. General Peritonitis, Septic Endometritis (Puerperal) .. 1 .. 1 1 .. Sept. Septicaemia Peritonitis, Infection of Uterus and Miscarriage .. .. 1 .. 1 1 .. ,, Hyperemesis Gravidarum operation, Therapeutic Abortion .. 1 .. .. 1 .. 1 •• Peritonitis, Abortion, Septic infection of Uterus •• 1 •• .. 1 1 •• 3rd Qr. .. 4 3 .. 7 6 1 Oct. Septicaemia following Abortion .. .. 1 1 1 .. Nov. Parturition .. .. 1 .. 1 •• 1 Dec. Toxaemia of Pregnancy .. 1 .. .. 1 .. 1 ,, Puerperal Septicæmia .. .. 1 .. 1 1 .. ,, Miscarriage .. .. 1 .. 1 .. 1 4th Qr. .. 1 4 .. 5 2 3 Total (Year) 4 10 13 .. 27 14 13 1st Quarter 10 = 7.2 per 1,000 births 2nd Quarter 5 3.3,, ,, ,, 3rd Quarter 7 =5.2 4th Quarter 5 = 4.2 ,, ,, ,, Year 27 = 4.9 per 1,000 Births 1929] 12 MATERNAL MORTALITY. The scheme outlined on page 13 of last year's Annual Report has been pursued this year. Exhaustive confidential enquiries have been made into every maternal death and confidential reports have been sent to the Secretary of the Maternal Mortality Committee, set up by the Ministry of Health. This central Committee will later issue a report generally upon any facts and conclusions derived from the investigations received throughout the country. PUERPERAL FEVER. Definition.—The Royal College of Physicians' definition of Puerperal Fever is-: Septicaemia, Pyaemia, Septic Peritonitis, Septic Metritis, and other acute septic inflammation in the pelvis occurring as the direct result of child-birth. Of the 38 cases coming to the knowledge of the Medical Officer of Health during 1929, 15 were notified by Medical Practitioners. The proportion of total cases to births was 6.9 per thousand. The notifications were 10 above the average (28) of the preceding ten years and showed an increase of 2.9 in the proportion of attacks to 1,000 births. Cases of Puerperal Fever notified and inquired into during the year 1929. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. SouthEast. The Borough Cases notified 2 4 2 2 9 15 4 38 Private Practitioners' Cases 1 1 - 2 4 6 1 15 Hospital Cases 1 3 2 — 5 9 3 23 Cases inquired into 2 4 2 2 9 15 4 38 Cases treated in Hospital 2 4 2 2 9 15 4 38 Cases treated at Home — — — — — - — — All of the 38 cases were treated in Hospitals. 12 of these contracted the disease in Hospital; 15 cases were removed to Metropolitan Asylums Board Hospitals; and 23 cases were removed to the Islington Infirmary and other London Hospitals. Deaths.—14 deaths were registered as being due to Puerperal Fever. PUERPERAL PYREXIA. The Notification of Puerperal Pyrexia. Regulations, 1926, made by the Ministry of Health, which came into operation on the 1st October, 1926, resulted in 88 cases being notified, as against 77 last year. Of these, 29 were Private Medical Practitioners' cases; 50 occurred in Hospital, while 9 were certified Midwives' cases. The notifications were in the proportion of 12.6 per 1,000 births. Cases of Puerperal Pyrexia notified and inquired into during the year 1929. Tufnell. Upper Hollo way. Tollington. Lower Holloway, Highbury. Barnsbury. SouthEast. The Borough Cases notified 7 14 4 12 10 20 21 88 Private Practitioners'Cases 3 1 1 4 5 4 11 29 Hospital Cases 4 12 3 7 4 13 7 50 Certified Midwives' Cases — 1 — 1 1 3 3 9 Cases inquired into 2 2 1 5 6 9 15 40 Cases treated in Hospital 7 14 3 12 8 18 18 80 Cases treated at Home - — 1 — 2 2 3 8 13 [1929 Opportunity was taken of the facilities afforded by the Metropolitan Asylums Board as mentioned in last year's report, p. 14, and also enquiries were made where the London County Council had taken swabs from a midwife. Case which died of Puerperal Septicaemia.—A throat swab taken from the " handy woman " revealed haemolytic streptococci. i Non-fatal cases.—In connection with a case odcurring in a Nursing Home, the Supervising Authority had a series of swabs taken from the finger and also from the tonsils of a nurse in attendance. On the first occasion that from the finger was positive and also the tonsils, and the tonsils remained positive on other two examinations made during the subsequent .fortnight. On the fourth examination the tonsils were negative as regards haemolytic streptococci. After this period the nurse ceased to practice as a midwife. Examinations were made in other cases with negative results. In respect of one Puerperal Fever case which recovered, swabs were taken from the midwife in attendance on the patient and from the mother-in-law. In another case, which also recovered, a swab was taken from the handywoman. In this particular year in none of the cases of Puerperal Pyrexia was it considered necessary to take swabs from the attendants. PEMPHIGUS NEONATORUM. During the year 1929, 8 cases which came to the knowledge of the Medical Officer of Health were investigated. THE MILK SCHEME FOR NECESSITOUS EXPECTANT AND NURSING MOTHERS AND CHILDREN UNDER FIVE YEARS OF AGE. During the year 1929, the sum expended in the provision of fresh and dried milk for necessitous, expectant and nursing- mothers, and children under five years of age, amounted to £1,190 14s. 4½d., as against £1,702 14s. 2d. in 1928. The total amount expended since the Order came into operation in 1918 is £51,146 8s. 7½d. The total recipients during the year numbered 4,736, and the quantity of milk supplied to them was equal to 87,964 pints (10,995½ gallons). DISTRIBUTION OF MILK TO NECESSITOUS MOTHERS AND CHILDREN. A revised scale of income was adopted by the Council on the 18th May, 1928, upon the recommendation of the Maternity and Child Welfare Committee, in view of a reduction of £486 on the Council's estimate of the cost of supplying Milk during the year 1928-29, by the Ministry of Heatlh. The amended scheme which has been in operation since the 1st July, 1928, is as follows:— 1929] 14 REVISED SCALE OF INCOME. Supply of Milk to Necessitous Cases. Net family income after deduction of rent. Number in family—excluding children earning:— 1 2 3 4 5 6 7 8 9 10 11 12 Up to 20s N ¾ ½ ¼ ¼ ¼ ¼ ¼ ¼ ¼ ¼ ¼ 20s. Id. to 25s. N N ¾ ½ ¼ ¼ ¼ ¼ ¼ ¼ ¼ ¼ 26s. Id. to 30s. N N N ¾ ½ ¼ ¼ ¼ ¼ ¼ ¼ ¼ 30s. Id. to 35s. N N N N ¾ ½ ¼ ¼ ¼ ¼ ¼ ¼ 35s. Id, to 40s. N N N N N ¾ ½ ¼ ¼ ¼ ¼ ¼ 40s Id. to 45s N N N N N N ¾ ½ ¼ ¼ ¼ ¼ 45s. Id. to 50s. N N N N N N N ¾ ½ ¼ ¼ ¼ The fractions f, and represent the amount of cost to be charged to each recipient. Children living at home and earning are NOT counted as members of family in this scale. All milk generally to be charged for, but discretionary power given to the Milk Sub-Committee (1) to grant free milk in certain cases and (2) to deal with applications where the gross family income is £3 a week or more. A modified Scale of income was adopted by the Council 26th July, 1929 (subject to approval of Ministry of Health), and operating from 1st August, 1929, as follows:— Per head. 6/- a week and under, after allowance for rent, Free. 6/1 to 7/5 a week, after allowance for rent, Quarter cost. 7/6 to 8/- a week, after allowance for rent, Half cost. Children living at home and earning not to be counted as members of the family for the purposes of the scale. Discretionary power given to the Milk Sub-Committee to deal with applications for milk where the gross family income is £5 a week or more. o« ►—» co to co SUMMARY OF WORK OF MUNICIPAL HEALTH VISITORS FOR YEAR ENDING 1929. District 1 2 3 4 5 6 7 8 Totals. I. Births, First Visits, Infants under 1 Year 629 582 631 867 816 455 485 468 4,933 II. Births, Re-Visits, Infants under 1 Year 839 521 516 613 502 636 542 530 4,699 III. Visits to Children, between 1st and 2nd Years 634 419 464 625 318 589 505 549 4,103 IV. Visits to Children, between 2nd and 5th Years 1,108 1,499 1,262 1,586 1,142 1,598 1,208 1,616 11,019 V. Visits re Still Births 16 17 23 20 25 13 14 12 140 VI. Deaths, Visits, yc Infants under 1 Year 18 12 18 3 13 9 10 10 93 VII. Deaths, Visits, ye Children 1 to 5 years 7 1 7 1 6 3 1 4 30 VIII. f Ante-Natal, Home Visits f/118 143 f/118 137 f/169 205 F/189 214 F/143 160 f/139 172 F/94 127 F/162 189 F/1,132 1,347 ty /Fever, Home Visits F/2 4 f. 5 p. 2 F/11 18 F/11 32 F. 1 Re 1 F/2 3 F/34 66 IX. fPuerperal do f/2 4 — F. 1 — Re 1 — — F. 1 F/4 7 Totals 3,402 3,193 3,129 3,947 3,015 3,476 2,893 3,382 26,437 X. Attendances at Welfare Centre 22 25 41 45 44 39 46 48 310 XI. Other Work by Direction 1,113 454 827 691 984 944 1,093 869 6,975 XII. Visits Declined 1 1 4 1 1 1 - 1 10 XIII. Visits, House Shut 818 703 489 1,086 259 872 499 445 5,171 XIV. Visits, Inopportune 4 5 6 69 — 55 21 24 184 Grand Total of Visits 5,360 4,381 4,496 5,839 4,303 5,387 4,552 4,769 39,087 H-* co bO co i—i t—« O SUMMARY OF VISITS BY MUNICIPAL HEALTH VISITORS—Continued. District ... 1 2 3 4 5 6 7 8 Totals. Analysis of Visits included in I.-IX. relating to tReported Ophthalmia f/11 24 f/6 15 f/5 8 Re/1 f/9 16 f/6 16 f/8 21 f/9 21 F54 122 (a) f Ophthalmia Neonatorum f/16 20 F/7 10 f/9 18 F/7 9 f/17 38 f/8 25 f/9 18 f/8 13 F/71 151 (£>) f Epidemic (Summer) Diarrhoea - f/2 - - - - - f/1 f/3 (c) Other Digestive Diseases - 2 3 - 1 5 - - 11 (d) Pneumonia and Bronchitis 2 17 4 11 - 47 20 55 156 (e) Rickets 4 4 12 57 - 39 1 55 172 (J ) +Measles and German Measles F/ 1 f/5 f/4 - F/1 f/8 - f/11 f/30 (g) tWhooping Cough f/8 F/39 41 f/39 f/I4 f/2 f/135 136 f/32 35 f'30 f/299 305 (A) Tuberculous Disease—P=Pulmonary; 0 = 0ther — o/l — — — - o/l - o/2 (i) Convulsions - - - - - - - - - (/) -.Polio-myelitis — — — — — - — - - (A) Premature Birth 5 1 19 25 2 23 12 21 108 (1) Atrophy, Debility and Marasmus 3 — 1 2 — 15 - - 21 (m) U1 other investigations (**Specify) .. — 16 7 - - 4 3 24 54 (n) Routine Visits included in I. to IX. and not included in (a) to (m) 3,335 3,079 3,014 3,828 2,955 3,158 2,782 3,151 25,302 ***Totals (a) to (n) 3,402 3,193 3,129 3,947 3,015 3,476 2,893 3,382 26,437 Total Families Visited 2,658 2,223 2,254 3,034 2,158 2,545 2,138 2,446 19,456 Registered Births. New Cases Handed to H.V's for Visitation Infant Mortality. Maternal Puerperal Mortality. Fever. Puerperal Pyrexia. Ophthalmia Neonatorum. No. Rate. Notified Births Non-Notified Births. Transfers In. No. Rate. No j Rate. Cases. Removals Cases. Removals. Cases. Removals. 5509 17 23 5584 189 419 403 73 26 7 38 37 88 77 69 11 **«.?.—Infectious Diseases other than Measles, Whooping Cough, Epidemic Diarrhoea, Polio-myelitis, etc. Syphilis, Rheumatism, N.N.B. Illegit, etc. • »*Totals (a) to (n) should correspond with Totals I. to IX. fF. in front of figures denotes a " First Visit." 17 [1929 REPORT OF THE WORK OF THE DAY NURSERIES RECEIVING GRANTS FROM THE BOROUGH COUNCIL. Lower Holloway Day Nursery, 547, Liverpool Road, N.7.—During the year ending March 31st, 1930, the attendances at this Day Nursery reached their highest on record, being 11,293, and 292 nursing mothers had dinner at the Nursery. The provision of meals to nursing mothers is an important item in the institution's activities, for no artificial feeding can really replace absolutely the milk piovided by the infant's own mother, and if she is at work she obviously has no time to prepare a proper meal. The increased attendance at this Centre is gratifying because, in the previous year, from unavoidable causes, the numbers had dropped to a lower total than usual. Long projected alterations and improvements have been carried out in the internal arrangements of the Nursery. The kitchen premises are more habitable and commodious; there is increased working space, and more light and ventilation has been obtained. Much time has been saved, and carrying work avoided, by the installation of a service lift. Minor alterations and improvements have been made in the laundry. The staircase has been brightened by redecoration in green and primrose, while the stairs have been relaid with linoleum reinforced with rubber. The Nursery schoolroom has also been redecorated. Most of the work was carried out in August during the annual closure, but certain structural alterations being necessary, the Nursery had to be closed for four weeks. St. Luke's Day Nursery, 64, Goodinge Road, N.7. (now removed to 29 and 30, Penn Road, N.).—The total attendances for the year has been 3,819. The Committee state that in the new premises it may be possible to increase the number to 45 per day with the extra accommodation available. South Islington Pro Patria Day Nursery, 8 and 9, Canonbury Place, N.l.— The attendance for the year, March, 1929-30, totalled 12,575. These are made up as follows:—Over 3 years—whole day—3,456, and under 3 years—whole day— 9,119. (Total half-days attendances numbered 532). The average attendance for the year was 50. This Day Nursery admits children from two weeks to five years old. A special leaflet is provided by the Nursery setting forth the terms of admission and particulars. Applications are to be made to the Matron at the Nursery. INVALID CHILDREN'S AID ASSOCIATION. The Islington Branch of this Association, to whom the Council gives a small giant, were the agency by which 53 Islington children under 5 years of age, who had suffered from ill-health in different forms, received for varied periods throughout the year (ending March 31st, 1930), convalescent residence in homes, some in the country, others at the seaside. In addition, this Association were the means of providing, in 25 cases (all under 5 years of age) instruments, such as surgical boots, splints, trusses, " tin shoes,' etc., for little sufferers who had been attacked with deforming diseases, and whose parents otherwise would have found it very difficult, if not impossible, to procure these alleviations unaided. 1 owards such services to these tiny Islingtonians the Borough Council gave a grant of £25. 1929] 18 REPORT OF WORK OF VOLUNTARY CENTRES. To summarise this work for the year ending 31st March, 1930, a Table has been added at the end of this Section. It might be noted here that this is the last year in which the Ministry pay, directly, grants to the individuai Centres. From the 1st April, 1930, under the provisions of the Local Government Act, 1929, the Centres come, in finance, more directly in touch with the Borough Council inasmuch as they will receive the grant formerly paid by the Ministry of Health from the Borough Council. It is important to remember that the Centre year ends with March, 1930, while the other matter in this Annual Report is for the calendar year. In February a communication was received from the Secretary of the Medical Branch of the Board of Education, on the work of this Branch of the Board of Education, on Adenoids and Tonsils. Its Committee had during the past four years been investigating the circumstances of origin and the effect of adenoids and enlarged tonsils amongst children of school age and had desired that further investigation should be pursued in the subject during the earliest years of school life. For this purpose it was necessary to carry out a following-up enquiry at a number of Infant Welfare Centres. I approached our four Voluntary Centres with a view to ascertaining if facilities could be given for this part of the research work, and, after consultation with their Medical Officers, the Centres were able to make suitable arrangements. Similar facilities for an investigation into the condition of the eyes of the pre-school child have been provided for two or three years at the North Centre. As reported on formerly, the Conjoint Committee of the Centres meet quarterly for the purpose of co-ordinating the work of the various Centres and the Maternity and Child Welfare work of the Borough Health Department. North Centre.—The Minister of Health, under date 13th July, upon the report of Dr. Cameron, a Medical Officer of the Department, expressed appreciation with the high standard of the work maintained at the Centre and of the ability and devotion displayed in its organisation. From the report of the Centre it is noted that there is a steady increase in all the Departments of its work. In particular it might be noted, the establishment of a third weekly ante-natal clinic and some extension of the work of the " Light " Department, the treatment having been found of special value to the mothers in cases of malaise and depression. In the ante-natal work there has been, quite possibly owing to the prominence now given to maternal mortality, an increasing number of midwives seeking closer touch with the Ante-natal Department of the Centre. In the propaganda work of the North Centre may be noted lectures during "Health Week " on the "Hygienic Disposal of Refuse." Practical demonstrations were given during the winter in cooking; these were well attended. Meals, as provided for children in the wards of this Centre, are often displayed as a demonstration of the quality and quantity of food suitable for a toddler. Under the auspices of the Mothers' and Fathers' Committee lectures on Smallpox and Vaccination, Poisons, the Unconscious Patient, and Severe Haemorrhage were given. Dr. Sigrid Pearson, who conducted the Eye Investigation on behalf of the Board of Education, very kindly offered to hold an Eye Clinic for children attending the Centre. 19 [1929 As reported on last year, the " Home Helps " employed by this Centre number five. They go to homes during the confinements to undertake the household management, the cost being met partly by the organisation of the "Home Help Club" at the Centre. The appreciation and the demand for this service is shown when the number of homes thus provided for is mentioned, namely, 252. From the report of the "Light" Department, apart from the "Light" treatment given as a preventive of rickets, to create a condition to resist infectious disease, and as a holiday substitute in the sunless months of the year, it is noted that definite cases of rickets, cases showing poor muscular tone, enlarged glands and a few cases of asthma, and, in skin complaints some cases of eczema, have shown great improvement. It has been found that cod-liver oil alone, without the " Light " treatment, has not, in the cases at this Centre, given such rapid results. Reference has been made previously to the use of "Light" for expectant mothers. 77 received this course. In addition to these, 156 Ailing Mothers derived benefit from the "Light," and in considering this it must not be forgotten that it is no easy matter for such a mother to attend regularly three times a week. Infant Welfare Wards, for mothers and babies.—The number resident during the year was 146, and, in addition, 53 cases were taken for supervision during the day, returning home at night, making a total of 199 dealt with. As regards length of stay, the average number of days was 40.5, the maximum 188 and minimum 1. This Centre has for many years been a "Mecca" for "pilgrims" from all parts of the world who come seeking information on Maternity and Child Welfare Centre work ; many of these arrive in parties. South Centre.—The formal opening of the extension of this Centre, which was dealt with fully in last year's report, took place on the 10th June, by H.R.H. Princess Mary, Viscountess Harewood. The enlarged premises have proved a great success, every Department showing an increase in work. ,The increased numbers owing to the facilities provided have been expeditiously dealt with, and the clerical and administrative work have gone smoother by this better accommodation. Extra fortnightly Ante-natal Sessions were started in May, and this has enabled the doctors to see a steadily increasing number of expectant and ailing mothers. Additional Dental Sessions were started in June. As regards the Canonbury Branch, the consent of the Ministry of Health and the Borough Council to an extra consultation here was obtained, and accordingly commencement was made in March. There has been also increase in the work at the Duncan Terrace Branch. It is noticed in the medical reports that there has been a marked increase in the number of toddlers who have received surgical treatment for tonsils and adenoids, and, while the health of the children was affected by the Measles epidemic, apart from this there had not been much serious illness. 1929] 20 Clephane Cottage was open from the 18th March to the 8th November, 1929, during which time 68 mothers and 73 children stayed there. Internal improvements have been carried out at the cottage, new gutters have been put round the roof, and the house is now in a thorough state of repair. The enlarged kitchen premises have greatly improved the domestic facilities. The total cost of £215 had to be met from the Centre funds. East Centre.—At this Centre the garden was further utilised on two afternoons a week by mothers who were invited to sew or rest there whilst their children played. This change for the mothers from the environment of their homes was much appreciated. The greater amount of sunshine during the year had a beneficial effect on the health of the children generally, and the mothers in these particular cases were able to share it. The cookery and dressmaking classes were very much taken advantage of by the mothers. The value of the work carried out on "Test Feeding" at this Centre has justified its continuance. Apart from the cases discovered where the babies are being underfed, the testing sometimes shows cases in which a baby may be losing weight owing to overfeeding. This latter sort of case would be difficult to convince a mother on if it were not for the actual demonstration at the test proving the fact to her. West Centre.—The work of this Centre, which is in one of the most congested and poorest districts of the Borough, has continued to attract the necessitous mothers in the neighbourhood. The Branch Centre at Goodinge Road, where a clinic is held, has been very fully and consistently taken advantage of. At the main Centre in Richmond Road " Artificial Sunlight " has been provided, as formerly, for the weakly and rickety babies, and has also been given in a case of chronic ulceration which had resisted other methods. The fine weather of the summer reflected itself in the marked improvement of the babies attending the Centre. In January and February an outbreak of diarrhoea had to be contended with, and a number of children succumbed. This was followed by an epidemic of Measles which affected for the time the attendances at the Centre. Ward.—The Ward at this Centre shows a lower number of admissions than usual, due to the fact that there was some shortage of staff at certain periods. The higher death-rate among those attending was due to the extremely serious condition of many of those admitted, but the Centre can point to the rescued babies who would have died but for the treatment they received in the Ward. 21 [1929 The various Departments of the Four Voluntary Centres, with the attendances for 1929 may be summarised thus :— North. South. East. West. Total. 1. Ante-Natal Clinics and Ailing Mothers Clinics. Number held weekly 4 2 1† 1 8 Number of attendances 2,429 855 714 395§ 4,393 2. Consultations for Children up to 5 Years of Age. Number held weekly 10 11 11** 7 39 Number of attendances 22,306 20,343 15,356 10,793 68,798 3. Home Visiting. Number of visits made 16,473 12,602 11 142 9,611 49,828 4. Dental Clinics. Number attending 554 250 63 44 911 Number of attendances or arrangements made for attendances 1,613 495 114 — 2,222 5. Morning Callers. Number of attendances 1,944 1,057 —* 921 3,922 6. Massage Clinics. Number of cases given massage or sent for massage 97 (& Sunlight treatment) 61 76 38 272 7. Wards. Number of beds 18 — 8 26 Number of patients received 146 — — 96 242 8. Number of Children on Books 1,851 1,657 1,218 1,089 5,815 *Not recorded. **Including 2 Observation Clinics. †One Extra Ante-Natal Clinic on 2nd Thursday in month to be added. § Attendances of Expectant Mothers only. WELFARE CENTRES' 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. Ward 7, 8 and Part of 4. Total. 1929 (Approximate Estimate) 92,298 91,860 50,850 84,792 319.800 28,250 up to 5 years old. BIRTHS. 1928 1,668 (Actual) 1,260 (Approximate) 980 (Approximate) 1,876 (Approximate) 5,790 1929 1,675 (Actual) 1,285 (Approximate) 895 (Approximate) 1,654 (Approximate) 5,509 Number on Books 31st March, 1930, 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" 15,462 22 1929] MATERNITY AND CHILD WELFARE. Contributions by the Borough Council. Year ending 31st March, 1930. Voluntary Welfare Centres. Day Nurseries. £. £. North Centre 2,155 Lower Holloway 80 South Centre 837 St. Luke's 40 East Centre 766 South Islington 100 West Centre 1,042 Total £220 Total £4,800 * This Nursery is a municipally owned building. No rent charged for its use). A contribution of £25 was made to the Islington Branch of the Invalid Children's Aid Association in respect of convalescence of invalid children under five years of age. Contributions for Maternity and Child Welfare Work per Case in Respect of Work Done. The Islington Borough Council has an arrangement with the North London Nursing Association for the attendance, by visitation, in cases of Ophthalmia Neonatorum, Acute Primary Pneumonia, Acute Influenzal Pneumonia, Measles, Whooping Cough and Epidemic Diarrhoea. The payments made to this Association, at the rate of one shilling per visit, were :— Under Maternity and Child Welfare £67 9 0 Under Public Health £35 18 0* Total £107 17 0 Contributions under arrangements for maternity cases admitted to beds at Maternity Hospitals, the contributions being a grant of 10s. per case, were : City of London Maternity Hospital, £2 0s. 0d. ; Royal Free Hospital, £17 10s. 0d. In addition to these cases of Ophthalmia Neonatorum and Marasmus are admitted to the Metropolitan Asylums Board's Hospital (St. Margaret's), Camden Town, N.W. * Includes also adult nursing (pneumonia). DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—2,535 persons died in the Public Institutions located in Islington, of whom 1,739 belonged to this Borough, the remaining 796 having come here for treatment or relief. Of these, 484 died in the Archway House, 150 in the Royal Northern Central Hospital, 79 in the London Fever Hospital, and 24 in the Islington Institution and Islington Infirmary. Of the 1,739 deaths of inhabitants, 1,269 occurred in the Islington Infirmary, 300 in the Islington Institution, and 118 in the Royal Northern Central Hospital. The proportion which the 1,739 deaths in the Public Institutions bore to the Borough mortality was 36.6 per cent. Without the Borough.—938 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, 31 in the North-Western Fever Hospital, 34 in the Children's Hospital, Great Ormond Street, 67 in St. Bartholomew's Hospital, 19 in the Colney Hatch 23 [1929 Mental Hospital, 65 in the Royal Free Hospital, 65 in the University College Hospital, 33 in the North-Eastern Fever Hospital, 35 in the Eastern Fever Hospital, 26 in the Middlesex Hospital, 8 in the City of London Maternity Hospital, and 21 in the Metropolitan Hospital. These 938 deaths represented 19.7 per cent. of all the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians numbered 2,677 and were equal to 56.4 per cent. of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— 56 inhabitants died from accidental deaths, or suddenly, in places outside Islington. During the previous year (1928) the total deaths in Local Institutions numbered 2,167, being 1,452 inhabitants of Islington in Local Institutions, plus 715 non-inhabitants of Islington in Local Institutions, the number in Islington Infirmary being 1,062, the number in the Royal Northern Hospital 113. The deaths of inhabitants of Islington in Institutions outside the Borough were 883. The total deaths is all Institutions, 2,335 ; and the proportion per 100 deaths from all causes, 56.1. Transferable Deaths.—During the year 55 deaths of residents that had occurred in outlying Institutions and other places in Provincial Boroughs were transferred by the Registrar-General to Islington. MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES. Small Pox, Measles, Scarlet Fever, Whooping Cough, Diphtheria, Fevers— Typhus, Enteric and Continued—and Diarrhceal Diseases. During the year 192 persons died from these diseases, the death-rate being 0.60 per 1,000 inhabitants, as contrasted with 0.73 in the corresponding period last year, and a decennial average mortality of 213 and a death-rate of 0.64 per 1,000. In London the death-rate from the epidemic diseases was 0.57, while in the six encircling Boroughs the death-rate was 0.57. Locally the deaths in the Sub-Registration Districts and Wards were as follows :— Showing the Deaths from each of tlu principal Epidemic Diseases in the several Wards and Sub-Registration Districts during the Year 1929. 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 — — — — 16 2 1 19 Up. Holloway Up. Holloway 1 — — 2 14 9 1 27 Tollington Tollington — — 1 — 9 2 — 12 Lr. Holloway Lr. Holloway — — 1 2 20 2 — 25 Highbury Highbury — — 2 — 4 5 1 12 Mildmay — — — 2 — — 1 3 Barnsbury Thornhill 1 1 — 25 6 3 36 Barnsbury — — — — 16 2 1 19 Islington South East St. Mary's — — — 1 6 1 2 10 Canonbury — — 1 — 6 — 3 10 St. Peter's — — 5 1 10 3 — 19 The Borough 2 — 11 8 126 32 13 192 Total Death Rates 0.01 — 00.3 0.03 0.39 0.10 0.04 0.60 24 1929] Showing the Deaths and Death-Rates from the Principal Epidemic Diseases during the ten years 191 -28 and for the Year 1929. 1919 1920 1921 1922 1923 1924 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 5* 0.02 3* 0.01 1 0.00 — — — — 4 0.01 Small Pox ... 1 0.00 — — — — — — — — — — Measles 12 0.04 92 0.27 27 0.08 134 0.40 16 0.05 103 0.30 Scarlet Fever 14 0.04 12 0.04 19 0.06 29 0.09 13 0.04 10 0.03 Whooping Cough ... 17 0.05 70 0.21 43 0.13 98 0.29 38 0.11 57 0.17 Diphtheria ... 51 0.16 135 0.40 110 0.33 59 0.18 21 0.06 33 0.09 Diarrhoea and Enteritis (under 2 years) 85 13.53 per 1,000 births 77 8.19 per 1.000 births 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 1925 1926 1927 1928 Mean 10 years 1929 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 4 0.01 1 0.00 — — 2 0.00 2 0.00 2 0.01 Small Pox ... — — — — — — — — — — — — Measles 22 0.06 69 0.20 29 0.09 156 0.48 66 0.20 11 0.03 Scarlet Fever 8 0.02 12 0.03 8 0.02 8 0.03 13 0.04 8 0.03 Whooping Cough ... 61 0.20 29 0.09 45 0.14 21 0.06 48 0.14 126 0.39 Diphtheria ... 21 0.06 31 0.09 25 0.07 25 0.08 51 0.15 32 0.10 Diarrhoea and Enteritis (under 2 years) I 69 10.54 per 1.000 births 69 10.68 per 1,000 births 48 7.79 per 1,000 births 67 11.57 per 1,000 births 80 11.44 per 1,000 births 68 12.34 per 1,000 births * Including 2 Malarial Fever. Showing the Deaths from Diarrhæal Diseases together with those classed, under Enteritis and its Sub-headings, arranged in quarterly periods, and in three groups of ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Ages. Diarrhoea. Enteritis, etc. Totals. Diarrhæa. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Under 1 year 2 11 13 1 9 10 5 13 18 5 22 27 13 55 68 1 to 5 years — 2 2 — 3 3 — 2 2 — 1 1 8 8 Over 5 years — 2 2 — 2 2 — 3 3 — 3 3 — 10 10 Totals 2 15 17 1 14 15 5 18 23 5 26 31 13 73 86 INFLUENZA. Influenza caused 207 deaths during the year and showed an increase of 166 on the return for the year 1928, and were 80 above the average of the preceding ten years 1919-28. The death-rate was equal to 0.65 per 1,000 inhabitants. The epidemic commenced in the third week in January. It progressed through February, in which month 111 deaths were registered as due to the disease. The deaths were mostly of persons over 40 years of age. The greater number were amongst persons aged 55 years and upwards. The report of the epidemic was before the Public Health Committee, and in accordance with the Circular of the Ministry of Health on Influenza, the Medical Officer of Health was authorised to set forth the precautions to be adopted to minimize the risk of infection, and the complications, and to communicate these through the medium of the Press. 25 [1929 Showing the Deaths from Influenza in the Quarters of the Year 1929, together with the averages of the corresponding periods, 1919-28. Years. Quarters. Totals. First. Second. Third. Fourth. 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 1 15 104 1925 47 3 1 21 72 1926 15 24 3 9 51 1927 118 15 7 12 152 1928 18 12 3 8 41 Average 87 20 4 16 127 1929 190 13 1 3 207 Increase or Decrease + 103 -7 -3 — 13 + 80 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 yea-- 1929 :— Ages. 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 Mean 10 yrs 1929 Difference. 0- 5 19 10 5 22 5 11 6 — 8 3 9 5 — 4 5-10 5 3 — 1 — 1 2 1 4 1 2 1 — 1 10-l5 8 3 1 — 2 2 — — 1 — 2 — — 2 15-25 48 12 5 11 — 10 2 2 3 3 9 2 — 7 25-35 82 21 9 14 6 7 1 4 13 1 16 9 — 7 35-45 47 18 15 18 4 10 3 8 21 6 15 19 + 4 45-55 48 17 18 42 12 12 11 6 22 4 19 38 + 19 55-65 42 17 13 37 5 19 11 12 28 6 19 43 + 24 65-75 36 13 14 43 16 16 19 8 34 7 21 52 + 31 75 & upward 21 4 13 33 8 16 17 10 18 10 15 38 + 23 All Ages 356 118 93 221 58 104 72 51 152 41 127 207 + 80 SEPTIC DISEASES. Erysipelas and Puerperal Septicaemia are the principal diseases of this class. Erysipelas.--13 deaths were returned from this disease, or 1 less than in the year 1928, and 3 above the average of the preceding ten years 1919-28. Puerperal Diseases.—These comprise Puerperal Pyaemra, Septicaemia, Septic Intoxication and Puerperal Fever, and they caused 14 deaths, being 4 above the return of 1928 and were 4 above the average of the ten years 1919-28. The death-rate was equal to 2.54 per 1,000 births. CANCER. Cancer. 471 deaths were registered from this malignant disease during the year compared with 518 in 1928, and with an average of 463 in the previous decennium. The deaths represent a death-rate of 1.47 per 1,000 of the civil population and is 0.08 above the average rate (1.39) of the last ten years; 228 deaths occurred among males and 243 among females. The following statement 26 1929] shows the ages at death of the persons attacked during the past ten years, and the return for the year 1929 :— Ages. 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 Mean 10 yrs 1929 Difference. 0- 5 2 3 2 — 1 1 1 — 1 — 1 3 + 2 5-15 1 — 1 — — 1 2 — — — — 1 + 1 15-25 4 1 1 4 6 4 3 3 1 3 3 1 — 2 25-35 5 10 10 8 10 9 5 6 5 14 8 10 + 2 35-45 36 32 34 34 27 38 40 27 24 36 33 22 — 11 45-55 101 74 98 88 88 77 93 73 74 83 85 84 — 1 55-65 120 110 140 124 138 131 168 142 137 147 136 153 + 17 65-75 123 124 131 110 125 149 144 144 135 155 134 106 — 28 75-85 39 43 52 47 68 52 71 51 65 71 56 81 + 25 85 & upwards 7 5 6 6 9 8 7 7 7 9 7 10 + 3 Totals 438 402 475 421 472 470 534 453 449 518 463 471 + 8 Showing the Deaths from Cancer or Malignant Disease in the several Sub-Districts during the Quarters and the year 1929. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 14 14 18 13 36 17 30 142 Second 12 13 8 13 30 8 22 106 Third 12 20 6 10 25 25 23 121 Fourth 10 12 11 10 24 12 23 102 The Year 48 59 43 46 115 62 98 471 TUBERCULOSIS. Tuberculosis caused 345 deaths, which were 57 below the average of the last decennium, and were 13 below the number registered in 1928. The deathrate resulting from them was equal to 1.08 per 1,000 of the civil population, and represented 7.3 per cent. of the deaths from all causes during the year. Tuberculosis of the Respiratory System (Phthisis or Pulmonary Tuberculosis), caused 314 deaths, as contrasted with the decennial average of 344, while the death-rate was 0.98 per 1,000 of the civil population as against the decennial rate of 1.03 per 1,000. There was a decrease of 30 on the ten years' average number of deaths, and of 0.05 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. 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 1925 382 1.13 9.18 12.3 1926 289 0.85 7.06 12.0 1927 314 0.94 7.61 12.3 1928 309 0.95 7.43 12.8 Average 10 years 344 1.03 8.07 12.8 1929 314 0.98 0.59 14.8 27 [1929 The following return gives the deaths at each age period :— Age Periods. Males. Females. Total. 0-5 6 2 8 6-15 — 3 3 15-25 34 37 71 25-35 36 28 64 35-45 38 20 58 45-55 48 22 70 55-65 24 5 29 65 upwards 6 5 11 Total 192 122 314 Showing the Deaths from Tuberculosis of Respiratory System in the Sub-Districts during the Four Quarters of the Year 1929. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 11 15 7 15 14 24 26 112 Second 4 6 10 8 10 7 21 65 Third 4 3 5 8 5 5 25 55 Fourth 3 9 7 11 16 21 14 81 The Year 22 33 29 42 45 57 86 314 Showing the Deaths from all forms of Tuberculosis during 1929. 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 2 6 306 192 122 22 33 29 42 45 57 86 314 Meningeal 1 4 7 5 7 — — 2 1 2 3 4 12 Abdominal 1 — 5 3 3 1 2 — 2 1 — 6 General — 2 5 3 4 1 — 2 1 1 2 — 7 Other forms — — 6 5 1 1 — — 1 1 — 3 6 All Tuberculosis 4 12 329 208 137 25 35 33 45 51 63 93 345 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 957 deaths, or 304 more than in 1928. They were equal to a death-rate of 3.0 per 1,000 of the civil population, and represented 20.1 per cent. of the total deaths registered in the Borough. Acute Bronchitis.—There were 146 deaths as compared with 70 in the previous year, 56 occurred among males, and 90 among females. The deaths of 12 infants under 12 months were registered. Chronic Bronchitis.- 187 deaths were ascribed to it, 96 being males and 91 females. This return is 69 above that for 1928. Pneumonia (All forms).— 436 deaths were registered, of which 251 were males and 185 females, 107 above the year 1928. 82 infants under a year old died from this disease, while between the ages of 1 and 5 years 73 died from it. Above 5 years of age the deaths numbered 281. 211 deaths accurred in Public Institutions, chiefly the Islington Infirmaries. 28 1929] Pleurisy.—There were 32 deaths registered from this disease, 12 deaths occurred in Public Institutions. Asthma and Emphysema—30 deaths were recorded from these diseases, all of which were adults. Other Diseases of the Respiratory System. 126 deaths were registered, as contrasted with 97 in 1928. VENEREAL DISEASES. Twenty-two deaths were ascribed to these diseases, as compared with 19 in 1928. Of these, 17 were males and 5 females. They were 9 above the mean deaths (13) of the preceding ten years 1919-28. The three groups of ages at death were as follows :—Under 1 year, 1 death; 1-5 years, 1 death ; and over 5 years, 20 deaths. The nearest treatment centres of these diseases are the Royal Northern Hospital, Holloway Road, N., and the Royal Free Hospital, Gray's Inn Road, W.C.I. A complete list is exhibited in the public conveniences under the control of the Council. Information and leaflets are distributed on application by letter or otherwise by the Medical Officer of Health, and if desired, he personally advises applicants as to what they should do to secure the necessary confidential treatment. Applicants of both sexes have taken advantage of these facilities for information. Mr. George Jewsbury, 39, Kelvin Road, N.5, the Secretary of the local branch of the British Social Hygiene Council, has supplied me with the following report on their work during the year. " The activities of the Islington Branch of this Council were during the months of July, August and September on alternate Thursdays in the open air at Highbury Corner. Mr. Spencer Duncan delivered lectures on the ' Problems of Health,' ' Evils of Dissipation and Consequences.' Lectures were given by Miss Dugdale to Womens' Meetings in various Churches from time to time during the year. Six lectures were given in October at the Central Library Hall :— 3 to women, by Dr. Rose Turner. 3 to men, by Dr. Feldman. ' The Problems of Life and Health,' and ' The Gift of Life.' Approximate attendance in open air, 200. In the Central Library, 50." DEATHS FROM COAL-GAS POISONING. During the year 25 deaths were registered from asphyxia caused by the inhalation of carbon-monoxide gas. Nineteen deaths from the same cause occurred in 1928. Twenty-one of these deaths were attributable to suicide, while the cause of the remaining 4 deaths was accidental, which were investigated at the request of the Ministry of Health. 29 [1929 Of the 25 deaths, 22 were males and 3 females, the ages ranging from 25 to 75 years. The Medical Officer of Health at the request of the Editor of " First Aid " (a journal circulating among ambulance workers), gave permission to reprint in their columns his notes on " Poisoning from Coal and Exhaust Gases." ACCIDENTAL DEATHS. The deaths due to accident numbered 149. Of this number 58 deaths were ascribed to vehicular traffic and 52 to accidental falls, including 42 aged people. The 58 deaths due to accidents in vehicular traffic may be summarised as follows :— Motor Car or Lorry. Bus or Tram. Taxi-cab. Other Vehicles. Total. 43 3 3 9 58 Of this number, 27 deaths occurred to Islington residents when in outlying districts. In addition to these, 10 non-residents were also killed by vehicles within the borough. INQUESTS AND MORTUARY. During the year 306 bodies were received into the Mortuary, as compared with an average of 315 in the preceding 10 years. Only four infectious bodies were received during the year. The daily average number of bodies received was 0.8, whilst in 1928 the average was 0.7. In 246 cases inquests were held, as contrasted with an average of 289 in the ten years 1919-28. Bodies received into Mortuary Inquests. 1919 429 321 1920 340 312 1921 313 299 1922 316 307 1923 288 279 1924 294 317 1925 275 306 1926 308 305 1927 309 240 1928 274 206 Average 315 289 1929 306 246 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1919-28 :— 1929 No. of bodies received. Daily Average. No. of Inquests held. 1928 No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 109 1.2 98 1st Quarter 82 0.9 64 2nd 61 0.7 53 2nd ,, 72 0.8 46 3rd 81 0.9 45 3rd ,, 57 0.6 43 4th 55 0.6 50 4th „ 63 0.7 53 Total for year 306 0.8 246* Total for year 274 0.7 206* * Inclusive of Inquests held by the Coroner upon bodies of deceased persons who died in Public Institutions in the borough. 30 1929] PREVENTION OF INFECTION. Notification, Isolation, Fatality, or 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. 2,439 cases of the principal diseases which are notifiable under the Public Health (London) Act, 1891, came to the knowledge of the Medical Officer of Health. This number does not include other communicable ailments, which are also notifiable. The complete list of infectious diseases which are notifiable in Islington will be found on page 36. The total cases notified are 179 more than those of the previous year (2,260), and 5 above the average (2,434) of the preceding ten years. The increases when contrasted with the decennial averages are to be found in the returns from Small Pox, Membranous Croup, Diphtheria, Enteric Fever, Erysipelas, and Puerperal Fever, and Continued Fever, which were respectively 71, 1, 53, 3, 14, 10 and 1 above the average, while Scarlet Fever showed a decrease of 148 cases on the ten years' average. The 2,439 cases were equal to an attack-rate of 7.62 per 1,000 of the civil population. The returns for the preceding ten years are given in the following statements :— Year. Cases. Attack-rates per 1,000 civil population. 1919 1,993 6.05 1920 2,853 8.49 1921 4,344 13.05 1922 2,787 8.34 1923 2,096 6.22 1924 2,085 6.06 1925 2,194 6.47 1926 1,918 5.65 1927 1,813 5.42 1928 2,260 6.96 10 years average 2,434 7.27 1929 2,439 7.62 Registration Sub-Districts.—The total number of cases notified in these districts was as follows Total cases notified. Tufnell 166 Upper Holloway 314 Tollington 269 Lower Holloway 331 Highbury 325 Barnsbury 484 Islington South-East 550 Total 2,439 SMALL-POX. In the previous year, 1928, outbreaks of Smallpox were limited in Islington to four cases. This year, 1929, we had 71 notified, the disease, however, affecting 70 persons, as one of these was notified, admitted to hospital, retained nine days, was subsequently re-notified and re-admitted. Of the 70 persons enumerated, 56 were unvaccinated, 12, all over 25 years of age, were vaccinated in infancy only, and in two casse the state of vaccination was not known, or doubtful. 31 [1929 The simplest way perhaps of giving the general idea of the infection within the Borough will be to consider the cases in groups, dealing with importations from outside, and in each group considering it from the point of view of the source of infection as far as this could be ascertained. Cases infected in St. Bartholomew's Hospital, and cases arising therefrom, accounted for four cases. As regards cases in private houses, a lad, unvaccinated, who is a shop assistant in another borough, contracted Smallpox from a customer who made purchases while she had the rash of Smallpox upon her; she had not sought medical advice. Seven other unvaccinated members of the family, including the father and mother, contracted the disease from this lad. Two others, brothers, aged 19 and 17 years of age, escaped infection; they had been vaccinated in infancy. An interesting case in a private house was that in which the first case was a disinfector, an elderly man, unprotected by recent vaccination, having been vaccinated in infancy only. This man contracted Smallpox while disinfecting houses infected with Smallpox in another part of London, as part of his work. He spread the disease to his wife, vaccinated in infancy only, and two unvaccinated daughters. Two other daughters, vaccinated in infancy, escaped. Cases in other ordinary private houses do not call for any special comment. Taking blocks of buildings, however, in Ebenezer Buildings, Rotherfield Street, a girl, unvaccinated, who had just left school and started work, contracted what was considered Chicken Pox. The Medical Officer of Health's attention was not called to this case for 19 days. In the same household the infection spread to two unvaccinated members, and to one aged 53 years, vaccinated in infancy only. The infection also extended in the same block, affecting an unvaccinated child of 10 years, another unvaccinated child of 15 years, whose mother, also unvaccinated, contracted the disease, and still in the same block the infection appeared in another family, affecting an unvaccinated person of 17 years and another of 8 years. Again, still two members of another family, twins, aged 11 years, were infected. In addition, a son of the first case mentioned in these buildings, living elsewhere, a frequent visitor, contracted the disease. It will be noted that the infection, except for this last, the son living elsewhere, apeared to be confined to the particular block. As regards Peabody Buildings, Popham Street, infection was introduced from the patient's workplace in East Ham. The patient was aged 19 years, but vaccination had not been successfully done in infancy, and had not been again attempted. His brother, living in an adjacent house of the same block, who had never been vaccinated and who refused vaccination when offered on the removal of his brother, contracted the disease. The outbreak in this particular set of buildings was confined to these two cases. In addition to the cases above mentioned, which are officially recorded as Islington cases of Smallpox, nine cases were dealt with by us which were temporarily within the Borough and who lived elsewhere. One, resident in Shoreditch, was seen by the Medical Officer of Health at the Islington Medical Mission ; one, resident in the City of London, was seen at the London Fever Hospital, Liverpool Road. The remaining 7 cases were removed from the Holborn and Finsbury Hospital, Archway Road. In connection with these cases at the Holborn and Finsbury Hospital, attention was drawn on page 32 of the Medical Officer of Health's Annual Report for 1928 to the worry caused by the transfer of such cases 32 1929] of undiagnosed Smallpox or persons known to be contacts who may eventually show signs of the disease. The matter was again taken up in 1929 with the Medical Officer of Health for Holborn in respect of two children who were sent to that hospital when other members of the family had been removed with Smallpox, no intimation being sent to the Medical Officer of Health of the district (Islington) of such transfer. It is to be hoped that with the change over of the Poor Law Hospitals to the London County Council better arrangements will be made in future, and that a ward, or a small hospital, will be specially set aside for such " suspect " cases, whom the Public Assistance Authority will, as successors to the Guardians, have to look after, and that the practice of sending these cases into large institutions where they come in contact with susceptible people will cease. Much extra work was thrown on the staff, both office and disinfecting station, and other work had to give place temporarily to the Smallpox precautionary work. A new leaflet on Smallpox and vaccination was distributed. Coincident with this being done the members of the Borough Council each received a letter discrediting vaccination and questioning statistical statements, which curiously enough must have been taken by the Society, judging the context, from an old leaflet issued by the previous Medical Officer years ago. Needless to say, such obvious straining for effect by quoting obsolete matter was quite evident to the recipients, and met w ith no response. Diphtheria was responsible for 1,008 cases of illness, which were 57 above the average (951) of the preceding ten years. The attack rate was equal to 3.14 per 1,000 of the civil population annually, and was 0.29 above the mean rate (2.85) of the decennial period. In London the attack-rate was 2.68 per 1,000, and the Encircling Boroughs 2.59. DIPHTHERIA ANTI TOXIN. Under the Special Order of 15th August, 1910, the then Local Government Board sanctioned the provision by the Sanitary Authority, in pursuance of section 77 of the Public Health (London) Act, 1891, of a temporary supply of Diphtheria Anti-toxin " for the poorer inhabitants of the district, subject to the following conditions, that is to say, the arrangements with respect to the keeping, distribution and use of the Diphtheria Anti-toxin shall be made in accordance with the advice of the Medical Officer of Health." The section of the Public Health Act referred to is that which enables the authority with the sanction of the Local Government Board to provide a temporary supply of medicine, etc., for the poorer inhabitants of their district. (See also page 37.) ANTI-TOXIN TREATMENT. During the year 98,000 units of Diphtheria Anti-toxin serum were issued to Medical Practitioners in the Borough. Of this quantity 54,000 units were sold, the total amount received by the Council being £3 9s. 4d. The remaining 44,000 units were given free, owing to the patients' limited means. 33 [1929 Scarlet Fever.—1,155 cases were notified, and they showed a decrease of 148 on the average (1,303) of the ten years 1919-28. The attack-rate was equal to 3.61 per 1,000 of the civil population annually, which is a decrease of 0.30 per 1,000 of the mean rate (3.91) of the preceding ten years. In London the attackrate was 3.60 per 1,000 of the civil population, while in the Encircling Boroughs it was 3.50. Enteric Fever.—18 cases were notified which were 3 more than the average that obtained during the ten years 1919-28. The attack-rate was 0.06 per 1,000 annually, or 0.02 per 1,000 above the mean rate (0.04) of the last ten years. In London the rate was 0.08, and in the Encircling Boroughs 0.07 per 1,000 of the civil population. Typhus Fever.—No case was notified. Puerperal Fever.—See page 12. Erysipelas.—148 cases were notified, and were 14 above the average of the preceding ten years, the attack-rate being 0.46 per 1,000 of the civil population. FATALITY FROM THE 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 2,439 cases notified, 57 deaths occurred, or 2.3 per cent., which contrasts with an average percentage of 3.5 in the preceding ten years 1919-28. During the year it was found that of the 2,439 cases notified, 57 deaths occurred, or 2.3 per cent., which contrasts with an average percentage of 3.5 in the preceding ten years 1919-28. Years. Cases. Deaths. Fatality. 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* 66 3.2 1925 2,194 51 2.3 1926 1,919‡ 63 3.3 1927 1,813 55 3.0 1928 2,260 60 2.7 Mean 2.434 86 3.5 1929 2,439 57 2.3 * Including 2 cases not notified. ‡ Includes 1 case not notified. Hospital Isolation.— Of the 2,439 cases of infectious diseases notified, 2,337 were isolated in hospital, equal to a percentage of 95.8, while only 4.2 per cent. of the patients were nursed at home. 34 1929] The following tabular statement shows the number of cases treated in the various public institutions :— Year. Cases treated in Hospital. Percentage of cases treated. 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 1926 1.852 96.5 1927 1,722 95.0 1928 2,153 95.3 1929 2,337 95.8 DISEASES TREATED IN HOSPITAL. Disease. Total cases. Cases isolated. Percentage of known cases. Small Pox 71 71 100.0 Scarlet Fever 1,155 1,124 97.3 Diphtheria 1,008 996 98.8 Enteric Fever 18 17 94.4 Erysipelas 148 93 62.8 Puerperal Fever 38 35 92.1 Continued Fever 1 1 100.0 2,439 2,337 95.8 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 1929. 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 71 — 71 100.0 — — — — — — — Scarlet Fever 1,124 31 1,155 97.3 2.7 8 — 8 0.7 — 0.7 Diphtheria 996 12 1,008 98.8 1.2 33 1 34 3.3 8.3 3.4 Enteric (Typhoid Fever) 17 1 18 94.4 5.6 2 — 2 11.7 — 11.1 Typhus Fever — — — — — — — — — — — Erysipelas 93 55 148 62.8 37.2 12 1 13 13.1 1.8 8.8 Puerperal Fever 38 — 38 100.0 — 14 — 14 36.8 — 36.8 Continued Fever 1 — 1 100.0 — — — — — — — Relapsing Fever — — — — — — — — — — — Cholera — — — — — — — — — — — Total 2,337 102 2,439 95.8 4.2 69 2 71 2.9 1.9 2.9 35 [1929 Showing the number of Cases and Attack Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1919-28 and in 1929. DISEASES. YEARS. Average number of cases, 1919-28 1929 Increase or Decrease 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 Small Pox Cases 2 — — — — — — 1 — 4 — 71 + 71 Rate 0.00 — — — — — — 0.00 — 0.01 0.00 0.22 + 022 Diphtheria Cases 645 1324 1548 1126 889 854 911 743 716 756 951 1004 + 53 Rate 1.96 3.94 4.65 3.37 2.64 2.48 2.69 2.19 2.14 2.33 2.85 3.14 + 0.29 Membranous Croup Cases 4 4 5 4 2 2 2 — 4 4 3 4 + 1 Rate 0.01 0.01 0.02 0.01 0.00 0-00 0.00 — 0.01 0.01 0.01 0.01 — Scarlet Fever Cases 1084 1307 2622 1496 1080 1077 1139 1010 909 1305 1303 1155 — 148 Rate 3.29 3.89 7.87 4.48 3.21 3.13 3.36 2.98 2.72 4.02 3.91 3.61 — 0.30 Enteric Fever Cases 16 24 10 9 16 14 10 18 12 19 15 18 + 3 Rate 0.05 0.07 0.03 0.03 0.05 0.04 0.03 0.05 0.03 0.06 0.04 0.06 + 0.02 Continued Fever * Cases 1 — — — — 3 — 1 — — — 1 + 1 Rate 0.00 — — — — 0.01 — 0.00 — — 0.00 0.00 — Puerperal Fever* Cases 29 29 34 20 22 19 23 27 33 38 28 38 + 10 Rate 4.62 3.08 4.31 2.68 3.10 2.79 3.50 4.18 5.40 6.56 4.00 6.89 + 2.89 Erysipelas Cases 212 165 125 132 87 116 109 118 139 134 134 148 + 14 Rate 0.64 0.49 0.38 0.39 0.26 0.34 0.32 0.35 0.42 0.41 0.40 0.46 + 0.06 Totals Cases 1993 2853 4344 2787 2096 2085 2194 1918 1813 2260 2434 2439 + 5 Rate 6.05 8.49 13.05 8.34 6.22 6.06 6.47 5.65 5.42 6.96 7.29 7.62 + 0.33 * Per 1,000 Registered Births. Showing the Cases of the Notifiable Infectious Diseases notified, in the SubRegistration Districts and the Wards during the Year 1929. SubRegistration Districts. Wards. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid' Fever. Typhus Fever Erysipelas. J Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Tufnell Tufnell — 106 46 — 2 — 10 2 — — — 166 Up. Holloway Up. Holloway 5 116 168 — 4 — 17 4 — — — 314 Tollington Tollington — 131 124 — 2 — 10 2 — — — 269 Lr. Holloway Lr. Holloway 6 199 102 3 1 — 19 1 — — — 331 Highbury Highbury 2 71 64 — 1 — 12 6 — — — 156 Mild may 2 89 60 — 2 — 11 5 — — — 169 Barnsbury Thornhill 7 123 94 1 1 — 24 7 1 — — 258 Barnsbury 17 90 103 — — — 9 7 — — — 226 Islington, S.E. St. Mary's 1 89 75 — 1 — 9 — — — — 175 Canonbury 22 78 68 — 2 — 13 1 — — — 184 St. Peter's 9 63 100 — 2 — 14 3 — — — 191 Totals 71 1,155 1,004 4 18 — 148 38 1 — — 2,439 Attack-Rates per 1,000 popula tion 0.22 3.61 3.14 0.01 0.06 — 0.46 0.12 0.00 — — 7.62 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 disease 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 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, and Tuberculosis. 36 1929] Acute Poliomyelitis. Three cases were notified from this disease druing the year, as contrasted with none in 1928, and 6 in 1927. 1929 1928 Cases. Deaths. Cases. Deaths. 1st Quarter Nil Nil Nil Nil 2nd „ 1 „ „ „ 3rd „ „ „ „ „ 4th „ 2 1 „ „ 3 1 Nil Nil Epidemic Cerebro-Spinal Meningitis. Nine cases came to the knowledge of the Medical Officer of Health, although only 6 were notified, as against 4 in 1928. During the ten years 1919-28 the cases averaged 8 per annum. A return of attacks of the disease during the past ten years is given in the following statement:— 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 Average 10 yrs. 1919-28 1929 Total Deaths, 1919-28. 1st Quarter 8 5 3 1 3 — 2 3 3 1 3 2 25 2nd „ 7 5 3 2 2 — 1 3 3 4 3 2 22 3rd „ 1 2 — — 2 2 2 3 — 2 1 2 8 4th „ — 2 1 — 1 4 1 2 1 1 1 3 9 Year 16 14 7 3 8 6 6 11 7 8 8 9 64 The deaths during the year numbered 4 and were equal to the very high rate of 44 per cent. of the cases notified. Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations, 1919. These Regulations came into force on the 7th January, 1919, and during the past 5 years the following cases were notified by medical practitioners to the Medical Officer of Health :— 1925 1926 1927 1928 1929 Malaria Nil Nil 2 — 2 Dysentery Nil Nil 5 1 6 Acute Primary Pneumonia 93 190 202 288 397 Acute Influenzal Pneumonia 41 55 124 50 122 Total 134 245 333 339 527 37 [1929 DYSENTERY. Six cases of Dysentery were notified during the year. Two occurred in Tollington, 2 in Barnsbury, 1 in Lower Holloway and 1 in Upper Holloway Wards. The Infectious Diseases (London) Regulations, 1927, came into force in 1928, superseding the regulations to which attention was drawn on page 35 of the Medical Officer of Health's Report for the year 1927. These amended regulations overcome the difficulties referred to. GLANDERS, ANTHRAX AND HYDROPHOBIA IN MAN. Order under Section 55 of the Public Health (London) Act, 1921, by the London County Council. (Came into operation on the 26th April, 1909.) No cases were known in Islington during the year . Acute Encephalitis Lethargica and Acute Polio-Encephalitis. These diseases became notifiable under an Order of the Local Government Board on the 1st January, 1919. During the year 8 cases of Acute Encephalitis Lethargica were known, but only 6 were notified. They showed an increase of 3 on the return of the previous year, whilst 3 deaths were registered; or 37.5 per cent. of the cases. The following summary shows the number of cases, and also the fatality of recent years :— Acute Encephalitis Lethargica. Years. 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 Average (10 years). 1929 Cases 5 8 11 3 10 39 17 21 7 5 13 8 Deaths 1 4 2 3 5 4 6 9 4 3 4 3 One case of Acute Polio-encephalitis only was known in the Borough. Ophthalmia Neonatorum. Purulent Disease of the Eyes of Newly-born Children. See p. 10. SUPPLY OF INSULIN TO NON-INSURED PERSONS. Under Section 77 of the Public Health (London) Act, 1891, a temporary supply of medicine, etc., for the poorer inhabitants of a district may with the sanction of the Minister of Health, be made. Under this section, the Minister on the 9th December, 1929, granted authority to the Islington Borough Council to make such provision for the poorer inhabitants. The sanction was given provisicnally for a period of twelve months. It is laid down by the Minister that practitioners applying for supplies of Insulin should state :— (a) the name and address, age and sex of each patients for whom it is wanted, and (b) to furnish a quarterly report in respect of each patient treated, giving the following information (1) The number of doses of Insulin administered ; (2) Whether any tests were made of the urine or of the blood of the patient, and, if so, by whom and with what results. 38 1929] The Minister of Health has to be furnished with a quarterly report by the Medical Officer of Health giving an abstract of the reports forwarded by the medical practitioners, the cost of the Insulin supplied by the Borough Council, and any general remarks as to the working of the arrangements. So far the demand for such assistance for patients comes through the Almoners of two of the largest hospitals. During the year under review one case had commenced to receive this assistance from the Borough Council. BLIND PERSONS ACT, 1920. SCHEME FOR THE WELFARE OF BLIND PERSONS IN THE CITY OF LONDON, AS APPROVED BY THE MINISTRY OF HEALTH. This scheme is administered by the London County Council. As regards children of school age, that is, up to five years, the London County Council, through the several Metropolitan Boroughs, communicate with the Borough Medical Officers of Health for the home visitation of such cases to be carried out by the Municipal Health Visitors. A watch is kept on the home conditions in case these should be unsuitable for the blind child. It is recognised, except in very exceptional circumstances, a blind child should not be removed from his or her home. In the event, however, of this being necessary, some watch is required as regards the arrangements which are proposed to be made with the consent of the parents or guardians. So far the children under five years of age who came under our supervision during the year 1929 remain the same two children. Their condition calls for no special comment. TUBERCULOSIS. 616 cases of Tuberculosis in its different forms were notified during the year. The attack rate was equal to 1.93 per 1,000 of the civil population. This number was a decrease of 78 on the return of the previous year, and of 0.21 per 1,000 on the attack-rate Respiratory (Pulmonary) Tuberculosis.—510 notifications were received, of which 278 referred to males and 232 to females, and represented an attack-rate of l.59 per 1,000 inhabitants. Showing the Notified Cases of Tuberculosis in the Wards during 1929. 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 24 31 55 4 5 9 64 2.00 Up. Holloway Up. Holloway 22 14 36 3 4 7 43 1.42 Tollington Tollington 26 15 41 5 5 10 51 1.72 Lr. Holloway Lr. Holloway 22 21 43 7 4 11 54 1.36 Highbury Highbury 28 17 45 5 5 10 55 1.80 Mildmay 27 15 42 2 7 9 51 1.85 Barnsbury Thornhill 24 20 44 5 11 16 60 2.07 Barnsbury 19 27 46 2 9 11 57 2.39 Islington, S.E. St. Mary's 20 22 42 2 7 9 51 2.92 Canonbury 31 21 52 2 5 7 59 1 .91 St. Peter's 35 29 64 3 4 7 71 2.49 Totals 278 232 510 40 66 106 616 1.93 33 [1929 THE PERIOD OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1929. Tubercular Diseases. Sex. Cases Notified in Whole District. At all ages. At Ages—-Years. Under 1 X to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and up. Respiratory Tuberculosis M. 278 — 3 7 46 124 84 14 F. 232 — 1 15 93 86 33 4 Tubercular Meningitis M. 3 — 1 1 1 — — — F. 2 1 — 1 — — — — Tabes Mesenterica M. 5 — — 2 2 1 — — F. 9 — 3 4 2 — — General Tuberculosis M. — — — — — — — — F. — — — — — — — — Other forms of Tuberculosis M. 32 — 5 15 8 4 — — F. 55 1 7 14 13 16 4 — All Tubercular Diseases M. 318 — 9 25 57 129 84 14 F. 298 2 8 33 110 104 37 4 Totals 616 2 17 58 167 233 121 18 Percentages at each life period to total cases 0 32 2.76 9.42 27.11 37.83 19.64 2.92 From the above statement it will be seen how the disease attacked people at the various ages, viz. : In every hundred cases 0.32 were under 1 year of age. „ „ 2.76 were aged 1 to 5 years. „ „ 9.42 were aged 5 to 15 years. Prime of Life „ „ 27.11 were aged 15 to 25 years. „ „ 37.83 were aged 25 to 45 years. „ „ 19.64 were aged 45 to 65 years. „ „ 2.92 were aged 65 and upwards. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1925. These Regulations provide that no person suffering from respiratory tuberculosis who is in an infective condition shall be engaged in any form of dairy work involving the milking of cows, the treatment of milk, or the handling of containers. No case has come to the notice of the Medical Officer of Health during the year which calls for action. The last case reported on was in the year 1927, page 39 of the Medical Officer of Health's Annual Report. ISLINGTON INTERIM TUBERCULOSIS CARE COMMITTEE. This Committee has not been taken over by the Borough Council, and the clerical work, etc., is done through the London County Council. To this Committee the department refers applications, which are occasionally received, regarding extra nourishment—milk, butter and eggs. It may be remembered that when the question of supplying this food was before the Public Health Committee, the amount allowed (expenses are limited to £2 per 1,000 of the population) was thought at that time to be inadequate, and if it were kept within bounds, it would 40 1929] be a difficult matter to make a selection as to who should receive the nourishment. Other Boroughs, however, took up the scheme and distributed the nourishment as far as it would go. Tht object of this provision is to assist the ex-sanatorium patients and other suitable cases. The nourishment is not intended for advanced cases where real improvement is not anticipated. Miss Thwaites, the Secretary of the Committee, has supplied me with the following examples of the work carried on during the year :— Examples of Constructive Care Work carried through by the Interim Tuberculosis Care Committee of Islington, 1929. Housing.—Patient (17) sharing bed with two younger children, because parents unable to evict lodgers. Member of Interim Tuberculosis Care Committee took case up to Court; eviction order given, costs paid by defendants. Room available. Several cases referred to Medical Officer of Health for Sanitary Inspector to visit. Defective lavatory repaired. House repairs carried out. Referred to Poor Man's Lawyer for advice re mortgage on death of patient. Relations finally took over mortgage on wife's behalf. Lodger found for spare room during patient's absence. Clothes.—Patient at Godalming. Overcoat supplied by member of Tuberculosis Care Committee, and boots by C.O.S. Many cases. Clothes and boots supplied by U.S.F. or C.O.S. on patients' admission or during treatment as required. Patient at home. No blankets on bed. Blankets supplied by members of Tuberculosis Care Committee. Dentures. — Patient at Godalming. Teeth paid for by C.O.S., wife being on Out-Relief. Patient at Godalming. Teeth paid for by C.O.S., patient contributing £1. Convalescence.—Patient sent to grandmother in Wales while awaiting sanatorium vacancy, on account of unsatisfactory home conditions, mentally deficient father having just returned from prison. Patient referred to U.S.F. for convalescence after second period of treatment, before returning to Firewood Factory. Patient died. Delicate mother prostrated with grief. Referred to C.O.S. and sent away with grandchild. Patient's husband, bad character. Children boarded out as " contacts " to remove them from father's influence. Patient then accepted further treatment. 41 [1929 Insurance.—Patient's insurance card lost? by agent. 39s. arrears paid by C.O.S. ; full benefit then received and money repaid to C.O.S. Qualifying stamps supplied ; full benefit then received. Patient, age 16½. Qualifying stamps supplied, benefit received after some delay, and money repaid for stamps by patient. Approved Society reported insurance card understamped by employer originally (i.e., card not stamped for first 6 weeks after patient's 16th birthday). Money for qualifying stamps reclaimed by Ministry of Health from employer, and by patient subsequently from Ministry. Loss of benefit, £3 4s. 6d., reclaimed by Tuberculosis Care Committee from employer on behalf of patient. Advice given in several cases about insurance difficulties, arrears, qualifying stamps, etc. ; others referred to Insurance Inspector for advice. Income supplemented.—Patient's wife referred to Italian Benevolent Society who made a grant of 10s. a week. Invalid dinners obtained for patients at home, 2s. a week being paid for them by U.S.F. or C.O.S. (3403/25, 040/29, 2485/29). Patient discharged himself owing to wife's serious illness. Referred to U.S.F. who granted 10s. a week and food tickets. Patient referred back to British Legion after final grant had been made. Case reconsidered and further grant made pending treatment. Patient referred to Red Cross who pressed claim for pension and helped meantime. Pension obtained. Help for patient obtained from Guardians by intervention of Tuberculosis Care Committee. Patient's children placed on free school dinner list, while patient away and husband out of work. Patient away. Wife and child on Out-Relief. Out-Relief increased by 8s. a week through intervention of Tuberculosis Care Committee. Patient away. Wife referred to Infant Welfare Centre. Milk given. Patient at home. Gross income 24s. a week for three people. Referred to Guardians who allowed 5s. a week and ½ cwt. coal. Patient died. Funeral expenses in excess of insurance money obtained from London County Council. Patient away. Pension of 5s. a week for blind mother obtained. Patient away. Wife ill at home. Doctor's fees paid. Employment.—Patient accepted for Godalming domestic training scheme. Patient unable to accept offer owing to death of married sister, leaving babyto be cared for. Advice given to patient about obtaining printing machine for work at home. Gross income otherwise 30s. a week for patient and wife and three children. Patient's wife refused to have him home for fear of infection. Vacancy obtained at Firewood Factory ; first week's wages advanced and subsequently repaid. 42 1929] Employment obtained at Spero Leather Factory. Patient was offered post under Godalming training scheme but refused it. Vacancy secured at Firewood Factory. Patients anxious to find work in the country. Offers to advertise for them were, however, declined by patients. Patient referred to Winter Distress League and was given work in the Parks. Patient referred to Winter Distress League and was given work in the Parks. Patient improved so much in consequence that recommendation for further sanatorium treatment was cancelled. Patient's wife referred to Guardians for work rather than Out-Relief. Employment given. Work found for patient's wife by member of Tuberculosis Care Committee. Neglect.—Information received from patient, through visitor, of ill-treatment of children of drunken tenants. N.S.P.C.C. informed. Children placed under supervision. New cases referred to I.T.C.C. during 1929, 300. New cases assessed by I.T.C.C. during 1929, 130. Cases visited by I.T.C.C. during 1929, 660. Contributions collected by I.T.C. during 1929, £542 13s. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1924. The provisions of these Regulations continue to be systematically carried out with regard to the Register of Notified Cases of Tuberculosis. A quarterly revision of the Register is made by the removal of the names of patients who have died, left the district, and those, who in the opinion of the Tuberculosis Officer, confirmed by the L.C.C. Medical Officer, should be denotified. The following is a statistical statement showing the number of cases of Notified Tuberculosis on the register at the commencement of the year, the numbers, removing during that period, and the actual number remaining at the close of the year, 1929 (i.e., ending 28th December, 1929) :— Lungs. Other Forms. Total. M. F. M. F. Numbers on register at the commencement of the year 1929 1,134 896 364 340 2,734 Notified cases added during the year 1929 278 232 40 66 616 Cases coming to the knowledge of the Medical Officer of Health (other than by notification) during Me year 1929 49 33 13 10 105 1,461 1,161 417 416 3,455 No. of cases removed from the register during the year 19)19 259 201 35 37 532 1,202 960 382 379 2,923 ■»>«.. . 43 [1929 Showing the Notified Cases of Tuberculosis in the Quarters during 1929. 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 78 60 138 72 60 132 68 60 128 60 52 112 278 232 510 Tubercular Meningitis ... 2 2 2 ... 2 1 ... 1 ... ... ... 3 2 5 Tabes Mesenterica ... 1 1 1 2 3 3 3 6 1 3 4 5 9 14 General Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other forms of Tuberculosis 8 14 22 15 19 34 6 11 17 3 11 14 32 55 87 Totals 86 77 163 90 81 171 78 74 152 64 66 130 318 298 616 Disinfection of Houses and Rooms after Tuberculosis,—The following statement gives the particulars for the year :— Houses. Rooms. 1st quarter 180 168 2nd „ 121 157 3rd „ 94 141 4th „ 76 101 Total 421 567 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 30th December, 1928, to the 28th December, 1929, in the Metropolitan Borough of Islington. Age-periods Notifications on Form A. Total Notifications on Form A. Number of Primary Notifications. 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 3 5 2 15 31 74 50 55 29 14 278 436 „ Females — 1 7 7 31 62 49 37 22 11 4 231 354 Non-pulmonary Males — 6 13 1 7 4 4 1 — — — 36 52 „ „ Females 2 6 13 4 7 10 13 5 4 — — 64 78 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 — — — — — 84 190 „ Females — 1 — 1 3 59 119 Non-pulmonary Males — 3 1 4 7 2 32 „ „ Females 1 1 — 2 4 4 34 44 1929] Showing New Cases of Tuberculosis and all Deaths during 1929. Age Periods. New Cases. Deaths, Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary M. F. M. F. M. F. M. F. Under 1 year 2 — — 3 2 — — 2 1-5 5 4 8 8 3 3 2 2 5-10 5 8 13 15 — 1 1 2 10-15 2 9 2 4 — 3 1 1 15-20 17 32 7 7 11 11 3 — 20-25 36 66 5 12 23 29 1 3 25-35 78 52 5 13 38 24 2 1 35-45 58 38 2 5 39 19 3 45 55 61 25 — 4 49 19 — — 55-65 32 13 4 — 22 8 4 1 65 and upwards 16 5 — — 6 4 — 2 Totals 312 262 46 71 193 121 17 14 61 Deaths not notified or 17.6 per cent. of Total Deaths. TUBERCULOSIS DISPENSARIES. The department has worked in close co-operation with the Tuberculosis Dispensaries. Unfortunately the state of Dr. H. F. Comyn's health, the Tuberculosis Officer for the Northern Dispensary District, had been giving considerable anxiety for some time, which did not improve in spite of convalescence leave granted by the hospital authority, and they reluctantly had to accept his resignation. The Dispensary at the Royal Northern, or as it was then called the Great Northern Central, Hospital, was opened in May, 1917, and Dr. Comyn was the first and only Tuberculosis Officer at this Dispensary. (The Southern Dispensary at the Royal Chest Hospital, City Road, a joint dispensary with the Boroughs of Shoreditch and Finsbury, had been opened earlier, 1st August, 1916, Tuberculosis Officer, Dr. A. J. McFarland). It is thus seen that at the time of his retirement Dr. Comyn was the remaining originally appointed Tuberculosis Officer. He was well liked by the patients, was a persona grata with the hospital staff, and his work, which was outstanding, will be remembered. 45 [1929 TUBERCULOSIS DISPENSARIES. RETURN SHOWING THE WORK OF THE SOUTH ISLINGTON TUBERCULOSIS DISPENSARY DURING THE YEAR 1929. Diagnosis. Pulmonary. Non-pulmonary. Total. (6) Adults. (6)Childr'n. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.— New Cases(7) examined during the year (excluding contacts): (a) Definitely tuberculous 61 41 3 3 2 13 6 3 63 54 9 6 (b) Doubtfully tuberculous(8) - - - - - - - - 1 2 1 — (c) Non-tuberculous - - - - - - - - 71 63 29 32 B.— Contacts examined during the year:— (a) Definitely tuberculous 14 27 2 6 - 1 1 2 14 28 3 8 (b) Doubtfully tuberculous(8) — — — — — — — — — 1 — — (c) Non-tuberculous - - - - - - - - 51 61 77 63 C.— Cases written off the Dispensary Register(9) as (a) Cured (10) - 1 - - 1 - 1 - 1 1 1 - (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) - - - - - - - - 124 125 108 95 D.— Number of Persons on Dispensary Register(9) on December 31st:— (a) Diagnosis completed 320 240 24 30 24 41 47 38 344 281 71 68 (b) Diagnosis not completed - - - - - - - - 1 3 3 — 1. Number of persons on Dispensary 10. Number of consultations with Register(9) on January 1st 672 medical practitioners:— 2. Number of patients transferred from (a) At Homes of Applicants 8 other areas and of "lost sight (b) Otherwise 135 of"(11)cases returned 84 11. Number of other visits by 3. Number of patients transferred to culosis Officers to Homes 363 other areas and cases "lost sight Number of visits by Nurses or 2,052 of" 74 Health Visitors to Homes for (Dispensary sister) 1,268 Municipal Tuberculosis Visiting Nurse 4. Died during the year 93 Dispensary purposes 1,268 5. Number of observation cases(8) Municipal under A (b) and B (b) above in Tuberculosis which period of observation ex- Visiting Nurse ceeded 2 months 1 13. Number of Number of attendances at the Dis- (a) Specimens of sputum, &c. pensary (including Contacts) 5,899 examined 736 (b) X-ray examinations made in 7. Number of attendances of non pul- (b) X-ray examinations made in connection with Dispensary monary cases at Orthopædic work 72 Out-stations for treatment or 14. Number of Insured Persons on Dispensary Register(9) on the 8. Number of attendances, at General 31st December 448 Hospitals or other Institutions approved for the purpose, of 15. Number of Insured persons under patients for Domiciliary Treatment(4) on the (a) "Light" treatment 18 31st December 280 (b) Other special forms of treatment 50 16. Number of reports received during 9. Number of patients to whom the year in respect of Insured Dental Treatment was given, at Persons:— or in connection with the Dis- (a) Form G.P. 17 12 pensary 7 (6) Form G.P. 36 - 28th February, 1930. G. CLARK TROTTER, Chief Tuberculosis Officer. 46 1929] RETURN SHOWING THE WORK OF THE NORTH ISLINGTON TUBERCULOSIS DISPENSARY DURING THE YEAR 1929. Diagnosis. Pulmonary. Non-pulmonary. Total. (6)Adults. (6)Childr'n. Adults. Children. Adults. Children. M. F. M. F. M. F. M. F. M. F. M. F. A.— New Cases(7) examined during the year (excluding contacts): (a) Definitely tuberculous 84 47 - - 2 6 4 3 86 53 4 3 (b) Doubtfully tuberculous(8) 11 7 1 1 — 3 3 2 11 10 4 3 (c) Non-tuberculous - - — — — - - - 58 54 22 10 B.— Contacts examined during the year:— (a) Definitely tuberculous 5 9 - - 1 - 1 - 6 9 1 - (b) Doubtfully tuberculous(8) 1 1 1 - - - - - 1 1 1 — (c) Non-tuberculous - - - - - - - - 18 62 40 41 C.— Cases written oft the Dispensary Register (9) as (a) Cured(10) - - - — - 1 - - - 1 - - (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases - - - - - - - - 76 116 62 51 D.— Number of Persons on Dispensary Register(9) on December 31st:— (a) Diagnosis completed 283 222 2 1 24 35 20 19 307 257 22 20 (b) Diagnosis not completed — — — — — — — — 6 7 1 — 1. Number of persons on Dispensary 10. Number of consultations with Register(9) on January 1st 667 medical practitioners:— 2. Number of patients transferred from (a) At Homes of Applicants 13 other areas and of "lost sight (b) Otherwise 236 of"(11) cases returned 41 11. Number of other visits by Tuber- 3. Number of patients transferred to culosis Officers to Homes 49 other areas and cases "lost sight 12. Number of visits by Nurses or 772 of" 178 Health Visitors to Homes for Dispensary Sister) 4. Died during the year 102 Dispensary purposes 1,614 5. Number of observation cases(8) Municipal under A (b) and B (b) above in Tuberculosis which period of observation Visiting Nurse exceeded 2 months 8 13. Number of 6. Number of attendances at the Dis- (a) Specimens of sputum, &c., pensary (including Contacts) 2,634 examined 262 (b) X-Ray examinations made in 7. Number of attendances of non-pul- connection with Dispensary monary cases at Orthopædic work 231 Out-stations for treatment or supervision - 14. Number of Insured Persons on Dispensary Register(9) on the 8. Number of attendances, at General 31st December 407 Hospitals or other Institutions approved for the purpose, of 15 Number of Insured Persons under patients for Domiciliary Treatment(4) on the (a) "Light" treatment 24 31st December 4 (b) Other special forms of treatment 167 16. N umber of reports received during 9. Number of patients to whom the year in respect of Insured Dental Treatment was given, at Persons:— or in connection with the Dis- (a) Form G.P. 17 4 pensary 3 (b) Form G.P. 36 2 Number discharged as cured, and returned during 1929 Nil 28th February, 1930. G. CLARK TROTTER. Chief Tuberculosis Officer. 47 [1929 During the year 1,177 persons were examined by the Tuberculosis Officers, and the patients made 8,533 attendances. At the Northern Dispensary there were 539 new cases, and at the Southern 638, while the attendances at the former were 2,634 and at the latter 5,899. The examination of contacts with tuberculous cases showed that 57 were suffering from tuberculosis, 25 were suspects, and 400 were not suffering. The nurses of the Northern Dispensary paid 772 visits, and those of the Southern 2,106, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 50 visits, and of the Southern 363 visits to the patients' homes for the purpose of examining them. Pneumothorax Treatment was also administered to sixteen patients at a cost of £113 18s. 6d. Finsen Light Treatment.— Nil. Artificial Sunlight Treatment.—The treatment of Tuberculosis by artificial sunlight came into operation on the 1st April, 1927. Light treatment was given to four patients at a cost of £2 2s. Od. The number of persons in attendance at the Dispensaries in each year was as follows:— TUBERCULOSIS. 1925 1926 1927 1928 1929 North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy New Cases 543 656 542 670 574 582 558 659 539 638 Actual Number of Attendances 3394 6176 3366 6672 2847 6044 2616 5802 2634 5899 Totals 3937 6832 3908 7342 3421 6626 3174 6461 3173 6537 A summary of the combined dispensaries is given for the following years:— Cases. Attendances. 1925 1,199 9,570 1926 1,212 10,038 1927 1,156 8,891 1928 1,217 8,418 1929 1,177 8,533 Totals 5,961 45,450 Table showing the number of Tuberculous Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1929. Date. Dispensary Jan. Feb. Mar. Apr. May. June July Aug. Sept. Oct. Nov. Dec. Year. Total. Attendances Northern 224 180 224 292 223 198 248 198 200 226 198 223 2,634 8,533 Southern 554 517 533 538 546 465 494 381 421 524 493 433 5,899 New Cases Including contacts Northern 45 39 52 68 54 28 55 46 37 56 32 27 539 1,177 Southern 55 71 67 54 77 42 68 24 39 37 60 44 638 Contacts. Tuberculosis Northern 2 - 2 1 1 - 2 1 1 1 2 1 14 57 Southern 2 4 6 5 4 4 2 2 3 2 6 3 43 Suspects Northern 4 2 - 1 1 1 - 1 - 1 2 2 15 25 Southern - 2 - - 2 1 2 1 1 - 1 - 10 Non-Tuberculous Northern 9 11 8 18 14 7 20 19 9 24 5 7 151 400 Southern 22 25 19 21 35 17 33 8 10 16 25 18 249 Nurses' Visits Northern 65 56 60 72 62 63 57 67 72 58 79 61 772 2,878 Southern 207 197 167 177 197 183 194 — 218 213 180 173 2,106 Tuberculosis Officers' Visits Northern 1 2 3 3 8 2 1 4 3 2 12 9 50 413 Southern 31 31 28 32 27 28 21 20 28 40 43 34 363 48 1929] HOME VISITATION— TUBERCULOSIS. Visits paid by Municipal Tuberculosis Visiting Nurse during the period 1st January, 1929, to 31st December, 1929. Month. North Dispensary. South Dispensary. Total. January 132 144 276 February 145 113 258 March 145 123 268 April 148 130 278 May 150 128 278 June 132 102 234 July 161 112 273 August 138 103 241 September 83 57 140 October 164 115 279 November 122 82 204 December 94 59 153 Totals 1,614 1,268 2,882 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 1,104 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 600 were Scarlet Fever and 480 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 16 - +16 Scarlet Fever 600 773 —173 Diphtheria 480 446 +34 Enteric Fever 6 2 +4 Other Diseases 2 — +2 Total 1,104 1,221 —117 Non-Notifiable Diseases.— 5,687 cases came to the knowledge of the Medical Officer of Health during the year, viz., 1,075 cases of Measles, 856 cases of Chicken Pox, 925 of Whooping Cough, and 2,831 of other diseases. The information respecting these cases was received from the teachers of schools within the borough. Exclusion of Scholars from Schools.— 3,517 children were excluded from classrooms of various schools owing to the presence of an infectious disease, chiefly 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 1,075 1,886 —811 Chicken Pox 856 929 —73 Whooping Cough 925 558 +367 *Other Diseases 2,831 2,312 +519 Total 5,687 5,685 +2 * Note.— "Other Diseases" include Mumps, Scabies, Ophthalmia, Itch. etc. 49 [1929 BACTERIOLOGICAL EXAMINATIONS. 3,129 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 Tuberculosis, Diphtheria and Enteric Fever, respectively. The number is an increase of 479 on that of the preceding year. It was also 982 above the decennial average. Of the total examinations, 365, or 11.7 per cent. gave positive results. Diphtheria.- 2,300 specimens were examined for Diphtheria, of which 412, or 17.9 per cent., were found to contain Diphtheria bacilli. Enteric Fever.— 17 specimens of blood were examined, 2 of which gave positive results. Tuberculosis.— 812 specimens of sputum were examined, 119, or 14.7 per cent., of which showed that the patients were suffering from pulmonary tuberculosis. DIPHTHERIA— PATHOGENICITY TESTS. 1929. No. Submitted for Examination. Negative Result. (Bacilli) Positive Result. (Bacilli) Non-Virulent. Virulent. 79 69 10* 7 1 *2 not tested for Pathogenicity Showing the result of the Bacteriological Examinations made for the Diagnosis of Diptheria, Enteric Fever and Pulmonary Tuberculosis, 1919-28, and in 1829. Periods. Diphtheria. Enteric Fever. Pulmonary Tuberculosis. Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined Positive Results. Negative Results. Total Examined Totals. 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 1925 232 1,618 1,850 2 12 14 160 762 922 2,786 1926 183 1,501 1,684 3 9 12 148 691 839 2,535 1927 260 1,573 1,833 3 21 24 111 661 772 2,629 1928 276 1,478 1,754 4 32 36 137 723 860 2,650 Average 10 years 234 1,183 1,417 3 17 20 128 582 710 2,147 1929 412 1,888 2,300 2 15 17 119 693 812 3,129 VACCINATION. Of the 4,744 births registered in 1928, the returns of vaccination shows that only 2,205 infants were successfully vaccinated, while 13 were found to be insusceptible. There were also 226 who died unvaccinated, and 1,755 statutory declarations of conscientious objection to vaccination were obtained by the parents 50 1929] or guardians; 39 vaccinations were postponed under medical authority, 365 were removed to other districts or places unknown, thus leaving 141 unaccounted for. The return of certificates of exemption, therefore, represents 37 per cent. of the registered births. Vaccination per 100 Years. births, less infants who died unvaccinated. 1921 44.9 1922 46.3 1923 54.8 1924 54.0 1925 50.4 1926 51.5 1927 | 49.9 1928 46.5 Certificates of Exemption.— The following tabular statement shows the decrease in number of these certificates in recent years:— 1921 2,506 1922 2,347 1923 1,751 1924 1,755 1925 1,973 1926 1,951 1927 1,896 1928 1,845 1929 1,755 Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the previous year 1828. Registration Sub-Districts. Number of Births registered in 1928. 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 (Defaulters). Total Number of Certificates of Primary Vaccination of children under 14 years received during year 1929. Number of Statutory Declarations of Conscientious Obiection received during year 1929. 1 2 3 4 5 6 7 8 9 10 11 12 Tufnell 345 173 5 - 126 22 - 7 7 5 1,486 120 Up. Holloway 809 367 2 — 247 44 2 79 51 17 246 Tollington 358 151 2 - 149 22 2 3 19 10 114 Highbury 796 376 1 - 293 26 8 36 32 25 259 Lr. Holloway 618 287 1 - 210 36 11 4 31 38 1,601 210 Barnsbury 845 427 1 - 307 38 7 5 45 15 311 Islington, S.E. 973 424 1 — 423 38 9 12 35 31 434 The Borough 4744 2205 13 - 1755 226 39 145 220 141 3,087 1,693 DISINFECTION. Disinfection of Rooms.— 4,210 rooms were disinfected, as contrasted with 3,644 in 1928. For this purpose formaldehyde in solution was employed, although it was sometimes augmented by sulphur fumigation, when it was necessary to kill vermin, for which purpose sulphur has been found effective. For the extermination of bugs, in addition all the architrave mouldings and skirting boards behind which they breed are removed, and the walls washed with hot lime. 51 [1929 The above figures also include the disinfection of houses and rooms after Tuberculosis, vide p. 43. Rooms Disinfected. 1929 1928 1st Quarter 901 842 2nd ,, 944 870 3rd ,, 974 779 4th ,, 1,391 1,153 The Year 4,210 3,644 Work at the Disinfecting Station. — 53,786 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 48,135 similar articles disinfected during the previous year. In addition to the above articles, 4,527 second-hand garments, mostly overcoats, jackets tunics and British warms were disinfected for clothing contractors trading in the Borough, who paid the Council for the work, amounting to the sum of £33 18s. 0d. Altogether 58,313 articles described in the two paragraphs preceding were disinfected. Since the disinfection station was established 2,333,637 large articles have been disinfected. Summary of the chief articles of Clothing, Bedding, etc., disinfected during the year 1929, and also in the preceding year 1928. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1929 1928 Beds 422 393 425 605 1,845 1,725 Blankets 1,082 1,031 983 1,521 4,617 4,962 Bolsters 402 390 430 589 1,811 1,799 Carpets - 13 16 8 37 30 Chair Bed Cushions 49 30 37 51 167 164 Mattresses 262 297 361 497 1,417 1,656 Palliasses 2 7 5 2 16 10 Pillows 1,059 957 1,088 1,594 4,698 5,318 Quilts 476 350 487 748 2,061 1,944 Sheets 880 882 820 1,343 3,925 3,809 Other Articles 5,745 9,576 8,261 9,610 33,192 26,718 Totals 10,379 13,926 12,913 16,568 53,786 48,135 The nature of the articles disinfected for the clothing contractors is shown below:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Overcoats 600 150 1,132 108 1,990 Jackets - - 1,000 200 1,200 Tunics - - - - - British Warms - - - - - Other Articles - - 1,300 - 1,300 Bales of Horsehair 21 6 — 10 37 Total 621 156 3,432 318 4,527 62 1929] 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 Ordinary. Special. Cwts. Gallons. Gallons. Gallons. To Householders 10 80 10 Nil. Disinfection of Premises — — — 80 Cost = £21 15s. 0d. Shelter House.- The Shelter House was occupied during the year, by four families, baths were given to 7 verminous persons, while their clothing was disinfected. Four midwives attended for the purpose of disinfection after attendance on cases of Puerperal Fever; and 27 other persons who had been in contact with cases of infectious diseases also had their clothing disinfected. Disinfestation of School Children (Cleansing from lice and other vermin).— During the year 5,664 (including 548 for Scabies) baths were given to children from the London County Council Schools, who attended the Disinfecting Station, and were cleansed by the nurse whom the Borough Council appointed for the work, while their clothing was undergoing disinfection. The agreement entered into between the London County Council and the Borough Council from the 1st January, 1921, 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 1s. for each bath given. The minimum payment to be paid to the Borough Council in respect of such cleansing shall not be less than £100 per annum. The amount paid during the year by the London County Council for the baths given to the children was £539. Proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, in 73 instances during the year. Of this number 69 parents were fined, when penalties ranging from 1s. to 10s. were inflicted. The total fines received amounted to £17 8s. 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 Acts, 1901, were carried out in his district during the year 1929. Inspections and Visits.— The inspections and visits made by the three Inspectors were as under:— Factories, including Factory Laundries 667 Workshops, including Workshop Laundries 846 Workplaces, other than outworkers' homes 667 Domestic Workshops 62 Bakehouses 242 Restaurant Kitchens (see also p. 69) 450 Outworkers' premises 1,131 Miscellaneous re-inspections and calls 5,465 Total 9,530 53 [1929 Notices Served In consequence of the 1,264 sanitary defects discovered as the result of the inspections above, 255 intimations and 19 statutory notices were served. Of these notices 78 were served on the owners of factories, 139 on the owners of the workshops and workplaces, and 18 on the owners of bakehouses and 27 of restaurant kitchens. In addition to these nuisances, 117 were discovered on Outworkers' premises, necessitating the service of 20 notices. Most of these defects were remedied and it was only found necessary in 5 instances to resort to legal proceedings. Orders were made in 4 cases, with £4 4s. Od. costs and in the other the summons was withdrawn on payment of £2 2s. Od. costs. Registers.— There were 2,507 workshops on the Registers, as contrasted with 2,469 in 1928, while the total number of workrooms were 2,530, as compared with 3,446 in the previous year; 136 workshops were added to the Registers, while 110 were removed from it. The various workshops and workplaces are tabulated as below:— Workshops and Workplaces. 1929. Total Workshops on Register. Total Workrooms on Register. Number added during Year. Number removed during Year. Workshops where Men are employed 1,145 1,755 82 47 Workshops where Women are employed 560 878 39 41 Laundries 41 55 — 2 Bakehouses 244 246 1 2 Restaurant Kitchens 446 525 10 18 Other Workplaces 71 71 5 — Total 2,507 2,530 136 110 Outworkers' Premises 3,376 — 540 325 Workshops Notified to Home Office during Year 1929. Trade. Number of Workshops. Women. Male Young Persons. Totals. Dressmaking 12 44 - 44 Leather Goods 2 6 - 6 Knitting 1 3 - 3 Tailoring 2 2 - 2 Millinery 2 4 - 4 Cigarettes 1 3 - 3 Embroidery 2 18 - 18 Furrier 3 4 - 4 Ties 1 6 - 6 Mantles 5 8 - 8 Artificial Florist 1 2 - 2 Dry Batteries 1 21 - 21 Upholstery 2 2 - 2 Chair Caning 1 2 - 2 Metal Toys 1 3 - 3 Paper Sorting 1 6 - 6 Confectionery 1 7 - 7 Total 39 141 — 141 54 1929] INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) Written Notices (3) Prosecutions. (4) Factories (Including Factory Laundries) 667 83 2 Workshops (Including Workshop Laundries) 846 90 1 Workplaces (Other than Outworkers' premises) 971 81 2 Miscellaneous Re-Inspections and calls 5,645 — — Total 8,129 254 5 DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts*— Want of cleanliness 348 336 - - Want of ventilation 34 36 - - Overcrowding 7 7 - — Want of drainage of floors 8 10 - — Other nuisances 468 490 - 2 Sanitary Accommodation insufficient 49 53 - 3 unsuitable, foul or defective 338 338 - — not separate for sexes 12 12 - — Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouse (s.101) - - - - Other offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921.) - - 1 - Total 1,264 1,282 1† 5 * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshops Act, 1901 as remediable under the Public Health Acts. †47 Workshops were also notified H.M. Inspector, of failing to affix Abstract of Factory and Workshop Act (s. 133). OUTWORKERS' PREMISES. Instances. Notices Served. Remedied. Prosecutions. Outwork in unwholesome premises (s. 108) 102 20 102 Nil Outwork in infected premises (s. 109, 110) 15 — — — Total 117 20 102 Nil OUTWORKERS' LISTS (s. 107): Lists received from Employers 1,477 Addresses received from Other Councils 1,767 Addresses forwarded to Other Councils 817 Firms failing to send in lists (No. letters sent) 295 55 [1929 OTHER MATTERS. Number. Matters notified to H.M. Inspector of Factories: Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 47 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5, 1901). Notified by H.M. Inspector 6 Reports (of action taken) sent to H.M Inspector 6 Other (New Factories reported under Home Office Memorandum, 1912) Nil Underground Bakehouses (s. 101) in use at the end of the year. 77 OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. Nature of Work. Instances. Notices served. Prosecutions. (1) (2) (3) (4) Wearing Apparel— Making, &c. 52 13 Nil Cleaning and washing - - — Household linen - - — Lace, lace curtains and nets - - — Curtains and furniture hangings 2 2 — Furniture and upholstery 2 — — Electro-plate — — — File making — — — Brass and brass articles — — — Fur pulling — — — Cables and chains — — — Anchors and Grapnels — — — Cart gear — — — Locks, latches and keys - - - Umbrellas, &c. 6 - - Artificial flowers 14 — - Nets, other than wire nets - - - Tents - - - Sacks - - - Racquet and tennis balls — — — Paper, &c., boxes, paper bags 14 5 — Brush making 5 — — Pea picking - — — Feather sorting — — — Carding, &c., of buttons. &c. - - - Stuffed Toys - - - Basket making - - - Chocolates and sweetmeats - - - Cosaques, Christmas Crackers, Christmas stockings, &c. 7 - - Textile weaving — — — Total 102 20 Nil SCAVENGING. Particulars are required in the Annual Report of any extension or improvement during the year of methods of scavenging or refuse disposal, and a statement as to the character and efficiency of the arrangements for the removal and disposal of house refuse. Mr. H.F.Wigfield, the Borough Cleansing Superintendent, has kindly supplied me with the following statement:— "During the year 1929 the following extensions or improvements have been effected:— (1) Street sweeping has been increased to the extent of over thirty miles per week. 56 1929] (2) One new "Dennis" Gully Emptier has been purchased in lieu of the old "Leyland" steam-driven vehicle, and as a consequence considerably more gullies are emptied each week than formerly. (3) Three "Simplex" Gritting Machines were ordered towards the end of the year and will, no doubt, be of great service in the spreading of grit, sand, and salt whenever conditions demand it. (4) Two "Shelvoke and Drewry" totally-enclosed 3-ton refuse collection vehicles were put into commission and are giving satisfactory service from a hygienic point of view. (5) The method of refuse collection is on the same principle as for the past few years; 79% is collected by mechanical vehicles and 21% by horses and vans. (6) The material is sent, as formerly, to dumps at Blackbridge and Holwell Hyde, in Hertfordshire, and tipped in layers of approximately 6 feet in depth, each layer being covered with 9 inches of soil." ASHBURTON GROVE DEPOT. During the year, investigation was made by the department into complaints of nuisance arising from the Ashburton Grove Depot, and the matter was brought before the Public Health Committee. The Cleansing Committee were at that time putting forward a scheme for an incinerator at the Depot, but during the year this suggestion did not materialize. REMOVAL OF DUST. 21 applications were received during the year by the Public Health Department for the removal of dust, which is equal to the number recorded last year. The applications received for the previous ten years were as follows:— 1919 19 1924 33 1920 36 1925 21 1921 21 1926 20 1922 15 1927 25 1923 16 1928 25 Dust Receptacles Provided.— During the year 1,168 dust receptacles were provided, while 12 were repaired after the service of sanitary notices. NUISANCES BY DOGS. During the year we issued as usual, and displayed throughout the Borough, the poster which was approved by the Public Health Committee in 1925, pointing out that the fouling of footways by dogs can be very considerably diminished if proper care is exercised by those in charge. During the year we had a number of enquiries from other places regarding our procedure, and asking for copies of the poster. DISTRICT INSPECTORS' WORK. During the year the fourteen district inspectors made a total of 55,893 inspections and calls, an increase of 187 inspections on the corresponding period of 1928; while 13,356 improvements were effected in 5,492 premises; as against 12,587 improvements in 5,818 premises for the preceding year. 57 [1929 Synopsis of Inspectors' Work.— The following statement gives a brief synopsis of the district inspectors' work in 1929:— House to house inspections 3,063 Other inspections of dwelling houses 5,308 Re-inspections and calls made 45,094 Visits of inquiry re notifiable infectious diseases 2,620 Butchers' shops, stalls, etc. (Saturday nights) 50 Ice cream shops and factories 226 Dairies and Milkshops 722 Stables and yards 817 Manure depots 4 Smoke observations 103 Notices Served.— There were 4,758 intimation notices served by the inspectors with respect to nuisances. In 550 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.— 88 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. Rag Flock Acts, 1911 and 1928.— These Acts prohibit the snle or use, for the purpose of making any article of upholstery, cushions or bedding, of unclean flock manufactured from rags. The expression "flock manufactured from rags" is defined as flock which has been produced wholly or partly by tearing up woven or knitted or felted materials, whether old or new, but does not include flock obtained wholly in the processes of the scouring and finishing of newly-woven or newly-knitted or newly-felted fabrics. In the routine inspections, the Sanitary Inspectors found no cause for action to be taken. Smoke Nuisances.— 72 complaints of smoke issuing from factory chimneys in the Borough were investigated, and as a result 103 observations were made by the District Inspectors, and 9 notices served upon the owners of the businesses requiring the abatement of the nuisance. It was not, however, found necessary to institute legal proceedings. Water Certificates.— 22 water certificates were granted in accordance with the provisions of sec. 48 (2) Public Health (London) Act, 1921, in respect of 207 separate tenements newly erected or rebuilt during the year. WIDOWS', ORPHANS' AND OLD AGE (CONTRIBUTORY) PENSIONS ACT, 1925. Since these powers were delegated by the London County Council, no case has arisen so far under Section 6, so none falls to be reported on in 1929. The Section deals with the special provisions as to additional allowances and Orphans' Pensions, and in certain cases the Orphan's Pension payable in respect of a child would in the interest of the child be administered by the local authority or some other person for the benefit of the child, where a representation is made to the Minister by the local authority, or otherwise. 58 l929] Summary of Sanitary Work from Inspectors' Reports for the year 1929. Districts. Totals 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 240 218 212 205 166 245 212 96 332 224 253 271 208 181 3063 Other premises inspected 268 352 298 575 254 381 256 308 495 393 442 490 424 372 5308 Re-inspections, Calls made, etc. 2156 2379 3806 3505 1853 3122 3340 2304 4332 3372 3989 3481 3790 3665 45094 Ice Cream Premises inspected 8 25 29 27 — 25 9 4 32 15 24 9 9 10 226 Dairies and Milkshops ,, 42 51 107 101 41 101 50 30 68 48 17 63 - 3 722 Stables ,, 7 4 13 3 58 10 4 1 2 - 5 5 - 1 113 Yards „ 38 17 169 26 252 20 111 4 12 33 5 2 10 5 704 Manure Depots „ — - — 4 — — — — — — — — — — 4 Vacant land, Passages and Courts inspected — 1 6 — 95 — 37 2 — 9 1 — 4 — 155 Urinals attached to P.H.'s inspected - 12 86 5 9 42 78 — 11 6 1 - 2 5 257 Premises (re Certificate Customs and Inland Revenue Acts) inspected - - - - - - - - - - - - - - - Premises (re Water Certificates) inspected - - h.toh 27 6 - 44 3 14 - - - - - - 94 Visits re Sale of Food and Drugs Acts - - - - - - - - - - - - - - - Smoke observations - 5 6 17 33 9 9 1 16 — — 5 2 — 103 Shops, Stalls and Markets (Saturday evening) 3 4 4 3 4 3 2 3 1 3 5 4 4 7 50 Total Inspections and Calls 2762 3068 4763 4477 2765 4002 4111 2767 5301 4103 4742 4330 4453 4249 55893 Notices Served. Intimation Public Health (London) Act, 1891 153 275 290 557 84 405 275 224 543 413 453 455 290 341 4758 Ice Cream Shops — — — 5 — — — — 5 — — 1 — — 11 Milk shop & Dairies — — — 3 — 2 2 — 4 — — 2 — — 13 Housing Act — — 2 7 — — — — 13 1 — — — — 23 Statutory Public Health (London) Act, 1891 10 49 6 79 7 46 45 22 114 50 39 45 22 16 550 Housing Act, 1925 — 1 - - - - - - 2 - - - - - 3 Improvements. Drains— 'Constructed - - - - - - - 1 - - - - - - 1 Re-constructed 5 4 2 5 5 3 2 3 13 22 1 3 1 7 76 Repaired 16 8 24 56 6 25 21 11 25 24 37 12 10 35 310 Ventilated 7 8 2 3 7 5 12 3 10 13 12 7 1 1 91 Gully and other traps fixed 29 32 16 12 30 9 26 17 48 64 16 8 1 11 319 Urinals— Water supply— cleansed - - 8 9 - - 1 - 7 2 3 - 1 - 31 Cesspools— Abolished - - - - - - - - - - - - - - - Water Closets— W.C. erected with pan, trap and Water Supply 2 1 1 2 - - - 4 6 4 - - - 2 22 Pan and trap only provided 29 37 35 45 18 30 27 15 31 68 77 24 4 37 477 Flushing apparatus repaired 31 46 34 40 3 40 41 20 185 30 72 37 16 21 616 Ventilated — 1 2 — 1 1 1 — 4 — 8 2 1 2 23 Walls, etc , cleansed 10 20 7 36 3 10 24 9 38 67 62 30 16 14 346 Position altered 2 — — — — — — — — — — — — - 2 Dust Bins Provided 42 80 71 178 5 74 104 81 108 121 122 84 42 56 1168 Repaired — — — 3 2 2 — — 3 — 2 — — — 12 Areas Constructed — — — — — — 1 1 — — — - — 1 3 Paved — 2 1 4 1 2 3 2 4 11 — 1 — — 31 Yards Paved — 2 - 1 3 — — 1 — — - — — — 7 Repaved 7 21 13 56 5 12 18 6 34 50 13 9 2 6 252 Sinks Provided 9 18 13 12 8 2 10 1 15 15 10 2 — 1 116 Waste pipe repaired 17 28 28 63 13 12 17 13 43 50 6 19 9 13 331 Domestic Water Supply— Cisterns Provided 1 - 2 - - - - - - - - - 1 - 4 Cisterns repaired and cleansed 8 19 15 20 1 9 15 6 10 4 5 2 1 2 117 Water supply provided to dwelling house 3 6 3 16 5 - 9 7 19 1 9 - 1 2 81 Water supply provided to tenement house 3 9 4 6 - 3 1 - 14 5 4 - 1 2 52 Walls and ceilings of Rooms cleansed and redecorated 94 168 167 464 29 231 294 125 376 339 427 380 145 366 3605 Carried forward 69 [1929  Districts. Totals 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Other improvements— Staircase and passages repaired, cleansed and redecorated 17 35 31 98 - 29 40 22 74 73 83 82 26 77 687 Floor space ventilated 2 1 6 1 — 2 1 — 7 11 1 1 - 1 34 Floors repaired 14 16 30 47 5 33 11 8 55 48 33 48 7 10 365 Guttering and rain water pipes repaired 11 25 21 47 7 21 39 19 25 45 21 35 23 15 354 Roofs repaired 28 38 48 175 7 57 78 33 110 72 107 77 45 49 924 Overcrowding abated 1 — — 6 1 4 2 — 2 2 1 — 1 1 21 Illegal use of underground rooms for sleeping discontinued - - - - - - - - 1 1 2 3 - - 7 Other improvements, or Nuisances abated 61 64 107 200 14 118 116 63 183 167 258 176 44 71 1642 Rooms Disinfected 202 154 177 159 24 55 77 18 20 24 130 12 125 52 1229 Total improvements 651 843 768 1764 203 789 991 489 1470 1333 1522 1054 524 855 13356 Total premises improved 334 378 453 710 75 320 393 233 520 425 665 336 311 339 5492 HOUSES LET IN LODGINGS. The 1,006 houses which come under the operation of the bye-laws received 669 inspections during the year, followed by 3,138 subsequent re-inspections and calls, so that the total visits amounted to 3,807. These inspections resulted in 402 intimations being served on the persons responsible, which were followed by 56 statutory notices to demand the abatement of the nuisances discovered by the Inspector especially engaged upon this work. Two prosecutions for non-compliance with the notices served were instituted, and an order was made by the magistrate for the necessary work to be done with payment of £1 1s. costs. Altogether 1,951 improvements were effected in 406 premises. We have had now for some years a vacancy in this specialised department, the work being done by one Inspector, where formerly there were two. Synopsis of Inspector's Work:- Improvements. Drains: Constructed - Reconstructed 1 Repaired 23 Ventilated — Gully and other traps fixed 6 Urinals: Water supply— cleansed - Cesspools: Abolished - Water Closets: W.C. erected with pan, trap and water supply - Pan and trap only provided 15 Water supply provided 75 Ventilated — Walls, etc., cleansed — Position altered — Dust Bins: Provided 119 Repaired — 60 1929] Areas: Constructed - Paved - Yards; Paved 5 Repaved 18 Sinks: Provided 15 Waste pipe repaired — Domestic Water Supply: Cisterns provided - Cisterns repaired and cleansed 10 Water supply provided to dwelling house — Water supply provided to tenement house 2 Walls and ceiling of Rooms cleansed and redecorated 450 Other Improvements: Staircase and passages repaired, cleansed and redecorated 88 Floor space ventilated 3 Floors repaired 81 Guttering and rain water pipes repaired — Roofs repaired 92 Overcrowding abated 3 Illegal use of underground Rooms for sleeping discontinued 1 Other Improvements, or Nuisances abated 944 Rooms Disinfected — Total Improvements 1951 Total Premises Improved 406 SEWER EMANATIONS. During the year fairly frequent complaints were received from residents in the neighbourhoods where manhole covers with openings were being used to ventilate the sewers, these particular covers having been previously quite closed. When these complaints were investigated it was found that the sewers in question were London County Council sewers. In Spencer Street the Sanitary Inspector who went to investigate the cause of the smells and sore throats reported that the stench was so strong that he himself was almost overpowered by it. Complaints were received in respect of Lucerne Road (at the corner of Ancona Road, Highbury), Barnsbury Street (outside the Syphon Factory), also outside the Motor Garage in Lofting Road. A petition was received from the inhabitants of Bemerton Street and adjacent streets regarding the strong stench at the corner of Lyon Street and Bemerton Street. The large number of complaints appeared to show that the ventilation in this manner could not be carried out without giving not only offence but causing risk to the health of the inhabitants nearby through the production of "septic" throats." The Clerk to the London County Council was written to and asked to call the attention of the appropriate Committee to these complaints, which on investigation we found to be justified. At the same time complaints were being forwarded to the Medical Officer of Health of the Borough Council from the Ministry of Heatlh, where they had been sent direct. A very considerable survey of the areas in which the smells occurred was undertaken by the Sanitary Inspectors. Most of the complaints were in regard 61 ^929 to the Middle Level Sewer No. 2, which runs in the County Council area from Padding-ton, through Islington, to Shoreditch, and follows roughly the line of Lyon Street, Caledonian Road, Thornhill Road, Lofting Road, Barnsbury Street, Spencer Street, and New North Road. This sewer is admittedly one of the foulest sewers in London, receiving manufacturing effluent from Brent, Edgware and surrounding districts, and it has been stated that where it passes through Paddington, the Paddington Borough Council had been in the habit of putting into the sewer quantities of chloride of lime in an endeavour to remedy the smell trouble from it within their Borough. One reason probably for ventilating through the sewer covers was the " scare " caused by the Holborn explosion. The London County Council were again communicated with by the Town Clerk in September, who expressed the hope that the County Council Authority would find some remedy for effectively ventilating their sewers without causing the inconvenience and discomfort which resulted from the present method in use. RATS AND MICE (DESTRUCTION) ACT, 1919. (9 and 10 Geo. 5. Ch. 72.) This Act came into operation on the 1st January, 1920, to make further provision for the destruction of rats and mice. During Rat Week our usual transparencies announcing Rat Week were used in the places visited by the Public in the Public Health Department. There was sold from our department a vermicide for rats put up in convenient containers with full directions. Summary of Work under the Rats and Mice (Destruction) Act during the years 1922-29:— 1922 1923* 1924 1925 1926 1927 1928 1929 Number of Streets visited 711 544 91 96 217 235 203 144 Number of Private Houses visited 1,023 650 176 133 320 368 349 223 Number of Shops and Factories visited 1,009 712 19 14 61 81 56 36 Total Premises inspected 2,032 1,362 195 147 381 449 405 259 Found Rat Infested 1,031 787 61 66 174 191 154 101 Found Mice Infested 72 66 1 2 5 8 2 4 Defective Drains Repaired (Cause of Rat trouble) 52 13 60 51 49 48 49 23 Number of Complaints received 177 67 118 105 173 202 150 124 * Appointment of temporary Rat Officer terminated 15th June, 1923. HOUSING. On the 5th April, 1929, the following representation by the Medical Officer of Health was forwarded to the London County Council:— 5th April, 1929. Sir, I beg to represent pursuant to the provisions of the Housing Act, 1925, that within the area in the Metropolitan Borough of Islington shown by a pink tint on the plan annexed hereto houses are unfit for human habitation and/or the narrowness, closeness and bad arrangement or the bad condition of the streets and houses or groups of houses within such area or the want of light or ventilation or proper conveniences or any other sanitary defects or one or more of such causes are dangerous or injurious to the health of the inhabitants either of the buildings of the said area or of the neighbouring buildings and that the most satisfactory method of dealing with the evils 62 1929] connected with such houses and the sanitary defects in such area is an improvement scheme for the re-arrangement and the re-construction of the streets and houses within such area or of some such streets or houses. I am, Sir, Your obedient Servant, G. CLARK TROTTER, Medical Officer of Health, Metropolitan Borough of Islington. The Clerk, London County Council. METROPOLITAN BOROUGH OF ISLINGTON. Public Health Department, Municipal Buildings, Upper Street, N. 1. 4th April, 1929. Georges Road, Hope Street, Eden Grove, and that part of Eden Grove, formerly known as Grove Street. These premises are comprised in an area which may conveniently be considered in two sections, one the extremely narrow, irregularly shaped strip on the south side of Georges Road, and a rectangular area bounded on the south by Georges Road, on the east by Hope Street, on the north by Eden Grove and on the west by that part now called Eden Grove which formerly was termed Grove Street. The premises comprised in the area have, since 1919, been the subject of representations by the late Dr. A. E. Harris to the Islington Borough Council in respect of their serious condition, only seven houses in Eden Grove facing north not having previously been represented. The conditions have progressively become worse with the lapse of time and the further deterioration of the properties. Much of the information supplied in support of my representation of the Georges Road Area which was brought to the notice of the London County Council on the 31st August, 1923, applies also to this new represented area. The Housing Committee of the Islington Borough Council on the 7th June, 1923, when considering the former scheme, had before them the conditions of this present area, and were then strongly of opinion that the narrow area in Georges Road called for prior consideration. At that time, however, it was more convenient to take the other area represented along with the Brand Street Area as a scheme. The condition of the properties meanwhile, as stated, has not improved but has become gradually worse. The site on which these houses stand has a total area of about 56,380 square feet, or approximately 1.29 acres. The total number of inhabited houses is 69, and the population 526. The area in the separate divisions is as follows:— Georges Road Section 21,380 square feet. Eden Grove, Hope Street Section 35,000 square feet. 63 [1920 The houses generally are old, damp and dilapidated, and are closely crowded and cannot be put into a reasonably habitable condition; the walls bulge, roofs sag, woodwork, plaster and fittings are in a bad condition, no proper provision is made for the storage of food or fuel, washing accommodation is poor and drying grounds are very small, the rooms are in many cases small, draughty and damp, staircases are badly planned and mostly insufficiently ventilated, the stairs leading from the lower rooms to the first floor are unlighted and sometimes without handrails, the stair treads are worn and dangerous, and handrails, if present, are loose; most of the stairs are too steep and narrow and have badly arranged winders. Gas cooking is common, and because of the smallness of the premises the cookers are generally in most unsuitable places, even being in combined living and sleeping rooms or on staircases. The water supplies are most unsatisfactory, being from draw-off taps in the yards; the service pipes freeze very quickly in the winter and the constant dripping and splashing of water makes the walls and surroundings very damp. Many of the houses are dark because these have not windows in the main back wall of the lower rooms, and also because of the proximity of the high walls at the rear. (This applies particularly to the narrow strip on the south side of Georges Road). The small yards are much shut in and the water closets are deprived of efficient lighting and ventilation. The streets are narrow and not well paved; the increasing heavy traffic in passing close to the buildings causes vibration, and there is considerable danger owing to the narrowness of the footpath. The rents are comparatively low, and this has caused continued occupation by the inhabitants. There being very small, in some cases, no, yards, the children are forced to play in the street. Complaint of rat infestation in the area is extremely frequent. While the houses in the area facing Eden Grove are somewhat better in quality, they are also poorly constructed, with decaying brickwork, and are necessary to complete the scheme. Inhabitants.— Most of the inhabitants are of the labouring class, some few being in constant work, but many of them casual labour only ; some are street traders. Area. 15 to 87a, Georges Road, 8 to 15, Hope Street, 83 to 97, Eden Grove, Population 214. Population 64. Population 80. Total population : 358. Total deaths from all causes in 5 years (1925 to 1929), 49. Average, 10 deaths per year. Death-rate per 1,000 population of area (5 years' average), 28.0. Death-rate for Lower Holloway Sub-District (5 years' average), 12.1. Death-rate for Borough of Islington (5 years' average), 12.3. Number of Infectious Disease Notifications (1923 to 1929), 28. Yearly Rate, 15.64. (Not including Measles, Whooping Cough or Chicken Pox, or those under 2 years). Number of Tuberculosis Notifications received (1925-1929), 4. Yearly Rate, 2.24. Average I.D. Notification Rate for whole Borough (1925 to 1929), 6.40. Average I.D. Notification Rate for Lower Holloway Sub-District, 6.89. 5 years' average Notification of Tuberculosis for Lower Holloway, 1.78. 5 year's average Notification of Tuberculosis for Borough, 2.13. 64 1923] Appended were:— (1) A general summary, address, floors, rooms, families, adults, children and rent, and (2) schedule of each house, owner, occupiers, and detailed description, setting forth defects. Summary of Housing from 1919 to 1929 (inclusive):— The number of houses or flats provided by the Islington Borough Council, the London County Council and by private enterprise in the Borough, was as follows:— 1919 to 1928. 1929. Total since 1919. Number of houses or flats provided by the Islington Borough Council 745 nil 745 Number of flats provided by the London County Council 236 135 371 Number of houses or flats provided by private enterprise 308 44 352 1,289 179 1,468 Particulars of houses or flats provided under the Council's Housing Schemes 1919 to 1928. 1929. Total since 1919. Halton Mansions (8 more flats to be erected on lease of two houses falling in during 1932). 160 - 160 City Mansions 47 — 47 Queen's Mansions 44 — 44 Warltersville Mansions 46 — 46 Manchester Mansions 31 — 31 Addington Mansions 107 — 107 435 435 *Conversion of 16 houses into 61 dwellings 61 Tyndale Mansions 102 — 102 Laycock Mansions 132 — 132 Houses, etc., Highbury Station Road 15 — 15 745 nil 745 *Includes:— 27, Rupert Road Not converted 8, Barnsbury Street 27 and 25, Canonbury Villas 2, Highbury Grange The number of overcrowding cases recorded as dealt with during the years 1920 to 1929, was:— 1920 7 1921 6 1922 10 1923 17 1924 13 1925 19 1926 26 1927 24 1928 37 1929 21 Total 180 65 [1929 These figures, of course, represent only the number of cases which have been dealt with officially. The number encountered was numerous, but in view of the difficulties of finding other accommodation, proceedings were not instituted in the majority of cases met with. HOUSING RECOMMENDATIONS FROM THE PUBLIC HEALTH DEPARTMENT. During the year 1929 representations were made to the London County Council regarding housing accommodation for "special hardship" cases. These were cases in which there was gross overcrowding, and in all 51 were so recommended for special consideration. In addition to above 25 special investigations were made, but as these did not come within the definition of "special hardship" they were not recommended. DEMOLITION OF HABITABLE DWELLINGS. During the year 1929, 141 houses have been demolished. Of this number, 51 came under the Improvement Scheme of the London County Council re Georges Road Area, and comprised the following:— Georges Road, Nos. 76, 78, 80, 82, 84, 86, 88, 90, 92. Hope Street, Nos. 1 (4 flats), la, 2, 3, 4, 5, 6, 7. Hope Place, Nos. 1, 2, 3, 4, 5, 6, 7, 8. Bratton Street, Nos. 1, 15, 16. James Street, Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16. Hartnoll Street, Nos. 10, 12, 14. Eden Grove, No. 45. The remaining 90 houses having been demolished for new cinemas and business premises. METROPOLITAN BOROUGH OF ISLINGTON. Housing Statistics for the Year. Number of new houses erected during the year:— (a) Total (including numbers given separately under (b).) 244 (b) With State assistance under the Housing Acts. (i) By the Local Authority Nil (ii) By other bodies or persons 244 Unfit dwelling-houses. Inspection— (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,397 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 1,290 (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 66 1929] (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,799 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 687 3. Action under Statutory Powers. (a) Proceedings under 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 owner 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 4,805 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 4,805 (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 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 67 [1929 RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS, 1920, 1923 and 1925. Number of applications for certificates and "reports" under 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. "Report" re completion of work mentioned in schedule issued with certificate. Certificates not issued Total 1920 25 28 — 1 54 1921 269 52 1 5 327 1922 157 25 11 2 195 1923 123 3 15 2 148 1924 117 6 19 — 112 1925 96 5 12 3 116 1926 68 4 26 2 100 1927 67 7 19 2 95 1928 53 6 15 6 80 1929 59 Nil 17 3 79 Totals 1034 141 135 26 1,336 STATE OF PAUPERISM IN THE BOROUGH. There was a decrease of 644 in the number of paupers relieved during the year for the weekly average was 7,175 compared with 7,819 in 1928. Appended is a statement furnished by the Clerk to the Islington Guardians:— Showing the State of Pauperism in the Borough during the year 1929. Quarers. Average number Relieved during each week. Borough Death rates, 1929. Indoor Paupers, Adults and Children. Outdoor Paupers. Totals, 1929 Totals corresponding periods 1928. Children Boarded out. Adults. Children under 16. 2 3 4 6 6 7 8 1st Quarter 3,206 3,461 1,316 7,983 8,902 15 26.7 2nd „ 3,028 3,174 1,054 7,256 7,917 15 11.6 3rd „ 2,874 3,022 855 6,751 7,089 13 9.4 4th „ 2,931 2,954 823 6,708 7,369 12 11.7 The Year 3,010 3,153 1,012 7,175 7,819 14 14.8 INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food— Inspection of.— Inspector Wilkinson reports that during the year he has paid 684 visits to the 13 Slaughter Houses now on the register, including one Horse Slaughter House, and that he has ascertained that 9,815 animals were killed therein, namely 428 oxen and cows, 7 calves, 5,520 sheep and lambs, and 3,860 horses for human consumption, these latter being entirely for export. The quality and sound condition generally of the animals is shown by the fact that no carcase, or part thereof, was found unfit for human food ; whilst the number of diseased organs were very few, as will be seen in the table on page 00. The Medical Officer of Health, as Designated Officer for Food Certification, issued 30 certificates in respect of foods prepared in Islington and exported abroad and to the Dominions. 68 1929] FOOD DESTROYED. 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 organs from slaughter-houses — 7 — 14* Fish surrendered in unsound condition — 9 2 7 Heat, surrendered at Factories, including two emaciated cow carcases and unsound ox and calves tongues 1 1 2 20 Decomposing Meat and Rabbits surrendered — 1 — 12 Meat and Poultry seized — 1 2 4† Various Fruits surrendered 1 1 — 18 Total 3 2 — 19 * Only 43 lbs. of this Tuberculous † 28 lbs. Tuberculous. The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 3 tons 2 cwt. 19 lbs. The diseases which affected animal food are set out in detail on page 71. UNSOUND FOOD. An important prosecution in respect of unsound meat exposed for sale was taken at the North London Police Court against a Holloway butcher. There were two summonses, one in respect of 6 geese and 7 fowls unfit for human food, and the other was in respect of 16 breasts, 3 necks and 3 shoulders of mutton, and two pieces of cooked beef. The Food Inspector in the course of his duty on an evening in August at 7 o'clock visited the said butcher's premises, and owing to the stale appearance of some meat decided to inspect the stock. Immediately inside the door were six geese and seven fowls which he found to be unfit for human food on account of decomposition. The butcher alleged that they had just been brought out of the cold store, but the fowls were found to be quite warm. These were seized, and upon inspection of the cold room, which contained a number of pieces of mutton, sirloin of beef, pieces of chilled beef, etc., he found 16 breasts, 3 necks and three shoulders which were unfit for human food, also two pieces of cooked meat, which on account of their mouldy condition were thorougly bad. The Magistrate pointed out that the law took a very serious view of these cases and had fixed a maximum penalty of £50. In view, however, of the defendant having nothing previously against him, he limited the fine to £5 and five guineas costs on each of the summonses. MERCURIAL POISONING. In investigating a case of alleged illness after partaking of food, and which at first sight might have been a case of food poisoning, an interesting case of mercurial poisoning from grey powder came to notice. Cases of poisoning from grey powder are very rare, only a few having been recorded in medical literature. It is known that children stand mercury well and can stand larger doses in proportion to their age than of other drugs, for instance, opium. A mother took her child who was suffering from a skin eruption to St. Bartholomew's Hospital, and purchased on her way home a quantity of fried haddock and plaice. It was alleged that the child along with her sister had partaken of this haddock, and the sister also had been taken ill, and the mother also complained of pains in the 'stomach. It was also alleged that the child had had a bar of " nut " chocolate, bought from a street vendor at Smithfield Market. The child took suddenly ill during the night and vomited, was taken to the Royal Northern Hospital, where his serious condition was recognised, and he was taken in. The 69 [1929 hospital were not satisfied as to the cause of death and an inquest was ordered. When making enquiries into the alleged food poisoning, the Sanitary Inspector was able to elicit that the mother had asked for grey powder tablets at St. Bartholomew's Hospital and had received them. When pressed she admitted thev had been given to the child to hold and that the tablets could not be found. We were able to put this aspect of the case before the Coroner, and the postmortem by Sir Bernard Spilsbury confirmed that the child had died from mercurial poisoning. The evidence left the impression that the relatives had given the information about food and sickness, but had omitted until it was discovered by our department all reference to the grey powder tablets, which undoubtedly the child had taken as if they were sweets. Shops, etc., Inspection of.— The 726 shops and places where foodstuffs are sold may be approximated for the year as follows:— Butchers, provision dealers, etc., shops, 254; meat, provisions, rabbits, tinned foods, etc., stalls, 30; food preparation establishments, 12; fish shops, 114; fish stalls, 14; fruit shops, 220; and about 105 fruit, etc., stalls and barrows, including stalls in the Metropolitan Cattle Market inspected on Tuesdays and Fridays. To these 25,789 visits were paid, apportioned as follows: — Butchers, Provision Dealers, etc., Shops 8,544 visits Food Preparation Establishments 156 ,, Butcher, Provision, etc., Stalls 2,096 „ Fish Shops 1,526 ,, Fish Stalls 820 ,, Fruit Shops 4,082 ,, Fruit Stalls 8,565 „ Total 25,739 „ No summonses were taken out under Sec. 47 of the Public Health (London) Act, 1891, during the year. Restaurant Kitchens.— The work of inspecting restaurant kitchens is tabulated under Workshops. This work is done by the two women inspectors, whose work was reviewed fully in the Report of 1926, p. 58. 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 65 20 Coffee and Dining Rooms 187 50 Refreshment Rooms 105 36 Provision (Cooked Meats, cooked but not consumed on premises) 92 22 449 128 SALE OF FOOD ORDER, 1921— LABELLING OF MEAT. At the request of the Public Health Committee an inquiry was made to ascertain the practice of the several Metropolitan Boroughs with regard to the enforcement of the labelling of imported produce under Part 3 of the Sale of Food Order, 1921, which was still in force. The information desired was as to the amount of Ho 1929] attitude allowed by means of a general label, "All imported unless otherwise marked," which label is very extensively used in London and generally tolerated, although it is not legal according to the wording of the Order. There has grown a practice among a proportion of dealers of using such a label in a way not fair to the purchaser, inasmuch as in the Order there is a proviso for labelling any slab, rail or counter where only imported meat is exposed, and a further provision for one label to be conspicuously exhibited where only imported is on offer. The label referred to might not impose any hardship if it were exhibited where it were easily seen, not " skied " or obscured by hanging meat, and if the small proportion of English meat were, each piece, labelled, but in many shops not one half of the English meat is labelled, and in very many instances not one-tenth, while both English and imported meat is mixed up indiscriminately with here and there an English label, so as to tax the ability of almost an expert to distinguish. The only guide left to the ordinary customer is whatever the butcher chooses to tell her. There seems also, curiously enough, to be a preference for exposing the general notice, "All meat imported unless otherwise marked," even although the whole of the meat is English with the exception of a few joints of New Zealand Lamb, or one or two pieces of Argentine Chilled Beef. Therefore it would appear that the notice is being used simply to make non-effective the spirit of the Order. It is not suggested that butchers as a rule will deliberately sell imported meat as English, but that a proportion of them are not anxious to enlighten customers exactly while it can be avoided. In other words, these particular traders do not mind a customer believing she is buying English when in fact the meat is imported without having definitely deceived her. The result of the inquiry showed that throughout the London Boroughs the general notice was tolerated. A number of boroughs replied that they had the same experience as Islington. For instance, in one borough the users of "skied" labels were warned in regard to the matter; in another borough on occasions it had been necessary to ask a butcher to give more publicity to the notice; in another the Inspectors had to enforce that care is taken as far as possible to ensure the separation of the two kinds of meat, imported and English. One was not satisfied that when a joint is displayed of English and Scotch meat, it is marked as such. One stated that the Order appears to require re-drafting in the light of experience; another that a close supervision was required to ensure that the interests of customers were safeguarded; another had experience that English and imported meat got mixed up indiscriminately. The City of London had experienced difficulty in relation to the size of labelling and lettering. As regards position of labels, any difficulty was only sometimes found. The inquiry was fruitful inasmuch as we had replies from every metropolitan area, and the concensus of opinion was, in the great majority of cases, that the same difficulties were experienced as in Islington, therefore it would appear that when this Order is being revised at any time it would be expedient to have it redrafted, 3S was expressed by one Borough, "in the light of experience." Cowsheds — Only one cowshed is now within the Borough and it received 3 visits by the Inspector. It was found to be in a satisfactory condition. 71 1929 Offensive Trades include 4 tripe dressers, 2 gut scrapers, 1 fat melter and gut scraper, and the knacker, which received a total of 52 visits. There was no cause for complaint in the conduct of the business carried on in them. Tabulation of meat and organs diseased as found in slaughter-houses during the year 1929:— No. of Cases. Description of Animal Affected. Nature of Disease. Extent of Disease. How disposed of. 1 Ox Tuberculosis Liver, mediastinal glands, &c. Council's Destructor. 1 Ox Tuberculosis Mediastinal glands only „ „ 1 Ox Tuberculosis Lungs, bronchial glands and costal pleura. „ „ 66 Oxen Parasitic (Dis. Hep.) Liver, or part „ „ 1 Sheep Parasitic (Dis Hep.) Liver „ „ 5 Oxen Abscess (simple or multiple.) Liver „ „ Milkshops and Dairies.—At the close of the year there were 581 milkshops and dairies on the register, 31 having been added to it, while 11 were removed. The District Sanitary Inspectors paid 722 visits to them, and served 13 notices for the carrying out of various sanitary improvements and the cleansing of dirty utensils. THE MILK AND DAIRIES (AMENDMENT) ACT, 1922; THE MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year 1929, the follow ing applications were made for. licences under the provisions of the above Order to enable the persons to sell Specially Designated Milk :— LICENCES GRANTED UNDER MILK (SPECIAL DESIGNATIONS) ORDER, 1923. Designation. No. of applications Number granted. Amount of Fees received. 1929. 1929. £ s. d. "Certified" 14 14 3 10 0 "Grade A." (Tuberculin tested) 26 26 8 7 0 "Grade A." 1 1 5 0 "Pasteurized" (Dealer) 4 4 1 0 0 "Pasteurized" (Pasteurizer) 5 5 5 5 0 "Pasteurized" (Supplementary) Nil. Nil. Nil. 50 50 £18 7 0 ADULTERATION OF FOOD AND DRUGS. During the year 1,318 samples of foods and drugs, including 403 informal samples, were submitted for analysis by Mr. Green, the Food and Drugs Inspector, who purchased the samples for submission to our Analyst, Mr. A. 1 inchin, B.Sc. Of the total samples 1,191 were reported to be genuine and 127 adulterated, or 9.6 per cent. This percentage is 3.6 above the previous year, and 2.6 above the average rate during the preceding 10 years. 72 1929 During the year 1929 in addition to the samples taken and submitted to the Public Analyst there was a total of 893 informal samples which were examined by the Food and Drugs Inspector. These informal samples comprised a number of varied articles. The greatest amount of detected adulteration occurred in the second quarter of the year, as shown by the figures given in the statement below, when it was 22.0 per cent, and contrasted with 3.2, 11.3 and 1.0 per cent., respectively, in the first, third and fourth quarters. Examined. Genuine. Adulterated. Per Cent. Formal Informal Formal Informal Formal Informal Adulterated 1st Quarter 237 74 228 73 9 1 32 2nd „ 209 95 190 47 19 48 22.0 3rd „ 265 152 227 143 38 9 11.3 4th ,, 204 82 202 81 2 1 1.0 The Year 915 403 847 344 68 59 9.6 Informal Sampling.—The informal samples purchased included the following:— No. of Article. Samples. Mil 6 Butter 130 Lard 10 Sweets 8 Cakes and Buns 6 Preserved Sausages 24 Sausages 62 Coffee 1 Jam and Marmalade 4 Sultanas 3 Bacon 2 Biscuits 3 Fish Paste 2 Honey 1 Lentils 1 Butter Creams 1 Cherry Brandy Creams 1 Cocoa 1 Cream Cakes and Pastries 77 Dried Full Cream Milk 8 Extract of Malt 1 Prawns 5 Rum Creams 1 Ham 4 Brawn 2 Tongue 2 Aniseed 1 No. of Article. Samples. Artificial Cream 2 Ice Cream 1 Marmalade 1 Meat Pie 1 Butter Toflee 1 Cherries Glace 4 Mincemeat 3 Mixed Peel 3 Wines (Alcoholic) 3 Ground Almonds 2 Preserved Ginger 2 Almonds (Whole) 1 Xmas Pudding 1 Chrystallised Fruit 1 Icing Sugar 1 vinegar Malt 1 Muscatels 1 Oatmeal 1 Olive Oil 1 Pearl Barley 1 Flour (Diabetic, Self Raising) 1 Suet 1 Treacle 1 Wines (Non-Alcoholic) 1 Total 403 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 124 8.95 3.52 12.47 Milk purchased on Week-days 362 8.93 3.49 12.42 Milk procured in transit at Finsbury Park Station 178 8.92 3.67 12.69 Official Standard - 8.50 3 00 11 50 73 1929 Sophistication of Milk.—The particulars as to the genuineness or otherwise of the samples procured or purchased on Sundays, Weekdays, and at Finsbury Park Railway Station are as follows:— Percentage Number taken. Genuine. Adulterated. Adulterated. On Sundays 142 140 2 1.4 On Week-days 236 231 6 2.1 At Railway Stations 161 152 9 5.6 (Farmers' Milks) 539 523 16 3.0 SUBSTITUTION OF ARTIFICIAL "CREAM" OR OTHER MIXTURE FOR GENUINE OR REAL CREAM IN CREAM CAKES AND CREAM PASTRIES. The Artificial Cream Act, 1929, came into operation on the 1st June, 1929. In this Act "cream" means that portion of the natural milk rich in milk fat which has been separated by skimming' or otherwise, and artificial cream means an article of food resembling cream and containing no ingredient which is not derived from milk, except water, or any ingredient or material which may lawfully be contained in an article sold as cream by virtue of the special proviso in sub-section 2 of Section 2 of the Food and Drugs (Adulteration) Act, 1928. This proviso " allows any ingredient or material not injurious to health added to the article of food or drug because it is required for the production or preparation thereof of an article of commerce in a state fit for carriage or consumption and not fraudulently to increase the bulk, weight or measure of the article of food or drug or to conceal the inferior quality thereof." During the year special purchases were made of cream cakes and cream pastries. In the second quarter of the year, 67 informal samples were purchased. Of these, 48 were "adulterated," the "cream" of the cakes consisting in every case of 100 per cent, fat other than butter fat, that is to say, margarine. It will be noted, of course, that of the samples 19 contained the genuine article, real cream. In the third quarter of the year 34 official samples were purchased, of which 29 were "adulterated," containing from 50 to 98 per cent. fat not derived from milk. In the same quarter four informal samples were purchased which were genuine cream. Regarding the official samples which were purchased, and which were found not to be genuine cream, the Council's Solicitor did not advise prosecution, holding that it was a "trade custom" to substitute foreign fat in the "cream" of these articles, and that the customers were not prejudiced, as they did not expect pure cream when they bought the cream cake. It is a remarkable fact, however, that after the Inspector's visits the majority of the shops withdrew the notices advertising the sale of cream cakes. The cakes were sold without being labelled as "cream" cakes. It must be a little difficult, I think, to be sure that the purchaser does not expect real cream in view of the number of samples we got in which real cream was used. Another point is that in certain-articles the housewife expects that they will be made in the same manner in which they are made at home. Thus, a cream trifle should be made with genuine dairy cream and not with an artificial substitute. I he matter is one which requires a definite legal decision, for after all, is not the customer entitled to know what she is purchasing? and an article labelled cream should not be made with artificial cream, or with synthetic cream, which 74 1929 latter is now usually termed "Confectionery Filling" in the Trade. Artificial cream is made from dried skim milk powder, butter and water in an cmulsifier. Svnthetie cream or "Confectionery Filling" is an emulsion of fats other than butter fat, comparable to margarine, and is "covered in law" not by the Artificial Cream Act but by the general provisions of the Food and Drugs Adulteration Act. The honest way would be to lable the articles what they are— "Synthetic Cieam Cakes." This would also be fair to the trader who uses dairy cream. The Food and Drugs Inspector spent a considerable part of three months in connection with the investigation of this cream substitute, and there is no doubt that the results of this investigation raises the question of what is undoubtedly a fraud on the public and unfair competition to reputable firms who use pure dairy cream in cake making. In addition there is the damage done to the home dairy industry by the substitution of the synthetic material. UNSATISFACTORY CHURNS. The Chairman of the Public Heatlh Committee and the Medical Officer of Health took the opportunity of visiting a large dairy establishment which had recently been opened with some ostentation, as it was undoubtedly very much upto-date. The visit was paid on the day after the place had been on view. They were astonished on entering the premises to be confronted with a considerable collection of old, dilapidatd churns. Some of these were the worst the Medical Officer of Health had ever seen, rusty, holes in the top through which rain, dust, etc., could easily enter and contaminate the milk. These churns contained milk an;l were just ready for despatch. On calling the attention of the Manager who was showing us round to these churns he admitted that he could not justify their use, but the excuse was made that they did not belong to the branch, that they had been sent with milk, and were being returned. The firm were written to very emphatically on the matter, and their attention was drawn to the fact that the excuse was quite wrong and would not hold legally under Part 8, Article 29, subsection 2, of the Milk and Dairies Order, 1926, "Every person shall cause every churn in which he distributes milk to comply, etc." The firm had from the condition of these churns every justification under the Order to reject them and not admit them to their premises. They were told that what struck us most on a visit to such a beautiful up-to-date plant was that the whole scheme should be nullified and rendered farcical by the action of putting pasteurised milk into such receptacles contrary to the Order. It is only fair to add that as result of this representation the matter was very thoroughly and efficiently taken up at headquarters, and we have had no further grounds for complaint. Observation has been kept on the cleansing of churns as required by the Milk and Dairies Order. These have to be returned clean. Inspections were made at the Railway Stations, in the streets, etc. On the whole the provisions of the Order were being carried out. Several firms were warned. In one instance, a particularly bad case, a prosecution was instituted. Milk was sent from Aberdeen, and it was found that a practice was made of omitting the cleansing before return. Some of the empty churns were found to contain a pint of stale milk, bits of string, pieces of paper, lead seals, etc. The Medical Officer of Health, Aberdeen, assisted us in our enquiry, enabling us to state the conditions in which churns from the particular firm arrived in that City. A conviction was secured with a fine of four pounds and three guineas costs. 75 l929 Giving the particulars of the Milks taken during each quarter of 1929 on Sundays, Week-days, and at the Railway Stations. 1929. 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 44 99 44 187 43 96 44 18.3 1 3 - 4 2 3 3.0 - 2.1 2nd ,, 34 11 35 80 33 9 31 73 1 2 4 7 3.0 18.2 11.4 8.7 3rd 29 51 39 119 29 51 34 114 - - 5 5 - - 12.7 4.2 4th „ 35 75 43 153 35 75 43 153 - - - - - - - - The Year 142 236 101 539 140 231 152 523 2 5 9 16 1.4 2.1 5.6 3.0 The number of samples of milk purchased was 539, of which 523 were genuine, and 10, or 3.0 per cent. were adulterated. In addition to this number, 4 informal samples were submitted to the Public Analyst and one sample from another Borough, taken under the Milk and Dairies (Consolidation) Act, 1915. Showing the samples of milk reported as genuine or adulterated during the past 10 vears and in 1929:— MILK ADULTERATION. Samples Analysed. Genuine. Adulterated Per cent Adulterated. 1919 638 679 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 1925 684 652 32 4.7 1926 586 565 21 3.6 1927 740 710 30 4.0 1928 664 638 26 3.9 Average 10 yrs. 659 622 37 5.6 1929 539 523 16 3.0 Showing the analysis of 7,132 milks examined in Islington during the 10 years 1919-28 and 1929, and distinguishing those purchased on Sundays, on Week-days, and procured at the Railway Stations whilst in transit from the Farmer to tha 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. 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 8.78 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 1924 120 8.74 3.42 399 8.78 3.48 162 8.87 3.65 1925 108 8.71 3.41 384 8.71 3.37 192 8.79 3.67 1926 83 8.81 3.65 409 8.78 3.63 94 8.88 3.62 1927 129 8.87 3.49 378 8.86 3.73 233 8.84 3.69 1928 124 8.95 3.52 362 8.93 3.49 178 8.92 3.67 Total samples and average constituents (10 years) 1,283 8.78 3.47 3,716 8.80 3.52 1,594 8.84 3.66 1929 142 9.02 3.50 236 8.99 3.41 161 9.01 3.80 76 1929 The Public Analyst, during the year reported on the genuineness of the articles examined as follows:— Showing the Samples of Foods and Drugs submitted to the Public Analyst during the Year 1929. Article. Number of Samples examined Samples adulterated. Formal Informal Total Formal Informal Total Milk 538 6 544 16 1 17 Butter 193 130 323 2 1 3 Lard 32 10 42 — — — Sweets — 8 8 — — — Cakes & Buns — 6 6 — — — Pepper 42 — 42 — — — Preserved Sausages — 24 24 — 3 3 Sausages 5 62 67 1 5 6 Whisky 7 — 7 2 — 2 Arrowroot 9 — 9 — — — Coffee 20 1 21 — — — Jam & Marmalade — 4 4 — — — Sultanas — 3 3 — — — Bacon — 2 2 — — — Biscuits — 3 3 — — — Butter Substitute 1 — 1 1 — 1 Fish Paste — 2 2 — — — Honey — 1 1 — — — Lentils — 1 1 — — — Mustard 2 — 2 — — — Rice 2 — 2 — — — Butter Creams — 1 1 — — — Cherry Brandy Creams — 1 1 — — — Cocoa 1 1 2 — — — Cream Cakes & Pastries 34 77 111 29 48 77 Dried Full Cream Milk — 8 8 — — — Extract of Malt — 1 1 — — — Peas 1 — 1 1 — 1 Prawns — 5 5 — — — Rum Creams — 1 1 - — — Ham — 4 4 — — — Brawn — 2 2 — — — Lemonade Crystals 2 — 2 — — — Tongue — 2 2 — — — Aniseed — 1 1 — 1 1 Artificial Cream 4 2 6 — — — Ice Cream — 1 1 — — — Marmalade — 1 1 — — — Meat Pie — 1 1 — — — Butter Toffee — 1 1 — — — Cherries Glace — 4 4 — — — Mincemeat — 3 3 — — — Mixed Peel — 3 3 — — — Wines (Alcoholic) — 3 3 — — — Ground Almonds — 2 2 — — — Preserved Ginger — 2 2 — — — Almonds (Whole) — 1 1 — — — Xmas Pudding — 1 1 — — — Crystallised Fruit — 1 1 — — — Icing Sugar — 1 1 — — — Malt Vinegar — 1 1 — — — Muscatels — 1 1 — — — Oatmeal — 1 1 — — — Olive Oil — 1 1 — — — Pearl Barley — 1 1 — — — Flour (Diabetic, Self Raising) — 1 1 — — — Suet — 1 1 — — — Treacle — 1 1 — — — Wines (Non-Alcoholic) — 1 1 — - — Margarine 22 - 22 16 - 16 Total 915 403 1,318 68 59 127 N.B.—With one exception all samples tested conformed with The Public Health (Preservatives, etc., in Food) Regulations, 1925-1927. 77 1929 Milk Prosecutions The summary of prosecutions showed that during the year 9 prosecutions were taken for adulterated miik, all of which were successful. Summary of Prosecutions during year 1929. (vide p.p. 85 to 89.) Total Prosecutions Successful. Dismissed. Withdrawn Amount of Penalties. Costs Received. £. s. d. £ s. d. "Public Health (London) Act, 1891" 33 30 la 2a 42 0 0 67 8 0 "Food and Drugs (Adulteration) Act, 1928" 17 16 - la 9 4 0 38 17 6 "Sale of Food Order, 1921" — — — — — — "Milk and Dairies Order, 1926 " 16 16 — — 25 3 0 19 18 0 "Milk and Dairies (Consolidated) Act, 1915" 1 1 - - 2 0 0 5 5 0 "Public Health (Condensed Milk) Regulations, 1923." - - - - - - L C.C. By-laws 5 4 - la 2 6 0 4 4 0 Totals 72 67 1 4 80 13 0 135 12 6 (a) Alternative Summons. 78 1929 Public Health Staff. The staff of the Medical Officer of Health (*G. CLARK TROTTER, M.D. ; D.P.H. ; F.R.S.E. is constituted as follows :— * Superintendent of Public Health Department and Chief Sanitary Inspector. GEORGE JAMES BRIDEL.f Cert. Sanit. Insp. Ex. Bd., Cert. San. Inst. *Inspector of Meat. Hargreaves Wilkinson, Cert. Sanit. Inst.f *Inspector of Workshops and Bakehouses and Senior Inspector. Harry John James Watson, Cert. Sanit. Inst. *Inspectors of Workshops, &-c., in which Females are Employed. Miss Eleanor Harriet Daniell, Cert. Sanit. Insp. Ex. Bd. ; C.M.B. ; Cert. H.V Mrs. Susannah Undery, Cert. Sanit. Insp. Ex. Bd. ; C.M.B. ; Cert. H.V. *Inspector of Houses Let in Lodgings. William H. G. Saunders, Cert. Sanit. Insp. Ex. Bd. *Inspector of Food and Drugs, &-c. Gilbert Stanley Green, Cert. Sanit. Insp. Ex. Bd t *Sanitary Inspectors. District 1. Thos. Wallace Agar, Cert. Sanit. Inst. ,, 2. Thomas H. Hancock, Cert. Sanit. Inst, Ex. Bl.f ,, 3. Allen Bagshaw, Cert. Sanit. Inst.f „ 4. Colin W. S. Lewis, Cert. Sanit. Insp. Ex. Bd.f „ 5. Chas. Edwin Horsman, Cert. Sanit. Inst. „ 6. Stanley P. Marks, Cert. Sanit. Insp. Ex. Bd.f „ 7. Edward I. Fortune, Cert. Sanit. Inst. „ 8. John Metcalf, Cert. Sanit. Inst. ,, 9. Robert Cecil Thorpe, Cert. Sanit. Insp. Ex. Bd. ,, 10. Alfred E. Wood, Cert. Sanit. Insp. Ex. Bd.f „ 11. Harold H. Uren, Cert. Sanit. Insp. Ex. Bd. „ 12. Leonard H. Pearson, Cert. Sanit. Insp. Ex. Bd. „ 13. Edward G. Holmes, Cert. Sanit. Insp. Ex. Bd. 14. James Stephenson Ashworth, Cert. Sanit. Insp. Ex. Joint Bd. t Also Meat Inspector's Certificati. Tuberculosis Visiting Nurse. Miss Emily McGoldrick, State Regd. Nurse, Cert. General Training. *Health Visitors. Miss Rosina Palmer, Cert. C.M.B. ; Cert. H.V. ; S.R.N. Miss Lily Flower, Cert. C.M.B. ; Cert. H.V. ; S.R.N. Miss Valerie Lainton, Cert. H.V. ; S.R.N. Mrs. Amy Main, Cert. C.M.B. ; Cert. H.V. ; S.R.N. Miss Ellen Oliver, Cert. C.M.B. ; S.R.N. Miss May Ritson, Cert. C.M.B. ; Cert. H.V. ; S.R.N. Miss Rosa Burgess, Cert. C.M.B. ; Cert. H.V. ; S.R.N. Miss Prudence Baker, Cert. C.M.B. ; Cert. H.V . ; S.R.N. Clerical Staff. § George Harold King (Chief Clerk), Henry Angel, Edward A. Abbott, Walter JWolfe, William G. Bunch, Clement M. Wheble, Arthur R. Wittrick, William R. Causton, Laurence W. Edis, William A. McAdam, "Charles J. Cridland, Leslie P. J. Regan, *Fredk. C. Green, "Albert E. Vanstone, "Daisy Francis (Milk Grants). § Died 14th December, 1929. Disinfecting Station. A. Lewis (Engineer), W. G. Jollie (Handyman Stoker), Mrs. Lewis (Caretaker, Shelter House), Mrs. Horne (Cleansing Station Attendant), G. Cooper (Motor Driver). Disinfectors. F. Webb, W. Hard wick, W. Woodley, A. Taylor. Mortuary Keeper. S. Maxwell. Public Analyst. † ERNEST A. PINCHIN, B.Sc. (Lond.), F.I.C., 9, Mincing Lane, E.C.3. † Died 23rd December, 1929. Solicitor. NORMAN ROBERTSON, 3, Bond Court, Walbrook, E.C.4. * Those marked with an asterisk indicates contribution was expected either under the Public Health Acts or by Exchequer Grants. APPENDIX. Vital and Sanitary Statistics, also Legal Proceedings. 1929. together with the PRESCRIBED RETURNS OF THE MINISTRY OF HEALTH. 80 1929 STATISTICAL APPENDIX Showing Deaths from all Causes in Islington during the Year 1929. Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. Institution; within Borough. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. I,.H. w B. S.E. Small Pox - - - - - - - - - - - - - - - - - - - - - - - - - (a) Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - - (b) Unvaccinated - - - - - - - - - - - - - - - - - - - - - - - - - (c) No Statement - - - - - - - - - - - - - - - - - - - - - - - - - 7 Measles 2 9 - - - - - - - - - - - 11 - - - 1 1 2 1 6 6 5 11 Scarlet Fever — 2 2 — 2 — 1 1 - — — — — 2 6 — 2 — 2 2 — 2 3 5 8 Typhus Fever — — — — — — — — - — — — — — — — — — — — — — — - - 21 Epidemic Influenza 1 4 1 — 1 1 9 19 38 43 52 31 7 5 202 25 25 25 19 32 27 54 12 95 207 15 Whooping Cough 46 77 3 — — — - — — — — — — 123 3 16 14 9 20 4 41 22 01 65 126 3 Diphtheria 3 15 15 1 - - - - - - - - - 18 16 3 9 2 2 6 8 4 20 14 34 2 Enteric Fever — — — — 1 — — 1 — — — — — — 2 — 1 — — — 1 — - 2 2 Asiatic Cholera — — — — — — — — — — — — — - - - - — - - — - - - - 2 Diarrhoea. Dysentery 11 - - - - - - - - - - - - 11 - - 1 - - 2 3 5 6 5 11 Epidemic Enteritis 2 — — — — — — — — — — — — 2 — 1 — — — — 1 — 2 — 2, Other Allied Diseases 5 ab - - 1a - - - - - - - - - 5 1 1 - — — 1 1 3 4 2 6 Hydrophobia - - - - - - - - - - - - - - - - - - - - - - - - - Glanders - - - - - - - - - - - - - - - - - - - - - - - - - Tetanus - - - - - - - - - - - - - - - - - - - - - - - - - Anthrax - - - - - - - - - - - - - - - - - - - - - - - - - CowPox - - - - - - - - - - - - - - - - - - - - - - - - - 9 Syphilis 1 1 — — — — 1 2 5 8 2 — — 2 18 3 — 2 1 5 5 4 15 5 20 Gonorrhoea - - - - - - - - - 1 1 - - - 2 - - - 1 - 1 - 2 - 2 Phagedaena — — — — — - — — — — — — — — - — - — — — — - - — - 12 Erysipelas — 1 — 1 — — — 2 1 2 5 1 — 1 12 — 1 1 1 — 5 5 5 8 13 8 Pueiperal Fever — — — — — 1 7 6 — — — — — — 14 1 2 1 — 4 2 4 — 14 14 3 Pyaemia — — 1 1 — 2 1 1 4 1 — — — — 11 2 1 1 — — 3 4 5 0 11 5 Infective Endocarditis — — — — 2 1 5 2 1 — 1 — — — 12 1 2 — 2 3 2 2 6 6 12 Other Allied Diseases — — — — — — — 1 — — 1 1 — — 3 1 1 — 1 — — — 2 1 3 Malarial Fever — — — — — — — — — — - — - - - - - - - - - - - - - 1 Rheumatic Fever — — 1 1 5 — 2 4 1 — 2 1 — — 17 2 1 1 4 3 5 1 4 13 17 1 Rheumatism of Heart — — 2 — 2 — 1 2 — — — — — — 7 — 1 2 1 1 — 2 5 2 7 4 Tuberculosis of Brain 1 4 3 1 1 1 — 1 — — — — — 5 7 — - 2 1 2 3 4 5 7 12 1 Tuberculosis of Larynx — — — - — — — — 1 — — — — — 1 — — — 1 — — — 1 — 1 109 Phthisis 2 6 — 3 23 48 64 58 69 29 10 1 — 8 305 22 33 29 41 45 57 80 191 122 313 2 Abdominal Tuberculosis 1 — — — — 2 — 1 — 2 — — — 1 5 1 2 — — 2 1 — 3 3 6 2 General Tube.rculosis — 2 — — — 1 — — — 2 1 1 — 2 5 1 — 2 1 1 2 - 3 4 7 Other forms Tuberculosis - - - - - 1 1 3 - 1 - - - - 6 1 - - 1 1 - 3 5 1 6 Other Infective Diseases - - - 1 - - - - - - - - - - 1 - - 1 - - - - - 1 1 Thrush - - - - - - - - - - - - - - - - - - - - - - - - - Actinomycosis - - - - - - - - - - 1 - - - 1 - - - - 1 - - 1 — 1 Hydatid Diseases - - - - - - - - - - - - - - - - - - - - - - - - - Scurvy - - - - - - - - - - - - - - - - - - - - - - - - - Other Diseases due to Altered Food - - - - - - - - - - - - - - - - - - - - - - - - - 1 Acute Alcoholism — — — — — — — 2 — — — — — — 2 — 1 1 — — — - 2 — 2 1 Chronic Alcoholism — — — — — — — 1 — 1 1 — — — 3 1 1 1 — — — - 2 1 3 Chronic Industrial Pois- onings - - - - - - - - - - - - - - - - - - - - - - - - - Other Chronic Poisonings - - - - - - - - - - - - - - - - - - - - - - - - — 1 Osteo-arthritis — — — — 1 — — — 1 — 6 5 — — 13 — 1 2 1 2 3 4 6 7 13 Gout — — — — — — — — — — — — — — — — — — - — — — — — — 103 Cancer 2 1 — 1 — 1 10 22 84 153 106 81 10 3 468 48 59 43 46 115 62 98 228 243 471 Diabetes Melhtus - - - - - 1 — 2 6 9 10 4 1 — 33 1 2 1 4 10 8 7 12 21 33 2 Purpura Haemorrhagica — — — — — — 2 — — — — — — — 2 — — — 2 — — — 1 1 Haemophilia — — — — — — — — — — — - — — — — — — — — — — — — — Anaemia - - - - - - - - 3 6 2 1 — — 12 3 1 1 1 5 — 1 3 9 12 Lymphadenoma — — 1 — — — 1 3 — 1 — — — — 6 — 1 — 1 2 — 2 4 2 6 1 Premature Birth 63 - - - - - - - - - - - - 63 — 7 8 3 11 9 8 17 30 33 63 Injury at Birth 4 - - - - - - - - - - - - 4 - 1 - - - - 2 1 4 — 4 Debility at Birth 4 — — — — — — — — — — — — 4 — — — — 1 1 1 1 4 — 4 1 Atelectasis 8 — — — — — — — — — — — — 8 — 2 2 — — 1 1 2 7 1 8 Congenital Defects 31 1 - - - - - - - - - - - 32 — 2 2 5 5 8 5 5 15 17 32 Want of Breast Milk — — — — — — — — — — — — — — — - — — - - — — — — Atrophy, Debility, Marasmus 22 — — — — — — — — — — — — 22 — 2 1 3 3 4 3 6 11 11 22 a Cerebro Spinal Fever. b Ophthalmia Neonatorum. 81 1929 Continued. Deaths in Institution; within Borough. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males Females. Totals 0- 1- 5- 10- 15- 20- 25- 35 45- 55- 65- 75- 85- Tuf. U.H. Toll. I..H. H. B. S.E. Dentition 2 - - - - - - - - - - - - 2 - - 1 - - 1 - - 1 1 2 Rickets - - - - - - - - - - - - - - - — — — — — — — 16 Old Age, Senile Decay — — — — — — — — — — 8 86 55 149 14 18 14 16 36 17 34 46 103 149 Convulsions 3 1 — — — — — — — — — — — 4 — 1 — — 1 — 1 1 4 — 4 1 Meningitis 11 4 2 — 1 1 2 4 1 1 1 — — 15 13 3 1 2 4 2 10 6 16 12 28 Encephalitis - - - - — — — 3 — 1 — 1 — — 5 1 1 — 1 1 1 — 2 3 5 1 Apoplexy - - - - - - 1 2 4 12 28 23 2 — 72 6 6 7 11 16 9 17 21 51 72 Softening of Brain — — — — — — — — 1 - - - - - 1 - - - - 1 - - 1 - 1 1 Hemiplegia — — — 1 - - - - 2 2 5 5 1 - 16 1 2 3 2 4 1 3 6 10 16 General Paralysis of Tnsane - - - - - - 1 5 1 5 1 - 1 - 14 1 1 - 2 2 5 3 12 2 14 Other forms of Insanity — — — — 1 — 3 2 4 1 1 — — 12 1 1 2 1 — 2 5 4 8 12 Chorea — — — - - - - - - - 1 - - - 1 - - 1 - - - - - 1 1 1 Cerebral Tumour - 1 - - - - - 3 4 2 3 - - 1 12 2 1 3 - 1 1 5 8 5 13 Epilepsy — — — — 2 1 1 2 1 1 1 — 9 — 3 1 — 1 2 2 2 7 9 Laryngismus Stridulus — — — — — — — — — — — - — — — — — — - - - 1 Locomotor Ataxy - - - - - - - 2 1 3 3 — — 9 2 — 1 1 2 1 2 7 2 9 1 Paraplegia — — — 1 — — — 2 1 3 4 3 — 14 2 2 1 1 5 — 3 6 8 14 7 Other Forms, Brain Diseases - 1 1c 1 - - 2 6 4 6 8 2 - 1 30 2 6 2 2 7 4 8 19 12 31 Otitis 1 1 2 1 4 — 1 1 — — — — — 2 9 — 3 2 2 3 1 — 8 3 11 Disease of Nose, Epistaxis - - - — — — — — — — — — — — — — — — — — — — — — — Disease of the Eve - - - - - - - - - - - - - - - - - - - - - - - - - 5 Pericarditis — 2 1 1 1 — — 1 1 — 1 — — 2 6 — — — — 1 1 6 4 4 8 3 Endocarditis 1 — — — 1 1 3 1 3 2 2 4 1 1 18 5 2 1 4 2 1 4 6 13 19 Hypertrophy of Heart - - - - - - - - - - 1 - - - 1 - - - - - - 1 1 - 1 Angina Pectoris - - - - - - - - 3 2 5 2 - - 12 1 1 - 2 7 - 1 7 5 12 2 Aneurism - - - - - - - - 2 3 2 4 — — 11 — — 1 — 2 4 4 7 4 11 22 Sensile Gngrene - - - - - 1 - - - 1 9 12 5 — 28 3 — 1 4 8 3 9 17 11 28 35 Embolism, Thrombosis — — — — 1 — — 1 3 13 16 12 3 — 49 5 7 4 9 8 5 11 35 14 49 1 Phlebitis — — — — — — — — — 4 3 — — — 7 2 — — 1 2 1 1 4 3 7 Varicose Veins — — — — — — — — — — 1 — — — 1 — — — — — 1 — — 1 1 295 Other Diseases, Heart and Vessels - 1 1 3 _4 6 16 37 100 210 351 293 68 1 1089 116 97 119 110 179 198 271 498 592 1090 Larvueitis — 2 — — - — — — — — — — 2 — — — — 1 — — 1 — 2 2 Croup — — — — — — — — — — — — — — — — — — — — — — — — 1 Other Diseases, Larnyx and Trarhea - - - - - - - 1 - - - - - - 1 - - 1 - - - - 1 - 1 50 Acute Bronchitis 12 5 — — — 2 1 6 27 36 46 11 17 129 12 15 6 23 26 31 33 56 90 146 73 Chronic Bronchitis 3 1 — — — 1 4 13 34 52 61 18 4 183 17 13 13 22 26 44 52 96 91 187 57 Lobar Pneumonia 10 15 2 1 1 2 11 14 24 27 14 5 1 25 102 12 10 11 7 18 25 44 81 46 127 147 Lobular Pneumonia 68 58 5 - - 3 — 3 15 35 42 45 11 126 157 22 29 29 47 38 47 71 155 128 283 7 Pneumonia 4 - 2 — — — 1 3 3 8 2 2 1 4 22 4 5 2 2 3 4 6 15 11 26 5 Emphysema Asthma - - — — 1 — — 2 6 9 5 6 1 — 30 3 5 3 3 1 3 12 20 10 30 12 Pleurisy — 3 1 1 — 1 3 2 6 9 3 3 — 3 29 1 1 5 4 10 7 4 24 8 32 91 Other Diseases, Respiratory System 1 - 2 - - 1 2 6 5 9 23 56 21 1 125 12 14 16 16 19 18 31 65 61 126 1 Diseases of Mouth and Annex* 1 - - - - - - - - - - 1 - 1 1 1 — - — 1 — — — 2 2 Diseases oi Plia-ynx 1 - - - - - - - - - - - - 1 - - - - - - 1 - 1 - 1 Diseases of Œsophagus — — — — — — — — — — — — — — — — — — — — — — — — — 3 Ulcer of Stomach and Duodenum - - - - - - 4 10 16 11 5 3 - — 49 4 6 4 7 7 4 17 37 12 49 1 Other Diseases of the Stomach 4 - - - - - - - - 1 2 - - 4 3 - - - 2 - 4 1 4 3 7 44 Enteritis 55 8 1 - — — 1 1 4 1 — 2 — 63 10 7 6 4 10 12 20 14 41 32 73 5 Appendicitis - 2 3 2 1 1 3 3 2 1 — — — 2 16 1 2 4 1 4 2 4 8 10 18 1 Obstruction of Intestines 4 - - - - - - 2 1 6 8 10 3 4 30 4 3 6 4 6 3 8 11 23 34 Other Diseases of Intestines - - - - - - - 1 - 2 1 - - - - - 1 2 1 - - - 3 1 4 9 Cirrhosis of Liver — 1 - - - - - 1 7 7 6 3 — 1 24 5 3 3 3 3 — 8 15 10 25 1 Other Diseases of Liver — — — — — — — — 1 — 1 1 — — 3 — 1 — 1 — 1 — 2 1 3 Peritonitis 1 1 - — — •— — — — 2 1 — — 2 3 — — 2 — 2 1 — 4 1 5 1 Other Diseases, Digestive System - - - - - - 1 1 - 1 1 1 - - 5 1 2 1 1 - - - 3 2 5 0 Diseases, Lymphatic System and Glands 1 - - - 2 2 1 1 1 4 1 - - 1 12 3 1 1 1 1 2 4 3 10 13 7 Acute Nephritis - 1 — — — — — 1 3 4 3 2 — 1 13 I 2 1 2 2 5 1 7 7 14 36 Bright's Disease - - 1 — 3 — 3 8 13 30 27 14 3 — 102 9 5 9 19 16 22 22 44 58 102 Calculus - - - - - - - - 3 5 2 1 — — 11 1 — — 2 3 4 1 6 5 11 1 Diseases ox Bladder and Prostate - - - - 1 - 1 - 1 5 13 13 3 - 37 3 5 - 5 8 6 10 36 1 37 2 Other Diseases, Urinary System - - 1 - - - - - 4 3 - - - - 8 2 2 - 1 - 2 1 3 5 8 Diseases of Testis and Penis 1 - - - - - - - 1 - - - - 1 1 - - - 1 1 - -. 2 - 2 Diseases of Ovaries - - - - - - 1 — 1 1 1 — — — 4 — 2 — 1 — 1 — — 4 4 1 Diseases of Uterus and Appendages - - - - - - - - 1 - - - - - 1 - 1 - - - - - - 1 1 Diseases of Vagina and External Genitals - - 1 - - - - - - 1 - - - - 2 - 1 - - - - 1 - 2 2 Diseases of Breast - - - - - - - - - - - - - - - - - - - - - - - - - z Abortion, Miscarriage - — — — 1 — 1 1 — — — — — — 3 — — 1 — 1 — 1 — 3 3 Puerperal Mania - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal Convulsions - - - - - - 1 - - - - - - - 1 - - - 1 - - - - 1 1 Placcnta Previa, Flooding - - - - — - - 4 - — — — - — 4 2 — 1 - — 1 — — 4 4 c Encephalitis Lethargica. * One Female 100 years 82 1929 Continued. Deaths in nstitutionsl within Borough. DISEASES. AGES. Under 5 1 Over 5 DISTRICTS. Males. Females. Totals. 0- 1- 5- 10- 15- 20- 25- 35- 45- 5r>- 65- 75- 85- Tuf. U.H. Toll. I.H H. B. S.E. Puerperal Thrombosis - - - - - - - - - - - - - - - - - - - - - - - - - 1 Other Diseases, Pregnancy and Childbirth - - - - - 2 1 1 - — — — — 4 — — 1 1 1 — 1 — 4 4 Arthritis, Ostitis, ostitis - - - - - - - - 1 - 1 - - - 2 - - - - - 1 1 1 1 2 Other Diseases, Osseous - 1 1 - - - - - 1 - - - - 1 2 - - - 1 - 2 - 2 1 3 Ulcer, Bedsore - - - - - - - - - - - - - - - - - - - - - - - - - Eczema — - - - - - - - - - - - - - - - - - - - - - - - - Pemphigus 1 - - - - - - - - - - - - 1 - - - - 1 - - - 1 - 1 Other Diseases, Integumentary System - - - - - - - - - - - - - - - - - - - - - - - - - Accidents and Negligence. In Mines and Quarries - - - - - - - - - - - - - - - - - - - - - - - - - 26 In Vehicular Traffic — 2 7 5 5 2 4 3 5 7 11 6 1 2 56 5 1 5 14 7 13 13 34 24 58 On Railways — — — — 1 — — 1 — — — — — — 2 — — 1 — 1 — 2 — 2 On Ships, Boats, etc. (not drowning) - - - - - - - - - - - - - - - - - - - - - - - - - In Building Operation - — — — — — — 1 1 — — — — — 2 — — — — 1 1 2 — 2 By Machinery - - - - 1 - - - - - - - - - 1 - - - - - 1 - 1 - 1 3 By Weapons and implements — — 1 — _ — - — 2 1 — — - — 4 2 — — 1 — — 1 3 1 4 5 Burns and Scalds 1 4 - — — — — — — I 1 1 — — 5 2 1 2 1 — 2 1 6 - 7 1 Poisons, Poisonous Vapours — — 1 — — — — — — — 1 — 1 — 3 — — 1 — 1 — 1 2 1 3 Surgical Narcosis - - - - - - - - - - - - - - - - - - - - - - - - - Effects of Electric S hock - - - - - - - - - - - - - - - - - - - - - - - - - Corrosions by Chemicals Drowning 1 - 1 - - 1 1 - 1 - - 1 - 1 5 - 1 1 — — — 4 5 1 6 Suffocation, Overlaid in Bed - - - - - - - - - - - - - - - - - - - - - - - — - Suffocation, Otherwise 5 1 — — — — — — 1 — 1 1 - 6 3 — 1 — 1 4 2 1 6 3 9 34 Falls, not specified 1 — 1 — — 1 3 1 3 7 13 16 6 1 51 5 5 5 3 8 10 16 23 29 52 Weather Agencies — — — — — — — 1 — — — — — — — — — — - — - - - - - 2 Otherwise, not stated 1 — — 1 1 — 1 — 1 — — — — 1 4 — 1 — — 2 1 1 2 3 5 Homicide - - - - - - 1 - 1 - - - - - 2 - - - - - 2 - 1 1 2 Suicide 1 By Poison - - - - - 1 4 5 5 12 3 1 — — 31 1 3 1 4 6 6 10 27 4 31 By Asphyxia — — — — — — — 1 2 — — — — — 3 — 1 1 — 1 — — 2 1 3 By Hanging and Strangulation - - - - - - 1 - - - - 1 - — 2 - 1 — 1 — — — 1 1 2 By Drowning — — — — — 1 3 — 2 1 — — — — 7 1 3 — 1 1 1 7 — 7 By Shooting — — — — — — — — — — | — 1 — — 1 1 — — — — — 1 — 1 2 By Cut or Stab — — — — — — 1 — 2 2 — — — 6 1 1 — — 2 — 2 3 3 6 By Precipitation from Elevated Places - - - - - - - - 1 - - - - - 1 - - - - - 1 - 1 - 1 By Crushing — — — — — — 1 — 1 1 — — — — 3 1 1 — — — 1 — 3 — 3 By other and unspecified methods - - - - - - - - - - - - - - - - - - - - - - - - - Execution - - - - - - - - - - - - - - - - - - - - - - - - - Sudden Death, cause not ascertained - - - - - - - - - - - - - - - - - - - - - - - - - Ill-defined r.nd unspecified causes - - - - - - - - - - - - - - - - - - - - - - - - - Males 227 130 34 16 35 35 106 162 292 479 459 370 69 357 2057 245 253 222 309 372 443 570 2414 - - Females 176 109 33 13 36 93 87 128 221 326 479 507 166 285 2049 216 226 227 257 434 391 983 — 2334 1,406 TOTAL DEATHS 403 239 67 29 71 88 193 290 513 805 938 877 235 642 4106 461 479 449 366 806 834 1153 - - 4748 83 [1929 (Ministry of Health Return.) Metropolitan Borough of Islington. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE CALENDAR YEAR 1929. Causes of Death. Sex All ages 0— 1— 2- 5— 15— 25— 45— 65— 75— All Causes M 2435 228 1 76 53 50 68 272 772 471 445 AQ/f F 2.163 177 68 42 46 90 213 548 495 Oo4 Enteric Fever M — — — — — — — F 2 — — — 1 1 Small Pox M — — — — — F — — — — — Measles M 6 2 3 1 — — — F 4 — 2 2 — — — Scarlet Fever M 3 — — 1 — 1 1 — ~~ F 5 — — 1 2 1 1 — Whooping Cough M 62 25 22 14 1 — — — — F 66 22 29 13 2 — — — i Diphtheria M 20 1 4 9 6 — — F 14 2 1 1 10 — — — — Influenza ... M 111 1 2 1 2 1 17 52 19 16 F 103 — 1 — — 2 10 31 34 25 Encephalitis Lethargica .. M 1 — — — — — 1 — — — F 3 — — 1 — 2 — — — Meningococcal Meningitis M 3 2 — — 1 — — — — F 4 3 — — — — 1 — — Tuberculosis of respiratory system • M 194 1 1 2 1 33 73 76 5 2 F 123 — 2 1 4 37 49 2* 5 Other Tuberculous Dis OQ COO - M 16 — 1 1 2 1 6 5 — — F 17 2 3 2 6 — 1 2 1 cdbcb ••• ••• •• Cancer, malignant diseas M 234 1 1 — 15 124 51 42 F 252 1 — — 2 1 21 118 59 50 Rheumatic Fever ... M 6 — — 1 2 1 1 — — F 8 2 2 4 — — — Diabetes . M 14 2 1 4 ) F 24 — — — — 1 1 7 99 10 90 5 99 Cerebral haemorrhage, &c M 76 — — — — 3 LA zy F 98 — — — 1 — 1 24 36 36 Heart Disease . M 403 — — — 1 5 28 140 131 98 F 501 1 — 3 16 31 114 146 190 Arterio-sclerosis ... . M 80 — 1 — — — — 16 32 32 F 75 — ! — — — 1 12 26 36 A Q Bronchitis M 165 7 2 1 — — 12 50 9 A 45 4o F 172 5 2 — 1 — — 2 48 ol Oft Pneumonia (all forms) M 296 54 32 13 9 6 24 82 37 oy F 214 38 24 11 2 3 13 43 36 44 Other respiratory diseases M 79 1 3 1 5 17 17 35 F 65 1 1 1 — 10 8 44 Ulcer of stomach or duodenum ... M 38 — — — — 12 20 5 1 Q F Hi _ i — — ; — — 2 5 2 & Diarrhoea, &c M 43 36 2 1 — 2 1 — 1 F 37 27 3 2 — — 4 — 1 Appendicitis and Typhliti M 6 1 — 2 — 2 1 Q — F 11 — — 1 2 1 4 6 Cirrhosis of Liver M 13 — — — — 1 7 4 1 F 7! — — — — — — 5 1 1 Acute and Chronic Nephritis M 53 — — — ! — — 8 21 9 17 l tt 7 22 F 74 — l 1 2 6 ID Puerperal Sepsis ... M — — — — — — F 12! — — — — — 12 — Other accidents and dis eases of Pregnancy anc Parturition M — — — — — — F 7 — — — — i 6 Congenital Debility anc Malformation, Prematun Birth M 68 67 — l — — — — F 62 60 — — 1 1 Suicide M 42 — — — 1 12 23 3 3 F 10 — — — 1 4 4 i i n i ± Other deaths from violence M 75 2 3 2 10 9 10 15 JU 1 A l ^ F 68 2 — 1 5 2 7 12 14 io Q 9 Other Defined Diseases M 329 29 3 5 : 10 8 37 92 62 oo F 324 14 3 4 6 11 35 69 51 131 Causes Ill-defined or un known M — — 1 — — — F — — — i — — "" Legitimate. Illegitimate I'M. ... 204 ... 24 Deaths under 1 year ...< p ^ ### 13 84 1929 (Ministry of Health Return.) Notifiable Infectious Diseases during the Year 1929. Disease. Ages. Totals Total Cases removed to Hospital Under 1. 1-2 2-3 3—4 4—5 5—10 10—15 15- 20 20—35 35-45 45-65 65 and upwds Small Pox Notifications 1 .. .. 1 .. 9 14 13 12 7 12 2 71 71 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever Notifications 7 35 56 89 111 534 160 73 67 19 4 .. 1,155 1,124 Deaths .. .. 1 1 .. 2 .. 2 1 1 .. .. 8 8 Diphtheria Notifications 24 33 71 110 78 389 120 70 80 23 9 1 1,008 996 Deaths 3 5 5 4 1 15 1 .. .. .. .. .. 34 33 Enteric Fever Notifications .. .. .. .. 3 3 3 3 3 3 .. .. 18 17 Deaths .. .. .. .. .. .. .. 1 .. 1 .. .. 2 2 Puerperal Fever Notifications .. .. .. .. .. .. .. 1 34 3 .. .. 38 38 Deaths .. .. .. .. .. .. .. .. 7 7 .. .. 14 14 Puerperal Pyrexia Notifications .. .. .. .. .. .. .. 7 61 20 .. .. 88 74 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Primary and Influenzal Pneumonia Notifications 49 54 23 24 13 47 11 41 88 42 101 26 519 .. Deaths .. 3 .. .. .. .. .. .. .. 4 13 4 24 14 OphthalmiaNeonatorum Notifications 69 .. .. .. .. .. .. .. .. .. .. .. 69 8 Deaths 1 .. .. .. .. .. .. .. .. .. .. .. 1 1 Encephalitis Lethargica Notifications .. .. .. .. .. .. .. .. 4 1 1 .. 6 6 Deaths .. .. .. .. .. 1 .. .. .. 2 .. .. 3 2 Cerebrospinal Fever Notifications 2 1 .. .. .. .. 1 .. .. 1 1 .. 6 6 Deaths 2 1 .. .. .. .. 1 .. .. .. .. .. 4 3 Acute Poliomyelitis Notifications .. .. 1 1 .. 1 .. .. 1 .. .. .. 4 2 Deaths .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. Anthrax Notifications .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery Notifications .. .. .. 1 2 3 .. .. .. .. .. .. 6 5 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Malaria Notifications .. .. .. .. .. .. .. .. .. .. 2 .. 2 2 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas Notifications 2 4 .. .. .. 4 5 12 15 22 61 23 148 93 Deaths .. 1 .. .. .. .. 1 .. .. 1 4 6 13 12 Continued Fever Notifications .. .. .. .. .. .. .. 1 .. ... ... .. .. 1 1 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. 85 1929 LEGAL PROCEEDINGS 1929 Date. Name and Address of Defendant. Offence. Result. 1929. Public Health (London) Act, 1891. Jan. 4th Barnes, Herbert Goddard, 118, Farringdon Road, E.C.I. Non-compliance with Statutory Notice re 30, King Henry Street Ordered to abate the nuisance within 14 days and to pay £1 1s. 0d. costs. Jan. 25th Shaw, Albert, 195, Blackstock Road Non-compliance with Statutory Notice re 8, Riversdale Road Ordered to abate the nuisance within 14 days and fined £5, and to pay £1 2s. 0d. costs Feb. 22nd Rickwood, William, 153, St. John's Road, Hoxton, N.l Non-compliance with Statutory Notice re 50, Rotherfield Street Ordered to pay £2 2s. 0d. costs. Mar. 15th Sukmanski, Sidney, 12, Woodberry Down, N.4 Non-compliance with Statutory Notice re 28, Blundell Street Ordered to abate the nuisance within 21 days. Fined £2 and ordered to pay £2 costs. Mar. 15th Tory, Frederick A., 91, Cannon Street, E.C.4 Non-compliance with Statutory Notice re 6, Crescent Street Ordered to abate the nuisance within 21 days. Fined £1 1s. 0d. and ordered to pay £1 1s. 0d. costs. Mar. 15th Benabo, Arthur, 53, Commercial Road, E. Non-compliance with Statutory Notice re 5, Anchor Dwellings Ordered to abate the nuisance within 14 days. Fined £1 and ordered to pay £2 costs. Mar. 1st Apl. 19th McKirdy, Mrs. Laura, 97, Holland Road, W.14 Non-compliance with Notice re 10, Upper Street Summons withdrawn on payment of £2 2s. 0d. costs. Mar. 1st Apl. 19th Zegansky, Madame Rose, 10, Upper Street Non-compliance with Notice re 10, Upper Street Summons withdrawn (alternative summons). Apl. 26th Ellis, Mr. G., 354, High Road, Tottenham, N.17 Non-compliance with Statutory Notice re, 140, St. Thomas' Road Ordered to abate the nuisance within 14 days and to pay £2 2s. 0d. costs. June 21st Flavell, Thomas W., 222, Holloway Road Non-compliance with Statutory Notice re 189, Blackstock Road Ordered to abate the nuisance within 14 days and to pay £1 1s. 0d. costs. June 21st Flavell, Thomas W., 222, Holloway Road Non-compliance with Statutory Notice re 189, Blackstock Road Ordered to abate the nuisance within 14 days and to pay £1 1s. 0d. costs. June 28th Brown, Joseph, 506, Caledonian Road Non-compliance with Statutory Notice re 84, Bemerton Street Ordered to abate the nuisance within 14 days and to pay £1 1s. 0d. costs. June 28th Brown, Joseph, 508, Caledonian Road Non-compliance with Statutory Notice re 88, Bemerton Street Ordered to abate the nuisance within 14 days and to pay .£1 1s. 0d. costs. June 28th Brown, Joseph, 508, Caledonian Road Non-compliance with Statutory Notice re 88, Bemerton Street Ordered to abate the nuisance within 14 days and to pay £1 1s. 0d. costs. Aug. 30th Ind Coope & Company, Ltd., 32, Bloomsbury Square, W.C.1 Non-compliance with Statutory Notice re boot factory next 113, Southgate Road Ordered to complete the work within 2 months and to pay £I 1s. 0d. costs. Aug. 30th Ind Coope & Company, Ltd., 32, Bloomsbury Square, W.C.1 Non-compliance with notice requiring additional w.c. at boot factory next 113, Southgate Road Ordered to complete the work within 2 months and to pay £1 1s. 0d. costs. Aug. 30th Ind Coope & Company, Ltd., 32, Bloomsbury Square, W.C.1 Non-compliance with Statutory Notice re 113, Southgate Road Ordered to complete the work within 2 months and to pay £1 1s. 0d. costs. Aug. 30th Ind Coope & Company, Ltd., 32, Bloomsbury Square, W.C.1 Non-compliance with notice re hairdresser's shop next 113, Southgate Road Ordered to complete the work within 2 months and to pay £1 1s. 0d. costs. 86 1929 LEGAL PROCEEDINGS 1929 Date. Name and Address of Defendant. Offence. Result. 1929. Public Health (London) Act, 1891—continued. Mar. 1st Wagstaff, Charles, 129, Bemerton Street Disobedience of Justices' Order re 129, Bemerton Street Summons withdrawn. Apl. 19th June 14th July 12th Sept. 20th Aug. 23rd Roberts, Mrs. Elizabeth M., 107, Highbury New Park Non-compliance with Statutory Notice re 95, Highbury New Park Ordered to abate the nuisance within 14 days and to pay £2 2s. 0d. costs. Sept. 27th Sept. 20th Quantrill, L., Laurel Cottage, Bagly, near Tliirsk, Yorkshire Non-compliance with Statutory Notice re 76, St. Peter's Street Summons adjourned sine die. Sept. 27th Laws, Mrs. Elizabeth, 24, Pooles Park Non-compliance with Statutory Notice re 24, Pooles Park Ordered to abate the nuisance within 14 days. Oct. 18th Home, Joseph, 206, Holloway Road Exposing for sale unsound Poultry Fined £5 and ordered to pay £5 5s. 0d. costs. Oct. 18th Home, Joseph, 206, Holloway Road Depositing for the purpose of sale certain Unsound Meat Fined £5 and ordered to pay £5 5s. 0d. costs. Oct. 18th Mr. R. McBain Tidey, Herbert Gordon Tidey and Sydney Brown (trading as Robert Tidey & Son), 3, Pentonville Road Non-compliance with Statutory Notice re 43, Cumberland Street Ordered to abate the nuisance within 14 days and to pay £3 3s. 0d. costs. Oct. 18th Mr. R. McBain Tidey, Herbert Gordon Tidey and Sydney Brown (trading as Robert Tidey & Son), 3, Pentonville Road Non-compliance with Statutory Notice re 71, Pembroke Street Ordered to abate the nuisance within 21 days and to pay £3 3s. 0d. costs. Nov. 15th Ricotti, Ernesto, 108, Pentonville Road, Finsbury, N.l Knowingly suffering an underground room to be occupied as a dwelling (at 73, Barnsbury Road) Fined £2 and ordered to pay £2 costs. Nov. 1st Nov. 15th Cook, Henry, 73, Barnsbury Road Illegally occupying an underground room as a dwelling Summons dismissed (alternative summons). Nov 15th Levi, Isaac, 27, Highbury Grove Non-compliance with Statutory Notice re Crown Mansions Ordered to abate the nuisance within 14 days. Fined £3 3s. 0d. and ordered to pay £2 2s. 0d. costs. Nov. 29th Brown, Joseph, 508, Caledonian Road Non-compliance with Statutory Notice re 7, Albion Street Ordered to abate the nuisance within 14 days. Fined £2 2s. 0d. and ordered to pay £2 2s. 0d. costs. Nov. 29th Brown, Joseph, 508, Caledonian Road Non-compliance with Statutory Notice re 11, Albion Street Ordered to abate the nuisance within 14 days. Fined £2 2s. 0d. and ordered to pay £2 2s. 0d. costs. Dec. 13th Scott, Mrs. Lilian, 59, Acton Street, Gray's Inn Road Non-compliance with Statutory Notice re 38, Vittoria Street Ordered to abate the nuisance within 14 days. ; Fined £2 2s. 0d. and ordered to pay £1 1s. 0d. costs. 87 1929 LEGAL PROCEEDINGS 1929 Date. Name and Address of Defendant. Offence. Result. 1929. Public Health (London) Act, 1891—continued. | Dec. 13th Nicolls, William John, 17, Minard Road, S.E.6 Non-compliance with Statutory Notice re 220, York Road Ordered to abate the nuisance within 7 davs Fined £5 5s. 0d. and ordered to pay £2 2s. 0d costs. Dec. 13th Nicolls, William John, 17, Minard Road, S.E.6 Non-compliance with Statutory Notice re 222, York Road Ordered to abate the nuisance within 14 days Fined £5 5s. 0d. and ordered to pay £2 2s 0d costs. Milk and Dairies Order, 1926. Mar. 15th Pike, Robert George, 173, Corporation Buildings, E.C.I Filling a bottle with milk in street instead of on registered premises Fined 20s. and ordered to pay 20s. costs. Apl. 12th Challis, Edward, 87, Glazemere Road, South Tottenham, N.15 Filling a bottle with milk in street instead of on registered premises (in Cleveland Road) Fined 30s. Apl. 12th Moseley, Alfred, 81, Milton Road, Stoke New ington, N.16 ditto. Fined 30s. Apl. 19th Fordham, Charles, 102, Brewery Road Filling and closing milk bottles in street instead of on registered premises Fined £1 and ordered to pay £2 2s. 0d. costs. Apl. 19th Cross, Frank, 15, Parkfield Street ditto. Fined £2 and ordered to pay £2 2s. 0d. costs. May 24th Spratley, Harry, 45, Langdon Road ditto. Fined 40s. June 7th Hills, William Frederick, 19a, Ecclesbourne Road ditto. Fined 40s. and ordered to pay £1 1s. 0d. costs. June 14th Bridge, Phillip, 29, Goodinge Road Delivering milk in bottles which had not been filled and closed on registered premises Fined £2 2s. 0d. and ordered to pay £2 2s. 0d costs. June 7th June 21st Swan, Fred John, 56, Corbyn Street Filling and closing milk bottles in street instead of on registered premises Fined £2 and ordered to pay £1 1s. 0d. costs. July 5th Gray, Fredk. Percival, 81, Eden Grove ditto. Fined £2 and ordered to pay £1 1s. 0d. costs. July 5th Smith, Alfred, 113, Shepperton Road ditto. Fined £2 and ordered to pay £1 1s. 0d. costs. July 12th Thomas, John, 48, Hollingsworth Street ditto. Fined £3 3s. 0d. and ordered to pay £2 2s. 0d costs. Aug. 28th Adams, William Charles, 102, Pembroke Street, N.l Using the premises No. 16, St. James's Road as a dairy, the said premises not being licensed as such Summons adjourned sine die, defendant to pa £3 3s. 0d. costs. Aug. 30th Sept. 12th Nov. 15th Hayward, Charles, 79, Hampdon Road, Hornsey Filling and closing milk bottles in street instead of on registered premises (in Florence .Street) Fined £1 1s. 0d. and ordered to pay £1 1s. 0d costs. Dec. 6th Hill, Daniel, 28, Andover Road Filling and closing milk bottles in street instead of on registered premises (in Hertslet Road) Fined £1 and ordered to pay £1 1s. 0d. costs. Dec. 20th Independent Milk Supplies, Ltd., 113, Cottenliam Road Failing to cause a milk churn to be thoroughly cleansed Fined £4 and ordered to pay £3 3s. 0d. costs. 88 1929 LEGAL PROCEEDINGS 1929 Date. Name and Address of Defendant. Offence. Result. 1929. London County Council By-laws. June 28th Sukmanski, Miss Lily, 12, Woodberry Down, Finsbury Park, N.4 Failing to maintain in a proper state of repair all pipes, drains, etc., at 30, Chalfont Road Summons withdrawn on payment of £2 2s. 0d. costs (work completed). June 28th Sukmanski, Moses Aaron, 12, Woodbeiry Down, Finsbury Park, N.4 Failing to maintain in a proper state of repair all pipes, drains, etc., at 30, Chalfont Road Summons withdrawn (alternative summons). Sept. 20th Earle, George Walter, 35, Mark Street, Stratford, E.15 Removing and carrying by road certain offensive and noxious matter during prohibited hours (in Caledonian Road) Fined £1 1s. 0d. and ordered to pay £1 1s. 0d costs. Oct. 18th Hornett, Frederick, 86, Harrow Road, Leytonstone, E. Removing and carrying by road certain offensive and noxious matter during prohibited hours (in Essex Road) Fined £1 and ordered to pay 10s. 6d. costs. Dec. 6th Mowberry, William Victor, 2, Sistova Road, Balham, S.W. Constructing a sink waste pipe at 2, Tollington Park of zinc, contrary to By-laws Fined 5s. and ordered to pay 10s. 6d. costs. Food and Drugs (Adulteration) Act, 1928. Jan. 18th Thompson, Peter, "Grafton Arms" P.H., 2, Grafton Road Selling whisky 36.9 degrees under proof Summons withdrawn on payment of £3 3s. 0d. costs. Feb. 22nd Biden, Walter George, "Golden Fleece" P.H., 216, Essex Road Selling whisky 40.8 degrees under proof Ordered to pay £10 10s. 0d. costs. Mar. 1st Jenkins, William Richard, 33, North Road Selling milk from which 11% original fat had been abstracted Fined £1 and ordered to pay £1 1s. 0d. costs. Mar. 15th Patch, Percy, and Tarlton, Robert, "The Prince Regent" P.H., 201, Liverpool Road Selling whisky 42.4 degrees under proof Ordered to pay £5 5s. 0d. costs. May 24th Latcliam, Raymond, 11, Highbury Park Selling margarine in an unstamped wrapper Fined £2 and ordered to pay £1 1s. 0d. costs. May 24th Latcham, Raymond, 11, Highbury Park Exposing for sale margarine to which was not attached a proper label Summons withdrawn (alternative summons). May 24th Latcham, Raymond, 11, Highbury Park Unlawfully describing margarine as "Finest Butter Substitute blended with Butter" Fined £2 and ordered to pay £1 1s. 0d. costs. May 28th Adams, William, 102, Pembroke Street Selling milk from which 54 per cent. original fat had been extracted Ordered to pay £2 4s. 6d. costs. May 28th Davies, Thomas (trading as T. Davies & Sons), 179, Hemingford Road Selling milk from which 23 per cent. original fat had been abstracted Summons withdrawn on payment of £1 1s. 0d. costs. May 31st Mason, P. J., Porch Farm, Godmanchester, Hunts. Selling and proceeding to deliver at Finsbury Park Station milk from which 8 per cent. original fat had been abstracted Ordered to pay 20s. costs. May 31st Mason, P. J., Porch Farm, Godmanchester, Hunts. Selling and proceeding to deliver at Finsbury Park Station milk from which 7 per cent original fat had been abstracted Ordered to pay 20s. costs. (Note.—Two further samples were taken since these summonses were issued, each of which was 5 per cent, deficient in fat. It was arranged in Court that no proceedings should be taken on these cases, Defendant agreeing to pay £2 2s. 0d. costs). 89 1929 LEGAL PROCEEDINGS 1929 Date. Name and Address of Defendant. Ofience. Result. 1929. Food and Drugs (Adulteration) Act, 1928— continued. July 12th Cohen, John E., 7, Gunton Street, Upper Clapton, E.5 Selling peas containing 0.0090 per cent. of crystallised copper sulphate (in Cattle Market) Fined £1 1s. 0d. and ordered to pay £1 1s. 0d. costs. July 12th Davies, Miss Blodwin, 226, York Road Selling milk from which 19 per cent. original fat had been abstracted Ordered to pay £1 1s. 0d. costs. Aug. 30th Daykin, R., Newbiggin, Askrigg, Yorkshire Selling and proceeding to deliver at Finsburv Park Station milk to which 12% water had been added Summons dismissed under Probation of Offenders Act on payment of £5 5s. 0d. costs. London County Council (General Powers) Act, 1922. Jan. 25th Shaw, Albert, 195, Blackstock Road Non-compliance with notice re 8, Riversdale Road Summons withdrawn. Milk and Dairies (Consolidate) Act. 1915. Apl. 5th Barnes, Charles, alias Allen, John, or Hallbury Henry, or Rhodes, Henry James, Bridgen Hall Dairy, Forty Hill, Enfield. Selling milk from a vehicle which had not his name and address inscribed thereon. Fined £2 and ordered to pay £5 5s. 0d. costs. 90 1929 (London County Council Return.) Metropolitan Borough of Islington. SUMMARY OF PROCEEDINGS DURING 1929. Premises. No. on Register at end of 1929 No.Added in 1929 No. Removed in 1929 Number of Inspections 1929 Number of Notices 1929 Number of Prosecutions 1929 Milk Premises †581 31 11 722 13 Nil Cowsheds I Nil Nil 3 - „ Slaughter Houses 13 „ „ 684 — „ *Other Offensive Trade Premises 17 „ „ 66 - „ Ice Cream Premises 219 „ „ 226 11 „ Registered Houses Let in Lodgings 1,006 — — 3,807 458 „ * Including the Knacker's Yard, 7 Fur Skin Dressers and 1 Fat Melter. † Including Bottle Milk only. Housing of the Working Classes- Number of houses inspected — (a) On account of complaints or illness (P.H. Act) 8,371 (b) House-to-house (Housing Consolidated Regulations, 1925) 1,290 Number of notices served— (a) Under P.H. Act:— (i) Intimation 4,758 (ii) Statutory 550 (b) Under Housing Act 23 Number of houses repaired or nuisances remedied under P,H. Act 5,492 Number of houses repaired under Section 3 of Housing Act— (a) By owners 23 (4) By L.A. in default of owners Nil Number of houses closed on notice by owner that they could not be made fit Nil Number of houses for the working classes— (a) Erected during year 15 (ib) In course of erection Nil Number of representations by Medical Officer or other person 1 Number of houses included in such representations 51 Number of Closing Orders made Nil Number of Closing Orders determined (i.e. Houses made fit) Nil Number of Demolition Orders Nil Number of houses demolished — (a) In pursuance of Orders Nil (b) Voluntarily Nil Total number of houses in the Bbrough about 45,900 Number of houses occupied by the working classes about 28,700 91 1929 Underground Rooms— Number illegally occupied 7 Number closed or illegal occupation discontinued 7 Overcrowding— Number of cases of overcrowding found 21 Number remedied 21 Number of prosecutions Nil Smoke nuisances— Number of observations . 103 Number of complaints 72 Number of notices served 9 Number of legal proceedings Nil Cleansing and Disinfection— Number of adults cleansed 42 Number of children cleansed 5,664 Number of premises cleansed:— (a) After infectious diseases 4,122 (b) For vermin 88 Water supply to tenement houses— Number of premises supplied 52 Number of prosecutions 1 Sanitary officers— Chief Sanitary Inspector (Whole time) 1 Number of Sanitary Inspectors (Whole time) Male, 19 Female 2 ,, (Part time) Male, Nil Female Nil Number of Health Visitors (Whole Time) 8 „ ,, (Part time) Nil Tuberculosis Visiting Nurse (Whole time) 1 References—Former M.O.H. Reports. The following Tables and Reports have appeared in the Annual Reports of the Medical Officer of Health enumerated. Reference is made to them here as they have not been reprinted to save space for other matters:— Annual Report 1921. Page 3 Illegitimate births in the Borough since 1851. Page 11 Deaths of inhabitants in local institutions and m institutions outside the Borough, deaths of non-inhabitants in local institutions from 1911. Page 46 Births and Birth-rate (Islington) 1841 to 1920 Page 46 Illegitimate births (Islington) 1841 to 1920. Page 47 Deaths and Death-rate (Islington) 1841 to 1920. Page 47 Infantile Mortality Returns, 1841-1920. Page 48 Cases of infectious disease (Islington) in quinquennial periods, 1891 to 1920. Annual Report 1922. Pages 1, 54 and 55 Cheap Milk Frauds. Pages 1 and 51 Inflation of Meat. Pages 2 and 57 Preservatives in Food. Pages 2 and 60 Dispensing of Prescriptions. Pages 2, 50 and 51 Unsound Food, Conference in Islington. rages 12-21 Report on Maternity and Child Welfare Work, including Assist tant Medical Officer of Health's Report on the Maternity and Child Welfare Scheme. Page 38 Vaccination. rages 41 and 42 Employed population, small factories, Steam Whistle Act, 1872. Page 5W Sale of unsound fruit by street traders. Pages 54, 58 and 59 Artificial Colouring Matter in Milk. 92 1929 Annual Report 1923. Pages 40 and 41 Summary of Rat Officer's reports. Page 41 Housing, representation to the London County Council re Georges Road and Brand Street Areas. Page 43 Food contamination by dust. Pages 45 and 46 Preservatives and colouring matter in food. Pages 46 and 47 Small shopkeepers, warnings. Page 47 Dispensing of prescriptions. Annual Report 1924. Page 13 Artificial Sunlight Treatment. Page 31 Deaths (Tuberculosis) London Table. Page 40 Smoke Nuisance. Page 43 Housing. Evidence of M.O.H. at Local Enquiry re Brand Street and George's Road Areas. Pages 47-48 Houses occupied by two or more families. Census of 1921. Population 1921, numbers living per room. Page 48 Overcrowding. Page 60 Sale of Food Order. Labelling of Meat and Eggs. Page 53 Special designated milk. Pages 54 and 55 Dispensing of prescriptions. Page 58 Petty Sessions Court established. Wrapping of Food. Annual Report 1925. Pages 2-5 Historical Survey, "Islington—Past and Present." Page 17 Artificial Sunlight Treatment. Pages 34-36 Tuberculosis, control and procedure. Page 51 Increase of Rent and Mortgage Interest (Restrictions) Acts. Page 52 Nuisance by Dogs. Pages 53 and 54 Licensed Premises. Page 55 Public Health (Meat) Regulations. Health Department Circular. Page 59 Boric Acid in Cream. Annual Report 1926. Page 9 Educational Propaganda. Page 13 Pemphigus Neonatorum. Page 16 Artificial Sunlight. Page 26 Occurrence of Smallpox. Page 29 Hospital Isolation. Secondary infections. Page 48 Disinfection of refuse dumps. Page 49 Dust nuisance, grinding of bricks and rubble. Page 58 Restaurant Kitchens. Page 58 Meat stored in bedroom. Pages 59 and 60 Meat Regulations, enforcement of, and Deputation of Traders Pages 60 and 61 Labelling of eggs, Sale of Food Order. Annual Report, 1927. Pages 4 and 6 "Still Births" (Registration). Pages 12-13 Research work by M.A.B. in cases of Puerperal Fever and Puerperal Pyrexia. Pages 17-20 Work of Voluntary Welfare Centres. Page 31 Schick Testing by Toxin Anti-toxin. Page 34 Dysentery. Page 35 Anthrax. Pages 43, 44 Bacteriological Diphtheria. Pages 47, 48 Public Baths and Washhouses in Islington. Pages 61, 62 Enquiry re Marking of Imported Eggs. Annual Report, 1928. Pages 4, 5 Co-ordination with Local Registrars — False and Inaccurate Registration. Pages 9, 10 Educational Propaganda. Pages 29, 30 Retention of Dead Bodies (Bodies of Persons Dying of Infectious Disease in Hospital)—"Double Purpose" Hearse. Pages 31, 32, 33, 34 Smallpox. Pages 39 and 46 Blind Persons Act, 1920. Page 46 Carriers, Diphtheria (Bacteriological). Page 47 National Association for Prevention of Tuberculosis. Pages 52, 53, 54 Scavenging. Page 56 Widows', Orphans' and Old Age (Contributory) Pensions Act, 1925. Page 58 Sanitary Inspectors, additional work. Page 67 Cattle Market (Metropolitan). Page 68 Food Poisoning. Page 69 "Devitalized" foodstuffs. Page 69 Egg labelling prosecutions. 93 1929 INDEX Page Accidental Deaths 23,29 Acreage 2 Adulteration of Food 7 1 Ages at Death 6 32 Anti-toxin treatment 37 Anthrax, occurrence of Appendix 79-82 Area 2 Artificial Cream 73,74 „ Sunlight Treatment 47 Bacteriological Examinations 49 Diphtheria 49 "Better Health " 9 Births 3- 4 „ Illegitimate 3-4 Notification of 4 „ Stillborn 4 Blind Persons Act, 1920 38 Cancer 25' 26 Cattle Market 69 Chicken Pox 48 Churns unsatisfactory 51 Cleansing of Verminous School Children 28 Coal gas Poisoning 26.38-44 Consumption (see Tuberculosis) 26, 38-44 Cow Sheds 70 Cream Cakes and Pastries 73,74 Day Nurseries 17 Deaths from all causes during the year 80-82 Deaths from Epidemic Diseases 23-24 „ „ Respiratory Diseases 26,27, 28 „ in Public Institutions 22-23 „ from Classified Causes 6 Maternal 10-12 „ Age at 6 Demolition of Habitable Dwellings 65 Density 2 Diphtheria 32.35 „ Anti-toxin treatment 32 „ Bacteriological 49 Diseases Treated in Hospital 34 Disinfectants distributed and used Disinfecting Station 51 Disinfection Work 41,50,51 Disinfestation of School Children 52 District Inspectors' Work 56 59 Dust, removal of 56 Dysentery 37 94 1929 Page Education Propaganda 9 Emanation, Sewer 60,61 Encephalitis Lethargica 37 Enteric Fever (Typhoid) 33, 49 Epidemic Diseases 23 „ Cerebro-Spinal Meningitis 36 Exemption Certificates 50 Erysipelas 25, 33 Factories and Workshops Administration 52-55 Fatality from Notifiable Infectious Diseases 33, 3t Finsen Light Treatment 47 Food, Inspection of, Unsound, Adulteration of 67-69, 71 Food Order 69 Food Poisoning 68 Gas (Coal) Poisoning 28 Georges Road and Hope Street Area 62-64 Glanders, Anthrax and Hydrophobia in Man 37 Health Visitors (Municipal) 10, 16, 16 Health and Baby Week 18 Home Visitations—Tuberculosis 48 Hospital Isolation of Infectious Diseases 33, 34 Housing 61-66 „ Accommodations 65 Houses Let in Lodgings 59 Ice Cream Premises 57 Infantile Mortality 7-9 Infant Welfare Work 10-22 Infection, Prevention of 30 Infectious Diseases in Schools 48 „ „ (Non-Notifiable) in Schools 48 Informal Sampling 72 Influenza 25 Inspection of Food 67 „ „ Houses 58-60 „ „ Kitchens of Restaurants 52, 69 „ Slaughter Houses and Cow Houses 67 „ Workshops 54 Institutions (Deaths in) V Increase of Rent (Restrictions) Acts 67 Inquests Insulin (Supply of) 37 Invalid Children's Aid Association 17 Isolation of Infectious Diseases 33, 34 Kitchens and Restaurants 52, 69 Legal Proceedings 77, 85-89 Public Health (Lond.) Act 85, 86 Sale of Food and Drugs Acts 88-89 „ „ Food Order 1921 69,70 Milk and Dairies Order 1926 87 Milk and Dairies (Consolidated) Act 1915 I.ight Treatment—Artificial Sunlight and "Finsen" 47 London County Council Return of Sanitary Work Malaria Malignant Diseases 25, 26 Marriages Maternity and Child Welfare Committee 11 Maternity and Child Welfare Work 10-22 Maternal Deaths 10-12 Measles (Deaths) 8, 24, 83 95 1929 Page Measles, Notifications by School Teachers 48 Meat Inspection 67-69 Meat, labelling of 69, 70 Medicines, Provision of 32,37 Mercurial Poisoning 68 Ministry of Health Returns 83, 84 Milk Scheme 13, 14 „ Adulteration 75 Milk Shops and Dairies 71 „ Special Designations Order—Licences 71 Mortuary and Coroner's Court 29 Notification of Infectious Diseases 30, 35 „ „ Tuberculosis 38 „ „ Births Act 4 ,, ,, Still-births 4 Non notifiable Infectious Diseases in Schools 48 Nuisances by Dogs 8® Offensive Trades 71 Ophthalmia Neonatorum 10 Outworkers' Premises 54 Other Notifiable Diseases 35 Pauperism "7 Pathogenicity Tests (Diphtheria) 49 Pemphigus Neonatorum 13 Phthisis 26, 38-44 „ Notification of 38 Places where Food is Prepared 69 Pneumonia 27, 36 Pneumothorax treatment 47 Poisoning (Gas) 28 „ Mercurial 68 Population at the Census, 1921 2 „ estimated, 1929 2 Preservatives 76 Prevention of Infection 30 Propaganda (Education) 9 Prosecutions, Summary of 77 Public Health Committee 11 „ Staff 78 ,, „ (Tuberculosis) Regulations 1924 42 1925 39 Puerperal Diseases 12, 25 „ Pyrexia 12 Polio-Myelitis, Acute "i6 Pulmonary Tuberculosis 26, 27, 38-44 Rag ard Flock Act (1911-1928) 67 Rats and Mice (Destruction) Act, 1919 61 Rateable Value ii References—M.O.H. Reports 91 Rent and Mortgage Interest (Restrictions) Acts 67 Respiratory Diseases 27, 28 „ Tuberculosis 26 38 Restaurant Kitchens 52, 69 Sale of food Order—Labelling of Meat 69, 70 Samples Analysed in 1929 72 Sanitary Inspectors' Work 56-59 Scavenging 55,56 Scarlet Fever 33 Schools 48 96 1929 Page Septic Diseases 12, 25 Sewer Emanation 60, 61 Shelter House 52 Slaughterhouses 67 Small Pox 30-32 Smoke Nuisances 57 Sophistication of Milk 73 Statistics 79-82 Still-Births, Registration 4 Street Accidents 29 Summary (Vital Statistics) iii Tuberculous Diseases 26, 38-44 Tuberculosis (Interim Care Committee) 39, 40 Tuberculosis Dispensaries 44-46 „ Notification of 38, 39 „ Deaths from 26-44 „ (Public Health) Regulations, 1912 43 „ Visiting Nurse 48 Typhoid Fever (see Enteric) 33, 49 Unsound Food 68 Vaccination 49, 50 Venereal Diseases Verminous Children, Disinfestation of 52 „ Premises 57 Voluntary Maternity and Child Welfare Centres 18-22 Water Certificates 57 Welfare Work by Health Visitors 10, 12, 15,16 Whooping Cough iv-48 (Deaths) 23, 24 Widows', Orphans' and Old Age (Contributory) Pensions Act, 1925 57 Workshops and Factories, Inspection of 52-55