ISL 70 AC 4361 1930 SEVENTY-FIFTH ANNUAL REPORT on the Health and Sanitary Condition Of The METROPOLITAN Borough of Islingtion 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. 1930 SEVENTY-FIFTH 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. ii MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (November, 1930, to November, 1931.) Mayor. Alderman FRANK LEYDEN SARGENT, J.P. Deputy Mayor. Alderman WILLIAM EDWIN MANCHESTER, J.P. Aldermen. HERBERT SAMUEL JORDAN WALTER FREDEKICK NOKES EDWARD HENRY TOMKINS, J.P. Councillors. WILLIAM AWCOCK, J.P, WALTER BLOUNT JOHN BRUCE CHAHLES BUNDOCK MIRIAM P. COLEMAM FREDEKICK C. COOKSEY WILLIAM H. GALE WALTER HARPER ARTHUR JAS. KENT M. A. MANCHESTER WILLIAM J. MITCHELL HENRY PENN WILLIAM T. RICKETTS EDWARD A. WILLIS Chairman Vice-Chairman Alderman JORDAN Councillor BUNDOCK MEMBERS OF THE MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1930, to November, 1931.) Aldermen. GEORGE HENRY BULL ALBERT EDWARD PETTET WM. EDWIN MANCHESTER, J.P. Councillors. JESSIE L. BLYTHE MIRIAM P. COLEMAN FREDERICK M. COLLIS ROSA ESSEX WILLIAM H. GALE H. J. GRIFFITHS ALBERT H. JACKSON Mrs. M. A. MANCHESTER LEONARD McCLANE WILLIAM J. MITCHELL WM. P. H. SPRINZ BLODWEN I. STEVENSON, J.P. MARGARET SUMMERS, Members appointed by the Council from outside their own body. Lady ANDREWS, Windy Gap, Merlon Lane, Highgate, N 6 Dr. ALICE VANCE KNOX, 10, North Hill, Highgate, N.G Dr. ELEANOR PULLEINE, 5, Hamilton Terrace, N.W.8. Mrs. WATT, 60, Highbury New Fark, N.5 Chairman Councillor SPRINZ Vice-Chairman : Councillor Mrs. M. A MANCHESTER iii SUMMARY of Vital Statistics in the Registration Year 1930 (53 weeks). Population (Enumerated at Census, 1921) 330,737 persons ,, Estimated Mid Year 1929* and 1930 319,800 persons The same estimate is being used meanwhile for 1930, pending Census figures being obtained. Decrease on Census population, 1921 10,937 persons Mean Population, ten years (1919 1929) 333,401 persons Area 3,092 acres Density (Mid-year 1929) 103 persons per acres Births Males 2,905 Females 2,780 person 5,685 Birth rate 17.4 per 1,000 inhabitants Deaths from All Causes Males 2,103 Females 1835 Persons 3,938 Death rate 12.1 per 1,000 inhabitants Males 125 Deaths from Principal Epidemic Diseases Females 106 231 persons Death rate 0.71 per 1,000 inhabitants Males 187 Deaths from All Tuberculosis Females 128 315 persons Death rate 0.97 per 1,000 inhabitants Males 169 Deaths from Respiratory Tuberculosis Females 111 280 persons Death rate 0.86 per 1,000 inhabitants Infantile Deaths under 1 year Males 226 Females 173 Total 399 Infantile mortality rate 70 per 1,000 births Excess of Births over Deaths 1,747 Rateable value of Borough of Islington £2,019,091 Sum represented by a penny rate £8,310 * See note, page 2. iv Public Health Department, Town Hall, Upper Street, N.1. Mr. Mayor, Ladies and Gentlemen, I have the honour to submit the Annual Report on the Health and Sanitary Condition of the Borough for the year 1930. The death-rate for the year was 12.1 per 1,000 inhabitants, as against 14.8 in the previous year. This rate, being based on the same population as the previous year as the new Census information was not available, is probably about 0.1 higher than what may actually prove to be the case when the population is readjusted. The infantile mortality rate was 70 per 1,000 births, the rate for the previous year being 73. This is a true figure not affected by population. Although it has not influenced the mortality rates of the Borough, but is, nevertheless, of supreme importance owing to the inconvenience to the individual attacked, the outbreak of smallpox which continued this year was disturbing. It threw a great deal of extra work on all branches of the Public Health Department, as in the emergency a great deal of extra work had to be done outside the usual office hours. The Medical Officer of Health had to visit cases on Saturdays and Sundays, when these cases had to be followed up, as it is essential to deal immediately with smallpox. The numbers had increased to such an extent that had the outbreak not begun to abate when it did, it would have been impossible for the present staff to cope with the epidemic. It will be noted that the report for this year covers a period up to and including the 3rd January, 1931, that is a 53 week year. During the year the work formerly carried out by the Guardians in respect of vaccination was taken over by the Borough Council and came under the Medical Officer of Health's Department. I desire to thank the Superintendent and members of my staff for their hearty co-operation during a year which has been most strenuous, the Chiefs of other departments for their willing help, and not least, the Chairmen, and members of the Council and Committees for the interest taken in the work of the department. Your obedient servant, Medical Officer of Health. REPORT OF THE Medical Officer of Health FOR THE YEAR 1930. 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 33-42. Occurrence of Smallpox, pages, 34-37. Whooping Cough, pages 9-50. 2. Tuberculosis, pages 43-50. Venereal Diseases, pages 31-32. 3. Provision of Medicines, etc.—Insulin, page 42. Diphtheria Antitoxin, page 37. Schick Immunisation, page 37. 4. Meat, Food and Drugs.—(a) Unsound food prosecution, page 76. (b) Labelling of meat, page 76. (c) Unsound chocolates as prizes, pages 76-77. (d) Restaurant Kitchens, pages 57, 78. (e) Tuberculous meat, page 76. (/) Certification of meat food Products, page 76. 5. Workshops, etc., pages 57-60. Shops enquiry, pages 60-65. Housing, pages 71-75. 6. Public Health Congress, page 10. Scavenging, page 65. 7. Health Visitation and work of Voluntary Centres, Artificial Sunlight, etc., pages 18-25, 49. Maternal mortality, pages 11, 13. 8. Hospitals. Nursery Schools, &c., page 83. 9. Legal Proceedings, pages 91-96. 10. Index to Report, pages 99-102. 2 1930] POPULATION. The number of the population at mid-year 1930, 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. NOTE. In the Registration Year of 1930 there were 53 weeks, so that in order to obtain the rates comparable with other years they are calculated on a population the one-fifty-second part larger than the estimate. The last time there were 53 weeks in the registration year was in 1924. Showing the Areas, Densities and Estimated Populations of the Subregistration Districts at the Middle of year 1930, also the Populations at the Census 1921. Sub-Districts. Area. Acres. Estimated Persons to an Acre. 1930. Estimated Population Mid-year 1930. 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 1930, also the Populations at the Census 1921. WARDS. Area in Acres. Estimated Persons to an Acre or Density of Population. Estimated Population Mid-year, 1930. 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—Mildmay 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 3 [1930 Showing the Estimated Number of Persons living in Islington at the Mid-year 1930, 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 MARRIAGES. Marriages, 3063; Marriage Rate, 18-80.—There were 6.126 persons married or 3,063 marriages, in 1930, and the marriage rate, that is to say, the number of persons married per 1,000 of the population was 18.80. Compared with the previous year these figures show an increase of 192 in the number of persons married, or of 96 marriages; and of 0.24 per 1,000 in the rate. The following statement shows the figures for the previous ten years 1920-29. Years. Marriages. Marriage Rate. Years. Marriages. Marriage Rate. 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 1924 2,872 17.03 1929 2,967 18.56 BIRTHS. During the year there was 5,685 live births registered, of which 2,905 were boys and 2,780 girls. Of this number, however, 1,473 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 17.4 per 1,000 of the population, as compared with a mean birth-rate of 20.7 in the preceding ten years. The lowest birth-rate recorded was 16.2 in the year 1918. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1930, 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 1929; together with the mean Borough Birth-rates for the 10 years 1920-29. Quarter. Males. Females. Total. Birth Rates. Islington, 1930. Islington, 1920-29. London, 1930. 107 Great Towns, 1930. First 761 671 1,432 17.9 21.9 16.3 16.8 Second 687 729 1,416 17.7 21.6 16.3 17.5 Third 694 677 1,371 17.1 20.7 15.8 16.8 Fourth 763 703 1,466 17.0 18.7 14.6 15.6 The Year 1930 2,905 2,780 5,685 17.4 20.7 15.7 16.7 1929 2,778 2,731 5,509 17.2 20.9 16.3 16.6 Increase or decrease +127 +49 +176 +0.2 —0.2 —0.6 +0.1 —The total registered births given by the Registrar-General for the Calendar year, 1930, will be found at the foot of table on p. 9. 1930] 4 Showing the Births of Males and Females and the Birth-rates in each quarter and for the year, 1930, and in the several Sub-Registration Districts. Tufnell. Upper Holloway. Tollington. Lower Holloway. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. Males. Females Total. Birth rates. 1st Quarter 56 46 102 12.6 131 104 235 31.0 64 54 118 15.9 98 67 165 16.6 2nd ,, 63 61 124 15.3 64 105 169 22.3 59 44 103 13.9 75 96 171 17.2 3rd 54 63 117 14.5 90 94 184 24.3 64 64 128 17.3 65 82 147 14.8 4th 68 63 131 15.9 109 99 208 26.9 56 57 113 15.0 76 86 162 16.0 Year 241 233 474 14.4 394 402 796 25.7 243 219 462 15.3 314 331 645 15.9 Showing the Births of Males and Females and the Birth-rates in each quarter and for the year 1930, 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 117 108 225 15.5 132 132 264 20.0 163 160 323 16.8 761 671 1,432 17.9 2nd 133 136 269 18.5 116 139 255 19.3 177 148 325 16.9 687 729 1,416 17.7 3rd 134 127 261 17.9 122 103 225 17.0 165 144 309 16.1 694 677 1,371 17.1 4th 119 129 248 16.7 151 105 256 19.0 184 164 348 17.8 763 703 1,466 ' 18.0 Year 503 500 1,003 16.9 521 479 1,000 18.6 689 616 1,305 16.7 2,905 2,780 5,685 17.4 Illegitimate Births (223).—The illegitimate births numbered 223 and show an increase of 16 on the return of the year 1929. They were equal to a rate of 3.9 per cent. of the total registered births. Notification of Births Act, 1907.—4,383 live births were notified (exclusive of 131 stillborn), or 77 per cent. of the total number that was registered during the year. Notified by Doctors. Midwives. Parents and other Persons. Total. Alive. Still born. Alive. Still born. Alive. Still born. Alive. Still born. 1930. 1st Quarter 192 11 618 21 305 7 1,115 39 2nd 184 9 609 19 312 6 1,105 34 3rd 188 9 579 21 281 3 1,048 33 4th 157 3 636 15 322 7 1,115 25 Year 721 32 2,442 76 1,220 23 4,383 131† Of the total number (149) registered still-births, 29 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 160 (i.e., 131 + 29) or 28.1 per 1,000 total births (including still-born). 5 [1930 REGISTERED STILL-BIRTHS. Period. Certified by Doctor. Certified by Midwife. By Other Persons. Total. Registered. Per 1,000 of Total Births (including still-born). 1930. 1st Quarter 30 11 3 44 30.7 2nd 30 11 1 42 29.0 3rd 30 4 — 34 24.8 4th 22 5 2 29 19.8 Year 112 31 6 149 26.2 DEATHS. The deaths registered during the year numbered 3,938 (exclusive of stillbirths), while the death-rate was equal to 12.1 per 1,000 of the estimated population, or 2.7 below that of the previous year (14.8), and 0.7 above the mean of the preceding ten years; whilst the death-rate of England and Wales was 11.4 and the 107 Great Towns 11.5. 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 112 13.8 79 9.8 94 11.6 110 13.3 395 12.0 Upper Holloway 114 15.0 88 11.6 76 10.0 83 10.7 361 11.7 Tollington 124 16.3 87 11.4 67 8.8 103 13.6 381 12.6 Lower Holloway 134 13.5 116 11.7 79 8.0 129 12.7 458 11.3 Highbury 190 13.1 185 12.7 135 9.3 209 14.1 719 12.1 Barnsbury 206 15.6 178 13.5 160 12.1 187 13.9 731 13.6 Islington (SouthEast) 265 13.8 219 11.4 175 9.1 234 12.0 893 11.4 The Borough 1,145 14.3 952 11.9 786 9.8 1,055 12.2 3,938 121 Showing the Deaths and Death Rates of Islington in 1930, 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 1920-29, and the deaths and death-rates in the year 1929. Quarter. Males. Females. Total. Death Rates. Islington, 1930. Islington, 1920-29. London, 1930. 107 Great Towns, 1930. First 613 532 1,145 14.7 17.3 13.7 13.6 Second 512 440 952 11.9 11.5 10.8 11.3 Third 439 347 786 9.8 9.6 9.3 9.4 Fourth 539 516 1,055 12.2 12.9 11.7 11.6 The Year 1930 2,103 1,835 3,938 12.1 12.8 11.4 11.5 1929 2,414 2,334 4,748 14.8 18.8 13.8 13.7 Increase or Decrease —311 —499 —810 —27 —2.4 —2.2 1930] 6 Causes of Death (Classified).—The following table shows the deaths arranged in classes of Disease from All Causes during the ten years 1920-29 and in 1930. Classified Causes of Death. Years. Mean 10 Yrs. 1930 Difference. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 I. Specific or Febrile Causes 552 464 639 273 391 286 285 355 371 482 409 298 — 111 1. Miasmatic Diseases 437 301 546 155 316 191 204 266 258 394 307 223 — 81 2. Diarrhoeal ,, 28 85 29 40 20 15 29 19 25 13 30 24 — 6 3. Malarial „ 2 - - - - - - - - - - - - - 4. Zoogenous „ 2 1 — — 2 3 - — 3 - 1 — — 1 5. Venereal „ 13 17 17 20 9 8 5 12 19 22 14 11 — 3 6. Septic „ 70 60 47 58 44 69 47 58 66 53 57 40 — 17 II. Parasitic Diseases 1 — 3 1 2 1 1 — 2 1 1 1 - - III. Dietetic 2 4 7 2 3 3 2 4 3 5 4 5 + 1 IV. Constitutional Diseases 918 985 935 945 945 1054 882 878 950 907 940 864 — 76 V. Developmental 556 486 477 377 396 404 467 289 248 256 396 294 — 102 VI. Local 2172 2203 2362 2106 2290 2211 2255 2415 2363 2887 2326 2277 — 49 1. Diseases of Nervous System 341 345 330 294 290 291 307 213 212 228 285 344 + 59 2. „ Organs of Special Sense 20 13 9 16 14 10 16 16 11 11 14 13 1 3. „ Circulatory System 592 651 734 745 822 740 802 929 1073 1226 832 787 — 45 4. „ Respiratory „ 822 717 903 598 797 756 709 835 653 960 775 650 — 125 5. „ Digestive ,, 224 260 204 259 192 225 223 203 205 229 223 242 + 9 6. „ Lymphatic ,, 10 14 11 11 8 7 19 10 8 13 11 7 — 4 7. „ Urinary ,, 129 168 134 157 136 142 142 179 167 172 153 204 + 51 8. „ Reproductive ,, 20 13 20 10 15 20 19 19 27 21 18 18 - - a ,, Orgs, of Generation 7 8 5 4 6 10 3 7 12 9 7 3 — 4 b „ of Parturition 13 5 15 6 9 10 16 12 15 12 11 15 + 4 9. „ Bones and Joints 5 3 8 8 10 10 11 8 4 5 7 8 + 1 10. „ Integumentary System 9 19 9 8 6 10 7 3 3 1 8 4 - 4 VII. Violence 179 142 137 151 156 169 169 168 199 205 167 184 + 17 1. Accident or Negligence 140 99 94 105 115 124 124 136 156 149 124 144 + 20 2. Homicide 2 3 3 8 2 2 3 - 8 2 3 2 - 1 3. Suicide 37 40 39 38 39 42 42 32 35 54 40 38 - 2 4. Execution — — 1 — — 1 — — — — — — - 5. By Bombs (Enemy Aircraft) - - - - - - - - - - - - - - VIII. Ill-Defined Causes 95 84 54 47 39 32 29 15 25 26 44 15 - 29 All Causes 4475 4368 4614 3902 14222 i4160 4090 4124 4161 4748 4287 3938 - 349 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, 1930. Mean Deaths (10 years, 1920-29.) Increase or Decrease on mean. 0-1 year 399 476 —77 1-5 years 228 273 —45 Under 5 years 627 749 —122 5-15 years 97 124 —27 15-25 „ 134 159 -25 25-35 „ 157 195 —38 35-45 „ 202 290 —88 45-55 „ 404 466 —62 55-65 „ 656 648 + 8 65-75 ,, 789 816 —27 75-85 „ 685 659 +26 85 upwards 187 180 +7 All Ages. 3,938 4,286 —348 7 [1930 There was a decrease of 122 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 5-55 years, were also below the decennial average. The deaths of aged people between the age period 65 years and upwards showed a decrease of 389 in the number of deaths when contrasted with the previous year 1929, and were 6 above the ten years' average (1920-29). INFANTILE MORTALITY. Infant Deaths, 399 , Mortality Rate, 70—The deaths of 399 infants under twelve months' old were registered during the year, or 77 below the decennial average (476), and they were equal to the infantile rate of 70 per 1,000 births. The lowest rate on record, however, is 53 per thousand births in the year 1927. The rate was 1 per 1,000 births above the mean annual record of the preceding ten years, and is 3 per 1,000 below the rate of last year (1929). In the quarters the mortality ranged from 82 per 1,000 births in the first quarter, 89 in the second, 58 in the third, and 66 in the fourth. In the sub-registration districts the infant mortality was as follows:— Sub-District. Infant Deaths. Mortality per 1,000 Births. Tufnell 37 78 Upper Holloway 21 26 Tollington 49 106 Lower Holloway 37 57 Highbury 60 58 Barnsbury 95 95 Islington South East 100 76 In London the infantile mortality was 59 per 1,000 births. The rate for England and Wales was 60 per 1,000 births. Infantile Mortality during each of the Ten Years 1920-29 and 1930. 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 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 46 56 38 53 324 53 1928 108 10 14 9 141 60 73 58 42 374 64 1929 103 18 16 11 147 64 68 73 51 403 73 Mean 10 years 114 28 22 16 180 76 90 67 63 476 69 1930 115 13 11 11 150 60 68 66 55 399 70 Increase or decrease on mean +1 —15 -11 —5 —30 —16 —22 —1 -8 —77 +1 1930] 8 Showing the Deaths among Infants per 1,000 Births during the Year 1930. and also the mortality rates for the Years 1920-1929. Sub-Districts. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 Mean 10 years 1930 Increase or decrease on mean Tufnell 41 53 83 46 54 47 64 52 65 75 58 78 + 20 Up. Holloway 69 76 59 64 70 57 30 31 44 42 54 26 —28 Tollington 58 83 58 55 60 65 92 63 85 71 69 106 + 37 Lr. Holloway 66 93 81 81 85 78 82 74 77 95 81 57 —24 Highbury 67 93 64 61 60 54 48 52 47 60 61 58 — 3 Barnsbury 89 87 86 59 77 75 90 59 75 87 78 95 + 17 Islington, S.E. 79 77 88 82 55 58 64 49 67 78 70 76 + 6 The Borough 72 81 77 66 66 63 66 53 64 73 68 70 + 2 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 yearsl920-29 : and in 1930 from certain specified causes. Causes of death. 1930. Rate per 1,000 Births. Mean rate 10 years 1920-29 per 1,000 Births. Difference. Premature Birth and Congenital Defects ... 22-3 185 + 38 Bronchitis and Pneumonia ... 11 4 15-3 — 3 9 Atrophy and Marasmus 20 56 — 3 6 Diarrhoeal Disease (all forms) 15-6 4-6 + 110 Convulsions ... ... 09 12 — 0 3 Whooping Cough 11 35 — 2 4 Measles 47 24 + 23 Diphtheria 1-2 0 3 + 09 Phthisis 00 0 3 — 03 Other forms of Tuberculosis 0-7 09 — 0'2 Total of above 599 52-6 + 73 All other causes ... 102 16-2 — 6-0 Total 701 68-8 + 13 9 [1950 INFANTILE MORTALITY during the Year 1930. Nett Deaths from stated causes at various Ages under One Year of Age. Cause of Death. Under 1 week Weeks. Total under 4 weeks Months. Total Deaths under 1 year 1-2 2-3 3-4 4 weeks and under 3 months 3-6 6-9 9-12 All Causes. Certified - - - - - - - - - - Uncertified - - - - - - - - - - Small-pox — - — — — 1 — — — 1 Chicken-pox — - - - - - - - - - Measles 1 - — — 1 1 2 8 15 27 Scarlet Fever — - — — — — — — — — Whooping-Cough — - — — — 1 2 2 1 6 Diphtheria, Croup - - - - - - - 4 3 7 Erysipelas - - - - - - 2 2 — 4 Tuberculous Meningitis - - - - - - 1 2 - 3 Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - 1 - - - 1 Meningitis (not Tuberculous) - 1 — 1 1 - 3a - 5 Convulsions - 1 2 — 3 1 1 — - 5 Laryngitis. - - - - - - - - - - Bronchitis - - — 1 1 1 3 — - 5 Pneumonia (all forms) - 1 - 1 2 13 11 18 16 60 Diarrhoea - - — — — 3 2 3 6 14 Enteritis - - — 2 2 13 30 19 11 75 G astritis - - — — — — — — 1 1 Syphilis - 1 — — 1 — 1 — — 2 Rickets - - - - - - - - - - Suffocation, overlying - - - - - - - - - - Injury at birth 4 - — — 4 — — — — 4 Atelectasis 11 - — — 11 — — — — 11 Congenital Malformations 20 2 - - 22 4 4 1 - 31 Premature birth 73 6 5 1 85 10 — - 1 96 Atrophy, Debility and Marasmus 1 - 1 3 5 4 2 - - 11 Other causes 6 2 2 3 13 5 7 4 1 30 Totals 116 13 11 11 151 59 68 66 55 399 (a) Post Basic Meningitis (2). Nett Births legitimate 5,420 Nett Deaths in legitimate infants 370 in the year illegitimate 275 the year of illegitimate infants 29 EDUCATIONAL PROPAGANDA. Apart from the propaganda during Rat Week, which is of a special character, information was given by the issue of various leaflets, many on demand, for instance, enquiries from Scout Masters training lads for the "Health-man" Badge. This has now become a fairly frequent annual demand. There were issued the Health Department leaflets, the one on Smallpox and Vaccination being in considerable demand, as was also the "Hints on the Care and Feeding of Infants," which was revised, and that on "Flies and Gnats." In addition there are also issued leaflets regarding:— Scarlet Fever. Diphtheria. Measles. Whooping Cough. Infectious Disease—Law, and "Hints for the guidance of patients at the Tuberculosis Dispensary." See also Lectures, etc., under Centres Report, pages 21-23. 1930]| 10 PUBLIC HEALTH CONGRESS, ROYAL AGRICULTURAL HALL. As the Council's delegate, the Medical Officer of Health attended the above Congress. There were over 1,000 delegates appointed by local authorities and representatives from Sweden, Norway, Denmark and Poland, present. In addition to the Congress proper, there was a comprehensive exhibition of Machinery, Vehicles, Material and Equipment in connection with refuse disposal, street cleansing and other aspects of municipal engineering. The Medical Officer of Health in a separate report to the Public Health Committee summarised the deliberations. 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 of infants within three weeks of birth. 65 cases of Ophthalmia Neonatorum were notified, compared with 69 cases last year. 87 cases of Ophthalmia were reported by the London County Council and Health Visitors as against 75 cases during the previous year. 27 out of the 65 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. 10 8 6 8 11 9 13 65 Ophthalmia. Cases reported by L.C.C. 4 12 11 3 5 23 26 84 Cases reported by Health Visitors 2 - - 1 - — — 3 Of the 65 cases investigated, both of the infants' eyes were affected in 44 instances, whilst in 7 the right eye was involved, and in 14 the left. Treatment.—8 of the 65 Ophthalmia Neonatorum cases were admitted to St. Margaret's Hospital, 11 being treated at other hospitals. 25 cases were treated at home by private Doctors. 30 cases of inflammatory disease of infants' eyes were nursed by the North London Nursing Association for the Council at a cost of £30 16s. Od. In 1929 35 cases were nursed at the cost of £38 6s. Od. Results.—Of the 65 Ophthalmia Neonatorum cases, vision was unimpaired in all cases. There were no fatal cases during the year. Ophthalmia Neonatorum Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths. Notified. Treated. At home. In hospital. 65 28 37 65 Nil Nil Nil 11 [1030 MATERNAL DEATHS. The number of women dying in, or in consequence of, child-birth during the year 1930 was 22, or 3.9 per 1,000 registered births. Of this number 7 occurred from Sepsis (Puerperal Septicajmia); whilst 15 died from other diseases of childbirth. The deaths for the preceding year numbered 27 and were equal to the proportion of 4 per 1,000 births. MATERNAL DEATH RATES FOR ISLINGTON. Year. No. of Births. No. of Maternal Deaths. Rate. 1911 8,113 17 2.1 1912 8,211 11 1.3 1913 8,359 26 3.1 1914 8,177 22 2.7 1015 7,537 17 2.3 1916 7,262 21 2.9 1917 5,837 12 2.1 1918 5,197 7 1.3 1919 6,278 23 3.7 1920 9,404 22 2.3 1921 7,886 17 2.2 1922 7,506 20 2.7 1923 7,100 15 2.1 1924 6,799 17 2.5 1925 6,580 18 2.7 1926 6,455 20 3.1 1927 6,108 24 3.9 1928 5,790 25 4.3 1929 5,509 27 4.9 1930 5,685 22 3.9 1930] 12 MATERNAL DEATHS, 1930. 1930. Month. Cause of Death. Ages at Death. Totals. 15 to 25 25 to 35 35 to 45 45 and upwd. Total. From Puerperal Sepsis From other Diseases of Childbirth. Jan. Puerperal Septicaemia .. 1 .. .. 1 1 .. „ Puerperal Septicœmia—Septic endometritis .. 1 .. .. 1 1 .. „ Septicœmia following Septic abortion .. .. 1 .. 1 1 .. Mar. Puerperal Septicaemia following birth of Still born .. 1 .. .. 1 1 .. „ Toxœmia Pyœmia and Septicœmia —Tears of cervix and perineum .. 1 .. .. 1 .. 1 „ Post operative shock following operation for relief of obstruction, due after Cœsarean Section. Complete paralytic ileus .. .. 1 .. 1 .. 1 „ Hœmorrhage from uterus consequent on abortion .. .. 1 •• 1 •• 1 1st Qr. .. 4 3 .. 7 4 3 May Anœsthia Parotitis septic perineal tear 1 1 1 „ Toxœmia of Pregnancy i 1 1 „ Post Partem Hœmorrhage (accidental Anti-Partum Hœmorrhage) l •• 1 •• 1 2nd Qr. 1 2 3 3 July Puerperal eclampsia 1 1 1 „ Peritonitis following upon an incomplete miscarriage 1 1 1 „ Septicaemia. Pelvis abscess.. 1 1 1 .. Aug. Pulmonary embolism Myocardial degeneration and Childbirth 1 1 1 „ Post partum hœmorrhage. Disease of Placenta 1 1 1 „ Hyperemesis Gravidarum 1 1 1 Sept Peritonitis Puerperal Sepsis 1 1 i .. ,, Nephritis of Pregnancy 1 .. 1 1 „ Eclampsia Toxœmia of Pregnancy i •• 1 l 3rd Qr. 3 2 4 9 2 7 Oct. Puerperal Septicaemia 1 1 1 .. Nov. Toxœmia Empyasmia Childbirth 1 1 1 Dec. Nephritis of pregnancy 1 1 1 4th Qr. 2 1 •• 3 1 2 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter 7 = 4.9 3 = 2.1 9 = 6.8 3 = 2.0 Year 22 = 8.9 13 [1930 MATERNAL MORTALITY. The scheme outlined on page 13 of the 1928 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 AND PUERPERAL PYREXIA. Appointment of Consultant, for Diagnostic Purposes. The Borough Council, on a reference from the appropriate Committee, having carefully considered a communication from the Ministry of Health calling particular attention to the need for establishing a Consultant Service for cases of Puerperal Fever and Puerperal Pyrexia, appointed a Consultant who could be called in, upon application to the Medical Officer of Health, for the purposes of diagnosis where the practitioner in charge of the case required assistance in this respect. This service commenced as from 23rd May, 1930. PUERPERAL FEVER. Definition.—The Royal College of Physicians' definition of Puerperal Fever is: Septicœmia, Pyœmia, Septic Peritonitis, Septic Metritis, and other acute septic inflammation in the pelvis occurring as the direct result of child-birth. Of the 36 cases coming to the knowledge of the Medical Officer of Health during 1930, 15 were notified by Medical Practitioners. The proportion of total cases to births was 6.3 per thousand. The notifications were 8 above the average (28) of the preceding ten years and showed an increase of 2.3 in the proportion of attacks to 1,000 births. Cases of Puerperal Fever notified and inquired into during the year 1930. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. SouthEast. The Borough Cases notified 4 5 3 7 9 3 5 36 Private Practitioners' Cases 2 2 — 2 5 2 2 15 Hospital Cases 2 3 3 5 4 1 3 21 Cases inquired into 3 3 3 7 9 3 6 33 Cases treated in Hospital 4 5 3 7 9 3 5 36 Cases treated at Home - - - - - - - - All of the 36 cases were treated in Hospitals. 19 of these contracted the disease in Hospital; 6 cases were removed to Metropolitan Asylums Board Hospitals; and 30 cases were removed to the Islington Infirmary and other London Hospitals. Deaths.—9 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 89 cases being notified, as against 88 last year. Of these, 27 were Private Medical Practitioners' cases; 47 occurred in Hospital, while 15 were certified Midwives' cases. The notifications were in the proportion of 15.6 per 1,000 births. 1930] 14 Cases of Puerperal Pyrexia notified and inquired into during the year 1930. Tufnell. Upper Hollo way. Tollington. Lower Holloway, Highbury. Barnsbury. SouthEast. The Borough Cases notified 10 7 7 9 10 24 22 89 Private Practitioners'Cases 8 1 3 1 4 7 8 27 Hospital Cases 6 5 4 7 4 12 9 47 Certified Midwives' Cases 1 1 — 1 2 5 5 15 Cases inquired into 10 7 7 9 10 24 22 89 Cases treated in Hospital 9 7 7 8 8 17 16 72 Cases treated at Home 1 - - 1 2 7 6 17 As occasion arose, the services of the Pathological Department of the London County Council Special Hospitals Section were utilised in regard to the examination of swabs taken from attendants on Puerperal Pyrexia and Puerperal Fever cases, and negative results were found in throat swabs in two instances, one from the Certified Midwife in the case (for whom your Medical Officer of Health made spccial arrangements with the hospital to secure the swab), and the other from the handywoman connected with the case. During an outbreak of puerperal illnesses in an Islington Nursing Home bacteriological reports were received fom the Home stating that swabs were taken from five of the attendants, and one showed Haemolytic Streptococci and Streptococci Veridans (which were also revealed in a swab taken later on), while in the other four no Haemolytic Streptococci were isolated but in each case Streptococci Veridans were found. Patients from this particular Nursing Home had been sent for isolation and from the hospitals concerned information was obtained. Case (a) Revealed a pure culture of haemolytic streptococcus obtained from the cervix, but the blood culture was sterile. Case (b) A cervical swab yielded a pure culture of haemolytic streptococci. The blood culture was sterile. Case (c) Cervical swab without result, but sputum yielded an abundant growth of haemolytic streptococci. Case (d) Cervical swab, haemolytic streptococci. Blood culture, no result. A further cervical swab yielded Aerobic-Diphtheroids and Anaerobic-Diphtheroids. Results of these investigations were obtained as the particular Nursing Home was in this Borough, but some of the patients were not Islington residents. SPECIALIST CONSULTATIONS. Two applications for the assistance of the Consultant in diagnosis were received by the Medical Officer of Health. In each instance the patient was subsequently removed to hospital. PEMPHIGUS NEONATORUM. During the year 1930, 7 cases which came to the knowledge of the Medical Officer of Health were investigated. 15 [1930 THE MILK SCHEME FOR NECESSITOUS EXPECTANT AND NURSING MOTHERS AND CHILDREN UNDER FIVE YEARS OF AGE. During the year 1930, 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 £1,945 0s. l½d., as against £1,190 14s. 4½d. in 1929. The total amount expended since the Order came into operation in 1918 is £53,091 8s. 9d. The total recipients during the year numbered 7,067, and the quantity of milk supplied to them was equal to 157,332 pints (19,666½ gallons). DISTRIBUTION OF MILK TO NECESSITOUS MOTHERS AND CHILDREN. 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 £3 a week or more. SUMMARY OF WORK OF MUNICIPAL HEALTH VISITORS FOR YEAR ENDING 1930. District 1 2 3 4 5 6 7 8 Totals. I. Births, First Visits, Infants under 1 Year 532 579 686 939 759 539 461 478 4,973 II. Births, Re-Visits, Infants under 1 Year 603 519 699 692 653 728 647 545 5,086 III. Visits to Children, between 1st and 2nd Years 693 424 566 547 584 689 517 554 4,574 IV. Visits to Children, between 2nd and 5th Years 802 1,461 1,459 1,360 1,364 1,579 1,502 1,610 11,137 V. Visits re Still Births 25 20 26 24 31 13 21 12 172 VI. Deaths, Visits, re Infants under 1 Year 15 13 8 6 16 15 6 12 91 VII. Deaths, Visits, re Children 1 to 5 years 2 2 3 1 9 11 — 2 30 VIII. †ante-natal, home visits F/150 177 F/124 172 F/248 333 F/208 231 F/129 146 F/194 257 F107/ 148 F/135 165 F/1,295 1,629 IX. †Puerperal Fever, Home Visits F/3 7 F/4 6 F/7 12 F/6 12 F/3 8 — F/2 3 f. 2 F/27 50 Pyrexia, do F/2 3 f. 1 f. 1 F 1 3 F. 5 - - — F/10 13 Totals 2,859 3,197 3,793 3,815 3,575 3,831 3,305 3,380 27,755 X. Attendances at Welfare Centre 24 26 50 48 38 55 48 45 334 XI. Other Work by Direction 1,434 689 1,002 788 468 1,046 1,458 1,015 7,900 XII. Visits Declined 2 1 1 - 1 - 1 — 6 XIII. Visits, House Shut 783 702 630 1,043 790 954 478 395 5,775 XIV. Visits, Inopportune 4 4 1 20 9 89 21 47 195 Grand Total of Visits 5,106 4,619 5,477 5,714 4,881 5,975 5,311 4,882 41,965 1930] 16 17 [1930 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 †Reported Ophthalmia f/10 14 f/11 18 - ' f/3 5 f/6 7 f/15 35 f/8 12 f/10 22 f/11 16 f/73 129 (a) †Ophthalmia Neonatorum f/8 17 f/7 13 f/9 16 f/9 12 f/6 14 f/4 10 F/2 9 f/2 f/47 93 (b) †Epidemic (Summer) Diarrhoea - f/1 — — — — — — f/l (c) Other Digestive Diseases 2 1 - - — 3 — 1 7 (id) Pneumonia and Bronchitis 1 12 6 1 — 86 14 40 160 (e) Rickets — 10 1 38 2 47 — 24 122 (J ) †Measles and German Measles f/52 f/167 183 f/48 f/15 f/32 f/93 F/91 104 f/56 58 f/554 585 (g) †Whooping Cough f/12 f/11 f/9 f/2 f/3 f/10 f/7 f/l 2 f/55 66 (h) Tuberculous Disease—P=Pulmonary; 0 = 0ther — — — — o/l — — — o/l (i) Convulsions — — - — — — — — — (j) †Polio-myelitis - - - - —— — — — — (k) Premature Birth 6 4 24 22 — 15 12 10 93 (l) Atrophy, Debility and Marasmus 2 2 2 — — 28 — 1 35 (m) All other investigations (**Specify) — 19 17 — 3 9 3 34 85 (n) Routine Visits included in I. to IX. and not included in (a) to (m) 2,753 2,923 3,665 3,718 3,485 3,518 3,134 3,192 26,388 Totals (a) to (n) 2,859 3,197 3,793 3,815 3,575 3,831 3,305 3,380 27,755 Total Families Visited 2,310 2,183 2,781 3,033 2,715 2,892 2,504 2,482 20,900 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. Rate Cases. Removals. Cases. Removals. Cases. Removals. 5635 17.4 5786 96 488 399 70 25 3.8 36 32 89 66 65 8 **e.g.—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. †F. in front of figures denotes a "First Visit." 1930] 18 REPORT OF THE WORK OF THE DAY NURSERIES RECEIVING GRANTS FROM THE BOROUGH COUNCIL. Lower Holloway Day Nursery, 547, Holloway Road, N.7. During the year ending December 31st, 1930, the attendances at this Day Nursery were:— Whole Day 10,633 Half Day 1,267 St. Luke's Day Nursery, 29 and 30, Penn Road, N.7. During the year ending December 31st, 1930, the attendances at this Day Nursery were:— Whole Day 4,099 South Islington Pro Patria Day Nursery, 8 and 9, Canonbury Place, N. 1. During the year ending December 31st, 1930, the attendances at this Day Nursery were:— Whole Day 12,670 Half Day 534 INVALID CHILDREN'S AID ASSOCIATION. This Association still pursues its course of bringing relief in affliction to some of the most needy of little Islingtonians stricken with distorted limbs and impaired health. The contribution of £25, which the Borough Council gives to the Local Branch of this Association, cannot be looked upon as the measure of the good afforded by the services rendered. A better means of gauging this is to be found in the numbers assisted during the year ended December 31st, 1930—62 Islington children, under 5 years of age, were enabled to benefit by periods of convalescence, either in the country or by the sea, while 20 children, of similar ages, were given some alleviation as handicapped cripples by the provision of leg irons, splints, special boots, etc. Taking also into account the additional numerous cases which, the Association states, are referred to them for supervision and visiting, etc., no one can gainsay that, for the small grant of the Borough Council for such work, immense value is received by these unfortunate and helpless little ones. REPORT OF THE WORK OF VOLUNTARY CENTRES. To summarise this work for the year ending 31st March, 1931, a Table has been added at the end of this section. Attention is drawn to the Table on page 00, which gives the contributions by the Borough Council to the Centres, Day Nurseries, etc., and to the note in connection therewith. The Centre year, it will be noted, ends with March, 1931, while the other matters in this Report are for the calendar year. For the purposes of co-ordination a conjoint meeting is held quarterly at which representatives from the various Centres attend, and also the Medical Officer of Health. This Committee has had under consideration the outstanding matters in connection with the work of the Centres. During the year it was decided that the Centres would issue, at cost price (3s. 2d.), Maternity Outfits, that these would be issued on the application of the doctor or midwife in attendance, and that the issue 19 [1930 would not be confined to those mothers who attended the Centres, but to all applicants residing in the Borough, and that necessitous cases would receive special consideration. Co-operation with the midwives practising in the Borough has been continued, and, generally, it is reported that the midwives are now agreed to take advantage of the services offered by the Ante-Natal Departments of the Centres. It would appear, however, from the report of the South Centre that in that area the midwives have only partially availed themselves of this co-operation. One of the Centres now uses the facilities for the treatment of mothers and children afforded by the Eastman Dental Clinic at the Royal Free Hospital, which was opened early in December. As regards the older children it is noted that the East Centre has on occasion taken advantage in some of their difficult cases of "Problem Children" of the Child Guidance Clinic. This Clinic in Islington has now for some time been doing excellent work, and we have had enquiries regarding it from other Boroughs. In the report of one of the Centres it is stated that "Working for and with children is a work of promise. There is nothing stationary about a baby. One cannot work only for the present. Even physically it is a case of working for:— "The right that lacks assistance The wrong that needs resistance For the future in the distance And the good that we can do.'' North Centre.— The report received from this Centre shows that there has been an increase in all the principal branches of its work, and it would appear from the number of expectant mothers on the register, that more than one half the expectant mothers in the area now make use of the Centre. "Valuable help has been given, both to expectant and nursing mothers by arranging for them to have dinners at the Centre. The effect of these good and nourishing meals (which on an average cost the Centre 8d.), is a marked improvement on the health and general outlook of the mothers." Thrift.—"In November last the Centre made an interesting departure by starting a branch of the National Savings Association and 18 members joined in the first week. By the end of March there were 143 members, £53 5s. 8d. had been collected, and 37 certificates (value l6s.) had been allocated. It has been very encouraging to see how ready the mothers are to save for their babies, and they find it a great help to contribute small sums weekly. This is the first branch to be started by an Infant Welfare Centre in London." "Light."—"During 1930-31 the 'Light' Department treated 440 children and 247 mothers, giving in all 5,764 treatments to children and 2,214 treatments to mothers." "Comparing these figures with those of 1929-30, a fall in the number of treatments given is noted, but actually the number of mothers and children treated has increased." "The proportion of children treated for catarrhal and ricketic conditions was greatly increased during 1930-31. 1929-30. 1930-31. Catarrhal 81.7 as against 66.3 per cent. Rickets 66 ,, 58.3 ,, 1930] 20 "We remain satisfied of the value of Light treatment in improving the general health and vitality of children and in stimulating retarded growth. We also find that children gain great benefit from a short course of Light treatment in the convalescent stage of illness and we use the Clinic largely for this purpose, as it is next to impossible to get these very young children into Convalescent Homes." "We are at present investigating the effect of 'Light' treatment in clearing up persistent ear discharge." "Expectant Mothers.—Expectant mothers derive real benefit from 'Light' treatment. We find apart from the general feeling of well-being experienced by the mothers, that 'Light' treatment has a good effect on the toxic conditions of pregnancy." "Vomiting of pregnancy can be alleviated and the depression so frequently met with in the early months of pregancy is greatly relieved." "We have also found it is of use in septic skin conditions (and this is important in view of the approaching' confinement) and in cases of asthma." "Out of the whole number of expectant mothers to attend, 66 per cent. were very much improved. In assessing improvement we arrive at our conclusions largely from the voluntary statements of the mothers." "Ailing Mothers.—Attendance of ailing mothers is, as might be expected, not quite so regular or satisfactory. Of the total number of ailing mothers only about half completed their course of treatment. The results of treatment were good in 66.5 per cent. of cases. Most of the ailing mothers are suffering from general debility following confinement and lactation, and if they could attend more regularly we are satisfied that a larger percentage of cases would show improvement." "Failing- Lactation.—We regret that our results in re-establishment of lactation are disappointing. The mother with failing lactation is the mother on whom the difficulty of attending presses most heavily, but we feel that the results would be better if we could get these mothers to attend more often. 21 mothers were treated—eight only completed the course." "Unemployment and consequent financial stress have been marked features of 1930-31. This has probably had some influence in reducing the number of attendances, both of mothers and children." "The cost of 'Light' treatment is small and is assisted in necessitous cases, but the cost of coming to the Centre remains, and this may have a deterrent effect." "Ante-Natal Clinics.—The attendances at these Clinics have been so numerous that one extra clinic, and sometimes two, have had to be held weekly." " 'Home-Helps.'—The North Centre employs 5 'Home-Helps,' who are paid 30/- per week, and they are employed at the Centre when not at a case. Their services are restricted to one mother and they are not resident as a rule. Their length of attendance is from 7 to 21 days, and they attend confinement cases, ailing mothers or in an emergency. If necessary they are available before delivery. The scheme is not self-supporting, the Centre bearing the balance of the cost, but 21 [1930 the mothers are encouraged to contribute the 30/- required by having to become a member of the 'Home-Help Club,' which takes small sums. The number in the Club is limited to 30. The 'Home-Help' is provided with food. At this Centre 'Home-Helps' have been a decided success; a good type is obtained as they are guaranteed constant employment." "Lectures and propaganda at this Centre included a lecture by Dr. Cameron on 'Some Disturbances of Sleep,' 'Housing' by Alderman Nokes, 'Sanitation' by Mr. Bridel, Superintendent and Chief Sanitary Inspector of the Public Health Department. Other lectures included 'Maternal Mortality,' 'Explanation of the Borough's Scheme for Providing Free Milk,' 'Gardening for the Working-man,' 'The Value of the Mothers' Committee,' 'Care of Milk in the Home,' 'Flies,' 'Common Sense,' 'The Value of Post-Natal Clinics for Mothers,' ' "Light" Treatment,' and ' Dental Care.' "The following leaflets are issued by this Centre, entitled collectively 'Suggestions and Advice for Mothers (Expectant),' 'Amount of Materials and Cost of Clothing that should be provided for Baby,' 'List of Requisites for a Normal Labour,' 'Hints for Mothers on Breast Feeding,' 'Care of Teeth during Pregnancy,' 'Ante-Natal Care and Medical Examination' (leaflet giving particulars of the Night Ambulance Service available between 11 p.m. and 8 a.m.), 'The New Mother,' setting forth the objects of the Welfare Centre, 'The Special Departments of the Centre for providing Help and Advice.' "A visit was also arranged for the mothers attending the Centre to a large dairy establishment. South Centre.—"By the time this report is issued the Duncan Terrace Branch will have been vacated and the Branch will be housed at 'The Rose,' 15, Popham Road, N.I. "The work at the Centre's Cottage at Flamstead and at Miss Fleetwood's Seaside Cottage has been carried on suceessfully, though not without some defects which seem unavoidable in this part of the work. There was an epidemic of Measle- in Islington in the early part of 1930, and in spite of the great precautions cases developed in both Homes and hindered the work. Nevertheless, 68 mothers and 71 children were sent to Flamstead during the year, and 65 children to Miss Fleetwood's Home. "Special mention is made in the South Centre report by the Medical Officer dealing with the older children and convalescence, of the difficulties the mothers have with the toddlers. This states that, as regards this Centre, ' One can look round with satisfaction on the increasing number of children who have left us to attend school in good condition and with well-established health. "On the other hand there are mothers who come merely to see if anything is being given away, and upon whom the teaching at the Centre makes but little impression. There are feckless and unintelligent ones, and there are the nervous, anxious mothers whom we try to reassure, and whom we advise to send their children to school as early as possible." 1930] 22 "Many mothers are glad to send a child to school as early as three years old. The difficulties of the present housing' conditions affect the children more adversely, both physically and psychologically, from that age than when they are babies. Also, an only child needs companionship, or soon becomes spoiled and difficult, and if another baby nas arrived the older child misses the mother's attentions, its needs are often overlooked, and disagreements start between parents and children. The regular routine, communal life and diversified interests of school-life often work wonders with a child's behaviour, health and appetite." "Many parents make a valiant fight and succeed in real home-making, and bring up healthy children even in the most difficult circumstances. They use the Parks and Open Spaces very much more than of old, and the Nurses give many helpful hints in their visits to the homes." "The practical lessons in training given at our two Convalescent Homes to members of about 130 families each year, have a marked effect both on these families and on their friends. The children sent to Miss Fleetwood's Home for Toddlers have all shown improvement, not only in health and weight, but also in conduct, and not one child has been returned as unmanageable or homesick." "We are making special efforts to keep in touch with our older children, up to school age. Some mothers bring as many as three children at a time to the Centre, but some find it difficult to bring up more than one. They are encouraged to bring the older children at fixed periods, and we now devote the first week in each month specially to toddlers' clinics, though the mothers can also bring their babies then. The toddlers are given a picture post-card with the date for their next visit." "It is more and more becoming realised that the emphasis in education for life is shifting to the earlier years, in which the habits, sentiments and trends of thought are established, and our Centre is playing its part in this early education of some 1,000 children." "Ante-Natal Consultations.—It is found to be a little difficult to make the work known to young women expecting their first baby, and the Centre is anxious to do more in this direction. Leaflets published by the Maternal Mortality Committee are being distributed by the Centre's Health Visitors, and it is hoped the necessity for ante-natal care will be more generally recognised in the district, as it is felt that the ante-natal work is on a very firm basis and a real help to the mothers who attend." East Centre.—"This Centre sustained a great loss in the death of one of its Vice-Presidents, Dr. Ethel Bentham, M.P., who died during the year. "The Committee report in their review of the work from the point of view of one of the mothers attending the Centre—formerly a shop assistant—an illustration of the work of this Centre, as instanced in the particular case, which must be typical of many others. This life history, given in miniature, is here quoted as an interesting way of showing what a Welfare Centre does. She settled in East Islington after marriage, and in due course found that she was expecting to become a mother. 'At first she was pleased at the prospect, and then became rather worried. She did not always feel well, and asked herself if all was as it should be.' 23 [1930 "She spoke about her fears to a neighbour, who frightened her with distressing tales of what might happen ; then she met a friend who advised her to go to the Ante.Naial Clinic at the Welfare Centre. She was rather timid, and hesitated, but eventually went, when she was welcomed by a Nurse and made to feel at home. The Doctor soon reassured her, gave her helpful advice and suggested regular attendance at the Clinic." "During the months that followed, she learned how to take care of her own health, and also that of the little new comer; how to make the baby's outfit; and above all, she was taught that she must nurse baby herself." "A few weeks after her son was born she brought him to the Centre and attended the Clinics regularly, and great was her joy when his weight increased steadily week by week." "Then came a set.back following an attack of influenza, and she was tempted to wean baby, but fortunately the Nurse visited her and persuaded her to come up for a day's observation and test feeds." "As a result, her difficulties were overcome and at the end of nine months baby was as nearly perfect as possible." "She had been learning about baby's diet and had attended the cooking class ; this had resulted in an improvement in her own cooking which was much appreciated by her husband, who had sometimes suffered from spoilt dinners." "During the following year she received much helpful information from a course of talks on" The Mind of a Child " and the best methods of bringing him up. The heat of the summer and the crowded conditions under which the family lived caused baby to look pale and pasty, and the doctor suggested sun and fresh. air treatment. So the mother brought him up daily from 9.30 to 12.30 to play in the garden with" nothings "on and was amazed and delighted to see the improvement in his health." "In this way the child was watched and cared for up to the age of 5, when all particulars of his case were sent to the School Authorities." West Centre..The Medical Officer of this Centre reports:. "Two things appear to stand out in our work during the past year. One is the increase in the number of breast.fed babies and the consequent decline in the amount of dried milk that we sell. This is a very good sign, and is evidence of much care and patient instruction on the part of the nursing staff. The other is the comparatively large number of toddlers who attend the clinics. In the case of children who accompany the new baby this may be taken as inevitable, but there are numbers of older children who are brought up regularly by their mothers for examination and inspection. We welcome this, for there is no doubt that a considerable gap exists between the supervision of the infant at a welfare centre and its medical supervision on reaching school age, during which period much harm may be done and much incipient disease may go undetected." "On the educative side this Centre had six interesting lectures and a Cookery Exhibition. These were supplied by the National Milk Publicity Council, and on two occasions parties of mothers were shown over an up.to.date dairy plant, which included the pasteurisation of milk." 1930] 24 The various Departments of the Four Voluntary Centres, with the attendances for 1930, may be summarised thus:. North. South. East. West. Total. 1. Ante.Natal Clinics and Ailing Mothers Clinics. Number held weekly 5§ 2 1† 1 9 Number of attendances 2,871 711 725 292* 4,599 2. Consultations for Children up to 5 Years of Age. Number held weekly 10 11 11** 7 39 Number of attendances 23,278 20,017 16,720 10,314 70,329 3. Home Visiting. Number of visits made 16,950 11,194 11 854 8,888 48,886 4. Dental Clinics. Number attending 628 236 82 53 999 Number of attendances or arrangements made for attendances 1,595 477 181 . 2,253 5. Morning Callers. Number of attendances 1,942 1,063 ‡ 960 3.965 6. Massage Clinics. Number of cases given massage or sent for massage 97 (& Sunlight treatment) 113 92 32 334 7. Wards. Number of beds 18 . . 8 26 Number of patients received 161 . . 81 242 8. Number of Children on Books 1,927 1,684 1,266 1.087 5,964 Not recorded. **Including 2 Observation Clinics. †Extra Ante.Natal Clinic, 2nd Thursday in month. ^Sometimes an extra Ante natal Clinic. *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. 1930 (Approximate Estimate) 92.298 91,860 50,850 84,792 319.800 28,250 up to 5 years old. Births. 1929 1,675 1,285 895 1 654 5,509 1930 (Actual) 1,732 (Actual) (Approximate) 1,305 (Approximate) (Approximate) 1,111 (Approximate) (Approximate) 1,537 (Approximate) 5,685 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 " 15,068 25 [1930 MATERNITY AND CHILD WELFARE. * 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. † Important changes in the law on and from 1st April, 1930, relating to contributions to Voluntary Associations, including welfare centres and day nurseries, in respect of maternity and child welfare were made by sec. 101 (6) of the Local Government Act, 1929, which is quoted as follows :. (6) As respects the County of London, the Minister shall before the beginning of each fixed grant period, after consultation with the Councils concerned, make a scheme determining, in relation to Voluntary Associations providing maternity and child welfare services, which of those services are to be treated as services in respect of which the London County Council are to contribute and which are services in respect of which the Common Council of the City of London and the Councils of the Metropolitan Boroughs are to contribute; and the scheme shall provide for the payment during the fixed grant period to the Association by the several Councils of contributions of such amount as may be specified in the scheme. 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 £64 3 0 Under Public Health £45 16 0* Total £109 19 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, £70 10s. Od.; Royal Free Hospital, £16 10s. Od. 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). Contributions by the Borough Council.† Year ending 31st March, 1931. Voluntary Welfare Centres. Day Nurseries. £. £. North Centre 5,098 Lower Holloway 244* South Centre 2,330 St. Luke's . 229 East Centre 1,712 South Islington . 712 West Centre 1,868 Total £1,185 Total £11,008 1930] 26 DEATHS IN PUBLIC INSTITUTIONS. Within the Borough..2,326 persons died in the Public Institutions located in Islington, of whom 1,570 belonged to this Borough, the remaining 756 having come here for treatment or relief. Of these, 440 died in the Archway House, 146 in the Royal Northern Central Hospital, 60 in the London Fever Hospital, and 26 in the Islington Institution and Islington Infirmary. Of the 1,570 deaths of inhabitants, 1,142 occurred in the Islington Infirmary, 253 in the Islington Institution, and 113 in the Royal Northern Central Hospital. The proportion which the 1,570 deaths in the Public Institutions bore to the Borough mortality was 39.9 per cent. Without the Borough..851 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, 29 in the North.Western Fever Hospital, 23 in the Children's Hospital, Great Ormond Street, 74 in St. Bartholomew's Hospital, 22 in the Colney Hatch Mental Hospital, 59 in the Royal Free Hospital, 64 in the University College Hospital, 24 in the North.Eastern Fever Hospital, 19 in the Eastern Fever Hospital, 23 in the Middlesex Hospital, 13 in the City of London Maternity Hospital, and 30 in the Metropolitan Hospital. These 851 deaths represented 21.6 per cent. of all the deaths registered in the year. Within and Without the Borough..The deaths of Islingtonians numbered 2,421 and were equal to 61.5 per cent. of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.. 26 inhabitants died from accidental deaths, or suddenly, in places outside Islington. During the previous year (1929) the total deaths in Local Institutions numbered 2,535, being 1,739 inhabitants of Islington in Local Institutions, plus 796 non.inhabitants of Islington in Local Institutions, the number in Islington Infirmary being 1,269, the number in the Royal Northern Hospital 118. The deaths of inhabitants of Islington in Institutions outside the Borough were 938. The total deaths in all Institutions, 2,677; and the proportion per 100 deaths from all causes, 56.4. Transferable Deaths..During the year 51 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 Diarrhoeal Diseases. During the year 223 persons died from these diseases, the death.rate being 0.68 per 1,000 inhabitants, as contrasted with 0.60 in the corresponding period last year, and a decennial average mortality of 219 and a death.rate of 0.67 per 1,000. In London the death.rate from the epidemic disease was 0.47. Locally the deaths in the Sub.Registration Districts and Wards were as follows:. 27 [1930 Showing the Deaths from each of 1lit principal Epidemic Diseases in the several Wards md Sub.Registration Districts during the Year 1930. SubRegistration Districts. Wards Enteric Fever. Small Pox. Measles Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea. Totals. Deaths Deaths Deaths Deaths Deaths Deaths Deaths Deaths Tufnell Tufnell . 1 9 2 1 3 1 17 Up. Holloway Up. Holloway . . 6 1 1 3 . 11 Tollington Tollington . . 10 1 1 5 1 18 Lr. Holloway Lr. Holloway . . 22 . 1 11 . 34 Highbury Highbury . . 7 3 1 3 1 15 Mildmav . . 4 . 1 1 1 7 Barnsbury Thornhill . . 28 2 2 2 6 40 Barnsbury . . 17 1 1 4 3 26 Islington South East St. Mary's . . 9 . . . . 9 Canonbury . . 14 3 . 7 1 25 St. Peter's . . 14 1 1 3 2 21 The Borough . 1 140 14 10 42 16 223 Total Death Rates . 0.00 0.43 0.04 0.03 0.13 0.05 0.68 Shewing the Deaths and Death.Rates fr»m the Principal Epidemic Diseases during the ten yeats 1920.29 and for the Year 1930. 1920 1921 1922 1923 1924 1925 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 3* 0.01 1 0.00 . . . . 4 0.01 4 0.01 Small Pox . . . . . . . . . . . . Measles 92 0.27 27 0.08 134 0.40 16 0.05 103 0.30 22 0.06 Scarlet Fever 12 0.04 19 0.06 29 0.09 13 0.04 10 0.03 8 0.02 Whooping Cough 70 0.21 43 0.13 98 0.29 38 0.11 57 0.17 61 0.20 Diphtheria 135 0.40 110 0.33 59 0.18 21 0.06 33 0.09 21 0.06 Diarrhœa and Enteritis (under 2 years) 77 8.19 per 1,000 births 156 19.78 per 1,000 births 71 9.46 per 1,000 births 1031 14.51 per 1,000 births 52 7.65 per 1,000 births 691 10.54 per 1,000 births 1926 1927 1928 1929 Mean 10 years 1930 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Enteric Fever 1 0.00 . . 2 0.00 9. 0.01 2 0.00 . . Small Pox . . . . . . . . . . 1 0.00 Measles 69 0.20 29 0.09 156 0.48 11 0.03 66 0.20 140 0.43 Scarlet Fever 12 0.03 8 0.02 8 0.03 8 0.03 13 0.04 14 004 Whooping Cough 29 0.09 45 0.14 21 0.06 126 0.39 59 0.18 10 0.03 Diphtheria 31 0.09 25 0.07 25 0.08 32 0.10 49 0.15 42 0.13 Diarrhœa and Enteritis (under 2 years) 69 10 68 per 1,000 births 48 7.79 per 1,000 births 67 11.57 per 1,000 births 68 12.34 per 1,000 births 78 11.3 per 1,000 births 97 171 per 1,000 births * Including 2 Malarial Fever. 28 1930] Showing the Deaths from Diarrhœal Diseases together with those classed under Enteritis and its Sub.headings, arranged in quarterly periods, and in three groups of ages. Ages. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. | Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Diarrhœa. Enteritis, etc. Totals. Under 1 year 10 12 22 1 18 19 1 20 21 2 25 27 14 75 89 1 to 5 vears 1 2 3 . 1 1 . 3 3 . 1 1 1 7 8 Over 5 years . 2 2 1 2 3 . 3 3 . 1 1 1 8 9 Totals 11 16 27 2 21 23 1 26 27 2 27 29 16 90 106 INFLUENZA. Influenza caused 16 deaths during the year and showed a decrease of 191 on the return for the year 1929, and were 96 below the average of the preceding ten years 1920.29. The death.rate was equal to 0.05 per 1,000 inhabitants. Showing the Deaths from Influenza in the Quarters of the Year 1930, together with the averages of the corresponding periods, 1920.29. Years. Quarters. Totals. First. Second. Third. Fourth. 1920 56 43 7 12 118 1921 33 17 2 41 93 1922 200 10 3 8 221 1923 21 22 7 8 58 1924 70 15 4 15 104 1925 47 3 1 21 72 1926 15 24 3 9 51 1927 118 15 7 12 152 1928 18 12 3 8 41 1929 190 13 1 3 207 Average 77 17 4 14 112 1930 5 4 3 4 16 Increase or Decrease . 72 . 13 . 1 . 10 . 96 The following statement gives the ages at death of the persons who suffered from Influenza during the preceding ten years as compared with the return for the year 1930 :. Ages. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 Mean 10yrs 1930 Difference. 0.5 10 5 22 5 11 6 . 8 3 5 8 1 . 7 5.10 3 . 1 . 1 2 1 4 1 1 1 . . 1 10.15 3 1 . 2 2 . 1 1 . . 1 15.25 12 5 11 . 10 2 2 3 3 2 5 . . 5 25.35 21 9 14 6 7 1 4 13 I 9 9 . . 9 35.45 18 15 18 4 10 3 8 21 6 19 12 . . 12 45.55 17 18 42 12 12 11 6 22 4 3S 18 5 . 13 55.65 17 13 37 5 19 11 12 28 6 43 19 3 . 16 65.75 13 14 43 16 16 19 8 34 7 52 22 2 . 20 75 & upward 4 13 33 8 16 17 10 18 10 38 17 5 . 12 All Ages 118 93 221 58 104 72 51 152 41 207 112 16 . 96 29 [1930 SEPTIC DISEASES. Erysipelas and Puerperal Septicaemia are the principal diseases of this class. Erysipelas.. 1G deaths were returned from this disease, or 3 more than in the year 1929, and 6 above the average of the preceding. ten years 1920.29. Puerperal Diseases..These comprise Puerperal Pytemia, Septictemia, Septic Intoxication and Puerperal Eever, and they caused 7 deaths, being. 7 below the return of 1929, and were 3 below the average of the ten years 1920.29. The death.rate was equal to 1.2 per 1,000 births. CANCER. Cancer. .467 deaths were registered from this malignant disease during the year compared with 471 in 1929, and with an average of 466 in the previous iecennium. The deaths represent a death.rate of 1.43 per 1,000 of the civil population and is 0.03 above the average rate (1.40) of the last ten years; 241 deaths otcurred among males and 22G among females. The following statement shows the ages at death of the persons attacked during the past ten years, and tl.e return for the year 1930:. Mean Ages. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 lOyrs 1930 Difference. 0.53 2 1 1 1 . 1 . ! 3 1 2 +1 5.15 1 . . 1 2 . . . 1 1 . j . 1 15.25 11 4 6 4 3 31313 X1.2 25.33 10 10 8 10 9 5 G 5 14 10 i 9 0.3 35.45 32 34 34 27 38 40 27 24 36 22 31 26 . 5 45.55 74 98 88 88 77 93 73 74 83 84 83 72 . 11 55.65 110 140 124 138 131 168 142 137 147 153 | 139 123 . 16 65.75124 131 110 125 149 144 144 135 155 106 132 139 + 7 75.85 43 52 47 68 52 71 51 65 71 8i 60 90 + 30 85 & upwards 566987779 10 78 + 1 Totals ... 402 475 421 472 470 534 453 449 j 518 j 471 j 466 467 + 1 Showing the Deaths from Cancer or Malignant Disease in the several Sub.Districts during the Quarters and the year 1930. Quarters. Tufnell. Upper Hollo. way. Tolling. ton. Lower Hollo. way. Highbury. Barns. bury. Islington, South East. The Borough First 9 14 16 10 22 19 25 115 Second 9 13 11 14 32 25 23 127 Third 14 8 9 13 14 21 25 104 Fourth 18 7 9 11 27 23 26 121 The Year 50 42 45 48 95 88 99 467 TUBERCULOSIS. Tuberculosis caused 315 deaths, which were 75 below the average of the last decennium, and were 30 below the number registered in 1929. The death. rate resulting from them was equal to 0.97 per 1,000 of the civil population, and represented 8.0 per cent. of the deaths from all causes during the year. 30 1930] Tuberculosis of the Respiratory System (Phthisis or Pulmonary Tuberculosis), caused 280 deaths, as contrasted with the decennial average of 337, while the death.rate was 0.86 per 1,000 of the civil population as against the decennial rate of 1.01 per 1,000. There was a decrease of 57 on the ten years' average number of deaths, and of 0.15 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. 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 1929 314 0.98 6.59 14.8 Average 10 years 337 1.01 7.87 12.8 1930 280 0.86 7.03 12.1 The following return gives the deaths at each age period:. Age Periods. Males. Females. Total. 0.5 5.16 3 3 6 15-25 15 28 43 25-35 37 29 66 35.45 30 24 54 45.55 40 11 51 55.65 32 10 42 65 upwards 12 6 18 Total 169 111 280 Showing the. Deaths from Tuberculosis of Respiratory System m the Sub.Districts during the Four Quarters of the Year 1930. Quarters. Tufnell. Upper Hollo. way. Tolling. ton. Lower Hollo. way. Highbury. Barns. bury. Islington, South East. The Borough First 14 7 7 7 10 18 23 86 Second 3 7 4 5 11 5 24 59 Third 7 6 6 5 8 13 16 61 Fourth 8 5 10 8 17 11 15 74 The Year 32 25 27 25 46 47 78 280 Showing the Deaths from all forms of Tuberculosis during 1930. Form. Ages. Sex. Districts. Total Deaths 0.1 1.5 over 5 M. F. Tuf. U.H. Toll. L.H. X CQ S.E. Respiratory . . 280 169 111 32 25 27 25 46 47 78 280 Meningeal 3 V 9 8 11 2 4 2 . 1 3 7 19 Abdominal . . 4 3 1 . 1 . . 3 . . 4 General . . 1 1 . . . . . . 1 1 Other forms 1 2 8 6 5 1 1 3 1 1 . 4 11 315 All Tuberculosis 4 9 302 187 128 35 31 32 26 51 50 90 . 31 [1930 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 648 deaths, or 309 less than in 1929. They were equal to a death.rate of 2.0 per 1,000 of the civil population, and represented 16.5 per cent, of the total deaths registered in the Borough. Acute Bronchitis..There were 14b deaths as compared with 146 in the previous year, 74 occurred among males, and 74 among females. The deaths of 5 infants under 12 months were registered. Chronic Bronchitis..HO deaths were ascribed to it, 57 being males and 23 females. This return is 107 below that for 1929. Pneumonia (All forms)..368 deaths were registered, of which 200 were males and 168 females, and were 68 below the year 1929. 60 infants under a year old died from this disease, while between the ages of 1 and 5 years 38 died from it. Above 5 years of age the deaths numbered 270. 179 deaths occurred in Public Institutions, chiefly the Islington Hospitals. Pleurisy..There were 20 deaths registered from this disease, 5 deaths occurred in Public Institutions. Asthma and Emphysema..18 deaths were recorded from these diseases, all but 2 were adults. Other Diseases of the Respiratory System. 14 deaths were registered, as contrasted with 126 in 1929. VENEREAL DISEASES. Eleven deaths were ascribed to these diseases, as compared with 22 in 1929. Of these, 7 were males and 4 females. They were 3 below the mean deaths (14) of the preceding ten years 1920.29. The three groups oi ages at death were as follows :.Under I year, 2 deaths; 1.5 years, 1 death ; and over 5 years, 8 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 list of activities during the year. 1. Lectures, with films, were delivered in April and May at the Central Library Hall, Holloway Road. The subject was " The Tragedy of Ignorance." The lectures were well attended. 1930] 32 2. Open Air Lectures were held at Highbury Corner on May 22nd, June 3rd and 19th, July 3rd, 17th and 31st, and September 18th. 3. Lectures were delivered in the Library Hall at Thornhill Square and Manor Gardens on the 11th and 18th November. 4. Lecture held at Caledonian Road Baths in January, 1930, the subject being " Deferred Payment." DEATHS FROM COAL.GAS POISONING. During the year 13 deaths were registered from asphyxia caused by the inhalation of carbon.monoxide gas. Twenty.five deaths from the same cause occurred in 1929. Twelve of these deaths were attributable to suicide, while the cause of the remaining death was accidental, which was investigated at the request of the Ministry of Health. Of the 13 deaths, 11 were males and 2 females, the ages ranging from 25 to 75 years. ACCIDENTAL DEATHS. The deaths due to accident numbered 144. Of this number 59 deaths were ascribed to vehicular traffic and 51 to accidental falls, including 43 aged people. The 59 deaths due to accidents in vehicular traffic may be summarised as follows:. Motor Car Other or Lorry. Bus or Tram. Taxi.cab. Vehicles. Total. 44 7 . 8 59 Of this number, l6 deaths occurred to Islington residents when in outlying districts. In addition to these, 8 non.residents were also killed by vehicles within the borough. INQUESTS AND MORTUARY. During the year 279 bodies were received into the Mortuary, as compared with an average of 302 in the preceding 10 years. Only two infectious bodies were received during the year. The daily average number of bodies received was 0.7, whilst in 1929 the average was 0.8. In 177 cases inquests were held, as contrasted with an average of 282 in the ten years 1920-29 Bodies received into Mortuary Inquests. 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 1929 306 246 Average 302 282 1930 279 177 33 [1930 The following Table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner during the years 1929 and 1930:. 1930 No. of bodies received. Daily Average. No. of Inquests held. 1929 No. of bodies received. Daily Average. No. of Inquests held. 1st Quarter 77 0.8 67 1st Quarter 109 1.2 98 2nd „ 57 0.6 45 2nd „ 61 0.7 53 3rd „ 60 0.7 35 3rd „ 81 0.9 45 4th „ 85 0.9 30 4th v 55 0.6 50 Total for year 279 9.7 177* Total for year 306 08 246* * Inclusive of Inquests held by the Coroner upon bodies of deceased persons who died in Public Institutions in the borough. 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. 3,057 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 page40. The total cases notified are 618 more than those of the previous year (2,439), and 578 above the average (2,479) 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, which were respectively 244, 3, 254, 16, 61 and 8 above the average, while Scarlet Fever showed a decrease of 8 cases on the ten years' average. The 3,057 cases were equal to an attack.rate of 9.38 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. 1920 2,853 8.49 1921 4,344 1305 1922 2,787 8.34 1923 2,096 6.22 1924 2,085 606 1925 2,194 6.47 1926 1,918 5.65 1927 1,813 5.42 1928 2,260 6.96 1929 2,439 7.62 10 years average 2,479 7.43 1930 3,057 9.38 34 1930] Registration Sub.Districts. The total number of cases notified in these districts was as follows:. Total cases notified. Tufnell 261 Upper Holloway 262 Tollington 314 Lower Holloway 424 Highbury 453 Barnsbury 590 Islington South.East 753 Total 3,057 SMALLPOX. The cases notified as Smallpox properly residing in the Borough numbered 244, as against 71 in the year 1929. Of these 244 cases, six were returned from hospital as unverified, that is, not considered to be smallpox. Of these notifications, 198 were unvaccinated persons, 43 were vaccinated in infancy only, and three were doubtful. One case, an unvaccinated infant at the breast, was not sent to hospital, but was isolated at home and special precautions were enforced to ensure that the isolation was complete. This baby was infected through another case which had occurred in the same household, and both the mother and the baby were then vaccinated, but in the case of the young infant it was too late to avoid infection, although undoubtedly the attack was modified. At this time it was doubtful if the mother would be admitted to hospital with the baby, and in the circumstances, as they could be isolated in an attic at the top of the house, in the best interests of the infant, this single case was kept at home. The cases are classified as was done in the Report for 1929, according to the source of infection. A small outbreak occurred in the Islington Institution through a case being for a time "missed." A man was admitted at the end of January to the Institution in a septic and verminous condition, his clothing having to be cut off and burned. Underneath the skin sores it was not imagined that he had also smallpox, and it was only by inference that he at a later stage was re.examined and found to be the cause of infection of the other nine cases which occurred. In St. Mary's Hospital 6 cases were notified at intervals throughout the year, but there was no outbreak in the hospital itself. One case occurred in a common lodging.house, 212 cases occurred in ordinary private houses, and 15 occurred in blocks of dwellings. Classification as to source of infection. Infection from previous cases 103 Infection from common lodging.houses 1 Infection from school 7 Smallpox in neighbourhood 7 Infection from workplace 21 Infection not traced 81 Contact with cases in other Boroughs 16 Infection in Hop Fields 1 Infection from hospital I Unverified cases (3 being members of family where previous case of verified smallpox had occurred 6 Total 244 35 [1930 It will be noted that even where the cases occurred in blocks of dwellings the spread was adequately controlled. To show the difficulty in tracing the source of infection in obscure cases, it is interesting to consider a man infected at a common lodging.house. He attended at one of the hospitals, re.attended for a special blood test, attended the skin department and the casualty department, is said to have slept at a Salvation Army Shelter, and came to reside with a relative in Islington three days prior to his discovery and removal to hospital. Such a case, which is typical of some others, shows the risk a person unprotected by vaccination runs of contracting smallpox from an unknown source, meeting such a case in the street, in a public vehicle, in waiting.rooms of hospitals, etc. The Medical Officer of Health was visiting some households in Holloway where there had been smallpox, when he noticed passing in the street a school.girl with a rash on her face. He stopped and questioned her and found the cookery teacher considered she "should not cook with such a face." She was therefore being sent by the teacher to attend the local school treatment centre. She was forthwith directed to go home, found to have smallpox, and was removed to hospital. In addition to the number notified, 6 cases occurred at Archway Hospital, Archway Road, the home addresses of the patients being.one in Holborn and five in Finsbury, and another case, which, however, was eventually returned as not smallpox, was a St. Marylebone case in the London Fever Hospital, Liverpool Road. The difficulty of tracing all contacts is instanced by a visitor at one of the households, who was a ship's steward. This man had left the very day the case was discovered, his address was not known, nor the ship to which he would be sent, nor the Shipping Company. Later it was known that a ship had been held up at Liverpool, the crew dismissed while the ship underwent disinfection, and a new crew engaged, all through a case eventually diagnosed as smallpox in a steward. The Medical Officer of Health communicated with the Medical Officer of Health for Liverpool to get particulars, and it turned out to be our lost contact. The Medical Officer of Health for Liverpool kindly supplied us with a memorandum from the Port Sanitary Authority, from which the following is gleaned:. "The vessel arrived at Liverpool on the 23rd February from Glasgow. The steward apparently joined at Cardiff on the 3rd February. He went with the ship to Glasgow, where he was treated for Influenza and sweat rash. He was examined again at Liverpool on the 25th February and diagnosed as smallpox." Having regard to the number of cases of smallpox in the previous year, 71 in number, and the grave possibility that the infection would continue and increase in 1930 owing to the large proportion of the population now unprotected by vaccination, the Medical Officer of Health drew attention to the fact that the Public Health Acts Amendment Act of 1907, which is an adoptive Act, gives under section 61 very useful powers to the local authority in connection with smallpox and other infectious diseases, and to the advantage that would be gained in having chicken. pox notifiable. This Act, however, had not been adopted in Islington. The Public Health Committee of the Council directed that the matter of the notification of chicken.pox in a modified form as suggested by the Medical Officer of Health should be taken up with the Ministry of Health. On enquiry it was stated that there were difficulties, as all cases of chicken.pox were not to be notified, and this 1930] 36 could not be done by adding "chicken.pox" to the list in the section of the Public Health (London) Act, 1891, but it was pointed out to the Ministry that as there were special regulations for Diarrhœa under 2 years of age, Malaria and Tuberculosis, made by Order under Section 113, it appeared feasible that an Order could be made for the notification of specified cases of chicken.pox. This was done, as chicken.pox, notified in the vaccinated child, is of no special value when chicken.pox is being notified merely as a precautionary measure in view of the prevalence of smallpox to enable most cases of smallpox to be discovered. The suggestions of the Medical Officer of Health were subsequently adopted and the Islington (Chicken.pox) Regulations, 1930, dated March, 1930, were made by the Minister of Health. These regulations came into operation on the 24th March, 1930. Notification by Parents or Guardians. Every parent or guardian, or other person, as soon as he becomes aware, or has reasonable grounds for supposing, that any person not under ten years of age who is in his charge and who is resident within the district, or any person under ten years of age who has not been vaccinated and who is in his charge and resident within the district is suffering from chicken.pox shall, unless the case has been already notified by a medical practitioner, forthwith notify the case to the Medical Officer of Health, stating the name, age, and address of the patient. Notification by Medical Practitioner. Subject to the provisions of these regulations, every medical practitioner, as soon as he becomes aware that any person not under ten years of age who is resident within the district, or any person under ten years of age who has not been vaccinated and who is resident within the district, and upon whom he is in professional attendance is suffering from chicken.pox, shall forthwith make and sign a notification of the case in the form set forth in Schedule A to the Public Health (Notification of Infectious Diseases) Regulations, 1918 (a), and shall transmit the notification to the Medical Officer of Health: Provided that a medical practitioner shall not be required to notify a case of chicken.pox under this article and shall not be paid a fee for so doing. (a) if he has reasonable grounds for supposing that the case has already been notified under these regulations ; or (b) if the case is being treated in a hospital for infectious diseases. Similar regulations have since been adopted by other Metropolitan Boroughs. While these regulations do not preclude the notification of chicken.pox in an adult protected within recent years by vaccination, nor strictly speaking force the notification of chicken.pox in a child just a few days vaccinated, it was considered advisable to make for simplicity and allow for some common sense on the part of the medical attendant, parent or guardian, besides adults with alleged chicken.pox when smallpox is prevalent are well known to be the cases amongst which " missed " cases of smallpox are found, and worth seeing. School supervision of contacts.. In Islington when smallpox occurs in a household the school children are excluded from school for at least three days to enable a thorough disinfection of the premises to be made and also because one case having occurred, it may be that there are more than one person infected at or 37 [1930 about the same time, and the rash may appear on another member of the household on the morrow or the next day. The school authorities undertake the supervision of the school child for the remaining period of the possible incubation, and we have found in practice that this is working. fairly well. Diphtheria was responsible for 1,242 cases of illness, which were 254 above the average (988) of the preceding ten years. The attack rate was equal to 3.81 per 1,000 of the civil population annually, and was 0.85 above the mean rate (2.96) of the decennial period. In London the attack.rate was 3.06 per 1,000. 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 42.) Applications in respect of 3 children were received for Diphtheria immunisation (Schick Test) during the year. ANTI.TOXIN TREATMENT. During the year 94,000 units of Diphtheria Anti.toxin serum were issued to Medical Practitioners in the Borough. Of this quantity 52,000 units were sold, the total amount received by the Council being £2 13s. Od. The remaining 42,000 units were given free, owing to the patients' limited means. Scarlet Fever..1,310 cases were notified, and they showed a decrease of 8 on the average (1,318) of the ten years 1920.29. The attack.rate was equal to 4.02 per 1,000 of the civil population annually, which is an increase of 0.07 per 1,000 of the mean rate (3.95) of the preceding ten years. In London the attack. rate was 3.7 per 1,000 of the civil population. Enteric Fever..31 cases were notified which were 16 more than the average that obtained during the ten years 1920.29. The attack.rate was 0.09 per 1,000 annually, or 0.05 per 1,000 above the mean rate (0.04) of the last ten years. In London the rate was 0.07. Summary :.5 probably not Typhoid nor Para.typhoid, cause of 3 untraceable, 4, imported, 4 subsequent cases, 4 from salad or watercress, 7 fish, 3 shellfish, 1 defective drain. Typhus Fever..No case was notified. Puerperal Fever..See page 13. Erysipelas..188 cases were notified, and were 61 above the average of the preceding ten years, the attack.rate being 0.58 per 1,000 of the civil population. 1930] 38 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 3,057 cases notified, 80 deaths occurred, or 2.6 per cent., which contrasts with an average percentage of 3.2 in the preceding ten years 1920.29. Years. Cases. Deaths. Fatality. 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 1,9191 63 3 .3 1927 1,813 55 3.0 1928 2,260 60 2.7 1929 2,439 57 2.3 Mean 2,479 82 3.2 1930 3,057 80 2.6 * Including 2 cases not notified. ‡ Includes 1 case not notified. Hospital Isolation..Of the 3,057 cases of infectious disease notified, 2,879 were isolated in hospital, equal to a percentage of 94.2, while only 5.8 per cent. of the patients were nursed at home. The following tabular statement shows the number of cases treated in the various public institutions:. Year. Cases treated in Hospital. Percentage of cases treated. 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 1930 2,879 94.2 DISEASES TREATED IN HOSPITAL. Disease. Total cases. Cases isolated. Percentage of known cases. Small Pox 244 243 99.6 Scarlet Fever 1,310 1,220 93.1 Diphtheria 1,248 1,236 99.0 Enteric Fever 31 30 97.0 Erysipelas 188 118 64.4 Puerperal Fever 36 32 88.8 3,057 2,879 94.2 39 [1930 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 1930. 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 243 1 244 99.1 0.9 1 - 1 0.4 - 0.4 Scarlet Fever 1,220 90 1,310 93.1 6.9 14 - 14 1.1 - 1.0 Diphtheria 1.236 12 1,248 99.0 1.0 39 3 42 31 25 0 3.4 Enteric (Typhoid Fever) 30 1 31 96.8 3.2 - - - - - - Typhus Fever - - - - - - - - - - - Erysipelas 118 70 1 8 62.7 37.3 12 2 14 102 2.8 7.4 Puerperal Fever 32 4 36 88.8 11.2 9 9 28.1 - 25.0 Continued Fever - - - - - - - - - - - Relapsing Fever - - - - - - - - - - - Cholera - - - - - - - - - - - Total 2,879 178 3,057 94.2 5.8 75 5 80 26 2.8 2.6 Showing the number of Cases and Attack Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1920.29 and in 1930. DISEASES. YEARS. Average number of cases, 1920 29 1930 Increase or Decrease 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 Small Pox Cases - - - - - - 1 4 71 244 + 173 Diphtheria Rate - - - - - - 000 0.01 0.22 . 0.75 + 053 Cases 1324 1548 1126 889 854 911 743 716 756 1004 988 1242 + 254 Membranous Rate 3.94 4.65 3.37 2.64 2.48 2.69 2.19 2.14 2.33 314 2.96 3.81 + 0.85 Cases 4 5 4 2 2 2 . 4 4 4 3 6 + 3 Croup Scarlet Fever Rate 0.01 0.02 0.01 0.00 0.00 0.00 0.01 0.01 001 0.01 001 Cases 1307 2622 1496 1080 1077 1139 1010 909 1305 1155 1318 1310 . 8 Enteric Fever Rate 3.89 7.87 4.48 3.21 313 3.36 2.98 2.72 4.02 3.61 3.95 402 + •007 Cases 24 10 9 16 14 10 18 12 19 18 15 31 16 + 0.05 Continued Fever Rate 0.07 0.03 0.03 0.05 0'04 0.03 0.05 0.03 006 0.06 004 009 Cases - - - - 3 . 1 . . 1 . . Rate - - - - 0.01 - 0.01 - - - a. ah Puerperal Fever* Cases 29 34 20 22 19 23 u w 27 33 38 u w 38 u uu 28 u uu 36 + 8 Rate 3.08 4.31 2.68 3.10 2.79 3.50 4.18 5.40 6.56 6.89 4.00 6.3 + 2 3 Erysipelas Cases 165 125 132 87 116 109 118 139 134 148 127 188 + 61 Rate 0.49 0.38 0.39 0.26 0.34 0.32 0.35 0.42 0 41 0.46 0.38 0.58 + 0 20 Totals Cases 2853 4344 2787 2096 2085 2194 1918 1813 2260 2439 2479 3057 + 578 Rate 8.49 1305 8.34 6-22 606 6'47 5.65 5.42 6.96 7.62 7.43 9.38 + 1.95 * Per 1,000 Registered Births. 1930] 40 Showing the Cases of the Notifiable Infectious Diseases notified, in the SubRegistration Districts and the Wards during the Year 1930. SubRegistration Districts. Wards. Small Pox. Scarlet Fever or Scarlatina. Diphtheria. Membranous Croup. Enteric (Typhoid. Fever. Typhus Fever Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total. Tufnell Tufnell 4 142 97 - 3 - 11 4 - - - 261 Up. Holloway Up. Holloway 23 98 110 - 9 - 17 5 - - - 262 Tollington Tollington 8 160 120 - 3 - 20 3 - - - 314 Lr. Holloway Lr. Holloway 15 205 162 2 4 - 29 7 - - - 424 Highbury Highbury 10 135 100 - 1 - 14 5 - - - 265 Mild may 12 80 75 - 4 - 13 4 - - - 188 Barnsbury Thornhill 47 152 124 1 1 - 21 2 - - - 348 Barnsbury 31 90 103 2 — - 15 1 - - - 242 Islington, S.E. St. Mary s 38 49 85 — 2 - 18 1 - - - 193 Canonbury 18 120 143 — 2 - 10 1 - - - 294 St. Peter's 38 79 123 1 2 - 20 3 - - - 266 Totals 244 1,310 1,242 6 31 - 188 36 - — — 3,057 Attack-Rates per 1,000 population 0.75 4.02 3.81 0.01 0.09 - 0.58 0.12 - - - 9.38 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 Poliomyelitis, Acute Encephalitis Lethargica, Acute Polio.Encephalitis, Acute Primary Pneumonia, Acute Influenzal.Pneumonia, Cerebro.spinal fever or Epidemic Cerebro.spinal Meningitis, Dysentery, Glanders or Farcy, Hydrophobia or Rabies, Malaria, Ophthalmia Neonatorum, Plague, Tuberculosis, Puerperal Pyrexia, and Chicken.pox (except in the vaccinated under 10 years of age). Acute Poliomyelitis. Four cases were notified from this disease during the year, as contrasted with three in 1929, and none in 1928. 1930 1929 Cases. Deaths. Cases. Deaths. 1st Quarter 2 Nil Nil Nil 2nd „ Nil „ 1 „ 3rd „ „ „ Nil „ 4th „ 2 „ 2 1 4 Nil 3 1 Epidemic Cerebro.Spinal Meningitis. Thirteen cases came to the knowledge of the Medical Officer of Health, although only 8 were notified, as against 6 in 1929. During the ten years 1920.29 the cases averaged 8 per annum. 41 [1930 A return of attacks of the disease during the past ten years is given in the following statement:. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 Average 10 yrs. 1920-29 1930 Total Deaths, 1920-29. 1st Quarter 5 3 1 3 - 2 3 3 1 2 2 4 19 2nd „ 5 3 2 2 . 1 3 3 4 2 3 5 20 3rd „ 2 - - 2 2 2 3 - 2 2 1 2 8 4th „ 2 1 1 4 1 2 1 1 3 2 2 11 Year 14 7 3 8 6 6 11 7 8 9 8 13 68 The deaths during the year numbered 10, and were equal to the very high rate of 77 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:- 1926 1927 1928 1929 1930 Malaria Nil 2 - 2 Nil Dysentery Nil 5 1 6 Nil Acute Primary Pneumonia 190 202 288 397 323 Acute Influenzal Pneumonia 55 124 50 122 36 Total 245 333 339 527 359 ISLINGTON (CHICKEN-POX) REGULATIONS, 1930. With regard to the reasons for the introduction of these regulations, these have been dealt with under the heading of "Smallpox," page 36. They came into operation on the 24th March, 1930, and from that time to the end of the year 610 cases were thus notified under these regulations. DYSENTERY. No case of Dysentery was notified during the year. 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 case was 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 4 cases of Acute Encephalitis Lethargica were known, but only 2 were notified. They showed a decrease of 4 on the return of the previous year, whilst no deaths were registered. 1930] 42 The following summary shows the number of cases, and also the fatality of recent years:- Acute Encephalitis Lethargica. Years. 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 Average (10 years). 1930 Cases 8 11 3 10 39 17 21 7 5 8 13 4 Deaths 4 2 3 5 4 6 9 4 3 3 4 - One case of Acute Polio-encephalitis only was notified. Ophthalmia Neonatorum. Purulent Disease of the Eyes of Newly-born Children. See page 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 provisionally for a period of twelve months, and was extended for a further period of 12 months from the 8th December, 1930. 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 patient 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. 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 4 cases have received this assistance from the Borough Council, the cost of the Insulin supplied being £14 9s. Od. 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 43 [1930 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. No additional children under five years of age have come under our supervision during the year 1930. One of those noted last year has reached the age of 5 and now attends school. TUBERCULOSIS. 590 cases of Tuberculosis in its different forms were notified during the year. The attack.rate was equal to 1.84 per 1,000 of the civil population. This number was a decrease of 26 on the return of the previous year, and of 0.09 per 1,000 on the attack.rate Respiratory (Pulmonary) Tuberculosis..494 notifications were received, of which 253 referred to males and 241 to females, and represented an attack.rate of 1.54 per 1,000 inhabitants. Showing the Notified Cases of Tuberculosis in the Wards during 1930. 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 20 19 39 7 5 12 51 1.58 Up. Holloway Up. Holloway 27 21 48 6 2 8 56 1.85 Tollington Tollington 19 26 45 5 2 7 52 1.79 Lr. Holloway Lr. Holloway 26 27 53 5 1 6 59 1.49 Highbury Highbury 23 19 42 4 4 8 50 1.63 Mild may 19 14 33 2 4 6 39 1.41 Barnsbury Thornhill 17 25 42 5 2 7 49 1.69 Barnsbury 18 16 34 5 4 9 43 1.81 St. Mary's 21 16 37 2 5 7 44 2.52 Islington, S.E. Canonbury 31 30 61 4 4 8 69 2.24 St. Peter's 32 28 60 6 12 18 78 2.74 Totals 253 241 494 51 45 96 580 1.84 THE PERIOD OE LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1930. Tubercular Diseases. Sex. Cases Notified in Whole District. At all ages. At Ages—Years. Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and up. Respiratory Tuberculosis M. 253 - 3 6 43 113 74 14 F. 241 - 10 81* 104 41 5 Tubercular Meningitis M. - - - - - - - - F. 3 1 - 2 - - - - Tabes Mesenterica M. 1 - - 1 - - - - F. 3 - - 2 1 - - - General Tuberculosis M. - - - - - - - - F. - - - - - - - - Other forms of Tuberculosis M. 50 2 7 17 14 9 1 - F. 39 - 5 14 11 7 2 - All Tubercular Diseases M 304 2 10 24 57 122 75 14 F. 286 1 5 28 93 111 43 0 Totals 590 3 15 52 150 233 118 19 Percentages at each life period to total cases 0.51 2.54 8.81 25.42 39.50 20 00 3.22 1930] 44 From the above statement it will be seen how the disease attacked people a the various ages, viz. : Id every hundred cases 0.51 were under 1 year of age. „ „ 2.54 were aged 1 to 5 years. „ „ 8.81 were aged 5 to 15 years. Prime „ „ 25.42 j were aged 15 to 25 years.* of „ „ 89.50 were aged 25 to 45 years. Life „ „ 20.00 J were aged 45 to 65 years. ,, 3.22 were aged 65 and upwards. Referring to the first Table above, it will be seen under "Respiratory Tuberculosis" that between the ages of 15 and 25, the males attacked number 43, while the females reached nearly double this number, 81. During recent years, that is, since the close of the War, the earlier age at which the adolescent female becomes the prey of tuberculosis is a matter for concern and investigation. Is this due to the adolescent women undertaking work usually performed by men to a greater extent than formerly, and thus being exposed to a greater risk of infection? Such work undertaken by young women during the War period has been continued by them. Is the young woman more susceptible than the man? The fact remains that in recent years in place of the adolescent male showing the greater incidence in this particular age, it is now the adolescent female. 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. The character of the work of this Committee was fully exemplified in the Medical Officer of Health's Annual Report for 1929, page 39, when individual cases and methods of help were given. The work of the Committee has been carried out on similar lines, but owing to lack of space this year the report has been considerably condensed, as the examples are similar. Help is given with regard to clothing, and also attention to the question of housing. Real help as regards the position of the patient and his National Health Insurance is given, and if he cannot ascertain the situation from the agent, the matter is taken up by the Care Committee Secretary with the head office of the Approved Society. Advice has also been given in respect of other insurances. There is a risk in other matters during the patient's absence, undergoing treatment, that such as furniture which may be on the hire purchase system being claimed, and means have been found to obtain sufficient assistance to avoid compulsory surrender. 1930. 1929. New cases received 317 300 Visits 1,071 660 Cases presented to Committee 669 447 45 [1930 Handicraft Glasses.-Under the auspices of this Committee a handicraft class for tuberculous patients was started on the 30th March, 1930. The number on the register is 12 men and 8 women, who do not now show infection in their sputum. The class is held weekly and the average attendance of about 10.6 is considered satisfactory, as this is really not a commercial proposition, these patients never expecting to compete with the regular workpeople. The handicraft consists of leather work, weavings, etc. Its purpose is served by the encouragement given to the patients, thus taking the mind off their ailment. A marked improvement has been noticed in their general apparance; the Tuberculosis Officer says this is also reflected in their physical condition as found by medical examination. 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, removed during that period, and the actual number remaining at the close of the year, 1930 (i.e., ending 27th December, 1930):- Lungs. Other Forms. Total. M. F. M. F. Numbers on register at the commencement of the year 1930 1,202 960 382 379 2,923 Notified cases added during the year 1930.. 253 241 51 45 590 Cases coming to the knowledge of the Medical Officer of Health (other than by notification) during Me year 1930 34 39 18 20 111 No. of cases removed from the register during the year 1930 1,489 262 1,240 190 451 38 444 45 3,624 535 1,227 1,050 413 399 3,089 Showing the Notified Gases of Tuberculosis in the Quarters during 1930. 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 89 61 150 70 64 134 42 52 94 52 64 116 253 241 494 Tubercular Meningitis ... 1 1 ... 1 1 ... ... ... ... 1 1 ... 3 3 Tabes Mesenterica 1 2 3 ... ... ... ... 1 1 ... ... ... 1 3 4 General Tuberculosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other forms of Tuberculosis 15 12 27 8 12 20 13 5 18 14 10 24 50 39 89 Totals 105 76 181 78 77 155 55 58 113 66 76 141 304 286 590 46 1930] Disinfection of Houses and Rooms after Tuberculosis.-The following statement gives the particulars for the year:- Houses. Rooms. 1st quarter 118 139 2nd ,, 70 96 3rd „ 74 93 4th „ 77 97 Total 339 425 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 29th December, 1929, to the 27th December, 1930, in the Metropolitan Borough of Islington. Age-periods Notifications on Form A. Number of Primary Notifications. Total Notifications on Form A. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and up. Total Primary Notifications. Pulmonary Males - 3 4 2 13 30 71 42 44 30 14 253 443 „ Females - 6 4 36 45 57 47 25 16 15 241 413 Non-pulmonary Males 2 7 12 6 5 9 4 5 1 - - 51 75 „ „ Females 1 5 12 6 5 7 6 1 1 1 - 45 60 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 - - - - - 104 209 „ Females - - - - - 61 166 Non-pulmonary Males - - 1 1 1 4 47 „ „ Females - - 1 1 1 4 38 Showing New Cases of Tuberculosis and all Deaths during 1930. Age Periods. New Cases. Deaths, Pulmonary. Non-Pulmonary. Pulmonary. Non-Pulmonary. M. F. M. F. M. F. M. F. Under 1 year - - 3 3 - - 1 3 1-5 3 - 12 10 - - 4 5 5-10 6 9 16 15 2 3 2 2 10-15 2 4 7 9 1 - 2 1 15 -20 15 41 5 6 4 13 3 - 20-25 30 50 11 10 11 15 2 2 25-35 79 66 6 6 37 29 2 1 35-45 48 56 6 2 30 24 1 1 45-55 52 27 3 1 40 11 1 - 55-65 36 20 - 2 32 10 - 1 65 and upwards 16 7 - 1 12 6 - 1 Totals 287 280 69 65 169 111 18 17 65 Deaths not notified or 20 6 per cent. of Total Deaths. 47 1930 TUBERCULOSIS DISPENSARIES. Dr. W. E. Snell was appointed by the Royal Northern Hospital Committee to succeed Dr. H. F. Comyn, who resigned in the year 1929. A summary of the work of the Islington Tuberculosis Dispensaries is given below. TUBERCULOSIS DISPENSARIES. RETURN SHOWING THE WORK OF THE NORTH ISLINGTON TUBERCULOSIS DISPENSARY DURING THE YEAR 1930. 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 87 56 1 2 9 10 13 4 96 66 14 6 (b) Doubtfully tuberculous(8) - - - - - - - 14 11 2 - (c) Non-tuberculous - - - - - - - - 68 46 11 14 B..Contacts examined during the year:. (a) Definitely tuberculous .. 3 16 1 1 - - - - 3 16 1 1 (b) Doubtfully tuberculous)8) - - - - - - - - - - 2 1 (c) Non-tuberculous - - - - - - - - 36 49 50 37 C..Cases written ofl the Dispensary Register)(9) as (a) Cured(10) - 4 - - 1 1 1 - 1 5 1 - (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases noti fied in error) - - - - - - - - 104 95 61 51 D..Nomber of Persons on Dispensary Register)(9) on ember 31st:- (a) Diagnosis completed 320 253 3 6 31 41 35 18 354 294 38 24 (b) Diagnosis not completed .. - - - - - - - - 4 1 4 1 1. Number of persons on Dispensary Register(9) on January 1st 620 2. Number of patients transferred from other areas and of " lost sight of (11) cases returned 18 3. Number of patients transferred to other areas and cases "lost sight of 60 4. Died during the year 84 5. Number of observation cases(B) under A (b) and B (b) above in which period of observation exceeded 2 months 6 6 Number of attendances at the pensary (including Contacts)2,910 7. Number of attendances of non monary cases at Orthopaedic Out.stations for treatment or supervision 5 8. Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for (a) "Light" treatment 10 (b) Other special forms of treatment (A..P.) 150 9. Number of patients to whom Dental Treatment was given, at or in connection with the pensary 10 10. Number of consultations with medical practitioners:. (a) At Homes of Applicants 7 (b) Otherwise 357 11 Number of other visits by Tuberculosis Officers to Homes .. 137 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes .. .. 2,284 13. Number of (a) Specimens of sputum, &c., examined 326 (b) X.ray examinations made in connection with Dispensary work 317 14. Number of Insured Persons on Dispensary Register(9) on the 31st December 461 15. Number of Insured persons under Domiciliary Treatment(4) on the 31st December 4 16. Number of reports received during the year in respect of Insured Persons:- (a) Form G.P. 17 3 (b) Form G.P. 36 4 G. CLARK TROTTER, Chief Tuberculosis Officer. 48 1930] RETURN SHOWING THE WORK OF THE SOUTH ISLINGTON TUBERCULOSIS DISPENSARY DURING THE YEAR 1930. 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(') examined during the year (excluding contacts) : (a) Definitely tuberculous 71 47 5 4 7 5 4 12 78 52 9 16 (b) Doubtfully tuberculcus(e) - - - - - - - - 2 1 - - (c) Non-tuberculous - - - - - - - - 63 54 30 30 B..Contacts examined during the year::- (a) Definitely tuberculous .. 15 25 1 1 2 - 2 2 17 25 3 3 (b) Doubtfully tuberculous(8) - - - - - - - - - - - - (c) Non-tuberculous - - - - - - - - 45 73 50 40 C..Cases written off the Dispensary Register (9) as (a) Cured(10) 1 1 - 1 - 1 2 1 1 2 2 2 (b) Diagnosis not confirmed or non-tuberculous (including cancellation of cases notified in error) - - - - - - - - 112 130 82 70 D..Number of Persons on Dispensary Register(9) on December 31st:- (a) Diagnosis completed 310 248 21 26 35 41 36 44 345 289 57 70 (b) Diagnosis not completed - - - - - - - - 1 1 1 - 1. Number of persons on Dispensary Register)9) on January 1st 771 2. Number of patients transferred from other areas and of " lost sight of "(11) cases returned 26 3. Number of patients transferred to other areas and cases " lost sight of 124 4. Died during the year 99 5. Number of observation cases(8) under A (6) and B (6) above in which period of observation exceeded 2 months 8 6. Number of attendances at the pensary (including Contacts) 5,443 7. Number of attendances of monary cases at Orthopaedic Out.stations for treatment or supervision - 8. Number of attendances, at General Hospitals or other Institutions approved for the purpose, of patients for (a)"Light " treatment - (b) Other special forms of treatment (A.P.) 21 9. Number of patients to whom Dental Treatment was given, at or in connection with the Dispensary 6 G. CLARK TROTTER, Chief Tuberculosis Officer. During the year 1,148 persons were examined by the Tuberculosis Officers, and the patients made 8,533 attendances. At the Northern Dispensary there were 563 new cases, and at the Southern 585, while the attendances at the former were 2,910 and at the latter 5,443. The examination of contacts with tuberculous cases showed that 61 were suffering from 10. Number of consultations with medical practitioners:- (a) At Homes of Applicants 9 (b) Otherwise 152 11. Number of other visits by culosis Officers to Homes 315 12. Number of visits by Nurses or Health Visitors to Homes for Dispensary purposes 3,068 13. Number of (a) Specimens of sputum, &c., examined 666 (b) X.Ray examinations made in connection with Dispensary work 128 14. Number of Insured Persons on Dispensary Register(9) on the 31st December 422 15. Number of Insured Persons under Domiciliary Treatment(4) on the 31st December 211 16. Number of reports received during the year in respect of Insured Persons:. (а) Form G.P. 17 6 (b) Form G.P. 36 - 40 [1930 tuberculosis, 30 were suspects, and 364 were not suffering. The nurses of the Northern Dispensary paid 757 visits, and those of the Southern 1,977, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 137 visits, and of the Southern 3'25 visits to the patients' homes for the purpose of examining them. Pneumothorax Treatment was also administered to twenty-six patients at a cost of £89 15s. 6d. Finsen Light Treatment—Nil. Artificial Sunlight Treatment.—One case under treatment remained in the year under review, the total cost of this being ten shillings. This treatment, as out-patient treatment, has now been discontinued following a recommendation from the London County Council that it might be given as an additional method of treatment under suitable conditions in residential institutions, as an investigation of the cases while they were under trial did not justify its continuance to outpatients. TUBERCULOSIS. The number of persons in attendance at the Dispensaries in each year was as follows:— 1926 1927 1928 1929 1930 North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy New Cases . 542 670 574 582 558 659 539 638 563 585 Actual Number of Attendances 3366 6672 2847 6044 2616 5802 2634 5899 2910 5443 Totals 3908 7342 3421 6626 3174 6461 3173 6537 3473 6028 A summary of the combined dispensaries is given for the following years:— Cases. Attendances. 1926 1,212 10,038 1927 1,156 8,891 1928 1,217 8,418 1929 1,177 8,533 1930 1,148 8,353 Totals 5,910 45,333 Table showing the number of Tuberculous Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1930. Date. Dispensary Jan. Feb. Mar. Apr. May. June July Aug. Sept. Oct. Nov. Dec. Year. Total. Attendances Northern 230 202 266 227 243 245 237 227 274 251 261 247 2,910 8,353 Southern 592 468 544 433 522 423 481 336 360 457 428 393 5,443 New Cases Including Contacts Northern 36 50 57 45 44 50 33 50 41 59 46 52 563 1,148 Southern 73 57 60 41 75 48 48 29 24 44 59 27 585 1 Contacts. Tuberculosis Northern 2 2 4 2 3 — — — 3 1 2 2 21 61 Southern 6 3 5 2 2 4 3 1 2 4 7 1 40 Suspects Northern — 3 4 — 3 4 — 1 1 2 2 1 21 30 Southern 1 — 1 1 2 — — 1 2 1 — — 9 Non-Tuberculous Northern 13 18 12 15 11 15 3 19 7 21 13 15 162 364 Southern 24 21 16 18 33 12 21 10 8 11 21 7 202 Nurses' Visits Northern 73 49 68 60 60 56 72 58 61 70 52 78 757 2.734 Southern 208 176 170 73 200 190 195 37 187 207 166 168 1,977 Tuberculosis Officers' Visits Northern 12 13 14 9 12 18 7 1 12 17 12 10 137 462 Southern 30 36 31 31 30 26 27 21 24 23 23 23 325 50 1930] HOME VISITATION—TUBERCULOSIS. Visits paid by Municipal Tuberculosis Visiting Nurse during the period 1st January, 1930, to 31st December, 1930. Month. North Dispensary. South Dispensary. Total. January 151 97 248 February 141 77 218 March 147 76 223 April 118 108 226 May 151 90 241 June 127 100 227 July 156 106 262 August 117 83 200 September 62 55 117 October 136 117 253 November 118 109 227 December 103 73 176 Totals 1,527 1,091 2,618 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 1,809 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 770 were Scarlet Fever and 635 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 68 — + 68 Scarlet Fever 770 781 — 11 Diphtheria 635 459 + 176 Enteric Fever 2 2 — Chicken Pox 334 — + 334 Total 1,809 1,242 + 567 N on - Notifiable Diseases.—6,107 cases came to the knowledge of the Medical Officer of Health during the year, viz., 2,979 cases of Measles, 1,273 cases of Chicken-pox, 178 of Whooping Cough, and 1,677 of other diseases. The information respecting these cases was received from the teachers of schools within the borough. Exclusion of Scholars from Schools.—5,205 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 2,979 1,948 + 1,031 Chicken Pox 1,273 961 + 312 Whooping Cough 178 589 — 411 *Other Diseases 1.677 2,302 — 625 Total 6,107 5,800 + 307 * Note.—" Other Diseases " include Mumps, Scabies, Ophthalmia, Itch, etc. 51 [1930 BACTERIOLOGICAL EXAMINATIONS. 3,564 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 435 on that of the preceding year. It was also 1,198 above the decennial average. Of the total examinations, 620, or 17.4 per cent. gave positive results. Diphtheria.—2,766 specimens were examined for Diphtheria, of which 492, or 17.8 per cent., were found to contain Diphtheria bacilli. Enteric Fever.—19 specimens of blood were examined, 1 of which gave a positive result. Tuberculosis.—779 specimens of sputum were examined, 127, or 16.3 per cent., of which showed that the patients were suffering from pulmonary tuberculosis. DIPHTHERIA—PATHOGENICITY TESTS. 1930. No. Submitted for Examination. Negative Result. (Bacilli) Positive Result. (Bacilli) Non-Virulent. Virulent. 50 43 7* 5 1 * 1 not tested for Pathogenicity. Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Pulmonary Tuberculosis, 1920-29, and in 1930. Periods. Diphtheria. Enteric Fever. Pulmonary Tuberculosis Totals. Positive Results Negative Results. Total Examimed. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. 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 1,634 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 1929 412 1,888 2,300 2 15 17 119 693 812 3,129 Average 10 years 264 1,336 1,600 2 17 19 130 617 747 2,366 1930 492 2,274 2,766 1 18 19 127 652 779 3,564 52 1930] LOCAL GOVERNMENT ACT, 1929. An important change was effected by this Act in the transfer of the administration of the Vaccination Acts to the Borough Council, and the two Vaccination Officers came under the Public Health Department. The Public Vaccinators who were under contract with the Guardians had their agreements endorsed and were taken over by the Borough. These Public Vaccinators are of two classes, the indoor, consisting of the Public Vaccinators in certain of the former Poor Law Institutions and Hospitals who were Public Vaccinators only for the inmates, not staff, of these institutions and hospitals. One of these hospitals was formerly under the Holborn and Finsbury Guardians, but being within the Borough of Islington the vaccination functions there were also transferred to Islington. Four Public Vaccinators came within this category. The second class were the outdoor Public Vaccinators, ten in number, who were available for the general public. These were likewise taken over. The following is the public notice issued at the time of the change:— METROPOLITAN BOROUGH OF ISLINGTON. Public Health Department. VACCINATION. NOTICE IS HEREBY GIVEN that the arrangements for Public Vaccination are as follows:— DISTRICT. PUBLIC VACCINATORS. RESIDENCE. Tollington Dr. M. J. HEALY 2, Hornsey Rise, N.19 Upper Holloway Dr. PHILIP INWALD 57, St. John's Road, Upper Holloway, N.19 Tufnell Dr. M. HYNES 652, Holloway Road, N.19 East Lower Holloway East of Hillmartor, Caledonian and Roman Roads. Dr. H. E. WHITEHEAD 475, Caledonian Road, N.7 West Lower Holloway West of Hillmarton, donian and Roman Roads, with small adjoining portion of Thornhill. Dr. S. N. FORBES 61, Ellington Street, N.7 Highbury and West Mildmay The portion to the West of Petherton Road. Dr. THOMAS GALBRAITH 161, Green Lanes, N.16 Canonbury East Mildmay The East part from and including Petherton Road. East St. Mary That part on the East of the middle of Upper Street to and including Cross Street, and East St. Peter That portion East of the centre of Elder Walk, Popham Road and South Street V to New North Road. Thornhill Dr. J. M. LYNCH 48, Canonbury Square, N.1 Except small portion included in West Lower Holloway District. Barnsbury and Dr. S. J. ROWNTREE 20, Richmond Road, N.1 West St. Mary That portion West of the middle of Upper Street. South St. Mary That part South of Cross Street, and Dr. L. M. LEVENTON 252, Liverpool Road, N.l West St. Peter That part West of the centre of Elder Walk, Popham Road and South Street to New North Road. Dr. G. MADDEN 53, Devonshire Street, N.l. 53 [1930 Vaccination Officer for Districts Tollington, Upper Holloway, Tufnell, Highbury and West Mildmay and East Mildmay:— Mr. J. JENNINGS, 279b, Liverpool Road, N.l. Vaccination Officer for Districts East Lower Holloway, West Lower Holloway, Canonbury, East St. Mary and East St. Peter, Tfcornhill, Barnsbury and West St. Mary and South St. Mary and West St. Peter:— Mr. C. W. BELLIS, '279b, Liverpool Road, N.l. Communications as to Vaccination, addressed to the Medical Officer of Health, or to the Public Vaccinators or Vaccination Officers of the respective Districts, will receive immediate attention. G. CLARK TROTTER, M.D., Medical Officer of Health. Town Hall, Upper Street, N.l. No vaccinations were performed by the Medical Officer of Health under the Public Health (Smallpox Prevention) Regulations, 1917, as it was possible to refer each case immediately to the Public Vaccinator of the district or institution. VACCINATION. Of the 4,432 births registered in 1929, the returns of vaccination shows that only 2,082 infants were successfully vaccinated, while 15 were found to be insusceptible. There were also 227 who died unvaccinated, and 1,642 statutory declarations of conscientious objection to vaccination were obtained by the parents or guardians; 27 vaccinations were postponed under medical authority, 172 were removed to other districts or places unknown, thus leaving 96 unaccounted for. The return of certificates of exemption, therefore, represents 37 per cent. of the registered births. Years. Vaccination per 100 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 1929 49.5 54 1930] Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the previous year 1929, Registration Sub-Districts. Number of Births registered in 1929. 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 1930. Number of Statutory Declarations of Conscientious Objection received during year 1930. 1 2 3 4 5 6 7 8 9 10 11 12 Tufnell 369 170 4 — 118 30 4 22 13 8 1,770 96 Up. Holloway 811 379 5 — 239 52 5 95 30 6 225 Tollington 324 149 — — 107 23 4 3 26 12 128 Highbury 706 347 1 — 249 23 2 35 34 15 268 Lr. Holloway 487 228 — — 198 23 7 2 13 16 1,853 185 Barnsbury 768 376 3 — 314 34 3 4 20 14 289 Islington, S.E. 967 433 2 — 417 42 2 11 35 25 374 The Borough 4432 2082 15 — 1642 227 27 172 171 96 3,623 1,565 Return showing the numbers of persons successfully vaccinated and re-vaccinated at the cost of the rates by the Public Vaccinators during the year ended 30th September, 1930:— Name of the Institution or Vaccination District. Name of the Medical Officer or Public Vaccinator. Number of successful primary vaccinations of persons. Number of successfu re-vaccinations, i.e., successful vaccinations of persons who had been successfully vaccinated at some previous time. Under one year. One year and upwards. Total. Tollington Dr. M. J. Healy 177 56 233 43 Upper Holloway Dr. P. Inwald 201 59 260 161 Tufnell Dr. M. Hynes 181 40 221 40 E. Lower Holloway Dr. H. E. Whitehead 96 26 122 15 W. Lower Holloway Dr. S. N. Forbes 180 48 228 29 Highbury and W. Mildmay Dr. T. Galbraith 258 63 321 85 Canonbury, E Mildmay, E. Dr. J. Lynch 295 206 501 176 St. Mary and E. St. Peter Thornhill Dr. S. I. Rowntres 193 127 320 133 Barnsbury and W. St. Mary Dr. L. M. Leventon 212 143 355 106 S. St. Mary and W. St. Peter Dr. G. Madden 133 71 204 58 St. Mary, Islington, Hospital* Dr. W. R. Turtle 15 45 60 59 St. John's Road L.C.C. Institution* Dr. K. A. Anklesaria 9 12 21 638 L.C.C. Schools, Andover Row* Dr. P. J. C.MacDonnell — 18 18 — L.C.C. Children's Homes, Hornsey Rise* Dr. P. J. C. MacDonnell — 9 9 — Total 1,950 923 2,873 1,543 Archway Hospital* (since transferred, formerly Holborn and Finsbury) Dr. T. Evans, April 1st to 30th September, 1930 8 7 15 2 Grand Total 1,958 930 2,888 1,545 * Institutions. 55 [1930 Vaccinations and re-vaccinations performed by the Public Vaccinators of the Council during the portion of the year 1st April, 1930, to 31st December, 1930:— Children entered in Form H by the Vaccination Officers 1,452 Children not included in such lists, but vaccinated 430 Successful vaccinations performed at Surgery or elsewhere than at the homes of the persons vaccinated 197 Successful re-vaccinations performed at Surgery or elsewhere than at the homes of the persons vaccinated 199 Successful vaccination or re-vaccination performed at the homes of the person vaccinated or re-vaccinated 1,803 Total 4,081 DISINFECTION. Disinfection of Rooms.—4,897 rooms were disinfected, as contrasted with 4,210 in 1929. 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. The above figures also include the disinfection of houses and rooms after Tuberculosis, vide p. 46. Rooms Disinfected. 1930 1929 1st Quarter 1,450 901 2nd „ 1,420 944 3rd „ 991 974 4th „ 1,030 1,391 The Year 4,897 4,210 Work at the Disinfecting Station.—57,096 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 53,786 similar articles disinfected during the previous year. In addition to the above articles, 15,159 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 £23 19s. Od. Altogether 72,255 articles described in the two paragraphs preceding were disinfected. Since the disinfection station was established 2,405,892 large articles have been disinfected. 56 1930] Summary of the chief articles of Clothing, Bedding, etc., disinfected during the year 1930, and also in the preceding year 1929. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1930 1929 Beds 629 612 470 603 2,314 1,845 Blankets 1,501 1,433 1,125 1,356 5,415 4,617 Bolsters 575 577 465 602 2,219 1,811 Carpets 4 1 1 8 14 37 Chair Bed Cushions 51 21 39 40 151 167 Mattresses 450 397 333 373 1,553 1,417 Palliasses 23 23 8 2 61 16 Pillows 1,5l5 1,358 1,014 1,159 5,046 4,698 Quilts 708 052 462 467 2,289 2,016 Sheets 1,235 1,161 926 1,240 4,562 3,925 Other Articles 9,064 7,581 7,572 9,255 33,472 33,192 Totals 15,755 13,821 12,415 15,105 57,096 53,786 The nature of the articles disinfected for the clothing contractors is shown below:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Overcoats 303 316 51 100 770 Jackets 3 — 1 — 4 Tunics — — — — — British Warms — — — — — Other Articles 1,224 2,000 10,436 675 14,335 Bales of Horsehair 40 10 — — 50 Total 1,570 2,326 10,488 775 15,159 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 Nil. Disinfection of Premises — — — 60 Cost = £19 12s. 6d. Shelter House.—The Shelter House was occupied during the year, by two families, baths were given to 11 verminous persons, while their clothing was disinfected. Three midwives attended for the purpose of disinfection after attendance on cases of Puerperal Fever; and 59 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 5,492 (including 842 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. 57 [1930 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 £507 2s. Od. Proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, in 58 instances during the year. Of this number 34 parents were fined, when penalties ranging from 3s. to 10s. were inflicted. The total fines received amounted to £12 18s. Od. 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 1930. Inspections and Visits.—The inspections and visits made by the three Inspectors were as under:— Factories, including Factory Laundries 746 Workshops, including Workshop Laundries 887 Workplaces, other than outworkers' homes 432 Domestic Workshops 36 Bakehouses 334 Restaurant Kitchens (see also p 78) 479 Outworkers' premises 1,108 Miscellaneous re-inspections and calls 5,137 Total 9,159 Notices Served —In consequence of the 1,184 sanitary defects discovered as the result of the inspections above, 314 intimations and 22 statutory notices were served. Of these notices 103 were served, on the owners of factories, 158 on the owners of the workshops and workplaces, and 32 on the owners of bakehouses and 35 of restaurant kitchens. In addition to these nuisances, 106 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 all cases, with £2 2s. Od. fines and £2 2s. Od. costs. Registers.—There were 2,552 workshops on the Registers, as contrasted with 2,507 in 1929, while the total number of workrooms were 3,588, as compared with 2,530 in the previous year ; 182 workshops were added to the Registers, while 128 were removed from it. 58 1930] The various workshops and workplaces arc tabulated as below:— Workshops and Workplaces. 1930. Total Workshops on Register. Total Workrooms on Register. Number added during Year. Number removed during Year. Workshops where Men are employed 1,174 1.814 101 72 Workshops where Women arc employed 572 877 41 32 Laundries 41 55 — — Bakehouses 235 247 1 1 Restaurant Kitchens 461 526 25 10 Other Workplaces 69 69 11 13 Total 2,552 3,588 182 128 Outworkers' Premises 3,371 — 360 317 Workshops Notified to Home Office during Year 1930. Trade. Number of Workshops. Women. Male Young Persons. Totals. Dressmaking 11 45 — 45 Polishing 1 1 — 1 Jam Making 1 9 — 9 Tailoring 2 5 — 5 Millinery 1 3 — 3 Lavender Novelties 1 7 — 7 Embroidery 1 1 — 1 Furrier 4 9 — 9 Ties 1 1 — 1 Mantles 5 10 — 10 Artificial Florist 1 11 — 11 Children's Frocks 1 2 — 2 Upholstery 1 1 — 1 Confectionery 1 1 — 1 Total 32 106 — 106 INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. WrittenNotices Prosecutions. (1) (2) (3) (4) Factories 746 103 5 (Including Factory Laundries) Workshops 887 89 — (Including Workshop Laundries) Workplaces 1,281 101 — (Other than Outworkers' premises) Miscellaneous Re-Inspections and calls 5,137 — — Total 8,051 293 5 59 [1930 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 Arts*— Want of cleanliness 364 370 — — Want of ventilation 19 16 — — Overcrowding 4 4 — — Want of drainage of floors 12 11 — — Other nuisances 349 337 — 5 Sanitary Accommodation insufficient 36 34 — — unsuitable, foul or defective 382 379 — — not separate for sexes 12 9 — — offences under the Factory and Workshop Arts— Illegal occupation of underground bakehouse (s. 101) — — — — Other offences — — 3 — (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.) Total 1,178 1,160 3† 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. †41 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) 94 20 94 Nil Outwork in infected premises (s. 109, 110) 12 — 12 — Total 106 20 106 Nil OUTWORKERS' LISTS (s. 107) : Lists received from Employers 1,204 Addresses received from Other Councils 1,903 Addresses forwarded to Other Councils 849 Firms failing to send in lists (No. letters sent) 341 OTHER MATTERS. Number.[/####] Matters notified to H.M. Inspector of Factories : Failure to affix Abstract of the Factory and Workshop Act (s 133, 1901) 41 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5, 1901). Notified by H.M. Inspector 16 Reports (of action taken) sent to H.M Inspector 16 Other (New Factories reported under Home Office Memorandum, 1912) 9 Underground Bakehouses (s. 101) in use at the end of the year. 76 60 1930] OUTWORK IN UNWHOLESOME PREMISES. SECTION 108. ature of Work. Instances. Notices served. Prosecutions. (1) (2) (3) (4) Wearing Apparel- Making, &c 24 7 Nil Cleaning and washing — — — Household linen 1 1 — Lace, lace curtains and nets — — — Curtains and furniture hangings 2 — — Furniture and upholstery — — — Electro-plate — — — File making — — — Brass and brass articles — — — Fur pulling — — — Cables and chains — — — Anchors and Grapnels — — — Cart gear — — — Locks, latches and keys — — — Umbrellas, &c. 3 1 — Artificial flowers 9 1 — Nets, other than wire nets — — — Tents — — — Sacks — — — Racquet and tennis balls — — — Paper. &c., boxes, paper bags 23 7 — Brush making 2 2 — Fea picking — — — Feather sorting — — — Carding, &c., of buttons, &c. — — — Stuffed Toys — — — Basket making — — — Chocolates and sweetmeats — — — Cosaques, Christmas Crackers, Christmas stockings, &c 9 1 — Textile weaving — — — Lampshades 1 — — Total 74 20 Nil SHOPS.—GENERAL INVESTIGATION AS REGARDS CONDITIONS, WITH SPECIAL REFERENCE TO SANITATION, VENTILATION, Etc., WHICH MAY AFFECT THE HEALTH OF THE EMPLOYEES. In reference to an enquiry by the Home Office in certain selected London boroughs with the object of getting a general idea of the conditions of shops in the metropolis, the Public Health Committee (Islington being one of the selected boroughs), gave permission for the Medical Officer of Health to utilize the services of the two women Inspectors and the Food and Drugs Inspector to enable him to summarise Islington. The main question of hours of employment, half-day closing, etc., was undertaken by the London County Council as the appropriate authority, but sanitation and the health conditions generally were done by the Health Departments of the Borough Councils concerned. Eighteen trades, including wholesale shops, were selected, ten of each being visited, making a total of 180. The report is as follows:— Shops Inquiry.—Conditions, Sanitation, Ventilation, Etc. The general impression from the visitation is that the hours are long, especially tobacconists, confectioners, and a little less so, greengrocers, fruiterers, fishmongers, provision merchants, and especially cooked meat and food shops, but not butchers. It was found that some of the confectioners who do not employ outside assistants do not close until a very late hour—11 p.m. or midnight. 61 [1930 In certain localities, such as Upper Street, Holloway Road, St. James's Road, Caledonian Road, Essex Road, and practically the whole of the poorer part of the Borough, Sunday trading (8 a.m. to 2 p.m.) is carried on, and is increasing. Only the very large businesses close on Sunday. Practically everything can be bought on Sunday; ironmongery, drapery, food, etc. There appears to be a general feeling that there should be compulsory closing on Sunday; the necessity for keeping open is purely competitive. As regards work carried on when shops are closed for selling, this was found to prevail among provision dealers and grocers, but those so employed are limited to the Manager and senior employees, who work about 1½ hours extra per day, finishing orders and clearing up. The extra time was not considered a hardship in view of the general consideration shown by the firms. In connection with special trades it was noticed that chemists have no clear half-day early closing day, as they dispense medicines on the evening of the early closing day, and morning and evening on Sunday. There appears to be a bad rota arrangement on the matter, which could be quite simply remedied in such a trade by mutual agreement for fewer shops, well distributed, to open. Generally speaking, in Islington the premises and hygenic conditions are good. Some shops are extremely cold in winter, owing to perishable goods being dealt with, or the nature of the stock. Heat is not provided except occasionally. In some, a radiator in the cash desk or a fire in the parlour behind is provided. The businesses thus involved—cold—are butchers, confectioners, cooked meats, tripe shops, dairies, tobacconists, fishmongers, greengrocers, provision dealers, fruiterers. Lighting on the whole is good. The sanitary condition was generally satisfactory, but in small businesses only one w.c. was provided for both sexes. If the proprietor lived on the premises, and this was the domestic w.c., the accommodation was clean and well looked after, and the arrangement was more satisfactory than where the proprietor was non-resident. In roughly half of the cases small mess accommodation was permitted in, say, a kitchen with gas stove, cookers to make their food hot if employees brought it in, and a chair or chairs and table. In the majority of cases there was no retiring room or separate room for eating. Heating usually done by a gas ring in the room. The kitchens, on the whole, were fairly clean, but not bright. Much improvement could be effected in making these more attractive. With few exceptions, cloak rooms, as such, were not provided, and there were very few retiring rooms for female assistants. If the proprietor lived on the premises, if the female hands did not feel well they used the house rooms. Personal washing arrangements; in most cases good provision was made and generally satisfactory. Seats.—In roughly about one quarter of the cases, although seats were provided and the Shop Hours Act " observed," the assistants were not encouraged to use the seats. Heavy weight lifting. 6 per cent. (e.g., two cwt. sacks of potatoes, sugar, etc.). Mostly in greengrocers, grocers, butchers, and in a few cases, dairies (churns, etc.). General Welfare Arrangements.—Not one firm had these arrangements, or a woman employed. In about half (46.6%) ambulance box provided. 62 1930] In one large multiple food firm, staff exceedingly well looked after; also, in large multiple dairies, conditions good. In a large drapery firm, subsidiary to a well-known West-end establishment, from the business and commercial point of view, everything appeared to be very much up-to-date, and one would have expected that the " living-in " accommodation would also have been in keeping. The hostels, however, were found to be very depressing; while the rooms were clean and accommodation as regards space adequate, the interior environment and appointments were distressing—three women in one room, no partition, no privacy ; two in other rooms, a chest of drawers shared by all the room occupants, no cupboards for the clothes, which had to be kept in boxes. No food was provided at the hostels ; during the week the restaurants of the business were available, but on Sundays there was no provision. In a firm of such standing the lack of interest in the hostel arrangements was difficult to account for, and unexpected. Generally speaking, in Islington it could not be said that the proprietor or the manager, as was the case in most shops, was indifferent to the health of the employee, in fact, in about half the places visited it was found that interest was taken, but with this proviso, that the interest was greater in the smaller type of shop, and tailed off until one came to the very large establishments. In some of these there was a very exceptionally energetic and real interest taken in the employees, but in the rest, as the size of the business increased, the real personal touch and interest in the employees waned. Some further examples.—In another establishment it was found that there were no facilities offered for food at a cheap rate, and the manager admitted that if his employees went outside and took a meal at the Co-operative Stores, and it became known, their positions would be imperilled. (Some examples in regard to sanitary conveniences, welfare, etc.).—At another firm : Three men, two women. One w.c. at the end of small passage in the yard. No accommodation for cooking, no heating. Small lock-up shops, conditions not good. One or two cases they used the public conveniences. In some cases the employers argue that there is free accommodation provided in the public conveniences and therefore they do not refund any payments for such use made by the employees. Girls complained very much of the inconvenience in having to go down to the Porters' room of the railway to get water. An employee spoke very highly of the way the porters and others treated her, but she had, of course, to go to the public convenience opposite; she had to pay because she did not care to use the free w.c. She, however, spoke highly of the firm. Two shops—one fruiterers. Have about four men and five girls; all have to use the public convenience. Small sink in shop. One shop, main thoroughfare. Employees have to use public conveniences and have to go about 200 yards. There appears to be a tendency to economise on the accommodation provided for welfare of the staff, particularly in not providing " brightness." The contrast between the shop proper and the accommodation provided for the assistants who run the shop is most marked. Assistants complained of having the shop door open summer and winter, but if shut there is a great decrease in the day's takings; this is undoubtedly a recognised fact, 63 [1930 Tobacconists' shops have no definite lunch hours. Assistants have to take their meals in between serving customers. Not allowed to leave the premises until closing time. In one multiple firm (Food).—Very prominent notices displayed on lavatory doors drawing attention of employees to the provision of washing facilities. In some of the other places there was a lack of towels and soap, but this was not general. Employees sometimes brought their own. About 15 per cent, of lock-up shops mostly, were served by a " Towel " firm. Summary of Statistics re Special Investigation of Shops. Class. In the main the shops were of the middle and artisan class. Ventilation.—Good, 68.5%. Moderate, 29.4%. Bad, 2.1%. On the whole the ventilation was good. In the majority of cases in which it has been classed as moderate, the fault was draughtiness, causing discomfort to shop assistants. This could be obviated by closing the doors, or shop front being enclosed. Overcrowding. The only instance of this was in a wholesale grocery establishment. Space taken up with stock. Heating.—Good, 37%. Moderate, 25%. Bad, 38%. The high percentage shown under the third heading was due to the business carried on at the premises concerned, e.g.:— Good. Bad. Moderate. Butchers — 90% 10% Fishmongers — 90% 10% Greengrocers — 90% 10% Cooked meats — 80% 20% Grocers — 90% 10% Tobacconists 10% 40% 50% Dairies 20% 70% 10% Lighting.—Good, 61.1%. Moderate, 38.9%. Conditions were generally good. Where the lighting was found to be moderate, classification thus was due, not to insufficiency, but to glare. Sanitary accommodation.—Satisfactory, 87.3%. Unsatisfactory, 9.4%. None, 3.3%. In eight of the unsatisfactory instances, the conditions were due to one w.c. being used by both sexes. Where no accommodation was provided, in every instance the premises were newly built lock-up shops, and the assistants had to make their own arrangements. Mess rooms.—Good, 23.6%. Moderate, 24.7 %. None, 51.7%. In the majority of shops visited no special provision was made for the staff to have meals on the premises, and in most instances where the provision was good, it was found that the staff were permitted to use the domestic rooms of the proprietor. This obtained in small shops only. Cloak rooms.—Provided as such, 8.4 %. Other provision, 91.6%. (Pegs, cupboards, etc.). In no case was it found that assistants were without some provision in this respect. 64 1930] Drying clothes.—Good, 38.4%. Moderate, 18.4%. None, 43.2%. The premises where no provision for drying clothes was available coincided with those in which no heat was provided owing to the nature of the business. Retiring (Rest) Room. In fourteen trades (140 cases) no retiring room was provided. In the remaining five (50 cases) some provision was made, but in only two out of 140 cases, i.e., 1.4%, could it be called adequate, Washing.—Good, 66.3%. Moderate, 29.4%. Bad (Roller or insufficient towels, etc.), 4.3%. Some provision for personal washing was made in every case. The moderate conditions were chiefly due to inadequate provision of towels and the dirty condition of same. The trades most affected were:— Good. Moderate. Bad. Wholesale 50% 40% 10% Cooked meats 50% 40% 10% Tobacconists 30% 50% 20% Hardware 40% 50% 10% Grocery 50% 40% 10% Dairies 70% 30% — Greengrocers 30% 60% 10% Fishmongers 60% 40% — It will be seen, therefore, that greater care should be enforced, having regard to the number of food shops which figure in the above list. Seats.—Provided, 59.4%. Not provided, 27.3%. Not used, 13.3%. No comment is needed here, except to say that hardship is caused to those assistants who are not allowed to use the seats provided. Welfare arrangements. In no case was it found that a Welfare Worker, as such, was provided. In approximately 50% of the premises visited it was found that either the proprietor or manager took some interest in the welfare of the staff. In the remainder it could not be said that any interest was taken. The larger shops were the most inconsiderate in this respect. First aid. In 46.6% cases only of the premises visited first aid equipment was provided. " Living-in." In five cases, where the staff numbered over five assistants, did the assistant} live on the premises. In four of these cases the conditions were found to be good. In addition to the above, there was a number of instances in which an only assistant lived with the proprietor's family. Conditions, in these instances, were invariably good. Hours. On the whole, the hours were long, particularly with regard to confectioners, tobacconists, cooked meats and chemists. Sunday Trading. This appears to be on the increase, and in the majority of instances is quite unnecessary. The most outstanding trades were confectionery, tobacconists, dairies and chemists. 65 [1930 Meal times, Holidays and Sickness. Enquiries were made under these headings, and it was found that in approximately 75% of the premises visited proper time was allowed for meals, also some holidays given, with pay, and illness paid for, less Insurance benefit, but in other cases it was found that little or no arrangement existed for these matters, and that meals were even taken sometimes in the interval of serving customers. This investigation was carried out by the two women Inspectors of Workshops and the Inspector for Food and Drugs and it is agreed that conditions do not compare favourably with factories, etc., where legislation obtains. G. Clark Trotter, Medical Officer of Health. Town Hall, Upper Street, Islington, N.l. October 15th, 1930. 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 1930 the following extensions or improvements have been effected:— (1) Street sweeping. No material alteration has taken place with regard to the mileage of streets swept during 1930 as compared with the previous year. (2) A further " Dennis " Gully Emptying vehicle was purchased and put into commission during the year, making the number of mechanical vehicles now engaged on gully cleansing and flushing four. (3) Up-to-date hygienic bodies having patent shutter covers were fitted to two electric refuse-collection vehicles, whereby the work of collection by these vehicles is renderd practically dustless. Further vehicles are gradually being converted into the dustless loading type. (4) The method of refuse collection is on the same principle as for the past few years. During 1930 81% was collected by mechanical vehicles and 19% by horses and vans. (5) The material is sent, as formerly, to contractors' dumps at Blacbridge and Holwell Hvde. Hertfordshire, where it is teated in accordance with the Ministry of Health recommendations. (6) The arrangements for the collection and disposal of the refuse are generally satisfactory, and compare favourably with those which exist in other Boroughs. REMOVAL OF DUST. 40 applications were received during the year by the Public Health Department for the removal of dust, which is double the number recorded last year. 66 1930] The applications received for the previous ten years were as follows:— 1920 36 1925 21 1921 21 1926 20 1922 15 1927 25 1923 16 1928 25 1924 33 1929 21 Dust Receptacles Provided.—During the year 1,275 dust receptacles were provided. NUISANCES BY DOGS. On occasion we still receive requests for copies of the poster approved by the Public Health Committee in 1925 in reference to the fouling of the footways bydogs. On the 19th July, 1930, the new bye-law made by the Borough Council came into force:—" No person being in charge of a dog in any street or public place and having the dog on a lead shall allow or permit such dog to deposit its excrement on the public footway. Any person offending against this bye-law shall be liable to a penalty not exceeding forty shillings." DISTRICT INSPECTORS' WORK. During the year the fourteen district inspectors made a total of 54,003 inspections and calls, a decrease of 1,890 inspections on the corresponding period of 1929; while 12,069 improvements were effected in 5,474 premises; as against 13,356 improvements in 5,492 premises for the preceding year. Synopsis of Inspectors' Work.—The following statement gives a brief synopsis of the district inspectors' work in 1930 :— House to house inspections 3,280 Other inspections of dwelling houses 2,652 Re-inspections and calls made 46,092 Visits of inquiry re notifiable infectious diseases 3,836 Butchers'shops, stalls, etc. (Saturday nights) 61 Ice cream shops and factories 121 Dairies and Milkshops 702 Stables and yards 537 Urinals attached to Public Houses 215 Smoke observations 128 Notices Served.—There were 4,604 intimation notices served by the inspectors with respect to nuisances. In 584 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.—103 rooms which were found to be in a verminous condition were fumigated. In 18 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 sale 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. 67 [1930 Smoke Nuisances—93 complaints of smoke issuing from factory chimneys in the Borough were investigated, and as a result 128 observations were made by the District Inspectors, and 18 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.—Four water certificates were granted in accordance with the provisions of sec. 48 (2) Public Health (London) Act, 1921, in respect of 152 separate tenements newly erected or rebuilt during the year. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1928. MERCHANDISE MARKS ACT, 1926. All the Sanitary Inspectors are officially appointed for this work. The special inspections for this particular duty under the Merchandise Marks Act and under the Agricultural Produce (Grading and Marking) Act, numbered 367. Under the Agricultural Produce (Grading and Marking) Act, certain articles were added to the list which may be graded and marked. At the end of the year regulations were in force applicable to apples and pears, beef, broccoli, canned fruits, peas and beans, cherries, cider, dressed poultry, eggs, glass-house grown tomatoes and cucumbers, malt flour and malt extract, potatoes, strawberries, wheat flour. No applications were received during the year for registration for cold storage or chemical storage of eggs. The Orders in force under the Merchandise Marks Act at the end of the year were in respect of honey, fresh apples, raw tomatoes, currants, sultanas and raisins, eggs in shell, and dried eggs, oat products, malt products. One fruiterer was prosecuted for exposing for sale imported fresh apples not bearing an indication of origin, and was ordered by the Magistrate to pay the costs. The Merchandise Marks Act so far as costermongers are concerned is found difficult to enforce. The Inspector, as often as not, is met with the plea of real or assumed ignorance. The number of comparatively young persons in these days of improved education who state that they cannot read or write and who plead ignorance of the difference between Colonial and Foreign is amazing. It is practically impossible to get from these costermongers their proper names and addresses. If such are presumably given, they are untraceable at the alleged address. The Police have the same difficulty, the barrow is generally a hired one, and the owner of the barrow point blank refuses to give any information, or pleads ignorance as far as the name of the hirer is concerned when asked. This, of course, applies to the itinerant vendor and the vendor within an enclosed or private area. The stationary vendor in a public thoroughfare has of course to be registered with the local licensing authority as a street trader. Repeated warnings have been verbally given to the former class without much effect, and it would appear that to make these warnings effective some further powers regarding compulsory exhibition of the name and address is necessary. 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 1930. 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, 68 1930] Summary of Sanitary Work from Inspectors' Reports for the year 1930 Districts. Totals 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 221 419 219 253 157 198 155 109 358 223 236 273 198 271 3290 Other premises inspected 202 187 135 296 139 108 237 173 102 200 251 255 171 196 2652 Re-inspections, Calls made, etc. 2868 3865 3516 3957 2314 3777 2373 2591 2899 3367 4054 3538 4066 2907 46092 Ice Cream Premises inspected — 19 35 11 2 26 2 3 2 5 8 5 1 121 Dairies and Milk Purveyors inspected 11 55 115 65 39 75 61 8 16 63 61 87 11 35 702 Stables „ 5 4 4 1 14 7 2 1 — 1 — 3 — — 42 Yards „ 8 15 78 3 331 7 14 — — 16 3 13 1 6 495 Agricultural Produce (Grading and Marking) Act, 1928 — — — — 15 1 — — 2 — — 8 — — 26 Merchandise Marks Act, 1926 — 20 1 13 — 3 — — 4 — — 1 3 — 45 Urinals attached to P.H.'s inspected 1 23 102 4 3 35 18 3 3 16 4 2 2 — 215 Premises (re Certificate Customs and Inland Revenue Acts) inspected. — — — — — — — — — — — — — — — Premises (re Water Certificates) inspected — — 92 2 — — — 1 — — — — — — 95 Rag and Bone Dealers 2 4 1 1 — — 1 — 8 — — 15 — 4 39 Rag and Flock Act — — — — — — — — — — — — — — — Smoke observations — 3 17 24 22 4 21 14 4 2 — 6 10 1 18 Shops, Stalls and Markets (Saturday evening) 5 5 5 5 6 5 2 1 5 4 5 3 5 5 61 Total Inspections and Calls 3323 4619 4320 4635 3042 4246 2886 2904 3403 3896 4625 4209 4469 3426 54003 Notices Served. Intimation Public Health (London) Act, 1891 176 527 250 553 93 370 219 183 366 430 409 447 202 348 4573 Housing Acts 2 10 3 1 1 — — — — — — 1 — 3 21 Ice Cream Shops — 2 — 2 — — — — — — — — — — 4 Dairies, etc. — 1 1 1 — — — — — — — 3 — — 6 Statutory Public Health (London) Act, 1891 13 116 24 68 5 43 24 27 42 63 49 67 20 19 580 Housing Acts — — 2 — — 1 — — — — — — — — 3 L.C.C. (General Powers) Acts — — — — — — — — — — — — — 1 1 Improvements. Drains— Constructed 2 — — — — — — — — 1 — 3 — — 6 Re-constructed 10 15 3 1 3 8 1 — 8 — 5 — 1 68 Repaired 19 27 17 24 5 10 4 4 8 9 24 6 4 4 164 Ventilated 1 35 11 10 1 7 5 4 — 15 4 2 2 — 107 Gully and other traps fixed 29 47 28 8 4 9 9 13 1 17 3 6 3 — 177 Urinals— Water supply—cleansed — 5 2 — — — — — — — — — — 10 Water Closets— W.C. erected with pan, trap and water supply 6 2 3 — 1 — 2 — — 5 2 1 3 — 25 Pan and trap only provided 32 42 59 54 5 32 33 35 14 59 31; 17 5 17 441 Flushing apparatus repaired 21 30 32 42 2 37 21 16 20 14 40 15 16 17 323 Ventilated 1 2 3 2 — 1 — 2 — 1 — — — — 12 Walls, etc., cleansed 5 13 4 17 1 8 6 1 1 15 22 6 2 13 114 Position altered — — 2 — — — — — — — — — — — 2 Dust Bins provided 99 110 56 188 14 110 116 76 93 131 117 61 20 85 1276 Areas paved 1 3 2 2 2 — 1 — 1 6 — 1 1 — 20 Yards paved or repaved 14 41 18 70 8 11 11 4 13 27 20 13 3 5 258 Sinks Provided 8 44 18 9 4 10 14 7 3 12 16 4 1 3 153 Waste pine repaired 1 39 27 54 3 20 S 10 15 56 6 18 6 12 291 Domestic Water Supply— Cisterns repaired and cleansed 4 15 8 13 1 9 2 4 6 8 7 3 — 1 81 Water supply provided to dwelling house — — 2 3 — ] — 1 2 2 — 1 — — 12 Water supply provided to tenement house — 35 2 11 1 8 1 1 16 6 10 1 1 3 96 Walls and ceilings of Rooms cleansed and redecorated 110 369 148 556 61 297 176 131 244 371 508 238 151 285 3645 Carried forward 69 [1930  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 26 85 23 96 12 51 31 13 42 69 80 43 28 67 666 Floor space ventilated 3 25 6 5 — 2 — — 2 18 10 3 — — 74 Floors repaired 15 37 9 37 2 23 8 6 32 24 37 29 8 15 282 Guttering and rain water pipes repaired 29 55 23 76 12 47 35 14 17 63 38 25 24 10 468 Roofs repaired 47 128 77 239 11 133 83 39 98 133 155 87 73 63 1366 Overcrowding abated 1 1 4 2 — 4 4 — 1 4 4 5 1 1 32 Illegal use of underground rooms for sleeping discontinued — — — 1 — — 1 — — 1 4 3 4 1 15 Other improvements, or Nuisances abated 29 65 37 111 13 68 45 15 34 72 122 50 20 45 726 Rooms Disinfected 304 5 159 213 34 31 17 3 12 247 6 103 10 1160 Total improvements 842 1275 794 1848 180 935 655 414 666 1159 1513 651 479 658 12069 Total premises improved 476 455 469 791 76 396 335 216 275 409 760 261 280 275 5474 HOUSES LET IN LODGINGS. The houses which come under the operation of the bye-laws received 557 inspections during the year, followed by 1,967 subsequent re-inspections and calls, so that the total visits amounted to 2,514. These inspections resulted in 469 intimations being served on the persons responsible, which were followed by 28 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 1,746 improvements were effected in 686 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 4 Repaired 31 Ventilated 1 Gully and other traps fixed 10 Water Closets: W.C. erected with pan, trap and water supply 6 Pan and trap only provided 7 Water supply provided 69 Ventilated 9 Walls, etc., cleansed 44 Position altered — Dusr Bins : Provided 69 Repaired 5 Areas : Constructed 8 Paved 7 70 1930] Yards: Taved — Repaved 38 Sinks : Provided 8 Waste pipe repaired 6 Domestic Water Supply: Cisterns provided — Cisterns repaired and cleansed 6 Water supply provided to dwelling house 3 Water supply provided to tenement house 1 Walls and Ceilings of Rooms cleansed and redecorated 669 Other Improvements : Staircase and passages repaired, cleansed and redecorated 116 Floor space ventilated 2 Floors repaired 36 Guttering and rain water pipes repaired 34 Roofs repaired 139 Overcrowding abated — Illegal use of underground Rooms for sleeping discontinued — Other Improvements, or Nuisances abated 438 Rooms Disinfected — Total Improvements 1746 Total Premises Improved 686 SEWER EMANATIONS. In reference to the report on sewer emanations on page 60 of the Medical Officer of Health's Annual Report for 1929 and the representations then made to the London County Council, a report of the Main Drainage Committee of the London County Council, dated the 15th May, 1930, states that it is considered desirable that the London County Council should conduct experiments in regard to the ventilation of the sewers, these experiments to ascertain the effects of suction fans in one or more of the existing brick ventilating shafts or other shafts erected on suitable sites for the purpose. 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. The Public Health Committee having sanctioned the necessary expenditure, 300 large posters were exhibited throughout the Borough during Rat Week directing attention to the fact of disease being spread by rats and mice, the cost of the damage done by these pests, as well as the large increase in their number when no destructive action is taken. The poster also dealt with the protection of food, the removal of garbage, rat-proofing, and the various methods for destruction of rats and mice; also a cordial invitation was given to those interested to call at the Town Hall or to write to the Medical Officer of Health for advice. During the week the Ministry of Agriculture's leaflet No. 244 was distributed gratis, and as in former years transparencies were exhibited in the Town Hall. 71 [1930 Summary of Work under the Rats and Mice (Destruction) Act during the years 1923-30:- 1923* 1924 1925 1926 1927 1928 1929 1930 Number of Streets visited 544 91 96 217 235 203 144 166 Number of Private Houses visited 650 176 133 320 368 349 223 387 Number of Shops and Factories visited 712 19 14 61 81 56 36 37 Total Premises inspected 1,362 195 147 381 449 405 259 424 Found Rat Infested 787 61 66 174 191 154 101 142 Found Mice Infested 66 1 2 5 8 2 4 3 Defective Drains Repaired (Cause of Rat trouble) 13 60 51 49 48 49 23 45 Number of Complaints received 67 118 105 173 202 150 124 176 * Appointment of temporary Rat Officer terminated 15th June, 1923. HOUSING. The representation made by the Medical Officer of Health on the 5th April, 1929, under the Housing Act of 1925, then in force, in reference to a portion of the south side of Georges Road and a rectangular area bounded on the south by Georges Road and the east by Hope Street, on the north by Eden Grove and on the west by that part now called Eden Grove which was formerly termed Grove Street, has not so far materialised. The area was dealt with at some length in the Medical Officer of Health's Annual Report for 1929. It is understood that some action has been taken by the London County Council as regards the purchase of some of the properties in the area, and that the area itself may be dealt with when certain difficulties have been overcome. In regard to the Housing Act of 1930, sections 25 and 31, during the year the Borough Council were negotiating with the Marquess of Northampton for the purchase of a site in the Borough comprising 1¼ acres, for the purpose of a housing scheme on which it is proposed to erect 92 dwellings. On the site of Nos. 27 and 28, Canonbury Villas, when the lease expires in September, 1932, it is contemplated to erect 8 flats. In regard to clearance areas, improvement areas, and individual houses in the Borough which may require to be demolished, it was not found possible to undertake a survey towards the end of the year under review, and such was left over for 1931. HOUSES UNFIT FOR HUMAN HABITATION.—CLOSING ORDER. The Medical Officer of Health in April reported on Nos. 15, 19 and 21, Maygood Street. A survey had been made of these premises and a schedule of the dilapidations, both internal and external, was prepared, and the following representation was made:— Town Hall, Upper Street, N.l. Ist May, 1930. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington. I beg to make representation as the result of visitation of the dwelling houses 15, 19 and 21, Maygood Street, that these dwelling houses are in a state so dangerous or injurious to health as to be unfit for human habitation, and I ask that the Local Authority shall make, a Closing Order prohibiting the use of the 72 1930] houses specified for human habitation until, in the judgment of the Local Authority, the houses are rendered fit for that purpose. I herewith append a detailed description of the houses and their appurtenances. Your obedient Servant, G. Clark Trotter, M.D., D.P.H., F.R.S.E. Medical Officer of Health, Metropolitan Borough of Islington. At the beginning of September the Medical Officer of Health was able further to report that the Closing Orders made by the Borough Council on the 16th May, 1930, had been complied with. All the premises were demolished by the owner. RE-CONDITIONING OF HOUSES. Notices were served under section 17 of the Housing Act of 1930 in respect of a dwelling house in Caledonian Road. As the Council was satisfied that the house mentioned was occupied or was of a type suitable for occupation by persons of the working classes and was unfit for human habitation, notices were served on the owner of the property in respect of the particulars, which were set out in a separate schedule. This notice involved the sending out of four other similar notices to interested parties according to the requirements of the Act. The work was not completed at the close of the year, and falls to be reported on finally later. Summary of Housing from 1919 to 1930 (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 1929. Total since 1930 1919. Number of houses or flats provided by the Islington Borough Council 745 152 897 Number of flats provided by the London County Council 371 nil 371 Number of houses or flats provided by private enterprise 352 1 353 1,468 153 1,621 Particulars of houses or flats provided under the Council's Housing Schemes 1919 to 1929. 1930. 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 Avenell Mansions — 40 40 Leyden Mansions — 111 111 435 586 *Conversion of 16 houses into 61 dwellings 1 62 Tyndale Mansions 102 — 102 Laycock Mansions 132 — 132 Houses, etc., Highbury Station Road 15 — 15 745 152 897 *Includes :—27, Rupert Road 8, Barnsbury Street 27 and 25, Canonbury Villas 2, Highbury Grange Not converted 73 [1930 The number of overcrowding cases recorded as dealt with by service of notice during the years 1921 to 1930 was:— 1921 6 1922 10 1923 17 1924 13 1925 19 1926 26 1927 24 1928 37 1929 21 1930 32 Total 205 40 others were dealt with by housing recommendations to L.C.C. HOUSING RECOMMENDATIONS FROM THE PUBLIC HEALTH DEPARTMENT. During the year 1930, recommendations were made to the London County Council regarding housing accommodation for " special hardship " cases. In all, 89 were recommended for special consideration. The basis on which these recommendations were made consisted of families living under overcrowded conditions, but in a number of cases ill-health of members of the family was the main reason for the support given to enable them to receive favourable consideration of their efforts to secure better housing conditions. Of the 89 cases recommended by the Medical Officer of Health, 40 of which were given on account of overcrowding, during the year:— 45 were provided with accommodation by the London County Council. 14 removed to an unknown address. 10 secured better accommodation in Islington. 20 still remained in their Islington occupation. In addition to these 89 cases in which a " special hardship " recommendation was given, several investigations were made into cases brought to the notice of the Medical Officer of Health which called for much sympathy, but which fell short of the standard of " hardship " laid down, namely, gross overcrowding, ill-health of members of the family, and the difficulty of the separation of the sexes. In some of these cases a recommendation was given for consideration should there be any spare accommodation apart from that allocated for " special hardship " cases. Since the scheme was inaugurated in January, 1929, the total number of " special hardship " recommendations given is 140. WATER SUPPLY. Number of houses which have not an adequate internal water supply, i.e., water supply from taps only. (a) In yard, 136. Premises on which notices have been served under the London County Council (General Powers] Act, 1907 (Additional Water Supply), 95. 74 1930] DEMOLITION OF HABITABLE DWELLINGS. During the year 54 houses have been demolished. Of this number, 11 in Hanover Street were required for an L.C.C. School, the remaining 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).) 152 (b) With State assistance under the Housing Acts. (i) By the Local Authority Nil (ii) By other bodies or persons Nil Unfit dwelling-houses. Inspection— (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 5,942 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 1,442 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 1,818 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 870 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 3 (2) Number of dwelling-houses which were rendered fit after service of formal notices— (a) By owners 24 (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 4,604 75 [1930 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 4,601 (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 1 (2) Number of dwelling-houses in respect of which Closing Orders were made 3 (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 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 8 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 1930 68 2 27 2 99 Totals 1,102 113 162 23 1,435 INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Food—Inspection of.—Inspector Wilkinson reports that during the year he has paid 716 visits to the 13 Slaughter Houses now on the register, including one Horse Slaughter House, and that he has ascertained that 9,203 animals were killed therein, namely, 313 oxen and cows, 21 calves, 5,150 sheep and lambs, and 3,719 horses for human consumption, these latter being entirely for export. The 76 1930] 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 TUBERCULOUS MEAT. One butcher stallholder at the Metropolitan Cattle Market was prosecuted under Sec. 47 Public Health (London) Act, 1891, for exposing for sale Tuberculous Beef which was seized and accounted for in the Annual Report, 1929, the summons not being heard until 17th January, 1930, when the defendant was fined £10 and £5 f>s. Od. costs. SALE OF FOOD ORDER, 1921. One prosecution was taken for exposing for sale imported meat not properly labelled. The defendant was fined £8 0s. 0d. and ordered to pay £1 1s. 0d. costs. PUBLIC HEALTH (MEAT) REGULATIONS, 1924. A prosecution was taken for exposing meat for sale from a stall not suitably covered over and screened at the sides and back, and the defendant was fined £1 0s. 0d. and £2 2s. 0d. costs. CERTIFICATION OF MEAT FOOD PRODUCTS FOR SHIPMENT ABROAD. The Medical Officer of Health, as Designated Officer for Food Certification, issued 44 certificates in respect of foods prepared in Islington and exported abroad and to the Dominions. UNSOUND 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 — 5 1 24 Hsh surrendered in unsound condition — 4 — 14 Tinned Fish and Fruits (Blown) — 2 1 24 Decomposing Meats and Rabbits surrendered — 1 — 10 25i Boxes of Chocolates — — 3 13 Tomatoes and various Fruits 1 11 — 20 Total 2 5 — 21 The total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 2 tons 5 cwt. 21 lbs. The diseases which affected animal food are set out in detail on page UNSOUND CHOCOLATES GIVEN AS PRIZES. Just towards the close of the year under review—which ends on the 3rd January, 1931—the department had a complaint from a lady who with her child had attended one of the large season entertainments in a public hall in the Borough, and the child had received a ticket for a prize in a so-called competition. Amongst the prizes available, which were distributed from a certain stall indicated on the ticket, were boxes of chocolates, and naturally the mother preferred the chocolates to any other prize for her child. This large box of chocolates was taken home and to the bitter disappointment of the child when it was opened the chocolates were found to be mouldy and unfit for eating. An investigation was immediaely commenced and an endeavour was made to purchase chocolates at the stall; but they 77 [1930 were not for sale, only given away as prizes. It transpired from the cross-questioning of an attendant that apart from this complaint we had received, someone else had also complained. A thorough examination was made of the whole of the stock of chocolates, with the result that 251 of the boxes were found to be unsound. In the circumstances, as they had not been sold and no chocolates were being sold from the stall, action could not be taken under the Public Health (London) Act, 1891, as the chocolates could not be considered as exposed or deposited for sale under section 17. The unsound chocolates, 251 boxes, weighing 3 qrs. 13 lbs., were surrendered and destroyed. It was stated by the owners that they had not examined them recently to see if they were all right, and an excuse was made that they had been stored in a cellar at a seaside place. The fact that no apparent investigation was made, even when as we ascertained a complaint had been made, showed that the stall attendant, if not actually the owner, had been, to say the least, indifferent. Cases have been known, I believe, in other towns where " unsound " shellfish from a polluted source have been given away to customers and no action could be taken as the particular shellfish were not sold. This is even more dangerous than chocolates, but even mouldy chocolates are injurious, especially to children. The matter latterly has come before the Standing Joint Committee of the Metropolitan Borough Councils. Shops, etc., Inspection of.—The 762 shops and places where foodstuffs are sold may be approximated for the year as follows :— Butchers, provision dealers, etc., shops, 256; meat, provisions, rabbits, tinned foods, etc., stalls, 30; food preparation establishments, 12; fish shops, 115; fish stalls, 14; fruit shops, 225; and about 110 fruit, etc., stalls and barrows, including stalls in the Metropolitan Cattle Market inspected on Tuesdays and Fridays. To these 27,514 visits were paid, apportioned as follows :— Butchers, Provision Dealers, etc., Shops 9,232 visits Food Preparation Establishments 145 ,, Butcher, Provision, etc., Stalls 2,879 ,, Fish Shops 1,599 ,, Fish Stalls 1,200 ,, Fruit Shops 2,839 ,, Fruit Stalls 9,620 ,, Total 27,514 „ Offensive Trades include 4 tripe dressers, 4 gut scrapers, 4 fur skin dressers, and Knackers' Yard, which received a total of 73 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 1930 :— No. of Cases. Description of Animal affected. Nature of Disease. Extent of Disease. How disposed of. 1 Ox Tuberculosis Head and Tongue, Lungs and Mediastinal Glands Council's Destructor 49 Oxen Parasitic (Dis. Hep.) Liver Partly Cats Meat Council's Destructor 6 „ Abscess (Simple or Multiple) „ Council's Destructor 1930] 78 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 62 17 Coffee and Dining Rooms 218 54 Refreshment Rooms 115 32 Provision (Cooked Meats, cooked but not consumed on premises) 89 14 479 117 ARTIFICIAL CREAM ACT, 1929. This Act is for regulating the manufacture and sale of reconstituted cream, a subject to which reference was made in the last Annual Report of the Medical Officer of Health, page 74. This "cream " is made by emulsifying butter with dried skimmed milk powder and water. No applications were received for registration of premises for its manufacture or sale during the year. Milkshops and Dairies.—At the close of the year there were 601 milkshops and dairies on the register, 32 having been added to it, while 12 were removed. The District Sanitary Inspectors paid 702 visits to them, and served 4 notices for the carrying out of various sanitary improvements and the cleansing of dirty utensils. THE GRADING OF MILK. BACTERIOLOGICAL EXAMINATION OF MILK. It has been known in the Public Health Department for some considerable time that the official standard, as laid down by the Ministry of Health as to the technique and media for the examination of graded milks, that is, pasteurised, etc., is far from satisfactory. A striking difference is found when the counts for bacteria are made on media other than the "Lemco" Agar officially recommended. In 1928 this matter was gone into by the Medical Officer of Health, and in discussion with the bacteriologists neither could explain why a media should be persisted in which gave such poor results when other media gave a more true estimate of the bacteriological condition of the milk. It is, however, only fair to the dairy companies concerned, as the standard is laid down officially, to state that they are bound by the official standard, poor as it is. At this time, when there is much discussion regarding an alteration in the grading of milk, the names being confusing to the public, and not properly understood, the matter of a revision of the bacteriological tests would seem to be opportune. THE MILK AND DAIRIES (AMENDMENT) ACT, 1922; THE MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year 1930, the follow ing applications were made for licences under the provisions of the above Order to enable the persons to sell Specially Designated Milk 79 [1930 LICENCES GRANTED UNDER MILK (SPECIAL DESIGNATIONS) ORDER, 1923. Designation. No. of applications Number granted. Amount of Fees received. 1930 1930. £ s. d. "Certified " 16 16 2 12 6 "Grade A" (Tuberculin tested) 31 31 10 1 6 " Grade A." Nil. Nil. Nil. " Pasteurized ' ... (Dealer) 18 18 3 2 6 " Pasteurized " (Pasteurizer) 5 5 5 5 0 " Pasteurized " (Supplementary) 1 1 2 0 71 71 £21 3 6 ADULTERATION OF FOOD AND DRUGS. During the year 1,132 samples of foods and drugs, including 420 informal samples, were submitted for analysis by Mr. Green, the Food and Drugs Inspector, who purchased the samples for submission to our Analyst, Dr. Alan W. Stewart. Of the total samples 1,090 were reported to be genuine and 42 adulterated, or 3.8 per cent. This percentage is 5.8 below the previous year, and 3.4 below the average rate during the preceding 10 years. (In addition to this work, the Inspector paid 101 visits to premises, under Merchandise Marks Act.) During the year 1930 in addition to the samples taken and submitted to the Public Analyst there was a total of 846 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 third quarter of the year, as shown by the figures given in the statement below, when it was 4.3 per cent, and contrasted with 3.9, 2.7 and 3.7 per cent., respectively, in the first, second and fourth quarters. Examined. Genuine. Adulterated. Per Cent. Formal Informal Formal Informal Formal Informal Adulterated. 1st Quarter 215 87 207 83 8 4 3 9 2nd „ 207 80 203 76 4 4 2.7 3rd „ 142 134 138 126 4 8 4.3 4th 148 119 141 116 7 3 3.7 The Year 712 420 689 401 23 19 3.7 1930] 80 Informal Sampling.—The informal samples purchased included the following:— No. of Samples No. of Article. Article. Samples. Milk 3 Cayenne Pepper 1 Butter 174 Turkish Delight 1 Lard 14 Crushed Linseed 3 Sweets 10 Swiss Roll 2 Cakes and Buns 6 Lime Juice 2 Preserved Sausages 6 Potato Salad 1 Sausages 54 Liver Sausage 1 Coffee 13 Sherbert 1 Jam and Marmalade 4 Bread 1 Pepper 6 Luncheon Sausage 1 Arrowroot 9 Pressed Beef 1 Biscuits 3 Roll and Butter 7 Fish Paste 1 Port Wine 1 Honey 4 Bread and Butter (cut) 2 Mustard 3 Lemonade Powder 1 Rice 8 Chocolates 3 Baking Powder 1 Cream Sherry Trifle 2 Cocoa 5 Tripe ] Cream Cakes and Pastries 2 Dripping 1 Dried Full Cream Milk 11 Fish 1 Cheese 3 Flaked suet with flour 1 Prawns 7 Formalin 1 Confectionery 3 Full Cream (unsweetened) Con- Ham 1 densed Milk 1 Cream 1 Ginger Wine 1 Ground Ginger 1 Mixed Peel 6 Glucose 1 Icing Sugar 1 Artificial Cream 1 Full Cream (sweetened) Con- Ice Cream 1 densed Milk 1 Tapioca 1 Ground Almonds 2 Tea 2 Raisins 1 Cream Sandwich 3 Minced Beef 1 Olive Oil 2 Jam 3 Cane Treacle 2 Milk Sugar 1 Total 420 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 110 8.86 8.69 12.55 Milk purchased on Week-days 439 8.85 3.61 12.46 Milk procured in transit at Finsbury Park Station 123 8.90 3.90 12.80 Official Standard 8.50 3.00 11.50 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 110 110 Nil 0 0 On Week-days 439 429 10 2.3 At Railway Stations 123 122 1 0.8 (Farmers' Milks) 672 661 11 1.5 81 [1930 Giving the particulars of the Milks taken during each quarter of 1930 on Sundays, Week.days, and at the Railway Stations. 1930. 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. Week. days. Railway Stations. All Milks.[/##] 1st Quarter. 30 142 25 197 30 137 25 192 5 5 – 3 6 2 5 2nd „ 20 136 42 198 20 134 41 195 — 2 1 3 – 15 2 4 1 5 3rd „ 20 101 15 136 20 100 15 135 – 1 – 1 – 0 9 – 08 4th „ 40 60 41 141 40 58 41 139 — – – 2 – 3.3 — 14 The Year 110 439 123 672 110 429 122 661 – 10 1 11 – 2 3 0 .8 1.6 Showing the samples of milk reported as genuine or adulterated during the past 10 years and in 1930 :— MILK ADULTERATION. Samples Analysed. Genuine. Adulterated Per cent. Adulterated. 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 1929 539 523 16 3.0 Average 649 616 33 5.1 10 yrs. 1930 672 661 11 1.6 The number of samples of milk purchased was 672, of which 661 were genuine, and 11, or 1.6 percent, were adulterated. In addition to this number, 3 informal samples were submitted to the Public Analyst. Showing the analysis of 6,494 milks examined in Islington during the 10 years 1920.29 and 1930, and distinguishing those purchased on Sundays, on IVeek.days, and procured at the Railway Stations whilst in transit from the Farmer to the London Milk Purveyor :— Years. Sunday Milks. Week.day Milks. Railway Milks (Farmers). No. cf Samples Per cent, of non. fatty solids. Per cent, of fat. No. of Samples Per cent, of non. fatty solids. Per cent, of fat. No. of Samples Per cent, of non. fatty solids. Per cent, of fat. 1920 162 8.71 3.42 3.38 8.76 3.52 142 8.86 3.66 1921 151 8.83 3.34 3.71 8.79 3.37 122 8.91 3.73 1922 120 8.78 3.39 3.56 8.76 3.34 162 8.75 3.60 1923 120 8.82 3.55 3.88 9.08 3.fi3 168 8.90 3.63 1924 120 8.74 3.42 3.99 8.78 3.48 162 8.87 3.65 1925 108 8.71 3.41 3.84 8 7 3.37 192 8.79 3.67 1926 83 8.81 3.65 4.09 8.78 3.63 94 8.88 3.62 1927 129 8.87 3.49 3.78 8.86 3.73 233 8.84 3.69 1928 124 8.95 3.52 3.62 8.93 3.49 178 8.92 3.67 1929 142 9.02 3.50 2.36 8.99 3.41 161 9.01 3.67 Total samples and average constituents tio years) 1,259 8.84 3.47 3,612 8.84 3.50 1,614 8.87 3.67 1930 110 8.86 3.69 439 8'85 3.61 123 8.90 3.90 19301 82 The Public Analyst during- the year reported on the genuineness of the articles examined as follows :— Showing ihe Samples of Food and Drugs analysed by the Public Analyst during the Year 1930. Article. Number of Samples examined. Samples adulterated Formal Informal Total Formal Informal Total Milk 672 3 675 11 11 Butter .. 16 174 190 – Lard 2 14 16 — – Sweets — 10 10 – Cakes & Buns.. 2 (> 8 1 4 5 Pepper 2 6 8 — — – Preserved Sausage — 6 6 — — — Sausages 4 54 58 2 8 10 Whisky 8 — 8 7 — 7 Arrowroot 1 9 10 — — – Coffee 2 13 15 – – Jam & Marmalade – 4 4 – – Biscuits — 3 3 – – Fish Paste – 1 1 – – Honey – 4 4 — — — Mustard — 3 3 – – – Rice – 8 8 – – – Cocoa 1 5 6 – – – Cream Cakes & Pastries – 2 2 – 1 1 Dried Full Cream Milk – 11 11 – – – Prawns – . 7 7 – – – Ham – 1 1 – – – Artificial Cream — 1 1 – – – IceCream — 1 1 – – – Baking Powder — J 1 – – — Cheese – 3 3 – – – Confectionery — 3 3 — – – Cream — 1 1 – – Ground Ginger — 1 1 – – — Glucose — 1 1 – – – Tapioca — 1 1 – — Tea — 2 2 – – Cream Sandwich — 3 3 – 2 2 Olive Oil — 2 2 — – – Cane Treacle – 2 2 – – – Milk Sugar — 1 1 — – — Cayenne Pepper — 1 1 – – – Turkish Delight — 1 1 — – – Crushed Linseed — 3 – – – – Swiss Roll – 2 – – – – Lime Juice – 2 2 – – – Potato Salad – 1 1 – – – Liver Sausage — 1 1 — – — Sherbert — 1 1 — – – Bread – 1 1 – – – Luncheon Sausage — 1 1 – – – Pressed Beef — 1 1 – – – Roll and Butter 1 7 8 1 1 2 Bread and Butter (Cut) 1 2 3 1 1 2 Port Wine — 1 1 – Lemonade Powder – 1 1 – Cream Sherry Trifle — 2 2 1 1 Chocolates — 3 3 1 1 Tripe — 1 1 – – Dripping — 1 1 – — Fish – 1 1 _ – Flaked Suet with Flour – 1 1 – – Formalin – 1 1 – – Full Cream unsweetened – – – – Condensed Milk — 1 1 – – Ginger Wine — 1 1 – Mixed Peel — 6 – ' Icing Sugar — 1 1 – – — Full Cream sweetened Condensed Milk – 1 1 – – – Ground Almonds – 2 2 – – – Raisins – 1 1 – – – Minced Beef — 1 1 – – – Jam — 3 3 – — — Total 712 420 1,132 23 19 42 83 [1930 Milk Prosecutions. The summary of prosecutions showed that during the year 10 prosecutions were taken for adulterated milk, 7 of which were successful, 2 were withdrawn as alternative summonses, and 1 was withdrawn upon satisfactory evidence by defendant that no offence had been committed. Summary of Prosecutions during year 1930. (vide pp. 93 to 95.) Total Prosecutions Successful. Dismissed. Withdrawn. Amount of Penalties. Costs Received. £ s. d. £ s d. "Public Health (London) Act, 1891 " 31 29 — 2 42 7 0 42 10 6 "Foodand Drugs (Adulteration) Act, 1928 " 16 13 – l + 2a 17 15 0 46 14 6 " Sale of Food Order, 1921" 1 1 — . — 8 0 0 1 1 0 "Milk and Dairies Order, 1926 " 24 21 2 1 42 5 0 20 9 0 " Milk and Dairies (Consolidated) Act, 1915" 3 3 – – 1 10 0 15 0 "Public Health (Meat) Regulations, 1924." 1 1 – – 1 1 0 2 2 0 L C.C. By-laws 3 3 — la 2 10 0 8 8 0 Merchandise Marks Act, 1926 1 1 — – – 2 2 0 L.C.C. General Powers Act, 1927 2 2 — – 4 4 0 4 4 0 Totals 82 74 2 6 119 12 0 128 6 0 (a) Alternative Summons. ISLINGTON HOSPITALS. Beds. St. Mary's (Islington) Hospital 800 Archway Hospital, Archway Road 575 Royal Northern Hospital 220 Mildmay Memorial Hospital 30 Mildmay Maternity Home 16 London Fever Hospital . 190 In addition, all the Central and North London Hospitals are used by Islington residents. Other Institutions. Islington Institution, St. John's Road. — Accommodation for 1,650. 18 beds reserved for Lying-in, and 2 in Labour room. A proportion of the other beds reserved for infirm cases. Duchess of York Centre (Maternity), Essex Road.—No "beds," but clinic, and receives cases for Royal Free Hospital. North Islington Nursery School, 110, Tollington Park, N.4.—Opened 28th May, 1930. 40 (possible extension to 80) children under 5 years. 1930] 84 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,† Cert. Sanit. Insp. Ex. Bd., Cert. San. Inst. *Inspector of Meat. Hargreaves Wilkinson, Cert. Sanit. Inst.† *Inspector of Workshops and Bakehouses and Senior Inspector. Harry John James Watson, Cert. Sanit. Inst. *Inspectors of Workshops, &-c., in xVhich Females are Employed. Miss Eleanor Harriet Daniell, Cert. Sanit. Insp. Ex. Bd. ; C.M.B.; Cert. H.V. Mrs. Susannah Undery, Cert. Sanit. Iilsp. Ex. Bd. ; C.M.B. ; Cert. H.V. *Inspector of Houses Let in Lodgings. John W. Aiken, Cert. Sanit. Insp. Ex. Bd. Donald V. Watkins, Cert. Sanit. Insp. Ex. Bd. *Inspector of Food and Drugs, &-c. Gilbert Stanley Green, Cert. Sanit. Insp. Ex. Bd.† *Sanitary Inspectors. District 1. Thos. Wallace Agar, Cert. Sanit. Inst. „ 2. Thomas H. Hancock, Cert. Sanit. Insp. Ex. Bd.† „ 3. Allen Bagshaw, Cert. Sanit. Inst.‡ „ 4. Colin W. S. Lewis, Cert. Sanit. Insp. Ex. Bd.† „ 5. Chas. Edwin Horsman, Cert. Sanit. Inst. „ 6. Stanley P. Marks, Cert. Sanit. Insp. Ex. Bd.† ,, 7 Edward I. Fortune, Cert. Sanit. Inst. ‡ „ 8. Leonard H. Pearson, Cert. Sanit. Insp. Ex. Bd. „ 9. John Metcalf, Cert. Sanit. Inst.‡ „ 10. Arthur Moxon, Cert. Sanit. Insp. Ex. Bd. „ 11. Alfred E. Wood, Cert. Sanit. Insp. Ex. Bd.† „ 12. Harold H. Uren, Cert. Sanit. Insp. Ex. Bd.† „ 13. Wm. C. Bartlett, Cert. Sanit. Insp. Ex. Bd.† „ 14. Edward G. Holmes, Cert. Sanit. Insp. Ex. Bd. „ 15 James Stephenson Ashworth, Cert. Sanit. Insp. Ex. Joint Bd. † Also Meat Inspector's Certificate ‡Resigned. Vaccination Officers. J. Jennings, C. W. Bellis. 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 Kenion, (appointed in March, resigned in September). Miss Julia Devine, 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. Henry Angel, (Chief Clerk), Edward A. Abbott, Walter J. Wolfe, William G. Bunch, Clement M. Wheble, Arthur R. Wittrick, William R. Causton, Laurence W. Edis, Albert E. Vanstone, 'Charles J. Cridland, Leslie P. J. Regan, *Fredk. C. Green, *S. A. Brown (temporary), *Daisy Francis (Milk Grants). 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. W. Hardwick, J. Brown, A. Taylor. C. Holcombe, E. Norman (Assistant Driver). Mortuary Keeper. S. Maxwell. Public Vaccinators (See pages 52-54). Public Analyst. ALAN W. STEWART, D.Sc., F.I.C., 37, Russell Square, W.C.I. 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. 1930. TOGETHER WITH THE PRESCRIBED RETURNS OF THE MINISTRY OF HEALTH. 1930 86 STATISTICAL APPEJN DIX Showing Deaths from all Causes in Islington during the Year 1930. Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. Institutions within Borough. DISEASES. AGES. Under 5 Over 5 | DISTRICTS. Males. Females 0- 1- 5- 10- l5- 20- 25- 35- 45- 55- 05- 75- 85- Tuf. U.H. Toll. L.H. H. B. S.E. Small Pox – – – – – – – – – – – – – – – – – – – – – – – – (a) Vaccinated – – – – – – – – – – – – – – – – – – – – – – – – (b) Unvaccinated 1 – 1 (c) no statement – — — — — — — — — — — — — — — — — — — — — 71 Meals 27 105 8 – – – – – – – – – – 132 8 0 0 10 22 11 45 37 80 60 Scarlet Fever — 7 5 1 1 – – – – – – – – 7 7 2 1 1 — 3 3 4 7 7 Typhus Fever — — — — — — — — — — — — — — — — — — — — — — — – 1 Epidemic Influenza — 1 – – – – – – 5 3 2 5 — 1 15 3 — 2 1 5 3 2 9 – 2 Whooping Cough 6 4 13 – – – – – – – – – – 10 — 1 1 I 1 2 3 1 4 – 11 Diphtheria 7 21 — 1 – – – – – – – – 28 14 3 3 0 11 4 0 10 21 – Enteric Fever – – – – – – – – – – – – – – – – – – – – – – – – Asiatic Cholera – – – – – – – – – – – – – – – – – – – – – – — – 8 Diarrhoea. Dysentery 14 1 – – – – – – – – – 1 — 15 1 1 — 1 — 2 9 3 1 4 3 Epidemic Enteritis 8 – – – – – – – – – – – – 8 – – – – – – 6 4 – Other Allied Diseases – – – – – – – – – – – – – – – – – – – – – – — – Hydrophobia – – – – – – – – – – – – – – – – – – – – – – — – Glanders – – – – – – – – – – – – – – – – – – – – – – — – Tetanus – – – – – – – – – – – – – – – – – – – – – – – – Anthrax – – – – – – – – – – — – — – – – – – – – – – — – Cow Pox – – – – – – – – – – – – – – – – – – – – – – — – 4 Syphilis 2 1 – – – – – 1 4 1 1 1 — 3 8 — 1 — — 5 4 1 – – Gonorrhoea – – – – – – – – – – — – – – – – – – – – – – – – Phagedaena – – – – – – – – – – – – – – – – – – 3 – – – – – 14 Erysi pelas 4 – – – – – – 1 3 5 1 2 — 4 12 1 1 2 — 7 2 12 3 Puerperal Fever – – – – – 1 4 2 — — — — — 7 — — 1 2 2 — 2 — – 7 Pyaemia 2 1 1 — 1 1 3 4 2 — 1 — 3 13 — 1 3 3 3 4 2 7 – 1 Infective Endocarditis – – – – – – – – – – – – – – – – – – – – – – – – Other Allied Diseases – – – – – – – – – – – – – – – – – – – – – – — – Malarial Fever – – – – – – – – – – – – – – – – – – – – – – – – 1 Rheumatic Fever — — — — 2 — — — —- 1 1 — — 4 — 1 — — 2 – 1 1 – 2 Rheumatism of Heart — — 1 2 2 1 1 1 —| — 3 — — — 11 — 1 1 — 1 5 3 4 – 4 Tuberculosis of Brain 3 7 4 2 — 1 – — — — — — — 10 9 2 4 2 — 1 3 7 8 – Tuberculosis of larynx – — — — — — — — — – — — — — — — — — — — — " – 87 Phthisis — — 5 1 17 20 00 54 51 42 17 1 — — 280 32 25 27 25 40 47 78 109 – 2 Abdominal Tuberculosis — — — — — 1 — 1 1 — 1 — — — 4 — 1 — — 3 — — 3 – General Tub.rculosis — — — — 1 — — — — — — — — — 1 — — — — — — 1 – 5 Other forms – – – – 2 – – – – – – – – – – – – – – – – – – – culosis 1 2 — 1 2 1 1 — 1 — — 3 8 1 1 3 1 1 — 4 6 – Other Infective Diseases – – – – – – – – – – – – – – – – – – – – – – – – Thrush – – – – – – – – – – – – – – – – – – – – – – – – Actinomycosis – – – – – – – – – – – – – – 1 – – – 1 – – – – – Hydatid Diseases – – – – – – – – – – – – – – – – – – – – – – – – Scurvy – – – – – – – – – – – – – – – – – – – – – – – – Other Diseases due to – – – – – – – – – – – – – – – – – – – – – – – – Altered Food – – – – – – – – – – – – – – – – – – – – – – – – Acute Alcoholism — — — — — — 1 — — — — — — — 1 — — — – — — 1 1 Chronic Alcoholism ... – – – – – – – – – 3 – – – – 3 2 – – 1 – – – 1 – Chronic Industrial Poisonings – – – – – – – – – – – – – – – – – – – – – – – – 1 Other Chronic Poison- – – – – – – – – – – – – – – – – – – – – – – 1 – 1 Osteo-arthritis — — — — — — — — — — 3 — — — 3 — 1 1 — — — 1 – Gout — — — — — — — — — — — — — — — — — — — — — – – – 181 Cancer 1 1 — — 1 — 0 20 72 123 139 90 8 2 405 50 42 45 48 95 88 99 241 – 14 Diabetes Mellitus – – – – – 1 — 1 4 8 17 0 — — 37 4 0 3 3 9 0 6 17 – 1 Purpura Haemorrhagica — — — — — 1 — — — — — — — 1 — 1 — — — — – 1 – Haemophilia — —- — — — — — — —— — — — — — — — — — — ' – – – 3 anaemia 1 1 — — — — 1 — 3 2 1 — 2 9 3 — 1 — I 2 4 4 – 5 Lymphadenoma 1 — — 2 2 — 3 1 2 1 1 2 — 1 14 1 — 1 4 3 4 12 – 18 Premature Buth 90 – – – – – – – – – – – – 90 — 12 4 12 8 lb 10 28 46 – Injury at Birth 4 — — — — — — — — — — — — 4 — — — — 1 — 1 1 – Debility at Birth 2 — — — — — — — — — — — — 2 — — — — — 1 — 1 2 – 1 Atelectasis 11 – – – – – – – – – – – – 11 — 1 — 1 1 1 2 5 9 – 5 Congenital Defects 31 2 1 — 1 – – – – – – – – 33 2 5 5 4 3 8 4 6 20 15 Want of Breast Milk — — — — — — — — — — — — — — — — — — — — — – – – Atrophy, Debility, Marasmus 11 1 — — — – — — — — — — — 12 – 1 2 1 1 2 2 3 8 – 87 1930 Continued. DISEASES. AGES. Under 5 Over 5 DISTRICTS. Males. Females. Totals 0- 1- 5- 10- 15- 20- 25- 35 45- 55- 65- 75- 85- Tut'. U.H. Toll. L.H H. B. S.E. Dentition – – – – – – – – – – – – – – – – – – – – – – – – – Rickets – – – – – – – – – – – – – – – – — — — — — — — — 88 Old Age, Senile Decay – – – – – – – – – – 14 80 54 — 14S °2 17 9 18 33 19 30 48 100 148 2 Convulsions 5 — — — — — — — — — — — — 5 — — 2 2 — — 1 — 4 1 5 1 7 10 Meningitis 5* 2 — — 1* 1 — 3 2* — — — 8 I 1 1 5 2 2 4 2 8 9 17 2 Encephalitis — 1† — — — — — — 26 — 1 — — 1 3 1 1 — — — 2 2 2 4 21 Apoplexy 3 – – – – – 2 — 19 50 73 48 7 3 199 18 22 22 21 47 29 40 93 109 202 4 Softening of Brain — – — — — — — — — 3 2 — — 5 — — — 2 1 2 4 1 5 5' Hemiplegia – – – – – – – 2 — 1 0 5 7 — 21 3 2 1 3 4 5 3 8 13 21 1 General Paralysis of Insane – – – – – – – 3 10 4 1 1 — — 19 1 — 3 3 3 6 3 15 4 19 2 Other forms of Insanity — — – — — — — 1 3 — 2 — — — 4 — 1 1 — 2 1 2 2 4 3 1 Chorea — —— — — — 1 — — — — — — — 3 — — – – – 2 2 11 7 Cerebral Tumour – – – – – – 1 2 5 2 — 1 — — 11 3 — 2 2 — 1 3 6 9 5 15 5 Epilepsy — 1 — — 2 2 3 1 1 1 4 — — 1 14 1 2 3 — 2 6 1 6 Laryngismus Stridulus — — — — — — — — — — — — – – – – – – 1 – 1 7 9 9 6 Locomotor Ataxy 1 — z o <5 – – 9 2 3 – o 1 1 2 1 Paraplegia — — 1 — — — — 2 — — — – – 3 – – – 1 – 1 I – – 3 13 Other Forms, Brain Discuses . la la 2* 1 16 1 2 3 96 3 2 2 24 2 4 6 2 6 3 3 13 13 6 26 68 Otitis 1 2 2 — 1 — — — 4 1 2 — — 3 10 1 — 1 — — 3 8 7 Disease of Nose, Epistaxis – – – – – – – – – – – – – – – – – – – — — — — — — Disease of the Eye — — — — — — — — — — — — — — — — — — — — — — 8 – 17 8 Pericarditis – 1 1 1 — 2 2 1 3 4 — 2 — 1 16 2 — 2 3 3 4 3 9 81 45 Endocarditis — 2 1 6 — 8 0 23 27 48 40 11 — 172 15 15 15 15 33 31 48 91 172 Hypertrophy of Heart — — — — — — — — — — — — — — — — — — — — — 1 Angina Pectoris – – – – – – – – 1 5 1 4 — — 11 2 1 3 1 2 1 q 1 5 6 11 1 Aneurism – – – – – – – 2 – 5 3 3 – – 16 1 5 o 3 11 6 16 5 Senile Gangrene – – – – – – – – – – 6 2 3 — 11 1 1 3 1 3 1 1 7 4 11 33 Embolism. Thrombosis – – – – – – – – 2 5 6 4 — — 17 — 4 1 4 3 3 2 12 2 5 17 Phlebitis – – – – – – – – – – – – – – – – – – 1 1 l – i Varicose Veins — — — — — — — — — — — — — — — — — — — — – – – – – 190 Other Diseases, Heart and Vessels – – 1 1 1 2 5 13 34 105 182 155 41 – 540 53 47 53 63 106 93 125 260 280 540 1 Laryngitis — — — — — — — — — — 1 — — — 1 — — — — — — 1 1 – Croup — — — — — — — — — — — — — — — — — — — – 1 Other Diseases, Larnyx and Trachea – – – 1 – – – – – – – – – – 1 – – – – – 1 — 1 — l 337 Acute Bronchitis 5 2 – 1 — 1 5 9 2C> 36 46 17 7 141 16 10 8 21 28 22 43 74 74 148 337 Chronic Bronchitis – 1 – – — 1 — 1 7 13 28 21 8 1 79 4 7 11 16 6 18 18 57 23 80 330 Lobar Pneumonia 2 7 – 1 2 1 4 8 17 30 11 2 — 9 76 13 TO 9 10 15 10 18 60 25 85 120 Lobular Pneumonia 47 29 4 2 — 5 5 3 23 33 35 36 8 76 154 23 92 16 33 41 48 44 117 113 230 29 Pneumonia 11 2 1 — — 1 — 1 4 6 22 5 13 40 8 7 1 3 13 8 13 23 12 11 30 6 9 53 3 Emphysema Asthma 1 1 – – – – – 1 2 4 7 2 — 2 16 3 — 3 2 5 2 3 18 20 5 Pleurisy 2 1 — — — — 1 3 7 2 3 1 2 18 — 3 5 2 1 4 5 ■ Other Diseases, Respiratory System 2 _ 1 1 2 3 1 2 1 1 2 12 3 1 — 3 2 3 2 10 4 14 Diseases of Mouth and Annex* 1 – – – – – – – – – – – – – – – – – – – – 1 — 1 1 Diseases of Pharvnx — 2 2 — — — — — — 2 — — — 2 4 — 1 — 1 2 1 1 5 I 0 Diseases of (Esophagus – – – – – – – – – – – – – – – – – – – – – – – – – 18 Ulcer of Stomach and Duodenum – – – – – 1 4 8 8 10 7 2 – 46 6 4 3 6 11 7 9 53 13 46 Other Diseases of the Stomach 1 1 – – – – – – – – – 3 – 2 3 1 – 1 – 2 — 1 2 3 5 56 Enteritis 67 7 – – — 1 — — 2 — 2 2 1 74 8 3 3 9 12 11 27 17 42 40 82 4 Appendicitis – – 2 – 1 — 1 2 4 1 1 — — — 12 4 — 1 1 2 — 4 5 7 12 12 2 Obstruction of Intestines 5 2 – – – – 2 _ 3 7 6 6 2 7 26 2 3 2 c 6 10 4 16 17 33 Other Diseases of Intestines – – – – – – – 1 – _ 1 1 1 – 4 – – – 1 1 1 1 3 1 4 3 Cirrhosis of Liver – – – – – – – 1 5 4 3 1 — — l: 1 2 3 3 2 1 2 7 7 14 5 Other Diseases of Liver 1 1 – – – – 1 1 6 5 3 — o 18 2 1 1 5 3 4 i 10 10 20 5 Peritonitis Other Diseases. 1 1 1 — 1 3 1 1 1 1 3 1 1 2 14 1 1 1 1 3 4 5 9 1 7 16 tive System – – – – – – — 1 1 — – 1 — — 3 — — — — 1 — 2 7 3 - Diseases, Lymphatic System and Glands – – – – – 1 1 1 3 1 – 7 2 1 __ 3 1 7 7 8 Acute Nephritis – – – – – 3 2 1 4 6 2 – – 21 4 2 1 3 4 0 2 11 10 21 45 Bright's Disease – – – – – – 1 7 19 36 36 30 — 129 10 18 12 12 23 30 24 65 64 129 calculus – – – – – – — – – – – – – – — — i— — — — — — — — — 26 Diseases oi Bladder and Prostate – – – – – – – – 2 2 14 1 18 2 7 – 43 2 5 6 3 9 7 11 41 2 43 8 Other Diseases, Urinary. System – – – – – – – – 2 0 – – 11 2 2 _ 2 5 10 1 11 1 Diseases of Testis and Penis – – – – – – – – – – – – – – – –– – – – – – – 1 – 1 1 Diseases of Ovaries – – – – – – – – – – – – – – – – – – – – – – – 2 – Diseases of Uterus and Appendages – – – – – – – – – – – – – – –– – – – – – – – – – – – – – – – Diseases of Vagina and External Genitals – – – – – – – – – – – – – – – – – – – – – – – – – Diseases of Breast ... – – – – – – – – – – – – – – – – – – – – – – – – – Abortion, Miscarriage – – – – – 1 – 2 – – – – – – 3 1 — — 1 1 — — — 3 3 Puerperal Mania – – – – – – – – – – – – – – – – – – – – – – – – – 1 Puerperal Convulsions – – – – – – – – – – – – – – – – – – – – 2 1 — 5 5 flacenta Prxvia. Flooding – – – – — __ 1 — — — — — — — 1 – — — 1 — — – – 1 1 * C.S.Fr. a Post Basic Meningitis † Polio Encephalitis b Encephalitis lethargic 1930 88 Continued. Deaths in Institutions within Borough. DISEASES. AGES. Under 5 1 Over 5 | DISTRICTS. 1 Males. I females. 0- 1- 5- 10- X5- 20- 25- 35- 45- 55- 65- 75- 85- Tuf. U.H. Toll. L.H H. B. S.E. Puerperal Thrombosis – – – – – – – – – – – – – – – – – – – – – – – – 1 ot her Diseases, Pregnancy and Childbirth – – – – – 1 2 3 – – – – – – 6 — 2 1 — — 1 2 – – 4 Arthritis, Ostitis, Peri- ostitis – – – – – – – 2 1 2 — 5 1 — 1 – 2 — 1 2 – 1 Oiher Diseases, Osseous System – 1 – 1 – – 1 — — — — — – 1 2 — – 1 — — – 2 2 – Ulcer, Bedsore – – – – – – – – – – – –– – – – – – – – – – – – – Eczenma – – – – – – – – – – – – – – – – – – – – – – – – Pemphigus 1 – – – – – – – – – – – – – – – – – – – – – – – Other Diseases, Integumentary System – – – – – – – – – – – – – – – – – – – – – – – – Accidents and Negligence. in mines and quaries – – – – – – – – – – – –_– – – – – – – – – – – – – 12 In Vehicular Traffic — 2 7 3 9 7 5 4 3 9 8 1 1 2 57 V 6 5 8 9 11 13 – – On Railways — — — — — 2 1 — — — – – – – – – – – – – – – – On Ships, Boats, etc. – – – – – – – – – – – – – – – – – – – – – – – – In Building Operation – – – – – – – – – – – – – – – – – – – – 1 – – – By Machinery – – – – – – – – – – – – – – – – – – – – – – – By Weapons and Im- – – – – – – – – – – – – – – – – – – – – – – – – 2 Burns and Scalds 2 3 – – – – – – – – – – – 5 2 — – 1 – – – 0 – – 2 Poisons, Poisonous Va- pour – – – – – – – – 1 1 1 1 — 4 1 1 1 1 — — — 1 3 Surgical Narcosis – – – – – – – – – – – – – – – – – – – – – – – – Effects of Electric shock – – – – – – – – – – – – – – – – – – – – – – – – corrosion by chemical – – – – – – – – – – – – – – – – – – – – – – – – Drowning — — – — — 1 I — — 2 — — — 5 1 – 1 – – – – Suffocation, Overlaid – – – – – – – – – – – – – — — — — — — — — — – – Suffocation, Otherwise 2 – – – – – – – – – – – 2 2 1 — 1 — — — 2 – – 32 Falls, not specified 1 — — 2 — — 2 4 7 15 14 – – – – – – – – – – – – Weather Agencies 1 – 3 – 1 – – 2 1 2 — – – 1 9 — — 4 2 1 1 2 8 1 – 1 Homicide – – – – – – – 2 – – – – – – 2 – – – – – – – – Suicide. – – – – – – – – – – – – – – – – – – – – – 4 8 11 ; 3 By Poison – – – – – 1 – –- 3 – – – – – 4 – – – – – – 3 _ By Asphyxia — — — — 1 — – – 3 2 – – – – 3 – – – – – – – – – By Hanging and Strangulation – – – – – – – – – – – – – – – – – – – – – – – – By Drowning – – – – – – – – 1 – – – – – 3 – – – – – – – – – by shooting – – – – – – – – – – – – – – – – – – – – – 1 – – By Cut or Stab — — — — — — 1 — — 2 — 1 – — 4 – 1 – 1 1 – – – – 2 By Precipitation from Elevated Places ... — — — — — 1 — 1 1 — – – – – 3 — — 1 1 1 — — 2 ! by crushing – – – – – – – – – – – – – – – – – – – – – – – By other and unspeci- fied method – – – – – – – – – – – – – – – – – – – – 2 1 2 1 Execution — – – – – – – – – – – – – – – – – – – – – – – – Sudden Death, cause – – – – – – – – – – – – – – – – – – – – – – – – Ill-defined and unspecified causes – – – – – – – – – – 1 – – – – – – – – – – 1 — 1 Males 226 117 40 14 30 42 84 111 244 400 407 331 57 343 1760 195 200 220 247 380 383 478 2103 - Females 173 111 31 12 28 34 73 91 160 256 382 354 130 284 1551 200 161 161 211 339 348 415 – 500 TOTAL DEATHS 399 228 71 26 58 76 157 202 404 656 789 685 187 627 3311 395 361 381 458 719 731 893 – – 89 1930 (Ministry of Health Return.) Metropolitan Borough of Islington. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE CALENDAR YEAR 1930. Causes of Death. Sex All ages 0— 1— 2— 6— 15— 25 45— 65— 75— All Causes M F 2061 1809 222 170 65 63 52 48 52 38 69 63 196 159 626 419 401 369 378 480 Enteric Fever M – – – – – – – – – – F – – – – – – – – – – Small Pox M – – – – — — — — — — F 1 1 — — — — — — – — Measles M 81 22 36 20 3 — — — — — F 65 9 27 25 4 — — — — — Scarlet Fever M 6 — 2 1 3 — — — — — F 6 — 1 2 2 i — — — — Whooping Cough M 6 2 2 2 — — — — — — F 8 5 2 — 1 — — — — — Diphtheria M 20 2 2 8 8 – – – – – F 16 2 3 5 5 i — — — — Influenza M 11 1 — 1 — — — 6 — 3 F 8 — — —. — — — 3 3 2 Encephalitis Lethargica M 2 — — — — — 1 1 — — F 3 — — — — i — 1 1 — Meningococcal Meningitis M 8 3 1 1 2 i — — — — F 1 1 – — — — — — — — Tuberculosis of respiratory System M 164 — — — 3 15 68 66 12 — F 109 — — — 1 29 52 21 5 1 Other Tuberculous Dis eases M 18 1 1 3 4 5 3 1 — — F 16 2 3 2 4 1 2 1 1 — Cancer, malignant disease M 242 — — 1 15 99 70 57 F 224 1 1 — — 16 95 67 44 Rheumatic Fever M 3 — — 2 1 — — — F 7 — 4 1 1 — 1 Diabetes M 21 — — — 1 2 8 7 3 F 23 – – – – – — 7 14 2 Cerebral haemorrhage, &c. M 79– – – – – – — 23 37 19 F 98 – – – – – — 26 29 41 Heart Disease M 379 — — — 2 7 14 127 117 112 F 412 — — — 3 9 25 90 121 164 Arterio-sclerosis M 53 – – – – – 1 13 17 22 F 43 – – – – – — 13 13 17 Bronchitis M 92 5 – – – – 6 27 22 32 F 70 3 2 — — — — 5 10 41 Pneumonia (all forms) M 162 34 9 5 3 4 12 62 21 12 F 123 19 16 9 3 3 4 21 23 25 Other respiratory diseases M 44 1 — 1 1 2 1 12 3 23 F 40 2 2 3 4 29 Ulcer of stomach or duodenum M 32 – — — – 1 10 13 5 3 F 14 – – – – – 1 10 3 Diarrhoea, &c M 55 45 4 — 2 — 2 — 2 F 46 40 1 1 1 — — 3 Appendicitis and Typhlitis M 5 – – 1 — 1 1 2 — — F 10 – – — 2 1 2 3 1 1 Cirrhosis of Liver M 7 — — — 1 6 — — F 5 – – – – – — 2 2 1 Acute and Chronic Nephritis M 77 — — — — 3 5 33 24 12 F 64 — — — — — 5 28 16 15 Puerperal Sepsis M — — — — F 10 — — — — 3 7 — — — Other accidents and diseases of Pregnancy and M – – – – – – – – – – F 9 – — – 2 7 – — — Parturition Congenital Debility and Malformation Premature M 76 74 1 1 – – _ F 72 70 1 1 – – – – Birth Suicide M 25 – – – – 2 9 11 2 1 F 11 – – – – 1 2 8 — — Other deaths from violence M 94 2 2 3 13 15 18 17 13 11 F 39 3 1 I 2 2 2 7 11 10 Other Defined Diseases . M 299 30 5 6 9 7 28 97 51 66 F 250 14 6 2 5 6 29 75 35 84 Causes Ill-defined or unknown M — — — — — — — — — — F — — – — — – – – – – Deaths under 1 year M. F. Legitimate. Illegitimate. 203 19 154 16 1930 90 (Ministry of Health Return.) Notifiable Infectious Diseases during the Year 1930. Disease. Under 1. Ages. Totals Total Cases removed to Hospital 1-2 2-3 3—4 4-5 5—10 10—15 1-5- 20 20—35 35- 45 45-65 65 ann upwds Small Pox Notifications 8 4 2 6 2 33 36 46 52 20 29 6 244 243 Deaths 1 , . 1 i Scarlet Fever Notifications 7 44 65 105 133 552 205 89 86 i7 7 1,310 1,220 Deaths •• 4 2 5 1 1 14 14 Diphtheria Notifications 88 97 106 92 107 477 141 55 99 34 7 1,248 1,236 Deaths 7 10 4 4 4 12 1 42 39 Enteric Fever Notifications •• •• •• 2 4 6 11 2 3 31 30 Deaths •• •• •• .. .. , , Puerpeial Fever Notifications •• •• •• • • •• 1 26 9 36 32 Deaths •• •• •• •• •• 6 3 9 9 Puerperal Pyrexia Notifications •• •• •• •• •• 9 60 19 i 89 66 Deaths •• •• •• .. •• .. Acute Primary and Influenzal Pneumonia 1 Notifications 38 50 29 14 11 35 8 12 52 30 68 12 359 .. Deaths 6 •• •• •• •• •• 2 3 4 20 25 62 3 OphthalmiaNeonatorum Notifications 65 •• •• •• •• •• •• •• •• •• •• . . 65 8 Deaths •• •• •• •• •• 1 •• •• •• •• •• •• •• .. Encephalitis Lethargica Notifications •• •• •• •• •• 1 •• •• 1 •• •• •• 2 2 Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• •• Cerebrospinal Fever Notifications 3 1 •• •• •• 1 •• •• 2 •• •• •• 8 8 Deaths 4 1 1 •• •• •• 2 •• •• 2 •• •• 10 9 Acute Poliomyelitis Notifications •• 2 •• 1 •• 1 •• •• ., •• •• 4 4 Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• Anthrax Notifications •• •• •• •• •• •• •• •• •• •• •• •• •• Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Dysentery Notifications •• •• •• •• •• •• •• •• •• •• •• •• •• •• Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• Malaria Notifications •• •• •• •• •• •• •• •• •• •• •• •• •• . . Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• Erysipelas Notifications 9 3 5 1 •• •• •• 15 18 23 73 35 188 118 Deaths 3 •• •• •• • • •• •• •• •• •• 8 2 14 12 Continued Fever Notifications •• •• •• •• •• •• •• •• .. •• •• .. •• •• Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• Chicken Pox (except in the vaccinated under 10 vears) Notifications 22 49 42 35 47 203 94 31 14 7 4 2 610 •• Deaths •• •• •• •• •• •• •• •• •• •• •• •• •• •• 1930 CO LEGAL PROCEEDINGS 1930 Date. Name and Address of Defendant. Offence. Result. 1930. Public Health (London) Act, 1891. Jan. 3 Benabo, Rebecca (trading as Chas. Benabo & Sons), 240, Mile End Road, E.l Non-compliance with Statutory Notice re 38, Blundell Street Fined £1 Is. Od. and ordered to pay £1 Is. Od. costs. Jan. 3 Benabo, Rebecca (trading as Chas. Benabo & Sons), 240, Mile End Road, E.l Non-compliance with Statutory Notice re 42, Cumberland Street Fined £l Is. Od. and ordered to pay ,£'1 Is. Od. costs. Feb. 7 Horton, Donald H. (trading as Gregory & Co.), 297, Hornsey Road Non-compliance with Statutory Notice re 48, Cromwell Road Ordered to abate the nuisance within 7 days. Fined 20s. and ordered to pay £'1 Is. Od. costs. Feb. 14 Verstappen, Jean, 19, St. Clement Street Non-compliance with Statutory Notice re 32, Cornelia Street (vacant site adjoining) Ordered to abate the nuisance within 60 days. Jan. 17 Smith, Frederick, 4, Warner Street Exposing for sale diseased meat Fined £10 10s. Od. and ordered to pay £5 5s. Od. Feb. 21 Quick Service Boot Repairing Co., Ltd., 240c, Seven Sisters Road Non-compliance with Statutory Notice re 240c, Seven Sisters Road Ordered to abate the nuisance within 7 days and to pay £2 2s. Od. costs. Feb. 21 Shaw, Alfred, 195, Blackstock Road Letting an underground room as a dwelling at 195, Blackstock Road Fined £i and ordered to pay £1 Is. Od. costs. Feb. 21 Holliday, Arthur (otherwise Alfred Oldham), 195, Blackstock Road Occupying an underground room as a dwelling at 195, Blackstock Road Fined 10s. Feb. 21 Finfer, Harry, 125, Amliurst Road, E.8 Non-compliance with Statutory Notice re 14, Canonbury Park North Ordered to abate nuisance within 14 days and to pay £1 Is. Od. costs. Mar. 7 Lloyd, John, Lloyd, J. R., and Lloyd, F. W. (trading as John Lloyd & Sons), 524 & 526, Mile End Road, E.3 Non-compliance with Statutory Notice re 19, Baxter Road Ordered to pay £1 Is. Od. costs. Mar. 21 Herbert, John Herbert, 20, Almeida Street, N.l Non-compliance with Statutory Notice re 58, Hazellville Road Ordered to abate the nuisance within 14 days, lined 40s., and ordered to pay £2 2s. Od. costs. Apl. 4 The Clerk, Islington Board of Guardians, St. John's Road, N.19 Non-compliance with Statutory Notice re 67, Highgate Hill Summons adjourned sine die. Apl. 4 The Clerk, Islington Board of Guardians, St. John's Road, N.19 Non-compliance with Statutory Notice rc 73, Highgate Hill Summons adjourned sine die. Apl. 25 Fish, Anthony, "Trevigur," 129, Sudbury Avenue, North Wembley Non-compliance with Statutory Notice re 240c, Seven Sisters Road Ordered to abate nuisance within 7 days. Fined 20s. and ordered to pay £2 2s. Od. costs. Apl. 25 Fish, Guy, "Trevigur," 129, Sudbury Avenue, North Wembley Non-compliance with Statutory Notice rc 240c, Seven Sisters Road Ordered to abate nuisance within 7 days. Fined 20s. and ordered to pay £2 2s. Od. costs. May 2 Herbert, Herbert John, 20, Almeida Street, Islington, N.l Disobedience of Magistrate's Order re 58, Hazellville Road Fined 20s. and ordered to pay £2 2s. Od. costs May 2 Pasmore, Percy, 91, Hornsev Road, Islington, N.7 Non-compliance with Statutory Notice re 91, Hornsey Road Ordered to abate nuisance within 14 days and to pay £1 Is. Od. costs. May 16 Lindenthan, Beatrice, 2, Roclifie Street, N.l Non-compliance with Statutory Notice re basement front room at 2, Rocliffe Street Ordered to abate nuisance in 14 days. 1930 LEGAL PROCEEDINGS 1930 Date. Name and Address of Defendant. Offence. Results 1930. Public Health (London) Act, 1891—continued. May 23 Fish, Guy, " Trevigur," 129, Sudburv Avenue, Disobedience of Magistrate's Order re 240c, Fined £4 and ordered to pay £2 2s. Od. costs. Fined £4 and ordered to pay £2 2s. Od. costs. May 23 North Wembley Fish, Anthony, " Trevigur," 129, Sudbury Avenue, North Wembley Seven Sisters Road Disobedience of Magistrate's Order re 240c, Seven Sisters Road June 6 The Clerk, Islington Board of Guardians, St. John's Road, N.19 Non-compliance with Statutory Notices re 71, Highgate Hill Ordered to close the premises within 14 days and to pay £5 5s. Od. costs. (To cover 3 June 20 Verstappen, Jean, 19, St. Clement Street, Disobedience of Justices' Order re 32, Cornelia summonses). Summons withdrawn. (Order complied with July 4 Islington, N. Lindenthan, Beatrice, 2, Rocliffe Street, Islington, N. Street (vacant site) Disobedience of Justices' Order re basement front room at 2, Rocliffe Street and nuisance abated). Fined £5 and .£1 Is. Od. costs. July 11 Benabo, Arthur, 53, Commercial Road, E. Non-compliance with Statutory Notice re 8, Elton Street Ordered to pay £1 Is. Od. costs. July 11 Ryness, Emanuel, 173, Lauderdale Mansions, Maida Vale, N.W. Non-compliance with Statutory Notice re 202, Holloway Road Ordered to abate nuisance in 21 days and to pay £l Is. Od. costs. Aug. 8 Ansell, Harold Frank, 25, Salisbury Road, \t in Destroying a gully trap at 5, Anatola Road Fined 20s. and £1 Is. Od. costs. Sept. 26 Burch, R., 89, Southfield Road, Enfield, Middlesex Non-compliance with Statutory Notice re 21, Medina Road Ordered to abate nuisance in 14 days. 10s. 6d. was allowed for costs. Sept. 26 Antcliff, H. P. and Boam, H. T. (trading as Antcliff & Boam), 26, Broadway, N.8 Non-compliance with Statutory Notice re 7, Baxter Road Summons withdrawn. Defendants agreeing to pay £2 2s. Od. costs. Sept. 26 James, Jane, 18, Archway Road, N. Non-compliance with Statutory Notice re 18, Archway Road (front basement room) Ordered to abate nuisance within six weeks. Nov. 21 Watts, Frederick John, 12, Cottenham Road, Islington, N.19 Non-compliance with Statutory Notice re 12, Cottenham Road Ordered to abate nuisance in 14 days and to pay £1 Is. Od. costs. Dec. 12 Benabo, Rebecca (trading as Charles Benabo & Sons), 240, Mile End Road, E.l Milk and Dairies Order, 1926. Non-compliance with Statutory Notice re 24, Edward Square Ordered to abate nuisance in 14 days, fined £5 5s. Od. and ordered to pav £2 2s. Od. costs. Feb. 7 Evans, Richard E., 285, New North Road Filling and closing milk bottles in street instead of on Registered premises Fined £2. Feb. 7 Hills, William Frederick, 120, Rotherfield Street Filling and closing milk bottles in street instead of on Registered premises Summons dismissed. Feb. 7 Hills, John, 120, Rotherfield Street Filling and closing milk bottles in street instead of on Registered premises Summons dismissed. Feb. 14 Cruse, Fred Charles, 33 Denmark Grove Filling and closing milk bottles in street instead of on Registered premises Fined £3 3s. Od. and ordered to pay £2 2s. Od. costs. Feb. 14 Cruse, Bert, 33, Denmark Grove Filling and closing milk bottles in street instead of on Registered premises Summons withdrawn. CO CO LEGAL PROCEEDINGS 1930 [###. Name and Address of Defendant. Offence. Result.[/### 1930. Milk and Dairies Order, 1926. Mar. 28 William Frederick Wateridge, 66, Kingsdown Road, N.19 Filling and closing milk bottles in street instead of on Registered premises Fined £1 and ordered to pay £1 costs. May 23 Paddon, Harry P., 219, Balls Pond Road, Islington, N. Using 219, Balls Pond Road as a Dairy contrary to Article 6 (3) of the Order Dismissed under Probation of Offenders Act and ordered to pay £1 Is. Od. costs. my 23 Wilsher, Leslie, 238, St. Paul's Road, N.l Filling milk bottle in street instead of on Registered premises Fined 40s. and ordered to pay £l Is. Od. costs. May 23 Stone, Edward, 12, Devonshire Road, Islington, N. Filling milk bottle in street instead of on Registered premises Fined 40s and ordered to pay £1 Is. Od. costs. May 23 Evans, David, 36, Orpingley Road, Islington, N. Filling milk bottle in street instead of on Registered premises Fined 40s. and ordered to pay £1 Is. Od. costs. May 30 Williams, Griffiths, 11, Matilda Street, Islington, N. Filling milk bottle in street instead of on Registered premises Fined £l and ordered to pay £l costs. May 30 Hayward, Charles, 79, Hampden Road, Horn sey, N. Failing to cause a bottle of milk to be filled and closed on Registered premises Fined £ 3s. Od. and ordered to pay £1 Is. Od. costs. May 30 Howard, Stanlev, 56, Cross Street, Islington, N. Failing to cause a bottle of milk to be filled and closed on Registered premises Dealt with as a first offender and ordered to pay £1 Is. Od. costs. July 4 Doulin, Herbert William, 31 & 32, Euston Market, Euston Road, N.W.I Carrying on the trade of purveyor of milk without being registered Fined 10s. and 10s. costs. Aug. 8 Gardener, Edward, 1, Avenell Mansions, Avenell Road, N.5 Pilling milk bottle in street instead of on Registered premises Fined 40s. and £l Is. Od. costs. Sept. 19 Figg, Harry, 19, Popham Street, N. Filling milk bottle in street instead of on Registered premises Fined £"2 2s. Od. and ordered to pay X2 2s. Od costs. Oct. 24 Stamp, Robert William, 115, Dartmouth Park Hill, N.19 Carrying on the trade of purveyor of milk without being registered Fined 40s. Oct. 24 Stamp, Robert William, 115, Dartmouth Park Hill, N.19 Filling and closing a milk bottle in street instead of on Registered premises Fined £5 and ordered to pay £1 Is. Od. costs. Nov. 14 Cross, Frank, 15, Parkfield Street, Islington, N.l Filling and closing a milk bottle in street instead of on Registered premises Fined £'7 7s. 0d. and ordered to pay X"2 2s. Od. costs. Nov. 14 Skinner, Henry, 76, Greenwood Road, Dalston, E.8 Filling and closing a milk bottle in street instead of on Registered premises Fined 40s. and ordered to pay 20s. costs. Nov. 21 Ling, Percv, 10, Sonderburg Road, Islington, N.7 Filling and closing a milk bottle in street instead of on Registered premises (in Grafton Road) F'ined 40s. Dec. 12 Wallis, Reuben Edward, 33e, Lewis Buildings, Islington, N.l Filling and closing a milk bottle in street instead of on Registered premises (in Hardinge Street) Fined 40s. and ordered to pay 20s. costs. Dec. 12 Melhuish, Henry Richard, 52, Highbury Park, Islington, N.5 Filling and closing a milk bottle in street instead of on Registered premises (in Cloudesley Square) Fined 20s. and ordered to pay 20s. costs. 1930 94 LEGAL PROCEEDINGS 1930 Date. Name and Address of Defendant. Offence. Result. 1930. Milk and Dairies Order, 1926• Dec. 12 Jones, William T., 35, Reculver Road, Rotherhithe, S.E.16 Food and Drugs (Adulteration) Act, 1928. F'illing and closing a milk bottle in street instead of on Registered premises (on staircase of 1' to 8, Tvndale Mansions, Upper Street) Ordered to pay 5s. costs. Mar. 14 Melvin, Minnie Florence, 41a, Linton Street, N.l Selling milk from which 46 per cent. original fat had been abstracted Ordered to pay £1 lis. 6d. costs. Mar. 28 Davies, William Isaac, 84, Offord Road, N.l Selling milk from which 59 per cent. original fat had been abstracted Fined £2 2s. Od. and ordered to pay £2 2s. Od. costs. Apl. 4 Targett, John Stewart, "duke of Clarence" P.H., 140, Rotherfield Street, N.l Selling whisky 37.1 degrees under proof Ordered to pay £3 3s. Od. costs. Apl. 4 Pritchards Restaurants, Ltd., 18, Laurence Pountney Hill, E.C.4 Selling real cream sherry trifle containing 29 per cent. of fat not derived from milk Dismissed on payment of £5 5s. Od. costs. Apl. 11 Rand, Albert, "The Fox" P.H., 81, Boleyn Road, N.16 Selling whisky 38.0 degrees under proof Ordered to pay £5 5s. Od. costs. May 30 Roberts, William James, 57, Brooks by Street, Islington, N. Selling milk containing 0.003 per cent. Formaldehyde Dealt with under Probation of Offenders Act, and ordered to pay £5 5s. Od. costs. May 30 Maurice, Samuel, "Twyford Arms" P.H., 26 & 27, Twyford Street, Islington, N. Selling whisky 41.5 degrees under proof Summons dismissed under Probation of Offenders Act, and ordered to pay £10 10s. Od. costs. July 4 Figg, Harry, 19, Popham Street, Islington, N. Selling milk containing 6.82 per cent. added water Fined £2 and £2 2s. Od. costs. July 18 Lee, Percy Nathan, 404, Liverpool Road, N.l Selling milk from which 28.66 per cent. of original fat had been abstracted Summons withdrawn. Aug. 22 The Retail Dairymen's Mutual, Limited, 3, South Wharf, W.2 Abstracting from milk 18.33 per cent. of its original fat Summons dismissed on payment of £2 2s. Od. costs. Aug. 22 Lipton, Limited, 196, City Road, E.C.I Selling pork sausages containing sulphur dioxide 107 parts per million Fined 10s. and £1 Is. Od. costs. Oct. 3 Gardella, Richard, 38, High Street, Islington, N. Selling an admixture of Margarine and Butter on rolls of bread, containing 60 per cent. of fat other than Butter fat Fined £3 3s. Od. and ordered to pay £2 2s. Od. costs. Dec. 19 Mead, Mr. W. G., 4, Fairview Place, Brixton, S.W. Selling milk from which 32 per cent. original fat had been abstracted F'ined £5 and £3 3s. Od. costs. Dec. 19 Mead, Mr. W. G., 4, Fairview Place, Brixton, S.W. Selling milk from which 43.66 per cent, original fat had been abstracted Fined £5 and £3 3s. Od. costs. Dec. 19 Mead, Mrs. E., 4, Fairview Place, Brixton, S.W. Selling milk from which 43.66 per cent, original fat had been abstracted Summons withdrawn. Dec. 19 Mead, Mrs. E., 4, Fairview Place, Brixton, S.W. Selling milk from which 32 per cent, original fat had been abstracted Summons withdrawn. 95 1930 LEGAL PROCEEDINGS 1980 Date. Name and Address of Defendant. Offence. Result. 1930. Milk and Dairies (Consolidation) Act, 1915. May 23 Evans, Jane, 36, Orpingley Road, Islington, N. Sealing milk from a vehicle which had not her name and address inscribed thereon Fined 20s. May 30 Jones, Thomas Aneurin (trading as Rd. Jones & Son), 414, St. John Street, E.C. Selling milk from a can and not having name and address inscribed on can Dealt with under Probation of Offenders Act and ordered to pay 5s. costs. July 4 Doulin, Herbert William, 31 & 32, Euston Market, Euston Road, N.W.I Sale of Food Order, 1921. Selling milk from a vehicle and not having name and address on vehicle Fined 10s. and 10s. costs. June 6 Goebbel, Richard, 6, Crouch Hill, Islington, N. Merchandise Marks Act, 1926. Exposing for sale imported meat not properly labelled Fined £8 and ordered to pay £1 Is. Od. costs. Dec. 12 Reynolds, George Fovvnes, 192, Upper Street, Islington, N.l Exposing for sale imported fresh apples not bearing an indication of origin Ordered to pay £2 2s. Od. costs. Jan. 17 Public Health [Meat) Regulations, 1924. Henderson, Edward, 5, Durham Row, Whitehorse Street," Stepney, E. London County Council (General Powers) Exposing meat for sale from a stall not suitably covered over and screened at sides and back Fined £1 Is. Od. and ordered to pay £2 2s. Od. costs. Nov. 14 Act, 1927. Levi, Isaac, 27, Highbury Grove, N.5 Failing to cause a staircase of a tenement building to be artificially lighted within one hour after sunset at 1 to 12, Crown Mansions Fined £2 2s. Od. and ordered to pay £2 2s. Od. costs. Nov. 14 Levi, Isaac, 27, Highbury Grove, N.5 London County Council By-Laws, 1930. Failing to cause a staircase of a tenement building to be artificially lighted within one hour after sunset at 13 to 24, Crown Mansions Fined £2 2s. Od. and ordered to pay £2 2s. Od. costs. Levi, Isaac, 27, Highbury Grove, N.5 July 18 Failing to maintain in a proper state of repair all pipes, drains, etc., at No. 1, St. James Mansions Fined £2 and £5 5s. Od. costs. Nov. 7 Mavcock, Ernest Benjamin, 8, Victoria Road, N.7 Failure to give notice of intention to carry out work in connection with w.c. at 3, Highburv Hill Summons dismissed under Probation of Offenders Act. Ordered to pay £2 2s. Od. costs. Dec. 19 W. T. Ricketts & Son, Ltd., 73, Southgate Road, Islington, N. Failure to give notice of intention to carry out work in connection with w.c. at No. 2, St. John's Villas Fined 10s. and £1 Is. Od. costs. 1930] 96 (London County Council Return.) Metropolitan Borough of Islington. SUMMARY OF PROCEEDINGS DURING 1930. Premises. No. on Register at end of 1930 No. Added in 1930 No. Removed in 1930 Number Number of of Inspections Notices 1930 1930 Number of Prosecutions 1930 Milk Premises f601 32 12 702 13 1 Cowsheds Nil Nil Nil Nil — Nil Slaughter Houses 13 „ „ 716 — ,, "Other Offensive Trade Premises 9 „ „ 73 „ Ice Cream Premises 250 „ „ 121 11 ,, Registered Houses Let in Lodgings 1.000 — 6 3,071 469 •• * Including the Knacker's Yard, 7 Fur Skin Dressers and 1 Fat Melter. t Including 181 Bottle Milk only. Housing of the Working ClassesNumber of houses inspected — (a) On account of complaints or illness (P.H. Act) 5,942 (4) House-to-house (Housing Consolidated Regulations, 1925) 1,442 Number of notices served— (a) Under P.H. Act:— (i) Intimation 4,573 (ii) Statutory 580 (b) Under Housing Act 24 Number of houses repaired or nuisances remedied under P.H. Act5,474 Number of houses repaired under Section 3 of Housing Act— (a) By owners ... 24 (b) 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 152 (b) In course of erection Nil Number of representations by Medical Officer or other person 1 Number of houses included in such representations 3 Number of Closing Orders made 3 Number of Closing Orders determined (i.e. Houses made fit) Nil Number of Demolition Ordersh Nil Number of houses demolished — (a) In pursuance of Orders Nil (ft) Voluntarily 3 Total number of houses in the Borough about 46,000 Number of houses occupied by the working classes about 28,700 Underground Rooms— Number illegally occupied 16 Number closed or illegal occupation discontinued .32 Number remedied 32 Number of prosecutions 1 97 [1930 Smoke nuisances— Number of observations 128 Number of complaints 93 Number of notices served 18 Number of legal proceedings Nil Cleansing and Disinfection— Number of adults cleansed 78 Number of children cleansed 5,492 Number of premises cleansed : — («) After infectious diseases 4,713 (6) For vermin 103 Water supply to tenement houses— Number of premises supplied 96 Number of prosecutions Ni 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 l'jcal 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. Pages 12-21 Report on Maternity and Child Welfare Work, including Assistant Medical Officer of Health's Report on the Maternity and Child Welfare Scheme. Page 38 Vaccination. Pages 41 and 42 Employed population, small factories, Steam Whistle Act. 1872. Page 50 Sale of unsound fruit by street traders. Pages 54, 58 and 59 Artificial Colouring Matter in Milk. 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. age 47 Dispensing of prescriptions. 1930 98 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 50 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 eduational 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 5 "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 dysenntery. 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 (Contributorv) 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. Annual Report, 1929. Pages 13 and 14 Distribution of Milk to Necessitous Mothers and Children. Pages 17 and 18 Work of Day Nurseries receiving Grants from Borough Council. Pages 30 and 31 Smallpox. page 37 Insulin, Provision of. Pages 39, 40, 41 Islington Interim Tuberculosis Care Committee. Pages 55, 56 Scavenging. Page 60 Sewer emanations. Pages 61, 62, 63, 64 Housing. Page 68 Unsound Food. Page 68 Mercurial Poisoning. Page 69 Pauperism in the Borough. Pages 69-70 Sale of Food Order, 1021. Labelling of Meat. page 74substitution of Artificial Cream in Cream Cakes, etc. Page 74 Unsatisfactory Churns. 99 1930 INDEX Page Accidental Deaths 26, 32 Acreage iii. 2 Adulteration of Food 79 Ages at Death 3 Agricultural Produce (Grading & Marking) Act, 1928 67 Anti-toxin treatment 37 Anthrax, occurrence of 41 Appendix 85 Area iii, 2 Artificial Cream 78 „ Sunlight Treatment 19, 49 Bacteriological Examinations 51 „ Diphtheria 51 Births 3 „ Illegitimate 4 „ Notification of 4 „ Stillborn 5 Blind Persons Act, 1920 42 Cancer 29 Cattle Market 77 Chicken Pox Regulations 36, 41, 50 Chocolates (unsound) given as Prizes 76 Cleansing of Verminous School Children 56 Coal gas Poisoning 32 Consumption (see Tuberculosis 30, 43 Cow Sheds 96 Cream Cakes and Pastries 80, 82 Day Nurseries 18 Deaths from all causes during the year 5 Deaths from Epidemic Diseases 27 „ „ Respiratory Diseases 30, 31 „ in Public Institutions 26 „ from Classified Causes 6 „ Maternal 11, 12, 13 „ Age at 6 Demolition of Habitable Dwellings 74 Density 2 Diarrhoeal Diseases 28 Diphtheria 37 „ Anti-toxin treatment 37 „ Bacteriological 51 Diseases Treated in Hospital 38, 39 Disinfectants distributed and used 56 Disinfecting Station 55 Disinfection Work 55 Disinfestation of School Children 56 District Inspectors' Work 66 Dust, removal of 35 Dysentery 41 1930 100 Page Education Propaganda 9 Emanation, Sewer 70 Encephalitis Lethargica 41 Enteric Fever (Typhoid) 37, 51 Epidemic Diseases 26 „ Cerebro-Spinal Meningitis 40 Exemption Certificates 53 Erysipelas 29, 37 Factories and Workshops Administration 57 Fatality from Notifiable Infectious Diseases 38 Finsen Light Treatment 40 Food, Inspection of. Unsound, Adulteration of 76, 79 Food Order 76 Gas (Coal) Poisoning 32 Georges Road and Hope Street Area 71 General Investigation of Shops 60 Glanders, Anthrax and Hydrophobia in Man 41 Health Visitors (Municipal) 10, 16 Home Visitations—-Tuberculosis 50 Hospitals 83 Hospital Isolation of Infectious Diseases 38, 39 Housing ... 71 „ Accommodations 72, 73 Houses Let in Lodgings 69 Ice Cream Premises 66 Infantile Mortality 7, 8, 9 Infant Welfare Work 10 Infection, Prevention of 33 Infectious Diseases in Schools 50 „ „ (Non-Notifiable) in Schools 50 Informal Sampling 80 fluenza 28 Inspection of Food 75 „ „ Houses 68 „ „ Kitchens of Restaurants 57, 78 „ „ Slaughter Houses and Cow Houses 75 „ „ Workshops 58, 59 Institutions (Deaths in) 26 Increase of Rent (Restrictions) Acts 75 Inquests 32 Inquiry—Shops 60 Insulin (Supply of) 42 Invalid Children's Aid Association 18 Isolation of Infectious Diseases 38, 39 Islington Chickenpox Regulations ._ 35, 41 Kitchens and Restaurants 57, 78 Legal Proceedings 91 Public Health (Lond.) Act 91 Food and Drugs (Adulteration) Act, 1928 94 ,, „ Food Order 1921 76 Milk and Dairies Order 1926 93 Milk and Dairies (Consolidated) Act 1915 95 I.ight Treatment—Artificial Sunlight and "Finsen" 19, 49 Local Government Act, 1929 52 London County Council Return of Sanitary Work 96 Malaria 41 Malignant Diseases 29 Marriages 3 101 [1930 Page Maternity and Child Welfare Committee ii Maternity and Child Welfare Work 10 Maternal Deaths 11, 12, 13 Measles (Deaths) 8, 27 Measles, Notifications by School Teachers 50 Meat Inspection 77 Meat, labelling of 76 Medicines, Provision of 42 Merchandise Marks Act, 1926 67 Ministry of Health Returns 89, 90 Milk, Grading, Bacteriological Examination 78 Milk Scheme 15 „ Adulteration 81 Milk Shops and Dairies 78 „ Special Designations Order—Licences 78 Mortuary and Coroner's Court 32 Notification of Infectious Diseases 33, 40 „ „ Tuberculosis 43 „ „ Births Act 4 „ „ Still-births 5 Non-notifiable Infectious Diseases in Schools 50 Nuisances by Dogs 66 Nursery Schools 83 Offensive Trades 77 Ophthalmia Neonatorum 10 Outworkers' Premises 57, 59, 60 Other Notifiable Diseases 40 Pathogenicity Tests (Diphtheria) 51 Pemphigus Neonatorum 14 Phthisis 30 „ Notification of 43 Places where Food is Prepared 75 Pneumonia 31 Pneumothorax treatment 49 Poisoning (Gas) 32 Population at the Census, 1921 2 „ estimated, 1930 2 Prevention of Infection 33 Propaganda (Education) 9 Prosecutions, Summary of 83 Public Health Congress 10 Public Health Committee ii Public Health (Meat) Regulations, 1924 76 „ Staff 84 „ „ (Tuberculosis) Regulations 1924 45 1925 44 Public Vaccinators 52 Puerperal Disease 12, 13, 29 „ Pyrexia 13 Polio-Myelitis, Acute 40 Pulmonary Tuberculosis 29,30 Rag a d Flock Act (1911-1928) 66 Rats and Mice (Destruction) Act, 1919 70 Rateable Valule iii References—M.O.H. Reports . 97 Regulations, Chickenpox Notification 36, 41 Rent and Mortgage Interest (Restrictions) Acts 75 Report on Work of Day Nurseries 18 1930 102 Page Respiratory Diseases 30, 31 „ Tuberculosis 30 Restaurant Kitchens 57, 78 Sale of food Order—Labelling of Meat 76 Samples Analysed in 1930 82 Sanitary Inspectors' Work 68,69 Scavenging 65 Scarlet Fever 37 Schools 50 School Supervision of Contacts 36 Septic Diseases 29 Sewer Emanation 70 Shelter House 56 Shop Investigations 60 Slaughterhouses 77 Small Pox 31 Smoke Nuisances 67 Sophistication of Milk 80 Specialist Consultations 14 Statistics 85 Still-Births, Registration 5 Street Accidents 26, 32 Summary (Vital Statistics) iii Tuberculous Diseases 29, 51 Tuberculous Meat 76 Tuberculosis (Interim Care Committee) 44 Tuberculosis Dispensaries 47 „ Notification of 43 „ Respiratory, All forms, Deaths 30 „ (Public Health) Regulations, 1912 46 „ Visiting Nurse 50 Typhoid Fever (see Enteric) 37, 51 Unsound Food, Destroyed, Prizes 76 Vaccination 53, 54 Vaccination Officers 53 Venereal Diseases 31 Verminous Children, Disinfestation of 56 „ Premises 66 Voluntary Maternity and Child Welfare Centres 18, 25 Water Certificates 67 Water Supply 73 Welfare Work by Health Visitors 10, 16 Whooping Cough 50 „ (Deaths) 8,9 Widows', Orphans' and Old Age (Contributory) Pensions Act, 1925 67 Workshops and Factories, Inspection of 58, 59