AC 4361 M ISL 74 1935 EIGHTIETH 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. Chief Executive Tuberculosis Officer; Chief Executive Officer under the Maternity and. Child Welfare Act. London: Vail & Co., Ltd., Printers, 170, Farringdon Road, E.C. 1. 1935 EIGHTIETH 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. Chief Executive Tuberculosis Officer; Chief Executive Officer under the Maternity and Child Welfare Act. London: Vail & Co., Ltd., Priuters, 170, Farringdon Road, E.C.I. ii MEMBERS OF THE PUBLIC HEALTH COMMITTEE. (1st January to 81st December, 1935) Mayor. Councillor HENRY GEORGE COLEMAN, J.P. Aldermen. HERBERT SAMUEL JORDAN HERBERT JAMES LOWTON LYGOE EDWARD HENRY TOMKINS, J.P. Councillors. ‡ WILLIAM AWCOCK, J.P. † Miss ETHEL MARGARET LITTMAN ‡STANLEY CECIL BOWERMAN † JAMES HENRY MANLEY JOHN BRUCE * LEONARD McCLANE. HENRY JAMES EDWIN CARTER. † WILLIAM JOHN MITCHELL STANLEY BENJAMIN FIDOE. ‡ JAMES PATTERSON WILLIAM HERBERT GALE. RUTHERFORD, LL.B. WALTER HARPER PRANK LEYDEN SARGENT † FREDERICK THOMAS WILLIAM GEORGE SCOTT HERRINGTON. Mrs MATILDA SOUTHGATE, J.P. § ALFRED CECIL KNIGHT, L.C.C. ‡ FRANK STONEHAM EDWARD ALBERT WILLIS Chairman Alderman LYGOE. Vice-Chairman Councillor BRUCE (to November, 1935) Councillor CARTER (from November, 1935) ‡ from November, 1935 * Died 16th June, 1935 § from July, 1935 † to November, 1935 MEMBERS OF THE MATERNITY AND CHILD WELFARE COMMITTEE (1st January to 31st December, 1935) Mayor. Councillor HENRY GEORGE COLEMAN, J.P. A Idler men. HERBERT JAMES LOWTON LYGOE Councillors. Miss ELEANOR MARION ADAMS Mrs. MIRIAM PRICE COLEMAN * JOHN DAVID AUBREY Mrs. ROSA ESSEX Mrs. JESSIE LEONIE BLYTHE WILLIAM HERBERT GALE * STANLEY CECIL BOWERMAN WALTER HARPER JOHN BRUCE § Miss ETHEL MARGARET Mrs. FLORENCE HILDA LITTMAN CANTWELL WILLIAM JOHN MITCHELL EDWARD NORMAN CARTER § REGINALD WALTER MORTON Miss FLORENCE MARY Mrs. MARGARET SUMMERS ELIZABETH CLARKE EDWARD ALBERT WILLIS § from November, 1935 * to November, 1935 Members appointed by the Council from outside their own body. Mrs. M. R. JENNER, 46. Milner Square. N.l. Mrs. J. J. JONES, 88, Addington Mansions, Highbury Grange, N 5. Mrs. H. L. REES, 28, Manchester Mansions, Sunnyside Roai, N.19. Mrs. C. STONHAM, 58, Queen's Road, N.4. Chairman : Councillor Mrs. MIRIAM PRICE COLEMAN. Vice-Chairman: Councillor Mrs. FLORENCE HILDA CANTWELL. iii SUMMARY of Vital Statistics in the Registration Year, 1935. Population (Enumerated at Census, 1931) 321,795 persons ,, Estimated Mid-year 1934 and 1935 308,170 persons Decrease on Census population, 1931 13,625 persons Mean Population, ten years, (1925-1934) 324,597 persons Area 3,092 acres Density (Mid-year, 1935) 99 7 persons per acre Births Males 2,303 Females 2,274 4,577 persons Birth rate 1485 per 1,000 inhabitants Deaths from All Causes Males 1,673 Females 1,714 3,387 persons Death Rate 10 99 per 1,000 inhabitants Deaths from Principal Epidemic Diseases Males 54 Females 45 99 persons Death rate 0.31 per 1,000 inhabitants Deaths from All Tuberculosis Males 124 Females 99 223 persons Death rate 0.72 per 1,000 inhabitants Deaths from Respiratory Tuberculosis Males 113 Females 89 202 persons Death rate 0.65 per 1,000 inhabitants Infantile Deaths under 1 year Males 138 Females 102 Total 240 Infantile mortality rate 52 per 1000 births Excess of Births over Deaths 1,190 Rateable value of Borough of Islington £2,142,447 Sum represented by a penny rate £8,675 iv Public Health Department, Town Hall, Upper Street, N.l, To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Islington, 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 1935. The death-rate, 10.99, is the lowest recorded in the annals of Islington. In 1923, and also in 1863, a rate of 11.60 was recorded. The infantile mortality rate was 52. This also is the lowest rate recorded in any year. (In 1927 the rate was 53). The death-rate for the previous year, 1934, was 11.85, and the infantile mortality rate was 62. The compulsorily notifiable infectious diseases show a reduction on the previous year. In 1935 1,639 cases were reported, as against 2,227 in 1934, a decrease of 588. This is contributed to by there having been no Smallpox, as against 70 in the previous year, also a reduction in the number of Scarlet Fever and Diphtheria cases. During the year the survey of underground rooms, commenced in October 1934, was continued, and towards the end of the year the survey of the Borough for overcrowding under the Housing Act, 1935, was undertaken, but had to be continued during the commencement of 1936. The work under the Shops Act, which came into force on the 30th December 1934, fell to be carried out during the year. In conclusion, I should like to express my thanks to the Members of the Council and particularly to the Chairmen of the Committees, Public Health, Maternity and Child Welfare, and Housing, for the great interest taken in the work of my department during the year, and to the Superintendent and members of my staff generally. I am, Your obedient servant, Medical Officer of Health. REPORT OF THE Medical Officer of Health FOR THE YEAR 1935. SPECIAL REPORTS (OTHER THAN THE HEALTH OF THE BOROUGH) AND OUTSTANDING MATTERS BROUGHT BEFORE THE PUBLIC HEALTH, MATERNITY AND CHILD WELFARE, OR HOUSING COMMITTEES DURING THE YEAR. 1. Extract of Vital Statistics and Population, Births and Deaths, pages 3, 4, 5. 2. Infectious Diseases, Dysentery, etc., pages 31-36. Tuberculosis, pages 38-45. 3. Provision of Antitoxin page 32, Diphtheria Immunisation, page 32, Bacteriological Work. Examination of Swimming Bath Water, etc., pages 46, 47, 48. 4. Municipal Health Visitation and Work of Voluntary Welfare Centres, pages 14-23. Infant Life Protection, page 19. Pneumonia, Nursing of, page 22. 5. Sanitary Work, page 57. Workshops, page 53. Shops Act, page 69. Sewer Emanations, page 62. Verminous Premises, Disinfestation, page 51. Rats, page 62. 6. Housing, pages 64-68. Clearance Areas, page 64. Demolition Orders, page 64. Underground Rooms, page 64. Overcrowding Survey, page 68. 7. Meat, Food and Drugs, pages 69-77. Inspection of places where Food is prepared, page 69. Food Poisoning, page 72. 8. Staff matters, page 2. Health Propaganda, page 78. 9. Index to report, page 87. 1935] 2 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 Workshops and Bakehouses and Senior Inspector. Harry John James Watson, Cert. Sanit. Inst. Inspector of Meat. Abraham Warren Haydock, Cert. Sanit. Inst., Ex. Joint Bd.† Inspectors of Workshops, &c., in which Females are Employed. Miss Eleanor H. Daniell, Cert. Sanit. Insp. Ex. Bd. ; S.C.M. ; Cert. H.V. Mrs. Susannah Undery, Cert. Sanit. Insp. Ex. Bd. ; S.C.M. ; Cert. H.V. Inspectors of Houses Let in Lodgings. Donald V. Watkins, Cert. Sanit. Insp. Ex. Joint Bd.f (Resigned 30/11/35) Norman Lighiowlers, Cert. Sanit. Insp Ex. Joint 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. Stanley P. Marks, Cert. Sanit. Insp. Ex. Bd.† 6. William Charles Bartlett, Cert. Sanit. Inst. Ex. Joint Bd.f „ 7. Leonard H. Pearson, Cert. Sanit. Insp. Ex. Bd. „ 8. Harry Raymond Homewood, Cert. Sanit. Insp. Ex. Bd.† 9. Arthur Moxon, Cert. Sanit. Insp. Ex. Joint Bd. „ 10. Alfred E. Wood, Cert. Sanit. Insp. Ex. Bd.† „ 11. Harold H. Uren, Cert. Sanit. Insp. Ex. Bd. „ 12. John William Aiken, Cert. Sanit. Insp. Ex. Joint Bd. „ 13. Edward G Holmes, Cert. Sanit. Insp. Ex. Bd. ,, 14. James Stephenson Ashworth, Cert. Sanit. Insp. Ex. Joint Bd. † Also Meat Inspector's Certificate. Wall Edward, Cert. Sanit. Insp. Ex. Joint Bd. Andrew Blair Holloway, Cert. Sanit. Insp. Ex. Joint Bd. † Leonard Thomas John Nash, Cert. Sanit. Insp. Ex. Joint Bd. Reginald William Norman, Cert. Sanit. Insp. Ex. Joint Bd. † Vaccination Officers. J. Jennings, L. Stevens (Assistant Vaccination Officer). Tuberculosis Visiting Nurse. Miss Emily McGoldrick, State Regd. Nurse, Cert. General Training. Health Visitors. Mrs. Amy Main, S.C.M. ; Cert. H.V. ; S.R.N. Miss Rosina Palmer, S.C.M. ; Cert. H.V. ; S.R.N. Miss Ellen Oliver, S.C.M. ; S.R.N. Miss Julia Devine, S.C.M. ; Cert. H.V. ; S.R.N. Miss Hilda Frances Harris, S.C.M. ; Cert. H.V.; S.R.N. Miss May Ritson, S.C.M. ; Cert. H.V. ; S.R.N. Miss Lily Flower, S.C.M. ; Cert. H.V. ; S.R.N. Miss Elsie Paley, S.C.M'; Cert. H.V.; S.R.N. (Appointed 20th Sept., 1935). Miss Mary McLean, S.C.M.; Cert. H.V.; S.R.N. (Resigned 31st Aug., 1935). Health Visitor and Infant Life Protection Visitor. Miss Gwenyth Sarah Lewis, S.C.M. ; Cert. H.V.; Cert. Sanit. Inspr. Ex. Bd. Clerical Staff. Henry Angel (Chief Clerk), Edward A. Abbott, Walter J. Wolfe, William G. Bunch, Clement M. Wheble, Arthur R. Wittrick, William R. Causton, William A. McAdam, Laurence W. Edis, Alfred E. Vanstone, Charles J. Cridland, Leslie P. J. Regan, George F. Kimmis, (Fredk. C. Green, S. A. Brown, Daisy Francis) ; (Milk Grants). Disinfecting Station. A. Lewis (Engineer), W. G. Jollie (Handyman Stoker), Mrs. Lewis (Caretaker, Shelter House), Mrs. Reid (Cleansing Station Attendant), G. Cooper (Motor Driver), E. Norman (Assistant Driver). Disinfectors. W. Hardwick, J. Brown (Retired June, 1935), A. Taylor, C. Holcombe, A. Starling. Mortuary Keeper. S. Maxwell (Retired Nov., 1935). Public Vaccinators (See page 49). Public Analyst. ALAN W. STEWART, D.Sc., 23, Queen's Square, W.C.I. 3 [1935 EXTRACT OF VITAL STATISTICS. Total. M. F. Live Births. Legitimate 4,404 2,222 2,182 Birth Rate per 1,000 of the estimated Illegitimate 173 81 92 resident population, 14.85 Stillbirths 98 Rate per 1,000 total (live and still) births, 21.00 Deaths 3.387 Death Rate per 1,000 of the estimated resident population, 10.99 Deaths from puerperal causes (Headings 29 and 30 of the Registrar-General's Short List) :— Deaths Rate per 1,000 total (live and still) births. No. 29. Puerperal sepsis 3 0.64 No. 30. Other puerperal causes 5 1.07 Total 8 1.71 Death rate of infants under one year of age :— All infants per 1,000 live births 52 Legitimate infants per 1,000 legitimate live births 50 Illegitimate infants per 1,000 illegitimate live births 115 Deaths from Measles (all ages) Nil ,, Whooping Cough (all ages) 9 ,, Diarrhoea (under 2 years of age) 59 POPULATION (ESTIMATED). The population at mid-year 1935, is estimated at 308,170* persons. A decrease in the population of 13,625, when compared with the number of inhabitants ascertained at the census in 1931. MARRIAGES. Marriages, 3,052 ; Marriage Rate, 19.8.—There were 6,104 persons married, or 3,052 marriages in 1935, and the marriage rate, that is to say, the number of persons married per 1,000 of the population was 19.8. Compared with the previous year these figures show an increase of 346 in the number of persons married, or of 173 marriages , and of 1.5 per 1,000 in the rate. The following statement shows the figures for the previous ten years, 1925-1934. Years. Marriages. Marriage Rate. Years. Marriages. Marriage Hate. 1925 2,788 16.44 1930 3,063 18.80 1926 2,749 16.21 1931 2,957 18.21 1927 2,844 17.01 1932 2,857 17.60 1928 2,883 17.80 1933 2,486 15.60 1929 2,967 18.56 1934 2,879 18.30 * M.O.H. figure as used during year. 1935] 4 BIRTHS. During the year there were 4,577 live births registered, of which 2,303 were boys and 2,274 girls. Of this number, however, 812 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 14.85 per 1,000 of the population, as compared with a mean birth-rate of 17.12 in the preceding ten years. In 1933 the lowest birth-rate (14.35) was recorded. Showing the Births (distinguishing Males and Females) and Birth-rates of Islington in 1935, 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 1934; together with the mean Borough Birth-rates for the 10 years 1925-34. Quarter. Males. Females. Total. Birth Rates. Islington, 1935. Islington, 1925-34. London, 1935. Great Towns, 1935. First 598 554 1,152 14.95 17.74 13.4 14.9 Second 555 595 1,150 14.93 17.73 13.7 15.5 Third 609 581 1,190 15.44 17.11 13.5 15.3 Fourth 541 544 1,085 14.08 15.87 12.2 13.7 The Year 1935 2,303 2,274 4,577 14.85 17.12 13.2 14.8 1934 2,436 2,188 4,624 14.72 17.63 13.2 14.8 Increase or decrease — 133 + 86 — 47 +0.13 — 0.51 N.B.—The total registered births given by the Registrar-General for the Calendar year, 1935, will be found at the foot of table on p. 81. Showing the Births of Males and Females and the Birth-rates in each quarter and for the year, 1935, 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 107 87 194 24.9 104 77 181 24.7 44 39 83 11.6 61 59 120 12.5 2nd 145 122 267 34.3 54 44 98 13.4 43 45 88 12.3 53 60 113 11.8 3rd 124 135 259 33.2 77 75 152 20.7 41 31 72 10.1 60 69 129 13.5 4th 144 131 275 35.3 46 50 96 13.1 39 29 68 9.6 49 55 104 10.9 Year 520 475 995 31.92 281 246 527 18.00 167 144 311 10.90 223 243 466 12.18 Showing the Births of Males and Females and the Birth-rates in each quarter and for the year 1935, 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 90 88 178 12.7 92 89 181 14.2 100 115 215 11.6 598 554 1,152 14.95 2nd ,, 77 117 194 13.8 75 95 170 13.4 108 112 220 11.9 555 595 1,150 14.93 3rd ,, 99 78 177 12.6 83 80 163 12.8 125 113 238 12.9 609 581 1,190 15.44 4th ,, 72 104 176 12.6 74 80 154 12.1 117 95 212 11.4 541 544 1,085 14.08 Year 338 387 725 12.93 324 344 668 13.14 450 435 885 11.96 2,303 2,274 4,577 14.85 5 [1935 Illegitimate Births (173).—The illegitimate births numbered 173 and show a decrease of 1 on the return of the year 1934. They were equal to a rate of 3.8 per cent. of the total registered births. Notification of Births Act, 1907.—3,682 live births were notified (exclusive of 69 stillborn), or 80 per cent. of the total number that were 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. 1935. 1st Quarter 221 5 512 13 126 2 859 20 2nd ,, 337 4 534 9 121 3 992 16 3rd ,, 420 5 428 4 108 1 956 10 4th „ 403 15 387 7 85 1 875 23 Year 1,381 29 1,861 33 440 7 3,682 69 REGISTERED STILL-BIRTHS. Period. Certified by Doctor. Certified by Midwife. By Other Persons. Total. Registered. Per 1,000 of Total Births (including still born). 1935. 1st Quarter 23 3 — 26 29.6 2nd „ 14 4 — 18 17.8 3rd ,, 13 4 — 17 17.6 4th „ 17 10 — 27 30.1 Year 67 21 — 88 23.4 DEATHS. The deaths registered during the year numbered 3,387 (exclusive of stillbirths), while the death-rate was equal to 10.99 per 1,000 of the estimated population, or 0.86 below that of the previous year (11.85), and 1.65 below the mean of the preceding ten years; whilst the death-rate of England and Wales was 11.7 and the 121 Great Towns 11.8. 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 118 15.1 96 12.3 96 12.3 97 12.4 407 13.0 Upper Holloway 92 12.6 92 12.6 78 10.6 79 10.8 341 11.6 Tollington 96 13.5 73 10.2 47 6.6 78 10.9 294 10.3 Lower Holloway 114 11.9 89 9.3 85 9.0 116 12.1 404 10.5 Highbury 176 12.5 161 11.5 123 8.8 154 11.0 614 10.9 Barnsbury 147 11.6 144 11.3 128 10.1 164 12.9 583 11.5 Islington (SouthEast) 217 11.7 174 9.4 141 7.6 212 11.5 744 10.1 The Borough 960 12.45 829 10.75 698 9.06 900 11.68 3,387 10.99 1935] 6 Showing the Deaths and Death Rates of Islington in 1935, 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 1925-34 and the deaths and death-rates in the year 1934. Quarter. Males. Females. Total. Death Rates. Islington, 1935. Islington, 1925-34. London, 1935. Great Towns, 1935. First 468 492 960 12.45 17.37 12.9 13.2 Second 412 417 829 10.75 11.21 11.0 11.7 Third 356 342 698 9.06 9.43 9.0 9.2 Fourth 437 463 900 11.68 12.50 11.4 11.6 The Year 1935 1,673 1,714 3,387 10.99 12.64* 11.1 11.4 1934 1,929 1,794 3,723 11.85 12.68 11.8 11.8 Increase or Decrease - 256 - 80 - 336 - 0.86 - 0.0 - 0.7 — 0.4 * Mean Annual death rate for preceding ten years. 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, 1935. Mean Deaths (10 years, 1925-34.) Increase or Decrease on mean. 0-1 year 240 359 — 119 1-5 years 67 190 — 123 Tinder 6 years 307 549 — 242 5-15 years 58 94 — 36 15-25 „ 108 145 — 37 25-35 „ 137 181 — 44 35-45 „ 186 242 — 56 45-55 „ 299 437 — 138 55-65 603 675 — 72 65-75 ,, 857 847 + 10 75-85 „ 639 728 — 89 85 upwards 193 204 — 11 All Ages. 3,387 4,102 — 715 There was a decrease of 242 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 26 in the number of deaths when contrasted with the previous year 1934, and 90 below the ten years' average (1925-34). INFANTILE MORTALITY. Infant Deaths, 240; Mortality Rate, 52.—The deaths of 240 infants under twelve months old were registered during the year, or 119 below the decennial average (359), and they were equal to the infantile rate of 52 per 1,000 births. This is the lowest rate on record. The rate was 13 per 1,000 births below 7 [1935 the mean annual record of the preceding ten years, and is 10 per 1,000 below the rate of last year (1934). In the quarters the mortality ranged from 66 per 1,000 births in the first quarter, 49 in the second, 40 in the third, and 55 in the fourth. In the sub-registration districts the infant mortality was as follows :— Sub-District. Infant Deaths. Mortality per 1,000 Births. Tufnell 31 31 Upper Holloway 16 30 Tollington 16 51 Lower Holloway 46 98 Highbury 38 52 Barnsbury 57 85 Islington South East 36 41 In London the infantile mortality was 58 per 1,000 births. The rate for England and Wales was 57 per 1,000 births. Infantile Mortality during each of the Ten Years 1925-34 and 1935. Deaths at various ages under One Year of Age. Years. Under one week. Weeks. Total under four weeks. 4 weeks and under 3 mths. Months. Total Deaths under one year. Deaths per 1,000 Births. 1-2 2-3 3-4 3-6 6-9 9-12 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 15 11 147 64 68 73 51 403 73 1930 115 13 11 11 150 60 68 66 55 399 70 1931 93 17 10 19 139 50 51 62 35 337 64 1932 92 15 9 8 124 66 66 49 35 340 68 1933 88 10 18 15 131 54 32 41 30 288 63 1934 85 7 14 8 114 61 53 36 25 289 62 Mean 10 years 98 15 14 12 139 59 63 54 44 359 65 1935 82 9 6 3 100 32 48 41 19 240 52 Increase or decrease on mean — 16 — 6 — 8 — 9 — 39 — 27 — 15 —13 — 25 — 119 — 13 Showing the Deaths among Infants per 1,000 Births during the Year 1935. and also the mortality rates for the Years 1925-1934. Sub-Districts. 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 Mean 10 years 1935 Increase or decrease on mean Tufnell 47 64 52 65 75 78 43 48 26 31 53 31 22 Up. Holloway 57 30 31 44 42 26 35 30 54 52 40 30 —10 Tollington 65 92 63 85 71 106 90 88 101 78 84 51 —33 Lr. Holloway 78 82 74 77 95 57 84 77 68 81 77 98 + 21 Highbury 54 48 52 47 60 58 64 83 51 58 57 52 — 5 Barnsbury 75 90 59 75 87 95 66 76 80 76 78 85 + 7 Islington, S.E. 58 64 49 67 78 76 68 72 72 69 67 41 —26 The Borough 63 66 53 64 73 70 64 68 63 62 65 52 — 13 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. 1935] 8 Showing the Mortality per 1,000 Births among Infants under one year of age in the ten years 1926-34 : and in 1935 from certain specified causes. Causes of death. 1935. Rate per 1,000 Births. Mean rate 10 years 1925-34 per 1,000 Births. Difference. Premature Birth and Congenital Defects 17.04 200 — 2.96 Bronchitis and Pneumonia 9.4 13.8 — 4.4 Atrophy and Marasmus 1.5 3.6 — 2.1 Diarrhoeal Disease (all forms) 12.9 5.2 + 7.7 Convulsions 0.2 0.9 — 0.7 Whooping Cough 1.3 3.1 — 1.8 Measles 2.5 — 2.5 Diphtheria 0.4 — 0.4 Phthisis — 0.2 — 0.2 Other forms of Tuberculosis 0.6 0.7 — 0.1 Total of above 43.0 50.4 — 7.4 All other causes 9.4 14.4 — 5.0 Total 52.4 64.8 — 12.4 INFANTILE MORTALITY during the Year 1935. Nett Deaths from stated causes at various Ages under One Year of Age. Cause of Death. Under 1 week Weeks. Total under 4 weeks 4 weeks and under 3 months Months. Total Deaths under 1 year 1-2 2-3 3-4 3-6 6-9 9-12 All Causes. Certified - - - - - - - - - - Uncertified - - - - - - - - - - Small-pox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles - - - - - - - - - - Scarlet Fever - - - - - - - - - - Whooping-Cough — — — - — — 2 4 - 6 Diphtheria, Croup - - - - - - - - - - Erysipelas - - - - - - - - - - Tuberculous Meningitis - - 2 - 2 Abdominal Tuberculosis - - - - - - - 1 - 1 Other Tuberculous Diseases - - - - - - - - - - Meningitis (not Tuberculous) - - - - - - 1 1 2 4 Convulsions 1 - — — 1 — — - — 1 Laryngitis - - - - - - - - - Bronchitis - - - - - 2 1 - — 3 Pneumonia (all forms) 3 3 1 7 6 14 5 8 40 Diarrhoea - - - - 1 1 1 — 3 Enteritis 1 - — — 1 11 17 22 5 56 Gastritis — - — — — — — — — — Syphilis — - — — — 2 — 1 — 3 Rickets - - - - - - - 1 — 1 Suffocation, overlying - - - - - - - - - Injury at birth 4 - — — 4 — — — — 4 Atelectasis 2 - — — 2 — — — — 2 Congenital Malformations 12 3 2 1 18 1 1 1 1 22 Premature birth 50 3 1 — 54 1 1 — — 56 Atrophy. Debility and Marasmus 1 - - 1 2 3 2 - 7 Other causes 8 - — — 11 5 6 4 3 29 Totals 82 9 6 3 100 32 48 41 19 240 BIRTHS. Nett Births /legitimate 4,404 4,577 Nett Deaths in /"legitimate infants 220 240 in the year illegitimate 173 the year illegitimate infants 20 9 1935 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. 39 cases of Ophthalmia Neonatorum were notified, compared with 60 cases last year. 118 cases of Ophthalmia were reported by the London County Council and Health Visitors as against 131 cases during the previous year. 11 out of the 39 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. 7 2 3 4 2 6 15 39 Ophthalmia. Cases reported by L.C.C. 7 4 7 17 9 37 29 110 Cases reported by Health Visitors 2 1 — 2 — 2 1 8 Of the 39 cases investigated, both eyes of the infant were affected in 32 instances, whilst in 6 the right eye was involved, and in 1 the left. Treatment.—16 of the 39 Ophthalmia Neonatorum cases were admitted to St. Margaret's Hospital, 16 being treated at other Hospitals, and 7 cases were treated at home by private Doctors. 14 cases of inflammatory disease of infants' eyes were nursed by the North London Nursing Association for the Council at a cost of £10 18s. Od. In 1934 26 cases were nursed at the cost of £34 17s. Od. Results.—Of the 39 Ophthalmia Neonatorum cases, vision was unimpaired in all cases. (Two of these cases died from intercurrent disease.) Ophthalmia Neonatorum Cases. Vision unimpaired. Vision impaired. Total Blindness. Deaths. Notified. Treated. At home. In hospital. 39 7 32 39 Nil Nil Nil MATERNAL DEATHS. The number of women dying, pregnancy being a factor, during the year 1935 was 16. Our investigations showed 3 to be classifiable as Puerperal Sepsis and 5 from other puerperal causes. These 8 cases would give a Maternal Mortality Rate of 1.7 per 1,000 registered (" live " and " still ") births. In addition, there were 8 deaths of pregnant women from the following :—2 from valvular disease of the heart, 2 from pneumonia, 2 from " Violence,"* 1 from rheumatic fever and 1 from peritonitis. (*In the two " Violence " cases one resulted from self-induced miscarriage and in the other there was an " Open verdict "—in both of these cases sepsis had followed.) Taking the deaths as 16 would give a rate of 3.4. (See Table p, 11.) 1935] 10 It has been our practice for some years back to record all deaths of women in which, as a result of our investigations, pregnancy was found to be a complication. A Table showing such investigations from 1911 is given. For details of the Maternal Deaths for the year 1935 see page 11. The deaths for the preceding year numbered 20, and were equal to the proportion of 4.2 per 1,000 births. MATERNAL DEATH RATES FOR ISLINGTON. Year. No. of Live 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 1915 7,537 17 2.8 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 1931 5,281 28 5.3 1932 4,950 16 3.2 1933 4,581 25 5.3* 1934 4,624 20 4.2* 1935 4,577 16 3.4* *Rate per 1,000 registered live births and still births. 11 [1935 METROPOLITAN BOROUGH OF ISLINGTON MATERNAL DEATHS, 1935. (For those in 1934, see p. 11 of the Medical Officer of Health's Annual Report for that year.) 1935. 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. Jan. Acute infective endocarditis. Mitral stenosis accompanied by normal labour at home. Natural. P.M. Inquest. Coroner. ... 1 ... ... 1 ... 1 (a) Pelvic cellulitis and malignant endocarditis following labour (full term). Coroner. After P.M. Without Inquest. ... ... 1 ... 1 1 ... Feb. Parturition and prolonged labour (Caesarean Section). Mitral Stenosis. Chronic Rheumatism. Endocarditis. Coroner. After P.M. Without Inquest. ... 1 ... ... 1 ... 1 (b) Mar. Gas' Gangrene and Septicaemia infection at or after self-induced miscarriage (Syringing) P-M. Inquest. ... 1 ... ... 1 ... 1 (c) ,, la. Puerperal Septicaemia, b. Pelvic cellulitis, c. Parturition. No P.M. ... 1 ... ... 1 1 ... 1st Qr. ... 4 1 ... 5 2 3 April Lobar Pneumonia and Pleurisy. Coroner. P.M. Without Inquest. ... 1 ... ... 1 ... 1 (d) May Anaemia and Obstetric shock. Difficult labour (primiparous). Coroner. After P.M. Without Inquest ... ... 1 ... 1 ... 1 2nd Qr. ... 1 1 ... 2 ... 2 Aug. Vomiting and pregnancy (4 months pregnant) Terminal Acute Broncho Pneumonia. P.M. Coroner. Without Inquest. 1 ... ... ... 1 ... 1 (e) Sept. Antepartum and Postpartum Haemorrhage. Toxeamia of pregnancy, full term. Coroner. After P.M. No Inquest. 1 ... ... ... 1 ... 1 3rd Qr. 2 ... ... ... 2 ... 2 Oct. la. Toxaemia, accidental Haemorrhage. (38 weeks). P.M. ... 1 ... ... 1 ... 1 Nov. la. Heart failure. b. Splenic Anaemia. 2. Childbirth (premature labour). Local Uterine Sepsis (peurperal). 1 ... ... ... 1 1 ... " Pyaemia. Uterine Sepsis at 4 months of pregnancy due to unknown cause. Open verdict. P.M. Inquest. ... 1 ... ... 1 1(f) ... " (a) Shock, (b) Post-partum Haemorrhage. P.M. ... 1 ... ... 1 ... 1 (a) Shock Haemorrhage and General Peritonitis, (b) following ruptured uterus after extraction of Hydracephalic foetus. P.M. ... ... 1 ... 1 ... 1 Dec. la. Morbus Cordis, (b) Mitral Stenosis (c) Myocarditis. II. Childbirth. Chronic Bronchitis. ... ... 1 ... 1 ... K(g) la. Subphrenic abscess, (b) General Peritonitis, (c) Caesarean Section 19-12-36. P.M ... ... 1 ... 1 ... 1(h) 4th Qr. 1 3 3 ... 7 2 5 Classifications (a) As Mitral Valve disease, (b) As Rheumatic Fever, (c) As Violence. (d) As Pneumonia. (e) As Pneumonia. (f) As Violence, (g) As Mitral Valve Disease. (h) As Peritonitis. 1st Quarter 5 = 4.2 2nd Quarter 2 = 2.0 3rd Quarter 2 = 2.0 4th Quarter 7 = 6.3 Year 1935 Total 16 = 3.4 Rate per 1,000 registered Live and Still-births. 1935] 12 PUERPERAL FEVER. Of the 24 cases coming to the knowledge of the Medical Officer of Health during 1935, 3 were notified by Private Practitioners. The proportion of total cases to births was 5.24 per thousand. The notifications were 11 below the average (35) of the preceding ten years and showed a decrease of 1.05 in the proportion of attacks to 1,000 births. Cases of Puerperal Fever notified and inquired into during the year 1935. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. SouthEast. The Borough Cases notified 3 2 4 2 5 6 2 24 Private Practitioners' Cases — — 1 1 — 1 — 3 Hospital Cases 2 2 3 — 5 6 2 19 Certified Midwives' Cases 1 — — 1 — — — 2 Cases inquired into 3 2 4 2 5 6 2 24 Cases treated in Hospital 3 2 4 2 5 6 2 24 Cases treated at Home — - - - - - - — All the 24 cases were treated in hospitals, 19 having the " onset " there, and the remaining 5 were subsequently removed to hospital. Of the cases, 4 were dealt with in London County Council Infectious Diseases Hospitals, and 20 in either St. Mary, Islington, Hospital, or other London Hospitals. Deaths.—3 deaths were registered as being due to Puerperal Fever. PUERPERAL PYREXIA. Notification of Puerperal Pyrexia Regulations, 1926.—There were 48 cases notified, as against 67 last year. Of these, 12 were Private Medical Practitioners' cases; 35 occurred in Hospital, while 1 was a certified Midwife's case. The notifications were in the proportion of 10.5 per 1,000 births. Cases of Puerperal Pyrexia notified and inquired into during the year 1935. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. SouthEast. The Borough Cases notified 5 7 2 2 8 10 14 48 Private Practitioners'Cases 1 2 — 1 1 3 4 12 Hospital Cases 4 5 2 1 6 7 10 35 Certified Midwives' Cases — — — _ 1 1 Cases inquired into 5 7 2 2 8 10 14 48 Cases treated in Hospital 5 6 2 1 6 10 14 44 Cases treated at Home - 1 — 1 2 — — 4 The services of the Consultant were sought on five occasions during the year. Early in the year this service was extended to include cases of Difficult Confinement. One bacteriological examination was made in a case of suspected Puerperal Sepsis, with negative result. PEMPHIGUS NEONATORUM. During the year 1935, two cases came to the knowledge of the Medical Officer of Health, and both recovered, 13 [1935 THE MILK SCHEME FOR NECESSITOUS EXPECTANT AND NURSING MOTHERS AND CHILDREN UNDER FIVE YEARS OF AGE. During the year 1935, 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 £1,967 5s. Id., as against £1,887 19s. 5d. in 1934. The total amount expended since the Order came into operation in 1918 is £66,162 8s. 10d. The total recipients during the year numbered 7,852, and the quantity of milk supplied to them was equal to 172,816 pints (21,602 gallons). DISTRIBUTION OF MILK TO NECESSITOUS MOTHERS AND CHILDREN. Scale of Income adopted by the Council, 18th January, 1935 :— 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 purpose 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. HOME HELPS. The Borough Council, towards the close of the year, adopted a Home Help Scheme, but no case was dealt with during the year under review. 14 1935] SUMMARY OF WORK OF MUNICIPAL HEALTH VISITORS FOR YEAR ENDING 1935. District No. 1 2 3 4 6 6 & 8 7 9 I.L.P. Not included in totals†. Totals. I. Births, First Visits, Infants under 1 Year 577 521 544 767 595 734 357 177 2 4,272 II. Births, Re-Visits, Infants under 1 Year 373 412 628 712 492 1,106 700 230 8 4,653 III. Visits to Children, between 1st and 2nd Years 386 391 597 578 500 1,356 434 118 9 4,360 IV. Visits to Children, between 2nd and 5th Years 1,071 1,341 1,630 1,652 1,141 1,890 1,525 723 18 10,973 V. Visits re Still Births 8 18 13 18 18 20 9 2 106 VI. Deaths, Visits, re Infants under 1 Year 9 6 16 6 9 15 3 1 65 VII. Deaths, Visits, re Children 1 to 5 years 1 — 4 — 2 4 — — 11 VIII. + Pre-Natal, Home Visits F/267 305 f/286 354 F/250 317 f/298 326 f/179 193 f/244 298 F/170 224 f/60 96 f 1 F/1,754 2,113 IX. fpuerperal f Fever, Home Visits F/3 5 F/4 8 F/5 13 f/5 6 F/3 6 f/ 2 f/ 1 f/23 41 Pyrexia, do — — - - f 1 F/1 2 - — f/2 3 Totals 2,735 3,051 3,762 4,065 2,957 5,427 3,253 1.347 38 26,597 X, Attendances at Welfare Centre* 46 24 46 46 48 1 44 25 17 280 XI. Other Work by Direction 1,111 547 1,207 794 600 1,120 1,537 391 6 7,307 XII Visits Declined 3 3 1 1 - 1 9 XIII. Visits, House Shut ... ... 850 1,079 846 989 1,065 736 607 627 6,799 XIV. Visits, Inopportune 71 9 5 - 20 7 2 — 114 Grand Total of Visits 4,816 4,710 5,869 5,894 4,691 7,292 5,443 2,391 61 41,106 * M.O. Consultation, Weighing babies. Dressings, Temperature taking, Selling of Dried Milk, Talk to Mothers, † Infant Life Protection Visits. 15 [1935 SUMMARY OF WORK OF MUNICIPAL HEALTH VISITORS FOR YEAR ENDING 1935—Continued. Disirict No. 1 2 3 4 5 6 & 8 7 9 I.L.P. Not included in totals Totals Analysis of Visits included in I.-IX. relating to (aa)†Reported Ophthalmia F/2 8 F/9 16 F/22 44 F/10 18 F/27 60 F/34 72 F/6 14 F/3 5 — F/1 13 237 (a) †Ophthalmia Neonatorum F/2 6 F/3 7 F/3 4 RE 1 F/5 14 F/9 19 F/14 9 F/2 5 — F/38 65 (b) †Epidemic (Summer) Diarrhoea — — — — — - — — (c) Other Digestive Diseases 1 1 — 1 1 — 4 (d) Pneumonia and Bronchitis 13 13 7 - 7 10 6 — — 56 (e) Rickets 14 14 7 9 5 14 — — — 63 (f ) †Measles and German Measles — — — — F 9 — — — F 9 (g) †Whooping Cough F 36 F/26 35 F/33 34 F. 2 F 26 F 50 F26 2 7 — — F 199 210 (h) Tuberculous Disease—P = Pulmonary; O=Other 0 1 — — — p 1 p 1 — — p2 ol 3 (i) Convulsions — — — — — — — — — — ( j ) †Polio-myelitis — — — — — — — — — — (k) Premature Birth 16 4 22 6 12 23 16 — — 99 (l) Atrophy, Debility and Marasmus - — — (m) All other investigations (**Specify) 12 20 27 — 21 42 6 — — 128 (m) Routine Visits included in I. to IX. and not included in (aa) to (m) 2,630 2,940 3,616 4,029 2,812 5,186 3,173 1,337 38 25,723 ***Totals (a) to (n) 2,735 3,051 3,762 4,065 2,957 5,427 3,253 1,347 38 26,597 Total Families Visited 1,974 2,103 2,864 3,118 2,138 4,178 2,560 1,116 38 20,051 Registered Births. New Cases Handed to H Vs. for Visitation Infant Mortality. Maternal Mortality. Puerperal Fever. Puerperal Pyrexia. Ophthalmia Neonatorum. No. Rate. Notified Births Non-Notified | Transfers Births. | In. No. Rate. No. Rate. Cases. Removals Cases. Removals. Cases. Removals. 4577 14.84 4,490 61 | 776 240 52 8 1.7 24 22 48 38 39 29 **e.g.—Infectious Diseases other than Measles, Whooping Cough, Epidemic Diarrhoea, Polio-myelitis, etc. Syphilis, Rheumatism, N.N.B. Illegit., etc. ***Totals (aa) to (n) should correspond with Totals I. to IX. †F. in front of figures denotes a "First Visit." 1935] 16 VOLUNTARY WELFARE CENTRES. Each year for comparative purposes a Table is given which summarises as far as possible the work of the Voluntary Welfare Centres. The Table is compiled from the reports provided by the Centres of information which the Medical Officer of Health has to supply to the Ministry of Health for the calendar year. Table—Calendar Year, 1935. North. South. East. West. Total. 1. Pre-Natal Clinics. Number held weekly 3 1 Ctr. 1 Rose 1* 1 7 „ of Expectant Mothers who attend 731 Br'ch. 260 105 1,293 197 „ of attendances 1,930 451 624 297 3,302 2. Post-Natal Clinics. Number held weekly 1 2 †l †l 5 „ of mothers who attend 277 146 45 40 508 „ of attendances 583 221 80 76 960 3. Consultations for Children up to 5 Years of Age. Total No. of children who first attended at the centres during year, and who, on the date of their First attendance, were:— i. Under 1 year 896 717 472 558 2,643 ii. 1—5 years 167 134 128 86 514 Number of attendances :— i. Children under 1 year 11,827 10,813 8,557 6.075 37,272 ii. 1—5 years 6,851 8,401 6,831 4,372 25,455 4. Home Visiting. Number of visits made to i. Expectant mothers:— (a) First Visits 447 131 186 77 841 (b) Total Visits 2,363 271 1,083 222 3,939 ii. Children under 1 year :— Total Visits 5,532 5,566 3,368 2,445 16,911 iii. Children 1—5 years 7,545 6,990 5,564 4,226 24,324 6. Wards and Homes. Number of beds 18 12 - 8 38 Number of patients received :— i. Mothers and Babies :— (a) Mothers 47 79 - 126 (b) Babies 47 86 133 ii. Babies only 98 — 95 193 6. Number of Children who attended at the Centres during the Year, and who, at end of Year, were :— i. Under 1 year 776 583 393 421 2,173 ii. 1—5 years 1,631 1,095 784 721 4,231 7. Convalescence. Number of cases :— i. Mothers 26 13 77 22 138 ii. Children 42 23 199 28 292 * Plus one extra Clinic per month. East and West Centres, Post-Natal Clinics are held with their Pre-Natal Clinics 17 [1935 THE WORK OF THE FOUR VOLUNTARY WELFARE CENTRES. The Centres themselves for the year 1935, through their Conjoint Committee, supplied for each Centre a report of activities, from which the following information has been compiled. This summary, of course, is on the nature of the work and is not intended to be a statistical review. The work of the four Voluntary Welfare Centres (North, South, East and West), and their Branches, which was described in some detail by the Secretaries in last year's Report, has been fully maintained this year. During 1935 the number of mothers and babies attending the Centres exceeded 8,200. It cannot be too clearly stated that the object of these Centres is preventive and educative health work for mothers and babies. They aim at helping the parents to rear healthy children by bringing the latest scientific knowledge within their reach and understanding, and by giving them the benefit of highly skilled supervision for the mother before and after the birth of her child, and for the child until it reaches school age. In order to do this the mothers are encouraged to come to the Centres for themselves, to the Pre-Natal and Post-Natal Clinics, and to bring their children for regular medical inspection to the children's clinics. The nurses visit the mothers in their homes, to help them to carry out the Doctors' directions and to overcome their individual difficulties. These activities have led the Centres to develop other preventive measures and to work in close contact with various individuals and bodies both inside and outside Islington, whose object is also to improve the health of mothers and children. Details were given last year and are to some extent indicated in the statistical tables. Activities Provided or Procured by all the Four Centres are :— 1. Pre-natal and Post-natal Clinics. 2. Children's clinics. 3. Visiting in the homes. 4. Morning callers. (Mothers who attend for help and advice between consultations.) . 5. Health Talks. Various classes. 6. Convalescence for mothers and children. 7. Dental clinics. 8. " Light " clinics. 9. Massage. 10. Extra nourishment. 11. The Training of Infant Welfare Students. The Additional Benefits Provided or Procured by the Centres are : 1. Convalescent Homes (a) Mothers and Infants (b) Toddlers 2. Residential Observation Wards 3. Savings Clubs 4. Training of Infant Welfare Pupils 5. Home Helps 6. Mothers' and Fathers' Committees (see Centre's own Annual Report) 7. Exercise Clinics 8. Immunisation (see p. 32) North South East West — + — — + — — + + + - — + + + - + - _ _ + + — — - - + — 1935] 18 NORTH ISLINGTON INFANT WELFARE CENTRE. 6 and 7, Manor Gardens, N.7. Pre-natal and Post-natal Clinics.—Closer co-operation has existed during 1936 between the Centre and the various hospitals that undertake pre-natal and postnatal clinics, which is obviously an advantage to the mothers. Although the work of the Centre has been somewhat affected by the increased number of pre-natal and post-natal clinics held at Hospitals, the total number of mothers attending the Clinics at the North Centre has increased during the past year. Free dinners are given at the Centre to nursing and expectant mothers with the assistance of the Mayor's Grant. SOUTH CENTRE. Centre, 6, Clephane Road, N.l. " Rose " Branch, 15, Popham Road, N.l. Canonbury Branch held at 100, Canonbury Road, N.L The work of the three Centres and the Convalescent Cottages for mothers and babies and toddlers has continued on the same lines as last year. The attendances are well maintained at the " Rose " Branch, which serves the poorest part of the district, and where there is much need of the teaching which the Centre can offer. The dinners provided through the Centre by the Invalid Kitchens from the Mayor's Grant for necessitous nursing mothers have proved of great value to the health of many mothers and infants. EAST CENTRE. Centre, 32, Drayton Park, N.5. Branch at Highbury Quadrant Mission Hall, Hurlock Street, N.5. A new venture on the educational side is the practical class given once a month to young expectant mothers. They are taught to bath a new baby—make its clothes—and the general hygiene of pregnancy. All East Islington mothers are welcomed, and many such have been sent by Hospital Almoners. Continued efforts have been made to reduce Maternal Mortality and Morbidity. Free dinners are given at the Centre to nursing and expectant mothers with very beneficial results. WEST CENTRE. Centre, 42 and 14, Richmond Road, N.L Branch held at St. Luke's Mission Hall, Goodinge Road, N.7. No new variety of work has been undertaken this year except that the massage clinic has been started again with good attendances and results. The observation wards have been full throughout the year, and the sunny balcony room fitted with vita-glass gives the maximum amount of air and sunshine to the babies and toddlers who are admitted to the Wards suffering from feeding difficulties, and for training in good habits of sleep and feeding, etc. The free dinners for which the Mayor sends a yearly Grant have been of the greatest benefit to the necessitous expectant and nursing mothers, and the improvement in health has been very noticeable. A Statistical Summary follows, extracted from the Annual Reports of the Centres for their year ending 31st March, 1935. 19 [1935 Attendances, etc., at the various Departments of the Four Voluntary Centres, year ending March 31st, 1935. North. South. East. West. Total. 1. Pre-Natal Clinics and Ailing Mother Clinics. Number held weekly 4 2 †l §1 8 „ of attendances 2,818 846 674 *269 4,607 2. Consultations for Children up to 5 Years of Age. Number held weekly 10 11 **11 7 39 „ of attendances 22,337 19,555 16,591 11,314 68,797 3. Home Visiting. No. of visits made 16,313 14,071 10,861 7,434 48,679 4. Dental Clinics. Number attending 613 180 110 76 979 „ of attendances or arrangements made for attendances 1,889 610 2,399 5. Morning Callers. Number of attendances 1,236 637 ‡- 1,109 2,982 6. Massage Clinics. No. of cases given massage or sent for massage 79 88 (& Sunlight treatment) 106 19 292 7. Wards. Number of beds 18 - 8 26 „ of patients received 166 — — 83 249 8. Number of Children on Books 1,987 1,468 1,146 891 5,492 § Birth Control Clinic takes the place of one Pre-natal Clinic on 2nd Tuesday in month. † Extra Clinic held 2nd Thursday in month. * Attendances of Expectant mothers only. ** Including 2 Observation Clinics. ‡ Not recorded. NATIONAL SOCIETY FOR THE PREVENTION OF CRUELTY TO CHILDREN. The three local Inspectors of the Society have throughout the year co-operated with my Department in dealing with cases coming within the objects of their work. In 30 new cases their assistance was sought, one being through the receipt by the Medical Officer of Health of an anonymous letter—the allegations proved to be true—and two others were connected with the Infant Protection Work of the Department. In addition, the Society's Inspectors kept close touch with 7 cases that had been reported to them in former years and still needed supervision. INFANT LIFE PROTECTION—CHILDREN AND YOUNG PERSONS ACTS—1908 to 1932. In this work the aim of the Department is to increase the number of fostermothers who would be willing to undertake the care of a child and thus reduce the number of children cared for by the individual foster-mother, our experience being that a child is more likely to get better attention where only one is in a household rather than in those cases where three or four are under the care of one foster-mother. Both the numbers of foster-mothers and foster-children on the register at the close of the year are slightly less than in the preceding year, but the number of children actually dealt with by the Department showed an increase. 1935] 20 Complaint of improper care in 6 cases was received and investigated, 2 of which led to prosecutions, and in one of these an Order from a Justice had to be obtained before the foster-mother would give up possession of the child. At the subsequent proceedings in the Police Court, this foster-mother was fined 10/- and ordered to pay 20/- costs for failing to notify a change of residence. This fostermother had been warned previously for a similar offence. In the second case proceedings were instituted for failing to notify a change of residence, with a like result as to fine and costs. Upon the Infant Protection Visitor reporting the above 6 cases, besides the two mentioned (Prosecutions), 3 were dealt with by the Maternity and Child Welfare Committee without recourse to legal proceedings, and the other was satisfactorily attended to by her. Of the three " Committee " cases, permission was given to one foster-mother for the nurse-child to be placed in a Day Nursery while the foster-mother was at work, pending the child's admission into Dr. Barnardo's homes. In another of these cases the child's mother was prevailed upon to find a foster-mother of a more satisfactory character, and no other children have been placed with the foster-mother complained of. The third case resulted in a night visit, mentioned below. Night visits were paid by the Superintendent and the Infant Protection Visitor to 3 foster-mothers, one of whom (referred to in the last paragraph) was subsequently summoned to appear before the Maternity and Child Welfare Committee on a charge of neglectful conduct towards the children under her care. This has resulted in a very marked improvement in the welfare of the children and the observance by the foster-mother of the requirements of the Acts. The other two visits showed that good care was being taken of the children during the night. Upon receipt of a notification from a person that she proposes to take a child for reward, the Infant Protection Visitor makes an investigation as to the suitability of the person and the premises, and in 8 cases conditions were such that the persons were advised to refrain from taking a child, and this advice was followed. During the year 3 deaths of foster-children occurred, one in the Royal Northern Hospital, one in St. Mary, Islington, Hospital, and the other in a " Home." No inquests were held. In each case the child was under 4 months of age. In the Royal Northern Hospital case there was no post-mortem, the cause of death being gastro enteritis and broncho-pneumonia. In the St. Mary, Islington, Hospital case a post-mortem was held, and the cause of death certified as gastroenteritis and marasmus. The " Home " case was found dead in bed, and the post-mortem showed the cause of death to be acute bronchitis and gastro-enteritis. In both the hospital cases the children were in poor condition when received by the foster-mother, and upon no improvement being made by careful feeding and attention, the assistance of the hospital was obtained. Number of foster-mothers on the Register who were receiving children on the 1st January, 1935 142 Do. do. on the 31st December, 1935 137 Number of foster-mothers added to the Register during the year 34 Number of foster-mothers removed from the Register during the year 3 Number of foster-children on the Register at 31st December, 1935 212* Number of foster-children attending Child Welfare Clinics 92 *Includes those in institutions, etc. 21 [1935 Total visits paid to homes 1,702 Special visits paid 9 Children removed compulsorily 1 Children removed to hospital 19 Children removed voluntarily 9 Deaths reported (Inquests—Nil) 3 Children for whom medical attention arranged 7 Cases recommended for prosecution 2 Other cases in which there was cause for complaint 4 Number of foster-children under 5 years on Register during 1935 318 (with foster-mothers 208) (with Institutions 110) Number of foster-children between 5 years and 9 years on Register during 1935 81 (with foster-mothers 78) (with Institutions 3) Total number of foster-children on Register during 1935 399 (with foster-mothers 286) (with Institutions 113) By Order of Single Justice including Infectious disease Institutions, including Schools.—110 children under 5 years of age passed through institutions. These children are medically examined periodically by an appointed Medical Officer. No resident school child under 9 years of age was reported during the year. The St. Luke's " Guest House," Penn Road, N.7, co-operates with the North Islington Welfare Centre, where the children may be sent for any treatment such as massage or artificial " Sunlight," and where cod liver oil, etc., may be obtained. Number of foster-children who attended Welfare Centres or under private medical practitioners, 101. Of these, 93 attended Centres and 8 private practitioners. REPORT ON THE WORK OF THE DAY NURSERIES RECEIVING GRANTS FROM THE BOROUGH COUNCIL. There are three Day Nurseries in the Borough. No. of places provided No. of attendances during 1935 i. Lower Holloway Day Nursery, 547, Liverpool Road, N. 50 10,288 ii. South Islington Pro Patria Day Nursery, 9, Canonbury Lane, N.l 50 8,803 iii. St. Luke's Day Nursery, 29 and 30, Penn Road, N.7 30 5,171* Total ... 130 24,262 *Guest House. The " Guest House " in connection with St. Luke's Day Nursery has accommodation for 12 children (and two extra in an emergency). During the year ending March 31st, 1935, the admissions numbered 50. The accommodation has always been fully taken up, and there were many demands for admission which could not be complied with. 1935] 22 MATERNITY AND CHILD WELFARE. Contributions by the Borough Council. Year ending 31 st March, 1936. Voluntary Welfare Centres. Day Nurseries. £. £. North Centre 5,461 Lower Holloway 244 South Centre 2,500 St. Luke's 229 East Centre 1,901 South Islington 600 West Centre 1,926 Total £1,073 Total £11,788 This Nursery is a municipally owned building-. (No rent charged for its use.) INVALID CHILDREN'S AID ASSOCIATION. The Borough Council contributes £25 per annum to the Local Branch of this Association. During the year, 45 Islington children under five years were given periods of convalescence either in the country or by the sea, and 26 crippled children of like ages, were provided with surgical appliances, splints, special boots, etc. 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 £12 1 0 Under Public Health £20 11 Of Total £32 18 0 f Includes also nursing of pneumonia (adult). 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, £60 10s. Od. ; Royal Free Hospital, £6 10s. Od. In addition to these, cases of Ophthalmia Neonatorum and Marasmus are admitted to the London County Council's Hospital (St. Margaret's), Camden Town, N.W. and Queen Mary's Hospital, Carshalton. GRANTS TO MIDWIVES. (i) " Necessitous cases " confined at home. (ii) Where Medical Officer of a Centre has intervened in sending the midwife's patient to hospital. The Borough Council of Islington during the year, with the approval of the Ministry of Health, have introduced a scheme, in certain approved cases of bona fide Islington residents, to provide a small grant to the Midwife where the family is necessitous and unable to pay the usual moderate charge of the Midwife for the confinement at the patient's home. In such cases the Midwife should apply to this Department for the application form on which to fill in the particulars which are required for the information of the Borough Council. 23 [1935 Also, the Minister of Health lias approved a small grant to Midwives, by way of compensation, where patients (bona fide Islington residents), under independent private practising Midwives are concurrently attending, on their advice, a Prenatal Clinic and are subsequently admitted to hospital, for confinement, on the recommendation of the Medical Officer of the Clinic. The Minister has laid down other conditions, which must be complied with, as follows :— (a) That in such cases the patient will be required to confirm the ment that she had engaged the midwife to attend her confinement and had been referred by the midwife to the clinic. (b) That the Medical Officer of the clinic will certify that he or she advised the patient to be confined in a hospital or " Home." (c) That no payment will be made to the midwife where the patient self has applied to be confined in a hospital or " Home." Any application for this grant should be made by the Midwife to the Medical Officer of Health, Public Health Department, Town Hall, giving full particulars. Special Reports.—During the year 1935 among other special matters reported on to the appropriate Committees were :— January 8.—Report by Medical Officer of Health on Maternity Services, dealing with (i) the pre-natal service, (ii) ensuring that the services of a trained midwife are available for all confinements, (iii) provision of beds for complicated cases and for patients where home conditions are unsuitable, (iv) provision for cases of puerperal sepsis, (v) provision of a Consultant in difficult or complicated cases of confinement. April 9.—Report on the three Day Nurseries in the Borough. May 23.—Report on sites for ,Nursery Schools and Day Nurseries. (Included in the latter might be mentioned the Scholefield Road site, brought before the Committee by the Medical Officer of Health on the 9th July, 1935, on which several reports have been made.) September 10.—Report on proposed establishment of Municipal Midwifery Service. November 5.—Report on the Home Help scheme (scheme since adopted). December 3.—Report on Salaried Service of Midwives. DEATHS IN PUBLIC INSTITUTIONS. Within the Borough.—2,380 persons died in the Public Institutions located in Islington, of whom 1,486 belonged to this Borough, the remaining 894 having come here for treatment or relief. Of this latter, 496 died in the Archway Hospital, 206 in the Royal Northern Hospital, 42 in the London Fever Hospital, 94 in the St. Mary, Islington, Hospital and Islington Institution, and 15 in the Mildmay Memorial Hospital. Of the 1,486 deaths, 1,075 occurred in the St. Mary, Islington, Hospital, 169 in the Islington Institution, 104 in the Royal Northern Hospital, and 91 in the Archway Hospital. The proportion whicn the 1,486 deaths in the Public Institutions bore to the Borough mortality was 43.8 per cent. During the previous year (1934) the total deaths in Local Institutions numbered 2,350, being 1,536 inhabitants of Islington in Local Institutions, plus 814 non-inhabitants of Islington in Local Institutions, the number in St. Mary, Islington, Hospital being 1,058, the number in the Royal Northern Hospital 118. The 1935] 24 deaths of inhabitants of Islington in Institutions outside the Borough were 1,293. The total deaths of Islingtonians in all Institutions were 2,829, and the proportion per 100 deaths from all causes equalled 76.0. Without the Borough.— 804 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, 10 in the North-Western Fever Hospital, 17 in the Children's Hospital, Great Ormond Street, 42 in St. Bartholomew's Hospital, 31 in the Infirmary, Friern Barnet, 42 in the Royal Free Hospital, 39 in the University College Hospital, 7 in the North-Eastern Hospital, 5 in the Eastern Fever Hospital, 29 in the Middlesex Hospital, 6 in the City of London Maternity Hospital, 27 in the Metropolitan Hospital, 24 at la, Manor Road, Ilford (Claybury), and 18 in Tooting Bee Hospital. These 804 deaths represented 23.7 per cent, of ajl the deaths registered in the year. Within and Without the Borough.—The deaths of Islingtonians numbered 2,290, and were equal to 67.6 per cent, of the total deaths registered during the year. Fatal Accidents or Sudden Deaths outside the Borough.— 27 inhabitants died from accidents, or suddenly, in places outside Islington. Transferable Deaths. —During the year 44 deaths of residents that had occurred in outlying Institutions and other places in Provincial Boroughs were transferred by the Registrar-General to Islington. MORTALITY FROM THE PRINCIPAL EPIDEMIC DISEASES. Small Pox, Measles, Scarlet Fever, Whooping Cough, Diphtheria, Fevers— Typhus, Enteric and Continued—and Diarrhceal Diseases. During the year 99 persons died from these diseases, the death-rate being 0.31 per 1,000 inhabitants, as contrasted with 0.46 in 1934, and a decennial averagi mortality of 163 and a death-rate of 0.50 per 1,000. In London the death-rate from epidemic disease was 0.26. 25 [1935 Locally the deaths in the Sub.Registration Districts and Wards were as follows :— Showing the Deaths from each of the principal Epidemic Diseases tn the several Wards and Sub.Registration Districts during the Year 1935. Sub. Registration Districts. Wards Enteric Fever. Small Pox. Measles Scarlet Fever. Whooping Cough. Diphtheria. Enteritis and Diarrhoea. Totals Tufnell Tufnell 2 8 10 Up. Holloway Up. Holloway 5 5 Tollington Tollington ... — — — — — 2 5 7 Lr. Holloway Lr. Holloway — — — — 1 2 15 18 Highbury Highbury — — — — 1 — 9 10 Mildmay — — — — — 1 6 7 Barnsbury Thornhill — — — — 1 — 9 10 Barnsbury — — — — 3 1 5 9 Islington South East"! St. Mary's — — — — 2 2 6 10 Canonbury 1 4 5 St. Peter's — — — — 1 2 5 8 The Borough — — — — 9 13 77 99 Total Death Rates — — — — 003 0.04 0.24 0.31 Showing the Deaths and Death.Rates from the Principal Epidemic Diseases during the ten yeats 1925.34 and for the Year 1935. 1925 1926 1927 1928 1929 1930 Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths. Death Rates. Deaths Death Rates. Deaths. Death Rates,[/$$$] Enteric Fever 4 001 1 0.00 2 0.00 2 0.01 Small Pox — — — — — — — — 1 0 00 Measles 22 0.06 69 0.20 29 0.09 156 0.48 11 0.03 140 0.43 Scarlet Fever 8 002 12 003 8 0.02 8 0.03 8 0.0:1 14 0.04 Whooping Cough 61 0.20 29 009 45 0.14 21 0.06 126 0.39 10 0.03 Diphtheria 21 0.06 31 0.09 25 0.07 25 0.08 32 0.10 42 0.13 Diarrhoea and Enteritis (under 2 years) 691 10.54 691 10.68 "{ 7.79 67 11.57 681 12.34 { 97 J 171 per per per per per per 1,000 1,000 1,000 1,000 1,000 1,000 births births births births births births 1931 1932 1933 1934 Mean 10 years 1935[/$$$] Deaths. , Death Rates j Deaths. | Death Rates. Deaths. Death Rates. Deaths. Death ! Rates. Deaths. Death Rates. Deaths. Death Rates. | Enteric Fever — — — 4 001 1 0.00 1 0.00 — Small Pox ... — — — — — — — — — — — Measles 7 0.02 52 0.16 14 004 39 0.12 54 0.16 — — Scarlet Fever 4 0.01 7 0.02 4 0.01 5 0.02 8 0.02 — Whooping Cough 32 0.10 23 0.07 23 0.07 15 0.05 38 0.12 9 0.03 Diphtheria 15 0.04 20 0.06 33 0.10 32 0.10 28 0.08 13 0.04 Diarrhoea and Enteritis (under 2 years) 67 12.7 73 j 14.7 63 13.7 47{ 10.2 67 121 65 14.2 per per per per per per 1,000 1,000 1,000 1,000 1,000 1,000 births births births births births births 19 35] 26 Showing the Deaths from Diarrhoeal 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. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals. Diarrhoea. Enteritis, etc. Totals.[/$$$] Under 1 year 1 23 24 12 12 9 9 2 12 14 3 56 59 1 to 5 years 3 3 1 1 2 2 — — —• — 6 6 Over 5 years 4 4 2 2 4 4 — 2 2 — 12 12 Totals 1 30 31 — 15 15 — 15 15 2 14 16 3 74 77 INFLUENZA. Influenza caused 29 deaths during- the year and showed a decrease of 10 on the return for the year 1934, and were 65 below the average of the preceding ten years 1925-34. The death-rate was equal to 0.09 per 1,000 inhabitants. Showing the Deaths from Influenza in the Quarters of the Year 1935, together with the averages of the corresponding periods, 1925-34. Years. Quarters. Totals.[/$$$] First. Second. Third. Fourth. 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 1930 5 4 3 4 16 1931 68 4 4 14 90 1932 82 9 4 8 103 1933 162 1 — 7 170 1934 17 12 1 9 39 Average 72 10 3 9 94 1935 6 16 1 6 29 Increase or Decrease — 66 + 6 — 2 — 3 — 65 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 1935. Ages. 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 Mean lOyrs 1935 Difference.[/$$$] 0- 5 6 8 3 5 1 4 5 4 4 3 — 1 5-10 2 1 4 1 1 — — — — 1 1 1 — 10-15 — — 1 — — — — — — 15-25 2 2 3 3 2 — 4 3 3 — 2 3 + 1 25-35 1 4 13 1 9 — 4 9 10 2 5 — 5 35-45 3 8 21 6 19 14 4 24 1 10 3 — 7 45-55 11 6 22 4 38 5 16 10 27 6 15 3 — 12 55-65 11 12 28 6 43 3 16 18 32 5 17 6 — 11 65-75 19 8 34 7 52 2 15 25 33 11 21 8 — 13 75 & upwards 17 10 18 10 38 5 17 29 37 13 19 2 — 17 All Ages ... 72 51 152 41 207 16 90 103 170 39 94 29 — 65 27 [1935 SEPTIC DISEASES. Erysipelas and Puerperal Septicaemia are the notifiable diseases of this class. Erysipelas—14 deaths were returned from this disease, or 10 less than in the year 1934, and 1 below the average of the preceding ten years 1925-34. Puerperal Diseases.-—These comprise Puerperal Pyaemia, Septicaemia, Septic Intoxication and Puerperal Fever, and they caused 8 deaths, being four less than in 1934, and were equal to the average of the ten years 1925-34. The deathrate was equal to 1.7 per 1,000 births. Anthrax, Glanders, Farcy, Tetanus, etc.—No death was recorded during 1935. INDUSTRIAL DISEASES. Lead Poisoning, Chrome, etc.— No death from any of these causes was recorded. CANCER. Cancer—489 deaths were registered from this malignant disease during the year compared with 577 in 1934, and with an average of 503 in the previous decennium. The deaths represent a death-rate of 1.6 per 1,000 of the civil population and is 0.05 above the average rate (1.55) of the last ten years; 231 deaths occurred among males and 258 among females. The following statement shows the ages at death of the persons attacked during the past ten years, and the return for the year 1935 :— Ages. 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 Mean 10 yrs 1935 Difference 0- 5 1 1 3 2 2 2 1 1 3 + 2 5-15 o — — — 1 — 3 1 1 1 1 2 + 1 15-25 3 3 1 3 1 1 1 2 3 — 2 1 — 1 25-35 5 6 5 14 10 6 10 12 9 11 9 13 + 4 35-45 40 27 24 36 22 26 25 19 23 24 26 24 — 2 45-55 93 73 74 83 84 72 85 78 84 83 82 45 — 37 55-65 168 142 137 147 153 123 138 157 160 160 148 149 + 1 65-75 144 144 135 155 106 139 167 158 146 200 149 162 + 13 75-85 71 51 65 71 81 90 83 92 70 87 76 75 — 1 85 & upwards 7 7 7 9 10 8 7 13 11 10 9 15 + 6 Totals ... 534 453 449 518 471 467 519 534 509 577 503 489 — 14 Showing the Deaths from Cancer or Malignant Disease Sub-Districts during the Quarters and the year 1935. in the several Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough First 23 8 10 14 18 11 34 118 Second 12 10 12 10 29 16 21 110 Third 19 13 8 13 20 19 28 120 Fourth 18 8 14 16 33 22 30 141 The Year 72 39 44 53 100 68 113 489 TUBERCULOSIS. Tuberculosis caused 223 deaths, which were 116 below the average of the last decennium, and were 57 below the number registered in 1934. The deathrate resulting from them was equal to 0.72 per 1,000 of the civil population, and represented 6.6 per cent, of the deaths from all causes during the year. 1935] 28 Tuberculosis of the Respiratory System (Phthisis or Pulmonary Tuberculosis), caused 202 deaths, as contrasted with the decennial average of 29(5, while the death.rate was 0.65 per 1,000 of the civil population as against the decennial rate of 0.91 per 1,000. There was a decrease of 94 on the ten years' average number of deaths, and of 0.26 on the mean death.rate. Tuberculosis (Respiratory System). Proportion of Deaths from Tuberculosis per 100 Deaths from All Causes. Death rates from All Cause* per 1,000 inhabitants.[/$$$] Years. Deaths. Death rates per 1,000 inhabitants. 1925 382 113 918 123 1926 289 0.85 7.06 120 1927 314 0.94 7.61 12.3 1928 309 0.95 7.43 12.8 1929 314 0.98 6.59 14.8 1930 280 086 7 03 121 1931 281 0.87 6.85 126 1932 264 0.81 6.58 12.4 1933 274 0.86 6.92 12.4 1934 253 0.81 680 11.8 Average 10 years 296 0.91 7.21 12.6 1935 202 0.65 5.96 10.99 The following return gives the deaths at each age period :— Age Periods. Males. Females. Total.[/$$$] 0.5 1 1 5.15 1 — 1 15.25 19 23 42 25.35 18 25 43 35.45 19 14 33 45.55 28 15 43 55.65 18 9 27 65 upwards 10 2 12 Total 113 89 202 Showing the Deaths from Tuberculosis of Respiratory System in the Sub.Districts during the Four Quarters of the Year 1935. Quarters. Tufnell. Upper Holloway. Tollington. Lower Holloway. Highbury. Barnsbury. Islington, South East. The Borough[/$$$] First 4 7 6 2 8 17 12 56 Second 3 5 5 4 9 8 13 47 Third 5 6 5 3 5 7 5 36 Fourth 6 6 5 10 8 11 17 63 The Year 18 24 21 19 30 43 47 202 Showing the Deaths from all forms of Tuberculosis during 1935. Form. Ages. Sex. Districts. Total Deaths.[/$$$] © C7T o Ox 5. CD *1 3 Tuf. U.H. Toll. L.H. H. B. S.E. Respiratory 1 201 113 89 18 24 21 19 30 43 47 202 Meningeal 1 5 5 7 4 1 — — 4 1 5 — 11 Abdominal 2 — 3 2 3 — — — 1 1 1 2 5 General — — 1 — 1 — 1 — — — — — 1 Other forms — 1 3 2 2 — — — — 3 — 1 4 All Tuberculosis ... 3 7 213 124 99 19 25 21 24 35 49 50 223 29 [1935 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 380 deaths, 167 below that of 1934. They were equal to a death-rate of 1.23 per 1,000 of the civil population, and represented 11.2 per cent, of the total deaths registered in the Borough. Acute Bronchitis.—There were 37 deaths as compared with 59 in the previous year, 16 occurred among males, and 21 among females. The death of 1 infant under 12 months was registered. Chronic Bronchitis. —76 deaths were ascribed to it, 40 being males and 30 females. This return is 45 below that of 1934. Pneumonia (All forms).—255 deaths were registered, of which 142 were males and 113 females, and were 82 below the year 1934. 41 infants under a year old died from this disease, while between the ages of 1 and 5 years 17 deaths were recorded. Above 5 years of age the deaths numbered 197. 127 deaths occurred in Public Institutions, chiefly the Islington Hospitals. Pleurisy.—No death was registered from this disease. Asthma and Emphysema.—2 deaths were recorded from Asthma. Other Diseases of the Respiratory System.—10 deaths were registered, as contrasted with 23 in 1934. VENEREAL DISEASES. Seventeen deaths were ascribed to these diseases, 3 more than last year. Of these, 10 were males and 7 females. They were 4 above the mean deaths (13) of the preceding ten years 1925-34. The three groups of ages at death were as follows:—Under 1 year, 3 deaths; 1-5 years, no death; and over 5 years, 14 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. Advantage has been taken 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 kindly reported to me on the work of the Local Branch in 1935. Open-air meetings were held at Highbury Corner on the 2nd May, 2nd June, 2nd July, and 2nd September. These were conducted by a lecturer of the British Social Hygiene Council, the subjects being the " Principles of Hygiene conducive to Health." On the 16th October a lecture was given at the Central Library, Holloway Road, to a mixed audience. The subject was " Advice to Parents on Health Problems; How best to Control one's Life." Lectures to parents were given in the following schools :—2nd September, Shelburne Road School; 10th 1935] 30 September, Blundell Street School; and on the 11th September, Ecclesbourne Road School. On each occasion the title of the lecture was " Hard to Tell." The lecturer indicated how to give advice to children advancing to adolescence. The attendances were good and the addresses well received. DEATHS FROM COAL-GAS POISONING. During the year 17 deaths were registered from asphyxia caused by the inhalation of carbon monoxide gas. This was 11 less than in 1934. Sixteen of these deaths were attributable to suicide, while the cause of the remaining one death was accidental. Of the 17 deaths, 12 were males and 5 females, the ages ranging from 25 to 75 years. ACCIDENTAL DEATHS. The deaths of Islington residents due to accident numbered 135. Of this number 42 deaths were ascribed to vehicular traffic and may be summarised as follows :— Motor Car Other or Lorry. Bus or Tram. Taxi-cab. Vehicles. Total. 22 4 2 14 42 Of this number, 23 deaths occurred to Islington residents when in outlying districts. In addition to these, 10 non-residents were also killed by vehicles within the borough. CORONER'S COURT, INQUESTS, AND MORTUARY. During the year 46 bodies were received into the Mortuary, as compared with an average of 210 in the preceding 10 years. No inquests were held, as contrasted with an average of 154 in the ten years 1925-34. Bodies received Year. into Mortuary. Inquests. 1925 275 306 1926 308 305 1927 309 240 1928 274 206 1929 306 246 1930 279 177 1931 230 65 1932 62 Nil 1933 35 Nil 1934 31 Nil Average 210 154 1935 46 Nil About the middle of the year the London County Council decided that it would give evidence before the Departmental Committee on Coroners which had been set up. The evidence given by the County was supported by the Islington Borough Council. It is understood that the object of the London County Council's submission was to obtain some measure of control of Coroners regarding the times and days on which they should hold inquests, and the places where they should be held. 31 [1935 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, Continued Fever, Puerperal Fever and Erysipelas. 1,639 cases of the principal diseases which are notifiable under the Public Health (London) Act, 1891, came to the knowledge of the Medical Officer of Health. This number does not include other communicable ailments, which are also notifiable. The complete list of infectious diseases which are notifiable in Islington will be found on page 35. No case of either Typhus or of Continued Fever was notified. ' The total cases notified are 588 less than those of the previous year (2,227), and 498 below the average (2,137) of the preceding ten years. The decreases when contrasted with the decennial averages are to be found in the returns from Scarlet Fever, Diphtheria, Enteric Fever, Erysipelas and Puerperal Fever, which were respectively 410, 43, 8, 24 and 11 below the average. The 1,639 cases were equal to an attack-rate of 5.32 per 1,000 of the civil population. The returns for the preceding ten years are given in the following statements :— Attack-rates per 1,000 Year. Cases. civil population. 1926 2,194 6j'47 1926 1,918 5-65 1927 1,813 542 1928 . 2,260 . 6-96 1929 2.439 . 7 62 1930 ... 3,067 ... 9 38 1931 ... 2,111 ... 6-50 1932 ... 1,962 ... e-04 1933 ... 2,016 ... 6-32 1934 ... 2,227 ... 7 08 10 years average 2,137 6 58 1935 ... 1,639 ... 5-32 Registration Sub-Districts.—The total number of cases notified in these districts was as follows :— Total cases notified. Tufnel 168 Upper Holloway 192 Tollington 211 Lower Holloway 172 Highbury 254 Barnsbury 267 Islington South-East ... 375 Total 1,639 SMALL POX. There was no case notified in 1935, as against 70 cases in 1934. Diphtheria was responsible for 760 cases of illness, which were 43 below the average (803) of the preceding ten years. The attack rate was equal to 2.46 per 1,000 of the civil population annually, and was 0.01 below the mean rate (2.47) of the decennial period. In London the attack rate was 2.2 per 1,000, 1935] 32 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 Ministry of Health, to provide a temporary supply of medicine, etc., for the poorer inhabitants of their district. During the year 74,000 units of Diphtheria Anti-toxin serum were issued to Medical Practitioners in the Borough. Of this quantity 20,000 units were sold, the total amount received by the Council being 19s. lOd. The remaining 54,000 units were given free, owing to the patients' limited means. Diphtheria Immunisatio n.—The Medical Officer of Health received direct applications in respect of 46 children for immunisation against Diphtheria during the year. In 45 of these the immunisation was completed. The remaining case had a suspicious throat and a swab was taken which on examination proved to be Diphtheria, and the child was removed to hospital. Information was received of 7 Islington children immunised at the Municipal Clinic in an adjacent borough ; that number therefore falls to be added to the 46 ; also one immunised for us at a hospital, making a total) of 54. The cost of this service was £22 17s. 6d. It was known that several of the medical practitioners in the Borough were also immunising children brought to them. In these circumstances it was found expedient, when making our infectious disease investigations at the homes on the occurrence of a case of Diphtheria, to make pertinent enquiries as to whether the particular case had undergone any immunisation treatment. In addition, there falls to be added to these immunisations done through the Public Health Department, hospitals and general practitioners, a number immunised at a clinic started for this purpose at the East Islington Welfare Centre. These for the period 14th October, 1935 to December, 1935, numbered 136. See also Centres' Conjoint Committee's report, see page 17. Scarlet Fever.—716 cases were notified, and they showed a decrease of 410 on the average (1,126) of the ten years 1925-34. The attack-rate was equal to 2.32 per 1,000 of the civil population annually, which is a decrease of 1.15 per 1,000 of the mean rate (3.47) of the preceding ten years. In London the attackrate was 2.6 per 1,000 of the civil population. Enteric Fever.—A total of 7 cases of Enteric Fever were notified. This is a decrease of 8 on the average (15) that obtained during the ten years 1925-34. I he attack-rate was 0.05 per 1,000 annually, the same as the mean rate, 0.05, of the last ten years. In London the rate was 0.05. Puerperal Fever.—See page 12. Erysipelas—130 cases were notified, and were 24 below the average of the preceding ten years, the attack-rate being 0.41 per 1,000 of the civil population, 33 [1935 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 1,639 cases notified, 30 deaths occurred, or 1.8 per cent., which contrasts with an average percentage of 2.7 in the preceding ten years 1925-34. Years. Cases. Deaths. Fatality. 1926 2,194 61 2-3 1926 1.919J 63 3 3 1927 1,813 55 3 0 1928 2,260 60 2'7 1929 2,439 57 23 1930 3,017 80 2-6 1931 2,111 43 20 1932 1.962 50 2 7 1933 2,016 67 33 1934 2,227 65 29 Mean 2,199 59 2'7 193 5 1,639 30 1-8 J Includes 1 case not notified. Hospital Isolation.—Of the 1,639 cases oi infectious disease notified, 1,572 were isolated in hospital, equal to a percentage of 94.7, while only 5.3 per cent, of the patients were nursed at home. The following tabular statement shows the number of cases treated in the various public institutions :— Cases treated in Percentage of Year. Hospital. cases treated. 1925 2.105 95 9 1926 1,852 96-5 1927 1,722 950 1928 2,153 95-3 1929 2,337 95-8 1930 2,879 94-2 1931 2,015 95 4 1932 1,879 95-7 1933 1,911 943 1934 2,064 92-6 1935 1,572 94-7 DISEASES TREATED IN HOSPITAL. j Cases isolated Percentage of Disease. Total cases. jn Hospital. known cases. | Scarlet Fever 716 701 9/9 Diphtheria 762 759 99 7 Enteric Fever 7 6 85 ' Erysipelas 130 84 64 6 Puerperal Fever 24 22 91 7 j 1,639 1,572 94-7 1935] 34 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 1935. 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 Scarlet Fever 701 15 716 97.9 2.1 — — — Diphtheria 759 3 762 99.7 0.3 12 1 13 1 6 0 1 1.7 Enteric (Typhoid Fever) 6 1 7 85'7 14.3 — — — — — — Erysipelas 84 46 130 64.6 35 4 11 3 14 85 23 10 8 Puerperal Fever ... 22 2 24 91.7 8.3 3 —. 3 12 5 — 12 5 Continued Fever Total ... 1,572 67 1,639 947 53 26 4 30 1.5 03 1.8 Showing the number of Cases and Attack Rates of the several Notifiable Infectious Diseases which occurred during each of the Ten Years 1925.34 and in 1935. DISEASES. YEARS. Average number of cases, 1925 34 1935 Increase or Decrease 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 Small.pox f Cases 1 4 71 244 66 162 11 70 t — Rate — 0 00 — 0.01 0.22 0.75 0 21 0.50 003 0.22 — — Diphtheria / Cases 911 743 716 756 1004 1242 710 598 547 811 803 760 — 43 Rate 2.69 2.19 2.14 2.33 314 3.81 2.19 1.84 1.72 2.58 2.47 2.46 — 0 01 Membranous / Croup \ Cases 2 — 4 4 4 6 4 3 4 4 4 2 — 2 Rate 000 — 001 001 001 001 001 001 001 001 001 001 — Scarlet Fever f Cases 1139 1010 909 1305 1155 1310 1093 983 1220 1089 1126 716 — 410 Rate 3.36 2.98 2.72 402 3.61 4.02 3.37 303 382 3.49 3.47 2.32 — 115 Enteric Fever / Cases 10 18 12 19 18 31 16 15 15 6 15 7 — 8 Rate 003 005 003 006 006 009 0.05 004 005 0.02 0.05 005 — Continued / Fever \ Cases — 1 _ 1 — 1 — — Rate — 0.00 — — 000 000 000 — — — — Puerperal / Fever* ... \ Cases 23 27 33 38 38 36 45 35 36 54 35 24 — 11 Rate 3.50 4.18 5.40 6.56 6.89 6.3 8.52 7.07 7.86 11.68 6.29 5.24 —105 Erysipelas ... / Cases 109 118 139 134 148 188 177 165 183 193 154 130 — 24 Rate 0.32 0.35 0.42 041 0.46 0.58 0.54 0.51 0.57 0.61 0.47 0.41 — 0 06 Totals ... _/ Cases 2194 1918 1813 2260 2439 3057 2111 1962 2016 2227 2137 1639 — 498 Rate 6.47 5.65 5.42 6.96 7.62 9.38 6.50 6.04 6.32 7.08 6.58 5.32 — 1.26 * Per 1,000 Registered Births. t Average where there has been continuance of disease during 10 years. 35 [193# Showing the Cases of the Notifiable Infectious Diseases notified, in the Sub_ Registration Districts and the Wards during the Year 1935. Sub_ Registration 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 72 80 1 12 3 168 Up. Holloway Up. Holloway — 95 82 13 2 192 Tollington Tollington — 106 90 11 4 211 Lr. Holloway Lr. Holloway — 78 77 3 10 4 172 Highbury ...< Highbury — 64 47 1 — 18 3 133 Mildmay — 51 57 2 10 1 121 Barnsbury ... < Thornhill 55 55 1 1 16 2 130 Barnsbury — 60 59 — — 15 3 137 Islington, S.E. _j^ St. Mary's — 33 59 — 9 — 101 Canonbury — 55 79 — 10 1 145 St. Peter's — 47 75 — 6 1 129 Totals — 716 760 2 7 — 130 24 — — — 1,639 Attack_Rates per 1.000 tion 2_32 2_46 001 0_05 0_41 0_07 532 1935] 36 DYSENTERY. Thirty-six cases were notified during- the year; the greater number of these are accounted for by two small outbreaks in two of our local hospitals. Both outbreaks were of the " Sonne " type, the infecting case occuring in patients admitted to hospital with other illness. The hospital authorities were fully alive to the situation, bacteriological examinations were persistently done, and the outbreaks were got under control. Such outbreaks are difficult to eradicate; a carrier of the " Sonne Bacillus " may be admitted suffering from another illness, and the infection is introduced and spread before the situation is realised. PNEUMONIA. The Medical Officer of Health reported at some length to the Public Health Committee during the latter part of the year on Pneumonia and the " visitingnurse " facilities available. In epidemic times, during its prevalence the medical profession is reminded of the nursing facilities available, and the Health Visitors also advise parents regarding the arrangements. A general bacteriological examination for the presence of the pneumococcus organism is made when the practitioner in attendance so desires; this bacteriological examination is made also for other organisms at the same time, namely, streptococcus and tubercle bacillus. Twenty-six patients had nursing attendance for pneumonia at a cost of £20 17s. Od., other cases were admitted to hospital under the new arrangements. ISLINGTON (CHICKEN-POX) REGULATIONS, 1930. The regulations came into operation on the 24th March, 1930, and from that time to the end of this year 2,725 cases had been notified. In 1935 the notifications were 374. GLANDERS, ANTHRAX AND HYDROPHOBIA IN MAN. Order under Section 56 of the Public Health (London) Act, 1891, by the London County Council. (Came into operation on the 26th April, 1909.) No case was recorded during the year. Acute Encephalitis Lethargica and Acute Polio-Encephalitis. These diseases became notifiable under an Order of the Ministry of Health on the 1st January, 1919. During the year no case of Acute Encephalitis Lethargica was known, and none notified; no death was registered. One case of Polioencephalitis was notified, and no death was registered. The following summary shows the number of cases, and also the fatality of recent years :— Acute Encephalitis Lethargica. Years, 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 Average (10 years). ###] Cases Deaths 17 6 21 9 7 4 5 3 8 3 4 4 2 4 1 4 3 2 8 3 — Ophthalmia Neonatorum. Purulent Disease of the Eyes of Newly-born Children. See page 9. 37 [1936 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 has been extended each year since for a similar period. 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 required, 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 three of the largest hospitals. During the year under review 11 patients have received this assistance from the Borough Council, the cost of the Insulin supplied being £29 Is. 9d. BLIND PERSONS ACT, 1920. Under this heading the number of " Totally Blind " and " Partially Blind " children under 5 years of age coming to the knowledge of the Medical Officer of Health, and under supervision either of the Health Visitors or Voluntary Welfare Centres in the Borough, were as follows :— Totally Partially Blind Blind No. of cases at the end of year 1934 3 9 No. of cases coming to the knowledge of M.O.H. during the year 1935 0 5 No. of cases which left during the year 1935— e.g., removed, address not known ; died 1 2 No. of cases under supervision at the end of the year 1935 2 12 PREVENTION OF DEAFNESS. Circular 1337a, Ministry of Health, dated 22nd May, 1933, on " Prevention of Deafness." The Islington Voluntary Welfare Centres dealt with cases coming under their supervision; some are treated'at Centres, others are sent to hospitals. The Borough Council's and Centres' Health Visitors are instructed to visit such cases and see that the prescribed treatment is being followed. Discharging ears after Scarlet Fever, coming to the knowledge of the Medical Officer of Health, 2 cases ; after Diphtheria, 4 cases (of which one died with Diphtheria as a contributory cause). In addition, 75 from other causes were visited 1935] 38 by the Health Visitors and the Centres, and 5 of these latter died (one with septicaemia complicated with otitis media ; one under operation for acute or chronic mastoiditis; one certified as acute diarrhoea and otitis media ; one certified as gastro enteritis and suppurative otitis media; and one as acute otitis media (Coroner, without inquest)). TUBERCULOSIS. 542 cases of Tuberculosis in its different forms were notified during the year. The attack-rate was equal to 1.76 per 1,000 of the civil population. This number was an increase of 8 on the return of the previous year, and of 0.06 per 1,000 on the attack-rate. Respiratory (Pulmonary) Tuberculosis.—454 notifications were received, of which 235 referred to males and 219 to females, and represented an attack-rate of 1.47 per 1,000 inhabitants. Showing the Notified Cases of Tuberculosis in the Wards during 1935. 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 18 38 8 6 14 52 1-77 Up. Holloway Up. Holloway 25 22 47 4 5 9 56 1-91 Tollington Tollington 28 21 49 4 4 8 57 2-00 Lr. Holloway Lr. Holloway 28 31 59 6 9 15 74 1-93 Highbury Highbury 26 21 47 3 6 9 56 1-90 Mildmay 14 25 39 3 1 4 43 1-62 Barnsbury Thornhill 14 15 29 4 4 8 37 1 33 Barnsbury 13 14 27 3 1 4 31 1-35 Islington, S.E. St. Mary's 18 9 27 3 2 5 32 1-90 Canonbury 24 19 43 1 6 7 50 1.68 St. Peter's 25 24 49 3 2 5 54 1-97 Totals 235 219 454 42 46 88 642 1-76 THE PERIOD OF LIFE AT WHICH TUBERCULOSIS ATTACKED THE PERSONS NOTIFIED DURING 1935. 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. 235 1 3 10 45 101 64 11 F. 219 1 15 74 95 25 9 Tubercular Meningitis < M. 2 — 1 1 — — — — F. 1 — — 1 — — — Tabes Mesenterica < M. 1 — — 1 — — — — F. 1 — 1 General Tuberculosis < M. F. Other forms of Tuberculosis M. 39 4 13 12 7 2 1 F. 44 — 3 13 13 13 2 — All Tubercular Diseases <^ M. 277 1 8 25 57 108 66 12 F. 265 — 5 28 88 108 27 9 Totals 542 1 13 53 145 216 93 21 Percentages at each life period to total cases 0-19 2-40 9'78 26-75 3985 17-16 3-87 39 [1935 From the above statement it will be seen how the disease attacked people at the various ages, viz. : In every hundred cases 2.40 were aged 1 to 5 years. „ „ 9.78 were aged 5 to 15 years. Prime „ ,, 26.75 ) were aged 15 to 25 years.* of „ ,, 39.85 . were aged 25 to 45 years. Life ,, ,, 17T6 j were aged 45 to 65 years. ,, 3 87 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 45, while the females reached 74. TUBERCULOSIS. Coming to Year. Notified Cases, knowledge. Total. Deaths. 1926 704 186 P. 654 890 P. 289 351 O.F. 236 O.F. 62 1927 640 161 P. 657 801 P. 314 348 O.F. 144 O.F. 34 1928 694 140 P. 659 834 P. 309 358 O.F. 175 O.F. 49 1929 616 105 P. 592 721 P. 314 345 O.F. 129 O.F. 31 1930 590 111 P. 567 701 P. 280 315 O.F. 134 O.F. 35 1931 588 133 P. 590 721 P. 281 332 O.F. 131 O.F. 51 1932 577 140 P. 578 717 P. 264 308 O.F. 139 O.F. 44 1933 565 157 P. 572 722 P. 274 312 O.F. 150 O.F. 38 1934 534 122 P. 544 656 P. 253 280 O.F. 112 O.F. 27 1935 542 128 P. 555 670 P. 202 223 O.F. 115 O.F. 21 The above table shows for the past ten years the totals of the known cases of respiratory tuberculosis (pulmonary), indicated by " P," and other forms of tuberculosis, the last column showing the deaths. PUBLIC HEALTH (PREVENTION OF 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 came to the notice of the Medical Officer of Health during the year which called for action. ISLINGTON TUBERCULOSIS CARE COMMITTEE. Miss M. Threlfall continued as Secretary of the Committee for the year 1935. As the Annual Report of the Care Committee has been circulated among the members of the Public Health Committee, in this summary of the work only specially outstanding items are mentioned, the more particularly as next year's Annual Report 1935] 40 is a " Review " Report. The Care Committee express their indebtedness for the active co-operation they have received from the Public Assistance Committee Officers in necessitous cases, the British Legion for their help in regard to ex-service men, the Charity Organisation Society, and the Mayor's Christmas Dinner Fund, from which the Committee were allocated 22 Christmas dinner parcels for the poor and deserving patients. They place on record among help received from others, the special work of Mrs. Alice Twidell, their member and voluntary social worker. Perhaps the most outstanding feature was the untiring efforts of the Chairman, Mr. W. G. Harris, in launching under the auspices of the National Association for the Prevention of Tuberculosis, to which the After-Care Committee is affiliated, the Christmas Seal Sale appeal, the receipts from which totalled £71, and the net profit percentage being the best of all the London Boroughs. The careful administration and discreet handling of such a fund enables many needy cases to be assisted that are of urgent necessity. Not least among the activities is the handicraft class which meets every week by kind permission at the Royal Chest Hospital. This occupation of convalescent patients, giving them something to occupy their minds and hands, keeping them from morbid reflections on their condition, has indeed a very beneficial effect. The movement is deserving of greater interest being shown to it by the outside public than obtains at present. For examples of the individual kind of work, visitations, and the results obtained, reference is made to the instances given in last year's Annual Report of the Medical Officer of Health, and to fresh items in the After-Care Committee's report to the Public Health Committee. During the year it is reported that there have been 389 new cases, 1,632 visits paid, 2,115 letters written, and 734 interviews. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. . 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 1935. Lungs. Other Forms. Total. M. F. M. F. Numbers on register at the commencement of the year 193-5 .. 1,221 1,009 390 375 2,995 Notified cases added during the year 1935.. 235 219 42 46 542 Cases coming to the knowledge of the Medical Officer of Health (other than by notification) during the year 1935 52 46 15 15 128 No. of cases removed from the register during the year 1935 .. 1,508 1,274 447 436 3,665 541 513 144 144 1,342 967 761 303 292 2,323 41 [1935 Showing the Notified Cases of Tuberculosis in the Quarters during 1935. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Males Females Total Males Females Total Males 1 I Females Total Males Females Total Males J Females Total Respiratory Tuberculosis 76 57 133 67 64 131 53 48 101 39 50 89 235 219 454 Tubercular Meningitis 2 1 3 2 1 3 Tabes Mesenterica ... 1 1 1 ... 1 1 1 2 General Tuberculosis ... ... ... ... Other forms of Tuberculosis 16 11 27 5 9 14 9 14 23 9 10 19 39 44 83 Totais 94 69 163 72 73 145 62 63 125 49 60 109 277 265 542 Disinfection of Houses and Rooms after Tuberculosis.—The following statement gives the particulars for the year :— Houses. Rooms. 1st quarter 77 97 2nd „ 79 94 3rd „ 70 92 4th 59 72 Total 285 355 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1930. Summary of Notifications during the period from 1 st January, 1935, to the 31it December, 1935, 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 65 to 65 65 and up. Total Primary Notifications. Pulmonary Males 1 3 6 4 19 26 68 33 37 27 11 235 358 „ Females — 1 11 4 20 54 67 28 17 8 9 219 335 Non-pulmonary Males — 6 8 7 5 7 1 6 2 — 1 42 56 „ „ Females 4 7 6 4 1O 11 2 1 1 46 80 Showing New Cases of Tuberculosis and all Deaths during 1935. Age Periods. New Cases. Deaths. Pulmonary. Nor-Pulmonarv. Pulmonary. Non Pulmonary M. M. F. M. F. M. F. Under 1 year 1 2 1 2 1 1-5 3 2 8 7 — 1 4 2 5-10 7 11 10 8 — — 10-15 6 4 9 6 1 — 1 1 15 20 19 24 6 4 4 7 1 20-25 36 62 7 14 15 16 1 1 25-35 82 84 4 13 18 25 1 1 35-45 46 36 7 2 19 14 1 — 45 55 42 23 2 1 28 15 — 55-65 34 10 — 1 18 9 1 65 and upward? 13 10 2 1 10 2 1 2 Totals 289 266 67 58 113 89 11 10 58 Deaths not notified or 25 0 per cent, of Total Deaths. 1935] 42 TUBERCULOSIS DISPENSARIES. RETURN SHOWING THE WORK OF THE NORTH ISLINGTON TUBERCULOSIS DISPENSARY FOR THE YEAR 1935. Diagnosis. pulmonary. Non-pulmonary. Total. Grand Total. Adults. Children. 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 107 91 9 3 9 27 10 8 118 118 19 11 264 (6) Diagnosis not completed .. — — — — — — — — — — — — — (c) Non-tuberculous 107 80 10 3 200 B.—Contacts examined during the year:— (a) Definitely tuberculous 3 8 — 2 — 1 1 — 3 9 1 2 15 (b) Diagnosis not completed — — — — — — — — — — -- — — (it) Non-tuberculous .. 51 79 79 72 281 C.—Cases written oft the Dispen sary Register as :— (a) Recovered .. 7 7 2 — 4 2 1 1 11 9 3 1 24 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 158 159 89 75 481 D.—Number of Cases on Dispensary Register on December 31st (a) Definitely tuberculous .. 299 279 21 14 35 51 34 20 334 330 55 34 75S (1>) Diagnosis not completed .. - 1. Number of cases on Dispensary Register on January 1st .. 642 8 Number of visits by Tuberculosis Officers to homes (including personal consultations) 189 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 63 9. Number of visits by Nurses or Health Visitors to homes for Dispensary purposes. Hospital Sister 1,234 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme and cases 1' lost sight of'' 130 Municipal Tuberculosis Visiting Nurse 1,710 10. Number of (a) Specimens of sputum, &c.t examined 285 4. Cases written off during the year as dead (all causes) 77 (b) X-ray examinations made in connection with Dispensary work 382 5. Number of attendances at the Dispensary (including contacts) 3,808 6. Number of Insured persons under Domiciliary Treatment on the 31st December 280 11. Number of " Recovered " cases restored to Dispensary Register, and included in A (a) and A(6) above 7. Number of consultations with medical practitioners*:— (a) Personal .. 11 12. Number of " T.B. plus " cases on Dispensary Register on the 31st December 372 (4) Other 504 * Hospital staff, 128. Number of Dispensaries for the treatment of Tuberculosis (excluding centres used only for special forms of treatment) provided by the Council—One in the Northern part of the Borough. G. CLARK TROTTER, Chief Tuberculosis Officer, 43 [1935 RETURN SHOWING THE WORK OF THE SOUTH ISLINGTON TUBERCULOSIS DISPENSARY FOR THE YEAR 1935. Diagnosis. Pulmonary. Non-pulmonary. Total. Grand Total. Adults. Children. 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 47 38 5 6 2 4 6 1 49 42 11 7 109 (b) Diagnosis not completed .. — — — — — — — — 3 2 1 — 6 (c) Non-tuberculous .. 67 48 23 20 158 B.—Contacts txamined during the year : — (a) Definitely tuberculous 10 6 2 2 — — — 3 10 6 2 5 23 (b) Diagnosis not completed .. — — — — — — — — — 1 — — 1 (c) Non-tuberculous 31 61 39 39 170 C.—Cases written off tne Dispensary Register as :— (a) Recovered 14 11 1 8 3 1 4 2 17 12 5 5 39 (b) Non-tuberculous (including any such cases previously diagnosed and entered on the Dispensary Register as tuberculous) 101 110 63 60 334 D.—Number of Cases on Dis pensary Register on Decern ber 31st:— (a) Definitely tuberculous 267 185 24 21 30 26 24 26 297 211 48 47 603 (6) Diagnosis not completed . — — — — 3 3 1 — 7 1. Number of cases or Dispensary Kegister on January 1st 637 8 Number of visits by Tuberculosis Office.-s to homes (including personal consultations) .. 190 2. Number of cases transferred from other areas and cases returned after discharge under Head 3 in previous years 60 9 Number of visits by Nurses or Health Visitors to homes for Dispensary purposes. Hospital Sister 1,997 3. Number of cases transferred to other areas, cases not desiring further assistance under the scheme, and cases "lost sight of " 115 Municipal Tuberculosis Visiting Nurse 1,412 10. Number of (a) Specimens of sputum, &c., examined 523 4. Cases written off during the year as dead (all causes) 66 (i) X-Ray examinations made in connection with Dispensary work 193 5. Number of attendances at the Dispensary (including Contacts) .. 4,166 6. Number of Insured Persons under Domiciliary Treatment on the 31st December 188 11. Number of "Recovered" cases restored to Dispensary Register, and included in A(a) and A(i) above 1 7. Number of consultations with medical practitioners :— (a) Personal 8 12. Number of "T.B. plus" cases on Dispensary Register on the 31st December 330 (4) Other 137 Number of Dispensaries for the treatment of Tuberculosis (excluding centres used only for special forms of treatment) provided by the Council—One in the Southern part of the Borough G. CLARK TROTTER, Qb'Pf Tuberculosis Officer. 1935] 44 At the Northern Dispensary there were 819 new cases, and at the Southern 470, while the attendances at the former were 3,808 and at the latter 4,210. The examination of contacts with tuberculous cases showed that 30 were suffering from tuberculosis, 27 were suspects, and 428 were not suffering. The nurses of the Northern Dispensary paid 1,234 visits, and those of the Southern 1,981, to the homes of the patients, while the Tuberculosis Officer of the Northern Dispensary made 178 visits, and of the Southern 191 visits to the patients' homes for the purposes of examining them. Pneumothorax Treatment was also administered to fifty-one patients at a cost of £379 lis. 6d. Finsen Light Treatment.—One patient at a cost of £2 15s. Od. Artificial Sunlight Treatment.—One case under treatment in the year under review at a cost of 18s. Kromeyer Lamp. TUBERCULOSIS. The number of persons in attendance at the Dispensaries in each year was as follows :— 1931 1932 1933 1934 1935 North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy North Dispy South Dispy New Cases 641 609 601 568 668 469 742 554 819 470 Actual Number of Attendances 3153 5001 3041 4545 3426 4091 3775 4294 3808 4210 Totals 3794 5610 3642 5113 4094 4560 4517 4848 4627 4680 A summary of the combined dispensaries is given for the following years :— Cases. Attendances. 1931 1.250 8,154 1932 1,169 7,586 1933 1,137 7,517 1934 1,296 8,069 1935 1,289 8,018 Totals ... | 6,141 39,344 Table showing the number of Persons attending the Borough Tuberculosis Dispensaries and the New Cases during 1935. Date. Dispensary Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Year. Total.[/$$$] Attendances Northern 328 331 318 329 297 327 350 245 337 326 329 291 3,808 j-8,018 Southern 380 337 392 343 403 319 335 292 339 416 360 294 4,210 New Cases / Including Contacts \ Northern 92 94 73 88 57 73 60 47 60 57 73 55 819 | 1,289 Southern 43 32 38 39 54 27 44 27 46 44 45 31 470 Contacts. Tuberculous < Northern 3 1 1 1 2 1 1 1 2 13 j 30 Southern — 2 1 2 2 1 2 3 1 2 1 17 Suspects < Northern 1 1 1 2 2 1 1 2 1 1 13 \ 27 Southern — — 2 — 1 1 4 4 2 14 Non-Tuberculous < Northern 31 40 24 30 12 28 17 3 14 25 32 14 270 \ 428 Southern 19 11 7 13 15 7 15 6 17 20 14 14 158 Nurses'Visits ... Northern 100 108 102 99 99 105 100 76 108 133 121 83 1,234 } 3,218 Southern 170 159 176 167 174 142 175 177 165 164 161 151 1,981 Tuberculosis f Officers' Visits \ Northern 14 19 17 15 12 12 13 12 20 15 17 12 178 } 369 Southern 11 15 12 18 17 14 13 13 26 22 18 12 191 45 1935] HOME VISITATION—TUBERCULOSIS. Visits paid by Municipal Tuberculosis Visiting Nurse during the period 1st January, 1935, to the 31st December, 1935. Month. North Dispensary. South Dispensary. Total. January .. 186 144 330 February 140 118 258 March 164 126 290 April 143 124 267 May 144 137 281 June 119 105 224 July 144 141 285 August 136 123 259 September 84 58 142 October 173 137 310 November 175 125 300 December 102 74 176 Totals 1,710 1,412 3,122 TUBERCULOSIS—HOUSING. 545 premises came under our observation in which resided persons notified during 1935 as suffering from Tuberculosis. 462 visits were made to premises with a view of ascertaining the sanitary condition generally of the residences of tuberculous patients and the following statement gives some idea of the conditions which were found to exist. It is satisfactory to note the large proportion of houses in a good sanitary condition ; in no case could it be said that the home conditions were very bad. House in a bad sanitary condition I Houses in good sanitary condition 317 Houses in which minor defects were discovered 43 Patient removed to another address 101 Patient deceased (no visit paid to house) 70 Patient in Mental Hospital 2 Patient in L.C.C. Hospital (Nursing Staff) or Government Building Staff 1 Notifications withdrawn 2 No visitation by request 8 545 THE INFECTIOUS DISEASES IN THE PUBLIC ELEMENTARY SCHOOLS. 1,095 cases of the notifiable infectious diseases occurred in the Public Elementary Schools of the Borough, of which 430 were Scarlet Fever and 435 Diphtheria. The number of notifications of the several diseases are given below :— Disease. No. of Notifications. Average of preceding 10 years. Increase or Decrease. Scarlet Fever 430 677 — 247 Diphtheria 435 380 + 55 Enteric Fever 1 2 — 1 Chicken-pox 229 + 229 Total 1,095 1,059 + 36 1935] 46 Non - Notifiable Diseases.—3,760 cases came to the knowledge of the Medical Officer of Health during the year, viz., 99 cases of Measles, 718 cases of Chicken-poxi 805 of Whooping Cough, and 2,138 of other diseases. The information respecting these cases was received from the teachers of schools within the borough. Exclusion of Scholars from Schools.—2,753 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 :— Notifications Average of Increase Disease. by Teachers. preceding 10 years. or Decrease. Measles 99 1,793 —1,694 Chicken-pox 718 1,038 — 320 Whooping Cough 05 593 + 212 •Other Diseases 2,138 1,786 + 352 Total 3,760 5,210 —1,450 * Note.—"Other Diseases " include Mumps, Scabies, Ophthalmia, etc. Scheme of Measles Control.—In co-operation with the School Medical Officer of the London County Council, early intimation is obtained where possible of children absent from school during times of measles outbreaks. The parents of such children as are suspected of having the disease, or where the disease is known to exist, receive a special circular from the Public Health Department drawing attention to the initial symptoms of measles, and the fact that measles should always be treated as a serious disease, especially in young children. Attention is drawn to the removal of the seriously ill to hospital and to the Borough Council's Health Department arrangements for nursing attendance in the home in special cases. Chickenpox, Rubella (" German" Measles), and Mumps.—In these diseases where either owing to the home conditions or the severity of the disease there is need for hospital treatment, cases since April have had hospital treatment afforded them on the recommendation of the Medical Officer of Health. BACTERIOLOGICAL EXAMINATIONS. Examinations numbering 2,550 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 a deciease of 205 on that of the preceding year and 294 below the decennial average. Of the total examinations, 370, or 14.5 per cent., gave positive results. Tuberculosis.—532 specimens of sputum were examined, 74, or 13.9 per cent., of which showed that the patients were suffering from pulmonary tubereulosis. These are in addition to routine examinations at the two Tuberculosis Dispensaries. Diphtheria.—2,003 specimens were examined for Diphtheria, of which 293 or 14.6 per cent., were found to be " positive." Enteric Fever.—15 specimens of blood were examined, 3 of which gave positive results. 47 DIPHTHERIA—PATHOGENICITY TESTS. 1935. No. of Swabs Submitted for Examination. Negative Result. (Bacilli) Positive Result. (Bacilli) Non-Virulent. Virulent. 35 27 *8 2 — * 6 not tested for Pathogenicity. Showing the result of the Bacteriological Examinations made for the Diagnosis of Diphtheria, Enteric Fever and Pulmonary Tuberculosis, 1925-34, and in 1935. Periods. Diphtheria. Enteric Fever. Pulmonary Tuberculosis. % Totals. Positive Results Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. Positive Results. Negative Results. Total Examined. 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 1930 492 2,274 2,766 1 18 19 127 652 779 3,564 1931 280 1,663 1,943 2 8 10 131 727 858 2,811 1932 238 1,746 1,984 5 9 14 111 684 795 2,793 1933 186 1,865 2,051 5 19 24 93 634 727 2,802 1934 268 1,846 2,114 1 21 22 97 522 619 2,755 Average 10 years 282 1,745 2,027 3 16 19 123 675 798 2,844 1935 293 1,710 2,003 3 12 15 74 458 532 2,550 BACTERIOLOGICAL EXAMINATION OF MILK. During the year 1935, 33 samples of milk taken in various parts of the Borough as supplied to the consumers and schools were tested bacteriologically, 15 of these samples being Pasteurised Milk in course of delivery to schools, and 4 of Pasteurised Milk in course of delivery to a London County Council Hospital (St. Mary, Islington, Hospital). All the samples were tested for tubercle, and in three cases the bacillus was discovered. A pasteurising plant was found to be defective in two of these cases, and the third was a sample of untreated milk; the three samples were obtained from the same dairy. Immediate action was taken, with the result that the firm ceased to carry on business in Islington. Twentyseven of the samples were examined for bacterial count, the majority of them being generally satisfactory. Three of the samples were tested for enteric organisms and were found to be free. BACTERIOLOGICAL EXAMINATION IN CASES OF PUERPERAL SEPSIS. During the year one swab was submitted, which was examined with a negative result. SPECIAL BACTERIOLOGICAL OR CHEMICAL EXAMINATIONS. Most of the work under this heading was in connection with alleged food poisoning, and the Ministry of Health Laboratory gave us very considerable help by examining samples submitted to them. In addition, examinations were made of specimens submitted by practitioners in cases of suspected cerebro-spinal 1935] 48 meningitis and dysentery; suspected cerebrospinal meningitis, 1 examined with negative result, 1 dysentery, negative result. In regard to food poisoning, the materials examined were: 2 samples of pilchards in tomato sauce, 1 dripping, 2 tinned salmon, 2 veal and ham pie, 1 salt meat, and in addition, 3 specimens of faeces from affected persons. During the year a sample of swimming bath water was taken from a public swimming bath in the Borough and examined both bacteriologically and chemically ; the result proved the water to be of excellent quality. VACCINATION. 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. Vaccinations.—Of the 3,702 births registered in 1934, the returns of vaccination show that only 1,669 infants were successfully vaccinated, while 8 were found to be insusceptible. There were also 168 who died unvaccinated, and 1,241 statutory declarations of consientious objection were obtained by the parents or guardians; 79 vaccinations were postponed under medical authority, 273 removed to districts the vacination officers of which were duly apprised, 236 removed to other districts or places unknown, and one had Smallpox, thus leaving 27 unaccounted for. The return of certificates of exemption, therefore, represents 33.5 per cent, of the registered births. Years. Vaccination per 100 births, less infants who died unvaccinated. 1925 50.4 1926 51.5 1927 49.9 1928 46.5 1929 49.5 1930 51.2 1931 50.0 1932 60.0 1933 47.0 1934 47.2 Certificates of Exemption.—The following tabular statement shows the decrease in number of these certificates in recent years:— 1925 1,973 1926 1,896 1927 1,845 1928 1,755 1929 1,642 1930 1,684 1931 1,477 1932 1,299 1933 1,213 1934 1,234 A statement is given of the prosecutions by the Vaccination Officers since the transfer from the Guardians in 1930. Prosecutions. Year. Northern Islington (No. 1 District) Southern Islington (No. 2 District) Total. 1930 (from 1st April) 4 3 7 1931 2 — 2 1932 7 4 11 1933 — — — 1934 — — — 1935 — — — 13 7 20 49 [1933 Return furnished by the Vaccination Officers respecting the Vaccination of Children in the Sub-Registration Districts during the previous year 1934. Registration Sub-Districts. Number of Births registered in 1934. 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 1935. Number of Statutory Declarations of Conscientious Objection received during year 1935. 1 2 3 4 6 6 7 8 9 10 11 12 Tufnell 699 313 2 162 53 2 92 75 - 1,446 237 Up. Holloway 674 303 2 — 235 27 — 95 10 2 231 Tollington 253 129 — — 79 14 6 5 18 2 76 Highbury 601 281 3 233 18 2 30 28 6 232 Lr. Holloway 346 177 111 9 14 13 16 6 - 857 105 Barnsbury 545 239 — — 202 20 27 15 37 5 156 Islington, S.E 584 227 1 1 219 27 28 23 52 6 197 The Borough 3702 1669 8 1 1241 168 79 273 236 27 2,303 1,234 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, 1935:— Name of the litution or Vaccination District. Name of the Medical Officer or Public Vaccinator. Number of successful primary vaccinations of persons. Number of successful re-vaccinations, i.e., successful vaccinations of persons who had been successfully vaccinated at some previous time. Remarks. Under one year. One year and upwards Total. iogton Dr. M. J. Healy .. 200 20 220 7 *r Holloway Dr. P. Inwald 167 7 174 7 'ell . . Dr, D. W. F. Latham 191 17 208 6 Lower Holloway Dr. F. E. Clay .. 17 — 17 — From 1/10/34 to 30/10/34, Resigned. ii (i •« Dr. T. Galbraith 15 1 16 — Interim from 1/11/34 to 18/12/34. Dr. C. V. Spark .. 64 8 72 1 From 19/12/34. lower Holloway Dr. S. N. Forbes 163 13 176 4 tary and W. Mildmay Dr. T. Galbraith .. 201 19 220 11 •"bury, E Mildmay. E. 1 Mary and E. St. Peter Dr. I. M. Lynch .. 210 25 235 14 mhill Dr, H. D. Christie 145 14 159 4 "sbury and W. St. Mary Dr. S. N. Forbes 49 7 56 1 Interim from 1/10/34 to 30/11/34. II Dr. B. Kessel 115 17 132 1 From 1/12/34. ! Mary and W. St. Peter Dr. G. Madden .. 86 8 94 7 John's Road L.C.C. Dr. K. A. Anklesaria 6 1 7 — titution "sry, Islington, Dr. W. R. Turtle 1 — 1 1 Hospital Total 1,630 157 787 64 1935] 50 Vaccinations and re-vaccinations performed by the Public Vaccinators of the Council during the year 1935:— Successful vaccinations performed at the surgery or elsewhere than at the homes of the persons vaccinated 78 Successful re-vaccinations performed at surgery or elsewhere than at the homes of the persons vaccinated 54 Successful vaccinations or re-vaccinations performed at the homes of the persons vaccinated or re-vaccinated 1,665 The above figures represent actual vaccinations or re-vaccinations performed by the Public Vaccinators during the year. The Vaccination Officers in the course of their duties forwarded the names of 1,708 children to the Public Vaccinators on Form "H." Other 471 children were vaccinated at the "request" of parents or guardians before Form "H" was issued. DISINFECTION. Disinfection of Rooms.—2,898 rooms wert disinfected, as contrasted with 2,975 in 1934. 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 board, behind which they breed, are removed, and the walls washed with hot lime, and in certain cases special insecticide fluids were employed. The above figures also include the disinfection of houses and rooms after Tuberculosis, vide p. 41. Rooms Disinfected. 1935 1934 1st Quarter 654 787 2nd „ 919 661 3rd „ 661 573 4th „ 664 954 The Year 2,898 2,975 Work at the Disinfecting Station.—27,966 large articles of bedding, etc., as detailed below, were disinfected by the steam disinfectors, at the Council's Disinfecting Station, compared with 39,708 similar articles disinfected during the previous year. In addition to the above articles, 230,675 second-hand garments were disinfected for clothing contractors trading in the Borough, who paid the Council for the work, amounting to the sum of £8713s. 0d. Altogether 258,641 articles described in the two paragraphs preceding were disinfected. Since the disinfecting station was established 3,710,438 large articles have been disinfected. 61 [1935 Summary of the chiej articles of Clothing, Bedding, etc., disinfected during the year 1935, and also in the preceding year 1934. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year 1935 1934 Beds 353 272 242 325 1,192 1,696 Blankets 1,018 782 542 1,101 3,353 4,703 Bolsters 251 208 173 229 861 1,250 Carpets — — — — 5 Cushions 72 79 65 60 276 463 Mattresses 396 343 307 403 1,449 1,808 Pillows 943 764 678 846 3,231 4,627 Pillow and Bolster Cases 677 481 323 557 2,038 3,077 Quilts 470 353 298 439 1,560 2,216 Sheets 914 645 578 840 2,977 4,219 Other Articles 3,301 2,545 2,213 2.970 11,029 15,644 Totals 8,395 6,472 5,419 7,680 27,966 39,708 The nature of the articles disinfecied for the clothing contractors is shown below:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year. Blankets 2,581 1,3X0 4,226 1,124 9,241 Garments 18,583 35,889 91,008 72,753 218,233 Other Articles 1,559 406 550 686 3,201 Total 22,723 37,605 95,784 74,563 230,675 Disinfectants Distributed and Used.—The following statement gives the quantity of disinfectants distributed by the Sanitary Authority, or used in disinfecting and cleansing rooms :— To householders:—Carbolic powder, 10 cwts. *Disinfectant fluid, 40 gals. *Strong disinfectant is diluted before distribution in place of the former weaker disinfectant used The figure given is as distributed. Disinfection of premises by Formaldehyde Solution, 30 galls. The total cost of disinfectant was £10 2s. 1d. together with £6 5s. 0d. the cost of sulphur candles used in the process of disinfestation of rooms. Shelter House.—The Shelter House was not occupied during the year; baths were given to 22 verminous persons, while their clothing was disinfected, nine of whom were sent from a Common Lodging House. 26 other persons who had been in contact with cases of infectious diseases, 21 of whom were employed in handling food, also had baths and their clothing disinfected. Baths were provided for 17 persons who were suffering from Scabies (a series of 3 baths in each case), making a total of 51 baths. Disinfestation of Rooms.—422 rooms were specially disinfested during the year. The method of dealing with such rooms is that upon the Sanitary Inspector becoming aware of bug infestation of rooms, he serves a notice under the London County Council (General Powers) Act, 1922, on the owner requiring the paper to be stripped from the walls, removal of the architrave mouldings and skirtings, and suitable treatment of the walls. It is advised that a plumber's blow lamp be used 1936] 52 on the infested surfaces which axe exposed. The occupier is also required to rid infested articles of furniture, etc., of bugs by washing with paraffin or using insecticide, and in some cases it is recommended that the articles be burned. In certain cases where application is made by either the owner or the tenant for the assistance of the local authority, a fee of five shillings per room is asked for. Prior to the room with the furniture remaining therein being sealed at the doors, fireplaces and windows, the walls, etc., are sprayed with an insecticide, and sulphur candles in receptacles placed about two feet above the floor level are burned while the air and the surroundings are moist. This process is repeated after a lapse of fourteen days, in order that the bugs from eggs which have hatched out may not be missed. During the year the Public Health Committee authorised the purchase of a a number of hand sprayers to be issued on loan to occupiers of rooms which were stated to be infested with vermin. These sprayers are loaned for a period of two weeks, a deposit of one shilling being required, and this is refunded when the sprayer is returned. The Medical Officer of Health was also authorised to purchase and issue at cost price small tins containing 16ozs. of a liquid vermicide. These facilities ar,e afforded to enable occupiers to spray infested furniture or parts of their rooms, and avoid the more drastic action of stripping the walls, removing architraves, mouldings, skirting boards, etc. being taken. The issue of sprayers and liquid1 was commenced on the 1st July, and immediately taken advantage of by a number of persons. From 1st July to the 31st December, 1935, 106 tins of liquid were supplied, 58 large (16 oz.) and 48 small (8 oz.), and 37 applications for the loan of sprayers received. A special leaflet is issued from the department on the eradication of vermin and the prevention of infestation of rooms and furniture. Disinfestation of School Children (Cleansing from lice and other vermin)—During- the year 6,251 (including 1,642 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 disinfestation. The amount paid during the year by the London County Council for the baths given to the children was ^543 0s. Od. There was an increase in the number of children treated for head lice, but a decrease in the number of scabies cases treated. The rate paid by the London County Council is two shillings for head cases and one shilling for scabies. Proceedings were instituted by the London County Council under Section 122 of the Children Act, 1908, during the year in 76 instances. In 19 cases no fines were imposed and in 57 cases fines ranging from 2/6 to 10/- were imposed. The total fines amounted to lis. 0d. S3 [1935 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 1935. Inspections and Visits.—The inspections and visits made by the three Inspectors were as under:— Factories, including Factory Laundries 905 Workshops, including Workshop Laundries 724 Workplaces, other than outworkers' homes 441 Domestic Workshops 106 Bakehouses 221 Restaurant Kitchens (see also p. 72) 774 Outworkers' premises 1,353 Miscellaneous re-inspections and calls 5,225 Total 9,749 Notices Served —In consequence of the 1,163 sanitary defects discovered as the result of the inspections above, 423 intimation and 21 statutory notices were served. Of these notices 172 were served on the owners of factories, 133 on the owners of the workshops and workplaces, 36 on the owners of bakehouses and 73 of restaurant kitchens. In addition to these nuisances, 83 were discovered on Outworkers' premises, necessitating the service of 10 notices. Most of these defects were remedied and it was not found necessary to resort to legal proceedings. 1935] 54 Registers.—There were 2,726 workshops on the Registers as contrasted with 2,695 in 1934, while the total number of workrooms was 3,850, as compared with 3,804 in the previous year; 136 workshops were added1 to the Registers, while 105 were removed from them. The various workshops and workplaces are tabulated as below:— Workshops and Workplaces. 1935. Total Workshops on Register. Total Workrooms on Register. Number added during Year. Number removed during Year. Workshops where Men are employed Workshops where Women are 1,315 2,072 56 27 ployed 500 778 33 39 Laundries 36 46 — — Bakehouses 233 249 1 2 Restaurant Kitchens 535 598 32 34 Other Workplaces 107 107 14 3 Total 2,726 3,850 136 105 Outworkers' Premises 3,491 — 425 405 Workshops Notified to Home Office during Year 1935. Trade. Number of Workshops. Women. Male Young Persons. Totals. Iodised Lockets 1 10 10 Dressmaking 11 45 — 45 Cleaning, etc., Electric Lamps 1 13 — 13 Soft Toys 1 1 — 1 Carpet Sewing 1 1 — 1 Chemists' Sundries 1 9 9 Quilts 1 1 — 1 Handbags 5 16 — 16 Artificial Florists 2 5 — 5 Photography 1 17 — 17 Upholstery 3 5 — 5 Furriers 2 2 2 Petrol Capsules 1 16 — 16 Motor Accessories 1 3 — 3 Optical Lenses 1 2 — 2 Optical Cases 1 1 — 1 Pleating 1 1 — 1 Tailoring 12 26 — 26 Dressing Gowns 1 10 10 Carnival Novelties 1 3 3 Chocolate Manufacturing 2 6 — 6 Engineers 1 2 — 2 Rag Sorting 1 1 — 1 Millinery 6 6 — 6 Total 59 202 — 202 INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (1) Number of Inspections. (2) WrittenNotices (3) Prosecutions. (4) Factories (Including Factory Laundries) 905 172 — Workshops (Including Workshop Laundries) 724 67 — Workplaces (Other than Outworkers' premises) 1,542 66 — Miscellaneous Re-Inspections and calls 6,573 47 1 Total 9,749 352 1 65 [1935 DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecu• tions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts*— Want of cleanliness 224 221 — — Want of ventilation 24 25 — — Overcrowding 4 4 — — Want of drainage of floors 8 9 — — Other nuisances 487 491 — 1 Sanitary Accommodation insufficient 21 26 — — unsuitable, foul or defective 306 305 — — not separate for sexes 26 27 — — Offences under the Factory and Workshops Arts— — Illegal occupation of underground bakehouse (s. 101) — — — — Other offences (Excluding offences relating to outwork and offences under the Sections mentioned in the Schedule to the Ministry of Health (Factories and Workshops Transfer of Powers) Order, 1921.) . — Total 1,100 1,108 — 1 * Including those specified in sections 2, 3, 7 and 8 of the Factory and Workshops Acts", 1901 as remediable under the Public Health Acts. 50 Workshops were also notified H.M. Inspector, of failing to affix Abstract of Factory and Workshop Act (s. 133). OUTWORKERS' PREMISES. Instances. Noticcs Served. Remedied. Prosecutions. Outwork in unwholesome premises (s. 108) 80 10 80 Nil Outwork in infected premises (s. 109, 110) 3 — 3 — Total 83 10 83 Nil OUTWORKERS' LISTS (s. 107): Lists received from Employers 1,080 Addresses received from Other Councils 1,645 Addresses forwarded to Other Councils 642 Firms failing to send in lists (No. letters sent) 318 OTHER MATTERS. Number. Matters notified to H.M. Inspector of Factories Failure to affix Abstract of the Factory and Workshop Act (s. 133, 1901) 1 Action taken in matters referred by H.M. Notified by H.M. Inspector 4 Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5, 1901). Reports (of action taken) sent to H.M Inspector 4 Other (New Factories and Workshops reported under Home Office Memorandum, 1912) 117 Underground Bakehouses (s. 101) in use at the end of the year 68 1951 56 OUTWORK IN UNWHOLESOME PREMISES. SECTION 108. Nature of Work. Instances. Notices served. Prosecutions. (1) (2) (3) (4) Wearing Apparel— Making, &c. 38 6 — Cleaning and washing — — — Household linen — — — Lace, lace curtains and nets — — — Curtains and furniture hangings 14 — — 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. — — — Artificial flowers 3 — — Nets, other than wire nets — — Tents — — Sacks — — Racquet and tennis balls — — — Paper, &c., boxes, paper bags 9 4 — Brush making — — — Pea picking — — — Feather sorting — — — Carding, &c., of buttons, &c. — — — Stuffed Toys 3 — — Basket making — — — Chocolates and sweetmeats — — — Cosaques, Christmas Crackers, Christmas stockings, &c 13 1 — Textile weaving — — — Lampshades — — — Total 80 11 — 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. During the year the Medical Officer of Health visited, with the Cleansing Superintendent, the dumping grounds where the contractors dispose of Islington refuse. Mr. Browning, the Cleansing Superintendent, has kindly supplied me with the following statement regarding the work during the year:— (1) Street Sweeping.—A further Hygienic "Bedford" lorry (making four in all) for receiving the contents of Galvanized sanitary containers installed in orderly trucks, was put into commission on the 2nd December, 1935. It is now only necessary to employ five open-type horse-drawn vans on this service. (2) Street Watering.—The apparatus fitted to horse-drawn vans (used during the summer months for street watering) has been adapted on all these vans so as to thoroughly wash the channels of the roads and streets. (3) Gully Cleansing.—In the very near future an additional mechanical vehicle, fitted with 1,000 gallons tank and special apparatus for washing down Street Markets, will be purchased. 57 [1935 (4) House and Trade Refuse Collection.—Sixteen low-loading hygienic horsedrawn vans have now been built to own design and by Council's own staff of mechanics, and are all in service daily. A further three vans are in course of construction. During the year 1935, 84% of refuse was collected by mechanical vehicles and 16% by horses and vans. (5) Disposal.—A scheme for handling the refuse at the Disposal Depot, Ashburton Grove, is now completed and the construction will be started almost immediately. This scheme, which is thoroughly up-to-date, will carry out the loading of railway wagons, etc., irn a most hygienic, cleanly and economic manner. Both house and trade refuse, and sweepings and gully silt, are sent by rail to contractors' dumps at Blackbridge and Holwell Hyde, Herts, where the material is deposited in layers approximately 6 feet in depth, each layer being covered with 9 ins. of soil and otherwise treated in accordance with the recommendations of the Ministry of Health. The dumps are frequently' inspected by the Cleansing Committee and myself and by the local Sanitary Authorities. REMOVAL OF DUST. 23 applications were received during the year by the Public Health Department for the removal of dust. The applications received for the previous ten years were as follows:— 1925 21 1930 40 1926 20 1931 36 1927 25 1932 44 1928 25 1933 21 1929 21 1934 23 Dust Receptacles Provided.—During the year 1,236 dust receptacles were provided by owners of property under notice. DISTRICT INSPECTORS' WORK. During the year the fourteen District Inspectors made a total of 51,811 inspections and calls, an increase of 1,573 inspections on the corresponding period of 1934; while 16,027 improvements were effected in 6,367 premises; as against 15,262 improvements in 6,168 premises, for the preceding year. Synopsis of Inspectors' Work.—The following statement gives a brief synopsis of the district inspectors' work in 1935:— House to house inspections 3,185 Other inspections of dwelling houses 4,928 Re-inspections and calls made 42,072 Visits of inquiry re notifiable infectious diseases 1,639 Butchers' shops, stalls.ietc. (Saturday nights) 98 Ice cream shops and factories 253 Dairies and Milkshops 522 Stables and yards 282 Urinals attached to Public Houses 132 Smoke observations 56 Notices Served.—There were 5,729 intimation notices served by the inspectors with respect to nuisances. In 800 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. 1935] 58 Verminous Premises—Bedding and Clothing.—422 rooms which were found to be in a verminous condition were fumigated. In 38 instances it was necessary to remove the bedding and clothing to the Disinfecting Station for purification or destruction. Rag; Flock Acts, 1911 and 1928.—In the routine inspection, the Sanitary Inspectors found no cause for action to be taken. It was not considered necessary to take any samples of rag flock for analysis to be certain that they came within the standard. In the previous year 2 suspected samples were analysed. Smoke Nuisances.—49 complaints of smoke issuing from factory chimneys in the Borough were investigated, and as a result 56 observations were made by the District Inspectors, and 16 notices served upon the owners of the businesses requiring the abatement of the nuisance. Water Certificates.—21 water certificates were granted in accordance with the provisions of sec. 48 (2) Public Health (London) Act, 1891, in respect of 222 separate tenements newly erected or rebuilt during the year. WATER SUPPLY. Number of houses which have not an adequate internal water supply, i.e., water supply from taps only, in yard, 120. Premises on which notices have been served under the London County Council (General Powers) Act, 1907 (Additional Water Supply), 228. AGRICULTURAL PRODUCE (GRADING AND MARKING) ACT, 1928. MERCHANDISE MARKS ACT, 1926. All the District Sanitary Inspectors are officially appointed for this work. Special inspections for this particular duty under the Merchandise Marks Act and under the Agricultural Produce (Grading- and Marking) Act, by these and by the Food and Drugs Inspector numbered 1,095. 6 prosecutions were taken under the Merchandise Marks Act, 1926, 5 of which were successful. The orders which have been made relate to:—Currants, sultanas, raisins, fresh apples, butter, bacon and ham, eggs in shell and dried eggs, honey, maize, oat products, starch, malt products, salmon and sea trout, dead poultry, raw tomatoes, chilled beef, boneless beef and veal, beef and veal, salted beef, salted pork, frozen mutton, lamb, pork, and edible offals. No premises have been registered for the cold storage or chemical storage of eggs. 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 1935. 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. 59 [1935 Summary 01 Sanitary Work from Inspectors Reports for the year 1933 Districts. Totals 1 2 3 4 5 6 7 8 9 10 11 12 13 14 House to House Inspections 194 359 219 223 140 116 263 256 273 174 222 251 133 362 3185 Other premises inspected 311 309 294 511 259 498 329 428 293 294 337 479 284 302 4928 He-inspections, Calls made, etc. 2791 3948 3437 3448 3314 2849 2627 2696 3155 2507 2830 2454 3218 2798 42072 Ice Cream Premises inspected 15 32 49 9 14 16 11 11 10 14 61 6 3 2 253 Dairies and Milk Purveyors inspected 7 54 101 31 38 42 50 24 31 37 14 22 6 65 522 Stables „ 33 11 35 — — — 10 7 — 3 — 4 — 8 111 Yards „ 36 7 111 — — — 3 2 1 3 3 4 — 1 171 Agricultural Produce (Grading and Marking) Act, 1928 — — — — — — — — — — — — — — — Merchandise Marks Act, 1926 1 33 19 7 10 11 6 3 4 5 2 3 4 5 113 Urinals attached to P.H.'s inspected — 2 96 1 2 5 — 7 — 14 — 3 — o 132 Children and Young Persons Acts 9 11 6 4 2 5 1 4 1 — 1 3 1 4 52 Premises (re Water Certificates) inspected — — 1 3 31 3 4 44 — — — 1 — 8 9o Rag and Bone Dealers — 3 — 6 — 4 1 1 2 — 2 — — 4 23 Rag and Flock Act — — — — — — — — — — — — — — Smoke observations 2 7 — 3 2 2 12 10 4 8 4 2 — 56 Shops, Stalls and Markets (Saturday evening) 7 9 8 6 7 5 7 8 7 5 7 7 7 8 98 Total Inspections and Calls 3406 4785 4376 4252 3819 3556 3324 3501 3777 3060 3487 3241 3658 3569 51811 Notices Served. Intimation Public Health (London) Act. 1891 169 494 284 599 348 508 342 485 522 374 314 441 220 263 5363 Housing Acts — 59 7 13 4 128 21 32 37 1 22 2 6 8 340 Ice Cream Shops — 1 1 — — 3 2 — — — — — — — 7 Dairies, etc. — 3 1 2 1 5 — 2 4 — — — — 1 19 Statutory . Public Health (London) Act, 1891 30 92 32 43 30 118 49 64 135 55 17 27 40 20 752 Housing Acts L.C.C. (General 8 5 1 — — — — 3 3 — — 1 — — 21 Powers) Acts — 2 — 1 — 10 2 — 9 — — — — 3 27 Improvements. — — — — — — — — — — — — — — — Drains— Constructed — — — — — — — — — — Re-constructed 8 9 4 3 4 2 5 — 1 14 11 1 5 4 71 Repaired 10 25 6 16 17 5 6 11 8 12 28 2 3 4 153 Ventilated 7 14 3 6 4 1 4 16 3 10 1 — 1 2 72 Gully and other traps fixed 21 31 7 4 12 1 7 1 32 27 1 — 2 154 Urinals— Water supply—cleansed — — 8 1 — 1 — — — — 10 Water Closets— W.C. erected with pan, trap and water supply 6 1 3 5 6 1 4 2 2 30 Pan and trap only provided 42 50 34 57 36 14 27 43 15 81 64 13 8 IS 502 Flushing apparatus repaired 19 24 15 47 16 20 14 15 40 11 22 4 5 10 262 Ventilated 1 2 3 — 7 21 6 — — — 1 — — 41 Walls, etc , cleansed 17 36 8 60 25 68 22 26 45 62 125 14 9 13 530 Position altered 1 1 2 1 1 — — 1 — — 7 Dust Bins provided 68 128 87 205 60 97 82 141 107 104 44 38 26 49 1236 Areas paved 4 11 3 7 3 2 5 2 — 14 — — — 1 56 Yards paved or repaved 20 38 18 45 27 34 20 17 22 30 14 — —5 5 303 Sinks Provided 93 79 39 56 48 30 29 69 37 79 29 18 9 17 632 Waste pipe repaired 51 41 21 78 58 95 33 70 35 33 14 11 3 12 555 Domestic Water Supply— Cisterns repaired and cleansed 6 12 6 14 3 7 11 4 6 — 2 — — 2 80 Water supply provided to dwelling house — — — — — — — — — — — — — — — Water supply provided to tenets ment house 17 29 9 30 18 22 3 1 25 38 15 10 5 6 228 Walls and ceilings of rooms cleansed and redecorated 141 336 141 524 177 576 203 279 449 236 329 256 117 206 3970 1935] 60 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 35 61 19 106 33 111 23 68 87 57 73 72 26 40 811 Floor space ventilated 9 37 5 8 1 7 2 14 2 3 6 — — 1 95 Floors repaired 49 59 29 72 24 75 18 43 55 41 51 20 13 20 569 Guttering and rain water pipes repaired 51 49 31 78 58 54 36 50 33 38 30 8 14 22 552 Roofs repaired 49 101 54 224 52 106 49 93 127 88 95 47 49 64 1198 Overcrowding abated 1 8 4 8 4 10 3 2 13 — 2 18 — 3 76 Illegal use of underground rooms for sleeping discontinued 8 36 2 8 2 75 5 16 42 8 16 32 4 10 264 Other improvements, or Nuisances abated 167 241 102 263 150 316 135 174 174 122 167 91 47 73 2222 Rooms Disinfected 142 128 118 120 67 71 58 76 76 82 111 102 97 100 1348 Total improvements 1043 1587 778 2044 912 1826 801 1244 1407 1203 1276 774 448 684 16027 Total premises improved 392 647 405 771 335 499 347 454 542 480 518 355 292 330 6367 HOUSES LET IN LODGINGS. The houses which come under the operation of the by-laws received 918 inspections during the year, followed by 4,830 subsequent re-inspections and calls so that the total visits amounted to 5,748. These inspections iesulted in 990 intimations being served on the persons responsible, which were followed by 199 statutory notices to demand the abatement of the nuisance discovered by the Inspectors especially engaged upon this work. Altogether 4,572 improvements were effected in 821 premises. Synopsis of Inspector's Work:— Improvements. Drains: Constructed — Reconstructed 1 Repaired 21 Ventilated 19 Gully and other traps fixed 2 Water Closets: W.C.. erected with pan, trap and water supply — Pan and trap only provided 26 Flushing apparatus repaired 89 Ventilated 9 Walls, etc., cleansed 262 Position altered — Dusr Bins: Provided 125 Areas: Paved 3 Yards: Repaved 53 61 1935 Sinks: Provided 49 Waste pipe repaired 55 Domestic Water Supply: Cisterns repaired and cleansed 1 Water supply provided to tenement house 21 Walls and Ceilings ot Rooms cleansed and redecorated 1,103 Other Improvements: Staircase and passages repaired, cleansed and redecorated 325 Floor space ventilated 2 Floors repaired 156 Guttering and rain water pipes repaired 113 Hoofs Repaired 254 Overcrowding abated 27 Illegal use of underground Rooms for sleeping discontinued 29 Other Improvements, or Nuisances abated 1,793 Rooms Disinfected 34 Total Improvements 4,572 Total Premises Improved 821 COMMON LODGING HOUSES. Another transferred power delegated to the Public Health Committee on the 17th March, 1933, was the registration of common lodging houses, taking over the duties under the Transfer of Powers (London) Order, 1933, of the registration, licensing, inspection and regulation of common lodging houses. The Committee considered the applications and renewed licences in respect of the under-mentioned premises :— 14 and 16, Barnsbury Street, beds for 51 men. 18, 20 and 22, Barnsbury Street, beds for 78 men. 13 and 14, Duncan Terrace, beds for 63 women. 155, Englefield Road, beds for 62 men. 87, Essex Road, beds for 52 men. 89, Essex Road, beds for 35 men. 8, Flowers Mews, beds for 30 men. 104 to 106, Georges Road, beds for 34 men. 1, Gordon Place, beds for 4 men. 2, Gordon Place, beds for 4 men. 3, Gordon Place, beds for 8 men. 4, Gordon Place, beds for 8 men. 5, Gordon Place, beds for 8 men. 6, Gordon Place, beds for 6 men. 7, Gordon Place, beds for 6 men. 13, Gordon Place, beds for 9 men. 47, 49 and 51, Wharfdale Road, beds for 65 women. The total licences granted was 17; during the year 1934,3 premises were vacated, leaving 24 on the register. Visits of inspection.—285 visits were paid by male Inspectors and 59 by women Inspectors, a total of 344 visits. 1935] 62 INFIRM PERSONS. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1928. During the year, 11 cases, 10 females and 1 male, came under the notice of the Medical Officer of Health. In 5 cases (all females) the circumstances were reported to the Public Health Committee, and authority given for action to be taken under the L.C.C. (General Powers) Act, 1928, should the circumstances warrant such procedure. This course, however, was not necessary, as two of the women died, one voluntarily entered the Islington Institution, one removed to her daughter's residence, and the remaining one is still at home, but being cared for by visiting nurses. Of the remaining 6 cases investigated, but not reported to the Public Health Committee, 4 were admitted to hospital, where one died, and in 2 cases no action by the Department was necessary. SEWER EMANATIONS. During the year complaints were received regarding sewer effluvium emanating from a ventilating shaft of the Middle Level Sewer No. 2 in the neighbourhood of Caledonian Road, this being particularly noticeable when a south-easterly wind prevailed. The London County Council were approached on the subject, and strong representations made for the matter to be investigated, which was done. It transpired that the ventilating shaft is fitted with an electrically driven fan, which has been in operation since the 3rd October, 1934, but owing to the high operating costs involved in running the fan continuously, experiments were carried out between the 1st and 16th July, 1935, inclusive, in running the fan intermittently. On the 15th July, the day on which the emanations were particularly complained of, atmospheric conditions seem to have caused the extracted air to descend. This is a rare occurrence, but the resumption of the continuous running of the fan and other steps taken by the London County Council resulted in the cessation of complaints. SCHOOLS. As stated in the Annual Report of the Medical Officer of Health for 1934, the inspection of school children in the Metropolitan Borough of Islington comes under the administration of the London County Council, but the general sanitary inspection is within the purview of the Borough Council's Public Health Department, The number of private schools remains as in 1934, namely, 15. RATS AND MICE (DESTRUCTION) ACT, 1919. (9 and 10 Geo. 5, Ch. 72.) In reporting on activities during National Rat Week, 4-9th November, 1935, it is difficult to say that these have differed much from those of the previous year, 1934. Approximately the same total number of handbills were distributed from the enquiry office of the Public Health Department at the Town Hall, and through the medium of the Sanitary Inspectors in the course of their district visitation, also by the Health Visitors. Posters were exhibited, and also our rat transparencies. It was noticed that Rat Week preceded the Parliamentary Elections, and the interest of the public was largely taken by the propaganda for this event, consequently one could not say that the interest was the same as during the year before; in fact, the callers were less. 63 [1935 An interesting' item which is worth recording was brought to notice previous to our propaganda week. Rats were caught at an address in the Borough for a period of several weeks, and an approximate estimate of the rats caught in these particular premises would be 60.70; then there was an interval in which the traps and cage traps were again set with no result as regards the capture of rats, although the presence of at least one was still suspected, as the baits were removed. An experiment was made of baiting a wire cage with sunflower seeds, and a large rat was caught; no more have been seen or heard since. The history of the use of sunflower seeds as a bait for rats is interesting; undoubtedly they are an irresistible bait for rats, probably due to their very large oil content. It is said that they were first tried by Captain Weedin, who had charge of animals at the Washington Zoo, U.S.A. The building was infested with rats, and although traps were used nothing would tempt the rats to enter. There happened to be in a store-room drawer in the building a quantity of sunflower seeds used as a food for some of the birds, and into this drawer the rats gnawed their way. This incident led Captain Weedin to experiment with them as a bait in the traps. The result is stated to have been that the rats could not be kept out of the traps; a trap which appeared overcrowded with six or seven rats was found some mornings to hold 15. These very old experiments I think are worth taking note of, and it may be that better results would be obtained if sunflower seeds were more generally used as bait. I have been unable to trace the original report of Captain Weedin, but an extract appeared in a Cincinnati newspaper, and this found its way into a little book, "Saxon's Curious Facts," edited by Don Lemon, and published as far back as 1890. During the year 1935 the number of complaints received was 199. The number of private houses visited under the Rats and Mice (Destruction) Act 412 The number of shops and factories visited 37 The total premises inspected 449 Street work visits numbered 239 Number of premises proved to be rat infested 190 Number of premises in which infestation was due to mice... 9 Number of notices served 140 Drain defects remedied as a result of complaint of rat trouble 42 The following Table summarises the work under the Act during the years 1928 to 1935. 1928 1929 1930 1931 1932 1933 1934 1935 Number of Streets visited 203 144 166 223 250 244 236 239 Number of Private Houses visited 349 223 387 385 391 388 364 412 Number of Shops and Factories visited 56 36 37 48 17 38 46 37 Total Premises inspected 405 259 424 433 408 426 410 449 Found Rat Infested 154 101 142 178 169 168 178 190 Found Mice Infested 2 4 3 10 9 8 6 9 Defective Drains Repaired (Cause of Rat trouble) 49 23 45 50 63 37 55 42 Number of Complaints received 150 124 176 216 203 194 212 199 RAG AND BONE DEALERS. During the year 73 visits were paid to 29 premises upon which is carried on the business of a rag and bone dealer, and all were found to be in a satisfactory Condition, 1935] 64 CHURCH LANE CLEARANCE AREA. In the Annual Report of the Medical Officer of Health for 1934 reference was made to the decantation of 391 persons from this area to Wakelin House. In that year 17 houses and shop premises were demolished, the remaining 36 houses being dealt with in 1935. PART I. HOUSING ACT, 1930. The representations by the Medical Officer of Health to the Housing Committee of ten small clearance areas under Part I. of the Act are still under consideration. HOUSING ACT, 1925-1935—UNDERGROUND ROOMS. The work of the four temporary Sanitary Inspectors who had been appointed for the survey of underground rooms was continued throughout the year. 8,273 inspections were made, 1,975 rooms found to be used for sleeping purposes, 433 of these being overcrowded; the remainder were used for living purposes only. The total number of inspections made since the commencement of the work in October, 1934, is 10,874; of these, 2,875 were found to be used for sleeping purposes, and 553 occupied in an overcrowded condition. Before a closing order was made prohibiting the use of an underground room for sleeping purposes, the Housing Committee summoned all interested persons to appear before them, and in 32 cases an undertaking was given by the person having control that the room would not be used for sleeping purposes, and in 105 cases closing orders were made. In consequence of the regulations governing such rooms being satisfactorily complied with, the Council determined 7 closing orders and cancelled 4 undertakings. Section 84 of the Housing Act, 1935, which came into foive on the 2nd August, removes the term " used for sleeping purposes "from section 18 of the Housing Act, 1925, so that now all basement rooms which do not comply with the regulations made by the Council under the latter enactment governing such rooms are deemed unfit for human habitation. DEMOLITION ORDERS. Demolition Orders were made in respect of 38 and 40, Wedmore Street, and 1, 2, 3 and 4, Webb's Cottages. The two houses in Wedmore Street were demolished and the site absorbed by the extension of an adjacent factory. RECONDITIONING OF HOUSES. The Medical Officer of Health reported on the unfitness for human habitation by reason of disrepair of Nos. 2 and 4, Mayville Street, with a view to a demolition order being made, and at a subsequent meeting of the Housing Committee, to which the person having control was summoned to appear, a representative of the owner gave an undertaking to recondition the premises and render them fit for human habitation ; this undertaking was accepted by the Committee and the repairs effected. HOUSING ACT, 1930. 119 dwelling houses were the subject of informal notices requiring owners to effect repairs, and during the year in 115 of these the repairs were satisfactorily carried out. It was found necessary to serve formal notices in 10 cases only, these premises being:—40, Cumberland Street, 109, Petherton Road, 34, Nicholay Road, 431, Caledonian Road, 1, Lyon Street 19, Freeling Street, 21, Freeling Street, 16, Hanley Road, 31, Scholefield Road, and 11, Brunswick Street. No case arose under Section 18 of the Act requiring the local authority to effect repairs in default of compliance with a notice under Section 17. 65 [1935 Summary of Housing from 1919 to 1935 (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 1934 1935 Total since 1919. Number of houses or flats provided by the Islington Borough Council 1073 8 1,081 Number of flats provided by the London County Council 455 120 575 *Number of houses or flats provided by private enterprise 653 176 829 2,181 304 2,485 *Also one Hostel containing 300 cubicles was erected in 1935. Particulars of houses or flats provided under the Council's Housing Schemes :— 1919 to 1934. 1935. Total since 1919. 1919-< Act. 'Halton Mansions 160 8 168 City Mansions 47 — 47 Queen's Mansions 45 — 45 Warltersville Mansions 46 — 46 Manchester Mansions 31 — 31 Addington Mansions 107 — 107 Comprising* 16 houses 57 dwell ings— 57 493 8 501 1924 Act/ 'Tyndale Mansions 102 — 102 Laycock Mansions 132 — 132 Houses, etc., Highbury Station Road 15 — 15 Avenell Mansions 40 — 40 .Leyden Mansions 111 — 111 1925 Act. 19301 Act._ The Highlands, Crouch Hill 71 — 71 Wakelin House 109 — 109 1,073 8 1,081 *Includes:—27, Rupert Road 8, Barnsbury Street 2, Highbury Grange Not converted. NUMBER OF HOUSES OWNED BY THE LOCAL AUTHORITY, DISTINGUISHING THOSE BUILT IN THE LAST TWO YEARS, AND HELD UNDER:— (1) Part III. of the Housing Act, 1925. (2) Part II. of the Housing Act, 1925, and (3) Other powers. Held under Total at 31st Dec., 1933 Erected in 1934 & 1935 Total[m###] Part III. of Housing Act 1925 Nil. 71 71 Part II. of Housing Act 1925 Nil. Nil. Nil. Other. Powers 893 117 1010 Total 893 188 1081 1935] 66 Cases of overcrowding- recorded annually as dealt with by service of notice since 1925 :— 1925, 19; 1926, 26; 1927, 24; 1928, 37; 1929, 21; 1930, 32; 1931, 59; 1932, 72; 1933, 42; 1934, 61; 1935, 76. Others were dealt with by housing recommendations to L.C.C. HOUSING RECOMMENDATIONS FROM THE PUBLIC HEALTH DEPARTMENT. During the year 1935, recommendations were made to the London County Council regarding housing accommodation for "special hardship" cases. In all, 113 were recommended for special consideration. The basis on which these recommendations was 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 113 cases recommended by the Medical Officer of Health, 40 of which were given on account of overcrowding, during the year:— 9 were provided with accommodation by the London County Council. 36 removed to an unknown address. 7 secured better accommodation in Islington. 56 still remained in their Islington occupation. 5 removed to addresses outside Islington. These 113 recommendations can be classified under the following headings ;— 40 were on account of overcrowding; 4 on account of overcrowding and Tuberculosis; 43 ill-health (including 9 tuberculous sufferers); 12 insufficient accommodation for the sexes; 7 better accommodation required; and 7 special circumstances. In addition to these 113 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. An agreement has been entered into between the Islington Borough Council and the London County Council by which families dehoused under the provisions of the Housing Act, 1930, are accommodated elsewhere by the London County Council. There are 10 such cases which arose through the operation of section 18 of the Housing Act, 1925, where families were occupying underground rooms which did not comply with the regulations governing such rooms, and were the subject of closing' orders. By this agreement the Borough Council undertakes to pay the London County Council a sum of £1 17s. 6d. annually for forty years, and obtains the right upon the cessation of the tenancy to nominate another family to occupy the vacated premises. DEMOLITION OF HABITABLE DWELLINGS. During the year 139 houses have been demolished, on the sites of 57 of these new business premises have been erected. 67 [1935 METROPOLITAN BOROUGH OF ISLINGTON. Housing Statistics for the Year, Ministry of Health Table. 1.—Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 8,113 (b) Number of inspections made for the purpose 8,113 (2) (a) Number of dwelling-houses (included under sub-head (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 1,679 (b) Number of inspections made for the purpose 1,679 (3) Number of dwelling-houses found to be in such state so dangerous or injurious to health so as to be unfit for human habitation 8 (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 983 2.—Remedy for Defects during the Year without Service of Formal Notices:— Number of defective dwelling-houses rendered fit in consequence of informal action by Local Authority or their officers 638 3.—Action under Statutory Powers during the Year:— (a) Proceedings under sections 17, 18 and 23 of the Housing Act, 1930— (1) Number of dwelling-houses in respect of which notices were served requiring repairs 119 (2) Number of dwelling-houses which were rendered fit after service of formal notices— (a) By owners 3 (b) By local authority in default of owners Nil (b) Proceedings under Public Health Acts— (1) Number of Dwelling-houses in respect of which notices were served requiring defects to be remedied 5,363 (2) Number of dwelling-houses in which defects were remedied after service of formal notices— (a) By owners 5,363 (b) By local authority in default of owners Nil (c) Proceedings under sections 19 and 21 of the Housing Act, 1930— (1) Number of dwelling-houses in respect of which Demolition Orders were made 6 (2) Number of dwelling-houses demolished in pursuance of Demolition Orders 2 (d) Proceedings under section 20 of the Housing Act, 1930— (1) Number of separate tenements or underground rooms in respect of which Closing Orders were mad 105 (2) Number of separate tenements or underground rooms in respect of which Closing Orders were determined, the tenement or room having been rendered fit 7 (N.B.—In addition 4 undertakings were cancelled). 1935] OVERCROWDING SURVEY. Part I. of the Housing Act, 1935, placed the duty on every local authority to cause an inspection of their district to be made with a view to ascertaining what dwelling houses therein were overcrowded according to a standard specified in the Act, and to submit to the County Council a report showing the result of the inspection and the number of new houses required in order to abate overcrowding- in their district. A letter from the London County Council addressed to the Town Clerk indicated the manner in which the overcrowding- survey should be carried out, and intimated that the work should be commenced on the 1st November, 1935. The employment of additional staff was approved and the Superintendent of the Public Health Department authorised to engage 30 enumerators at a wage of £3 per week for five weeks, 16 survey assistants at a wage of £3 5s. Od. per week for eight weeks, and 6 clerical assistants at a wage of £3 per week for ten weeks. The clerical assistants commenced duty on the 28th October, and prepared prescribed forms for the subsequent use of the enumerators and survey assistants. On the 1st November the enumerators commenced the systematic visitation of the dwelling houses, and were followed by the survey assistants on the 7th November, who were engaged to measure up the rooms occupied in doubtful overcrowded premises. By the 6th December the work of the enumerators was completed, and 44,390 structurally separate dwelling houses had been visited. Of this number 12,886 were reported as doubtful overcrowded cases, and of these, 5,231 found to be actually overcrowded. The completion of the survey was effected in the early part of 1936, and will be dealt with in that year's Report. RENT AND MORTGAGE INTEREST (RESTRICTIONS) ACTS, 1920, 1923, 1925 and 1933. 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 — 142 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 — 17 3 79 1930 68 2 27 2 99 1931 35 4 22 1 62 1932 26 4 11 — 41 1933 25 2 10 1 38 1934 39 — 19 4 62 1935 28 — 23 6 57 Totals 1,255 153 247 40 1,695 69 [1935 SHOPS ACT, 1934. The following' is a summary of the work under the Shops Act, which came into operation on the 30th December, 1934. Number of inspections during the year:— Workshops and District Inspectors, 212. Shops Act Inspector (December), 333. Number of notices served:— Intimation. Statutory. Workshops and District Inspectors 27 5 Shops Act Inspector (December)17 44 5 Exemption certificates issued, 17. Cases where requirements were met voluntarily, 4. SWIMMING BATHS AND POOLS. (a) Public Baths—Borough Council Baths. Hornsey Road Baths.—There is a filtration, purification and sterilization installation—Bell Bros, mechanical system and Wallace & Tiernan's Chlorine Gas apparatus and Ammonia Gas apparatus in operation. Essex Road Baths.-—Ditto, filtration, purification and sterilization installation —Kennicott Water Softener Co. 's system and Wallace & Tiernan's Chlorine Gas apparatus and Ammonia Gas apparatus in operation. Caledonian Road Baths.—Ditto, filtration, purification &nd sterilization installation—Paterson Engineering Co.'s system and Wallace & Tierman's Chlorine Gas apparatus and Ammonia Gas apparatus in operation. London County Council. Swimming Pool at Highbury Fields. Area 1,452 square yards; estimated length and breadth, 62 yards by 22 yards, water purified by filtration. (b) Privately owned swimming baths or pools.— Nil. See also report on water sample, page 48. INSPECTION AND EXAMINATION OF FOOD AND PLACES WHERE FOOD IS PREPARED. Slaughter Houses—Inspector Haydock reports in respect of the inspection of meat and other foods that the premises visited which were licensed comprised 7 private slaughterhouses and 1 slaughterhouse for the slaughter of horses for export, and 1 knacker's yard. The visits numbered 461. During the year 1 slaughterhouse was licensed by the Council only on the undertaking of the proprietor that no oxen be kept there overnight, and one licence was not renewed. There is, therefore, a reduction in the number from 8 to 7. The following is the tabulated report:— Number of animals slaughtered for human food:— Oxen. Sheep and Lambs. Pigs. Horses (for export) 302 3,207 2 1,554 1935] 70 UNSOUND FOOD DESTROYED. The food destroyed or otherwise disposed of so as to prevent its use for human consumption was as follows:— Tons. cwts. qrs. lbs. Diseased meat including organs from slaughter-houses (surrendered) — 12 0 51½ Meat and Tinned Food from shops and stalls (surrendered) — 8 3 19 Fish from shops, fryers and wholesale dealers (surrendered) — 6 0 15 Fruit and Vegetables (surrendered) 1 1 1 13 Confectionery (surrendere — — 1 6¾ Confectionery (seized) — — — 5½ Fruit and Vegetables — 2 2 18 Total 2 11 1 26¾ From the above Table it will be seen that the total amount of unsound or diseased meat, fish, fruit, and other food destroyed was 2 tons 11 cwts. 1 qr. and 26J lbs. The diseases which affected animal food are set out in detail above. No. of Cases. Description of Animal affected. Nature of Disease. Extent of Disease. How disposed of. 17 Oxen Distomatosis Liver (whole or part) Destructor or on premises. 7 ,, Tuberculosis Lungs Destructor 1 ,, ,, Lungs, Liver & 2 pts. carcase ,, 1 ,, ,, Liver, Lungs and Mesentery ,, 2 ,, ,, Lungs and Liver ,, 2 ,, ,, Offals and 1 part of carcase ,, 1 ,, ,, Lungs and Mesentery ,, 1 ,, ,, Offal ,, 2 ,, ,, Head ,, 1 ,, ,, Head, Lungs and Liver ,, 2 ,, ,, Head and Tongues ,, 1 ,, ,, Head, Tongue and Lungs ,, 1 ,, Angiomatosis Liver ,, 1 ,, Actinomycosis Tongue ,, 2 ,, Cirrhosis Liver ,, 2 ,, Cystic Lungs ,, 2 ,, Abscesses Liver ,, 1 ,, ,, Lungs, Skirt and Liver ,, 2 Sheep ,, Forequarters ,, 1 Oxen Pneumonia Lungs ,, 71 1935 Shops, etc., Inspection of.—The number of visits made to shops, etc., by Inspector Haydock is as follows:— Butchers, Provision Dealers, etc., Shops 1,972 Meat, etc., Preparation Factories 84 Fish, Shops 400 Fruit, Shops 1,405 Markets 239 Stalls 459 Offensive Trades 161 Total 4,720 Merchandise Marks Act, 1926—The marking of imported meat which had previously been regulated by the Sale of Food Order, 1921, was brought within the scope of the Merchandise Marks Act early in the year (February). When the change was about to take place every meat trader in the Borough was circularised as to the requirements applicable to retail traders; 211 circulars were distributed. During the remainder of the year 64 traders were found to be not carrying out the Order satisfactorily and were warned, no prosecutions being taken. Fruiterers are also required to indicate the origin of certain fruits under this Act, and 36 received written warnings for omitting to carry out the requirements of the Act. Public Health (Meat) Regulations, 1924.—No prosecutions were taken under these Regulations during the year; 6 traders however were warned for infringing them. Prosecutions for exposing for sale Unsound Food. During the year two stall holders at the Caledonian Market were successfully prosecuted for exposing for sale "sleepy" pears, one of the vendors was also summoned for depositing for sale a similar commodity at the same time, the aggregate of fines being '£4 2s. Od., and costs £3 2s. 0d. A confectioner was also fined £1 10s. 0d. at North London Police Court for exposing for sale Nursery Buns infested with maggots. Prosecutions taken under Merchandise Marks (Imported Goods), Orders.—Four prosecutions were taken, which were successful, against three traders who failed to mark certain fresh fruit with the country of origin. In one case a fine of £1 1s. 0d. and £1 1s. 0d. costs was inflicted, and the other three were dismissed under the Probation of 0ffenders Act on payment of £1 Is. Od. costs in each case. All three had been warned previously for omitting to carry out these Orders. Diseases of Animals Act, Orders of the Ministry of Agriculture.— No special order was made applying to this Borough during the year. Slaughter of Animals Act, 1933—Thirty-four slaughtermen who had held licences under this Act during 1934 applied for them to be renewed, and seven new applications for licences were received, and after investigation were granted, making a total of 41 granted. Offensive Trades,The offensive trades inspected by me consist of 3 tripe dressers and 5 gut scrapers. 161 visits were made during the year and no breach of the Public Health Acts was observed. In addition, 17 visits to these premises were made by the Workshops Inspector. 1935] 73 Under the London County Council (General Powers) Act, 1932, Part 2 Section 5, a Register of Premises used for the Manufacture or Preparation of Preserved Food is kept. This register practically takes in all butchers with few exceptions, as a limited quantity of preservative in the form of Sulphur is allowed in sausages. For this purpose and for the boiling and smoking of hams, the premises come under the Act referred to. Although the main business in the register is that of butcher, others preparing or making articles of preserved food have also to register; thus grocers, provision and other shops are registered as well. (See Preserved Food and Ice Cream, p. 73). CERTIFICATION OF MEAT FOOD PRODUCTS FOR SHIPMENT ABROAD. The Medical Officer of Health, as Designated Officer for Food Certification, issued 10 certificates in respect of foods prepared in Islington and exported to foreign countries or to the Dominions. LICENSED STREET TRADERS IN THE BOROUGH OF ISLINGTON FOR THE YEAR 1935. Meat, etc., 33; Fish, Poultry, Rabbits, 42; flee Cream, 59; Confectionery, Minerals, etc., 16; Grocery, Provisions, etc., 67; Coffee Stalls, etc., 9; Fruit, Vegetables, Greengrocery, etc., 276. † Some also sell confectionery and minerals. Restaurant Kitchens.—The work of inspecting restaurant kitchens is tabulated under Workshops, and is done by the two women inspectors. The following is a tabulated statement of the premises examined, and the results. In each case the unsatisfactory conditions were remedied without having to resort to prosecution. Number Inspected. Number found Unsatisfactory. Hotel and Restaurant Kitchens 111 28 Coffee and Dining Rooms 285 66 Refreshment Rooms 234 62 Provision (Cooked Meats, cooked but not consumed on premises) 144 38 774 189 NOTIFICATION OF FOOD POISONING. During the year 13 cases of food poisoning were notified, the alleged poisoning foods being Pilchards in tomato sauce 5, Pressed Pork 1, Tinned Salmon 2, Haddock 1, Veal and Ham Pie 3, Sausages 1. Particular note might be taken of the cases of poisoning from veal and ham pie. These cases did not at first come to the knowledge of the Medical Officer of Health by direct notification, although they were notified subsequently after he had investigated. A firm in the Borough asked for a veal and ham pie to be examined, as a customer living in Highgate had complained of illness after partaking of it. We received a portion of this veal and ham pie from the firm, and at this time the Medical Officer of Health was asked by a medical practitioner to see a patient with a rash w hich it was thought might possibly be Scarlet Fever. As the case appeared 73 [1935 to be one, possibly, of food poisoning', investigation was made and it was found that the patient had partaken of one of the same batch of veal and ham pies as mentioned above, and that the person with the rash was not the only sufferer, as two others in the house were recovering from the effects of the consumption of the same pies. When the firm was criticised for not having given all the information, as a complaint had been made to them regarding these other cases also, it was alleged that the messenger had been instructed on delivering" the pie to intimate all the cases, but he had only mentioned the one in respect of the particular portion of pie he was delivering for examination. The cause of the poisoning in these three Islington cases and the one outside the Borough is interesting. The firm were satisfied that " the meat used in the preparation of the pies was fresh," and they stated that in their opinion " the only possible source of contamination would be that when these pies were prepared a supply of stock normally used for filling the pies after baking was exhausted, and .a quantity of gelatine and water was prepared and used. As this mixture was not sterilized by boiling before adding it to the meat pies, it is possible that some source of infection may have had access in this way." It speaks well for the expert examination by the Bacteriologist that this very suggestion was conveyed to the Medical Officer of Health by telephone when the examination of the pie was made, long before the explanation by the firm was forthcoming. It is inexcusable to introduce unboiled gelatine solution, or even boiled if kept overnight, as is sometimes done with such pies; the solution should be freshly prepared and kept as clean as possible, since it makes a favourable medium for bacterial growth. Such laxity by an employee may cause a firm very considerable damage, not only in subsequent loss of trade, but the people who are taken ill have in justice to be compensated. PRESERVED FOOD AND ICE CREAM. On page 67 of the Annual Report for 1932 the registration of premises in respect of these articles was fully dealt with. In 1934 166 premises were on the register for preserved food ; 3 were registered during the year 1935 and 2 were removed from the register. The total on the register at the end of the year, therefore, was 167. The number of ice cream premises in 1934 was 448. 2 cases were removed from register in 1935 ; 34 additional were registered, so that the ice cream premises on the register totalled 480 at the end of the year. MILK AND DAIRIES ORDER, 1926. Milk Purveyors and Dairies.—At the close of the year there were on the register : 399 dairies. There were also in the borough 385 premises, from which milk in sealed containers was being purveyed. The latter premises are not subject to the provisions of the Milk & Dairies Order 1926, in view of the definition of the word " dairy " in Art. 19 of the Milk & Dairies (Consolidation) Act, 1915. The person occupying the premises is, however, registered as a purveyor of milk. During the year, five premises were added to, and seven premises removed from, the Register of dairies, while 30 purveyors' names were added to, and 5 removed from, the Register of the purveyors of milk. The occupiers of the dairies are ipso facto registered purveyors of milk, 74 1935] Where a change of occupation of a milkshop or dairy has been effected, or where it is proposed to open a new business, each has been visited by the Superintendent, the total number of visits for the year being 33. For prosecution under the Milk & Dairies Order, see p. 77. THE MILK AND DAIRIES (AMENDMENT) ACT, 1922; THE MILK (SPECIAL DESIGNATIONS) ORDER, 1923. During the year 1935 the following applications were made for licences under the provisions of the above Order to enable the persons to sell Specially Designated Milk :— LICENCES GRANTED UNDER MILK (SPECIAL DESIGNATIONS) ORDER, 1923. Designation. No. of applications Number granted. Amount of Fees received. £ s. d. Certified 8 8 1 17 6 Grade A (Tuberculin tested) 29 29 7 2 6 Grade A (T.T.) (Bottling) - - ,, (Pasteurized) 2 2 10 0 Grade A 6 6 1 7 6 ,, (Bottling Licence) - - -. Pasteurized (Dealer) 28 28 6 12 6 „ (Pasteurizer) 5 5 5 5 0 Supplementary:— Pasteurized 5 5 10 0 Grade A (Tuberculin Tested) 2 2 4 0 Certified 1 1 2 0 86 86 23 11 0 PUBLIC HEALTH (CONDENSED MILK) REGULATIONS, 1923 and 1927. During the year one informal sample was taken under the above Regulations, and found in order. PUBLIC HEALTH (DRIED MILK) REGULATIONS, 1923 and 1927. 23 informal samples were taken and found in order. MILK AND DAIRIES (CONSOLIDATION) ACT, 1915. For prosecutions under this Act see page 77. ADULTERATION OF FOOD AND DRUGS—FOOD AND DRUGS (ADULTERATION) ACT, 1928. During the year the number of Samples of Food and Drugs taken for Analysis was 1,257, including 825 informal samples; all the purchases were made by Inspector Green or his Agent and were submitted to the Islington Public Analyst, Dr. Alan W. Stewart. Of the total samples 1,247 were reported to be genuine and 10 adulterated, or 0.8 per cent. This percentage is 2.2 below the previous year and 4.6 below the average rate for the preceding 10 years. There were 12 prosecutions under the Food and Drugs (Adulteration) Act, 1928, 9 of which were successful, 75 [1935 33 samples ot milk were submitted by the Inspector for bacteriological examination, see page 47. In addition to this work, Inspector Green made 982 visits under the Merchandise Marks Act. Prosecutions are included in the complete list (p. 77). During- the year as formerly, where prosecutions were not taken for varying reasons, such as the deficiency being perhaps slight, or the case being one of neglect properly to mark the article, and the offender had not been previously warned, etc., strong letters of warning were sent. During the year 1935, 2 formal and 3 informal samples of cream were taken ; all proved to be genuine. A wide selection (the varieties numbering 116) of informal samples were taken during the year, as these form the basis upon which information is obtained to enable us to buy formal samples with a view to prosecution. The informal samples of butter numbered 200, cheese 12, pepper 38, honey 10, sausages 5, olive oil 14, tea 54, cocoa 26, coffee 18 and margarine 39. During the year 1935 in addition to the samples taken and submitted to the Public Analyst there was a total of 190 informal samples, which were examined by Inspector Green. These informal samples comprised a number of varied articles. The greatest amount of detected adulteration occurred in the first quarter of the year, as shown by the figures given in the statement below. Examined. Genuine. Adulterated. Per Cent. Formal Informal Formal Informal Formal Informal Adulterated. 1st Quarter 126 176 122 174 4 2 2.0 2nd „ 83 138 83 138 - - 0.0 3rd „ 120 199 120 199 — — 0.0 4th „ 103 312 100 311 3 1 0.9 The Year 432 825 425 822 7 3 0.8 Milk.—The qualitative results of the Analyses of the milk samples taken during the year are as follows:— No. of Samples. Solids not Fat. Fat. Total Solids. Milk purchased on Sundays 88 8.65 3.54 12.19 Milk purchased on Week-days 321 8.64 3.58 12.17 Milk procured in transit at Finsbury Park Station — - - - Official Standard - 8.50 300 11.50 78 1935] 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:— Number taken. Genuine. Adulterated. Percentage Adulterated. On Sundays 88 ... 88 — — On Week-days 321 ... 317 4 1.2 At Railway Stations - ... — — — (Farmers' Milks) - - - - 409 405 4 0.9 Giving the particulars of the Milks taken during each quarter of 1935 on Sundays. Week-days, and at the Railway Stations. 1935. No. of Samples Taken. Genuine. Adulterated. Per cent. Adulterated. Quarters. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. Sundays. Weekdays. Railway Stations. All Milks. 1st Quarter 26 96 - 122 26 94 - 120 - 2 - 2 - 21 - 1.6 2nd „ 7 76 - 83 7 76 - 83 - - - - - - - - 3rd „ 21 99 - 120 21 99- 120 - - - - - - - - 4th „ 34 50 - 84 34 48 - 82 - 2 - 2 - 4.0 - 2.4 The Year 88 321 - 409 88 317 - 405 — 4 - 4 — 1.2 — 0.9 The number of samples of milk purchased was 409, of which 405 were genuine, and 4, or 0.9 per cent., were adulterated. Showing the samples of milk reported as genuine or adulterated during the past 10 years and in 1935 :— MILK ADULTERATION. Samples Analysed. Genuine. Adulterated Per cent. Adulterated. 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 1930 672 661 11 1.6 1931 610 595 15 2.5 1932 596 579 17 2.8 1933 546 524 22 4.0 1934 515 505 10 2.0 Average 10 yrs. 615 595 20 3.3 1935 409 405 4 0.9 77 [1935 Showing the analysis of 6,152 milks examined in Islington during the 10 years 1925-34 and 1935, and distinguishing those purchased on Sundays, on Week-days, and procured at the Railway Stations whilst in transit from the Farmer to the London Milk Purveyor:— Sunday Milks. Week-day Milks. Railway Milks (Farmers). Years. No. of Samples Per cent. of nonfatty solids. Per cent. of fat. No. of Samples Per cent. of nonfatty solids. Per cent. of fat. No. of Samples Per cent. of nonfatty solids. Per cent. of fat. 1925 108 8.71 3.41 384 8.71 3.37 192 8.79 3.67 1926 83 8.81 3.65 409 8.78 3.63 94 8.88 3.62 1927 129 8.87 3.49 378 8.86 3.73 233 8.84 3.69 1928 124 8.95 3.52 362 8.93 3.49 178 8.92 3.67 1929 142 9.02 3.50 236 8.99 3.41 161 9.01 3.80 1930 110 8.86 3.69 439 8.85 3.61 123 8.90 3.90 1931 95 8.82 3.63 329 8.83 3.64 186 8.93 3.79 1932 111 8.83 3.56 306 8.82 3.60 179 8.89 3.72 1933 114 8.79 3.46 263 8.80 3.54 169 8.85 3.67 1934 122 8.74 3.59 316 8.73 3.56 77 8.84 3.69 Total samples and average constituents (10 years) 1.138 8.84 3.55 3,422 8.33 3.56 1,592 8.88 3.72 1935 88 8.65 3.53 321 8.64 3.53 - — - Summary of Prosecutions during• the year 1935. Statute. Total Prosecutions Successful. Dismissed. Withdrawn. Amount of Penalties Costs Received. Public Health (London) Act, 1891 32 28 4 £ s. d. £ s. d. 50 19 6 44 5 0 Food and Drugs (Adulteration) Act, 1928 12 9 2 1 2 10 0 16 11 0 Public Health (London) Act, 1891, and Public Health (Smoke Abatement) Act, 1926 2 2 - - 1 0 0 3 3 0 Merchandise Marks Act, 1926 6 5 - - 1 1 0 5 5 0 London County Council (Drainage) By-laws, 1934 14 14 - - 4 15 0 13 10 0 London County Council By-laws, 1926 3 3 - - 4 2 0 5 3 0 Milk and Dairies (Consolidation Act, 1915 1 1 - - 1 0 0 London County Council (General Powers) Act, 1902 3 3 - - 2 10 6 1 0 0 London County Council (General Powers) Act, 1922 2 1 - 1 5 0 0 2 2 0 Housing Act, 1930 7 5 - 2 6 0 0 1 1 0 Children Act, 1908 1 1 - - 0 10 0 1 0 0 Children Act, 1908 and Children and Young Persons Act, 1932 1 1 -- - 0 10 0 1 0 0 Totals 84 73 2 8* £78 18 0 £95 0 0 *1 case not proceeded with. ISLINGTON HOSPITALS, CLINICS, ETC. Beds. St. Mary, Islington, Hospital 858 Archway Hospital, Archway Road 564 Royal Northern Hospital 300 Mildmay Memorial Hospital 30 Mildmay Maternity Home 17 London Fever Hospital 200 In addition, all the Central and North London Hospitals are used by Islington residents. 78 1935] OTHER INSTITUTIONS. Islington Institution, St. John's Road, N.—Accommodation for 1,525 (including those for "Petty Officers," that is, those inmates who are employed in the Institution). In "Sick" Ward: Males, 131 beds; females, 194; (also 38 beds in ward closed for repairs). In "Infirm" Ward: Males, 173 beds; females, 249; 8 beds, nursing and expectant mothers. In Main body of the Institution (including the "Petty Officers" accommodation) for the able-bodied cases and Receiving Ward : Males, 485 beds; females, 213; and 34 cots. 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. 50 children under 5 years. Islington Dispensary, 303, Upper Street. Islington Medical Mission, Britannia Row. The Almeric Paget Massage Corps, Islington Centre, Britannia Row, N.l (Light treatment, Massage, etc.). Child Guidance Clinic, Tudor House, Canonbury Place, N.l. Clinics, etc., not including Public Assistance, were enumerated on page 79 of the Report for 1931. PROPAGANDA WORK. The activities of the department are tabulated in poster form, these posters being on boards in the most prominent parts of the Borough. The Empire Marketing Board at Islington Green eventually came under the control of this department and was utilized for the display of artistic posters on child welfare. The blue covered booklet, "Hints on the Care and Feeding of Infants," was revised so as to include recent activities of the department and to emphasize these more in view of the decision of the Maternity and Child Welfare Committee as regards home helps, etc.; also to make more widely known the facilities which are not so readily taken advantage of, as for instance, protection against Diphtheria. The activities of the Welfare Centres are also described in a leaflet issued by the Public Health Department, entitled, "The Islington Child—The Citizen of the Future," which deals with the welfare of little children. The year 1936 being a review year, it is proposed to further revise and augment the propaganda work. The literature on Measles, Whooping Cough, Diphtheria, Scarlet Fever, Infectious Disease—Law, was widely distributed during the year, as also were the "instructions to foster parents," this latter more especially in connection with infant life protection work. A large number of leaflets on the "Bed Bug" and on "Flies" were issued, in view of their educational value as propaganda in health and cleanliness, to emphasize the fact that the slightest infestation is far better attacked at once, because when such invasion progresses in a household it frequently gets beyond the control of the tenant, and eventually involves the dislodgment of woodwork, and redecoration. The Housing Department were supplied with leaflets for the instruction of the tenants in the Council's properties. During the year the "Health Talks" and Mothercraft Classes were carried on as previously by the four Voluntary Welfare Centres. Requests were received for short lectures from several social Organizations; these were provided by sending a member of the staff, and at the larger meetings the Medical Officer of Health attended. APPENDIX. Vital and Sanitary Statistics, 1935 TOGETHER WITH THE PRESCRIBED RETURNS OF THE MINISTRY OF HEALTH. 80 1935] STATISTICAL APPENDIX Deaths registered in the Borough of Islington during the year ending 1935. Deaths of Non-Residents in Hospitals are excluded. Deaths of Residents in Public Institutions are distributed. CAUSE OF DEATH. Sex All ages AGES. DISTRICTS. 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- 75- 85 & up Tuf. U.H. Toll. L.H H B S.E. ALL CAUSES M. 1,673 138 39 21 12 22 32 58 95 175 329 429 268 55 207 160 149 202 286 295 374 F. 1,714 102 28 16 10 21 33 79 91 124 274 428 371 138 200 181 145 201 329 288 370 Typhoid and paratyphoid fevers (1-2) M. F 1 - - - - - - - - - - - - - - - - - - 1 - Measles (7) M F. - - - - - - - - - - - - - - - - - - - - - - Scarlet Fever (8) M. F. - - - - - — — — — — — — — — — — — — — — — — Whooping Cough (9) M. F. 5 4 6 3 - - - - - - - - - - - - - - 1 1 6 1 Diphtheria (10) M. F. 9 4 - 5 7 1 - - - - - - - - - 2 - 2 2 1 1 5 Influenza (11) M. F. 14 15 2 1 1 — — 3 — 3 3 6 8 1 1 4 5 1 3 6 1 6 Encephalitis lethargica (17) M. F. 1 — — — — — — — — — — 1 — — — — — — — 1 - Cerebro-spinal Fever (18) M. F. 4 3 3 1 1 — 1 — 1 — — — — — — - 1 — 2 — 2 2 Tuberculosis of Respiratory System (23) M. F. 113 89 — 1 - 1 11 30 44 33 43 27 12 — - 18 24 21 19 30 43 7 Other Tuberculous diseases (24) M. F. 11 10 3 6 — 2 1 2 2 1 — 1 3 — — 1 1 — 5 5 6 3 Syphilis (34) M. F. 10 7 3 — — — — — 2 1 6 3 2 — — — 2 1 3 3 6 2 General Paralysis of the Insane— tabes dorsalis. M. F. 9 a — — — 1 — — 4 1 5 1 — — 3 1 1 1 — 1 5 (83) Cancer Malignant disease M. F. 231 258 — 3 1 1 - 1 13 24 45 149 162 75 15 72 39 44 53 100 68 113 (45, 46) Diabetes (59) M. F. 8 21 — — — — 1 — 1 1 1 8 13 3 1 1 3 4 2 5 10 4 Cerebral haemorrhage, &c. (82) M. F. 63 119 4 - — 1 1 — 1 6 14 31 63 53 8 21 17 16 25 39 24 40 Heart disease (90-95) M. F. 418 506 1 1 2 3 6 5 12 29 68 157 288 278 74 106 104 72 110 163 163 206 Aneurysm (96) M. F. 4 4 — - - - - - - - 3 1 2 2 — 2 — — — — 2 4 Other circulatory diseases (97-103) M. F. 44 60 - - - - - — 1 — 8 20 40 32 3 14 12 9 12 22 13 22 Bronchitis (106) M. F. 62 51 2 — — — — 1 1 5 12 11 37 28 10 9 11 12 12 19 23 27 Pneumonia (all forms) (107-108) M. F. 142 113 41 17 — 2 2 6 9 11 17 46 64 31 9 27 24 28 35 44 39 58 Other respiratory diseases (110-114) M. F. 5 7 — — - — — — 1 — 2 4 2 1 2 — 2 1 1 3 5 - Ulcer of Stomach and duodenum (117) M. F. 40 11 — — — — — — 3 6 13 15 10 3 1 6 4 4 4 7 12 14 Diarrhoea, etc. (119-120) M. F. 40 37 59 6 1 — — — — 1 2 3 4 — 1 8 5 5 15 15 14 15 Appendicitis (121) M. F. 12 9 — 3 — 2 3 — 2 — 1 4 4 2 — 6 4 2 3 3 1 2 Cirrhosis of liver (124) M. F. 2 4 — — — — — — 1 1 1 3 - - - - - - - 1 2 3 Other diseases of Liver, &c. (125) M. F. 1 3 1 - - - - - 1 1 1 - - - - - 2 - - - - 2 Other digestive diseases (115, 115, 122, 123, 126-129) M. F. 26 31 1 2 2 — 1 — 2 6 6 16 15 7 2 8 9 7 4 11 7 14 Acute and Chronic Nephritis (130-132) M. F. 50 42 1 — 1 — 1 3 7 7 10 18 31 13 — 14 8 8 14 20 12 16 Puerperal sepsis (140-145) F. 3 — — — — — 1 1 1 — — — — — 2 — — - - 1 Other puerperal causes (146-150) F. 5 — — — — — — 3 2 — — — — — 1 — — 1 — 1 2 Congenital debility, Premature birth, Malformations, &c. (157-159) M. F. 51 36 85 — 2 - - - - - - - - - - 12 4 6 17 15 22 11 Senility (162) M. F. 46 73 - - - - - - - - - 1 6 65 47 18 21 14 10 22 15 19 Suicide (163-171) M. F. 28 13 — — — — 1 — 2 8 8 13 6 3 — 6 2 3 5 10 6 9 Other Violence (172-198) M. F. 78 57 4 13 7 4 8 9 10 8 5 18 22 18 9 16 7 15 11 25 24 37 Other defined diseases M. F. 146 111 24 5 11 5 5 4 16 27 29 43 60 24 4 30 29 18 32 45 49 54 Causes ill-defined or unknown M. - — - - - - - - - - - - - - - - - - - - - F. 1 - - - - - - - - - - 1 - - - - - 1 - - - 81 1935 (Ministry of Health Return.) Metropolitan Borough of Islington. CAUSES OF DEATH AT DIFFERENT PERIODS OF LIFE DURING THE CALENDAR YEAR 1935. Causes of Death. Sex All ages 0— 1— 2— 5— 15— 25— 35— 46— 55— 65— 75— All Causes M 1695 138 18 21 33 56 60 96 179 339 429 326 F 1739 104 11 16 23 55 81 92 124 281 435 517 Typhoid and paratyphoid fevers M - - - - - - - - - - - - F 1 — — — — — 1 — — — — — Measles M — — — — — — — — — — — — F - - - - - - - - - - - - Scarlet Fever M - - - - - - - - - - - - F - - - - - - - - - - - - Whooping Cough M 6 4 1 1 - - - - - - - - F 6 4 - 2 - - - - - - - - Diphtheria M 9 — 2 2 5 — — — — — — — F 4 — — 1 3 - - - - - - - Influenza M 16 2 — — — 1 — 1 3 4 4 1 F 17 - — 1 1 2 1 2 — 3 6 1 Encephalitis Lethargica M 1 — — — — — — — — — 1 - F - - - - - - - - - - - - Cerebro-spinal fever M 4 2 - 1 1 - - - - - - - F 3 1 — — - 1 1 — — — — - Tuberculosis of respiratory system M 114 - - - 1 17 19 20 28 19 10 - F 87 - 1 — — 22 25 13 15 9 2 - Other Tuberculous Diseases M 11 2 2 2 1 1 1 1 — — 1 - F 10 1 1 1 1 2 1 — — 1 2 - Syphilis M 11 2 - - - - - - 5 3 1 - F 7 2 — — — — 2 - 1 2 — - General paralysis of the insane, tabes dorsalis M 16 - — — — 1 — 3 2 9 1 - F 4 — — — — — — 2 — 2 — - Cancer, malignant disease M 241 — 1 2 2 1 5 7 22 76 89 36 F 266 — — — — 1 9 17 26 79 76 58 Diabetes M 11 - - - - - - - - 5 4 2 F 28 — — — — 1 1 1 1 5 14 5 Cerebral haemorrhage, &c. M 45 - - - - - - 1 1 7 23 13 F 99 - - - - - 1 2 7 16 31 42 Heart Disease M 409 — — — — 8 4 18 39 73 130 137 F 499 — — - 4 7 10 11 25 71 146 225 Aneurysm M 12 — — — — 1 — 1 4 1 4 1 F 10 - - - - - - - 1 4 2 3 Other circulatory diseases M 53 - - - - - 1 - 5 11 21 15 F 68 1 — — — — — — 7 14 28 18 Bronchitis M 61 3 — — — — — 2 9 9 15 23 F 49 2 — — — 1 — 1 2 2 21 20 Pneumonia (all forms) M 151 24 7 2 1 5 6 8 14 29 37 18 F 101 20 4 2 2 4 4 4 3 11 27 20 Other respiratory diseases M 37 — — — — — 1 2 2 3 2 27 F 61 - - - - - - 2 1 5 2 41 Peptic ulcer M 37 - - - - - 2 6 10 12 6 1 F 12 - - - - - 1 2 1 2 3 3 Diarrhoea, &c. M 33 29 2 - - - - - 2 — — — F 35 20 3 — 1 — — 1 1 3 4 2 Appendicitis M 16 — — 1 1 1 3 - 1 3 6 - F 12 — — 2 2 2 1 — — 2 — 3 Cirrhosis of Liver M 3 — — — — — 1 — — 2 — — F 7 - - - - - - 2 — 4 1 — Other diseases of liver, etc M 5 — - - - - - - - - 3 2 F 9 - - - - - 1 2 — 2 4 — Other digestive diseases M 29 2 1 1 — 1 — — 4 10 5 5 F 28 2 — 2 1 — 1 4 2 7 5 4 Acute and Chronic Nephritis M 54 1 - - 1 2 4 4 8 12 16 6 F 53 - - - 1 3 4 4 5 12 17 7 Puerperal Sepsis F 4 — — — — 1 2 1 — — — — Other puerperal causes F 7 - — — — 2 2 3 — — — — Congenital Debility and Premature Birth, Malformation, etc. M 57 56 — — 1 - - - - - - - F 45 44 — — 1 — - — — - - - Senility M 14 - - - - - - - - 1 1 12 F 25 - - - - - - - - - - 25 Suicide M 27 - - - - 1 1 5 4 10 3 3 F 15 - - - - — 2 3 4 5 1 - Other violence M 78 1 2 7 8 14 7 6 2 12 11 8 F 51 2 2 2 2 3 2 2 4 5 10 17 Other Defined Diseases M 132 10 - 2 11 2 5 11 14 28 34 15 F 121 5 — 3 4 3 9 13 18 13 32 21 Causes Ill-defined or unknown M 2 - - — — — — — — — 1 1 F 5 - - - - - - - - 2 1 2 Deaths under 1 year M. F. Legitimate 124 94 Illegitimate. 14 10 Registered Births M. F. 2273 2250 82 1935] (Ministry of Health Return.) Notifiable Infectious Diseases during the Year 1935. Disease. Ages. Totals Total Cases removed to Hospital Under 1. 1-2 2-3 3—4 4-5 5—10 10—15 15—20 20-35 35-45 45—65 65 and upwds Small Pox Notifications .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever Notifications 5 27 51 66 68 290 101 39 59 7 3 .. 716 701 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria Notifications 16 28 54 67 .. 305 106 30 53 17 7 2 762 759 Deaths .. 2 2 1 .. 7 1 .. .. .. .. .. 13 12 Enteric Fever Notifications .. .. 1 1 .. .. 1 .. .. 1 3 .. 7 6 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerpetal Fever Notifications .. .. .. .. .. .. .. 2 16 6 .. .. 24 22 Deaths .. .. .. .. .. .. .. .. 3 .. .. .. 3 3 Puerperal Pyrexia Notifications .. .. .. .. .. .. .. 5 36 7 .. .. 48 38 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Acute Primary and Influenzal Pneumonia Notifications 7 6 6 6 2 22 4 11 48 23 58 17 210 83 Deaths 1 2 1 1 .. 1 .. .. 8 4 29 18 65 28 OphthalmiaNeonatorumj Notifications 39 .. .. .. .. .. .. .. .. .. .. .. 39 29 Deaths ,, .. .. .. .. .. .. .. .. .. .. .. .. .. .. Encephalitis Lethargica Notifications .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cerebro Spinal Fever. Not'fications 3 .. .. .. .. .. .. 1 2 .. .. .. 7 7 Deaths 3 .. .. 1 .. 1 .. 1 1 .. .. .. 7 6 Acute Poliomyelitis Notifications .. .. .. 1 1 2 1 1 .. .. .. .. 6 6 Deaths .. .. .. .. 1 .. .. .. .. .. .. .. 1 .. Anthrax Notifications .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery Notifications 3 .. .. .. .. .. .. .. .. .. .. 6 36 36 Deaths 1 .. .. .. .. .. .. .. .. .. .. 1 2 2 Malaria Notifications .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas Notifications 2 .. .. .. .. .. .. .. .. .. 47 23 130 84 Deaths .. .. .. .. .. .. .. .. .. .. 8 6 14 11 Continued Fever Notifications .. .. .. .. .. .. .. .. .. .. .. .. .. .. Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken Pox (except in the vaccinated under 10 years) Notifications 11 17 33 16 45 165 53 21 12 1 .. .. 374 38 Deaths .. .. .. .. .. .. .. .. .. .. .. .. .. .. 83 [1935 (London County Council Return.) Metropolitan Borough of Islington. SUMMARY OF PROCEEDINGS DURING 1935. SANITARY AREA. Premises. No. in Borough on 31st December, 1935. No. of Inspection. No. of Prosecutions. Common Lodging Houses 24 344 1 Seamen's Lodging Houses — — — Cowsheds (licensed) — — — Slaughterhouses (licensed) 7 Horse Slaughter house 1 461 — Knacker's Yard 1 Other Offensive Trades 12 178 - Milkshops 399 690 — Ice Cream Premises 480 253 2 Restaurants and Eating Houses 598 774 - Registered Foster Mothers 137 1,259 2 Nurse Children kept 212 1,624 - *Excluding Bottle Milk Purveyors Smoke Nuisances— (1) No. of observations 56 (2) No. of intimations served 16 (3) No. of complaints received 49 (4) No. of Statutory Notices served 3 (5) No. of legal proceedings 2 (6) No. of convictions 2 (7) Amount of penalty and costs imposed in each case— One, to abate nuisance in 14 days and to pay £2 2s. Od. costs. One fined £1 and to pay £1 1s. 0d. costs. Cleansing and, Disinfection— No. of adults cleansed 64 No. of children cleansed 6,251 No. of premises cleansed— (a) After infectious diseases 596 (b) For vermin 68 Water Supply to Tenement Houses— No. of premises supplied 228 No. of prosecutions 1, HOUSING. 1. Total number of houses in the Borough about 46,000 2. Number of of houses occupied by the working classes about 30,000 Public Health Act. 3. Number of houses inspected on account of complaints or illness 8,113 4. Number of Statutory Notices served 752 5. Number of houses repaired 6,367 houses Nuisances remedied 16,027 84 1935] Housing Acts (1925-35). 6. Number of houses inspected—House to house (Housing solidated Regs., 1925) 1,679 7. (a) Number of houses included in representations by the Borough Medical Officer under Sec. I of Housing Act, 1930 Nil (b) Number of houses demolished following representation by Borough Medical Officer under Sec. I of Housing Act, 1930 36 8. Number of houses repaired under Sections 17 and 18 of Housing Act, 1930— (a) By owners 115 (b) By Local Authority in default of owners Nil 9. Number of houses demolished— (a) In pursuance of orders under Sec. 19 of the Housing Act, 1930 2 (b) Voluntarily 139 10. Number of houses (wholly or in part) the subject of Closing Orders (excluding underground rooms) 1 11. Number of Closing Orders determined (i.e., houses made fit) 7 12. Number of houses in accepted schemes for redevelopment or reconditioning by owners under Part V of the Housing Act, 193 Nil 13. Number of certificates of fitness issued under Sec. 55 of Housing Act, 1935 Nil 14. Number of houses erected by the Borough Council for working classes during year 8 15. Houses Let in Lodgings. Number in Borough 983 Number of inspections 5,748 Number of prosecutions 10 Number of complaints remedied under the By-laws (not included under any other heading) 821 16. Underground Rooms. Estimated number occupied but unfit under Sec. 18 of Housing 1925 as modified by Sec. 84 of Housing Act, 1935. Survey in progress Number closed or modified occupation approved under Sec. 84, Housing Act, 1935 105 17. Overcrowding (Housing Act 1935). Number of houses inspected under Sec. I of Housing Act, 1935 10,022 Number of families found to be living in overcrowded conditions, Sec. of Housing Act, 1935 5,231 Sanitary officers— Chief Sanitary Inspector (Whole time) 1 Number of Sanitary Inspectors (Whole time) Male, 23 Female 2 ,, ,, Temporary) Male, 4 Female Nil Number of Health Visitors (Whole Time) 8 „ ,, 1 Infant Life Protection Visitor Tuberculosis Visiting Nurse (Whole time) 1 85 [1935 Social Conditions. During the year there did not appear to be any marked improvement in the economic conditions of the populace, the unemployment in July being 10.3 per cent, of the insured population, which was 114,080. These figures are given by the Local National Employment Exchange of the Ministry of Health. It is stated, however, that at the close of the year unemployment had slightly decreased. Two of the main industries in the Borough, namely, laundries,and wireless components, have in each case extended their premises and consequently engaged more labour. References—Former M.O.H. Reports. Tables and Reports have appeared in previous Annual Reports of the Medical Officer of Health. See reference page 91, report 1929, for years 1921-1929. Annual Report 1930. Page 10 Public Health Congress. Royal Agricultural Hall. Pages 34, 35 and 36 Smallpox. Page 41 Islington (Chicken-Pox) Regulations, 1930. Page 52 Local Government Act, 1929. Page 57 Cleansing (Disinfection) of School Children. L.C.C. Agreement, p. 57. Pages 60, 61, 62, 63, 64 Shops—General Investigation Regarding Conditions, Etc. and 65. Page 66 Nuisances by Dogs. Rag Flock Acts. Page 67 Agricultural Produce (Grading and Marking) Act, 1928. Merchandise Marks Act, 1926. Pages 70 and 71 Rats and Mice (Destruction) Act, 1919. Pages 71, 72, 73, 74 and 75 Housing. Page 75 Rent and Mortgage Interest (Restrictions) Acts. Page 76 Unsound Chocolates given as Prizes. Page 78 The Grading of Milk—Bacteriological Examination. Pages 78 and 79 The Milk and Dairies (Amendment) Act, 1922; The Milk (Special Designations) Order, 1923. Annual Report 1931. Page 9 Report on Maternity and Child Welfare Work. Page 17 Work of the Day Nurseries. Pages 17, 18 and 19 Report of the Work of Voluntary Centres. Page 30 Prosecution non-notification of Infectious Disease. Pages 39 and 40 Islington Interim Tuberculosis Care Committee. Pages 60, 61, 62, 63, 65, Housing. 66 and 67. Pages 63 and 64 Basement Rooms. Pages 69 and 70 Census. Page 75 Cheese Sandwiches, Black Currant Pastilles. Annual Report 1932. Page 17 Work of the Day Nurseries. Page 25 Coroner's Court and Mortuary. Page 32 Dysentery. Page 43 Tetanus. Page 44 Sterility of Maternity Outfits. Pages 59-61 Housing. Page 67 Unsound Food as Prizes ; Preserved Food. Pages 67 and 68 Notification of Food Poisoning. Page 68 Food Poisoning—Definition. Page 72 Migratory Vendors—Warning. Misleading Descriptions—Wine and Spirit Mixtures. Page 74 The Almeric Paget Corps; Child Guidance Clinic. Open Spaces. 86 1935] Annual Report 1933. Page 17 Work of the Voluntary Centres. Page 20 Day Nurseries. Page 21 Invalid Children's Aid Association. Page 21 National Society for the prevention of Cruelty to Childr Page 22 Infant Life Protection. Page 29 Death from Copying Ink Pencil. Page 32 Typhoid Fever at Camp. Pages 39 and 40 Interim Tuberculosis Care Committee. Page 48 Food Poisoning. Pages 49 and 50 Water Softening. Page 58 Scavenging. Page 64 Non-compliance with Statutory Notice. Page 65 Rats & Mice (Destruction) Act, 1919. Page 67 Housing. Page 68 Church Lane Clearance Area. Page 71 Housing Recommendations. Page 76 Unsound Food Prosecution. Page 77 Pickled Horse Flesh. Page 78 Foot and Mouth Disease Order. Annual Report 1934. Pages 9-11 Maternal Deaths. Page 21 Infant Life Protection. Page 33 Smallpox. Pages 34 and 35. Diphtheria Immunisation. Page 40 Blind Persons Act. Pages 40 and 41 Prevention of Deafness. Pages 42-44 Tuberculosis Care Committee. Page 52 Toy Pistol—Tetanus. Page 65 Sewer Emanations. Page 65 Private Schools. Page 67 Clearance Areas. Page 77 Food Poisoning. Page 83 Health Propaganda. Page 83 Survey of the Public Health Services of the Borough. 87 [1935 INDEX Page Accidental Deaths 24, 30 Acreage iii Acute Poliomyelitis 36 Adulteration of Food 74 Ages at Death 6, 7, 8 Agricultural Produce (Grading & Marking) Act, 1928 58 Anti-toxin treatment 32 Anthrax 27 Appendix 79 Area iii Areas—Clearance 64 Artificial Sunlight Treatment 44 Attack Rates—Infectious Diseases 34 Bacteriological Examinations 46, 47 „ Diphtheria 46, 47 Bakehouses 53, 54 Basement Rooms 64 Births iii, 4, 5 „ Illegitimate 5 „ Notification of 5 „ Stillborn 5 Blind Persons Act, 1920 37 Cancer 27, 80, 81 Certification of Meat Food Products 72 Census Information iii Chicken Pox Regulations 36 Children and Young Persons Acts 19-21 Church Lane Clearance Area 64 Cleansing of Verminous School Children 52 Clearance Areas 64 Clinics 77-78 Coal gas Poisoning 30 Common Lodging Houses 61 Condensed Milk Regulations 74 Consumption (see Tuberculosis) iii, 27, 28, 38-41 Contributions to Voluntary Welfare Centres 22 Coroner's Court, &c. 30 Cream 75 Day Nurseries 21 Dairies and Milkshops (Inspection of) 59, 74 Deaths from all causes during the year iii, 5, 80, 81 Deaths from Epidemic Diseases iii, 25, 26 ,, —Infants iii, 6, 7, 8 ,, „ Respiratory Diseases iii, 27, 28,80, 81 „ in Public Institutions 23, 24 „ and Death Rates 5, 6 „ Maternal 9, 10, 11 „ Age at 6,7,8,80,81 Demolition of Habitable Dwellings 66 88 1935] Page Density iii Diarrhceal Diseases 26, 80, 81 Diphtheria 31,80,81 „ Anti-toxin treatment and immunisation 32 Diphtheria Bacteriological 46,47 Diseases Treated in Hospital 33, 34 Disinfectants distributed and used 51 Disinfecting Station 50, 51 Disinfection Work 41, 50,51 Disinfestation of School Children 52 Distribution of Milk 13 District Inspectors' Work 59, 60 Dried Milk Regulations 74 Dust, removal of 57 Dust receptacles provided 57 Dysentery 36 Emanations, Sewer 62 Encephalitis Lethargica 36 Enteric Fever (Typhoid) 32, 46, 47 Epidemic Diseases iii, 25, 26 „ Cerebro-Spinal Meningitis 35, 80, 81 Extract of Vital Statistics 3 Erysipelas 27, 32 Factories and Workshops Administration 53-56 Fatality from Notifiable Infectious Diseases 33 Finsen Light Treatment 44 Food, Inspection of, Unsound, Adulteration of 69-72 Food Licensed Street Traders 72 Food Order 81 Food Poisoning 72 Gas (Coal) Poisoning 30 Glanders, Anthrax and Hydrophobia in Man 27,36 Health Propaganda 78 Health Visitors (Municipal) 14, 15 Home Helps 13 Home Visitations—Tuberculosis 45 Hospitals—Clinics 77, 78 Hospital Isolation of Infectious Diseases 33, 34 Housing 64-68 „ Accommodation and Recommendations 66 Housing—Tuberculosis 45 Houses Let in Lodgings 60 Ice Cream Premises 59, 73 Illegitimate Births 5 Increase of Rent (Restrictions) Acts 68 Industrial Diseases 27 Infant Life Protection 19-21 Infantile Mortality iii, 6, 7, 8 Infant Welfare Work 14-23 Infection, Prevention of 31 Infectious Diseases (London) Regulations, 1927 35 Infectious Disease (Notifiable) 35 Infectious Diseases in Schools 45 „ „ (Non-Notifiable) in Schools 46 Infirm Persons 62 Informal Sampling 74, 75 Influenza 26, 80, 81 Inspection of Food 69 „ „ Houses 57, 59, 60 89 [1935 Page Inspection of Kitchens of Restaurants 53, 72 „ „ Milkshops and Dairies 59, 73 ,, „ Slaughter Houses 69, 83 „ „ Workshops 53-56 Institutions 78 Institutions (Deaths in) 23 Inquests 30 Insulin (Supply of) 37 Invalid Children's Aid Association 22 Isolation of Infectious Diseases 33, 34 Islington Chickenpox Regulations 36 Islington Tuberculosis Care Committee 39, 40 Kitchens and Restaurants 53, 72 Lead Poisoning 27 Legal Proceedings, Summary of 77 Light Treatment—Artificial Sunlight and "Finsen" 44 London County Council Return of Sanitary Work 83 Malaria 35 Malignant Diseases 27 Marriages 3 Maternity and Child Welfare Committee ii Maternity and Child Welfare Work 9, 14, 15 Maternal Deaths 9-11 Measles (Deaths) 8, 80, 81 Measles, Notifications by School Teachers 46 Measles, Scheme of Control 46 Meat Inspection 69-72 Meat, labelling of 71 Medicines, Provision of 37 Merchandise Marks Act, 1926 58, 75, 77 Ministry of Health Returns 81, 82 Milk and Dairies (Consolidation) Act, 1915 74, 77 Milk and Dairies Order, 1926 73, 77 Milk, Bacteriological Analyses 47 Milk Scheme 13 ,, Adulteration 74, 77 Milk Purveyors and Dairies 73 ,, Special Designations Order—Licences 74 Mortuary and Coroner's Court 30 National Society for the Prevention of Cruelty to Children 19 Notification of Infectious Diseases 31-36 ,, „ Tuberculosis 38-41 „ „ Births Act 5 „ „ Still-births 5 Non-notifiable Infectious Diseases in Schools 46 Notices served 57 Nursery School 78 Offensive Trades 71 Ophthalmia Neonatorum 9 Outworkers' Premises 53-56 Other Notifiable Diseases 35 Pathogenicity Tests (Diphtheria) 47 Pemphigus Neonatorum 12 Phthisis 27, 28, 38-41, 80-81 „ Notification of 38, 41 Places where Food is Prepared 69,72 Pneumonia 29, 35 Pneumothorax treatment 44 Poisoning (Gas) 30 „ (Lead) 27 90 1936] Page Polioencephalitis 36 Population at the Census, 1931 iii „ estimated, 1934 and 1935 iii, 3 Preserved Food (a) Inspectors' Visits 71 (b) Registration of Premises 73, 83 (e) London County Council Table 83 Prevention of Deafness 37 Prevention of Infection 31 Propaganda 78 Prosecutions, Summary of 77 Prosecutions—Unsound Food 71, 77 Public Health Committee ii Public Health (Meat) Regulations, 1924 71 „ „ (Tuberculosis) Regulations, 1930 40, 41 Public Institution Deaths 23, 24 Public Vaccinators 49 Puerperal Diseases 12, 27 Puerperal Fever and Pyrexia 12 Polio-Myelitis, Acute 35 Pulmonary Tuberculosis 28, 38 Rag and Bone Dealers 63 Rag and Flock Act (1911-1928) 58 Rats and Mice (Destruction) Act, 1919 62 Rateable Value iii Recommendations—Housing 66 Reconditioning of Houses 64 References—M.O.H. Reports 85 Regulations, Chickenpox Notification 36 Removal of Dust 57 Rent and Mortgage Interest (Restrictions) Acts 68 Report on Maternity and Child Welfare 9 Report on Work of Day Nurseries 21 Representations of Medical Officer of Health 64 Respiratory Diseases iii, 29, 35, 36 „ Tuberculosis 28, 38 Restaurant Kitchens 53, 72 Rooms Disinfected 41,50 Sale of food Order—Labelling of Meat 71 Samples Analysed in 1935 74 Sanitary Inspectors' Work 59 Scavenging 56 Scarlet Fever 32 Schools 45,52, 62 Septic Diseases 27 Sewer Emanations 62 Shelter House 51 Shops Act, 1934 69 Shops, Inspections of 71 Slaughterhouses 69, 83 Slaughter of Animals Act, 1933 71 Small Pox 31 Smoke Nuisances 58 Social Conditions 85 Sophistication of Milk 76 Specialist Consultations 12 Staff 2 Statistics 79 Still-Births, Registration 5 Street Accidents 30 91 [1935 Page Street Traders 72 Summary of Housing 65 Summary of Vital Statistics iii Swimming Baths and Pools. 69 Synopsis of Inspectors' Work 57 Tetanus 27 Tuberculous Diseases iii. 27. 28, 38-41 Tuberculous Meat 70 Tuberculosis Care Committee 39, 40 Tuberculosis Dispensaries 42 Tuberculosis—Housing 45 „ Notification of 38-41 ,, Respiratory, All forms, Deaths iii, 27, 28 „ (Public Health) Regulations, 1930 40, 41 „ Visiting Nurse 45 Typhoid Fever (see Enteric) 32, 46, 47 Underground Rooms and Basements 64 Unemployment 85 Unsound Food, Destroyed 70 Unsound Food-Prosecutions 71, 77 Vaccination 48-50 Vaccination Officers 49 Venereal Diseases 29 Verminous Children, Disinfestation of 52 ,, Premises 51,58 Vital Statistics—Summary iii Extract 3 Voluntary Maternity and Child Welfare Centres 16-19, 22, 78 Water Certificates 58 Water Supply 58 Welfare Work by Health Visitors 14, 15 Whooping Cough 8, 46 (Deaths) 80, 81 Widows', Orphans' and Old Age (Contributory) Pensions Act, 1925 58 Workshops and Factories, Inspection of 53-56