ISL 104 Health and Sanitary Condition OF THE Parish of St. Mary. Islington. With the Medical Officer's Compliments. Public Health Department, Vestry Hall, Islington. Londom• Chas. Straker & Sons, Ltd., "Avenue Works," Bibhopsgath Avanue. 1896. ISL 104 Health and Sanitary Condition OF THE Parish of St. M ary. Islinglon. Quarterly Return OF THE MEDICAL OFFICER OF HEALTH, Third Quarter of 1895, BY ALFRED EDWIN HARRIS. London• Chas. Straker & Sons, Ltd., "Avenue Works," Bishopsgats Avanue. 1896. Health and Sanitary Condition OF THE Parish of St. Mary. Islington. Quarterly Return OF THE MEDICAL OFFICER OF HEALTH, Third Quarter of 1895, by ALFRED EDWIN HARRIS. London· Chas. Straker & Sons, Ltd., "Avenue Works," Bishopsgate Avenue. 1 8 9 6. CONTENTS Page Adulteration of Food 26, 27 Births 5, 31 Deaths—All Causes 6, 31, 34 „ in Upper Holloway 8, 31 „ in Islington South West 8, 31 „ in Islington South East 8, 31 „ in Highbury 8, 31 „ in North London Districts 8, 11 „ in Public Institutions 33 „ from Zymotic Diseases 11, 32, 37 Diarrhoea 15, 32 Diphtheria 13, 21, 32, 38 Disinfection Station 25 Drainage Regulations 24 Enteric Fever 15, 21, 32, 38 Erysipelas 21, 38 Fatality 22 Gas Supply 40 Infantile Mortality 10 Measles 12, 32 Mortuary and Coroner's Court 28 Notification of Infectious Disease 19, 38, 39 Nuisances, Summary of 43 Phthisis 19 Prosecutions 28 Puerperal Fever 19, 21, 38 Sale of Food and Drugs Acts 26 Salvation Army Shelters 23 Scarlet Fever 12, 20, 32, 38 Summary of Sanitary Work 42 Water Supply 41 Whooping Cough 15, 32 OFFICERS OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health. ALFRED EDWIN HARRIS, L.R.C.S., L.R.C.P.Edin. Solicitor. WILLIAM LEWIS. Public Analyst. FRANK LITHERLAND TEED, D.Sc., F.I.O., F.C.S. Superintendent of Public Health Department and Chief Sanitary Inspector. JAMES RICHARD LEGGATT. Inspectors of Nuisanese and Sanitary Inspectors. District 1 WILLIAM COOK, Cert. Sanit. Inst. „ 2 JAMES WILLIAM COWLING. „ 3 WILLIAM WALTER WARD. „ 4 ELIAS JAMES GRIVELL, Cert. Sanit. Inst. „ 5 WILLIAM HOLSGROVE FLOOD, Cert. Sanit. Inst. ,, 6 ALLEN BAGSHAW. Cert. Sanit. Inst. „ 7 CHARLES LAWRENCE, Cert. Sanit. Inst. ,, 8 JOHN METCALF, Cert. Sanit. Inst. ,, 9 WILLIAM IRVING, Cert. Sanit. Inst. „ 10 HARRY JOHN JAMES WATSON, Cert. Sanit. Inst. „ 11 EDWARD ISAAC FORTUNE, Cert. Sanit. Inst. „ 12 HENRY HILLYARD, Cert. Sanit. Inst. „ 13 WILLIAM ROLFE. „ 14 PATRICK MERNAGH, Cert. Sanit. Inst. Inspector of Factories, Workshops and Bakehouses, and Smoke Nuisances. GEORGE WEST. Inspector of Houses let in Lodgings. JAMES JARVIS JORDAN. Inspector of Factories, Workshops, &e., in which Females are employed. JESSY MACDONALD STEWART GRAY, Cert, Sanit. Inst. Engineer in charge of Steam Disinfectors. JOSEPH TWIZELL. Caretaker of Shelter House. MRS. TWIZELL. Distributor of Disinfectants. JOHN REDDY. Disinfectors. ARTHUR ROBINSON and JOHN WRIGHT. Clerical Staff. Chief Clerk GEORGE HAROLD KING. Second Clerk HENRY ANGEL. Third Clerk ALBERT ERNEST HITCHIN. Fourth Clerk GEORGE JAMES ELDRIDGE. Fifth Clerk EDWARD ALBERT ABBOTT. Sixth Clerk JOSEPH WOLFE. QUARTERLY REPORT ON THE HEALTH & SANITARY CONDITION of ST. MARY, ISLINGTON. Third Quarter, 1895. Thirteen Weeks ending Sept. 30th. No. 11. Public Health Department, Vestry Hall, December, 1895. To the Chairman and Members of the Vestry of St. Alary, Islington. Madam and Gentlemen, I have the pleasure to report to you on the health and sanitary condition of your parish of St. Mary, Islington, during the third quarter of the year 1895. And first as regards the BIRTHS. I find that 2,487 infants were born, of whom 1,266 were males and 2,487 were females. These represent an annual birth-rate of 29.59 per 1,000 of the population. Both in proportion to population and in actual numbers, the largest record was that of South-west Islington, in which there were 859 births, and of which the birth-rate was 31.95. The smallest number of births was registered in Highbury, where the newly born infants were 432, and the birth-rate 2773. In Upper Holloway 708 6 children were born, the birth-rate being 28.24, while in South-east Islington there were 488 births, which gave a birth-rate 30.01. The birth-rate of the corresponding third quarters of 1893 and 1894 were respectively 29.20 and 28.17, so that the rate now reported (29.59) is slightly in excess of those periods. It was also slightly higher than the birth-rate of the quarter immediately preceding, which was 29.27. In London the birth-rate was 30.4, and in the 33 large towns 31.1 per 1,000. DEATHS. There were 1,292 deaths recorded in the third quarter, which were equal to a death-rate of 15.37 annually of the estimated population. Although these deaths showed the slight increase of 82 on the return for the second quarter, yet it cannot but be looked on, when compared with other populous places, as highly satisfactory. Indeed, I doubt very much if there be any other great community of the same size which at the present time shows such a small mortality rate. In the returns for the third quarter issued by the Registrar General, I find that the death rate for England and Wales was 17.4, for 100 towns, mainly Urban in their character, 18.9, in the rural areas 14.4, in London 18.6, in the 33 largetowns 20.2, and in the North London Districts 15.94. And if a comparison be made with individual large towns with populations approaching that of Islington, it is still equally satisfactory. Thus in West Ham the death rate was 19.1, in Bristol 14.4, in Birmingham 18.7, in Nottingham 18.4, in Liverpool 28.2, in Manchester, 25.6, in Salford 27.2, in Bradford 20.9, in Leeds 20.9, in Sheffield 22.6, in Hull 25.3, and in Newcastle 19.7. The low death rate of the district is the more remarkable in view of the fact that it is more densely populated than any one of the places I have named. In order that this may be seen more plainly, I have constructed the following table which shows the districts, whose inhabitants number more than 200,000, their populations, their densities, and their death rates from all causes, from Zymotic diseases, f'om Diarrhœa, and from infantile mortality. 7 Districts. Populations. Persons per Acre. I)eath Rates. Zymotic Diseases Rates. Diarrhoea Death Rates. Infantile Mortality Rate. 33 large Towns io-59I-53o 35 '3 20'2 4*97 3'4i 252 London 4,392,346 58-8 18-6 4'3° 241 222 Manchester 524,865 407 25-6 5'59 3-81 278 Liverpool 503.967 967 28-2 6'83 4-5i 278 Birmingham 496,751 39-1 187 4"35 3-40 222 Leeds 395>546 18-3 20-9 5-80 4'94 297 Sheffield 342,768 174 22-6 6-69 5-8I 309 Islington 335,924 1080 15-3 3-05 1-67 172 West Ham 249,473 53o 191 6-05 2-51 241 Bristol 228,139 51'1 14'4 i-8: i-37 141 Nottingham 226,658 207 18-4 522 4 76 289 Bradford 226,384 21 -o 209 5-85 4'93 3H Hull 216,72a 26*3 a5"3 8-66 7'94 365 Salford 208,253 40'3 27-2 776 5-56 322 Newcastle 207,021 38'5 197 3-12 2*1 I 250 From this Table it is seen that the only town of over 200,000 inhabitants which showed better health returns than your Parish was Bristol, whose density is not half that of Islington, and whose population is less by 107,785 persons. It will be noticed that the only town which at all approached Islington in density was Liverpool, with 96-7 persons to the acre, but its death rate was far higher, being 28-2 annually per 1,000 of its population. Even several of the sea side resorts were less healthy, thus Portsmouth* was 17*5, Brighton 16 0, Plymouth 16-7, and Scarborough 25-0. Hastings, Eastbourne, Bournemouth and Ryde had, however, lower death rates (calculated on the enumerated population) these being * That small portion of the town known as Southsea, showed a death rate of about xi'o. 8 respectively 12.0, 14.0, 13.0 and 14.0, but their populations are, however, very small, when compared to that of this Parish, as they only range from 52,223 in Hastings, to 17,846 in Ryde. But even the death rates of these sea side resorts were not so gcod as the Parish sub-district of Highbury, in which the death rate was as low as 12.58, although its population is 62,501. The deaths and death rates in the several Parish Sub-districts were as follows:— Deaths, Death Rat . Upper Holloway 374 14.92 South-west Islington 442 16.44 South-east ,, 280 17.22 Highbury 196 12.58 The Parish 1,292 15.37 These comparisons with other communities are interesting as showing that even great density of population does not always signifiy high mortality returns, and that clean and wholesome surroundings, wide streets, well kept slums, and good sanitary management have their effect even in such a dense population as that of Islington. NORTHERN DISTRICTS. I again give a return showing the deaths in the neighbouring Northern Districts in the Metropolis:— Northern Districts.* Population (estimated). Density of Population. Deaths. Death Rates. Marylebone 137.392 91.2 609 16.27 Hampstead 77,592 34.5 199 15.50 St. Pancras 233,543 87.4 1,072 19.37 Islington 335.929 108.0 . 1,292 15.37 Stoke Newingtor 35,234 55.2 100 11.35 Hackney 215,623 54.7 856 15.88 Total 1,035,313 76.7 4,118 15.91 * The deaths are taken from the Registrar General's Report, third Quarter, 9 From these figures it is seen that even among its neighbours, all of which have smaller populations than Islington, the death rate of the Parish stood in a very favourable position, although its density of population is the greatest. In the following table the deaths for the third quarter are given, together with those for the corresponding quarter of 1894. In the third column the increase or decrease on the corresponding quarter of the preceding year are shown. Table I. 1894. 1895. * Increase or † Decrease. Miasmatic Diseases 119 119 – Diarrhoeal ,, 70 142 * 72 Zoogenous ,, 0 0 – Venereal ,, 9 3 † 6 Septic ,, 2 7 * 5 Parasitic ,, 0 0 — Dietic „ 12 13 * 1 Constitutional „ 241 266 * 25 Developmental ,, 90 95 * 5 Diseases of Nervous System 123 128 * 5 „ Organs of Special Sense 4 4 — ,, Circulatory System 75 93 * 18 ,, Respiratory „ 123 103 † 20 „ Digestive „ 92 119 27 ,, Lymphatic System 0 0 – ,, Glandlike Organs, &c. — 1 * 1 ,, Urinary System 20 32 * 12 ,, Reproductive System 8 11 * 3 ,, Bones and Joints 8 4 † 4 ,, Integumentary System 14 12 † 2 Violence 40 43 * 3 Ill-Defined Causes 81 97 * 16 1,131 1,292 * 161 10 Ages at Death.—The ages at which persons died were as follows 1894. 1895. *Increase or † Decrease. Under 1 year 363 427 * 64 1 to 5 years 154 I90 * 36 Total under 5 years 517 617 *100 5—years 64 48 † 16 15—25 „ 50 62 * 12 25—35 „ 70 83 * 13 35—45 „ 69 88 * 19 45—55 „ 112 93 † 19 55—65 „ 96 114 * 18 65—75 „ 71 109 * 38 75—85 „ 67 68 * 1 85—95 „ 15 9 † 6 95 and upwards 0 1 * 1 Total 1,131 1,292 * l6l The increase of 161 deaths, which the returns showed in excess of the corresponding period of last year, was distributed over all the age periods with the exception of three. Exactly 100 of this increase occurred in the age period 0-5, of which 64 were contributed by infants who died before they had attained the age of twelve months, the bulk of the mortality being attributed to Diarrhoea, which caused, at this latter age, 106 deaths, as against 59 in the third quarter of 1894. Infant Mortality.—As there were 427 infants died who had not attained their first year of life, and as there were 2,487 births during the third quarter, the infantile mortality rate was 172 per 1,000 children born. This rate contrasted favourably with that of London, in which it was 222 per 1,000, and also with that of the great towns in which it reached the high figure of 252. It also contrasted most favourably with the rate for the Metropolitan Northern Districts in which it was 196. 11 The Registrar General gives the infant mortality rates in the neighbouring districts as follows:— South-Marylebone 176 per 1,000 infants born. Hampstead 178 „ „ ,, ,, St. Pancras 223 „ „ ,, ,, Stoke Newington 156 „ „ ,, ,, Hackney 231 „ „ ,, ,, As the infantile mortality rate is considered one of the tests of the sanitary condition of a district, it is satisfactory to note that in an exceptionally severe summer for children it was as good as it has been. In the several sub-districts the infant mortality rates were as follows: Upper Holloway 186 per 1,000 infants born. South west Islington 192„ „ South-east ,, 161 ,, ,, Highbury 118 ,, ,, The Parish 172 ,, ,, ZYMOTIC DISEASES. There were 257 deaths registered during the third quarter from the Zymotic Diseases. These were equal to an annual death-rate of 3.05 per 1,000 inhabitants. This was the highest death-rate registered in any similar period since the second quarter of 1894, at which time 277 deaths were recorded, and when the death-rate was 3.32 per 1,000. The chief item in the death-rate, now stated, was diarrhoea, which caused 141 deaths, whereas in the second quarter of 1894 it was 118 deaths from Measles. Singularly enough Measles was also unusually fatal in the quarter now reported on, having caused 50 deaths. Small Pox was the registered cause of one death, which occurred in Upper Holloway. No death had been recorded from the disease since the corresponding quarter of 1894, when one death was also registered. Happily the district continues to keep clear from this terrible malady, from which only 6 deaths have occurred during the last three years. 12 Measles was returned as the cause of 50 deaths, which was the highest return since the second quarter of 1894, when 118 deaths were known. These 50 deaths were equal to an annual mortality rate of 0.59 per 1,000 of the population. They were distributed in the Sub-districts as follows:— Upper Holloway 8 deaths = 0.31 per 1,000 per annum. South-west Islington 24 ,, = 0.89 ,, ,, South-east ,, 14 ,, = 0.86 ,, ,, Highbury „ 4 „ = 0.25 „ ,, 50 = 0.59 From this statement it will be seen that its effects were most felt in the more congested parts of the Parish, namely in South-east and Southwest Islington. Unsatisfactory as the local return is, yet it is not so bad as that of London, in which 753 deaths were registered, equal to a death-rate of 0.69, or 0.10 more than the death-rate of the Parish. In St. Pancras, which bounds the Parish on the west, 51 deaths occurred, producing a death-rate of 0.87; while in Hackney (inclusive of Stoke Newington), which bounds Islington on the east, 40 deaths, equal to a death-rate of 0.65, were recorded, each of which death-rates was higher than that of the Parish. Scarlet Fever caused 19 deaths, as against 14 in the preceding quarter and 17 in corresponding quarter of 1894. Although the cases of this disease continued to be numerous (vide page 20) yet the death returns were comparatively small, the largest number of deaths registered from it during the preceding ten quarters being 27, in the fourth quarter of 1893, when 27 occurred. Of the 19 deaths 6 were registered in Upper Holloway, 7 in Southwest Islington, 4 in South-east Islington, and 2 in Highbury. The death-rate was equal annually to 0.22 per 1,000 inhabitants, which differs very little from the death-rate of the great towns, in which t was 0.19, or from that of the Metropolis, namely 0.23. 13 Diphtheria was responsible for 31 deaths, compared with 17 in the preceding quarter, and with 45 in the third quarter of 1894, and with 52 in the similar quarter of 1893. The 31 deaths were equal to an annual death-rate of 0.36 per 1,000 inhabitants. It is the lowest return, with the exception of the first quarter of 1895, known for the preceding ten quarters. It is a matter of satisfaction to note that since the return for the quarter ending March, 1894, the disease has shown a distinct tendency to decline, as the following statement will show. 1893, 1st quarter 32 deaths = 0.39 death-rate per 1,000 per annum. ,, 2nd ,, 42 " = 0.51 " "" " 3rd " 52 " = 0.63 ,, „ ,, " 4th " 63 " = 0.76 ,, ,, ,, 1894, 1st „ 64 „ = 0.76 " 2nd 60 " = 0.72 ,, ,, ,, " 3rd " 45 " = 0.54 " " " " 4th " 39 " — 0.46 ,, ,, ,, 1895, 1st „ 25 „ — 0.29 ,, ,, ,, " 2nd ,, 17 " = 0.20 ,, ,, ,, " 3rd " 31 " = 0.36 ,, " ,, It is now unquestioned that school influence is a great factor, although in my opinion not nearly the only factor, in the production of this disease. This being so it is certain that precautions which are taken to prevent suspected children from mixing with others who are perfectly healthy must have a favourable influence in holding the disease in check, and I am therefore convinced that the much greater care exercised by the school teachers of this district in excluding children with sore throats from the schools is having its influence. Whatever they may do in other Metropolitan Districts I have to record that the teachers of the Islington Schools are fully alive to their responsibilities, and are most loyally endeavouring to assist the Public Health Authority in its work. I have the greatest pleasure in bearing testimony to their zealous endeavours to check not only this disease, but all the notifiable diseases, and I trust that they may succeed in obtaining results even still better than those now indicated. It is a noteworthy fact that the teachers frequently communicate with me as regards sickness and insanitary conditions, which have come to their knowledge, and for this I am very thankful, and with, I have not the least hesitation in saying, very good results. I trust that the Sanitary 14 Authority shall continue to be afforded their co-operation and assistance, for I can assure them that these are of the very greatest service, and can only tend to promote the health, and to preserve the lives, of the thousands of children for whose education they are responsible and in whose welfare they naturally take an interest. The death rate (0.36) of the district from this disease compared favourably with that (0.55) of London, and it was almost the same as that of the large towns (0.33), in some of which, however, the death rate was exceptionally high. Thus in West Ham it was 0.85 per 1,000, in Wolverhampton 0.65, and in Burnley 0.72. When, however, I turn to these large and populous places, which I tabulated on page 7, I find the death rates from diphtheria were as follows, and that the returns as a whole were considerably better than our own or of London. West Ham 0.85 per 1,000 inhabitants Islington 0.36 „ „ Salford 0.33 ,, ,, Birmingham 0.25 ,, ,, Liverpool 0.23 ,, ,, Newcastle 0.23 ,, „ Bristol .. 0.16 ., ,, Hull 0.15 „ „ Sheffield 0.14 ,, ,, Leeds 0.14 „ ,, Bradford 0.09 ,, " Manchester 0.08 ,, ,, Nottingham 0.07 ,, ,, To account for the great difference in the death rates of the several communities affords food for reflection, for it is certainly strange to find such places as Manchester, Leeds, Sheffield, Bristol, Nottingham, Bradford and Hull, with death rates so low, as to almost mean the immunity of their towns from the disease. It is even more extraordinary still to find from the Registrar-General's returns that there was not a single death from Diphtheria during the third quarter in Plymouth, Blackburn, Preston or Sunderland, a town with which I was so long connected as its Medical Officer of Health. I intend to treat this subject more fully in my Annual Report for 1895. 15 Whooping Cough had 11 deaths ascribed to it, as against 25 in the preceding quarter, and 33 and 53 respectively in the corresponding quarters of 1894 and 1893. The death rate was only 0.13, which is far lower than any return during the preceding 10 quarters. Four of the deaths occurred in Upper Holloway, four in South west Islington, two in South-east Islington, and only one in Highbury. The neighbouring Northern Districts seem also to have had low returns from the disease, as only 11 deaths were known in St. Pancras, 9 in Hackney and one in Stoke Newington. The local death rate, 0.13, contrasts favourably with that of London, 0.24, and with that of the 33 large to wns in which it was 0.30. Typhus Fever.—No death from this disease was known, and indeed, only two deaths have occurred during the last three years. Enteric Fever was the cause of only 4 deaths, producing the low death-rate of 0.04. In the preceding quarter one death was registered, while in the corresponding quarters of 1893 and 1894, 13 and 5 persons died. Diarrhoea was exceptionally fatal, having caused 141 deaths. It must not be forgotten, however, in discussing this disease, that it is much more prevalent in the third quarter than in any other period of the year. This fact will be immediately apparent by the study of the figures relating to the disease during the several quarters of 1893 1894 and 1895. 1893, 1st quarter 12 deaths = 0.14 per 1,000 of the population. „ 2nd „ 54 " = 0.65 3rd 154 " = 1.87 " " " " 4th " 17 " = 0.20 ,, ,, ,, 1894, 1st ,, 7 " = 0.08 " " " „ 2nd „ 7 " = 0.08 ,, ,, „ " 3rd " 68 „ = 0 81 ,, ,, ,, „ 4th 11 = 0 13 1895, lst " 7 ,, = 0.08 ,, ,, ,, 2nd „ 19 ,, = 0.22 ,, ,, ,, " 3rd " 141 " = 1.67 16 It is now pretty well understood that there is a very close connection subsisting between temperature—especially the earth temperature at four feet deep—and the prevalence of Diarrhoea. Iregretthatlhave not the means at my disposal of observing the earth temperatures in this district, and I am, therefore, unable to give them. I may say, however, that as a rule within 14 days of the earth having obtained a temperature of 56° Fan. at a depth of four feet, the deaths from Diarrhoea begin to increase . The only air temperature data at my disposal is that given by the Astronomer-Royal in the Registrar-General's weekly reports. They may, however, be taken to be as nearly as possible the temperature which obtained in the Parish during the quarter. I might remark that the weather in June was dry, fine, bright and sunny, and that the high day temperature was above the average, and the low night temperature was about its average. The mean daily temperature was above the average till the 11th of the month, and again from the 20th to its close. Thus July set in with temperature conditions most favourable to the propagation of Diarrhoea, and therefore one is not surprised to find that the disease became at once very fatal. In July the weather was generally wet and dull during the first week, then dry, the sun being occasionally bright, till the 17th, and generally wet and dull from the 18th. The rainfall was 0.80 inch above the average of 54 years. August was wet, dull and unsettled until the 14th, then bright and fine to the end of the month, and the mean day temperature was a little higher than the average, while the mean night temperature was a little above its average. The mean daily temperature of the air was generally below its average until the 15th and generally above from the 16th. The weather in September was very warm, fine and dry, with a remarkably hot period, extending from the 24th to the 29th. The mean high day temperature was 75.4°, being 8.1 above the average, which, with one exception, 1865, had not been so high since 1841. The mean * I am indebted to the Astronomer-Royal's Reports to the Registrar-General for the facts as to the weather, 17 low night temperature was 51.3°, or 2.3° above the average. The mean daily temperature of the air was above its average from the 1st to the nth, below from the 12th to the 21st, and above from the 22nd to the 30th, being particularly so from the 12th to the 21st, when it was 12.9° above the average. The mean temperature to the 30th September was 10.4 in excess of the average. From these facts it will be seen that the weather was most favourable to the propagation of Diarrhoea. Weeks ending Deaths. Air Temperatures. Highest. Lowest. Mean. Deg. Deg. Deg. July 6 18 71.8 53.8 61.8 ,, 13 21 78.7 53.7 65.6 „ 20 19 73.3 54.0 62.8 „ 27 19 71.7 55.9 62.6 Aug. 3 23 67.2 53.1 59.0 „ 10 7 71.3 52.7 60.3 „ 17 6 71.4 53.9 61.7 „ 24 5 78.4 55.9 66.2 „ 31 6 72.6 53.3 61.8 Sept. 7 5 78.8 53.7 65.1 „ 14 6 71.8 51.4 60.7 " 21 1 68.8 46.8 56.9 „ 28 4 81.8 52.4 65.6 As I have already stated, the high temperature towards the end of June quickly accelerated the deaths from Diarrhoea, so that the 1, 5 and 9 deaths which had occurred in the last three weeks of that month, rose to 18 and 21 in the first two weeks of July. In the week ending July 13th, the mean of the high day temperatures was 78.7°, while the mean temperature was 65.6°. The natural result was that the deaths increased to 23, the highest number registered in seven days, in the week ending August 3rd. It is noteworthy, that in London, as a whole, as well as in the neighbouring towns of West Ham and Croydon, the highest point of the Diarrhoea curve was reached in the fourth week, ending July 27th, of the quarter, whereas in Islington it was not reached until the fifth. 18 The several parts of the Parish were not affected simultaneously; thus, Highbury showed its greatest number of deaths in the first week of the quarter, Upper Holloway in the third, and South-east and South-west Islington in the fifth week. The following Table gives the deaths and death-rates during four months. It will be remarked that Highbury was exceptionally free from Diarrhoea. Table II. Showing the Diarrhoeal deaths in the four months ending September 28th. 1895. Weeks ending. Deaths. Death Rates. U.H. s.w. S.E. H. Total. U.H. s.w. S.e. H. Total. June 1 .. .. .. .. .. .. .. .. .. .. " 8 .. .. .. • • .. .. .. .. .. .. " 15 1 .. .. .. 1 0.51 .. .. .. 0.15 „ 22 2 2 1 .. 5 1.03 0.96 0.80 .. 0.77 ,, 29 5 3 1 .. 9 2.59 1.45 0.80 .. 1.39 8 5 2 .. 15 0.82 048 0.12 .. 0.46 July 6 8 2 4 4 18 4.15 0.96 3.20 3.33 2.79 " 13 9 10 2 .. 21 4.67 4.84 1.60 .. 3.26 „ 20 11 4 4 .. 19 5.70 1.93 3.20 .. 2.95 " 27 9 8 2 .. 19 4.67 3.87 1.60 •• 2.95 37 24 12 4 77 4.79 2.90 2.40 0.83 2.98 August 3 4 12 7 .. 23 2.07 5.8 5.60 .. 3.57 „ 10 4 2 1 .. 7 2.07 0.96 0.80 .. 1.03 " 17 2 2 1 1 6 1.03 0.96 0.80 0.83 0.93 " 24 3 •• 1 1 5 1.55 .. 0.80 0.83 0.77 13 16 10 2 41 1.68 1.93 2.00 0.41 1.59 August 31 4 .. 1 1 6 2.07 .. 0.80 0.83 0.93 September 7 3 2 1 .. 6 1.55 0.96 0.80 .. 0.93 " 14 3 3 .. .. 6 1.55 1.45 .. .. 0.93 " 21 .. 1 .. .. 1 .. 0.48 .. .. 0.15 „ 28 2 1 .. 1 4 1.03 0.48 •• 0.83 0.62 12 7 2 2 23 1.24 0.67 0.16 0.33 0.71 Third Quarter 62 47 24 8 141 2.47 1.74 1.47 0.51 1.67 19 Islington with its death-rate of 1.67 from Diarrhoea contrasted very favourably with London whose death-rate was 2.41, and with the 33 great towns whose death-rate was 3.41. The highest rate among individual great towns was attained at Hull, where it was 7.94, whilst the lowest was at Swansea with 1.07 per 1,000. I may remark that since 1884 Diarrhoea had not been so fatally prevalent in England and Wales as in this third quarter of 1895. Puerperal Fever.—Only four deaths of women from Puerperal Fever were registered after 2,348 confinements, so that out of every 1,000 child-births only 170 women died. Influenza.—Only one death from Influenza, that of a woman aged under 35, was known in the Parish; it was registered in South-west Islington. In the preceding quarter 29 deaths were certified, while in the corresponding quarter 4 were entered in the registers. Phthisis.—The deaths from Phthisis numbered 117, which were equal annually to a death-rate of 1-39 per 1,000 inhabitants. In the corresponding quarter of 1894 113 deaths were registered, the death-rate being 1.35. There were 28 deaths in Upper Holloway, 38 in Islington Southwest, 25 in Islington South-east, and 26 in Highbury. NOTIFICATION OF INFECTIOUS DISEASES. This third quarter has been the healthiest third quarter of the year, so far as the notifiable infectious diseases are concerned, since 1891, as there were only 770 cases of infectious sickness reported. These were equal to an annual sickness rate of 8.41 per 1,000 inhabitants. The sickness rate in London was equal to 11.65 per 1,000 inhabitants per annum. The following are the returns for each third quarter since 1891:— Third quarter 1891 537 cases notified. 1892 1,082 ,, ,, " " 1893 1,678 „ „ " " 1894 794 " " " " 1895 770 " " 20 Small Pox was notified in 18 instances, as against 2 cases in the preceding quarter, and 15 in the corresponding quarter of 1894. Happily only 1 death resulted, so that the disease has been of a mild type. Scarlet Fever was unusually prevalent, 487 cases having been notified, compared with 261 in the preceding quarter, and an average of 579 cases in the corresponding quarters since 1891. The returns for the several third quarters since 1891 were— Third quarter 1891 166 cases. ,, ,, 1892 621 „ 1893 1,128 „ „ „ 1894 401 „ ,, 1895 487 " From this statement it is seen that the quarterly average during these years was greatly influenced by the great outbreak of the disease in 1893. Scarlet Fever was not confined, however, to Islington, for everywhere in the Metropolis it was prevalent, and consequently, as the quarter advanced, it became almost impossible to obtain isolation for patients in hospital, at all events without considerable delay. The following statement, giving the number of beds occupied with the disease at the end of each week in the Metropolitan Asylums Board's hospitals, will show how, from week to week, the pressure on the resources at the command of that Board increased. week ending. Hospital. July 6th 2,044 " 13th 2,241 „ 20th 2,267 27th 2,347 Aug. 3rd 2,423 „ 10th 2,511 ,, 17th 2,529 Weekending. Hospital. Aug. 24th 2,507 „ 31st 2,512 Sept. 7th . 2,600 „ 14th 2,674 „ 21st 2,732 „ 28th 2,807 From this return it will be seen that with the exception of the last two weeks in August there was a regular and steady increase in the number of cases under hospital treatment from the commencement of 21 the quarter. Thus it began with the isolation of 2,044 cases and ended with 2,807, or an increase of 763 cases. The returns for the several districts of the Parish are given in Table X. in the appendix. Diphtheria was notified in 131 instances, which is the smallest return for any third quarter since 1891, for I find the past figures to have been:— 3rd quarter, 1891 233 cases notified. „ 1892 223 „ „ 1893 248 „ „ 1894 222 „ „ 1895 131 „ This is very satisfactory, and it is hoped that the improvement may be maintained. In the past there can be no doubt that much of the disease had been contracted by direct personal intercourse, particularly among children at school, or by other school influences. I believe that the more these facts are recognised the more likelihood will there be that the disease will be checked in its spread, or at all events its attacks reduced to reasonable limits. Enteric Fever was reported by medical practitioners in 40 instances, which is also the lowest figure for any third quarter since 1891. 3rd quarter, 1891 55 cases notified. „ 1892 84 „ „ 1893 70 „ ,, 1894 64 „ „ 1895 40 „ Typhus Fever showed a nil return. Erysipelas was notified in 83 cases compared with 66 cases in the preceding quarter, and with 206 in the corresponding quarter, and with an average of 120 for the similar periods since 1891. Puerperal Fever was notified on five occasions, a return which is one less than the average for the third quarter of the year. The five cases occurred in the practices of five different medica practitioners, and were in the proportion of 2.12 per 1,000 births. 22 FATALITY. TABLE A. Quarterly Summary of Sickness and Deaths recorded. Small Pox. Scarlet Fever. Diphtheria. Membranous Croup. Enteric (Typhoid Fever.) Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing- Fever. Cholera. Totals Total Cases 18 487 131 3 40 ... 83 5 3 ... 1 771 Cases Removed to Hospitals 15 286 48 ... 19 ... 6 2 1 ... ... 377 Deaths. Total 1 19 31 2 4 ... 3 4 2 ... 1 67 In Hospital 1 14 11 ... ... ... ... 2 1 ... ... 29 At Home ... 5 20 2 4 ... 3 2 1 ... 1 38 TABLE B.—Showing the Percentage of a ll oases notified which were removed to hospital, and the fatality among cases treated at Home and in Public Institutions. Small Pox. Scarlet Fever. Diphtheria. Membranous Croup. Enteric (Typhoid Ferer.) Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Percentages. Percentage of notified cases removed to Hospital. 83.3 58.7 36.6 ... 47.5 ... 7.2 40.0 33.3 ... ... 48.9 Deaths. Total 5.5 3.9 23.6 66.6 10.0 ... 3.6 80.0 66.6 ... 100.0 8.6 In Hospital 6.6 4.8 2.2 ... ... ... ... 100.0 100.0 ... ... 7.6 At Home ... 2.4 24.0 66.6 19.0 ... 3.8 66.6 50.0 ... 100.0 9.6 23 SALVATION ARMY SHELTERS. Upon a reference from the Vestry the Public Health Committee considered letters from the Wandsworth and Clapham Union, pointing out the desirability of bringing the Salvation Army Shelters within the operation of the Common Lodging House Act, with a view to the adoption of measures for the prevention and spread of small pox. These authorities also stated that representations had been made to the Local Government Board and the London County Council on the subject. They asked that the Vestry should make a similar representation. As this was a matter which appealed strongly to the sympathies of the Committee in the interest of the health of the Parish, for some of the 18 cases of small pox which had been notified were among persons who had recently slept in these shelters, the Public Health Committee had no difficulty in recommending the Vestry to make the desired representation. There can be no question that it is high time that all these places should be put under strict public control, not with a view of curtailing their usefulness to the poor, but in order that the persons who use them should themselves be protected, and also that the public should be safeguarded against the spread of infectious disease. I can imagine nothing so likely as the crowding, which Dr. Waldo the Medical Officer of Health of St. Saviour's, Southwark, has described, to propagate and spread Typhus Fever. Happily this fever is almost unknown in London, and it is therefore all the more necessary that nothing should be left undone to prevent its re-appearance. It is a fever so fatal in its effect, so easily conveyed by one person to another, and so immediately spread in crowded buildings, that an outbreak of it among the denizens of the shelters would speedily result in its being carried broadcast throughout London, and especially through the slums. It has been my lot to have had to deal with several outbreaks in the North of England, and I cannot easily efface from my mind the effect it has had among the poorer classes, among persons with whom they dealt for their small groceries, among the nurses who tended those attacked, and among others whose duties brought them in contact with the disease. I know no disease so terrible, not even small pox, for against its infection 24 vaccination affords strong protection, as an epidemic of Typhus Fever, and I therefore am of opinion that no precautions taken against it by the prevention of overcrowding, and the enforcement of regulations as regards cleanliness, can be considered too stringent. I feel certain that the Salvation Army rulers themselves would feel awed if they once experienced the dire effects of the disease, and would blame themselves, when too late, for not having adopted measures to ensure sufficient air space for their lodgers. Although I have no doubt that after their experience in the Courts they will in future loyally assist in preventing overcrowding, yet I consider, the matter being of such vital importance to the public weal, that the control of such places should not be left to the discretion of individuals, but that they should be governed by hard and fast rules in a similar manner to common lodging houses, and that they should be systematically supervised by the Sanitary Authorities. DRAINAGE REGULATIONS. The Drainage Regulations which govern the Parish having, since the issue of the London County Council By-laws, come, in some measure, into antagonism with the latter, it was decided by the Works Committee to bring them into harmony with each other. It had become a constant excuse with builders executing works under the Public Health Department, but who had carried them out contrary to the Council's By-laws, to urge that such works were in conformity with the Vestry's regulations, and they pleaded they had been so executed, because they thought that the Regulations overrode the By-laws wherever the two came into conflict. This cannot occur again, for now the regulations have been altered so as to read in a like manner to the By-laws. In the old regulations the construction of intercepting traps with inspection chambers was compulsory; now, however, while the intercepting traps are still insisted on, the construction of the chambers, although strongly recommended by the Vestry, has been left to the option of the owners of the property. I must say that I am not in favour of this change, for I think that an intercepting trap, although it be fitted with a plunging eye, but without a chamber, is very likely to become a source of great annoyance and nuisance to the householders through becoming choked. Situated as such 25 traps are at the lowest point of the drain, nearest to the sewer, but within the curtilage of the premises, they are not infrequently 8, 10, or 12 feet deep. In such cases the difficulties and expense of clearing them was very great, and, hence, the owner finds out to his sorrow that after all the first cost of the chamber is the least. I have seen a great deal of this annoyance, and I would therefore prefer that the drain should be soundly laid, in iron pipes if possible, with the ventilation pipe carried to the highest point of the roof, and the intercepting trap abolished. I know of thousands of houses thus drained, and I have not known any ill results. DISINFECTION STATION. This Station, which consists of two steam disinfecting machines, manufactured by Messrs. Goddard, Massey & Warner, Nottingham, and a laundry were brought into use immediately on their completion (June 21), since which time they have been kept busily engaged, as the following return shows :— June (1½ weeks) 403 articles disinfected. July 2,088 „ August 2,448 „ September 2,708 „ 14½ weeks 7,647 „ These articles included 50 bundles of small articles which were not opened. Among the items were included:— 501 Beds. 514 Palliasses. 233 Matresses. 629 Blankets. 620 Sheets. The working of the apparatuses has given complete satisfaction. 26 THE SALE OF FOOD AND DRUGS ACTS, 1875 & 1879. Report of the Public Analyst appointed for the Parish of St. Mary, Islington, upon the Articles Analysed by him under the above Acts during the Quarter ending the 30th September, 1895. To the Members of the Vestry of the Parish of St. Mary, Islington. Madam and Gentlemen, During the quarter now ended I have analysed 192 samples of Food and Drugs submitted to me by your Inspectors. No private purchaser has availed himself of the Acts during the quarter. It has sometimes been stated that drugs are never adulterated, but this is a view that cannot be maintained, as samples of drugs submitted to me from time to time are found incorrect, either through intentional fraud or through gross carelessness, amounting to criminal negligence. In the present quarter out of four ointments taken by your Inspectors, three were wrongly compounded ; in one case the active ingredient being present to the extent of only a third of the required quantity. In another instance there was a minor exhibition of carelessness, a prescription being compounded with common water instead of distilled water; the prescription was otherwise correct. Such instances show that it is very necessary to keep watch on the druggists as well as on the food vendors. Annexed will be found the result of the analyses of every sample. I am, Madam and Gentlemen, Your obedient Servant, FRANK L. TEED, Public Analyst. 27 SALE OF FOOD AND DRUGS ACT.—The Public Analyst, Dr. F. L. Teed, examined the following samples which were submitted to him for analysis :— No. of Samples. Description. Genuine. Adulterated. 1ll Milk 96 15 — Brandy — — 4 Whisky 3 1 — Rum — — 6 Gin 6 — — Cocoa — — 6 Coffee 5 1 — Green Tea — — — Black Tea — — — Moist Sugar — — — Black Pepper — — — White Pepper — — 2 Mustard 2 — — Arrowroot — — — Flour — — — Lime Juice — — — Pickles — — — Vinegar — — — Bread — — 29 Butter 26 3 4 Lard 4 — 4 Cheddar Cheese 4 — — Precipitated Sulphur — — — Diluted Acetic Acid — — — Yeast — — 6 Margarine 1 5 — Tinned Peas — — — Ground Ginger — — — Tinned Mushrooms — — — Yellow Wax — — — Tincture of Quinine — — — Solution of Iodine — — 4 Sweet Spirit of Nitre 4 — — Sal-Volatile — — 2 Prescription 2 — 2 Tincture of Rhubarb 2 — 4 Tincture of Opium 4 — 4 Ointment 1 3 4 Pills 4 — 192 164 28 28 PROSECUTIONS. QUARTERLY SUMMARY OF PROSECUTIONS UNDER THE SALE OF FOOD AND DRUGS ACTS AND THE MARGARINE ACT. Samples Adulterated. Prosecutions. Successful. Withdrawn. Dismissed. Penalties. Milk *8 7 — — From 8s. to £2 with costs. Margarine 1 1 — — To pay 12s. 6d. costs. Cocoa 1 1 — — Fined 20s. with costs. Butter 2 2 — — Fined £2 and 12s. 6d. costs. * One adjourned sine die. PROSECUTIONS UNDER PUBLIC HEALTH LONDON ACT, 1891. 1895. September 23 Wilful exposure of person suffering Scarlatina. Fined £2 and 2s. costs. 23 Failing to notify that patient was suffering from Scarlatina. Fined 10s. and 2s. costs. MORTUARY AND CORONER'S COURT.—The following table gives a return of the bodies received into the Mortuary and the inquests held by the Coroner:— Month No. of bodies received. Daily Average. No. of Inquests held. 1895 July 77 2.5 37 August 52 1.6 20 September 51 1.7 26 Totals for Quarter 180 1.9 83 I am, Your obedient Servant, ALFRED E. HARRIS, Medical Officer of Health. APPENDIX. STATISTICS RELATING TO BIRTHS, DEATHS, & INFECTIOUS SICKNESS, ALSO A SUMMARY OF THE SANITARY WORK Carried out by the Public Health Department, together with TABLES SHOWING the ANALYSES of the GAS and WATER supplied to the Parish during the Third Quarter, 1895. 31 TABLE I.—Showing tub Births and Birth-Rates in the sevbral Sub- Registration Districts. sub-districts. Males. Females. Totals. Girth Rates. Upper Holloway 375 333 708 28.24 South West Islington 440 419 859 31.95 South East Islington 239 249 488 30.01 Highbury 212 220 432 27.73 The Parish 1,266 1,221 2,487 29.59 London .. .. 33,246 30.4 33 Large Towns .. .. 82,003 31.1 TABLE II.—Showing the Deaths and Death-Rates from all Causes in the several Sub-Registration Districts. sub-districts. Males. Females. Totals. Death Rates. Upper Holloway 201 173 374 14.92 South West Islington 220 222 442 16.44 South East Islington 121 159 280 17.22 Highbury 91 105 196 12.58 The Parish 633 659 1,292 15.37 London .. .. 20,388 18.6 33 Large Towns .. .. 53,277 20.2 32 TABLE III.—Deaths from the Principal Zymotic Diseases Inclusive of the Deaths of Parishioners in Hospitals outside the Parish. districts. Small Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhœa. TOTALS. Kate per 1000 of Population.  Upper Holloway 1 8 6 11 4 .. 2 62 94 3.75 South West .. 24 7 10 4 .. .. 47 92 3.42 South East .. 14 4 7 2 .. 2 24 53 3.25 Highbury .. 4 2 3 1 .. .. 8 18 1.15 The Parish 1 50 19 31 11 .. 4 141 257 30.5 Corresponding Quarter, 1894 l 14 17 45 33 .. 5 68 183 2.19 TABLE IV.—Death-Rates from the Principal Zymotic Diseases. Inclusive of the Deaths of Parishioners in Hospitals outside the Parish. district. Small Pox. Measles. 8carlet Fever. Diphtheria. Whooping Cough. Typhus Fever. Enteric (Typhoid Fever) Diarrhoea. TOTAL. DEATH KATE. Upper Holloway 0.03 0.31 0.23 0.43 0.15 .. 0.07 2.47 3.75 South West .. 0.89 0.26 0.37 0.14 .. .. 1.74 3.42 South East .. 0.86 0.24 0.43 0.12 .. 0.12 1.47 3.25 Highbury .. 0.25 0.12 0.19 0.06 .. .. 0.51 1.15 The Parish 0.01 0.59 0.22 0.36 0.13 .. 0.04 1.67 3.05 London 0.03 0.69 0.23 0.55 0.24 0.15 2.41 4.30 33 Large Towns 0.02 0.51 0.19 0.34 0.30 0.20 3.41 4.97 Corresponding Quarter, 1894 0.01 0.16 0.20 0.54 0.39 •• 0.06 0.81 2.19 33 TABLE V.—Deaths of Parishioners in Public Institutions (within the Parish) Distributed to their respective Sub.Registration Districts. public institution. Upper Holloway. Islington SouthWest. Islington South East. Highbury. Non. Residents. Total. Parishioners. Holborn Infirmary . . . . . . . . 99 . . Islington Infirmary 37 50 21 11 . . 119 Islington Workhouses 4 5 2 1 . . 12 Workhouse Schools . . 1 . . . . . . 1 Great Northern Hospital 16 4 . . 2 12 22 Small Pox Hospital . . . . . . . . . . . . London Fever Hospital 1 . . . . . . 3 1 Aged Pilgrims' Asylum . . . . . . . . 1 . . St. Pelagia's Creche 1 . . . . . . 4 1 Memorial Cottage Hospital . . . . . . . . . . . . . . Aged Blind Home . . . . . . . . . . 1 Invalid Home, Aubert Park •• . . . . . . 1 1 1 H.M. Prison, Holloway . . . . . . . . 4 . . H.M. Prison, Pentonville . . . . . . . . . . . . Children's Nursing Home . . . . . . . . . . . . Kingsdown Orphanage . . . . . . . . . . . . Alexandra Orphanage . . . . . . . . . . . . Winifred House . . . . . . . . . . . . Totals 59 60 24 15 124 158 TABLE VI. . Deaths of Parishioners in Public Institutions (without the Parish) Distributed to their Respective Sub.Registration Districts. Sub.Registration Districts. July. August. September. Quarter. Males Females Total Males Females Total Males Females Total Males Females Total. Upper Holloway 6 6 12 7 6 13 9 5 14 22 17 39 South West Islington 13 8 21 9 3 12 7 9 16 29 20 49 South East Islington 5 5 10 5 7 12 8 12 20 18 24 42 Highbury 9 4 13 . . 2 2 4 7 11 13 13 26 Totals 33 23 56 21 18 39 28 33 61 82 74 156 34 TABLE VII.—Deaths Registered in Islington During Thirteen Weeks Ending 28th September, 1895. (Deaths of Non.Residents in Hospitals excluded.) (Deaths of Residents in Public Institutions are distributed). #]Causes of Death. Under 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 to 95 95 and upwards. Under 5 Over 5 Males. Females. Upper Holloway Islington South West Islington, south East Highbury. Totals. I. Specific, Febrile, &c 132 97 22 5 4 2 3 3 2 1 .•• .•• 229 42 131 140 96 100 55 20 271 II. Parasitic Diseases .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• III. Dietic Diseases 2 .•• 1 .•• 4 3 1 2 .•• .•• .•• .•• 2 11 6 7 1 6 2 4 13 IV. Constitutional Diseases 40 43 9 22 38 33 32 27 15 7 .•• .•• 83 183 132 134 64 95 53 54 266 V. Developmental Diseases 48 1 .•• .•• .•• .•• .•• 4 10 27 4 1 49 46 47 48 23 33 26 13 95 VI. Local Diseases 105 40 13 31 31 44 54 75 79 31 4 .•• 145 382 248 259 151 157 116 83 507 VII. Deaths from Violence 7 5 3 4 6 6 3 3 3 2 1 .•• 12 31 26 17 9 13 9 12 43 VIII. Deaths from Ill.defined Causes 93 4 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 97 .•• 43 54 30 38 19 10 97 TOTALS 427 190 48 62 83 88 93 114 109 68 9 1 617 675 633 659 374 442 280 196 1292 I. Specific or Febrile Causes. 1.—Miasmatic Diseases 23 73 18 2 2 1 .•• .•• .•• .•• .•• .•• 96 23 54 65 32 48 29 10 119 Small Pox Vaccinated .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 1 .•• 1 .•• .•• .•• 1 Unvaccinated .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Unknown .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Measles 15 84 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 49 1 18 31 8 24 14 4 50 Scarlet Fever (Scarlatina) 1 12 6 .•• .•• .•• .•• .•• .•• .•• .•• .•• 13 6 14 6 6 7 4 2 19 Diphtheria 1 19 10 .•• .•• 1 .•• .•• .•• .•• .•• .•• 20 11 14 17 11 10 7 3 31 Whooping Cough 5 6 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 11 .•• 4 7 4 4 2 1 11 Typhus Fever .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Enteric or Typhoid Fever 1 2 .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• 3 1 2 2 2 .•• 2 .•• 4 Simple Continued & Ill.definedFever .•• .•• 1 .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• 2 1 1 .•• 2 .•• .•• 2 Influenza .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• 1 .•• .•• 1 Other Miasmatic Diseases .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 2. .Diarrhœal Disease 106 24 4 1 .•• 1 1 2 2 1 .•• .•• 130 12 74 68 62 48 24 8 142 Simple Cholera .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Cholera 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• 1 .•• .•• 1 Diarrhœa, Dysentery 105 24 4 1 .•• 1 1 .•• 2 .•• .•• .•• 129 12 73 68 62 47 24 8 141 3.—Malarial Diseases .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Remittent Fever .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Ague .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 4.—Zoogenous Diseases .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Cow Pox, Effects of Vaccination .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Hydrophobia .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Glanders .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Splenic Fever .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 5.enereal Diseases 3 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 3 .•• 2 1 1 2 .•• .•• 3 Syphilis 3 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 3 .•• 2 1 1 2 .•• .•• 3 Gonorrhoea, Stricture of Urethra .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 6.—Septic Diseases .•• .•• .•• 2 2 .•• 2 1 .•• .•• .•• .•• .•• 7 1 6 1 2 2 2 7 Erysipelas .•• .•• .•• .•• .•• .•• 2 1 .•• .•• .•• .•• .•• 3 1 2 .•• 1 1 1 2 Pyaemia, Septicæmia .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Puerperal Fever .•• .•• .•• 2 2 .•• .•• .•• .•• .•• .•• .•• .•• 4 .•• 4 1 1 1 1 4 II. Parasitic Diseases .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Thrush .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Hydatids .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Worms .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Other Animal Parasitical Diseases .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 35 TABLE VII.—continued. Causes of Death. Under 1 1 TO 5 5 TO 15 15 TO 25 25 TO 35 35 TO 45 45 TO 55 55 TO 65 65 TO 75 75 TO 85 85 TO 95 95 and upwards. Under 5 Over 5 Males. Females. Upper Hollo way. Islington, South West. Islington, South East. Highbury Totals. III. Dietic Diseases 2 .•• 1 .•• 4 3 1 2 .•• .•• .•• .•• 2 11 6 7 1 6 2 4 13 Starvation, Want of Breast Milk 2 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 2 .•• 1 1 .•• 1 .•• 1 2 Scurvy .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• 1 .•• .•• 1 Chronic Alcoholism, Delirium Trem .•• .•• .•• .•• 4 3 1 2 .•• .•• .•• .•• .•• 10 5 5 1 4 2 3 10 IV. Constitutional Diseases 40 43 9 22 38 33 32 27 15 7 .•• .•• 83 183 132 134 64 95 53 54 266 Rheumatic Fever, & Rheum, of Heart .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Rheumatism .•• .•• 1 .•• .•• .•• 1 1 .•• i .•• .•• .•• 4 2 2 2 2 .•• .•• 4 Gout .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Rickets .•• 2 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 2 .•• 2 .•• 1 1 .•• .•• 2 Cancer, Malignant Disease .•• .•• .•• 2 9 7 16 23 12 6 .•• .•• .•• 75 36 39 23 20 20 12 75 Gangren 1 .•• .•• .•• .•• .•• 2 .•• .•• .•• .•• .•• 1 2 .•• 3 .•• .•• .•• 3 3 Tabes Mesenteriea 11 4 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 15 .•• 6 9 2 9 1 3 l5 Tubereir, Meningitis, Hydrocephalus 18 20 2 1 1 .•• .•• .•• .•• .•• .•• .•• 38 4 21 21 4 23 6 9 42 Phthisis 9 15 6 18 23 26 11 2 2 .•• .•• .•• 24 93 60 57 28 38 25 26 117 Other Tubercular and Scrofulous Dis .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• 1 .•• .•• 1 .•• 1 Purpura, Hæmorrhagic Diathesis .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Anæmia, Chlorosis, Leucocythæmia .•• 1 .•• 1 .•• .•• .•• .•• 1 .•• .•• .•• 1 2 2 1 1 1 .•• 1 3 Glycosuria, Diabetes Mellitus .•• .•• .•• .•• .•• .•• 2 1 .•• .•• .•• .•• .•• 3 2 1 2 1 .•• .•• 3 Other Constitutional Diseases 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• 1 .•• .•• .•• l V. Developmental Diseases 48 1 .•• .•• .•• .•• .•• 4 10 27 4 1 49 46 47 48 23 33 26 13 95 Premature Birth 42 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 42 .•• 29 13 10 15 13 4 42 Atelectasis .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Spina Bifida 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• .•• .•• 1 1 Cyanosis .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Congenital Malformations 5 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 6 .•• 4 2 2 3 1 .•• 6 Old Age .•• .•• .•• .•• .•• .•• .•• 4 10 27 4 1 46 13 33 11 15 12 8 46 VI. Local Diseases. 1.—Diseases of Nervous System 21 6 3 4 7 10 17 24 26 10 .•• .•• 27 101 63 65 49 34 26 19 128 Inflammation of Brain or Membranes 6 4 .•• 1 2 .•• .•• .•• .•• .•• .•• .•• 10 5 11 4 6 3 2 4 15 Apoplexy 2 .•• .•• 2 1 7 3 11 10 3 .•• .•• 2 37 15 24 17 9 5 8 39 Softening of Brain .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• 1 .•• l Hemiplegia .•• .•• .•• .•• .•• .•• 3 2 1 .•• .•• .•• 6 3 3 2 2 1 1 6 Brain Paralysis .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Insanity, Genl. Paralysis of the Insane .•• .•• .•• 1 2 1 4 3 4 4 .•• .•• .•• 19 6 13 9 2 6 2 19 Epilepsy .•• .•• 1 .•• 1 1 3 .•• 2 1 .•• .•• .•• 9 4 5 4 2 3 .•• 6 Convulsions 13 2 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 15 .•• 11 4 3 6 4 2 15 Laryngismus Stridulus .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Paralysis Agitans .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Paraplegia .•• .•• .•• .•• .•• .•• 4 5 6 1 .•• .•• .•• 16 7 9 5 7 3 1 16 Diseases of Spinal Cord .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• 2 2 .•• .•• 1 1 .•• 2 Other Diseases of Nervous System .•• .•• .•• .•• 1 .•• 2 1 2 .•• .•• .•• .•• 6 4 2 3 2 .•• 1 6 2.—Dis. of Organs of Special Sense 1 .•• .•• 2 .•• 1 .•• .•• .•• .•• .•• .•• 1 3 1 3 1 2 1 .•• 4 Ear, Diseases of 1 .•• .•• 2 .•• 1 .•• .•• .•• .•• .•• .•• 1 3 1 3 1 2 1 .•• 4 Eyes .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Nose .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 3.—Diseases of Circulatory System 1 2 3 10 5 12 10 18 21 10 1 .•• 3 90 46 47 19 30 22 22 93 Endocarditis .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• 1 1 .•• .•• .•• .•• 1 1 Valvular Diseases of Heart .•• .•• 2 2 1 3 1 4 6 2 .•• .•• .•• 21 12 9 5 3 2 11 21 Pericarditis .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Other Diseases of the Heart 1 2 1 8 4 8 6 14 15 7 1 .•• 3 64 32 35 13 27 17 10 67 Aneurism .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• 1 1 .•• 1 .•• .•• .•• 1 Embolism, Thrombosis .•• .•• .•• .•• .•• 1 1 .•• .•• .•• .•• .•• .•• 2 .•• 2 .•• .•• 2 .•• 2 Other Diseases of Blood Vessels .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• 1 .•• 1 4.—Diseases of Respiratory System 26 18 4 3 7 5 9 13 15 3 .•• .•• 44 59 59 44 31 36 23 13 103 Croup 1 .•• 2 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 2 .•• 3 1 1 .•• 1 3 Laryngitis .•• .•• 1 .•• .•• .•• 1 1 .•• .•• .•• .•• .•• 3 2 1 .•• 1 1 1 3 Bronchitis 13 8 .•• .•• 1 2 4 3 11 3 .•• .•• 21 24 24 21 9 18 11 7 45 Pneumonia 12 10 .•• 1 4 2 3 8 3 .•• .•• .•• 22 21 25 18 18 12 10 3 43 Pleurisy .•• .•• 1 1 .•• 1 .•• .•• .•• .•• .•• .•• .•• 3 2 1 .•• 3 .•• .•• 3 Emphysema .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Asthma .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• 1 1 .•• 1 .•• .•• .•• 1 Other Diseases of Respiratory System .•• .•• .•• 1 1 .•• 1 1 1 .•• .•• .•• .•• 5 5 .•• 2 1 1 1 5 36 TABLE VII.—continued. Causes of Death. Under 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 to 95 95 and upwards. Under 5 Over 5 Males. Females. Upper Holloway. Islington South West. Islington South East. Highbury. Totals 5.—Diseases of Digestive System 52 13 2 5 2 6 9 14 10 4 2 .•• 65 54 53 66 34 39 26 20 119 Dentition 10 3 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 13 .•• 2 11 3 5 4 1 13 Sore Throat, Quinsey .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Diseases of Stomach 1 .•• .•• 2 .•• .•• .•• .•• 1 .•• 1 .•• 1 4 2 3 .•• 2 .•• 3 5 Enteritis 34 8 .•• .•• .•• .•• 2 2 1 .•• .•• .•• 42 5 30 17 18 12 12 5 47 Gastritis 2 1 .•• .•• .•• .•• .•• 2 1 2 1 .•• 3 6 1 8 4 2 1 2 9 Peritonitis .•• 1 2 1 .•• 1 1 .•• 1 .•• .•• .•• 1 6 1 6 2 2 1 2 7 Ulceration of Intestines .•• .•• .•• .•• 1 .•• .•• .•• 1 .•• .•• .•• .•• 2 1 1 .•• 1 .•• 1 2 Hernia .•• .•• .•• .•• .•• .•• 1 1 .•• .•• .•• .•• .•• 2 1 1 .•• 1 1 .•• 2 Stricture of Intestines .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• .•• l 1 .•• .•• 1 .•• .•• 1 Obstructive Diseases of Intestines 1 .•• .•• 1 .•• .•• 1 3 1 1 .•• .•• l 7 1 7 2 3 2 1 8 Ascites .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Cirrhosis of Liver .•• .•• .•• .•• 1 5 3 l 1 .•• .•• .•• .•• 11 7 7 2 5 3 1 11 Other Diseases of Liver 3 .•• .•• .•• .•• .•• .•• 4 2 .•• .•• .•• 3 6 5 4 2 4 .•• 3 9 Other Diseases of Digestive System 1 .•• .•• l .•• .•• l 1 .•• 1 .•• .•• 1 4 4 1 1 1 2 1 5 6••Diseases of Lymphatic System .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Lymphatics and of Spleen .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 7.—Diseases of Glandlike Organs of Uncertain Use .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 1 .•• .•• .•• 1 Bronchocele .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Addison's Disease .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• l .•• l 1 .•• .•• .•• 1 8.—Diseases of Urinary System .•• .•• l 2 4 6 7 4 6 2 .•• .•• .•• 32 19 13 9 7 11 5 32 Nephritis .•• .•• l 2 2 2 1 1 2 .•• .•• .•• .•• 11 6 5 4 .•• 6 1 11 Blight's Disease, Albuminuria .•• .•• .•• .•• 1 3 4 2 2 1 .•• .•• .•• 13 8 5 5 4 2 2 13 Disease of Bladder .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• 1 1 .•• .•• 1 .•• .•• 1 Disease of Prostate .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• .•• .•• 2 2 .•• .•• .•• 2 .•• 2 Other Diseases of the Urinary System .•• .•• .•• .•• 1 1 l 1 1 .•• .•• .•• .•• 5 2 3 .•• 2 1 2 5 9••Dis. of Re.productive System A —Of Organs of Generation. .•• .•• .•• 3 4 2 l 1 .•• .•• .•• .•• .•• 11 .•• 11 2 4 3 2 11 Male Organs of Generation .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Fomale Organs of Generation .•• .•• .•• 1 .•• .•• 1 1 .•• .•• .•• .•• .•• 3 .•• 3 .•• 1 .•• 1 3 B.—Of Parturition. Abortion, Miscarriage .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• 1 .•• 1 Puerperal Convulsions and Fever .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• 1 .•• 1 Placenta Prævia, Flooding .•• .•• .•• .•• 1 1 .•• .•• .•• .•• .•• .•• .•• 2 .•• 2 1 .•• .•• 1 2 Other Accidents of Childbirth .•• .•• .•• .•• 3 1 .•• .•• .•• .•• .•• .•• .•• 4 .•• 4 .•• 3 1 .•• 4 10.—Diseases of Bones and Joints .•• 1 .•• .•• 1 .•• .•• l .•• l .•• .•• 1 3 .•• 4 1 .•• 1 2 4 Caries, Necrosis .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• .•• 1 1 Arthritis, Ostitis, Periostitis .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• .•• 1 .•• 1 1 .•• .•• .•• 1 Other Diseases of Bones and Joints .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• 1 .•• .•• 1 .•• 1 Spine Diseases .•• .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• .•• 1 1 11.—Dis. of Integumentary System 4 .•• .•• 2 .•• 2 l .•• 1 l 1 .•• 4 8 7 5 4 5 3 .•• 12 Carbuncle .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• 1 .•• 1 1 .•• .•• .•• 1 Phlegmon .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Cellulitis 1 .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• 1 l 2 .•• .•• 2 .•• .•• 2 Other Dis. of Integumentary System 3 .•• .•• 2 .•• 2 1 .•• 1 .•• .•• .•• 3 6 5 4 3 3 3 .•• 9 VII. Violence. 1.—Accident or Negligence 7 5 3 4 6 6 3 3 3 2 1 .•• 12 31 26 17 9 13 9 12 43 Fracture and Contumon .•• 4 3 .•• 1 2 1 1 1 2 .•• .•• 4 11 12 3 5 6 2 2 15 Gunshot Wounds .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Cut, Slab .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Burn and Scald .•• .•• .•• .•• 1 1 .•• .•• 1 .•• .•• .•• .•• 3 .•• 3 .•• 1 1 1 3 Poison .•• 1 .•• .•• .•• 1 .•• 1 .•• .•• .•• .•• l 2 1 2 1 .•• 1 1 3 Drowning .•• .•• .•• 1 .•• .•• 1 .•• .•• .•• .•• .•• .•• 2 1 1 .•• 1 .•• 1 2 Suffocation 7 .•• .•• .•• 1 .•• .•• .•• .•• .•• 1 .•• 7 2 5 4 1 2 2 4 9 Otherwise .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 1 .•• .•• .•• .•• 1 1 2.—Homicide .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Manslaughter .•• .•• .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 1 .•• .•• .•• .•• 1 1 Murder .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 3.—Suicide .•• .•• .•• l 3 2 l l 1 .•• .•• .•• .•• 9 5 4 2 3 3 1 9 VIII. Deaths from Ill.defined Causes 93 4 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 97 .•• 43 54 30 38 19 10 97 Dropsy .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Haemorrhage .•• 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• .•• 1 1 .•• .•• .•• 1 Debility 21 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 22 .•• 7 15 2 11 6 3 22 Marasmus and Atrophy 51 2 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 53 .•• 27 26 20 21 6 6 53 Inanition 20 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 20 .•• 8 12 7 6 6 1 20 Sudden Death .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• Other causes not specified or ill.defined 1 .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• .•• 1 .•• 1 .•• .•• .•• 1 .•• 1 37 TABLE VIII.—Birth and Death Rates. 1895. Week ending. ISLINGTON. 33 GREAT TOWNS. LONDON. Birth.Rates. Death.Rates—All Causes. Death.Bates—Zymotic Diseases. Birthrates. Death.Rates. Birthrates Death.Rates. U. H. S. W. S. E. H. Whole Parish. U. H. S. W. S. E. H. Whole Parish. U. H. S. W. S. E. H. Whole Parish. All causes. Zymotic. All causes. Zymotic. July 6 33.72 33.91 29.60 30.05 32.30 13.49 16.47 26.40 17.53 17.70 4.67 2.42 10.40 5.00 5.12 31.45 17.5 3.3 31.28 18.0 4.0 ,, 13 21.79 32.46 29.60 29.21 28.10 23.35 26.16 25.60 15.02 23.13 5.18 7.26 4.00 •• 4.65 31.33 19.9 4.3 30.51 21.0 5.3 „ 20 21.79 34.88 28.00 36.73 29.97 21.27 10.08 17.60 13.35 16.46 2.07 2.90 5.60 2.50 4.65 30.70 21.9 5.6 30.17 23.7 6.5 „ 27 30.09 29.55 35.20 34.22 31.68 17.64 23.74 13.60 15.86 18.48 5.70 5.29 1.60 0.83 4.19 31.14 22.5 6.2 30.38 23.0 6.9 Aug. 3 28.53 34.39 33.60 18.36 29.50 19.19 19.86 25.60 7.51 18.48 5.18 7.75 8.00 •• 5.59 32.64 20.7 5.8 30.96 21.4 6.6 ,, 10 25.94 29.55 20.80 22.53 25.46 12.97 17.92 16.80 9.18 14.59 3.63 1.93 3.20 •• 2.32 28.49 20.8 5.3 27.61 19.0 4.7 „ 17 30.09 41.18 29.60 20.87 31.83 10.89 25.98 16.00 10.01 13.35 2.59 4.36 2.40 1.66 2.85 31.93 19.1 4.6 31.22 17.3 3.8 „ 24 2.2.83 29.07 31.20 23.37 26.55 12.45 12.11 14.40 12.52 12.73 2.59 1.93 2.40 2.50 2.32 30.49 19.9 4.8 28.88 17.0 3.0 31 32.69 27.13 41.61 28.38 31.83 15.56 12.59 15.20 13.35 14.13 3.63 0.96 3.20 0.83 2.01 30.97 19.9 5.3 30.88 15.9 3.3 Sept. 7 28.02 26.64 26.40 24.20 26.55 11.41 12.59 12.00 10.01 11.64 2.07 1.93 0.80 •• 1.39 31.01 19.9 5.3 29.33 16.1 3.2 ,, 14 30.61 30.03 33.60 39.23 32.61 8.82 12.59 12.00 13.35 11.64 2.07 2.42 0.80 0.83 1.70 30.16 19.3 4.9 30.18 15.4 2.9 „ 21 30.09 36.33 21.60 20.87 28.73 11.93 14.53 8.00 13.35 12.26 1.55 1.93 •• •• 1.08 30.76 19.8 4.8 29.98 16.0 2.7 „ 28 28.35 31.00 29.60 32.55 28.73 15.02 16.47 20.80 12.52 16.15 2.59 2.42 •• 0.83 1.70 30.73 21 0 4.5 30.89 18.2 3.0 Quarter 28.24 31.95 30.01 27.73 29.59 14.92 16.44 17.22 12.58 15.37 3.75 3.42 3.25 1.15 3.05 31.1 20.2 4.97 30.4 18.6 4.30 38 TABLE IX.—Notifications of Infectious Diseases. Cases of Infectious Disease notified under the Act during the undermentioned periods. Month Ending. Small Pox. Scarlet Fever. Diphtheria. Membranous Croup. Enteric (Typhoid Fever.) Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals each Month. Rate of Sickness per 1,000 of Population. 1895. 27th July 4 177 33 •• 3 •• 28 2 3 •• •• 250 9.70 24th August 3 120 37 3 9 •• 19 2 •• •• •• 193 7.48 28th Sept. 11 190 61 •• 28 •• 36 1 •• •• •• 327 10.13 Totals for Quarter 18 487 131 3 40 •• 83 5 3 •• •• 770 8.41 TABLE X.—Cases of Infectious Diseases. Occurring in the following Sub.Districts during the Quarter. district. Small Pox. Scarlet Fever. Diphtheria. Membranous Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals Rate of Sickness per 1,000 of Population. U. Holloway 6 109 46 l 11 •• 31 3 3 •• •• 210 8.37 South West 7 184 28 l 11 •• 24 1 •• •• •• 256 9.52 South East 3 95 35 l 9 •• 17 •• •• •• •• 160 9.84 Highbury 2 99 22 •• 9 •• 11 1 •• •• •• 144 9.21 The Parish 18 487 131 3 40 •• 83 5 3 •• •• 770 8.41 Preceding Quarter 6 261 95 2 10 •• 66 4 4 1 •• 449 5.24 Corresponding Quarter, 1894. 15 401 222 6 64 •• 79 6 1 •• •• 794 9.52 39 TABLE XI.—Sickness Rates from Infectious Diseases. Occurring in the following Sub.Districts during the Quarter. districts. Small Pox. Scarlet Fever. Diphtheria. Membranous Croup. Enteric (Typhoid Fever.) Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Total Sickness Rates. U. Holloway 0.23 4.34 1.83 0.03 0.43 •• 1.23 0.11 0.11 •• •• 8.37 South West 0.26 6.84 1.04 0.03 0.40 •• 0.89 0.03 •• •• •• 9.52 South East 0.18 5.84 2.15 0.06 0.55 •• 1.04 •• •• •• •• 9.84 Highbury 0.12 6.35 1.41 •• 0.57 •• 0.70 0.06 •• •• •• 9.24 The Parish Sickness Rates 0.21 5.79 1.55 0.03 0.47 •• 0.98 0.05 0.03 •• •• 8.41 Preceding Quarter 0.07 3.10 1.13 0.02 0.11 •• 0.78 0.04 0.04 0.01 •• 5.24 Correspond. ing Quarter, 1894. 0.18 4.81 2.66 0.07 0.76 •• 0.94 0.07 0.01 •• •• 9.52 TABLE XII.—Cases of Infectious Disease Notified to the Several Sanitary Authorities in London. Month Ending Small Pox. 8carlet Fever. Diphtheria. Membranous Croup. Enteric (Typhoid Fever). Typhus Fever. Erysipelas. Puerperal Fever. Continued Fever. Relapsing Fever. Cholera. Totals each Month. 1895. 27th July 168 1960 1099 35 182 1 483 13 13 •• 11 3965 24th August 287 1665 827 37 220 •• 395 23 2 •• 5 3461 28th Sept. 154 2464 1210 32 466 1 605 19 12 •• 8 4971 Totals for Quarter 609 6089 3136 104 868 2 1483 55 27 •• 24 12397 Total Sickness Rates. 0.57 5.72 2.94 0.09 0.81 0.00 1.39 0.05 0.02 •• 0.02 11.65 40 TABLE XIII.—Illuminating Power and Quality of the Gas Supplied to Islington. Week ending. Illuminating Power (In Standard Sperm Candles). Sulphur (Grains in 100 cub. ft. of Gas). Ammcnia (Grains in 100 cub. ft. of Gas). Sulphuretted Hydrogen. 1895. Max. Min. Mean. Max. Min. Mean. Max. Min. Mean. 6 th July 17.0 16.4 16.7 12.5 10.5 11.2 0.4 02 0.2 None 13th ,, 17.1 16.3 16.8 113 96 10.6 0.4 0.2 0.2 „ 20th „ 17.1 16.5 16.8 10.2 9.3 9.6 0.4 0.1 0.3 „ 27th „ 16.8 16.8 16.8 12.1 10.3 11.2 0.8 0.8 0'8 „ Average for July 17.0 16.5 16.7 11.6 9.9 10.6 0.5 0.3 0.3 „ 3rd August 16.2 15.8 16.0 13.1 9.3 11.2 0.8 0.1 0.5 None 10th „ 16.8 16.0 16.3 13.0 11.4 12.1 0.3 0.0 0.2 „ 17th „ 16.5 15.2 16.4 13.7 10.8 11.9 0.4 0.2 0.3 „ 24th „ 16.6 16.0 16.3 13.8 10.3 12.3 0.6 0.3 0.4 „ Average for August 16.5 16.0 16.2 13.4 10.4 11.8 0.5 0.1 0.3 „ 31st August 17.0 16.2 16.6 14.2 9.6 12.3 0.5 0.0 0.3 None 7th Sept. 17.3 16.4 17.0 13.1 9.1 12.1 0.3 0.0 0.1 „ 14th „ 17.3 16.3 16.7 14.3 11.3 12.7 0.1 0.0 0.1 „ 21st ,, 17.4 16.0 16.8 14.4 10.8 12.3 0.3 0.0 0.1 „ 28th „ 17.4 16.4 16.8 16.3 11.1 12.5 0.4 0.0 0.2 „ Average for Sept. 17.2 16.14 16.7 14.4 10.3 12.3 0.3 0.0 0.1 „ Average for Quarter 16.9 16.2 16.5 13.1 10.2 11.5 0.4 0.1 0.2 „ Note.—The standard illuminating power of the Gas supplied by the Gas Company is lb sperm candles. Sulphur not to exceed 22 grains in the 100 cubic feet of Gas on an average of three days. Ammonia not to exceed 4 grains in the 100 cubic feet of Gas on an average of three days. The Standard Burner used in testing is known as " Sugg's London Argand, No. 1." Pressure between Sunset and Midnight to be equal to a column of one inch of water. ,, between Midnight and Sunrise to be equal to a column of six.tenths of an inch of water. 41 TABLE XTV.—Analysis of Water for Quarter ending 28th September, 1895, by Dr. Wm. (Jrookes. (The results are stated in Grains per Imperial Gallon of 70,000 grains.) april. may. june. average for quarter. Samples from Works. Grains. Samples from Mains. (Average) Grains. Samples from Works. Grains. Samples from Mains. (Average) Grains. Samples from Works. Grains. Samples from Mains. (Average) Grains Samples from Works. Grains. Samples from Mains. (Average) Grains. Total Solid Matter per gall. 22.90 •• 21.40 •• 21.20 •• 21.83 •• Chlorine „ 1.224 1.296 1.224 1.296 1.296 1.272 1.248 1.288 Equal to Chloride of Sodium ,, 2.006 2.124 2.006 2.124 2.124 2.085 2.045 2.111 Nitrogen as Nitrates ,, 0.104 0.182 0104 0.170 0.118 0.156 0.108 0.169 Ditto as Ammonia ,, 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Oxygen required to oxidise Organic Matter ,, 0.011 0.018 0.015 0.019 0.023 0.014 0.016 0.017 Degree of Hardness ,, 15.26 15.00 15.47 15.40 15.47 15.54 15.40 15.31 Ditto after boiling quarter of an hour ,, 3.99 •• 4.90 •• 4.69 4.52 Organic Carbon ,, •• 0.039 •• 0.049 •• 0.062 •• 0.050 Organic Nitrogen „ •• 0.007 •• 0.009 •• 0.009 •• 0.008 42 TABLE XV.—Summary of Sanitary Work from Inspectors' Reports. From 1st July, 1895, to 28th September, 1895. DISTRICTS. s. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Number of Houses inspected 101 106 105 141 58 139 74 79 77 115 295 149 176 163 1778 Re-inspections, Calls made, &c 1221 812 947 752 690 686 1125 836 926 723 1950 1124 1098 1347 14137 Visit to Bakehouses •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Do. Cowhouses 2 •• •• •• •• •• •• •• 4 7 1 •• 11 •• 25 Do. Slaughter-houses 4 •• •• 1 4 •• •• 24 5 4 5 5 6 2 60 Do. Stables and Yards 4 •• •• •• •• •• •• 99 3 •• 3 10 270 60 449 Do. courts, &c. •• •• •• •• •• •• •• •• •• •• •• •• •• 3 3 Do. Factories and Workshops •• •• •• •• •• •• •• 1 •• •• •• •• 1 •• 2 Do. Fields, Lanes, &c. •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Do. Factories, Horse Slaughterhouses, Piggeries, &c Belle Isle •• •• •• •• •• •• •• •• 2 •• •• •• •• •• 2 Do. Under Sale of Food and Drugs Acts 8 16 16 16 19 •• •• •• •• 12 16 18 •• 19 140 Dust Removals Ordered •• •• •• •• •• 3 •• •• •• •• •• •• •• •• 3 Registered Lodging Houses •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Total Inspections, &c. 1340 934 1068 910 771 728 1199 1039 1017 861 2270 1306 1562 1594 16599 43 TABLE XVI.—Summary of Nuisances discovered by Sanitary Inspectors during the Quarter ending 30th Sept., 1895, for the abatement of which notices have been served. NUISANCES. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1. The house or part of the house in a dirty condition 23 30 4 10 •• 11 6 7 15 6 10 35 19 14 189 2. ,, ,, in a damp condition 2 2 3 13 1 6 5 •• 5 7 36 6 7 6 99 3. ,, in a dilapidated condition 11 15 1 8 •• 9 4 4 9 8 3 11 8 3 94 4. The inlet of surface drain improperly trapped 12 21 8 6 6 28 9 11 40 20 95 37 33 33 359 5. The water-closet so foul as to be a nuisance 56 15 16 3 1 4 8 22 11 27 49 24 9 16 261 6. ,, ,, without a water supply 16 5 4 3 2 5 3 4 2 10 5 •• 8 11 78 7. „ ,, with a deficient supply of water 2 8 7 2 1 8 9 2 3 3 17 30 10 4 106 8. ,, ,, improperly constructed so as to be a nuisance 67 60 10 48 7 45 14 10 39 30 125 30 50 41 576 9. ,, ,, so defective as to be a nuisance 6 1 6 4 1 22 6 8 3 2 4 4 8 17 92 10. „ ,, stopped 2 2 3 1 •• •• •• 3 2 1 2 1 2 5 24 11. ,, ,, placed in an improper position 2 •• •• 12 1 •• •• •• 10 5 14 3 3 1 51 12. Insufficient external ventilation to water-closet 7 4 l 5 2 32 1 3 18 8 33 12 20 7 163 13. Insufficient water-closet accommodation 3 4 •• 1 •• •• •• •• 3 1 2 1 •• 15 14. The soil-pipe defective 21 19 8 43 1 7 1 4 8 3 1 1 8 8 133 15. ,, unventilated 15 29 9 40 7 13 10 14 8 15 28 8 19 10 225 16. ,, improperly ventilated 18 13 9 7 2 2 3 11 3 2 2 •• 3 5 80 17. The yard in a condition injurious to health by reason of the want of proper paving 26 20 12 24 2 34 10 12 28 12 63 44 25 22 334 18. The yard dirty 1 •• •• •• •• •• •• •• 14 2 2 23 8 1 51 19. ,, undrained 2 2 •• 31 . 1 •• 6 8 5 1 2 3 7 68 20. A gully trap improperly placed within the house 25 4 •• 27 2 8 1 6 19 1 21 11 17 8 150 21. The waste-pipe of sink directly connected with the drain 20 14 10 25 5 30 9 14 9 14 64 17 17 17 265 22. „ ,, improperly trapped •• •• •• 5 6 4 •• 8 13 •• 2 2 10 2 52 23. „ untrapped •• •• 2 6 2 7 5 4 1 3 5 3 22 18 78 24. ,, of lavatory directly connected with the drain l •• •• •• •• 1 1 4 •• •• •• •• 2 3 12 26. „ ,, improperly trapped •• •• •• l •• •• •• •• •• •• •• •• 1 •• 2 26. „ ,, untrapped •• •• 4 •• 2 5 4 •• 2 2 •• 3 •• 22 27. ,, of bath directly connected with the drain 2 •• •• l •• •• 4 5 •• •• •• •• •• • • 12 28. „ , improperly trapped 1 •• •• •• 1 1 •• 1 •• •• •• •• •• •• 4 29. ,, ,, untrapped •• •• 4 3 3 1 6 1 •• 3 •• •• 1 •• 22 30. The water cistern so foul as to be a nuisance 15 7 1 •• 1 1. •• 2 7 7 •• 2 3 4 69 31. ,, ,, being without a close-fitting cover 16 9 13 4 4 30 11 9 7 28 33 19 10 11 204 32. ,, „ being placed in an improper position 4 •• 3 •• 1 •• 1 1 2 3 1 •• 3 2 21 33. ,, ,, defective •• •• 1 1 1 2 1 •• 1 •• 4 1 1 •• 13 34. An accumulation or deposit of refuse injurious to health, by reason of the want of a proper dustbin or ashpit 14 12 4 •• •• 2 1 3 3 7 16 4 1 9 76 44 TABLE XYI.—Continued. NUISANCES. DISTRICTS. Totals. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 35. The dustbin or ashpit defective 22 6 10 22 8 20 10 15 31 22 87 68 11 12 344 36. „ ,, placed in an improper position •• •• •• •• 1 1 3 5 •• 24 10 6 3 53 37. The drain foul 3 2 •• 2 •• •• •• 2 1 1 3 1 •• •• 15 38. ,, defective 65 32 21 55 11 19 20 32 47 24 75 54 19 10 484 39. ,, choked or stopped 5 5 2 4 3 7 4 2 2 1 9 4 4 6 58 40. ,, unventilated 6 3 2 24 •• 35 3 8 46 9 121 55 19 18 349 41. The rainwater pipe in direct communication with the drain 22 23 17 32 7 27 15 26 16 29 61 26 23 33 357 42 ,, ,, in direct communication with the soil-pipe 8 2 •• •• •• •• 1 4 •• 1 3 •• 1 20 43. ,, ,, defective 5 1 1 9 1 4 1 2 2 1 2 3 8 7 47 44. The water supply used for domestic purposes connected with the cistern which is used for flushing the W.C. 21 18 11 39 7 23 12 23 5 19 104 3 12 15 312 45. The house without a proper water supply 1 2 •• 4 3 6 1 3 10 4 5 7 6 23 75 46. The roof defective 9 4 3 9 1 6 5 3 7 1 6 13 8 12 87 47. The guttering defective 4 1 2 4 1 7 1 2 3 •• 7 2 10 2 46 48. The area improperly paved 1 •• •• 1 •• •• •• •• 6 1 •• 10 10 6 35 49. ,, dirty •• •• •• •• •• •• •• •• 5 1 1 5 •• 4 16 50. ,, undrained 1 •• 1 37 •• •• •• •• 1 3 12 •• 5 3 63 51. The paving of the washhouse defective 6 2 •• 1 •• 7 •• 3 16 4 10 4 9 1 63 52. The back addition walla defective •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 53. The want of a proper manure receptacle 2 1 1 •• 1 2 13 1 1 3 •• 2 4 31 64. The bakehouse walls dirty •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• 55. An animal kept in such a manner as to be a nuisance •• 3 •• 1 1 1 1 4 2 5 7 10 3 38 56. The house or part' of the house so overcrowded as to be injurious or dangerous to the health of the inmates 1 1 1 1 1 3 3 •• 6 •• 5 19 4 5 50 57. An underground room occupied as a dwelling contrary to the provisions of the Act •• •• •• •• •• 1 •• •• 1 •• 1 7 •• 3 13 58. A tent, van, shed, or similar structure used for human habitation which is in such a state as to be injurious or dangerous to the health of the inmates •• •• •• •• •• •• •• •• •• •• •• •• •• 3 3 59. The space below floor in the basement or ground floor being unventilated 1 •• •• 4 •• 8 1 2 14 8 •• 42 5 7 92 60. The space below floor in the basement or ground floor being improperly or insufficiently ventilated •• •• •• 1 •• 6 •• 1 24 4 100 11 20 •• 167 573 402 215 584 107 495 215 325 544 371 1282 693 527 465 6798