Bet 75 5 YEAR 1859. FIFTH REPORT ON THE SANITARY CONDITION OF BETHNAL GREEN, BY SAMUEL PEARCE, MEDICAL OFFICES OF HEALTH. London: printed by order of vestry, By john smith & co., long acre, w.c. 1860. the medical officer of health OF BETHNAL GREEN, HAS THE HONOUR TO DEDICATE his sanitary report for 1859, TO HIS PRECEPTOR AND FRIEND, dr. archibald billing, f.r.s., MEMBER OF THE SENATE AND EXAMINER IN MEDICINE OF THE UNIVERSITY OF LONDON, BY WHOM HE WAS INSTRUCTED IN PREVENTIVE AND CURATIVE MEDICINE. 135, BETHNAL GREEN ROAD, Apeil 16th, 1860. Gentlemen, The Report which I have now the pleasure to submit comprises our Statistics and Progress in 1859. As heretofore, the one represents the sanitary appliances, the other the Births and Deaths of the year. Happily, when contrasted with 1858, the Birth rate advanced, the health of the population improved, and the mortality decreased. Meteorologically the temperature of the year was beyond the mean ; on April 1st and 7th, its readings varied nearly 54° ; on two days in July they attained 93° in the shade, and 115° in the sun ; and on December 19th they fell to 14°, or 18° below the freezing point. Table 1 points out the influences month by month that the atmospheric vicissitudes had on life. It shows that the mean reading of the Barometer was, at Greenwich, 29.772 inches, the mean temperature of the air 50° '8, the dew point temperature 44°.6, and the rain-fall 25.9 inches;—that the mortality of London was 61,617, and that of Bethnal Green 2273. In the latter District the return of deaths was least (26 and 25) in the weeks ending April 2nd and April 30th; and greatest (71 and 70) in the weeks dating July 23rd and July 30th. As to Seasons, 600 persons were cut off in the 1st quarter; 486 in the 2nd; 603 in the 3rd; and 584 in the 4th. In point of comparison their per centage equivalents differ from those of 1858 in being .19 in excess in the Winter; 2.41 less in the Spring; l.83 more in the Summer; and .39 higher in the Autumn. Of the sum total, 22 deaths were not certified, and 16 had not the attendance of any Medical Man. 4 The following Table gives a two-fold view of the Population of Bethnal Green, from the Census of 1851, to the middle of 1859:— Sub-Districts Population By Excess of Births over Deaths By Census Returns Hackney Road 3643 27611 Green 1886 31184 Church 3516 26314 Town 3357 21728 90193* Totals 102595 106837 The 2nd column enumerates the increase from the surplus of births; the 3rd superadds the immigration to the other amount. 'In the 10 years 1841-50,' as quoted in my Report on 1856, 'out of a total increase of 15,991, the excess of births over deaths was 10,697, the immigration—addition 5294 or 529.4 per year.' So, on the present occasion, the difference between the two columns (4242) exactly accords with the foregoing rate of increase. For the reasons that o o large spaces are yet uncovered, and that years "ill elapse before they are immured, I have framed my calculations on the second of the estimates presented above. Should the first be the more correct of the two, the deaths to the living would be nearly 9 per 10,000 more than in Table 1. The Population thus deduced ranges at each age as below:— * The Population in 1851. 5 Ages Numbers Living 0 — 5 15738 5 — 10 13351 10 — 20 21322 20 — 40 32938 40 — 60 17588 60 — 80 5512 80 — 100 387 Above 100 1 Totals 106837 Excluding those still-born, the Births of 4103 children were registered in 1859, or 181 more than in the preceding year. Of these the Boys numbered 2088, and the Girls 2015. Their rate to each 1000 living is 38.4, and to the Deaths as 1.8 to 1. In all England the ratio per 1000 for the last 10 years is 33.8, and in the Metropolis during 1859, 33.3. With us the maximum was attained in the Winter, and the minimum in the Autumn. Irrespective of migratory changes, the number in excess of the Deaths was 1830. Of each 1000 born within the year there died 148, while to every 100 deaths the proportion dying out of the annual births was 26.7. Among the 4103 Births those out of wedlock amounted probably to 88, for on an average of 7 years the illegitimate births in the Registrar-General's Returns are divided thus:— 6 Illegitimate Sub-District Females Births Males Totals Hackney Road 62 62 124 Green 145 135 280 Church 39 41 80 Town 78 55 133 324 293 617 "The proportion of Births," says the Registrar-General, "is by the Returns in London 4 in 100." In the City the proportion is 3, and in England and Wales, 5.5. Vi;wed morally, the advantage is therefore in favour of Bethnal Green; the illegitimate returns being little in excess of 2 per cent. In Social Statistics the mean age at death was of the Gentry, 56.45; of the Tradesmen, 23.51; and of the Artisans, 20.47 years. During 1839 the average ages of the 3 classes* were, of Gentlemen 45, of Tradesmen 26, and of Operatives (excluding Paupers) 16 years. After the first Vicermiad, the years of life of the 1st class were 66.78, of the 2nd 49.84, and of the third 52.61. Of all who died the mean lifetime averaged 38.73 years, and the mean age 22.17. Our ratio consequently " of the mean age at death to the mean duration of life" was 1 to 1.7 ; throughout England it is "1 to 1.4." Nos. 3 and 4 of the Appendix elucidate the Class and Sub-District means. The Mortuary Table, No. 2, shows that the fatality from all causes was 2273, and that the deaths were fewer by 169 * Mr. Chadwieck* Report, page 159. 7 than in the year 1858. A.mong these, 1148 were of the maie and 1125 of the Female Sex. Placing side by side the death estimates of London and Bethnal Green, the former gives a per centage of 2.229 and the latter of 2.127. Proportionally to population these signify one death in each 45 and 47 persons; the minimum being in favour of Bethnal Green. Tested by the corrected average of the preceding 10 years, our mortality was lower by 130. Tested however by 17 deaths per 1000—the rate of the dwellers in certain of England's most healthy spots where the mean lifetime is 49 —it " exhibits" on our part 4 ''degrees of insalubrity," or the quota of avertible deaths. Nevertheless in one of our Sub-Districts, that of Hackney Road, this healthy rate was reached, and the deaths to the 1000 were only 17.05. Table 2 contrasts the loss by every disease in 1858 and 1859. It shows that Affections in the several Classes of Dropsy, the Brain, the Respiratory Organs, the Stomach, Malformation, Premature Birth and Debility, Atrophy, Old Age and Violent Death, were most destructive in 1858; that (with the exception of the Kidneys) the residue of the Classes devoted to Zymotic, Heart, Childbirth, Joint, Skin and Sudden Death Diseases carried off the greatest numbers in 1859, and that Diseases of the Kidneys were co-equal in each year. Descending from classes to certain individual diseases in 1859, Consumption killed 266, Diarrhoea 187, Pneumonia 170, Scarlatina and Diphtheria 157, Tabes or ''Mesenteric Consumption" 131, Bronchitis 118, Small Pox 111, Convulsions 95, Typhus 71, Teething 57, Measles 56, Whooping Cough 55, and Water on the Brain 33. Altogether these amount to 1507 deaths, whereof 993 were under 5 years of age. The Zymotic Group—which, besides the Epidemics, includes the loss of 12 by Croup, of 23 by Puerperal and Rheumatic Fevers, and of 13 by Erysipelas—formed about 8 31 per cent. of the deaths. Numerically the 6 Epidemics proved fatal to 494 children under the age of 5, to 87 individuals between 5 and 20 years, and to 56 who had passed their twentieth year. Their virulency was greatest in the Autumn, and least in the Spring. In per centage their proportion was to the deaths 28.02, or 6 in excess of the Metropolitan rate. Small Pox raged fearfully, and destroyed 91 more than in 1858. It is difficult, and in fact impossible, to vaccinate every child, so many are the scruples against vaccination. "Some of the objections are excuses for negligence, others are based on a sort of fatalism," as was the case vith the mother at Nottingham, who lost a child by Small Pox, and then declared to the Registrar that" she wou d rather lose half-a-dozen children by it than fly in the face of Providence in having one vaccinated." As a public vaccinator, I have met with similar cases myself. Measles carried off 35 fewer children than in the foregoing year. The severity of Scarlatina and Diphtheria, and of Whooping Cough also declined. Typhus, too, was much less destructive than in any of the years in which I have had to record its returns. One Death among every 1,544 persons occurred from it in London, and one among every 1,504 in Bethnal Green. On the other hand, the fatality of Diarrhoea increased, and swept off in the summer 160 of the 187 who died of it in 1859. Of the three classes, the Gentry suffered 1 out of every 8 deaths by Epidemics, the Tradesmen 1 in 3*5, and the ArtisanSalso 1 in 3.5. Relatively, our Epidemic proportions with those of London and its East Districts make up Tables 5 and 6. Whooping Cough ranks highest in London, Scarlatina and Typhus in the East Districts, Small Pox, Measles, and Diarrhœa in Bethnal Green. The " Diseases of variable or uncertain seat" destroyed 54 persons, 5 of whom died by various forms of Iloemorrhsge, 22 by Dropsy, 13 by Cancer, and 3 by Mortification. 9 437 Deaths were occasioned by Tubercular Affections, to which Marasmus, or Wasting, Hydrocephalus, or Water on the Brain, and Consumption, "the inexorable destroyer of men and women in the prime of life," all belong. On the death roll of the Gentry, Consumption was fatal to 1 in 9 ; of the Tradesmen to 1 in 7; of the Artisans to 1 in 9. It attained its monthly maximum (29) in November, the next highest point (27) in March; its lowest point (14) in October, and the next lowest (17) in August. Above the age of 15, one in every 9.6 of the deaths arose from this cause. " A certain amount of consumption, probably about 1 in 7 of all deaths above 15 years of age, which is nearly the proportion occurring in the higher orders, and in the most healthy professions, may be considered as inevitable; but all above that proportion admits of prevention." Of all deaths Consumption formed throughout London 12'4 per cent., throughout Bethnal Green 11.7 ; while, from the living, 1 in 361 was cut off in London, and 1 in 401 in Bethnal Green. In the Brain and Nerve class, Convulsions caused 95 deaths, Paralysis 51, Apoplexy 35, Epilepsy 15, and Delirium Tremens 2. Heart Diseases, many of which terminated suddenly, took away from us 59. To Diseases of the Respiratory Organs 350 deaths are ascribed. These with Consumption, out of every 10,000 persons, earned off 57.6. Per myriad, there die in London from these diseases 67.5; in England and Wales 55.2; and in Glendale, the far-famed, 21'6. In the next, or Digestive Group, Teething removed 57; Complaints of the Intestinal Canal 15; Disorders of the Liver 18 ; and of the Stomach 8. Affections of the Kidneys killed 15 persons; those referable to the class of Childbirth 20; those to the Joints 6, and to the Skin 4. 10 The next 5 classes which include the Malformations, the Premature Decay and Atrophy of Children, with Sudden Deaths and Old Age, caused a fatality of 194. The Violent Deaths, the last in the classification, comprised 58. Juries were summoned on the deaths of 76; of whom the children (16 Boys and 19 Girls) numbered 35, and the adults (27 males and 14 females) 41. The verdicts returned, read as below: — "Scalded," 1; by "Train of Eastern Counties Railway," 1; " Fracture of the Skull," 1; "Wound of Head," 1; "Coup de Soleil," 1; "Effusion on the Brain," 1; " Fungus Hcematodes attacking scalp, side of face ear and eye," 1; " Poison, from an infusion of herbs," 1; "Wilfully Murdered," 2 (Infants Newly Born, and thrown into Canal and Bonner's Fields); by " Excessive Drinking," 2 ; "Exhaustion from insufficient nourishment," 3; by " CutThroats," 3; "Hanging," 4; "Falls," 5; by "Accidental" and "Suicidal Drowning," 6; "Found Dying," or "Dead," 8; "Accidentally Suffocated," 15; and by "Natural" and "Sudden," Deaths, 20 more. Those who committed suicide and thus ''abandoned the post in which God placed them," were 11, and consisted of a Female Unknown, a Cabinet Maker's Wife, a Shoe Maker's Wife, a Porter, a Warehouseman, a Dealer in Poultry, and 4 Weavers. The quantum is somewhat less than our ratio by population, for " the tendency to suicide is, in the metropolis in 100,000 persons, 12.6." The youngest of the suicides was 31, and the eldest 79. The Deaths in the Institutions of the Parish happened thus:—84 Males and 79 Females in the Workhouse; 24 Males and 20 Females in the Lunatic Asylum; 16 Males and 10 Females in the Consumption Hospital; 1 Male and 2 Females in the Trinity Ground; 1 Male in Parmiter's Alms Houses; 1 Male at the Barracks in Globe Street; and 4 Males and 3 Females in the Model Lodgings in Columbia 11 Square. Specially in the Workhouse, Respiratory Diseases destroyed the most; Consumption ranked the next; Brain Affections carried off 22, and Epidemics 12. 21 Children fell below 5, and 25 Persons under 20 years; and in the second, third, fourth and fifth vicenniads, 18, 34, 79 and 7 of the Inmates died; two of whom lived to the age of 91, and 1 to 95. Enrolling all—Children and Adults—under the head of Avocation or Position, the Servants numbered 66, the Weavers 33, the Labourers 16, the Hawkers 5, the Shoemakers 4, the Carpenters 3, the Bakers 3, the Unknown 3; the Printers. Sawyer.-, Bricklayers, Binders, Laundresses and Seamstresses, each 2; whilst 1 Winder, 1 Stay-maker, 1 Dress-maker, 1 Charwoman, 1 Nurse, 1 Twine-Spinner, 1 Green-grocer, 1 Pipe-Maker, 1 Plasterer, 1 Tailor, 1 Dyer, 1 Draper, 1 Potman, 1 Carver, 1 (iunmaker, 1 Flutemaker, 1 Artist and 1 Orphan complete the list. At Christmas the Inmates consisted of 308 Men, 327 Women, and 217 Children ; or of a total of 852, being 44 less than at a like period of 1858. The Out-door Paupers, on the other hand, were 6omewhat in excess—861 vice 764. The Birth rate and its proportion to the living in each Sub-District was, as under stated:— Sub-Districts Births Ratio to 1000 Living Males Females Total Hackney Road 512 490 1002 36.28 Green 593 569 1162 37.26 Church 519 501 1020 38.76 Town 464 455 919 42.29* Totals 2088 2015 4103 * This high ratio of 1 birth to every 23 6 persons implies that the population of the Town exceeds the sum of its Census Return. 12 As heretofore, the ratio of the Town stood the highest; that of the Hackney Road the lowest of the four. In comparative longevity the mean lifetime ranked 1st, in the Green; 2nd, in the Hackney Road; 3rd, in the Church, and 4th, in the Town; bat after the 20th year, the average age reached its maximum in the Green, was less in the Hackney Road, lower in the Town, and at its minimum in the Church. Tables 4 and 9 contrast the Sub-District Ages, and the mortality in each. Severally the per centage on every 100 deaths was in the Hackney Road, 1.705; in the Church, 1.919 ; in the Town, 2.236; and in the Green, (including the Workhouse, Lunatic Asylum, Consumption Hospital, &c.,) 2 600. Rated by Epidemics, 1 death out of every 3.1 occurred in Sub-District 1; 1 in 5.4 in No. 2; 1 in 3.3 in No. 3; and 1 in 2.6 in No. 4. To every myriad of population, the rates by the Zymotic, Tubercular, and Respiratory Diseases are seen at a glance below:— Deaths to 10,000 Living Sub-Districts Zymotic Tubercular Respiratory Class Class Class Hackney Road 62 28 28 Green 55 56 42 Church 62 36 28 Town 93 39 29 Arranged in their scale of sequence, the deaths below the age of 5 were to each 10,000—91, 103, 110, and 148. These figures with the respective death-rates show how superior health was in Hackney Road compared with health in the Town, and that the life-destroying forces differ greatly in degree. The mortality of infants below 5 years was 1191; of 13 viduals between 5 and 20 years, 184; of adults from 20 to 60, 546 ; and of those beyond 60, 352. In the first of these divisions there died_at less than 3 months, 250; from 3 months to 6, 137; from 6 months to 12, 220; at 1—2, 312; at 2—3, 128; at 3—1, 87; and at 4—5 years, 57. Out of this infantile mortality " the functions of whose lives remain wholly unfulfilled", the proportion dying under 1 year was to the births as 1 to 6.7. Below 5 years, of 100 living 7.567 per cent. or 1 out of every 13.21 infants died; while in 1838—44 the ratios were 8.565 per cent, or 1 out of every 11.67. As the mortality of these little children " increases as the social condition of the parents sinks" the advantage would be great were Day Nurseries instituted "where," says Mr. Roberton," women working from home may deposit their infants in the morning, return to suckle them at certain hours, and take them home again in the evening," or where " if the child be weaned, it may be fed and amused, or if old enough instructed." In the second division, 109 were cut off at 5—10, and 75 at 10—20 years: thus in the first vicenniad the death loss numbered 1375 and formed a per centage of 60*4. Among adults " the efficient part of the population" whose deaths 11 in a political point of view are of great importance" 250 were swept away at 20—40 and 296 at 40—60 years. If in the words of a former Report—' to die between the ages 20—60 be to perish prematurely, then in addition to our large infantile loss' out of 2273, 546 ' were untimely deaths'. Those who lived over threescore and ten aud reached "the broken arches of the bridge" amounted to 149, those beyond fourscore to 48, those above ninety years to 8; of whom 2 attained the age of 95. Respectively the Septuagenarians constituted 1 in 15 deaths; the Octogenarians, 1 in 57 ; the Nonagenarians, 1 in 284. By Table 8 the per centages of the dying to the living are given at seven ages and contrasted with the Table in 1858. 14 Balanced with the ratios of London in 1855, the difference of the annual mortality in Bethnal Green on every 1000 of population is at 20—40 minus 2; at 40—60 minus 6, at 60—80 minus 17; at 80—100 minus 100. These minima numbers (125) on the part of Bethnal Green agree with the Composition of Deaths at page 12 of my Report on 1858. where it is shown that compared with all London ' 124 more of our population died under 20 years and conversely 124 less at after ages.' Table 10 points out the Professions or Occupations of the Male Adults. Of the numbers living in each Avocation in Bethnal Green at the Census of 1851, there died of Annuitants 1 in 12; of House Proprietors 1 in 13; of Gentlemen, Independent, 1 in 16; of Licensed Victuallers and Beer Shop Keepers 1 in 20; of Seaman 1 in 20; of Messengers and Porters 1 in 34; of Butchers 1 in 39; of Labourers 1 in 39; of Bakers 1 in 40; of Tailors 1 in 44 ; of Carpenters 1 in 47; of Bricklayers 1 in 50; of Painters, Plumbers and Glaziers 1 in 52; of Weavers 1 in 59 ; of Cowkeepers and Milksellers 1 in 62; of Cabinet Makers and Upholsterers 1 in 77; of Grocers 1 in 88; and of Shoemakers 1 in 109. The Statistics of both sexes of 147 Adult Weavers, show a loss by Epidemics of 1 in 9'8 deaths, and by Consumption, of 1 in 6-6; that 1 died of poison from taking herbs, 1 from want of nourishment; 1 by Carbuncle; 1 by Coup de Soleil; 1 by Cut-Throat; 1 by Drowning; 2 by Cancer; and 2 by Hanging;—that 40 passed over 70, 7 over 80, and 2 beyond 90 years; and that their mean age was 59.13. Some of the places noted down before—as Sherwood Place, Thorold Square, Butler's Buildings, Ely and Helen Places, John's Court and Prospect Terrace—suffered a less mortality in 1859. In others, however, the per centage of the dying was far beyond the general rate; thus the 15 lation ranged per cent. from 3 in Turville Buildings to 5 in Sweet Apple Square, to 7 eacli in Lenham Buildings, and Elizabeth and Providence Places, to 8 in Hare Court and Miring's Place, on to 11 (through Scarlatina) in Accidental Place. And until many of these miserable abodes are erased from our map, depopulation will ever go on, and our death rate be inevitably beyond our deserts. But when erased their sites may be reclaimed, even as Miss Burdett Coutts has revivified the wastes of Nova Scotia Gardens with the noble model terraces of Columbia Square. The summary of the foregoing tells of Bethnal Green:— 1. That the death rate of the population, estimated either by the excess of Births over Deaths, or by Census returns, was less than the Metropolitan rate, 2. That the Epidemic rate, on the contrary, was much in excess. 3. That Fever was more and Consumption less destructive than in the London returns. 4. That the fatality of Children under 5 yeara of age fell from 83.5 per 1,000 in 1857, and from 82.6 in 1858 to 75.6 in 1859. 5. That the mean ages, total and adult, if compared with 1858, were slightly in defect, but that the mean lifetime was 2 years more. I have next to lay before you the Sick Rolls of the Workhouse, and of the 5 out-door Divisions. In reference thereto, the 312 returns of the Medical Officers specify 6,510 new cases of Disease from January 2nd to December 31st, 1859. The gross amount is 262 less than in 1857, and 834 fewer than in 1858. 924 were attended in the "Workhouse by Mr. Smart, 557 in the out-door division of Mr. Moore, 1,339 in the second part by Mr. Defriez, 1,065 in the third part by Mr. Yandenbergh, 1,246 in the fourth part by Mr. Eagles, and 16 1,379 in the fifth part by Mr. Welch. Respectively, the Epidemics varied in force from 11.6 per cent, in the Workhouse to 21.3 in No. 1, to 28.9 in No. 4, to 30 in No. 2, and from 34.8 in No. 5, to a maximum in No. 3 of 37.5. Small Pox, Measles, Whooping Cough, and Fever predominated in the District of Mr. Defriez; Scarlet Fever and Diarrhoea in the practice of Mr. Welch. The ratio to the sum total was of Small Pox 1 in 17, of Measles 1 in 43, of Scarlet Fever 1 in 41, of Whooping Cough 1 in 90, of Diarrhœa 1 in 9, and of Fever 1 in 12 attacks. Besides the Epidemics, the Nosological Table No. 11, enumerates severally the Acute Pulmonary Inflammations, the cases of Erysipelas and Carbuncle, of Puerperal and Rheumatic Fevers, and of other forms of disease, with the deaths in each sub-division. One death occurred in every 14.7 cases, and one attack of Pauper illness to every 16.4 of the inhabitants of Bethnal Green. Several cases of Diarrhœa partook of the Choleraic character, but fortunately all got well. With respect to Fever, increase of sewerage and surface-drainage, more perfect scavenging, the paving of streets, and the purer supply of water, have materially diminished its physical causes, and reduced its amount from 2,084 continued cases* in 1837, to 683 in 1858, and 543 in 1859. "Wherever," says Dr. Southwood Smith, "the Commissioners of Sewers have not been, there Fever is prevalent; and, on the contrary, wherever they have been, there Fever is comparatively absent." Hence, from sanitary improvements, Fever now is much less than when Bethnal Green was all but undrained. At the Dispensary, 2188 cases came under the care of the medical staff, and of these 474 had their diseases specified, * Here, I beg to observe, and the same observation applies to former reports, that under the heading " Continued Fever, Typhus, and Typhoid," I have registered only the cases visited at home, and not those seen or prescribed for at the Surgery without attendance at the house. 17 while 1714 were not classified byname. Of the Specified, the Epidemics amounted to 138, Spitting and Vomiting of Blood to 7, Consumption and the Wasting of Children to 51, Diseases of the Heart to 18, Pulmonary Affections to 158, Brain Diseases to 21, and those of the Digestive Organs to 72; whilst 2 Fractures. 2 Dislocations, 3 cases of Carbuncle, and 3 of Diseased Knee Joints, occurred in the Surgery of the year. The In and Out-Patients of the City of London Hospital for Diseases of the Chest were 341 and 8,304; and the inmates treated in the Guardian Asylum—namely, for Diarrhoea 6, Rheumatic Fever 3, Bronchitis and Catarrh 8, and for other diseases 4—were 21. I regret that I am not able to supply the Sick List of Bethnal House Asylum, for the reason that I have not been so fortunate as to be favoured with the return. I now pass to the sanitary improvements from March 26th, 1859, to March 25th, 1860. Foremost among these is the N ew Block of Sewers, No. 8, which comprises " the remainder of undrained streets in the parish, except such as will be interfered with by the Main Intercepting Sewers to be constructed by the Metropolitan Board of Works, and also except such streets as, under the provisions of the Metropolis Local Management Act, the owners are bound to drain." Next in importance is the work done within the Vaults. Invited by Mr. Grainger, the Government Inspector under the Burials Acts, I accompanied that gentleman to the vaults under the National Schools, St. John's and St. James the Less. The Orders in Council consequent on those inspections are subjoined:— Order 1.—"That the Coffins contained in the Vaults under the National Schools attached to St. Matthew's Church, Bethnal Green, be covered with fresh earth and powdered B 18 charcoal; that the existing entrance and ventilators be blocked up, and that two ventilating tubes be carried from the Vaults to the roof of the School." The underground area here described measured, in length, 47 feet; in breadth, 37; was subdivided into 4 public and 13 private Vaults, and contained 252 Coffins, 4 of which were without lead, and 3 in a leaking state. After the temporary suspension of scholastic duties and the free use of McDougal's Powder, the Coffins were deposited along the passages and floors, were covered over with 2 feet of earth, and finally surmounted with 3 inches of charcoal, 60 sacks of which were used. The entrance from the churchyard was then walled-up, all the original ventilators were bricked in, and two ventilating tubes—one on the northern and the other on the southern side—were carried outwards from the vaults, above the roof. Nothing, in a sanitary point of view, could so materially benefit the National Schools as this grand hygienic appliance in 1859. Order 2. — "That the Coffins contained in the Vault beneath St. John's Church, Bethnal Green, be covered with 4 feet of earth, and that the entrance from the Porch be blocked up. 2. That the works be effected under the supervision of the Medical Officer of Health of the District, and that McDougal's Powder, Chlorine, or other disinfectant, be used whenever necessary." From this admirably ventilated Vault one Coffin was removed by friends, two were allowed to remain in a private vault, while the others, numbering eleven, were placed iu the central gangway and embanked under 4 feet of earth. In addition the entrance from the Porch was filled-up with bricks. As only one infant was buried under St. James the Less, no order was issued or required. 'Deepening the Sewer in the Old Pord Road, and carrying it under the Regent's Canal, was another life-saving work ; 19 whereby the areas of many houses are now drained which before were flooded and poisoned by mepliitic gas. Great good also has been effected by abolishing the Cow Yard and Rubbish Dep6t in Wilmot Street, and by erecting cottages on their site. The collection too of road mud, dust and dung, in the yard of Mr. Rook, by Gibraltar Walk has, through magisterial influence, been removed. The manufacture likewise of Manure under the Railway Arch, No. 87, which—though stopped two years ago, was re-established on a larger scale—is now altogether done away. And happily, manure is no longer baked at Digby Street in Baker's Yard. The Slaughter Houses have had due attention; Pig keeping in many instances has been prevented, and two cellar dwellings have been closed. Moreover, the carcass of a diseased cow about to be chopped into sausage meat was condemned, and cut up at a boiling-house for dogs. A handsome Drinking Fountain, surmounted with the appropriate motto, Health, Strength, and Peace flow from me," has been erected on the Green, and presented to the Parish by J. D. Link, Esquire. Numerous nuisances from Boiling of Meat, Melting of Fat, and Smoking of Fish, have, as far as practicable, been remedied and abated. These, with the erection of 4 new houses in Hammond's Gardens, the paving of Fountain Alley and other parts, the filling up of the ditch in Bridge Road, the drainage of certain streets where water flowed in wet weather from the yards to the shops, where the soil was .uo damp that the fowls died "mildewed;" the re-supply of water to Prospect Terrace whence it was off some months; with the sewer, drain, cesspool, and other works in Table 12, constitute our Progress in 1859. Though we know not how many lives sanitation has saved, nor what widowhood, orphanage, and pauperism it has B 2 20 tailed, yet, as we purify our houses within and without, and supply them with all the requirements of health, so must we, step by step, improve the physique of Bethnal Green. " The rate of death of a district represents the commercial value, in its widest sense, of its men, women, and children ; its revelations are not simply of the actual loss of human life, but of the waste of human intellect and human strength." Such wastes, through morbific causes, imply with us an excess of 4 deaths per 1000 over the normal or healthy rate of 17 ; and such, more perfect hygiene can alone correct. " Any deaths in a people exceeding 17 in 1000 annually are unnatural deaths." That number, therefore, should be our maximum, and until that be attained our sanitary status will not rank high. If, however, our infantile death rate continue to fall 7 in the 1000 as was the case in 1859, we may hereafter expect our majority to glide off from life—like the Quakers of Great Britain wheresoever they dwell—not under 5 but between 70 and 80 years. " To supply the arm strong to labour, to substitute productive for unproductive citizens," to decrease the death-roll of the young, and to protract life beyond its present span— these are the tasks that sanitary science imposes on us— these the duties that we have constantly to fulfill! These, moreover, will advance the prosperity of Bethnal Green, and confer on many " Health till Death through ripe old age." I have the honour to be, Gentlemen, With great respect, Very faithfully yours, SAMUEL PEARCE. To the Gentlemen of the Vestry of St. Matthew, Bethnal Green. 21 APPENDIX TO THE 5th REPORT; Or, Tables of the Mortality and Progress of Bethnal Green, during the Year 1859. -oM0' 1. London Weather and Deaths, with the relative tality of Bethnal Green. 2. Nosology of every Death. 3. Mean Ages of Gentry, Tradesmen, and Artisans. 4. Mean Ages in the 4 Sub-Districts. 5. Sub-District Epidemic Deaths. 6. Comparative Mortality by Epidemics in London, East Districts and Bethnal Green. 7. Workhouse Deaths. 8. Mortality at 7 Ages. 9. Vital Statistics of the 4 Sub-Districts. 10. Deaths according to Occupations. 11. Practice of the Poor-Law Medical Staff. 12. Synopsis of Sanitary Works. TABLE I. Showing the London "Weather and Deaths, and the relative Mortality in Bethnal Green. METEOROLOGY. DEATHS. 1859, Months. Mean Beading of Barometer. Mean Temperature of Air. Mean Dew point Temperature. Relative proportion of Wind. Daily Horizontal Movement of Air. Amount of Bain in Inches. In Bethnal Green. In London. Total. Annual percentage of Deaths in Bethnal Green. Epidemic. Percentage of Epidemic to Total Deaths. Total. Annual percentage of London Deaths. Epidemic. Percentage of Epidemic to Total Deaths. N. E. S. W. In. o o Miles. In. January 30.037 40.4 37.0 6 2 6 17 124 0.8 194 40 5476 1087 February 29.823 43.1 37.6 2 1 6 19 150 0.9 208 35 4899 904 March 29.806 46.4 40.0 7 0 5 19 130 1.3 198 50 5772 1038 April 29.614 46.6 38.9 3 8 6 13 133 2.2 142 27 4618 2.229 782 May 29.789 53.1 45.9 10 18 1 2 75 2.4 156 2.127 34 4263 749 June 29.766 61.4 53.8 8 8 1 13 57 1.4 188 47 28.02 4843 or 883 21.95 July 29.937 68.1 58.3 5 5 10 11 57 3.3 230 or 114 5650 1807 August 29.818 63.5 54.2 6 3 11 11 86 1.1 187 75 5038 1 Death 1748 September 29.709 56.7 50.0 8 1 9 12 97 3.8 186 1Death 60 5322 1419 October 29.523 50.9 47.9 2 9 7 11 ... 3.6 142 43 3856 in 45. 937 November 29.824 42.1 38.3 3 8 12 7 ... 2.9 174 in 47. 41 4773 919 December 29.623 36.8 33.4 5 11 4 10 ... 2.2 268 71 7107 1257 Totals of year 29.772 50.8 44.6 65 74 78 145 ... 25.9 2273 637 61617 13530 TABLE 2. DEATHS REGISTERED IN THE PARISH OF SAINT MATTHEW, BETHNAL GREEN, IN THE 52 WEEKS, ENDING DECEMBER 31ST, 1859. CAUSES OF DEATH AGES Total QUARTERS Total of 1858 CAUSES OF DEATH AGES Total QUARTERS Total of 1858 Under 5 Under 20 20 and under 40 4 0 and under 60 60 and under 80 80 and above 1 2 3 4 Under 5 Under 20 20 and under 40 40 and under 60 60 and under 80 80 and above 1 2 3 4 I. Zymotic:—712. Peritonitis ... 1 1 1 ... ... 3 1 1 1 ... 5 Ascites ... ... ... 1 ... ... 1 1 ... ... ... 5 Small-pox 82 22 5 2 .. .. 111. 25 34 28 24 20 Ulceration of Intestines ... ... ... 2 ... ... 2 2 ... ... ... 3 Measles 53 3 .. .. .. .. 156 7 5 8 36 91 Hernia (Rupture) ... 1 1 2 1 ... 5 2 ... 2 1 4 Scarlatina 111 43 3 .. .. .. 157 48 30 32 47 188 Ileus ... 1 ... 1 1 ... 3 2 1 ... ... ... Whooping Cough 54 1 .. .. .. .. 55 20 17 7 11 114 Intussusception ... 1 1 ... 1 ... 3 1 ... 1 1 7 Croup 12 .. .. .. .. .. l2 5 2 3 2 22 Stricture of Intestinal Canal ... ... ... ... ... ... ... ... ... ... ... ... Thrush 5 .. .. .. .. .. 5 .. .. 3 2 7 Disease of Stomach, &c. ... ... 2 4 2 ... 8 2 2 1 3 6 Diarrhœa (Bowel Complaint) 174 .. 1 1 10 1 187 6 6 160 15 104 Disease of Pancreas ... ... 1 ... ... ... 1 1 ... ... ... ... Dysentery .. .. .. .. 1 .. 1 .. .. 1 .. 6 Inflammation of Liver (Hepatitis) .. ... ... ... 1 2 ... 3 1 1 1 ... 5 Cholera 3 .. 1 .. .. .. 4 .. .. 3 1 2 Jaundice 5 ... ... ... ... ... 5 1 2 ... 2 9 Influenza .. .. .. .. .. .. .. .. .. .. .. .. Disease of Liver 1 ... 4 9 4 ... 18 6 4 5 3 13 Scurvy and Purpura 3 2 1 .. .. .. 6 1 1 .. 4 2 Diseases of Spleen ... ... ... ... ... ... ... ... ... ... ... ... Ague .. .. .. 1 .. .. 1 .. 1 .. .. .. VIII. Kidneys, &c. :—15. Remittent Fever 1 1 .. .. .. .. 2 .. 1 .. 1 Infantile Fever .. .. .. .. .. .. .. .. .. .. .. .. Nephritis ... ... ... 1 ... ... 1 1 ... ... ... 1 Typhus Fever 20 18 9 14 10 .. 71 19 l6 14 22 107 Nephritis (Britht's Disease) ... 1 3 l ... ... 5 ... 1 2 2 4 Puerperal Fever (Metria) .. 2 10 1 .. .. 13 3 3 2 5 10 Ischuria ... ... ... ... 1 ... 1 ... 1 ... ... 3 Rheumatic Fever 1 3 2 2 2 .. 10 4 2 1 3 11 Diabetes ... ... ... ... ... ... ... ... ... ... ... 1 Erysipelas (Rose) 5 2 1 2 2 1 13 6 3 .. 4 18 Stone ... ... ... ... ... ... ... ... ... ... ... ... Syphilis 7 .. .. .. .. .. 7 1 2 2 2 6 Cystitis ... ... ... ... 2 ... 2 ... 1 1 ... 2 Noma (Canker) 1 .. .. .. .. .. 1 • • .. 1 .. .. Stricture of Urethra ... ... ... ... 2 ... 2 ... 2 ... ... ... Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Disease of Kidneys, &c. ... 1 1 1 1 ... 4 2 2 ... ... 4 II. Dropsy, &c. :—54. Childbirth:-20. Hæmorrhage 1 .. 2 1 1 .. 5 1 1 2 1 7 Paramenia ... ... ... ... ... ... ... ... ... ... ... 1 Dropsy 1 4 2 9 6 .. 22 4 5 9 4 24 Overian Dropsy ... ... 1 ... 2 ... 3 ... ... 1 2 4 Abscess (Gathering) 3 .. .. 1 1 .. 5 4 1 .. .. 6 Childbirth(see Metria) ... ... 2 2 ... ... 4 1 ... ... 3 4 Ulcer 1 .. .. 1 .. 1 3 2 1 .. .. 1 Disease of Uterus, &c. ... ... 4 6 3 ... 13 5 2 4 2 2 Fistula .. .. .. 1 1 .. 2 .. 1 1 .. 1 Mortification .. .. .. .. 3 .. 3 1 .. 1 1 7 X. Joints, Bones &c.:-6. Cancer .. .. 1 8 3 1 13 3 2 4 4 19 Rheumatism ... ... ... 1 2 ... 3 ... 3 ... ... ... Gout .. .. .. .. 1 •• 1 .. •• 1 •• 1 Arthritis ... ... ... ... ... ... ... ... ... ... ... 1 III. Tubercular:—437. Disease of Joints ... 1 1 1 ... ... 3 ... 2 1 ... 4 Scrofula 4 3 .. .. .. .. 7 3 2 2 .. 4 XI. Skin, Cellular Tissues, &c. —4. Tabes Mesenterica 124 7 .. .. .. • • 131 25 29 52 25 125 Phthisis (Consumption) 17 29 132 80 8 .. 266 71 68 6l 66 255 Carbuncle ... ... ... 1 1 ... 2 ... ... 1 1 2 Hydrocephalus (Water on the Brain) 32 1 .. .. .. •• 33 9 6 10 8 43 Phlegmon ... ... ... ... ... ... ... ... ... ... ... ... IV. Brain and Neryes :—243. Disease of Skin, &c. 2 ... ... ... ... ... 2 ... ... 1 1 ... Cephalitis 4 2 3 1 .. .. l0 4 3 1 2 18 XII. Malformation :—2. Apoplexy 1 .. 2 9 23 .. 35 10 9 12 4 33 Palsy (Paralysis) 1 .. 7 23 18 2 51 19 10 12 10 59 Spina Bifida ... ... ... ... ... ... ... ... ... ... ... ... Delirium Tremens .. .. 1 1 .. .. 2 .. 1 1 .. 5 Other Malformations 2 ... ... ... ... ... 2 ... ... 2 ... 3 Chorea .. .. .. .. .. .. .. .. .. .. .. .. XIII. Premature Birth and Debi lity :—57. 55 1 ... ... 1 ... 57 11 21 11 14 70 Epilepsy 1 5 4 2 3 .. 15 5 4 2 4 13 Tetanus 1 .. ,. .. .. .. 1 .. .. 1 .. 2 Insanity .. .. 3 5 5 .. 13 6 4 2 1 15 XIV, Atrophy :—14. 14 ... ... ... ... ... 14 1 3 7 3 19 Convulsions 94 1 ,. .. .. .. 95 28 16 24 27 72 Disease of Brain, &c. 11 3 3 2 2 .. 21 2 7 6 6 36 XV. Old Age:-109. ... ... ... 1 71 37 109 28 24 17 4 123 V. Heart A Blood Vessels :—69. XVI. Sudden Death:-12 5 ... ... 7 ... ... 12 ... 3 4 5 10 Pericarditis .. 2 1 .. .. 1 4 .. .. 3 1 4 XVII. Violent Death :—58. Aneurism .. .. 1 2 .. .. 3 .. 2 1 .. 2 Disease of Heart, &c. 2 9 6 18 17 .. 52 15 11 10 16 40 Intemperance ... ... 1 1 ... ... 2 1 1 ... ... 2 VI. Lungs and Organs or Respiration :—350. Privation of Food ... ... 1 2 1 ... 4 3 ... ... 1 1 Want of Breast Milk 2 ... ... ... ... ... 2 ... ... 1 1 2 Neglect ... ... ... ... ... ... ... ... ... ... ... ... Laryngitis 9 1 .. .. .. .. 10 2 2 3 3 5 Cold ... ... ... ... 1 ... 1 ... ... ... 1 1 Bronchitis 27 2 10 29 48 2 118 45 25 11 37 159 Poision ... ... ... 1 ... ... 1 ... 1 ... ... 1 Pleurisy .. .. ,. 2 1 .. 3 1 .. 2 .. 4 Burns and Scalds 4 ... ... ... ••• ... 4 2 1 ... 1 2 Pneumonia 148 5 6 6 5 .. 170 70 29 l6 55 217 Hanging (Suicide) ... ... 1 ... 3 ... 4 ... ... 3 1 4 Asthma .. .. 2 14 26 1 43 16 9 2 16 61 Suffocation 15 ... ... ... ... ... 15 1 4 3 7 6 Disease of Lungs 2 .. .. 2 2 .. 6 3 1 .. 2 15 Drowning ... 2 2 2 ... ... 6 ... 4 1 1 8 Fractures and Contusions 1 ... ... 1 ... ... 2 1 1 ... ... 1 VII. Stomach and Digestive Organs :—121. Wounds ... ... 1 2 ... ... 3 1 2 ... ... 1 Other Violent Causes 2 1 2 2 1 1 9 4 1 1 3 8 Teething 57 .. .. .. .. .. 57 17 19 10 11 70 Not Specified 5 ... ... ... ... ... 5 3 2 ... ... 44 Quinsey 3 .. 1 .. .. .. 4 2 2 • • .. 5 Gastritis 1 .. .. .. .. .. 1 .. .. .. 1 3 Enteritis 1 2 .. 2 2 .. 7 2 .. 4 1 6 * TOTALS 1191 184 250 296 304 48 2273 600 486 603 584 2442 23 TABLE 3. Mean Ages of Gentry, Tradesmen, and Artisans. Classes Nos. of Deaths Years of Life Mean Age at Death Percentage of each Class to Total Deaths Yrs. Mths. Wks. Days Gentry 55 3105 0 3 0 56.45 2.42 Tradesmen 620 14578 1 1 4 23.51 27.28 Artisans, Labourers and Paupers 1598 32720 11 3 1 20.47 70.30 Totals 2273 50404 1 3 5 22.17 100.00 TABLE 4. Mean Ages in the 4 Sub-Districts. Sub-Districts Nos. of Deaths Years of Life Mean Age at Death Yrs. Mths. Wks. Days Hackney Road 471 9462 2 2 6 20.08 Green 811 24261 9 2 6 29.91 Church 505 9553 4 1 5 18.91 Town 486 7126 9 0 2 1466 Totals 2273 50404 1 3 5 22.17 24 TABLE 5. Sub-District Epidemic Mortality in 1859. Sub-Districts of Bethnal Green Small Pox Measles Scarlatina Whooping Cough Diarrhœa Typhus Total of Epidemics Percentage to Total Deaths Hackney Road 25 8 46 11 46 15 151 Green 19 16 39 10 44 22 150 Church 30 12 31 18 42 18 151 28.02 Town 37 20 41 16 55 16 185 Totals 111 56 157 55 187 71 637 TABLE 6. Comparative Mortality by Epidemics in London, East Districts, and Bethnal Green. Epidemics Percentages to Total Deaths London East Districts Bethnal Green Small Pox 1.8 2.6 4.8 Measles 2.1 1.8 2.4 Scarlatina 6.8 7.0 6.9 Whooping Cough 2.8 2.6 2.4 Diarrhœa 5.4 6.7 8.2 Typhus 2.9 3.4 3.1 25 TABLE 7. Causes of, and Ages at, Death, in the Workhouse, Bethnal Green, during the 52 weeks ending December 31st, 1859. Zymotic or Epidemic Class Tubercular Class Brain, Nerves, &c. Heart, &c. Respiratory Organs Digestive Organs Violence, Privation, &c. All other Diseases General Total 12 30 22 6 38 5 2 48 163 AGES 0—1 1—5 5—10 10—20 20—40 40—60 60-80 80-100 General Total 11 10 2 2 18 34 79 7 163 TABLE 8. Mortality at 7 Ages. Ages Numbers Living Numbers Dying Death Percentages Death Percentages in 1858 0— 5 15738 1191 7.567 8.268 5— 10 13351 109 0.816 1.100 10— 20 21322 75 0.351 0.325 20— 40 32938 250 0.759 0.743 40— 60 17588 296 1.682 1.675 60— 80 5512 304 5.515 6.347 80—100 387 48 12.403 21.578 Above 100 1 ... ... ... 26 TABLE 9. Comparative Mortality, Causes of, and Ages at, Death, in each of the Sub-Districts of Bethnal Green, during the 52 weeks ending December 31st, 1859. Sub-Districts. CAUSES. DEATHS. Zymotic or Epidemic Class. Tubercular Classs. Brain Nerves, &c. Heart, &c. Kespiratory Organs. Digestive Organs. Violence, Privation, &c. All other Diseases. Males. Females. General Total. Hackney Road 171 79 49 14 78 24 5 51 228 243 471 Green 173 176 110 26 13? 49 24 121 419 392 811 Church 164 97 42 14 76 29 15 68 250 255 505 Town 204 85 42 5 64 19 14 53 251 235 486 Totals 712 437 243 59 350 121 58 293 1148 1125 2273 Sub-Districts. AGES. DEATHS. —1 1—5 5—10 10—20 20—40 40—60 60—80 80—100 Males. Females. General Total. Hackney Road 132 122 35 18 46 55 54 9 228 243 471 Green 166 156 ?5 34 108 134 159 29 419 392 811 Church 151 141 24 11 58 58 53 9 250 255 505 Town 158 165 25 12 38 49 38 1 251 235 486 Totals 607 584 109 75 250 296 304 48 1148 1125 2273 TABLE 10. Occupations of Males, aged 20 years and upwards, whose deaths were registered in Bethnal Green, during the 52 weeks ending December 31st, 1859. OCCUPATIONS OF MALES AGED TWENTY AND UPWARDS. Living in Bethnal Green at the ceusus of 1851. Deaths registered in the 52 weeks ending December 31st, 1859. OCCUPATIONS OF MALES AGED TWENTY AND UPWARDS. Liring in Bethnal Green at th e censu s of 1851. Deaths registered in the 52 weeks ending December 31st, 1859. Total Ages at Death. Total Ages at Death. Aged 20 & upwards Aged 20 & upwards 20- 40- 60- 80 and upwards Aged 20 & upwards Aged 20 & upwards 20- 40- 60- 80 and upwards Class Class Brought forward 8035 197 61 80 53 3 1. (1) Post Office 39 2 1 1 12. (2) Tallow Chandler 79 1 1 Customs 77 1 1 Comb Maker 49 3 2 1 (3) East India Service 58 1 1 (3) Skinner 2 1 1 2. (1) Soldier 13 3 1 2 Currier 50 2 2 Chelsea Pensioner 44 2 2 (5) Hair Manufacture 51 1 1 3. (2) Solicitor 16 1 1 Brush and Broom Maker 109 2 1 1 (3) Other Medical Men 8 1 1 (7) Silk Manufacture 4356 73 9 28 34 2 (5) Law Clerk 54 1 1 12. (1) Green Grocer 120 2 1 1 4. (1) Editor, Writer 7 1 1 Corn Merchant 41 1 1 (2) Painter (Artist) 23 2 1 1 Miller 16 2 1 (4) Schoolmaster 46 1 1 Baker 363 9 1 4 1 6. (2) Inn Servant 104 3 1 1 1 Confectioner 92 1 1 2 2 (3) Hatter 106 4 1 2 1 (2) Brewer 128 10 2 4 3 1 Tailor 351 8 2 4 2 Licensed Victualler, Beer shop keeper 208 11 4 3 4 Hosier, Haberdasher 23 1 1 Shoemaker 1643 15 5 7 3 Sugar Refiner 11 1 1 Others providing dress 212 1 1 Grocer 177 2 2 7. (1) House Proprietor 78 6 1 4 1 Tobacconist 45 2 2 Salesman 13 2 1 1 (3) Oil and Colourman 69 3 2 1 Accountant 38 1 1 French Plisher 78 1 1 Commercial Clerk 173 6 2 3 1 (4) Timber Merchant 38 1 1 Commercial Traveller 45 4 1 2 1 Other Dealers, Workers in Timber 63 2 2 Hawker, Pedlar 190 7 2 4 1 Other engaged in Road veyance 146 4 3 1 (5) Cork Cutter 52 2 1 1 8. (2) Coach Cabowner 9 3 2 1 (6) Sawyer 148 6 2 3 1 Carman,Carrier,Carter,Drayman 280 7 5 2 (7) Cabinet Maker, Upholsterer 614 8 4 3 1 Others engaged in Road veyance 60 1 1 Turner 172 4 1 3 Chair Maker 234 5 2 2 1 (4) Seaman 100 5 4 1 Box Maker 117 2 2 Others connected with Sea Navigation 472 2 1 1 Others dealing in Wood niture 109 1 1 Dock Service, Dock Labourer 5 3 1 1 (8) Cooper 186 2 1 1 (5) Engaged in Warehousing 147 3 2 1 (11) Rope Maker 123 2 1 1 (6) Messenger, Porter 446 13 3 3 7 Other workers, Dealers in Hemp 72 3 2 9. (1) Farmer 15 1 1 Agricultural Labourer(out-door) 73 2 2 (12) Draper 75 1 1 1 (3) Gardener 65 2 1 1 Cotton Manufacture 17 1 10. (1) Farrier, Veterinary Surgeon 39 2 2 Packer and Dresser 1 1 Drover 30 1 1 (13) Stationer 52 4 4 11. (1) Publisher, Bookseller 42 1 1 Other Paper Workers, Dealers 38 1 1 Bookbinder 54 2 2 14. (1) Chimney Sweeper 14 1 1 Printer 168 10 8 2 (2) Brick Maker 42 1 1 (3) Musical Instrument Maker 43 1 1 Road Labourer 8 3 1 2 (7) Civil Engineer 1 1 1 (4) Glass Manufacture 73 2 1 1 (9) Philosophical Instrument Makers and Dealers 78 1 1 (8) Goldsmith, Silversmith 69 1 1 Carver, Gilder 97 6 4 1 1 (10) Gunsmith 51 2 2 (13) Brass Founder 67 3 1 1 (12) Coachmaker 87 1 1 (14) Iron Manufacture 53 2 1 1 Others connected with Carriage making 3 3 Whitesmith 36 3 2 1 1 Blacksmith 189 1 1 (13) Saddler 29 1 1 File Maker 8 1 1 (15) Surveyor 5 1 1 15. (1) Labourer (branch undefined) 1010 26 5 11 10 Carpenter, Joiner 572 12 2 5 5 (2) Mechanic, Manufacturer man (branch undefined) 12 5 2 1 2 Bricklayer 452 9 3 3 3 Mason, Pavior 72 2 1 1 Others of indefinited Occupation 9 2 1 1 Plasterer 95 3 1 1 1 16. (1) Gentleman, Independent 32 2 1 1 Painter, Plumber, Glazier 367 7 6 1 Annuitant 75 6 1 3 2 (17) Dyer, Scourer, Calenderer 119 2 2 Lunatic Attendant 1 1 32 12. (1) Cowkeeper, Milkseller 124 2 1 1 Persons of no stated tion of Condition 221 4 2 1 1 Cheesemonger 57 1 1 Butcher 275 7 2 4 1 Poulterer 32 1 1 Others dealing in Animal Food 70 2 1 1 Carried forward 8035 197 61 80 53 3 TOTAL 18205 441 125 165 136 15 27 TABLE 11. New Cases of Disease attended by the Poor Law Medical Staff, during the year 1859. DISTRICTS. 1 2 3 4 5 Workhouse. TOTAL.[/##] Small-pox 7 121 61 83 93 3 368 Chicken-pox 4 5 1 2 3 ... 15 Measles 12 67 20 11 39 ... 149 Scarlatina 4 15 39 27 71 ... 156 Whooping-cough 2 29 12 16 13 ... 72 Group ... ... ... 1 1 ... ... Diarrhœa 45 134 147 147 198 33 704 Dysentery 1 4 ... ... 3 ... 8 Cholera ... ... ... ... ... ... ... Ague ... ... ... 1 1 ... 2 Continued Fever 69 137 121 77 67 72 543 Rheumatic Fever 7 9 6 23 18 6 69 Erysipelas 4 9 3 14 9 8 47 Delirium Tremens ... ... ... ... ... ... ... Insanity 5 8 5 8 14 36 76 Bronchitis and Catarrh 31 110 33 92 152 8 426 Diphtheria ... 7 3 ... 3 ... 13 Pleurisy 4 6 5 25 6 ... 46 Pneumonia 24 15 10 23 18 9 99 Puerperal Fever ... ... ... 2 ... ... 2 Pyaemia ... ... ... ... ... ... ... Carbuncle 2 3 ... 1 4 ... 10 All other Diaeaaes 221 679 466 553 713 175 2807 336 660 599 693 666 749 3703 Total 557 1339 1065 1246 1379 924 6510 Deaths 7 44 37 119 71 163 441 28 TABLE 12. Synopsis of Sanitary Works,* from March 26th, 1859, to March 25th, 1860. 1. ARRANGED IN WARDS. Wards Houses Inspected Drains Constructed Drains Trapped North 156 79 81 South 182 66 76 East 74 35 65 West 202 114 120 Totals 614 294 342 Wards Drains Improved Cesspools filled up Cesspools emptied North 42 98 4 South 36 46 17 East 16 58 9 West 78 124 11 Totals 172 326 41 Wards Privies altered to Water Closets New Closets constructed Dust Removals North 110 7 3143 South 59 13 2987 East 60 5 2629 West 130 36 2431 Totals 359 61 11,190 2. MISCELLANEOUS. Sewer Blocks constructed Sewer Ventilators made Gullies Flushed Gullies Trapped and made No. 1 Nos. 12 Nos. 878 Nos. 144 Houses connected with Sewers New Manholes Total Works Nos. 343 Nos. 52 Nos. 14,829 3. ABOUT TO BE COMMENCED. Sewerage Block, No. 9. * For the figures I am indebted to the Surveyor and Inspector, to whom I beg to return my thanks.