Saint Methew,BethnalGreen. SANITARY STATISTICS and PROCEEDINGS FOR THE YEAR ENDING MARCH, 1871; WITH APPENDIX, THOMAS SARVIS, M.D., medical officer of health. LONDON: PRINTED BY ORDER OF THE VESTRY, by j. s. forsaith and sons, bethnal green road, e. 1871. Report, September,. 1871. Gentlemen: In the present Report I have the honour to lay before you, not only the ordinary Vital and Sanitary Statistics, but also those in relation to the Census for the years 1861—71. This shows an increase in the population of our District, as also in the number of our inhabited houses. The population of Bethnal Green in 1861 was 105,101; in 1871 it amounted to 120,200; this is an increase in the ten years of 15,099; and this increase is nearly the same as that which took place in the ten years 1851—61, as will be seen by the following figures, which show the population at the Censuses of 1851, 90,193;—1861, 105,101 ;—1871, 120,200. The 120,200 inhabitants of Bethnal Green are living on 760 acres, which gives a population of 158 persons to the acre; whereas, in 1861, there were only 138, showing an increase of 20 to the acre. They inhabit 15,981 houses, giving an average of 7½ persons to each house; in 1861, the average was only 7 persons to each house; in fact, the density of our population has steadily increased, for, in 1841, there were 6.3 persons per house; in 1851, 6.7 persons per house; in 1861, 7 persons per house; and now, in 1871, the average has risen to 7.5. The District which shows the greatest number of persons per house is the "Town" Registration Sub-Division, which has, in 2573 houses, 21,375 souls, or an average of 8.3 per house. 4 The "Green" Sub-Division has 5558 houses, containing 42,443 persons, giving an average of 7.6 per house. The "Hackney Road" Sub-Division has 4059 houses, with a population of 29,808, or 7.3 per house. The "Church" Sub-Division, with 3791 houses, has a population of 26,574, or 7 per house; so that the "Town" Sub-Division has the greatest, and the "Church" the smallest number of persons to each house. The following Tables will show at a glance the population, with the number of inhabited houses, and average per house, in 1861 and 1871:— 1861. Registration Sub-Divisions. Inhabited Houses. Population. Average per House. Hackney Road 3745 26,298 7 Church 3849 25,528 6.6 Town 2671 21,486 8 Green 4466 31,789 7,1 14,731 105,101 7 1871. Registration Sub-Divisions. Inhabited Houses. Population. Average per House Hackney Road 4059 29,808 7.3 Church 3791 26,574 7 Town 2573 21,375 8.3 Green 5558 42,443 7.6 15,981 120,200 7.5 It will be seen that the "Town" Sub-Division has more persons to the house than heretofore; yet it is the only one in the Parish in which the population has positively decreased during the last ten years. The cause of this diminution is mainly to be ascribed to the demolition 5 of dwelling-houses, required to afford space for the construction of new lines of railway. There are now 98 houses less than in 1861, and the inhabitants have only decreased 111. Now, in this District in 1861, the houses were inhabited by, on an average, 8 persons each; the taking down of 98 houses would dislodge 764 persons; these would have to find other homes, and help to overcrowd this and the neighbouring Parishes. This brings us to the question that must arise in the minds of all Sanitarians—"How to provide healthy homes for the poorer portion of "our increasing population, at a rental within their means, and to give "sufficient space to prevent the demoralizing influence of the indiscri" minate mixing together, in families, of all ages and both sexes?" There is no doubt that such buildings as those erected by Baroness Burdett-Coutts, Mr. Peabody, and Sir Sydney Waterlow, have a great tendency to prevent such a state of things. The rooms are well ventilated, healthy, and conveniently arranged; and I hope that many more of our small unhealthy houses will give place to such handsome and commodious dwellings. Although the ''Town" Sub-Division is the only one in which there is an actual decrease in the population as compared with 1861, the same cause which has produced that result has affected all the other Sub-Districts; and anyone passing from the Goods Station, in Hare Street, to Cambridge Heath, can see the devastation there, not only on the houses demolished for the new line of railway, but also for the new streets. This will be a great improvement when finished; but at present it has considerably diminished the number of residents in the Parish, especially in the "Hackney Road" and "Church" Sub-Division; and I am convinced that, had the Census been taken last year, the population would have been found to be nearer 125,000 than 120,200. DEATH RATE. The deaths during the past year were considerably below the average, the total, from all causes, being 2894, as compared with 3378 in the previous year, showing a decrease of 484. 6 In the deaths from diseases of the Zymotic class, there was a considerable decrease, as will be seen by the Table below: — 1870. 1871. Fever 93 77 Small Pox 2 252 Measles 76 38 Scarlatina 452 107 Diphtheria 16 2 Diarrhœa 148 164 Cholera 4 9 Whooping Cough 172 66 963 715 Total Diseases 248 The decrease was shown principally in Scarlatina, which fell from 452 to 107; Whooping Cough from 172 to 66; Measles from 76 to 38; Fever from 93 to 77. There was a slight increase in the deaths from Diarrhoea, which rose from 148 to 164; and so-registered Cholera from 4 to 9. Upon investigation, however, I found these cases to he English Cholera, and not at all of the Asiatic type. The disease which showed the greatest increase in the number of deaths was Small Pox (see Appendix), which carried off 252 during the past year, against only 2 in that preceding; yet, nevertheless, our total deaths . from Zymotic disease were fewer in number during the year by 248. The total death rate for the whole of London during the past year was 24.12 per 1000, or 1 person died of every 41 living. The average for the Eastern Districts was 25.38 per 1000, or 1 died in every 38 living. The total death rate for Bethnal Green during the .same period was 24 per 1000, or 1 in every 41.5 living, 1 death in every 4 being from Zymotic disease. This shows our death rate during the year to have been slightly under the average of the whole Metropolis, and 1.38 per 1000 under that of the Eastern group of Districts. For the year ending March, 1870, the average death rate for the whole of London was 24.66 per 1000, or 1 person died of every 40.6 living. For 7 Bethnal Green, the death rate for the same period was 27 per 1000, or 1 person died of every 36.7 living, I death in 3.5 being from Zymotic disease. The death rate in the different Registration Sub-Divisions was as follows:—"Hackney Road," with 7.3 persons to each house, 1 died of every 43.7 living, or at the rate of 229 per 1000; in the "Church," with 7 persons per house, 1 of every 51.7 living, or at the rate of 19.3 per 1000; in the "Town," with 8.3 per house, 1 in every 45.5, or 21.9 per 1000; and in the "Green," with 7.6 per house, 1 person died of every 47 living, or at the rate of 21.2 per 1000. This is exclusive of the 271 deaths which took place in the Workhouse, 54 in the Hospital for Consumption and Diseases of the Chest, and 38 in Bethnall House Lunatic Asylum; due allowance is made, however, for the inmates of these Institutions. "We cannot apportion to the general death rate of the "Green" (in which these Institutions are situated), the deaths which took place in those establishments; for if we were to do so, it would appear that 1 person died of every 34.5 living, or at the rate of 28.9 per 1000, thus making the death rate of the "Green" seem much higher than it really is. Of course the deaths in Public Institutions form part of the 2894, which was the total number of deaths which took place in the Parish during the past year, and which form the basis of all the calculations as to our death rate. BIRTH RATE. While the death rate was low, the birth rate was high—5196 births having been registered during the year: this gives 2302 as excess cf births over deaths. The births registered in Bethnal Green during the year were 2641 boys, and 2555 girls: this gives 1 birth to every 23.1 persons living, or a natural increase at the rate of 43.4 per 1000. The rate for the whole of London during the same period was 35.3 per 1000, our birth rate considerably exceeding that of the average of the whole Metropolis. The birth rate in the different Registration Sub-Districts was, in the "Hackney Road," 1 to every 22 persons living, or 45.4 per 1000; the " Church," 1 to 24.8 persons living, or 40.3 per 1000; the "Town," 1 8 to every 23.5 living, or 42.5 per 1000; the " Green," 1 to every 22.6 living, or 44.2 per 1000. The excess of registered births over deaths in this Parish, between the years 1861—71, was 18,201, and our population increased only 15,099; thus there is a total loss of 3102 on our natural increase. The excess of births over deaths does not, however, form the real increase of a population; for emigration and immigration have at all times a most important influence, and must always be taken into account in any estimate upon the subject. For instance: in the "Hackney Road" Sub-District there was registered, between 1861—71, an excess of 5329 births over deaths; yet the population only increased by 3510. There was thus a loss on natural increase of 1819. The "Church" had an excess of births over deaths of 4910, and the population increased by only 1046: loss, 3864. The "Town" showed an excess of births over deaths of 3943; but not only is there the loss of this number, which should naturally form an increase of the population of this division, but we have here positively 111 fewer inhabitants. Now, if there is this loss in our natural increase in these Sub-Districts, what has become of the inhabitants? Some have migrated to other Districts, and others have gone to a Sub-District where many new houses have been built—the "Green." In this division the excess of births over deaths was 4019, and there was an increase in the population of 10,654. This is not only the natural increase, but 6635 added to the population by immigration. PAUPER ILLNESS. The following is tho number of New Cases attended during the year by theDistrict Medical Officers:— District No. 1 Mr. Massingham 1727 Cases. ,, 2 Dr. Welch 1268 „ „ 3 Dr. Richards 1460 „ ,, 4 Mr. Defriez 1623 „ ,, 5 Mr. Burgess 814 „ ,, 6 Dr. Sarvis 924 „ Total 7816 Cases. 9 In May last a change was made in the several boundaries of the Out-door Medical Officers' Districts, and the number was reduced from 7 to 6. Three Dispensaries were established; one Dispenser and two Medical Officers being attached to each; the drugs and appliances were provided by the Guardians. Too short a period has as yet elapsed to form a decided opinion as to the benefits resulting from this arrangement in comparison with that formerly obtaining. I regret to state that Mr. Evans, the Dispenser first appointed to Dispensary No. 3, in Church Row, died January 21st, at the early age of twenty-nine, of Small Pox, contracted in the execution of his duty. Such an event is not surprising, when we consider the number of persons attending the Dispensaries to obtain medicines for patients suffering from this fearful malady, for there were no less than 685 cases attended by the District Medical Officers between September, 1870, and March, 1871. Many of these were of the most virulent type; the Hospital at Hampstead was full, and that at Homerton had not then been opened, so that the Medical Officers had to continue to attend the patients at their own homes; and as many of the cases required visiting daily for two or three weeks, and their medicine to be frequently changed, much extra work also fell to the lot of the Dispensers. Shortly after her bereavement, Mrs. Evans fell ill with the same complaint, and gave birth prematurely to a son. The infant did not live long, but succumbed to the same disease as its father. In this sad state of things, all was done that could be done to comfort the widow in her affliction; nor did she leave Bethnal Green without a substantial acknowledgment by the Board of Guardians, of sympathy for her loss, and of esteem for her departed husband. WORKHOUSE. The number of cases attended in the Infirmary was 2275. There were 108 births here during the year—51 males and 57 females: of the males, 30 were illegitimate; of the females, 36; so that the illegitimate births were in excess of legitimate. 10 DEATHS IN PUBLIC INSTITUTIONS. males. females. total. Workhouses 162 109 271 City of London Hospital 32 22 54 Bethnall Green Lunatic Ayslum 23 15 38 On the night of the Census, the Workhouse contained 1080 persons Inmates:—Males, 530; females, 508; total, 1038. The remainder were master, matron, officers, &c. In the City of London Hospital there were 117 persons. Patients:— Males, 57; females, 42; total, 99. The remainder were medical officers, matron, nurses, &c. In Bethnall Green Lunatic Asylum there were 411 persons Patients:— Males, 130; females, 224; total, 354. The remainder were medical officers, attendants, &c. QUEEN ADELAIDE'S DISPENSARY. The following is the Medical Report of this Charity for the year ending December 31st, 1870:— New Patients have been admitted, who have had Advice and Medicine, Gratis, at the Dispensary, or at their own homes 3131 Have been visited at their own homes 676 "Were so visited during the last week of the year 1870 20 Have been discharged Cured, or not returned their Letters 1937 Ditto, Relieved 1633 Have died 35 "Were still under Medical treatment in the last week of December, 1870 350 The total number of Patients' attendances during 1870 having been 45,036 CITY OF LONDON HOSPITAL FOR DISEASES OF THE CHEST. The following is the Medical Report for the Year 1870:— IN-PATIENTS. Patients under treatment on the 1st January, 1870 100 Admitted since 772 872 Remaining under treatment 31st December, 1870 100 Total under treatment during the year 772 Of these there have been— More or less relieved 713 Died 59 Patients admitted from the opening of the Wards in 1855, to Dec. 31, 1870. 7299 11 OUT-PATIENTS. Under treatment on the 1st January, 1870 1050 Admitted since13,128 14,178 Remaining under treatment on the 31st December, 1870 1004 Total treated during the year 13,174 Patients admitted, from the opening of Institution in 1848, to the 31st December, 1870 183,721 Average attendance of Out-Patients each week 1077 COW-HOUSES AND SLAUGHTER-HOUSES. The application for licences for new Cow-houses were as follows:— Job Mansfield, Digby Street; William Robert North, White Street; John Elliott, 1, Vivian Road; William Filley, 5, Virginia Row; J. Moss, for renewal of licence of 4, Essex Street, Three Colt Lane; Joseph Wise, Three Colt Lane (who has had his cow-house pulled down to make space for railway), applied for licence to 87 Arch. The Sanitary Committee having inspected the premises, it was resolved not to oppose the applications; consequently, the licence was granted in each case. The applications for licences for new Slaughter-houses were as follows: William Dupuy, 218, Green Street; William Hornsey, 6, Barnet Street; Thomas Philip Howes, 1, King Street, Bethnal Green Road; Robert Cleare Mears, 172, Green Street. The premises sought to be licensed were viewed by the Sanitary Committee, and the applications were granted, with the exception of Mr. Howes'. This was opposed on the ground that Mr. Howes, who is a baker in the Bethnal Green Road, applied for the licence for his son, who is a minor, and because the premises were ill adapted for the purpose. The licence was opposed, and consequently refused by the Magistrates. The number of Cow-houses is 46, viz:— Bailey, John 46, Somerford Street Boakes, "William 12, Barnet Street Brace, Edward Oval, Hackney Road Bunn, John Lisbon Street 12 Cow-houscs (continued):— Chamberlain, "William 8½, North Street Childs, James17, Coventry Street Coleman, Isaac Spencer Passage, Hackney Road. Ditto 399, Hackney Road Davies, Richard 64, Squirries Street Day, Thomas Hanchard 21, West Street Dupuy, William, 218, Green Street Ditto Cranbrook Road Edwards, Edward 4, Boundary Street Edwards, Micah 3, Birdcage Walk Elliott, John 1, Vivian Road Filley, "William 5, Virginia Row Grcenslade, John12, East Street Griffiths, Humphrey 4, William Street Harrington, Thomas12, Gibraltar Walk Hills, "William 46, Edward Street Hodges, William Manners Digby Street Holloway, William 4, Albion Street Jones, Edward 4, Sclater Street Laurie, John 1, Gibraltar Walk Lockyer, John Henry 8, Minerva Street Maddams, Williams 23, Old Castle Street Mann, James 1, Three Colt Lane Mansfield, Job Digby Street Marchant, John 8, James Street, Barnet Street Meredith, Evan 8, Edward Street Moore, William 389, Bethnal Green Road Moss, J 4, Essex Street North, William 8, Essex Street North, William Robert White Street Parsons, William 45, Gloucester Street Pettit, William 24, Bacon Street Ditto 26, Ditto Reynolds, George 10, Elizabeth Street Robinson, Rebecca 44, Squirries Street Skinner, Frederick 18, Prospect Place Stapleford, Alfred 3, Russia Lane Starbuck, Joseph 5, Gloucester Place, Cambridge Heath Stephenson, Charles 381, Cambridge Road Ward, Joseph 31, Austin Street Wisby, Samuel 15, Norfolk Street Wise, Joseph 87 Arch, Tapp Street 13 The number of Slaughter-houses is 54, viz.:— Attwell, Orlando Thomas 278, Hackney Road Barwell, Alfred 11, Chester Place, Green Street Budd, Honry 482, Bethnal Green Road Bull, Benjamin 161, Green Street Button, Edwin 326, Hackney Road Carpenter, James 202, Hackney Road Chittenden, Thomas Robert Canrobert Streot Coram, John James 515, Hackney Road Day, Thomas Hanchard 21, West Street Dupuy, William 218, Green Street Emblem, Elizabeth 112, Bethnal Green Road Freeman, William John 20, Hackney Road Galloway, Joshua 47, Bethnal Green Road Gray, Richard 212 Bethnal Green Road Green, Joseph Abbott 226, Hackney Road Gregory, George 291, Cambridge Road Groves, Catherine 140, Brick Lane Harman, Charles 397, Hackney Road Harris, John William 3, Heath Place, Cambridge Heath Hornsey, William 6, Barnet Street, Birdcage Walk James, Susan Burgess 334, Hackney Road Kingston, Ann 360, Bethnal Green Road Knight, Charles 145, Brick Lane Lisenden, John 1, Essex Street, Cambridge Road Long, Isaac 2, Essex Street, Cambridge Road Mason, George 416, Bethnal Green Road Mead, Henry 349, Cambridge Road Meadway, George 354, Bethnal Green Road Mears, Robert Cleare 172, Green Street Morley, John 76, Hare Street Payne, John 124, Brick Lane Penny, Henry 5, Hinton Street Pollard, James 224, Bethnal Green Road Proye, Joseph 156, Hackney Road Read, James 294, Bethnal Green Road Richard, Daniel 44, Brick Lane Roan, William Vaughan 317, Cambridge Road Robinson, Frederick 17, Cambridge Road Rolfe, Robert 25, Cambridge Road Simmond, S. R 252, Green Street Skinner, Frederick 18, Prospect Place 14 Slaughter-houses (continued):— Stacey, Charles Frederick 88, Bethnal Green Road Stevenson, Charles 381, Cambridge Road Sutton, Mary Ann 4, Essex Streot Turpin, Esther 21, Old Ford Road (Bates' Place) Volland, Charles 240, Bethnal Green Road "Wagstaff, Henry 29, Green Street "Watson, William 470, Bethnal Green Road Willkina, Charles 3, Wellington Streot Woods, Henry 469, Hackney Road Wooster, Henry 131, Brick Lane Wragg, John 247, Bethnal Green Road Wright, William 31, Lisbon Street Youdan, George1, Middle Row, Green Street MEAT. The carcass of a heifer was seized, on August 27th, at the rear of 422, Bethnal Green Road: it was taken to "Worship Street, and there condemned by the Magistrate, and a summons granted against J. Mills, the owner. The case was one of a most unusual character, inasmuch as the heifer had been taken into a private stable, killed with a common hammer in a brutal manner, and dressed in a very rough style. There can be little doubt that had the seizure not been made, the meat would, in a few hours, have been converted into sausages. When the hearing came on, the defendant did not appear, and a warrant was issued: this was never served, however, as the offender, fearing the consequences of his act, absconded, and has not since been heard of. Two pieces of beef were seized, on November 10th, by Inspector J. W. Burrows, at a chopping-house in the occupation of Mr. Cousins, situated at Beehive Wharf, Pritchard's Row. It was stated, and afterwards proved in Court by evidence, that the pieces of beef had not been bought by Cousins, but had been sent to him by a meat salesman of the name of Sketchley, who resides close to the City of London Meat Market, but just outside the City boundary. The owner of the meat was summoned to Worship Street, when Cousins gave evidence that he had never bought the meat, but that it had been sent to him to use, and that he found it so bad that he declined to do so. The defendant was fined £3 and costs, 15 I believe that this prosecution has had a most salutary effect on the meat salesmen, and also on the sausage makers in the Parish ; for, under the most careful supervision, no fresh seizure has been made since this case. FISH. On August 5, 1870, sixty-eight trunks of haddocks, in a putrid condition, were found in the possession of Mr. William Reed, a wholesale fish salesman in Columbia Market. It had come to the knowledge of Inspector W. W. Burrows that some men had been sent to different smoke-houses to get these haddocks smoked for the purpose of sale. In company of the Inspector, I proceeded to the Market, and when about to seize the fish, was prevented from so doing by some of the employees, abetted by the Market Inspector, who said he had already condemned them, and that we had no jurisdiction there. The men at once proceeded to load the fish in a van, which had been hired in the neighbourhood, and it was not without great difficulty—for the men were very violent—that we succeeded in seizing one trunk of the haddocks. They were taken to Worship Street, and condemned by the Magistrate. A summons was granted, and the defendant fined £10 and costs. This decision was most satisfactory, as the Sanitary Staff have since been able to inspect the fish in the Market without molestation from the employees or others. Mr. Reed has since left the Market. We continue to condemn fish brought to us, as we find it acts beneficially upon costermongers and others; for it often happens, that when these poor people get the fish home from market, it is in a putrid condition. When that is the case, they bring it to myself, or one of the Inspectors, and have it condemned: a certificate is given, and the money is returned by the wholesale dealers; thus is prevented the sale of large quantities of unwholesome fish. There was condemned during the year 77½ pads, 19 barrels, 7 flats, 7 kits, 5 bags, 8½ turns, 4 trunks, 5 boxes: these consisted of soles, eels, cod, plaice, maids, herrings, haddocks, crabs, shrimps, &c. FISH-CURING IN PEEL GROVE. On October 6th, a complaint was made by some of the inhabitants of 16 Peel Grove that the fish-curing process, as carricd on by Mr. Cushway in that locality, was a nuisance, and injurious to health, and the Vestry was asked to take steps for its removal or abatement. The matter was referred to the Sanitary Committee. Previous to this date I had visited the premises on several occasions, and on Friday, October 7th, between five and six o'clock p.m., without any previous notice to the proprietor, and in company of the members of the Committee, I again inspected tho establishment, saw the fires lighted, and had the whole process thoroughly explained by the foreman. At the next meeting of the Vestry, on October 20th, the following Report was presented and read:— TO THE VESTRY OF ST. MATTHEW, BETHNAL GREEN. Gentlemen, I have to report upon the business of Fish Curing or Smoking, newly set up in Peel Grove, on premises occupied by William Cushway; and it will be my endeavour to place the facts before you, so that you may be able to judge whether the process can be carried on without being a nuisance and injurious to the health of the surrounding inhabitants. The premises under consideration are situated about the centre of a block of houses, bounded on the north by Patriot Square, and that part of Peel Grove running parallel with it; on the east, by Peel Grove; on the south, by Victoria Park Square, and a part of the Old Ford Road; on the west, by Cambridge Road. These premises are over 70 feet from the roadway, and are nearly 29 feet from the nearest dwelling house. In length they are about 120 feet; breadth, 55 feet; height, to top of wall, 12 feet. The roof is open and slanting, and rises 7 feet in the centre. In the middle is the smoke-house. This is well built; the lower portion principally of brick, the upper of wood, which mainly consists of doors and shutters, by opening or closing which the draught to the fires is regulated. This building is 45 feet long by 11 feet 6 in. wide; at its highest part it is 19 feet 6 in., and is divided into four compartments, two of which are 13 feet by 10 feet; the other two are 7 feet 6 in. by 10 feet (inside measurement). These compartments communicate with each other, at the lower part, by doors, which can be shut if needed, so that one or more compartments can be used, accord, ing to the number of fish required to be smoked. The space around the smoke-house is used for the stowage of barrels, baskets, wood for the fires, and utensils of trade. Where the fish are washed it is well paved; there is a plentiful supply of water, and good drainage. The business is carried on as follows: Fish—principally herrings—are brought in the morning; they are then washed and thoroughly cleansed, threaded on sticks, and are so put on as not to touch each other; they are then placed in the smoke-house, at the highest part first, and so from above downwards, until it is filled to within seven or eight feet of the floor. 17 Now, up to this point, there is nothing at all deleterious to health, if the fish are fresh and the premises are kept clean; but, about six or seven in the evening, when the fires are lighted, the objectionable process bogins; there are no fireplaces; a log of wood— usually the stump of an oak tree—is placed on the floor; then it is ignited by setting fire to chips, and leaving the doors open to create a draught to set the log burning. When this is accomplished, the smoking goes on for six or seven hours; the fish is then fit for sale; the men come between twelve and one a.m. to pack and send them to market early, so that they are frequently eaten the day after they are cured. It is in the process of smoking that the nuisance is said to occur; for it is by the slow combustion or destructive distillation of wood that the gases aro evolved necessary for curing the fish. These consist of carbonic acid gas, pyroligneous or acetic acid, tar acid, &c., all of which are irritants to the lungs; but it is necessary that the fish should become impregnated by these gases to give them their flavour. I am not aware that any method has been invented by which fish can be cured so as to prevent the liberation and diffusion of the gases before mentioned. These premises have been visited by the Sanitary Committee, and frequently by myself and staff. We have always found extreme good order and cleanliness. Having given you these facts, I must leave it for you to decide what course of action shall be taken in the matter. I am, Gentlemen, Yours obediently, THOMAS SARVIS, 350, Bethnal Green Road, Medical Officer of Health. October 20th, 1870. After some discussion, it was resolved not to take any steps at that time, but to leave it in the hands of the Sanitary Committee for further investigation. After this I visited the premises several times, both during the day and at night, and found them in the same condition as they were when reported upon in October. I conferred with the proprietor, and discussed with him several suggestions thrown out by different persons, each of which, it was said, would prevent any nuisance arising; but he was of opinion that none of these suggestions were of a practicable nature, and would involve the spending a large sum of money without any commensurate benefit. Subsequently to the date to which this report extends, a summons was taken out by Mr. Taylor, an inhabitant of Peel Grove, against Mr. Cushway, charging him with carrying on a business injurious to the B 18 health of the surrounding neighbourhood. The case was heard before Mr. Bushby, at "Worship Street, on April 4th, and the charge dismissed. The following is a copy of the report of the case as it appeared in a local paper, of April 8th:— "THE ALLEGED SMOKE NUISANCE IN PEEL GROVE. "On Tuesday afternoon, at Worship Street Police Court, Mr. Cushway, the proprietor of the fish-curing premises in Peel Grove, appeared before Mr. Bushby to answer a summons taken out by Mr. Taylor, an inhabitant of Peel Grove, charging him with carrying on a business injurious to the health of the surrounding neighbourhood. Mr. Abbott, solicitor, appeared to prosecute, and Mr. Montague Williams, barrister (instructed by Mr. Pelham, solicitor, of Stepney), attended on behalf of the defendant. Several members of the Bethnal Green Vestry, connected with the Sanitary Department, were present in Court, and were prepared to prove that the business in question was not in any way prejudicial to the health of the inhabitants in its vicinity. "The prosecutor and two others having been examined in support of the summons, Mr. Abbott called— "Mr. John Paterson, who having been sworn, said—I have been a resident in Peel Grove for some years. I believe the premises in which the defendant carries on his business are situated within forty feet of my house. There are from forty to sixty traps from which the smoke complained of issues in immense volumes. When the process of smoking is in full operation, the premises appear like a huge building of fire. The effect of the smoke upon me has been highly injurious. I have at times been seized with a fit of coughing so violent that blood has gushed from my nose and mouth. Of late the nuisance has not been so bad, but we have experienced it more or less ever since last August. I have lived in Peel Grove for fourteen years. On some occasions the effect of the smoke has been such that I have been obliged to get out of my bed in the night to save my wife and children from 'strangulation,' the smoke having penetrated our dwelling in such great volumes. "By Mr. Williams—I am a qualified chemist and scientific analyst. The premises in question are at least within fifty feet of my house. "The learned Counsel then proceeded to call the attention of the witness to a report given in a contemporary of a tragical scene that was enacted at a meeting of the Bethnal Green Vestry, in which Mr. Paterson took the leading part, and gave a striking exhibition of his native eloquence. "Mr. Williams—Was it you who, on going before the Vestry in reference to Mr. Cushway's place, called the members ' swine,' and said ' To hell with you all, you villains ?' "Mr. Paterson—That's not a correct report, sir. I come here for justice, and hope I shall get it. But I say it is a great injustice for me and my family to be subjected to suffocation. My wife's health (getting very excited) is much injured by the smoke, and she has not been able to attend properly to her duties in consequence. There are some dyeing works in immediate proximity with defendant's premises. 19 "Ann Meed said she had lived with her husband in Peel Grove for three years. She complained that the smoke entered her dwelling day and night, and was, she considered, injurious to their health. "Robert Gurnell was next sworn. He said—I reside at 17, Peel Grove, and am a letter carrier. The distance from my house to the wall separating defendant's premises from my yard is exactly 36 feet 5 inches. I have lived there for ten years. The smoke has had the effect upon me of producing sickness and headache, and I have been under medical treatment for the same. The curing-house has seemed as if it was on fire ; and the quantity of smoke emitted therefrom at night has been so great that our bedroom has frequently been filled with it. The smoking usually commences at five or six in the evening, and continues till the hour of four or five in the morning, every day in the week, Sunday included. "Dr. Tripe, medical officer of health for Hackney.—The substance of his evidence was, that the symptoms complained of by previous witnesses were identical with what he had met with in persons in his own district who lived close to places where haddocks were cured. But the process of preparing haddocks for market was much more offensive than anything that could arise from the premises now in question. "In addressing his worship for the defence, Mr. Williams intimated that these proceedings had mainly arisen from the circumstance that a lodger had left the prosecutor and gone to live with the defendant. The sufferings described by Mr. Paterson were quite likely, owing to the excitability of his temperament, of which he had given proof in Court, for he seemed fit to jump out of the witness box. This witness had applied to the local authorities, who, after fully investigating his complaint, did not consider it deserved to be entertained. Mr. Paterson and his friends then collected a number of old ladies, and put them in the witness box to say that they suffered with sickness and headache, and some of them said they were in a consumption. Yet only one of the females had been accompanied by her husband. Mr. Williams then said that he would at once call upon Dr. Letheby, who was a great authority upon matters of this kind, and whose evidence alone would suffice to show that complainant had no ground whatever for the proceediugs he had instituted. "Dr. Henry Letheby was then sworn. He deposed—I am medical officer of health for the City of London, and have had great experience in manufacturing processes generally. I have seen the premises of Mr. Cushway in full working operation. With respect to the effect produced by the business conducted there, I would observe, that in fish-curing there are two distinct operations—one is smoking, the other is drying. In the former sulphur is largely employed; but no sulphur is used by the defendant at these premises, for the operation carried on is simply that of drying. On visiting the place I was astonished that it should have been the subject of any complaint. If litigation in cases like this were to be encouraged, the whole business of the country would be brought to a standstill. The complaint is a most trifling one. I noticed particularly, that although the process has been carried on so long, yet the quantity of smoke generated has been only sufficient to barely stain the woodwork. The fumes evolved do not, I am satisfied, contain anything noxious or likely to injure health. 20 " By Mr. Abbott—There are four smoke rooms. The traps are opened to let out the heat rather than the smoke. The fires in the neighbouring streets produce much more smoke than there emanates from these premises. " Mr. Abbott—But the neighbouring houses burn different wood ? "Dr. Letheby—Certainly they do. They burn wood of a much worse description. These premises arc simply U3ed for drying the fish—not for smoking them. I should say with regard to some of the effects complained of by some of the witnesses, that either their symptoms were monstrously exaggerated, or were due to some other cause. I am so well acquainted with this sort of thing, that it would have been impossible for anyone to practise any deception upon me on my visiting the premises. "By Mr. Williams—The smoke from any wood which is employed by the defendant is not irritating. I do not think it possible for anyone in the neighbourhood to have had his room filled with smoke, unless there was some other source for the smoke. "By the Magistrate—There is not the least smell of fish with the smoke given off— the smell is just like that of a wood fire in the country. "Dr. F. Aubin said he entirely agreed with the evidence given by last witness. He had had considerable experience with respect to these matters; there was nothing obnoxious or detrimental to health in the vapours issuing from the premises of defendant. There were fish-curing houses which were offensive ; but those were places where haddocks were cured, and where the parties employed mahogany and common sawdust, smoke from which would cause irritation. But nothing of that kind is used at these premisos, which I consider a perfect model. "Further evidence of a voluminous character was taken, showing that the business of Mr. Cushway was so conducted as not to give rise to any smell of an offensive kind from the fish; and overwhelming evidence was adduced to show that the 6moke complained of by a convention of old ladies was, in reality, no nuisance at all. "The Magistrate, in reviewing the evidence before him, said—Dr. Tripe had only succeeded in raising a suspicion that there was a nuisance ; but the evidence on the other side was perfectly irresistible, and the summons must therefore be dismissed."—Bethnal Green Times, April 8, 1871. I have since frequently visited the premises, and have always found them clean and in good order, and in consequence of the above decision, no further legal steps have been taken up to the present time. WORKSHOPS ACT. Many workshops have been visited, and our best endeavours have been used to induce the employers to conform to the regulations of this Act, and I am happy to say that, in most cases, we have met with success. 21 SANITARY MISCELLANEA. The Report of the Sanitary Inspectors gives the following results:— Houses Inspected 6752 Notices Served 2890 Compulsory Notices Served 583 Summonses Issued 48 Number of Summonses Heard 43 Number of Visits to ascertain the Progress of Work required to be done under Notices Served 12,334 Workshops Inspected 495 Work Executed in compliance with Notices Served. Houses Cleansed and Purified 1751 Houses Closed as unfit for Human Habitation 29 Cases in which Defective Drainage has been remedied 1301 Cesspools Abolished 29 Closets Cleansed and Purified 2062 Privy Accommodation Provided 0 Urinals Cleansed 414 Removals of Accumulations of Dung and other Offensive Matter 179 Animals Removed in consequence of being a Nuisance, or kept in a Condition Injurious to Public Health 138 Slaughter-Houses Cleansed 46 Cow-Houses Cleansed 54 Workshops Cleansed 329 SCAVENGING AND DUSTING. This department has been much neglected during the year; but I have every reason to believe that, under the contracts just entered into, they will be better performed. Thanking the Vestry, and especially those Members forming the Sanitary Committee, for their cordial co-operation and support, I have the honour to remain, Gentlemen, Yours obediently, THOMAS SAEYIS. TABLE I. Shewing the Births and Deaths for each District and Quarter, for the Year ending March, 1871. Districts. BIRTHS For each District and Quarter. Districts. BIRTHS (Male and Female), for each District and Quarter. 1st Qr. 2ndQr. 3rd Qr. 4th Qr. Totals. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. M. F. M. F. M. F. M. F. Hackney road . 322 359 349 319 1349 Hackney road . 170 152 165 194 179 170 159 160 1349 Church 275 257 249 287 1068 Church 143 132 140 117 125 124 143 144 1068 Town 244 224 211 229 908 Town 127 117 120 104 100 111 127 102 808 Green 457 469 438 507 1871 Green 221 236 233 236 225 213 264 243 1871 Totals .... Totals 1298 1309 1247 1342 5196 661 637 658 651 629 618 693 649 5196 Districts. DEATHS For each District and Quarter. Districts. DEATHS (Male and Female), for each District and Quarter. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Totals. M. F. M. F. M. F. M. F. Hackney road 125 164 200 192 681 Hackney road . 68 57 83 81 97 103 95 97 681 Church 121 120 119 154 514 Church 72 49 66 54 54 65 79 75 514 Town 81 133 104 151 469 Town 40 41 68 65 54 50 79 72 469 Green 261 304 312 353 1230 Green 150 111 164 140 156 156 183 170 1230 Totals Totals 588 721 735 850 2894 330 258 381 340 361 374 436 414 2894 1870-71. Total Births 5196. Total Deaths 2894. Excess of Births 2302. TABLE II. Shewing the Deaths from all Causes in the Year ending March, 1871. CAUSES OF DEATH. DEATHS. First Quarter. Second Quarter. Third Quarter Fourth Quarter. Total.. Fever 14 17 24 22 77 Small Pox 9 29 67 147 252 Measles 9 11 12 6 38 Scarlatina 16 29 40 22 107 Diphtheria and Malignant Sore Throat - - 1 1 2 Diarrhoea 11 132 13 8 164 Cholera - 8 1 9 Dysentery 1 1 - 2 \V hooping Cough 19 6 21 20 66 Croup 10 7 13 17 47 Erysipelas 5 4 11 3 23 Diseases of the Abdominal Organs 22 17 22 22 83 Bronchitis, Pleuritis, and Pneumonia 88 54 162 182 486 Phthisis 91 80 75 78 324 Hydrocephalus and Convulsions of Infants 59 48 44 75 226 Mesenteric Disease and Marasmus 53 79 39 32 203 Dropsy 17 12 11 18 58 Cancer 9 8 9 4 30 Hernia - 2 1 1 4 Diseases of the Heart and Large Blood Vessels 30 32 28 32 122 Apoplexy, Paralysis, and other Diseases of the Brain 43 38 33 38 152 Childbirth, and Diseases incident thereto 5 5 12 9 31 Premature Birth, and Debility from Birth 33 39 26 20 118 Teethinsr 5 5 5 9 24 Old Age and Natural Decay 25 30 32 48 135 Violence, Privation, and Poison 11 8 19 20 58 Other Diseases, chiefly Chronic 3 20 14 16 53 Totals 588 721 735 850 2894 TABLE III. Shewing the Deaths from all Causes, at different Ages, during the Year ending March, 1871. CAUSES OF DEATH. DEATHS OF PERSONS OF THE AGES Under 5 years. 5 and under 10. 10 and under 20. 20 and under 30. 30 and under 40. 40 and under 50. 50 and under 60. 60 and under 70. 70 and upwards. Total of all Ages. Fever 15 16 14 11 5 6 4 6 - 77 Small Pox 170 47 15 10 8 2 - - - 259. Measles 34 3 1 - - - - - - 38 Scarlatina 81 17 3 5 1 - - - - 107 Diphtheria and Malignant Sore Throat 2 - - - - - - - - 2 Diarrhoea 146 - - - 1 1 2 5 9 164 Cholera 9 - - - - - - - - 9 Dysentery 2 - - - - - - - - 2 Whooping Cough 64 2 - - - - - - - 66 Croup 42 4 - 1 - - - - 47 Erysipelas 15 - 1 - 9 1 4 23 Diseases of the Abdominal Organs 23 4 4 7 11 10 14 9 1 83 Bronchitis, Pleuritis, and Pneumonia 242 15 11 5 93 32 45 67 46 486 Phthisis 14 5 25 86 74 55 44 20 1 324 Hydrocephalus and Convulsions of Infants 226 - - - - - - - - 226 Mesenteric Disease and Marasmus 203 - - - - - - - - 203 Dropsy 14 2 1 - 4 6 16 9 6 58 Cancer - - - - 6 9 7 7 1 30 Hernia - - - - - - - - 2 4. Diseases of the Heart and Large Blood Vessels 2 4 1 9 20 92 94. 90 19 1 99 Apoplexy, Paralvsis, and other Diseases of the Brain - 1 5 6 12 26 28 30 35 152 Childbirth, and Diseases incident thereto - - 2 16 7 2 3 - - 31 Premature Birth, and Debility from Birth ii8 - - - - - - - - 11s Teething 24 - - - - - - - - 01 Old Age and Natural Decay - - - - - - 2 19 114. 1 35 Violence, Privation, and Poison 34 3 2 2 4 4 4 3 2 58 Other Diseases, chiefly Chronic 26 4 4 3 3 2 3 4 4. 53 Totals 1506 127 89 160 182 179 197 210 244 2894 TA. 4 IV. SHEWING THE CAUSES OF DEATH FOR EACH DISTI ???ND QUARTER, FOR THE YEAR ENDING MARCH, 1871. CAUSES OF DEATH in DISTRICTS. Fever. Small Pox. Measles. Scarlatina. Diphtheria and Malignant Sore Throat. Diarrhoea. Cholera. Dysentery. Whooping Cough. Croup. Erysipelas. ??? ??? Pneumonia. Phthisis. Hydrocephalus and Convulsions of Infants. Mesenteric Disease and Marasmus. Dropsy. Cancer. Hernia. Diseases of the Heart and Large Blood "Vessels. Apoplexy, Paralysis, and other Diseases of the Brain. Childbirth, and the Diseases incident thereto. Premature Birth and Debility from Birth. Teething. Old Age and Natural Decay. Violence, Privation, and Poison. Other Diseases, chiefly Chronic. TOTAL. Hackney road—1st Quarter 3 6 3 1 0 5 0 0 11 4 1 18 11 16 15 5 0 0 4 5 1 5 1 3 2 2 125 5 1 3 3 0 1 0 0 4 4 1 19 22 9 12 2 4 0 3 6 2 6 2 1 5 0 121 Town ........ ,, 1 1 2 5 0 2 0 1 1 1 1 11 14 13 9 3 1 0 1 3 1 5 0 3 0 0 81 Green „ 5 1 1 7 0 3 0 0 3 1 2 1 40 44 21 17 7 4 0 22 29 1 17 2 18 4 1 261 Total 14 9 9 16 0 11 0 1 19 10 5 3 88 91 59 53 17 9 0 30 43 5 33 5 25 11 3 588 588 Hackney road—2nd Quarter 8 12 3 6 0 30 2 0 0 2 1 17 10 14 25 2 2 0 6 5 2 7 3 0 0 4 164 Church. ,, 4 0 2 9 0 23 2 0 0 1 1 15 10 6 10 2 2 0 3 5 1 13 0 1 1 5 120 Town . ,, .. 2 15 2 4 0 33 2 0 1 1 0 10 10 11 8 1 3 0 4 9 1 1 2 3 5 2 133 Green „ 3 2 4 10 0 46 2 1 5 3 2 12 50 17 36 7 1 2 19 19 1 18 0 26 2 9 304 Total 17 29 11 29 0 132 8 1 6 7 4 54 80 48 79 12 8 2 32 38 5 39 5 30 8 20 721 721 Hackney road—3rd Quarter 5 33 2 17 0 3 1 0 13 0 3 43 14 10 18 2 0 0 4 3 5 7 1 2 6 6 200 Church „ 4 4 1 8 1 3 0 0 4 4 1 29 10 7 4 3 1 0 2 7 2 9 2 4 2 1 119 Town ,, 8 23 0 2 0 1 0 0 0 3 1 29 6 12 4 0 0 0 4 1 0 1 1 0 3 1 104 Green „ 7 7 9 13 0 6 0 0 4 6 6 61 45 15 13 6 8 1 18 22 5 9 1 26 8 6 312 Total 24 67 12 40 1 13 1 0 21 13 11 162 75 44 39 11 9 1 28 33 12 26 5 32 19 14 735 735 Hackney road—4th Quarter 6 55 1 3 1 3 0 0 7 6 0 36 17 13 10 0 2 0 2 7 0 4 2 7 7 1 192 Church ,, .. 5 35 2 4 0 1 0 0 5 4 0 39 12 16 5 2 1 0 7 4 0 2 0 4 1 3 154 9 ?S 0 5 0 0 0 0 2 1 0 34 9 19 4 2 0 1 1 4 3 6 3 a 5 5 151 Green „ 2 29 3 10 0 4 0 0 6 6 3 73 40 27 13 14 1 0 22 23 6 8 4 32 7 7 353 Total 22 147 6 22 1 8 0 0 20 17 3 182 78 75 32 18 4 1 32 38 9 20 9 48 20 16 850 850 Total 2894 Appendix. SMALL POX. The present epidemic of Small Pox, which is now happily subsiding, assumed its present type in London about the middle of last year, but did not much engage public attention until October 8th, when the RegistrarGeneral reported, in his weekly returns, that "tho number of deaths registered last week from Small Pox was unusually large, namely 27; 9 of the fatal cases were returned from the Sub-District of Islington West, 8 of which occurred in the Small Pox Hospital between the 2nd and 8th instant." The disease continued to prevail, and in the first week of November it carried off 23 persons; in the second week, 40; in the first week in December, 60; and in the last week of 1870, 110. The increase still went on until tho first week in May, when it reached its culminating point, when no fewer than 288 deaths took place from this dire scourge. Whilst the Metropolis generally was suffering, Bethnal Green remained comparatively exempt up to the month of December, when the disease commenced to show itself, with its characteristic virulcnce. The locality first visited was that behind Shoreditch Church, including Old Nichol Street and New and Half Nichol Streets, where its ravages were most severely felt. The outbreak of the disease in this neighbourhood entailed a large amount of arduous work on the part not only of the Parochial Medical Officer of the District, but also on the Sanitary Inspector, Mr. W. W. Burrows, who had to visit each place where a case was reported, 0 0 11 and to serve notice on the owner in regard to disinfecting and cleansing the premises, at the same time supplying their occupants with disinfectants for immediate use. The epidemic continued its course in a south-easterly direction, while it still maintained its grasp on the district surrounding the locality of its first appearance. At that period no special Hospital had been opened for the treatment of patients suffering from this loathsome complaint. About this time a Special Small Pox Committee was formed, to whom the following Report was presented:— MEDICAL OFFICER'S REPORT. 4th February, 1871. Gentlemen : By desire of the Sanitary Committee, I beg to lay before you a statement of the proceedings tbat have been taken to prevent the spread of the present epidemic. You will remember that, owing to the prevalence of Small Pox, a Committee was summoned on December 20th last to consider the subject. After the meeting, some premises were viewed, which were deemed suitable to be converted into a Hospital; but as the patients that required accommodation were chiefly of the pauper class, the Guardians were waited upon and urged to take premises; and Pembroke House was suggested. The Board at this time declined to take action, as there was more accommodation to be provided at Hampstead, and the Hospital at Homerton was soon to be opened. The Yestry also at that time saw no reason for providing a Hospital, for the reason before mentioned, that the patients requiring it were mainly of the pauper class. The Sanitary Inspectors were then set vigorously to work to discover cases. The Clergy were written to, as also the Medical Men, who have had stamped forms for return of cases. The Registrars have had forms, so as to get early information of deaths, and the District Medical Officers' books have been periodically examined; but as many persons conceal their illness, no accurate and reliable return can be obtained. All known cases have been visited, disinfectants liberally supplied, and beds burnt, and replaced where necessary. Placards have been issued cautioning parents against sending children to school from infected houses, and pressing upon them the necessity of vaccination. Cards are being prepared for the purpose of informing the Vaccinating Officer of infected Districts ; also some cards, to be distributed by the Sanitary Inspectors, giving name, place, and time of attendance of appointed Vaccinators. All these means have been taken without, I am sorry to say, any abatement of this dreadful disease. The Hospital at Hampstead is full; the one at Homerton, opened on - iii the 1st instant, is rapidly filling; so that, if the disease goes on as it has done for the last few months, there will shortly be no place for the reception of patients from this District; and as isolation is of the first importance, 1 trust you will take into your serious consideration the necessity for providing Hospital accommodation. If you decide upon doing so, the best course to be adopted would be to get premises easily adaptable for the purpose, and without delay have them fitted up for use. If such premises cannot be obtained, then a piece of ground should be hired, and a temporary Hospital erected thereon immediately. The next in importance is a mortuary; and there is no doubt that such a building for the Parish is a necessity, for it often happens that a person who has died of contagious disease is left in a room for two or three days where the family are living. Then comes a disinfecting apparatus. This also is a necessity, because we require it at all times. The one I recommend is patented by Fraser & Co., Commercial Road, as I believe it to be the most perfect yet made. It covers a space of about eight feet square (this could be placed in any building), and a truck is made just large enough to fit it. The truck is sent to the people's houses, the bedding, &c., is put into it, it is then wheeled into the disinfecting room, and is disinfected with the clothing, &c. The mortuary and disinfecting apparatus should certainly be placed together, so that the same person should attend to both, and thus save expenses; and if a plot of ground was bought, you could place hospital, mortuary, and disinfecting apparatus together. I remain, Yours obediently, THOMAS SARVIS, Mcdical Officer of Rtalih. February 4, 1871. No action was taken on this Report, but several meetings were held by the Committee, with a view of establishing a Hospital under the control of the Vestry. Various sites were inspected, but as none which were considered eligible could be obtained, and for the reasons mentioned in my Report of February 4th, it was deemed advisable—the Small Pox Hospital at Homerton having in the interim been opened—to leave the matter in the hands of the Metropolitan Asylum District Board. The disease continued to prevail, and extended itself in a south-easterly direction, visiting, in its progress, Sclater Street, Hare Street, St John Street, Church Row, and the streets adjoining. Cases also occurred in Winchester Street, Scott Street, and North Street; but it displayed special virulence among the inhabitants of that poor and densely populated iv locality in which are situated Trafalgar Place, Duke Street, Wellington Street, Collingwood Street, and those small streets on the eastern confines of our Parish. While it was raging in this part, it still continued, though in a milder degree, in the streets at the back of Shoreditch Church, and the northwest portions of the Parish generally; nor is it passing away without having visited the streets abutting on the Hackney Road, and also extending, in an eastern direction, to Green Street, Digby Street, Cranbrook Street, Globe Street, &c. In fact, no portion of the Parish wholly escaped, and all the District Medical Officers had a large amount of additional labour thrown upon them, as will be seen from Tables annexed:— The number of New Cases of Small Pox attended by the District Medical Officers during the Quarter ending December 31 st, 1870, and the Deaths which took plact during the same period:— OCTOBER NOVEMBER DECEMBER Total. 8 15 22 29 5 12 19 26 3 10 17 24 31 1. Massingham 1 1 4 3 • • 1 10 2. Welch 1 4 2 6 2 2 17 3. Richards 1 1 2 1 2 3 4 3 2 2 3 3 9 36 4. Dkfhiez 3 2 5 4 5 3 5 3 7 14 11 26 5 93 5. Burgess 1 4 1 4 2 1 5 3 3 7 2 33 6. Sarvis 1 4 1 2 3 2 6 2 21 Total Cases 6 3 7 9 8 10 17 9 24 24 28 44 21 210 Number of Deaths 1 1 3 3 5 1 7 7 6 6 9 4 14 67 During Quarter ending April 1 st, 1871:— JANUARY FEBRUARY MARCH APRIL Total. 7 14 21 28 4 11 18 25 4 11 18 25 1 1. Massingham 3 1 3 3 5 1 o 12 7 2 2 41 2. Welch .... 5 6 5 9 4 15 4 6 2 18 2 5 16 97 3. Richards .. 2 8 3 3 10 4 11 13 5 2 3 5 9 78 4. Defuiez .... 16 21 12 16 19 14 13 8 3 5 3 4 3 137 5. Bukgess .. 1 9 3 4 10 6 8 4 4 6 55 6. Sarvis ... 1 6 3 8 5 3 9 3 4 6 7 8 4 67 Total Cases.... 28 51 29 40 51 42 50 75 16 47 22 24 40 475 Number of Death:. 12 5 10 13 10 20 9 11 14 5 17 11 10 147 v During Quarter ending July 1st:— APRIL MAY JUNE JULY Total. 8 15 22 29 6 13 20 27 3 10 17 24 1 1. Massingham 1 4 4 5 1 • • 3 1 4 1 12 1 3 40 2. Welch 6 12 3 4 2 5 • • 5 2 2 • • 4 44 3. Richards 5 5 3 1 1 1 • • 2 2 1 3 1 25 4. Defkiez 3 1 2 • • 2 • • 1 3 4 2 18 5. Bukgess • • 5 • • • • 3 • • 2 • • 1 • • 11 6. Sarvis 3 4 11 8 6 5 15 10 5 3 4 4 78 Total Cases 17 30 22 20 10 16 18 19 18 7 12 13 14 216 Number of Deaths 9 8 15 12 17 7 13 10 5 5 10 10 12 133 During Quarter ending September 30th:— JULY AUGUST SEPTEMBER Total. 8 15 22 29 5 12 19 26 2 9 16 23 30 1. Mas8ingham. 4 7 6 2 2 • • • • 3 6 • • 1 8 39 2. Welch 4 1 1 6 3. Richards • t 1 1 4. Defrif.z 1 • • 1 2 5. Burgess • • 1 1 2 6 Sarvis 1 1 ? 1 1 6 Total Cases 10 8 9 4 3 1 • • 3 6 • • 2 10 • • 56 Number of Deaths 5 7 5 7 5 6 1 2 7 4 3 6 2 60 The foregoing Tables show that the brunt of the epidemic was borne by Dr. Defriez, who attended a large number of cases at a time when little Hospital accommodation was provided ; consequently, the patients were nearly all treated at their own homes during the whole period of their illness. Early in February the Hospital at Homerton was opened, affording us some slight relief; but that Institution soon became full, and for some time Ave were in nearly as bad a position in regard to Hospital accommodation as before. Indeed, it frequently happened that admission was sought for a patient, but there was no vacancy; and by the time there was room, the disease was too far advanced for the patient's removal. In this exigency we not only sent the patients to Homerton (the Hospital proper for the District), but we were also obliged to send them to Hampstead and Stockwell. VI All the cases sent to Hospital were first visited by one of the District Burgeons, and were frequently attended for some time prior to their removal. Tho total number of patients attended amounted to 95/5—tho deaths during tho same period being 407. It sometimes happened that patients, after having an Order for Removal to tho Hospital, refused to go. When this was the case 1 visited them, and, by persuasion, generally obtained their consent. In one instance, however, I had to apply to the Police Magistrate for a Compulsory Older of Removal under tho Public Heulth Act, of which the following is a copy:— SAINT MATTIIKW, BETHNAL GREEN. I, Thomas Sarvis, of Bethnal Green Road, in the County of Middlesex, Medical Officer of Health for the Parish of Saint Matthew, Bethnal Green, being a duly qualified Medical Practitioner, hereby certify that Robert Hoy, of 20, New Nichol Street, in the said Parish, is suffering from Small Pox, a contagious and infectious disease, and is without proper accommodation. THOMAS SARV1S, M.D., M.R.C.S.L. 350, Bethnal Green Road, February 7, 1871. Middlesex to wit. J WORSHIP STREET POLICE COURT. WHEREAS, it has been certified to me, Henry Jeffreys Bushby, one of the Magistrates of the Police Courts of the Metropolis, silting at the Worship Street Police Court, in the Metropolitan Police District, and County of Middlesex, by Thomas Sarvis, of Bethnal Green Road, in the County of Middlesex, Medical Officer of Health of the Parish of Saint Matthew, Bethnal Green, in the County of Middlesex, a legally qualified Medical Practitioner, that Robert Hoy, of No. 20, New Nichol Street, in the said Parish, is suffering from a contagious and infectious disorder, namely, Small Pox, and that the said Robert Hoy is without proper accommodation; and it appears to me, on the oath of the said Thomas Sarvis, that the consent of the superintending body of the Small Pox Asylum, at Homerton, within the Metropolitan District, to receive the said Robert Hoy has been obtained; Now, I do hereby direct the removal of the said Robert Hoy to the said Small Pox Asylum, at the cost of the Nuisance Authority. Dated this 7th day of February, One thousand eight hundred and seventyone H. J. BUSHBY. • • vii Information was easily obtainable of the number of new cases attended by the Parochial Surgeons, but it was not so as regards cases occurring in private families; and it was found utterly impracticable to get an exact knowledge of such cases, as, in some instances, no medical man attended, and in others the medical men would not make a return, although stamped forms were supplied to them for the purpose. We, however, obtained some returns from private medical men, some from the Clergy and Sisters of Charity; and the number of cases brought under our notice were—in W. W. Burrows' District, 1258; J. Lapworth's, 755; J. W. Burrows', 456; total, 2469. All these cases were visited several times by the Sanitary staff, and disinfectants supplied where the patients were poor. The number of supplies given was nearly 1700. In all cases notices were served upon the owners to have the premises cleansed, disinfected, &c. ; and as it was necessary that no delay should take place, the Inspectors worked until very late hours, sometimes until 10 or 11 at night. The destruction of infected bedding was a most important matter, as we had to guard against imposition on the one hand, and yet take care that the disease did not extend by any neglect on our part. Nearly all beds were seen by me, and the order for destruction given to W. W. Burrows, under whose superintendence all beds were burned by a man appointed for the purpose (J. Osborn). This duty was of a most repulsive nature to those who had to carry it out, as well as to the persons living in the neighbourhood where it was done. The first place used was the dust yard in Tyssen Street, Brick Lane; but so great was the outcry against it, that the Inspector had to desist. Then Mr. Mansfield kindly allowed his yard in Digby Street to be used for the purpose; but here the inhabitants rose up one night, and would have assailed the Inspector, if the police had not been called in. The number of beds destroyed was 198; palliasses, 12; mattresses, 7; quantities of bedding, 37; and 57 lots of clothing were destroyed from the house of the Sisters of Charity, in Thomas Street, Brick Lane. To these ladies all honour is due, as they provided a Convalescent Home at Ascot, and sent to it from our District numbers of persons of all ages and sexes (paupers and others). The clothes they had on when they came to the house in Thomas Street were destroyed, and others provided; the • • • viii patients were then sent in a kind of ambulance to Ascot, where they remained a fortnight, and in bad cases longer. Thus were restored to perfect health many who would have pined and died for want of fre??? air. During the epidemic vaccination has been thoroughly attended to by the gentlemen appointed under the Vaccination Act. I cannot close this Appendix without acknowledging the activity and zeal displayed by the whole Sanitary Staff during the entire period to which this Report refers, viz.: from September 30th, 1870, to September 30th, 1871. I have the honour to remain, Tours obediently, THOMAS SAKVIS, Medical Officer of Health. 350, Bethnal Green Road, Oct. 3rd, 1871.