BET 3 REPORT OF THE Sanitary Condition AND Vital Statistics OF THE Parish of St. Datthem, BETHNAL GREEN, DURING THE YEAR 1895. by GEORGE PADDOCK BATE, M.D, Fellow of the Royal College of Surgeons and Licentiate of the Royal College of Physicians of Edinburgh ; Fellow (and President Elect) Incorporated Society of Medical Officers of Health; Fellow of the Royal Microscopical Society; Fellow of the Obstetrical Society of London; and medical Officer of Health for the Parish of Bethnal Green. London: Printed by J. WILLIAMS-COOK, 26, Bethnal Green Road. 1896. REPORT OF THE Sanitary Condition AND Vital Statistics OF THE Parish of St. Datthem, BETHNAL GREEN, DURING THE YEAR 1895. by GEORGE PADDOCK BATE, M.D, Fellow of the Royal College of Surgeons and Licentiate of the Royal College of Physicians of Edinburgh; Fellow (and President Elect) Incorporated Society of Medical Officers of Health; Fellow of the Royal Microscopical Society; Fellow of the Obstetrical Society of London; and Medical Officer of Health for the Parish of Bethnal Green. London: Printed by J. WILLIAMS-COOK, 326, Bethnal Green Road. 1896. SUMMARY. — 1894. 1895. Estimated population of Bethnal Green 123,000 128,000 Young Children under 5 years 18,210 18,960 Made up as follows Old People, over 60 years 7,195 7,490 Area—755 Acres Number of Inhabited Houses 17,109 (Census 1891) Total number of Deaths in the year . 2,642 2,769 Average number of Persons to each Acre 163 169 „ „ London 58 59 Total number of Births in the year 4,636 4,771 Total number of marriages 1,390 1,310 Marriage Rate—Bethnal Green 22.6 20.4 Marriage Rate—London 17.0 17.1 Death Rate-Bethnal Green 21.4 21.6 Death Rate-London 17.4 19.4 Birth Rate—Bethnal Green 37.7 37.3 Birth Rate—London 30.1 30.5 Infantile Death Rate (on Births)—Bethnal Green 1520 162.0 Infantile Death Rate (on Births)—London 143 0 165.0 Young Children's Death Rate (on estimated number of Young children) 68.3 68.7 Old People's Death Rate (on estimated number of Old People) 55.0 60.6 Zymotic Death Rate—Bethnal Green 3.6 34 Zymotic Death Rate-London 2.6 2.6 Inquest Cases 286 297 Uncertified Deaths (no Inquests held) 2 0 Synopsis OF MEDICAL OFFICER'S ANNUAL REPORT, 1895. Vital Statistics page Population 5 Census 5 Births 6 Death-Rate 8 Births and Birth Rate 9 Marriages 10 Deaths of Infants 10 Deaths of Young Children 10 Old Persons' Death Rate 10 Analysis of the Vital and Mortal Statistics of the Sanitary Districts of the Metropolis, after Distribution of Deaths occurring in public Institutions, during the year 1895 16 Special Causes of Death— Summary of Table (K2 3) Deaths Registered during the year 1895, in the Metropolitan Sanitary; District of Bethnal Green, classified according to Diseases, Ages, and Localities 11 Specific Febrile or Zymotic Diseases 17 The Seven Principal Zymotic Diseases 17 Notification of Infectious Diseases 18 Institution Deaths 20 Small Pox 21 Scarlet Fever 21 Fevers 22 Diphtheria (including Membranous Croup) 23 Whooping Cough 26 Measles 26 Diarrhcea 26 Phthisis 26 Respiratory Diseases 26 page Ice Creams 27 East London Water Company 29 Re-organisation of the Sanitary Staff 38 Drainage Regulations 49 Tenement House Regulations 53 Cow-houses and Slaughter-houses 53 Factories, Workshops,and Laundries 54 Tables— I.—Showing Population, Births, Deaths, and Marriages, for 1895, and ten years preceding 65 II.—Annual Birth Rate, Rate of Mortality, Death Rate among Children, and Deaths in Public Institutions for the year 1895, and ten years preceding 66 (K2) III.—Deaths registered at several groups of ages, from different causes during the year 1895 67 IV.—Showing the Mortality from certain Classes of Diseases and proportion to population, and to 1000 Deaths, 1895. 70 V.—Showing the number of Deaths from the Seven Principal Zymotic Diseases, inclusive of Hospital Deaths, in the ten years, 1884 to 1895, and in the year 1895 71 VI.—Inspectors' Report of Sanitary Work 72 Legal Proceedings 73 Street List 74 REPORT. Gentlemen, I beg to lay before you my twentieth Annual Report on the Vital Statistics of Bethnal Green; it is for the year 1895, which terminated on the 28th of December last. As much information as is possible is presented in the usual tablular form, but I have this year departed from the custom of giving a double set of tables, and have constructed all I now present on the basis of the forms required by the Local Government Board; these forms are compulsory for all officers appointed or re-appointed since 1891, and though I still contend that the tables settled by the Society of Medical Officers of Health are preferable, time is too short to prepare a double set, as this report is required, by order of the Board, to be ready in May at the latest. POPULATION. I roughly estimate the population of Bethnal Green at 128,000; this number is probably inaccurate, as the depopulation and slow reoccupation of the Boundary Street area have exercised a very disturbing influence upon my calculations. QUINQUENNIAL CENSUS. Whilst this report is in course of preparation, the first quinquennial census of the whole of London is being taken, but the figures will not be available in time for me to make use Of them. The scope of the present enumeration is limited, and by order of the Local Government Board, a simple count of the 6 bers of the people, and of the houses they occupy will be made, so that the Board may be in a position to inform the London County Council of the exact number of persons inhabiting each sanitary area within the administrative County of London, in order that the sixpenny rate levied under the Equalization of Bates Act 1894 may be apportioned upon the basis of population in each district. A separate house is defined as "all the space within the external and party walls of the building," although it may be occupied by several families living in distinct tenements, flats or appartments. The directions to the enumerators are, that each separate block of model dwellings or flats (no matter how many of these or how assessed), will be counted as a single house only, but separate householder's schedules will be left by the enumerators:— (a) For each head of a family occupying the whole or part of a house or block of tenements. (b) For a lodger or lodgers separately occupying a room or rooms and not boarding with the family. (c) For out-door servants or caretakers residing in mews or lodges. (d) For the proprietors of Inns or Hotels. Institutions, Empty Houses, and locked-up Shops and Offices will all require to be distinguished by the enumerators. Probably when these particulars are published we shall have a better knowledge of what machinery will be requisite to work our new tenement house regulations which have just been sanctioned by Local Government Board. BIRTHS. The number of births registered in the three Sub-districts of Bethnal Green are shewn in the following table, together with the estimated populations; the census enumerations of 1891, and the births registered in that year are also shown for purposes of comparison. 7 TABLE A. Population and Births in Sub-Districts for the year 1891 and 1895. SUB-DISTRICTS. 1891. 1895. Population enumerated at census. Registered Births. Population estimated. Registered Births. North 51,520 2063 49,000 1905 South 33,489 1360 34,000 1343 East 44,123 1575 45,000 1523 Total 129,132 4998 128,000 4771 BIRTIIS. The Births during the year were 4771 against 4636 in 1894, an increase of 135; the excess of the births over the deaths was 2002. Table "B" shews this and compares the two years. TABLE B. 1894. 1895. Estimated population in the middle of the year 123,000 128,000 Total Births 4,636 4.771 Total Deaths 2,642 2,769 Excess of Births over Deaths, shewing the natural increase of the Population 1,994 2,002 8 DEATH RATE. The total number of deaths registered in the Parish during the year 1895 was 2,564, against 2,398 in the previous year; this includes 150 non-parishioners who died in Bethnal Green Hospitals, and whose deaths must be excluded from the number. On the other hand I have received information from Somerset House of the deaths of 355 inhabitants of Bethnal Green who died in various Hospitals in other parts of London ; after adding these deaths and subtracting the non-parishioners there is a net total of 2,796. The deaths in each sub-district, corrected by distribution in a similar manner, were as under:— North 1024 South 789 East 956 Total 2769 Upon the basis of the estimated population we shew a mortality rate for the year 1894 of 21.6, this is an increase of 0.2 per thousand on the rate for the previous year and is 2.2 per thousand in excess of the general rate for the whole of London which was 19 4. The mortality in the three sub-districts, into which the Parish is divided, was as under:— North 20.9 South 23.2 East 21.2 Since the demolition of the houses in the Boundary Street area, the north sub-district appears to have the lowest mortality, whilst the south sub-district, which contains some of the worst houses in the Parish, has the highest. In the following table the mortality rates for London and for Bethnal Green are compared by quarters, the mean temperature and rainfall for each three months are also shewn. 9 TABLE C. Quarter ending. London Death Rate. Bethnal Green Death Rate. Mean Temp. Fahr. Rainfall inches. March 26.0 25.8 35.2 3.27 June 16.7 16.5 55.1 1.19 September 18.6 21.8 62.3 6.46 December 18.0 22.3 44.7 8.09 BIRTHS AND BIRTH RATE. The births registered during the year were 4,771, this is equal to a rate of 373, and is about 0.4 per thousand lower than the birth rate of the preceding year, it is as usual nearly seven per thousand in excess of the general Metropolitan rate which was 30 5. In the registration sub-districts of Bethnal Green the birth rate was as under;— North 38.9 South 39.5 East 33.8 The following table compares the birth rates for Bethnal Green find for London by quarters:— Quarter ending. London. Bethnal Green. March 32.5 35.4 June 30.8 38.8 September 30.4 36.2 December 28.5 35.9 10 MARRIAGES. In this Parish there are fourteen Churches, fifteen Chapels, and one Registry Office licensed for Marriages : of these there were in the First Quarter 199 Second Quarter 368 Third Quarter 335 Fourth Quarter 408 Total 1310 This total indicates a marriage rate of 10.2 to every thousand persons ; or, as in each marriage there are two contracting parties, 20 4 per thousand of our population entered the bonds of matrimony, DEATHS OF INFANTS. Twenty-seven per cent. of the deaths from all causes were those of infants aged less than twelve months, for out of 4,771 children born alive 772 died before reaching the age of one year. This gives a death rate calculated upon the births of 162.0, while the corresponding rate for the whole of London was 165.0. DEATHS OF YOUNG CHILDREN. Nearly half of the deaths (1304, that is 47 per cent), were those of children aged less than five years, this gives a rate of 68.7, calculated upon the estimated population of young children. OLD PERSONS DEATH RATE. The deaths of elderly persons, that is to say those over 65 years of age, numbered 454. This gives a rate of 60.6 per thousand calculated upon the estimated population of old persons. SPECIAL CAUSES OF DEATH (Summary of Table K2 3). Deaths during the year 1895, in the three Sub-Districts of Bethnal Green, classified according to Diseases, Ages, and Localities (institution deaths have been distributed and non-parishioners excluded). SUB-DISTRICTS Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Erysipelas. Measles. Whooping | Cough. Diarrhcea and Dysentery. Rheumatic Fever. Influenza. Phthisis. Bronchitis Pneumonia & Pleurisy. J Heart Disease. Injuries. All Other Diseases. Total. Enteric or Typhoid. Puerperal. North, Sub-District. Deaths at Home ... 3 18 7 7 2 5 33 11 57 1 10 56 190 35 31 282 750 „ „ Deaths in Public Institutions ... 5 22 ... 1 ... 1 ... ... 2 1 ... 38 64 28 16 96 274 Total ... 8 40 7 8 2 6 33 11 59 2 10 94 254 63 47 378 1024 South, Sub-District, Deaths at Home ... 6 9 3 2 1 3 30 5 44 ... 9 35 119 31 23 213 533 „ „ Deaths in Public Institutions 2 7 11 ... 3 ... ... 3 ... 1 1 ... 36 49 25 27 91 256 Total 2 13 20 3 5 1 3 33 5 45 1 9 71 168 56 50 304 789 East, Sub-District, Deaths at Home ... 4 11 6 2 1 2 43 17 55 3 9 37 145 43 20 258 656 „ „ Deaths in Public Institutions 2 5 13 ... 2 ... 5 1 ... 1 ... ... 41 73 25 18 114 300 Total 2 9 24 6 4 1 7 44 17 56 3 9 78 218 68 38 372 956 Grand Totals 4 30 84 16 17 4 16 110 33 160 6 28 243 640 187 135 1054 2769 Mortality per thousand population at all ages 0.03 0.23 0.78 0.13 0.03 0.12 0.85 0.25 1.25 0.04 0.21 1.89 5.00 1.46 1.05 8.23 21.64 12 I am indebted to the British Medical Journal for the following Extract:— THE DEATH-RATES of LONDON SANITARY AREAS in 1895. "In the accompany table will be found summarised the vital statistics of the forty-three sanitary areas of the Metropolis, based upon the Registrar General's returns for the year 1895. The mortality figures in the table relate to the deaths of persons actually belonging to the respective sanitary areas, and are the result of a complete system of distribution of deaths occuring in the public institutions of London amongst the various sanitary areas in which the patients had previously resided. The 133,715 births registered in London during 1895 were equal to an annual rate of 30.5 per 1,000 of the population, estimated at 4,392,346 persons in the middle of that year. In the two preceding years the birth-rate was 30 9 and 30.1 per 1,000 respectively. In the various sanitary areas the birth-rates showed, as usual, wide variations, owing principally to the differences in the sex and age distribution of their populations. In Kensington, St. George's Hanover Square, Hampstead, St. Martin-in-the-Fields, London City, and Lee, the birth rates were considerably below the average ; while in St. Luke, Bethnal Green, Whitechapel, St. George-in-the-East, St. George Southwark,and Bermondsey, the birth rates showed a marked excess. The deaths of persons belonging to London registered during the year under notice were 85,138, equal to an annual rate 19.4 per 1,000 of the population, against 20.3, 20.9, and 17.4 in the three preceding years. The rate in 1895 was 0.4 per 1,000 below the mean rate in the ten preceding years 1885-94, although it exceeded by 2.0 per 1,000 the very low rate recorded in 1894. The lowest death rates last 0 year in the forty-three sanitary areas were 12.0 in Hampstead, 13.4 in Stoke Newington, 14.4 in Lewisham (excluding Penge), 14.5 in Lee, 14.8 in Wandsworth, 15.2 in Plumstead, and 15.9 in St. George Hanover Square ; in the other 13 districts the rates ranged upwards to 25.2 in Holborn, 25.3 in Strand, 25.4 in St. George Southwark, 25.5 in St. Saviour Southwark, 27.3 in Limehouse, 29.5 in St. George-in-theEast, and 30.2 in St. Luke. During the year under notice 11,466 deaths resulted from the principal zymotic diseases in London; of these, 3,574 were referred to diarrhoea, 2,628 to measles, 2,289 to diphtheria, 1,480 to whooping cough, 829 to scarlet fever, 611 to different forms of "fever" (including5 to typhus, 596 to enteric fever, and 10 to simple and ill-defined forms of fever), and 55 to small pox. These 11,466 deaths were equal to an annual rate of 2.6 per 1,000 against 2.8, 3.0, arid 2.6 in the three preceding years; this rate was slightly below the average rate in the ten years 1885-94, which was 2.7 per 1,000. In the various sanitary areas the rates ranged from l.0 in Hampstead, 11 in Stoke Newington, 1.3 in St. James Westminster and in Wandsworth, 1.4 in Lee, and l.5 in Lewisham, to 3.4 in Bethnal Green and in Newington, 3.8 in Shoreditch, 3.9 in Clerkenwell and in Mile End Old Town, 4.0 in Poplar, 4.6 in Limehouse, and 5.5 in St. Luke and in St. George-in-the-East. Compared with the averages in the ten preceding years, the mortality from small pox, measles, scarlet fever, whooping cough, and "fever" was below the average, while that from diphtheria and and from diarrhoea showed an excess. The 55 fatal cases of small pox registered in London last year showed a further decline from the numbers recorded in the two preceding years, and included 9 which belonged to Marylebone, 7 to Camberwell, 4 to Bethnal Green, 4 to Whitechapel, 4 to Newington, and 3 to Greenwich sanitary areas. During the year under notice 1,018 cases of small pox were admitted into the Metropolitan Asylum Hospitals, and 75 remained under treatment at the end of the year. Measles caused the highest proportionate fatality in Holborn, Clerkenwell, St. Luke, Whitechapel, St. George-in-the-East, Limehouse, Poplar, Newington and Bermondsey sanitary areas. Scarlet 14 fever showed the highest proportional fatality in Strand, Clerkenwell, Whitechapel, St. George-in-the-East, and Limehouse sanitary areas; 11,411 scarlet fever patients were admitted into the Metropolitan Asylums Hospitals during 1895, and 2,708 remained under treatment at the end of December last. Diphtheria caused the highest proportional fatality in Bethnal Green, Whitechapel, St. George in-the-East, Limehouse, Mile End Old Town, Poplar, Botherhithe, Camberwell, and Greenwich sanitary area. There were 4,459 admissions of diphtheria patients into the Metropolitan Asylums Hospitals during the last year, and 687 remained at the end of December. Whooping cough was proportionally most fatal in Clerkenwell, St. Luke, Shoreditch, Limehouse, St. George Southwark, and Newington; enteric fever in City of London and Plumstead ; and diarrhoea in St. Luke, Shoreditch, Bethnal Green, St. George-in-the-East, Mile End Old Town, St. George Southwark, and St. Olave Southwark sanitary areas. Infant mortality in London during 1895, measured by the proportion of deaths under 1 year of age to registered births, was equal to 165 per 1,000, and exceeded by 16 per 1,000 the average rate in the ten preceding year3. While the rate of infant mortality did not exceed 116 in Stoke Newington, 132 in Wandsworth, 133 in Plumstead, 135 in Hampstead and in Lewisham, and 138 in St. George Hanover Square and in Marylebone, it ranged upwards in the other sanitary areas to 201 in Newington, 202 in Limehouse, 205 in St. Saviour Southwark, 206 in St. Olave Southwark, 212 in Holborn, and 265 in St. Martin-in-theFields. Analysis of the Vital and Mortal Statistics of the Sanitary Districts of the Metropolis, after Distribution of Deaths occurring in Public Institutions, during the Year 1895. Sanitary Areas. Estimated Population middle of 1895. Births. Deaths. Annual Bate per 1,000 Living. Deaths from Principal Zymotic Diseases. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping-Cough. Typhus. Enteric Fever. Simple and Undefined Fever. Diarrhoea. Phthisis. Deaths of Children under 1 year of age to 1,000 births. Births. Deaths. Principal Zymotic Diseases. LONDON 4,392,346 133,715 85,138 30.5 19.4 2.6 11,466 55 2,628 829 2,289 1,480 5 596 10 3,574 7,742 165 West Districts. Paddington 122,756 2,077 2,107 24.3 17.2 1.7 207 ... 19 14 47 20 ... 13 ... 94 163 164 Kensington 167,671 3,621 2,759 21.7 16.5 1.9 322 ... 34 28 90 38 ... 15 1 116 253 172 Hammersmith 108,429 2,909 1,810 26.9 16.7 2.1 225 1 27 17 44 43 ... 12 ... 81 160 166 Pulham 117,745 3,930 2,195 33.5 18.7 2.9 342 ... 51 21 77 50 ... 12 1 130 154 187 Chelsea 99,930 2,734 1,913 27.4 19.2 2.2 221 1 11 25 57 35 ... 13 ... 79 185 168 St.GeorgeHanoverSq 74,037 1,470 1,175 19.9 15.9 1.6 117 1 10 10 24 26 ... 9 1 36 105 138 Westminster 54,003 1,284 1,146 23.8 21.3 2.1 111 ... 25 6 21 15 ... 3 ... 41 125 185 St.JamesWestmnstr. 23,149 542 411 23.5 17.8 1.3 31 ... 2 3 4 10 ... 6 ... 6 35 144 North Districts. Marylebone 137,392 4,400 2,843 31.2 20.8 1.7 239 9 25 14 35 39 ... 23 1 93 299 138 Hampstead 77,592 1,453 931 18.8 12.0 1.0 78 9 8 14 7 1 9 1 29 75 135 St. Paneras 233,543 7,118 4,778 30 5 20.5 3.2 741 1 228 52 131 94 ... 30 ... 205 428 174 Islington 335,929 9,879 5,753 29.5 17.2 2.0 686 1 141 67 146 79 1 30 2 219 532 143 Stoke Newington 35,234 813 471 23.1 13.4 1.1 39 ... 7 1 5 5 ... 4 ... 17 37 116 Hackney 215,623 6,172 3,735 28.7 17.4 2.5 545 1 120 41 83 65 1 45 ... 189 314 154 Central Districts. ... St. Giles 37,654 1,120 859 29.8 22.9 2.1 77 2 13 6 13 13 ...... 2 ... 28 127 160 St Martin-in-Fields 13,536 189 244 14.0 18.1 1.8 24 1 2 2 7 6 ... 1 ... 5 24 265 Strand 22,586 612 569 27.2 25.3 2.2 49 2 6 9 13 3 ... 5 ... 11 76 175 Holborn 32,188 821 810 25.6 25.2 2.8 90 ... 45 6 7 8 ... ... ... 24 98 212 Sanitary Areas. Estimated Population middle of 1894. Births. Deaths Annual Rate per 1,000 Living. Deaths from Principal Zymotic Diseases. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping-Cough. Typhus. Enteric Fever. Simple and Undefined Fever. Diarrhoea. Phthisis. Deaths of Children under 1 year of age to 1,000 births. Births. Deaths. Principal Zymotic Diseases. Clerkenwell 65,030 2,083 1,491 32.1 23.0 3.9 250 ... 93 17 34 41 1 11 ... 53 159 192 St. Luke 40,763 1,904 1226 46.8 30.2 5.5 224 ... 106 5 20 21 ... 6 ... 66 113 184 London City 33,824 553 720 16.4 21.4 1.6 55 ... 15 4 8 3 ... 13 ... 12 51 157 East Districts. ... Shoreditch 122,932 4,352 2,856 35.5 23.3 3.8 460 2 106 30 58 87 ... 22 ... 155 283 199 Bethnal Green 130,061 4,771 2,769 36.8 21.4 3.4 441 4 116 30 101 34 ... 17 ... 139 245 102 St. George-in-East 45,227 1,972 1,330 43.7 29.4 5.5 246 ... 88 20 50 21 ... 7 ... 60 113 196 Limehouse 56,885 2,035 1,547 35.9 27.3 4.6 261 1 86 20 45 40 ... 10 ... 59 136 202 Mile End Old Town 108,443 4,204 2,436 38.9 22.5 3.9 424 1 113 26 111 42 ... 17 ... 114 182 165 Poplar 171,230 6,071 3,865 35.6 22.6 4.0 677 1 216 48 152 80 ... 33 ... 147 273 183 South Districts. St. Saviour Southw'k 26,570 830 677 31.3 25.5 2.9 76 ... 17 6 13 13 ... 1 ... 26 84 205 St. George Southw'k 60,168 2,188 1,524 36.5 25.4 3.2 194 ... 49 14 17 38 ... 7 ... 69 186 198 Newington 119,358 4,234 2,872 35.6 24.1 3.4 401 4 132 16 52 71 ... 15 1 110 263 201 St. Olave Southw'k. 13,065 428 314 32.9 24.1 2.4 31 ... 3 4 7 ... 2 ... 15 32 206 Bermondsey 83,861 3,212 1,869 38.4 22.3 3.2 270 ... 114 16 29 20 ... 11 ... 80 190 162 Rotherhithe 40,713 1,304 783 32.1 19.3 2.7 110 1 19 8 31 10 ... 9 ... 32 76 148 Lambeth 284,883 9,341 5,567 32.9 19.6 2.6 741 2 150 53 112 132 ... 26 2 264 511 152 Battersea 165,130 5,264 2,872 32.0 17.4 2.7 442 1 98 30 92 53 1 22 ... 145 247 177 W andsworth 185,956 4,721 2,747 25.5 14.8 1.3 250 2 30 16 46 24 ... 26 ... 106 213 132 Camberwell 252,737 7,528 4,610 29.9 18.3 2.6 648 7 111 46 179 68 ... 33 ... 204 394 164 Greenwich 175,183 5,475 3,305 31.3 18.9 2.7 465 3 49 36 184 55 ... 17 ... 121 268 150 Lee 38,832 826 561 21.3 14.5 1.4 54 ... 18 5 11 5 ... 3 ... 12 56 140 Lewisham 82,410 2,037 1,187 748 24.8 14.4 1.5 126 ... 12 9 14 32 ... 7 ... 52 76 135 Woolwich 42,768 1,331 31.2 17.5 1.7 73 ... 6 11 14 3 ... 9 ... 30 92 153 Plumstead 61,494 1,877 929 30.6 15.2 2.5 153 2 24 10 36 5 ... 30 ... 46 90 133 17 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of deaths from this group of diseases was 442, a figure which represents nearly sixteen per cent. of the total deaths from all causes. Of these deaths 384 were amongst young children under five years of age. The total Zymotic deaths exceeded those of the previous year by four, the decennial average for the ten years 1885 to 1894 was 480 (see table V.) The death rate from these seven Zymotic diseases was 3.4 against 3 6 in 1894. The corresponding rates for London were 2.6 in each of the years 1894 and 1895. TABLE D. 1895. 1894. Small Pox 4 5 Measles 110 135 Scarlet Fever 30 27 Diphtheria 102 133 Whooping Cough 33 70 Typhus Fever Enteric Fever 17 26 Simple Fever Diarrhoea 146 54 Cholera Total 442 450 18 Table F shows the percentage of deaths from each disease as compared with the total number of Zymotic deaths. TABLE F. Small Pox 0.90 per cent., or 1 in 110.50 deaths. Measles 24.88 „ „ 4.02 „ Scarlatina 6.78 „ „ 34.73 „ Diphtheria 23.08 „ „ 4.33 „ Whooping Cough 7.47 „ „ 13.40 „ Enteric Fever 3.84 „ „ 26.00 „ Diarrhœa 33.03 „ ,, 3.03 „ NOTIFICATION OF INFECTIOUS DISEASES. A total of 1,761 notification certificates has been received, and copies of all these have been duly forwarded to the Asylums Board, but twenty-four of the certificates were duplicate notifications, that is to say the same case was reported by more than one medical man. Table (B) K II shews the part of the Parish in which the residence of the patient was situated, and Table G gives particulars of the number of cases month by month, together with the hospital admissions and discharges. 19 TABLE G. Infectious Cases, 1895. CERTIFICATES OF INFECTIOUS CASES RECEIVED BY THE MEDICAL OFFICER OF HEALTH. Admitted to Asylums Board's Hospitals. Small Pox. Fevers & Diphtheria. Small Pox. Scarlet Fever. Diphtheria Enteric Fever Erysipelas Puerperal Fever Admitted Discharged Died Remaining Admitted Discharged Died Remaining January 0 41 29 8 23 0 0 0 0 0 31 38 3 62 February 0 21 22 3 18 0 0 0 0 0 31 22 1 70 March 1 20 14 3 20 1 o 0 0 0 35 30 3 72 April 0 13 14 5 17 0 0 0 0 0 24 24 4 68 May 1 28 29 5 22 1 1 1 0 0 22 38 7 45 June 0 44 25 7 19 0 0 0 0 0 41 19 7 60 July 16 63 73 8 32 0 3 0 0 3 39 20 6 73 August 37 85 38 13 16 2 47 9 2 39 61 35 5 94 September 24 116 56 21 23 1 21 22 0 38 60 33 6 115 October 8 132 71 23 54 2 7 19 2 24 85 53 9 138 November 2 95 43 17 31 0 0 19 0 5 53 66 3 122 December 2 61 39 8 26 0 0 3 0 2 29 44 3 104 Total 91 719 453 121 301 7 79 73 4 2 511 422 57 104 20 TABLE H. Table of Deaths during the Year 1895, of Inhabitants of Bethnal Green in the various Public Institutions, within and without the Parish, classified according to Diseases, Ages and Sub-districts from which the Sick Persons were removed for purposes of Medical and Surgical Treatment. SUB-DISTRICTS. All Ages. Mortality prom subjoined cases. Smallpox. Scarlatina. Diphtheria. Mambranous Croup. Fevers Erysipelas. Measles. Whooping Cough. Dirarrhcea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia & Pleurisy. Heart Disease. Injuries. All other Diseases. Total. | Enteric or | Thypoid. | Puerperal North 274 ... 5 22 ... 1 ... 1 ... ... 2 1 38 64 28 16 96 274 South 256 2 7 11 ... 3 ... ... 3 ... 1 1 36 49 25 27 91 256 East 300 2 5 13 ... 2 ... 5 1 ... 1 ... 41 73 25 18 114 300 Total 830 4 17 46 ... 6 ... 6 4 ... 4 2 115 186 78 61 301 830 21 SMALL POX. (Decennial average 4-1). The total number of cases of this disease notified during the year was 92, of these 85 were removed to hospital, but four were sent home again as not being cases of small-pox. There was no death in the Parish, but four of the sufferers removed died in Hospital, all of these were unvaccinated. With regard to the sanitary condition of the houses where these cases occured, the Inspectors report that 26 were found to be fairly satisfactory, but the internal drainage was defective in two and the outside drains in eight, whilst other minor insanitary conditions obtained in fifteen instances. Sixteen of the cases removed were amongst families occupying one room only. REPORT OF CASES ADMITTED INTO SMALL POX HOSPITALS DURING THE YEAR 1895. Hospitals. No. of Cases remaining at end of 1893. No. of Cases admitted. Discharged. Died. No. of Cases remaining at end of 1894. Hospital Ships 0 79 and 8 from Gore Farm. 43 and 38 transferred to Gore Farm. 1 2 Gore Farm 0 38 from Hospital Ships. 30 and 8 transferred toHospital Ships. 0 0 Total 0 79 73 4 2 SCARLET FEVER. (Decennial average 53.2). The number of cases of Scarlet Fever notified during the year was 716, resulting in 30 deaths, a mortality of 4.1 per cent. on the notifications. 22 The Scarlet Fever death rate last year was equal to 0.23 per thousand population, whilst that for the whole of London was 0.19, about 69 per cent. of these Metropolitan deaths took place in public institutions, as against 66 per cent. in this Parish. In the North district 237 cases were notified, in the South 223, and in the East 238. 227 Scarlet Fever patients were removed to Hospital where 16 of them died. The Inspector's reports on the sanitary condition of the houses, where these cases occurred, give the following particu'ars:— In 286 instances everything was found to be in a fairly satisfactory condition, but in eight the closets had no water supply, in twentyfour the internal drainage arrangements were defective, and in fiftynine the outside drains were faulty, in seven the domestic water supply was drawn from the closet cistern, while other various minor insanitary conditions were found in 138. Sixty-seven of the cases occured amongst families occupying one room only. CONTINUED FEVERS (Typhus, Enteric, Simple). (Decennial average 24.5). No case of Typhus was reported. The total number of Enteric Fever cases reported during the year was 120, of these 17 died, a case mortality of 14.1 per cent. on the notifications, these deaths were equal to a rate of 0.13 per thousand population, a shade lower than the general Metropolitan rate which was 0.14. The patients removed to hospital numbered 49, and six of them died. Of the removals, thirty were admitted to Asylums Board Hospitals, and the remainder to general hospitals. Of the cases, 47 were reported from the North District, 29 from the South and 33 from the East. In 52 instances the residence of the patient was found to be in a satisfactory condition, but in two the watercloset had no supply, in fourteen the external drainage arrangements were faulty, in five the drains inside the house were bad, and other insanitary conditions were found in 38. Seventeen cases occured in families occupying one room only. 23 DIPHTHERIA : (including Membranous Croup.) (Decennial average 81.1.) The number of cases reported to me under these two heads was 456. The number of deaths registered was 102 which is equal to a mortality of 22.3 per cent. on the notifications. On the estimated population at all ages the mortality was 0 78 against 15 last year. The general Metropolitan rate was 0.53. The Registrar General remarks in his recently published summary for 1895, that, "The mortality from Diphtheria was considerably greater in the East group of Sanitary districts than in any other, being equal to 0 81 per thousand." Seventy-seven of the Diphtheria deaths were amongst young children aged less than five years, this was 4 0 per thousand on the estimated population of young children. The cases removed to Hospital numbered 136, and 44 of them died. So far as I can ascertain all the severe cases admitted to hospital were treated by the administration of antitoxic serum. A most elaborate and carefully drawn report upon the new treatment has been prepared by the Superintendents of the various Hospitals where this treatment was in use, the report was issued conjointly. Its concluding paragraphs are as follows:— The improved results in the diphtheria cases treated during the year 1895, which are indicated by the foregoing statistics and clinical observations, are (i.) A great reduction in the mortality of cases brought under treatment on the first and second day of illness. (ii.) The lowering of the combined general mortality to a point below that of any former year. (iii.) The still more remarkablejreduction in the mortality of the laryngeal cases. (iv.) The uniform improvement in the results of tracheotomy at each separate Hospital. (v.) The beneficial effect produced on clinical course of the disease. 24 A consideration of the foregoing statistical tables and clinical observations, covering a period of 12 months and embracing a large number of cases, in our opinion sufficiently demonstrates the value of antitoxin in the treatment of diphtheria. It must be clearly understood, however, that to obtain the largest measure of success with antitoxin it is essential that the patient be brought under its influence at a comparatively early date—if possible, not later than the second day of disease. From this time onwards the chance of a successful issue will diminish in proportion to the length of time which has elapsed before the treatment is commenced. This, though doubtless true of other methods, is of still greater moment in the case of treatment by antitoxin. Certain secondary effects not infrequently arise as a direct result of the injection of antitoxin in the form in which it has at present to be administered, and even assuming that the incidence of the normal complications of diphtheria is greater than can be accounted for by the increased number of recoveries, we have no hesitation in expressing the opinion that these drawbacks are insignificant when taken in conjunction with the lessened fatality which has been associated with the use of this remedy. We are further of the opinion that in antitoxic serum we possess a remedy of distinctly greater value in the treatment of diphtheria than any other with which we are acquainted. (Signed) W. GAYTON. JOHN MacCOMBIE. E. M. BRUCE. F. FOOBD CAIGER. E. W. GOODALL. C. E. MATTHEWS. March 25th, 1896. REPORT OP FEVER AND DIPHTHERIA CASES ADMITTED INTO FEVER HOSPITALS DURING THE YEAR 1895. Hospitals. No. of Cases remaining at end of 1894. No. of Cases Admitted. Discharged. Died. No. of Cases remaining at end of 1895. Eastern Hospital (Homerton) 40 271 147 and 100 transferred to Winchmore Hill. 31 33 Northern Hospital (Winchmore Hill) 22 100 fromEastern Hospital, 33 from North-Eastern Hospital, 5 from North-Western Hospital and 3 from New Cross Hospital. 133 0 30 North-Western Hospital 5 75 46 and 5 transferred to Winchmore Hill. 18 11 North-Eastern Hospital 4 152 91 and 3 transferred to Winchmore Hill. 6 26 New Cross Hospital 1 9 3 and 3 transferred to Winchmore Hill. 1 3 South Western Hospital 0 1 1 0 0 Western Hospital 0 3 1 1 1 Totals 72 511 422 57 104 26 WHOOPING COUGH. (Decennial average 106.2). Whooping Cough caused 33 deaths, all amongst young children, and shewed a mortality of 1.7 per thousand on the estimated population of young children. MEASLES. (Decennial average 1154). Measles caused 110 deaths, of which all but four were amongst young children aged less than five years, this being a mortality of 5'9 per thousaud on the estimated population of young children under five years of age. DIARRHŒA. (Decennial average 96.2). Diarrhoea was the registered cause of 160 deaths, but as in twenty instances some other disease than diarrhoea contributed to the fatal termination, I have not included them in my calculations. The mortality was in the proportion of 1.25 to each thousand inhabitants. PHTHISIS. To Phthisis, 243 deaths were referred, the mortality was equal to 1.89 per thousand persons living as compared with 177 in the whole of London. The Registrar General notes that the death rate from Phthisis was in 1895 highest (2.65) in the central group of sanitary districts and next highest (2.05) in the east group. RESPIRATORY DISEASES. The deaths from chest diseases other than Phthisis and Pulmonary Influenza were 640, being about 23 per cent. of the total mortality from all causes, and corresponding to a rate of 5.0 per thousand population at all ages. 27 ICE CREAMS. The articles used in the manufacture are milk, eggs, flour, sugar, flavoring essences and coloring matters of various kinds; these materials are mixed in various proportions in a metal cylinder, which is placed in a wooden tub, and packed round with broken ice and salt. The intense cold thus produced freezes the mixture in the cylinder, which is stirred up in the process with a long wooden spoon. When the freezing is complete, the tub containing the cylinder with its contents and packing of rough ice, &c., is transferred to a barrow, constructed for the purpose, and the cream is retailed at very low prices at street corners and places of public resort. It is usually served in shallow glasses, no spoons are provided, and the children, who are the largest purchasers, lick the cream out of the glasses and appear to thoroughly enjoy it. The trade is largely in the hands of low-class Italians, who reside and manufacture in the neighbourhood of Saffron Hill. These people are not above increasing their legitimate gains by a little sly gambling, and I have seen some very shady transactions of this nature between the proprietor and the idle youngsters hanging round his barrow. At the instance of the Medical Officer of Health for Islington, a most careful bacterioscopic examination of these ice-creams was made by Dr. Klein last year, and many samples purchased from barrows were examined. Dr. Klein's investigations conclusively shewed that the ice creams must have been manufactured under conditions of indescribable filth, for in several instances the material shewed evidence of contamination with human excrement, a bacillus whose known habitat is the human intestine was found, and also a germ which was believed to be identical with that known to cause the acute diarrhœa, which is so fatal to children in the summer and autumn. Following in the steps of the Islington authorities, the Vestry of Clerkenwell recently had a chemical and bacterioscopic examination made of samples of water in which ice-cream glasses had been washed; the samples were taken from street stalls where a brisk 28 trade was in progress. The water, upon examination, proved to be of the nature of diluted sewage, and contained an enormous number and variety of bacteria, shewing that it had been contaminated in various ways. Microscopic examinations of melted ice-cream, made by subsequent observers, shewed the presence of epithelial 6cales from skin and mucous membrane, of flue, dust, human hairs, fibres of various textile materials, and the eggs, and bodies of vermin. There appear to be four main sources of contamination— 1. The insanitary condition and filthy surroundings of the premises in which the manufacture is carried on. 2. Unclean vessels, or the careless admixture of the rough impure ice in the tub with the contents of the cylinder while the process of freezing is going on. 3. The uncleanly habits of the venders, who have been frequently seen to wipe their sweaty bodies with the towel provided for the glasses. 4. The method of sale, or rather of serving the cream, from shallow glasses, out of which it is licked; these glasses are sometimes washed after use in the filthy water previously spoken of, but more often they are simply refilled with cream just as they are left by the tongues of the little purchasers, and if the children happen to be convalescent from scarlet fever or diphtheria, the germs of infectious diseases may easily be transferred from one child to another. The filthy conditions under which this trade is carried on, and the beastly habits of the venders undoubtedly constitute a grave source of danger to the public. I have repeatedly urged in previous reports, that all premises where food is prepared, stored or sold, for the use of man, should be registered, and periodically inspected, just as dairies and milk shops are at present. It would not be difficult for Parliament to extend the powers of the London County Council and the local authorities in this direction. Regulations could then be drawn up and enforced:— (a) For the good sanitary condition of premises where the food of man is prepared and sold. 29 (b) For the protection of eatables against contamination or infection. (c) For requiring the scrupulous cleanliness of all vessels used to contain food during the process of preparation or sale. The sale of ice-creams in glasses should be forbidden, paper receptacles could easily be provided which should be of such a nature as to be incapable of use a second time. I strongly recommend the Vestry to support the action of Islington and Clerkenwell, and to urge the Local Government Board to promote legislation in the direction indicated. On this report the Sanitary Committee recommended:— "That the Vestry concur with the Vestry of Clerkenwell that it is desirable control be exercised over the manufacture and vending of ice-cream, and support the application for legislation with that object." And this was agreed to. EAST LONDON WATER WORKS COMPANY. The year 1895 will long be remembered in East London on account of the water famine. The intense and prolonged cold of the early months of the year caused the water in the service pipes and in many of the superficial mains belonging to the Company to become frozen, and little or no water was obtainable from the ordinary supply taps. The East London Company, I believe, did their best and put up stand pipes wherever possible; these, however, rapidly became useless from frost and the Company then requisitioned the the water-carts of the various Vestries and distributed water by means of these. When the frost broke up, the disastrous effects were apparent all over the district; burst water pipes, broken closet apparatus, flooded basements, and reeking walls abounded, and the expenditure of many thousands of pounds was necessary before the damage was repaired. In June owing to the depletion of their reservoirs, the East London Water Company found it necessary to reduce the supply of water pumped into their district, and in the middle of July the supply was still further restricted, the water being only turned on for about a couple of hours daily. The fire mains 30 were kept charged as required by law, and only those houses connected with these particular mains received a constant supply; I was fortunate to be so placed at my private residence in Hackney and got a full supply during the whole of the water famine, but at my Surgery in Bethnal Green I only received the regulation two hours allowance, though I have a meter and am charged according to the amount I use. When I was appointed Medical Officer of Health for this District, some twenty years ago, the water supply of the whole of East London was on the intermittent principle; the water was turned on daily for a limited period (often to be reckoned by minutes) and shut off for the remainder of the twenty-four hours. This was the recognised condition of things, and every house and court had some provision for storage, either a water-butt or tank. Many of these receptacles were in a very foul condition, and most of them were badly placed, a favourite position was on the top, and forming the roof, of the closet, the soil pan of which was, however, rarely supplied with water. These cisterns were usually uncovered and frequently received the drippings from roofs and gutters. They were moreover often in close proximity to dustbins, and children amused themselves by throwing into the water all sorts of filthy rubbish, including an occasional dead puppy or kitten. In better-class houses the cisterns were usually placed in top bedrooms, but frequently so close to the ceilings as to be absolutely inaccesible for cleaning purposes; as a matter of fact even at the present time the inspection of cisterns and tanks in good-class houses and public buildings is neglected for months, and in some cases even years are allowed to pass without any examination taking place. I extract the following remarks from a fifteen year old report of Colonel Bolton, the late Water Examiner under the 1871 Act. "It is disheartening to reflect that notwithstanding the efforts that have been made, and the large expenditure that has been incurred in works for properly treating and improving the quality of the water, these efforts are rendered nearly abortive and but of little value by the apathy and carelessness of a great number of the householders. 31 The water delivered for domestic purposes is frequently deteriorated after leaving the Companies' mains by the dirty state of the cisterns on the premises of the consumers. Many of the cisterns, tanks and butts for containing water, in small tenement houses in the Metropolis, are in a disgusting and filthy state. An opportunity for inspecting these presents itself when travelling on some of the Metropolitan and Suburban lines. Cisterns may be seen without lids (and with portions of rotten lids floating in the water) full of rank and decaying vegetation and other most objectionable substances, such as old rags and paper, and on closer examination the contents would show more or less organic deposit, and under the microscope would be found to abound in infusorial life. The purest and best filtered water in England would be poisoned by such a system of storage. The Public Health Act gives power to any Local Authority to inspect and remedy such evils, but probably the only remedy for this state of affairs will be found in the establishment of the constant supply system and the consequent total abolition of these unfit receptacles.'' As time went on, the East London Water Company instituted and gradually extended a constant supply of water over the whole of their district; we were promised that this would be a real constant supply, only to be shut off in the event of pipes requiring repair. Well knowing the foul condition of the water receptacles all over the parish, the Sanitary Department of the Vestry endeavoured by all means in their power to abolish improperly placed tanks and waterbutts, and advised a supply of water to be drawn, for domestic purposes, direct from the rising mains. We did not absolutely forbid cisterns, but as a matter of fact we discouraged their use as we knew that the water supplied by the Company would be deteriorated by the condition into which most of the cisterns would probably get, and therefore we considered them harmful. The Water Company, however, have never taken this view, but have always strongly 32 advised the maintenance of the cisterns. It has been urged that there must be storage somewhere, and that it cannot very much matter whether this be in open Reservoirs or in well-placed and well-cared-for house cisterns, but this contention is not sound. In large shallow reservoirs, such as those at Walthamstow, the greatest care is taken to protect the contents from contamination, and the water is freely exposed to sun and wind. The effect of sunlight in the destruction of disease germs is well known, and the water in these reservoirs is improved by keeping. Contrast with this the condition of the water in the best-placed, best-cared-for house cistern, where there is no wind, and no sun, but a good deal of dust, and probably a somewhat higher temperature, conditions all favourable to the cultivation, instead of the destruction of disease germs, I heartily trust we shall never be compelled to revert to the discredited cistern-system for drinking purposes. As a result of our action in the direction indicated very few new cisterns were provided, and most of the old ones were disconnected and put out of use, so that the district was utterly unprepared for the short supply of June and July last. In conjunction with the Surveyor and the Clerk, I attended with a deputation from the Vestry at the offices of the East London Water Company. We were received by the Directors and Chief Officers of the Company and the whole subject was thoroughly discussed. Our suggestions to the Company were:— 1. The erection of stand-pipes in connection with the constantly charged fire-mains wherever possible. 2. An increased supply to certain indicated districts of the Parish, such supply to be divided into two portions and given morning and evening. This was done, but the sudden limitation of one of the principal necessaries of life, though mitigated by the means taken at our instance, must have had an effect on the health of the district; anyway it was coincident with an enormous increase in the mortality. In the month of June this was about three per thousand below the average and the deaths numbered about forty per week, the first week in July they increased to fifty-four, the next week they fell to fifty-two, and in the middle of the month they went up to seventy- 33 six, the increase was maintained during the early part of August but fell at the end of the month to the ordinary summer level. This increased mortality was due chiefly to the large number of deaths from Diarrhoea. In the week ending the 6th of July these were four, in the second week the number went up to thirteen, in the third to twenty-two, in the fourth week the number remained the same, in the week ending August 3rd it fell to twenty-one, and continued to fall week by week till it reached the ordinary level of four at the end of August. The Diarrhoea deaths registered in Bethnal Green during the whole of the year numbered 162 against 54 in the preceding year, exactly treble the mortality. Of course I cannot say that this increased mortality was due directly to short supply of water, as there is always a rise in the number of diarrhoea deaths during July and August, but I feel certain that the water-famine increased and intensified the ordinary conditions. Overflowing closets and choked drains abounded all over the district, and gave the Sanitary Inspectors much additional work in getting them put right, and I am not quite sure that the modern short hopper closet pan unsupplied with water for flushing purposes is as good under these conditions as the old fashioned funnel-shaped long hopper; semi-solids slide down the steep sides of the latter, while they are delayed by the basin-shaped form of the modern pattern, which is dependent upon a proper water-flush for the removal of its contents. In addition to nuisances caused by choked drains, I received a large number of complaints of inconvenience and distress, caused by the short supply. I know of cases of sudden illness in the night where poultices could not be made and hot fermentations and hot baths could not be used for the relief of pain and spasm. Many tradesmen and manufacturers have complained that they were hindered and greatly inconvenienced in the conduct of their business by the short supply. All sorts of receptacles were requisitioned for storage purposes; in addition to proper water cans and jugs, foot-baths, slop-pails, buckets, kettles, and pots and pans of various kinds were used. As a rule, people do not possess a superabundance of articles of 34 this nature, and much inconvenience resulted to the poorer inhabitants from inability to put their cooking utensils to their proper use; moreover, these temporary receptacles were often kept in most improper positions, under beds and in corners of living rooms, where the contents were certain to become fouled. It has been officially stated that during the whole of the water famine, the average quantity pumped into the district was over thirty gallons per head per diem; and with economy this should have been ample, twelve gallons a day per head is sufficient, and this estimate allows for a daily sponge bath and share of laundry, etc. A weekly hot bath would account for another five gallons a day, manufacturing purposes take up perhaps another five gallons, and an allowance for street watering would raise the total to something under twenty-five gallons a day for each inhabitant. This is considerably less than the quantity the Company assert they have pumped into the district. If their statements are correct, and I have no reason to doubt them, there must be an enormous leakage somewhere, and I am afraid our own people are responsible for a good deal of it. Constantly when I visit premises in the course of my duties as Medical Officer of Health, I find the water tap in the back yard running to waste, frequently the fittings are faulty, but more often than not, people are too lazy to turn off the tap after drawing water, and leave it running either full bore or only half turned off. Thousands of tons of water are thus thrown away without any good result, except that of assisting to keep the sewers flushed. I am of opinion that the Water Company is much to blame for not instituting an efficient system of inspection which should have for its object the checking of this frightful waste, and the punishment of careless consumers. By direction of the Local Government Board, an inquiry was held at the Hackney Town Hall in the early part of October by Colonel Ducat and Dr. Barry. Many witnesses were examined, and amongst others your Surveyor, Medical Officer, and Sanitary Inspectors gave evidence before the Commission. As an outcome of the inquiry an elaborate report was presented to the President of the Local Government Board, of which it is only necessary to reproduce here the concluding paragraphs:— 35 "In concluding our comments upon this branch of the inquiry, whilst we would point out the difficulty of avoiding fallacies in drawing inferences from vital statistics over short periods of times, we are of opinion that however grave the inconvenience that has resulted from the scarcity of water in the area of the East London water supply during July and August 1895, there is no evidence to show that it had detrimentally influenced the public health of the districts involved. III.—The Means which should be adopted with a view of preventing a becurrence of any such deficiency. With regard to this head of our inquiry we do not think that much need be said. The conditions presented by the year 1895 were very exceptional. An unprecedented drought following a most unusually severe frost created difficulties not likely to be exceeded in the future, and it may be assumed, for purposes of calculation, that a maximum strain was this year put on the resources of the Company. We have already stated that by January 1896 it is expected that the works now in progress in connection with the Bacecourse reservoir and the additional pumping plant will be completed. These works will give an additional storage capacity for 200,000,000 gallons, as well as power to obtain an additional 3,000,000 gallons a day from the Chalk. In addition to these works other reservoirs, under the powers given by the East London Water Act, 1894, are in course of construction, which will finally increase the present storage of the Company to 1,200,000,000 gallons, an amount equivalent to some 27 days average supply. Under these circumstances we consider that, when Parliament passed the Act of 1894, they furnished the East London Water Company with powers sufficient to prevent the recurrence of a deficiency of water in their district until such time, at any rate, as the population to be supplied shall have again outgrown the provision made. 36 On behalf of the Water Company it was urged that if powers were given to them with regard to fittings similar to those conferred upon a number of Corporations in the country it would be possible very materially to reduce in the future the waste which ordinarily takes place within their district. Incidentally we would here refer to the advantage to the consumer of having a small storage of water in every house. It was shown that, throughout this scarcity, persons occupying houses provided with cisterns suffered no inconvenience. No doubt ill-designed and badly placed house cisterns are open to objection from a health point of view, and nothing could be further from our intention than to advocate any return to the old defective cisterns with their movable wooden covers, but we do advocate the provision of properly designed cisterns. By a properly designed cistern we mean a cistern which shall be so constructed as to exclude alike the possibility of the entrance of dirt from the atmosphere, and the accumulation of any deposit from the water itself, whilst at the same time the water iu the cistern is under the same pressure as the water in the main itself; in other words, the cistern that would satisfy us is merely a local enlargement of the water main. Such a cistern is, in our opinion, subject to none of the objections commonly urged against the use of cisterns. Under the best arrangements there must be times when short periods of interruption of a constant service will occur, and at such times the want of water for domestic purposes, for flushing water-closets, sealing water traps, &c., is calculated to lead to conditions injurious to health, which should not be allowed to exist, and which a proper use of really efficient cisterns would guard against. With respect to the contention advanced on behalf of the Vestries, that the real remedy for the defects in the Water Company's arrangements which resulted in the scarcity of the water supply in East London during July and 37 August 1895, is to be found in sweeping away the Water Companies altogether, and transferring all their works to the hands of a public authority, we think that the question thus raised is not one for us to consider here, and that it does not come within the scope of this inquiry. In conclusion, we may briefly summarise the results of our consideration of the evidence placed before us in this inquiry. I. That the scarcity of water in the East London Water Company's area during the summer of 1895 was due to the following causes:— (a) Exceptional waste, beyond the undue waste of ordinary years, of water owing (1) to non - repair of fractures in the consumers' pipes, brought about during the unusually long and severe frost of the previous winter; and (2) to excessive garden watering during the drought in May and June. (b) Decrease in the volume of the River Lea due to the unprecedented drought which occurred during the first six months of 1895. (c) Means of storage possessed by the East London Water Company inadequate to enable them to meet the combined waste and deficiency of water noted under headings (a) and (b). We would also note under this heading that in our opinion the inconvenience experienced by consumers was much aggravated by the want of proper means for domestic storage of water. II. That although the scarcity of water undoubtedly gave rise to considerable inconvenience and hardship, there is no evidence to show that it had any appreciable deleterious influence upon the public health within the area of the East London Water Company. III. (a.) That steps have already been taken by the East London Water Company which should in our opinion afford sufficient storage of water to meet any deficiency in 38 the supply of water within their district for many years to come. (6) That for the protection of the consumer against unavoidable temporary intermissions of the supply, we consider that there would be distinct advantage in having properly designed means for storage of water in houses." RE-ORGANISATION OF THE SANITARY STAFF. The first rough attempt in this direction was made some ten years ago when Messrs. J. W. and W. W. Burrows retired from their positions as Sanitary Inspectors. Up to this period the only records kept in the office were a simple complaint book and the Sanitary Committee minute book; no report sheets were used, and no clerical assistance was afforded to the Inspectors. The constitution of the staff was discussed at several meetings of the Sanitary Committee, and the Vestry was recommended to appoint a Chief Inspector, two Assistants, and a Clerk. This recommendation was not accepted, but the Clerk was agreed to, and it was ultimately decided that there should be two Inspectors, each responsible for a district comprising as nearly as possible one half of the parish. One of these was apportioned to Mr. Lapworth, and Mr. Weston was appointed to the other. Mr. Meadway was selected as Sanitary Clerk, and a scheme of records, report forms, and notices was devised and approved by the Sanitary Committee. As soon as the new officers entered on their duties I commenced to attend at the Vestry Hall daily for the purpose of supervising the work of the department. This was resented by the Senior Inspector, who complained that he had not been accustomed to work in " leading strings,'' and preferred to be responsible solely to the Committee. The matter was discussed, and a proposal that "the Inspectors be ordered to report daily to the Medical Officer of Health, and to act generally under his supervision" was lost and the consideration of the whole matter was postponed. Affairs drifted on in the old way until the year 1888, when an "inquiry into the immediate sanitary requirements of the Parish" was held in accordance with a recommendation of the Royal Commission on the Housing of the Working Classes. 39 The inquiry was held at the Vestry Hall by the late Mr. D. Cubitt Nichols and Mr. Shirley F. Murphy (the present Medical Officer of Health for the County of London), with whom were associated, on behalf of the Vestry, Mr. Christopher Forrest and Mr. James George Hilditch. Much evidence was taken, and many houses were inspected by the Commissioners. Eventually a report was presented to the Home Secretary and by him to both Houses of Parliament. The concluding paragraphs of this report were as follows:— " We are of opinion that the immediate sanitary requirements of the Parish may be summarised as follows:— 1. The re-organisation of the Sanitary Department, so that the work of the Inspectors is to a greater extent superintended or controlled by the Medical Officer of Health. 2. The appointment of additional Sanitary Inspectors; we be'ieve that two officers in addition to those now engaged is the minimum increase which should be made. 3. The institution of a system of periodical house-tohouse inspection throughout the Parish, especially in those parts occupied by the poorer people. 4. The adoption of regulations as to houses let in lodgings. 5. The exercise by the Vestry and the Metropolitan Board of Works respectively of the powers conferred by the Artizans and Labourers Dwelling Act, 1862-82, and the Metropolis Local Management Act, and Buildings Acts (amendment) Act, 1882, for the removal of structural conditions rendering houses unfit for occupation . 6. The more complete exercise of the powers under the Nuisance Removal Acts, 1855, &c., and the Metropolis Local Management Act, 1855, as to the cleanliness and wholesomeness of houses, the water supply to closets, and the better paving of yards and courts. 40 7. The making of bye-laws as to house - drains and drain-fittings under Section 202 of the Metropolis Local Management Act. We are fully aware that the work of raising Bethnal Green to a proper standard of healthiness is great and onerous, and that it will require sustained efforts during a prolonged period for this purpose. The Vestry are, however, advised by able and energetic officers, and are possessed of considerable power from the legislature for the performance of their public health duties. In the course of our inspection we have received every assistance from Mr. Forrest and Mr. Hilditch, and our thanks are due to the Vestry for the use of the Vestry Hall, and also to their officers who supplied us with all the information required." We are, &c.. (Signed) D. CUBITT NICHOLS. SHIRLEY F. MUEPHY. "Having been present throughout the inquiry, we concur in the foregoing report, excepting that taking into consideration the assistance given to the Sanitary Inspectors by other officers of the Vestry, we are of opinion that one additional Inspector, or three in all, would be sufficient to meet the requirements of the Parish." (Signed) CHRISTOPHER FORREST. JAMES GEORGE HILDITCH. The report of the Commissioners was referred to a special Committee for consideration, and after several sittings it was decided to appoint one additional officer. Accordingly in December 1889, Mr. Gerald Watts was made a third Sanitary Inspector. With the increase in the staff, I again offered to attend daily at the Vestry Hall for the purpose of supervising the work of the department, and this time my offer was accepted as an experiment for twelve months, but taking into consideratfon the reluctance with which any authority over the staff was delegated to me, I never felt that I had any mandate to do more than exercise a general super- 41 vision over the Inspectors; I gave advice and instructions as to procedure on the written reports which were daily submitted to me by the Inspectors, and from their reports I selected such cases for personal visits of examination as I considered necessary, but I never acted or professed to act as a Chief Inspector of Nuisances. The temporary arrangement was never formally confirmed by the Vestry, but I have much pleasure in testifying that the Inspectors have always cheerfully complied with my directions so far as they were able, and I take this opportunity of thanking them for their courtesy and good faith. The selection of Mr. Gerald Watts was not a happy one; his work was found to be most unsatisfactory, and on my reporting to this effect he was called upon to resign, and Mr. John Foot was elected in his place. We had now a staff of Inspectors second to none in London. Mr. Lapworth, a man of long experience (though not in his first youth), and Messrs. Weston and Foot, young, active and enthusiastic sanitarians, who worked early and late, devoting themselves mind and body to the improvement of the health of the Parish. The new system showed an enormous improvement over the old one, and the face of the district rapidly changed for the better; hundreds of dilapidated hovels were pulled down instead of being patched up and sound healthy dwellings were erected on their sites. We were then happily ignorant of the subtle distinction between drain and sewer on private property, and dealt boldly with insanitary conditions wherever found. But new duties were thrown by Parliament on Sanitary Authorities necessitating much additional clerical work, and though Messrs. Weston and Foot wrote out most of their notices at home after office hours, I was obliged to employ my son, Mr. Frank Bate, as an additional clerk, in order to keep pace with the requirements of the law. In December 1893, Mr. Kelf was appointed fourth Sanitary Inspector. His duties were at first restricted to the inspection and regulation of trade premises, but on the appointment of Mr. Henley as a fifth Sanitary Inspector, in January 1895, this arrangement was 42 terminated and the parish was redivided into five districts, as at present, and one of these was apportioned to each officer. Other duties now called Mr. Frank Bate away and he ceased to act as junior Clerk. Moreover, as the staff had been so largely increased, Messrs. Weston and Foot did not feel called upon to devote their evenings to clerical work at home but wrote out their notices at the Vestry Hall during office hours as did the other three Inspectors. Little or no assistance in this direction could be rendered by Mr. Medway as his whole time was absorbed in posting up the various records, and in preparing and forwarding the notifications required by the Public Health (London) Act. Moreover our system of book-keeping had grown up by various additions into a somewhat cumbrous patchwork which obviously required revision. Quite half the Inspectors' day was now absorbed by office and Police Court work, so that my promise (on the appointment of a fifth Inspector) to initiate periodical house-to-house visitation could not be kept, indeed as a matter of fact very little more real work was accomplished with a staff of five Inspectors than in the old days when we had only three. Late in the year 1894, the London County Council directed Dr, Young (one of their Assistant Medical Officers) to report on the sanitary condition and adminstration of Bethnal Green. "The results of this inquiry into the sanitary condition of Bethnal Green may be briefly summarised as follows:— 1. The death rates in the Parish, from all causes, from the seven chief zymotic diseases and the infant mortality, based upon the figures contained in the yearly reports of the Local Medical Officer of Health, are in excess of the corresponding rates relating to London generally. 2. There is evidence of much work having been done and considerable improvement having been effected in the Parish, but in a large proportion of houses visited defective conditions have been found to exist. 3. Systematic house-to-house inspection throughout the district has not been undertaken, indeed the sanitary staff is not sufficiently large for this purpose. 43 4. No houses have been registered under the bye-laws relating to premises occupied by members of more than one family, indeed bye-laws for this purpose have only recently been made by the Vestry and submitted for confirmation by the Local Government Board. 5. Although the inspection of workshops has been commenced it would appear that but a small proportion have yet been visited. 6. No shelter for the accomodation of persons during the disinfection of their rooms has yet been provided. In concluding this report I would refer to the fact that in the year 1888 a report as to the sanitary requirements of the Parish of Betbnal Green by Messrs. Cubitt Nicholls and Shirley Murphy was presented to Parliament. There is little doubt that since the date of that report improvement has been effected in the condition of the Parish, owing to the adoption of some of the recommendations which were then made, more particularly the re-organisation of the Sanitary Department and its more complete supervision by the Medical Officer of Health. Amongst other recommendations it was at that time considered needful that there should be an addition of two Inspectors, making a total of four Sanitary Inspectors. The Vestry, however, made at that time only one such appointment, a fourth Inspector was not appointed till the end of the year 1893, when it was found necessary to increase the staff in order to cope with new duties which had been imposed on Sanitary Authorities in London by recent legislation. The Vestry have already recognised that this increase in the staff is inadequate for the purpose of dealing with the additional work entailed by the passing of the Public Health (London) Act, 1891, and since the commencement of my inquiry, have resolved that another Sanitary Inspector shall be appointed, making a total of five. I do not, however, think that five Inspectors will be sufficient for carrying out the work which requires to be done in the Parish. The character 44 of the district, which is almost entirely inhabited by an industrial population, a large proportion of which belongs to the poorer classes, together with the condition of the dwellings observed during the inspection, show that there is great need for a systematic house-to-house inspection; again, nothing short of a complete inspection of the district in this sense will ensure an adequate supervision of workshops in Bethnal Green. Further, the proposed bye-laws as to honses let in lodgings which have been deposited with the Local Government Board for confirmation will increase both the amount of inspection and the clerical work of the department. The addition of one other Sanitary Inspector, making a total of six for the Parish, and additional clerical aid, will I think be necessary, in order that the work of the department may be efficiently carried out. The Vestry should take steps to provide a shelter for persons during the disinfection of their rooms.'' C. W. F. Young, Assistant Medical Officer of Health. This report was referred to the Sanitary Committee by whom it was considered, but as so little improvement had resulted from the appointment of the last two officers I was not encouraged to advise further increase in the number of Inspectors, but strongly urged the necessity of an additional Clerk; the Committee, however, reported to the Vestry "That they were of opinion that the existing number of Inspectors was sufficient, and recommended that the Council be so informed." This report was not accepted by the Board but was sent back for reconsideration and further report. Much dissatisfaction was expressed by prominent members of the Vestry at the small benefit which had resulted from the late appointments in the Sanitary Department; the opinion was also expressed that the staff was already too large, and that the limited supervision a Medical Officer of Health, who was in private practice could exercise was insufficient. Obviously two courses were open, either to require the Medical Officer to retire from private practice, or to 45 appoint a Chief Inspector. Mr. Foot brought the matter to a climax by presenting a very carefully thought out memorandum on the subject, in which he pointed this out. Very wisely, in my opinion, the Committee adopted the latter alternative, and sent up to the Vestry the following report, in every line of which I concur. "Your Committee have considered with care the entire subject involved in the report of Dr. Young, the Assistant Medical Officer to the London County Council, which suggests that the existing staff of the Sanitary Department is insufficient. The opinion of the Committee is that the existing staff is not as effective as it might be, owing to the present absence of organised control by a Departmental Officer directly responsible to the Sanitary Committee. It must be borne in mind that the staff of the Sanitary Department has rapidly increased in numbers during the past few years. Ten years ago there were only two Nuisance Inspectors, while at the present time the staff under the control of the Sanitary Committee comprises eighteen persons exclusive of the Medical Officer, these are:— Five Sanitary Inspectors. Sanitary Department Clerk. Disinfecting Engineer. Two Disinfecting Assistants. Seven Dust Pail Men. Mortuary Keeper. Urinal Flusher. The Sanitary Committee has in time past shown great reluctance to delegate any portion of its powers of control to an officer, and preferred to retain the direct supervision of the department in its own hands. Until the year 1888 the Inspectors reported to, and took their instructions direct from, the Committee. It was repeatedly proposed that the Medical Officer of Health should undertake the supervision of the Inspectors, but it was not until after the inquiry 46 and report of Messrs. Cubitt Nichols and Shirley Murphy that the offer of Dr. Bate to attend at the Vestry Hall daily for the purpose of receiving the reports of the Inspectors and advising thereon was accepted by the Vestry as an "experiment." Since that year the Medical Officer of Health has exercised and continues to exercise a partial and qualified control over the Sanitary Inspectors, but there is no understanding, direction, bye-law or resolution of the Vestry giving him any authority over the remaining thirteen members of the staff, and he states that he has never in any way considered himself responsible for these officials. The manner in which the duties are at present performed is the following:— The five Inspectors report daily to, and take their instructions from, the Medical Officer (save and except all matters connected with the administration of the Food and Drugs Acts). Mr. Lapworth acts as Cashier. Mr. Foot is responsible for the Mortuary, Mr. Weston for the Disinfector, and Mr. Lapworth, Mr. Weston and Mr. Foot, supervise the Pail Men. But there is no one person responsible for the whole of the staff. It is only just to the Inspectors to state that the Medical Officer reports invariable cheerful compliance on their part with his suggestions, and that it is merely inability to cope with the mass of work requiring attention under present conditions that precludes systematic house-to-house inspection. The Committee consider that a re-adjustment and concentration of the duties of the staff under a principal officer would effect great saving in the time of the Inspectors, both as regards Police Court Work and the supervision of Drainage Works in course of construction, and they think that the direction of such a large staff demands a closer attention and check than the weekly meetings of the Committee afford. 47 Accordingly they advise that a new officer be appointed who may be designated Chief Inspector or Sanitary Superintendent, this officer would, in consultation with, and subject to the direction of the Medical Officer, control and direct the operations of the entire Sanitary Staff, and by such means as he devises and the Sanitary Committee approve, keep himself informed of the work performed by persons now or hereafter forming part of the Sanitary Staff. This officer would examine and classify the daily reports of the District Inspectors, and in consultation with the Medical Officer of Health make recommendations to the Sanitary Committee to issue such orders for the execution of works as might in their opinion be necessary. He would superintend the making out and serving of all notices. He would, under the instructions of the Committee, take all proceedings at the Police Court, so that in future the attendance of the District Inspectors would only occasionally be required for the purpose of giving evidence. He would supervise all drainage works in progress, and test and certify all new work. The records at present kept in the Sanitary Department admit of considerable simplification without loss of efficiency. A modification in this respect would reduce the clerical work and enable the present Clerk to relieve the Inspectors of some of the office work which they now perform to the detriment of their out-door duties, but the Committee are of opinion that the District Inspectors should do as little office work as possible, and recommend that a J unior Clerk should be appointed who could, under the direction of the Chief Inspector, write out notices and documents at present prepared by the District Inspectors. The Committee make the following Kecommendations. 1. That a Chief Sanitary Inspector be appointed. 2. That Mr. Foot be the Chief Inspector at a salary of £220 per annum, increasing to £250 per annum by annual increments of £10. 48 3. That a Sanitary Inspector be elected in place of Mr, Foot at £120 per annum with annual increments of £10 up to £200 per annum. The increase each year to be dependent on a recommendation of the Sanitary Committee. 4. That a Junior Clerk be engaged by the Sanitary Committee at 15/0 per week. 5. That it be referred to the Committee to advertise for and select suitable candidates for the election by the Vestry of a Sanitary Inspector. 6. That it be left for the Committee to determine the detail as to the books and work in the Sanitary Office after the Chief Inspector enters on his duties." The recommendations of the Committee were accepted without a single dissentient, and Mr. Foot was made Chief of the staff; I feel sure the new officer will perform the duties of Sanitary Superintendent very much more efficiently than I could, moreover the duties appertaining to this office are, in my opinion, more appropriately performed by a Chief Inspector than by a Medical Officer of Health, who can scarcely be expected to act as either timekeeper or drain Inspector, and who as head of his department should be in a position to deal with matters of Sanitation on a broad basis without being cramped with details. The Chief Inspector is required to act "in consultation with and subject to the direction of the Medical Officer" but in matters of order and discipline he is supreme and since the end of 1895 I have ceased to exercise any direct authority over the other members of the staff. New rules for the conduct of the officers have been formulated and issued by the Committee. Mr. Foot has designed a system of report forms and sanitary notices characterised by great simplicity, clearness, and directness of purpose; the District Inspectors are no longer required to write out notices, but simply indicate on their report forms the number of the appropriate paragraph in the schedule of requirements. These recommendations are revised by the Chief Inspector, submitted by him to the Sanitary Committee, 49 and when authorised the notices are made out by the Clerks an I served by Messenger. The Chief Inspector also personally conducts all Police Court proceedings and supervises and certifies new drain age work. The District Inspectors are thus enabled to devote their whole time and energies to the inspection of house property and trade premises, and already the new arrangement shews an increased efficiency of at least fifty per cent. over the old system. DRAINAGE REGULATIONS.. So long ago as 1888 the Royal Commissioners strongly urged the Vestry to make " bye-laws as to house drains and drain fittings under Sec. 202 of the Metropolis Local Management Act" but for some reason or other this has never been done. This failure to make proper Regulations has led to complaints of irregular sanitary administration, and it has been alleged that certain forms of sanitary appliance (interceptors &c.) have been considered indispensable in some parts of the Parish which were not insisted upon in others. I am not aware that any special form of apparatus has ever been required under a Statutory Notice, but I cannot deny that the personal influence of particular Inspectors may have been exercised to obtain results over and above the exact requirements of the formal notice. With this action I confess I have found no fault so long as the result has been satisfactory. The Drainage Regulations printed below have been formulated and sanctioned by the Vestry. They will apply to the whole of the Parish and I trust there will now be no more complaints of inequality. Regulations respecting Drains and Sanitary Arrangements of Houses and other Buildings. Notices to be given to Vestry and plans submitted before commencing any building or drains. Before beginning to dig out or lay the foundation of any new house or building or to rebuild any house or building, and also before making any drain for the purpose of draining, directly or indirectly, into any sewer, or re-constructing or altering the drains of any house or building, seven days. 50 notice in writing shall be given to the Vestry. The necessary forms for such notices will be supplied by the Vestry and the notice shall specify the nature of the proposed works and any other information the Vestry may require, and shall include a plan drawn upon the said form of application to the scale marked upon the said form. The plan must shew the position of and size of all existing and proposed drains (the existing drains to be shewn in black and the proposed drains in red). The plan must also shew the existing or proposed building and the curtilage thereof, also the position of the adjoining building on either side. The dimensions of the building must be marked in plain figures on the plan. The position of all existing or proposed sinks, gullies, rainwater pipes, w.c.'s, urinals, ventilating pipes, etc., must be marked. The depth of the lowest floor of the proposed building below the level of the pavement of the street must also be stated. Works not to be commenced until plans have been approved by the Vestry. The works (the subject of the application) shall not be commenced until the sanction of the Vestry has been given to the person making the application, and no deviation shall be made from the plan approved by the Vestry, nor from any order or direction which may have been given by the Vestry's officers with respect to any such work without the consent in writing of the Vestry. The foundation of every new house or building shall be laid at such level as the Vestry may direct. Every house or other building shall be provided with a drain and such branches thereto of such materials and size and laid in the direction and to the levels as the Vestry direct and with such fall as shall be adequate for the drainage of such house or building, and shall also be provided with fit and proper paved surfaces for conveying the surface-water 51 to such drains, also with sinks, gullies, traps, inspection chambers, w.c. apparatus, urinals, soil and ventilating pipes, water supply and apparatus, and whatsoever fit and proper works the Vestry or its officers may consider necessary for the proper working of the drain. No house or building hereafter erected or rebuilt shall be occupied until the drains and other works to which these regulations apply have been constructed and afterwards approved by the Surveyor, or Sanitary Inspector appointed for the purpose, nor until a sufficient and satisfactory water supply has been provided in accordance with the requirements of the Public Health (London) Act, 1891. No drain or any connected works or apparatus shall be covered up until the same has been inspected by the Surveyor or Sanitary Inspector, and it shall be the duty of any person constructing such drains, etc., to give twentyfour hours' notice (at least), stating the day and hour when the drains, etc., will be ready for inspection. Pipes. All pipes used must be true in section and well glazed. All joints must be made in neat Portland cement. The whole of the drain where it passes under any building shall be laid upon a bed of Portland cement concrete, and be covered over and surrounded with a layer of Portland cement concrete not less than six inches in thickness. Care must be taken that all joints are thoroughly cleaned off internally. All new drains will, before being passed, be tested by the Sanitary Inspector by the hydraulic, smoke, chemical, or other test. No right angled or straight out junctions shall be used, but Y junctions only. All drains shall be laid as far as practicable in straight lines and outside of the houses or buildings. At all points of junction where it is necessary for the course of the drain to be altered so as to be at or near a right 52 angle with the original drain a proper inspection chamber shall be provided. Sizes. With the exception of drains from sinks and lavatories, no earthenware pipe drain of less diameter than four inches will be allowed. Interceptor traps. In cases where there are forecourts to the buildings or other satisfactory means to enable an interceptor trap to be fixed, so as to be readily accessible for the purpose of examination and cleansing, such traps may be fixed, but no manholes or interceptor traps will be permitted under the public footways. B. W. Pipes, Sink Drains, Lavatory Drains, Bath Wastes, etc. Eain water pipes, sink drains, lavatory drains, bath wastes, &c., shall be constructed to discharge into the open air over trapped or side inlet gullies. All bath and sink wastes must be trapped immediately under the baths or sinks. Gullies. All gullies shall be of glazed stoneware with a water seal of not less than two inches deep, and shall be fixed on and bedded in concrete. Bell traps, masons' traps, lip traps, D traps will not be permitted under any circumstances. Manholes. All manholes constructed shall be of sufficient size to admit of ready access to the drain for the purposes of examination or cleansing. They shall be built of sound stock or other approved brick in Portland cement mortar and be rendered internally with Portland cement. All manholes shall be covered with air tight iron covers. Ventilating Pipes. There shall be constructed in connection with every manhole in which an interceptor trap is fixed, a proper air inlet with mica valve to prevent up-draught, and the drain in connection therewith shall be ventilated at its highest 53 point by carrying up an iron or lead pipe not less than four inches in diameter without bends, to a height of not less than four feet above the top of any window opening within a horizontal distance of twelve feet of the said pipe, and shall also not be fixed near any chimney pot or smoke flue. Persons executing drainage work must, in all cases, carry out the requirements of the bye-laws made by the London County Council under the Public Health (London) Act, 1891." TENEMENT HOUSE REGULATIONS. The adoption of regulations as to houses let in lodgings was also ft recommendation of the Royal Commissioners in 1888, and this recommendation was one in which Messrs. Hilditch and Forrest, on behalf of the Vestry, concurred. No action, however, was taken until after the passing of the Public Health (London) Act, 1891, which renders the making of these bye-laws compulsory. Recently bye-laws were drawn up and agreed to by the Vestry, these have been sanctioned by the Local Government Board, and are now in force in the district; they only apply to registered houses, but so far no houses have been placed on the register. SLAUGHTER-HOUSES. The eleven slaughter-houses in the Parish have been kept under observation, and are in good condition. At the sessions in October there were only ten applications for renewals, the owner of one allowed his license to lapse. All the applications were successful. COW-HOUSES. Of the twenty-four licensed cow-houses, only twenty-two of the owners applied in October for renewals, and three of these applications were opposed on behalf of the London County Council. J. Richards, 95, Collingwood Street. The Cow house abuts on two dwelling houses, the dung receptacle is inside the cow-house, and there is no proper accommodation for washing the milk vessels. 54 I advised that the license of these premises should be opposed orr behalf of the Vestry, and the shed was visited by the Sanitary Committee. The owner promised to make certain alterations, and after consideration it was decided not to oppose the license. The officers of the County Council, however, contended that the premises were unsuitable for the purpose of keeping cows. They made good their contention and the licence was refused. Jones Bros., 216, Columbia Road. The license was opposed on behalf of the Council on the ground that certain structual works required had not been executed, but as evidence was forthcoming that the works had been satisfactorily completed, the opposition by the officers of the council was withdrawn and the license was granted. R. Webb, 56, Coventry Street. As these premises were not used by applicant for the purpose of keeping cows and had not been so used for the past twelve months, the license was refused. FACTORIES, WORKSHOPS & LAUNDRIES. The new Factory Act of 1895 greatly modifies the regulation of workshops, &c. It was somewhat hurried through Parliament, is complicated, difficult to administer, and renders codification of the existing law urgent. It is now eighteen years since what is known as the "Principal" Factory Act (1878) became law; four amending Acts have since come into operation, two Shop Hours Acts and a. Truck Amendment Act have also been passed. A short account of the history of legislation as applied to workshops will not be out of place here, as it will help us to understand the intentions of Parliament in this direction. The Bakehouse Act was passed in 1863, by it the regulation of the hours of labour in bakehouses as well as the supervision of their sanitary condition was placed in the hands of the local authorities and the public health officers. In August, 1867, a Factory Act was passed, which applied to all places where fifty or more persons were employed in any manufacturing process; shortly afterwards in the same year, the 55 shops Regulation Act was passed, which legislated for similar establishments, where less than fifty persons were employed, and by it the enforcement of the law as to hours of labour and sanitary condition in workshops was (like that of the bakehouses) entrusted to Local Authorities and Officers of Health. Unfortunately an opinion, not justified by the wording of the Act, gained ground amongst Sanitary Authorities, that they were at liberty to please themselves whether they should enforce the law or not in their respective districts. Many Town Councils, when called upon by the Home Office to carry out the law expressed their determination "not to meddle with trade matters in their Parishes." The published reports of the Home Office Inspectors for 1868 and 1869 show that the Workshops Regulation Act was a dead letter throughout nearly the whole Country, though in a few districts of Staffordshire and Leicestershire the best results were obtained through the indefatigable activity of the Municipal Officers. The difficulties arising through the neglect of the Local Authorities in carrying out the Workshops Regulation Act, induced Parliament in the year 1871 to pass another Factory Act which completely transferred the duty of enforcing the provisions of the Workshops Act from the Sanitary Authorities to the Home Office Inspectors, and the 1878 Factory Act did the same thing for the bakehouses. This comprehensive law, though essentially a consolidating Act, may be said to mark an epoch in trade legislation, for by it the Sanitary administration of factories, workshops and bakehouses was definitely placed in the hands of the Home Office Inspectors to the practical exclusion of Local Authorities. The experiment of entrusting the supervision of the smaller manufacturing industries to the Local Authorities appeared to have failed, and for the following reasons:— 1. Too much was expected. The regulation of the hours of labour, overtime, school attendance of children, and holidays are not matters for a Sanitary Authority to deal with. 2. The machinery necessary to work the law did not exist. 56 3. The Local Authorities would not act and the Central Authority did not compel them to do their duty or even to provide the staff necessary to make the inspections. Since 1878 the opinion that sanitary matters should be left in the hands of Sanitary Authorities has gradually gained ground. Moreover the enormous accession of duty that continued to be thrown upon the Factory Department of the Home Office rendered the practical application of this idea a necessity, as the Inspectors of the department are few in number, and though all of them are highly educated engineers, they are not necessarily trained in practical sanitation. First in 1883 the sanitary adminstration of bakehouses was handed back to Local Authorities, then in 1891 the workshops followed, and I understand that it is seriously contemplated in high places that by future legislation H. M. Factory Inspectors are to be relieved of their responsibility for the sanitary condition of the factories. MEMORANDUM on the DUTIES of the VESTRY WITH RESPECT to WORKSHOPS AND WORKPLACES, Etc. The duties and obligations of the Sanitary Authorities in London, with respect to Factories, Workshops, Laundries, and Bakehouses, are set forth in the Factory and Workshops Acts of 1878, 1883, 1891, and 1895, and the Public Health (London) Act of 1891. workshop The expression "Workshop" means any premises, room or place, enclosed or in the open air, (not being a Factory within the meaning of the Act), wherein any manual labour is exercised by way of trade, or for the purpose of gain. (a) In the making of any article, or part of an article. (b) ??? the altering, repairing, ornamenting, or finishing of any article. (c) In adapting any article for sale by sorting, packing, folding or labeling. 57 Note.—Machinery may be used for any of the above purposes, but so long as this is driven by animal power and not by "mechanical" power, the above description holds good. The Factory Acts do not apply (except where so stated), to workshops in which neither children, yonng persons nor women are employed. The expression "Factory'' includes any premises wherein trades factory. -are carried on as above, but where Steam, Gas, Water, or Electrical "power " drives the machinery used in the manufacturing processes carried on therein. Also certain scheduled trades, which are treated as Factories whether "mechanical" power be used or not; these are Print Works. Bleaching and Dyeing Works. Earthenware Works. Lucifer Match Works. Percussion Cap Works. Cartridge Works. Paper Staining Works. Fustian Cutting Works. Blast Eurnaces. Copper Mills. Iron Mills. Foundries. Paper Mills. Glass Works. Tobacco Works. Letterpress Printing Works. Bookbinding Works. Flax Scutch Mills. laundry, Factory Act 1895, Sec. 22. Note.—All the works printed in italics are carried on in Bethnal Green. The word "Laundry" is not defined in the Acts, but it is usually understood to mean a place where woven fabrics are cleansed or washed, or "got up'' or prepared for use or sale. Hitherto all Laundries have been "Workplaces" only, and excluded from the operation of the Factory Acts, but after this year All such as:— (a) Are carried on for purposes of gain, or by way of trade, will be regulated by special rules under section 22 of the 1895 Act. (b) Prison, School, Institution, and Private Laundries will still be considered workplaces, as also will small Laundry Businesses, where only two workpeople, other than the family of the proprietor are employed. 58 WORKPLACE. Laundries classed (a) are either "Factories" or Workshops according as "power " is employed or not. Class (b) will still be excluded from the operation of the Factory Acts, but will be, as hitherto, subject to all the provisions of the Public Health (London) Act, just as an ordinary dwelling house is. There is no definition of the word "Workplace" in any of the Acts, but I understand it to mean, any premises where work of any kind is carried on, but which do not come within the definition of either Factory or Workshop. A Cabinet Maker's workroom where men only are employed would be a Workplace. BAKEHOUSES Public Health (London) Act Sec. 141. A Bakehouse means any place in which is baked bread, biscuits or confectionery, from the baking or selling of which a profit is derived. Factory Act 1878, Sec. 61. Bakehouses are always Workshops (or Factories if power be used), and never Workplaces, and whether they are "Domestic" or ordinary, are under no circumstances exempted the obligations of the Factory Acts as to periodical cleansing, etc. DOMESTIC WORKSHOP. Factory Act 1878, Sec. 16 A "Domestic Workshop" (or Factory) is defined by the principal Act to be a "Workshop" or "Factory" where no mechanical power is used and in which the only persons employed are members of the same family dwelling there; such places (excepting bakehouses) as come within this definition are exempted from the sanitary regulations of the Factory Acts, and from affixing notices in the workrooms, but they remain under the supervision of the Vestry in respect to sanitary condition, and the provisions of the Public Health (London) Act apply in their entirety. BAKEHOUSES Factory Act 1678. Secs. 34, 35, and 81. Factory Act 1883, Secs. 15 and 16. Factory Act 1895, Sec. 27 Public Health (London) Act 1891, Sec. 26 (2) All the Sections in the Factory Acts applying to Workshop bakehouses are administered by the Sanitary Authority:— Bakehouses must either be painted in oil or varnished every seven years, and washed with hot water and soap every six months, or they must be limewashed every six months. No W. C. may be within or communicate directly with a bakehouse, nor may any drain have an opening within a bakehouse. Sleeping places on a level with bakehouses require to be specially arranged. 59 After the first day of January 1896, a place underground may not be newly used as a bakehouse. The word "underground" is not defined, but I take it to mean an underground room, within the meaning of Section 96 of the Public Health (London) Act, which room is used for the purpose of baking bread, &c. Factory Act 1833, Sec. 17. The regulation of the sanitation of Retail Bakehouses was transferred from the Factory Inspector to the Medical Officer of Health by this Act, and the Medical Officer of Health was invested with the same powers of entry, inspection and taking legal proceedings as a Factory Inspector, and by the Factory Act of 1891 and the Public Health (London) Act of the same year, all Workshop-bakehouses (whether retail or wholesale), were similarly transferred to the Local Authority. WORKSHOPS Public Health (London) Act 1891, Sec. 25 and 2 (9) factory Act 91, Sec. 3. The duty of preventing overcrowding, and enforcing cleanliness, limewashing, ventilation, and freedom from effluvia in workshops of all kinds was taken away in 1891 from the Factory Inspector and laid upon the Sanitary Authority by the two Acts named in the margin, but though the Factory Inspector is thus relieved from sanitary duties in Workshops, he is still required to visit these places for the purpose of regulating hours of employment and generally carrying out the provisions of the Factory Acts. If in the course of the visits he discovers "any act, neglect or default, in relation to ventilation, cleanliness or W. C. accommodation, that Inspector is required to give notice in writing to the Sanitary Authority in whose district the workshop is situated, and it shall be the duty of the Sanitary Authority to make such injury into the subject of the notice, and take such action thereon as may seem proper to that Authority for the purpose of enforcing the law, and it shall be the duty of the Sanitary Authority to inform the Inspector of the proceedings taken in consequence of the notice. If within a month of this notice, no proceedings have been taken for punishing or remedying the act, neglect, or default, the Factory Inspector may himself take the like proceedings as the Sanitary Authority might have taken and in successful proceedings, may recover the expenses incurred, from the Sanitary Authority, or if he prefers he may proceed under Factory Act 1891, Sec. 2 amended by Factory Act 1895, Sec. 2 and 3. 60 Factory Act, 1895, Sec. 2. Section 2, under which, on receiving a complaint from an Inspector, and after being satisfied that the place used as a Workshop, &c., is in such condition that any manufacturing process or handicraft carried on therein cannot be so carried on without danger to health, or to life or limb, a court of summary jurisdiction may by order prohibit the place from being used for the purpose of that process or handicraft, until such works have been executed as are in the opinion of the court necessary to remove the danger; fine during contravention, forty shillings a day. Public Health (London) Act. Sec.2 (g) and 25. As previously mentioned it is the duty of the Vestry to deal with sanitary defects in Workshops, under the Public Health (London) Act, as nuisances. Should the Vestry neglect, generally, its duties in this respect the Home Secretary may by order, authorise and direct a Factory Inspector to take over, during such period as may be mentioned in the order, the powers, and duties of the Sanitary Authority with respect, to all Workshops in that particular district, or any class of them, and the Factory Inspector so authorised is entitled to recover his expenses from the defaulting Sanitary Authority. Factory Act 1875, amended by Factory Act 1891, Sec. 26 and Factory Act 1895, Sec. 41. After January 1896, the occupiers of all workshops who have not already given notice of their occupation to the Factory Office will be required to do so before the end of the year, under a penalty of five pounds ; all notices sent to the Factory Inspector under this section must be forwarded forthwith to the Sanitary Authority of the district in which the workshop is situated. Hitherto when these notices have been received by me, I have directed the Sanitary Inspectors to visit the workshop and report to me as to the condition of the the premises, the sufficiency of the W.C. accommodation, and the number and sex of the persons employed. Under our new arrangements the District Inspectors will, I suppose, report these particulars to the Chief Inspector, who will in turn report to me, so that I can comply with the clause of the 1891 Factory Act, which requires that:— If any child, young person or women is employed in a Workshop, and the Medical Officer of the Sanitary Authority becomes aware thereof, he shall forthwith give written notice thereof to the Factory Inspector of the district. PROTECTED PERSONS Factory Act 1891, Sec. 3(3) 61 Public Health Act (London) Sec. 27. These instructions are repeated in the Public Health (London Act almost word for word. Child means a person under the age of fourteen years. Young person means a person (male or female) over fourteen and under eighteen years of age. Woman means a woman over eighteen years of age. OVERCROWDING Public Health (London) Act, Sec 2 (giii) Amended by Factory Act 1395, Sec. 1. The new Factory Act defines overcrowding, and requires a minimum of 250 cubic feet of air space to be given to each of the persons employed in any workroom ; during any period of overtime this minimum is raised to 400 cubic feet for each worker. The Home Secretary may, if he thinks fit, still further increase this allowance of air space as regards any particular manufacturing process or handicraft, and also may increase the allowance for any period during which artificial light (other than electric light) is employed for illuminating purposes ; probably cellar and basement workshops, where artificial light is used all day, will be required to conform to some special regulation in this direction. OVERTIME. Means an extra two hours over the ordinary ten-and-a-half hours' day, and may be worked by women, three days a week for thirty days in any one year, in certained specified trades; it may not be worked on Saturdays; children and young persons are forbidden to work overtime. NOTICE. Number of workers in proportion to cubic capacity Factory Act 1878, Act 1878, Sec 78, amened by Factory Act 1895, Sec. 1 (3) It is further required in the same section, that there shall be affixed in every workshop (except workplaces and domestic workshops) a notice specifying the number of persons who may be employed in each workroom (in proportion to the air space contained therein) in accordance with the provisions of the principal Act. This notice is required to be in such form and to be affixed in such parts of the workshops, &c., as the Factory Inspector directs, under a penalty of forty shillings. It will thus become the duty of every manufacturer who employs women or young persons, to carefully measure and cube his work rooms, and prepare and post the above notice wherever directed by the Factory Inspector, and less of the time of your Inspectors will be taken up in measuring workshops, though they will still be required to perform this duty where legal proceedings to abate overcrowding are contemplated. 62 Should the M. O. H. or Sanitary Inspector certify that the limewashing, cleansing, or purifying of any workshop is necessary for the health of the persons employed therein, it is the duty of the Sanitary Authority to serve a notice on the owner or occupier requiring him to do the necessary work. The fine for non-compliance with the notice is a sum not exceeding £5 and a continuing penalty of 10s. a day, in default after conviction. Adequate means must be taken for securing and maintaining a "reasonable" temperature in each room in which any person is employed. Contravention of this section can only be enforced by a Factory Inspector. Special means of ventilation (mechanical or otherwise) must be provided where dust or noxious gases are generated ; this also can only be enforced by a Factory Inspector. The expression " Sanitary Conveniences " includes waterclosets and urinals, there is no fixed regulation as to the proportion these should bear to the number of persons employed, each case must be dealt with on its merits by the Sanitary Authority, regard being had to the number of persons employed in, or in attendance at, such building, and also where persons of both sexes are, or are intended to be, employed, or in attendance, with proper separate accomodation for persons of each sex. Hitherto nothing in the Factory Acts has given H. M. Inspectors any power to require water-closets in Factories, except in case of default by Sanitary Authority (and defective provision of sanitary conveniences is obviously one of the matters intended by Sec. 4 of the principal Act to be notified to the Sanitary Authority in order that they may make enquiry into the subject of the notice and take such action thereon as may seem proper); by Sec. 35 of the new Act this power is granted to H. M. Inspectors (so far as London is concerned) in the exact terms of the Public Health (London) Act, penalty in case of default, £10. Sanitary Authorities and their Officers have the right to enter trade premises for the purpose of examining as to the existence thereon of any nuisance, at any hour when business is in progress or is usually carried on. LIMEWASH ING. Public Health (London) act Sec. 25. ??? ??? Factory Act 1895, Sec 82. Dust and nox ious gasses. Factory Act 1878, Sec. 36. Factory Act 1895, Sec. 33. SANITARY CONVENIENCES. Public Health (London) Act Secs. 38 & 141. ??? 63 The expression " house " includes schools, also factories and other buildings in which persons are employed. All manufacturers of wearing apparel (and also certain other trades when so required by the Secretary of State) are required to keep lists of all persons employed by them as out-workers ; these lists may be inspected by any officer of a Sanitary Authority, but by Sec. 42 of the new Act these lists have to be sent twice a year to the Factory Office. I have suggested to the Home Office Authorities that they should act as a clearing house, and dissect these lists and classify the outworkers according to districts ; under these circumstances we 6hould receive twice in each year a list of out-workers residing in Bethnal Green, the Sanitary Inspectors could then visit the residences of these people, in order to see that they are in a proper sanitary condition See. 6 of the new Act authorises a Factory Inspector to forbid a manufacturer to give out work to persons who inhabit insanitary premises, and if after notice he continues to give out work to such persons he may be fined ten pounds. Sec. 6 is not restricted to outworkers but applies in addition to occupiers of factories, workshops and laundries. It forbids the making, cleaning, or repairing of wearing apparel " in any dwelling house, or building occupied therewith, whilst any inmate of the dwelling house is suffering from Scarlet Fever, or Small Pox ; then unless the occupier or contractor proves that he was not aware of the existence of the illness in the dwelling house and could not reasonably have been expected to become aware of it, he shall be liable to a fine not exceeding ten pounds." In the administration of this section, which requires provision of means of escape in case of fire, the London County Council takes the place of the Sanitary Authority in the administrative County of London. It will thus be seen that certain Sanitary provisions of the Factory Acts in workshops can only be enforced by the Sanitary Authority, and some by H. M. Inspe ctors, while others can only be worked by the conjoint action of the two Authorities. Moreover a new principle is introduced by the 1895 Act, and, for the first time, a Sanitary Authority is required to report its proceedings to the Factory OUTWORKERS Factory Act 91 Sec. 27 amended byFactory Act 1895, Sees. 5, 6 and 42. Safety in case of Fire. Factory Act 1891, Sec. 7. GENERAL. 64 Inspector of the district. However I do not anticipate any friction and I have been assured by Mr. Gould, H.M. Superintending Inspector of Factories that every assistance in the power of the department will be given to Sanitary Authorities in carrying out the requirements of this very complicated and unwieldy Act of Parliament. I have the honor to be, Gentlemen, Your very obedient Servant, Medical Officer of Health for St. Matthew, Bethnal Green 65 BETHNAL. GREEN SANITARY DISTRICT. TABLE I. Shewing the Population, Births, Deaths, and Marriages for the year 1895, and ten years preceding. GROSS NUMBERS. The Year Estimated Population Marriages Registered Births. Corrected number of Deaths. Deaths in Public Institutions. Total all Ages. Under One Year. Under Five Years. 1895 128,000 1310 4771 2769 772 1304 625 1885 129,055 2532 5158 2850 750 1213 534 1886 129,895 2437 5194 3040 888 1533 532 1887 129,895 2415 4989 2917 814 1412 598 1888 130,500 2282 4936 2958 770 1443 556 1889 131,000 2314 4939 2708 718 1311 561 1890 129,134 2015 4611 3199 791 1402 641 1891 129,134 1856 4998 3282 827 1449 707 1892 127,040 1447 4911 2984 779 1459 588 1893 123,000 1403 4756 3257 849 1467 722 1894 123,000 1390 4636 2642 709 1244 570 Average of 10 years, 1884 to 1893. 128,165 2009 4912 2983 789 1393 600 BETHNAL GREEN SANITARY DISTRICT. TABLE II. Shelving the Annual Birth Bate, Bate of Mortality, Death Bate among Children, and Deaths in Public Institutions for the year 1895, and 10 years preceding. YEAR. Birth Rate per 1000 of the Population. Annual Kate of Mortality per 1000 living. Deaths of Children under 1 year; per centage of Total Deaths. Per centage of Deaths of Children under 1 year to Registered Births Deaths of Children under 5 years; per centage of Total Deaths. Total Number of Deaths in Public Institutions. 1895 37.30 21.64 27.88 16.18 47.10 625 1885 39.96 22.08 26.31 14.54 42.56 534 1886 40.00 23.45 29.21 17.10 49.77 532 1887 38.41 22.45 27.90 16.31 48.40 598 1888 37.82 22.65 26.03 15.60 48.78 556 1889 37.70 20.67 26.51 14.10 48.40 561 1890 37.25 24.78 23.70 16.20 43.80 641 1891 38.70 25.41 25.22 16.54 44.12 707 1892 38.60 23.49 26.10 15.86 48.25 588 1893 38.60 26.47 26.00 17.70 45.00 722 1894 37.70 21.40 26.00 15.20 47.00 570 Average of 10 years, 1885 to 1894. 38.47 23.28 26.29 15.91 46.60 600 K2 3 (A). Table of Deaths during the year 1895, in the Bethnal Green Metropolitan District, classified according to Diseases, Ages, and Localities. Names of Localties adopted for the purpose of these Statistics ; public institutions being shown as separate localities. Mortality from all causes, at subjoined Ages. Mortality prom subjoined causes, distinguishing Deaths of Children under Five Years op Age. At all ages. Under 1 year. 1 1 and under 5. 5 and under 15. 15 & under 25. 25 & under 65. 65 & upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Erysipelas. Measles. Whooping Cough. Diarrhcea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis Pneumonia & Pleurisy. Heart Disease. Influenza. Injuries. All Other Diseases. Total. Enteric or Typhoid. Puerperal. North, Sub-District 750 282 159 30 31 166 82 Under 5 17 7 2 32 n 53 4 101 3 2 24 185 441 5 upwds. 3 1 2 7 2 3 1 4 i 52 89 32 8 7 97 309 South, Sub-District 533 212 116 13 14 122 56 Under 5 4 9 3 ... 2 29 5 40 6 62 2 1 18 147 328 5 upwds. 2 2 1 1 1 4 29 57 29 8 5 66 205 East, Sub-District 656 226 153 19 13 154 91 Under 5 3 10 4 ... 1 41 17 50 1 68 4 1 13 166 379 5 upwds. 1 1 2 2 1 1 2 5 3 36 77 39 8 7 92 277 Workhouse 458 22 14 1 9 219 193 Under 5 1 ... 1 2 32 36 5 upwds. 4 ... 1 1 83 141 39 2 ii 140 422 Bethnal House Asy. 43 1 25 17 Under 5 ... 5 upwds. 1 ... 4 11 5 i 21 43 Mildmay Hospital 29 5 6 5 13 Under 5 1 1 1 l 1 5 5 upwds. 1 5 3 4 l 10 24 Victoria Pk. Hos.... 95 2 7 14 72 ... 1 1 2 5 upwds' 67 3 17 6 93 Totals ... 2564 742 449 76 87 771 439 7 38 14 5 103 33 144 19 235 9 4 56 531 1191 5 upwds. 6 3 4 11 4 2 4 15 5 276 381 165 26 32 432 1373 The subjoined numbers havo also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons not belonging thereto. 355 32 86 38 33 132 34 Under 5 3 15 25 1 3 2 2 18 1 15 34 118 5 upwds 1 2 19 ... 6 2 1 21 25 33 2 34 91 237 Deaths occurring within the district among persons belonging thereto. 150 2 3 14 14 98 IS Under 5 1 1 3 5 5 upwds 1 i 67 18 21 2 35 145 K2 II (B). Table of Population, Births, and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1895, in the Sanitary District of Bethnal Green; classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics. Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Ages under 5 or over 5 New Cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such cases removed from their homes in the several Localities for treatment in Isolation Hospitals. Census 1891. Estimat'd to Middle of 1895. Small Pox. Scarlatina. Diphtheria & Membranous Croup. FEVERS. Cholera. Erysipelas. Small Pox. Scarlatina. Diphtheria & Membranous Croup. FEVERS. Typhus. Enteric or Typhoid. Puerperal. Enteric or Typhoid. North, Sub-District 51,520 49,000 1,905 Under 5 5 80 78 ... 3 ... ... 11 5 26 24 ... 5 upwards 18 157 114 ... 44 5 ... 113 18 67 29 23 South, Sub-District 33,489 34,000 1,343 Under 5 6 91 63 ... 3 ... ... 6 6 40 16 1 5 upwards 24 132 72 ... 26 2 ... 71 23 54 26 14 East, Sub-District 44,123 45,000 1,523 Under 5 7 72 46 ... 1 ... ... 10 7 22 15 ... 5 upwards 20 116 74 ... 32 ... ... 67 17 63 22 11 Workhouse ... ... ... Under 5 1 ... 1 ... ... ... ... ... 1 ... ... ... 5 upwards 4 3 ... ... 4 ... ... 22 4 3 ... ... Mildmay Hospital ... ... ... Under 5 ... 1 1 ... 1 ... ... ... ... 1 ... ... 5 upwards ... 1 3 ... 5 ... ... ... ... 1 3 ... Victoria Park Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... 1 ... ... 1 ... ... ... ... BethnalHouse Asylum ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... Children's Home ... ... ... Under 5 ... 1 1 ... ... ... ... ... ... ... 1 ... 5 upwards ... 12 3 ... ... ... ... ... ... ... ... ... Totals 129,132 128 000 4,771 Under 5 19 245 190 ... 8 ... ... 27 19 89 56 1 5 upwards 66 471 266 ... 112 7 ... 274 62 188 80 48 Isolation Hospitals : Homerton, St. Anne's, Tottenham, and Hospital Ships. 69 NOTES ON TABLE A & B. The deaths classified in Table (A), and summed up in the horizontal line of " Totals," are the whole of those registered as having actually occurred in the several localities comprised within the district. But the registered number of deaths requires correction before it can give an exact view of the mortality of the district; and the two lowest horizontal lines indicate what the extent of such corrections should be. Area and Population of the District or Division to which this Return relates. Area in Acres 755 Population (1891) 129,134 Death Rates. General21.6 Infant (under one year of age) 162.0 per 1,000 Population, estimated to middle of 1895. per 1,000 Births Registered. In recording the facts under the various headings of Tables A and B, attention has been given to the notes endorsed on the Tables. 70 BETHNAL GREEN SANITARY DISTRICT, TABLE IV. Shewing the Mortality from certain classes of Diseases, and proportions to Population, and to 1000 deaths, 1895. DIVISION I. (All Ages). Total Deaths Deaths per 1000 of Population (all ages). Proportion of Deaths to 1000 Deaths (all ages). 1. Seven Principal Zymotic Diseases 442 3.4 159.6 2. Pulmonary Diseases (other than Phthisis) 640 5.0 231.1 3. Phthisis 243 1.89 87.7 DIVISION II. (Young Children). Total Deaths. Deaths per 1000 Children Proportion of Deaths to 1000 Deaths Children 4. Pulmonary Diseases 252 13.3 193.2 5. Zymotic Diseases 384 20.2 294.5 BETHNAL GREEN SANITARY DISTRICT. TABLE V. Shewing the Number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospital Deaths, in the ten years 1885 to 1894 and in the year 1895. DISEASE. 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 Annual Average of ten years. 1885—1894. Proportion of Deaths to 1000 Deaths in ten years, 1885-1894. 1895 Proportion of Deaths to 1000 Deaths in 1895. Small Pox 22 0 1 1 0 0 0 5 7 5 41 1.37 4 1.40 Measles 163 108 73 124 132 106 100 131 82 135 115.4 38.65 110 39.73 Scarlet Fever 62 35 61 120 40 34 29 53 71 27 53.2 17.83 30 10.83 Diphtheria and Membranous Croup 19 21 26 52 102 133 69 119 137 133 81.1 27.18 102 36.84 Whooping Cough 92 148 101 167 62 113 128 122 59 70 106.2 35.60 33 11.92 Fever 21 29 31 21 21 29 19 22 26 26 24.5 8.21 17 6.14 Diarrhœa 84 166 123 67 95 94 77 74 128 54 96.2 32.25 146 52.37 Total in Bethnal Green 463 507 416 552 452 509 422 526 510 450 480.7 161 442 159 BETHNAL GREEN SANITARY DISTRICT, TABLE VI. Inspector's Report of the Sanitary Work, &c., completed in the year ending December 31st, 1895. Number of Houses, Premises, &c., Inspected 5,794 Number of Re-inspections 1,6872 Results op Inspection— Orders issued for Sanitary Amendments of Houses and Premises 3,916 Houses and Premises, &c., Cleansed, Repaired and Whitewashed 1,968 Houses Disinfected after Infectious Diseases 1,024 House Drains— Repaired, Cleansed, &c. 252 New Provided 187 Trapped or Ventilated 328 Stack Pipes and Waste Pipes Disconnected 191 Privies and Water Closets— Repaired, Cleansed, &c 1,346 Supplied with Water and Water Supply Apparatus 377 New Provided 26 Ventilated 47 Water Supply— Houses Provided with Water Supply 116 Houses Supply Disconnected from Closet Cistern 32 Miscellaneous— Paving of Yards Repaired 898 Washhouses Paved, &c 66 Stables Paved and Drained 42 Removal of Accumulation of Dung, and other Refuse 76 Offensive Effluvia Abated 59 Removal of Animals improperly kept 34 Overcrowding Abated 28 Number of Dust Complaints received and attended to 54 New Dung Pits Provided 28 Illegal Occupation of Cellars discontinued 1 Bakehouses Regularly Inspected 104 Fish-Curing Premises „ „ 42 Licensed Cowhouses „ „ 25 Licensed Slaughterhouses „ ,, 10 Legal Proceedings under the Pood and Drugs Act 10 No. of Food Samples obtained and submitted to the Public Analyst 102 73 PUBLIC HEALTH (LONDON) ACT, 1891. Returns for 1895. Number of Summonses issued, heard and Magistrates' Orders obtained for the abatement of nuisance 20 Number of Summonses issued, heard and Magistrates order to close obtained 6 Number of Summonses issued and Penalties imposed 2 Number of Summonses issued and withdrawn 62 Summonses issued in 1894, but withdrawn in 1895 19 Summonses issued in 1894, but Magistrate's Orders obtained in 1895 2 Summonses issued in 1895, but adjourned to 1896 15 PROCEEDINGS UNDER THE HOUSING OF THE WORKING CLASSES ACT DURING THE YEAR 1895. Number of Houses certified during the year 18 Number of Houses closed under Magistrates' order 9 Number of Houses closed by owner 10 Houses repaired and re-opened 13 Number of Houses demolished 9 Number of Magistrates' orders obtained during the year 9 Summonses withdrawn 1 Summons issued against Occupier for failing to comply with Magistrate's closing order. Fine imposed 1 Ditto. but order obtained for costs 1 ST. MATTHEW, BETHNAL GREEN. STREET LIST. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Abbey street 2 ... 1 3 6 Bonner road 1 ... 4 2 7 Abingdon street 1 1 1 3 6 Bonner street 2 1 3 2 8 Accidental place ... ... ... ... ... Bon well street 3 ... 3 3 9 Ada place 1 2 2 3 8 Boreham street ... ... 2 ... 2 Ainsley street ... 2 ... 1 3 Boundary street 2 1 ... .1 4 Albert road ... ... ... ... ... Bradys buildings ... ... ... 1 1 Albion place ... ... ... ... ... Brady street 5 3 3 9 20 Alfred place ... ... 1 ... 1 Braemar street ... ... 3 2 5 Alma road 3 2 2 3 10 Bratley street 1 ... 1 1 3 Ames place ... ... ... ... ... Brick lane 3 1 .1 20 29 Ames street 2 ... 2 2 6 Brierley street 1 1 ... 2 4 Angela gardens 1 ... 1 3 5 Buxton street ... ... 1 ... 1 Andrews road 2 ... ... 2 4 Buckhurst street 1 1 4 6 12 Anglesea street ... ... 2 3 5 Bullards place 1 l ... 1 3 Anns place ... ... 1 ... 1 Bunsen street ... ... ... ... ... Antill road ... ... ... 4 4 Burgoyne road ... 1 ... ... 1 Approach road ... ... ... 5 5 Burnliam square ... ... ... Arbery road 1 1 1 7 10 Burnside street 1 l ... 2 4 Archer street 3 ... ... 2 5 Busby street ... l 3 4 8 Arline street 2 1 ... 1 4 Busby square 1 ... 1 ... 2 Artillery street 2 ... ... 2 4 Butlers hidings. ... ... 1 1 2 Arundel street 2 1 ... 11 14 Ash well road 1 ... ... 2 3 Auckland road 2 2 5 5 14 Cadell street 2 l 1 3 7 Austin street 2 ... 2 1 5 Cambridge circus ... ... ... ... Bacon street 10 4 7 8 29 Cambridge street cambridge road ... 5 1 2 ... 8 1 19 2 34 Baden place ... ... ... ... ... Cambridge bldgs 1 1 1 4 7 Baker street ... ... 1 1 2 Camden street 2 3 3 3 11 Bakers court ... ... ... ... ... Canrobert street ... 4 2 7 13 Bandon road 2 1 1 6 10 Carlisle street ... ... ... 1 1 Barnet grove 1 ... 1 2 4 Carlton place ... ... ... ... ... Barnsley street 3 2 6 5 16 Carter street ... ... 2 ... 2 Baroness road 1 ... 1 5 7 Catherine street ... ... 1 2 3 Bath grove ... 1 1 1 3 Centre street ... ... 1 3 4 Bath street ... ... ... ... ... Chambord street 3 8 3 6 20 Baxendale street 3 5 3 9 20 Chance street ... 1 ... ... 1 Bedford row ... ... ... ... ... Chapel street 2 2 ... 2 6 Bellhaven street ... 1 1 2 4 Chapman gdns ... ... ... ... ... Bennetts place ... ... ... ... ... Charles terrace 2 2 ... ... 4 Bethnal green road 6 5 6 13 30 Charlotte court ... ... ... ... ... Birkbeck street 1 ... ... 1 2 Charlotte street ... 2 4 6 Bishops road 3 3 5 8 19 Charlotte bldngs ... ... ... ... ... Blythe street ... 2 2 4 8 Cheshire street 2 ... 5 10 17 75 STREET LIST (continued). Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total.   Chester street 1 1 1 3 6 Digby walk 1 ... 1 1 3 Chester place ... ... ... ... ... Dinmont street ... ... ... 1 1 Chilton street 6 3 1 7 17 Diss street ... ... 2 3 5 Chisenhale road 3 2 5 6 16 Dixie street 1 ... ... 3 4 Christopher street ... ... ... ... ... Doveton street ... ... ... ... ... Church street 1 1 4 4 io Ducal street ... ... 1 1 2 Church row 1 3 2 11 17 Durant street ... ... ... 4 4 Clare street ... 3 1 ... 4 Claremont street ... ... ... 1 1 Eastman street 2 ... ... 2 4 Clarkson street 1 ... 1 2 4 Ebor street ... ... ... ... ... Clarence street 2 1 2 4 9 Eckersley street ... ... ... 2 2 Cleveland street ... ... 1 2 3 Edward street 2 1 2 6 11 Club row 1 ... ... ... 1 Edward place ... ... ... ... ... Code street 2 ... ... ... 2 Ezra street 1 ... ... ... 1 Collingwood place ... ... ... ... ... Elwin street ... 2 2 2 6 Collingwood street 2 3 7 16 28 Elizabeth court ... ... ... ... ... Colliers court 1 ... ... 1 2 Ellesmere road 1 2 1 9 13 Collins place 1 1 3 5 10 Elvidge court ... ... ... ... ... Columbia square 3 3 1 4 11 Emma street 1 ... 3 3 7 Columbia road 19 7 9 21 56 Ernest place ... ... ... ... ... Conyer street ... ... ... 1 1 Cooper's gardens 1 4 1 4 10 Faith street ... 1 ... 1 2 Cordova road 1 1 5 7 14 Falcon buildings ... 1 ... 1 2 Corfield street 1 3 7 22 33 Felix street 1 1 4 6 12 Cottage place ... ... ... ... ... Fellbrigg street 1 ... 2 2 5 Coventry street 2 2 5 8 17 Finnis street 5 3 3 5 16 Coventry place ... ... ... ... ... Fleet street hill l ... ... ... 1 Cranbrook street 4 ... 5 5 14 Flint court l 1 ... 1 3 Cranbrook road ... ... 1 ... 1 Florida street 2 1 1 4 8 Craven buildings ... 1 ... 1 2 Foster street 2 ... 3 3 8 Crescent place 1 5 ... 6 12 Foundry yard ... ... ... ... ... Cross street ... ... ... ... ... Fountain court 1 ... ... ... 1 Crossland square ... 1 ... ... 1 Fournier street ... ... ... ... ... Cudworth street 1 2 1 2 6 Fox street ... ... ... 1 1 Cymon street ... ... ... 1 1 Fuller street 1 2 6 11 20 Cyprus street ... 1 6 6 13 Cygnet street 1 ... 1 1 3 Gales gardens 1 2 6 4 13 Garden place ... ... ... 1 1 Dagnall place ... 1 1 ... 2 Gardners road 1 ... 3 5 9 Daniel street ... ... 1 2 3 Garden row ... ... ... ... ... Darling row 1 ... 1 1 3 Gascoyne place ... ... 1 1 2 Davis place ... 1 ... 1 2 Gawber street 1 1 3 2 7 Derbyshire street ... 4 3 6 13 Gays buildings ... ... ... ... ... Derby place ... ... ... 1 1 Georges place ... ... ... 1 1 Delta street ... ... ... 1 1 Georges terrace ... ... ... ... ... Devonshire place ... ... ... ... ... Georgina gardens, ... ... ... ... ... Devonshire street ... ... ... ... ... George gardens ... 1 3 9 13 Digby street 1 2 5 3 11 Gernon road ... ... ... 2 2 76 STREET LIST {continued). Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Gibraltar place ... ... ... ... ... Huntingdon bldgs. 1 2 1 1 5 Gibraltar gardens 1 1 ... 2 4 Inkhorn yard ... ... ... ... ... Gibraltar walk 3 4 2 2 11 Gibraltar buildings. ... ... ... ... ... Gillman street ... 1 2 3 6 Ion square ... 5 2 4 11 Glass street ... ... ... 2 2 Ivimey street ... ... ... 2 2 Globe road 1 2 3 7 13 Jacobs place ... ... ... ... ... Gloster street 2 1 4 4 11 Gloster gardens ... ... ... ... ... Jacobs street ... ... ... ... ... Godfreys place ... ... ... ... ... James street ... ... 1 4 5 Gore road ... ... ... 2 2 James court ... ... ... ... ... Gossett street 8 1 5 17 31 James place ... ... ... ... ... Granby row ... ... ... ... ... Jane street 1 ... ... 4 5 Granby street ... 2 3 3 8 Jersey street ... 5 1 2 8 Granby place ... ... ... ... ... Jubilee place ... ... ... ... ... Green street 8 4 3 22 37 Grove street ... ... ... 1 1 Kay street ... ... ... 2 2 Grove road 2 2 2 14 20 Grt. Eastern bldngs. ... 1 ... 4 5 Kelsey street ... ... ... ... ... Kenilworth road 1 ... 4 2 7 Hackney road 4 3 9 16 32 Key street 1 3 2 3 9 Hague street 3 ... 1 1 5 Key court ... ... ... ... ... Hague place ... ... 1 ... 1 Kings place 1 ... ... 1 2 Hague buildings ... ... ... ... ... Knottisford street 1 ... ... 5 6 Half Nichol street. ... ... ... 1 1 Hammonds gdns ... ... ... 1 1 Lansdell place ... 1 ... 2 3 Hamilton road 2 1 ... 5 8 Lark row ... 1 2 ... 3 Hare row ... ... ... ... ... Lawfranc road ... 1 ... 1 2 Hare marsh ... ... ... ... ... Letchford place ... ... ... ... ... Hare street 6 5 7 11 29 Lenham buildings. ... ... ... ... ... Hare court ... 1 ... 1 2 Leopold buildings. 2 ... 2 4 8 Harrold street 2 2 2 2 8 Lessada street 1 3 5 9 Hartley street 3 1 3 6 13 Linden buildings ... 2 1 4 7 Harts lane 4 4 2 2 12 Lisbon street 2 ... 1 3 6 Hassard street 1 5 3 3 12 Little Collingwood street ... ... ... ... ... Hassard place ... 1 ... 1 2 Havelock place 1 ... 1 2 4 Little York street. ... ... 2 1 3 Helens place 2 ... ... ... 2 London street ... ... 1 3 4 Henrietta street 2 ... 1 3 6 Lucas street ... 1 ... ... 1 Hereford street 2 ... 1 5 8 Lyte street ... ... 2 ... 2 Hereford buildings ... ... ... 1 1 Hersee place 2 ... 3 5 10 Hill street ... ... 2 4 6 Mace street 4 ... 3 6 13 Holly bush gardens 1 2 ... 3 6 Maidstone place ... ... ... ... ... Hollybush place ... ... 1 ... 1 Manchester bldgs. ... ... ... ... ... Horatio street 1 ... 3 3 7 Manchester place ... ... ... ... ... Horts yard ... ... ... ... ... Mansford street 1 10 3 19 33 Hunslett street 3 1 ... 1 5 Mape street 3 ... 2 3 8 77 STREET LIST (continued). Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Margaret place ... 1 2 4 7 Old Ford road 10 ... 9 20 39 Marian street ... ... 2 2 4 Old Nichol street ... ... 4 5 9 Marian place ... ... ... ... ... Olga street 1 ... 4 2 7 Marion square ... ... 1 3 4 Orange street 1 ... ... 2 3 Martha court 1 ... ... ... 1 Orange court ... ... ... ... ... Matilda street ... ... 1 2 3 Oval 2 ... 1 4 7 Mead street ... ... ... ... ... Oxford street ... i ... ... 1 Medhurst road 3 1 2 1 7 Medway road ... ... 1 3 4 Palestine place ... i ... ... 1 Melina place ... ... ... ... ... Palm street 1 ... 1 5 7 Menotti street 1 1 1 5 8 Palmers road ... ... ... ... ... Middleton street 1 2 4 6 13 Park street 1 i 2 2 6 Minerva street 3 1 4 4 12 Park place ... ... ... ... ... Minto street ... ... ... 1 1 Parliament place ... ... ... ... ... Miring place ... ... ... ... ... Parliament street ... ... ... ... ... Monkford place ... ... ... ... ... Parmiter street 1 ... 1 3 5 Morpeth street 2 1 3 8 14 Patriot square ... 2 2 6 10 Morpeth road 2 ... ... 4 6 Peacock street ... ... ... 1 1 Moss street 1 1 4 10 16 Peacock place ... ... 1 2 3 Mount street 3 ... 3 1 7 Pedley street ... 1 4 2 7 Mount square ... ... ... ... ... Peel grove ... ... ... 1 1 Mowlem street 3 1 2 3 9 Pereira street 3 2 3 5 13 Museum buildings ... ... ... ... ... Peter street ... 1 ... 1 2 Pitt street ... ... 2 3 5 Pollard row ... 1 3 9 13 Nant street ... ... ... ... ... Pollard street 4 2 1 8 15 Neath place 1 2 2 5 10 Pott street 1 ... 2 2 5 Nelson street ... 1 2 2 5 Poyser street ... 1 2 4 7 Nelson place 1 ... ... ... 1 Preston street 2 1 3 12 18 New Castle street ... ... ... ... ... Primrose street ... ... ... ... ... New Church street. ... ... ... ... ... Princes court 2 1 ... 4 7 New Nichol street 1 ... 2 3 6 Princess place ... ... ... ... ... Now Turville place. ... ... ... 1 1 Prichards road 3 1 5 7 16 New Tyssen street 1 1 1 4 7 Prospect terrace 2 4 3 2 11 New square 1 1 1 2 5 Providence place ... 1 1 ... 2 New street ... ... ... ... ... Punderson gardens 1 1 3 5 10 Newling street 1 ... 2 2 5 Nichols row ... ... ... 1 1 Queen street ... ... ... ... ... Norah street 2 2 1 2 7 Queens buildings 1 ... ... 2 3 North passage ... ... 1 ... 1 Queen Caroline place ... ... ... ... ... North place 1 1 1 2 5 Northampton street 4 ... 2 2 8 Quilter street 7 2 4 5 18 Nottingham street 1 1 1 2 5 Quinns square 9 4 5 13 31 Norton street 1 1 ... 1 3 Ramsey street 1 1 2 1 5 Octagon street ... ... 2 2 4 Ravenscroft street. ... ... 4 ... 4 Old Bethnal Green road 4 2 1 9 16 Reform square ... ... ... ... ... Rappley place ... ... ... ... ... 78 STREET LIST (continued). Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Reuben street 1 ... 1 ... 2 Surat place ... ... ... ... ... Riders court ... ... ... ... ... SweetApple square ... ... ... ... ... Robert street 1 1 1 3 6 Sidney street 1 1 1 3 6 Robinson road ... ... 1 ... 1 Roman road 2 ... 3 4 9 Tagg street 4 2 1 1 8 Ropley street 1 ... 2 1 4 Tapp street 1 ... ... 1 2 Royal Victor place ... ... ... ... ... Tavistock street ... ... 1 2 3 Royston street 4 3 3 10 20 Teal street ... ... 1 ... 1 Russia lane 1 ... 6 5 12 Teesdale street 3 1 2 6 12 Temple street 1 ... 4 5 10 Sale street 2 ... 6 10 18 Tent street 3 ... 2 4 9 Sarah street ... ... ... ... ... Theydon road ... ... 1 2 3 Satchwell rents ... ... 2 ... 2 Thomas passage ... ... ... ... ... Satchwell street ... ... ... 2 2 Thomas place ... 1 ... ... 1 School place ... ... ... ... ... Thorold street ... 3 ... 4 7 Sclater street 2 3 3 6 14 Three Colts corner ... ... ... ... ... Seott street 1 4 1 3 9 Three Colts lane ... ... 3 3 6 Seabright street 1 3 7 7 18 do. Waterlow dwellings ... ... 1 1 2 Seabright gardens ... ... 1 ... 1 Sely street ... 1 1 6 8 Thurlow place ... ... ... ... ... Sewardstone road 6 1 5 5 17 Totty street 1 ... 3 1 5 Shacklewell street ... ... ... ... ... Toye's buildings 4 2 2 4 12 Sheep lane ... ... ... ... ... Treadway street ... 3 5 11 19 Sheldon place 1 ... ... ... 1 Trinity ground ... ... 1 2 3 Sherwood place ... 1 ... ... 1 Turin street ... 1 2 4 7 Shipton street 3 1 2 2 8 Turk street ... ... 1 ... 1 Short street ... ... ... ... ... Turville street 1 1 ... 1 3 Swan street ... ... ... ... ... Turville buildings. ... ... ... ... ... Smart street ... 2 1 1 4 Turville square ... ... 1 ... 1 Smith's place ... 1 ... 2 3 Tuscan street ... ... 1 3 i Southampton place ... 1 ... ... 1 Type street ... ... ... 2 2 Southampton cotgs. ... ... 1 ... 1 Tyrrell street 1 ... ... 1 2 Southampton ter ... 1 ... 1 2 Southborough place ... ... ... 1 1 Usk street 1 2 1 6 10 Spencer passage ... ... ... ... ... Squirries street ... 1 3 4 8 Valley place ... ... ... ... ... St. Andrew street 1 ... ... 1 2 Viaduct street 3 1 4 8 16 St. James road ... 1 ... 1 2 Viaduct place ... ... 2 1 1 St. John street 3 ... 2 ... 5 Victoria street ... ... 2 1 3 St. Jude street 1 2 3 1 7 Victoria place ... ... ... ... ... St. Matthias place ... ... ... ... ... Victoria park sqre. ... 1 1 2 4 St. Peter square ... ... 1 ... 1 Violet street ... ... ... ... ... St. Peter street 2 1 1 5 9 Violet row ... 1 ... 1 1 Stainsbury street 1 ... ... 4 5 Virginia road 1 4 6 11 22 Strahan road 2 1 ... 5 8 Vivian road 2 3 1 2 8 Stroud place ... ... ... ... ... Wadeson street 1 ... 1 4 6 Sugarloaf walk ... ... 1 1 2 Walsby place ... ... ... ... ... Summerford street 3 4 2 6 15 Walter street 2 1 2 3 8 79 STREET LIST (continued). Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Warner place 2 2 3 3 10 Wimbolt street ... ... 1 3 4 Warley street 3 ... 2 8 13 Winchester place 1 ... ... ... 1 Waterloo place ... ... ... ... ... Winchester crsnt ... ... ... 5 5 Waterloo terrace ... ... ... 1 1 Winchester street 2 1 ... 3 6 Waterloo road ... ... 2 2 4 do. dwellings ... ... ... ... ... Weaver street 1 4 ... 2 7 Wolverly street ... ... 1 3 5 Weldon street ... ... ... ... ... Wood street ... ... ... 1 1 Wellington row 3 3 3 5 14 Woods Close ... ... ... ... ... Wellington place 2 ... ... 1 3 York street ... ... 1 ... 1 Wenmngton road ... 2 1 3 6 York place ... ... l ... 1 Wharf road ... ... ... ... ... Wharncliffe street 3 ... 1 1 5 BethnallH. Asylum ... ... l 1 2 White street 1 3 5 6 15 Mildmay Hospital ... ... ... 4 4 Whites court ... ... ... 1 1 Militia Barracks. ... ... ... 1 1 Whitechapel road ... ... ... ... ... Regents Canal ... ... ... 1 1 William place ... 1 ... ... 1 Victoria Park Hos. ... 2 ... ... 2 Willow walk ... 1 1 4 6 Workhouse 2 3 3 37 45 Wilmot street 4 6 3 13 26 Resid'ncenot kwn. 1 9 19 37 66