BET 4 REPORT OF THE Sanitary Condition AND Vital Statistics OF THE Parish of St. Datthem, BETHNAL GREEN, DURING THE YEAR 1896. by GEORGE PADDOCK BATE, M.D., Fellow of the Royal College of Surgeons and Licentiate of the Royal College of Physicians of Edinburgh; President of the 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. 1897. SUMMARY. 1895. 1896. Estimated population of Bethnal Green at all ages 128,000 129,200 ,, „ Young Children under 5 years 17,960 18,000 „ ,, Old People, over 65 years 4,705 4,748 Area—755 Acres Number of Inhabited Houses 16 542 (Census 1891) Average number of Persons to each Acre 169 171 Total number of Births in the year 4,771 4 869 Total number of Marriages 1,310 1,384 Marriage Rate—Bethnal Green 20.4 21.4 Marriage Rate—London 17.1 18.0 Death Rate—Bethnal Green 21.6 22.5 Death Rate — London 19.4 18.2 Birth Rate—Bethnal Green 37.3 37.7 Birth Rate—London 30.5 30.2 Infantile Death Rate (on Births)—Bethnal Green 162.0 170.3 Infantile Death Rate (on Births)—London 165.0 160.0 Young Children's Death Rate (on estimated number of Young Children) 72.6 82.6 Old People's Death Rate (on estimated number of Old People) 94.3 93.5 Zymotic Death Rate—Bethnal Green 3.4 4.2 Zymotic Death Rate—London 2.6 3.1 Inquest Cases 297 296 Uncertified Deaths (no Inquests held) 0 0 Synopsis of MEDICAL OFFICER'S ANNUAL REPORT, 1897. Vital Statistics page Census 5 Population 6 Births 7 Deaths 7 Death-Rate 8 Birth Rate 9 Marriages 9 Deaths of Infants 10 Deaths of Young Children 10 Old Persons' Death Rate 10 Special Causes of Death 10 Table of Deaths during the year 1896, in three Sub-Districts of Bethnal Green, classified according to Diseases, Ages, and Localities 11 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 1890 15 The Seven Principal Zymotic Diseases 17 Notification of Infectious Diseases 18 Table G. Infectious Cases, 1896 19 Small Pox 20 Scarlet Fever 20 Enteric Fever 21 Diphtheria (including Membranous Croup) 21 Report of Fever and Diphtheria Cases admitted into Fever Hospitals during the year 1896 23 Whooping Cough 24 Measles 24 Diarrhoea 24 Tubercular Diseases 24 Respiratory Diseases 25 page Tenement House Regulations 25 Total Tenements and Tenements with less than Five Rooms, distinguishing those occupied by various numbers of Persons in the Sanitary Areas of Bethnal Green 26 Slaughter-houses 28 Cow-houses 29 Bakehouses 29 St. Matthias' School, Hare Street 29 Sale of Food and Drugs Act 29 Factories and Workshops 33 Housing of the Working Classes Acts 35 Sanitary Staff 39 Tables— I.—Showing Population, Births, Deaths, and Marriages, for 1896, and ten years preceding 41 II.—Annual Birth Rate, Rate of Mortality, Death Rate among Children, and Deaths in Public Institutions for the year 1896, and ten years preceding 42 (K2) IIB).—Table of Population, Births, and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1896, in the Sanitary District of Bethnal Green ; classified according to Diseases, Ages, and Localities 43 (K2) IIIa.—Table of Deaths during the year 1896, in the Bethnal Green District, classified according to Diseases, Ages, and Localities 44 V.—Showing the number of Deaths from the Seven Principal Zymotic Diseases, inclusive of Hospital Deaths, in the ten years, 1886 to 1895, and in the year 1895 45 IV.—Showing the Mortality from certain Classes of Diseases and proportions to Population, and to 1000 Deaths, 1896 46 VI.—Inspectors' Report of Sanitary Work 47 Sanitary Improvements, New Drains, W.C.'s, &c., in the Parish, during the year 1896 48 Street List 49 REPORT. Gentlemen, I this year attain my majority as a Medical Officer of Health, and have the honour to present to you my Twenty-first Annual Report on the vital statistics of Bethnal Green for the year 1896, the fifty-second week of which terminated on the 2nd of January, 1897. QUINQUENNIAL CENSUS. On the night of March 29th, a census of the administrative County of London was taken, and Bethnal Green was found to contain on that date, 129,162 persons, The official report of the Registrar General was issued in the following August; it, however, merely contains the bare numbers of the population in the Wards into which the forty Metropolitan Parishes have been divided for the election of Vestrymen. The numbers are as follows, and the corresponding figures of the 1891 census are shewn for purposes of comparison, together with the inhabited houses in that year. RETURN OF THE POPULATION ENUMERATED ON THE NIGHT OF MARCH 29th IN THE FOUR WARDS INTO WHICH BETHNAL GREEN HAS BEEN DIVIDED FOR THE ELECTION OF VESTRYMEN. WARD. Population in 1896. Population in 1891. Inhabited houses. East 43,155 42,467 5,058 North 22,402 19,930 2,600 West 25,221 31,636 3,733 South 38,384 35,099 5,151 Total 129,162 129,132 16,542 6 POPULATION. It is a matter for considerable regret that the details in the Census report are so meagre; the object, however, of the enumeration was not statistical, but merely for the purpose of enabling the London County Council to apportion the rate levied under the Equalization of Rates Act of 1894 upon an accurate basis. The populations of the three Registration districts into which the Parish is divided are not given in the Census report, but as the figures are set forth in the recent weekly returns of the Registrar General, I am in a position to correct my estimate of last year and bring it up to the middle of 1896. The figures printed in the table below are those of the Registrar General for the South and East districts, but I have made a slight addition to the official figures for the North district, as the new buildings on the Boundary Street Area are filling up as fast as they are ready for occupation. The estimated populations of the three Registration sub-districts are shewn in the accompanying table, and the number of inhabited houses for 1891 is also stated, as a comparison with the enumeration of that year. POPULATION IN REGISTRATION DISTRICTS (ESTIMATED;. DISTRICT. Estimated in 1896. Enumerated in 1891. Inhabited houses. North 49,339 51,520 6,607 South 34,194 33,489 4,579 East 45,667 44,123 5,356 Total 129,200 129,132 16,542 7 BIRTHS. The births during the year were 4,869 against 4,771 in 1895, an increase of 98; the excess of the births over the deaths being 1,960. Table " B " shews this, and compares the two years:— TABLE B. 1895. 1896. Estimated population in the middle of the year 128,000 129,200 Total Births 4 771 4,869 Total Deaths 2,769 2,909 Excess of Births over Deaths, shewing the natural increase of the Population 2,002 1,960 The North District contributed 1,892 of the births as against 1,905 in the previous year, the South 1,333 as against 1,343, and the East 1,644 as against 1,523. DEATHS. In the three sub-districts of Bethnal Green a total of 2,717 deaths was registered in 1896, against 2,564 in the previous year; but in this number are included the deaths of 177 persons who were not in any way connected with Bethnal Green beyond the fact that they were patients in one of the public institutions within our boundaries, and died there. On the other hand I receive a monthly return from Somerset House of the deaths of persons ordinarily residing in Bethnal Green who have died in the various Hospitals in the other parts of the Metropolis. These persons having probably contracted their diseases in this parish, the fatal termination must be taken into account just as though they had actually died here, and there were no less than 369 of these deaths; adding these and subtracting the non-parishioners gives a net total of 2,909. 8 The deaths in each of the sub-districts, corrected by distribution in a similar manner, were as under:— North 1,142 South 814 East 953 Total 2,909 DEATH RATE. I regret that our mortality for the year under consideration exceeded that of the previous year; to the causes of this increase I shall refer later on. Upon the basis of the estimated population I calculate a death rate of 22.5. This is an increase of nearly one per thousand over the rate of the previous year, and is no less than 4.3 in excess of the corresponding rate for the whole of London, namely 18.2. The mortality in the three sub-districts was as under:— North 23.15 South 23.80 East 20.87 In the following table the mortality rates for London and for Bethnal Green are compared by Quarters, and the mean temperature and rainfall for each three months are also shewn:— TABLE C. Quarter ending. London Death Rate. Bethnal Green Death Rate. Mean Temp. Fahr. Rainfall (inches.) March 19.2 27.3 42.2 3.99 June 17.4 21.0 55.6 2.77 September 18.4 21.6 60.4 8.67 Jan. 2nd. 17.7 20.1 42.4 6.99 Average 18.2 22.5 50.1 22.42 T1. R.F. 9 BIRTH RATE. The births registered during the year were 4,869, which is equal to a rate of 37.7, and is about 0.4 per thousand higher than the birth rate of the preceding year, and also seven-and-a-half per thousand in excess of the general Metropolitan rate, which was 30.2. In the registration sub-districts the birth rates were as under: — North 38.3 South 39.0 East 36.0 The following table compares the birth-rates for Bethnal Green and for London by quarters:— Quarter ending London. Bethnal Green. March 30.3 39.8 June 30.3 37.1 September 29.4 34.4 January 2nd 30.7 39.9 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 229 Second Quarter 354 Third Quarter 358 Fourth Quarter 443 Total 1,384 This total indicates a marriage rate of 10.7 to every thousand persons ; or, as in each marriage there are two contracting parties, 21.4 per thousand of our population entered the bonds of matrimony. 10 DEATHS OF INFANTS. Twenty-eight and a half per cent. of the deaths from all causes were those of infants aged less than twelve months, for, out of 4,869 children born alive, 829 died before reaching the age of one year, thus giving a death rate, calculated upon the births, of 170.3, while the corresponding rate for the whole of London was 160. DEATHS OF YOUNG CHILDREN. More than half the deaths (1,487, that is 51 per cent.) were those of children aged less than five years, equivalent to a rate of 82.6 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 444. This gives a rate of 93.5 per thousand calculated upon the estimated population of old persons. SPECIAL CAUSES OF DEATH. Table K23 (A) in the appendix is prepared strictly in accordance with the directions of the Local Government Board. It is, however, useless for statistical purposes, as it takes into account only the deaths actually registered in the parish, and I make no further reference to it. I have prepared a modification of this table in which all Institution deaths of parishioners, either in or out of the parish, have been allocated to their districts, and I call this Table III. (B). I have calculated out a mortality rate for each of the diseases or classes of disease set forth, and compared them with similar calculations for 1895. The diseases shewing increased mortality over last year are:— Scarlet fever, enteric fever, measles, whooping cough, and rheumatic fever. Those shewing a diminished mortality are:—Diphtheria, erysipelas, diarrhœa, phthisis, heart disease, and injuries. TABLE III. (B). Table of Deaths during the year 1896, in the three Sub-Districts of Bethnal Green, classified according to Diseases, Ages, and Localities (institution deaths have been distributed and non-parishioners excluded). Names of Localties adopted for the purpose of these Statistics. Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 & under 25. 25 & under 65. 65 & upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis Pneumonia & Pleurisy. Heart Disease. Injuries. All Other Diseases. Total. Typhus. Enteric or Typhoid. Continued Relapsing. Puerperal. North, Sub-District 1142 326 278 58 35 282 163 Under 5 5 upwds ... 15 18 2 ... 1 ... ... ... 1 63 67 40 ... 5 162 4 23 203 604 ... 4 5 1 ... 6 ... ... 3 ... 1 1 2 1 3 91 143 58 24 195 538 Total. ... 19 23 3 ... 7 ... ... 3 ... 2 64 69 41 3 96 305 62 47 398 1142 South, Sub-District 814 240 208 31 28 195 112 Under 5 5 upwds. ... 10 19 5 ... 2 ... ... ... ... 1 47 38 26 ... 5 100 ... 15 180 448 ... 1 3 1 ... 3 ... ... ... ... 1 3 2 3 2 47 86 48 11 155 636 Total. ... 11 22 6 ... 5 ... ... ... ... 2 50 40 29 2 52 186 48 26 335 814 East, Sub-District 953 263 172 36 35 278 169 Under 5 5 upwds ... 7 14 3 ... 1 ... ... ... ... ... 32 40 33 ... 3 99 3 14 186 435 ... 3 5 1 ... 8 ... ... 2 1 3 3 2 5 3 84 129 65 15 189 518 Total. ... 10 19 4 ... 9 ... ... 2 1 3 35 42 38 3 87 228 68 29 375 953 Totals 2909 829 658 125 98 755 444 Under 5 all ages. ... 32 51 10 ... 4 ... ... ... 9. 142 145 99 ... 13 361 7 52 569 1487 ... 40 64 13 ... 21 ... ... 5 1 7 149 151 108 8 235 719 178 102 1108 2909 Mortality per thousand population at all ages ... 0.30 0.49 0.10 ... 0.16 ... ... 0.03 0.00 0.05 1.15 1.16 0.83 0.06 1.81 5.06 1.37 0.78 8.58 22.52 12 I am indebted to the British Medical Journal for the following Extract:— THE DEATH-RATES of LONDON SANITARY AREAS in 1896. " In the accompanying 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 1896. The mortality figures 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 occurring in the public institutions of London among the various sanitary areas in which the patients had previously resided. The 135,796 births registered in London during 1896 were equal to an annual rate of 30.2 per 1,000 of the population, estimated at 4,421,955 persons in the middle of that year. In the three preceding years the birth-rate was 30.9, 30.l, and 30.5 per 1,000 respectively, In the various sanitary areas the birth-rates showed, as usual, wide variations, owing principally to the differences in the age and sex distribution of their populations. In Kensington, St. George Hanover Square, St. James Westminster, Hampstead, St. Martin-in-the-Fields, and London City, the birth-rates were considerably below the average; while they showed a marked excess in St. Luke, Shoreditch, Bethnal Green, Whitechapel, St. George-in-the-East, Mile End Old Town, and St. George Southwark sanitary areas. The deaths of persons belonging to London registered during the year were 81,721, equal to an annual rate of 18.2 per 1,000 of the population, against 20.9, 17.4, and 19.4 in the three preceding years. The rate in 1896 was 1.6 per 1,000 below the mean rate in the ten preceding years, 1886-95, and with one exception was lower than in any year on record. The lowest death-rates last year in the forty-three sanitary areas were 11.9 in Hampstead, 12.7 in Stoke Newton, 13.4 in Lee, 13.6 in St. George Hanover Sqnare, 14.3 13 in Wandsworth and in Lewisham, and 15.3 in Paddington; in the other districts the rates arranged upwards to 22.7 in Strand, 22.8 in St. Saviour Southwark, 22.9 in Limehouse, 23.4 in Holborn, 24.0 in St. George Southwark, 24.5 St. George-in-the-East, and 25.1 in St. Luke. During the year under notice 14,009 deaths resulted from the principal zymotic diseases in London ; of these, 3,692 were referred to measles, 3,192 to diarrhoea, 2,931 to whooping-cough, 2,663 to diptheria, 940 to scarlet fever, 582 to different forms of " fever " (including 5 to typhus, 564 to enteric fever, and 13 to simple and ill-defined forms of fever), and 9 to small pox. These 14,009 deaths were equal to an annual rate of 3.11 per 1,000, against 3.05, 2.64, and 2.62 in the three preceding years; this rate exceeded by 0.40 per 1,000 the mean rate in the ten years 1886-95, and was higher than the rate recorded in any year since 1887, when it was also 3.11 per 1,000. In the various sanitary areas the zymotic death-rates ranged from 1.39 in St. George Hanover Square, 1.44 in London City, 1.83 in Hampstead, 1.88 in Lee, 2.15 in Westminster, and 2.24 in St. James Westminster, to 3.92 in Woolwich, 3.94 in Chelsea, 3.99 in Limehouse, 4.24 in St. George Southwark, 4.25 in Bethnal Green, 4.31 in Shoreditch, and 4.81 in St. Olave Southwark. Compared with the averages in the ten preceding years the mortality from small pox, scarlet fever, and "fever" was below the average, while that from each of the other zymotic diseases showed an excess. The 9 fatal cases of small pox registered in London last year showed a further decline from the numbers recorded in the three preceding years, and included 2 which belonged to Lambeth, 2 to Greenwich, and 1 each to Paddington, Islington, Holborn, Shoreditch, and Newington, sanitary areas. During the year under notice 236 cases of small pox were admitted into the Metropolitan Asylums Hospital, and only 3 remained under treatment at the end of the year. Measles caused the highest proportional fatality in 14 St. James Westminster, St. Marylebone, Strand, Shoreditch, Bethnal Green, St. George Southwark, and Woolwich sanitary areas. Scarlet fever was proportionately most fatal in St. Luke, Shoreditch, St. George-in-the-East, Mile End Old Town, St. Olave, Southwark, and Plumstead sanitary areas; 16,271 scarlet fever cases were admitted into the Metropolitan Asylums Hospitals during 1896, and 3,599 patients remained under treatment at the end of December last. Diphtheria caused the highest proportional fatality in Chelsea, Islington, Limehouse, Mile End Old Town. St. Olive Southwark, Bermondsey, Camberwell, Greenwich, Lewisham, and Plumstead sanitary areas; there were 5,409 admissions of diphtheria patients into the Metropolitan Asylum Hospitals during last year, and 829 cases remained under treatment at the end of December. Whooping-cough was proportionally most fatal in Shoreditch, Bethnal Green, Limehouse, Poplar, St. George Southwark, St. Olave Southwark, and Bermondsey sanitary areas ; enteric fever in St. Martins-in-the-Fields, Clerkenwell, City of London, and Rotherhithe sanitary areas; and diarrhœa in Fulham, Clerkenwell, St. Luke, Shoreditch, St. George-in-the-East, and St. Olave Southwark sanitary areas. Infant mortality in London during 1896, measured by the proportion of deaths under one year of age to registered births, was equal to 160 per 1,000, and exceeded by 5 per 1,000 the mean rate in the ten preceding years. The lowest rates of infant mortality did not exceed 123 in Hampstead, 126 in Stoke Newiugton, 133 in Plumstead, 136 in Lambeth and in Lewisham, and 137 in City of London; while they ranged upwards in the other sanitary areas to 179 in Hammersmith, 180 in Shoreditch, 181 in St. George Southwark, 184 in Clerkenwell and in Newington, 193 in Strand, 194 in Holborn, and 213 in St. Saviour Southwark. 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 1896. Sanitary Areas. Estimated Population middle of 1896. 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. LONDON 4,421,955 135,796 81,721 30.2 18.2 3.11 14,009 9 3,692 940 2,663 2,931 5 564 13 3,192 7,567 160 West Districts. Paddington 124,838 3,068 1,947 24.2 15.3 2.52 320 1 103 22 65 49 ... 13 1 66 161 156 Kensington 170,660 3,719 2,914 21.4 16.8 2.65 459 ... 173 40 70 99 ... 10 1 60 247 178 Hammersmith 104,551 3,007 1,828 28.3 17.2 2 80 228 ... 62 21 52 62 1 13 2 85 149 179 Fulbam 115,008 4,068 2,057 34.8 17.6 3.59 419 ... 101 29 77 69 ... 9 ... 134 194 175 Chelsea 96,657 2,651 1,850 26.9 18.8 3.94 388 ... 110 23 115 63 ... 10 1 66 179 168 St. George Hanover Sq 80,041 1,407 1,108 17.3 13.6 1.39 112 ... 32 11 24 16 ... 9 ... 20 104 149 Westminster 53,477 1,223 978 22.5 18.0 2.15 117 ... 18 10 20 25 ... 9 ... 35 122 170 St JamesWestmnstr. 22,955 496 397 21.3 17.0 2.24 52 ... 31 3 2 3 ... 3 ... 10 44 149 North Districts. Marylebone 141,114 4,416 2,855 30.8 19.9 3.16 453 ... 195 26 74 70 ... 20 ... 68 280 141 Hampstead 75,812 1,462 916 19.0 11.9 1.83 141 ... 58 7 30 22 ... 7 ... 17 86 123 St. Pancras 241,066 7,040 4,442 28.7 18.1 2.47 608 ... 133 37 99 128 ... 31 ... 180 474 168 Islington 337,639 9,924 5,871 28.9 17.1 3.04 1,043 1 275 57 255 247 ... 47 1 160 499 150 Stoke Newington 33,615 841 434 24.6 12.7 2.35 80 ... 5 8 19 16 ... 5 ... 27 28 126 Hackney 213,774 6,435 3,414 29.6 15.7 2.81 612 ... 95 36 103 147 1 37 1 192 306 146 Central Districts. St. Giles 38,158 1,064 737 27.4 19.0 2.29 89 ... 41 7 7 14 ... 4 ... 16 113 147 St Martin-in-Fields 13,003 214 214 16.2 16.2 2.28 30 ... 11 3 3 5 ... 3 ... 5 26 164 Strand 23,820 570 550 23.5 22.7 2.44 59 ... 28 6 3 8 ... 1 ... 13 70 193 Holborn 30,932 883 736 28.1 23.4 3.21 101 1 33 ... 12 27 1 5 ... 22 102 194 Sanitary Areas. Estimated Population middle of 1896. 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. Diarrhœa. Phthisis. Deaths of Children under 1 year of age to 1,000 births. Births. Deaths. Principal Zymotic. Diseases. Clerkenwell 66,195 2,223 1,393 33.7 20.7 3.78 255 ... 53 15 42 42 ... 15 ... 88 145 184 St. Luke 41,478 1,968 1,059 46.7 25.1 3.82 161 ... 35 21 26 23 ... 4 ... 52 123 154 London City 31,409 546 626 17.1 19.6 1.44 46 ... 6 7 11 7 ... 10 ... 5 51 137 East Districts. Shoreditch 122,265 4,387 2,656 35.9 21.4 4.31 536 1 143 39 74 126 ... 17 ... 136 232 180 Bethnal Green 129,151 4,869 2,902 37.8 22.1 4.25 557 ... 153 35 75 160 ... 20 1 113 236 170 Whitechapel 78,886 3,241 1,655 41.6 20.6 2.62 210 ... 51 20 48 36 ... 9 1 45 193 141 St. George-in-East 47,589 2,098 1,187 44.5 24.5 3.26 158 ... 28 18 30 17 ... 5 ... 60 124 154 Limehouse 58,347 2,042 1,357 35.2 22.9 3.99 236 ... 62 15 49 61 ... 3 ... 46 133 176 Mile End Old Town 111,226 4,300 2,252 39.0 19.9 3.61 409 ... 84 34 97 83 ... 16 ... 95 156 157 Poplar 169,379 6,011 3,550 35.7 20.6 3.70 637 ... 147 33 105 158 ... 26 ... 168 302 176 South Districts. ... St. Saviour Southw'k 25,276 790 587 30.9 22.8 3.23 83 ... 17 5 18 19 ... 1 ... 23 80 213 St. George Southw'k 60,301 2,213 1,472 36.9 24.0 4.24 260 ... 77 17 40 55 ... 7 ... 64 165 181 Newington 121,191 4,276 2,527 35.7 20.5 3.35 410 1 98 29 71 66 ... 18 ... 127 245 184 St. Olave Southw'k. 11,673 419 261 35.4 22.0 4.81 57 ... 11 5 9 13 ... 2 ... 17 26 153 Bermondsey 85,508 3,203 1,873 37.6 21.6 3.78 328 ... 75 20 73 97 ... 11 ... 52 176 160 Rotherhithe 40,432 1,346 834 33.6 20.3 3.82 157 ... 43 10 26 36 ... 11 ... 31 90 159 Lambeth 296,036 9,579 5,084 32.9 16.9 2.42 729 2 182 65 139 140 24 1 175 489 136 Battersea 165,864 5,358 2,985 33.0 17.7 3.64 614 ... 179 32 82 138 ... 16 1 166 242 177 Wandsworth 188 908 4,825 2,749 26.5 14.3 2.71 520 ... 151 29 40 158 ... 21 ... 121 187 150 Camberwell 253,975 7,662 4,602 30.7 17.8 3.59 928 ... 206 52 260 196 37 ... 176 398 156 Greenwich 176,293 5,723 3,323 33.0 18.5 3.72 666 2 193 51 140 127 ... 32 1 120 281 157 Lee 38,714 861 526 22.6 13.4 1.88 74 ... 14 8 17 18 ... 2 ... 15 50 141 Lewisham 83,723 2,130 1,216 26.2 14.3 2.56 218 ... 39 7 75 28 ... 9 ... 60 89 136 Woolwich 41,334 1,288 861 31.3 20.5 3.92 165 ... 72 9 31 22 ... 2 1 28 88 172 Plumstead 59,610 1,950 936 33.6 15.4 3.54 214 ... 59 18 55 35 ... 4 ... 33 82 133 17 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of deaths referred to this class of disease was 547, of these 483 being young children under five years of age. In table "D" the deaths from each of these diseases are shewn and compared with those of the preceding year. From this it will be seen that an increase has occurred chiefly under the heads of Measles and Whooping Cough, whilst Diphtheria and Diarrhœa show a considerable decrease. TABLE D. 1896. 1895. Small Pox ... 4 Measles 149 110 Scarlet Fever 40 30 Diphtheria 77 102 Whooping Cough 151 33 Typhus Fever ... ... Enteric Fever 21 17 Simple Fever ... ... Diarrhœa 108 146 Cholera 1 ... Total 547 442 Eighteen per cent. of the total deaths from all causes were referred to the diseases included in table "D" against sixteen per cent. in 1895. The actual increase in number was 105, the decennial average for the ten years 1886 to 1895 being 478 (see table " V "). B 18 The death rate from these seven Zymotic diseases was 4.2 against 3.4 in 1895, while the corresponding rates for London were 2.6 in 1895 and 2.1 in 1896. Table "F" shews the percentage of Zymotic deaths from each disease as compared with the total number of Zymotic Deaths. TABLE F. Measles 27 24 per cent., or 1 in 3.67 deaths. Scarlatina 7.31 „ „ 13.67 ,, Diphtheria 14.07 „ „ 7.10 ,, Whooping Cough 27.60 „ „ 3.62 ,, Enteric Fever 3.83 „ „ 26.05 „ Diarrhœa 19.92 „ „ 5.01 NOTIFICATION OF INFECTIOUS DISEASES. A total of 2,305 notification certificates has been forwarded to me by Medical gentlemen practising in this neighbourhood; copies of all these certificates have been duly forwarded to the Asylums Board day by day as received, but 167 of the certificates were duplicate notifications, that is to say, the same case was reported by more than one Medical Man. The Head Teachers of Schools have been notified as required by law. Table (B) K2II in the Appendix shows the part of the parish in which the residence of the sick person was situated, and table "G" gives particulars of the number of oases month by month, together with the Hospital admissions and discharges. TABLE G. Infectious Cases, 1896. 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 and Membranous Croup Enteric Fever Erysipelas Puerperal Fever Relapsing Fever Admitted Discharged Died Remaining Admitted Discharged Died Remaining January 0 69 33 14 29 3 0 0 2 0 0 46 46 4 100 February 0 43 44 15 17 0 0 0 0 0 0 42 41 3 98 March 0 53 23 5 10 0 0 0 0 0 0 31 58 1 70 April 0 67 33 6 23 0 0 0 0 0 0 36 27 2 77 May 2 114 50 8 31 1 1 0 0 0 0 66 35 4 104 June 0 125 45 9 30 3 0 0 0 0 0 76 45 2 133 July 0 117 62 9 31 2 0 0 0 0 0 67 47 3 150 August 0 157 53 9 35 0 0 0 0 0 0 79 78 3 148 September 0 239 34 24 46 4 0 0 0 0 0 98 42 4 200 October 0 191 46 17 41 0 0 0 0 0 0 97 76 4 217 November 0 97 23 10 26 0 0 0 0 0 0 78 81 2 212 December 0 80 35 8 23 0 0 0 0 0 0 52 75 2 104 Total 2 1,352 461 134 342 13 1 0 2 0 0 768 651 34 187 B 2 20 SMALL POX—NO DEATHS. (Decennial average 2.3), Only two cases of this disease were notified during the year, both were removed to hospital, but were sent home again as they were cases of chicken pox only. SCARLET FEVER—40 DEATHS. (Decennial average 50). The number of Scarlet Fever cases notified during the year was 1,219, nearly double the number reported in 1895; only, however, ten more deaths occurred, bringing the total number up to forty, ten below the average, a rate, on the notifications, of 3.2 per cent. as against 4.1 in the previous year. The Scarlet Fever death rate last year was equal to 0.3 per thousand population at all ages, whilst that for the whole of London was 0.2. In the North District 401 cases were reported with 19 deaths, in the South, 390 with eleven deaths, and in the East, 428 cases with ten deaths; amongst the notified cases in the latter district were three in the Workhouse, two in the Victoria Park Hospital (all imported cases), and 37 at the Children's Home in the Bonner Road. The outbreak at this Institution caused me much anxiety, although there were no deaths. Everything possible was done by the Director of the Institution, Dr. T. B. Stephenson, and the Medical Officer, Dr. Tunstall, to stamp out the epidemic, but the type of Fever was so mild, that, notwithstanding the greatest care on the part of those in authority, the disease was spread by unrecognized cases. I made a special report on the epidemic to the Local Government Board and to the London County Council. The Inspectors' reports on the sanitary condition of the houses where Scarlet Fever was notified give the following particulars:— In 419 instances everything was found to be in a fairly satisfactory condition, but in 117 the closets were faulty, in 21 the internal 21 drainage arrangements were defective, and in 69 the outside drainage arrangements required amendment; in six the domestic water supply was drawn from the W.C. cistern, whilst other minor insanitary conditions were found in 219. 102 of the cases occurred amongst families inhabiting one room only. 645 persons suffering from Scarlet Fever were removed to Hospital, where 19 of them died. ENTERIC FEVER—21 DEATHS. (Decennial average 24). The total number of Enteric Fever cases reported during the year was 134, and of these 21 died, a case mortality of 15.6 per cent. on the notifications. These deaths are equal to a rate of 0.16 per thousand population, the corresponding Metropolitan rate being 0.14. Of the cases, 41 were notified from the North District, with seven deaths, 47 from the South with five deaths, and 45 from the East with nine deaths. In 46 instances the residence of the patient was found to be in satisfactory condition, but in fourteen the water-closets were defective, in twelve the external drainage arrangements were faulty, in nine the drains inside the house were leaky, and other insanitary conditions were found in 31 instances. Sixteen cases occurred in families occupying one room only. The patients removed to Hospital numbered 67, of whom 12 died. DIPHTHERIA : (Including Membranous Croup.) TOTAL DEATHS, 77. (Decennial average 89.) The number of cases reported to me under these two heads was 461; the deaths registered were :— Diphtheria 64 Membranous Croup 13 22 The total of these (77) equals a mortality rate of 16.7 per cent. on the notifications. On the estimated population at all ages the mortality was 0.6 per thousand living, a little lower than that of the previous year, the general Metropolitan rate being 0.6. Of the cases, 191 were reported from the North District with 26 deaths, 135 from the South with 28 deaths, and 135 from the East with 22 deaths. In 162 instances the residence of the patient was found to be in a satisfactory condition, but in 55 the W.C.'s were defective, in 39 the external drainage was faulty, and in 16 the drains inside the house were leaky, while various other insanitary defects were noted in 168 instances. 49 cases occurred in families occupying one room only. The cases removed to hospital numbered 134, of whom 29 died. No case of Typhus was reported. The following table shews the admissions and discharges of Fever and Diphtheria patients at the various Asylums' Board Hospitals: — REPORT OF FEVER AND DIPHTHERIA CASES ADMITTED INTO FEVER HOSPITALS DURING THE YEAR 1896. Hospitals. No. of Cases remaining at end of 1895. No. of Cases Admitted. Discharged. Died. No. of Cases remaining at end of 1896. Eastern Hospital (Homerton) 33 283 138 and 134 transferred to Winchmore Hill and 1 to North Eastern. 16 27 Northern Hospital (Winchmore Hill) 30 134 from Eastern Hospital. 36 from North-Eastern Hospital, 99 from North-Western Hospital and 3 from Western Hospital. 236 0 66 North-Western Hospital 11 92 46 and 36 transferred to Winchmore Hill. 5 16 North-Eastern Hospital 26 246 and 1 from Eastern Hospital 140 and 99 transferred to Winchmore Hill. 4 30 New Cross Hospital 3 99 30 and 45 transferred to Gore Farm. 8 19 South Western Hospital 0 40 15 and 15 transferred to Gore Farm. 1 9 Western Hospital 1 2 3 transferred to Winchmore Hill. 0 0 Shooters Hill Hospital 0 6 6 transferred to Gore Farm. 0 0 Gore Farm 0 45 from New Cross Hospital, 15 from South Western Hospital, and 6 from Shooters Hill Hospital. 46 0 20 Totals 104 768 651 34 187 24 WHOOPING COUGH, DEATHS 151. (Decennial Average 100.) Whooping-Cough, the most fatal of the Zymotics, caused 151 deaths, all except six amongst young children, giving a mortality of 8 per thousand on the estimated population of young children. MEASLES, DEATHS 149. (Decennial Average, 110). Like Whooping-cough, Measles chiefly affects children, and no less than 142 little ones died from this disease during the year under consideration; a mortality of 7.8 per thousand on the estimated population of young children. DIARRHŒA DEATHS, 109. (Decennial Average, 102.) Diarrhoea was the cause of 120 deaths, almost entirely amongst young children; in eleven instances the disease which caused the diarrhoea was also set forth in the certificate, and I have preferred to classify the death under the more definite heading. The mortality was in the proportion of 5.5 per thousand on the estimated population of young children. TUBERCULAR DISEASES Phthisis. Eight per cent. of the total mortality from all causes was referred to pulmonary tuberculosis, which caused 235 deaths, equal to a mortality of 1.8 per thousand persons living. The corresponding Metropolitan mortality was 1.7. I believe that some of the high mortality from tubercular disease in this district is attributable to 25 the dampness of many of the dwellings. For years past, the Sanitary Department has been fighting against this evil ; we do what we can, get leaky roofs and gutters repaired, walls pointed, and damp courses inserted where possible, but in many instances the dampness is the result of the use of improper materials, and is incurable, the only remedy being demolition and rebuilding. RESPIRATORY DISEASES. The deaths from chest diseases formed 24 per cent. of the total mortality and numbered 719, equivalent to a rate of 5.5 per thousand population at all ages. TENEMENT HOUSE REGULATIONS. The enumerators report that at the last complete census in 1891, Bethnal Green contained a total of twenty-eight thousand tenements with less than five rooms in each holding. Of these:— 6951 are single room lettings. 6694 are two room lettings. 6059 are three room lettings. 4080 are four room lettings. The following table shows the total tenements, and tenements with less than five rooms in Bethnal Green, distinguishing those occupied by various numbers of persons:— Total Tenements and Tenements with less than Five Booms, distinguishing those occupied by Various Numbers of Persons, in the Sanitary Areas of Bethnal Green. Sanitary Area. Rooms in Tenement. Number of Tenements with less than five Rooms. Number of Occupants op Tenements. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12 or more. Bethnal Green 1 6,561 1,555 2,079 1,379 828 423 198 62 27 8 2 Total tenements 27,998. 2 6,694 263 1,253 1,344 1,251 1,007 728 451 248 99 33 14 3 3 6,059 110 712 980 1,029 944 837 656 419 228 98 32 14 4 4,080 43 298 450 580 567 609 562 432 275 156 71 37 27 The tenement house regulations drawn up and agreed to by the Vestry have been sanctioned by the Local Government Board, and are therefore in force in this district upon such houses as the Vestry select for registration, but so far not a single house has been placed upon this register, and, therefore, we have not had a chance to ascertain whether these bye-laws are workable or not; personally I think they are, but the Sanitary Committee thinks otherwise. Some houses in Fuller Street caused repeated trouble to my Department, and as this trouble was in a great measure owing to the absence of proper control by a resident caretaker to each block of dwellings, I strongly urged the Committee to recommend the Vestry to register four of the worst of these houses, as an experiment; very unwillingly the Sanitary Committee agreed to do this, but on the discussion of the report at the full Board so much opposition was manifested that it was agreed to refer the matter for reconsideration. At the next meeting of the Committee it was decided to proceed no further with the proposal to register the houses, but to deal with the Fuller Street premises under the Public Health Act. Notices were directed to be served in the usual form to remove the insanitary conditions, which were:—A generally dirty and dilapidated condition of rooms, passages and staircases; yards filthy and strewn with house refuse: closets often choked; soil-pans frequently broken; and water-supply defective. The landlord did almost nothing, and dangerous nuisances were permitted to exist month after month, or to recur shortly after ineffectual repairs. Summonses were of course taken out by order of the Committee and everything your Chief Inspector could do was done, but the Magistrate at Worship Street, before whom the cases were heard, seemed to have got hold of the idea that we were acting vindictively and were persecuting the landlord, so he permitted the summonses to be adjourned time after time on the owner's promise to do the necessary work. These proceedings were spread over a period of nearly six months (from February to July), and I believe I attended at Worship Street no fewer than seven times in support of the summonses, for we are compelled to be in a position to prove the nuisance by medical 28 evidence upon each occasion. Ultimately fines were inflicted amounting to six pounds, exclusive of costs, and a somewhat better sanitary condition has since been maintained. But with tenants such as inhabit dwellings of this nature, nuisance orders and small fines upon the owner are almost useless, as he soon discovers that it is cheaper to let things slide and submit to small penalties in the shape of costs, than to execute proper repairs at once. Take as an instance, that a closet has been refitted; in a couple of days the trap may be choked through careless usage, or even broken in a rough attempt to remove the obstruction; the Inspector reports on this condition at his next visit and a notice is sent at once, but if the landlord declines to obey, three weeks or a month must elapse before a nuisance order can be obtained, and even then the Magistrate always gives time for the work to be done, so that a landlord may usually calculate on a month's respite at the expense of six shillings in costs, whereas, if he does the repairs on receipt of the notice, he might possibly have had the new closet trap broken again before the expiration of a month. Substantial penalties are rarely inflicted at Worship Street in nuisance cases, as the Magistrates object to impose them, on the ground that they are receivable by the Vestry who authorize the proceedings. Under the Tenement regulations, medical evidence as to the existence of a nuisance dangerous to health is not necessary, as it is sufficient to prove breach of the bye-laws, for which a specific penalty is laid down, though the amount of the fine is within the discretion of the Magistrate. I cannot absolutely affirm that we should have fared any better had we been able to take proceedings under the bye-laws, but I think the experiment ought to have been tried, and at any rate the time of your medical officer can be more profitably employed than in attendance at the Police court to prove that a choked closet is a dangerous nuisance. SLAUGHTER HOUSES. The ten slaughter houses in the parish have been kept under observation and are in good condition, no objection to the renewal 29 of the licenses was offered by the Vestry at the annual sessions, and the whole of them were granted. COW HOUSES. Of the twenty cow houses in the parish only nineteen licensees applied for renewals, and, as the whole of our notices had been obeyed, no opposition was offered on behalf of the Vestry. The Inspector of the London County Council, however, objected that at 381, Cambridge Road, and at 2, Lisbon Street there were sleeping apartments over the cowhouses, contrary to the bye-laws. This was not denied, but it was proved that the buildings had been so constructed and occupied long before the issue of the bye-laws. Ultimately the licenses were granted, but a caution was given that at the next sessions, in 1897, the question of permitting sleeping rooms over a cowhouse would be reconsidered, and most probably no licenses would be granted where such conditions obtained. The owner of 21, the Oval, Hackney Road, having ceased to occupy his premises as a cowhouse, was refused a license. BAKEHOUSES. The whole of these, ninety-one in number, have been kept under supervision, and are in a fair condition; forty-four required cleansing etc., and four were unoccupied. ST. MATTHIAS' SCHOOLS, HARE STREET. On September 3rd, the drainage arrangements at these premises were found to be in a very defective state, and on October 12th, the drain having been exposed, was seen to be in such a condition as to necessitate entire reconstruction. I recommended that the schools should be closed whilst the work was in progress, and by order of the Sanitary Committee notice to this effect was served by Mr. Voss: on the 9th of November the schools were closed; the works were proceeded with rapidly, and on the 17th were so far completed that permission was given for the schools to be re-opened. SALE OF FOOD AND DRUGS ACT. The number of samples taken and analysed by Mr. Stokes, the Public Analyst, was 102, exactly the same number as in the previous 30 year; details will be found in Mr. Stokes' report. Ten of the samples were found to be adulterated, and the vendors were prosecuted at Worship Street. In one case, although the defendant admitted the offence (milk adulterated with ten per cent. of added water), the Magistrate objected to the form of the certificate and the summons was withdrawn; the other nine vendors were fined in sums varying in amount from nine shillings to as many pounds. Since the retirement of Mr. Bushby from the bench there appears to be no system upon which these penalties are inflicted, and some of them are absurdly small. Mr. Bushby worked upon a very simple plan, and was accustomed to grade the penalty according to the amount of the adulteration. Thus, in a first offence, if the adulteration was stated by the analyst to be ten per cent., we knew that the penalty would be ten per cent. of the maximum fine, and so on; for a second offence the full penalty was inflicted. With reference to this matter the following communication was received from Mr. Paget, the Vestry Clerk of St. James' Clerkenwell. Vestry of the Parish of St. James & St. John, Clerkenwell, Town Hall, Clerkenwell, Bosebery Avenue, E.C. Dear Sir, The attention of this Vestry has been drawn to the very small fines which are sometimes inflicted by the Police Magistrates on prosecutions by the Vestry under the Sale of Food and Drugs Acts. In a recent case a fine of 6d. and 2s. costs was imposed upon an offender who was then convicted for the fourth time. I have therefore been directed to communicate with the Home Secretary and the Local Government Board, urging that some effective means may be adopted to prevent what is practically an encouragement of adulteration, and to ask the support of your Vestry in the matter. Yours faithfully, R. E. PAGET, Vestry Clerk. R. VOSS, Esq. 31 The matter was referred to the Sanitary Committee, and for their information the following return was prepared by Mr. Meadway of all fines inflicted during the past three years at Worship Street at the instance of this Vestry:— 1894, 1895, 1896. Penalties under the Sale of Food and Drugs Acts. Article of Food. Extent of Adulteration. Penalty Costs allowed. Name of Magistrate. Milk 16 per cent. of added water £ s. s. d. Mr. H. Corser 2 0 23 0 „ 20 „ „ 8 0 2 0 Mr. Bushby „ 20 „ „ 8 0 2 0 „ „ 90 „ of cream abstracted 18 0 2 0 „ „ 25 „ „ 5 0 — „ „ 60 „ „ 2 0 — Mr. Mead „ 13 ,, of added water 1 0 12 0 Mr. Corser „ 30 „ „ 6 0 2 0 Mr. Bushby „ 10 „ „ 2 0 2 0 „ „ 38 „ „ 2 0 23 0 Mr. Corser „ 22 „ „ 1 0 23 0 „ „ 17 „ „ 1 0 2 0 Mr. Mead „ 12 „ „ 2 0 12 6 Mr. Corser Butter 78 „ of Margarine 15 0 2 0 Mr. Bushby „ 85 „ „ 17 0 2 0 „ „ 90 „ „ 18 0 2 0 „ „ 90 „ „ 18 0 2 0 „ „ 95 „ „ 19 0 2 0 „ (Reduced by Home Office to £5.) „ 90 „ „ 2 0 2 0 Mr. Corser „ 90 „ „ 2 0 12 6 Mr. Dickinson „ 94 „ „ 1 10 12 6 „ „ 99 „ „ 2 0 12 6 „ „ 99 „ „ 2 0 12 6 „ „ 40 „ „ 1 0 2 0 Mr. Lane „ 90 „ „ 10 0 — Mr. Mead „ 75 „ „ 0 10 23 0 Mr. Corser „ 96 „ „ 1 0 12 6 „ 2 0 „ „ 98 „ „ 1 0 12 6 „ 1 0 2 0 „ „ 98 „ „ 2 0 14 6 „ Margarine Supplied without proper wrapper 1 0 4 6 „ Coffee 80 per cent. of chicory 2 0 23 0 „ „ 20 „ „ 1 0 12 6 Mr. Cluer 32 Averages of each Magistrate. Name of Magistrate. Total Amount of Fines. No. of Summonses. Average Fine per Summons. Average amount for 1 per cent. of adulteration. Mr. Bushby £ s. d. 11 £ s. d. s. d. 134 0 0 12 3 7 4 2½ Mr. Corser 18 10 0 14 1 6 5 0 6½ Mr. Mead 13 0 0 3 4 6 8 1 6½ Mr. Dickinson 7 10 0 4 1 17 6 0 4¾ Mr. Cluer 1 0 0 1 1 0 0 1 0 Mr. Lane 1 0 0 1 1 0 0 0 6 After discussion, it was agreed to recommend the Vestry to support the action of the Clerkenwell Vestry in their endeavour to obtain a more uniform system in the amount of penalties imposed in the Metropolis under the Sale of Food and Drugs Act, and that for the second and each subsequent offence the amount of the previous fine should be doubled. To this the Vestry agreed. Table VI. in the appendix gives a summary of the work completed in my department during the year 1896. For full details I must refer the Vestry to the report presented in January by Mr. Foot to the Sanitary Committee; this report the Committee desired should be made direct to them, instead of in the usual way through the Medical Officer to the Vestry, and by their direction this was done. Mr. Foot reports a gross total of 27,464 visits made by the Inspectors under his control, an increase of 4,798 visits over the total of the previous year; seventy-three per cent. of these visits were reinspections, six and a half per cent. were visits to cases of infectious disease, and a like proportion of visits were for the purpose of investigating complaints, whilst twelve and a half per cent. were house to house inspections. I have no hesitation in saying that the periodical inspection of his district is the most important duty of an Inspector; grave Sanitary defects of construction are discovered at a first visit and when known can be remedied, but it is only by re-inspection at short intervals and worrying people in an informal 33 manner, that recurring nuisances can be dealt with satisfactorily. Next to overcrowding, the unhealthiness of large towns is in a great measure, due to accumulations of filth in all sorts of places. Dirty walls and ceilings, foul closets, stagnant water in ill-paved yards, decaying vegetable matter and such like, keep up a constant condition of atmospheric impurity. In the open country effluvia of all kinds are rapidly diluted and blown away, but in towns the effect of the wind is checked by the buildings, and the stagnant foul air poisons the inhabitants and runs up the death rate. In a model district every house should be visited by a Sanitary Inspector at least once in each year, but Mr. Foot estimates that with the staff at his disposal a complete inspection of the parish will take five years to accomplish. The proportion of re-inspections (20,168) to abated cases (4,078) appears to me much greater than it should be; six visits, five of them re-inspections, seems an excessive expenditure of time and shoeleather to get a nuisance abated, and points to defective powers of persuasion or want of activity on the part of some members of the staff. If I remember rightly, when Mr. Foot was a District Inspector, he succeeded in getting nuisances abated by about three visits per case on an average, and this is what ought to be accomplished; however 1896 has been an exceptional year on account of the acute condition of the drain and sewer question, and your officers have frequently been obliged to deal tenderly with defective conditions when they would have much preferred to adopt a more determined attitude. Let us hope the dispute will soon be settled one way or another, as at present the whole matter is on a most unsatisfactory basis, and constitutes a real hindrance to sanitary progress. FACTORIES AND WORKSHOPS. No periodical supervision of workshops, as such, has been undertaken, but trade premises of all kinds have been dealt with by the inspectors, wherever discovered, in the ordinary course of their duties. All premises complained of by H.M. Factory Inspectors, have been visited and reported upon to the Committee, by whose C 34 directions notices have been served to remove such insanitary conditions as were found to exist. The “proceedings" taken in each case have been reported to the Factory Inspector of the district as required by Section 2 of the 1891 Factory Act. There is a tendency on the part of the Home Office Inspectors as regards workshops where both sexes are employed, to push the requirement of separate closet accommodation to an extent which has not met with the support of the Sanitary Committee of this Vestry. The words of the section governing the matter in the Public Health Act, are as follows:— SANITARY CONVENIENCES FOR MANUFACTORIES, &c. (1). "Every factory, workshop, and workplace, whether erected before or after the passing of this Act, shall be provided with sufficient and suitable accommodation in the way of sanitary conveniences, 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 accommodation for persons of each sex. (2). "Where it appears to a sanitary authority that this section is not complied with in the case of any factory, workshop, or workplace, the sanitary authority shall, by notice served on the owner or occupier of such factory, workshop, or workplace, require him to make the alterations and additions necessary to secure such compliance, and if the person served with such notice fails to comply therewith he shall be liable to a fine not exceeding twenty pounds, and to a fine not exceeding forty shillings for every day after conviction, during which the non-compliance continues. As I read the section, it is left to the Sanitary Authority to decide what is “sufficient and suitable accommodation," and “proper separate accommodation," for persons of each sex. The Sanitary Committee of this Vestry has, in one or two instances, declined to 35 endorse the complaint of a Factory Inspector, and refused to require the owner of a small workshop to provide two closets where only one or two workers of each sex were employed. In the opinion of the Sanitary Committee, the attempt to enforce such an order would certainly have been nullified by the discharge of the women, and their replacement by male young persons. The wording of the corresponding section in the Factory Act is somewhat more stringent, for, unless a workshop is provided with proper separate accommodation for each sex, that workshop is declared not to be kept in conformity with the law, and the owner is liable to a penalty of ten pounds. It is quite within the powers of H.M. Factory Inspectors to take proceedings on their own account, if they are dissatisfied with our refusal to act on their complaints, but, I am convinced, that the result of the infliction of a penalty would be, not only that a number of women would lose their employment, but that very few additional closets would be erected. In compliance with Section 3 (3) of the 1891 Factory Act, I report to the Factory Inspector of the district whenever I find children, young persons, or women employed in workshops (except domestic workshops), unless I find evidence that the premises are already under inspection by the Home Office Authorities. HOUSING OF THE WORKING CLASSES ACT. (Part II.) During the past year I certified seventy-six houses as unfit for habitation. The following list gives details of proceedings taken under this Act during the past year :— c 2 Situation of Premises. Date of Closing Order made by Magistrate. Date of Closing of Premises. Date of Re-opening of Premises Repaired Date of Demolition of Premises. Remarks. 4, Centre street 16th July, 1894 29th Oct., 1894 10th Sep., 1896 ...... Closed in 1894 and 1895. Repaired and re-opened in 1896 26, ditto ...... 1st Nov., 1895 22nd April, 1896 ...... 28, ditto ...... Ditto 23rd March, 1896 ...... 30, ditto ...... Ditto 22nd April, 1896 ...... 27,20 31,33,35, 37, 39,41, 43,45 & 47, Columbia road No Order made. Closed by Owners on receipt of Vestry's Notices 7th Aug., 1896 ...... 27th August Premises demolished 54, 56, 58, 60,62.64, 66,68, 70, 72, 74, 76, 78, 80, 82, 84, 86, 88, 90, 92 & 94, Ravcnscroft street Ditto 1st August ...... 7th August Premises demolished 86, 88, 90, 92 & 94, Virginia road ...... ...... ...... ...... This Block to stand over until after the completion of adjoining Block, Nos. 96 to 110. 96, 98, 100, 102, 104, 106, 108 & 110, Virginia road 28th July, 1896 23rd September ...... ...... Premises demolished 37, Chambord street 28th July 16th September ...... ...... Premises demolished 39, ditto Ditto 30th July ...... ...... 41, ditto Ditto 30th December ...... ...... 1, Princes place ...... 25th August ...... ...... Situation of Premises. Date of Closing Order made by Magistrate. Date of Closing of Premises. Date of Re-opening of Premises Repaired. Date of Demolition of Premises. Remarks. HOUSING OF THE WORKING CLASSES ACT.—Continued. 32, 34 & 36, Gossett street ......... 23rd September 12th December ......... Repaired and re-opened Still closed 40, Gossett street 21st July 24th July ......... ......... 7, Virginia road Ditto 30th September ......... ......... Premises demolished 9, ditto Ditto 23rd September ......... ......... 11, ditto Ditto Ditto ......... ......... 13, ditto Ditto 15th December ......... ......... 15, ditto Ditto 14th November ......... ......... 17, ditto Ditto 24th July ......... ......... 19, ditto Ditto Ditto ......... ......... 1, Matilda street ......... 24th June ......... ......... Premises demolished 3, ditto ......... Ditto ......... ......... 5, ditto ......... Ditto ......... ......... 33, ditto 21st July 8th September ......... ......... Premises repaired and re-opened 35, ditto Ditto Ditto ......... ......... 37, ditto Ditto 24th July .. ......... 39, ditto Ditto Ditto ......... ......... 27, Felix street Ditto Ditto 26th September ......... Premises repaired and re-opened 29, ditto Ditto Ditto Ditto ......... 31, ditto Ditto 1st September Ditto ......... 33, ditto Ditto 8th September ......... ......... These premises have been repaired and re-opened 35, ditto Ditto Ditto ......... ......... 37, ditto Ditto 28th September ......... ......... 39, ditto Ditto Ditto ......... ......... 41, ditto Ditto 1st December ......... ......... 43, ditto Ditto Ditto ......... ......... 38 A large proportion of the houses in the above list has been demolished, but the demolition has been carried out by the owners of their own free-will without any compulsion on the part of the Vestry, which has never yet seen fit to make a demolition order. Some houses shut up years ago on my certificate remain closed and unrepaired, of which the following is a list:— List of Premises closed under the Housing of the Working Classes Act, 1890, and not repaired or demolished. 1 and 2, Parliament Court, closed 26th August, 1891, occupied as workshops, 4th September, 1895. 3, Digby Walk, closed 2nd November, 1891. 1, 2, 3 and 4, Abingdon Court, closed 7th June, 1892, action being taken to make a demolition order. 1, 2, 3, 4 and 5, Manchester Place, closed 30th November, 1892. 181 and 183, Cambridge Road, closed 18th January, 1893. 137 and 139, Columbia Road, closed 25th October, 1895. 40, Gossett Street, closed 24th, July, 1896. It seems to me that the demolition or repair of premises closed under the Act is decided upon, not so much by the condition of the premises as by the nature of the holding and the terms of the lease under which they are held. As a general rule I refrain from certifying houses under the Act unless I consider them incapable of being rendered fit for habitation, but as there is no power in the Act to forbid repairs if owners choose to undertake them, I think it would be very much better if nothing of the kind could be commenced until it had been shewn to the satisfaction of a competent and unbiassed expert that such repairs could be satisfactorily carried out. Year after year houses are patched up and rendered temporarily fit for habitation by leaseholders who are not in a position to rebuild, and large sums of money are wasted, which could have been profitably expended in reconstruction, after demolition of the worn-out ho uses. 39 SANITARY STAFF. I need scarcely remind the members of the Vestry that since the end of 1895 I have ceased to exercise any direct authority over the District Inspectors. The Chief Inspector is required to control the Staff "in consultation with, and subject to, the direction of the Medical Officer of Health" but, as Mr. Foot is responsible to the Committee for the due performance of the duties of all the sanitary officials, I have carefully refrained from interference, as I think a divided responsibility is fatal to good government. On the whole, the new system has worked admirably, especially since three somewhat objectional members of the staff have been removed and replaced by better men. Mr. Foot has not spared himself, working early and late in the performance of his duties, and the close attention and supervision he has been able to give has resulted in a large increase in the number of premises brought under inspection, as is shewn in table VI. At the risk of being considered tedious, I must again refer to the system of reporting and notice serving introduced by Mr. Foot. When he first suggested that Statutory Notices could be served by reference to numbered paragraphs printed at the back of the notice forms, instead of writing out the requirements in extenso, I was apprehensive that objections would be raised, either by the property owners, or by the Police Court Magistrates, but the arrangement has worked without a hitch, and has resulted in an enormous economy of time. Mr. Foot instructs the Clerks as to the preparation of every notice, signs it and directs the manner in which it shall be served, personally taking out every summons and conducting all proceedings at the Court. No fewer than 147 summonses under the Public Health Act were taken out during the year, although this step has never been taken until every other means to get the notice obeyed has failed. With some property owners, repeated notices, letters, and personal persuasion are disregarded, and nothing short of a Magistrate's order produces any effect. No case has been recommended for legal proceedings until the premises have been carefully examined by your 40 Medical Officer, and Mr. Foot and I have visited nearly six hundred houses together, in order to verify the Inspectors' reports that the nuisances existed, and that the notices had been disobeyed. Each case was considered on its merits, and our joint opinion was laid before the Committee. As a result of all this care and attention not a single summons has been dismissed, and Mr. Foot has recovered all costs with the exception of six shillings, a record difficult to beat. The increased activity of the Department of course materially augments the work of your Medical Officer, but I now attend at Worship Street with a feeling of absolute contentment and certainty that every preliminary step has been correctly taken, and every legal formality complied with. I cannot conclude this report without expressing my warm admiration of the manner in which Mr. Foot has carried out the arduous duties of his responsible position; he has shewn tact, command of temper, and administrative faculties of a very high order, and has devoted himself with a single mind to the interests of the parish. I trust that the Vestry will recognize the good work Mr. Foot has accomplished by a substantial increase to his present very inadequate salary. I have the honor to be Gentlemen, Your very obedient servant, Medical Officer of Health for St. Matthew, Bethnal Green. 41 BETHNAL GREEN SANITARY DISTRICT. TABLE I. Shewing the Population, Births, Deaths, and Marriages for the year 1896, 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. 1896 129,200 1384 4869 2909 829 1489 638 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 1895 128,050 1310 4771 2769 772 1304 625 Average of 10 years, 1886 to 1895. 128,059 1886 4874 2975 791 1402 610 BETHNAL GREEN SANITARY DISTRICT. Table II. Showing the Annual Birth Rate, Rate of Mortality, Death among Children, and Deaths in Public Institutions for the year 1896, and 10 years preceding. YEAR. Birth Rate per 1000 of the Population. Annual Rate of Mortality per 1000 living. Deaths of Children under 1 year; percentage of Total Deaths. Percentage of Deaths of Children under 1 year to Registered Births Deaths of Children under 5 years; percentage of Total Deaths. Total Number of Deaths in Public Institutions. 1896 37.70 22.52 28.5 19.0 51.0 638 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 1880 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 1895 37.30 21.64 27.88 16.18 47.10 625 Average of 10 years, 1886 to 1895. 37.20 23.64 26.45 16.07 47.06 610 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 1896, 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 of Asylums Boards. Census 1896. Estimat'd to Middle of 1895. Small Pox. Scarlatina. Diphtheria & Membranous Croup. fevers. Erysipelas. Small Pox. Scarlatina. Diphtheria & Membranous Croup. fevers. Enteric or Typhoid. Continued Relapsing. Puerperal. Enteric or Typhoid. North, Sub-District 49,301 ... ... Under 5 ... 139 80 2 ... 1 ... 13 ... 64 42 2 5 upwards ... 262 111 38 ... ... 6 120 ... 135 29 23 South, Sub-District 34,194 ... ... Under 5 ... 154 67 6 ... ... ... 12 ... 89 29 3 5 upwards ... 236 68 40 1 ... 1 65 ... 136 23 30 East, Sub-District 45,667 ... ... Under 5 ... 156 56 5 ... ... ... 9 ... 62 21 1 5 upwards ... 230 79 40 ... ... 4 105 ... 123 19 16 Workhouse ... ... ... Under 5 ... 1 ... ... ... ... ... ... ... ... ... ... 5 upwards ... 2 ... ... ... ... 1 12 ... 2 ... ... Mildmay Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... 1 ... ... ... ... ... ... ... 1 Victoria Park Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... 2 ... ... ... ... ... ... ... 2 ... ... BethnalHouse Asylum ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... Children's Home, Bonner Road ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... 37 ... ... ... ... ... 1 ... 36 ... ... Totals Under 5 ... 450 203 13 ... 1 ... 34 ... 215 92 6 5 upwards ... 769 258 119 1 ... 12 303 ... 434 71 70 Isolation Hospitals: Homerton, St. Anne's, Tottenham, and Hospital Ships. K2 3 (A). Table of Deaths during the year 1896, in the Bethnal Green District, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. (Columns for Population and Births are in Table B.) Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under 6. 5 and under 15. 15 and under 25 25 and under 65 65 & upwards. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa and Dysentery. Rheumatic Fever. Phthisis. Bronchitis Pneumonia & Pleurisy. Heart Disease. Injuries. All Other Diseases. Total. Enteric or Typhoid. Puerperal. North, Sub-District 843 313 243 28 21 159 79 Under 5 9 10 2 ... ... ... 1 62 66 38 ... 5 152 2 19 190 556 5 upwds. ... 1 1 1 3 ... 1 1 2 1 3 52 80 25 11 105 287 South, Sub-District 574 215 167 22 10 106 54 Under 5 3 9 5 1 ... ... 1 46 36 24 ... 5 85 ... 11 156 389 5 upwds. 1 2 1 ... ... ... ... 3 2 2 2 22 50 24 4 79 192 East, Sub-District 662 240 149 28 21 144 80 Under 5 3 9 3 1 ... ... ... 30 40 31 ... 2 90 3 11 166 384 5 upwds. 3 4 1 5 2 1 2 3 1 3 2 44 66 38 8 90 273 Workhouse 449 26 16 4 10 193 200 Under5 ... 1 ... ... ... ... ... 1 3 4 ... ... 3 ... ... 30 42 5 upwds. ... ... ... ... ... ... 1 ... ... 3 2 68 146 34 8 145 407 Bethnal H. Asylum 29 1 0 0 0 17 11 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... 2 8 4 ... 14 28 Mildmay Hospital 34 0 4 6 1 22 1 Under 5 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 1 4 5 upwds. ... ... ... 2 ... ... ... ... ... ... 1 4 3 8 3 9 30 Victoria Pk. Hosp. 126 1 1 8 31 84 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 2 5 upwds. ... ... ... ... ... ... ... ... ... 1 ... 87 4 22 1 9 124 Totals 2717 796 580 96 94 725 426 Under 5 15 29 10 3 ... ... 2 139 145 97 ... 12 333 5 42 544 1376 5 upwds. 4 7 3 8 5 1 4 7 5 10 10 279 357 155 35 451 1341 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto. 369 35 80 40 35 137 42 Under 5 15 23 ... 1 ... ... ... 3 ... 4 ... 1 29 2 10 27 115 5 upwds. 4 6 ... 8 ... ... 1 ... 1 ... ... 26 22 41 24 121 254 Deaths occurring within the district among persons not belonging thereto 177 4 3 16 29 111 14 Under 5 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 5 7 5 upwds. ... ... ... ... ... ... ... ... ... 1 ... 83 12 35 6 33 170 BETHNAL GREEN SANITARY DISTRICT. TABLE V. Shewing the Number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospitals Deaths, in the ten years 1886 to 1895, and in the year 1895. DISEASE. 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 Annual Average of ten years, 1886—1895 Proportion of Deaths to 1000 Deaths in ten years, 1886-1895. 1896 Proportion of Deaths to 1000 Deaths in 1896. Small Pox 0 1 1 0 0 0 5 7 5 4 2.3 0.7 ... ... Measles 108 73 124 132 106 100 131 82 135 110 110.1 37.0 149 51.22 Scarlet Fever 35 61 120 40 34 29 53 71 27 30 50.0 16.8 40 13.75 Diphtheria and Membranous Croup 21 26 52 102 133 69 119 137 133 102 89.4 30.0 77 26.47 Whooping Cough 148 101 167 62 113 128 122 59 70 33 100.3 33.7 151 51.91 Fever 29 31 21 21 29 19 22 26 26 17 24.1 8.0 21 7.21 Diarrhœa 166 123 67 95 94 77 74 128 54 146 102.4 34.4 109 37.47 Total in Bethnal Green 507 416 552 452 509 422 526 510 450 442 478.6 160.6 547 188.03 46 BETHNAL GREEN SANITARY DISTRICT. TABLE IV. Shewing the Mortality from certain classes of Diseases, and proportions to population, and to 1000 deaths, 1896. 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 547 4.2 188.0 2. Pulmonary Diseases (other than Phthisis) 719 5.5 249.1 3. Phthisis 235 1.8 80.7 DIVISION II. (Young Children). Total Deaths. Deaths per 1000 Young Children Proportion of Deaths to 1000 Deaths of Children 4. Pulmonary Diseases 361 20.0 242 5. Zymotic Diseases 483 26.8 324 NOTES. 1. Includes: Small Pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Fever and Diarrhœa. 2. Includes: Pleurisy, ; Bronchitis, ; Pneumonia, 47 BETHNAL GREEN SANITARY DISTRICT. TABLE VI. Chief Inspector's Report of the Sanitary Work, &c., completed in the year ending December 31st, 1896 in the Parish of St. Matthew, Bethnal Green. Inspections- Cases of Infectious Disease 1,786 Complaints of all kinds 1,843 House to House Inspections 3,488 Trades Inspections, Bakehouses, etc. 179 Re-inspections of cases in hand 20168 Total of inspections 27,464 Results of Inspection— 4078 Nuisances were abated. 846 Patients were removed to Hospital. 1,455 Premises, rooms, etc., were disinfected and an enormous number of articles of clothing, etc. 2,771 Intimation Notices were served under the Public Health Act. 4,220 Statutory Notices were served under the Public Health Act. 76 Statutory Notices were served under the Housing Act. 1,035 Final Notices before taking legal proceedings. 2,990 Notices were served in respect of Dust Pails. 2,431 Dust Pails were sold, and the sum of £303 17s. 6d. in respect of the same was paid into the Vestry's account. 173 Notices to the District Surveyors of dangerous structures were sent. 1,718 Letters were written, and probably four times as many received. 8 Parcels of unsound food were condemned, including two boxes of oranges, four trunks of fish, and two bags of mussels. One vendor of butcher's meat was cautioned. 48 TABLE OF SANITARY IMPROVEMENTS. The number of Sanitary Improvements, New Drains, W.C.'s, &c., in the Parish during the year 1896. Premises, &c.- Number of Premises, &c., Cleansed, Repaired, and Whitewashed 2,878 Houses Disinfected after Infectious Diseases 1,455 House Drains— Repaired, Cleansed, &c. 245 New Provided 325 Trapped or Ventilated 467 Rain Water Pipes and Waste Pipes Disconnected 264 Water Closets— Repaired, Cleansed, &c. 1,734 Supplied with Water and Water Supply Apparatus 476 New Provided 28 Ventilated 97 Water Supply— Houses Provided with Water Supply 122 House Supply Disconnected from Closet Cistern 22 Miscellaneous— Paving of Yards Repaired 1,368 Washhouses Paved, &c. 114 Forecourts Paved 125 Stables Paved and Drained 52 Removal of Accumulations of Dung, and other Refuse 76 New Dung Pits Provided 91 Removal of Animals improperly kept 34 Illegal Occupation of Cellars discontinued 4 Overcrowding Abated 22 Cisterns Repaired, Covered, &c. 16 Urinal Accomodation Provided 32 Offensive Effluvia Abated 49 Number of Dust Complaints received and attended to 47 Bakehouses Periodically Inspected 78 Licensed Cowhouses Periodically Inspected 20 Licensed Slaughterhouses 10 JOHN FOOT, Chief Sanitary Inspector. 49 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 1 ... 1 2 4 Bonner road 1 1 1 5 8 Abingdon street 3 1 2 3 9 Bonner street 2 1 4 7 Andrews road ... ... 2 2 4 Bonwell street 2 1 1 5 9 Ada place ... ... 2 ... 2 Boreham street ... 1 ... ... 1 Ainsley street ... ... ... 1 1 Boundary street 1 1 ... 2 4 Albert road ... ... ... ... ... Bradys buildings 1 1 ... 2 4 Albion place ... ... ... ... ... Brady street 6 4 5 10 25 Alfred place 1 ... ... 1 2 Braemar street ... ... 1 3 4 Alma road 2 2 6 2 12 Bratley street ... ... ... 3 3 Ames place ... ... ... ... Brick lane 5 4 10 14 33 Ames street 3 ... 4 3 10 Brierley street ... ... 2 4 6 Angela gardens ... ... 1 2 3 Buxton street ... ... 1 1 2 Anglesea street ... ... ... 1 1 Buckhurst street 4 ... 2 5 11 Anns place 1 ... 1 1 3 Bullards place 1 ... ... ... 1 Antill road 2 ... 1 2 5 Bunsen street ... ... ... ... ... Approach road ... ... ... 2 2 Burgoyne road ... 1 1 2 4 Arbery road ... 2 ... 3 5 Burnham square 1 ... 1 ... 2 Archer street 2 ... ... ... 2 Burnside street ... ... 2 2 4 Arline street 2 ... 2 3 7 Busby street 2 2 2 7 13 Artillery street ... ... ... ... ... Busby square ... ... ... ... ... Arundel street 2 ... 5 2 9 Butlers bldings ... ... 1 ... 1 Ashwell road ... ... 1 1 2 Butler street ... ... ... ... ... Auckland road 2 1 2 7 12 Austin street 1 ... 1 2 4 Cadell street 1 ... 1 2 4 Cambridge circus 1 1 ... ... 2 Cambridge street 2 ... 3 2 7 Bacon street 3 5 4 14 26 Cambridge road 4 3 4 19 30 Baden place ... ... ... ... ... Cambridge bldgs ... ... 3 ... 3 Baker street 1 1 ... 1 3 Camden street 1 ... 9 5 15 Bakers court ... ... ... 1 1 Canrobert street 7 2 1 9 19 Bandon road 2 1 1 3 7 Carlisle street 1 ... ... 1 2 Barnet grove 1 ... ... 2 3 Carlton place ... 1 1 1 3 Barnsley street ... 3 4 8 15 Carter street ... ... ... ... ... Baroness road 1 ... 2 5 8 Catherine street 1 2 1 3 7 Bath grove ... ... 1 ... 1 Centre street 1 1 1 5 8 Bath street ... ... ... ... ... Chambord street 5 1 3 4 13 Baxendale street ... 3 3 2 8 Chance street 2 ... ... ... 2 Bedford row ... ... ... ... ... Chapel street 1 1 1 1 4 Bellhaven street 1 ... ... 2 3 Chapman gdns. ... ... ... ... ... Bennetts place ... ... ... ... ... Charles terrace ... ... ... ... ... Bethnal green road 9 2 9 23 43 Charlotte court ... ... ... ... ... Birkbeck street ... 1 1 ... 2 Charlotte street ... ... 4 5 10 Bishops road 2 ... 3 7 12 Charlotte bldngs ... ... ... ... ... Blythe street ... ... 3 1 4 Cheshire street 3 ... 5 7 15 D 50 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 2 Digby walk ... ... 2 2 4 Chester place ... 1 ... ... 1 Dinmont street ... ... 1 2 3 Chilton street 1 ... 5 10 16 Diss street ... ... 1 1 2 Chisenhale road 1 ... ... 3 4 Dixie street ... ... ... 5 5 Christopher street ... ... ... ... ... Doveton street ... ... ... ... Church street ... 3 2 6 11 Ducal street ... ... 1 3 4 Church row 1 1 ... 6 8 Durant street ... 1 1 3 5 Clare street 1 ... 4 5 10 Claremont street ... ... 3 ... 3 Eastman street 4 1 1 5 11 Clarkson street ... ... 1 1 2 Ebor street ... ... 1 2 3 Clarence street 1 1 3 6 11 Eckersley street ... ... ... ... ... Cleveland street ... ... 2 3 5 Edward street ... ... ... ... ... Club row ... ... ... ... ... Edward place 3 ... ... 1 4 Code street 2 2 ... 2 6 Ezra street ... 1 ... ... 1 Collingwood place ... ... ... ... ... Elwin street ... ... 4 2 6 Collingwood street 2 ... 5 15 22 Elizabeth court ... ... ... ... ... Colliers court ... ... ... ... ... Ellesmere road 2 2 2 ... 6 Collins place 2 3 5 3 13 Elvidge court ... ... ... ... ... Columbia square 4 2 2 4 12 Emma street 1 ... 4 2 7 Columbia road 4 5 12 15 36 Ernest place ... ... ... 3 3 Conyer street 2 ... 1 ... 3 Cooper's gardens 2 ... 4 5 11 Faith street 1 ... ... 3 4 Cordova road ... ... ... 2 2 Falcon buildings 2 1 1 ... 4 Corfield street 6 2 15 21 44 Felix street 2 1 4 4 11 Cottage place ... ... ... ... ... Fellbrigg street ... 1 4 9 14 Coventry street 2 2 9 8 21 Finnis street 4 2 5 6 17 Coventry place ... ... ... ... ... Fleet street hill ... ... ... ... ... Cranbrook street 4 6 7 6 23 Flint court ... ... 1 1 2 Cranbrook road ... ... ... ... ... Florida street 3 2 3 2 10 Craven buildings ... 2 1 2 5 Foster street 1 2 2 1 6 Crescent place 3 1 3 4 11 Foundry yard ... ... ... ... ... Cross street ... ... ... ... ... Fountain street ... .... 1 1 2 Crossland square ... ... ... 4 4 Fournier street ... ... ... 2 2 Cudworth street 2 ... 2 2 6 Fox street ... ... 1 1 2 Cygnet street ... ... 1 ... 1 Fuller street 4 2 ... 6 12 Cymon street ... ... ... ... ... Cyprus street 5 2 2 7 16 Gales gardens 1 4 6 5 16 Garden place 1 ... 1 ... 2 Dagnall place ... ... 2 ... 2 Gardners road 2 ... 4 1 7 Daniel street 2 ... .... 2 4 Garden row ... ... ... ... ... Darling row ... 2 ... ... 2 Gascoyne place 1 ... 3 1 5 Davis place ... ... ... ... ... Gawber street ... ... 3 ... 3 Delta street 1 ... ... 2 3 Gays buildings ... ... ... ... ... Derbyshire street 5 2 1 6 14 Georges terrace ... ... ... ... ... Derby place 2 1 ... ... 3 Georgina gardens,. ... ... ... 3 3 Devonshire place ... ... ... ... ... George gardens 3 1 6 4 14 Devonshire street ... 2 ... ... 2 George place ... ... ... ... ... Digby street 2 2 2 3 9 Gernon road ... ... ... 4 4 51 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. ... ... ... 2 2 Gibraltar gardens 1 1 ... 1 3 Gibraltar walk 2 3 12 7 24 Inkhorn yard ... ... ... ... ... Gibraltar buildings. 2 ... ... 2 4 Ion square 5 ... 5 2 12 Gillman street 1 ... 4 6 11 Ivimey street ... ... ... 1 1 Glass street ... ... 2 3 5 Globe road 4 4 7 10 25 Gloster street 2 1 3 5 11 Jacobs place ... ... ... ... ... Gloucester passage. ... ... ... ... ... Jacobs street ... ... ... ... ... Gloster gardens ... ... ... ... ... James street ... 1 4 5 10 Gore road ... ... ... ... ... James court ... ... ... ... ... Gossett street 11 4 3 10 28 James place ... ... ... 1 1 Granby row ... ... 1 ... 1 Jane street ... ... ... 3 3 Granby street 2 1 1 4 8 Jersey street 2 ... 1 6 9 Granby place ... ... ... ... ... Green street 6 7 7 15 35 Grove street 1 ... 1 2 4 Kay street ... ... ... 1 1 Grove road 1 2 8 15 26 Kelsey street ... ... ... ... ... Kenilworth road 5 ... ... 4 9 Guinness bldngs ... ... ... ... ... Kerbela street 1 ... 4 8 13 Key street 2 ... 2 1 5 Hackney road 2 2 5 15 24 Key court ... ... ... ... ... Hague street ... 2 1 1 4 Kings place ... ... ... ... ... Hague place ... ... ... ... ... Knottisford street 1 ... 1 1 3 Hague buildings ... ... ... 1 1 Half Nichol street ... 1 ... 1 2 Hammonds gdns. ... ... ... ... ... Lansdell place ... ... ... 2 2 Hamilton road 3 1 1 3 8 Lark row ... ... 2 4 6 Hare row ... ... ... ... ... Lawfranc road 1 1 1 2 5 Hare marsh ... ... ... 2 2 Letchford place ... ... ... ... ... Hare street 3 8 4 9 24 Lenham buildings. ... ... ... ... ... Hare court ... ... ... ... ... Leopold buildings. 2 1 2 2 7 Harrold street ... ... 5 1 6 Lessada street 1 1 1 10 13 Hartley street 1 2 2 2 7 Linden buildings 2 l 1 2 6 Harts lane 3 ... 3 4 10 Lisbon street 1 2 1 3 7 Hassard street .. ... 2 3 5 Little Collingwood street ... ... 1 1 2 Hassard place ... ... ... ... ... Havelock place ... ... 1 3 4 Little York street. ... ... 1 2 3 Helens place ... ... ... ... ... London street 3 ... 1 6 10 Henrietta street ... 2 2 2 6 Lucas street ... ... 1 1 2 Hereford street ... 1 1 3 5 Lyte street 1 ... 2 2 5 Hereford buildings.. ... ... 1 ... 1 Hersee place ... 1 ... 1 2 Hill street ... 2 ... l 3 Mace street 1 ... 2 6 9 Hollybush gardens.. 3 ... 4 2 9 Maidstone place ... ... ... ... ... Hollybush place ... 1 1 ... 2 Manchester bldgs.. 1 ... ... 1 2 Horatio street 5 1 ... 2 8 Manchester place ... ... ... ... ... Horts yard ... ... ... ... ... Mansford street 9 5 14 22 50 Hunslett street 1 1 ... 3 5 Mape street 1 3 2 4 10 D 2 52 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 ... ... 3 1 4 Old Ford road 10 5 9 24 48 Marian street ... ... 1 3 4 Old Nichol street ... ... ... 2 2 Marian place ... ... ... ... ... Olga street ... ... ... 2 2 Marion square ... 1 1 4 6 Orange street 1 ... 2 2 5 Martha court ... 2 3 2 7 Orange court ... ... ... ... ... Matilda street ... ... 1 ... 1 Oval ... ... ... 4 4 Mead street ... ... ... ... ... Oxford street ... ... ... 1 1 Medhurst road ... 1 ... 2 3 Medway road ... 2 2 4 8 Palestine place ... ... 2 ... 2 Melina place ... ... ... ... ... Palm street ... ... 4 5 9 Menotti street 4 1 3 1 9 Palmers road ... ... ... ... ... Middleton street 2 2 2 3 9 Park street 1 ... 1 1 3 Minerva street 1 4 1 6 12 Park place ... ... ... ... ... Minto street ... ... 1 1 2 Parliament place ... ... ... ... ... Miring place ... ... ... 1 1 Parliament street ... ... ... ... ... Monkford place ... ... ... ... ... Parmiter street ... 1 ... 5 6 Morpeth street 2 4 1 6 13 Patriot square l 2 1 2 6 Morpeth road ... ... 2 3 5 Peacock street ... ... ... ... ... Moss street 5 3 2 6 16 Peacock place ... ... 1 ... 1 Mount street 3 ... 1 4 8 Pedley street ... 1 1 1 3 Mount square ... ... ... ... ... Peel grove ... ... 1 2 3 Mowlem street ... ... 2 2 4 Pereira street 1 3 7 6 17 Museum buildings ... ... ... ... ... Peter street ... ... ... 1 1 Pitt street 3 1 3 3 10 Pollard row 2 1 2 10 15 Nant street ... ... ... ... ... Neath place 1 1 1 2 5 Pollard street 1 1 2 3 7 Nelson street 3 2 4 4 13 Pott street 1 2 4 3 10 Nelson place ... ... 2 1 3 Poyser street 4 ... 2 5 11 New Castle street ... ... ... 1 1 Preston street 2 2 2 10 16 New Church street. 2 ... 1 1 4 Primrose street ... ... ... ... ... New Nichol street ... ... 2 3 5 Princes court 3 3 ... 3 9 New Turville place. ... ... ... ... ... Paradise row ... 2 1 2 5 New Tyssen street 2 3 1 2 8 Princess place ... ... ... ... ... Prichards road 4 3 3 11 21 New square 1 ... ... 2 3 Prospect terrace 2 3 1 2 8 New street ... ... ... ... ... Providence place ... ... ... 2 2 Newling street 2 3 3 4 12 Punderson gardens ... 4 2 3 8 17 Nichols row ... ... ... ... ... Norah street 2 1 3 5 11 Queen street ... ... ... 1 1 North passage ... ... ... ... ... Queen buildings ... ... 1 3 4 North place ... ... 1 6 7 Queen Caroline place ... 1 ... 1 2 Northampton street 1 2 2 5 10 Nottingham street ... ... ... ... ... Queen Caroline gardens 4 2 5 5 16 Norton street l 1 1 5 8 Quilter street ... ... ... ... ... Octagon street ... ... 1 1 2 Quinns square 13 4 9 11 37 Old Bethnal Green road 4 3 4 16 27 Ramsey street 3 ... ... ... 3 53 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. Ravenscroft street ... 3 1 5 9 Surat place ... ... ... ... ... Rappley place ... ... ... ... ... Sweet Apple square 1 ... ... 3 4 Reuben street ... ... 1 ... 1 Sidney street 2 2 5 4 13 Riders court ... ... ... ... ... Robert street 1 ... 3 2 6 Tagg street 4 2 7 2 15 Robinson road 1 ... 2 4 7 Tapp street ... 1 1 2 4 Roman road ... 2 1 10 13 Tavistock street 1 ... ... ... 1 Ropley street ... 1 ... 3 4 Teale street 1 ... 3 4 8 Royal Victor place ... ... ... ... ... Teesdale street 3 ... 6 3 12 Royston street 2 3 7 7 19 Temple street 4 3 3 3 13 Russia lane 3 1 4 2 10 Tent street 4 ... 1 2 7 Theydon road ... ... ... 2 2 Sale street ... ... 2 10 12 Thomas passage ... ... ... ... ... Satchwell rents 3 ... 1 1 5 Thomas place ... ... ... 1 1 Satchwell street ... 1 2 ... 3 Thorold street 2 1 2 3 8 School place ... ... ... ... ... Three Colts corner ... ... ... ... ... Sclater street 1 1 1 6 9 Three Colts lane 2 2 1 3 8 Scott street 3 ... 2 5 10 do. Waterlow dwellings ... ... 1 4 5 Seabright street 3 3 6 7 19 Seabright gardens 2 ... 1 4 7 Thurlow place ... 2 ... ... 2 Selby street 2 ... ... 2 4 Totty street 2 2 ... 3 7 Sewardstone road 3 1 ... 8 12 Toye's buildings 4 ... 3 4 11 Shacklewell street ... ... ... ... ... Treadway street ... 2 5 9 16 Sheep lane ... ... ... ... ... Trinity ground ... ... ... ... ... Sheldon place ... ... 2 1 3 Turin street 1 1 1 7 10 Shipton street ... ... 1 3 4 Turk street ... ... ... ... ... Short street ... ... ... ... ... Turville street 2 1 2 ... 5 Swan street ... ... ... ... ... Turville buildings. ... ... ... ... ... Smart street 1 ... ... 2 3 Turville square ... ... ... ... ... Smith's place ... ... ... ... ... Tuscan street 1 1 1 3 6 Smith's buildings ... ... ... 4 4 Type street 2 1 3 ... 5 Southampton place ... ... ... ... ... Tyrrell street 3 ... 1 2 6 Southampton cotgs ... ... 2 1 3 Southampton ter. 1 1 ... ... 2 Usk street 1 1 2 6 10 Spencer passage ... ... ... ... ... Vallance road 3 1 1 7 12 Squirries street ... 1 2 2 5 Valley place ... ... ... ... ... Andrew street ... 1 ... 7 8 Viaduct street 4 1 6 13 24 St. James road ... ... ... 5 5 Victoria street ... ... ... ... ... St. John street ... ... 1 4 5 Victoria place ... ... ... ... ... St. J ude street 2 ... 1 2 5 Victoria park sqre. ... ... 1 2 3 St. Matthias place ... ... ... ... ... Violet street ... ... ... ... ... St. Peter square ... ... 1 1 2 Violet row ... ... 1 1 2 St. Peter street 5 4 6 7 22 Virginia road 6 4 4 7 21 Stainsbury street 1 ... 1 2 4 Vivian road 1 ... 1 2 4 Strahan road 2 1 3 4 10 Stroud place ... ... ... ... ... Wadeson street 1 ... 3 3 7 Sugarloaf walk ... ... ... 1 1 Walsby place ... ... ... ... ... Summerford street 1 1 4 3 9 Walter street 2 1 1 3 7 54 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 1 1 3 2 7 Winchester place 2 ... 1 ... 3 Warley street 3 2 5 4 14 Winchester crsnt 1 ... ... 1 2 Waterloo place ... ... ... ... ... Winchester street ... 2 1 4 7 Waterloo terrace ... ... ... 2 2 do. dwellings ... ... ... ... ... Waterloo road ... ... 1 4 5 Wolverly street ... 4 2 2 8 Weaver street 2 1 2 4 9 Wood street 1 1 l 3 6 Weldon street ... ... ... ... ... Wood Close ... ... ... 1 1 Wellington row 5 ... 6 9 20 Wellington place 1 1 ... 2 4 York street ... ... ... ... ... Wennington road 2 2 ... 2 6 York place 1 ... ... ... 1 Wharf road ... 1 1 ... 2 Wharncliffe street ... ... 1 2 3 BethnallH. Asylum ... 1 ... 1 2 Whites court ... ... ... ... ... Mildmay Hospital l 1 l 4 7 Whitechapel road ... ... 1 1 2 Militia Barracks ... ... ... ... ... William place ... ... ... ... ... Regents Canal ... ... ... ... ... Willow walk 3 1 2 2 8 Victoria Park Hos. ... ... 1 ... 1 Wilmot street 7 4 6 8 25 Workhouse ... 6 5 37 48 Wimbolt street ... 1 ... 3 4 Resid'nce not kwn. ... 5 8 30 43