REPORT on THE SANITARY CONDITION of the CITY OF LONDON, FOR THE YEAR 1866—1867; WITH A REPORT ON THE CHOLERA EPIDEMIC OF 1866. by H. LETHEBY, M.B., M.A., Ph.D., &c., medical officer of health for the city of london, and professor of chemistry in the college of the london hospital. LONDON: m. lownds, printer, fenchurcii street, city. 1868. At a Meeting of the Commissioners of Sewers of the City of London, held at the Guildhall of the said City, on Tuesday, January 1th, 1868:— The Medical Officer of Health laid before the Court his Annual Report. Ordered— That the same be printed and circulated as usual. JOSEPH DAW, Principal Clerk, CONTENTS. PAGE. Births, Deaths, and Marriages in the City 7 ,, ,, in each district of the City 8 Death-rate of City compared with that of other cities 9 Ages at Death 10 Causes of Death 11 REPORT ON THE CHOLERA OF 1866. Its route from the East compared with that of former visitations 12 Its first appearance in London and other Continental Cities in 1866 14 Weekly Account of Deaths in London and in the City 15 Mortality per 10,000 of Population in various Cities 17 „ ,, in former Epidemics 18 Death-rate per 100 persons attacked 19 Effects of Sanitary Operations in the Death-rate 20 Local Habits of the Disease 21 Effects of Elevation on the Death-rate 22 Effects of Poverty „ 25 Effects of Personal Habits ,, 26 Pettenkofer's Theory of the Local Causes of the Disease 27 Hypothesis that the Water Supply was Polluted 27 The alleged Pollution an improbable assumption 28 Dates of the Outbreak in different Districts, opposed to the HypothesiS 30 Complete immunity of numerous places using the Water, opposed to it 31 Large Mortality in places not using the Water, opposed to it 32 Statement of all the Facts opposed to the Water Hypothesis 33 Review of the most important Facts of the several Visitations of Cholera in 1832, 1848, 1854, and 1866 35 vi. CONTENTS. PAGE Returns of Sickness among the Poor of the City during the Year 43 Meteorology of the Year 43 Statement of the Sanitary Work of the Year 44 Necessity for more complete Inspection of Shipping in London 45 Amount of Meat and Fish Condemned in the Year 46 Names of Persons Convicted of Sending Diseased Meat to the City Markets for Sale as Human Food, during the Year 47 APPENDIX. Table I. Enumeration of Births, Deaths, and Marriages in each District of the City for each Quarter of the Year. ,, II. Classification of Births in each District. ,, III. Classification of Deaths in each District. „ IV. Classification of Deaths according to Age. ,, V. Classification of Deaths according to Causes of Death. „ VI. Meteorology of the Year. „ VII. Account of Sanitary Work for the Year. „ VIII. Account of Meat Seized during the Year. „ IX. Account of the Fish Condemned during the Year. „ X. List of Slaughter-houses in the City. ,, XI. List of Cow-houses in the City. ,, A. Showing the Mortality from Cholera in the several District* of London during the Epidemics of 1832-3, 1848-9, 1861, and 1866; as well as the Elevation above Trinity High Water Mark, and the density of the Population in 1866 REPORT on the SANITARY CONDITION of the CITY OF LONDON. THE NINETEENTH ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH. To the Honourable Commissioners of Sewers of the City of London. Gentlemen, I have the honour to submit my Report of the Sanitary Condition of the City of London for the past year. In the course of that time there were 1,337 marriages, 2,390 births, and 2,137 deaths registered in the City—the annual average for the last ten years being 1,655 marriages, 3,018 births, and 8 2,799 deaths; consequently there has been a falling off of 19 per cent, in the marriages, 29 per cent, in the births, and 24 per cent, in the deaths. The distribution of the 1,337 marriages is as follows:—431 were in the Eastern Union, 397 in the Western, and 509 in the City proper. These numbers are in the proportion of 10'4 per 1,000 of the population of the first-named district, 14.8 of the second, and 109 of the third—the average for the whole City being 11.7. In all England the average is 16-8 per 1,000 of the population. Of the 2,390 births in the year, 989 were in the Eastern district, 653 in the Western, and 756 in the central—numbers which are at the rate of 23 9 per 1,000 of the population of the first district, 244 of the second, and 16'3 of the third; the birth-rate of the whole City being 209 per 1,000, while that of England is 34.9. And of the 2,137 deaths, 809 were in the Eastern Union, 572 in the Western, and 756 in the City—the proportions being 19.6 per 1,000 of the first-named Union, 21.4 of the second, and 16.3 of the third—the average for the whole City being 18.6. In the whole of England the average death-rate ia 22.5 per 1,000 of the population, and 9 in the chief towns and town districts of England it is 24-6, while in country districts it is 20*1. Measured, therefore, by these standards, the deathrate is remarkably small; and, as will be seen by the following Table, it is smaller than that of any considerable town in the kingdom. Death-rate per 1,000 of the Population in various Cities in 1866 and 1867. Number of Persons per acre. Deathrate in 1866. Deathrate in 1867. Sheffield 10 28 25 Leeds 11 33 27 Salford 22 29 29 Hull 30 24 25 Dublin 33 28 27 Bristol 35 25 23 Edinburgh 40 27 27 Birmingham 44 24 24 Manchester 81 32 31 Glasgow 87 30 29 Liverpool 96 42 30 West London Union 40 26 23 West London Union 185 27 21 East London Union 246 24 20 City of London Union 92 18 16 Entire City 142 22 19 10 The ages at death are classified in Table No. IV. of the Appendix; and it will be noticed that of every 1,000 deaths in the City during the year, 170 were among infants of less than a year old, and there were 305 among children at less than five years of age, while 74 were at from five to twenty years of age, 147 from twenty to forty, 193 from forty to sixty, and 271 at sixty and upwards. The infant mortality is undoubtedly excessive, although it is not so large as it has been in former years; in fact, it has declined from an average of 185 per 1,000 of the children born to 152. This is close to the average (151) for the whole metropolis, but it is a little above the average for all England (149). In the Eastern division of the City the infant mortality has reached to 168 per 1,000 of the births, while in the Western it has been but 147 per 1,000, and in the City proper only 136. These numbers represent not only the differences in the sanitary condition of the several districts, but they also represent, as I have before explained to you, the poverty and other necessitous means of the population. 11 The chief causes of death during the year are shown in Table No. V. of the Appendix, and they may be thus expressed:— 1867. Average of Ten Years. Phthisis 325 349 Tabes and Scrofula 115 174 Hydrocephalus 29 70 Convulsions and Teething 115 159 Alvine disorders of Adults 43 34 Do. Do. Children 60 67 Continued Fever 70 107 Scarlet-fever 30 95 Small-pox 31 25 Measles 13 83 Whooping-cough, Croup, &c. 70 159 Erysipelas 12 16 Pneumonia and Bronchitis 341 473 Violence and Privation 160 156 So that the deaths from tubercular diseases have fallen from an average of 593 in the year to 469; Zymotic diseases from 586 to 329, and inflammatory diseases of the lungs from 473 to 341. The most notable of these reductions is in the case of continued fever, where the number has fallen from 107 in the year to 70. It is also remarkable in the cases of scarlet-fever, measles and whoopingcough, where the mortality has been considerably less than half the usual proportion; in every case, indeed, it is the smallest on record, and it indicates a large improvement in the sanitary condition of the people. 12 REPORT ON THE CHOLERA OP 1866. At the close of last year when cholera was still among us, I had not the opportunity of submitting to you other than a very general account of its ravages; but now that it has left us (for the last recorded death from it in the City, was in the week ending the 10th day of November, 1866), we are in a condition to review its progress, and to examine the facts which have been brought to light; and firstly, as I have already stated, its journey to us, and its method of invasion were peculiar. Instead of coming to us as it did in the epidemics of 1831-32, and 1848-49, through the north-western provinces of India, and by Persia to the shores of the Black Sea and the Caspian, and thence by the Don, the Danube, and the Volga, northward and westward through Europe to the shores of the Baltic, and so into an eastern port of England, the epidemic of 1865-66 reached us almost directly from its tropical home through Arabia, the lied Sea, and the Mediterranean. And again, excepting the third great visitation in 1854, which did not come from the East, but was developed from foci already existing on the Continent, both the previous epidemics (1832 and 1848) occupied years in their progress from India. Not so, however, with the last; for it liardly took 13 a couple of months to journey from Asia to Europe: in fact, on the 10th of May, 1865, it was decimating the pilgrims at Mecca, and on the 23rd of July it was at Marseilles. The rapid progress of the disease was due entirely to the quick movements of commerce; for the pilgrims who left abruptly their festival at Mecca, carried it with them in all directions. On the 12th of May it was at Jedda, and on the 22nd of the same month it was at Suez. Eleven days later (June 2nd) it was at Alexandria, and from that City it followed the track of commerce to Malta, Constantinople, Odessa, Valencia, Ancona, Marseilles, and Gibraltar. At first it confined itself to the shores of the Mediterranean, but during the autumn of 1865, it passed inland into Italy, Spain, and the south of France; and soon it appeared with terrible severity in Paris— so that in the months of October and November it there caused about 6,000 deaths. Touching us lightly (for it reached Southampton at the end of September, and was. fatal to thirty-five persons), it disappeared for the season—one death only having occurred in London, and that was of a woman who came here ill from Paris, and died on the 22nd of October, 1856. Early in the spring of 1866 (April 21) the disease appeared at Rotterdam, and then at 14 werp (May 19). It was in London a little later (May 28), and later still at St. Petersburg (June 26), Memel (July 10), Dantzic (July 12), and other places. In every case, however, the disease was imported. It came to us with German and Dutch emigrants from Rotterdam, and was thus brought to Hull, Liverpool, and London; and it was carried in like manner to New York. The mortality returns for the Metropolis, show that the first deaths from Asiatic cholera in 18(»(i, occurred at Walworth on the 28th of May. On the 13th of June another such death was recorded at Newington; a fortnight later (June 27) two deaths from it occurred at Bromley; two days after (June 29) a fifth was returned at Hammersmith; then a sixth (July 5) in the Borough Road; a seventh and eighth on July 9th at Hoxton, and Bermondsey; and during the week which ended on the 14th of July, there were 48 deaths from the disease in London, of which 13 were in the eastern districts of the metropolis. This was the beginning of the epidemic; for in the next four weeks the mortality from it quickly rose to 1,169 in the week, and then it gradually declined. The following are the weekly returns of cholera deaths in London and in the City, during the whole of the epidemic. 15 Weekly Mortality from Cholera in London and in the City during the Epidemic of 1866. Weeks ending Saturday (1866). Number of Deaths from Cholera. In London. Pop. 8,087,991. In the City. Pop. 114,472. „ July 7 1 0 „ 14 48 1 „ 21 480 0 „ 28 1,081 7 Aughust 4 1,169 18 „ 11 747 15 „ 18 419 8 „ 25 227 7 September 1 198 2 „ 8 157 3 „ 15 182 7 „ 22 150 6 „ 29 177 3 October 6 182 9 „ 13 207 6 „ 20 144 6 „ 27 112 3 November 3 73 2 „ 10 67 0 „ 17 32 0 „ 24 8 0 December 1 3 0 „ 8 1 0 Total 5,865 103 It will be thus seen, that the highest mortality from the disease was in the week ending the 4th of August,—that is a month after its decided appearance in London. In the epidemic of 1854 the mortality was greatest in the ninth week; and in 16 that of 1849 it was at its climax in the fourteenth week. The duration of the epidemic (six months), was also short compared with that of former visitations. The distribution of the deaths in the City was as follows:— Deaths from Cholera. Choleraic Diarrhœa. Total. East London Union 63 9 62 West London Union 17 4 21 City of London Union 18 2 20 Total in City 78 15 103 Besides which there were 27 deaths from the disease in the City of London Workhouse at Bow 5 in the West London Workhouse at Holloway, and 1 in that of the East London Union at Homerton —all outside the City. In order that you may be able to judge of the severity of the epidemic in the City, as compared with other places, I submit the following Table:— 17 Mortality from Cholera per 10,000 of the population. City of London Union 4.3 West London Union 7.8 East London Union 15.0 Entire City 9.0 London 18.3 Liverpool 36.2 Paris 39.2 Amsterdam 42.0 Vienna 51.3 Naples 51.5 Dutch Cities and Towns 107.3 Brussels 163.7 Belgian Cities and Towns 185.6 From which it will be seen that the force of the epidemic in the City has not been serious. It was, indeed, only half as severe as in the whole of London; a fourth of that at Liverpool and Paris; a ninth of that at Vienna and Naples; and only a sixteenth of what it was at Brussels, and the chief towns of Holland and Belgium. So also if we compare it with the epidemics of 1849 and 1854, the lightness of its touch is equally apparent. B 18 Mortality from Cholera per 10,000 of the population in the Epidemics of 1849, 1854, and 1866. Epidemics of 1849. 1854. 1866. Mean. East London Union 46 23 15 28 West London Union 147 10 8 55 City of London Union 38 14 4 19 Entire City 56 16 9 27 All London 62 43 18 41 And again, I may remark that in the cholera year of 1849 the total mortality in the City was 30 per 1,000 of the population; in 1854, it was 257 per 1,000, and in 1866 it was only 222. # These are evidences of great improvement in the sanitary condition of the City; for in 1849 you had only just obtained your sanitary powers, in 1854 they were largely in operation, and in 1866 they were still more fully developed,* Nor are these the only evidences of the beneficial effects of your sanitary operations; for the *See page 20 of my last Annual Report of the Sanitary Condition of the City for the year 1865-66 for an account of the yearly increase of sanitary work. 19 turns of cases of cholera attended by the Medical Officers of the East and West London Unions, show that the proportion of deaths to attacks was singularly small. Compared in fact with the mortality in other places it stands thus:— Death from Cholera per 100 persons attacked in the Epidemic of 1865-66. East London Union 15.8 West London Union 25.0 Cholera Ward, Bishopsgate 28.1 St. Bartholomew's Hospital 48.8 Cholera Hospital, Whitechapel 54.0 London Hospital 54.9 Hospitals, Dublin 54.7 Ditto Paris 51.6 Ditto Ancona 57.1 In the Epidemic of 1854, the deaths in England were 45.2 per cent. of those attacked, and in that of 1848 the deaths in different cities were as follow:—London 48.7 per cent.; Hamburg 47.8; St. Petersburg 65; and Berlin 65.5. Who therefore can doubt, considering the proximity of the City to the very focus of the epidemic b 2 20 in the eastern districts of London, that the low mortality from the disease was referable to the active sanitary measures employed during the whole period of the epidemic.* This accords with all previous experience of the disease; for wherever attention has been paid to the sanitary condition of a place, the force of the epidemic has been checked, and the aggregate mortality from it has been small. London, for example, which has always been in advance of other cities in its sanitary arrangements, has invariably suffered less from visitations of cholera than they have. In the epidemic of 1831-32, while the mortality from the disease in London was only at the rate of 36 per 10,000 of the population, in Paris *During the cholera epidemic a staff of workman, forty-five in number, acting under the direction of the sanitary committee, were occupied in lime-whiting the courts and alleys of the City, as well as in disinfecting and cleansing the worst class of houses (2,000 in number). Another staff of men, fifteen in number, were engaged in flushing, cleansing, and disinfecting the courts and alleys (184 in number); and a third staff of fifteen extra men were employed in supplying carbolic acid to the watercarts, and so keeping the streets constantly drenched with a weak solution of the disinfectant. In this manner 8 tons of chloride of lime, 4 cwt. of carbolate of lime, and nearly 1,000 gallons of carbolic acid were used, at a cost to the Commissioners for extra labour and materials of nearly £3,000. Nor must I omit to mention the energetic measures taken by the guardians of the three City Unions, who for the time were invested with sanitary powers. 21 it was no less than 235. So also in the visitation of 1848-9, the mortality in London was but 62 per 10,000, although at Liverpool it was 163, at Hull 236, at Belfast 154, at Limerick 11.4, at New York 112, at Cologne 138, at Paris 182, at Cairo 205, at Alexandria 236, at Riga 316, at Stockholm 452, and at Cronstadt 546. A like difference was observed in the epidemic of 1854, and now also in the epidemic of 1866. As in former visitations of the disease, the epidemic has been singularly local—occurring with greatest severity in low lying districts, with a sodden soil and having a dense and poor population. In the epidemics of 1849 and 1854, the great ravages of the disease were within nine well defined regions, which the Registrar-General has aptly termed cholera fields; and there, among a population of about seven millions, the mortality was at the rate of 65 per 10,000 of the people in 1849, and 21 per 10,000 in 1854; while in the rest of England it was only at the rates, respectively, of 6 and 4 per 10,000. The same fact, namely special localisation of the disease, has been observed in every large city. In London, for instance, the death-rates in the 22 several districts during each of the last three epidemics of cholera, were as follows:— Deaths from Cholera in the several Districts of London, per 10,000 of the population in 1849, 1854 and 1866. Districts. Average height in feet above high water. Epidemics of 1849. 1854. 1866. Mean. North 89 20.4 14.7 6.1 13.7 Central 50 44.0 16.4 9.2 23.2 West 32 33.8 50.8 3.6 29.4 East 30 66.0 29.3 64.3 53.1 South 8 120.1 86.8 8.1 71.7 All London 39 61.8 42.9 18.3 41.0 The most remarkable feature of this Table is that the average death rates are inversely proportional to the elevations of the districts; and when the facts are exhibited in greater detail as in Table A of the Appendix, and in the following Table, which is from the returns of the Registrar-General, they are still more striking. 23 Mortality from Cholera in London, per 10,000 of the population at different elevations above Trinity high water mark. Elevation in feet above Trinity High Water. Epidemics of 1849. 1854. East & SouthEast Districts, 1866. Mean. Under 3 146 108 167 140 3 to 10 89 94 89 91 10 „ 20 60 50 88 66 20 „ 40 62 32 26 40 40 „ 60 45 16 17 26 60 „ 80 25 27 4 19 80 and. over 15 13 0 9 All London 62 46 56 55 So that, taking the mean of the mortality in London at different elevations, there was but one death from cholera in a thousand of the population residing at a height of 80 feet or more above the river, while there were fourteen per thousand among those who lived at the level of it. In the intermediate stages the death-rates are inversely proportional, and with an increasing ratio, for they are in the proportion of 81, 66, 10, 7 and 4 for every 10 feet from the level of the river. This fact was the subject of able comment by Dr. Farr, in his report to the Registrar-General on the cholera epidemic of 1849 and 1854; and he concluded his remark by saying that "no such fixed relation is formed between the density of the 24 population, or the annual value of their houses, as is observed between the mortality by cholera, and the elevation of the ground on which the people live." But although it is difficult to obtain an exact account of the density of the population, and their social condition, there can be no doubt that poverty, filth, and overcrowding, have much to do with the intensity of the disease. Even in the City of London the differences in the moan mortality of the disease in the several Unions are due in great part to differences in social condition, for in the central district, where the population is generally well to do, the average death-rate during the last three epidemics was only 19 per 10,000 of the population, while in the Eastern and Western Unions it ranged from 28 to 55 per 10,000—the average being 42. Looking also at the districts of Islington, Hackney, Clerkenwell, Kensington, and St. George's, Honover Square, where the population is chiefly of the better class, and comparing them with the districts of St. Giles, Shoreditch, Bethnal Green, Whitechapel, and St. George's-inthe-East, where the poor arc congregated, it will be seen that, independently of elevation, there are other causes in operation, which make the death-rate of the one but 17 in the 10,000, while the others range from 40 to 67 in the 10,000. 25 Average Mortality per 10,000 from Cholera, in rich and poor districts of London. Districts. Cholera Deaths per 10,000 (1849,1854, and 1866). Average Elevation above Trinity high water (feet). Islington 11.1 94 Hackney 13.2 53 Clerkenwell 13.3 65 Kensington 23.9 40 St. George's, Hanover Square 21.1 34 Mean 16.7 57 St. Giles 39.9 68 Shoreditch 46.7 48 Bethnal Green 57.3 38 Whitechapel 68.6 32 St. George's-in-the-East 49.7 21 Mean 52.2 41 How far the intemperate habits of individuals may be concerned in intensifying the disease, and provoking its attacks is hardly discoverable; but it does seem that the mortality from it among those who were members of provident and temperance societies was much below the average; and a very remarkable fact presents itself when we classify the deaths from cholera in 1866 according to the days of the week, namely that much the largest mean mortality occurred in the middle of the week, on Wednesdays, and the smallest on Fridays—as if the disease grew in severity from Sunday to Wednesday and then gradually declined. The actual 26 total number of deaths on each day of the week is as follows:— Classification of the deaths from Cholera daily recorded in London from July the 8th to September the 1st, inclusive 1866). Number of deaths on 8 Sundays 593 „ „ „ Mondays 597 „ „ „ Tuesdays 616 „ „ „ Wednesdays 712 „ „ „ Thursdays 665 „ „ „ Fridays 572 „ „ „ Saturdays 607 Total in 8 weeks 4,362 But difficult as the problem is, to determine the exact value of the several circumstances which influence the severity of the disease, and especially those which give to it its marked local intensities, enough has been ascertained to indicate its general habits, and to show that it fixes itself at low levels in proximity to tidal rivers, among dense populations, that are living in ill-constructed houses, that are filthy, badly ventilated, badly drained, and generally defective of sanitary provisions; and the inference is that the actual agent of cholera, be it 27 what it may, can only find congenial conditions for its full development in damp and impure air. The theory of Pettenkofer is that the essential conditions for the active manifestations of the disease are a porous soil, charged with excrementitious matter, and having a certain degree of hydration, as happens when the subsoil water has been just drawn off or is slowly retiring. All these conditions were singularly coincident with the localisation of the disease in the eastern districts of London; for the soil is gravelly and therefore very porous to air and water, and it is largely charged with excrementitious matters derived from the local tide-locked sewers. It is also remarkable that for some months before the outbreak of the disease, the subsoil water had been gradually sinking in consequence of the drainage operations that were necessary for the construction of the main low-level sewer, and its branch to the Isle of Dogs. Now according to Pettenkofer, it is exactly under these circumstances that a district is most liable to choleraic infection. Another theory which has been advanced to account for the local character of the outbreak is, that the water distributed to the infected districts was charged with choleraic matter; but looking at all the facts of the case, it is clearly evident that while 28 none of them are discordant with Pettenkofer's theory, a large number are in open and direct antagonism to the water hypothesis. In point of fact it is necessary for the acceptance of such a speculation, not only that some clear proof should be given of the actual pollution of the water with choleraic matter, but also that the time of the outbreak throughout the infected district, was coincident with the distribution of such water, and that it did not notably fail to produce the disease whereever it was sent. It is likewise necessary to show that the disease was strictly confined to the area of such distribution, and that the use of other water was not accompanied with like severe results. The alleged pollution of the water rests upon a series of assumptions, many of which are in the highest degree improbable. It happened that two deaths from cholera occurred on the 27th of June, at Bromley, immediately in the neighbourhood of the East London Water-works, though far removed from their source of supply; and it is assumed that the alvine discharges of the two sick persons were cast into the privy and found their way, through the sewers, into the river Lea, where, by being diffused through a large volume of water, they passed upward against the current of the stream, and arrived opposite an open, but rarely used, reservoir of the Water Company; that they then soaked through 29 a thick embankment, and so obtained access to the water of the uncovered reservoir; that on a certain day some of this water was admitted into the covered reservoir, from which the public supply was taken; and that it was thus distributed to the district supplied to the Company. But if, for the sake of argument, it were admitted that all this did in reality happen, it would be a curious mathematical problem to determine what was the degree of final dilution after the alvine matters had entered the sewers, then the river Lea, then the open reservoir, and, lastly, the covered reservoir; for it is not supposed that the choleraic discharges were bodily conveyed to the covered reservoir, but that only a small portion of each of the successive dilutions became mixed with larger and larger volumes of water.* Apart, however, from the improbabilities of these assumptions, it is a fact that the water which is said to have been thus polluted did not produce its effects in the several districts to which it was distributed in anything like uniformity of time or force. Suppose, by way of illustration, that alcohol or arsenic had become mixed with the water, and *I need not discuss another supposed source of pollution, the cholera cases at Theydon Bois, eleven miles from the works, for that hypothesis is abandoned. 30 that on a certain day it was distributed to the public, we should expect to find that the action of the poison was not only manifested at the same time over the whole district of supply, but that itwas confined to that district. Not so, however, with the water in question, for although it is not alleged to have been more than once polluted, yet the first effects in the several districts occurred at long intervals; and there were many places to which it was distributed, where there was no sign of the disease; while others which did not receive the water, were seriously affected. The dates of the outbreak of the disease in the districts supplied with the East London water, were as follows: Bromley, June 27th; Poplar and Bethnal Green, June 30th; Shoreditch and Mile End, July 7th; Whitechapel, Stepney, and St. George'sin-the-East, July 14th; and the East London Union, July 28th. A month therefore elapsed between the first outbreak of the disease in the several districts. It is, moreover, remarkable that, while it was so violent in many of the districts of supply, it was absolutely powerless in others. The death rate for example of Bethnal Green was 63 per 10,000 of the population; Whitechapel, 78; Poplar, 85; and St. George's-in-the-East, 93; whereas the districts of Stamford Hill, Upper Clapton, Walthamstow, 31 Woodford, Wanstead, Leytonstone, Buckhurst Hill. North Woolwich, and Silvertown,* were absolutely untouched by the disease, notwithstanding that they received the same water, and at the same time. More remarkable still, there were places in the very heart of the cholera field, and others close adjoining it, where the residents received the same suspected water, and used it freely, without suffering in the least degree. In the Limehouse School, around which the cholera was frightfully fatal, there were 400 children who drank the same water as their neighbours, and yet there was not even a case of diarrhœa among them. In the London Hospital, which is also in the heart of the cholera field, for it is surrounded by the districts of Whitechapel, Bethnal Green, Mile End Old Town, and St. George's-in-the-East, there was an average resident population of 463 persons, and, although they drank freely of the unfiltered East London water, yet there was not a case of illness among them.† *Silvertown was affected towards the end of the epidemic, when no water theory could account for it. †574 cases of cholera were treated in the Hospital, but they were all brought into it sick of the disease. A nurse who lived out of the Hospital died of the disease. 32 Again, in the Eastern Division of the City of London, which adjoins the cholera field, the suspected water was supplied to 161 houses, with a population of about 1,732 persons, but, except in one of these houses (20, Somerset Street), which is on the boundary of Whitechapel, there was not a single death from cholera,* and to verify this, I have obtained the addresses of all the persons who died in the cholera ward in Bishopsgate Street. But, besides this, the disease was singularly fatal in places where the suspected water was never used. In Crown Court, Blue Anchor Yard, Whitechapel, where the water supply is from the New River, the mortality was at the rate of 284 per 10,000. In Boar's Head Yard, of the same district, which is also supplied by the New River, the death-rate was 193 per 10,000; and indeed there are eighteen courts in Whitechapel, where none of the East London water was used, and yet, out of an aggregate population of 4,351 persons, there were 30 deaths from cholera, the mortality being at the rate of 69 per 10,000; that of the whole district being but 77. Another such an instance is the case of the *There were two deaths in this house from cholera, but both were late in the season; viz.: one in the first week of August, and the second in the third week. 33 City of London Union at Bow. In the midst of the cholera districts it suffered in common with the whole neighbourhood, for out of 765 persons it lost 27 from the disease, which is at the rate of 353 per 10,000. But during the whole of the time the residents used no other water than that from a deep artesian well, which on being analysed, was found to be good and wholesome. So that on carefully examining the facts in their relation to the water theory, we find— 1. That there is no proof whatever of choleraic pollution of the water. 2. That there was no coincidence of time in the appearance of the disease in the several districts supplied with the suspected water. 3. That numerous districts receiving the same water, but situated at high level, or placed beyond the cholera field, were entirely exempt from the disease. 4. That even in the very heart of the cholera field, there were places receiving and using the suspected water with impunity. c 34 5. That other places not supplied with the water, but situated within the infected area, suffered equally with the neighbourhood. I am far from wishing it to be thought that choleraic matter diffused through water will not produce disease. There is abundant evidence to show that it is often a prolific source of it; but I am anxious in dealing with a question of so much public importance as the origin of the late epidemic, that none of the facts should be perverted, and that no hasty or ingenious hypothesis without solid foundation should take possession of the public mind. In the conduct of inquiries like this, there should be a calm, a full, and a candid examination of the facts;—we should endeavour to study the phenomena in a philosophical spirit, and apply to them the tests of sound induction; we should strive also to deduce from them such laws as will not only expose the nature of the malady, but will, at the same time, enable us to treat it successfully. Rash opinions, boldly asserted, and tenaciously held, though they may force themselves on public attention, rarely lead to useful results; and while they have their hold on the popular mind they seriously hinder the progress of real knowledge. Looking back, however, on the experience 35 gained by the last visitation of cholera, and comparing it with that of other visitations, we may fairly ask if any general conclusions may be deduced from the most prominent facts. It appears indeed:— 1. That cholera is not indigenous to this country, or even to Europe. Its home is the swampy and low-lying districts of India, where, from the year 1817, it has been native to the soil. No other tropical ground is persistently occupied by it; for, although it may visit other such localities, and for a time be severely fatal, yet it never fixes itself endemically in any place beyond the Indian Peninsula. The Delta of the Nile seems, at first sight, to be as congenial to it as the banks of the Ganges and the Hooghly, but although cholera visits it in its migrations, it never permanently occupies it. 2. That in its journey from India it always follows the lines of traffic, moving from port to port along the coast, and passing inland by the track of navigable rivers. Until the last visitation, its course from India was always the same, but the rapid advance of commerce has changed its route, and made it pass at once from the Eastern frontiers of Asia to Southern and Western Europe. c 2 36 3. That it is always imported into this country from an infected district, and generally from Holland or the ports of the Baltic. 4. That the visitation is not preceded by any remarkable condition of the atmosphere; for although in the epidemics of 1832, 1848, 1854, the weather was warm, the barometric pressure high, the air stagnant with prevalent mists, and there was but little rain, yet in the visitation of 1866, the condition of the weather was almost exactly the reverse of this—for the barometer was generally low, the season was cold, the atmosphere was constantly in motion, with frequent gales, and there was much rain. 5. That although the disease is of tropical growth, and is generally most severe in its manifestations during the summer and autumn heat, yet it is not always checked by the cold of winter. The epidemic of 1830 was terribly fatal at Moscow during the winter of that year. The same was also the case at Berlin in 1832; and the epidemic of 1849 was at its height in Glasgow, Paisley, and other towns of Scotland in the middle of winter; so also in the epidemics of 1854 37 and 1866 the deaths from cholera at St. Petersburg were very numerous when the thermometer was below the freezing point. It may be that the conditions as to temperature and moisture within the houses at this time were not very different from those of summer time. 6. That the advent of the disease is generally marked by some increase as it were of the zymotic force. It is difficult to judge of the general condition of the public health at the time of the visitation in 1832, but at the coming of the epidemics of 1848 and 1853, there was an unusual amount of zymotic disease. At Moscow and St. Petersburg, and in other Russian towns, the outbreak of 1848 was preceded by a general prevalence of influenza, and of intermittent fever; the latter disease, in many continental cities, taking the place of typhus in this country. Diarrhoea also in the European cities first attacked, was generally prevalent before the actual outburst of the. disease. At Berlin intermittent fever, diarrhoea, and dysentery, but especially diarrhoea, were epidemic. The same disease, but particularly intermittent fever, scarlet-fever, and influenza, were prevalent at Hamburgh. In London 38 there had been, during the preceding five years, a progressive increase in the whole class of zymotic disease—amounting to an excess of 31 above the average—the diseases which chiefly contributed to this excess were typhus, scarlet-fever, influenza and diarrhoea.* A like increase in nearly the same diseases, preceded the epidemic of 1854, as if the public health was below the standard, and the conditions existed for the development of zymotic maladies. Not so, however, at the coming of the last epidemic ; for, excepting a very slight increase in the proportion of deaths from typhus and small-pox, there was nothing to indicate an unfavourable state of the public health ; and diarrhoea, the common precursor of cholera, was much less prevalent and fatal than usual. 7. That the habitats of the disease are low and marshy ground, along the margin of tidal rivers, where the soil is porous, and is sodden with animal excreta and where the population is dense and not of cleanly habits. It has, however, its eccentricities of selection; for sometimes it will fix itself * Report of the General Board of Health on the Epidemic Cholera of 1848-9. 39 on one side of a street, and not touch the other; or it will localise itself in one ward only of a prison or lunatic asylum, or workhouse. There is no doubt a sufficient reason for this, but at present its capriciousness passes our comprehension. 8. That when it attacks a place, it always commences with a few straggling cases; it then rapidly increases in violence, and gradually abates. The circumstances which give intensity to its action are entirely local, as the altitude of the place, the density of the population, and its sanitary condition. The altitude of a place appears to have the largest influence; and next to this the density of the population. In the epidemic in 1849, this was well exemplified by the duration of the disease; for in 41 registration sub-districts, each with a population of less than 10,000, the average time of the epidemic was but 81 days; in 44 sub-districts with from 10,000 to 20,000 inhabitants, the the mean duration of it was 108 days; and in 35 sub-districts with from 20,000 to 30,000 persons it was 117 days. But it has its caprices in this respect, for in the three epidemics of 1849, 1854, and 1866, the time of its reaching its greatest intensity in 40 don was 14 weeks, 9 weeks, and 5 weeks respectively; and the duration of the disease was equally variable—the last epidemic remaining with us but six months, while in former visitations it was here for more than a year. The influence of sanitary measures may have had something to do with these results, for their beneficial action has everywhere been abundantly proved. 9. That as regards the individual attacked by the disease, it has been generally observed that he has suffered from diarrhoea for one, two, or three days before the setting in of serious symptoms; and this is ordinarily amenable to treatment. 10. That the period of incubation of the disease—that is the time which elapses between exposure to infection and the coming on of well marked symptoms is variable, although it probably ranges from three to eight days. 11. That the duration of an acute attack when the symptoms are fully developed is rarely over a day, while that of common English Cholera is not less than three days, and of ordinary diarrhoea six days. 41 12. That the mortality is always most severe at the beginning of an epidemic, when, as in the London Hospital, it may amount to 85 per cent. of those attacked; whereas at the end of the visitation it is much less severe, and may not exceed 37 per cent. Throughout the whole of the epidemic, however, the mortality has generally been from 41 to 50 per cent., excepting when, as in Continental cities, the sanitary conditions are unfavourable, and then it may amount to from 60 to 70 per cent. 13. That the disease is only infectious in the sense that the alvine discharges of the sick are capable in all probability of communicating the disease to the healthy. Observation indeed, in every part of the world, leads to the conclusion that they are the sole agents in propagating the disease; but the exact element or materies morbi which is thus concerned in communicating it is not known. The researches of Dr. Parkes in this country, Dr. Thome, of Cologne, Professor Klob, of Vienna, and Professor Hallier, of Jena, have shown that the alvine discharges of persons sick of cholera, contain myriads of low cryptogamic organisms of the nature of a minute microscopic fungus, which 42 is capable of rapid growth and multiplication within the human intestine, and which feeds on and destroys the mucous coat of the bowel. It would seem too, from the experiments of Dr. Thiersch, of Munich, and of Dr. Sanderson, of London, on mice fed with paper saturated with choleraic matter, that the alvine discharges are not infectious in their fresh condition; but that after the fourth day and up perhaps to the eighteenth day, they possess infectious power. If further experiments give a conclusive value to these results, their importance cannot be overestimated ; for it points to the means of at once arresting the course of the epidemic by the quick destruction of the alvine discharges, and of all things that are soiled by them. 14 and lastly.—It is unquestionable that active sanitary measures employed even during the visitation of an epidemic, are of the greatest value in checking its course. The differences in the force of the disease at its several visitations to the City afford ample proof of the usefulness of your sanitary measures; and standing, as the City does, on the confines of the cholera field of 1866, I have no doubt that the active operations 43 which were then enforced prevented the spread of the disease westward, especially along the low lying districts of the river, and thus formed a barrier to its progress.* The sickness returns for the year, as recorded in the books of the Medical Officers of the City Unions, indicate a less than usual proportion of illness among the poor, for there were only 9,040 cases of sickness, the yearly average, for the last seven years, being 11,005, and of these 645 were cases of fever, 1,047 of diarrhoea, and 25 of cholera. In the preceding year there were 11,419 cases of illness attended by the Union Medical Officers, of which 756 were fever, 3,613 diarrhoea, and 98 cholera. The Meteorology of the several months of the year is shown in Table No. VI of the Appendix. It is deduced from observations at Guildhall, under the superintendence of Mr. Haywood, and the principal facts may be thus expressed:— * The measures and agents employed in disenfecting the crowded houses of the City poor, are detailed in a paper furnished by me to the RegistrarGeneral at his request, and published by him in his Weekly Report for November 24th, 1866. 44 Mean Temperature, Humidity and Rainfall of the quarters of the year, 1866, compared with the averages of the last nine years. Quarter ending Temperature. Humidity Saturation = 100. Rainfall. Number of Wet Days. 1866. Averages of 9 yrs. 1860. Averages of 9 yrs. 1866. Averages of 9 yrs. 1866. Averages of 9 yrs. Deg. Deg. Deg. Deg. Inches. Inches. No. No. December 48.3 47.7 89 84 5.86 6.17 42 41 March 40.7 41.4 86 84 6.11 4.93 42 40 June 54.0 54.3 71 75 5.94 6.05 48 41 September 60.8 61.8 72 74 8.32 6.54 34 41 Yearly Average 509 51.3 79 79 6.56 5.92 41 41 so that while the temperature has been generally a little below the average, the rainfall has been a little above it; and the amount of moisture in the air, and number of wet days have been exactly the mean proportion for the last nine years. The particulars of the Sanitary work for the year will be found in Table No. VII of the Appendix. Broadly, it may be stated that the four Sanitary Officers have inspected 22,447 houses in the year, and have found 4,113 of them more or less defective in their sanitary condition, for the amendment of which 6,057 orders have been issued and complied with. The inspector of shipping, appointed to carry out the instructions of the 45 Sanitary Act of 1866, has made 2,103 inspections of ships during the year, and has effected sanitary improvement in 156 of them. As far as I am aware, he is the only officer appointed for such a purpose in the port of London; and, therefore, practically, there is no sanitary inspection of shipping in this port, excepting in the narrow strip of the river on the City side, between Blackfriars and the Tower. Considering how frequently ships are defective in their sanitary condition, not merely in the close and filthy state of the forecastle, where the crew are lodged, but also in the dirty and overcrowded berths of the passengers; it is of great public importance that there should be a general inspection of shipping throughout the whole of the port of London. Attention has already been called to this subject by papers lately published on the Hygienic condition of our Mercantile Marine, and among the most emphatic writers on the subject are the Medical Officer to Her Majesty's Customs, Dr. Dickson, and the resident Medical Officer of the hospital-ship, "Dreadnought," Mr. Harry Leach, as well as one of the physicians of the ship, Dr. Barnes, all of whom have exposed the unhealthy state of our shipping, and have shown that fever exists, to a great extent, in our coasters, and scurvy in ocean-going vessels. As regards the latter disease Dr. Barnes affirms that nearly half of the men received into the 46 Sailors' Home at Poplar are at the time of their admission suffering from scurvy; and that it is not uncommon for from 20 to 70 per cent. of a ship's crew to be thus diseased at one time. Who knows, therefore, how many of the disasters at sea, with loss of life and property have been occasioned by the weakness of the crew and loss of power from the disease, so that they have been unable to work the ship in stormy weather? The sole cause of the disease is the neglect by owners or captains of vessels to victual their crew in a proper manner. To some extent the law has provided for this matter, but the hygienic provisions of various acts of parliament relating to it are openly disregarded; and it is high time that measures should be taken to have them enforced. None perhaps, would be more effective than those which are delegated to local authorities under the Sanitary Act of 1866, by which the condition of ships entering our ports can be systematically observed. Lastly, I have to report to you that the markets and the slaughter-houses of the City have been daily inspected, and that the two officers appointed to this duty have condemned 287,974 lbs. or nearly 129 tons of meat as unfit for human food —129,312 lbs. of it were diseased, 125,275 lbs. were putrid, and 33,387 lbs. were from animals 47 that had died from accident or disease. It consisted of 1,428 sheep and lambs, 122 calves, 1,001 pigs, 902 quarters of beef, and 3,697 joints of meat; beside 4 deer, 2 bucks, 6 quarters of venison, and 817 heads of game and poultry. The two Fish-meters in Billingsgate Market have likewise condemned during the year, on account of putridity, 863,311 fish (chiefly dabs, haddock, and whiting), 1,130 lbs. of eels, 836 lbs. of cod-sounds, 120 lbs. of caplins, 2 barrels of cods' roes, 62 bushels of sprats, 276 bushels of oysters and periwinkles, 205 bags of whelks and mussels, and 8,071 gallons of shrimps, all which were destroyed and converted into manure. The particulars of these returns are set forth in Tables VIII and IX of the Appendix. The prosecutions and convictions during the year for sending diseased meat to the City Markets for sale as food were as follows:— 1. James Poole, butcher, Cunberton, near Cambridge, fined £5 and costs. 2. Robert Puddy, jobbing butcher, of East Brent, near Weston-super-Mare sentenced to two months' imprisonment. 48 3. George Rutt, farmer, of Purleigh, in Essex, fined £10 and costs. 4. William Drewell, carrier and pig-feeder, of Kensal Green, fined two guineas and costs. 5. Samuel Smalley, butcher, of Louth, in Lincolnshire, fined £10 and costs. 6. Thomas Sallows, butcher, of Halesworth, in Suffolk, fined two guineas and costs. 7. John Pilgrim, farmer, of Chesterfield, in Essex, fined two guineas and costs. 8. John Sargent, butcher, of Eaton, Socen, in Bedfordshire, fined £10 and costs. 9. Thomas Jackson, butcher, of Peterborough, sentenced to two months' imprisonment. 10. David Strickson, butcher, of Brougton, in Lincolnshire, fined £10 and costs. 11. Walter Pike, farmer, of Hasland, in Derbyshire, discharged. 12. Thomas Crowhurst, butcher, of Saint 49 Mary's Cray, sentenced to twenty-one days' imprisonment. 13. Adolphus Boyce, farmer, of Soham, in Cambridgeshire, fined £10 and costs. 14. Gerard Samson, butcher, of Preston, in Dorsetshire, sentenced to a month's imprisonment. 15. Kennard Knott, farmer, of Lyde, near Yeovil, sentenced to a month's imprisonment. I remain, Gentlemen, Your obedient Servant, HY. LETIIEBY. Guildhall, 30th December, 1867. D APPENDIX. d 2 No. I.-Enumeration of Births, Deaths, and Marriages in each of the City Unions for the Year ending September 1867, and a Comparison with the Averages of the last Ten Years. Quarters ending. East London Union. West London Union. City of London Union. Entire City. Births. Deaths. Marriages. Births. Deaths. Marriages. Births. Deaths. Marriages. Births. Deaths. Marriages. December 1866 223 190 125 176 132 107 166 185 136 570 507 368 Average of 10 Quarters 327 267 147 185 187 145 248 245 150 760 699 442 March 1867 266 237 81 151 148 86 207 240 119 624 625 286 Average of 10 Quarters 347 299 117 200 218 106 258 286 146 805 803 369 June 1867 250 170 127 156 150 111 185 158 129 591 478 367 Average of 10 Quarters 326 260 127 191 176 128 238 232 157 755 668 412 September 1867 245 212 98 170 142 93 190 173 125 605 527 316 Average of 10 Quarters 296 251 129 172 164 134 230 214 169 698 629 432 Sum of the 4 Quarters 989 809 431 653 572 397 748 756 509 2390 2137 1337 Average of 10 Years 1296 1077 520 748 745 513 974 977 622 3018 2799 1655 No. II.—Annual Enumeration of Births for the Year ending September 1867. Births in tub Four Quarters. Total. East London Union. West London Union. City of London Union. Saint Botolph. Cripplegate. Total. North. South. Total. s. w. N. W. South. S. E. N. E. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Quarter ending Dec. 1866 278 292 60 61 47 60 107 121 34 37 56 49 90 86 22 22 13 13 15 17 15 14 16 19 81 86 570 121 107 228 71 105 176 44 26 32 29 35 166 Quarter ending March 1867 310 314 77 80 62 47 139 127 36 41 34 40 70 81 17 19 18 21 24 21 14 23 28 22 101 106 624 157 109 266 77 74 151 36 39 45 37 50 207 Quarter ending June 1867 304 287 73 52 62 63 135 115 29 37 47 43 76 80 25 22 18 13 16 21 16 13 18 23 93 92 591 125 125 250 66 90 156 47 31 37 29 41 185 Quarter ending Sept. 1867 317 288 65 58 63 59 128 117 40 30 53 47 93 77 29 23 16 9 11 20 17 17 23 25 96 94 605 123 122 245 70 100 170 52 25 31 34 48 190 Sum of the Four Quarters 1209 1181 275 251 234 229 509 480 139 145 190 179 329 324 93 86 65 56 66 79 62 67 85 89 371 377 2390 526 463 989 284 369 653 179 121 145 129 174 748 Annual Average of the last ten years 1539 1479 347 325 312 312 659 637 173 170 204 201 377 371 92 96 78 69 106 98 94 82 133 126 503 471 3018 672 624 1296 343 405 748 188 147 204 176 259 974 No. III.—Annual Enumeration of Deaths for the Year ending September 1867. Deaths in the Four Quarters. Total. East London Union. West London Union. City of London Union. Saint Botolph. Cripplegate. Workhouse. North. South. Workhouse. s. w. N. W. South. S. E. N. E. Workhouse. Quarter ending Dec. 1866 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 274 233 55 38 47 36 7 7 26 29 33 27 10 7 13 16 16 8 17 13 20 13 22 19 8 20 507 93 83 14 55 60 17 29 24 30 33 41 28 Quarter ending March 1867 320 305 52 64 46 46 21 8 25 19 38 37 19 10 14 17 19 18 17 16 22 17 23 22 24 31 625 116 92 29 44 75 29 31 37 33 39 45 55 Quarter ending June 1867 257 221 43 36 38 33 11 9 21 26 38 41 , 17 7 14 15 12 12 16 4 17 9 11 18 19 11 478 79 71 20 47 79 24 29 24 20 26 29 30 Quarter ending Sept. 1867 277 250 39 44 47 47 12 23 26 16 40 27 22 11 22 9 8 11 14 16 17 18 11 13 19 15 527 83 94 35 42 67 33 31 19 30 35 24 34 Sum of the Four Quarters 1128 1009 189 182 178 162 51 47 98 90 149 132 68 35 63 57 55 49 64 49 76 57 67 72 70 77 2137 371 340 98 188 281 103 120 104 113 133 139 147 Annual Average of the last Ten years 1452 1347 239 236 244 236 63 59 135 116 184 173 79 59 78 72 71 61 92 79 91 70 103 104 73 82 2799 475 480 122 251 357 138 150 132 171 161 207 155 No. IV.—Classification of Deaths in the City Unions according to Age, for the Year ending September 1867, and a Comparison with the Averages of the last Ten Years. City Districts. Total. Under 1. Under 5. 5 to 10. 10 to 15. 15 to 20. 20 to 30. 30 to 40. 40 to 50. 50 to 60. 60 to 70. 70 and over. East London Union, 1867 809 166 295 23 6 18 52 74 82 75 88 96 Average of Ten Years 1077 231 474 44 15 19 57 CO 86 90 105 114 West London Union, 1867 672 96 177 17 10 19 33 52 48 60 86 70 Average of Ten Years 745 140 292 26 11 16 48 61 67 73 76 75 City of London Union, 1867 756 102 202 26 15 25 53 51 65 83 104 132 Average of Ten Years 977 151 310 35 18 23 56 69 94 102 123 147 Entire City, 1867 2137 364 674 66 31 62 138 177 195 218 278 298 Average of Ten Years 2799 522 1076 105 44 58 161 203 247 265 304 336 No. V.— Classification of Deaths according to Causes, during the Year 1867, and a Comparison with the Averages of the last Ten Years. City Districts and PopuLation in 1861. Violence, Privation, Premature Birth, and Poison. Tubercular Diseases. Convulsions and Teething. Zymotic Diseases. Pneumonia, Bronchitis, and Asthma. Others, chiefly chronic. Total. Phthisis. Tabes and Scrofula. Hydrocepha lus. Alvine Flux. Con. tinued Fever. ScarletFever. SmallPox. Measles. Whooping Cough Croup, & Diphtheria. Erysipelas. Adults. Children. East London Union (Population 41,282) 1867 48 121 54 17 49 26 33 37 14 11 4 30 7 114 244 809 Average 47 131 73 32 65 14 33 42 45 11 37 67 7 188 285 1077 West London Union (Population 26,739) 1867 53 88 32 6 31 9 12 13 6 9 7 17 0 93 196 572 Average 46 97 54 20 37 8 18 32 21 6 23 39 5 129 210 745 City of London Union (Population 46,451) 1867. 59 116 29 6 35 8 15 20 10 11 2 23 5 134 283 756 Average 63 121 47 18 57 12 16 33 29 8 23 53 4 156 337 977 Entire City (Population 114,472) 1867. 160 325 115 29 115 43 60 70 30 31 13 70 12 341 723 2137 Average 156 349 174 70 159 34 67 107 95 25 83 159 16 473 832 2799 No. VI.—Meteorology of the City of London for each Month in the Year ending in September 1867' from Observations made at the Engineer's Office, Guildhall, under the direction of Mr. Haywood. MONTHS. 1866.67. Barometer. Dry Thermometer. Wet Thermometer or Hygrometer. Rain Gauges. Mean Pressure. Highest Pressure. Lowest Pressure. Mean Temperature. Highest Temperature. Lowest Temperature. Mean Daily Range. Mean Temperature. Dew Point. Degree of Humidity. Weight of vapour in cubic foot of air. Vapour required to saturate ditto. Total Fall. Greatest Fall. Lowest Fall. Wet Bulb. Dry Bulb. On Roof. On Grnd. On Roof. On Grnd. On Roof. On Grnd. Inches. Inches. Inches. Deg. Deg. Deg. Deg. Deg. Deg. Deg. Deg. Grns. Grns. Ins. Ins. Ins. Ins. Ins. Ins. October 30.026 30.488 29.692 52.9 63.6 39.9 8.8 50.4 52.9 48.0 83 3.7 0.8 2.20 2.28 0.82 0.85 0.01 0.01 November 29.899 30.332 29.326 46.3 58.2 31.9 8.9 44.0 46.3 41.2 83 3.0 0.6 1.46 1.55 0.34 0.36 0.02 0.02 December 29.890 30.506 29.312 46.0 57.0 33.5 8.0 44.4 46.0 42.8 89 3.2 0.4 2.06 213 0.49 0.49 0.02 0.02 January 29.426 30.142 28.782 36.2 54.0 14.4 8.8 35.6 36.2 34.7 94 2.3 0.2 2.13 2.65 0.43 0.42 001 0.02 February 30.019 30.576 28.880 46.2 56.0 36.9 8.0 44.3 46.2 42.1 86 3.1 0.5 1.34 1.38 0.34 0.31 0.01 0.01 March. 29.512 30.778 29.308 38.2 560 28.9 8.7 35.6 38.2 30.9 75 2.0 0.7 1.88 2.09 0.30 0.30 0.02 0.02 April 29.778 30.472 29.340 49.2 64.6 36.9 11.7 46.1 49.2 42.8 79 3.1 0.9 2.40 2.55 0.21 0.23 0.01 0.01 May 29.852 30.172 29.538 53.9 78.3 36.4 15.7 49.7 53.9 46.1 74 3.5 1.2 1.73 1.84 0.45 0.46 0.01 0.02 June 30.037 30.600 29.728 59.0 81.0 47.2 15.3 54.2 59.0 49.9 72 4.0 1.6 1.26 131 0.72 0.72 0.03 0.04 July 29.806 30.334 29.534 59.7 75.0 50.5 12.6 55.4 59.7 51.6 75 4.3 1.4 3.84 .. 0.40 0.41 0.03 0.04 August 29.908 30.228 29.740 62.4 840 49.5 11.9 57.8 62.4 53.9 74 4.6 1.7 2.22 2.29 0.66 0.67 0.02 0.03 September 30.037 30.500 29.818 58.6 760 44.4 11.9 56.6 58.6 55.2 90 4.8 0.6 2.06 2.16 0.47 0.47 0.03 0.04 Barometer. The highest readings were on October 6, November 29, December 22, January 31, February 21, March 2, April 1, May 24, June 27, July 8, August 29, September 25. The lowest readings were on October 25, November 16, December 31, January 8, February 6, March 19, April 20, May 11, June 7, July 15, August 8, September 12. Temperature. The highest were on October 3, November 2, December 6, January 24, February 15, March 26, April 19, May 6, June 12, July 1, August 14, September 1. The lowest were on October 29, November 20, December 1, January 4, February 28, March 18, April 1, May 23, June 22, July 30, August 3, September 25. Rain. .The greatest fall on October 19, November 19, December 6, January 10, February 17, March 22, April 9, May 11, June 3, July 27, August 20, September 5. The least fall on October 6, November 24, December 28, January 24, February 4, March 23, April 18, May 17, June 17, July 3, August 9, September 7. Electricity. Positive generally throughout the year. WILLIAM HAYWOOD. No. VII.—Account of the Sanitary Work performed in the City during the Year 1867. Quarters Ending. Number of Houses Inspected. Number of Houses requiring Amendment. Total Number of Orders Issued for Sanitary Improvement. PARTICULARS OF THE ORDERS ISSUED. Number of Ships Inspected. Number of Orders Issued for Improvement of Ships. For Cleansing and Lime-whiting Rooms. For Erecting and Repairing Dust Bins. For Paving Cellars and Yards. For Amending the Water Supply. For Removing Cess-pools. For Amending Sinks & Drains. For Removing Waste-Water. For Cleansing & Repairing Privies. For Improving the Ventilation. For Abating Smoke. For Removing Animals Improperly Kept. Sundry other Sanitary Orders. December 1866 2408 466 554 162 28 - 158 0 105 11 86 0 0 0 4 546 68 March 1867 7338 1438 1942 989 50 164 209 3 179 35 345 2 0 29 27 476 43 June 1867 6547 1528 2542 1745 52 63 81 16 112 23 370 3 3 13 58 49S 24 September 1867 6154 681 1019 580 29 49 35 8 71 23 164 5 4 7 42 583 21 Entire Year 22447 4113 6057 3476 159 276 486 27 467 92 965 10 7 49 131 2103 156 Total Houses Inspected in 1867 22447; Orders Issued, 6057. Yearly Average of Ten Years 9080; ,, ,, 2407. No. VIII.— Quarterly Account of the Meat condemned in the City Markets during the year 1867, and comparison with the Averages of the last Six Years. Quarters ending WHERE CONDEMNED, AND WHY CONDEMNED. Newgate Market. Aldgate Market. Leadenhall Market. Total. Dead. Diseased. Putrid. Total. Dead. Diseased. Putrid. Total. Dead. Diseased. Putrid. Total Dead Diseased. Putrid. Total. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. lbs. December 1866 6568 17744 17343 41655 1126 1215 536 2877 270 2802 6048 9120 7964 21761 23927 53652 Average of 6 Quarters 7128 22071 5988 35187 720 2159 270 3149 411 3536 1864 5811 8259 27766 8122 44147 March 1867 3387 32425 4048 39860 721 2100 94 2915 667 2459 3855 6981 4775 36984 7997 49756 Average of 6 Quarters 4675 24503 5379 34557 735 2184 269 3188 1287 4465 3287 9039 6697 31152 8935 46784 June 1867 13088 25200 32478 70766 1050 2914 634 4598 1270 6420 15674 23364 15408 34534 48786 98728 Average of 6 Quarters- 5111 18256 13263 36630 560 2282 226 3068 781 5046 1942 7769 6452 25584 15431 47467 September 1867 2445 31976 31137 65558 576 2356 1189 4121 2219 1701 12239 16159 5240 36033 44565 85838 Average of 6 Quarters. 3350 21541 32342 57233 927 4198 1366 6491 898 2484 7651 11033 5175 28223 41359 74757 Entire Year 25488 107345 85006 217839 3473 8585 2453 14511 4426 13382 37816 55624 33387 129312 125275 287974 Average of 6 Years 20264 86371 56972 163607 2942 10823 2131 15896 3377 15531 14744 33652 26583 112725 73847 213165 The Meat consisted of 1,428 Sheep and Lambs, 122 Calves, 1,001 Pigs, 902 Quarters of Beef, and 3,697 Joints of Meat. Besides which, there were condemned in the City Markets on account of putridity 4 Deer, 2 Bucks, 6 Quarters of Venison, and 817 head of Game and Poultry. No. IX.—Quarterly account of the Fish condemned by the Fish-meters in Billingsgate Market, during the Year 1867. Quarter ending Dec. 1866. Quarter ending March 1867. Quarter ending June 1867. Quarter ending Sept. 1867. Entire Year. Dabs 80,600 500 25,300 61,059 167,459 Plaice 42,311 2,345 23,640 29,209 97,505 Whiting 63,846 2,200 9.800 126,700 202,546 Gurnets 6,031 200 15,500 34,300 56,031 Haddocks 4,986 5,316 32,826 64,813 107,941 Herrings 4,150 2,425 14,350 72,890 93,815 Thornbacks 960 70 4,516 795 6,341 Smelts 64,330 18,800 10,300 2,000 95,430 Cod 238 1,338 982 499 3,057 Soles 438 .... 230 1,286 1,954 Various Fish 5,847 55 836 22,274 29,012 Lobsters and Crabs 363 27 1,165 665 2,220 Total 274,100 33,276 139,445 416,490 863,311 Sprats 13 bhls. 49 bhls. .... .... 62 bhls. Oysters .... .... .... 200 bhls. 200 „ Periwinkles .... .... 75 bhls. 6 „ 76 „ Shrimps 2,549 galls. 262 galls. 2,855 galls. 2,405 galls. 8,071 galls. Whelks .... .... .... 97 bags 97 bags Mussels .... .... .... 108 „ 108 „ Besides which there were condemned 1,130 lbs. of Eels, 836 lbs. of Cod-sounds, 120 lbs. of Caplins, and 2 barrels of Cod-roes, all on account of putridity Table A.—Showing the mortality from Cholera in the several Districts of London during the Epidemic of 1832-3, 1848-9, 1854, and 1866; as well as the Elevation above Trinity High Water Mark, and the density of the Population in 1866. Districts. Deaths from Cholera per 10,000 population. Elevation in feet above Trinity. High Water. Number of Persons per Statute Acre (1866). 1832-3 1848-9 1854. 1866. Mean. Hampstead 0 7 13 0.8 5.2 350 11 Islington 10 19 11 4.4 11.1 94 62 Marylebone 29 17 19 2.9 17.0 87 106 St. Pancras 22 27 11 6.0 16.5 73 78 St. Giles 53 69 28 9.6 39.9 68 213 Clerkenwell 14 17 11 11.1 13.3 65 168 Hackney 2 24 15 11.7 13.2 53 25 Holborn 11 37 6 5.6 14.9 53 217 St. Luke 25 31 11 15.9 20.7 51 258 Shoreditch 9 116 49 12.7 46.7 48 212 Kensington 10 33 49 3.7 23.9 40 31 Bethnal Green 56 87 23 63.1 57.3 38 145 St. George's, Hanover Square 12 26 49 1.6 22.1 34 81 Whitechapel 115 58 24 77.5 68.6 32 188 Lewisham 0 62 41 6.1 27.2 28 5 Wandsworth 14 101 70 4.9 47.5 24 7 St. George's.in.the.East 32 36 38 92.7 49.7 21 197 Chelsea 84 44 52 3.5 45.9 12 76 Greenwich 23 123 73 19.5 59.6 8 27 Poplar 40 71 42 85.1 59.5 8 34 Camberwell 38 122 107 5.9 68.2 4 19 Southwark 123 161 129 7.9 105.2 3 132 Lambeth 39 160 51 6.5 64.1 3 44 Westminster 53 42 131 6.2 58.1 3 74 Newington 45 127 94 2.6 67.1 0 148 Bermondsey 71 155 183 5.6 103.6 0 94 Rotherhithe 15 198 171 9.0 98.2 0 33 All London 36 62 43 18.3 40.6 39 39 East London Union .. 46 23 15.0 28.0 40 246 West London Union .. 147 10 7.8 54.9 29 185 City of London Union .. 38 14 4.3 18.7 31 92 Entire City 49 56 16 9.0 32.5 33 142