LON 107 REPORT ON THE SANITARY CONDITION of the CITY OF LONDON, FOR THE YEAR 1870—1871. 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. Judd & Co., Printers, Phœnix "Works, Doctors' Commons, E.C. (By Appointment to the City Commissioners of Sewers.) 1872. At a meeting of the Commissioners of Sewers of the City of London, held at the Guildhall of the said City, on Tuesday, 19 th March, 1872, 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 Night Population of the City since 1801 8 Ditto ditto in 1871 8 Day Population of the City in 1871 9 Density of the City Population 9 Estimated Population of the City 11 Number of Births, Deaths, and Marriages in each of the City Districts 11 Marriages per 1,000 of the Population 13 Births ditto ditto 13 Deaths ditto ditto 14 Fallacy of the Death-rate as a Measure of Salubrity 15 Classification of Deaths according to Age 16 Causes of Death 16 Mortality from Small-pox in 1871 Compared with Former Years 17 Biennial periodicity of Small-pox 18 Proportion of "Vaccinated to Un-vaccinated 19 Necessity for Primary and Secondary Vaccination 20 Mortality per cent. from Small-pox at different Ages among Vaccinated and Un-vaccinated 21 Prophylactic Powers of Primary Vaccination 22 Absolute Immunity from the Diseases after Secondary Vaccination 23 Large average Mortality from the Disease during the Present Epidemic 25 Comparison of the Present with Former Epidemics of the Disease 26 Rise and Progress of the Present Epidemic 27 Complementary Proportions and Average Quantivalance of Zymotic Diseases 29 Attempts to Correlate them 30 Sickness Returns in the City 32 Meteorology of the Year 32 Quality of the "Water Supply of London 33 Occsional Turbidity, and Nature Thereof 35 ii. contents. PAGE Meaning of the phrase "Previous Sewage Contamination" 38 Objectionable Mode of Expressing the Composition of Water in Tons 40 Average Amount of Water Supplied Daily to London 43 Prospective Constant Service of Water, and Conditions Thereof . 44 Summary of the Provisions of the "Metropolitan Water Act, 1871." 44 Penalties to which Consumers are liable for Wasting or Fouling Water 46 Sanatary Work of the Year 48 Number of Inspections of Houses, &c., by each of the Inspectors during the Year 49 Number of Ships Inspected during the Year 50 Necessity for a More Effective Inspection of Ships in the Port of London 51 Disinfecting Chambers, and Mortuary of the City 54 Proceedings to be taken for removal of Dead Bodies from the Houses of the Poor 55 Number of Articles Disinfected, and of Dead Bodies received at the Mortuary 57 Inspection of Meat and Markets 57 Quantity of Meat and Fish Condemned 58 Number of Convictions during the year 59 APPENDIX Table No. I. Census of City in 1841—1871. „ II. Births, Deaths, and Marriages. „ III. Annual Enumeration of Births. „ IV. to No. VII. Mortality Tables. „ VIII. Meteorology of the City in 1871. „ IX. Account of Sanitary Work in 1871. „ X. and No. XI. Account of Meat and of Fish seized in 1871. „ XII. and No. XIII. Lists of Slaughter Houses and Cow Houses in the City. „ XIV. to No. XIX. Modes of Proceeding and Forms of Certificates, &c., for removing Dead Bodies from the Houses of the Poor. REPORT on the SANITARY CONDITION of the CITY OF LONDON. THE TWENTY-THIRD 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 official year which terminated in September last; and foremost of the Statistical facts which have been brought to light in the course of the year, are those which relate to the census of the City. 8 At. the beginning of the present century (1801) there were 128,833 persons living within the city boundaries; and in the four succeeding decades the numbers fluctuated between 121,124 (1811), and 125,065 (1821); but in the year 1851 it rose to 129,171.* This is the largest population of the City during the present century, and it is perhaps the densest on record; for it is in the proportion of 9 persons to every house, or 180 persons to an acre. In the following year (1861) the number of the population fell, according to the Registrar General's Returns, to 112,063 persons, which is at the rate of 8.4 persons to each inhabited house, or 155 persons to an acre; and then, at the census of 1871, the number of the resident inhabitants of the City was returned at only 74,732, which is less than sixtenths of the population of 1851. It must not bo forgotten, however, that the census of the City was taken at a time when the number of the population was at its very lowest; for at midnight on Sunday, in the early part of April, the City is to a very largo extent deserted. This fact is briefly alluded to by the Registrar General in his Preliminary Report of (ho Census of England and Wales for 1871, wherein he says: "Thus it comes that the ancient and venerable City of London, under the sceptre of the Lord Mayor, associated with the liberties, the * Mr. Simon, in his Annual Report for 1801, estimated it at 129,682. 9 rights, the history and the power of England, had, 'within and without its walls,' on the Census night, only 74,732 people; down to which number it had dwindled since 1861, when the numbers enumerated were 112,063. The decrease in ten years is 37,331 or nearly one out of three of the original number. Its streets empty and almost silent during the night, present a very different aspect during the day, and the Corporation of the City deemed it right, in order to determine the numbers, to take a daycensus in 1866, with the following results: they found that, in addition to the ordinary sleeping population, the mercantile men engaged in the city daily amounted to 170,133. The numbers have probably increased since that date, for the City was never before so full as it is now in the day-time." In point of fact, the day population of the city cannot be less than a quarter of a million; for, to say nothing of the 509,611 persons who at the daycensus of 1866 were found in the city as clients and customers, there were 170,133 merchants, shopmen, clerks, and others, engaged in the city warehouses and shops. These, with the 74,732 who sleep in the City at night, make a total of 244,865 persons as the resident day population of the City. Distributed among the 9,321 inhabited houses of the City, they amount to rather more than 26 persons to a house, or to more than 338 persons to an acre. 10 Even the night population of the City amounts to about 103 persons to an acre. Whereas in the whole of the Metropolis the number is but 41.7 to an acre; and in the 20 chief towns of England, to which the Registrar General refers in his weekly reports of mortality, &c., the average density of the population is but 33.8 persons to an acre—the range being from 10.6 at Sheffield, to 96.8 at Liverpool. Again, in the 198 districts and sub-districts comprising the chief towns of this country, the number of persons to an acre is but 3.9, and in all England and Wales it is only 0.6, or just three persons to five acres of ground. It is manifest, therefore, that notwithstanding the great reduction of the population of the city in the course of the last twenty years, the density of it is still excessive; and, considering the quality of a very large portion of the population in respect of its poverty and vice, there can be no doubt of the necessity for the same vigilant exercise of your sanitary powers, as has been hitherto practised. In all former reports of the sanitary condition of the City, the area of it has been divided into three districts or unions—namely, the Eastern, the Western, and the Central. These divisions, however, were abolished in 1870, when the three unions of the City were incorporated; but as the sub-districts 11 of these unions are still used for registration purposes, I have thought it best to retain the old primary divisions, in order that comparison may be made of the present sanitary state of the City with the past; and with the view of correcting the number of the population of these districts, as determined by the Registrar General in the census of April last, I have excluded from the St. Sepulchre sub-district of the western division of the City the 518 patients of St. Bartholomew's Hospital, who were not citizens, and I have brought into the City, and distributed proportionally, the 2,390 persons who were in the City workhouses and schools at the time of the census. In this manner I have estimated the number of the resident or night population of the City at 76,604; and of this number 27,883 belong to the eastern division, 18,815 to the western, and 29,906 to the City proper, or central division. Looking at the second table of the appendix, it will be seen that among this population there were 1,268 marriages, 1,854 births, and 1,762 deaths, during the year which has expired. The average number for the corresponding periods of the last ten years being 1,451, 2,579, and 2,502 respectively. It appears, therefore, that notwithstanding the large decrease of the City population since the census of 1861, as from 112,063 to 74,732 (according to the 12 Registrar General's returns), the number of births in that interval has been slightly in excess of tho deaths. This shows that there has been a considerable migration of the City population; and it is no doubt due to the extensive demolition of houses for City improvements—as in making the street from the Mansion House to the Thames Embankment, in constructing the Holborn Viaduct and its approaches, in building the new Metropolitan Meat Market, and in clearing the ground for the several large railway stations of the City. At the present time much of the ground which has been thus cleared is still vacant, and "it is very probable," to use the language in the report of the Local Government and Taxation Committee of the City, "that at no period in the history of the City since the Fire of London (in 1666) was so large a proportion of the area vacant as in the year 1871." This is clearly shewn by the falling off in the number of inhabited houses; for while in 1861 they amounted to 13,298, in 1871 they were but 9,321. It cannot, however, be long before the vacant ground of the City will be again occupied, and then the number of the population will rise to something like its former proportions; but the disadvantage of the present abnormally low proportion of the population is, that all along until the next census it will seriously affect the apparent death-rates and birth-rates of the City. 13 Marriages. Taking the number of the population at 76,604, the marriages in the course of the last year have been at the rate of 16.5 per 1,000 of the inhabitants—the rate for the last ten years having been 15.1 per 1,000. In all England the average proportion is but 8.4 per 1,000; in Austria it is 8.4; in France 8.0; and in Italy 7.5. If, therefore, the number of marriages is an indication of prosperity, it is evident that the City of London is in a very flourishing condition. Births. The distribution of births in the City during the year has been as follows:— 821 in the eastern division, 525 in the western, and 508 in the central; making a total of 1,854 for the entire City. These are at the rate of 29.4 per 1,000 of the population of the first-named district, 27.8 of the second, and 17 of the third; the average for the whole City being 24.2. In the whole of the Metropolis the average birth-rate is 35.1 per 1,000 of the population, and in the 17 chief towns of the United Kingdom, as selected by the Registrar General, it is 35.9 In all England and Wales it is 35.4 per 1,000; in Austria it is 40.2; in Spain 38.0; in Italy 37.5; and in France 26.3. Measured, therefore, by these proportions, it is evident that the birth-rate of the City is remarkably low. 14 Deaths. Of the 1,762 deaths in the City during the year, there were 703 in the eastern division, 428 in the western, and 631 in the central. These are at the annual rate of 25.2 per 1,000 of the first district, 22.7 of the second, and 21.1 of the third, the average for the entire City being 23 per 1,000 of the population. In the course of the last 10 years it has been 26.2, and in the whole of the Metropolis it averages 24.1. In the 14 chief towns of this kingdom it is 26.1, and in all England and Wales it is 22.5. In Austria it is 32.2; in Italy, 30.5; in Spain, 29.5; and in France, 23.7: so that the deathrate in the City (23 per 1,000 of the population) during the last year has not been excessive. Allowance, however, must be made for the comparatively low birth-rate of the City, as well as for the migration of the population, and the peculiar circumstances connected with the ages of the people, all of which affect to a considerable extent the local death-rate. I have already alluded to the influence of the birth-rate, and have shown that it cannot be disregarded in judging of the mortality of a place. Very recently the effect of migrations in disturbing the local rates of mortality has been very ably discussed by Mr. Thomas A. Welton in a paper which he read before the Institute of Actuaries, and in which he illustrates the effects of the migration of 15 young adult lives, and of old and infirm ones, on the death-rate of both town and country. "It is," he says, "rather disquieting to have one's attention called to the unsoundness of the basis upon which local death-rates, tables of mortality, and I know not what else, have been calculated; "and, indeed, he concludes from his investigations that "if we wish to form an idea as to the comparative salubrity or otherwise of two country districts, we must rely on the death-rates at the ages of 0—10 and 45—75, and abandon the thought of deducing any instructive result from mortuary statistics at the intervening ages. And the same remark," he adds, "subject to some correction, will apply to town districts." In point of fact it is fast becoming a well-grounded conviction that the death-rate of a place affords no indication of its salubrity without reference to the various circumstances which affect it, and that the weekly publications by the Registrar General of the death-rates of 18 of the chief towns of England are of no practical value.* * See on this head the following :— "Inconsistencies of the English Census, 1861." By William Lucas Sargant. A paper read before the Statistical Society, January, 1865. "Notes on the Principles of Population." By Andrew A. Watt, of Montreal. 1869. "On the Comparative Mortality of Large Towns." By Dr. E. J. Syson. A paper read before the Manchester Statistical Society, January, 1871. "On the Effect of Migrations in disturbing Local Bates of Mortality." By Thomas A. Welton. 1871. 16 Ages at Death. In the fifth table of the appendix the deaths in the City are classified according to age, and the results are, that of the 1,762 deaths in the year, 276 were among infants of less than a year old, and 557 among children under 5 years of age: 123 were at from 5 to 20 years of age, 259 from 20 to 40, 334 from 40 to 60, 220 from 60 to 73, and 269 at 70 and upwards. As in the case of all town populations, the mortality of infants in some parts of the City is somewhat large, for it amounts in the eastern division of it to nearly 16 per cent. of the births, and in the western to rather more than 16 percent.; but in the central division it is only 11.2 per cent., the average for the entire City being 14.9 per cent. In the course of the last ten years the average has been 17.5, and in the whole of the Metropolis in 1869 it was 16.9 per cent. In 10 of the chief towns of England, as given in the Registrar-General's Annual Report for 1869, it was 19.7; and in all England and Wales it averages 15.2 per cent. Excepting, therefore, in the worst districts of the City, the infant mortality has not been excessive, and it has fallen considerably below the average for the preceding ten years. Causes of Death. As to the causes of death it will be remarked (see Table No. VI.) that with one exception the mortality 17 from each of the diseases specified has been greatly below the average—phthisis, for example, has declined from 326 in the year to 209 ; tabes and scrofula from 153 to 58; hydrocephalus from 46 to 33; convulsions and teething from 140 to 96; inflammatory affections of the lungs from 405 to 324; alvine disorders from 93 to 61; continued fevers from 98 to 33; scarlet fever from 94 to 61; measles from 69 to 19; and whooping cough, croup, and diphtheria from 130 to 58: but the deaths from small-pox have advanced from an annual average of 16 to 88. Altogether, however, the aggregate proportion of deaths from zymotic diseases has not been excessive, for it stands as 334 in the year, against an annual average of 515. Small-pox. The chief feature in the table of causes of death is the large mortality from small-pox—a mortality which has been only once exceeded during the whole period of your sanitary labours from the year 1848, as will be seen from the following table:— Number of Deaths from Small-pox in the City in each of the following Years (1849—1871). Years. Deaths. Years. Deaths. Years. Deaths. 1849 17 1857 14 1865 8 1850 33 1858 6 1866 29 1851 41 1859 47 1867 31 1852 96 1860 60 1868 18 1853 15 1861 4 1869 2 1854 9 1862 4 1870 3 1855 58 1863 44 1871 88 1856 33 1864 22 18 A glance at this table will show the remarkable periodicity of the disease, in the circumstance that, at intervals of about every two years, it acquires epidemic violence, and becomes alarmingly fatal, and then declines for a couple of years. Taking, for example, the two years successively, from 1849 to 1871, it will be seen that the number of deaths in each of the biennial periods is as follows:—50, in 1849-50; 137, in 1851-52; 24, in 1853-54; 91, in 1855-56; 20, in 1857-58; 107, in 1859-60; 8, in 1861-62; 66, in 1863-64; 37, in 1865-66; 49, in 1867-68; 5, in 1869-70; and 88, in 1871—the average annual mortality of the epidemic periods being 49, and of the alternating years only 12. This condition of tilings is not peculiar to the City, but is common to the whole metropolis, and to every large town in England, although the intervals of the epidemic are not in all cases the same. In London, for instance, the interval is about three years, and in other centres of population it varies from four to five years. This is no doubt determined by the relative density of the population, and by other circumstances which favour the development of the disease—as the habits of the people and the neglect or otherwise of vaccination. I have discussed this question to some extent in a former report, and have shewn that the force of an epidcmic of smallpox is always proportional to the neglect of proper and 19 effective vaccination. That a sort of vaccination is very frequently performed, but without effect, there can be on doubt; for, in the course of the last thirteen years, I have caused inquiries to be made into the particulars of 1,555 cases of small-pox in the City, and have been told that in 1,150 of them vaccination had been performed in infancy with success. This is in the proportion of 73.9 per cent. of all the persons attacked. At the Small-pox and Vaccination Hospital at Upper Holloway the proportion is 79.3 per cent. of all the cases admitted since the year 1854; and at the three hospitals of the Metropolitan Asylum District it ranged from 59.2 per cent. at Homerton, to 80.5 per cent. at Hampstead—the average for the whole of the patients in all the Hospitals in 1871 being 74.8 per cent. It is also worthy of note that the proportion of cases in which vaccination had been performed has been steadily advancing during the last 20 years; for, according to the returns of the Small-pox Hospital, Upper Holloway, it appears that during the sixteen years which terminated with 1851 ,the average number of vaccinated cases was only 53 per cent. of all the patients admitted, whereas in the epidemic years of 1854, 55 and 56, it amounted to 71 per cent; in 1859-60,it was 78 per cent.; in 1862-66, it was 81 per cent.; and in 1871, it was 91.5 per cent. 20 These facts are suggestive of two things, namely: 1st. That vaccination is often imperfectly performed, and therefore fails of its prophylactic power; and 2nd. That even when it has been well performed in infancy, the effect of it is weakened by time. Looking, indeed, at the ages of those who have been attacked with small-pox in the City, I find that of the 1,150 that had been vaccinated, 158 were under five years of age, 508 were at from five to fifteen years of age, and as many as 484 were at fifteen and upwards—so that of every 100 cases of small-pox after vaccination 13.7 were at the first period of life, 44.2 at the second, and 42.1 at the third. It is manifest from this that the protective power of vaccination has failed, either from its having been imperfectly performed, or from its having been weakened by time. In the epidemic of 1864, the statistics of Berlin showed that 64.6 per cent. of all the cases of small-pox were among persons at twenty and upwards, and that 40.7 per cent. of the deaths were at these ages. The mortality of the cases in the City of London during the last thirteen years has been in the proportion of 43.1 por cent. among infants, 16.2 at from five to fifteen 21 years of age, and 40'7 at fifteen and upwards. These figures afford additional proof of the fact that vaccination sometimes fails of its protective power because of its having been imperfectly performed, and because it has been weakened by the lapse of time. But even in spite of this its prophylactic agency is enormously great. Taking the 1,555 cases of small-pox which have been the subjects of investigation in the City, the per centage proportions of death among the vaccinated and the unvaccinated at different ages have been as follows:— So that while the general mortality has been at the rate of 15.1 per cent. of all who were attacked with the disease, it has been only 7.5 with the vaccinated, and as high as 36.8 with the un-vaccinated. These numbers are not very different from the proportions which Mr. Marson, in his large experience at the Small-pox Hospital, has found to be the average tor the records of the hospital for many years shew Mortality per cent, of the Cases of Small-pox in the City at different ages. Ages. Mortality per Cent. OF Total Cases. Vaccinated. Unvaccinated. Under 5 years 38.5 23.4 50.8 From 5 to 15 years 6.3 2.7 23.4 At 15 and upwards 10.3 7.2 24.8 All ages 15.1 7.5 36.8 22 that when the disease attacks those who have not been vaccinated, it is fatal to 37 per cent. of them, or rather more than one in three; whereas in those cases where vaccination has been performed, whether properly or improperly, the mortality is only at the rate of 6.8 per cent., or about one in fifteen. He finds, moreover, that the protective power of vaccination is directly proportional to the way in which it has been performed ; for if it has been so done as to leave upon the arm the well marked signs of the operation, the mortality is only at the rate of 2.5 per cent., whereas in badly marked cases it is 8.8 per cent. And, by going still further with the enquiry, he has ascertained that, when there are four well marked cicatrices upon the arm, the mortality is only 0.6 per cent.; when there are three, it is 1.9 per cent.; when there are two, it is 4.7 per cent.; when there is but one, it is 7.7 per cent.; and when there are none apparent, although vaccination is said to have been performed in infancy, the mortality is at the rate of 23.6 per cent. of those who are attacked with the disease; the mortality of un-vaccinated being as high as 37 per cent. It would seem, indeed, from his investigations, that vaccination when properly performed is even more protective of fatal consequences than a previous attack of small-pox; for in the latter case the mortality is as high as 19 percent. "Not a single 23 fact," say Dr. Monk, and Mr. Marson, in their report of the Small-pox and Vaccination Hospital for 1871, has occurred within our experience at the hospital during the past year to shake our confidence in vaccination, when properly performed, or to detract in any degree from that high estimate of its value, which many years experience in the wards of the hospital, and a close study of small-pox have led us to form. But vaccination is an operation of considerable delicacy, and requires much care in order to secure the advantageous results it is capable of imparting. The failures of vaccination to prevent fatal small-pox, which have occurred, are almost all of them due to the careless and imperfect manner in which it has been practised; "and they go on to remark that, "in the present state of the population, re-vaccination is of scarcely less importance to the adult than is primary vaccination to the infant. A very large number of the adult population of this country are without adequate protection from vaccination, and are liable to take small-pox in its gravest and most deadly form. All persons who have not already had small-pox and have been, or are likely to be exposed to the infection of that disease, and all who have not several (at least four) good marks, testifying to the character and efficiency of the primary vaccination, ought to be re-vaccinated. Re-vaccination has proved itself to be a most important and efficient 24 means of preventing small-pox. For upwards of thirty years all the nurses and servants of the smallpox Hospital, who had not previously had small-pox, have been re-vaccinated within two or three days of entering on their respective duties, and in no one instance has it failed to preserve them from Smallpox. We believe therefore, that re-vaccination extensively practised, and with the same precautions to ensure efficiency, as ought to be observed in primary vaccination, will prove to be the most certain mode that could be adopted of checking the present epidemic of small-pox." This accords with the experience all observers of this disease, and there are many remarkable facts in proof of it. At Christ's Hospital for example, where there is an average of about 800 boys it is the practice to vaccinate them directly they enter the institution, and this has been found so thoroughly protective that, according to Dr. Stone, there has been but one death from small-pox, for fifty years. So also with regard to secondary vaccination in adult life, wherever it is compulsory its prophylactic power is equally manifest. In the recent epidimic of 1871, when small-pox was severely fatal at Verona, killing as many as 21 per cent. of those who were attacked with it, the mortality from the disease among the re-vaccinated soldiers of the garrison was only 0.4 per cent. At Vienna also, where the re-vaccination of soldiers and all 25 ment officials is obligatory, it is found that 39 per cent. of those who are vaccinated at 20 and upwards, exhibit such a condition of the vaccine vesicle as to prove beyond all doubt that they were susceptible of the disease if exposed to the contagion of smallpox. It would seem therefore that the vaccination of infancy is protective during the growth of the body, and that a second vaccination is necessary when the structures have almost reached their full development; and then if properly and successfully performed, it needs no repetition to ensure its continued prophylactic power. The general mortality of the epidemic, which is still among us, is unusually large; for it has amounted to 19 per cent. of the admissions into the Small-pox Hospital at Upper Holloway; and in the three hospitals of the Metropolitan Asylum District it has ranged from 18.2 per cent., at Stockwcll, to 19.8 at Homerton—the average for the whole of the cases treated in the hospitals being 19.1 per cent. In the City of London Small-pox Hospital, in Newstreet, it has been only 8.9 per cent; and in the whole of the City, as far as I have been able to estimate the mortality of the disease, it has been at the rate of 15.1 per cent. of those attacked. Taking all the available returns for London, I find that the mortality among the 12,725 cases on record during 26 the epidemic has been at the rate of 18.0 per cent. This is an unusually high proportion ; for, according to the statistics of the Small-pox Hospital, the deathrate ordinarily ranges from 12.9 per cent. (1864), to 17 per cent. (1863),—the average for many years being only 14.3 percent. The force of the epidemic may also be estimated by the number of deaths from the disease among the general population of London and the City. In all England during the last 20 years, the averago mortality from small-pox has been only 1.9 per 10,000 of the population; and in London during the last 10 years it has been 2.9 per 10,000, and in the City l.6; whereas in the year 1871 it amounted to 24 per 10,000 of the population of London, and 11.5 per 10,000 of the City—the range being from 4.3 per 10,000 of the Western district, to 21.1 of the Eastern. Although, therefore, the mortality from small-pox in the City has been large, it has not been so large as in the rest of the metropolis. It may be interesting to know that, according to Sir Gilbert Blane, the average mortality from smallpox in England before vaccination was adopted, was 30 per 10,000 of the population. From 1838 to 1840, when it was much practised, but before any public vaccinators had been appointed, it was 7.7 27 per 10,000. From 1841 to 1853, when it was still more in vogue, but was not compulsory, although provision was made for gratuitous vaccination by public vaccinators, it was 3 per 10,000: from 1854 to 1863, when it had become compulsory by Act of Parliament, it was 1.7 per 10,000; and from 1864 until the present time, it has been at about the same proportion, although in 1867 it was only 1.2 per 10,000; in 1868, 0.96; and in 1869, but 0.72. What more striking and trustworthy proof could be offered of the benefits of vaccination ? With respect to the onset and progress of the present epidemic, it would seem, from the returns of cases admitted into the Small-pox Hospital, that the disease begun to manifest unusual severity as far back as the month of November, 1869, for in that month the number of admissions rose from an average of about 31 in the month to 51. During the five following months the rate of increase was steadily advancing, and in May, 1870, it amounted to 112, at which proportions it remained until the following October, when it rose to 144, then to 159, and lastly to 178. This was the closing month of 1870, and the number was the highest for the whole period of the epidemic; for from that time it gradually declined to nearly its normal proportions. Looking at the weekly returns of deaths from 28 pox in London, it appears that the normal proportions of about 12 in the week were maintained until the first week of October, 1870, when the number rose to 27 in the week. After that, with slight variations, it slowly and steadily increased, so that at the close of the year the number of deaths from the disease was over a hundred in the week. Throughout the months of January, February, March, April, May, and June, the weekly number was more than 200, and in the first week of May (1871) it reached to 288. This is the largest weekly mortality for the year; for, although the disease continued to be very severe during the whole of May, June, and July, yet it began to decline from the first week of May. It is evident from this that the chief force of the epidemic, as estimated by the weekly returns of deaths from small-pox, was manifested for a period of seven months—namely, from the last week of the year 1870 to the end of the following July, and that it reached its climax in the first week of May. In the City of London, judging from the returns of sickness among the poor, it would seem that small-pox began to be somewhat prevalent in the month of October, 1870, and that in the two following months it was notably severe. This severity has lasted, with more or less variation, until the present time, although the period of its greatest violence in the City was from November, 1870, to June of last year. 29 The lesson to be learnt from this epidemic of small-pox, like that from others which have so often preceded it, is the danger of neglected vaccination, whether it be the primary vaccination of infancy or the secondary of adult life. I refrain from discussing the question, which I have more than once alluded to in my former Reports, viz.: the complementary or compensating laws which evidently govern the manifestations of the so-called zymotic diseases, and which point to a fixed and almost determinate quantity of zymotic energy. This is so remarkable, that attempts have been made to correlate these diseases, after the manner of the correlation of physical phenomena, and opinions have been hazarded of even the probable identity of all zymotic contagions. "Is it possible," says Mr. Wolff, in his recent essay on this subject, "that the true explanation of the variety of zymotic diseases may be, not that there is a multiplicity of poisons, each exciting a specific disease, but that there is one cause common to all, and that the variety of the disease depends upon the channel through which the noxious agent finds access to the body? Is it possible that the same agent gaining access to the body through the direct medium of the blood, as in syphilis and dissecting-wound fever, may give rise to the 30 toms characterising these and cognate diseases; that the same agent striking through the alimentary canal may give rise to the symptoms of enteric fever, cholera, and that group ; that the respiratory organs acting as another channel may perhaps lead to the phenomena that we express by the terms 'scarlatina,' 'measles,' &c.?" and that the hygienic and other conditions under which the subject of infection lives may also modify the results. Given, in fact, a molecule of organic matter in a peculiar state of motion or decay, and he believes, from the investigations of Laplace, of Berthollet, and of Liebig, that it will communicate its motion to other molecules of matter which are susceptible of such motion, and thus produce zymotic disease, so that ''A certain number, of individuals subjected to the contagion of these molecules in motion have the action extended to their bodies, and diffuse the diseased action in a constantly widening circle. And this very diffusion, whilst extending the ravages, tends to limit the duration, and gradually diminish the intensity of the disease. As the undulations of ruffled water gradually die away in the distance—as the waves of sound decrease in intensity as they are diffused through a larger space—as a heated substance gradually imparts its motion to contiguous matter until a condition of statis is arrived at, so this poisonous action loses in intensity as it gains in extension, 31 until the diseased action is too feeble to overcome the resistance of healthy action, and a state of statis (restoration of health in the individual, cessation of the epidemic in the community) is the result." But although the entire phenomena of zymotic diseases, and especially the reproductive powers of them, are hardly consonant with what we know of the physical manifestations of molecular motion, yet there is much about them, as for example, their modes of attack, their periodicity, the regularity of their progress, the order of their decline, and, above all, the quantitative or complementary relations of them, which point to a probable correlation of some kind. But whether the relation is in the quality of the contagion, or in the nature of the material upon which it acts, or in the force which governs its manifestations, is a problem for searching enquiry; for at present no man can safely dogmatise on this obscure subject, by saying that these diseases are caused by matter in a peculiar state of motion, or by living germs with their faculty of reproduction, or by the so-called "zymotic principles" of the Registrar-General. All that we can certainly say of these maladies is, that, be their origin what it may, or their correlation as close as can be, they are governed by laws which are quite within the reach of human investigation; and that although perhaps we shall never be able to banish such diseases from the 32 munity, yet we have always power to mitigate their force, to regulate their actions, and to bring them under the control of Hygienic influence. This, in fact, is the practical aim of sanitary science, however much it may be disturbed by the fanciful theories of dreamy physicists, or by the sensational rhapsodies of popular writers. Sickness Returns. These have been somewhat above the average for the last ten years—in the proportion of 10,856 to 10,605; but, except in the case of small-pox, which has risen from an average of 66 in the year to 476, the returns have been below the usual proportions. Cases of fever, for example, have declined from 648 to 328, and alvine disorders from 971 to 356. Meteorology. The particulars of the Temperature, Barometric pressure, Humidity, and Rainfall for the year are shewn in the 8th table of the Appendix; and, as usual, they have been deduced from the observations at Guildhall under the superintendence of Mr. Haywood. The principal facts are as follows:— 33 Rainfall, Humidity, Dew-point, and Temperature, in each quarter of the Year. Quarter ending December, 1870 Quarter ending March, 1871 Quarter ending June, 1871. Quart. ending September, 1871 Entire Year. Total Rainfall (inches) 7.78 3.79 6.59 4.99 23.15 Average in City for 10 years. 6.27 5.70 5.19 6.14 23.30 Number of Wet Days 39 34 36 32 141 Average in City for 10 years 41 43 37 37 158 Degree of humidity (Sat= 100) 78 79 69 68 73 Average in City for 10 years 83 85 74 72 78 Dew-point (Faht.) 38.8 30.1 44.3 52.9 43.0 Average in City for 10 years 43.0 37.9 46.1 52.7 44.9 Temperature (Faht.) 47.0 41.5 52.8 63.9 51.3 Average in City for 10 years 47.6 41.7 54.0 61.7 51.2 Quality of the Water Supply. This, as heretofore, has been the subject of regular investigation, not only in respect of the quality of the water supplied to the City, but also of that supplied to the whole of the Metropolis ; and the principal facts of the inquiry are classified in the following table:— 34 Average Chemical Composition of the Metropolitan Waters for the Year 1871. Names of Water Companies, &c. Total Solid Matter per gallon. Common Salt. Oxygen* required Organic Matter, &c. Nitrogen. Hardness. As Nitrates &c. As Ammonia. Before Boiling After Boiling. Grains. Grains. Grains. Grains. Grains. Degrees Degrees. Thames Water Companies Grand Junction 19.56 1.88 0.102 0.128 0.003 14.8 3.8 West Middlesex 18.71 1.83 0.040 0.124 0.001 14.4 3.3 Southwark & Vaux hall 19.44 1.91 0.089 0.125 0.003 14.8 3.8 Chelsea 19.48 1.87 0.093 0.136 0.003 14.9 3.8 Lambeth 19.79 1.79 0.082 0.123 0.003 15.0 3.8 Other Companies Kent 27.69 2.56 0.010 02.15 0.000 20.7 5.7 New River 19.19 1.68 0.032 0-132 0.001 14.8 3.5 East London 20.39 2.10 0.060 0-143 0.001 15.0 4.. The quantity of solid or rather saline matter dissolved in the water supplied to London during the year has ranged, in the case of the Thames supply, from 18*71 grains per gallon (West Middlesex Company) to 19-79 grains (Lambeth Company) ; in the New River Water, which is that chiefly supplied to the City, it has averaged 19-19 grains per gallon; in the River Lea water of the East London Company, 20-39 grains ; and in the water from the deep chalk wells of the Kent Company, it has amounted to 27-69 grains per gallon, The fluctuations of these 35 proportions have not been considerable during the year, although in all cases the water has contained more saline matter in winter during wet weather than in summer—the maximum being in January and February, and the minimum in September. The hardness of the general supply has ranged, in the case of the river water, from 14.8 to 15 degrees of Clark's scale, and this has been reduced to about 4 degrees by boiling for a quarter of an hour. In the case of the chalk-well water, the hardness has been 20.7 degrees, and after boiling it has fallen to 5.7 degrees. The proportion of organic matter in the water has been very small, for the quantity of oxygen required to act on every description of oxydizable matter has ranged from only 0.01 of a grain per gallon in the chalk water of the Kent Company, to 0.102 of a grain in the Thames water supplied by the Grand Junction Company; and the amounts of ammonia and of organic nitrogen, as determined by Wanklyn's process, have not exceeded the 100th part of a grain per gallon of water. As regards turbidity, the water supplied to the City by the New River and the East London Companies has been invariably bright and nearly colourless, and so also has been that of the Kent and the West-Middlesex Companies, but that of the Southwark and Vauxhall Company has been turbid on 36 one occasion, that of the Lambeth Company on five occasions, and that of the Chelsea and of the Grand Junction Companies on eight occasions respectively. The turbidity has been at all times due to the presence of a very small quantity of finely divided clay in which there was occasionally a trace of vegetablo tissue; and no doubt it had been caused by the heavy floods of the river. Although perfectly harmless, a slight turbidity of the water is sure to command attention, and may easily be made the subject of popular clamour. On several occasions it has been described by the Registrar-General, on the authority of Dr. Frankland, in very alarming language, as that the water was turbid, very muddy, contained living organisms, was polluted with organic impurity, and was entirely unfit for domestic use. It is fortunato for both the water companies and the public that the Board of Trade has power, under the 35th and 36th section of the Metropolis Water Act, 1871, to institute enquiries into the truthfulness of such statements; and accordingly, at the instance of the vestry of St. Mary, Newington, who were terrified boyond moasure at the accounts given by Dr. Frankland of the condition of the water supplied to the parish, the Board of Trade appointed their officer, Major Bolton, who is the water examiner, to investigate the facts of the case; and in his report, which I have before mo, heverifies the statement of Dr, Frankland as to the occasional 37 turbidity of the water supplied by the Lambeth and the Southwark and Vauxhall Companies, and as to the presence of living organisms, but he attaches so little importance to the fact, that he says, "it is to be regretted that such terms as 'living organisms' and 'moving organisms' have been used so frequently and so indefinitelyfor not only do they exist in all water, but "it is impossible altogether to get rid of the simplest forms of vegetable and animal life, which should be understood by such terms, even by the most perfect filtration;" and in proof of the wholesomeness of Thames water, when properly filtered, he quotes from the Report of the Royal Commission on the quality of the water from the Thames Basin, to the effect that ''in the present state of chemical science, analysis fails to discover in properly filtered Thames water anything positively deleterious to health. Whatever may be the difference of opinion with respect to the time required for removal of all the objectionable organic matter, all chemists agree that in Thames water taken from the present source, and properly filtered, all such matter has disappeared, and that the resulting compounds, such as nitrates, &c., remaining therein, are innocuous and harmless." Dr. Frankland, however, who is not a medical man, is not altogether of this opinion, for he thinks that water once charged with organic impurities is for ever after dangerous, and 38 hence he uses the sensational phrase of "previous sewage contamination"—attributing all the combined nitrogen in water, with a small deduction for that which may have been acquired from the atmosphere during its fall as rain, to sewage or other such contamination; but the phrase, as Major Bolton remarks, is more alarming at the first glance than when closely examined; for it really implies—not that sewage or organic matter is contained in the water, but that the metamorphosed elements of these matters are present; and so they are in all the food we eat, for the corn, the fruit, the vegetables, and even the wine produced upon land manured with organic matter, must contain the metamorphosed elements thereof, and must, in the peculiar language of Dr. Frankland, be the products of "previous sewage or manure contamination;" but who cares for this when the meaning of the phrase is clearly understood? It is, however, unfortunate that the Registrar General should continue to employ it—seeing that it is constantly being misunderstood, and therefore creating unnecessary alarm in the public mind. As an illustration of this I may refer to a report of the recently appointed medical officer of health for Lambeth, wherein he states that the water supplied to his district is "extensively diluted sewage." The publication of such a statement is sure to excite the gravest apprehension, which, as might be expected, 39 is not confined to the district in question, but extends to the whole Metropolis. Officers of health have, therefore, had to allay the feeling of alarm, and in one case it has been made the subject of a special report. Thus Dr. Whitmore, who, like myself, has been engaged for years past in examining the water of his district, gives assurance to his vestry that it is "excellent in quality and perfectly wholesome." The subject has also commanded the attention of Dr. Alfred Swaine Taylor, F.R.S., the Professor of Medical Jurisprudence, and late Professor of Chemistry at Guy's Hospital, whose published report is before me. "There has been of late years," he says, "a great outcry on the subject of 'sewage contamination,' and some sanitary reformers have gone so far as to describe the Thames water as so much 'diluted sewage.'" "Dr. Whitmore," he says, "finds neither sewage nor the products of sewage decomposition in the water supplied by the West Middlesex Company. This, he adds, "is quite in accordance with the results which I have obtained by an examination of the water supplied to my house. Since the threatened approach of cholera in 1870—71, I have, for my own information, frequently examined the water for the products of decomposition, but have found none. As to 'previous sewage contamination,' I believe it to be a myth, if we are to understand thereby that the 40 sence of sewage-products in water at any previous time renders that water noxious or unfit for use ever after. Those who adopt this theory can have but little faith in chemistry, or in the chemical changes which are going on around us;" and with regard to the phrase "living organisms," he says, "if water is to bo condemned as unwholesome and unfit for domestic use, because 'living and moving organisms,' i.e., animalcules, are found in it, then there is no water in the world which can escape condemnation. The waters of the lakes of Wales and Cumberland and even the water of Loch Katrine of Scotland, which is commonly taken as a type of purity for domestic use, would, on this ground, be pronounced 'undesirable for human consumption.' In short those who would keep these minute infusorial animalcules out of any river or lake water on the earth, must adopt some scheme for preventing water-plants from growing in the water, or leaves, grass, or other organic substance from falling into it." But the Registrar-General is not content with the use of these objectionable phrases, having reference to the quality of the water, and which are frequently associated with some statement respecting the dangers of cholera or typhus, and the connection of these diseases with bad water, but the quantities of the so-called impurities of water are represented in 41 enormous proportions, as in thousands of tons. Dr. Taylor, however, thinks that "a gallon of water is an intelligible quantity. A man," he says, "may easily calculate within what period of time he consumes a gallon by daily use, and with it the 21 grains of innocent solid substances contained in it. This is preferable to a system now adopted of giving the assumed constitution of 100,000 tons, or a corresponding number of kilogrammes or cubic metres of water. So enormous a quantity is, of course, beyond the reach of chemical analysis, and the tons of chalk, salt, and organic matter said to exist therein are only arrived at by multiplication. A ton of water represents 224 gallons. Within what period of time will a ton of water be consumed by any unit of the community? The answer to this question will show that such modes of laying plain matters before the public are more sensational than practical." The Royal Commission on Water have expressed themselves to the same effect, for at page 93 of their report, after condemning the term "impurities" as used by Dr. Frankland, they say, "And further, we cannot but consider it unphilosophical when, in addition to treating as 'impurities' substances perfectly harmless even in much larger quantities, the minute quantities present in a gallon, or any other small measure of water, are multiplied by taking masses of water, such as the individual never 42 has to deal with, and given to the public in figures so large as to tend to cause misconception, and perhaps unnecessary alarm in the minds of those not conversant with all the conditions of the case."* I have been tempted to discuss this matter somewhat fully by the desire to allay any feeling of apprehension in the public mind as to the wholesome quality of the water supplied to this Metropolis, and I have endeavoured to shew that although the phrases made use of by the Registrar-General on the authority of Dr. Frankland are at first sight undoubtedly alarming, yet when closely examined they are found to be but mere figures of speech with perhaps a rather bold touch of exaggeration. It is, however, satisfactory to know that this kind of phraseology is quite exceptional, and is not used or even accepted, so far as I am aware, by any practical sanitary authority. The quantity of water supplied to the Metropolis during the year is shewn in the following table:— * Since this report was written, Dr. Bristowe, the Medical Officer of Health for Camberwell, has also felt it necessary to report on this subject, and to condemn the use of Dr. Fiankland's phrases of "previous sewage contamination," and " living organisms." 43 Average amounts of Water supplied daily to London by the Water Companies, during each Month of the Year, 1871. Gallons per Day. Number of Houses supplied. Total. Per Head. October, 1870 104,073,197 31.9 482,565 November ,, 101,063,124 30.9 482,880 December ,, 97,371,249 29.8 482,982 January 1871 102,824,606 31.5 485 328 February ,, 100,782,216 30.9 483,566 March ,, 101,557,556 31.2 484,969 April ,, 103,593,573 31.8 485,734 May 108,692,357 33.3 487,198 June ,, 111.292,104 34.1 487,692 July 112,107,697 34.4 489,331 August ,, 116,799,067 35.8 489,545 September ,, 114,354,087 3.53 490,332 Average 106,209,236 32.5 486,010 So that the quantity has ranged from 97,371,249 gallons per day in December, 1870, to 116,799,067 gallons per day in August, 1871—the average for the whole year being 106,209,236 gallons per day, or 32.5 gallons per head of the population. The average number of houses supplied has been 486,010, and therefore a little more than 218 gallons have been delivered to each house daily. About six million gallons of each of the day's supply has been derived from the Thames, four million gallons from the New River and the River Lea, and the remainder, about seven million gallons, from the chalk 44 wells of the Kent Company. Up to the present time the supply has been intermittant, but by the "Metropolis Water Act, 1871," which was passed on the 21st of August of last year, the companies are bound, after the expiration of eight months from the passing of the Act, to provide and keep throughout their water limits, or throughout such parts of such limits as they may be required so to do, in the manner provided by the Act, a constant supply of pure and wholesome water, sufficient for the domestic use of the inhabitants thereof, at such pressure as will make the water reach the top story of the highest houses within such limits (but not exceeding the level prescribed by any special Act); and this supply is referred to in the Act as a "constant supply." But no company can be compelled to give a constant supply to any promises in their district until the regulations provided for by the Act are in operation in the disirict, and the prescribed fittings are provided by at least four-fifths of the inhabitants ; and in case there is any default in respect to those fittings, the Metropolitan authority may, by notice in writing, require the owner or occupier of any such premises to provide the same within a specified time; and if he fails therein the Metropolitan authority may provide the necessary fittings, or repair them, as the case may be, and charge the cost thereof to the person liable to pay the rate of the 40 water supplied to the premises. The Metropolitan authority has power to apply to the water company to furnish a constant supply to a district, and if there is any reasonable delay in such supply the Board of Trade has power to require it, when complaint is made thereof. In those cases when e a group or number of dwelling-houses are situate in a court or passage, or otherwise in contiguity with one another, and it appears to the Board of Trade, on the report of the nuisance authority, that a constant supply cannot be well and effectually provided for such group of houses, except by means of a stand-pipe or other apparatus placed outside the dwelling houses, the Board of Trade may order such means of supply, and the expense thereof shall be borne by the owner of the dwelling-houses, or, if there be more than one owner, by the respective owners in such proportion as the Board of Trade may direct. And with the view of preventing such waste of water as might occasion public calamity, it is provided that within six months of the passing of the Act, the Companies shall, with the approval of the Board of Trade, make such regulations as are necessary or expedient for the purpose of preventing the waste or misuse of water; and therein, amongst other things, they may prescribe the size, nature, 46 and strength of the pipes, cocks, cisterns, and other apparatus to be used, and they may interdict any arrangements, and the use of any apparatus, which may tend to cause waste or misuse of water. But as these regulations may from time to time require amendment, it is provided that they may be repealed, altered, or made anew by the companies, with the sanction of the Board of Trade, or by order of the Board of Trade, after enquiry into any complaint or appeal, relating thereto, by the Metropolitan authority, or by any ten consumers of water supplied by the company. And when such regulations are made and are in force, the owners and occupiers of houses in any district of constant supply arc bound to provide, and keep in proper use and condition the prescribed fittings; and in default thereof they are liable to a penalty not exceeding five pounds. Moreover, the company can, if it think fit, after proper notice, and within twenty-four hours thereof, provide or repair such fittings, and charge the cost of it to the person in default, or it may even adopt the summary process of cutting off the supply of water to the house, and reporting the matter to the sanitary authorities, when such a house shall be deemed a nuisance within the sections, 11 to 19 inclusive, of the Nuisances Removal Act, 1855, and shall be considered as unfit 47 for human habitation. The penalties, therefore, for the waste, misuse, or fouling of water are sharp and decisive; and the companies have power to send their officers at all reasonable times into any house or premises for the purpose of examining the pipes, cocks, cisterns, fittings, and other apparatus, and ascertaining whether they are in accordance with the Regulations. All this is essentially necessary to guard against the terrible consequences of want of water from undue waste; and it is the more necessary in London from the circumstance that the fittings and apparatus of almost every house are so defective and imperfect that the waste of water through them is enormous. This is abundantly evident in the fact that with the present intermittant supply of only for about twenty minutes in the day, the average quantity of water delivered to the public amounts to 32.5 gallons per head of the population, or 218 gallons per house; and if with such a condition of things the constant service were adopted, the waste would be beyond the capabilities of the companies, even if the entire volume of the Thames were at their disposal. With proper care and supervision, however, the daily consumption of water in this Metropolis need not exceed 20 gallons per head of the population, for that is the amount supplied in those cities and towns of England where the constant service is properly managed. 48 With respect to the obligations of the water companies, the Act provides that if any company violates, refuses, or neglects to comply with any of the provisions of the Act, as regards the proper filtration and storage of the water, and the constant supply of it at the prescribed pressure, it shall be liable to a penalty not exceeding two hundred pounds; and to a further penalty not exceeding one hundred pounds for every month of default, after it shall have received notice in writing from the Board of Trade to remedy such default; and the Act imposes on the Board of Trade the Duty of appointing a competent and impartial person to be a "Water Examiner" for tho purpose of ascertaining whether the companies have complied with tho regulations as regards the effective filtration, and proper storage of the water. Sanitary Work of the Year. This is to a large extent tabulated in the Table No. IX. of the Appendix; and it will be observed that tho four Sanitary Inspectors have examined the condition of 20,380 houses in the year, besides making 303 inspections of the bakehouses of the City, and delivering 2,928 notices for the periodical cleansing of the Lodging-houses of tho City in accordance with the 6th Regulation for the same. The distribution of this work has been as follows:— 49 Number of Inspections of Houses, and of Bakehouses and of Orders issued for the amendment of the same by each of the Sanitary Inspectors of the City, during the Year 1871. Namesof the Sanitary Inspectors. Lodging Houses. Bakehouses. Number of Inspections Orders for Sanitary Improvement. Notices under 6th Regulation. Number of Inspections Orders for Saintary Improvement. William Clark 4,331 628 750 74 6 Job Payne 4,966 554 680 78 4 Thomas Saltmarsh 5,482 265 748 63 6 Thomas Shurmuf 5,601 716 750 88 9 Total 20,380 2,163 2,928 303 25 These inspections resulted in the issuing and executing of 1,045 orders for cleansing and limewhiting the rooms of houses, 428 for cleansing and repairing privies, 293 for amending sinks and drains, 137 for improving the water supply, 92 for removing waste water, 54 for paving yards and cellars, 13 for erecting dust-bins, 12 for abating smoke nuisance, 6 for removing animals improperly kept, 5 for abolishing cesspools, and 96 for sundry other improvements of houses. Proceedings have also been taken under "The Artizans' and Labourers' 50 lings' Act, 1868," commonly called Torrens' Act, for the Improvement of the Houses in Three Herring Court, Cree Church Lane—this being the third place in the City which has been amended under that Act of Parliament. The Inspector of Shipping has made 1,796 inspections of ships during the year, and has found 30 requiring sanitary improvement in respect of cleanliness or ventilation. At present, the small area of the Port of London within your jurisdiction—extending from the Tower to the Temple—is the only part of the Port which is systematically inspected in accordance with the 32nd section of the Sanitary Act, 1866. This is manifestly an inconsistency; for, as I gather from a report by Mr. Harry Leach, the resident surgeon of the Seaman's Hospital, there are about 25,000 vessels entering the Port of London yearly, besides about 2,300 sailing barges, and nearly 4,000 dumb barges, which belong to the Thames. These represent a floating population of about 15,000 persons, which are at present almost entirely without sanitary supervision; and that they require it is shewn by the results of your own inspections of vessels within the limited area of the City—an area which comprises only half of the river for about a thousand yards on each side of London Bridge. In the course of the last five years there 51 have been 10,013 inspections of ships within that area, and 263 have been found defective in their sanitary arrangements. At first, in 1867, the annual proportion of defective ships amounted to 146, whereas in the year which has just expired it was only 30— shewing that when the captains and owners of vessels become aware of their sanitary supervision, they take care to have them in tolerably good condition. That there is great necessity for such inspection of shipping there can be no doubt, for over and over again it has been shewn that fever and scurvy and epidemic diseases are very prevalent in the vessels which trade with this port, and that they are referable to defective sanitary arrangements. And not alone do they affect the floating population, for they are generally the means whereby certain forms of zymotic disease are imported into this country, and when this happens the defects of our sanitary laws are strikingly exemplified. As an instance, of this I may refer to the misadventure, if I may so call it, of the orders in Council of July and August of last year, when there was a threatened invasion of cholera. These orders had reference to the condition and treatment of ships arriving from infected ports, and the local or nuisance authorities of the port were intrusted with their execution. But the Port of London comprises an area with 13 nuisance authorities, whose districts abut on the 52 Thames, besides the Conservators of the Thames, the Commissioners of Customs, and the Board of Trade—all of whom have more or less of sanitary power. The execution of the orders was, therefore, impossible; for, although each of the nuisance authorities has control of a ship while it is within its district, yet the rapid movements of the vessel quickly carries it beyond the limited area of any individual district, and it is hardly fair that the little district of Gravesend, where the supervision begins, should be called on to perform at its own cost the supervision of all the ships that enter the port of London. In view, however, of the emergency of the case, tho Nuisance Authorities abutting on the Thames endeavoured to meet the difficulty by conjoint action, and they even went so far as to provide a sanitary staff of officers, as well as a hospital ship in case they should be required; but all their proceedings were illegal; and although they frequently met at Guildhall under the chairmanship of Mr. Pedler, the former Chairman of your Sanitary Committee, yet they were unable to cope with the difficulties of the case—created by faulty legislation. They, therefore, sought an interview with Mr. Stansfeld, the President of the Local Government Board, and submitted to him the following resolution:— 53 "That to provide for the possible appearance of "cholera in the Metropolis, and with a view to the ''effective and uniform sanitary inspection, super"vision, and treatment of seamen arriving in the "Port of London and in the Docks, the duty of "which inspection at present devolves on various "River-side Nuisance Authorities within the Port "of London, it is expedient that some legislative "enactment be passed, to enable those authorities, ''in conjunction with representatives from the ''remainder of the Metropolis, to take measures for ''the formation of a staff of medical officers and ''assistants necessary to carry out such purpose, and "also with power to make a call on the several "Authorities for defraying the necessary cost of ''such inspection—such contributions to be collected "by the several districts and vestries with their "general rates." Mr. Stansfeld expressed himself as fully alive to the importance of the matter; and, recognising the difficulties of the case, he promised to introduce a clause into his forthcoming Public Health Bill to meet the objects of the resolution. This he has done; for in the 19th Section of the Bill he provides for the permanent appointment of any sanitary authority whose district abuts upon any part of a port in England, or any conservators, 54 sioners, or other persons having authority in or over such port or any part thereof, the sanitary authority for the whole port, by provisional order of the Local Government Board; and with respect to the Port of London he leaves it open for Parliament to decide which of the authorities shall be the sanitary authority for the port. Considering, however, that the Conservators of the River Thames are already the sanitary authorities of the port as regards the protection of the river from pollution, and that their authority extends from Staines, in the county of Middlesex, to Cricklade, in the county of Wilts, with power over the moorings of all vessels in the port, and having a staff of officers conversant with every part of the port, it appears to me that they would be best able to carry out the sanitary inspection of the port, and that they should be named in Mr. Stansfeld's Bill as the Sanitary Authority for the Port of London—the expenses thereof being defrayed in the manner prescribed in the 20th Section of the Bill—that is, from a common fund to be contributed by the several sanitary authorities of the whole of the metropolis in such proportions as the Local Government Board thinks just. Disinfecting Place, and Mortuary Chamber. Since the date of my last yearly Report, the provisions of the 23rd, 24th, 27th, and 28th sections of 55 the Sanitary Act, 1866, and of the 89th and 90th Sections of the City of London Sewers' Act, 1848, have received attention from the Commissioners; and a place has been provided in Grolden-lane, with all necessary apparatus and attendance, for the disinfection of clothing, bedding, and other infected articles free of charge (Sect. 23); and a proper place has also been provided in Grolden-lane for the reception of dead bodies (Sections 27 and 28 Sanitary Act, 1866, and Sections 89 and 90 of the City of London Sewers' Act, 1848). Both of these places have been constructed on the most approved principles from the designs of Mr. Haywood, and the general arrangement of them may be seen from the drawing which accompanies this Report. A Keeper has been appointed to take charge of these places, and I have drawn up a statement of the duties which he has to perform. (See No. XIV. of Appendix). As regards the removal of dead bodies, I have prepared a general notice of the method of procedure, and of the provisions of the two Acts of Parliament—(see No. XV. of Appendix)—which I am of opinion should be freely circulated among the Surgeons, the Poor Law Officers, and the Undertakers of the City. When proceedings are taken under the provisions of the Sanitary Act, 1866 (Section 27), it is necessary in the first place to obtain .00 the certificate of a duly qualified medical practitioner (See Form No. XVI. of Appendix), to the effect that the dead body of one who has died of an infectious disease is retained in a room in which persons live and sloop, or that a dead body is in such a state as to endanger the health of the inmates of the room. This certificate is to be transmitted to the Sanitary Clerk, who will thereupon immediately fill up a form (No. XVII. of the Appendix), and take it to tho Justice Room for the order of the Justice to remove tho dead body from the room in question. The Sanitary Clerk will then send an order to tho Contracting Undertaker of tho Commission to removo tho body to tho Mortuary, where it will bo received by tho Kooper and kept in proper and decent custody. Tho Sanitary Clerk will also send a printed notico to tho Relieving Officer requesting him to bury the body at tho expense of tho Poor Rate within tho time specified in the Justices order. I have prepared a statement of tho method of these proceedings for the guidance of tho Sanitary Clerk and others (see No. XVI11. in tho Appendix). If, however, tho removal of the body is to bo effected under tho provisions of the 90th section of tho City of London Sowers' Act, 1848, it must bo done through the agency of tho Medical Officer of Health for tho City; and with the view of enabling 57 the poor themselves to make use of the Mortuary for their own benefit, and of their own free choice, I have advised that it should be done through the undertaker employed in the case, who will make applications to the Sanitary Clerk at the Sewer's Office, and fill up a form (No. XIX.) in which he agrees to send the body in a proper coffin, and to bury it within a specified time. Already these places have been of the greatest service to the poor, especially during the recent epidemic of small-pox; for from tho month of February of last year until the end of September (only seven months) there have been 3,350 articles of clothing and bedding disinfected and returned to the owners. They comprised 216 mattresses, 242 beds, 142 bolsters, 253 sheets, 375 blankets, 440 quilts,. 434 pillows, 108 carpets, 486 articles of clothing, and 654 sundries. Besides which there have been 9 dead bodies received into the Mortuary, seven of which were cases of small-pox. Inspectors of Meat and Markets. The Markets, Cow-houses, and Slaughter-houses of the City have been duly inspected, and the officers have condemned 132,388 lbs. or nearly 60 tons of meat as unfit for human food. This is much 58 below the average for the corresponding period of the last ten years (212,406lbs.), and it is no doubt due to the recognised vigilance of the officers, and to the knowledge of the fact that the penalties for sending diseased and unsound meat to the City Markets are constantly enforced. Of the 132,388 lbs. of meat which were seized and condemned, 124,7561bs. were from the New Meat Market, 7,502 lbs. from Aldgate, and only 130 lbs. from Leadenliall; 77,083 lbs. of it were diseased, 40,9871bs. were putrid, and 14,318lbs. were from animals that had died from accident or disease. It consisted of 576 sheep and lambs, 159 calves, 367 pigs, 698 quarters of beef, 2,180 joints of meat; besides 1,863 plucks, 562 kidneys, 36 tongues, and 17 barrels of sheeps' tongues, 29 livers, 23 hearts, 50 hams, 5 sides and 20 pieces of bacon, 33 lbs. of sausages, 2 deer, 3 fawns, 7 quarters of venison, 12 hares, 418 rabbits, 1 box and two cases of rabbits, and 475 head of game and poultry. In addition to this the officers of Billingsgate and Columbia Markets have seized, on account of putridity, .about two million fish, weighing about 343^ tons; besides 16,719 gallons of shrimps, 334 bushels of whelks, 154 of mussels, 454 of periwinkles, 77 of sprats, and 5 of oysters. There have been nine prosecutions and seven convictions during the year for sending diseased and 59 unsound meat to the City Markets for sale as human food, namely:— 1. Walter Stevenson, Derby—6 months prisonment. William Birks, Derby—£100 recognisances to come up for judgment when called upon. 2. Robert Watts, Butcher, of Chipping Norton— 2 months imprisonment. 3. George Benner, Farmer, of Weston, Lincoln shire—£10 and costs. 4. William Parker, Butcher, of Bridport—£10 and costs. 5. Thomas Fowler Timms, Farmer, of Ilston-on- the-Hill, Leicester—Summons dismissed. 6. Robert Moon, Butcher, of Berwick-upon- Tweed—2 months imprisonment. 7. John Robinson, Butcher, of Clare, Suffolk— 2 months imprisonment. 8. John Des Forges, Farmer, of Withern, tershire—20s. and costs. 9. Messrs. Adams, Fruit Salesmen, Pudding- lane—Summons dismissed. 60 Lastly, I liave to state that I liaye at your request revised the duties of the Insj)ectors of Meat, Slaughter-houses, and Cow-houses within the City, and have amended the Rules and Regulations for the same. I remain, Gentlemen, Your obedient Servant, HENRY LETHEBY. Guildhall, March 19th, 1872. APPENDIX. No. I.—Number of Inhabited Houses, Number of the Population, and Density of the Population in each of the City Districts, in the Census Years—1841, 1851, 1861 and 1871. city districts. Area in Statute Acres. Inhabited Houses. Population. Persons to a House. Persons to an Acrc. 1841 1851 1861 1871 1841 1851 1861 1871 1811 1851 1861 1878 1141 1851 1861 1871 East London Union 153 4,796 4,739 4,489 3,336 39,655 44,406 40,687 28,123 8.3 9.4 9.0 8.4 260 290 266 184 West London Union 136 3,010 2,C70 2,580 1,874 29,142 28,833 27,145 18,746 9.7 10.8 10.4 10.0 214 212 200 138 City of London Union. 434 7,921 7,297 6,362 4,225 55,920 55,932 45,555 28,973 7.0 7.7 7.1 6.8 129 129 105 67 Entire City 723 15,727 14,706 13,431 9,435 124,717 129,171 113,387 75,842 7.9 8.8 8.4 8.0 172 178 157 105 Note.—The Census of the City in 1871 represents the population on a Sunday at midnight, when it is at its very minimum; for the day population of the City is perhaps above a quarter of a million. In 1866 the mercantile day population was ascertained, and it amounted to 170,133. The number has no doubt increased since that time, but taking it at only 170,133, the day population of the City will be 245,975 (170,133 + 75,842). It appears, therefore, that, in the day time, the density of the City population is not less than 340 persons to an acre, and in the night time 105 to an acre. In the whole of the Metropolis it is but 41 7 persons to an acre, and in the 20 chie towns of England it is only 33.8; while in the districts of all the chief towns of the Kingdom, it is but 3.9 per acre; and in all England and Wales it is but 0.6 per acre. The density of the City population is therefore still excessive. No. II.—Enumeration of Births, Deaths, and Marriages in each of the City Unions for the Year ending September, 1871, and a Comparison with the Averages of the last Ten Years. Qitakteks Ending. East London Union. West London Union. City of London Union. Entire Citt. Births. Deaths. Marriages. Births. Deaths. Marriages. Births. Deaths. Marriages. Births. Deaths. Marriages. December, 1870 200 151 .. 127 112 .. 136 148 .. 463 411 353 Average of 10 Quarters 273 243 .. 169 168 .. 200 210 .. 642 621 394 March, 1871 211 217 .. 134 127 .. 143 199 .. 488 543 369 Average of 10 Quarters 300 264 .. 175 191 .. 209 250 .. 684 705 325 June, 1871 204 161 .. 121 83 .. 115 163 .. 440 407 322 Average of 10 Quarters 283 233 .. 164 164 .. 197 260 .. 644 597 364 September, 1871 206 174 .. 143 106 .. 114 121 .. 463 401 324 Average of 10 Quarters 261 237 .. 155 152 .. 193 190 .. 609 579 368 Sum of the 4 Quarters 821 703 .. 525 428 .. 508 631 .. 1,854 1,762 1,268 Average of 10 Years 1,117 977 .. 663 675 .. 799 850 .. 2,579 2,502 1,451 No. III.—Annual Enumeration of Births for the Year ending September, 1871. Births in the Four Ouarters. Total. East London Union. West London Union. City of London Union. Saint Botolph. Cripplegate. Total. Saint Seplhre. Saint Bride. Total. Castle Baynard ChristChurch. Queenhithe. Allhalls., Barking. Broad Street. 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. 1870 240 223 53 46 48 53 101 99 28 23 39 37 67 60 6 4 14 14 3 9 16 14 33 23 72 64 463 99 101 200 51 76 127 10 28 12 30 56 136 Quarter ending March 1871 229 259 41 67 55 48 96 115 24 30 41 39 65 69 16 9 8 12 11 13 15 18 18 23 68 75 488 108 103 211 54 80 134 25 20 24 33 41 143 Quarter ending June 1871 222 218 64 48 50 42 114 90 28 28 33 32 61 60 9 4 3 21 10 10 13 15 12 18 47 68 440 112 92 204 56 65 121 13 24 20 28 30 115 Quarter ending Sept. 1871 239 224 57 52 55 42 112 94 31 28 39 45 70 73 5 6 16 13 12 12 6 4 18 22 57 57 463 109 97 206 59 84 143 11 29 24 10 40 114 Sum of the Four Quarters 930 924 215 213 208 185 423 398 111 109 152 153 263 262 36 23 41 60 36 44 50 51 81 86 244 264 1854 428 393 821 220 305 525 59 101 80 101 167 508 Annual Average of the Utst Ten years 1312 1267 302 286 266 263 568 549 143 143 193 184 336 327 77 80 63 59 80 79 77 71 111 102 408 391 2579 588 529 1117 286 377 663 157 122 159 148 213 799 No. IV.—Annual Enumeration of Deaths for the Year ending September, 1871. Deaths iv the Four Quarters. Total. East London Union. West London Union. City of London Union. Baint Botolph. Cripplegate. Workhouse. Saint Scplhre. Saint £ride. Workhouse. C'as le Baynurcl ChristChurch. Queenhithe. Allhalls., Harking. Broad Street. Workhouse. 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 Dcc. 1870 198 213 33 42 27 32 8 9 10 17 26 40 11 8 9 6 10 10 12 12 22 9 16 12 14 16 411 7 59 17 27 66 19 15 20 24 31 28 30 Quarter ending March 1871 289 254 46 41 64 43 12 11 19 24 23 35 13 13 7 13 9 12 22 13 23 15 24 11 27 23 543 87 107 23 43 58 26 20 21 35 38 35 50 Quarter ending June 1871 233 174 43 27 50 23 7 11 16 12 21 24 6 4 7 7 11 12 9 7 15 14 23 18 24 16 407 70 73 18 28 45 10 14 23 16 29 41 40 Quarter ending Sept. 1871 219 182 45 42 43 34 4 6 25 15 27 21 10 8 8 5 1 3 12 12 8 11 16 13 20 12 401 87 77 10 40 48 18 13 4 24 19 29 32 Sum of the Four Quarters 939 823 167 152 184 132 31 37 70 t8 97 120 40 33 31 31 31 37 55 44 68 49 79 54 85 67 1762 319 316 68 138 217 73 62 68 99 117 133 152 Annual Averago of the last Ten years 1296 1206 215 223 213 206 60 60 119 . 102 172 155 74 53 64 60 61 51 74 65 82 61 90 90 72 80 2502 438 419 120 221 327 127 124 112 139 143 180 152 No. A .— Classification of Deaths in the City Unions according to Age, for the Year ending September, 1871, 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, 71 703 131 261 25 10 12 49 55 62 60 78 90 Average of Ten Years 977 201 408 42 14 18 54 67 82 85 100 107 West London Union, 71 428 88 164 18 4 8 22 32 38 31 50 61 Average of Ten Years 675 127 256 25 11 15 41 57 61 69 68 72 City ofLondonUnion, 71 631 57 132 16 15 15 43 58 67 76 92 117 Average of Ten Years 850 123 250 32 16 21 51 58 82 91 116 133 Entire City, 71 1,762 276 557 59 29 35 114 145 167 167 220 269 Average of Ten Years 2,502 451 914 99 41 54 146 182 225 245 284 312 No. VI.— Classification of Deaths according to Causes, during the Year 1871; and a Comparison with the Averages of the last Ten Years. City Districts and Population in 1801. Violence, privation, Pi cimture Birth, and Poison Tubercular Diseases Convulsions and Teething. Zymotic Diseases. Pneumonia, Bronchitis, und Asthma Others, chiefly chronic. Total. Phthisis. Tabes and Scrofula. Hydrocepha lus. Alvine Flux. Continue d Fever. Scarlet Fever. Small Pox. Measles. Whooping Cough, Cioup, & Diphtheria. Erysipelas. Adults. Children. East London Unton (Population 27,883) 1 1871 38 66 22 16 45 4 28 16 19 59 9 20 4 128 229 703 Average 45 127 67 22 59 13 33 42 43 6 30 59 7 154 270 977 West LondonUnion (Population 18,815) 1871 37 46 27 11 27 2 14 10 17 16 4 13 4 85 115 428 Average 46 90 46 13 36 6 16 24 22 5 21 32 4 114 200 675 City of London Union (Population 29,906) 1871 49 97 9 6 24 o o 10 7 25 13 6 25 6 111 240 631 Average 58 109 40 11 45 10 15 32 29 5 18 39 4 137 298 850 Entibe City (Population 76,60-1) 1871 124 209 58 33 96 9 52 33 61 88 19 58 14 324 584 1762 Average 149 326 153 46 140 29 64 98 94 16 69 130 15 405 768 2502 No. VII.—Classification of Deaths according to causes, during the four quarters of the Year 1871; and a Comparison with the Averages of the last Ten Years. Quartebs Ending. Violence, Privation, Premature Birth, and Poison. Tubercular Diseases. Convulsions and Teething. Zymotic Diseases. Pneumonia, Bronch'tis, and As him. Others, chiefly chronic. Total. Phthisis. Tabes and Sciofula. Hydrocephalus. Alvine Elux. Conti lied Fev. r. Scarlct Fever. Small-Pox. Measles. Whor ping Cough, roup, & Diphtheria. Erysipelas. Adults. Children. December, 1870 43 48 15 3 24 2 3 11 33 9 4 12 4 74 126 411 Average of Ten Years 37 81 3S 9 34 8 8 27 35 2 16 28 .4 108 186 621 March, 1871 30 59 16 8 24 2 2 6 15 48 1 23 o O 149 157 543 Average of Ten Years 41 86 34 13 37 2 3 26 18 5 16 38 3 152 231 705 June, 1871 31 50 9 9 21 0 4 7 5 26 5 16 5 69 150 407 Average of Ten Years 34 81 34 15 38 2 7 23 10 6 22 40 3 100 173 597 September, 1871 20 52 18 13 27 5 43 9 8 5 9 7 2 32 151 401 Average of Ten Years 37 73 43 10 32 17 46 22 25 3 15 25 4 52 175 579 Entire Year 124 209 58 33 96 9 52 33 61 8S 19 58 14 324 584 1,762 Average of Ten Years 149 324 149 47 141 29 64 9S 94 16 69 131 14 412 765 2,502 No. VIII.—Meteorology of the City of London for each Month in the Year ending in September, 1871 ,from Observations at the Engineer.s Office, Guildhall, under the direction of Mr. Haywood. 1870.71. MONTHS. Barometer. Dry Thermometer. Wet Thermometer or Hygrometer. Rain Gauges. Mean Pressure. Highest Pressure. Lowest Pressure. Menn Temperature. Highest Temperature. Lowest Temperature. Mean Daily Range. Mean Temperature. Dow Point. Degree of Humidity. Weight of vapour in cubic foot of air. Vapour required to saturate foot of air. Total Pall. Greatest Fall. LowestFall. Dry Bulb. Wet Bulb. On Grnd. 51 ft. above Grnd. On Grnd. 51 ft. above Grnd. On Grnd. 51 ft. above Grnd. Inches. Inches. Inches. Deg. Deg. Deg. Deg. Deg. Deg. Deg. Grns. Grns. Ins. Ins. Ins. Ins. Ins. Ins. October 29.715 30.532 28.924 51.8 67.5 40.0 12.5 51.8 49.2 45.0 72 3.4 1.0 3.62 3.59 0.83 0.83 0.02 0.02 November 29.722 30.536 29.128 44.6 56.0 31.5 8.9 44.6 42.1 38.5 78 2.7 0.7 1.56 1.54 0.66 0.65 0.01 0.01 December 29.830 30.636 29.150 37.5 58.0 20.0 9.2 37.5 35.7 33.0 83 2.2 0.5 2.80 2.73 0.53 0.52 0.10 0.10 J anuary 29.729 30.258 28.910 36.0 46.0 23.3 6.8 36.0 34.9 31.5 87 2.1 0.4 1.72 1.71 0.38 0.38 0.02 0.02 February 29.959 30.422 29.250 44.4 55.3 27.5 8.0 44.4 42.2 39.5 81 2.8 0.5 1.03 0 99 0.30 0.28 0.04 0.04 March 29.969 30.504 29.326 45.9 64.3 33.0 12.0 45.9 42.2 37.4 74 2.6 1.0 0.84 0.83 0.28 0.28 0.02 0.02 April 29.732 30.200 29.172 49.1 62.0 35.5 10.6 49.1 45.8 42.3 78 3.0 1.0 2.39 2.32 0.59 0..56 0.01 0.01 May 30.007 30.312 29.828 53.2 75.6 42.0 14.1 53.2 48.1 42.9 68 3.1 1.5 1.10 1.08 0.30 0.29 0.01 0.01 June 29.870 30.288 29.584 55.2 71.5 43.6 11.5 55.2 51.1 47.6 76 3.8 1.1 3.15 3.11 0.69 0.68 0.02 0.02 July 29.784 30.234 29.414 62.6 76.0 52.5 13.0 62.6 57.1 51.9 67 4.3 2.1 3.19 3.18 1.28 1.28 0.01 0.01 August 29.914 30.278 29.492 65.6 86.0 54.0 15.1 65.6 60.0 00.3 69 4.8 2.1 0.86 0.84 0.56 0.56 0.02 0.01 September 29.831 30.314 29.144 58.9 75.0 47.0 11.3 58.9 55.0 51.6 77 4.3 1.3 4.33 4.36 1.02 1.00 0.02 0.02 Barometer. The highest readings were on October 4. November 2, December 2, January 31, February 24, March 1, April 6, May 20, June 26, July 6, August 11, September 14. The lowest readings were on October 24, November 22, December 14, January 16, February 10, March.16, April 19, May 25, June 17, July 25, August 18, September 27. Temverature. The highest were on October 1, November 24, December 14, January 16, February 27, March 26, April 13, May 2o, June 16, July io, August 13, September 1. The lowest were on October 11, November 19, December 28, January 2, February 11, March 22, April 8, May 17, June 5, July 11, August 5, September 29. Rain The CTeatest fall on October 24, November 23, December 16, January 19, February 8, March 16, April 19, May 1, June 19, Julv 11, August 18, September 30. The least fall on October 18, November 15, December 13, January 7, February 10, March 8, April 28, Mav 3, June 30, July 15, August 21, September 7. W. HAYWOOD No. IX.—Account of the Sanitary Work performed in the City during the Year 1871, and comparison with the Averages of the last Four Years. 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 Bepairing Dustbins. For Paving Cellars and Yards. For Amending 'he Water Supply. For Rem-ving Cesspools. For Amending Sinks and Drams. For Removing Waste-Wafer. For Cleansing and Repairing Privies. For Improving the Ventilation. For Abating Fmoke. For Removing Animals Improperly Kept. Sundry other Sanitary Orders. December, 1870 5,222 258 421 204 1 12 14 0 60 22 93 0 2 2 29 42S 14 Average 5,031 564 S40 393 21 32 81 4 94 15 108 0 4 2 so 476 22 March, 1871 5,907 451 706 313 5 15 69 0 70 19 178 0 1 0 36 429 11 Average 6,337 S37 1,202 645 23 63 99 0 117 24 197 1 1 8 50 520 19 June, 1871 2,926 315 370 200 1 6 14 2 64 17 56 0 4 0 7 478 2 Average 5,855 1,170 1,955 1,335 21 32 93 0 85 19 284 4 7 5 45 523 12 September, 1871 6,325 482 666 328 6 21 40 3 99 34 101 0 5 4 24 461 3 Average 5,873 672 1,017 605 15 33 49 5 103 21 144 1 9 3 33 530 9 Entire Year 20,380 1,506 2,163 1,045 13 54 137 5 293 92 428 0 12 6 96 1,796 30 Average 23,096 3,243 5,014 2,978 80 160 322 19 399 79 733 6 21 18 208 2,049 62 Total number of Houses inspected in 1871 20,380. Average „ ,, ,, 10 years 15,320. Eequiring Amendment 1,506. „ „ 2,897 No. X.— Quarterly Account of the Meat Condemned in the City Markets during the Year 1871, and comparison with the Averages of the last Ten Years. Quarter Ending. WHERE CONDEMNED ASD WHY CONDEMNED. New 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 1870 3306 20215 4845 28366 207 1244 95 1546 60 60 — 120 3573 21519 4940 30032 Average of 10 Quarters 6767 20111 8585 35463 582 1584 260 2426 465 3182 2138 5785 7814 24877 10983 43674 March 1871 1953 17994 1292 21239 324 2802 480 3606 - - - - 2277 20796 1772 24845 Average of 10 Quarters 4472 25231 4136 33839 538 1770 171 2479 877 3286 2456 6619 5887 30287 6763 42937 June 1871 3898 21258 9507 34663 170 1140 - 1310 - - 10 10 1068 22398 9517 35983 Average of 10 Quarters 6241 19969 14330 40540 686 1796 273 2755 649 4241 3016 7906 7576 26006 17619 51201 September 1871 4035 11969 24484 40488 365 401 274 1010 - - - - 4400 12370 24758 41528 Average of 10 Quarters 3050 20030 36151 59231 799 3034 1093 4926 869 1872 7696 10437 4718 24936 44940 74594 Entire Year 13192 71436 40128 194756 1066 5587 849 7502 60 60 10 130 14318 77083 40987 132388 Average of 10 Years 20530 85341 63202 169073 2605 8184 1797 12586 2860 12581 15306 30747 25995 106106 80305 21240 It consisted of 576 Sheep and Lambs, 159 Calves, 357 Piars, 698 Quarters of Beef, 2,180 Joints of Meat; besides 1,863 Plucks 562 Kidneys, 36 Tongues, and 17 Barrels of Sheeps Tongues, 29 Livers, 23 Hearts, 50 Hams, 5 Sides and 20 Pieces of Bacon, 33 lbs. of Sausages, 2 Deer, 3 Fawns, 7 Quarters of Yenison, 12 Hares, 418 Babbits, 1 Box and 2 Cases of Babbits, and 475 head of Game and Poultry. No. XI. Quarterly Account of the Fish Condemned by the Fish-Meters in Billingsgate and Columbia Markets, during the Year 1871. Quarter ending Dec. 1S/0 Quarter ending JIar. 1871 Quarter ending June 1871 Quarter ending Sept. 1871 Entire Year Dabs 130 278 1,153 28,850 30,108 Plaice 13,273 8,975 6,323 87,834 116,405 Whiting 6,140 1,670 580 71,290 79,680 Gurnets 400 480 1,260 200 2,340 Haddocks 9,634 10,011 3,496 84,993 108,134 Herrings 92,658 47,120 119,901 288,460 548,139 Thornbcks 1,311 984 154 2,232 4,681 Smaelts 143,600 52,600 48,000 1,800 246,000 Cod 104 624 418 10,978 12,124 Soles 1,286 709 640 4,711 7,346 Various Fish 3,975 815 900 24,588 30,278 Lobsters and Crabs 744 35 473 5,498 6,750 Total 273,255 124,301 183,295 611,434 1,192,285 Sprats (bushels) 60 9 .. .. 77 Oysters „ .. 2 3 .. 5 Periwinkles „ 23 26 314 91 454 Shrimps (gallons) 3,584 316 7,016 4,803 16,719 Whelks (bushels) 20 13 94 207 334 Mussels „ 30 6 16 104 156 The total weight of the condemned fish amounted to 343 tons, 7 cwt., and 1 qr., and of this 325 tons, 5 cwt., and 2 qrs., were condemned in Billingsgate Market, and 18 tons, 1 cwt, and 3 qrs., in Columbia Market. No. XII.—List of Slaughter-Houses in the City of London, 1871. East District. West District. No. 44, Aldgate High Street No. 70, Fetter Lane 45 „ „ 117, Fore Street 46 „ „ 82, Aldersgate Street 48 „ „ Paved Passage 51 „ „ No. 4, Hosier Lane 52 „ „ 4, Warwick Lane 53 „ „ 6, j? j. 55 „ „ 10, 56 „ „ 6, Newgate Market 57 „ „ 25 „ „ 58 „ „ 26 „ „ 59 „ „ 27 „ „ 60 „ „ 28 „ „ 62 „ „ 66 „ „ 67 „ „ 68 „ „ 68 „ „ 68 „ „ 68 „ „ 69 „ „ 70 „ „ 73 „ „ 74 „ „ 75 „ „ Harrow AlleyNo. 53, Minories 154, Bishopsgate Street 123, Gun Yard, Norton Folgate East District 30 West „ 13 Total 43 No. XIII.—List of Cow-IIouscs in the City of London, and Number of Cows kept. 1871. East District. West District Name of Owners. Situation. No. of Cows. Name of Owners. Situation. No. of Cows. W. Andrews . . Garden Court 9 W. Reeder Whitefriars Street 2 Smith „ „ 5 W. Phillips New Street Hill 2 T. Davies St. James' Place 4 Rowland Bartholomew Close 7 J. Roberts Half Moon Mews 6 W. Goodman Bridgewater Square 11 M. Evans Widegate Street 13 H. Elmes „ „ 6 M. Halfhead Catherine Wheel Alley 2 No. of Cow-houses 6 No. of Cows 39 No. of Cow-houses 5 No. of Cowa 28 Total Cow-houses 11 Total No. of Cows 67 No. XIV. CITY OF LONDON. Duties of the Keeper of the Mortuary Boom and Disinfecting Chambers in Golden Lane. Prepared by the Medical Officer of Health, by direction of the Sanitary Committee. 1. The keeper of the Mortuary Room and Disinfecting Chambers shall act under the direction of the Sanitary Committee, through the Medical Officer of Health and the Inspector of Nuisances ; and he shall also attend to the instructions of the principal Clerk in matters relating to the duties of his office. 2. He shall reside in the apartments provided for him by the mission, and shall not absent himself from the premises unless required to attend the Meeting of the Commission or Sanitary Committee at Guildhall; or without leave from the Sanitary Committee. 3. He shall receive and take charge of all the dead bodies sent to the Mortuary by order of the Justice, or by direction of the Medical Officer of Health, and he shall keep them in proper and decent custody until they are removed from the Mortuary. (Sanitary Act, 1866, Sect. 27. City Sewers' Act, 1848, Sect. 8'J, 90 ) 4. He shall enter in a book, kept for the purpose, all particulars concerning each of the dead bodies sent to the Mortuary, and received therein; stating when it was received; the name and address of the person from whom it was received ; in what manner it was brought to the Mortuary ; the name sex, and age of the deceased, and the cause of death; the number of the house and the name of the street from which dead body was removed; by whose order it was removed and the date of the order; the time specified in the order for the burial of the body; the date of its removal from the Mortuary; the manner of its removal; and the name and address of the person removing it. 5. He shall receive and take charge of all articles sent to the placo by the Sanitary Officers of the Commission, for disinfection or for destruction; and ho shall disinfect or destroy tlio same, as the case may be, in the manner directed by the Medical Officer of Health, from whom he will receive from time to time specific instructions for the purpose. G. He shall enter in a book kept for the purpose, an account of all the articles received at the place for disinfection or destruction, stating in each case when the articles were received, from whom they were received, by whose order they were sent to the place, and why they are to be disinfected, the description of each article, the name and address of the person to whom they belong, in what manner they were disinfected when they were sent away, and to whom they were delivered. 7. lie shall keep all the Buildings, Mortuary Chamber, and fecting apparatus in a cleanly state, and in good working order. 8. lie shall attend at the Sewers' Office, Guildhall, every Tuesday morning, at half-past 11 o'clock, and shall deliver to the Sanitary Clerk a tabulated return of the work done during the week, and of the condition of the Mortuary Chamber and disinfecting apparatus, and he shall bring with him the books above referred to, and he shall remain, if required, during the sitting of the Commission or the Sanitary Committee. 9. He shall not engage himself directly or indirectly, or be in any manner concerned, with any occupation whatever that does not strictly belong to the duties of his office, as set down in these B.ules, but shall give the whole of his time and attention to ihe Sanitary Work herein specified, unless he receive permission from the Sanitary Committee. Approved and Adopted by the Commissioners of Sewers, March 7, 1871. JOSEPH DAW, Principal Clerk. Skweus' Office, Guildhall. Match 8, 1871. No. XV. CITY OF LONDON SEWERS. Mortuary Chamber, Golden Last. General Notice. In accordance with the provisions of the "Sanitary Act, 1868," and the " City of London Act, 1848," it is desirable that the Mortuary Chamber in Golden-lane should be used by the poor and others of the City of London as a depository for their dead, whenever the retention of such dead body in a room or house, occupied by the living, is likely to endanger the health of the inmates thereof. To this end the Commissioners of Sewers, who are the sanitary authority for the City of London, hereby give notice that the said Mortuary Chamber can at all times be used in the manner specified in the 27th Section of the Sanitary Act, 1866, that is upon the transmission of a certificate to the Sanitary Clerk, at the Sewers' Office, Guildhall, by a legally qualified medical practitioner, stating that the retention of a dead body, in a room in which persons live and sleep, is likely to endanger the health of the inmates thereof,* on receipt of which the Sanitary Clerk will immediately take the necessary measures for the speedy removal of the dead body to the Mortuary Chamber. The following is the clause of the Act above referred to:— 27th Section of the "Sanitary Act, 1866." "Any nuisance authority may provide a proper place for the reception of dead bodies, and where any such place has been provided and any dead body of one who has died of any infectious disease is retained in a room in which persons live or sleep, or any dead body which is in such a state as to endanger the health of the inma'es of the same house or room, is retained in such house or room, any justice may, on a certificate signed by a legally qualified medical practitioner, order the body to be removed to such proper place of reception at the cost of the nuisance authority, and direct the same to be buried within a time to be limited in such order, and unless the friends or relations of the deceased undertake to bury the body within the time so limited, and do bury the same, it shall be duty of the Relieving Officer to bury such a body at the expense of the poor rate, but any expense so incurred may be recovered by the Relieving Officer in a summary manner, from any person legally liable to pay the expenses of such burial." * Forms of Certifiates may be obtained at the Sewers' Office, Guildhall. Furthermore, as the Commissioners of Sewers are desirous that the poor themselves should use the said Mortuary, in accordance with the provisions of the 89th Section of the " City of London Sewers' Act, 1848," as a fit and proper place in which their dead may remain, until removed for interment, they also give notice that permission will be granted under proper rules and restrictions, to deposit the bodies of their dead, at the City Mortuary Chamber in Golden-lane, previously to interment; and for this purpose, application through the undertaker, should be made to the Sanitary Clerk at the Sewers' Office, Guildhall, where all information on the subject may be obtained. The clause of the Act last referred to is as follows :— 89//i Section of the " City of London Sewers Act, 1848." "And whereas the poor at all times have great difficulty in obtaining and frequently are utterly unable to obtain a fit and proper place, in which their dead may remain until removed for interment; but are compelled to let the corpse remain in the room which the living occupy, whereby great mortality is often occasioned, especially in cases of contagious and infectious disorders. Be it enacted that it shall be lawful for the Commissioners, from time to time, if they Shall I think fit so to do, to provide fit and proper places, in which the poor under proper rules and restrictions, may be permitt d to deposit the bodies of their dead previously to interment, and to cause the bodies so deposited therein to be decently taken care of, so long as the Commissioners shall allow the same to remain." Rules and Restrictions for depositing the Bodies of the Poor In the Mortuary Chamber in Golden Lane, according to the Provisions of the 89th Section of the "City of London Sewers' Act, 1848":— 1st.—Application for permission to deposit a dead body in the Mortuary Chamber, must at all times be made to the Sanitary Clerk, by the undertaker employed in the case. 2nd.—The said undertaker shall fill up a form, stating, that the dead body shall be enclosed in a proper coffin, and that it shall be conveyed to the Mortuary Chamber, and also removed therefrom in a hearse, or otherwise in a decent and proper manner, and he shall undertake to remove the dead body for interment, within the time prescribed in the order. 3rd.—That in case the undertaker fails to remove the dead body, within the time specified in the order, notice he given to the Relieving Officer of the Parish, to bury such body at the expense of the Poor Pate. 4th.—That the Sanitary Clerk be empowered to issue an Order to the Keeper of the Mortuary Chamber, to receive such dead bodies in accordance with the provisions of the Sewers' Act, 1848. No. XVI. MEDICAL CERTIFICATE. Sanitary Act, 1866, 29 & 30 Vict. Cap. 90. CITY OF LONDON. I hereby certify that the dead body of who died on the aged years, being the corpse of one who has died of an infectious disease, namely— is retained in a room in the house situate at No. in the City of London, in which room persons live or sleep; and is in such a state as to endanger the health of the inmates of the said house or room. (Name) (Address) [Legally qualified Medical Practitioner.] To [One of the Justices of the Peace for the said City.] Dated this day of 187 [This certificate when signed by the Medical Practitioner is to be Bent as addressed on the outside.] Extract from the Ad of Parliament above mentioned. S. 27.—Any nuisance authority may provide a proper place for the Reception of dead bodies, and where any such place has been provided, and any dead body of one who has died of any infectious disease is retained in a room in which poisons live or sleep, or any dead body which is in such a state as to endanger the health of the inmates of the same house or room, is retained in such house or room, any justice may, on a certificate signed by a legally qualified medical practitioner, order the body to be removed to such proper place of reception, at the cost of the nuisance authority, and direct the same to be buried within, a time to be limited in such order; and unless the friends or relations of the deceased undertake to bury the body within the time so limited, and do bury the same, it shall be the duty of the Relieving Officer to bury such body at the expense of the Poor Rates, but any expense so incurred may be recovered by the Relieving Officer in a summary manner from any person legally liable to pay the expenses of such burial. No. XVII. JUSTICES' ORDER. Sanitary Act, 1860, 29 & 30 Vict. cat. 90. CITY OF LONDON. London I, the undersigned, to Wit. being one of Her Majesty's Justices of the Peace in and for the said City and the Liberties thereof, having before me a certificate signed by , a legally qualified medical practitioner, and dated the day of ,187 , do hereby, pursuant to "The Sanitary Act, 1866," Section 27, order that the body of who died on the day of of a certain infectious disease, called and which body is now in the house, No. , in the said City, and is in such a state as to endanger the health of the inmates of the same house, shall be forthwith removed to the Mortuary Building in Golden-lane, being the proper place provided for the reception of dead bodies in and for the said City, by the Nuisance Authority thereof, and I do direct that the said dead body be buried within 24 hours after such removal. Given under my hand this day of ,187 , at the in the said City. To The Commissioners of Sewers, Being the Nuisance. Authority for the City of London, Guildhall. No. XVIII. Sanitary Act, 1860.—29 & 30 Victoria, cap. 90. PROCEEDINGS FOR THE REMOVAL OF A DEAD BODY TO THE MORTUARY. 1. Only to be clone. 1. On receipt of certificate by the Sanitary Clerk of the missioners of Sewers, who are the Nuisance Authority for the City, signed by a duly qualified medical man, with particulars duly written therein. 2. "Which certificate is to be at once taken by the Sanitary Clerk to the Mansion House, or the Justice Room, Guildhall, after being by him duly filled up with the particulars, and there to obtain the signature of the Lord Mayor or Alderman thereto. 2. The certificate and order are to be retained by the Sanitary Clerk, who is, immediately on receipt of the Justice's Order for removal, to send an order to the Contractor to remove the body from the house in which it is retained to the Mortuary. 3. The Keeper of the Mortuary is to give a receipt for such body to the Contractor. 4. On receipt of such body the Keeper of the Mortuary is to act in manner described in the rules already given to him, and to enter all particulars in the book provided for such purpose. 5. A printed notice is to be sent by the Sanitary Clerk to the Relieving Officer to bury the body at the expense of the Poor Rate within the time limited by the Justice's Order, unless the friends or relations of the deceased undertake to bury the body within the time so limited. JOSEPH DAW, Principal Clerk. Sewers' Office, Guildhall, May 23rd, 1871. No. XIX. NON-CONTAGIOUS CASES. City Sewers' Office, Guildhall. THE CITY OF LONDON SEWERS' ACT. 1848.—Section 89. To the Sanitary Clerk of the Commissioners of Sewers of the City of London. I undertaker, residing at apply on behalf of the friends and relatives of who died on the , lately residing at to have the dead body removed to the Mortuary, in Golden-lane and I undertake that the same shall be enclosed in a proper coffin:— which I will remove in a decent hearse and inter the same within the time prescribed in the Order, namely:—within days from the date hereof, and in accordance with the rules and restrictions specified by the Commissioners. (Signed) Dated 187