HAC 38 REPORT ON THE SANITARY STATE of the HACKNEY DISTRICT, FOR THE QUARTER ENDING July 3rd, 1858, BY JOHN W. TRIPE, M.D. Medical Officer of Health to the District. Member of the Council of the Meteorological Society, &c. Printed by Order of the Board. BY charles potter, 16, warwick place, kingsland. 1858. REPORT To the Bond of Works for the Hackney District. Gentlemkn, The sanitary state of your District during the second quarter of this year has been good, for although the deaths, even after allowing for increase of population, have been somewhat in excess as compared with those which were registered during the corresponding quarter cf last year, yet the new cases of sickness attended by the Parochial Medical Officers and at the German Hospital, which afford very valuable evidence of the sanitary condition of the district, have been very much below the average number. There have been registered five cases of Diptheria. and an excess of deaths in new.born children from premature birth, debility, and atrophy. There has also been an unusual mortality of children, of all ages, from measles, and of those 1 year old from hcoping.cough, and a slight increase from diarhœa, but considering the extraordinarily hot weather, which so increased the mortality of the whole of London, the mortality from diarrhoea, was less than might have been expected. 4 The localities in which I have made sanitary inspections during the quarter having been reported in my weekly minutes, need not be again enumerated, especially as there was but one point of general importance, viz : the question as to whether or not you would allow dust.contractors and others to deposit refuse in pits from which gravel had been dug. I think your decision to prosecute parties who shall bring refuse into the district, or allow deposits on their ground will be attended with good results ; and I feel assured that it cannot be too widely known that individuals will not be allowed to deal with their property in such a manner, as to cause injury to the public health. For although individual liberty has long been the boast of England, yet there is a point beyond which it cannot be tolerated with safety; and private good should always be made to give way to the public welfare. Indeed, the working of the Metropolis Local Management Act may often be characterised as a war of the community against individuals for the common good. A return which has just been made to the House of Commons in accordance with a resolution of the House, will place this in a striking light. The return embraced the following particulars— "1.—The number of houses in respect of which your Medical Officer of "Health has recommended the issue of orders for sanitary improve. "ment since January 1st. 1856. "2.—The number of houses in respect of which orders for sanitary im. "provements have been issued since January 1st. 1856. by the "Board of Works for Hackney District. " 3.—The number of houses in which the sanitary improvements thus "ordered have been afterwards certified by the Officer of the Hack. "ney Board to have been satisfactorily executed. "4. The number of other nuisances injurious to health similarly certified to have been remedied." 5 The number of nuisances abated or in progress, to June 30th, 1858, is as follows:— Houses drained into the Sewer 814 Cesspools emptied 846 Houses cleaned and repaired 356 Drains „ „ 544 Other Nuisances abated 1453 Works in progress 79 Total 4092 The large number of nuisances abated speaks well for the energy and perseverance of Mr. Valentine, the Inspector of Nuisances, especially when we find that only 30 persons have been summonsed to the Police Courts, and 2 prosecuted at common law. The plan, however, which has been adopted at this Board on my recommendation, of requiring persons to attend here previously to proceedings being taken in the Police Courts, has strengthened our hands considerably, for no less than 165 persons have been summonsed here during two years, of whom 141 have done the works required. This plan has therefore saved a great amount of trouble to the officers and of expense to the district. In all these cases, as well as in a very large number of others, I made personal inspection of the premises complained of, to ascertain in wnat degree they were injurious to health and the urgency or otherwise of the works requisite for abatement of the nuisances. In connection with nuisances, I may mention the conviction which has been obtained against Mr. Robins, of Homerton, for carry ing on a manufactory of Japanned cloth in. such a manner as to prove a nuisance to the neighbourhood. He pleaded guilty to the indictment on the day fixed for trial, and agreed to move from the manufactory at Christmas next ensuing. The births registered during the thirteen weeks have been 580 in number, and the deaths 346, so that the excess of births over deaths was 233, or at the rate of 167 births to each 100 deaths, whilst the numbers for the whole metropolis were 107,193 deaths to 169,170 births or at the rate of 158 births to each 100 deaths. This comparison affords 6 a satisfactory proof of the good state of the public health in Hackney district, The number of deaths in Hackney District during this quarter was 347 against 318 in the corresponding quarter of last year, and the number in the whole Metropolis was 107,193, against 100,205 during the second quarter of last year, or after allowing for the different rate of increase, of 107 deaths in Hackney District and in the Metropolis against each 100 during the corresponding quarter of 1857, It is therefore evident that London was not so healthy this year as last, and that Hackney shared pro rata in the increased mortality. The extreme alternations of temperature experienced during the quarter of this, as compared with those of the preceeding year account for this increase. Of the total births 31 were registered in Stamford Hill sub.district 48 in Stoke Newington; 217 in Hackney; 103 in South Hackney; and 181 in West Hackney. Of the total deaths 32 were registered in Stamford Hill; 22 in Stoke Newington; 163 in Hackney; 48 in South Hackney, and 92 in West Hackney sub.districts. Of the 347 deaths from all causes, 77 were registered as having been produced by zymotic diseases; 19 by dropsy, cancer, and other maladies having an uncertain seat; 53 from tubercular diseases; 32 from affections of the brain and spinal cord; 11 from diseases of the heart and great vessels; 53 from affections of the lungs; 25 from diseases of the stomach, liver, &c.; 6 from kidney affections; 14 from premature birth ; 33 from old age; and 8 from suicide or other violence. The number who died at different ages were as follows : 83 died during the first year of life, 14 of whom as above stated, were registered as caused by premature birth. The others were 86 between 1 year and 20 years of age; 42 who were above 20 but under 40; 46 above 40 and under 60; 68 above 60 and under 80, and 22 who were above 80 years of age. The meteorology of the quarter has been very unusual, the temperature having varied enormously, the highest thermometer reading having 7 been 93.4°, the lowest 28.2o. affording a range of 65.2. The mean temperature of the quarter was 55.1° and of the dew point was 45.3°, the mean humidity only 70.2° (saturation being 100) so that although the usual amount of rain fell, viz., 6.08 (or perhaps a little below the mean) yet the air was unusually dry in each month. The month of April was about an average temperature, May was about 1 degree below the average, and June was nearly 6 degrees above it. The quantity of ozone registered was about one fifth less than during the corresponding period of 1857. The day on which the greatest heat occurred was the 16th. of June, when it reached 93.4° at Hackney, 94.5° at Greenwich, 97.6° in the Commercial Road, 94.8 at St, Thomas's Hospital, 94.9 at St. Mary's Hospital, Paddington, and 92.0 at Hammersmith. I remain, Gentlemen, Your obedient Servant, JOHN W. TRIPE. Aug, 21. 1858. 8 TABLE I. Deaths registered in the District of Hackney during the Thirteen Weeks ending July 3, 1858. Causes of Death. . Ages. Total Under 1* 0 and under 20. 20 and under 40. 40 and under 60 60 and under 80. 80 and above . I. Zymotic : Small.pox ... ... ... ... ... ... ... Measles 5 18 ... ... ... ... 18 Scarlatina ... 6 ... ... ... ... 6 Hooping Cough 12 19 ... ... ... ... 19 Croup ... ... ... ... ... ... ... Thrush ... ... ... ... ... ... ... Diarrhoea (Bowel Complaint) 4 6 ... ... ... ... 7 Dysentery ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... Influenza ... ... ... ... ... ... ... Scurvy and Purpura ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... Remittent Fever ... ... ... ... ... ... ... Infantile Fever 4 4 ... ... ... ... 4 Typhus Fever 1 5 3 ... ... ... 14 Puerperal Fever (Metria) ... ... 1 ... ... ... 1 Rheumatic Fever ... ... ... ... ... ... ... Erysipelas (Rose) 1 1 ... ... ... ... 1 Syphilis 2 2 ... ... ... ... 2 Noma (Canker) ... ... ... ... ... ... ... Diptheria ... 5 ... ... ... ... 5 77 II. Dropsy, &c. Haemorrhage 1 1 ... ... ... ... 1 Dropsy ... •• 1 4 4 ... 9 Abscess ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... Fistula ... ... ... ... 1 ... 1 Mortification ... ... ... ... 1 ... I Cancer ... ... ... 5 2 ... 7 Gout ... ... ... ... ... ... 19 III. Tubercular Diseases : Scrofula ... ... ... 1 ... ... 1 Tabes Mesenterica 4 5 ... ... ... ... 5 Phthisis (Consumption) ... 11 20 5 ... ... 36 Hydrocephalus (Water on Brain) 2 11 ... ... ... ... 11=53 IV. Brain and Nerve. Meningitis 1 4 ... 1 ... ... 5 Cerebritis 1 1 ... ... ... ... 1 Apoplexy ... ... 1 3 2 ... 6 Palsy (Paralysis) ... ... ... 2 5 1 8 Delirium Tremens ... ... ... ... 1 ... 1 Epilepsy ... ... ... ... ... ... Tetanus ... ... ... ... ... ... ... Insanity ... ... 1 ... ... ... 1 Convulsions 5 7 ... ... ... ... 7 Disease of Brain, &c ... 2 ... ... ... ... 3 „ Spinal Cord ... ... ... ... 1 ... ..=32 Carried forward 53 108 27 23 21 2 181 * These deaths in the first column are incorporated with those in the second. 9 TABLE I.—Continued. Causes of Death. Ages. Total. Under 1 0 and under 20 20 and under 40 40 and mder CO 60 and | under 80 80 and above Brought forward 53 108 27 23 21 2 181 V Heart and Blood Vessels : Pericarditis ... ... ... 1 ... ... 1 Endocarditis ... ... ... ... ... Aneurism ... ... ... ... ... ... ... Disease of Heart, &c. ... 1 2 4 1 2 10=11 VI. Lungs and Organs of Inspiration : Larygismus Stridulus 1 1 ... ... ... ... 1 Laryngitis ... 5 ... ... ... ... 5 Bronchitis 5 10 ... 8 7 2 27 2 Pleurisy ... 1 ... ... 1 ... Pneumonia 2 10 2 1 3 ... 16 1 Asthma ... ... ... ... 1 ... Disease of Lungs ... 1 ... ... ... ... 1 53 VII. Stomach and Digestive Organs : Teething 1 4 ... ... ... ... 4 Quinsey ... ... ... ... ... ... ... Gastritis ... ... ... ... 2 ... 2 Enteritis ... 1 ... ... 1 ... ... Peritonitis ... 2 ... ... Ascites ... ... ... ... ... ... ... Ulceration of Intestines 1 1 ... ... 1 1 ... ... ... Hernia (Rupture) ... ... ... ... ... Intussusception ... ... ... 1 ... ... 1 Disease of Bowels ... ... ... ... ... ... ... Abdominal Tumour ... ... ... ... ... ... ... Stricture of Intestinal Canal 1 1 ... ... ... ... ... Disease of Stomach, &c. ... ... ... 2 ... ... 1 Disease of Pancreas ... ... ... ... ... ... 2 Inflammation of Liver (Hepatitis) ... ... 2 ... ... ... 2 Jaundice 1 1 ... ... ... 1 ... ... Disease of Liver ... 2 ... 1 ... ... Disease of Spleen ... ... ... ... ... ... =25 VIII. Kidney, &c.: Nephritis ... 1 ... ... ... ... 1 Nephria (Blight's Disease) ... ... ... 1 2 ... 3 Diabetes ... ... 1 ... ... ... 1 Stone ... ... ... ... 1 ... 1 Cystitis ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... Disease of Prostrate Gland ... ... ... ... ... ... ... Disease of Kidney ... ... ... ... ... ... ... IX. Childbirth: Childbirth (see Metria) ... ... 1 ... ... ... 1 Disease of Uterus, &c ... ... ... ... ... ... ... Ovarian Disease ... ... ... ... ... ... 1 Carried forward 65 118 37 41 44 7 277 10 TABLE I.—Continued. Causes of Death. Ages. Total. under 1 0 and junder 20 20 and : under 40 40 and under 60 60 and under 80 SO and above Brought forward 60 148 37 41 44 7 277 X. Joints Bones, &c. : 1 Chronic Rheumatism ... ... ... 1 ... ... 1 Disease of Joints ... ... ... ... ... ... ... Disease of Bones ... ... ... ... ... ... ... Disease of Spine ... ... ... ... ... ... ... XI. Skin, Cellular Tissus;, &c : Carbuncle and Boils ... ... ... ... ... ... ... Phlegmon ... ... ... ... ... ... ... Disease of Skin, &c. ... ... ... ... ... ... ... XII. Malformation : ... ... ... ... ... ... ... Spina Bifida Other Malformations ... ... ... ... ... ... ... XIII. Premature Birth and Debility 14 14 ... ... ... ... 14 XIV. Atrofy 3 3 ... ... ... ... 3 XV. Old Age and Decay ... ... ... ... 18 15 53 XVI. Sudden Deaths ... 2 1 2 5 ... 10 XVII. Violent Deaths ... ... ... ... ... ... ... Intemperance ... ... ... ... ... ... ... Privation of Food ... ... ... ... ... ... ... Want of Breast Milk ... ... ... ... ... ... ... Neglect ... ... ... ... ... ... ... Amputation of Leg ... ... ... ... ... ... ... Poisoned Wounds ... ... ... ... ... ... ... Burns and Sc.lds ... ... ... ... ... ... ... Hanging (Suicide) ... ... 1 ... ... ... 2 Suffocation ... ... ... ... ... ... ... Drowning (Suicide) 1 2 ... ... ... ... 3 Fracture and Contusions ... ... 2 ... ... ... 2 Wounds ... ... 1 ... ... ... 1 Other Violence ... ... ... ... ... ... ... XVIII. Not Specified ... ... ... ... ... ... ... Totals 83 169 42 46 68 22 347 Under 1 Under 20 20 and Under 40 40 and Under 60 60 and Under 80 80 and Above Total. TABLE II. Summary of Meteorological Observations taken daily during the undermentioned Weeks, at the Town Hall, Hackney, by Dr. Tripe. Deaths registeredfrom epidemi disease in the week which is' subsequent to the date given Deaths registered in the week which is subsequent to the date given. Excess or minus of temperature in each week, when compared with mean for 43 years. 1858 Week Ending Barometer. Temperature of the Air. Moisture Mean weight of a cubic foot of air. Rain Ozone Mean of Seven Observations corrected Absolute. Average Mean Dew.point Temperature Mean degree of Humidity saturations 100 Mean Weekly Amount. Mean Daily Amount. Highest Lowest Range Mean of seven daily Maximums. Mean of seven daily Mini mums. Mean of seven daily Ranges.' Adopt.. Mean Temperature April 10 0 29.796 0 56.8 0 34.2 0 22.6 o 48.9 o 37.2 o 11.7 o 41.6 o 36.1 o 83.6 0 550.9 Inches. 1.26 3.0 34 8 494.9 17 23 .971 73.0 28.2 44.8 57.3 39.1 18.2 46.6 38.5 74.2 548.5 0.20 2.4 31 6 -+ 4.9 24 30.187 74.2 35.6 38.6 07.4 40.7 26.7 52.6 43.3 70.5 545.5 0.00 1.6 27 2 + 5.8 May 1. 29.098 63.6 38.5 25.0 57.1 41.7 15.4 48.1 42.8 81.6 542.7 0.96 0.6 33 8 -1.5 8 29.920 63.0 34.6 28.4 58.2 38.1 20.1 46.0 37.0 71.8 548.3 0.26 1.0 98 6 -5.8 15 29.803 63.2 38.2 28.0 61.7 41.8 19.9 49.9 42.4 75.2 541.6 0.55 0.3 19 3 -1.9 22 29.940 09.8 44.6 25.2 65.0 47.6 17.4 54.7 43.9 66.5 537.3 0.24 0.4 24 6 + 1.6 29 30.012 74.2 43.6 30.0 64.8 47.8 17.0 53.7 45.0 72.3 540.9 1.33 0.4 29 4 -0.9 June 5 30.037 84.0 53.0 31.0 79.0 56.5 22.5 65.6 51.9 61.0 528.8 1.04 1.4 24 6 + 9.6 12 29.928 81.4 51.6 29.8 76.8 55.0 21.8 64.2 54.4 72.1 528.8 0.08 1.6 28 6 + 6.2 ,, 19 29.926 93 4 51.0 42.4 82.6 57.6 25.0 69.4 57.8 65.0 522.2 0.00 0.6 29 6 + 85 26 30.196 85.0 51.0 34.0 79.2 54.8 24.4 65.1 49.9 60.0 533.1 008 0.7 22 5 + 4.3 July 3 30 .053 774 48.6 28.8 70.6 51.9 18.7 59.1 45.3 59.4 637.9 0.08 2.0 27 10 -2.8 Means. 29.959 73.9 42.5 31 4 66 8 469 19'9 55*1 45 3 70.2 539 0 0.47 1.2 27 6 + 1.6; Note.—All the Meteorological Instruments have been compared and certified by Mr. Glaisher. All the Observations have been corrected for error, range, &c., and reduced by Glaishev Tables, last editions. HAC 38 REPOR T ON THE SANITARY STATE of the HACKNEY DISTRICT, FOR THE QUARTER ENDING OCT. 2nd, 1858, BY JOHN W. TRIPE, M.D. Medical Officer of Health to the District. Member oj the Council of the Meteorological Society, 4.C. Printed by Order of the Board. by CHARLES POTTER, 16, WARWICK PLACF, KINGSLAND. 1858. REPORT. To the Board of Works for the Hackney District. Gentlemen, In consequence of Typhoid Fever having occurred in several localities of your District, I am induced to lay before you some of the details connected with the different cases. The worst outbreak was that which appeared in the vicinity of the Tottenham Road, on the confines of this and of the Islington District. The first case appeared in the Middleton Road, in the house of a baker who was employed in Islington district, at a shop where there was a large cesspool which frequently smelt badly. Soon after his attack, and long before his death, a case occured in the baker.s house, then two in the adjoining Public house, in which were accumulations of stable manure which smelt very badly. All these cases proved fatal. At the house in Middleton Road three deaths happened, viz., that of the father, of the eldest daughter, and eldest son. The house in the Middleton Road was well drained, but, on carefully examining it, I found an untrapped sink. stone from which the Widow stated that a bad smell frequently came. The house itself was not clean, and was somewhat overcrowded, but not sufficiently so to admit of your interference. At all the other cases in the neighbourhood I found stinking privies, untrapped drains, and otherwise defective sewerage. I have also visited several localities in which the same kind of fever broke out ; and in all cases, except one, I found open privies, or untrapped drains, through which disgusting odours made their way into the house. The way in which fever occurred in one house here, and another there, was worthy of notice, being quite distinct from the course which typhus fever would have pursued. I would also remark, as a statement has appeared in the "Times" Newspaper, that this variety of Typhoid Fever is not contagious, that the mode in which it has spread in the district proves quite the contrary. In one case a child first showed symptoms of the disease, and as the 3 parents were told that the disease " was not catching," the mother put him into her own bed during the day, whilst she aired and made tha child.s. She did the same a day or two afterwards with her daughter.s bed. Before a week had expired the father presented symptoms of it ; next, a day or two afterwards, the daughter, aged 20, and both died. In the Middleton Road, four out of six inmates took the disease from the father, and three died. I might add other cases, but these will suffice to make persons careful how they expose themselves unnecessarily to infection. There have also been an increased number of deaths from Diptheria in this district, the disease having been, in some cases, extremely fatal ; three children in one family having died from it. This disease I believe to be slightly contagious, but not to a greater extent than Typhoid Fever. It is not a new disease, but has prevailed more extensively of late years than previously, and appears to arise in part from local causes, as the worst cases usually take place in localities near which there are accumulations of decomposing animal and vegetable matter. The worst cases in this district happened near the Brook, which will, I trust, speedily be filled in. I should advise any family in which the disease shows itself, to remove for a time into some other neighbourhood, as it is in its worst form very intractable to curative means. On comparing the mortality during this quarter with the corresponding one for last year we find that the total number of deaths have been 355 against 362, so that the general health of the inhabitants of this District has been better than usual. The total number of births have been 607 against 613 during the corresponding quarter last year. It is very remarkable that in both these respects the District returns agree with those for all London. Why there should not only have less deaths in London, but also less births I cannot conceive, (we find a similar coincidence to have happened in 1853,) unless it be in consequence of the marriages having fallen off during the latter half of 1857. This however was not the case as regards 1852. The excess of births over deaths was 254, or 2 more than in the corresponding quarter of 1857. The total excess of births over deaths during the three quarters of the present year has been no less than 692, so that the increase of population would be about 1} per cent, after allowing for that produced by the excess of immigration over emigration; which, during the 10 years 1841—51 was about 3 per cent annually. Of the 607 births, 220 were registered in Hackney sub.district; 209 in West Hackney; 28 only in Stamford Hill; 42 in Stoke Newington; and 108 in South Hackney Sub.Districts. Of the total deaths 157 were registered in Hackney; 102 in West Hackney; 21 in Stamford Hill; 17 only in Stoke Newington; and 56 in South Hackney Sub.Districts. The ages at death in periods of 20 years were as follows, 185 deaths happened in young persons under 20 years of age, and of these 106 occurred in children under 1 year old; Of the remainder, 52 took place, in persons more than 20 but below 40; 39 in persons aged more than 40 4 and less than 60 ; CO in persons who were above 60 but under 80, and 19 in those who were above 80 years of age. The causes of death were varied, but by far the largest mortality was caused by the Zymotic class, as no less than 107 were registered from this group of diseases. Of the others, diseases of uncertain seat, dropsy, haærmorrage, &c. caused a mortality of 13; Tubercular diseases, 62; Diseases of the brain and nerves, 42; Affections of the heart, 19; Of the lungs only 22; Of the digestive organs, 13; From child.birth only 2; From premature birth no less than 20; From old age, 20; Sudden death, 3 ; From want of breast milk, 3 ; From violent deaths, 12. There was not one death from small.pox ; 7 happened from measles ; 20 from scarlet fever; 10 from hooping.cough; 30 from diarrhoea, and 1 from Cholera which was of a severe kind, death having occurred in 30 hours from the attack. There were bad smelling drains and an open privy on the premises, and no other pre.disposing cause could be ascertained for the death, as the patient was a very regular and steady man. The number of nuisances removed by Mr. Valentine, the Inspector of Nuisances were as follows :— Cesspools emptied, filled up and drained into the sewer 592 Cesspools emptied 78 Horse, cow. pig and vegetable refuse removed 87 Foul and offensive drains cleansed or reconstructed 31 Other nuisances 35 Total 826 The meteorology of the Quarter was remarkable for the high temperature of September which was 4 degrees above the average of the last 87 years. It was the hottest September during the present century, ex. except in the years 1815 and 1818. The highest temperature recorded during the quarter was 88 0° and the lowest 416; so tha the extreme range was no less than 46.4°. The mean temperature was 611° or 0.1" above that of Greenwich. The mean humidity of Hackney wss 70.1, and of Greenwich 73.0. The amount of rain fall was less than the average. I remain, Gentlemen, Your obedient Servant, J. W. TRIPE. Nov. 18th. 1858. 5 TABLE I Deaths registered in the District of Hackney during the Thirteen Weeks ending October.nd, 1858. Causes of Death. Ages. Total Under 1 0 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above x. Zymotic Diseases : Small.pox ... ... ... ... ... ... ... Measles 2 7 ... ... ... ... ... Scarlatina 9 19 ... ... ... ... 7 Hooping Cough 4 10 1 ... ... ... 20 Croup ... ... ... ... ... ... ... Thrush 3 3 ... ... ... ... 0 Diarrhoea (Bowel Complaint) 20 26 1 ... 3 ... 3 Dysentery 1 2 I 2 ... ... 30 Cholera ... ... ... ... 1 ... 4 Influenza ... ... ... ... 1 ... 1 Scurvy and Purpura ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... Remittent Fever ... ... ... ... ... ... ... Infantile Fever ... ... ... ... ... ... ... Typhus Fever ... 6 3 1 3 ... ... Puerperal Fever (Metria) ... ... 1 2 ... ... 13 Rheumatic Fever ... ... 1 2 ... ... 3 Erysipelas (Rose) ... 1 ... ... ... ... ... Syphilis 1 ... ... ... 1 ... 3 Noma (Canker) ... ... ... ... ... ... ... Diptheria 2 10 2 ... 1 ... 13 = 107 II. Dropsy, &c. : Haemorrhage ... ... ... ... ... ... ... Dropsy ... 1 1 2 1 ... 5 A bscess ... ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... ... Mortification ... ... ... ... 1 ... ... Cancer ... ... ... 2 3 2 7 Gout ... ... ... ... ... ... =.13 III. Tubercular Diseases : Scrofula ... ... ... ... ... ... ... Tabes Mesenterica 8 11 ... ... ... ... 11 Phthisis (Consumption) ... 7 24 13 1 2 47 Hydrocephalus (Water on Brain) 3 4 4=62 IV. Brain and Nerves : Meningitis ... 1 ... ... 1 ... 2 Cerebritis ... ... ... ... ... ... ... Apoplexy ... ... 1 1 3 ... 5 Palsy (Paralysis) ... ... 1 2 7 ... 30 Delirium Tremens ... ... 2 1 1 ... 4 Epilepsy ... ... 1 ... ... ... 1 Tetanus ... ... ... ... ... ... ... Insanity ... ... 1 1 ... ... 2 Convulsions 7 8 ... ... ... ... 8 Disease of Brain, &c 3 4 ... 2 4 ... 10=42 » Spinal Cord ... ... ... ... ... ... ... Carried forward 63 120 , 39 29 31 5 224 6 TABLE !•—Continued. Causes of Death. Ages. Total. Under 1 0 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Broaght forward 63 120 39 29 31 5 224 Y Heart and Blood Vessels : Pericarditis ... ... ... ... ... ... ... ... Endocarditis ... ... ... ... ... ... Dneurism ... ... ... ... ... 1 1 Disease of Heart, &c ... 3 2 4 9 ... 18=19 VI. Lunss and Organs of spiration : Larygismus Stridulus ... 1 ... ... ... ... 1 Laryngitis ... 4 ... ... 1 ... 5 Bronchitis 3 6 ... 1 ... ... 7 Pleurisy ... ... ... ... ... ... ... Pneumonia 2 4 ... 1 1 ... 6 Asthma ... ... ... ... 2 ... 2 Disease of Lungs ... 1 ... ... ... ... 1=22 VII. Stomach and Digestive Organs: Teething ... ... ... ... ... ... ... Quinsey ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... Enteritis 1 3 2 ... ... ... 5 Peritonitis ... ... ... ... ... ... ... Ascites ... ... ... ... ... ... ... Ulceration of Intestines ... ... ... ... ... ... ... Hernia (Rupture) ... ... 1 1 ... ... 2 Intussusception ... ... ... ... ... ... ... Disease of Bowels ... ... ... ... ... ... ... Abdominal Tumour ... ... ... ... ... ... ... Stricture of Intestinal Canal ... ... ... ... ... ... ... Disease of Stomach, &c. ... ... ... ... ... ... ... Disease of Pancreas ... ... ... ... ... ... ... Inflammation of Liver(Hepatitis) ... ... 1 ... ... ... 1 Jaundice ... ... ... ... ... ... ... Disease of Liver ... 1 1 1 ... 1 ... 4 Disease of Spleen ... ... ... 1 ... 1=13 VIII. Kidney, &c.: Nephritis ... ... ... ... ... ... ... Nephria (Bright.s Disease) ... ... 3 ... 2 1 5 Diabetes ... ... ... ... ... 1 Stone ... ... ... ... 2 ... 2 Cystitis ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... Disease of Prostrate Gland Disease of Kidney ... ... ... ... ... ... ... ... =6 IX. Childbirth: Childbirth (see Metria) ... ... 1 1 ... ... 1 Disease of Uterus, &c. ... ... ... ... ... ... ... Ovarian Disease ... ... ... ... ... ... 1=2 Carried forward 69 143 49 39 50 7 288 7 TABLE I.—Continued. Causes of Death. Ages. Total. under 1 0 aod under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Brought forward 69 143 49 39 50 7 288 X. Joints Bones, &c. : Chronic Rheumatism ... ... .. ... ... ... ... Disease of Joints ... ... 1 ... ... ... 1 Disease of Bones ... ... ... ... ... ... ... Disease of Spine ... ... ... ... ... ... ... XI. Skin, Cellular Tissue, &c. : Carbuncle and Boils ... ... •• ... ... ... ... Phlegmon ... ... ... ... ... ... ... Disease of Skin, &c. ... ... ... ... ... ... ... XII. Malformation : Spina Bifida ... ... ... ... •• .. ... Other Malformations ... .. ... ... .. ... ... XIII. Premature Birth and Debility ... 20 20 ... ... ... ... 20 XIV. Atropy 6 6 ... ... ... ... 6 XV. Old Age and Decay ... ... ... ... 10 12 22 XVI. Sudden Deaths 3 3 ... ... ... ... 3 XVII. Violent Deaths Intemperance ... ... ... ... ... ... ... Privation of Food ... ... ... ... ... ... ... Want of Breast Milk 3 3 ... ... ... ... 3 Neglect ... ... ... ... ... ... ... Amputation of Leg ... ... ... ... ... ... ... Poisoned Wounds ... 1 ... ... ... ... ... Burns and Scalds ... 1 ... ... ... ... 1 Hanging (Suicide) ... ... ... ... ... ... 1 Suffocation 2 2 ... ... ... ... ... Drowning (Suicide) 2 3 2 ... ... ... 2 Fracture and Contusions ... 2 ... ... ... ... 5 Wounds ... ... ... ... ... ... 3 Other Violence 1 1 ... ... ... ... ... XVIII. Not Specified ... ... ... ... ... ... 1=15 Totals 106 185 52 39 60 19 365 Under 20 | 20 and under 40 40 and under 60 60 and under 80 80 and above Total. TABLE H. Summary of Meteorological Observations taken daily during the undermentioned Weeks, at the Town Hall, Hackney, by Dr. Tripe. Rain. Deaths registered in the week which is subsequent to the date given. Excess or minus of temperature in each week, when compare d with mean for 43 years. 1858 Week Ending Barometer. Temperature of the Air. Moisture Mean weight of a cubic foot of air. Ozone Rain Mean of Seven Observations corrected Absolute. Average Mean Dew.point Temperature Mean degree of Humidity saturation=100 Mean Weekly Amount. Mean Daily Amount. No. of Days. Amount: Highest Lowest Range Mean of seven daily Maximums. Mean of seven daily Mini mums. Mean of seven daily Ranges. Adopt. Mean Temperature July 10 o 29.775 0 71.4 0 48.5 o 22.9 o 67.1 o 49.9 o 17.2 o 56.4 o 47.3 o 72.5 0 533.9 Inches. 1.4 7.0 5 1.22 25 0 —5.3 „ 17 29.950 88.0 52.0 36.0 78.6 57.9 20.7 66.6 65.7 66.5 525.9 1.0 5.0 i 0.58 27 + 4.2 24 29.903 78.2 51.2 27.0 75.3 53.9 21.4 62.3 52. 1 69.8 529.7 0.6 8.0 4 0.44 27 + 1.5 31 29.861 78.0 50.2 27.8 73.1 50.9 22.2 59.8 47.0 62.4 531.7 2.3 6.0 9, 0.48 35 .2.4 Aug. 7 30.037 78.8 46.8 32.0 76.1 52.7 23.4 62.7 50.1 64.7 531.9 0.2 5.0 1 0.06 26 —0.1 „ 14 30.073 86.2 46.8 39.4 81.0 55.0 26.0 65.5 56.4 73.0 529.9 1.6 6.0 3 1.16 37 + 3.4 21 29.79 81.4 50.2 31.2 73.4 56.9 16.5 63.2 53.3 70.2 626.9 0.6 5.0 4 0.64 27 + 2.0 28 29.9 76.2 48.8 27.4 71.0 50.8 20.2 59.0 47.5 65.5 535.0 1.6 3.0 1 0.10 15 —1.0 Sept. 4 29.715 72.8 45.8 27.0 68.9 51.6 17.2 59.6 47.4 69.0 529.4 0.0 8.0 2 0.24 37 + 0.3 11 30.012 83.4 49.0 34.4 76.1 53.9 22.2 63.4 56.2 77.9 530 .1 0.9 6.0 2 0.14 19 + 1.9 „ 18 29.858 73.3 47.8 25.5 69.1 53.8 15.3 59.9 61.3 73.3 531.4 0.0 9.0 3 0.40 28 + 6.5 25 30.032 70.6 45.8 24.8 66.3 53.2 13.1 58.6 49.9 73.0 535.8 1.4 7.0 2 O.Sfl 23 + 30 Oct. 2 30.036 72.0 41.6 30.4 66.4 51.6 14.8 57.9 50.6 74.0 537.4 0.9 6.0 2 008 21 + 3.5 Means. 29.915 88.0 41.6 46.4 72.5 53.2 19.3 61.1 51.1 70.1 546.8 0.45 1.0 2 4 27 + 1.3 Note.—All the Meteorological Instruments have been compared and certified by Mr. Glaisher. All the Observations have been corrected for error, for diurnal range. &c., and reduced by Glaisher Tables, last editions. HAC 38 REPORT ON WATERING THE ROADS, AND ON THE SANITARY STATE of the HACKNEY DISTRICT, FOR THE QUARTER ENDING JAN. 1st, 1859, BY JOHN W. TRIPE, M.D. Medical Officer of Health to the District. Member of the Council of the Meteorological Society, &c. Printed by Order of the Board. BT warles potter, 16, warwick place, KINGSLAND. 1869. REPORT. To the Board of Works for the Hackney District. Gentlemen, In accordance with the Resolution passed by you that I should "draw up and present to the Board a Report upon the Sanitary effects and advantages to be derived from Watering Streets and Roads during the summer months,"I beg to lay the following before you. The chief object in a sanitary point of view to be obtained by watering the streets and roads is to prevent the dust from being blown about, and consequently inhaled by the passers by; but we must not lose sight of the cooling effect which it exercises, nor the increased humidity of the atmosphere which it induces. In very hot weather it is important to adopt all measures that will reduce temperature, as you may thereby assist in reducing the sickness and probably the mortality from diarrhoea. It is also advisable to increase the humidity of the air in large towns, as the meteorological observations lately made by the medical officers of Health, and other members of the Meteorological Society show that the air of the Metropolis is drier the nearer we approach the centre of London, even at the river side. The presence of pavement which prevents rain from soaking into the ground, and the absence of verdure which exhales moisture, contribute to this result. Now, as the chief things for consideration in this present Report are the chemical and physical effects produced by Watering the Roads, it will be necessary in the first place to consider of what the road drift is composed. Road-drift varies greatly in its composition according to the surface on which it occurs. On roads paved with blocks of granite it is chiefly composed of dried animal excrement, mixed with fine particles of granite and iron abraded by and from the shoes of the horses and tyres of the wheels ; it also contains a small proportion of leather worn away from the shoes of passengers. Road-sweepings of this kind are readily saleable to agriculturists, and their value forms an item in the estimate of scavengers when contracting to keep the roads clean. On the other hand the road-drift of localities which have macadamised roads and gravelled foot-paths is composed chiefly of granite and sand mixed with a comparatively small quantity of animal excrement, which is valueless to farmers as manure. These differences are perceptible not only to 2 the purchasers of the drift and to the chemist, but to the passers-by, as I think anyone can testify who has inhaled a mouthful of it whilst passing over London Bridge or along any crowded thoroughfare. When water in moderate quantity is poured on either variety of dust no chemical change important to health can occur, even in the hottest day in summer, because the water evaporates before any fermentative process can be set up; whilst the clouds of dust are temporarily prevented. But it is also evident that merely watering the roads cannot entirely prevent the annoyance when the paths, like most of those under your control, are covered with loose fine gravel. It was my intention to have considered this matter statistically, but on carefully considering the whole subject I find it impossible to compare on this one point alone, your district with the whole of London, or even with any district which is paved with granite throughout, Thus the number of persons to an acre, the proportions of young children and of the aged to those in the prime of life, the condition of the inhabitants as regards the comparative presence or absence of comforts, by which I mean plenty of food and clothing, protection from the vicissitudes of weather, &c. vary so greatly in the different districts, and even in the same district at different times, that it could only lead to erroneous results if we attempted to draw conclusions from any one element in which they differ. I have however calculated the death rates from pulmonery diseases af all kinds in Hackney District, per se, and in Loudon at large, and I find that the advantage considerably preponderates in favour of Hackney, for, whilst in all London at an average of some years 1 person died annually from pulmonary disease in each 150 living, in Hackney the average was only about 1 in each 190 living. There is however no doubt that the inhalation of fine hard particles, such as stone, sand (silex), or metal is injurious to health. The investigations which have been made by various medical men respecting the effects of fork-grinding and other similar trades, and the means which have been adopted for preventing injury to health sufficiently prove this. The following testimony from the last sanitary work published by the Board of Health, supports the position I have taken; Mr. Simon observes in regard to the tables formed by Dr. Greenhow that a high death-rate from pulmonary diseases "mainly depends on the local pursuit of particular branches of industry." "Two kinds of occupation are in this respect especially hurtful; first, those which give rise to mechanical irritation of the air passages, by diffusing in the air of work-places any considerable amount of metallic or earthy grit, or even of flax dust, or cotton or woollen fluff; secondly, those in which the operatives are exposed to abrupt changes of temperature." Towns in which the manufacture of metals is carried on (especially the manufacture of cutlery) are also shown to suffer a high rate of mortality from pulmonary disease. In addition to the above testimony I know from my own experience that persons employed in any dusty trade, as bakers, stone cutters, &c, suffer very considerably from pulmonary affections. 3 From all these considerations I am undoubtedly of opinion that the inhalation of the dust which blows so profusely about your roads in the summer time, containing as it does so large a proportion of pulverized stone and sand, must prove decidedly detrimental to health; and that there is no sanitary objection to the watering of roads on the grounds of fermentation of the animal matter contained in the dust. We must not look to the mortuary tables alone for evidence of injury to health, but rather to the amount of personal discomfort suffered by those who are exposed to the influence of any annoying or irritating agent, for if it were otherwise, it is quite clear that no proceedings could be successfully instituted against persons causing a nuisance. So, in the same way, we must not look to the Hackney mortuary tables and say that because the duration of life is high and the rate of death from pulmonary and other diseases comparatively small, that no causes for ill health exist in the District, for there is still a great deal to be done, besides watering the roads, before the district will be in as good a sanitary condition as could be wished. I allude chiefly to the drainage works which have to be completed. It must not. however, be supposed that the drainage works have not been attended to as usual, for on the contrary there has not been so large a number of cesspools filled up and of privies converted into water-closets as during the past quarter; and the sewers are being completed with moderate speed. The return of Mr. Valentine, for the past quarter, shows that no less than 950 nuisances have been remove 1,, which may be classified as follows:— Privies and cesspools emptied, filled up and connected with the sewer 793 Privies and cesspools emptied 33 Houses and rooms (tenements) cleaned and purified 20 Drains repaired and cleansed 43 Collections of animal refuse removed 27 Other nuisances 25 Total 950 The total number of births in the district have been 610, and of deaths 475, so that the excess of births over deaths have been 135; of the total births 36 were registered in Stoke Newington sub-district; 40 in Stamford Hill; 2'25 in Hackney sub-district; 123 in South Hackney; and 180 in West Hackney. Of the 475 deaths, 31 were registered in Stoke Newington; 19 in Stamford Hill; 200 in Hackney sub-district; 95 in South Hackney; and 130 in West Hackney. Of the 475 deaths in the district 109 were registered of children under 1 year of age, 116 of young persons above 1 year but under 20 years of age; 03 who were above 20 but under 40 years; 75 who were more than 40 but less than 60 years; 89 who were above 60 and under 80; and no less than 23 who were more than 80 years old, Of the 475 deaths a very large proportion, viz. 58, arose from hoopingcough and scarlatina, 38 having been from scarlatina and 20 from hoopingcough. The mortality from hooping-cough was reudered so great by 4 inflammatory diseases of the lungs induce dby the extreme severity of the weather which produced a similar effect all over the metropolis, There was less fever than usual, 9 cases only having been registered, and there were 8 deaths from diphtheria, The total mortality from epidemic diseases was 97, Of the remaining 378 deaths, 26 were caused by diseases of uncertain seat, viz.: hœmorrhage, dropsy, mortification, cancer and gout. The two latter were unusually fatal; 12 deaths having occurred from cancer and 3 from gout. There were 73 deaths from tubercular diseases, including consumption; 55 deaths from diseases of the nervous system, of which no less than 13 happened from apoplexy. As I have stated on other occasions we find this disease most fatal at those periods of the year which are attended by rapid oscillations in the readings of the thermometer and barometer. There were 20 deaths from diseased heart, and 90 from inflammatory disease of the lungs, against 80 during the corresponding period of last year. Of the 90 no less than 50 were attributed to bronchitis. There were also 28 deaths from diseases of the digestive organs; 7 from child-birth; 20 deaths of very young infants from premature birth, 28 of persons who were stated to have died from old age; also 9 sudden and 4 violent deaths. As this Report has extended already beyond its usual limits I will not recapitulate any part of the contents of my weekly minutes, except to mention the necessity of kerbing all the roads and streets which have a continuous line of houses on either side. Also of keeping the footways in as firm a state and of using as little fine gravel in making them up as possible, so as to diminish the quantity of dust in dry weather. There is also another matter in connection therewith to which I wish to draw your attention, viz. the state of those streets which have not yet been dedicated. The meteorology of the quarter was somewhat unusual, the temperature having been above the average in October and December and very considerably below it in November, especially on the 23rd. and 24th. when the temperature was lower than on any two consecutive days in November for the last 45 years. On many days the temperature was more than 10 degrees below the average. The mean pressure of the air was below the average in November and December, and above it in October. The amount of rain Was less than usual, and the quantity of ozone noted was also unusually small. I remain, Gentlemen, Your obedient Servant, J. W. TRIPE. 5 TABLE II Deaths registered in the District of Hackney during the Thirteen Weeks ending January Ist, 1859. Causes of Death. Ages. Total Under 1 0 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and above I. Zymotic Diseases: Small-pox ... ... ... ... ... ... ... Measles 3 5 ... ... ... ... 5 Scarlatina 3 38 ... ... ... ... 38 Hooping Cough 10 20 ... ... ... ... 20 Croup ... ... ... ... ... ... ... Thrush 1 1 ... ... ... ... 1 Diarrhœa (Bowel Complaint) 4 5 ... ... 2 ... 7 Dysentery ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... Influenza ... ... ... ... 2 ... 3 Scurvy and Purpura ... 1 ... ... ... ... 1 Ague ... ... ... ... ... ... ... Remittent Fever ... ... ... ... ... ... ... Infantile Fever ... ... ... ... ... ... ... Typhus Fever ... 4 5 ... ... ... 9 Puerperal Fever (Metria) ... ... 1 ... ... ... 1 Rheumatic Fever ... 3 ... ... ... ... 3 Erysipelas (Rose) ... ... 1 ... 1 ... 2 Syphilis 2 2 ... ... ... ... 2 Noma (Canker) ... ... ... ... ... ... ... Diptheria ... 6 1 1 ... ... 8 = 100 II. Dropsy, &c.: Hæmorrhage 1 1 ... 1 ... ... 2 Dropsy ... 1 ... ... 4 ... 5 Abscess ... ... ... ... ... ... ... Ulcer ... ... ... ... ... ... ... Fistula ... ... ... ... ... ... ... Mortification ... ... ... 1 3 ... 4 Cancer ... ... ... 4 7 1 12 Gout ... ... ... ... 3 ... 3—26 III. Tubercular Diseases: Scrofula ... 1 ... ... ... ... 1 Tabes Mesenterica 5 7 ... ... ... ... 7 Phthisis (Consumption) ... 11 33 13 2 ... 59 Hydrocephalus (Water on Brain) 3 6 ... ... ... ... 6=73 IV. Brain and Nerves: Meningitis 1 4 1 1 ... ... 6 Cerebritis ... ... 1 2 ... ... 3 Apoplexy ... ... 1 7 4 1 13 Palsy (Paralysis) ... ... ... 1 7 ... 8 Delirium Tremens ... ... ... 1 ... ... ... Idocoy ... ... ... ... ... ... ... Epilepsy ... ... ... ... ... ... ... Tetanus ... ... ... ... ... ... ... Insanity ... ... ... 1 2 ... 3 Convulsions 9 14 ... ... ... ... 14 Disease of Brain, &c. ... 1 ... 2 3 1 7 „ Spinal Cord ... 1 ... ... ... ... 1=55 Carried forward 42 132 42 36 40 4 254 6 TABLE II.—Continued. Causes of Death. Ages. Total. Under 1 0 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Brought forward 42 132 42 36 40 4 254 V Heart and Blood Vessels: Pericarditis ... 1 1 1 ... ... 3 Endocarditis .. ... 1 ... ... ... 1 Aneurism ... ... ... ... ... ... ... Disease of Heart, &c. 1 1 1 3 9 2 16—20 VI. Lungs and Organs of Respiration: Laryngitis 2 10 ... ... ... ... 10 Bronchitis 12 17 5 10 17 1 50 Pleurisy ... ... ... ... ... ... ... Pneumonia 16 22 4 ... ... ... 26 Asthma ... ... ... 1 2 1 4=90 Disease of Lungs ... ... .. ... ... ... VII. Stomach and Digestive Organs: Teething 4 4 ... ... ... ... 4 Quinsey ... 1 ... ... ... ... 1 Gastritis 1 1 ... 2 ... ... 3 Enteritis 1 1 ... 3 ... ... 4 Peritonitis ... 1 1 ... ... ... 2 Ascites ... ... ... ... ... ... ... Ulceration of Intestines ... ... ... ... ... ... ... Hernia (Rupture) ... ... ... ... ... ... ... Intussusception 1 1 ... ... ... ... 1 Disease of Bowels ... ... ... ... ... ... ... Abdominal Tumour ... ... ... ... ... ... ... Stricture of Intestinal Canal ... ... ... ... ... ... ... Disease of Stomach, &c. ... ... ... 1 1 ... 2 Disease of Pancreas ... ... ... ... ... ... ... Inflammation of Liver(Hepatitis) ... ... ... 2 ... ... 2 Jaundice ... ... ... ... ... ... ... Disease of Liver 1 2 ... 6 ... 1 9 Disease of Spleen ... ... ... ... ... ... =28 VIII. Kidney, &c.: Nephritis ... ... ... 1 ... ... 1 Nephria (Bright's Disease) ... ... ... 2 2 ... 4 Diabetes ... ... 1 ... ... ... 1 Cystitis ... ... ... ... ... ... ... Stricture of Urethra ... ... ... ... ... ... ... Disease of Prostrate Gland ... ... ... ... 1 ... 1 Disease of Kidney ... ... ... 1 ... ... 1=8 IX. Childbirth: Childbirth (see Metria) ... ... 5 ... .. ... 5 Disease of Uterus, &c. .. ... ... .. ... ... ... Ovarian Disease .. .. 2 .. .. ... 2=7 Carried forward 81 194 63 69 72 9 407 7 TABLE II,—Continued. Causes of Death. Ages. . under 1 0 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Brought forward 81 194 63 69 72 9 407 X. Joints Bones, &c.: Chronic Rheumatism ... ... .. ... ... ... .. Disease of Joints ... ... ... ... ... ... ... Disease of Bones ... ... ... ... ... ... ... Disease of Spine ... ... ... ... ... ... ... XI. Skin, Cellular Tissue, &c,: Carbuncle and Boils ... ... .. ... 1 ... 1 Phlegmon ... ... ... ... ... ... ... Disease of Skin, &c. ... ... ... ... ... ... ... XII. Malformation: Spina Bifida ... ... ... ... .. .. ... Other Malformations ... .. ... ... .. ... ... XIII. Premature Birth and Debility 20 20 ... ... ... ... 20 XIV. Atropy 6 6 ... ... ... ... 6 XV. Old Age and Decay ... ... ... ... 14 14 28 XVI. Sudden Deaths .. 3 ... 4 2 ... 9 XVII. Violent Deaths Intemperance ... ... ... ... ... ... ... Privation of Food ... ... ... ... ... ... ... Want of Breast Milk ... ... ... ... ... ... ... Neglect ... ... ... ... ... ... ... Amputation of Leg ... ... ... ... ... ... .. Poisoned Wounds ... .. ... ... ... ... ... Burns and Scalds ... ... ... ... ... ... ... Hanging (Suicide) ... ... .. ... ... ... ... Suffocation 1 1 ... ... ... ... ... Drowning (Suicide) ... ... ... ... ... ... 1 Fracture and Contusions ... ... ... 1 ... ... ... Wounds ... ... ... 1 ... ... 1 Other Violence 1 1 ... ... ... ... 1 XVIII Not Specified ... ... ... ... ... ... Totals 109 225 63 75 89 23 475 Under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Total. TABLE I. Summary of Meteorological Observations taken daily during the undermentioned Weeks, at the Town Hall, Hackney, by Dr. Tripe. Deaths registered from epidemic disease in the week which is subsequent to the date given. Deaths registered in the week which is subsequent to the date given. Excess or minus of temperature in each week, when compared with mean for 43 years. 1858 Barometer. Temperature of the Air. Moisture Mean weight of a cubic foot of air. Ozone Rain Mean of Seven Observations corrected Absolute. Average Mean Dew-point Temperature Mean degree of Humidity saturations 100 Mean Weekly Amount. Mean Daily Amount. Week Ending Highest Lowest Range Mean of seven daily Maximums . Mean of seven daily Mini mums. Mean of seven daily Ranges. Adopt. Mean Temperature 0 0 0 0 0 0 0 0 0 0 0 Inches. 0 Oct. 9 29.800 66.6 36.0 30.6 6.1 44.9 16.2 52.4 42.1 68.5 538.0 0.52 0.1 5 29 —0.4 „ 16 29.850 67.0 39.0 28.0 61.2 46.4 14.8 52.2 46.3 80.8 539.8 0.20 0.0 5 32 + 2.5 „ 23 29.816 62.2 42.2 20.0 59.0 46.2 12.8 51.6 47.8 87.3 539.2 0.38 0.6 5 28 + 2.2 „ 30 30.230 57.6 34.0 23.6 54.2 41.8 12.4 47.5 43.0 83.7 552.0 0.26 0.2 6 38 0.0 Nov. 6 30.321 52.8 30.6 22.2 51.0 37.6 13.4 43.8 39.2 84.0 558.0 0.01 0.3 8 38 -2.7 „ 15 301.90 50.2 29.0 21.2 46.6 32.6 14.0 39.4 35.0 82.8 560.7 0.00 0.0 10 32 —5.3 „ 20 29.664 47.2 25.8 21.4 40.0 31.8 8.2 35.8 30.2 76.4 555.2 0.00 0.0 10 42 —7.0 „ 27 29.692 57.4 21.4 36.0 43.6 32.2 11.4 37.8 35.0 86.4 553.3 0.24 0.0 9 48 -39 Dec. 4 29.606 53.8 36.8 17.0 51.0 41.8 9.2 46.8 43.2 85.7 541.1 0.49 0.0 6 46 + 4-.7 „ 11 30.246 50.2 31.0 19.2 40.2 33.8 6.4 36.8 34.0 86.4 564.7 0.00 0.0 7 42 —4.2 „ 18 29.990 52.0 33.2 18.8 43.0 35.0 8.0 39.2 36.0 87.0 557.0 0.32 0.3 10 39 —1.1 „ 25 29.568 55.6 35.4 20.2 49.0 39.0 10.0 47.0 40.6 84.8 542.6 0.80 0.0 5 40 + 6.5 Jan 1 29.872 50.2 32.5 17.7 45.2 38.0 7.2 4.8 38.2 87.8 551.8 0.22 0.0 10 34 + 4.4 Means. 29.910 55.6 32.8 22.8 49.6 38.8 11.1 43.9 39.3 83.2 550.3 0.26 0.1 7 . 38 + 0.3 Note.— All the Meteorological Instruments have been compared and certified by Mr. Glaisher. All the Observations have been corrected for error, for diurnal range. &c., and reduced by Glaisher Tables, last editions. 20 HAC 38 REPORT on the SANITARY STATE of HACKNEY DISTRICT, FOR THE YEAR 1858. BY JOHN W. TRIPE, M.D., Medical Officer of Health to the District. Member of the Council of the Meteorological Society, etc. Printed by Order of the Board, by JOHN COVENTRY, CHURCH STREET, HACKNEY. 1859. ANNUAL RETORT. To the Board of Works for the Hackney District. Gentlemen, 'THE last year has been, so far as this District is concerned, a year of drainage, for the Surveyor, Mr. Lovegrove, informs me that a very considerable length of Sewers has been constructed, and Mr. Valentine's reports shew that the owners of 1518 houses have emptied and filled up the cesspools existing on their premises, and connected them with the sewers. In addition to these works, 138 Drains have been cleansed and repaired, making a total of 1656 houses which have been benefitted through the notices of this Board. The total cost of these Works may be estimated at £ for the Sewers, and £7670 for the House Drains. Now, to obtain the performance of so large an amount of work, it has been necessary to summons only ten persons before the magistrates; but, I have, after personally inspecting the premises, required eightysix persons to attend before you preparatory to summonses being issued, by which the work in seventy-six instances was done, a great amount of time saved to your officers, and a large cost to the owners of property. But although much good has accrued to the District from these extensive drainage works, yet the benefit has not been so great as it otherwise would have been if an efficient plan of trapping and ventilating the drains had been in use. At present there are no efficient traps to be got, although those in use are of great value. Thus, on several occasions after houses had been drained into the sewers, the inhabitants complained of bad smells, and in some instances of illness, both of which were much relieved by the introduction of traps, which had been neglected when the drains were made. There have also been several fatal cases of fever, and 4 other similar diseases, in houses which drained into cesspools only, and in which very fetid smells were of common occurrence: the only really efficient plan of trapping and ventilating house drains is that patented by your Surveyor, Mr. Lovegrove. As it is extremely important to place this matter before the public in its true light, I propose briefly describing the old, and Mr. Lovegrove's plans. In the old plan, when complete, all the inlets, whether in the house or in the yard and outbuildings, are supplied with a watertrap, and the outlet into the sewer with a flap or shakle-trap; or else a dip-trap is placed near the outlet. Now, when water is poured into the drain it drives out a corresponding quantity of air, unless there be a dip-trap, in which case a considerable pressure is exerted on all the bell-traps; when, if they or any joint be defective, the foul air will be driven into the house. If there be a shakletrap, the water in escaping from the house drains separates it from the mouth of the outlet and fills the lower part, but allows the passage of air from the sewer into the house drain, to replace that which had been previously driven out. This current at times is so great, that on a large pailful of water being poured quickly down a water closet, I have seen a lighted candle blown out by the rush of air from a bell-trap which had become dry. A similar train of events takes place when the house drains are connected with a covered cesspool, but with greater certainty, because the cesspool being filled with drainage matters, and with air and the gases evolved during decomposition, the bulk of water poured in must displace in the cesspool a similar bulk of these noxious gaseous bodies If, therefore, the traps are in good order no great interchange of air and gases will occur; if not (and the film of water in a bell-trap is so thin as soon to admit of the free passage of air into and out of the sewer, unless frequently supplied with water), a free communication will exist between the houses and the sewers, and more danger will be incurred by the inmates than if they had no drainage at all. Now, Mr. Lovegrove's plan provides a remedy for all these evils; for, not only are his water-traps at the inlets of a much better construction than those already employed, and the trap at the outlet also more efficient, (as it is composed of a dip-trap and shakletrap), but especially because he provides the means of ventilating the house drain, and of allowing the bulk of air displaced by the 5 water poured into the drain to escape into the sewer instead of into the house. Further, if the air of the house drain should find its way into the house, it is not so highly charged with noxious compounds as under ordinary circumstances, and the air from the sewers cannot interchange with that of the house drain. I have seen a series of experiments tried with his apparatus, and found, on water being poured into a water-closet, that a strong current took place through the supply-valve into the house drain; that the air-valve opening into the sewer was strongly acted on, and allowed a ready passage of air into the sewer from the house drain, without any current from the sewer into the house, whilst the shakle-trap was not acted on until the water rushed out, and then no current of air passed into the house drain as with an ordinary trap. In my Quarterly Reports for the year I have pointed out the most prominent occurrences as regards the sanitary condition of the District; and must, therefore, refer to them for many particulars which would otherwise have been enumerated here. In my first Report I showed that, during the years 1847—55, there were 154 births to each 100 deaths; and during the past year, there were 2454 births against 1629 deaths: or, at the rate of 156 births to each 100 deaths. The deaths in all the public institutions, as well as the births, are included in these numbers; so that the proportion of births to deaths is smaller than it would have been had they been confined to the District proper. The following Table shows the number of deaths in each Subdistrict in each quarter:— Per cent. 1858—Births in each Sub-district. Quarters. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. TOTALS. First 42 27 233 247 108 657 Second 48 31 181 217 103 580 Third 42 28 209 220 108 607 Fourth 36 40 186 225 123 610 Totals 168 126 809 909 442 2454 Births 6.7 5.1 32.9 37.3 18.0 100 Pop. 1851 8.4 9.6 31.7 35.7 14.6 100 We see from the above that the smallest birth rate occurred in Stamford Hill Sub-district, where only 51 births were registered 6 out of each 1000 in the whole District. In 1851, the proportion of the population was 96 in each 1000; but as the population in the other Districts has increased more rapidly than in Stamford Hill, we should expect the per centage of births to be smaller now than in 1851. The proportionate numbers in the various Sub-districts are—in Stoke Newington, 67; in Stamford Hill, 51; in West Hackney, 329; in Hackney, 373; in South Hackney, 180 in each 1000 births in the District at large. The total number of deaths in the District was 1629, of which 103 were registered in Stoke Newington Sub-district; 99 in Stamford Hill; 431 in West Hackney; 727 in Hackney; and 271 in South Hackney. If the population has continued to increase since 1851 at the same rate as between 1.841 and 1851, the number of inhabitants on June 30th would be 74959; and if the deaths be corrected by subtracting the 156 deaths which happened in the German Hospital and East London Union, we ascertain that 10 deaths happened in each 509 persons residing in the District; or, 196 deaths in each 10,000 inhabitants. This is a favourable death rate when contrasted with that for the whole of London, but it is larger than in the previous year. As pointed out in my Quarterly Report, ending January 2nd, the extremely cold weather in November had altered the death rate for the whole year, by the enormous increase in the number of deaths which it produced. It is also probable, as shown by the rates and other data, that the increase of population in the District has exceeded 4 per cent. per annum: and if so, the death rate would be proportionably diminished. The following Table shows the number of deaths in each Subdistrict during the different quarters; and, by comparison, the effect of the cold weather at the beginning and latter end of the year on the poorer Districts:— 1858—Deaths in each Sub-district. Quarters. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. TOTALS. First 33 33 197 107 72 452 Second 22 22 92 163 48 347 Third 17 23 102 157 56 355 Fourth 31 19 130 200 95 475 Totals 103 97 431 727 271 1629 Per cent. 6.3 5.9 26.5 44.6 16.7 100.0 7 We see from the above, that out of the total deaths 103 were registered in Stoke Newington; 97 in Stamford Hill; 431 in West Hackney; 727 in Hackney; and 271 in South Hackney Sub-districts. The above numbers being uncorrected give a very erroneous idea of the rate of deaths belonging to each Sub-district, for the deaths in the German Hospital, East-London Union, and Hackney Workhouse, are included in the returns for the Hackney Subdistrict. To arrive at the truth we must, therefore, subtract the deaths in the East London Union and German Hospital, and distribute the mortality in the Hackney Workhouse over the whole District in proportion to the population. We then find the numbers to be as follows— Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. TOTALS. Uncorrected. 103 97 431 727 271 1629 Corrected 109 103 457 509 286 1464 Percentages. 6.3 5.9 26.5 44.6 16.7 100. Corrected 7.4 7.0 31.2 34.8 19.6 100. In the Quarterly Reports a detailed account will be found of the ages at and causes of death, so that it is unnecessary to recapitulate them; but I propose showing the mortality in each quarter from the various groups of diseases. Deaths in 1858. 1 st Qr. 2nd Qr. 3rd Qr. 4th Qr. Total. per CENT Zymotic Diseases 74 77 107 100 358 21.9 Diseases of uncertain seat 18 19 13 26 76 4.7 Tubercular Diseases 51 53 62 73 239 14.7 Diseases of the Brain 73 32 42 55 203 12.4 ... ... Heart 24 11 19 20 74 4.5 ... ... Lungs, &c 98 53 22 90 263 16.2 ... ... Stomach, &c 26 25 13 28 92 5.6 ... ... Kidneys 7 6 6 8 27 1.6 ... ... Childbirth 1 1 2 7 11 0.7 ... ... Bones, Joints, &c 1 2 1 ... 4 0.3 ... ... Skin ... ... ... 1 1 0.1 Malformations 1 ... ... ... 1 0.1 Premature Birth and Debility 15 14 20 20 69 4.2 Atrophy 8 3 6 6 23 1.4 Old Age 32 33 22 28 115 7.1 Sudden Deaths 12 10 3 9 34 2.1 Violent Deaths 11 8 15 4 38 2.4 452 347 355 475 1629 100. This table shews that the largest mortality for the year was induced by the zymotic class of diseases, which includes smallpox, 8 measles, scarlet fever, hooping cough, diptheria, diarrhoea, fever, erysipelas, and some other similar affections. The deaths from these causes were 358 in number; or, 21 9 per cent. of the whole. The next most fatal class of diseases was those of the lungs and organs of respiration (excluding consumption), as no less than 263 deaths were registered from these causes. Consumption is excluded, because it is a constitutional disease, and belongs to the tubercular class, which caused a mortality equal to 14.7 per cent. of the whole. Diseases of the brain were next in order of fatality, as 203 deaths were registered under this class; or, 12.4 per cent. Under the heading of "old age" we have 115 deaths; or, 7.1 per cent. From the above we perceive that 65.4 per cent. of the total number of deaths in this District, during last year, were caused by four groups of diseases; whilst, in 1857, 66.1 per cent. were recorded from the same diseases. Diseases of the stomach, liver, &c., caused a mortality of only 5.6 per cent.; of the heart, of 4.5 per cent.; from premature birth and debility, 4.2; whilst 2.4 per cent. were caused by accident or suicide. The deaths from the severe chief epidemic diseases were unusually large during the past year—scarlatina and diptheria having prevailed to a most unusual extent. I would observe here, in connection with scarlet fever, that the most effectual means for preventing the spread of the disease in a family, where it has broken out, is to separate the persons who are afflicted with it from the rest of the family; to prevent any one entering the room, except for absolutely necessary purposes; to prohibit the female attendants wearing woollen dresses; and to place the patient in the top room of the house, which must be kept well ventilated. The same observations apply, though in a very far less degree, to diptheria, which appears to be more a local (endemic) than a contagious disease. 1858—Mortality from Epidemic Diseases. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Totals. Smallpox .... .... .... .... .... Measles 6 18 7 5 36 Scarlet Fever 12 6 20 38 70 Diptheria 1 5 13 8 27 Hooping Cough 15 19 10 20 64 Diarrhœa 6 9 30 7 50 Fever 15 14 13 9 51 Totals 55 69 93 87 304 9 This Table shows that the largest mortality from these diseases occurred in the quarter ending October 2nd; and the next, in that ending January 1st, 1859: that no death was registered from small pox, whilst no less than 76 deaths happened from scarlet fever, 27 from diptheria, 64 from hooping-cough, 50 from diarrhœa, and 51 from fever. These latter diseases have been gradually declining each year, and I do not doubt but that when the drainage works are completed, they will be materially diminished. The following Table shows the number of deaths from the above-named diseases, corrected for increase of population :— CORRECTED DEATHS, FROM CERTAIN EPIDEMIC DISEASES. Years. Small Pox. Measles. Scarlet Fever. Hooping Cough. Diarrhœa. Fever. 1855 17 7 84 56 29 73 1856 13 42 54 30 69 66 1857 1 23 43 59 72 61 1858 0 36 76 64 50 51 The mortality assigned to scarlet fever in this Table is too small as compared with other years, for 27 deaths were registered from diptheria in 1858, whilst two only were registered in 1857. There can be no doubt that several deaths from scarlet fever have been returned under the name of diptheria, for there is great difficulty at times in deciding to which disease a particular case should be assigned. The following Table shews that the fourth quarter of the year was the most fatal, 475 deaths having been registered against 452 in the first or winter quarter. This is an exception to the rule; for, in the years 1853—7, the mortality was about 27 per cent, in the first quarter against 25 per cent. in the fourth. As beforementioned, the extremely cold weather in November produced so large a death rate as to disturb the rate of mortality for the whole year: the same cause also produced an increased number of deaths in young children, 24.4 per cent. of the whole mortality in 1858 having occurred in children under one year old, whilst only 22.4 per cent. happened at the same age in 1857. The greatest number of deaths in young children frequently occurs in the third quarter. 10 1858—Ages at Death. Quarters. Under 1 year. Under 20 years. Between 20 and 40. Between 40 and 60. Between 60 and 80. Above 80. Totals.. Per cent. First 100 183 63 73 110 23 452 27.7 Second 83 169 42 46 68 22 347 21.3 Third 106 185 52 39 60 19 355 21.8 Fourth 109 225 63 75 89 23 475 29.2 Totals 398 762 220 233 327 87 1629 100. Per cent 24.4 46.8 13.5 14.3 20.1 5.3 100.0 From the above we ascertain, that of 1629 deaths registered in the District, including the German Hospital and East London Union, 398 occurred in children under one year of age; 374 who were above one year but under twenty; 220 in persons who were more than twenty but less than forty years of age; 233 in those who were above forty but under sixty; no less than 327 were more than sixty but under eighty; and 87 happened of persons who were above eighty years of age. To calculate the death rate and average duration of life of the inhabitants of Hackney District, it is necessary to eliminate the deaths which have occurred in the German Hospital and East London Union. I ascertained, on posting up the returns of these Institutions to the District Registrar, that 6 deaths arose in children under one year of age; 19 between one and twenty years of age; 41 between twenty and forty; 38 between forty and sixty; 54 between sixty and eighty; and 7 above eighty years of age. Deducting, then, these deaths, 165 in number, from the total mortality of the District, we find that 1464 deaths belong to the District, and that the average age at death was 33.3 years; or, 33 years and 121 days. Now, as the population on the 30th day of Jane may be calculated at 74,408, and the mortality of the District was 1464, there would be 10 deaths in each 508 inhabitants; so that the expectation of life in the District may be assumed to be 45 years. The principle on which these calculations are founded has been explained in my preliminary Report: this calculation is not so favourable as for the year 1857, but it is more so than a similar comparison for the whole of London. The nuisances abated by Mr. Valentine have been reported in each quarter, but the aggregate for the year is as follows:— 11 Privies and Cesspools emptied, filled up, and drained into the Sewer 1518 Privies and Cesspools emptied 277 Stable and other Refuse removed 261 Premises lime-washed, purified, and repaired 67 Filthy Premises, &c., cleansed 65 Pigsties cleansed and repaired, &c 60 Choked Drains cleansed and repaired 138 Ditches cleansed 25 Other Nuisances abated 101 Total 2512 To obtain the removal of so large a number of nuisances, it has been necessary to take summonses out against ten persons only. This extremely favourable result has been obtained partly by the plan of requiring the attendance at the Board of all parties who neglect or refuse to remove nuisances, after they have received the proper notices; partly by my personal inspection, and by the energy displayed by Mr. Valentine in following up the cases. There were 86 owners of property summoned to the Board, of whom 76 did the necessary work. The meteorology of the year has been considered in each of the separate quarters, so that it is quite unnecessary for me to recapitulate. I remain, Gentlemen, Your obedient Servant, JOHN W. TRIPE. May, 1859. Received, and ordered to be Printed and Distributed, in the usual way, J. J. TANNER. Chairman. 30th June, 1859.