25 HAC 43 REPORT ON THE SANITARY STATE OF THE HACKNEY DISTRICT, FOR THE YEAR 1863. by JOHN W. TRIPE, M.D., MEDICAL OFFICES OF HEALTH 10 THE DISTRICT. LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS, ED., ETC. VICE-PRESIDENT OF THE BRITISH METEOROLOGICAL SOCIETY. AUTHOR OF NUMEROUS ESSAYS RELATIVE TO VITAL STATISTICS, AND ON MEDICAL METEOROLOGY. Printed by Order of the Board, BY ANDREW T. ROBERTS, HACKNEY ROAD, SHOREDITCH. 1863. REPORT FOR THE YEAR 186 3. To the Board of Works for the Hackney District, Gentlemen, During the year I have, in company with Mr. Valentine, inspected the following localities, either in consequence of information that nuisances existed thereon; or that epidemic diseases were prevailing therein; or in the ordinary course of my inspection of the houses inhabited by the poor, viz: Crown-court, Homerton (10 houses); College-street, Homerton (12 houses); Plough-lane, Mare-street; London-lane; Tudor-grove; High-street, Homerton; Pickle's - buildings, Lower Homerton: The Oval, Cambridge-heath; Albion-road, Morning-lane; St. John's-place, Wells-street(3houses); Hockley-street, Morning-lane (5 houses); Lawrencebuildings and vicinity (19 houses); John-street, West Hackney; Samuel-row, West Hackney (8 houses); Elizabeth-place, Dalston (20 houses); Buccleugh cottages, Upper Clapton (10 houses); Needham-terrace, Clarenceroad (10 houses); Bower-road, White Post-lane; Parkroad, Hackney-wiek; Victoria-grove, Morpeth-road; 4 Harringtons-hill and Orchard-terrace, High-hill-ferry; Salem-place, Water-lane; Larter's-yard, Homerton; Tyssen-place, Shacklewell; Camomile-terrace, Queen'sroad, Homerton; Fishers-place, Shepherd-lane (8 houses); Robin-hood-hill, High-hill-ferry; High-street, West Hackney; Springvale-grove, High-street, Stoke Newington; Falcon-place, Stoke Newington; Ditch and Road, near Rectory, Stoke Newington; Union-court, and Duke's-court, Stoke Newington; Thomas-street, Water-lane; Lark-row (8 houses); Cambridge-heatli (6 houses); Water-lane; Godfrey's-row, Shacklewell; Cow-shed, and Cows kept without a license, at Providence-villas, Homerton; Caroline-street, Brook-street (14 houses); Cranbrook-farm (Cows kept without a license); Albert-street, Homerton (14 houses; Brookstreet, Homerton (26 houses); Bain's-buildings (10 houses); Tingey's-buildings (8 houses); Payne'scourt (4 houses); Orchard-street and Court (21 houses); William-street (15 houses); Victoria-street, Homerton (19 houses); Mayfield-road; St. Thomas's-square; Exmouth - place, Mare-street (16 houses); Jones'cottages, High-hill-ferry (6 houses); York-buildings, Stoke Newington (18 houses); Birch's and Barker'scottages (6 houses); Retreat - place, High-hill-ferry (9 houses); Robinson's Widows'-retreat (12 houses) ; Melina-place, Sheep-lane; Chapel-court, High-street, Stoke Newington (5 houses); Brunswick-street, Homerton; Jerusalem-square (22 houses); Duncan-square, Sheep-lane (17 houses); Grove-terrace; Cock and 5 Castle-lane (7 houses); John's-place, Stoke Newington; Pratt's-row, Brooksby's-walk (4 houses); Sanford-lane, West Hackney; Church-street, Stoke Newington; Margaret-street, Well-street (18 houses); Mortimerroad; Southgate-road; Mead's-place. West-street; Middlesex-place (5 houses); Orchard-street, Wellstreet (5 houses); Tottenham-square, Kingsland (9 houses); Messrs. Feast, Tottenham-road; Lordshiproad, Stoke Newington; Queen's-road; Wilmot-road; Tottenham-road (64 houses); Railway-cottages (4 houses); Castle-street, Kingsland (6 houses); Chathamplace; Park-cottages; James-place, Shacklewell (8 houses); Cambridge-terrace, Kingsland (5 houses); Eliza-cottages; Grove-street, South Hackney (6 houses); Draper's-court (10 houses); Wellington-street; Clarence-terrace; Saxony-cottages, Mare-street (10 houses); John-street, Cambridge-heath (4 houses); Pleasantplace (7 houses); Henry-street (11 houses); Coldbathlane (8 houses); Barnes-street, Stoke Newington; Chapel-yard, Stoke Newington; Park-street; Frederick-place, Tottenham-road (5 houses); Queen's-court, Well-street (8 houses); Warwick-villas; Englefieldroad; Blayney's Cow-yard and piggeries; Roseberrycottages (4 houses); Warwick-place; Morning-lane (5 houses); Providence-terrace, High-hill-ferry; Truroterrace, Alma-road (7 houses); Whitmore-road, Kingsland; Tudor-grove; Warburton-road; Ann's-place, Cambridge-heath; Graham-cottages (4 houses); GeorgeStreet, London-fields; Alma-cottages (5 houses); Grove- 6 lane, Stamford-hill; Denmark-place, Well-street (10 houses); Church-street, Hackney; Warwick-place; Navarino-terrace, Dalston; Park-place, Grove-street (12 houses); Margaret-street, Homerton (7 houses); Queen's-road, Dalston; Park-cottages; Arthur-street, Water-lane; Albany-cottages, Stoke Newington (4 houses); Navarino-road, Dalston (16 houses); Payne'scourt; Rehard-terrace, High-hill-ferry (7 houses); Lamb-lane, Mare-street (4 houses); Homerton Parochial-school; Devonshire-cottages, Green-lanes (10 houses); Victory-place, Green-lanes (5 houses); Millfield-place, Green- lanes (16 houses); King's - road, Homerton; Duncan-street; Upper Brunswick-street (8houses); Pear-tree-court, Clapton (4houses); Lamblane, Clapton; Wick-road; Bowles'-cottages; Fieldwick-cottages, Brunswick-street (4 houses); Johnstreet, Shacklewell (11 houses); Hertford-road; Churchroad, De Beauvoir-square; Woodland-street, Dalston; James-place, Shacklewell (9 houses); Bower-road, White-post-lane (4 houses); Wallace-road, White-postlane; Little Margaret-street, Stamford-hill (6 houses); Chapel-road, Stamford-hill; Orchard-hill, High-hill-ferry (4 houses); Retreat-cottages, High-hill-ferry (8 houses); Augusta-place, High-hill-ferry (10 houses); Truman'scottages (5 houses); Hammond's-cottages, Lea-bridge (12 houses); Brook-street (5 houses); Buckinghamroad; College-lane, Homerton; Lordship-road, Stoke Newington; Clarence-cottages; Buck's-square, Morning-lane (16 houses); Graham - place, Dalston-lane; 7 Wood-street, Clapton; Robinson's-row (4 houses); Brown's-place; Abbot-street, Kingsland; Grahamroad (8 houses); Tyssen-place, Dalston (7 houses); Caroline-cottages; Pear-tree-place; Wilson's-cottages, Sanford-lane; John-street, West Hackney; Unionrow, and Nelson-terrace, Morning-lane; Downhamroad; Southgate-road; Victoria-street, Homerton (4 houses); Pleasant-place, Sandford-lane (4 houses); Lawrence-buildings (6 houses); Ufton-road; Exmouthplace; Melina-place, Sheep-lane (5 houses); Woodstreet, Clapton; Conduit-street and Place, Clapton (8 houses); Grove-lane; Abney-gardens; Ada-street, Sheep-lane; George-street, Sheep-lane (14 houses); Bridge-place, Stamford-hill; Drapers-court (5 houses); Prate's-row, Homerton (4 houses), Courtenay-terrace, Kingsland; Swiss-cottages, South Hackney (4 houses); Harrington's-place (6 houses); Harrison's Factory; Nursery-row, Newington-common; Bowling-greenstreet; King's-road, Homerton (7 houses); Yorkbuildings, Stoke Newington (10 houses); Courtenayterrace, Essex-street, Mare-street (9 houses); Bailey'slane, Stamford-hill; Cock and Castle-lane (4 houses); Chapel-court, Stoke Newington; William-street (9 houses); Bayne's-buildings (10 houses); Tingey'sbuildings (8 houses); Orchard-street (12 houses); Caroline-street (6houses); George-terrace, Brookstreet (5 houses); Willow-place (3 houses); Frederickplace, Brook-street (5 houses); Victoria street (5 houses); Henry-street, Kingsland (4 houses); Clapton-terrace, 8 Hill-street (17 houses); Laurel-street, Dalston; Morning-lane (4 houses); Brook-street, Homerton; Goringstreet, Sheep-lane; Mount-pleasant-lane, Clapton (4 houses); and Arthur-street, Water-lane. In addition to the places just enumerated, 83 cowhouses, 69 slaughter-houses, and 90 bakehouses have been inspected by myself and Mr. Valentine during the year. As the bakehouse inspections were performed at a different part of the year to those of the slaughter and cow-houses, and as they are scattered all over the district, considerable time and labour were bestowed on them. The bakehouses were generally in good condition as regards ventilation and drainage: in no instance did any person sleep in the bakehouse, or was employed therein in contravention to the Act of Parliament. Where bed-rooms are provided for the men they are generally comfortable and well ventilated, but it was necessary to serve notices to repair and ventilate the bed-rooms in a few instances. The majority of the bakehouses also required cleansing and whitewashing, and notices were served on the owners to do the necessary works. At one bakehouse there was a large cesspool immediately under the bakehouse floor, which smelt offensively, and at a few others the drainage was sufficiently imperfect to require cleansing, trapping, or re-construction of the drains. The inspections of the cow-houses, slaughter-houses, and bakehouses have all been performed in conformity 9 with Acts of Parliament passed since the Metropolis Local Management Act came into operation, and will assist in maintaining the public health in a good state when the district shall become a comparatively crowded one. The year 1863 comprises in the Registrar General's Reports a period of 53 instead of 52 weeks as usual; but I have in my mortality tables included only 52 weeks, so as to compare the deaths of this year with those of other years. The corrected death-rate for the whole of London was above the average of the last 24 years, having been so high as 2.481 per cent. against the mean of 2.452 per cent. This excessive mortality has been caused chiefly through the unusual prevalence and fatality of fever and scarlet fever, 2892 deaths having been recorded from the former, and 5075 deaths from the latter disease; and in addition, 724 deaths from diphtheria—a large proportion of which were, doubtless, caused by scarlet fever. As I pointed out in a former report, and in essays published separately, scarlet fever is a disease which appears to depend less as to its spread on the sanitary state of the neighbourhood than other eruptive diseases. Thus, it is well known that its intensity depends chiefly on the constitution or diathesis of the person attacked: as one member of a family will have it in its severest form, and another very lightly. There cannot, however, be any doubt, that a depressed state of health induced by want of fresh air, the 10 ing of air tainted with gases resulting from decompositon, and especially from overcrowding and dirt, is a very frequent cause of a severe instead of a mild attack. The first quarter of 1863 was remarkably mild and very unhealthy; but although the mortality was unusually high, the amount of sickness was not so great as usual, in consequence of the prevalent diseases being very severe, and death resulting after an unusually short illness. The month of March was an extremely fatal one, through a great and sudden fall of temperature. In the second quarter of the year (April, May, and June), the death-rate was 2.313 per cent. of the population for the whole of London, which was greater than that of any quarter since 1853. In the third quarter it was again excessive, having been 2.325 per cent. of the population; whilst in the last quarter it was 2.236 per cent., or 0.058 per cent. above the average for the quarter. The births throughout the Metropolis have been decidedly on the increase, and especially in the Hackney District: 3,075 births having been registered in 1863 against 2,768 in 1862. I shall now proceed to a consideration of the Sanitary state of the Hackney District during this year. The first table to which I shall direct your attention is one showing the number of births in each quarter, and in each Sub-District. We learn by it, that of the 3075 11 births registered in 52 weeks, 189 took place in Stoke Newington Sub-District, 165 in Stamford-hill, 802 in West Hackney, 1193 in Hackney, and 726 in South Hackney. That the largest number was registered in the second quarter in Stoke Newington, in the first and second in Stamford-hill, in the first in West Hackney, in the first in Hackney and South Hackney. Also, that 842 births were registered in the whole district in the first quarter against 788 in the second, 722 in the third, and 723 in the fourth. The table also shows that in proportion to the population in 1861 the birth rate was largest in South Hackney, and smallest in Stoke Newington. Table 1. 1863.—Births in each Sub-District. Quarters. Stoke Newington Stamford Hill West Hackney Hackney South Hackney Totals 46 45 225 330 196 842 Second 55 45 214 294 180 788 Third 39 44 199 272 168 722 Fourth 49 31 164 297 182 723 Totals 189 165 802 1193 726 3075 Per Centages Births 6.1 5.3 26.1 38.9 23.6 100 Pop.1961 7.9 60 29.2 37.8 18.5 100 The next table, which may be considered as supplemental to the other, shows the birth-rate in each sub-district for the years 1856-63. The rate of births 12 in Stoke Newington has varied but little, the highest number having been 69 in each 1000 for the whole district, and the lowest 58. In Stamford-hill the rate has varied between 46 per 1000 and 62 per 1000, the rate in this district having decreased considerably since 1857. In West Hackney the rate varied between 261 per 1000 and 329, having also decreased very considerably since 1857-58. In Hackney the rate has been comparatively stationary, the highest proportion having been 397, and the lowest 367, whilst in South Hackney the highest has been 236, and the lowest 170. This variation in the birth-rate arises chiefly from variations in the number of inhabitants residing within the district, and the varying rates they bear to one another in different years. The rate in Hackney and South Hackney will increase; and in the others retrograde, in consequence of the greatly increased number of houses which have been lately built, or are being erected in these sub-districts. Table II. 1857-63.—Birth-rate in each Sub-District. Years Stoke Newington Stamford Hill West Hackney Hackney South Hackney Totals 1857 6.8 6.2 32.2 37.8 17.0 100 1858 6.7 5.1 32.9 37.3 18.0 100 1859 6.7 6.1 31.8 36.7 18.7 100 1860. 5.8 5.0 31.5 38.6 19.1 100 1861 6.2 4.6 29.8 39.7 18.5 100 1862 6.9 5.0 27.9 39.0 21.2 100 1863 6.1 5.3 26.1 38.9 23.6 100 18 Table 3. shows the number of deaths in each subdistrict registered in each quarter of the year; the deaths for the whole District in each quarter; and the corrected numbers for each district for the whole year, as well as the per centages of deaths and of the population. By the corrected numbers, I mean the deaths which take place in each sub-district, with a proper correction for deaths in the East London Union, German Hospital, and Union Workhouse. The total deaths registered in the Hackney sub-district were 867. Of these, 149 deaths occurred in the East London Union and German Hospital, which, in accordance with the usual custom, have been excluded from the totals. The deaths in the Hackney Workhouse amounting to 81 are also in the corrected numbers distributed amongst the sub-districts in proportion to their population. Table HI. 1863.—Deaths in each Sub-District. Quarters Stoke Newington Stamford Hill West Hackney Hackney South Hackney Totals First 28 30 122 264 102 546 Seoond 29 26 103 226 101 485 Third 39 16 121 198 100 474 Fourth 32 30 101 179 82 427 Totals 128 102 450 867 385 1932 Corrd.Nos. 134 107 474 668 400 1783 Per centgs, Deaths Corctd. 7.5 6.0 26.6 37.3 22.4 100 Popln. 7.9 6.0 29.2 37.8 18.5 100 14 From this table we learn that 128 deaths happened in Stoke Newington; 102 in Stamford-hill; 450 in West Hackney; 867 in Hackney; and 385 in South Hackney. After excluding the deaths in the East London Union and the German Hospital, and distributing, proportionately, those in the Workhouse, we find the corrected numbers to be 134 for Stoke Newington; 107 for Stamford-hill; 474 for West Hackney; 668 for Hackney; and 400 for South Hackney;—making a total of 1783. Of the total number of deaths, 1932, 546 were registered in the first quarter, 485 in the second, 474 in the third, and 427 in the fourth. These departures from the mean for the year were far greater than occurred in London generally, arising chiefly from the small mortality in Hackney during the last quarter of the year, when the mortality is ordinarily nearly as great as in the first quarter. The correspondence between the population in 1861 and the deaths for 1863 is moderately close in Stoke Newington, Stamford-hill, and Hackney sub-districts, but varies considerably in West Hackney and South Hackney, the death-rate having been smaller than the proportion of population in West Hackney, and larger than the proportion in South Hackney. The birth-rate, however, as already stated, as well as the next table, show that the population of South Hackney has increased since 1861 at a greater rate than in the other sub-districts. The next table (No. 4.) shows the ratio which the 15 number of deaths registered in each sub-district (corrected for deaths as before mentioned), bears to the total corrected deaths for the whole district. That is to say, that during the year 7'5 per cent. of all the deaths registered in the district belonged to Stoke Newington; 6.0 per cent. to Stamford-hill; 26.6 per cent. to West Hackney; 37.5 per cent. to Hackney; and 22.4 per cent. to South Hackney. It will be seen that whilst the proportionate death-rate has decreased since 1857 in Stoke Newington, Stamford-hill, and West Hackney, it has increased in Hackney and South Hackney. Table IV. 1857-G3.—Corrected Rates of Death in the SubDistricts. Years Stoke Newington Stamford Hill West Hackney Hackney South Hackney Totals 1857 9.8 7.8 31.9 34.2 16.3 100 1858 7.4 7.0 31.2 34.8 19.6 100 1859 6.7 6.1 31.8 36.7 18.7 100 1860 7.4 6.3 31.7 34.9 19.7 100 1861 6.7 5.0 31.5 35.9 20 9 100 1862 7.9 6.0 28.7 35.1 22.3 100 1863 7.5 60 26.6 37.5 22.4 100 Table 5, shows the causes of death in eighteen groups for the year 1863, the per centages for the year 1857.63. and the mean temperatures for the same years. In the year 1863, no less than 457 deaths were caused by epidemic or zymotic diseases. This class as will be seen in reference to the last table, includes small-pox, measles, scarlet fever, diphtheria, whooping cough, croup, diarrhoea, influenza, all kinds of fever, syphilis, and rheumatic fever. The number of deaths in this 16 class was considerably in excess, chiefly from the immense increase in the number of deaths from smallpox, scarlet fever, and diphtheria. Class 2, or diseases of uncertain seat were below the average, 85 only having been registered. In class 3, which includes consumption and strumous diseases generally, viz: water in the head and mesenteric disease. 299 deaths were registered, which was a smaller number than usual, having been only 15.5. In the next class, which embraces inflammation of the brain and spinal cord and their coverings, apoplexy, paralysis, St. Vitus's dance, epilepsy, insanity, and nervous diseases generally. An excess of mortality is again decidedly marked, 255 deaths, or 13.2 per cent. of the whole having been registered. This is, with two exceptions, the largest rate of death from these diseases in any year since my appointment, and would of course have been larger still if the mortality from epidemic diseases had been of its usual amount. Diseases of the heart and vessels show a diminution, as 4.3 per cent. only was registered. Affections of the lungs caused death in 283 persons, or at the rate of l4.6 per cent. of the whole: this was a low rate. The deaths from the diseases included in classes 1, 3, 4, and 6, were no less than 1294 or 67.0 of the deaths from all causes. This was in excess of 18G2, when they were 64.5 per cent.; and of 1861, when they were 65.6 per cent. Diseases of the digestive organs were fatal to 112 persons; old age, to 119 persons, or 6.2 per cent; and 70 deaths from accidents and 17 violence, or 3.7 per cent. The proportion of sudden deaths, or deaths from violence and accidents varies but little; thus, in 1857 it was 4.4 per cent.; in 1858, 4.5 per cent.; in 1859, 4.0 per cent.; in 1860, 5.3 per cent.; in 1861, only 3.2 per cent.; in 1862, 3.4 per cent.; and ' in 1863, 4.6 per cent. of the total deaths. Table V. Per Centages of Deaths in 1857-63 from all Diseases. 1857 51°0 1858 49°2 1859 50°7 1860 47°0 1861 49°4 1862 49°5 1863 50°3 Total Deaths 1863 1 Zymotic (Epidemic) Diseases 19.8 21.9 23.0 16.8 19.9 21.5 23.7 457 2 Diseases of uncertain seat 5.4 4.7 45 4.6 5.1 6.0 4.4 85 3 Tubercular Disease 18.5 14.7 15.9 16.8 16.5 171 15.5 299 1 Diseases of Nervous System 10.9 12.4 14.0 13.7 11.8 12.0 13.2 255 5 Heart 3.9 4.5 3.8 6.3 6.5 6.3 4.3 6.3 4.3 84 6 Lungs, &c 16.9 16.2 14.1 18.5 17.4 13.9 14.6 283 7 Digestive Organs 4.8 5.6 5.8 3.6 51 4.8 5.8 112 8 ... Kidney, &c l.6 1.6 2.2 1.6 1.8 1.5 1.7 32 9 from Childbirth 1.3 0.7 1.0 0.7 0.8 0.6 1.1 21 10 of the Bones, Joints, &c 0.5 0.3 0.4 0.3 0.3 0.7 0.7 13 11 Skin 02 0.1 0.3 0.1 0.2 0.2 0.0 1 12 Malformations 0.1 — 0.1 0.4 0.2 0.8 0.4 9 13 Premature Birth and Debility 2.5 4.2 3.1 3.0 3.4 3.4 3.0 58 14 Atrophy 1.7 1.5 1.0 1.2 1.0 1.2 0.8 16 15 Old Age 7.2 7.1 6.8 7.1 6.9 6.6 6.2 119 16 Sudden Deaths 1.6 2.1 0.8 0.4 0.2 0.4 0.9 18 17 Deaths fr.Violence Accidents 2.8 2.4 3.2 4.9 3.0 3.0 3.7 70 18 Not specified 0.3 — — — 0.1 — — — 100 100 100 100 100 100 100 1932 The next table is an unusually interesting one, as it shows the number of deaths, uncorrected for increase of population, from epidemic diseases since my appointment. It will be seen that Hackney has participated in the small.pox epidemic of 1863, in common with the rest of the metropolis, but not to so great an extent; for 18 whilst the mortality in. Hackney was 41, in the whole of London it was 2012, or at the rate of 48 deaths in 100,000 inhabitants for Hackney, and of 79 deaths in each 100,000 inhabitants for all London. The deaths from measles were about an average, viz: 37; from scarlet fever and diphtheria enormously large, 125 deaths having been registered from scarlet fever, and 34 from diphtheria. The mortality from whoopingcough, diarrhoea, and fever, was less than usual. I would especially point out the small number of deaths, 49, from fever, which, after making allowance for increase of population, is, with the exception of the cold rainy year 1860, the smallest number which has been registered since the introduction of the Metropolis Local Management Act. Table VI. 1856-63.—Deaths from Epidemic Diseases. 1856 1857 1858 1859 1860 1861 1862 1863 49°0 51°0 4u°2 50°7 47°0 49°4 49°5 50°o 13 1 0 5 2 1 2 41 Measles 39 22 36 10 43 36 32 37 Scarlet Fever 51 41 76 82 64 82 64 58 83 125 Diphtheria — — 27 27 11 24 27 34 Whooping Cough 29 .57 64 36 51 62 56 28 Diarrhœa 65 69 50 87 19 55 25 60 Fever 62 59 51 55 38 55 89 49 Totals 259 249 304 302 228 291 314 374 By table 7, we learn the great variations in the rate of deaths at one period of the year as compared with another; and also that the rate of death varies in one 19 quarter as compared with the corresponding quarters of other years. Thus, in 1857 277 per 1000 of the total mortality for the year was registered in the first quarter; 277 per 1000 in the first quarter of 1858; 244 in that of 1859; 318 in that of 1860; 292 in that of 1861; 271 in that of 1862; and 283 in that of 1863; proving, that with one exception the first or winter quarter was the most unhealthy during the years 18571863. I have, in former occasions, pointed out the great increase in the number of deaths when cold weather set in, an increase greater than obtains for the whole of London, and the necessity, therefore, of protecting especially the young, weakly and old from extreme atmospheric changes. Table VII. Per Centages of Deaths in each Quarter, 1857 to 1863. 1867 1858 1859 i860 1861 1862 1863 Temperature 51°0 49°2 50°7 47 °0 49°4 49°5 350° Quarters First 27.5 27.7 24.4 31.8 29.2 27.1 28.3 Second 21.4 21.3 21.4 23.5 22.4 24.1 25.1 Third 24.4 21.8 27.2 200 24.6 20.1 24.5 Fourth 26.7 29.2 27.0 24.7 23.8 28.7 22.1 Total 100 100 100 100 100 100 100 In the year 1863 no less than 437 children died during the first year of life, or 22.7 per cent of the total 20 deaths. Of the remainder, 535 died between 1 and 20 years of age, or 277 per 1000; 240 or 124 per 1000 between 20 and 40 years of age; 253 or 13.1 per 1000 between 40 and 60 years of age; 368 or 190 per 1000 between 60 and 80; and 99 or 51 per 1000 who were above 80 years old. The per.centage of deaths of children under 1 year old was greater than that of any year since 1858 ; but the large proportion of deaths at this age from diarrhoea, mesenteric disease, water on the brain, and convulsions partially account for this. There was also an excess of deaths between the ages of 1 and 20 arising from no less than 111 deaths from scarlet fever at these ages. On the other hand the rate of death was unusually small for the ages 20.40 years, 40.60 years, and 60.80 years. The proportion of deaths of those who were above 80 years old was the same as for last year, but was less than that of former years. Table VIII. Ages at Death in 1863, and Per Centages for 1857.6E Years Under 1 Year Between 1 and 20 Between 10 and 40 Between 40 and 60 Between 60 and 80 Above 80 Totals Total 1863 437 535 240 253 368 99 1932 Per Centages 1857 22.4 22.5 13.8 14.7 20.8 5.8 100 1858 24.4 22.4 13.5 14.3 20.1 5.3 100 1859 18.9 25.1 13.5 14.5 21.3 6.7 100 1860 19.3 2g.2 13.0 13.7 21.4 6.4 100 1861 18.8 26.8 11.5 16.0 21.0 6.9 100 1862 17.2 25.2 13.8 15.5 23.2 5.1 100 1863 22.7 27.7 12.4 13.1 19.0 5.1 100 21 As before stated, the mortality for the whole of London was unusually high for the year 1863, having been 24½ per 1000 of the whole population. The northern, which include Marylebone, Hampstead, Paneras, Islington, and Hackney, have suffered far more from disease and death than most of the other metropolitan districts; for instead of having the smallest mortality, they have had a larger death-rate than the west and south districts. Hackney, however, has not had so large a mortality as the other northern districts, or so large as for the whole of London; for if we allow the population on the 1st of July to have been 90,740, and the corrected number of deaths 1783, we shall have a death-rate of 10 in each 509 inhabitants, or 19½ in each 1000 living. As I have excluded the deaths in the German Hospital, I must add the proportion of death to the population for London generally, which was about 16 per 10,000, making the total only 212 in each 10,000 living, or 26 in 10,000 below the average for the whole of the northern districts. The last table shows the ages at death and the causes of death in fuller detail than table 5. The large proportion of deaths from small-pox amongst young persons, and the very large proportion of deaths from fever, of persons under 20 years of age, are very remarkable. Also the great number of deaths from cancer is worthy of notice, as this disease appears to be considerably on the increase in Hackney: 22 The number of nuisances removed by Mr. Valentine during the year is larger than for any year since 1858. The numerous house to house visitations which I have made in company with him, the inspection of the slaughter-houses, cow-houses, and bakehouses to a great extent account for the excess; but it also arises partially from choking of the drains through the careless habits of the poor, and the mischievousness of their children. The total number was 1696 against 1435 in 1862, 1417 in 1861, 1267 in 1860, 1224 in 1859, 2512 in 1858, 1789 in 1857, and 1567 in 1856. The amount of work necessary to remove so large a number of nuisances has been in excess of that required for any other year, the nuisances have been more scattered than formerly, and more urgent. Privies emptied, filled up, and drained into the Sewer 330 Privies and Cesspools emptied 17 Stable, Pig, Cow-dung, and other refuse removed 200 Premises repaired and lime-washed 367 Gulleys trapped, Roads cleansed, &c 33 Pigs removed, and Pigsties repaired and cleansed 95 Choked Drains cleansed, repaired, and re-constructed 359 Ditches, Urinals, and other offensive places cleansed 60 Other nuisances 235 Total 1696 To obtain the removal of this large number of nuisances, only 8 owners of property were summonsed before the magistrates, but 77 have been required to attend before the Board previously to a summons being issued. This plan of giving persons an opportunity of 23 appealing to the Board against the opinion of the Medical Officer of Health and the Inspector, previously to a summons being applied for at the Police Court, is not adopted, so far as I am aware, by any other Board, and is most valuable. It has been adopted to supersede the functions usually exercised by a Sanitary Committee, and acts as a safeguard against any excess of zeal or error of judgment by the Officers of the Board. It also in many instances, saves the expense and loss of time which would otherwise result from appearing at the Police Courts, to obtain a Magistrate's order for the removal of the nuisances. 24 Table 9. Deaths registered in the District of Hackney, during the Fifty-two Weeks ending December 26th, 1863. CAUSES OP DEATH, AGES Total Under l 1 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above I. Zymotic— Small-pox 14 12 12 2 1 ... 41 Measles 4 33 ... ... ... ... 37 Scarlatina 11 111 2 1 ... ... 125 whooping-Cough 9 19 ... ... ... ... 28 Croup 4 22 ... ... ... ... 26 Throush 1 ... ... ... ... ... 1 Diarrhœa (Bowel complaint) 41 13 1 ... 4 1 60 Dysentery 2 ... 1 2 1 ... 6 Cholera ... ... ... ... ... ... ... Influenza 3 ... ... ... 4 1 8 Ague ... ... ... ... 1 ... 1 Remittent Fever ... 4 ... ... ... ... 4 Continued Fever ... 27 10 4 7 1 49 Puerperal Fever (Metria) ... ... 7 ... ... ... 7 Rheumatic Fever ... 3 3 3 1 ... 10 Erysipelas (Rose) 2 2 2 2 3 3 14 Syphilis 6 ... ... ... ... ... 6 Diphtheria 6 27 1 ... ... ... 34 457 II. Dropsy. &c.— Hæmorrhage ... 1 2 2 2 ... 7 Dropsy ... 3 2 6 10 1 22 Abscess 1 1 ... ... ... ... 1 1 4 Ulcer ... ... ... ... 1 ... 1 Fistula ... ... ... ...... ... ... Mortification 1 3 1 ... 4 2 11 Cancer ... ... 3 18 17 1 39 Gout ... ... ... ... ... ... 1 85 III. Tubercular— ... ... ... ... ... ... ... Scrofula 1 1 ... ... ... ... 2 Tabes Mesenterica 35 16 ... ... ... ... 51 Phthisis (Consumption) 1 29 99 58 5 ... 192 Hydrocephalus (water on brain) 31 23 ... ... ... ... 54 299 IV. Brain and Nerves— Inflammation of Brain, &c 8 19 6 12 13 1 59 Apoplexy ... ... 3 18 26 2 49 Palsy(Paralysis) ... ... ... 17 33 7 58 Delirium tremens ... ... 2 1 ... ... 3 Chorea ... 1 ... ... ... ... 1 Epilepsy 1 3 3 2 1 ... 10 Insanity ... ... ... ... 3 . 5 Convulsions 55 13 ... ... ... ... 68 Other Diseases of Brain ... ... ... ... ... ... ... Diseases of Spinal Cord ... 1 ... ... ... ... 2 255 Carried forward 237 388 160 151 139 21 1096 25 Table 9.—(continued). Causes of Death AGES Total Under 1 1 and under 20 20 and under 40 40 and under 60 CO and under 80 80 and above Brought forward 237 388 160 151 109 21 1096 V. Heart and Blood Vessels — Inflammation of Heart, &c ... 2 ... ... 1 ... 3 Aneurism ... ... ... ... ... ... Disease of Heart and Vessels 2 14 14 12 36 3 81 84 VI. Lungs and Organs op ration- Laryngismus Stidulus 4 3 ... ... ... ... 6 Laryngitis ... 3 ... ... 1 ... 4 Bronchitis 28 26 1 is 64 10 144 Pleurisy ... 1 2 2 ... ... 5 Pneumonia 30 42 9 9 7 5 102 Asthma ... ... ... 2 5 ... ... Disease of Lungs (not specified) 4 1 1 4 5 ... 15 283 VII Stomach and Digestive Organs— Teething 8 8 ... ... ... ... 16 Quinsey ... 4 1 ... ... ... 5 Gastrittis ... ... 2 2 1 ... 5 Enteritis 1 5 1 1 ... ... 8 Peritonitis ... 2 4 2 ... ... 8 Ulceration of Intestines ... ... ... 1 2 ... 3 Hernia(Rupture) ... 1 ... ... 1 1 3 Ileus 1 1 ... ... ... ... 2 Intussusception ... ... ... ... 1 ... 1 Disease of Stomach, &c ... 1 ... 1 2 ... 4 Inflammation of Liver (Hepatitis ... 3 5 7 5 l 21 Jaundice 3 1 ... ... 10 ... 14 disease of Liver ... 3 5 8 5 l 22 112 VII. Kidney, &c.— Nephritis ... ... ... 1 ... ... 1 Nephria (Bright's disease) ... 1 4 10 4 ... 19 Diabetes ... ... ... 1 1 ... 2 Stone ... 1 ... ... ... ... 1 Cystitis ... .. ... ... 2 ... 2 Disease of Kidney ... 1 ... 1 3 2 7 32 IX Childbirth— Childbirth (see Metria) • •• 1 7 ... ... ... Disease of Uterus, &c ... ... 3 5 ... ... 8 Ovarian Disease ... ... 3 1 1 ... 5 21 Carried forward 318 514 222 234 296 44 1628 26 Table 9.—(continued.) Causes of Death Ages Under 1 1 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Total Brought forward 318 314 222 234 296 44 1628 X. Joints, Bones, &c.— Disease of Joints and Bone ... ... 1 4 1 ... 6 Disease of Spine .. 6 1 ... ... ... 7 13 XI. Skin, Cellular, Tissue, &c. Carbuncle and Boils ... ... ... ... ... ... 1 XII. Malformation-- Spina Bifida 1 ... ... ... ... ... 1 Other Malformation 7 1 ... ... ... ... 8 9 XIII. Premature Birth and Debility— 58 .. ... ... ... ... 58 XIV. Atrophy 16 ... ... ... ... ... 16 XV. ... ... ... ... 66 53 119 XVI. Sudden Deaths 18 ... ... ... ... ... 18 XVII. Violent Deaths— Intemperance ... ... ... ... ... ... ... Privation of Food ... 1 ... ... ... ... 1 Want of Breast Milk ... ... ... ... ... ... ... Surgical Operations ... ... ... ... 1 ... 1 Poison ... 1 2 1 ... ... ... Burns and Scalds 1 4 1 2 ... ... 8 Suffocation 1 ... ... ... ... ... 8 Drowning 8 4 5 5 1 ... 15 Fractures and Contusions ... 3 5 3 2 1 15 Wounds 1 1 3 2 1 ... 7 Other Violence ... ... ... ... ... ... •• 70 XVIII. Not Specified ... ... ... ... ... ... ... Total 437 535 240 253 368 99 1932 Under 1 1 and under 20 20 and under 40 40 and under 60 60 and under 80 80 and above Total