HAC 48 REPORT ON THE SANITARY STATE OF THE HACKNEY DISTRICT, FOR THE YEAR 1868. BY JOHN W. TRIPE, M.D,, L.R.C.P.E, &c, vice-president of the meteorological society. medical officer of iiealtii to tiie district. Printed by Order of the Board, by a. t. roberts, steam works, 5, iiackney road, london. 1869. SANITARY REPORT For the Year, 1868. To the Board of Works for the Hackney District. Gentlemen, I have to enumerate several Acts of Parliament which have either come into operation or have been passed this year. The Workshop Regulation was passed in 1867, and came into operation on the first day of January, 1868. By this Act it is rendered illegal to employ in a workshop or workplace in which less than fifty persons are employed: (1) a child under eight years in any handicraft; (2) any child under thirteen years in any handicraft for a longer period than six and a-half hours daily, or between eight at night and six in the morning; (3) any young man or woman under eighteen years of age, or any woman, for more than twelve hours out of any twenty-four hours, with intervening period of rest of not less than one and a-half hours; (4) any child, young person, or woman in any handicraft on Sunday or after two on Saturday afternoon, except in cases where not more than five persons are employed in the same establishment, and where such employment consists in making or repairing articles to be sold by retail on the premises. The penalty on the employer is to be not more than three pounds, and on the parent one pound for each offence. A fan is to be used in every workshop where grinding, glazing, or polishing on a wheel, or in which any process is carried on 4 generating dust, under a penalty of not more than ten pounds or less than three pounds for each offence. By section 9 of the Act, on the complaint of any officer of health, inspector of nuisances, or other officer appointed by a local authority, or any superintendent of police, it appears to any justice of the peace, that there is reasonable ground for believing that any of the provisions of this Act or of the Sanitary Act, 1866, are contravened in any workshop, it shall be lawful for such justice to empower the complainant to enter into such workshop to ascertain if the provisions of this Act or of the Sanitary Act, 1866, are carried out. Any person refusing admission is liable to a penalty not exceeding twenty pounds. By section 12, all penalties may be recovered summarily before a police magistrate. By section 14 and 15 it is enacted that every child employed in a workshop shall be sent to school by the parent for at least ten hours every week, under a penalty of not more than one pound; aud by section 16 the employer shall obtain a certificate of the attendance at school, and retain it for one month under a penalty of not more than three pounds. By section 18 it is provided that " it shall be the duty of the local authority to enforce within their jurisdiction the provisions of the Act, so far as relates to any powers or authorities conferred on them by the Act. Under these provisions the officers of the Sanitary Staff have inspected a Targe number of workplaces, and have served an abstract of the Act on 203 occupiers of workshops. It has not been necessary to take out any summons for a breach of this Act. The provisions of the Artizans' Dwellings Act has also been put in force for the first time within this district during this year. The notices necessary for carrying out this Act are numerous and difficult to frame; but your officers have not allowed the difficulties of the Act to prevent them for doing 5 their best to carry out its provisions. I reported to you on the 22nd day of October that fifteen houses in Lawrence buildings and five at the back of Lawrence buildings were in such a condition or state as to be dangerous to health and unfit for human habitation, when you directed Mr. Lovegrove to report thereon. Mr. Lovegrove, at a subsequent meeting, brought up his report, in which he stated that ten required structural alterations and five should be demolished. Notices were then drawn up and served on the owner, but as it has been necessary to serve seven notices for each house, the progress has been necessarily slow. A new Petroleum Act has also been passed, and is likely to entail considerable extra work on your sanitary officers, as it will be necessary to examine the premises of each person applying for a license. By this Act, " Petroleum" " is a rock or other oil which gives off' an inflammable vapour under 100° F.," and is therefore very likely to cause fires. The River Lea Conservancy Act also passed this year, and its clauses will come into operation in February, 18G9. From and after that date it will be illegal to open into the Lea or any of its tributaries, or any cut, dock, canal, ditch connected therewith, any sewer, drain, pipe or channel into or through which sewage or other offensive matter may run into the river, under a penalty not exceeding one hundred pounds, and not exceeding fifty pounds after the adjudication of such penalty. Also by the 92nd and 93rd sections, where such offensive matter is suffered to flow into the Lea, the Conservancy Board shall give notice to the authority causing or suffering the same so to flow or pass, requiring them within the time specified in the notice to discontinue the flow or passage thereof, under similar penalties of hundred pounds and fifty pounds respectively; and the Board may also stop up the outlet of the ditch, sewer, &c., at any time after such conviction, and recover the cost of so 6 doing from the authority or person causing or allowing the nuisance. Under the 94th section, there is a power of appeal to one of her Majesty's principal Secretaries of State as regards the time within which the necessary works must be carried out. In connection with this Act, I may mention that a considerable amount of correspondence has been carried on respecting the drainage from several houses, situate in this district, on Stamford Hill and in Bailey Lane, which runs into a ditch in Tottenham, and eventually into the Lea. I brought this matter before you on two occasions during the year, in consequence of complaints received from Mr. Slipper, and proposed on the last occasion that a committee should be appointed to confer with the Tottenham authorities. At that meeting it was arranged, subject to the approval of both Boards, that a plan of the houses should be prepared by Mr Lovegrove, and a list of the assessments made by Mr. Ellis, and forwarded to the Tottenham authorities, to make a basis on which a sewer rate should be paid to them in return for permission to connect these drains with their sewer. The conditions on our part have been complied with, and I therefore hope that the arrangement will be satisfactorily carried out. A most important point respecting the cow sheds and slaughter houses was mooted at the meeting of the magistrates in October last, viz., how far the provisions of the Old Building Act are now in force. It is therein provided that no such business shall be carried on within 50 feet of a house, or 40 feet of a public way, unless established before 1845. The Act under which licenses are granted was passed in 1862, and might be considered to abolish the old Act, but inasmuch as no reference whatever was made to it, the question is still undecided. Under these circumstances the Sanitary Committee held a special meeting at which it was determined that in their opinion great 7 care should be exercised as regards the granting of fresh licenses. They also appointed a sub-committee to ascertain with me the precise position as regards the distance from roads and houses of all the cow sheds and slaughter houses in the district. They also recommended that the sheds should be examined at an early period of 1869, to ascertain the alterations required, if any, to render the sheds, &c., as innocuous as possible to the neighbourhood. I inspected South Hackney Churchyard, in consequence of complaints from inhabitants of the neighbourhood. On examining the ground I found it very full indeed, and therefore wrote to the Secretary of State for the Home Department, who directed Mr. Holland, the medical inspector of churchyards, to meet the vicar and churchwardens in the vestry, as well aa me, on the 13th day of March. The burial records showed that between January 1st, 1861 and December 31st, 1867, no less than 2487 interments had been made there, or at the rate of 350 a year in one and a half acres of ground. We then went over the churchyard, and found that there was only space for four new graves and two vaults, but that many of the old graves were by no means full; this applied chiefly to the family graves. After some conversation it was arranged that Mr. Holland should advise the Secretary of State, " that no interment should be made in ordinary graves unless there were at least five feet of ground above the coffin, measured to the level of the earth. That after receipt of the order closing the ground, no burial should be allowed except in private graves, and then only subject to the above restriction, and also that the ground should not be removed within one foot of the coffin last placed therein." I have also inspected Homerton churchyard and Abney Park cemetery. There have been 206 burials in the two years 8 ending December, 1867, in tbe former, and there is still space for a good many more, especially as in many instances only one coffin has been placed in a grave. As regards Abney Park cemetery, it is by no means full, and the regulations issued by Her Majesty's Privy Council are strictly observed. I have also made numerous inspections of manufactories during the year, and have appeared at the police courts to give evidence, under the 54th and 55th sections of the Old Building Act, against the proprietors of the Star works, the Varnish manufactories in Valentine Road and White Post Lane, Hackney Wick. I have also inspected several times Redwood's factory, the Parkseine works; the Fat Melters'; and Messrs. Barnes at Hackney Wick. The Star works were opened for the purification of paraffin for making candles, and a large quantity of rock (paraffin) oil was used in the manufacture. The smell was extremely disagreeable and was very much complained of. It was situated in a very crowded neighbourhood, and carried on in a building within a few feet of a house. When the case was called on, the magistrates adjourned it for two months to allow the defendant to obtain other premises. During the interval, they were burnt down, and have not been occupied for a similar purpose. The Fat Melters was also much complained of by persons in Victoria Park, and after several inspections, finding that several alterations required by me had not been carried out, I obtained an order for the prosecution of the owner. It was not necessary, however, to put it into force, as the business was removed during the autumn. I also paid several visits to Mr. Redwood's chemical manufactory adjoining the Hackney Union, and suggested several alterations which were immediately carried out by Mr. Redwood. Amongst other works which I requested him to perform was 9 the erection of a shaft to carry off the effluvia evolved during the drying of rice starch, to a height considerably above that of the adjoining houses. This effectually prevented the nuisance to the neighbourhood. I also requested hint to remove the apparatus for making oxide of iron to a distance from the workhouse grounds (as complaints were made of the escape of steam and small quantities of sulphuretted hydrogen) also to pass the vapours, &c., through coke and a solution of caustic potash or soda. Since these have been done no new complaints have been made to us. In consequence of numerous letters having been received complaining of unpleasant smells escaping from the drains into the houses at Hackney Wick, I examined some of the sewage (which was procured for me by direction of Mr. Lovegrove) escaping from Messrs. Barnes' factory, at Hackney Wick, and found it to contain naptha washings and carbolic acid. On calling at Mr. Barnes' factory it was arranged that the washings should be passed through a large filter containing quick lime, and that the quantity of carbolic acid used for disinfecting the liquid should be diminished. These means have been effectual in removing the smell, except on very rare occasions. I also laid a report before you respecting the refuse which escaped from Messrs. Griffiths' manufactory, for the distillation of gas tar, into a sewer at Bow, which communicated with the low level sewer. A copy of this report was sent to the Metropolitan Board of Works, who succeeded in obtaining some of the refuse, and in convicting Messrs. Griffith for the offence. I have also inspected an essential oil distillery at Ash grove, in consequence of complaints from the inhabitants of the adjoining houses of an unpleasant smell therefrom. I advised several slight alterations to be made, which have had the desired effect. The supervisions of the dust contract has entailed a great deal of work on the sanitary staff, as we have had to give notice to 10 the contractor of 1529 applications for the removal of accumulations of dust and refuse, and have also, in several cases, had to investigate complaints of incivility of the men, of refusals to remove refuse, &c. In some instances the men were justified in their objections, as the accumulations consisted partly of trade refuse, which the owners have to remove at their own expense. The number of houses inspected under the provisions of the Sanitary Act was larger than in 1867, as 5857 were examined in 1868, against 5169 in 1867. The great number of small houses which have been erected in Hackney during the last ten years, account not only for this, but also for much of the increased sanitary work. A recent return of assessments ordered by resolution of the Trustees in January, 1869, shows that out of each 1000 houses in the parish of St. John at Hackney no less than 163 are assessed at £10 per annum or under, 254 between £10 and £20, and 324 between £20 or £30, making no less than 741 houses in each 1000, which are assessed at £30 per annum or for a smaller amount. The number of nuisances abated during the year was not so large as in 1867, yet it was much greater than in any year before the passing of the Sanitary Act. I append an epitome as usual:— Nuisances removed during the Year, 1868. Privy Cesspools emptied, filled up, and drained into the sewer 67 Privy Cesspools emptied (where there is no sewer) 58 Choked Drains cleansed and repaired, or re-laid 181 New Traps provided 369 Yards drained 193 Total number of nuisances from defective drainage, &c. 868 11 Brought up 868 Yards paved 461 Houses repaired, white-washed, &c. 1321 Houses in which the ventilation was improved 131 Houses to which a better water-supply was given 99 Total number of nuisances from defects in houses 2012 Houses disinfected 318 Houses overcrowded 97 Pigs removed 68 Stable and other refuse removed 67 Filthy places cleansed 29 Other nuisances removed 464 Total number of nuisances abated 3923 Number of houses measured under the Sanitary Act . 168 „ „ inspected „ ,, „ 5857 „ lodging-house notices served 1651 „ letters sent out 514 „ Preliminary notices served 3492 „ Peremptory notices served 1623 „ Statutory notices served 688 „ Persons summoned before Magistrates . 98 „ Copies of Summonses and Orders made out 588 „ Notices served under the Artizans'Dwelling Act 80 „ Workshop Regulation Act 202 „ Accumulations of dust and refuse removed . 1529 The greatest reduction in the number under any one heading has been under that of improved ventilation, for in 1867 no less than 1238 houses against 131 in 1868 were thus improved. There were more houses whitewashed and repaired in 1868, 12 and nearly as many yards paved and drained, showing that we cannot expect a great reduction, if indeed any, in the number of houses requiring repair. There were no less than 5857 houses inspected under the Sanitary Act, being about 700 more than in 1867, and 2317 of these were wanting in some of the requisites necessary to make them fit and proper places to dwell in. In many the houses were not only in a bad state, but the paving or drainage imperfect, so that 3433 nuisances were found by inspection out of the total of 3923 abated. The great necessity for an annual house to house visitation, even in a suburban district like this, is therefore very evident. In addition to the house inspected we examined 77 bakehouses, 96 greengrocers' yards, 13 fishmongers' yards' and poulterers', and 165 urinals, making a total of 359. There were 75 nuisances discovered in these premises. We also inspected 95 cow sheds and 77 slaughter houses, many of them more than once, as the owners objected to perform the work deemed necessary by the committee and myself. There were also several hundreds of dead animals removed from public places and buried under the supervision of your sanitary officers. Before concluding this part of my report I desire to express my satisfaction at the manner in which Mr. Self, your chief sanitary inspector, Mr. Jones, the second inspector, and Mr. Watts, the sub-inspector, have performed their duties, and for the prompt and active aid they have at all times given me in carrying out the various Acts of Parliament which are now in force, for the preservation and improvement of the public health. During the year there have been 32 bodies removed to the mortuary, making a total of 109 since it was opened during the cholera epidemic." The causes of the 32 deaths were as follows : 13 small pox 1, fever 5, cholera 1, choleraic diarrhœa 1, 1 woman found dead iu the police cell, 1 from convulsions, 14 from drowning, 6 newly-born, and 2 from accidents. The small-pox and fever cases were removed from rooms in which people were living. I shall now proceed to lay before your a statistical account of the birth and death rates in the sub-districts; the causes of death; the ages at death; and other tables necessary to ascertain the sanitary condition of the district during the year. TABLE I. 1868.—Birtiis in each Sub-District. 52 Weeks. Quarters. Stoke Newingtn. Stamford Hill. West Hackney Hackney. South Hackney Totals. First 50 44 213 396 279 982 Second 40 27 221 364 262 914 Third 52 52 207 331 239 881 Fourth 67 53 249 352 278 999 Totals 209 176 890 1443 1058 3776 Before discussing table 1, I may mention that the Registrar General included 53 weeks in the year, but for purposes of comparison I have excluded the week ending January 4th, 1868, and made up my return for 52 weeks as usual. This is an error of one day in each year, which does not affect the results for purposes of comparison. Table 1 shows that there were 3776 births registered during the year, of which 982 took placc in the first quarter, 914 in the second, 881 in the third, and 999 in the fourth : that 209 births were registered in the Stoke Newington sub-district, 176 in Stamford Hill, 890 in West Hackney, 1443 in Hackney, and 1058 in South Hackney. 14 TABLE II. 1861 & 68,—Per Centage of Births in each Sub-District. Births. Stoke Newingtn. Stamford Hill. West Hackney. Hackney. South Hackney. Totals. Per centages. 1857.66 6.3 5.2 28.9 38.7 20.9 100 1867 5.4 4.3 24.4 39.4 26.5 100 1868 5.5 4.7 23.6 38.2 28.0 100 1861 6.2 4.6 29.8 39.7 19.7 100 Popultn. 1861 7.9 6.6 29.2 37.8 18.5 100 Table 2 shows the per centages of births in each sub-district for years 1857-66, for 1861 and 1868, also of the population in 1861. In 1861 the per centages of births were less than those of the population in Stoke Newington and Stamford Hill, but greater in West Hackney, Hackney and South Hackney. The per centages of births have diminished in Stoke Newington, West Hackney, and Hackney, slightly increased in Stamford Hill, and are very much greater in South Hackney. This is nothing more than might have been expected, considering the very large number of houses which have been built in South Hackney since 1861. The per centages as compared with 1867 have increased in the same sub-districts to the extent of 0.4 per cent. in Stamford Hill, and 1.5 per cent. in South Hackney. The total number registered in South Hackney was more than double that in 1861, viz. 1058 against 514. 15 TABLE III. 1868.—Deaths in each Sub-District. 52 Weeks. Quarters. Stoke Newingtn Stamford Hill. West Hackney. Hackney. South Hackney. Totals. First 28 28 99 251 106 512 Second 30 13 109 254 110 516 Third 42 22 114 254 131 563 Fourth 34 35 149 299 135 652 Totals 134 98 471 1058 482 2243 PerCentgs. 6.0 4.4 21.0 47.2 21.4 100 This Table cf Deaths in 1868 indicates a very favourable state of the public health, as although we have every reason to believe that the population has increased, yet the mortality was less than in 1867, 2243 deaths having been registered against 2269 in the last named year. The deaths were more numerous than usual in Stoke Newington, Stamford Hill, and West Hackney, but fewer in Hackney and South Hackney. The per centages were, in Stoke Newington 6.0, in Stamford Hill 4.4, in West Hackney 21.0, in Hackney 47.2, and in South Hackney 21.4. The per centage for Hackney is much larger than properly belongs to it, as the deaths in the Hackney Union, the East London Union, as well as in the German Hospital, have to be eliminated and distributed pro rata over all the sub-districts, before the proper number for each sub-district can be obtained. All the deaths in the above-named Institutions are registered in the Hackney sub-district. 16 TABLE IV. Births & Deaths in Hackney ; 52 Weeks in each Year. Tears. Hackney No. of Births. Hackney No. of Deaths. Hackney No. of Births to 100 Deaths. London Death-rate por 10,000 Inhabitants corrected. Hackney Death-rate per 10,000 Inhabitants correctod. Hackney No. of Houses. 1847 1527 1128 135 269 234 1848 1541 1040 148 258 209 1849 1609 1194 135 301 231 1850 1656 924 179 210 178 1851 1799 1074 157 234 199 10,561 1852 2000 1117 179 225 199 1853 1891 1207 156 243 203 1854 2038 1417 144 203 229 1855 2180 1449 150 243 205 1856 2275 1371 165 221 190 1857 2434 1484 165 224 192 1858 2454 1629 151 239 211 1859 2570 1563 164 227 197 1860 2632 1542 171 225 191 1861 2752 1745 157 231 206 14,296 1862 2768 1749 158 235 188 1863 3075 1932 159 244 214 1864 3170 2142 148 264 224 1865 3356 2187 153 243 208 1866 3508 2394 150 264 229 1867 3858 2269 170 229 210 1868 3776 2243 163 236 206 19,471 54,869 34,800 157 239 207 Table 4 shows the number of births and deaths in Hackney between 1847 and 1868, during which period the births have considerably more than doubled, and the deaths also doubled. The number of houses is also more than twice as great as in 1847. The ratio of births to deaths has also considerably increased, the average for the whole period being 157 births to each 100 deaths, in 1847 it was 135, and in 1868 163 to each 100. This shows not only that the district is in a better sanitary condition, but also that there is a larger proportion of married persons of middle age than there was in 1847. The 17 rate of death in Hackney has been very considerably below that for all London, the average for the last 22 years being 239 per 10,000 for all London, and only 207 for Hackney. In 1867 the death rate for London was 236, and for Hackney 206 in each 10,000 inhabitants. In making this calculation I have excluded 73 deaths in the German Hospital, and 115 in the East London Union from the mortality of Hackney, and added on one death for each 623 inhabitants, which is the average of deaths in hospitals for the whole metropolis. I have also calculated that the population in the district was 108,419 on July 1st., being an increase of more than 24,000 since the census in 1861. There have been 5175 houses built since 1861, the total number now being about 19,471. This, at the rate of six persons to each house, which was the proportion in 1861, gives a number closely approximating, indeed exceeding that calculated as above. This result is eminently satisfactory, because as I pointed out in previous reports, we must not expect the comparative death rate to remain so low for Hackney as in previous years, because when the Metropolis Local Management Act was passed, Hackney was in a much better sanitary condition than the other east and north-east parts of London, so that there was not so much room for improvement. The district also contains now a much larger proportion of children of the working classes, and also of poor, than it did in 1856 (as evidenced by the increased poor-rates) amongst whom a greater mortality takes place than in the rich and in their servants. The increased rate of death in children under one year old also indicates a great change in the social condition of the inhabitants, for during the 10 years 1850-59 the proportion of children who died under one year old was only 201 in each 1000 deaths, but it was no less than 254 in 1868. It is true that this great 18 mortality in 1868 was some what exceptional, and was chiefly caused by diarrhoea; but a rate nearly equally as great has obtained for several years past. TABLE V. Deaths in Hackney. CAUSES OF DEATH. Deaths from Totals 1868. Per Centages. 1868. 10 years' average. Miasmatic, (Epidemic) diseases 379 16.6 20.8 Diathetic, &c., diseases 119 5.2 4.8 Tubercular diseases 406 17.8 16.6 Diseases of the Nervous Svstem 312 13.7 13.0 „ „ Organs of Circulation 134 5.9 5.2 „ „ Respiratory Organs 328 14.4 16.3 „ „ Digestive and Urinary do. 145 6.3 6.5 „ „ Skin and Joints 14 0.6 0.6 Premature Birth and Atrophy 157 6.9 4.9 Childbirth, &c. 27 1.2 0.9 Old Age 180 7.9 7.0 Violent doatha 80 3.5 3.4 total 2281 100 100 Having laid before you a brief resume of the births and deaths, I now proceed to discuss the " causes of death." Table 5 shows that out of the 2281 deaths 379 or 16.6 per cent. were caused by miasmatic or epidemic diseases, that is to say by scarlet fever, measles, fever, diarrhoea fever, &c. This is a very much smaller rate than the average of the 10 years previously to 1866, and is very satisfactory, as it indicates that the energetic carrying out of the Sanitary Act, which was passed in 1866, has produced beneficial results. As this per centage is calculated on the deaths, and not on the population, some of the other " causes of death " must show a higher rate ; thus we see that the per centages are higher in the diathetic and tubercular classes, also from diseases of the nervous system, heart, and premature birth and atrophy. This latter we might expect, 19 considering that the birth-rate is higher than it used to be. There were 406 deaths or 17.8 per cent. from tubercular diseases, 312 or 13.7 per cent. from diseases of the nervous system, and 134 or 5.9 per cent. from diseases of the heart and great vessels. The deaths from affections of the lungs were considerably less than before, as 328 or 14.4 per cent. only were registered against 16.3 per cent. in 10 years, and 16.0 in 1867. There were 157 deaths or 6.9 per cent. against 4.9 per cent. registered from premature birth, and 180 or 7.9 per cent. from old age against 7.6 per cent. The deaths from violence vary perhaps as little as any, 80 or 3.5 per cent. having been registered against an average of 3.4 per cent. This is very singular, as it shows that the causes of death from violence are but little altered by the changes in the social and sanitary condition of the population. TABLE VI. 1857-68.—Deatiis from Seven Epidemic Diseases. Hackney. 1857 1858 1859 1860 1861 1862 18g3 1864 1865 1866 1867 1868 51°0 49°2 50°7 47°0 49°4 49°5 50°3 48°5 50°3 49°8 48°6 51°6 Small-Pox 1 0 5 2 1 2 41 12 6 31 27 6 Measles 22 36 10 43 36 32 37 79 22 26 15 35 Scarlet Fever 41 76 82 64 58 83 125 64 98 68 49 49 Diphtheria ... 27 27 11 24 27 34 15 22 12 16 14 WhoopingCough 57 64 36 51 62 56 28 48 56 89 72 42 Diarrhœa 69 50 87 19 55 25 60 71 125 162 75 120 Fever 59 51 55 38 55 89 49 77 75 76 63 54 Totals 249 304 302 228 291 314 374 366 404 464 317 320 Corrected 359 425 410 301 373 389 449 425 452 501 330 320 The total number of deaths from the seven most fatal epidemic diseases was 320, which although greater than the number in 1867, and all the years previous to 1863, yet is smaller than in any year, except 1860, when the increase of population is taken into account. The line of figures placed opposite the word "corrected," shows the number of deaths 20 from these diseases, which would probably have occurred if the population had been as great then as it now is. The summer of 1860 was remarkably cool and wet, so that the mortality from fever and diarrhoea was much less than usual, 19 deaths only having been registered from diarrhoea, being 100 less than in 1868, and only 38 from fever against 54 in 1868. The proportion of deaths from diarrhoea in 1868 was excessively large, being more than one third of the total from all these diseases, whereas the average is about one-fifth. Against this excess of deaths is to be placed the reduction in the mortality from whooping cough, scarlet fever and fever. As regards scarlet fever it is remarkable that Hackney should have escaped the epidemic which has raged in most of the metropolitan districts. I attribute this chiefly to the prompt disinfection of the rooms, clothes, and the excrements of persons suffering from this disease. TABLE VII. Hackney.—Ages at Death in 1868. Year. Under 1 year 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 to 95 95 and upwds 1868 579 317 109 115 176 158 162 177 243 194 49 2 Totals 1868. 25.4 13.9 4.4 5.1 7.8 6.9 7.1 7.8 10.7 8.6 2.2 0.1 per Centg. This important Table shows that 254 deaths of children under one year old were registered in each 1000 deaths. That out of each 1000 deaths, 139 were registered between 1 and 5 years of age; 44 between 5 and 15; 51 between 15 and 25; 78 between 25 and 35; 69 between 35 and 45 ; 71 between 45 and 55; 78 between 55 and 65; 107 between 65 and 75; 86 between 75 and 85; 22 between 85 and 95, and 1 above 95 21 years of age. The mortality of children under one year of age was, as before stated, unusually large. But there is no doubt that the alterations in the social condition of the inhabitants which has already been alluded to, has induced a greater proportionate mortality of infants. During the 10 years, 1850-50 the average number of deaths under one year was 201 in each 1000 deaths, and has increased since 1860 to the present rate of 254. I trust, however, that as the proportion of deaths of young children from diarrhœa is not likely to be so great next year, that the rate will be diminished considerably. In addition to attendance at the Board meetings, I have been present at 42 meetings of the Sanitary Commitee, and obtained from them 651 orders for removal of nuisances, disinfection of premises, and abatement of overcrowding. I have also given evidence at the Worship Street or Clerkenwell Police Courts against 98 persons who had neglected to abate the nuisances existing on their premises. The number of summonses was much larger than in any previous year, and gave me a very large amount of additional work, as I drew up or examined all the summonses and orders of the magistrates. It will be seen by a reference to the list of nuisances removed, that 588 copies of summonses and orders were made out during the year. I trust, however, that there will not be so much work of this kind in future years, as it occupied me and the chief inspector for more than 50 afternoons, sometimes, including the time occupied in going and returning, from a little after one until past live o'clock. The following are the particulars of some of the cases of indecent overcrowding discovered in this district during the year 1868. At No. 13, Bath Row, Dalston, we found five grown up persons, including two married couples, an unmarried daughter of 23, a boy of 13, aud an infant living and sleeping in a small 22 room only only large enough for the occupation of two adults. The breathing space for each adult was less than 150 cubic feet if the room had been empty. At 22, Templar Road, a family consisting of the father, mother, two daughters, of 16 and 3 years old, slept in one small room. At 16, Palace Road, three grown up persons and four children were found living and sleeping in a room sufficiently large for two adults and one child only. At 51 New Church Road, two men (one a lodger) one woman and four children lived and slept in a room which should only have contained two adults and one child. No. 18, Rosina Street, a house containing only four living rooms, was occupied by four families, consisting of 17 persons. In one of the rooms, a very small one, the father, mother, two daughters, one 29 and the other 15; two boys, one of 12, the other 7 years old, lived and slept. And in another room of the same house father, mother, a son of 15, and two girls lived and slept. At a house in William Street, Kingsland, one of the rooms was occupied as a living and sleeping room by the father, mother, a daughter of 20 and her illegitimate child, a boy of 14 and two girls of 11 and eight years respectively. At 4, Pratt's Court, Homerton, the father, a daughter of 12, and three sons aged 18, 16, and 8 years lived and slept in a very small room. At 5, Silk Mill Hill, in a room only large enough for two, there lived and slept, the father, mother, two daughters of 17 and 10, and three boys of 14, 7, and 3 years old. At 13, King's Terrace, Homerton, two women, an unmarried lodger, a girl of 17, a boy of 15 and three children, making altogether eight persons lived and slept in a room large enough only for four. At a house in Albert Street, Homerton, the mother, father, daughters of 23 and 17, and an illegitimate infant lived and slept in a room only large enough for two adults; another room in same house contained the father, mother, a girl 17, and a boy of 12, who lived and slept in a room only large enough for two adults. 23 These are only a sample of the worst cases of overcrowding, for although a smaller number was entered on the books during this year as compared with last, yet they were in many instances of a worse description. Very few were caused by the landlords letting the rooms separately, but by the occupiers underletting them, often without the sanction or knowledge of the landlords. This is a horrible state of things, and can only be checked by active and constant supervision, All these, and indeed nearly all the other cases of overcrowding, were discovered by Mr. Jones whilst making his inspections under the Sanitary Act. The whole of the cases were abated, with one exception, without taking out a summons. In many of the overcrowding cases I inspected the rooms myself, and expostulated with the people on the injury to health and morals which such a course must produce. The excuse in most instances was " want of work," but on enquiry it was found generally to be the result of drunken habits on the part of the parents. The mean temperature of January was about 1 degree below the average, of February 4 degrees, and of March degrees, of April 1 degree, of May nearly 4 degrees, of June degrees, of July 3 degrees, of August 1½ degrees, and of September 2 degrees above the average of 27 years. In October the temperature was 2¼, and in November nearly 2 degrees below the average, whilst in December it was nearly 6 degrees above it. The year 1868 was therefore unusually warm, indeed with the exception of 1806 and 1852, the month of December was the warmest known since accurate records have been kept. The mean temperature of the year was 51°6 Farenheit, or 3 degrees in excess of the average of the last 97 years. The highest temperature recorded at Hackney was 96½ degrees, and the lowest 23 degrees, giving a range of no less than 73½ degrees during the year. The 24 fall was about 25 inches, which is nearly an average. The summer was very dry and the autumn wet. This extreme heat accounts for the excessive infantile mortality from diarrhoea, and the warm winter for the unusually small number of deaths from affections of the lungs. I append to this Report a list of streets inspected, of the number of houses examined in each, and of nuisances discovered therein; also a table of causes of and ages at death. I remain, Gentleman, Yours obediently, JOHN W. TRIPE, M.D. Medical Officer of Health. Received and ordered to be printed and circulated. J. J. Tanner, June 3rd, 1869. Chairman. 25  No. of Houses. No. of Houses. Inspected In which Nuisncs were discvrd Inspected In which Nuisncs were discvrd Ada-street 40 16 Brought forward 1174 444 Arthur-street 33 18 Caroline-street 49 19 Anderson-road 24 15 Conduit-street & place 44 17 Albert-street 22 10 Charles-street 2 1 Austin's-building's 10 4 Chapel-court, StokeNewington 5 2 Abbot-street 28 16 Acton-street 18 9 Churchill-road 6 1 Albert-grove 9 3 Cross-street 18 5 Aldham-place 9 4 Chapman-road 15 5 Amhurst-terrace 15 11 Chapel-road 39 27 Andrew's-road 19 9 Church-road 5 4 Abney-gardens 37 19 Clarke's-building's 4 4 Albert-place 6 3 Clapton-square 19 14 Albion-road 6 ... Church-road, Homerton 37 8 Bentham-road 15 2 Culford-road 5 2 Ball's-buildings 14 7 Brook-street 28 11 Duncan-street 50 24 Barn-street 18 6 Duncan-terrace 8 6 Brooksby's-walk 38 11 Duncan-square 36 20 Baxter's-court 2 1 Durham-grove 9 4 Bohemia-place 15 3 Downham-road 16 5 Brunswick-street 50 19 De Beauvoir-road 9 4 Brook-street 131 40 Dagmar-road 2 2 Bowling Green-street 38 13 Devonshire-place 6 2 Bay-street 31 4 Draper's-court 10 5 Brunswick-grove 15 1 Derby-road 32 21 Brown's-place 27 15 De Beauvoir-square 14 10 Bath-row 13 3 Bower-road 17 8 Eaton-place 46 18 Bowling Green-place 6 1 Exmouth-place 25 15 Bartholomew-place 30 14 Essex-street 25 12 Bloomfield-street 53 9 Ebenezer-terrace 23 20 Back-road 9 3 Elizaboth-cottages 7 ... Bridge-street 32 9 Edward's-lane, Stoke Newington 18 5 Collego-lane 11 2 Eliza-place 3 ... College-street 45 14 Elgin-street 69 16 Cottage-place 13 4 East-street 3 2 Crozier-terrace 66 28 Elizabeth-place 20 8 Cold Bath-lane 17 6 Clarence-road 53 26 Fairey-street, Stoke Newington 13 5 Cock & Castle-lane 93 41 Cross-street 8 4 Frame-court, Stoke Nowington 2 2 Church-yard, Hackney 10 2 Carried forward 1174 444 Carried forward 1868 759 26  No. of Houses. No. of Houses. Inspected In which Nuisncs were discvrd Inspected. In which Nuisncs were discvrd. Brought forward 1868 759 Brought forward 2916 1180 Fisher's-place 8 2 John-street, West Hackney 20 4 Frederick-place 3 ... Falcon-alley & court John-st., Shacklewell 38 13 Stoke Newington 11 4 Jane's.place, Homerton 8 5 Fulham-place 10 4 Fountain-yard 2 2 James'-place, Shacklewell 18 11 Goring-street 44 29 John-street, Londonfields 14 5 Grove-lane 32 8 Grove-street 36 12 King's.road 80 30 George-st., Ada-st 25 9 George-street, Londonfields 25 7 Kenton.road 3 1 Grove, Homerton 31 10 Laurence-buildings, Stoke Newington. 22 16 Grove.lane, Stamfordhill 45 16 Lime-grovo 12 5 Green-lanes 16 8 Lamb-lane 16 4 Gainsboro'-road 21 4 Lea Bridge-road 129 70 Grove-road, Stamfordhill 22 4 Lark-row 9 5 Lordship-road 22 6 George-place, Stamford hill ... ... Laurel-street 20 6 Havelock-road 60 18 Margaret-street 52 23 Morning-lane 69 24 Hemsley-street and terrace 32 8 Morpeth-road 17 1 Mehetabel-road 14 ... Hockley-street 22 8 Mason's-court 3 3 Hedger's-grove 47 24 Matthias-street 27 8 Hertford-road 31 9 Margaret-street 22 6 Hartwell-street 6 2 Meadow-street 13 5 Homerton-terrace 11 5 Marian-street 13 3 High Hill-ferry 151 93 Mead's-place 3 ... High-street, Homerton 47 16 Middle-street 5 2 Homer-road 34 11 Mayfield-street 42 8 Hindle-street 37 23 Moscow-terrace 13 2 Hill-street 7 2 Myrtle-street 32 5 Holly-street 94 26 Heslop-place 11 4 New Church-road 55 18 Heart-place 3 ... North-street, Cambridge Heath 83 26 John-street, Cambridge Heath 62 26 Nursery-row 12 6 Jerusalem-gardens 50 24 Orchard-street, Kingsland 17 2 John-street, Homerton 12 3 Carried forward 2916 1180 Carried forward 3819 1501 27  No. of Houses. No. of Houses. Inspected In which Nuisncs were discvrd Inspected In which Nuisncs were discvrd. Brought forward 3819 1501 Brought forward 4314 1759 Orchard Cottages 13 5 Stonebridge-common 49 26 Orchard-street, Wellsstreet. 16 4 Silk Mill-hill & court 21 13 Shepherd's-lane 15 4 Pear-street-court 10 3 Saxony Cottages 13 3 St. Thomas's Cottages 8 ... Plough-lane 20 7 Stapleton's-buildings, Stoke Newington 16 5 Park-street 41 18 Percy-road 35 8 Samuel, row, Stoke Newington 12 3 Palace-road 67 31 Prospect-place 27 10 Saint John's-place 21 18 Pickles-buildings 6 1 Swiss Cottages 17 5 Paragon-road 9 3 Shacklewoll-row 26 11 Prince's-road 49 31 South-row 8 2 Providence-square 9 3 Stanborough-yard 3 3 Palatine Houses, Stoke Newington 5 1 Spring Vale-grove 4 ... Sanford-lane 24 8 Pullen's-place, Stoke Newington 5 1 Shopherd's-place 9 4 Snther-street 10 2 Pawnbrokers'-alley, Stoke Newington 6 1 Taylor's-buildings 1 ... Park-street, Stoke Newington 15 4 Tottenham-road 124 37 Thomas-street 18 10 Pleasant-place, Stoke Newington 11 3 Tyssen-street 37 18 Templar-road 54 14 Tyle-place, Stoke Newington 3 2 Tudor-grove 14 7 Tyssen-street, Stoke Newington 24 11 Queen's-road 44 27 Tingay's-buildings 7 5 Queen's-court 7 7 Tranquil-place 9 3 Temple-street 24 8 Ridley-road 24 9 Tryon's-court 5 3 Robinson's-row 14 6 Trafalgar-place 4 4 Rosina-street 19 5 Tennyson-terrace 7 2 Rechester-place 6 1 Urban-place 16 9 Rigby's-buildings 4 4 Rock.place 3 ... Union-street, Newington common 32 11 Red Lion-lane 6 4 Roseberry-place 24 6 Union-street, Stoko Newington 22 8 Retreat 7 2 Rustic Cottages 6 ... Union-row, Kingsland 8 3 Newington-common 12 5 Sheep-lane 72 44 Union-court 3 3 Shacklewell-lane and Green 12 7 Curried forward 4314 1759 Carried forward 4991 2027 28 No. of Houses NUMBER OF NUISANCES ABATED In the following years. spected In which Nuisncs were discvrd Brought forward •1991 2027 In 1856 1567 Victoria-street 31 8 1857 1789 Victoria-grove 18 7 1858 2515 1859 1224 Wick.road 230 79 1860 1267 Wellington-street 66 29 1861 1417 Warburton-road and square 126 41 1862 1435 1863 1696 Well-street 26 8 1864 1410 West-street 14 8 1865 1512 Wastorn-plaee 20 5 1866 4260 Wharf-road 20 5 1867 5811 Woolpack-place 8 3 1868 3923 Wood-street 34 11 White Post-lane 21 8 Warwick-villas 35 4 Waterloo-place 29 16 Woodland-street 78 31 Winchester-place 4 2 Water-lane 18 5 William-street 22 3 Willmer-grove 13 ... White Hart-court 4 ... Whitmore-road 31 10 Wallis-road 3 1 York-buildings 10 3 Other places 15 3 TOTALS 5857 2317* * On a large number of these promises a defective state of the drainage and paving existed, as well as a dirty and dilapidated condition of the houses, so that 3433 separate nuisances were found on the 2317 premises. TABLE OF DEATHS REGISTERED IN THE HACKNEY DISTRICT, DURING THE YEAR 1868. AGES Under 1 year 1 to 5 5 to 15 15to25 25to35 35to45 45to55 55to65 65to75| 75 to 85 85 to 95 95 and upwds Total. CLASS 1.—Order 1. Small Pox ... 4 ... ... 1 ... ... ... 1 ... ... ... 6 Measles 6 26 3 ... ... ... ... ... ... ... ... ... 35 Scarlatina 5 29 11 3 ... 1 ... ... ... ... ... ... 49 Diphtheria 2 7 3 1 1 ... ... ... ... ... ... ... 14 Croup 2 11 6 ... ... ... ... ... ... ... ... ... 19 Whooping Cough 17 25 ... ... ... ... ... ... ... ... ... ... 42 Fever ... 8 11 11 11 6 4 ... 3 ... ... ... 54 Erysipelas 8 ... ... ... ... ... 3 3 2 ... 1 ... 17 Carbuncle ... ... ... ... ... ... 1 1 ... ... ... ... 2 Influenza ... ... ... ... ... ... ... ... ... ... ... ... 0 Dysentery ... ... ... ... ... ... ... ... ... 1 ... ... 1 Diarrhœa 82 14 1 ... ... ... ... 1 ... 3 ... ... 101 Choleraic Diarrhœa 11 3 1 ... 1 2 ... ... ... 1 ... ... 19 Cholera 1 ... ... ... 1 1 ... ... ... ... ... ... 3 Remittent Fever 2 ... ... 1 ... 1 1 ... ... ... ... ... 6 Rheumatism ... ... 1 6 ... 2 1 ... 1 ... ... ... 11 Order 2. —379 Syphilis 1 ... ... ... ... ... ... ... ... ... ... ... 1 Order 3. — 1 Privation ... ... ... ... ... ... 1 ... ... ... ... ... 1 Want of breast milk 6 ... ... ... ... ... ... ... ... ... ... ... 6 Purpura and Scurvy ... ... ... ... ... ... ... ... ... ... ... ... 0 Alcohol Del.Trems. ... ... ... 1 ... 4 1 ... ... ... ... ... 6 Intemprce ... ... ... ... 1 1 ... ... 1 ... ... ... 3 Order 4. — 16 Thrush 2 ... ... ... ... ... ... ... ... ... ... ... 2 CLASS 2.—Order 1. — 2 Gout ... ... ... ... ... ... ... 2 l ... ... ... 3 Dropsy 1 1 1 ... ... ... 2 3 9 3 ... ... 20 Cancer ... ... ... ... 2 10 12 20 13 4 ... ... 61 Mrtfiction. & Abscess 4, 1 ... 1 ... 1 3 3 ... 3 ... ... 16 Order 2. —100 Scrofula ... 2 ... ... ... 1 ... ... ... ... ... ... 3 Tabes Mesenterica 57 30 5 ... ... ... ... ... ... ... ... ... 92 Phthisis 3 9 18 53 77 49 28 23 9 1 ... ... 270 Water on the brain 15 24 2 ... ... ... ... ... ... ... ... ... 41 CLASS 3.—Order 1. —406 Inflam. of the Brain 14 14 4 3 3 6 5 9 10 6 ... ... 74 Apoplexy ... 1 1 2 4 7 6 12 13 10 1 ... 57 Paralysis ... ... ... 2 2 3 9 11 14 22 4 ... 67 Insanity ... ... ... ... ... 1 1 4 2 1 ... ... 9 Epilepsy 1 1 3 ... 1 ... 2 3 2 2 ... ... 15 Convulsions 58 27 ... ... ... ... ... ... ... ... ... ... 85 Disea. of brain & cord ... 1 ... ... ... ... 2 1 1 ... ... ... 5 Order 2. —312 Inflam. of the heart ... ... 2 ... 1 1 ... ... ... ... ... ... 4 Aneurism ... ... ... ... ... ... ... ... ... ... ... ... 0 Heart disease 1 ... 6 7 11 22 17 27 27 11 1 ... 130 Order 3. —134 Laryngitis& Stridulus 7 6 2 ... ... ... ... 1 1 ... ... ... 17 Bronchitis 35 37 5 1 3 4 15 13 40 23 3 ... 179 Pleurisy ... 1 2 3 3 1 2 1 1 1 ... ... 15 Pneumonia 32 30 2 1 9 6 4 3 10 2 1 ... 100 Asthma ... ... ... ... 1 1 1 1 2 ... ... ... 6 Lung Disease ... 1 ... ... 4 ... 3 1 2 ... ... ... 11 —328 Carried up 373 313 91 96 137 131 124 143 105 94 11 ... 1678 TABLE OF DEATH S-Continued. AGES Under 1 year 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 | 85 to 95 95 and upwds Total. Brought up 373 313 91 96 137 131 124 143 115 94 11 ... 1678 CLASS 3.—Order 4. Gastritis 3 ... ... ... ... ... ... ... ... 2 ... ... 5 Enteritis 6 ... 1 ... 1 ... ... ... 1 1 ... ... 10 Peritonitis 2 ... 6 1 2 1 1 3 5 1 ... ... 22 Ulcratn of Intestines 1 ... 1 ... 2 ... ... 3 1 ... ... ... 8 Hernia ... ... ... ... ... 2 1 1 1 1 ... ... 6 Ileus ... ... ... ... ... ... ... ... ... ... ... ... 0 Intussusception ... ... ... ... 1 ... ... ... ... 1 ... ... 2 Stomach disease ... ... ... ... 2 ... 1 ... 3 ... ... ... 6 Hepatitis ... ... 1 1 4 2 4 1 1 ... ... ... 14 Jaundice 8 ... ... ... 1 ... 1 ... 2 ... ... ... 12 Liver disease ... ... 1 ... 3 2 3 5 2 2 ... ... 18 Spleen disease ... ... ... ... ... 1 ... ... ... ... ... ... 1 Order 5. —104 Nephritis ... ... ... ... ... ... 1 ... ... ... ... ... 1 Nephria ... ... ... ... 1 2 7 2 3 ... ... ... 15 Diabetes ... ... 1 1 2 1 2 ... ... ... ... ... 7 Stone ... ... ... ... ... ... ... ... ... ... ... ... 0 Cystitis ... ... ... ... ... ... 1 1 5 ... ... ... 7 Kidney disease ... ... ... ... ... 3 1 4 1 2 ... ... 11 Order 6. — 41 Ovarian Dropsy ... ... ... ... ... ... 1 1 1 ... ... ... 3 Uterus, Disease of ... ... ... ... 1 ... ... ... ... 1 ... ... 2 Order 7. — 5 Joint disease & bone ... 2 1 1 1 ... 3 1 ... ... ... ... 9 Order 8. — 9 Ulcer 1 ... ... ... ... 1 ... ... 1 ... ... ... 3 Skin disease 2 ... ... ... ... ... ... ... ... ... ... ... 2 CLASS 4.—Order 1. — 5 Premature birth 85 ... ... ... ... ... ... ... ... ... ... ... 85 Cyanosis 5 ... ... ... ... ... ... ... ... ... ... ... 5 Spina Bifida 1 ... ... ... ... ... ... ... ... ... ... ... 1 Other Malformations 2 ... ... ... ... ... ... ... ... ... ... ... 2 Order 2. — 93 Childbirth ... ... ... 5 13 3 1 ... ... ... ... ... 22 Order 3. 22 Old Age ... ... ... ... ... ... ... 7 49 85 37 2 180 Order 4. —180 Atrophy & Debility 64 ... ... ... ... ... ... ... ... ... ... ... 64 CLASS 5.—Order 1. — 64 Accident or Neglgnce. ... ... ... ... ... ... ... ... ... ... ... ... 0 Fracture—Contusns. ... ... 3 2 2 2 4 1 ... 3 1 ... 18 Gun Shot ... ... ... ... 1 ... ... ... ... ... ... ... 1 Cut—Stab ... ... ... 1 ... ... ... ... ... ... ... ... 1 Burns—Scalds ... 1 1 2 ... ... 1 1 1 ... ... ... 7 Poison 1 ... ... ... ... ... ... ... ... ... ... ... 1 Drowning ... ... 2 1 1 3 1 3 ... 1 ... ... 12 Suffocation 14 ... ... 1 ... ... 1 ... ... ... ... ... 16 Otherwise 8 ... ... 1 ... 1 1 ... 1 ... ... ... 12 Order 2. — 68 Murder & Manslghtr. 3 ... ... ... ... ... ... ... ... ... ... ... 3 Order 3. — 3 Suicide ... ... ... 2 1 3 2 ... ... ... ... ... ... 8 Cause not specified ... l ... ... ... ... ... ... ... ... ... ... ... 1 TOTALS 579 317 109 115 176 158 162 177 243 194 49 2 2281