HAC 56 Board of Works for the Hackney District REPORT on the SANITARY CONDITION OF THE HACKNEY DISTRICT, For the Year, 1876, BY JOHN W. TRIPE, M.D., L.R.C.P.E., ETC. Hon. Sec. of the Meteorological Society, &c. Author of numerous Essays on Sanitary Statistics. Medical Officer of Health for the District. LONDEN: A. T. ROBERTS, STEAM PRINTING AND LITHO' WORKS, 5, HACKNEY ROAD. 1877. SANITARY OFFICES, Town Hall, Hackney. April 26th, 1877. To the Board of Works for the Hackney District. Gentlemen, The chief sanitary event in the District for the year, 1876, was the outbreak of Small Pox, which was by no means expected, except by those who had carefully examined the death rates from this disease in the years 1873, 1874, and 1875; and although the epidemic might fairly have been looked for, yet, until the first week of November, it could scarcely have been expected that it would be so severe. The first case reported to me in Hackney was on the 24th of July, which occurred in a servant, and was contracted outside the district. The second case happened in Banbury Terrace, nearly a quarter of a mile away from the first, both being in South Hackney. The next was at Upper Clapton, also a servant, on September 16th; the next on the 18th, in Mare Street; then on the 26th, in Brooksby's Walk; on October 4th, in Navarino Road, Daiston; and on the 6 th, when the epidemic commenced—eases occurred in Homerton, South Hackney, and Kingsland. During the remainder of the month of October 4 until the 28th, there was no marked localisation of the disease, cases having cropped up in the Clapton Park Estate, in Clapton, Kingsland, Shacklewe11, and Stoke Newington; but on the 30th there was a severe outbreak reported in Homerton, South Hackney, and Hackney Wick, with other cases in Kingsland and Lower Clapton, no less than 14 being in Homerton. From this time the progress of the disease in the various districts is shown by the following facts, viz., that at the end of the year— say January 4th, 1877, we had received notice of 506 cases, of which 65 had occurred in Hackney, 61 in Clapton, chiefly near to Homerton, 165 in Homerton, 65 in Hackney Wick, 80 in South Hackney, 24 in Dalston, 14 in Kingsland, 7 in De Beauvoir Town, 4 in Stoke Newington, 1 in West Hackney, and 1 in Stamford Hill. Also, that by the 29th of March, we had received notice of 827 cases, being 32] in the three months. The 827 cases occurred as follows:—261 in Homerton, 127 in Clapton (including the Clapton Park Estate), 117 in Hackney, 114 in South Hackney, 93 in Hackney Wick, 48 in Dalston, 28 in Kingsland, only 15 in Stoke Newington, 11 in West Hackney, 10 in De Beauvoir Town, and and 3 in Stamford Hill. It is therefore evident that while the focus of the disease was concentrated after a short time in Homerton and the adjacent districts of South Hackney, Clapton Park, and Hackney Wick, yet that it did not commence in Homerton. Also, that after allowing for the time during which the disease remains dormant in the system, the small pox infective matter must have been extensively spread about Homerton on the 14th of October or thereabouts. The number of Hackney cases under treatment in the hospitals by the Metropolitan District Asylum Board, at different times, will afford a fair indication of the severity and progress of the epidemic. In the first week of October there were 10 cases under treatment, which had increased up to 27 before the end of the month. In the first week in November there 5 were 45, and by the end there were 123; so that the number of new cases in excess of the deaths and recoveries in the month were 78. In the first week in December the highest number of Hackney patients in the hospitals was attained, viz., 160, and from this the number gradually decreased to 93. In the first week in January there were but 80, but before the end of the month there were as many as 119. From this time the number under treatment became gradually less until the second week in March, when there were only 49; but there was a revival of the disease in the third week, so that in the second week in April there were 72. The following shows a comparative statement of the number of cases and of deaths which came to our knowledge in corresponding months during the course of the two epidemics. Table I.—Small Pox. Showing the Number of Cases reported, and the Deaths in the Hackney District in the corresponding months of the Epidemics, 1871-2 and 1876-7. Hackney Cases. Hackney Deaths. London Deaths. 1871-2 1876-7 1871-2 1876-7 1871-2 1876-6 1st month 13 47 7 8 101 106 2nd „ 92 209 27 37 207 212 3rd „ 198 201 47 47 315 363 4th „ 33 197 57 49 676 368 5th „ 130 83 64 16 869 350 6th „ 144 67 59 22 776 358 7th „ 174 79 39 25 1026 295 Totals 884 883 300 204 3970 2052 This Table shows that the present epidemic was much more severe at the outset than that of 1871-2, but that it was more quickly reduced in its proportions, as the mortality in the third month was the same in both years, whilst in the fifth month it 6 was only one fourth of that in 1872. The number of cases in the fifth month was also little more than one third of that in the second, whilst in 1872 it was much larger. As, however, the disease returned in October, 1872, and caused a mortality of 111 in 1873, we must not feel by any means certain that its worst effects are over; at the same time, the deaths in London during the corresponding period of four weeks have remained so singularly even in this epidemic, since the third mortality period, as to lead us to suppose that although it will probably last as long as usual, viz., about twelve months, more or less, yet that it will not increase in severity, In my report for 1871 I gave some tables showing the total number of deaths from small pox in all London since 1839, and the mortality in different groups of years. The latter also contained the percentage of the deaths in the first year of each of the four-yearly periods (which is the one in which the disease has generally been epidemic) and showed that 43.9 per cent. occurred in the 8 first, 23.9 in the 8 last years of each period, 20.3 in the second, and only 11.9 in the third. Now according to this table the year for small pox to have assumed an epidemic form was 1875, but the large number of attacks in 1871-2 appear to have reduced the number of those who were susceptible to it in an unusual ratio, so that the disease did not become epidemic until 1876. As, however, the death rate per 10,000 population, since 1872, from small pox has been exceedingly small, we can scarcely expect the epidemic to subside without causing a larger number of deaths than usual, unless vaccination of adults has been better carried out than in previous years. The ordinary death rate per 100,000 inhabitants from small pox, in London, is about 41.0; but it was only 3.4 in 1873, 1.6 in 1874, 2.2 in 1875, 21.1 in 1876, and at the annual rate of 136.2 in the first quarter of 1877; so that if the number of deaths should continue the same in London for the remainder of this year (1877) there would not be a larger number than usual for 7 these five years. Hackney has suffered since the commencement of the epidemic, at the very high annual rate of 229.5 per 100,000 population, which is, as just shown, very far in excess of that for all London. As, however, vaccination has of late been very actively carried out in the district, it is to be hoped if the present rate be maintained, that small pox will become much less fatal in future than it has been on an average of the last seven years. The examination of the children attending the School Board's schools in this district shows that a very large proportion, something like 25 per cent. of the children under 12 years, were not properly protected by a sufficient number of satisfactory vaccination marks against an attack of small pox. I had some correspondence with the Local Government Board on this subject, and was informed that payment cannot be made out of the public funds for the re-vaccination of children under 12 who have been successfully vaccinated. The correspondence did not define what is meant by "successfully vaccinated," but as experience has shown that less than three good marks are not sufficiently protective, I consider that either the fees should not be paid in the first instance, unless three good marks resulted from the vaccination, or else, that during an epidemic, all those who have not that number of good marks should be re-vaccinated at the public expense, if the parents cannot afford to pay for the operation, even if they are under 12 years of age. It is somewhat difficult to draw the precise line of'"successful vaccination," but undoubtedly a single white mark or even more, without any depressions, cannot be considered protective. It should not be forgotten that vaccination is not so simple a matter as it seems to be, for due care must be used in selecting and storing the lymph, whether it be on points or in tubes; and some febrile excitement should result, for unless the disease, vaccinia, which the vaccination should cause, be induced, the proper protective power of the lymph will, most probably, not be afforded. 8 The large number of children under 5 years, viz., 64, or as nearly as possible one third of the whole, also points to neglect of or to inefficient vaccination; but it is only fair to state, that the proportion at that age is about the same as in the years 1868-72 for all England. In Hackney there were 64 deaths under 5 out of a total of 195, which were registered up to March 31st; 37 between 5 and 15; 53 between 15 and 35; and 41 above 35. There were also 96 males and 99 females, the largest proportion of male deaths having occurred below 15, viz., 55 to 46, and the largest of females above that age, viz., 53 to 41 under 15 years of age. The best direct evidence with which I am acquainted of the efficacy of proper vaccination in protecting persons against small pox, is furnished by an extract from Dr. Jenner's evidence before the House of Commons in 1802; by the immunity of the nurses and others at the small pox hospitals; and the great difference in the death rates of vaccinated and unvaccinated persons. Dr. Jenner, in his evidence, stated that "during the investigation of casual cow pox, I was struck with the idea that it might be practicable to propagate the disease by inoculation, after the manner of small pox, first from the cow, and finally from one human being to another. I anxiously waited some time for an opportunity of putting this theory to the test. At length the period arrived. The first experiment was made upon a lad of the name of Phipps, in the spring of the year, 1796, in whose arm a little vaccine virus was inserted, taken from the hand of a young woman who had been accidentally infected by a cow. Notwithstanding the resemblance which the pustule thus excited in the boy's arm bore to a variolous inoculation, yet, as the indisposition attending it was barely perceptible, I could scarcely persuade myself the patient was secure from small pox. However, on his being inoculated (with smallpox) seven months afterwards, it was proved that he was secure.* This case inspired me with * This boy was inoculated again with small pox matter nearly five years afterwards, and only suffered from a local inflammation around the punctures. 9 confidence; and as Soon as I could again furnish myself with virus from the cow, I made an arrangement for a series of inoculations. A number of children were inoculated in succession, one from the other, and after several months had elapsed, they were exposed to the infection of small pox, some by inoculation, others by variolous effluvia, and some in both ways; but they all resisted it." I have quoted the passage at length in Dr. Jenner's words, as giving the early history of vaccination, but need scarcely say that it is illegal now to put the efficacy of vaccination to a similar proof to that just described. The passage also shows to its fullest extent the protective power of vaccination when properly performed. As regards the immunity of nurses and Others employed in the small pox hospitals, I would point out that Dr. Marson, late Surgeon of the Highgate hospital for nearly 40 years says that "I have never had a nurse or servant the whole time who has taken small pox there, and I re-vaccinate them when they come there." In 1871-3 not one of the attendants employed at the small pox hospitals contracted the disease, and in the present epidemic, out of 341 employed, 2 suffered from the disease in a severe form, not having been vaccinated, whilst all the others who bad had small pox, or been re-vaccinated, escaped, except three who had slight attacks, although many suffered from langour, loss of appetite. &c. As regards the difference in the death rates of vaccinated and unvaccinated persons, Dr. Marson stated in his evidence before the House of Commons, 1871, that the arms of 13,670 patients were examined on their admission into the hospital with the following results:— 2,920 were unvaccinated, and 1,043 died=34.89 per cent. deaths. 30 had a second attack of small pox, and 6 died=20 per cent. deaths. 29 after inoculation with small pox, 5 died=17.85 per cent. deaths. 10,398 were vaccinated and 685 died=6.65 per cent. deaths. 10 263 were reported as vaccinated—no marks, 106 died= 39.39 per cent. deaths. Also, that of those with one mark, only 13.81 percent. died; but with two or more marks, only 7.7 per cent. died. In the small pox hospitals of the Metropolitan Asylum Board there were 3,125 persons admitted, of whom 1,898 were vaccinated, and 1,227 unvaccinated. The mortality amongst the vaccinated was 8.6 per cent., and amongst the unvaccinated, 37.8 per cent. During the present epidemic the mortality up to March 24th, 1877, amongst both classes, has been greater, viz., 10.8 percent. amongst the vaccinated, and 45.8 amongst the unvaccinated, as calculated on Dr. Brewer's plan, which gives a lower percentage than on that ordinarily adopted. I have devoted a rather considerable space to prove the necessity not only for primary vaccination, but for re-vaccination, at any rate, after 15 years of age. The disinfection of houses and infected articles has been very actively carried out, as in most cases the infected articles were removed to the Board's disinfecting chamber, but in the beginning of the epidemic the cases occurred so rapidly that it was impossible to remove all, so that in slight cases which were taken early to the hospital the articles were disinfected with sulphur in the rooms, and in no case did the disease spread from the rooms, bedding, &c., so disinfected. In all cases where the patients remained at home until cured, the infected articles were removed, and the beds and bedding not worth disinfection were burnt in fourteen instances. The total number of houses disinfected by the Officers of the Board was 570. The disinfecting accounts being made up for the year, I have not had the entries separated for the purposes of this epidemic, so that the return for the year includes disinfection done for scarlet fever and fever. 11 Articles Disinfected for Year 1876. Beds. Mattrasses Paliasses Bolsters Pillows Blankts. Sheets Quilts Other Articles Total Rooms fumigated 592 132 118 368 771 657 635 323 1752 5348 729 The following are the expenses incurred in carrying out the disinfection above mentioned, exclusive, however, of the salary of the Inspector, who attends to other things as well. The cost of labour was £91 3s. 0d., and would have been much more if the men engaged had not been put to other work when not employed in disinfecting. The coal and coke cost £15 6s. 8d.; repairs to the disinfecting chamber, £6 10s. 0d.; for new wheels and repairs at different times to the covered truck, £12 16s. 8d.; for disinfectants, £71 11s. 4d., which, however, includes those used for disinfecting drains and gullies; and £5 14s. 6d. for petty expenses, making a total of £111 8s. 6d. Against this outlay we have to place a sum of £23 19s. 0d. paid by persons who were in a position to defray the cost of disinfecting their beds, bedding, and other articles, leaving a nett cost of £87 19s. 6d. to be charged on the rates. Having thus briefly discussed the statistics of the small pox epidemic, I shall now proceed, as usual, to lay before you various matters connected with the sanitary condition of the district. The first general table is one which shows the estimated population for the ten years, 1867-76, the density of population per acre, the number of marriages, births and deaths, and the number of births to 1000 population. 12 Table II.—Hackney District, 1867-76. Estimated Population on July 1st. Density of Population per acre. Births * Deaths corrected Marriages No. of Births to 1000 Population 1867 107,300 27.3 3858 2135 1021 35.9 1868 111,643 28.4 3976 2129 1123 35.6 1869 116,269 29.6 3913 2520 1109 33.7 1870 120,986 30.8 4029 2356 1102 33.3 1871 125,886 31.9 4184 2820 1181 33.2 1872 129,666 32.9 4401 2506 1278 33.2 1873 133,896 34.0 4431 2594 1276 33.2 1874 139,020 35.3 4755 2799 1271 34.7 1875 145,144 36.9 4970 2948 1415 35.1 1876 152,648 38.8 5409 2825 1425 36.3 Population at Census, 1871 124,951 No. of Inhabited Houses at Census, 1871 19.347 No. of Families or separate Occupiers at Census, 1871 26,045 No. of Persons on an average in each Inhabited House at Census, 1871 6,46 *NOTE.—The deaths are corrected bo as to allow for deaths in and population of the Small Pox and Fever Hospitals, in the German Hospital and City of London "Workhouse, which are situate in the Hackney District; also for the proportion of deaths in other Metropolitan Hospitals. It will probably be noticed that I have not calculated, since the middle of the year, 1873, the rate of increase of population in the same proportion as from 1871, or indeed from 1867, as the number of empty houses has greatly decreased since 1873, whilst a much larger number has been erected than in each of the previous years. This increase has been rateably much larger in Stoke Newington than in Hackney, especially in 1876-77. The calculated population is probably below rather than above the true number, as the rating of Hackney increased 23.3 per cent. in five years, and of Stoke Newington 36.1, which is considerably in excess of the calculated rate of increase in the population. The large excess in the births also points to a greater number of inhabitants than that given above; indeed, it is probable that it is underestimated by about 3,000, but the statistics for 1877 will, I hope, enable me to arrive at a more accurate opinion. The density of population is rapidly increasing, being now 38.8 against 273 per cent. to an acre in 1867, so that we may fairly expect our death rate to increase in accordance with the statistics 13 on this subject, which have been calculated by the Registrar General. The density of population would be largely in excess if the acreage of the Marshes and of the River Lea, which bound our district, were excluded from it, which they should be for this purpose, as there would then be 43.1 persons per acre. As regards the births to which I have just referred, it will be seen that in 1867 there were only 3858 registered in the district against 5469 in 1876; and also by comparing the births and deaths in the two years, we see that the birth rate has increased more rapidly than the death rate, as in 1867 there were 180 births to each 100 deaths, whilst.in 1876 there were as many as 193 births to 100 deaths. This is a very satisfactory return, and goes a long way to prove the fallacy of the belief that a high birth rate necessarily induces a high death rate; indeed, our death rate for the year (1876) even including the deaths from small pox, was as low as 18.5, being the smallest recorded since 185G. The death rate for all London was also low in 1876, despite the small pox epidemic, but it was 22.3 against 18.51 for Hackney, which indicates a very satisfactory condition of our public health. It is also especially noteworthy that our normal death rate is 22.04 per 1000 population, so that there were about 540 deaths less than the normal number—that is to say, than the number calculated by the English Life Tables on the ages and sex of our population. The normal death rate was calculated on the Census of 1871, and is correct for the present population, certainly within 0 5 deaths per 1000 population. It will also be observed that the marriages have largely increased since 1867. 14 Table III. 1876.—Births in each Sub-District. Quarters. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. TOTALS First 122 77 323 500 311 1333 Second 144 50 326 502 319 1341 Third 142 47 288 502 363 1352 Fourth 153 49 297 584 360 1443 Totals 561 223 1234 2098 1353 5469 Per cent 10.3 4.1 22.5 38.4 24.7 100 „ in 1871 7.6 4.9 23.4 38.2 25.9 100 From this table we learn that out of the 5469 births 561 were registered in Stoke Newington, 223 in Stamford Hill, 1234 in West Hackney, 2098 in Hackney, and 1353 in South Hackney; so that there were 10.3 per cent. of the whole number in Stoke Newington, 4.l per cent. in Stamford Hill, 22.5 per cent. in West Hackney, 38.4 in Hackney, and 24.7 per cent. in South Hackney. On comparing these percentages with those for 1871 we find that the proportion has decreased in Stamford Hill, and West Hackney and South Hackney, but has slightly increased in Hackney, and especially in Stoke Newington. I do not believe that this alteration has been caused by any material change in the constitution of the population, but in the increase in the population of the Hackney sub-registration district, which includes the Clapton Park Estate, and more especially in that of Stoke Newington. 15 Table IV. 1876.—Deaths in each Sub-District. Quartets. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackncy. s First 65 40 162 298 163 728 Second 67 28 117 289 138 639 Third 58 39 151 307 174 729 Fourth 62 26 119 372 150 729 Totals 252 133 549 1266 625 2825 „ 1872 191 121 568 1038 569 2487 This table shows that 252 deaths out of the 2825 were registered in Stoke Newington, 133 in Stamford Hill, 549 in West Hackney, 1266 in Hackney, and 625 in South Hackney, being a smaller number in West Hackney than in 1872, but a larger number in all the other sub-districts, especially in Stoke Newington and Hackney, as might have been expected from the birth rates. I have taken 1872 instead of 1871 as a basis of comparison in consequence of the excessive mortality from small pox in the latter year. I have also not made any calculations of the death rates in the sub-districts, in consequence of the deaths in the German Hospital, the Small Pox and Fever Hospitals, the East London Union, and the Hackney Union being all registered in the Hackney sub-district. If these deaths were eliminated the population must be eliminated also, and the deaths in the Workhouse distributed pro rata to population in the other sub-districts. As the population has increased more in one district than another, this would introduce many elements of error, so that I prefer leaving it out at any rate until after the next Census. 16 Table V. Deaths registered from all causes during the Year, 1876, the Deaths of Non-residents in the Fever and Smalt Pox Hospitals being excluded. Cause of Death. AGE AT DEATH. Percentages. Classes. 0 1 1 0 2 5 5 15 15 25 25 35 35 45 45 55 55 65 65 75 75 85 85 and upwds. Totals Zymotic 203 86 88 66 20 28 15 19 10 10 9 4 558 19.8 Constitutional 62 41 28 19 70 108 85 60 48 33 10 1 565 20.0 Local 252 84 60 41 52 45 92 120 181 182 106 26 1241 43.9 Developmental 231 .. .. .. 5 12 13 1 .. 12 76 28 378 13.4 Violent Deaths 23 3 7 9 7 6 5 9 5 1 5 1 81 2.9 Not Specified 2 .. .. .. .. .. .. .. .. .. .. .. 2 Totals 773 214 183 135 154 199 210 209 244 238 206 60 2825 100 Percentages of Deaths 27.4 7.6 6.5 4.8 5.4 7.0 7.5 7.4 8.6 8.4 7.3 21 100 - This is an important table, as it shows not only the ages at death, but the proportion of deaths from different groups of disease. Thus there were 558 deaths from zymotic diseases, being 19.8 per cent. of the whole, which is a very low percentage, considering that there were 92 deaths from small pox against 2 the year before. There were 565 deaths from constitutional diseases, or 20.0 per cent. of the whole. This group includes gout, dropsy, cancer, mortification, scrofula, tabes-mesenterica, consumption, and water on the brain; so that it affords a fair indication of the healthiness of a locality, and, to a certain extent, of the social condition of the people, as the mortality from these diseases is high amongst the ill-fed and badly lodged. The largest proportion of deaths occurred from local diseases— that is to say, from inflammation of the brain, apoplexy, paralysis, convulsions, and other affections of the brain and spinal cord. Also from head disease, inflammatory diseases of 17 the lungs, affections of the liver, stomach, bowels, joints, and diseases of women. There were, as might have been expected, as many as 1241 deaths from these causes, or 43.9 per cent. of the whole. The number of deaths in each order differed considerably from those of last year, as in 1875 there were 356 deaths from brain disease, against 379 in 1876; whilst the deaths from heart disease differed very little, having been 187 in one year and 186 in the other. The mortality from affections of the lungs was very much larger in 1875 than in 1876, owing to the great severity of the winter in the former year, as no less than 372 deaths from bronchitis and 100 from inflammation of the substance of the lungs were registered in 1875, against 282 from bronchitis, and 145 from pneumonia in 1876. The total from diseases of the lungs, exclusive of consumption, was 622 in 1875, and only 479 in 1876. The deaths from affections of the stomach and bowels were nearly the same in both years, viz., 118 and 123. The mortality from developmental diseases, which include premature birth and debility, malformations from birth, and deaths from old age, also never varies very much, so that it is not surprising to find 370 in 1875 against 378 in 1876. The percentage from this class was 13.4 of the whole. Violent deaths were also very close, viz., 85 and 81, or 2.9 per cent. of all the deaths in each year. The ages at death varied considerably from those in former years, as a very large proportion of deaths happened during the first year of life, and less than usual between 1 and 5; so that although there were as many as 27.4 per cent. of deaths under 1 year against 24.5 last year, the percentages of total deaths under 5 were nearly the same, viz., 41.5 in 1876, and 41.3 in 1875, the mean of 1866-75 having been 40.02. This large proportion of deaths of infants to total deaths has been increasing of late, in consequence of the greater number of births, but as there were only 14.6 deaths to each 100 births, the death rate is much below the average for all London, which B 18 was 15.7 per 100 births. The excess in Hackney was caused by the unusual fatality of diarrhoea and whooping cough. The total number of deaths under 5 years was 1170 out of 2825. There were 135 deaths or 4.8 per cent. between 5 and 15 years, 154 or 5.4 per cent. between 15 and 25, 199 or 7.0 per cent. between 25 and 35, 210 or 7.5 per cent. between 35 and 45, 209 or 7.4 percent. between 45 and 55, 244 or 8.6 per cent. from 55 to 65, 238 or 8.4 per cent. between 05 and 75, 206 or 7.3 per cent. between 75 and 85, and 60 or 2.1 per cent. above 85. There were 21 deaths at 80 years of age and below 81, 17 at 81-2, 22 at 82-83, only 10 between 83 and 84, as many as 26 at 84-85 years, 14 at 85-86, 10 at 86-87, 6 between 87 and 88, 5 above 88, 5 between 89 and 90, as many as 7 between 90 and 91, and no less than 5 between 91 and 92; 1 at 92, 1 at 93, 4 at the very advanced age of 94, and 1 only above 95, viz., at the patriarchal age of 98, making a total of 155 deaths above 80 years of age, or 5.5 per cent. of the total number, and 19 above 90 years of age. Table VI. Showing the Mortality from certain classes of Diseases, the percentages TO Population and to total Deaths.—1876. Total Deaths. Percentage of Deaths to Total Deaths. Deaths per 1000 population. 1876 1875 1. Zymotic Diseasas (Class I, Order I) 558 19.8 3.80 3.6 2. Tubercular 430 15.2 2.91 3.1 3. Pulmonary, other than Phthisis 479 16.9 3.25 4.4 4. Convulsive Diseases of Infants under 1 year 120 4.3 0.81 0.72 5. Wasting Diseases of Infants 212 7.5 1.43 1.3 2. Includes Phthisis, Scrofula, Rickets, Tabes Mesenterica, and deaths registered as being caused by Hydrocephalus in children of more than 1 year. 4. Includes Infantile Hydrocephalus, Meningitis, Convulsions, and Teething. 5. Includes Marasmus, Atrophy and Debility, Want of Breast Milk, and Premature Birth. 19 The mortality from zymotic diseases was in excess of those last year, as already mentioned; but the proportion to population was not excessive, having been 3.80 per 1000 population against 3.60 in 1875, and 3.30 in 1874. There were 2.91 deaths per 1000 population from tubercular diseases, or 15.2 per cent. of the deaths from all causes; 479 deaths, which are equal to 16.9 of total deaths, or 3.25 per 1000 population, occurred from inflammatory diseases of the lungs, against 4.4 in 1875; and 332 deaths from convulsions and wasting diseases of infants, which are equal to 11.8 per cent. of all the deaths, and 2.24 deaths per 1000 population, which is a little above the mean. The deaths under the heading of zymotic disease include rheumatism, which I do not think they should, but the number is too small to materially affect the result. It will be seen that tubercular affections include phthisis, scrofula, rickets, tabes mesenterica, and deaths caused by water on. the head in children above 1 year of age; so that the mortality from these causes per 1000 population afford a fair index of the sanitary and social condition of our population, and therefore a reduction in the rate is satisfactory. The extreme cold in 1875, and mild weather in 1876 account for the great differences in the death rates from pulmonary diseases, other than phthisis, in the two years. This difference is best shown by the proportion of these deaths to those from all causes, as in 1875 they were as high as 21.1, and in 1876 only 16.9 per cent. of the total. Convulsive and wasting diseases of infants, which include marasmus, atrophy and debility, want of breast milk, and premature birth, as well as water on the brain in infants, inflammation of the brain in infants, convulsions and teething, indicate when in excess either a poor population or a bad sanitary condition of the place, and sometimes both. It will be seen that there is an excess in 1876 as compared with 1875, but only to a slight extent, and this probably arose from deaths having occurred from inflammatory diseases of the lungs, which would otherwise have been caused by one of these affections. B 2 Table VII. 1866-1876.—Deaths from the principal Infect iocs Diseases and Diarrhœa—52 weeks in each Year 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 Mean Temperature for each Year 49°8 48°6 51°6 49°5 48°7 48°7 50°7 49°1 49°4 49°4 Small Pox 31 27 6 6 16 400 111 9 5 2 Measles 26 15 35 64 40 25 59 28 68 6l Scarlet Fever 68 49 49 247 181 85 51 27 97 78 Diptheria 12 16 14 l6 9 8 7 21 10 21 Whooping Cough 89 72 44 102 39 76 97 81 52 113 Fever 76 63 54 60 51 34 50 53 45 58 Diarrhoea 162 75 120 97 115 123 115 161 102 116 Totals—Hackney 464 317 320 592 451 751 490 380 379 449 Totals for London 14,761 11,660 14,638 17,413 16,476 19,455 12,729 11,170 11,230 13,411 Hackney Annual Average No. of Deaths 1866-1875. Hackney Percentage of Deaths to Total Deaths. 1866-1875. Hackney Mean Annual No. of Deaths per 10,000 population 1866-1875. Deaths in 1876. Totals. 10,000 Population Small Pox 61.3 2.3 4.9 92 6.0 Measles 42.1 1.6 3.4 15 1.0 Scarlet Fever 93.2 3.6 7.4 57 3.9 Diptheria 13.4 0.5 1.6 23 1.2 Whooping Cough 76.5 2.9 6.0 126 8.2 Fever 54.4 2.1 4.3 44 2.9 Diarrhoea 118.6 4.6 9.4 136 9.0 Hackney 46.95 17.6 37.0 493 32.5 London 14,386 l8.9 45.9 12,565 36.0 20 21 At the present time this table is of somewhat unusual importance, as it shows, amongst other facts, the number of deaths from small pox during the last eleven years, as well as from the other six zymotic diseases. Thus we see that the mortality from small pox varied between 2 and 100 deaths in different years, the latter number having occurred in 1871, and the former in 1875, against 111 in 1872, and 92 in 1876. These figures indicate that the present epidemic is scarcely likely to be as fatal as that of 1871-2. The table also shows that the deaths from measles and fever were far more uniform than those from scarlet fever, whooping cough, and diarrhoea, as the highest mortality in the eleven years, from measles, was 61, and the lowest, 15; from fever the highest was 76 in 1866, and the lowest 34 in 1871, and the next 44, in 1876, the two years when small pox was epidemic. In 1869 there were as many as 247 deaths from scarlet fever, whilst in 1873 there were only 27; in 1876 there were as many as 126 deaths from whooping cough, against 39 only in 1870. This last-named disease was very fatal in 1875, as well as in 1876, so that we have just had two successive years of very unusual mortality from this infectious disease. There is, I believe, far too great apathy, indeed I may say neglect, as regards the treatment and prevention of the spread of whooping cough, for if proper medical means bo used, and due care be taken in keeping the affected children in-doors, and, if possible, in one room, during the whole of the inflammatory part of the disease; and also in not exposing them too soon to cold winds out of doors, this disease would comparatively rarely prove fatal. The numbers given in the table are those which were registered, and are uncorrected for increase of population, so that the figures for 1866 would have to be increased by at least 40 per cent. to render them comparable with the mortality for last year. 22 Table VIII. Percentages of Deaths to the total Deaths in Hackney from 1856 to 1876, arranged in 12 groups. Zymotic diseases Diseases of uncertain seat Tubercular diseases Diseases of the nervous system Diseases of the circulator)* organs Diseases of the respiratory organs Diseases of the digestive and urinary organs Diseases of the skin and joints Premature birth and atrophy Childbirth and diseases of women Old age Violence 1 2 3 4 5 6 7 8 9 10 11 12 1856-65 20.80 4.84 16.77 12.18 5.04 16.39 6.50 0.60 4.89 0.93 6.96 4.10 Temperature 1866-75 20.42 4.69 16.52 12.09 5.88 16.64 6.15 0.52 6.45 1.16 6.34 3.19 1871 28.4 41 156 10.6 5.7 15.7 5.7 0.4 5.7 0.6 5.1 2.4 48.7 1872 22.2 4.8 16.2 12.5 6.0 16.2 6.3 0.5 5.9 1.5 4.8 3.1 50.7 1873 17.1 4.6 15.1 12.8 6.8 19.1 6.4 0.5 7.0 1.1 6.2 3.3 48.9 1874 16.4 4.8 15.3 13.3 6.9 17.9 7.3 0.4 6.4 1.5 6.4 3.4 48.1 1875 17.7 4.0 15.6 12.1 6.5 22.1 6.5 0.9 7.2 1.2 4.5 2.9 49.4 1876 19.8 4.8 15.5 13.4 6.6 16.9 5.9 0.1 8.2 1.4 4.1 2.8 50.1 Means 20.27 4.65 15.55 14.45 6.41 17.98 6.35 0.47 6.73 1.21 5.18 2.98 49.3 Some of the groups contained in this table have been already referred to, so that we shall discuss the figures for 1876, chiefly in their relation to those of former years. In the first place it is very noticeable how little the mortality in each of these groups has varied, with the exception of zymotic diseases, and even these have caused a very even rate, when periods of at least five years, or better still, ten years are taken. Thus we see that in the ten years, 1856-65, the mean zymotic mortality was 20.80, in 1866-75 20.42, and in 1871-76, 20.27 percent. of 23 the deaths from all causes, which is decidedly satisfactory, as the mean of the last six years and of 1876 is below the average of both the deciminal periods, although the severe epidemic of small pox in 1871-2 is included in these years. The number of deaths from zymotic diseases, as compared with the deaths from all causes, varies however but very little in all England, or in large districts, if extended over a sufficient number of years. Thus in the Supplement to the i53th Annual Report of the Registrar General, the number of deaths are given for the ten years, 1861-70, in every registration district in England, so that it is easy to calculate out the proportion of deaths from certain diseases to those from all causes. Table IX. Showing Number of Deaths and Rate of Death under 5 years, out of 100,000 children born alive in the Healthy Districts, all England, and Liverpool.. Healthy Districts. England. Liverpool Deaths from all causes 17,541 26,318 46,037 Total Zymotic Diseases 4,976 8,710 17,101 Rate of death, all causes 100 138 229 „ „ Zymotic Diseases 100 140 228 Now taking the number of deaths from all causes, under 5 years of age, in the healthy districts* at 100, I have calculated the mortality in all England and in Liverpool, and performed the same operation at the same ages for zymotic diseases, and have obtained the following results, which, for the sake of clearness, I have tabulated above, viz., that for each 100 deaths from *See the Supplement to the 35th Report of the Registrar General, p. xxix, &c. 24 all causes in children under 5 years old in the healthy districts of England and Wales, there were 138 in all England, and 229 in Liverpool; whilst from zymotic diseases there were 140 in all England and 228 in Liverpool to 100 in the healthy districts. By these you will see that the death rates from all causes and from zymotic diseases bear, we may almost say, precisely the same ratio in both instances. These figures certainly show, in my opinion, that the comparative mortality from zymotic diseases is not a better proof, under existing legislation and practice, of the sanitary condition of a locality than are the deaths from all causes; and they also, I think, point out the fallacy of terming zymotic diseases "preventable," as though medical officers of health or others have the power of preventing all the deaths from these causes. That small pox is preventable to a very great extent by vaccination I do not doubt, or that the mortality from scarlet fever, measles, whooping cough, diarrhoea, and especially of fever, may be reduced by proper sanitary measures I fully admit; but I certainly object to the word preventable being thus applied, as though every death from these diseases could be prevented. The figures in Table VIII also show that the mean number of deaths from the following groups of diseases were below the average in 1876, viz., from diseases of uncertain seat, affections of the nervous system, of the respiratory organs, of the digestive and urinary organs, and from old age; whilst those from atrophy, debility, and premature birth, as well as diseases of women and childbirth, were decidedly in excess. There was a rather large number of deaths from puerperal fever in one sub-district of Hackney, and chiefly in the practice of one practitioner, which accounts for the excess of deaths from childbirth. The mortality from tubercular diseases and affections of the circulatory organs differed but little from the average of the six years, but was decidedly below those from 1850-65, and 1866-75. 25 Table X. Showing the decennial mean numbers in the years 1841- 71, of the births and deaths, of the ratios op births to deaths, op births to population, op deaths under 1 year to total births, op deaths from all causes, and from seven most fatal zymotic diseases, to 1,000 population. Also the same for each year during 1871-76. Years. Hackny Hackny Hackny Hackny Hackny Hackny London Death rate per 1000 population from seven principal epidemic diseases. N umber of births. Total number of deaths. Correctd No. of births to each 100 deaths. No. of births to 1000 population. Deaths under 1 year to 100 births. Death rate per 1000 population. Correctd Death rate per 1000 inhabitants. Englnd. London Hackny 1841 to 1851 1398 946 146 28.3 12.8 19.18 24.77 3.64 4.442 • • 1851 to 1861 2223 1391 159 31.8 12.7 19.14 23.77 3.864 4.551 3.56 18611 to 1871 3440 2182 156 33.8 14.3 20.37 24.43 4.163 4.789 3.78 1871 4184 2814 149 33.2 15.2 22.4 24.6 4.55 5.55 5.96 1872 4401 2487 174 33.2 14.9 19.3 21.5 3.98 3.83 3.77 *873 4431 2594 171 33.2 15.1 19.1 22.5 2.92 3.39 2.85 1874 4775 2799 170 34.7 13.9 20.0 22.6 3.64 3.30 2.76 1875 4970 2948 168 35.1 14.6 20.6 23.7 3.30 3.89 3.17 1876 5469 2825 193 35.8 13.9 18.5 22.3 3.00 3.60 3.25 Means 4705 2744 171 34.2 14.6 20.0 22.9 3.56 3.93 3.63 This table shows, amongst other things, the enormous increase in the population of the district, as the mean annual number of births during the ten years in 1841-50 was only 1398, against 5469 in 1876, and 4705 for the six years, 1871-6. The deaths have also increased in about an equal ratio, as the average of the first ten years was only 946, that of the third ten 26 years was 2182, and of the years 1871-6, as many as 2744, and 2825 in 1876. The proportion of births to deaths has also very greatly increased, especially during the last few years; as in 1841-50 there were on an average only 146 births to 100 deaths; in 1871-6 there were 171, and in 1876 as many as 193, which is a singularly large proportion. The birth rate per 1000 population has also increased, especially during the last two years, when it amounted to 35.1 and 35.8, against 28.3 in 1841-50. The deaths under 1 year to 100 births, which afford a pretty failcriterion as to the sanitary and social condition of the population (other things being equal), have increased from 12.8 and 12 7 in the years 1841-50 and 1851-60, to 14.3 in 1861-70, and 14.6 in 1871-6. Taking this fact in connection with the large increase in the birth rate, and the low death rate at all ages per 1000 population, it is evident that the general social condition of our population, as regards wealth, has decreased, and also that the greater density of our population is acting detrimentally on the health of infants. At the same time the percentage of 13'9 in 1876 compares favourably with that for all London, which was 15.7 in that year, and generally obtains an average of nearly 16.0 deaths under 1 year per 100 births. The death rate from all causes, viz., 18.5 per 1000 population, is singularly low, being lower than any one of the decennial means, or for any year since 1856, which was also singularly healthy. The mean for all London was also unusually low, having been only 22.3, against 24.77, 23.77, and 24.43 in each decennial period since 1841. The mean rate of mortality during 1876 in the West districts of London was 21.0; in the North, 21.4; in the Central, 24.0; in the East also 24.0, and in the South, 22.1; so that the death rate in the West and North districts was much below the average. The table also shows that while the death rate from the seven chief zymotic diseases, per 1000 population, had increased during the three decennial periods of 1841-70, in England and Wales, from 3.64 to 4.16, being an increase of one-seventh, yet, in spite of 27 the small pox epidemic of 1871-2, the rate has decreased in 1871-76 to 3.56, or to less than in 1841-50. In London, although the increase during the thirty years was not so great, yet the decrease subsequently was greater, as the percentage was only 3.93 for the years 1871-6, against 4.44 in 1841-50. Now as the former period includes the epidemic of small pox in 1871-2, and the commencement of that now raging, it is evident that some cause or causes must have been in operation in London that did not extend to the whole country; and the only reason I can suggest to account for the decrease is the establishment of the hospitals for infectious diseases by the Metropolitan Asylum Board. In Hackney the decrease is not so decided. As regards the deaths from small pox in 1876, it will be seen that although they have in Hackney raised the death rate of the seven chief zymotic diseases from 3.17 to 3.25 per 1000, yet they have not raised it so as to equal the means of 1856-60, and of 1861-70. I fear, however, that we shall scarcely be able to say as much for 1877, as there is but little evidence at present of a decline in the mortality from the epidemic, and there is also a probability that we shall suffer from an epidemic of measles. I have attended 34 Sanitary Committee meetings in the year, at many of which important matters concerning the general sanitary arrangements of the district were considered, as well as the steps necessary to prevent as far as possible the spread of small pox, the details connected with the removal of house refuse from the district and other allied matters. I also attended 16 meetings of Sub-Committees, appointed by the Sanitary Committee, to inspect the cowsheds and slaughter houses, the disinfecting chamber and several streets and rows of houses specially complained of, making a total of 50 meetings. Also several meetings of other committees as well as the Board meetings, so that I have attended 77 meetings during the year. There were 93 cowsheds and 79 slaughter houses inspected, many of them more than once, by the View Committee and 28 myself, and on several other occasions by the Inspector, Mr. Thomas. At the first meeting of the Justices at Prescott Street the applications for licenses to eight cowsheds and two slaughter houses were opposed, and the granting of the licenses was adjourned to their meeting in November, to allow of certain works being done, of which the occupiers had had notice. At the last named meeting the opposition was withdrawn as regards six of the eowkeepers, but was continued as regards two. In these cases the licenses were refused because the proprietors would not provide a water supply from the Company's main, although they had none except from pumps. The opposition to two slaughter houses was also successful, as regards one because the occupier would not provide proper lighting and ventilation, and as regards the other because the Metropolitan Board of Works objected to declare it a newly established slaughter house, which it was, but proposed to transfer the license from an old shed to the new one; but as the old shed was in fair order the magistrates continued that license at our suggestion. During the year two attempts have been made to establish anew two offensive businesses in the district, both being bladder blowers, one in a shed at the back of the Kingsland Road, and the other at Stonebridge Common. Summonses were taken out against the parties and the magistrate convicted both in small penalties with the understanding that if they were brought up again they would be heavily fined. They both left the neighbourhood immediately after the convictions without paying the penalties, and without leaving any trace as to the places to which they went. Other important proceedings were taken in the Police Courts for the abatement of nuisances; in one ease for a nuisance in Shoreditch causing injury to the health of some inhabitants of this district, in which the magistrate ordered its abatement, being the first order of the kind we have obtained; and the other against the builder of a house for having erected and let it without providing a proper water supply and water 29 supply apparatus for the use of his tenant. In this case a penalty of 40/- with costs was inflicted. Also for exposing meat unfit for the use of man, when a £10 penalty was ordered to be paid, and many eases of defective water supply apparatus, in which penalties were inflicted, and paid to the Board. On the 14th of June last I brought up a report pointing out that the Metropolitan Board had just had under their consideration a letter from Mr. Secretary Cross respecting the building of houses on rubbish foundations. That the Board had replied to the effect that there were great difficulties in the way of obtaining a new Building Act, and therefore asked Mr. Cross to assist them in preventing this and other injurious practices. I therefore suggested that this Board should consider the advisability of requesting the Metropolitan Board to introduce a Bill for making certain alterations in the law, without waiting for the introduction of a new Building Bill. The alterations I suggested were— 1. That road scrapings should not be used for making mortar, or fine siftings of house refuse for making plaster. 2. That means should be taken for preventing the ground damp from penetrating through or rising up the walls of newly-built houses, by the use of cement or other suitable material, and the introduction of a damp-proof course above the ground. 3. That the floor joists should not be laid on the ground or in channels cut out of the ground, but that in all cases there should be a clear space of at least one foot between the joists and the ground, and also that sufficient means of ventilation should be adopted for ventilating the space. 4. That the open space in the rear of dwelling houses being often of such an irregular shape, as not to admit of sufficient circulation of the contained air, 30 that therefore there should not be less than 8 feet from any part of the newly-built house to the nearest wall, and that additions should not be allowed to be built out at any future time, so as to reduce the distance to less than 8 feet. 5. That additional legislation should be framed so as to prevent the use of bad or objectionable materials, and especially of the use of mortar from old houses. (i. That the building on foundations of house refuse or other rubbish should be subject to the limitations proposed in my last report, or altogether prevented. I append the resolutions agreed to by you when this matter was under discussion in 1875, although they were not referred this year to the Sanitary Committee for consideration and report at the same time with the above. 1st Resolution.—That no building be hereafter erected on made ground unless the whole internal area of the premises be covered with a thick layer of good concrete, at least 6 inches thick, to the satisfaction of the Surveyor to the District Board or Vestry. 2nd. That all drain pipes passing under buildings so erected, or outside the walls, if within 4 feet thereof, shall be constructed of glazed drain pipes, embedded in a layer of concrete, at least 6 inches in thickness, to the satisfaction of the Surveyor to the Board or Vestry. 3rd. That no building shall be erected on a foundation of house refuse until after a lapse of two years from the time of deposit; or, in the case of any other newly made ground, until the Surveyor to the Board or Vestry be satisfied that sufficient time has elapsed for consolidation of the ground, and for cessation of decomposition in the deposited matters. 31 I also desire to say that resolution 2 is framed somewhat in accordance with the "regulations relating to house drains," which have been m force in this district at any rate since 1870, one of which is as follows:— Every drain carried under a house or building, not having 3 feet of ground from the top thereof to the general level of the ground under the floor, and every drain carried at the back or side of a house or other building, if it be within 5 feet of the wall, and above the foundation thereof, must be bedded in and covered over with 6 inches of concrete. Resolution No. 2 was not proposed as being necessary for this district, but because it was thought that uniform legislation should be introduced for the whole metropolis. This report was referred to the Sanitary Committee who reported that it was not necessary to have proposal No. 2 carried out, as the Metropolitan Board had just then instructed their Surveyors to prevent the use of improper materials in the making of mortar and plaster. That as regards the other proposals, they advised the Board to agree with them, and forward a copy to the Metropolitan Board of Works. They advised slight alterations, so as to make the proposals more definite, and that there should be 10 feet instead of S in the rear of newly-built houses, and that no erection should hereafter be made on the open space of either new or old houses, if they reduced the space below 10 feet. A copy of this report was forwarded to the Metropolitan Board of Works. In connection with this subject I may mention that several fatal cases of diphtheria have occurred in houses where the rain-water pipes were connected, with the drains without being trapped, and when the persons attacked slept in rooms close to open joints of the pipes, so that they were exposed to sewer emanations, which escaped into their bedrooms. In the early part of the year I was directed to make certain 32 enquiries respecting the manner in which the dust and other house refuse was removed in other districts, and, as the result, the Sanitary Committee decided to recommend the Board to divide the district into two parts, one to be worked on the old plan of a fixed price per load for a man, horse, cart, and implements to be supplied by the contractor, and the dust to be his property; whilst in the other, the dust collected was to be the property of the Board, and the contractor was to provide only men, horses, and harness, the Board finding carts and implements. The contract price for the district in which the contractor provided all the plant, but retained the dust, was 2/7 per load; in the other it was 2/10 per load, but the Board having agreed to sell the dust collected at 5d. per load, the price was 2/5 with about 4½d. per load added on for the carts and implements. Considering that the facilities for shooting were not quite so good in one district as the other, the prices may be considered as about the same, at any rate there was no saving by adopting the latter plan, and the work has not been carried out any better, indeed not so well, as by the per load system. The total number of loads removed during the year was 17,867, being a reduction of about 1500 loads; but the increased price per load above that paid in 1875-6, has raised the total to £2924. 14s. lid., even after allowing for the amount due, but not as yet paid, for part of the loads delivered. The sum paid to the men employed by the Board was £476 3s. 0d., against £433 16s. 0d., the difference having been caused by an increase in their wages during the current year. The total number of requests, made at the Town Hall, to remove dust during the year amounted to 2918, against 3383 in 1876. There was one case of cholera that was fatal in about 16 hours after the choleraic symptoms developed themselves, but the man had suffered from neglected diarrhoea for three days. The structural sanitary arrangements about the house were good, but the closet was very foul and the cistern by no means clean. 33 There was no connection between the cistern and the water closet, and no other case occurred in the neighbourhood, so that I am quite unable to account for its origin, although the symptoms were identical with those of malignant cholera. At various times during the year I received complaints respecting certain peculiarly offensive smells which occasionally pervaded the atmosphere of the south-western parts of our district, and in the early part of October my suspicions that they came from the Haggerstone Gas Works were confirmed, by a most frightful smell in the day time, when I sent two Inspectors at once to the Works, and after receiving their report, communicated with Dr. Sutton, the Medical Officer of Health for Shoreditcli, offering my assistance, if required, for suppressing the nuisance. The Shoreditch authorities took active steps to prevent a recurrence, so that the nuisance has been abated without any legal proceedings having been necessary on the part of this Board. Complaints were also received about the Blood Drying Works in Bow, so that I reported the matter to the Sanitary Committee, who brought up a report recommending that the Metropolitan Board of Works be communicated with, which was agreed to. The number of nuisances abated during the year was 6445, which is nearly 200 more than in 1875-6. Of this number 597 consisted of nuisances arising from defective or choked drains, 149 of yards that were either undrained or in which the means of draining were defective, 411 in which the traps were broken or the cover wanting, and 28 from cesspools which were discovered on making a search, affording a total of 1314 nuisances from defects in the arrangements for drainage. The number from defects in houses was much greater, viz., 3870, of which 2196 were caused by the want of whitewashing, cleansing, and repairing, 537 by broken dust bins, 296 from defective paving in the yards, and as many as 841 from improper water supply apparatus. There were also 651 houses disinfected by the officers of the Board, 30 cases of overcrowding abated, 49 pigsties c 34 removed, 131 accumulations of dung and other offensive matters taken away, and 241 other nuisances abated. This is a very large number considering the great amount of time abstracted from the usual work by attention to the small pox epidemic. The number of houses inspected in their regular order, details of which can be found in the Table of Streets, &c., was 6103 against 517 houses or other premises respecting which complaints were received. The great sanitary advantages derived in this district from a regular yearly inspection of the poorer houses can be readily appreciated by this comparison as the number of nuisances complained of were not more than oneseventh part of those that were discovered during the systematic inspection. This plan has been carried out regularly since 1866, and has doubtless assisted most materially in keeping the death rate of our district so low in comparison with that of most metropolitan parishes and districts. In addition to these works were the inspections of cowsheds and slaughter houses, numbering 172, not only previously to the licensing time, but also at other periods of the year; of greengrocers, fishmongers and poulterers' yards, and a systematic oversight of the urinals. There were also 167 bakehouses visited and orders issued for the limewhiting and cleansing of those that were found to be dirty. The total number of separate premises inspected was 8127, to most of which several visits were paid. Besides the visits just enumerated we must add those paid to the 6103 houses inspected without complaint, but in which no nuisances were discovered. The table in the appendix shows that 2987 houses were examined throughout, as well as the yard, water closets and water supply apparatus without any nuisances having been discovered, and also that a very large number of visits were paid to houses to ascertain if the dustmen carried out their duties properly. As regards the 6103 houses inspected it was found that 25,996 rooms were used for living or sleeping in or for both purposes, being rather more than the same proportion 35 the year before; that there were 37,697 persons residing in them against 37,882 in 6037 houses the year before ahd nuisances were found on 3016 premises against 2993 in 1875. These numbers are singularly close, and show the great importance of a regular and systematic inspection of all the houses occupied by the poor. I am glad to say that there were not any of those abominable cases of indecent overcrowding which were occasionally met with in former years. The total number of overcrowding cases was 30 against 31 in 1875. This table also shows the streets in which the majority of the small pox and other cases of infectious diseases occurred, as out of 459 cases of small pox as many as 304 occurred in the 6103 houses and amongst 37,698 inhabitants, against 155 cases in the rest of the district. It is true that we were not informed of all the cases, although we we know of all the deaths; and therefore the comparison is not perfect, still this return shows its extreme prevalence amongst the poor. In addition to these there were 121 lodging-house notices served, 2918 dust complaints attended to, 59 bodies received at the mortuary and afterwards delivered up to the friends of the deceased, 242 houses disinfected for small pox and the infected articles, to the number of 2459, removed to the disinfecting chamber of the Hoard, and returned after disinfection to their owners. There were also 801 letters sent out, 3697 preliminary, 2863 statutory and other notices made out and served, 79 persons summoned before a magistrate, and 474 copies of summonses and orders made out, the sanitary books properly kept, the dust accounts and other bills checked, so that there was an enormous amount of clerical work done in this department in addition to the out-door work. I need scarcely say after this resume and the work done, that all the inspectors have devoted their best energies to their work and have given me perfect satisfaction. I may also state that I have myself inspected a large number of houses, of c 2 36 accumulations of offensive matter, some premises whereon noxious trades were carried on, and mauy other places, as well as the cow-sheds and slaughter-houses. During the year the Bye Laws for the regulation of the business of a Blood boiler, Bone boiler, Manure manufacturer, Soap boiler, Tallow melter, and Tripe boiler, prepared by the Metropolitan Board of Works, have been confirmed by the Secretary of State. Under these bye laws every precaution necessary for reducing the offensive character of the businesses to a minimum must be adopted. All vapours and gases must be conveyed into a furnace fire, so as to burn them before escaping into the open air; proper places have to be erected for the storage of the materials used in the said businesses, except that of a tripe boiler; and air-tight boxes or other receptacles for conveying any offensive matter to and from the places of manufacture. It is also purposed that Bye Laws shall be extended to the following businesses, viz., a manufacturer of Mineral Acids, of Ammonia, or of any of its salts or compounds from gas liquor; of Glue and Size. There is also a probability of Bye Laws being prepared for the following, viz., Animal Charcoal making, Fish curing, Neat's-foot Oil making, Anthracene, Nitro-Benzine fnaking, India-rubber making, Oil boiling, Japanning and Galvanizing Iron. Scarcely any of these Bye Laws will apply to this district, as action has always been taken for years past, under the Nuisances Removal Act, or the Old Building Act, against persons newly establishing an offensive trade in Hackney. The water supply to the district has been generally good during the year. I have received several complaints respecting it, but on comparison between the water as delivered and that obtained from kitchen taps, it was in all cases found that the cisterns or pipes inside the house were at fault. In one instance, where two cases of typhoid occurred, the water as delivered was almost free from ammonia, but that which was drank contained as much as 0.014 grains per gallon. The 37 cistern was found to be fairly clean, but the interior of the pipes was covered with a gelatinous deposit. The New River water, as reported by Drs. Frankland and Tidy, was generally clear and bright, but the East London was not quite clear in July and December. They contained between 16.22 and 23.21 grains per gallon of total solids, which is not excessive, or in any way injurious, indeed, on the contrary,.especially for children, would be likely to be beneficial as supplying some of the salts necessary for maintaining the bodily structure. I also made some analyses of the East London water, and found the total solids to vary between 18.02 and 19.40 grains per gallon. The meteorology of the year was somewhat unusual, as the mean temperature was 50°1, which is 1°3 F. above the average of 105 years, as deduced from the observations taken at the Observatory, Greenwich. The mean temperature for January was 37°3; for February, 41°1; for March, 41°1; for April, 47°2; for May, 49°4; for June, 58°5; for July, 65°9; for August, 63°7; for September, 55°8; for October, 52°8; for November, 44°0; and for December, 44°1; so that the mean temperature for February and March were the same, and that for December was absolutely 0°1 higher than that of November. The average temperature for July was 4°3 in excess, and for August, 2°9; the highest temperature in the shade'recorded in July having been 94°0, and in August 93°8; the mean of all the highest in July having been 80°0, and in August 76°8. The lowest temperature recorded in January was 17°1; in February, 21°8; in November, 25°5; and in December, 28°3. The rainfall was 24.2 inches, which is nearly an average, but as much as 8.9 inches fell in November and December, being the largest amount of rain in that month that has been recorded since 1821. There were but two weeks in which-the mean temperature fell below freezing point, viz., in the second week in January and in February. The temperature in July was in excess for each week as follows, 4°0, 3°1, 8°0, and 1°3 F.; whilst in the 38 first week in August it was below the average 1°1, after which the temperature increased again, being in excess during the whole of the week ending August 12th, and on two days to the extent of 4°6 and 10°5, after which it fell again. The effect of the high temperature was very marked, as it raised the annual death rate for the fortnight ending August 5th to 29.6, causing 55 deaths from diarrhoea, of which 46 were of children under 1 year. After this time the continued hot weather did not increase the mortality, as all those susceptible to its influence appear to have succumbed at its first onset. I remain, Gentlemen, Yours obediently, JOHN W. TRIPE, M.D., Medical Officer of Health. April 11th, 1877. Received and Ordered to be Printed and Circulated. JOHN KELDAY, Chairman. 39 TABLE OF DEATHS REGISTERED IN THE HACKNEY DISTRICT DURING THE YEAR 1876. AGES Under 1 year 1 to 2 2 to 5 5 to 5 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Total. CLASS 1—Order I. Small Pox 11 7 20 17 8 13 8 5 2 .. 1 .. 92 Measles 4 7 2 2 .. .. .. .. .. .. .. .. 15 Scarlatina 1 13 23 15 .. 3 1 1 .. .. .. .. 57 Diphtheria 2 3 8 10 .. .. .. .. .. .. .. .. 23 Croup 3 3 4 5 .. .. .. .. .. .. .. .. 15 Whooping Cough 59 38 25 4 .. .. .. .. .. .. .. .. 126 Tvphus Fever .. .. .. 1 2 2 1 1 .. .. .. .. 7 Typhoid Fever .. .. 5 7 7 6 1 4 3 I .. .. 34 Simple Fever .. .. .. 1 2 .. .. .. .. • • .. .. 3 Erysielas 9 .. .. .. 1 1 1 5 2 4 2 1 26 Influenza .. .. .. .. .. .. .. .. .. .. .. .. .. Dysentery .. .. .. .. .. .. .. .. .. 2 .. .. 2 Diarrhœa 111 13 .. 1 .. 1 .. .. 1 2 5 2 136 Choleraic Diarrhœa 3 2 .. 1 .. .. .. 1 1 .. .. I 9 Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Rheumatism .. .. 1 2 .. 2 3 2 1 1 1 .. 13 203 86 88 66 20 28 15 '9 10 10 9 4 558-558 Order 2: Syphilis 8 .. .. .. .. .. .. .. .. .. .. .. 8— 8 Order 3. Privation .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. 7 Purpura and Scurvy .. .. .. .. .. 1 1 .. .. .. .. .. 2 A lcohol Del.Tremen. Intmprnce .. .. .. .. .. 1 1 .. 1 .. .. •• 4 7 .. .. .. .. 2 2 .. 1 1 •• .. 13— 13 Order 4. Thrush 2 .. .. .. .. .. .. .. .. .. .. .. 2— 2 CLASS 2—Order 1. Gout .. .. .. • • .. .. .. .. 1 .. .. .. 1 Dropsy .. .. .. .. .. 1 .. .. .. 1 3 .. 5 Cancer .. .. .. .. .. 4 5 23 23 19 2 .. 76 Mortification & Abscess 3 1 2 •• •• 4 •• 1 3 2 5 1 22 3 1. 2 .. .. 9 5 24 27 22 10 1 104—104 Order 2. Scrofula .. 4 1 4 3 .. 1 .. .. .. .. .. 13 Tabes Mesenterica 2.5 23 11 4 .. .. .. .. .. .. .. .. 63 Phthisis 9 8 5 6 07 97 77 36 20 10 .. .. 335 Water on the Brain 8 5 9 5 .. .. .. .. .. .. .. .. 27 42 40 26 19- 70 97 78 36 20 10 .. .. 438-438 40 TABLE OF DEATHS—Continued. AGES Under 1 year 1 to 2 2 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 and upwards Total. CLASS 3—Order i. Inflammation of Brain 18 15 18 9 8 5 6 5 8 12 4 1 109 Apoplexy .. .. .. .. .. 4 12 14 15 19 5 .. 69 Paralysis .. .. 1 .. 2 .. 3 7 14 9 16 4 56 Insanity .. .. .. .. .. 1 .. 1 1 . .. .. 4 Epilepsy .. .. 1 2 2 3 2 2 .. 3 1 .. 16 Convulsions 87 17 7 .. .. .. .. .. .. .. .. .. 111 Diseases of Brain .. .. .. .. 1 .. 3 .. .. .. 2 .. 9 Diseases of Spinal Cord .. 1 .. .. .. .. 1 1 •• 2 •• .. 5 105 33 27 11 13 13 28 30 38 48 28 5 379—379 Order 2. Inflammation of Heart .. .. .. 3 .. .. .. 1 .. .. .. .. 5 Aneurism .. .. .. 1 .. 1 2 .. 2 2 1 .. .. Heart Disease .. .. .. 7 13 8 16 17 37 45 20 8 172 .. .. 2 11 13 9 18 18 39 47 21 8 186—186 Order 3. Laryngism Stridulus 18 3 .. .. .. .. .. .. .. .. .. .. 21 Laryngitis .. .. 2 .. .. .. .. .. .. .. 1 1 4 Bronchitis 75 26 12 1 3 4 9 19 37 46 42 8 282 Pleurisy .. .. .. .. .. .. 3 4 5 2 .. .. 15 Pneumonia 43 20 10 3 9 9 14 12 12 9 2 2 145 Asthma .. .. .. .. .. .. .. 3 2 2 .. .. .. Lung Disease .. .. .. .. .. .. 1 3 1 •• •• • • 5 136 49 24 4 12 14 27 41 57 59 45 11 479—479 Order 4. Gastritis .. .. 1 .. .. 1 .. .. 1 1 .. .. 4 Enteritis 3 2 .. 2 .. 1 .. 1 2 .. 1 .. 12 Peritonitis 2 .. .. 1 4 .. 1 1 1 1 1 1 13 Ulcratn. of Intestines .. .. .. 1 1 1 2 3 .. 2 .. .. 10 Hernia .. .. 1 1 .. 1 .. 1 4 1 2 .. 11 Ileus .. .. .. .. .. .. .. .. .. .. 1 .. 1 Intussusception 1 .. .. 1 .. 1 .. 1 1 .. .. .. 5 Stomach Disease .. .. .. .. .. .. 1 .. .. 1 .. .. 2 Hepatitis .. .. 1 .. .. .. 2 3 5 2 1 .. 14 Jaundice 5 .. .. .. .. .. .. .. 2 .. 1 .. 8 Liver Disease .. .. .. .. 2 .. 6 8 14 8 3 1 42 Spleen Disease .. .. .. .... .. .. .. 1 .. •• .. •• 1 11 2 3 6 7 5 12 19 30 16 10 2 123—123 Order 5. Nephritis .. .. .. 2 .. .. 1 2 .. 1 .. .. 6 Nephria .. .. .. .. 1 1 2 5 7 5 .. .. 21 Diabetes .. .. .. .. .. 2 .. 1 2 .. .. .. 5 Stone .. .. .. .. .. .. .. .. .. .. .. .. .. Cystitis .. .. .. .. .. .. .. .. 1 3 1 .. 5 Kidney Disease .. .. 1 1 1 .. .. 1 2 1 .. .. 7 .. •• 1 3 2 3 3 9 12 10 1 .. 44— 44 41 TABLE OF DEATHS—Continued. AGES Under 1 year I to 2 2 to s 5 to 15 15 to 25 25 to 35 35 to 45 45 to 35 55 to 65 65 to 75 75 to 85 85 and upwards Total. Order 6. Ovarian Dropsy .. .. .. .. 1 .. 2 .. 2 .. 1 .. 6 Utrus, Disease of .. .. .. .. .. .. .. 1 2 .. .. .. 3 .. .. .. .. 1 •• 2 1 4 .. 1 •• 9— 9 Order 7. Joint Disease •• .. 2 6 3 •• 2 2 1 1 .. .. 17— 17 Order 8. Skin Disease .. .. 1 .. 1 1 .. .. .. 1 •• •• 4— 4 CLASS 4—Order I. Premature 145 .. .. .. .. .. .. .. .. .. .. .. 145 Cyanosis 5 .. .. .. .. .. .. .. .. .. .. .. 5 Spina Bifida 3 .. .. .. .. .. .. .. .. .. .. .. 3 Other Malformations 11 .. .. .. .. .. .. .. .. .. .. .. 11 Teething 7 .. .. .. .. .. .. .. .. .. .. .. 7 171 .. .. .. .. .. .. .. .. .. .. .. 171—171 Order 2. Childbirth .. .. .. .. 5 12 13 1 •• .. .. .. 3i— 31 Order 3. Old Age .. .. .. .. .. .. .. .. .. 12 76 28 116—16 Order 4. Atrophy & Debility 60 .. .. .. .. .. .. .. .. .. .. .. 60— 60 CLASS s—Order I. A ccidents— Negligence Fracture—Contsns .. 1 2 1 2 1 1 2 3 1 4 1 19 Gun Shot .. .. .. .. .. .. .. 1 .. .. .. .. 1 Cut-stab .. 2 .. .. .. 1 .. .. .. .. .. .. 3 Burns—Scalds .. .. 3 2 .. .. .. .. 1 .. .. .. 6 Poison .. .. 2 .. .. .. .. 1 .. .. .. .. 3 Drowning .. .. .. 6 3 2 2 2 1 .. .. .. 17 Suffocation 20 .. .. .. .. .. .. .. .. .. .. .. 20 Otherwise .. .. .. .. .. .. .. .. .. .. .. .. .. 20 3 7 9 5 5 3 6 5 1 4 1 69— 69 Order 2. Murder & Manslghtr. 1 .. .. .. 1 .. .. .. .. .. .. .. 2— 2 Order 3. Suicide .. .. .. .. 1 1 2 3 .. .. 1 .. 8 2 .. .. .. .. .. .. .. .. .. .. .. 2 2 .. .. .. 1 1 2 3 .. •• 1 .. 10— 10 Totals 773 214 183 135 154 199 210 209 244 238 206 60 2825 42 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Diseases occurred. NAME OF STREET OR ROAD. Number of Houses Inspected. Number of Booms. Number of Families. Number of Inmates: No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Typhus Fever. Fever. Abbott street 27 87 43 153 17 .. .. .. .. Abney gardens 29 57 38 430 23 1 .. .. 2 Action street 13 46 20 62 9 .. .. .. .. Ada street 40 158 76 274 18 1 .. .. .. Albert place 6 24 8 38 3 .. .. .. .. Albert grove 9 49 12 5° 4 .. .. .. .. Albert street 18 53 29 91 14 3 .. .. .. Albion road 8 32 18 38 4 2 .. .. 1 Aldham place 9 42 3 71 .. .. .. .. .. Amherst terrace 10 42 12 67 1 .. .. .. .. Anderson road 26 74 35 84 24 .. .. .. .. Andrews road 13 61 26 98 11 .. .. .. .. Arthur street 33 134 40 167 26 2 .. .. .. Austin's buildings 10 20 10 24 6 .. .. .. .. Back road 14 39 19 82 12 2 .. .. .. Bailey's lane 3 12 3 14 .. .. .. .. .. Ball's building 14 54 18 90 12 2 .. .. .. Barn street 11 48 '7 70 3 1 .. .. .. Bath row 14 34 14 61 9 .. .. .. .. Baxter's court 2 8 2 12 1 .. .. .. .. Bay street 20 86 28 117 16 .. .. .. .. Bentham road 4 18 6 31 1 6 1 .. .. Berger road S3 213 86 334 21 5 .. .. .. Blackstone road 43 279 9i 409 27 2 .. .. 1 Blanchard street 11 77 22 108 0 .. .. .. .. Blanchard road 34 289 75 475 18 .. .. .. .. Bloomfield street 46 230 9j 394 21 2 .. .. .. Bohemia road 14 54 18 61 11 1 .. .. .. Boreham street 10 40 17 69 6 .. .. .. .. Bowling green street 32 108 40 162 25 .. .. .. .. Bowling green place 6 24 8 41 1 .. .. .. .. Bower road 18 66 20 111 8 1 .. .. .. Broosby walk 41 167 57 176 19 14 2 .. 1 Brook street, Clapton 120 491 281 911 69 4 1 .. 2 Brown's place 27 108 34 149 14 .. .. .. .. Bridze 23 90 26 108 17 4 2 .. .. Brunswick street 49 198 76 301 21 .. 3 .. .. Brunswick grove 17 67 19 64 14 .. .. .. .. caroline place 11 47 14 70 5 1 .. .. .. Caroline street, Clapton 49 '36 58 234 26 .. .. .. .. Charles street 2 8 3 17 .. .. .. .. .. Chapel court 5 11 5 13 2 .. .. .. .. chapel road 48 170 56 216 23 1 .. .. 1 Chapman road 13 56 18 81 9 1 .. .. •• Carried forward 1005 4207 1702 6728 577 56 9 •• 8 43 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Diseases occurred. NAME OF STREET OR ROAD. Number of Houses Inspected. Number of Rooms. Number of Families. Number of Inmates. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Typhus Fever. Fever. Brought forward 1005 4207 1702 6728 577 56 9 .. 8 Church road, Homerton 41 254 61 296 23 .. 5 .. .. Church road, West Hackney 2 8 3 19 1 .. .. .. .. Church street, Stoke Newington 6 24 7 39 .. .. .. .. .. Church terrace 11 48 23 115 9 .. 1 .. .. Church yard, Hackney 9 48 15 69 6 .. .. .. 2 Clarence road 46 194 62 306 23 1 .. .. .. Castle street 8 48 16 76 4 .. .. .. .. Cold Bath lane 9 27 11 48 8 .. .. .. .. College lane 16 64 20 91 4 4 .. .. .. College street 45 180 54 219 23 4 1 .. .. Conduit street and place 43 143 52 186 28 4 1 .. Conrad street 15 7° 17 91 9 .. .. .. .. Cottage place 13 26 13 39 10 .. .. .. .. Cowdray street 78 21 111 6 2 .. .. .. Cross street 8 32 10 51 8 5 2 .. .. Cross street, South Hackney 1 19 76 25 131 10 2 .. .. .. Crozier terrace 64 256 91 361 33 5 .. .. .. Culford road 2 8 3 17 1 .. 1 .. .. Derby road 32 192 63 262 20 .. .. .. 1 De Beauvoir road 7 28 9 43 5 .. .. .. .. Devonshire place 5 15 5 26 4 .. .. .. .. Digby road 80 304 106 464 39 1 .. .. 1 Downham road 14 64 17 89 6 .. .. .. .. Duncan street 51 201 111 424 36 1 .. .. .. Duncan terrace 6 24 II 44 4 .. .. .. .. Duncan sauare 36 144 6l 291 19 1 .. .. 1 Duncan place 4 18 6 31 2 .. .. .. .. Durham grove 10 3i 9 42 8 1 .. .. .. East street 2 8 2 IS 1 .. .. .. .. Eaton place 54 233 "79 297 24 .. .. .. .. Edward's lane 16 64 20 81 3 .. .. .. .. Eleanor road 7 28 11 46 3 .. .. .. .. Elgin street 348 81 391 38 8 .. .. .. Elizabeth cottages 20 40 20 67 18 .. .. .. .. Essex street 22 88 31 106 10 .. 1 .. 1 Exmouth place 22 83 30 181 12 1 .. .. .. Fairey street 13 52 19 69 9 .. .. .. .. Falcon court 10 38 12 49 6 .. .. .. .. Farm place, Homerton. 12 48 22 99 10 3 .. .. .. Carried forward 1856 7942 2931 13010 1070 96 21 1 14 44 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Diseases were found. NAME OP STREET OR ROAD. Number of Houses' Inspected. Number of Rooms. Number of Families. Number of Inmates. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Typhus Fever. Fever. Brought forward 1856 7942 2931 13010 1070 96 21 1 14 Fenn Street 9 37 12 51 4 5 .. .. .. felstead street 29 145 36 148 10 7 1 .. .. Fisher's place 9 36 9 39 6 .. .. .. .. Florefield road 40 152 50 266 19 .. .. .. .. Ford place 4 28 8 36 2 2 .. .. .. Fountain yard 2 4 2 6 1 .. .. .. .. Frederick place 3 12 3 17 2 .. .. .. .. Fulham road 10 33 10 41 10 .. .. .. .. Gainsboro road 21 120 36 156 14 2 .. .. .. George place 6 18 6 33 . 2 .. .. .. .. George street, Ada street 25 100 49 177 12 .. .. .. .. George street, London fields 6 36 6 41 .. .. 2 .. .. Goring street 42 176 91 367 28 .. .. .. .. Green lanes 10 51 12 63 2 .. .. .. 1 Grove, Homerton 31 124 40 127 19 8 .. .. .. Grove lane, Hackney 14 54 16 67 8 .. .. .. .. Grove lane, Stamford hill 38 154 51 168 13 .. .. .. .. Grove road, Stamford hill 11 38 20 96 6 .. .. .. .. Grove street 16 86 21 89 9 .. .. .. .. Grove street 6 24 6 31 2 1 .. .. .. Hartwell street 3 12 4 21 2 .. .. .. .. Havelock road 59 240 103 463 36 2 .. .. .. Haywood's buildings 4 16 5 31 1 .. .. .. .. Hedger's grove 45 220 79 318 26 1 1 .. .. Hemsley street and place 24 99 24 101 11 .. 1 .. .. Hertford road 55 275 81 336 31 3 .. .. 2 Heslop place 12 48 14 59 6 .. .. .. .. High 154 469 180 629 81 .. .. .. 1 Holmbrook street 60 244 87 318 35 12 2 .. .. High street, Homerton 41 168 63 279 17 10 .. .. 1 Hill street 6 24 8 34 4 .. .. .. .. Hindle street 33 132 49 181 19 .. 1 .. 1 Hockley street 23 85 29 126 18 .. .. .. .. Holly street 21 126 39 136 12 .. .. .. .. Homer road 33 148 39 197 18 5 .. .. .. Homerton row 6 24 8 41 2 1 .. .. .. Jane's place 8 16 8 39 6 .. .. .. .. Jerusalem gardens 43 129 47 179 20 2 .. .. 1 John street, Homerton 22 78 24 57 10 3 .. .. .. John street, London fields 12 76 18 88 4 .. .. .. .. John street, Shacklewell 33 132 55 203 18 .. .. .. 1 John street, West Hackney 20 78 25 93 8 .. .. .. .. Carried forward 2905 14009. 4504 19868 1624 160 30 1 22 45 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Diseases occurred. NAME OF STREET OR ROAD. Number of Houses Inspected. Number of Rooms. Number of Families.. Number of Inmates. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Typhus Fever. Fever. Brought forward 2905 14099 4504 19868 1624 160 30 1 22 Kenton road 3 12 3 21 1 .. .. .. .. Kossuth terrace .. .. .. .. .. .. .. .. Lamb lane 15 68 23 91 10 .. .. .. .. Landfield street 41 242 71 301 33 .. .. .. .. Lark row 9 32 12 54 .. .. .. .. .. Laurel street 8 32 10 59 4 .. .. .. .. Lea bridge road 136 445 158 642 53 4 .. .. .. Lime grove 9 48 12 59 6 .. .. .. .. Lordship road 10 42 13 59 5 .. .. .. .. Margaret street 43 165 73 218 21 3 1 .. .. Margaret st., Stamford hill 20 63 48 56 11 .. .. .. .. Marian street 22 88 24 59 3 4 1 .. 4 Marlow road 56 280 91 367 31 2 3 .. .. Mason's court 3 6 3 14 2 .. .. .. .. Matthias street 30 71 32 128 13 .. .. .. .. Mayfield street 40 168 61 201 12 .. 1 .. .. Mead's place 18 52 21 99 11 .. .. .. 1 Meadow street 12 49 12 151 2 .. .. .. .. Mehetable road 6 38 12 50 2 2 .. .. .. Middle street 5 30 8 33 1 .. .. .. .. Middlesex place 7 23 7 36 4 .. .. .. .. Millington street 31 184 51 241 21 .. .. .. .. Morning lane 42 138 49 179 20 10 1 .. 3 Morpeth road 6 24 6 51 1 .. .. .. .. Montague terrace 35 136 49 201 27 10 1 2 .. Moscow terrace 6 24 7 51 2 .. .. .. .. Myrtle street 28 114 36 134 14 .. .. .. .. Newington common 10 42 11 56 6 .. .. .. .. New Church road 56 217 71 289 21 .. .. .. .. New street 12 84 15 71 4 .. .. .. .. North street 75 301 96 388 31 1 1 .. .. Nursery row 17 58 20 89 7 .. .. .. .. Orchard's street, Kingsland 12 60 16 8l 5 1 .. .. .. Orchard street, Well street 15 62 18 94 10 1 .. .. .. Orchard cottages 13 5° 18 110 6 .. .. .. 1 Ottaway street 36 26 68 300 10 .. .. .. .. Palace road 70 285 93 372 21 4 .. .. .. Paragon road 6 26 8 47 3 2 1 .. .. Park cottages 3 12 3 17 .. .. .. .. .. Park street, Hackney wick 29 116 37 149 11 .. .. .. .. Carried forward 3900 19912 5968 26486 2076 204 40 3 31 46 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Diseases occurred. NAME OF STREET OR ROAD. Number of Houses Inspected. Number of Rooms. Number of Families. Number of Inmates. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Typhus Fever. Fever. Brought forward 3900 19912 5968 26486 2076 204 40 3 31 Pawnbrokers' alley 6 24 6 41 1 .. .. .. .. Pear tree place 10 22 10 31 2 2 .. .. .. Percy road 36 176 49 199 16 2 .. .. .. Percy terrace 42 168 53 218 19 1 .. .. .. Pickle's buildings 6 12 6 18 2 .. .. .. 1 Pleasant place 10 40 13 52 4 .. .. .. .. Plough lane 13 39 15 66 5 1 .. .. .. Prince Edward's road 41 205 61 259 19 2 3 .. .. Prospect place 27 104 41 166 18 .. .. .. .. Pyle place 3 9 3 14 1 .. .. .. .. Queen's court 7 14 7 33 4 .. .. .. .. Railway crescent 33 132 46 196 12 2 1 .. 1 Rayner street 6 24 8 43 1 .. .. .. .. Red Lion lane 6 24 6 33 2 .. .. .. .. Retreat, The 6 24 8 41 3 1 .. .. .. Richmond place 12 48 14 66 4 .. .. .. .. Ridley road 4 8 4 20 2 .. .. .. .. Rigby's buildings 3 13 3 16 1 .. .. .. .. Rochester place 6 14 6 30 3 .. .. .. .. Rock place 3 12 4 21 3 .. .. .. .. Roseberry place 30 120 36 139 24 .. .. .. .. Rosina cottages 19 58 20 143 8 .. .. .. .. Rosina street 19 72 31 129 11 5 1 .. 1 Saint John's place 25 61 25 211 26 .. .. .. .. Saint Thomas cottages 8 24 8 36 1 .. .. .. .. Samuel row 12 48 17 76 12 .. .. .. .. Sanford lane 33 132 40 171 26 .. .. .. .. Saxony cottages 13 37 16 89 8 .. 1 .. .. Sedgwick street 47 251 64 309 13 21 .. .. .. Shacklewell lane and green 10 43 12 68 4 1 .. .. 1 Shacklewell row 37 139 46 194 28 .. 1 .. .. Sheep lane 71 221 106 420 33 5 .. .. .. Shepherd's lane 9 36 13 62 2 .. .. .. .. Shepherd's place 9 18 9 47 3 .. .. .. .. Silk Mill hill and court 22 69 24 59 10 .. .. .. .. South row 6 16 6 36 1 .. .. .. .. Spring Vale grove 4 10 4 23 1 .. .. .. .. Stanboro' yard 2 4 2 6 .. .. .. .. .. Stellman street 25 90 33 139 13 .. .. .. .. Stonebridge common 55 182 63 172 30 1 4 .. .. Suther street 10 40 12 51 3 1 1 1 .. Carried forward 4641 21695 7613 29626 2455 249 52 4 35 47 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Discuses occurred. NAME OF STREET OR ROAD. Number of Houses Inspected. Number of Rooms. Number of Families. Number of Inmates. No. of Houses in which Nuisanoes were found. Small Pox. Scarlatina. Typhus Fever. Fever. Brought forward 4641 21695 7613 29626 2455 249 52 4 35 Sussex street 5 20 5 31 2 .. .. .. .. Swiss cottages 10 36 10 50 3 .. .. .. .. Taylor's buildings 1 15 6 44 1 .. .. .. .. Tennyson terrace 7 38 10 51 3 .. .. .. .. lemplar road 64 275 90 371 22 12 .. .. .. Temple street 16 80 21 109 9 .. .. .. .. Thomas street 17 72 19 76 7 .. 2 .. .. Tottenham road 109 451 133 603 31 1 1 .. .. Tranquil place 9 33 9 42 .. .. .. .. .. Triangle road 31 124 40 1186 21 .. .. .. .. Tryon's court 3 10 3 17 2 .. .. .. .. Tudor grove 21 84 36 129 6 1 .. .. 1 Tyssen passage, Dalston 23 81 33 133 10 .. .. .. .. Tyssen street, Dalston 21 124 36 156 9 .. .. .. .. lyssen street, Stoke Newington 19 56 21 91 6 .. .. .. .. Union street, West Hackney .33 114 36 143 8 .. .. .. .. Union street, Stoke Newington 17 68 20 91 5 .. .. .. .. Union row 8 32 14 57 3 2 .. .. .. Urban place 17 68 30 99 7 .. .. .. .. Victoria grove 18 90 32 129 4 .. .. .. .. Victoria road 66 264 101 429 27 10 2 .. 1 Vyner street 67 287 120 499 4 2 .. .. 1 Wallis road 13 52 16 74 4 .. .. .. .. Warburton road and square 83 333 112 469 51 8 1 .. 1 Warwick villas 35 140 38 201 4 1 .. .. .. Waterloo place 28 84 32 169 14 .. .. .. .. Water lane 36 134 41 179 18 .. .. .. .. Wellington street 64 296 81 344 36 4 .. .. .. Well street 31 136 40 171 11 1 3 .. 1 West street, Triangle 9 30 9 46 3 .. .. .. .. West street, Well street 13 40 15 71 2 .. .. .. .. Western place 14 58 17 79 4 1 .. .. .. Whaterell road 10 40 12 56 1 .. .. .. .. W harf road 11 44 15 71 6 1 .. .. .. White Hart court 3 6 3 11 1 .. .. .. .. Whitmore road 38 198 46 199 20 .. .. .. .. Wick road 236 1011 306 1414 111 9 3 .. 1 Carried forward 5847 24909 8681 36325 2932 302 64 4 42 48 Streets and other Places Inspected in 1876. No. of Houses in which Epidemic Diseases occurred. NAME OF STREET OR ROAD. Number of Houses Inspected. Number of Booms. Number of Families. Number of Inmates. No. of Houses in which Nuisances were found. Small Pox. Scarlatimu Typhus Fever. Fever. Brought forward 5847 24909 8681 36325 2932 302 64 4 42 William street 20 146 18 154 4 .. .. .. .. Wilman grove 3 13 5 17 3 .. .. .. .. Winchester place 4 16 6 33 3 .. .. .. .. Windsor road 32 128 46 199 13 .. .. .. .. Winslade road 62 290 81 289 6 .. .. .. .. wood street 44 132 48 173 8 .. .. .. .. Woodland street 64 270 108 376 29 .. .. .. 1 Woolpack place '4 58 14 66 12 .. .. .. 1 York buildings 10 20 10 51 3 .. .. .. .. York place •• .. .. .. .. .. .. .. .. Other place 3 14 3 14 3 .. .. .. .. Other cases of Epidemic Disease .. .. .. .. •• 155 41 6 30 Total 6103 25996 9040 37697 3016 459 108 10 74 49 Privy Cesspools emptied, tilled up, and drained into the Sewer 28 Choked Drains cleansed or repaired, or re-laid 597 New Traps provided 411 Yards drained 149 Water-closet Pans choked 129 Total number of Nuisances from defective drairrage 1314 Yards paved or Paving re-laid 296 Number of Dust Bins provided or repaired 537 Houses repaired, whitewashed, &c.— 2196 No. of houses in which the ventilation has been improved No. of houses to which a better supply of water has been given, or the apparatus improved 841 Total number of Nuisances from defects in houses 3870 Number of houses disinfected 651 „ „ overcrowded 30 Pigs removed from separate premises 49 Stable dung and other refuse removed dust) 131 Filthy places cleansed 159 Other nuisances removed 241 1261 Total number of nuisances abated, 1876 6445 50 Number of Lodging Houses' Notices served 121 „ Notices for disinfecting premises 651 „ Letters sent out 801 „ Preliminary notices served 3697 „ Peremptory 1753 ,, Statutory 1110 „ Persons summoned, before a magistrate 79 „ Copies of summonses and orders made out 474 ,, Dust complaints received, and. attended to 2918 „ Bodies deposited and taken to the? Mortuary 59 „ Houses from which bedding, &c., was removed to be disinfected at the Board's Appparatus 242 „ Articles disinfected at the Board's Apparatus 2459 „ Fish condemned unfit for human food pads 41 PREMISES INSPECTED DURING THE YEAR 1876. Number of Houses inspected under the Sanitary Act, 1866 6103 „ „ in which epidemic disease has appeared 651 „ Premises inspected from complaints received 517 „ Cowsheds inspected 93 ,, Slaughter houses inspected 79 „ Greengrocers'yards inspected 166 „ Fishmongers' and Poulterers' yards inspected 84 „ Bakehouses inspected 167 „ Houses measured as well as inspected 28 „ Urinals inspected 239 Total number of premises inspected 8127