HAC 64 Board of Works for the Hackney District REPORT on the SANITARY CONDITION HACKNEY DISTRICT, For The Year 1884, by JOHN W. TRIPE, M.D., Member of the Royal College of Physicians, Edin., &c.; Vice-President of the Society of Medical Officers of Health; Secretary and formerly President of the Royal Meteorological Society; Member of Council of the Society of Public Analysts; Corresponding Foreign Member of the Royal Society of Public Medicine of Belgium; Foreign Associated Member of the French Society of Hygiene; Author of Essays on Scarlatina; Meteorological Phenomena in connection with Disease; and of numerous Papers on Sanitary Statistics, Disinfectants, &c.; Medical Officer of Health and Public Analyst for the Hackney District. London: Roberts, Son & Co., Steam Printing Works, 5, Hackney Road. E, 1885. Board of Works for the Hackney District. SANITARY REPORT For the Year, 1884. To the Board of Works for the Hackney District. Gentlemen, As the most important matter connected with the prevalence of disease in this district, during this year, is the severe epidemic of Small-pox, I propose commencing my report by a disoussion of the main incidents of the outbreak, dating back to October 1st, 1883, as from that date to the end of September usually constitutes an epidemic year. I do not mean to say that during this period an epidemic of this disease begins and ends, because that is by no means the fact, but that in the early autumnal months there is such a diminution as to justify the course I propose taking. This is also the more advisable as the Managers of the Asylums Board decided in June last not only to reduce permanently the number of cases in the hospital, but also to cease bringing very large numbers of sick from other districts and parishes on this side of the Thames to the Homerton hospital. It is therefore probable that the incidence of the disease will hereafter prove to be very different from A 2 4 what it has hitherto been since the opening of the Homerton hospital. The chief feature hitherto has been the recurrence of the disease in the streets and places within half a mile of the hospital at each epidemic period, and its persistence to a greater or lesser extent within the same area when it was nonepidemic. The course of the disease during the time under consideration has been similar, having chiefly attacked the inhabitants within half a mile radius, with local outbreaks in other places of considerable severity, such as those in Ash Grove and Ottaway Street. Thus in 1871 there was a severe outbreak in the streets between the London Fields and the Regent's Canal. In 1876 there were outbreaks at Hackney Wick, and in the vicinity of Palace Road and in Shacklewell. The disease has not since then shewn itself as an epidemic in these localities, although they are occupied by a somewhat similar class to those living around the hospital and the inhabitants are poorer and more densely packed than in most of the streets on the Clapton Park Estate, which has suffered so severely this year. The first case of the disease occurred on the 10th of October, 1883, in Bentham Road, followed on the 16th by another in Ufton Road, making two cases only reported to me in Hackney during the month of October. In November numerous cases occurred. On the 4th one was reported in College Avenue; on the 5th, in Paragon and Glynn Roads; on the 13th, in Sedgwick Street; on the 14th and 15th, in Urswick Road, Digby Road and Dyssal Street; on the 18th five cases were reported in Lower Brunswick Street, Clifden Road, Wick Road, Church Road, Homerton and Manor Place; and on the 23rd, in Meynell and Bentham Roads; on the 27th, another case (same house) in Dyssall Street; cases in Brooksby's Walk, Digby Road, Warwick Villas and Homerton Infirmary; so that the cases occurred largely in or near the 5 quarter-mile radius; but by no means exclusively so. The total number of cases reported to me in November was 20, and in December 38. In the last-named month 2 cases occurred in the Upton House School, 4 in Clifden Road (in different houses), 3 in Healthy Terrace, Homerton, 3 in Brooksby's Walk, 2 in Dunlace Road, 1 in Templar Road, and several in Glynn Road; so that about half the total number occurred within or quite close to the quarter-mile radius. There were 43 cases reported to me in January and 27 in February, but of these 5 cases occurred in one house in Berger Road and 2 in Ash Grove. There were fewer cases in the vicinity of the hospital in February as compared with January. During the first fortnight in March there was not a large number reported to me, viz.: 11 during the first week, and only 4 in the second week; but on the 20th the epidemic fairly set in, as 7 cases were reported on the 21st (which occurred on the 20th); 16 on the 22nd; 23 on the 23rd and 24th; 11 on the 25th; and 10 on the 26th—making a total of 67 cases in one week. Although Hackney suffered so severely, there were comparatively few cases in other districts and parishes north of the Thames. The majority of these occurred in Bethnal Green, Shoreditch and Islington, all of which adjoin the Hackney district. The number of cases removed by the Asylums Board during the week ending March 22nd was 60; and of these 35 were removed from Hackney, 7 from Bethnal Green, 6 from Islington, and 6 from Shoreditch. In the week ending March 29th there were 84 cases removed from the parishes north of the Thames; 38 being from Hackney, 10 from Bethnal Green, 12 from Islington and 9 from Shoreditch. As regards the Hackney cases a majority occurred in a comparatively narrow line extending in a south-westerly direction from the hospital; and as the wind during the infective period had generally been from the south-west, I was 6 unable to account for the outbreak if it arose from the hospital, as I could scarcely imagine it would travel against the wind. I therefore applied to the Astronomer Royal at Greenwich, and to Mr. Whipple at Kew, for returns during the month of March showing the daily and hourly direction and force of the wind. From these, which were most kindly furnished to me, I find that on the 6th the wind veered slowly from the south-west all round the compass by way north and east to south and south-west, taking four hours for the process, and blowing for three-quarters of an hour from the north-east at a very low rate of velocity, viz., three miles an hour which is nearly a calm. A similar occurrence happened on the 7th, when only two hours were occupied in the veering, &o., twenty minutes out of which time the wind blew from the north-east, at a rate of two miles an hour. These results are in accordance with the statements of Mr. Power as regards the spread of small-pox from the Fulham hospital. On the 10th and 11th the wind, which was then blowing from the south-west, backed (i.e., went against the course of the sun) by way south and east to north, occupying sixteen hours in the backing, and blowing from the east or north-east for about seven hours. The velocity of the wind was probably not quite so favourable during this time for the spread of the disease, having had a mean velocity varying from 6 to 9 miles per hour. Of course this does not mean that the wind did not move slower or faster than these rates during that time. The greatest number of oases were reported to me on the 21st, 22nd and 23rd, so that it is pretty certain that the chief infection on the 6th and 7th, but most probably also a portion occurred on the 10th and 11th. It may be asked why, with a south-west or west wind the disease does not spread in the district generally, to which I reply that except in Brooksby's Walk and Glynn Road there are no houses on the north-cast and east of the hospital. The inhabitants of Brooksby's Walk aud the part of Glynn Road near the hospital have suffered severely. 7 As the latent period of small-pox is about a fortnight up to the appearance of the rash, and as the epidemic occurred between the 20th and 26th, it is evident that the infection must have taken place between the 6th and the 12th of March. Now the only cases reported to me during the week ending Maroh 12th were in Southgate Road, Florefield Road, Sandbrook Road, Ash Grove, and Elderfield Road, but none of these were in the quarter-mile radius, while the fresh cases were spread over a large portion of the district, but chiefly for above a mile in a direction north-east from the hospital. There were other cases near the hospital, almost all round it, and it must be remembered that the wind blew from all points of the compass on those days. If we go back several days we find that there were cases in Templar Road, College Avenue, Clifden Road, Ash Grove, Presburg Street, Lynscott Road and High Street, Homerton, which might perhaps have been the source of some near the hospital; but I cannot account, in an ordinary way, for the large number of cases to the south-west of the hospital, as none was near them. In the absence of any known source of infection, and from the fact that those attacked could not assign any reason for the infection, with the other faot of the wind going all round the compass on those oecasions, i.e., on the 6th, 7th, 10th and 11th (which dates agree with those when the infection of these people occurred), I feel that I may reasonably assign this outbreak to infection coming from the hospital. It has been replied to this assumption that the hospital then contained fewer patients than usual, but at this time the practice of moving a large number of patients from other districts to the hospital was in operation, so that the number who were returned as occupying beds afforded no criterion as to the number in the hospital at different times of the day. The total number of cases reported to me in each month was as follows:—In October, 1883, 2 ; in November 20; in 8 December 38; in January 43; in February 27; in March 103; in April 138; in May 348; in June 272; in July 112; in August 40; and in September 67, there having been another rather severe outbreak between September 25th and October 1st. This outbreak somewhat resembled that of March by the absence of cases a fortnight before to account for the infection, the locality of these cases being far distant from those that occurred between the 11th and 18th of September. The outbreak in May was the severest I ever knew and lasted from May 21st to June 3rd inclusive. During these few days as many as 223 cases were reported to me between the 22nd and June 3rd inclusive. The total number reported in May was 348, and in June 272, making 620 cases in the two months. A considerable number was treated at home, and several were taken to Highgate, so that 486 only were removed to the Asylum Board's hospitals. The chief force of the outbreak was spent upon Hackney and Bethnal Green, as in addition to the 486 cases removed from Hackney there were 311 removed from Bethnal Green, 176 from Mile End, 156 from Shoreditch, 88 from Islington, 80 from Whitechapel, and 68 from Stepney, making a total of 1,365 removed from these 7 parishes, and against 359 during the same period from all the other metropolitan parishes on this side of the Thames. Although I have referred to the epidemic of 1880 in my report for that year, yet I think it necessary to recapitulate the main facts so far as they bear on the present subject, viz., the influence of the hospital on the surrounding neighbourhood. The hospital was closed from September, 1879, to February 9th, 1880, and although no cases had occurred in the neighbourhood since October, yet, a month after the hospital was opened, the disease became epidemic in the streets near it, 40 cases having been reported to me in 1880, out of 363 in the whole district. There were also numerous other cases within the quarter-mile radius to the north of the hospital, as the total number of cases 9 reported to me between October 1st, 1881, and September 30th, 1882, was 1,271; and of these 220 happened in the quartermile radius (including all the houses within this circle), 382 between the quarter and half-mile radii, and 669 in the remainder of the district. The number of homes in the quartermile radius in 1881 was 1,750; in the space between the quarter and half-mile radii, 4,026; and outside, 21,724; or at the rate of 126 cases per 1,000 houses in the quarter-mile, 95 between the quarter and half-mile radii, and only 31 per 1,000 houses outside this circle. As this last number includes a large proportion of cases between the half-mile and one-mile radii, this contrast is the more striking. During the epidemic of 1883-84 (October 1st, 1883, to September 30th, 1884), to which I shall more especially refer, there were 1,211 cases reported, of which 278 occurred in the quarter-mile radius, 410 between the quarter and half-mile radii, and 523 outside. Of these 310 happened between the half-mile and one-mile radii, making a total of 998 cases out of the 1,211 within the one-mile radius. The streets in the quarter-mile radius were most severely affected, as there were 158 cases per 1,000 houses there, against 92 between the quarter and half-mile radii, and only 22 outside. These facts can be seen on reference to the map. The number of deaths in 1883-84 registered in Hackney, and of Hackney cases in the ships and at Darenth, was 125: a much smaller number than in 1881 (when 225 deaths were registered), although the number of cases was nearly as large as in the latter year, and somewhat smaller than in 1877. The deaths occurred as follows:—42 amongst patients from the quartermile radius, 44 within the quarter and half-mile radii, and only 39 outside the half-mile radius. The following table shows the chief statistical facts connected with the outbreak. 10 HACKNEY.—Percentage of Cases of and of Deaths from Small-Pox in different radii, 1883-84. 1883-84. Cases. Deaths. Houses. Quarter-mile 22.9 33.6 6.1 Between Quarter and half-mile radii. 33.9 36.2 14.7 Totals 56.8 68.8 20.8 Outside half-mile radius 43.2 31.2 76.9 Totals 100 100 100 Between half mile and mile radii 25.6 16.8 As the 125 deaths include those of all the inhabitants, a comparison between the percentages of houses and of deaths affords a fairly reliable estimate of the prevalence of the disease in different parts of the district, although it is evident from the percentages of cases in the different radii that the disease was more fatal amongst the inhabitants of the quarter-mile radius than elsewhere. Thus, there were 22.9 per cent. of the total oases and 33.6 per cent. of the total deaths amongst its inhabitants. The contrast between 336 per cent. of all the deaths from small-pox, and 22.9 per cent. of the cases, against 6.1 per cent. of the whole number of houses, is very marked, and fully bears out the conclusions previously drawn from the deaths during 1871-80. The table also shows that 33.9 per cent. of all the cases reported to me, and 35.2 per cent. of all the deaths, occurred between the quarter and half-mile radii, whilst the percentage of houses was only 14.7. On the other hand, there were 43.2 per cent. of cases reported, and 31.2 per cent. of deaths, in the rest of the district, which contained 76.9 per cent. of all the houses. There were also 68.8 per cent. of the deaths in the space between the hospital and the half-mile radius. As similar results were obtained by the discussion of 11 the deaths in the epidemics of 1871-72, 1876-77, and 1880-81, it appears an inevitable conclusion that the small-pox hospital has exerted a decidedly injurious effect, ever since it was opened, on the public health of this district. The important question now arises: Is this injurious influence unavoidable? In other words, is a small-pox hospital injurious per se? The answer to this must depend partly on answers to the following queries:—(a) Does the disease spread by aerial infection? (b) If so, can the infective matter be destroyed before the air charged with it passes outside? (c) If spread chiefly or entirely by infected persons, i.e., by visitors, the sick in ambulances, nurses, and other servants, can this be prevented? (d) Does overcrowding the hospital, or the presence of a certain number of patients in one ward or hospital, assist in spreading the disease? and (e) Does the presence of a comparatively small number of acute cases by themselves, in a hospital, act as injuriously as a larger number of mixed cases? The answer to the first question cannot safely be given at present, but my opinion now is that the disease can be spread by aerial infection. I say now, because, the outbreaks in some of the streets adjacent to the hospital seemed inexplicable on any other theory, yet the evidence was not so strong as I could wish previously to the present epidemic. I however, stated this to be my opinion in the evidence I gave before the Royal Commission in 1882. The peculiar outbreak in March, 1884, seems however to me to be conclusive in the matter. I will now proceed to give a summary of the evidence as to other localities. The street in which the disease was most prevalent in 1883-84 was Templar Road, which is situated on the western side of the hospital, having the City of London Infirmary between them. There were no less than 38 cases, although there are only 81 houses in the street, but more than once two or more cases ocourred simultaneously in one house, without any ordinary cause for the infection being traceable. Thus, in November, 12 1883, three cases occurred at No. 35 on the same day; two cases in March and two in May, both at the same time. There were cases in this street in January, February, March, and one in April, which was removed on the 14th, and the rooms and clothes disinfected. Single cases occurred on the 5th, 12th, 14th, and 23rd of May, followed by seven cases in different houses on the 26th and 27th, and one on each day on the 28th, 29th, 30th, and 31st. Now, it is a somewhat singular coincidence —if it be merely a coincidence—that the wind veered round on the 12th, just a fortnight before, from W.S.W. to N.N.E., E. and E.S.E., being precisely the direction (easterly) which would carry the disease from the hospital to Templar Road. Another small outbreak, after a quiescence of more than five weeks, happened on the 27th, 29th, and 30th of September, and on the 1st of November, the wind having blown generally from the E.N.E., and a short time from E. and S.E. on the 12th, 13th, 14th, 15th, and 16th. The residents of Holmbrook Street, which is situated to the south of the hospital, behind The Grove, suffered most during April and the first twelve days of May, the wind being northerly for the greater part of the time from the 24th March to the end of April. Again, there was an outbreak in Brooksby's Walk (which is situated on the east of the hospital) on 25th, 26th, 27th, and 28th of May, and the wind was generally westerly on the 11th, 12th, 13th, 14th, and 15th of the month. The next instance I will mention is that of Clifden Eoad, which is on the north of the hospital, where an outbreak took place on the 22nd, 23rd, 25th, 26th, and 28th of May. The wind was variable, but more or less southerly from the 6th to the 17th of May. I have thus shown that the inhabitants of the streets immediately adjacent to, and those situated to the north, south, east, and west of the hospital, suffered most from the disease, when the wind blew towards them from the hospital about a fortnight before. The intervention of the infirmary 13 between the hospital and Templar Road, and the Fever Hospital and Clifden Road, do not seem to have had any effect in preventing the spread of the disease in these streets. It also agrees with this view, that The Grove intervenes between the hospital and Holmbrook Street, and yet the inhabitants of The Grove did not suffer much in 1883-84, and those of Holmbrook Street did. The disease was, however, very severe in The Grove in former epidemics; but the same may be said of Holmbrook Street, Brooksby's Walk, Clifden Road, and Templar Road. A very striking outbreak took place on October 30th, and on November 1st and 3rd, 1876, in Templar Road, Churchill Road, College Street, and Homerton College, amounting in all to 11 cases, and without any known causes of infection. As regards Homerton College, I would mention that the person attacked was the only one who had not been re-vaccinated. The persons attacked did not know one another, or have anything in common. The wind during this first fortnight of October was more or less southerly, veering from the west to the east, but on the 14th and 15th it was easterly, and remained E. or N.E. for some days. From the 13th to the 19th inclusive, its velocity was much below the average, and it contained an unusual amount of moisture, especially on the 14th and 15th, so that all the conditions favourable for the spread of the disease from the hospital to the streets were present at the time that the infection of these persons took place. There had not been any cases in these streets for months, so that I think I am justified in assuming that the infection was carried by the air to the affected persons. In order to prevent aerial infection of the neighbourhood surrounding a small-pox hospital, it has been proposed, I think by Dr. Sanderson, to have the hospitals built of a circular form, with arrangements for drawing all the air through a furnace, and destroying all the organic matter. There is no doubt that infection by what is called personal 14 contact, that is to say, by infected persons or things coming or being brought near to the healthy, is the ordinary manner in which the disease is spread. An examination of the order in which the cases occurred, at any rate in the early part of an epidemic, shows that there was an outbreak at first nearly 14 days after the first cases. For instance, at Hackney Wick, a severe outbreak took place on October 30th (one case having occurred on the 17th), and others subsequently on the 14th and 15th of November, and I have noticed this in every epidemio at different plaoes. I mention Haokney Wick because it is comparatively isolated from the remainder of the distriot and surrounded by open country. Every precaution should therefore be taken to prevent a hospital being a source of infeotion to a neighbourhood, both as regards the structure and the general and ambulance arrangements. At Homerton, as the tradespeople and others have to enter the hospital grounds to deliver goods, and as there is only one common entrance for patients and visitors to the Small-pox and Fever Hospitals, I cannot say that the best practical means have hitherto been carried out, although they will, I hope, soon be, by the completion of the works now nearly finished. One question of great moment is the number of patients who may be treated at one time in a small-pox hospital without much risk to the inhabitants of the surrounding neighbourhood. During an early period after the establishment of the hospital, the disease did not become epidemic in its vicinity until nearly 80 patients were in the hospital; but I stated in 1882, before the Royal Commission, that I did not think more than 60 patients should be placed on the site at Homerton. I then referred to mixed cases, and especially mentioned small wards, as I believe that the present wards are too large, and allow the aggregation of too many patients in one room. I cannot now say that 60 or even 30 patients suffering in the acute stage oan be safely treated at Homerton; but as a very large number of 15 patients have been moved into and out of the hospital—as many as 224 having been brought in and taken away in one week in May, very few of whom were counted as patients because they did not sleep there—I cannot say how far this incessant oarrying about of small-pox patients in the district assisted in infecting the neighbourhood, but I believe it was decidedly injurious. As a contrast, I may mention that in 1871 there was a small-pox hospital at Clapton, in which there were not, to the best of my knowledge, so many as 30 patients at any one time, and the moving of patients to and fro was comparatively rare. The disease spread to two houses only, and those were next the hospital recreation ground. The back gardens of a row of houses behind the hospital were within 30 feet of the hospital, but the disease did not spread to any of the inmates. There is, however, a difficulty arising from the more or less perfeot vaccination of those exposed to small-pox infection, and therefore I cannot say if the disease would have spread if the inhabitants of these houses had been susceptible to the disease. There was not any house near the front or sides of this hospital, except the two just mentioned. Before concluding these remarks, I desire to express my opinion that the number of patients who may be safely treated in a hospital during non-epidemic periods should not be received and kept there during an epidemic. I am also of opinion that all the evidence I have read shows that every one of the metropolitan small-pox hospitals has proved injurious to the public health of the neighbourhood in which it is placed; but I believe that it is possible to treat patients in small numbers in hospitals in London without injurious results. The wards, in my opinion, should be small; the traffic of ambulances, visitors, tradespeople, and others as restricted as possible; the open space surrounding the wards and recreation ground as large as can be obtained; and that means should be taken to prevent small solid particles being blown 16 from the wards into the open air. If wire-gauze were spread over the window openings, as was done by my direction at the Clapton Hospital in 1871, (to which I attribute much of the immunity from disease in the neighbourhood,) I believe the metropolitan hospitals would cease to be so injurious as they now are. Although I express this adverse opinion to the prosent hospitals as arranged and conducted, I do not consider that they should be closed; on the contrary, I believe that they can be carried on in such a way as to confer much benefit, and cause little injury to the neighbourhoods in which they are placed. I have also to report that every sanitary and other moans practicable were taken to prevent the spread of the disease. lie-vaccination of children between 10 and 12 years of age was ordered by the Board, new stations were opened, and bills were distributed in the district, giving the necessary information. Also all persons above 12 years of age who came either to the ordinary or new stations were re-vaccinated. Letters were sent to the medical men, ministers of religion, schoolmasters and others, requesting information as to cases of the disease. Every house in which the disease appeared was disinfected by the officers of the Board, and the clothing, beds, &c., were taken to the disinfecting chamber. Seven hundred and seventy persons were re-vaccinated in consequence of these arrangements. In concluding this part of my report, I append a table which shows that the severe outbreak in Hackney during April, May and June, corresponded with the time during which the whole of the cases that occurred on the north side of the Thames, were brought to the Homerton Hospital for a decision whether they should be retained there or sent to the ships. It will be seen that in spite of the severe outbreak in March, the number of cases removed from Hackney in April, May and June, were largely in excess in each month to those in March, and that during these three months no less than 577 of our cases were 17 removed, out of a total of 923 for the whole year. I sincerely trust that under the new arrangements fewer cases will occur within the half-mile radius. The total number of cases reported to me in the year 1884 was 1,333. return shewing the number of Small-pox Patients removed by the asylums board to their hospitals from the several metropolitan parishes on the North side of the Thames; also the total number of cases REPORTED at the TowN HaLL, HaCKNEY, and the number transferred to the Hospital-Ships from the Metropolis from October 1st, 1883, to September 30th, 1884. Total Cones reported at Hackney Town Hull. Months Total Cases Removed to Hospital and Ships. Total Cases, Hackney, Removed. Patients Transferred to Ships. Hackney. Percentages to Total Cases in each Month. 1883. 2 October 21 2 none 9.5 20 November 38 14 .. 37.0 38 December 64 33 .. 51.6 1884. 43 January 68 33 .. 48.5 27 February 66 21 .. 31.8 103 March 201 89 147 44.2 138 April 253 99 219 39.1 348 May 859 285 763 33.1 272 June 865 193 331 22.3 112 July 402 67 84 16.6 40 August 192 23 39 12.0 68 September 311 64 32 20.5 1211 3340 923 1615 Having discussed at considerable length the statistics of the small-pox outbreak of 1883-84, I shall now proceed to treat of the other sanitary statistics, and also of the sanitary work performed during the year. B 18 TABLE I. Showing the Population, Marriages, Births, Deaths, and Density of Population per Acre for the Year 1884, and Ten Years preceding. CORRECTED GROSS NUMBERS. The Year. Estimated Population. Marriages. Registered Births. * Corrected Number of Deaths. Density of Population per Acre. Total all Ages. Under One Year. Under Five Years. 1884 205,400 1433 6827 3700 880 1510 62.3 1874 139,020 1271 4755 2799 616 853 36.3 1875 145,144 1415 4970 2948 723 967 36.9 1876 152,648 1425 5469 2825 773 987 38.7 1877 160,000 1485 5562 3092 756 1212 40.7 1878 167,250 1441 5978 3392 858 1408 42.5 1879 174,350 1440 6207 3285 770 1298 44.5 1880 181,538 1425 6331 3321 918 1586 46.2 1881 188,240 1494 6377 3614 832 1513 47.8 1882 195,200 1488 6423 3505 768 1451 49.6 1883 200,200 1458 6502 3545 816 1402 51.1 Average of 10 Years, 1874—84. 170,359 1434 5857 3233 788 1271 43.3 * Registered in 63 weeks. 1871. 1881. Population at Census 124,951 186,400 No. of Inhabited Houses at Census 19,347 27,503 No. of Persons on an average in each Inhabited House at do. 6.46 6.78 Total No. of Acres 3,935 3.936 No. of Acres of Water and Open Spaces 568 568 * NOTE.—The Deaths are corrected by adding on the Deaths of Inhabitants in the Small-pox and Fever Hospitals, in the German Hospital, which are situate in the Hackney District, and also the Deaths in other Metropolitan and the Asylums Board's Hospitals outside tho District, and by taking out the deaths of all non-residents. 19 Table I. shows, to a great extent, the general statistics for the distriot during the last 11 years. During this period the population has increased from 139,000 to 205,000 (negleoting odd numbers), showing a very large addition to our numbers. This addition means more houses and roads, as well as a great increase in the sanitary work of the district, especially as a very large proportion of the new houses are occupied by artizans and the lower classes. The increased numbers also means greater density of population, and, therefore, a greater tendency towards a higher mortality, as the late Dr. Farr, in some of his elaborate and careful statistics, proved that, to a very great extent, the death-rate corresponds with the density of population. This table does not show the annual death-rates, as they will be found in another table, but I deemed it advisable to point out that in these years the density had increased from 35.3 to 523 persons per acre, and, therefore, on Dr. Farr's data, the deathrates ought, especially as there are proportionately more poor inhabitants, to have been larger during the latter part of this period. The number of births registered in 52 weeks of 1884 was 6,334, against 4,755 in 1874, the mean for the 10 years being 5,857. The deaths in 1884 amounted to 3,700, against an average for the 10 preceding years of 3,233, and in 1874, of 2,797. The number of deaths of infants and young children under 1 and 5 years were 880 and 1,510 respectively in 1884, against 788 and 1,271 in 1874-83. There was an excess of deaths above 1 and under 5 years in 1884, which will be referred to in the proper place. B 2 20 TABLE II. Hackney District.—Showing the Annual Birth and Death Rates, and Death Rates of Children in a Thousand Deaths for the Year 1884, and Ten Years preceding. In Year. Birth Bate per 1000 of the Population. Corrected Death Rate per 1000 of the Population. Deaths of Children under 1 year, per 1000 of Registered Births. Deaths of Children under 1 year, per 1000 of Total Deaths. Deaths of Children under 5 years, per 1000 of Total Deaths. Hackney. Hackney. London. Hackney. London. Hackney. Hackney. 1884 30.8 18.0 20.3 124 168 238 408 1874 34.7 20.0 22.6 139 156 238 305 1875 35.1 20.6 23.8 146 162 245 328 1876 35.8 18.5 22.2 139 157 274 349 1877 34.7 19.3 21.9 136 146 244 392 1878 35.6 20.2 23.5 144 164 226 480 1879 36.0 18.8 23.1 122 148 233 395 1880 35.1 18.3 22.2 142 158 273 477 1881 33.9 19.2 21.2 130 148 230 424 1882 32.9 17.9 21.4 119 162 219 414 1883 32.3 17.6 20.4 125 146 230 396 Average of 10 yrs. 1 34.6 19.0 22.2 134 155 241 396 1874-| 1883 Means 34.7 19.6 22.6 142 168 1871 —80 1861 33.8 20.4 24.4 143 162 —70 1851 31.8 19.1 23.8 128 155 -60 As the year 1884 included 53 weeks, I have in this table, for purposes of comparison, taken the number of births in 52 weeks. The deaths are those recorded between January 1st and December 31st, 1884. The Registrar General's returns include the deaths as well as the births in 53 weeks. The 21 birth-rate per 1,000 population, which had gradually increased up to 1879, when it was 360, became reduced in 1880 to 35.1; and in 1881, the census year, to 33.9, and to 32.9 in 1882. It was only 32.3 in 1883, and 30.8 in 1884, the average for the 10 years, 1874-83, having been 34.6. The corrected death-rate for the district in 1884 was 18.0, and for all London 20.3 per 1,000 population. For the l0 years, 1874-83, it was in the District 19.0; for 1871-80, 19.6; for 1861-70, 20.4; whilst for all London it was 22.2 in 1874-83; 22.6 in 1871-80; and 24.4 for 1861-70, which shows a fairly satisfactory state of the public health in all London, and, considering the present density of population, a very low death-rate for the Hackney district. The deaths of children under 1 year, as compared with the births, is also satisfactory, as there were only 134 per 1,000 births, against 155 for all London. In 1874-83 the numbers were 134 for Hackney, and 155 for London; and in 1861-70, 143 for Hackney, against 162 for London. The number of deaths amongst children under 1 year old was 238 per 1,000 deaths at all ages, against 241 in 1874-83, whilst for children under 5 years of age there were as many as 408, against 396 per 1,000 deaths in 1874-83. The causes of death at these ages will be discussed further on. TABLE III. Showing the Number of Deaths at all Ages in 1884 from certain groups of diseases, and proportions to 1,000 of Population, and to 1,000 Deaths from all Causes; also the Number of Deaths of Infants under One Year of Age from other groups of 22 Diseases, and proportions to 1,000 Deaths from all Causes under One Year, and of Deaths to 1,000 Population. Total Deaths. 1884. Per Milleage of Deaths to Total Deaths, 1884. Deaths per 1000 population. 1881 1882 1883 1884 1. Zymotic Diseases 820 222 4.82 3.39 2.63 3.99 2. Pulmonary, other than Phthisis 603 163 3.77 3.96 3.31 2.93 3. Tubercular 515 140 2.27 2.59 2.63 2.05 4. Wasting Diseases Under 1 year 219 695 1.26 0.98 1.19 1.06 5. Convulsive Diseases 145 393 1.02 0.65 0.78 0.71 2. Includes Phthisis, Scrofula, Rickets, Tabes Mesenterica, and deaths registered as being oaused by Hydrocephalus in children more than one year old. 4. Includes Infantile Hydrocephalus, Meningitis, Convulsions and Teething, under 1 year. 6. Includes Marasmus, Atrophy and Debility, want of Breast Milk, and Premature Birth. Table III. shows the total number of deaths from certain important groups of diseases. It shows that from all zymotic diseases there were 820 deaths, which give 222 per 1,000 deaths from all causes, and 3'99 per 1000 population, being much above the means for 1882 and 1883, but below it for 1881. The deaths from tubercular affections numbered 515, or 140 per 1,000 deaths from all causes, and 2.05 per 1,000 population. This is a much smaller proportion than in former years, as the numbers were 2.27 in 1881,2.59 in 1882, and 2.63 in 1883. Deaths from inflammatory diseases of the lungs were also below the mean, as they were only 2.93 per 1,000 population, and caused only 163 deaths out of 1,000 deaths from all causes. Convulsive diseases of infants, under 1 year, induced 145 deaths, or 393 per 1,000 deaths from all causes; and wasting diseases of infants 219 deaths, or 595 per 1,000. The deaths included under these headings can be ascertained by referring to the foot note of the table. The rate per 1,000 population of all ages was less than 1 as regards convulsive diseases, and a little above 1 from wasting diseases. 23 TABLE IV. Showing the Number of Deaths from the principal Zymotic Diseases in Hackney during the 10 Years 1874 to 1883, and in the Year 1884. Diseases. 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 Annual Average of 10 Years, 1874-1883 Proportion of Deaths to 1000 Deaths in 10 Years, 1874-1883 Total Deaths in 1884 Proportion of Deaths to 1000 Deaths in 1884 Small-pox 5 2 92 179 86 10 69 225 13 19 70.0 19.4 210 56.7 Measles 68 61 15 91 31 81 21 149 43 117 67.7 18.9 55 14.9 Scarlet Fever 97 78 57 58 123 70 81 118 144 63 88.9 24.7 72 19.4 Diphtheria 10 21 23 18 23 19 14 1 51 43 22.3 6.2 39 10.5 Whooping-Cough 52 113 126 43 135 110 141 70 182 56 102.8 28.5 157 42.4 Fevers. Typhus 45 58 44 62 70 47 27 64 63 46 52.6 14.3 1 84 22.7 Enteric 80 . Simple Continued 3 Diarrhœa 102 116 136 86 159 67 170 135 99 104 117.4 32.6 190 51.3 Totals 379 449 493 537 627 404 523 762 595 448 521.7 144.6 807 217.9 Totals—London 11,230 13,411 12,565 12,292 14,734 12,256 13,681 13,811 13,558 10,801 12,834 158.9 13,629 24 It will be seen from table IV. that the number of deaths from these diseases varies very much from the average nearly every year. Thus, since 1873, the number of deaths from small-pox had varied between 5 in 1874, 2 in 1875, 225 in 1881, and 210 in 1884. The disease was epidemic in Hackney in 1871, 1877, 1881 and 1884, the long interval between 1871 and 1877 having been caused by the exceptional severity of the outbreak in 1871. In 1884 the proportion of deaths from this disease to 1,000 deaths from all causes was nearly 57, against 194 for the 10 years 1874-83. The mortality from measles was less than usual, the total deaths having been 55, against 117 in 1883, and an average of 68 for the preceding 10 years. Scarlet fever also oaused fewer deaths than usual, viz., 72, against the average of 89, and the proportion of 19.4 deaths per 1,000 population, against the mean of 24.7. From diptheria, however, there was a somewhat unusual number of deaths, viz., 39, against the mean of 22, and 10.5 per 1,000 deaths from all causes, against the mean of 6.2. Whooping cough was unusually fatal, having occasioned 157 deaths, against the mean of 103. The proportion of deaths from this disease to 1,000 deaths from all causes was 42.4, against the average of 28.5. Typhoid fever caused 80 deaths, against an average of 52, and rather above 21 deaths per 1,000, against a mean of 14. There did not appear to be any special cause for the excess, as enquiry was made in every case, and by no means an unusual amount of bad drainage or of contact with the sick was ascertained. Diarrhoea was also excessively fatal, 190 deaths having been registered from this disease, against an average of 117, so that the same causes which produced the excessive mortality from enteric fever, were most probably those which induced the great number of deaths from diarrhœa. The temperature was very high in August, which accounts, to a groat extent, for the increased number of deaths. 25 TABLE IV. The Deaths Registered at different Ages from all causes during the year 1883, the deaths of NonResidents in the Fever and Smai,l-Pox Hospitals being excluded; inhabitants in hospitals outside the District being included. AGE AT DEATH. 0 1 5 15 25 35 45 55 65 75 85 and upwards. Totals. 1 5 15 25 35 45 55 65 75 85 1884 Totals 880 630 233 217 254 251 283 329 303 248 72 3700 Per cents 23.8 17.0 6.3 5.9 6.9 6.8 7.6 8.9 8.2 6.7 1.9 100 Per cents. 1885 23.0 16.5 4.5 4.6 6.3 7.7 8.3 9.2 10.6 7.6 1.7 100 1882 21.2 19.5 6.6 4.3 6.0 7.5 7.8 8.3 9.3 6.7 2.1 100 1881 23.0 19.7 6.5 5.5 6.7 6.7 6.6 7.1 10.3 6.6 1.3 100 1880 27.7 17.1 4.1 4.6 6.7 7.2 6.6 8.1 9.0 7.0 1.9 100 1879 23.4 16.1 4.6 4.2 6.0 7.9 8.8 9.6 10.8 6.8 1.8 100 1878 25.3 16.2 4.9 5.7 5.8 7.5 7.3 8.9 9.5 7.0 1.9 100 1877 24.4 14.8 5.0 6.2 7.2 7 .9 7.1 9.1 9.5 7.6 2.1 100 1876 27.4 14.1 4.8 5.4 7.0 1.0 7.4 8.6 8.4 7.3 2.1 100 Per cents. of death, 24.4 16.7 5.1 5.1 6.5 7.4 7.5 8.6 9.7 7.1 1.9 100 Do. 1866-75 24.3 15.7 5.1 5.3 7.1 7.3 7.4 8.0 9.8 7.8 2.2 100 Do. 1856-65 21.0 16.4 6.1 5.1 6.9 7.2 7.3 8.9 10.9 8.0 2.2 100 The number of deaths under 1 year and between 1 and 5 year?, as compared with total deaths at all ages, and especially of infants under 1 year of age to total births, is considered to afford a good indication as to the salubrity or non-salubrity of a locality. This however, must be accepted with considerable reservation, as the proportion of deaths amongst young children depends to a very great extent on the social status of the parents. Amongst the upper and upper middle classes, the mortality of children is little more than one-third of that 26 amongst the lowest classes, partly from the hereditary tendency to mortal disease being less, and partly on account of the care and attention bestowed upon, and the provision of all the necessaries of life provided for children of the upper classes. As we have a much larger proportion of working and poor population now than we had twenty years and more ago, we should expect, in the ordinary course of things, that the mortality of young children would have increased year by year. An increase has taken place since 1856-65, when the death rate to total deaths was only 21 per cent. of the total deaths, against 24.3 in 1866-75; 24.4 in 1876-83. This year, in consequence of the number of deaths from small-pox, whooping cough and diarrhoea, the proportion of deaths at this age period has increased to 23.4 under 1 year, and 17.4 between 1 and 5, making the total deaths under 5 years to be 40.8 per cent. of the deaths at all ages. There was also an excess of deaths at the age period of 5—15 years, for which unvaccinated cases of small-pox is chiefly responsible, as the large number of 55 deaths from this disease occurred in children under 15 years of age amongst the unvaccinated, against 11 who were known to he vaccinated, and of 41 whose vaccination was doubtful. Now as the unvaccinated do not, so far as I can ascertain, constitute more than about 4, or say 5 per cent. of the population, it is evident that many unnecessary deaths have occurred. As the total number of deaths from small-pox at 0—15 was only 103, if the proportion of deaths of unvaccinated children had been pro rata to the number of unvaccinated persons living, we should not have had more than 5 or 6 deaths instead of 55. In other words, it seems to me that 50 persons have died at these ages from small-pox, who would have been saved if they had been vaccinated, and the death rate at these ages would have been below the average instead of above it. The proportion of deaths at other ages do not vary very much from the average, except that the total deaths below 65 years of age was 27 somewhat above the mean, and consequently the number above 65 years was below it. The number of deaths above 80 continues about the same as in past years. There were 15 deaths at 80-1 years of age, 18 deaths at 81-2 years, 19 deaths at 82-3 years, 20 deaths at 83-4 years, 16 at 84-5 years, 14 at 85-6 years, 8 at 86-7 years, 7 at 87-8 years, 4 at 88-9 years, and 6 at 89-90. No less than 9 deaths were recorded between 90 and 91 years of age, 4 between 91 and 92, 5 between 92 and 93, 4 between 93 and 94, and 1 each at following very advanced ages, viz., at 95-6, 96-7, 97-8, 98-9, 99-100, and 1 above 100 years of age. Having now treated of the statistics of Hackney as a whole I now propose devoting a short space to the different subdistricts. The tables which I have to lay before you are not absolutely correct as regards the deaths, as there are many institutions in the Hackney sub-districts, and the number of deaths belonging to each sub-district cannot be accurately assigned to it, as I do not know the boundaries of each. As regards the births, they are comparable, as these causes of error do not exist. The birth-rate for all London, as well as in Hackney, was lower than in any year since 1860, although the births registered in 1884 consisted of those recorded in 53 weeks. Births in the Sub-Districts of Hackney, 1884—52 Weeks Quarters. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. Totals. First 189 119 341 667 346 1662 Second 181 106 298 666 349 1600 Third 202 96 280 636 314 1528 Fourth 189 96 284 645 330 1544 Total 761 417 1203 2614 1339 6334 Percent 1884 12.0 6.6 19.0 41.3 21.1 100 ,, ,, 1883 11.9 5.4 20.0 41.2 21.5 100 ,, „ 1882 12.2 5.4 19.6 40.6 22.2 100 ,, ,, 1881 12.2 5.2 20.2 40.8 21.6 100 ,, ,, 1871 7.6 4.9 23.4 38.2 25.9 100 Per Population .1881 12.2 4.9 20.2 41.2 21 .5 100 ,, ,,1871 7.9 5.3 22.4 40.1 24.3 100 28 The number of births in Stoke Newington was fewer than in 1883, having been only 761 against 777. In Stamford Hill sub-district there were 417 against 357, owing to the great increase in the number of houses; whilst in West Hackney it was only 1,203 against 1,300 in 1883; in Hackney, 2,614 against 2,667; and in South Hackney, 1,339 against 1,401. This decrease is somewhat singular when viewed simply as a statistical fact, especially when taken into consideration with the returns for all London, which show a smaller proportion of births this year than in any other for the last 24 years. Deaths in each Sub-District, 1881-84. Stoke Newington. Stamford Hill. West Hackney. Hackney. South Hackney. Totals. 1881360 148 678 1,728 700 3,614 1882 379 175 625 1,698 628 3,505 1883 369 176 659 1,646 695 3,545 1884 361 172 645 1,827 695 3,700 The number of deaths belonging to Stoke Newington has not varied much during the last four years, the lowest number having been 360 in 1881, and the highest 379 in 1882, that for last year having been only 361. In Stamford Hill sub-district, the number increased comparatively suddenly in 1882, owing to the comparatively large number of new houses that were built in and since 1881; whilst in West Hackney the number has decreased since 1881, when it was 678 against 645 in 1884. In Hackney there has been a large increase, viz., from 1,728 in 1881, 1,646 in 1883, to 1,827 in 1884. This increase was entirely due to the severity with which small-pox raged on the Clapton Park Estate and in the more immediate vicinity of the hospital, as may be seen by a reference to the spot maps which although it shows only cases, quite corresponds with the map of deaths which was prepared but not printed. The number of deaths in the German Hospital, the hospitals of the Asylums Board, and other extraneous hospitals have been got out and distributed as far as possible to the sub-district, to which they belong. 29 The number of houses and articles disinfeeted during the year was larger than in any year of recent date, as no less than 1,159 houses or portions of houses were disinfected with burning sulphur by the officers of the Board, and as many as 6,791 articles of bedding and clothing were removed to the Board's disinfecting chamber, and submitted to a temperature of between 240 and 250 degrees Fahr. for four hours, and again exposed to sulphur fumes. As the artioles removed are always exposed to burning sulphur before they are removed, and afterwards in the disinfecting chamber, they are exposed to three disinfecting processes, and, so far as I know, when returned have never been a cause of subsequent disease. Whatever may be the theory of what is necessary for a thorough disinfection of rooms and articles of bedding, &c., I believe it to be quite certain that the prooess just detailed has removed all infection. The appended list shows the number of beds, mattrasses, &c., as well as of artioles of bedding, wearing apparel, &c., in each year since 1878. In most instances no charge was made, as the sufferers belonged to poor families, but all who could reasonably be expected to pay did so, the sum charged being for labour only. The sum received last year was £38 17s. Large quantities of disinfectants were given away to the poor, and were also used for the gullies by the Surveyor's staff, the cost of the whole being £95. Articles Disinfected for the Years 1878 to 1884. Years. Beds. Mattrasses. Palliasses. Bolsters. Pillows. Blankets. Sheets. Quilts. Other Articles. Totals Houses disinfected. 1878 286 121 44 259 459 567 432 248 1661 4066 416 1879 95 63 48 80 177 227 78 52 492 3012 112 1880 339 153 106 248 684 375 312 197 2269 4483 415 1881 751 232 46 549 1204 782 510 424 2084 6582 1045 1882 172 101 88 119 258 332 148 69 1022 2312 366 1883 227 104 82 167 423 337 184 117 1086 2727 345 1884 785 227 69 616 1441 1101 747 550 1265 6791 1159 30 The total number of houses inspected under the powers conferred upon the Board by the Sanitary Act, and also in consequence of infectious diseases, was 6,179. In addition to these, a very large number, viz., 1,663, not only of houses, but of premises where nuisances existed, were inspeoted in consequence of oomplaints. The detailed list of nuisances shows that there were no less than 3,761 nuisances from defeotive drainage removed, of which 713 consisted of ohoked drains, which were cleansed, repaired and reconstructed; 281 of choked closet-pans ; 1,368 in which defective traps—chiefly bell traps— were removed and yard gullies substituted; 953 houses in which the sinks were disconnected from the drains; and 357 where the stack pipes, which opened near to windows, were also cut off from the house drains. There was also a large number of houses in which the drains were ventilated by proper pipes being put in, but of these there is no separate record. The number of houses repaired or cleansed and whitewashed was 2,067, and in which dust-bins were provided or repaired 1,344. The yards of 177 houses were repaired or relaid, making 4,083 improvements in houses and yards. The number of houses in which the work of having water laid on to closets was large, viz., 977. In carrying out this, and providing flushing boxes where the cisterns had hitherto been supplied the closets directly much vigor has been shewn, as in the 977 instances 401 flushing boxes were provided. There were also 218 closets in which the water supply apparatus was defective, and 46 screw-down taps with a length of pipe provided to enable the occupiers to draw water direct from the main supply to the house were provided. The number of houses overcrowded was very small, 19 orders to abate only having been necessary. Thirty-seven accumulations of stable manure and other refuse were removed, and 1,745 requests for the removal of dust were attended to. Considering the large number of houses in the district, I consider this to be but a small number. There were 31 52 summonses taken out, including those for adulterated food, and in all cases they were successful. The total number of houses inspected under the Sanitary Act and Nuisances Removal Act was 6,179, and of premises visited in consequence of complaints 1,663, and all the objectionable arrangements that Could be remedied were abated. There were many complaints, especially from the Sanitary Aid Society, which were either not nuisances under the Acts, or were so slight that notices for their removal could not be served, and consequently no return of these visits has been made in the above numbers. In addition to these, all the fishmongers' and greengrocers' yards were inspected during the year, many more than once. The cow-sheds, amounting to 105 on 64 premises, were also visited on several occasions, as well as many of the butchers and all the bakehouses. With a few exceptions the latter were in a very fair condition, but in two the means of ventilation and drainage were not in good order. The total number of nuisances abated during the year was 11,837. The number of loads of dust removed during the year was 24,836, which is somewhat in excess of the number for the previous year. The total cost was as follows:—The wages of the men employed by the Board, £696 1s. 2d.; the inspector's salary, £104 0s. 0d.; and the amount paid to the contractors, £2,277 8s. 9d., making a total of £3,077 9s. 11d.,—making a cost of 2s. 5fd. per load of 60 cubic feet. The offensive state of the River Lea during many months of the year exoited muoh attention, not only on part of the public, but of the Sanitary Committee and the officers. Numerous visits were paid by myself and the inspectors, and one special inspection was made by the whole of the Sanitary Committee. The legal questions involved were referred to Mr. Ellis, and counsel's opinion taken, from which it appeared that there is not any power given by Act of Parliament by which proceedings 32 can be taken, unless it be by an individual aggrieved, against the River Lea Conservancy Board, or the Tottenham Local Board. An enquiry was held in February last (at which I gave evidence) against the Tottenham Board, by the Local Government Board, and at the instance of River Lea Conservancy Board. After a full enquiry, the Inspector of the Local Government Board reported that the Tottenham Local Board had not used the best practicable means to disinfect their sewage, so that the Lea Conservancy Board gave the necessary notice for the provision of efficient disinfection in 12 months, which will soon expire. Two new tanks have been provided by the Tottenham Local Board, but I fear that nothing except taking the sewage away from the Lea will remedy the evil. At present (April) the river is in a very fair condition and the water free from smell. I have attended 30 meetings of the Sanitary Committee during the year, all the Board meetings, 9 meetings of the View Committee, and 8 special meetings respecting the River Lea, the new regulations for houses let in lodgings, and the tenders for the removal of dust in the district. There has been a good deal of oorrospondence with the Local Government Board respecting their approval, under the 35th section of the Sanitary Act, of the new regulations, which was not given at the end of 1884, but which has been lately obtained. I trust that the carrying out of the amended regulations will be attended with benefit to the houses of the poor, as the remedy therein provided for dirty and otherwise unhealthy houses is more prompt than under the Nuisances Removal Acts. The weather during the year was somewhat unusual. On the 1st of January there was a fall of snow, but for three weeks subsequently the weather was unusually fine and warm, so that despite gales, storms and snow on two days, the mean temperature was as much as 7'4 degrees above the average, there having been only two instances of so warm a January, except 33 in 1796 and 1834. In February the weather was fine, aa until the 24th there were only 3 days colder than usual, and the mean temperature of the month was above 3 degrees in excess of the average. March presented very similar meteorological features, being unusually mild from the 4th to the 24th, after which there was rather sharp cold. The mean for the month was 3'4 degrees above the average. In April the weather was pleasant at the beginning, but there was unusual cold subsequently, so that the mean temperature was 2 degrees below the average. In May it was 1.6 degrees above the mean, and in June less than 1 degree above, with a prevalence of S.W. winds and an excess of rain. In July, August and September the mean temperature was nearly 3 degrees in excess, having been + 1.7 degrees in'July, + 4.4 degrees in August, and + 2.8 degrees in September, and the amount of rain was considerably in defect, the total at Greenwich having been only 4½ inches, against a mean of more than 7 inches. In October it was very fine and dry, but the mean temperature was more than 1 degree in defect, and the rain 17 inches below the average. November and December were warm, the latter month having had a temperature of nearly 2 degrees in exoess of the average. I now present a table showing the highest, lowest and mean temperatures, as well as the total rainfall at my house in the Richmond Road, showing that the high temperature of 91.6 degrees was reached in August; 87.2 degrees in July; 83.4 degrees in September; 83.0 in June; and 80.8 in May. The minimum temperature in any month of the year occurred in November, when it was 25.8 degrees, or more than 6 degrees below freezing point; 27.4 degrees in March; 27.6 in February; and 29.0 in December, so that no very low temperature was recorded during the year. C 34 Temperatures at Hackney, 1884. Highest. Lowest. Mean Temperature. Rain in Inches. January 55.2 31.2 44.0 1.76 February 56.8 27.6 41.6 1.47 March 68.2 27.4 44.4 1.36 April 67.6 29.6 45.0 1.11 May 80.8 36.0 53.8 0.63 June 83.0 44.2 57.6 2.57 July 87.2 45.8 65.0 2.54 August 91.6 48.6 65.2 0.75 September 83.4 42.4 59.6 1.60 October 63.8 33.6 49.2 0.91 November 61.0 25.8 42.0 1.48 December 56.2 29.0 41.4 2.06 18.24 The deaths from inflammatory diseases of the lungs were unusually small during the first four months of the year, but early in May they were somewhat in excess. Diarrhœa also was not quite so fatal as usual, until the first week in July, when a sudden rise took place, so that in the week ending July 12th there were 336 deaths registered, against an average of 221, the temperature for the week ending July 5th having been 5 degrees, and for that ending July 12th, 3 degrees above the average. The number of deaths continued in excess during the following weeks, viz., in the week ending July 19th it was 533, against an average of 291; in that ending July 26th, 466, against 314; and for August 2nd, 301, against 271, when, in consequence of colder weather towards the end of July, it osscillated with the temperature, but not to a very great extent, up to the middle of October. Inflammatory diseases of the lungs were also below the average during November and December, and thus more than counterbalanced the excess from diarrhœa. As the work done in years past for carrying out the "Regulations" are but little known to the present members of 35 the Board, and as it is, and has been of the greatest value to the district, I shall conclude my report by extracts, pp. 28 and 29, from the First Report of Her Majesty's Commissioners on the Housing of the Working Classes. "Hackney is a district of a different character from "Chelsea. Only a small proportion of its inhabitants are of "the wealthier classes, and its area is occupied entirely by "the middle and lower classes. The Hackney District Board "in September, 1866, soon after the passage of the Sanitary "Act, applied to the Secretary of State for the confirmation "of draft regulations, and when this was obtained two special "Inspectors were appointed to measure the rooms in streets "where houses were chiefly occupied by members of more "than one family. The services of these Inspectors were "continued until 4,600 houses were inspected, under the "personal supervision of the medical officer. The work "appears to have been of a thorough character; the measure"ment of each room was entered into a book, and the number "of persons who might legally occupy each room was fixed ; "notices were served upon the owners or persons letting the "house, requiring them to limit the number of lodgers and to "cleanse their houses, and the number of notices served in "1867-8 was nearly 3,000. The work is said to have been "so well done that, without any care being relaxed, the "numbers dropped from nearly 1,300 in 1870, to 68 in 1873. "Since that time the annual number seems to have been on "the average about 150, and most of them are served upon "new houses or re-sold after change of ownership. "The consequence of the work being taken in hand in "Hackney systematically from the beginning is that out of "6,000 houses occupied among the lower classes by members "of more than one family, over 5,000 are registered, and are "under inspection and visitation." "The foregoing shows what good work can be done with "existing legislation by local authorities, provided they are "well disposed. Given energetic medical officers and "surveyors, and intelligent and disinterested members of "local Boards to support them in their suggestions, and half "the difficulty of the question is at once met. But, on the "other hand, a very different state of things has been "described in evidence as to some other local bodies in the " metropolis. c 2 36 "The disadvantage of each of the several districts of the "metropolis having a separate sanitary system of its own was "demonstrated incidentally by witnesses, the tenour of whose "evidence shows that they are not the supporters of very "sweeping changes. The medical officer of Hackney stated "that one result of the enforcement of their regulations was "that persons who did not like to submit to them, or for "whom there was no room without overcrowding, had to "leave the district and go to others where the local authority "allowed the people to live in whatever condition they "pleased." As the general work has increased with the extension of the district, it has been scarcely possible to give that attention to the carrying out of the regulations as in former years, even although a temporary Inspector has been appointed to assist those previously appointed, and it will therefore be necessary for another Inspector to be permanently appointed if the work, upon which so marked an eulogium was made, is to be performed with equal energy and usefulness in future. I remain, Gentlemen, Yours obediently, JOHN W. TRIPE, M.D., Medical Officer of Health. Received and ordered to be printed and circulated in the usual manner, WILLIAM LANE GANE, Chairman May 13th, 1855. 37 TABLE OF DEATHS REGISTERED IN THE HACKNEY DISTRICT DURING THE YEAR, 1884. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 26 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upward. Total. Smallpox Vaccinated . 1 3 7 14 11 9 6 .. .. .. .. 51 Unvaccinat'd 17 23 15 8 2 1 2 .. .. .. .. 68 Vacc.doubtfl. 3 7 31 18 13 12 .. 5 2 .. .. 91 - 210 210 Measles 6 40 9 .. .. .. .. .. .. .. .. 55 Scarlet Fever 6 43 19 4 1 .. .. .. .. .. .. 72 Typhus Fever .. .. .. .. 1 .. .. .. .. .. .. 1 Whooping Cough 53 99 5 .. .. .. .. .. .. .. .. 157 Diphtheria 1 21 13 1 1 .. 2 .. .. .. .. 39 Simple Fever .. .. 1 .. .. .. .. 1 .. i .. 3 Enteric Fever .. 5 12 27 15 12 4 4 1 .. .. 80 Other Miasmatic Diseases .. .. .. .. .. .. .. .. .. .. .. .. Simple Cholera 7 5 .. .. .. .. .. .. .. 1 .. 13 Diarrhoea, Dysentery 138 31 2 .. .. .. 1 2 8 6 2 190 Ague, Remittent Fever .. 1 .. .. .. .. .. .. .. .. .. 1 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis, &c 9 .. .. .. .. .. .. .. .. .. .. 9 Erysipelas 7 .. 1 .. 1 2 1 4 1 .. .. 17 Pyaemia, Pupereal Fever 2 .. 1 3 6 7 1 1 .. .. .. 21 - - - - - - - - - - - - 868 249 278 116 75 51 43 17 17 12 8 2 868 Thrush,Vege Parasites 4 .. .. .. .. .. .. .. .. .. .. 4 Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 4 .. .. .. .. .. .. .. .. .. .. 4 Alcoholism .. .. .. 1 5 3 3 3 .. .. .. 15 - - - - - - - - - - - - 23 Constitutional Diseases. 8 .. .. 1 5 3 3 3 .. .. .. 23 - - - - - - - - - - - - Rheumatic Fever and Heart Affections .. .. 5 1 2 2 .. 1 .. .. .. 11 Rheumatism .. .. 1 1 .. .. .. 3 .. 1 .. 6 Gout .. .. .. .. .. .. 1 2 3 .. .. 6 Rickets .. .. .. .. .. .. .. .. .. .. .. .. Cancer .. .. .. 1 .. 12 29 25 21 9 .. 101 Tabes Mesenterica 50 30 4 .. .. .. .. .. .. .. .. 84 Tubercular Meningitis 33 31 8 1 1 1 .. .. .. .. .. 75 Phthisis 2 11 11 64 102 72 54 35 5 .. .. 356 Scrofula, Tuberculosis 10 11 2 2 1 1 1 .. .. .. .. 28 Purpura Hæmoraga 1 .. 1 1 .. 1 .. .. .. .. .. 4 Anæmia, Leucocytha .. 1 .. 1 .. 1 .. .. .. .. .. 3 Diabetes .. .. 2 .. .. 1 2 2 1 1 .. 11 Syphilis 2 .. .. .. .. .. .. .. .. .. .. 2 Other Constitutional Diseases .. .. .. .. 1 .. .. .. .. .. .. 1 - - - - - - - - - - - 688 98 84 34 72 113 91 87 68 30 11 .. 688 Premature Birth 119 .. .. .. .. .. .. .. .. .. .. 119 Malformations 22 .. .. .. .. .. .. .. .. 24 .. 46 Old Age .. .. .. .. .. .. .. .. 44 65 42 151 - - - - - - - - - - - - 316 Totals 141 .. .. .. .. .. .. .. 44 89 42 316 38 TABLE OF DEATHS- Continued. AGES Under 1 year. 1 to 5. 5 to 16. 15 to 25. 26 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 8o and upward. Total. Nervous Diseases. Inflammation of Brain or Membranes 18 38 11 2 .. 3 8 7 13 8 3 11 Apoplexy, Hemiplegia .. 1 .. 6 3 10 23 31 51 18 3 146 Insanity, General Paralysis .. .. .. .. 2 3 3 3 7 1 3 22 Epilepsy .. .. .. .. .. 3 4 1 .. .. .. 8 Convulsions 91 31 2 4 3 .. .. .. .. .. .. 131 Laryngismus Strids 8 10 .. .. .. .. .. .. .. .. .. 18 Diseases of Spinal Cord 2 .. 1 2 2 .. .. 2 .. .. .. 9 Paraplegia .. .. .. .. .. . 1 .. .. 1 .. 2 Other Nervous Diseases .. .. 1 1 1 1 2 .. .. 1 .. 7 Diseases of Circulating Organs. - - - - - - - - - - - - 454 119 80 15 15 11 20 41 44 71 29 9 454 - - - - - - - - - - - - Peri and Endo-Carditis .. 1 1 2 .. 2 1 1 .. .. .. 8 Valvular Disease of Heart .. .. 1 2 4 1 4 7 2 2 .. 23 Other Diseases of Heart 1 1 8 6 15 18 34 41 33 25 .. 182 Aneurism .. .. .. .. 3 5 4 .. .. .. .. 12 Respiratory Organs. - - - - - - - - - - - - 225 1 2 10 10 22 26 43 49 35 27 .. 225 - - - - - - - - - - - - Laryngitis .. 6 4 .. 1 .. .. .. .. .. .. 11 Croup 33 10 1 .. .. .. .. .. 44 Asthma .. .. .. .. .. .. 4 3 3 2 .. 12 Bronchitis 73 59 10 .. 1 5 15 44 50 46 10 313 Pneumonia 38 41 9 1 12 16 16 27 13 9 1 189 Pleurisy .. 2 2 3 3 5 6 5 2 1 .. 29 Other Respiratory Dis .. .. .. .. 2 .. 1 .. .. 1 1 5 Diseases Digestive System. - - - - - - - - - - - - 603 111 141 35 11 19 26 42 79 68 59 12 603 - - - - - - - - - - - - Dentition 13 10 .. .. .. .. .. .. .. .. .. 23 Quinsy, Sore Throat 1 .. .. .. .. 1 .. .. .. .. .. 2 Disease of Stomach 1 .. .. 3 1 1 1 3 .. 2 1 13 ,, of Bowels .. 1 .. 1 .. .. .. 2 .. 1 .. 5 Enteritis 4 2 1 .. .. 1 1 .. 1 .. .. 10 Obstruction of Intestines 4 2 4 1 1 1 1 5 3 2 2 26 Peritonitis 1 .. 3 5 4 1 .. 3 3 1 .. 21 Ascites .. .. .. .. .. .. .. .. .. .. .. Jaundice Liver 6 2 .. .. .. 14 20 21 12 6 .. 81 Diseases of Urinary System. - - - - - - - - - - - - 181 30 17 8 10 6 19 23 34 19 12 3 181 - - - - - - - - - - - - Kidney .. 1 .. 1 2 .. 2 1 .. .. .. 7 Nephritis .. 5 3 .. 1 .. 3 3 .. .. 1 16 Bright's Disease .. .. 1 2 2 7 12 11 8 5 .. 48 Bladder and Prostate .. .. .. .. 2 1 3 4 .. .. 10 - - - - - - - - - - - - - 81 Totals .. 6 4 3 7 7 18 18 12 5 1 81 39 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 and upward. Total. Disease of Uterus .. .. .. .. .. 3 1 2 .. .. .. 6 30 Abortion, Flooding .. .. .. 5 9 2 .. .. .. .. .. 16 Pupereal Pyaemia .. .. .. 1 1 .. .. .. .. .. .. 2 Ovarian Dropsy and Diseases of Womb .. .. .. .. .. 2 .. 1 3 .. .. 6 Bones and Joints, &c. .. .. .. 6 10 7 1 3 3 .. .. 30 Caries, Necrosis .. 2 1 4 2 1 1 1 1 .. .. 13 18 Arthritis, Ostitis .. .. .. .. .. .. .. .. 1 .. .. 1 Carbuncle, Phlegmon .. .. .. .. .. .. .. .. .. 1 .. 1 Other Skin Diseases 2 .. .. .. .. .. .. .. 1 .. .. 3 Violence. 2 2 1 4 2 1 1 1 3 1 .. 18 Accidents & Violence 17 8 9 3 5 3 2 9 .. 3 3 62 76 Homicide .. 1 .. 1 .. .. .. .. .. .. .. 2 Suicide .. .. .. 3 2 3 3 1 .. .. 12 Ill-defined Causes 17 9 9 7 7 6 6 10 .. 3 3 76 Dropsy . .. .. .. .. 1 .. .. .. .. .. 1 136 Debility and Atrophy 96 2 .. .. .. .. .. .. 1 1 .. 100 Mortification 1 4 .. 1 .. .. .. .. 1 3 .. 10 Tumour 1 .. .. .. .. .. .. .. 2 .. .. 3 Abscess 3 4 1 1 .. .. .. .. 1 .. .. 10 Hemorrhage 2 1 .. 1 1 .. 2 3 .. .. .. 10 Sudden Deaths (doubtful) 1 .. .. .. .. .. .. .. .. .. .. 1 Causes not Specified.. .. .. .. .. .. .. .. .. 1 .. .. 1 104 11 1 3 1 1 2 3 6 4 .. 36 Totals 880 630 233 217 254 251 283 329 303 248 72 3700 40 Streets and other Places Inspected in 1881. Number of Cases of Epidemic Diseases. 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. Diphtheria. Typhoid Fever. Typhus. Abbott street 22 88 29 101 18 .. .. 1 .. .. Abney gardens 10 30 10 42 5 .. .. .. .. .. Acton 6treet 1 5 1 7 1 .. .. .. 1 .. Ada street 41 181 61 278 31 3 .. .. .. .. Albert grove .. .. .. .. .. .. .. .. .. .. Albert street 19 78 29 135 12 4 .. .. .. .. Aldham place .. .. .. .. .. .. .. .. .. .. Anderson road 26 110 34 171 22 2 .. .. .. .. Andrews road 6 .. .. .. .. 1 5 .. .. .. Antwerp street 24 120 33 166 10 .. .. .. .. .. Arthur street 41 161 60 270 34 2 .. .. 2 .. Ash grove 56 336 81 396 31 .. .. .. .. .. Ashton place .. .. .. .. .. .. .. .. .. .. Austin buildings .. .. .. .. .. .. .. .. .. .. Amherst terrace 15 90 20 95 10 1 .. .. .. .. Assembly row 12 48 15 61 10 .. .. .. .. .. Ballance road 9 42 7 39 9 7 1 .. 1 .. Balcorne street 6 24 6 31 6 5 .. .. 1 .. Ball's buildings 16 65 22 113 4 8 .. .. 1 .. Barn street 8 32 9 39 3 .. .. .. .. .. Bartrip street 6 24 8 50 6 6 2 .. .. .. Bay street 1 6 1 5 1 .. .. .. .. .. Baxter's court 2 8 3 10 2 1 .. .. 1 .. Bentley road 17 75 29 123 17 .. .. .. .. .. Bcntham road 8 48 10 46 8 8 1 .. .. .. Benn afreet, H.W 34 186 48 240 31 4 1 .. 1 .. Berger road 53 268 74 348 28 14 .. .. .. .. Blackshaw place 4 8 4 18 4 .. .. .. .. .. Blackatone road 6 30 8 41 5 5 .. .. .. .. Blanchard street .. .. .. .. .. .. .. .. .. .. Blanchard road 10 58 16 65 10 10 .. .. .. .. Bloomfield street 7 49 12 61 7 7 .. 1 .. .. Bohemia place 13 .. 16 66 4 1 1 .. .. .. Boleyn road .. .. .. .. .. .. .. .. .. .. Bowling Green street .. .. .. .. .. .. .. .. .. .. Bowling Green place .. .. .. .. .. .. .. .. .. .. Bower roa 20 102 25 156 9 1 .. .. .. .. Bradbury street 18 126 34 138 17 .. .. .. .. .. Bridge street 3 14 3 17 3 3 .. .. .. .. *Brooksbys walk 20 106 28 141 16 16 .. .. .. .. Brown's place .. .. .. .. .. .. .. .. .. .. Boreham street 13 50 22 86 7 4 .. .. .. .. Brunswick street 55 *223 88 351 45 9 5 .. 2 .. Bushberry road, H.W 3 26 6 30 3 3 1 .. 1 .. Church street, S.N. 1 6 1 5 1 1 .. .. .. .. Coach yard, S.N 3 9 3 12 3 .. .. .. .. .. * Streets marked thos, twice inspected. 41 Streets and other Places Inspected in 1884. Number of Caws of Epidemic Diseases. 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. Diphtheria. Typhoid Fever. Typhus. Cambridge cottages 4 20 6 31 4 .. .. .. .. .. Caroline street, Clapton 51 154 66 208 29 .. .. .. .. .. Cassland road 4 24 6 31 4 4 .. .. 3 .. Casterton street 44 231 67 281 18 12 .. .. 1 .. Castle street 28 128 49 194 27 2 .. .. 1 .. Chapel road, S.H. 2 16 2 17 2 2 .. .. 1 .. Chapman road 17 81 17 69 6 .. .. .. .. .. Caroline place 9 8 2 9 2 2 .. .. .. .. Charles street 2 8 2 12 .. .. .. .. .. .. Chalgrove road 17 78 25 126 17 17 1 1 2 .. Church road, Homerton 80 472 103 452 61 6 1 .. 1 .. Church road, W.H 1 6 1 7 1 .. .. .. 1 .. Church terrace 12 60 79 17 4 2 2 .. .. .. Churchyard, Hackney 10 62 18 66 6 .. 1 .. 3 .. Churchill road 17 85 24 106 15 15 .. .. .. .. Clarence road 15 70 28 123 15 7 .. .. 2 .. College lane 9 36 l4 60 6 6 .. .. .. .. College place 13 56 24 126 8 4 .. .. .. .. College street 50 205 73 299 32 5 .. .. .. .. Conduit street & place . 42 218 49 202 29 .. .. .. .. .. Conrad street 3 18 3 23 3 3 .. .. .. .. Cottage place 9 15 9 41 7 .. .. .. .. .. Cowday street 18 92 29 117 13 .. .. .. .. .. Cross street, Homerton 15 60 19 58 11 1 .. .. .. .. Cross street, S.H. 18 90 36 151 38 .. .. .. .. .. Crozier terrace 67 258 138 505 59 6 .. .. .. .. Culford road 4 32 5 31 4 4 .. .. .. .. Chapel court 4 8 4 13 1 .. .. .. .. .. Church path, S.N .. .. .. .. .. .. .. .. .. .. Cottage Dlace 9 15 9 34 6 .. .. .. .. .. Coopesale road 5 30 5 30 5 5 .. .. .. .. Chatsworth road 15 96 20 91 17 17 .. .. .. .. Dalston lane 14 84 14 51 10 14 3 .. .. .. Daintry street 18 78 19 90 13 2 .. .. .. .. De Beauvoir road 10 66 12 63 8 2 4 .. 2 .. De Beauvoir square 1 8 1 7 1 .. .. .. 2 .. Derby road 3 18 3 13 3 2 .. .. 1 .. Devonshire place 6 24 6 31 3 .. .. .. .. .. Digby road 23 92 33 162 23 14 7 .. 2 .. Dagmar road 2 8 2 11 2 1 1 .. .. .. Dunn street 1 4 1 5 1 1 .. .. .. .. Downham road 15 77 12 58 10 .. .. .. .. .. Duncan street 49 189 72 353 35 1 1 .. .. .. Duncan terrace 6 24 8 39 4 .. .. .. .. .. Davis cottages 4 10 4 7 1 .. .. .. .. .. 42 Streets and other Places Inspected in 1884. Number of Cases of Epidemic Diseases. Name of Street or Road. Number of Houses Inspected. Number of Rooms. Number of Families. Number of Inmates. No. of bouses in which nuisances were found. Small Pox. Scarlatina. Diphtheria. Typhoid Fever. Typhus. Duncan square & road. 67 268 81 356 46 16 .. .. 1 .. Durham grove 9 36 9 52 9 .. .. .. .. .. Dysael street 2 8 2 10 2 2 .. .. .. .. Dunlace road 3 18 5 26 2 .. 2 .. .. .. Eaton place 57 234 87 379 31 6 .. .. .. .. Edwards lane 4 13 4 17 1 .. .. .. .. .. Elgin street 58 321 106 506 48 1 1 .. .. .. Eleanor road 7 36 8 35 7 6 .. .. .. .. Elsdale road 52 260 76 381 40 3 .. .. .. .. Elizabeth cottages 2 8 2 10 2 2 .. .. .. .. Exmouth place 47 248 65 273 22 1 1 .. .. .. Exmouth place 24 85 30 141 14 2 .. .. .. .. Fox cottages, Morning lane 8 12 8 34 2 1 .. .. .. .. Fairey street 1 4 1 6 1 1 .. .. .. .. Falcon court and place. 10 26 15 51 3 .. .. .. .. .. Fairfield road 27 216 51 230 18 4 .. .. .. .. Felstead street 34 166 47 245 30 .. .. .. .. .. Fenn 4 16 4 23 4 4 .. .. .. .. Field View, L. Fields 2 12 2 16 2 1 1 .. .. .. Fishers place 8 30 8 34 8 2 .. .. .. .. Florefield road 7 35 7 30 7 5 1 .. .. .. Fords place 5 28 5 27 5 5 .. .. .. .. Fulham place 8 32 8 43 8 .. .. .. .. .. *Gainsboro' cottages 46 224 54 252 22 2 .. .. .. .. *Gainsboro' road 50 124 35 142 19 4 2 .. .. .. *Gainsboro' square 21 86 31 139 15 .. .. .. .. .. Gillett street 22 154 68 276 22 .. .. .. .. .. Gibsons buildings 5 20 5 31 5 5 .. .. .. .. Goring street 42 164 68 297 34 2 3 .. .. .. Green lanes 3 18 3 17 3 1 .. .. 2 .. Grove, Homerton 31 124 38 169 20 3 1 .. 1 .. Grove lane, Hackney 12 48 15 71 12 4 .. .. .. .. Grove lane, S. Hill 2 8 2 11 2 1 1 .. .. .. Grove road, S. Hill 3 14 3 19 3 3 .. .. .. .. Grove passage and place, Hackney 9 57 12 63 8 3 .. .. 2 .. Glynn road 29 136 36 161 27 28 1 .. 2 .. Haggerston road .. .. .. .. .. .. .. .. .. .. Hamburg street 2 10 2 9 2 2 .. .. .. .. Hartwell street 3 12 3 9 .. .. .. .. .. .. Hassett road,Homerton 18 108 31 128 18 8 7 .. 3 .. *Streets marked thus, twice inspected. 43 Streets and other Places Inspected in 1884. Number of Oases of Bpideraic Diseases. Name of Street or Road. Number of Houses Inspected. Number of Rooms. Number of Families. Number of Inmates. No. of bouses in which nuisances were found. Small Pox. Scarlatina. Diphtheria. Typhoid Fever. Typhus. Havelock road 3 12 3 16 3 3 .. .. .. .. Hay woods buildings 4 12 4 24 4 3 .. .. .. .. Hayes buildings 10 40 18 89 10 4 .. .. .. .. Hedgers grove 50 242 60 323 30 4 .. .. .. .. Helmsley street & place 1 4 1 6 1 1 .. .. .. .. Hertford road 68 363 106 464 63 4 .. .. .. .. Heslop place 10 40 14 56 9 .. .. .. .. .. *High nill ferry 184 637 221 881 92 2 1 .. 2 .. High street, Homerton 174 876 196 820 97 24 1 .. 1 .. High street, S. New 1 6 1 7 1 .. 1 .. .. .. Hill street .. .. .. .. .. .. .. .. .. .. Hindle street .. .. .. .. .. .. .. .. .. .. Hockley street 23 188 80 354 17 5 1 .. .. .. Holeroft road 2 8 2 11 2 2 .. .. .. .. Holmbrook street 59 236 96 396 43 24 .. .. .. .. Holly street 3 18 3 21 3 3 .. .. .. .. Homer road 34 163 45 219 29 1 .. .. .. .. Homerton row 5 25 9 40 2 5 .. .. .. .. Homerton terrace 38 234 57 239 23 11 .. .. .. .. Humphrey street 33 150 44 213 31 1 4 .. 3 .. Isabella road 1 6 1 6 1 .. .. .. 1 .. Jacksons buildings 1 4 1 6 1 1 .. .. .. .. Jarvis buildings (Mod.) 16 48 18 91 16 7 .. .. .. .. Janes place 16 64 26 104 10 .. .. .. .. .. Jerusalem gardens 6 24 6 33 6 5 .. .. 1 .. John street, Homerton. 22 69 22 94 9 1 1 .. .. .. John street,Shackle well Jolly Butcher's yard 4 16 5 23 4 .. .. .. .. .. Lamb lane 3 15 3 17 3 2 1 .. .. .. Landfield street 41 231 81 368 21 .. 2 .. .. .. Lark row 4 16 6 28 4 1 3 .. .. .. Lauriston road 5 35 5 37 5 4 .. .. .. .. *Lea Bridge road 146 266 67 337 57 5 1 .. .. .. Lime grove 20 93 26 114 14 1 .. .. .. .. London lane & terrace 2 12 2 16 2 2 .. .. .. .. Lenthall road 7 35 7 41 7 6 .. .. .. .. Lockhurst street Priory 5 30 10 41 5 4 .. .. .. .. Lordship road 1 6 1 6 1 .. 1 .. .. .. Laural street 2 8 2 11 2 2 .. .. .. .. Marsh hill 7 42 13 60 7 12 1 .. 2 .. McLaren street 4 24 4 26 4 2 1 .. 1 .. Mallard street 43 208 54 239 37 2 .. .. .. .. * Streets marked thus, twice inspected. 44 Streets and other Places Inspected in 1884. Nnmber of Case, of Epidemic Diseaaen. 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. Diphtheria. Typhoid Fever. Fever. Margaret street, S.H.. 43 165 64 245 36 3 .. .. .. .. Margaret street .. .. .. .. .. .. .. .. .. .. Marian street 27 116 35 160 21 5 .. .. .. .. Mario w road 57 295 79 353 46 9 .. .. .. .. Masons court and place 6 17 7 29 2 .. .. .. .. .. Matthias street 28 84 34 139 27 1 .. .. .. .. Mayfield road 3 18 3 21 3 2 .. .. .. .. Mealds Place 4 16 4 20 1 .. .. .. .. .. Meadow street .. .. .. .. .. .. .. .. .. .. Mehetable road 7 35 7 31 7 7 .. .. .. .. Middle street .. .. .. .. .. .. .. .. .. .. Middlesex place & sqr. 9 36 11 52 9 .. .. .. .. .. Millington street 31 189 59 306 19 1 .. .. .. .. Morning lane 27 98 36 154 27 27 .. .. .. .. Montague road 69 260 81 357 31 1 1 .. .. .. Montague terr. & place 28 130 36 171 25 .. 1 .. .. .. Morpeth road .. .. .. .. .. .. .. .. .. .. Moscow terrace 15 68 16 76 10 .. .. .. .. .. Myrtle street .. .. .. .. .. .. .. .. .. .. Mandeville street 7 .. .. .. 7 7 7 .. .. .. Nesbitt street 76 271 94 397 51 7 5 .. .. .. New street 4 24 4 31 4 2 2 .. .. .. North street 73 360 94 455 46 .. 1 .. .. .. North wold road 126 412 186 591 97 .. .. .. .. .. Nursery Row 7 28 9 4 2 .. .. .. .. .. New Tyssen street .. .. .. .. .. .. .. .. .. .. Orchard cottages 1 6 1 7 1 1 .. .. .. .. Orchard place 46 276 83 415 42 2 .. .. .. .. Orchard street 12 48 17 79 8 1 .. .. .. .. Osborn road 62 311 99 495 49 1 1 .. .. .. Oswald road 10 52 10 61 10 9 .. .. 1 .. Ottaway street 36 134 46 230 8 3 .. .. .. .. Overberry street 26 98 34 147 26 22 1 2 2 .. Oriel road and terrace 8 42 8 41 8 8 .. .. .. .. Plover street 33 162 60 209 28 3 2 .. 1 .. Palace road 9 36 9 61 9 5 4 .. .. .. Paragon road 1 4 1 6 1 1 .. .. .. .. Park place, Homerton. 6 35 8 32 6 .. .. .. .. .. Park street, S.N 14 74 19 95 14 .. .. .. .. .. Pear Tree place .. .. .. .. .. .. .. .. .. .. Pedro street 24 110 36 145 24 24 .. .. .. .. Percy road, Well street 43 257 62 394 42 3 .. 1 .. .. 45 Streets and other Places Inspected in 1884. Number of Cases of Epidemic Diseases. 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. Diphtheria. Typhoid Fever. Typhus. Percy terrace 62 226 81 371 42 2 1 .. 1 .. Peiuberton place 7 29 8 35 2 2 2 .. .. .. Pickles buildings 6 12 6 17 3 3 .. .. .. .. Plough lane 6 33 10 51 2 .. .. .. .. .. Prince Edward road 58 258 71 344 41 2 7 .. .. .. Prouts road 79 553 134 610 61 7 1 .. .. .. Pond lane 12 48 12 61 12 10 2 .. .. .. Pond lane 3 20 5 23 3 .. .. .. .. .. Queen's court 5 26 5 26 5 .. .. .. .. .. Rayner street .. .. .. .. .. .. .. .. .. .. Railway crescent 31 117 36 161 20 .. .. .. .. .. Red lion lane 3 12 3 13 .. .. .. .. .. .. Redwald road, Priory 8 42 8 47 8 7 .. .. 1 .. Retreat place 6 36 6 43 6 6 .. .. 2 .. Ridley road 7 30 7 38 7 4 2 .. 1 .. Rigby's buildings 4 8 4 11 .. .. .. .. .. .. Rochester place 4 8 4 10 1 .. .. .. .. .. Roseberry place 1 6 1 5 1 1 .. .. .. .. Rosina cottages 19 71 19 8? 19 2 .. .. .. .. Rosina street 20 95 28 130 16 7 1 .. 2 .. Rossington street 44 204 49 220 35 .. .. .. .. .. St. Johns place 20 40 20 47 6 .. .. .. .. .. St. Thomas cottages 8 16 8 26 8 .. .. .. .. .. silk mill court 3 6 3 9 3 .. .. .. .. .. Sandford lane .. .. .. .. .. .. .. .. .. .. saxony cottages 13 33 14 51 12 1 .. .. .. .. Sedgwick street 7 28 7 34 7 4 1 .. 2 .. Shacklewell row 38 153 55 226 19 .. 1 .. 1 .. Shepherd's place 6 28 6 26 2 .. .. .. .. .. Shepperd lane 11 58 18 90 6 5 .. .. .. .. Sewdley street 2 8 2 11 2 2 .. .. .. .. Sheep lane 69 252 97 410 40 1 3 .. .. .. Silk Mill place 3 12 3 16 4 .. .. .. .. .. Spring Vale grove 3 8 3 13 .. .. .. .. .. .. Stanboro' yard 2 6 2 7 .. .. .. .. .. .. stelman street 22 122 35 148 1 7 .. .. .. .. Stockmar road 2 8 2 13 2 2 .. .. .. .. Sussex street .. .. .. .. .. .. .. .. .. .. Suther street 10 50 12 69 8 .. .. .. .. .. Swiss cottages 12 49 18 82 8 .. .. .. 2 .. Summerford grove 36 252 37 181 13 .. .. 1 .. .. Sidney road 78 410 81 335 16 4 .. .. 2 .. 46 Streets and other Places Inspected in 1884. Number of Cases of Epidemic Diseases. 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. Diphtheria. Typhoid Fever. Typhus. Taylors buildings 1 16 3 26 1 4 .. .. .. .. Templar road 81 446 147 634 80 36 1 .. .. .. Temple street 2 8 2 11 2 .. .. 1 1 .. Thomas street 18 77 25 104 17 5 .. .. .. .. *Tottenham rd. & square 159 793 211 844 123 3 2 .. 1 .. Tranquil place 6 24 6 38 3 .. .. .. .. .. Trelawney road 8 41 8 39 8 5 3 .. .. .. Triangle road 32 84 41 188 16 10 6 .. .. .. Tudor grove 20 95 29 133 15 .. .. .. .. .. Tyrons court 4 10 4 17 1 .. .. .. .. .. Tyssen passage & place 1 4 1 5 1 1 .. .. .. .. Tyssen street 2 8 2 11 2 1 .. .. 1 .. Triangle cottages 5 20 6 34 1 .. .. .. .. .. Union street, W.H. .. .. .. .. .. .. .. .. .. .. Urban place 17 85 25 112 8 1 .. .. .. .. Victoria grove 1 6 1 6 1 1 .. .. .. .. *Victoria road 83 388 115 461 58 2 .. .. 2 .. Vyner street 2 8 2 12 2 1 .. .. 1 .. Wallis road 13 45 16 69 10 .. .. .. .. .. Warburton rd. & square 71 175 96 392 32 .. .. .. .. .. Warburton street 6 24 8 38 5 .. .. .. .. .. Warwick villas 2 8 2 11 2 1 .. .. .. .. Water lane 40 158 61 219 20 .. 1 .. .. .. Wellington street .. .. .. .. .. .. .. .. .. .. Well street 16 60 25 98 12 .. 4 .. .. .. West street, Triangle .. .. .. .. .. .. .. .. .. .. Western place 14 56 19 75 11 1 .. .. .. .. Wetherell road .. .. .. .. .. .. .. .. .. .. Wharf road 2 8 2 13 2 .. .. .. .. .. White Hart court 3 6 3 9 .. .. .. .. .. .. White post lane 11 55 12 56 8 .. .. .. .. .. Whitmore road 3 16 3 21 3 .. .. .. .. .. Wick road 28 110 28 103 24 17 7 .. 1 .. Williams cottages 6 32 9 43 6 .. .. .. .. .. Willman grove 3 15 3 19 3 .. .. .. .. .. Winchester place 4 16 4 21 1 .. .. .. .. .. *Windsor road 84 420 118 601 76 5 .. .. .. .. Winslade road 63 355 89 390 43 .. .. .. .. .. Woodland street 5 20 5 31 5 4 .. .. .. .. Woolpack place 16 62 19 96 15 1 .. .. .. .. York place 10 20 10 26 2 .. .. .. .. .. Totals 5681 26134 8764 34080 4004 915 160 15 104 .. * Streets marked thus, twice inspected. 47 SUPPLEMENTAL LIST OF STREETS IN WHICH MORE THAN TWO CASES OF SMALL-POX, &c., OCCURRED IN 1884. Name of Street or Road. Number of Houses inspected. Small-pox. Scarlet Fever. Diptheria. Typhoid. Typhus. Abersham road 1 1 .. .. .. .. Albion road, Stoke Newington 3 4 .. .. .. .. Albion road, stoke newington 3 .. 3 .. .. .. Albion grove 3 2 .. .. 1 .. Alkham road 2 1 .. 1 .. .. Albion square 5 6 1 .. 1 .. Annis road 1 1 .. .. .. .. Appleby road 1 3 .. .. .. .. April street 1 1 .. .. .. .. Aspland grove 7 6 .. .. 1 .. Ash grove 6 7 .. .. 1 .. Aveling road 1 1 .. .. .. .. Bayford street 3 4 .. .. .. .. Bayston road 1 .. .. 1 .. .. Bailey's lane 1 .. .. .. .. .. Barrett's grove 1 1 .. .. .. .. Balmes road 1 3 .. .. .. .. Breckholme road 3 2 2 .. .. .. 2 1 2 2 1 1 1 1 Brampton road 2 3 4 3 i Broadway, London fields 4 4 6 11 3 2 i i 7 2 5 l Bodney road 3 1 2 •• 1 1 1 i 3 2 i 6 5 I Church road 1 l Chippendale street 3 i 4 .. 2 1 1 .. 1 1 1 1 2 1 i 12 io 1 i l 9 6 1 l l 2 1 l Colverstone crescent 2 2 3 3 .. .. .. 1 1 • • 48 SUPPLEMENTAL LIST OF STREETS, &c., 1884.—Continued. Name of Street or Road. Number of Houses inspected. Small-pox. Scarlet Fever. Diptheria. Typhoid. Typhus. Darnley road 6 4 1 .. 1 .. Devonshire road 5 3 1 .. 1 .. Downs Park road 2 1 1 .. .. .. Dunlaoe road 9 10 .. .. .. .. Dynevor road 1 1 .. .. .. .. Edenbridge road 2 1 2 .. .. .. Elderfield road 10 9 .. 1 .. .. Ellingford road 4 6 .. .. 1 .. Englefield road 2 1 .. 1 .. .. Evering road 5 2 3 .. .. .. Farleigh road 1 1 .. .. .. .. Fassett square 5 6 .. .. .. .. Fever Hospital 1 .. 1 .. 1 .. Ferron road 1 1 .. .. .. .. Forest road 1 1 .. .. .. .. Fortescue avenue 1 2 .. .. .. .. Frampton Park road 6 6 .. .. .. .. Fremont street 1 .. 2 .. .. .. Gayhurst road 1 1 .. .. .. .. Gascoyne road .. 1 .. .. 2 .. Glaskin street 1 2 .. .. 1 .. Gotha street 1 .. 5 .. .. .. Gore road 3 3 .. .. .. .. Glenarm road 22 15 4 4 2 .. Grangecourt road 1 .. 1 .. .. .. Graham road 9 9 3 .. 1 .. Greenwood road 6 6 1 .. 1 .. Harrowgate road 7 6 1 .. .. .. Heathland road 1 .. .. .. 1 .. High street, Kingsland 2 1 .. .. 1 .. Horton road 2 1 .. .. 1 .. John Campbell road 1 1 .. .. .. .. Invers road 1 .. .. 1 .. .. Kersley road 3 2 .. 1 .. .. Kenmore road 1 1 .. .. .. .. Kenninghall road 1 .. 1 .. .. .. King Edward road 2 1 .. .. 2 .. Kingsland road 5 2 1 1 1 .. Kynaston road 2 2 .. .. .. .. 49 SUPPLEMENTAL LIST OF STREETS, Ac., 1884.—Continued. Name of Street or Road. Number of Houses inspected. Small-pox. Scarlet Fever. Diptheria. Typhoid. Typhus. Lauriston road 1 .. .. 1 .. .. Lavers road 1 1 .. .. .. .. Lansdowne road 4 1 3 .. 1 .. London Fields 2 2 .. .. .. .. Londesboro' road 2 1 1 .. .. .. Loddiges road 6 6 1 .. .. .. Lidford road 1 .. 1 .. .. .. Lyncott road 1 1 .. .. .. .. Maury road 1 1 .. .. .. .. Manor road 2 .. 1 .. 2 .. Mare street 13 11 1 .. 2 .. Mayola road 1 1 .. .. .. .. Malvern road 2 2 .. .. .. .. Meynell road 3 3 .. .. .. .. Median road 4 3 l .. .. .. Middleton road 4 4 .. .. .. .. Mortimer road 3 2 .. .. 1 .. Navarino road 5 7 .. .. 1 .. Neville road 3 2 l .. .. .. Norfolk road 1 1 .. .. .. .. Oakfield road 2 .. 2 .. .. .. Olinda road 1 1 .. .. .. .. Oldfield road 1 .. .. .. 1 .. Parkholme road 1 1 .. .. .. .. Palatine road 2 3 .. .. .. .. Pembury road 4 4 .. 1 .. .. Penshurst road 2 3 1 .. .. .. Poole road 8 8 .. .. .. .. Powerscroft road 4 4 .. .. .. .. Queens Downs road 5 4 .. .. 1 .. Queens road, Dalston 10 11 .. .. .. .. Raven sdale road 1 .. 1 .. .. .. Rectory 1 .. 1 .. .. .. Rendlesham Road 1 1 .. .. .. .. Ritson road 1 1 .. .. .. .. Richmond road 7 6 .. .. 1 .. Ruthven street 1 1 .. .. .. .. Rushmore road 15 18 2 3 1 .. Rutland road 1 3 .. .. .. .. 50 SUPPLEMENTAL LIST OF STREETS, &c., 1884.—Continued, Name of Street or Road. Number of Houses inspected. Small-pox. Scarlet Fever. Diptheria. Typhoid. Typhus. Sandbrook road 2 2 .. .. .. .. Salisbury road 4 1 4 .. .. .. Sandringham road 2 1 .. 1 .. .. Saint thomes road & place 8 7 1 Saint Johns church road 3 3 .. .. .. .. Saint phillips road 1 1 .. .. .. .. Sigdom road 2 2 .. .. .. .. Shellgorve road 1 .. 2 .. .. .. Shore road 2 .. .. 3 .. .. Shakespeare road 1 1 .. .. .. .. Shafton road 2 1 3 .. .. .. Southgate road 1 1 .. .. .. .. Spurstowe road 7 3 4 .. .. .. Speldhurst road 8 4 1 .. .. .. Sptamford hill 5 5 .. .. .. .. Speldhurst road 1 .. 1 .. .. .. Stamford hill 4 4 .. .. .. .. Stoke Newington green 1 1 .. .. .. .. Sutton place 6 5 1 .. .. .. Sydner road 1 1 .. .. .. .. Terrace road 3 1 2 .. .. .. Tower street 2 2 .. .. .. .. Tudor road 4 2 1 .. 1 .. Urswick road 4 5 1 .. .. .. Union Infirmary 1 8 .. .. .. .. Union road 2 1 2 .. .. .. valentine road 14 12 4 .. .. .. Victoria Park road 10 9 1 .. 1 .. Wellington road 1 .. .. 1 .. .. Wetherell road 1 2 .. .. .. .. Wilton road 1 .. 1 .. .. .. Winston road 3 2 l .. .. .. Total 6179 1333 266 46 147 .. 51 Privy Cesspools emptied, filled up, and drained into the Sewer 6 Choked drains cleansed, repaired, or reconstructed 713 Number of Premises in which Choked Water- closet Pan were released 281 Number of Premises in which Yards were drained 83 Number of Premises in which new Traps were provided 1368 Number of Premises in which Sinks were disconnected with drains 953 Number of Premises in which Stacks Pipes were cut off from drains 357 Total number of Nuisances from defective means of drainage 3761 Number of Premises in which Yards were newly paved or the paving relaid 677 Number of Premises in which Dust Bins were provided or repaired 1344 Number of Houses repaired, whitewashed, &c. 2067 Number of Houses in which the Ventilation has been improved 3 4091 Number of Water-closets to which a supply of water has been given 977 Number of Houses supplied by Closet-cistern which required a Flushing-box 401 Number of Houses supplied by Butt only, and Cistern substituted 46 Number of Closets in which apparatus was defective 218 Number of Screw-down Taps provided to enable occupiers to draw water from the main of the house 46 Total number of Nuisances from defects in houses 1688 Carried forward 9540 52 Brought forward 9540 Number of Houses disinfected 1159 Number of Houses overcrowded 19 Number of Premises from which Pigs were removed 26 Number of Premises from which stable dung and other refuse were removed (excluding dust) 87 Number of filthy places cleansed 93 Number of other Nuisances removed (having no special heading) 913 2297 Total number of Nuisances abated in 1884 11837 Number of Lodging Houses' Notices served none „ „ Notices for disinfecting premises 1159 „ „ Preliminary Notices served 5170 „ „ Peremptory „ „ 753 „ „ Statutory „ „ 1678 Number of Letters sent out 2105 ,, ,, Persons summoned before a Magistrate 52 „ „ Copies of Summonses and Orders made out 312 „ „ ltequests to remove Dust received and attended to 1745 „ „ Bodies deposited and taken to the Mortuary 72 „ „ Houses from which Bedding, &c., was removed to be Disinfected at the Board's apparatus 1188 „ „ Articles Disinfected at the Board's apparatus 6791 „ „ Fish condemned unfit for human food —pads 28 53 PREMISES INSPECTED DURING THE YEAR. Number of Houses inspected under the Sanitary Act, 1866, and Nuisances Removal Acts 6179 „ „ Houses visited in which infectious diseases had appeared 1376 „ „ Premises inspected from complaints received 1663 „ „ Cowsheds inspected —(premises) 64 —(sheds) 105 „ „ Slaughter-houses inspected 42 „ „ Greengrocers' yards inspected 135 „ „ Fishmongers' and Poulterers' yards inspected 63 „ „ Bakehouses inspected 126 „ „ Houses measured as well as inspected none „ „ Urinals inspected (twice) 93 „ „ Tripe and Gut Dressers inspected 2 9848 NUMBER OF NUISANCES ABATED. IN THE FOLLOWING YEARS. In 1856 1567 1857 1789 1858 2515 1859 1224 1860 1267 1861 2481 1862 1235 1863 1996 1864 1410 1865 1512 1866 4260 1867 5811 1868 3923 1869 4354 1870 4240 In 1871 5180 1872 3099 1873 5406 1874 6110 1875 6262 1876 6445 1877 6257 1878 5912 1879 5468 1880 5720 1881 12055 1882 13753 1883 11054 1884 11837