HAC 65 Board of Works for the backney District REPORT ON THE SANITARY CONDITION OF THE HACKNEY DISTRICT, FOR THE YEAR 1885, BY JOHN W. TRIPE, M.D., Member of the Royal College of Physicians, Ed in., &c.; Secretary and formerly President of the Meteorological Society; Lately President of the Society of Medical Officers of Health; Foreign Member of the Socieété Française d' Hygiène; Corresponding Foreign Member of the Royal Society of Public Medicine of Belgium, &c.; Author of Essays on Scarlatina, Meteorological Phenomena in connection with Disease, and numerous Papers on Sanitary Statistics, on Disinfectants, &c. Medical Officer of Health and Public Analyst for the District. london: A. T. Roberts, Son & Co., Printers, 5, Hackney Road, E. 1886, REPORT FOR 1885. A comparison between the map attached to the last report and that issued with this, shows that although Small-pox has been more rife this year within the quarter and half-mile radii of the Homerton Hospital than in other parts of the District, yet the number of cases reported within these lines are proportionately smaller than in 1883-4. During the year 1884-5, the enormous traffic of Small-pox cases to and from the Hospital, which obtained during part of the preceding year, has been much diminished, as most of the cases were removed direct to the hospitals or ships instead of being brought first to Homerton. As I mentioned in my last year's report, as many as 859 cases were removed to and from the Homerton Hospital in one month, and 763 were transferred to the ships, whilst during this year the largest number taken from the Hospital in one month was 113, and I believe all of these had received treatment in the Hospital. Above 60 cases were taken to their homes from the Hospital in the month of January, so that with the 113 removed to the ships, nearly 180 cases were removed to or from the hospitals during that month. It is therefore evident that under the arrangements then in force the risk to a locality in which a hospital for infectious diseases is placed is not to be measured only by the number under treatment at any one time, but partly also by the number moved to and from the Hospital. A question has been raised and answered in the affirmative by Mr. Power, as to the probability of the disease being spread through the air 4 from. 9 or 10 patients in a hospital. The evidence adduced by him in favour of this is strong, but it does not follow, even if it did occur in this particular instance, that it will or is likely to do so on all or most occasions. My reasons for stating this, is that the experience I have obtained here shows that the emanations from some patients are much more infectious than from others, not only as regards Small-pox, but as to Cholera, and probably also Scarlet Fever. Thus, an outbreak occurred some years ago in Shacklewell which arose from one family, every member of which spread Small-pox wherever he went, and eventually as many as 52 cases occurred in connection with them. Something similar occurred in 1866, in the persons of a family attacked with Cholera, when the attendants in the German Hospital and others who attended on the sick took the disease. I have seen the same happen, but to a much more limited extent, in my private practice. In no case, however, except that mentioned in Shacklewell, have I traced the extension of the disease from other persons to anything like this extent. Indeed, the history of the outbreaks of Small-pox in the Clapton Park Estate in 1884 and in 1885, when the disease was very prevalent, does not point to much of its spread in this way, as the cause of infection could rarely be ascertained, and yet repeated outbreaks, rather than a continued series of attacks occurred. As regards aeërial infection I am more fully persuaded than ever that it can and does happen, but I believe that a particular state of the air, as regards moisture and movement, as well as a particular condition of the patients as regards infectiousness, are necessary to spread the disease through the air, especially when a limited number only of patients are contained in one building. I believe also that the large Ward system at present in use in the Asylums Board's Hospital is much more likely to be injurious than small Wards containing only four or six patients. This question requires much more investigation, but it is evident to my mind that even with the reduced number of patients at present treated in 5 and removed to and from the Hospital it has been a source of infection to the neighbourhood, although in a much reduced degree as compared with former years. I now propose to lay before you the statistics for the past and previous epidemic years, that is to say, from October 1st, 1883, to September 30th, 1884, and for the same period in 1884-8,5. TABLE I. Hackney.—Percentage of Cases of, and of Deaths from, Small-pox in different radii, 1883-4 and 1884-5. Radii. Percentage of Cases. Percentage of Deaths. Houses. 1883-4 1884-5 1883-4 1884-5 1883-4 1884-5 Quarter mile 22.9 17.1 33.6 19.9 6.1 6.1 Between quarter & half-mile radii 33.9 31.2 35.2 34.7 14.7 15.0 Totals within half a mile 56.8 48.3 68.8 64.6 20.8 21.1 Between the half mile & mile radii 25.6 27.2 16.8 17.3 31.4 31.6 Outside the mile radius 17.6 24.5 14.4 28.1 47.8 47.4 Totals 100.0 100.0 100.0 100.0 100.0 100.0 The table shows a very decided difference in the incidence of Small-pox in the two years 1883-4 and 1884-5, between October 1 and September 30, inclusive for each year. In 1883-84 the percentage of the total number of cases reported to me from the quarter-mile radius of the Hospital was 22.9 against 171 in 1884-5, the number of houses contained in this space being 6.l of the whole. In 1883-4 33.9 per cent. of all the cases were reported to me amongst the persons living in the space between the quarter and half-mile radii, against 31.2 in 1884-5; the proportion of houses in 1883-4 being 14.7, and in 1884-5, 15.0 per cent. of the whole, making 56.8 per cent. of 6 all the cases in 1883-4 in 20.8 per cent. of the houses, against 48.3 per cent. cases in 1884-5, in 21 "1 per cent. of the houses. In 1883-4 there were 25 6 per cent, of cases reported from the houses situated in the space between the half and one-mile radii, and 27.2 per cent. in the same space in 1884-5, the percentage of the houses being 31.4. Outside the mile radius there were only 17.6 per cent. of cases in 1883-4, and 24.5 per cent. in 1884-5, amongst 47.8 per cent. of all the houses, making 43.2 per cent. of all the cases in the population outside the halfmile radius against 51.7 per cent. in 1884-5. These figures show a very decided diminution in the cases within the halfmile radius as compared with the whole District. The percentages of the deaths do not correspond with those of the cases, which arise probably either from a smaller proportion of the cases being reported to me outside the half-mile radius, or from the disease having been proportionately more fatal there. The first supposition was probably the chief cause of the difference, as I have never had notice of a large proportion of the cases occurring outside the half-mile radius, because the residents are generally more wealthy and live in better class houses. The deaths of persons attacked with Small-pox in the quarter-mile radius, dying there or removed thenoe to hospitals, was 33*6 per cent, of the total deaths in 1883-4, and only 199 in 1884-5 ; and between the quarter and half-mile radii 35*2 in 1883-4, against 34*7 in 1884-5, making in 1883-4 a total of 68*8 per cent, of all the deaths from Small-pox within the halfmile radius, against 54 6 in 1884-5. Between the half and onemile radius there occurred 16'8 per cent, of all the deaths in 1883-4 and 17"3 per cent, in 1884-5, and in 1883-84 only 14-4 per cent, of all the deaths from this disease occurred amongst the residents outside the mile radius against as many as 28'1 per cent, in 1884-5. The increase outside the mile radius in 1884-5 is very striking, the percentage having been nearly double, and affords a great contrast to the mortality in former epidemic years. 7 TABLE II. Tubular Statement of Small-pox Cases removed between October 1st and September 30th, 1883-4 and 1884-5, to the Homerton Hospital. Also the number of Deaths and of persons transferred or sent to their homes. Hackney Cases. Hackney and other Cases. Removed from Hackney. Total Cases reported at Town Hall. Cases transferred to other Hospitals Deaths. Transferred to their homes. Average No. in Hospital. 1883-4 923 1211 1656 214 470 42 1881-5 491 602 703 217 335 21 This table shows a large reduction in the number of cases in 1884-5, that were reported to me as having been treated at home or removed to the Hospital, as compared with 1883-4. In the former year, 1884-5, there were only 602 oases reported against 1211 in the last-named year, and 491 removed to the Hospital against 923 in 1883-4. It is however very significant as to the alteration in the character of the cases treated in the Hospital, that although in 1883-4 the average number of Small-pox patients reported to be under treatment at the end of every fortnight was 42 in 1883-4 and only 21 in 1884-5, that the number of deaths in the former year was 214 and of the latter 217. It is evident, therefore, that the worst cases only were treated in the Hospital in 1884-5, and that the patients were removed at an earlier period of the disease in 1884-5 than in 1883-4, so that the proportion of acute cases to the whole number treated was much greater in the first-named than in the latter year. The treatment of a number of Smallpox patients in the acute stage in one Ward is, in my opinion, attended with greater risk to the neighbourhood than a larger number of mixed cases, and probably accounts for the continuance 8 of the disease, although to a reduced extent, in the vicinity of the Hospital. It is also worth notice that a much larger proportion of those admitted were transferred to the Atlas in 1884-5 than in 1883-4, showing their earlier transference from one hospital to another. TABLE III Total number of Hackney cases of Small-pox reported at the Town Hall in the undermentioned months, and the number of Cases from all Parishes treated in the Hospital. 1884-5. Hackney Cases. Statistics, Homerton Hospital. Months. Hackney Cases Reported Removed from Hackney to Hospital or Ship. Transferred to Ships. Cured. Died. Totals. 1884 October 87 74 44 98 16 142 November 41 33 117 12 26 129 December 49 43 98 49 28 147 1885 January 63 57 113 64 26 177 February 75 51 51 2 20 63 March 44 30 32 61 0 93 April 48 38 48 19 22 67 May 55 66 75 3 29 78 June 82 69 76 9 19 84 July 38 25 28 7 17 35 August 14 13 20 8 4 28 September 7 3 2 3 1 6 603 491 703 335 217 1038 9 This table shows a considerable reduction in the number of Hackney cases and of the total number brought into and taken from the Homerton Hospital in 1884-5, as compared with 1883-4, but it also shows the numerous cases treated in the Hospital during the year, although the number under treatment at one time was comparatively small. I have already pointed out the excess of cases in the quarter and half-mile radii of the Hospital, and the conclusions as to the injuriousness of the Hospital at which I arrived. These conclusions have been corroborated by the report published by Mr. Shirley Murphy, the late Medical Officer of Health to St. Pancras, as to the effect on the health of the inhabitants of that Parish, caused by the presence of the Hampstead and Highgate Smallpox Hospitals, of which I append a summary. Mr. Murphy states that the Hampstead Hospital was closed for Small-pox cases in 1880-3, but was opened in May, 1884, for a limited number of cases, with the following results. In the four years when this Hospital was closed, the houses in the special area of one mile round, were attacked less than those in the remainder of the Parish; but in 1884, when the Hospital was reopened, the special area suffered three times as much as the rest of the Parish. That during the year when the Hospital was closed against Small-pox, the houses in the radius nearest to the Hospital did not suffer in a greater ratio than the others; but the reverse occurred when the Hospital was opened, as the largest proportion of attacks to houses occurred in the half-mile radius next the Hospital, in the proportion of 2 to 1 in the half and three-quarter mile radii, and of 5 to 1 in those situated in the space between the threequarter and one mile radii. Mr. Murphy also investigated the incidence of the disease around the Highgate Small-pox Hospital, with similar results, except that the number of cases was greater in the three-quarter and one mile radii, than in the houses between the half and three-quarter mile radii. This 10 difference, however, was explained by the houses within the first-named space being within the influence of the Hampstead Hospital. Mr. Murphy therefore concludes that his figures for St. Pancras show that Small-pox Hospitals as at present constructed and managed, are a source of disease to the neighbourhood in which they are situated. He also points out that the Managers have not adopted the recommendations of the Commissioners; that these hospitals should be constructed so as to admit of the destruction of all the air the hospitals have contained, so that if the incidence of the disease has been caused by air-borne infection, there is still some hope of the hospitals being used without much injury to the adjacent neighbourhood. Dr. Verdon, the Medical Officer of Health for Lambeth, corroborates the opinions expressed by Mr. Murphy and by myself, that Small-pox Hospitals as at present constructed and managed are injurious to the adjacent populations, but we believe this to arise from the traffic to and from the Hospital, partly by aerial infection, and, some think, by continuity of drainage. At any rate the balance of evidence shows that in London these hospitals assist in spreading Small-pox in the localities in which they are placed. The Report of the German Yaccination Commission, lately published in Germany, is a most important document, as it gives the most recent statistics concerning the protective power of human lymph. The results entirely support those derived from English returns, and are especially valuable, as the efficacy of vaccination abroad has been questioned in this Country. This Commission was appointed by the German Government to make inquiry into (a) the present aspect of vaccination, especially as regards any attendant evils; (b) to frame rules for the eventual introduction of animal vaccine lymph into general use in public vaccination; (c) to draw up a scheme for the institution of an effective supervision of public vaccination; and (d) to arrange for an imperial statistical 11 return of the Small-pox mortality. The answers by the Commissioners to eight questions propounded by the Imperial Board of Health, were as follows:— 1. With rare exceptions, one survived attack of Small-pox confers immunity against further attacks. 2. Vaccination exerts a similar protection. 3. The duration of the protection afforded by vaccination varies within wide limits, but is about ten years on the average. 4. At least two well developed vaccine vesicles arc necessary to ensure efficient protection. 5. Revaccination is necessary ten years after primary vaccination. 6. A well vaccinated condition of the community increases the relative protection which the individual has acquired against Small-pox; and thus vaccination is useful, not only individually, but generally, against Small-pox. 7. Vaccination may, under certain circumstances, be injurious to health. In the case of human lymph, the danger of transfering syphilis, although extremely slight, cannot be entirely excluded. Any other injurious effects are apparently due only to accidental wound-diseases. All these dangers may, by precautions in the performance of vaccination, be reduced to such a minimum, so that the benefits of vaccination infinitely outweigh any possible injurious effects. 8. Since the introduction of vaccination, no scientifically provable increase of any special disease or of the general mortality has occurred, such as might be regarded as a consequence of vaccination. The statistics brought forward by the Imperial Board of Health to show the effect of the law of 1874, introducing compulsory revaccination throughout Germany at the age of 12, have been already published. Other valuable statistics were now produced, in particular the Bavarian statistics of Dr. von Kerchensteiner; the Leipzig statistics of Dr. Seigel, and the elaborate army statistics of Dr. Grossheim. In the last case, accurate particulars were known as to 1,005 Small-pox cases, with 61 deaths. Of these 1,005, 4 were not vaccinated, with 1 death, or=25 percent.; 109 were successfully revaccinated, with 2 deaths,=1.1 percent.; 224 were unsuccessfully vaccinated, with 10 deaths,=4.5 per cent.; 531 were not 12 revaccinated, with 46 deaths.=8.6 per cent. In 130, where the result of revaccination was unknown, there was 1 death,= 0.7 per cent. In 7 cases where the result was doubtful, there were 110 deaths. The whole number of cases in the German Field Army during the epidemic of 1870-71, was 4,991, with only 297 deaths,=nearly 6 per cent. of the cases. Whether the number of cases in the French Army, given by some French writers as regards the Field Army, viz., 23,469 cases, was absolutely correct or not, it was impossible to say; but in the Paris Army alone, numbering 170,000, the cases were 11,500, and the deaths 1,600 (nearly 14 per cent.). Again, the French prisoners in Germany were 372,918; the Small-pox cases were 14,178, the deaths 1,963, that is over 13 per cent.; while the unmobilised German army, on the other hand, numbered 300,424, the Small-pox cases 3,472, and the deaths only 162, that is, 4-6 per cent. This was a striking instance of the protective power of vaccination, for Dr. Grossheim amply proved that the French army was far less thoroughly vaccinated than the German. The reverse of this picture is contained in the Annual Report of the Medical Superintendent of Health for the City of Providence, which contained, in 1885, 118,070 inhabitants. The large number of vaccinations and revaccinations in a city where vaccination is not compulsory shows a higher standard of intelligence or less prejudice than is to be found in this Metropolis, and compares most favorably with the results obtained by this Board when revaccination was carried out under great difficulties, and a comparatively small number of children revaccinated:— The number of persons vaccinated by this department during 1885 was 16,766. Of the 16,766 persons vaccinated during the year, scarcely more than a dozen had sufficient trouble with their arms to require medical assistance. In all 13 the visits made by the vaccinators, not a hundred unprotected persons were found who refused to be vaccinated. A study of the above facts only corroborates the experience of past years in regard to the wisdom of not making vaccination compulsory in this community except for certain classes of persons, as the children in the public schools. The number of persons who flatly refused to be vaccinated is extremely small, and would certainly be very much increased by making it compulsory. The vaccinators report finding many persons who offered great objections to vaccination until they learned that it was an entirely voluntary matter with them. There is at present an excellent public sentiment in regard to vaccination, due, I believe, partly to the familiarity with it caused by the vaccination of school children, partly to the care with which public vaccination has been done, and partly to the freedom of this city from small-pox, a result which is believed to be due to vaccination. The best way to keep the people of this city protected from small-pox is to see that the State law in regard to the vaccination of children is strictly enforced, and then from time to time, as danger threatens, vaccinate from house to house and in the manufacturing and mercantile establishments, and also provide evening vaccination in different parts of the city, and have all well advertised. In this way not only will large numbers of persons avail themselves of public vaccination, but a strong public sentiment on the subject will be aroused, which will render entirely superfluous any attempt at compulsion, and will effectually save this city from the disgrace and enormous loss which so many other cities have suffered through their negligence. Whether or not if the performance of vaccination or revaccination in this country were carried out by Sanitary instead of Poor Law officials, untramelled by the restrictive orders of the Local Government Board, framed under Act of Parliament, would be more successful than at present it is somewhat difficult to say. In my opinion it would be, as anything done and paid 14 for by Poor Law officials is looked upon by many as a species of Poor Law Relief. At any rate, the fact that 16,766 vaccinations and revaccinations were performed in Providence amongst 118,070 inhabitants during the year, without a compulsory law, is very significant. Eleven Physicians were appointed vaccinators to make a house to house inspection, and visited nearly all the houses except those occupied by the more wealthy classes. As all children attending public schools must provide a certificate of vaccination before admittance, they would not be included in in the above mentioned number. In continuation of the tables given in former years, I now lay before you the following tables of the number of oases of Small-pox amongst the vaccinated and unvacoinated in the years 1881—1884 and 1885, which bear out to a great extent the remarks and statistics quoted from the report of the German Vaccination Commission. It is also especially interesting as showing that although the number of cases reported in 1884 and 1885 were fewer than in 1881, the percentage amongst children under 5 years of age to total cases had not diminished. In 1881 there were 1,235 cases reported to me, as to which information was obtained regarding vaccination and nonvaccination; in 1884 there were 1,253 reported; and in 1885, a much smaller number, viz., 380, making a total of 2,868 cases, of which 297, or more than 10 per cent. of the whole were stated to have been unvaccinated. The vaccinated cases included all stated to have been vaccinated, without reference to the amount of protection afforded by the vaccination, and without any personal examination of the patients. 15 TABLE IV. Percentages of Vaccinated and Unvaccinated Cases of Small-pox at different ages in Hackney. Years 1881—1884 and 1885 and Population. VACCINATED CASES. UNVACCINATED CASES. Ages 0 1 1 5 5 10 10 15 15 25 25 35 35 45 45 and above Total number of Cases 0 1 1 5 5 10 10 15 15 25 25 and above Total number of Cases 1881 0.5 6.0 10.9 16.0 83.9 19.2 8.8 4.7 1075 25.0 24.4 20.6 12.5 14.4 3.1 160 1884 .9 5.6 12.9 17.9 85.9 15.5 6.9 4.4 1155 18.4 36.8 21.4 14.3 8.1 1.0 98 1885 1.2 2.9 11.1 15.5 41.4 13.8 8.2 5.9 341 28.2 25.6 25.6 7.7 12.9 • 39 Means .8 4.8 11.6 16.5 37.1 16.2 8.0 5.0 Means 23.9 28.9 22.5 11.6 11.8 1.4 5.6 52.8 Percentage of Population. 129 11.1 10.0 20.4 15.8 11.5 18.3 100 12.9 11.1 10.0 20.4 45.6 100 The table shows that whilst the number living at the age period of 0/5, that is to say, under 5 years, was 12.9 per cent. of the whole, the cases of small-pox at that age amongst the vaccinated were 56 per cent. of the total, whilst amongst the unvaccinated there were as many as 52.8 per cent. of the total unvaccinated cases. This shows the almost certainty that the probability of an attack of small-pox at 0/5 age amongst those who are unprotected by vaccination is nearly ten times as great as amongst those who are vaccinated, whether properly or not. This, however, is only a small portion of the advantage of vaccination, as the death rate amongst the unvaccinated under 5 years old is about 55 per cent. of those attacked against none amongst the well-vaccinated and 15 amongst the badly vaccinated. The large proportion of cases between 15 and 25 years of age amongst the vaccinated as compared with those at 16 25/15, viz., 28..1 at 5/15 against 37.1 at 1/2 5/5 years, shows that at 15 years and above (if not before) there is an absolute necessity for vaccination. The large proportion of cases in 1885 as compared with those in 1884, and especially in 1881, show that this necessity still exists, at any rate, to as great an extent as in years gone by. It was the knowledge of this great increase in the number of small-pox cases at this age period, that made me press upon the Board the necessity for revaccination, especially between 12 and 14 years of age. It will be noticed that the percentage of population was 21.0 at 5/15 years of age, against 20.4 at 1/2 5/5 years. The number of unprotected children between 10 and 14 years of age, who were revaccinated in 1883 (770), at the expense of this Board, does not appear to have exerted any appreciable effect in the spread of the disease at this age period, and shows the necessity for a more extended revaccination at these ages and of older persons. The revaccination of those who are above 14 years of age can be paid for by the Board of Guardians, and above 12 years of age when small-pox is epidemic, but there is great difficulty in inducing persons to apply to the public vaccinators unless special facilities are offered them as regards both time and place. It is true that revaccination is not a perfect protection against an attack of small-pox, although it is in a very large majority of cases, but an attack of small-pox itself is not a greater protection than revaccination. I have attended several persons a second time with small-pox, two of whom were deeply scarred in the first attack, and yet died from the second. 17 TABLE V. HACKNEY DISTRICT. Percentages for 1884. VACCINATED CASES. UNVACCINATED CASES. Ages 0 1 1 5 5 10 10 15 15 25 25 35 35 45 45 and above Totals. 0 1 1 5 5 10 10 15 15 25 25 and above Totals. Totals 11 64 150 206 414 179 80 51 1155 18 36 21 14 8 1 98 Percentages .9 5.6 12.9 17.9 35.9 15.5 6.9 4.4 100 18.4 36.8 21.4 143 8.1 1.0 100 Cases 6.5 55.1 Population 12.9 11.0 10.0 20.4 15.8 11.5 18.3 100 12.9 11.1 10.0 20.4 45.6 100 Percentages for 1885. VACCINATED CASES. UNVACCINATED CASES. Ages 0. 1 1 5 5 10 10 15 15 25 25 35 35 45 45 and above Totals. 0 1 1 5 5 10 10 15 15 25 25 and above Totals. 4 10 38 53 141 47 28 20 341 11 10 10 3 5 . 39 Percentages 1.2 2.9 11.1 15.5 41.4 13.8 8.2 5.9 100 28.2 25.6 25.6 7.7 12.9 100 4.1 53.8 Population 12.9 11.1 10.0 20.4 15.8 11.5 18.3 100 12.9 11.1 10.0 20.4 45.6 100 Total Percentages for the three years, 1881, 1884, 1885. VACCINATED CASES. UNVACCINATED OASES. Ages 0 1 1 5 5 10 10 15 15 25 25 35 35 45 45 and above Total number of Cases 0 1 1 5 5 10 10 15 15 25 25 and above Total number of Cases 1881 0.5 6.0 10.9 16.0 33.9 19.2 8.8 4.7 1075 25.0 24.4 20.6 12.5 14.4 31 160 1884 .9 5.6 12.9 17.9 35.9 15.5 6.9 4.4 1155 18.4 36.8 21.4 14.3 8.1 1.0 98 1885 1.2 2.9 11.1 15.5 41.4 13.8 8.2 5.9 341 28.2 25.6 25.6 7.7 12.9 . 39 Means .8 4.8 11.6 16.5 37.1 16.2 8.0 5.0 2571 Means 23.9 28.9 22.5 11.5 11.8 1.4 5.6 52.8 Percentage of Population 12.9 11.1 10.0 20.4 15.8 11.5 11.3 100 12.9 11.1 10.0 20.4 45.6 100 18 A Circular was received in September last from the Managers of the Metropolitan Asylums Board's Hospitals on the subject of the Removal and Treatment of Non-Pauper cases of Infectious Disease in their Hospitals, requesting the Board to enter into an agreement with the Managers for the payment of the expenses incurred (settled at £4 4s. 0d. each) and to defray other sums that might otherwise become chargeable to the Board, for new clothing, &c., or for burial in the event of death. This Circular was referred to the Sanitary Committee for consideration and report, and at their request I drew up and presented to them the following report:— Gentlemen, I have carefully considered the Agreement submitted by the Managers of the Asylums Board respecting the reception into their hospitals of persons suffering from a dangerous infectious disorder and not being persons chargeable to any Union or Parish, and am of opinion that such an agreement is unnecessary, decidedly objectionable., and would be very unfair, so far as this District is concerned. I am of opinion it is unnecessary because up to the present time there has not been any difficulty in obtaining admission of such patients into the Asylums Board's Hospitals, or other Hospitals for Fever and Small-pox, except at a time when the Asylums Board's Hospitals were full, and no patient could be received into them, either by payment or otherwise. That the proposed arrangement is objectionable because a conflict of jurisdiction would necessarily arise between the Relieving Officers of the Guardians and myself as to the chargeability of the said persons to the Union. I am of opinion that all persons suffering from such diseases are chargeable to the Union or Parish, if they or their relations cannot procure the necessary medical attendance, nursing, and medical comforts, and also if they have not homes of their own where they can be properly treated. The Relieving Officers might hold a different opinion to this, in which case 19 much loss of time in the removal would take place, causing in all cases injury to the patients, and perhaps preventing removal at all. In many cases it might lead to loss of life by the removal being delayed too long. It would also be found very objectionable in practice, as the friends of the patients would have to go a considerable distance to reach the central place where the representative of the Board would attend to issue the orders. At present, on application has to be made to the Relieving Officer of the SubDistrict in which the sick person lives, and as there are nine Officers, viz., one for each Sub-District, theie is not at present any undue loss of time in the removal. It has been stated by a Manager of the Asylums Board that nine-tenths of the patients removed to their hospitals are non-paupers, so that if this opinion were entertained by the Relieving Officers, about 900 persons would have been referred to this Board during the year, September 30th, 1883, to October 1st, 1884, and as many as 54 in one day, which could scarcely be done from one centre without great inconvenience to those requiring it. The cost of the removal and treatment of nearly all these could not have been paid by the patients or their friends, so that there would have been scarcely any financial benefit to the District, indeed the contrary, to counterbalance the objections to the new plan, especially as the Board of Guardians can recover the cost from non-pauper patients at the present time when removed by their Officers. There is also the certainty that if most persons were called upon to pay for the removal and treatment of themselves or relations to hospitals, a very much larger proportion of the cases would be treated at home, and not reported here, or to the Relieving Officers, so that the risk of infection would be considerably increased. I also consider it would be most unfair to this District that not only should there be an hospital for such diseases in our midst, which I believe to have been a centre for spreading disease, but also that this Board should be called upon to pay the Asylums Board for taking charge of persons who may have been infected through the Hospital. Besides this, the proposed 20 Agreement would render the Board liable not only for the £4 4s. 0d. proposed as payment for the removal and treatment, but also for new clothes if deemed necessary, and for the funeral expenses if the patient died. I do not think that these charges should be defrayed by this Board but out of the General Rates of the Metropolis, as the sick are removed to the hospitals chiefly for the public good. It also seems evident that persons who would have to be buried or clothed at the expense of the rates can scarcely be considered to be nonpaupers. I remain, Gentlemen, Yours obediently, JOHN W. TRIPE, M.D., Medical Officer of Health for the Hackney District. The Sanitary Committee, after fully considering the Circular, the proposed Agreement, and my Report, arrived at the conclusion that in their opinion it is advisable not to adopt the proposal on the grounds set out in my report, and also because the circular did not define what the Asylums Board Managers mean by the word "non-pauper." They also were of opinion that the costs incurred by the removal of those who are sick with an infectious disease should be defrayed out of the general and not the local rates, except as regards such persons as were able to pay the £4 4s. Od. at the time of admission. Also that the Managers should have power, by Act of Parliament, to recover the amount from all persons who could afford to pay, instead of this duty being, as at present, cast on the Boards of Guardians. I now propose discussing the ordinary Tables in connection with the mortality of the District. Table I. indicates the population of, and the births, marriages and deaths in the District during 11 years. The increase of population has not been calculated at so large an annual rate since 1882 as before, in consequence of the increased proportion of houses unoccupied in the District, as shown by the Rate Books, so that I have calculated the population on July 1, 1885, at 210,600 only, 21 instead of about 218,000, which it would have been if the ordinary increase previously to 1881 had continued. The number of births points in the same direction, as in 1885 there were only 6,585 registered in the District against 6,377 in 1881, when the population was 188,240. It is true that the birth rate for London and all England in 1885 was below the average of former years, so that I have not been guided entirely bv the birth rate. TABLE VI. Shotting the Population, Marriages, Births, Deaths, and Density of Population per Acre for the Year 1885 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. 1885 210,600 1496 6585 3682 897 1555 53.5 1875 145,144 1415 4970 2948 723 967 36.9 1876 152,648 1425 6469 2825 773 987 38.9 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 1543 47.8 1882 195,200 1488 6423 3505 768 1451 49.6 1883 200,200 1458 6502 3545 816 1402 51.1 1884 205,400 1433 *6827 3700 880 1510 52.3 Average of 10 Years, 1876—86 176,997 1450 6065 3323 809 1336 45.0 * Registered in 58 weeks. 1871. 1881. Population at Census 124,95 186,400 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 3,93c 3,935 No. of Acres of Water and Open Spaces (chiefly on the borders of the District 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 the District, and by taking out the deaths of all non-residents. It will be seen by the table that in 1875 the population was calculated at 145,144 persons, and that the Census of 1881 22 confirmed that calculation, so that the number I have fixed upon is probably rather below than above the truth. The births registered in 1875 were 4,970, and the average of the 10 years, 1875-84, was 6,065 against 6,585 in 1885. The total deaths in 1885 were fewer than in 1884, viz., 3,682 against 3,700, but the deaths of infants under 1 year was somewhat in excess, having been 897 against 880. The same remark applies to the total deaths under 5 years, as these numbered 1,555 in 1885 against 1,510 in 1884, and an average of 1,336 in 1875-84. The excess was caused ohiefly by measles and diarrhoea, as will be shown in another part of the report. The density of population has increased to 53.5 persons per acre, so that the diminished number of deaths is the more satisfactorv. TABLE VII. [Iackney District.—Showing the Annual Birth and Death Rates, and Death Rates of Children in a Thousand Deaths for the Year 1885, and Ten Years preceding. In Year. Birth Rate 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. 1885 30.9 17.6 19.7 137 148 246 422 1875 35.1 20.6 23.8 146 162 245 328 1876 36.8 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 32.3 176 20.4 125 146 230 396 1884 30.8 180 20.3 124 168 238 408 Average of 10 years, 1875—84 34.2 18.8 22.0 133 156 241 406 Means. 1871—80 34.7 19.6 22.6 142 168 247 392 1861—70 33.8 20.4 24.4 143 162 - - 1861—60 31.8 19.1 23.8 128 166 - - 23 I have just mentioned the diminution in the birth rates of England and London for some years past, in which Hackney to a very great extent has participated. Thus in the 10 years 1861-70 and 1871-80 the mean birth rates in this District were 33.8 and 34.7 respectively, but in 1882 it was only 32.9; in 1883, 32.3; in 1884 only 30.8; and in 1885, 30.9 per thousand inhabitants. The reduction in all London was about the same, so that some general cause must have been in operation to cause these results. In France also a similar reduction has been observed. The death rate, however, was very low during these 4 years, so that the natural increase of population has not been diminished by the low birth rate, as the excess of births over deaths in Hackney was no less than 11,896 in those years. In 1885 the excess was 2,903. The corrected death rate was only 176 per 1000, which, as it is based on the total deaths of inhabitants registered not only in this District, but in the hospitals of tbe Asylums Board, including the ships and Darenth Camp, and also in all the Metropolitan Hospitals and at the Asylums for Idiots and Lunatics outside the Metropolis, is very satisfactory. Until lately I was not able to present you with an accurate return of these deaths, but I made an allowance for them by comparing the number of deaths in all Institutions, except Workhouses, in London with the total deaths, and allowing in due proportion, pro rata to population, for Hackney. The corrected death rate for all London was 19.7, which is the lowest, as well as that for this District, since I was appointed in 1856 ; indeed it is the lowest for many years before that time. The number of deaths under 1 year per 1000 births was not so satisfactory as I could have wished, as there were 137 deaths at this age in this District, against 133 for the 10 years 1874-85 and 148 for 1885 in all London. This was caused by the large proportion of deaths under 1 year from measles, diarrhoea, convulsions, bronchitis, premature births and atrophy. The deaths of children under 5 years per 1000 deaths at all ages were also unsatisfactory, as they numbered 246 under 1 year of 24 age, and 422 under 5 years (including of course those under 1 year), the average for the 10 years having been 241 under 1 year, 165 between 1 and 5 years, making a total of 406 under 5 years. The excessive number of deaths from measles, viz. 168, of which 155 occurred under 5 years, fully account for the increase this year. TABLE VIII. Showing the Number of Deaths at all Ages in 1885, from certain groups of Diseases, and the proportions to 1000 of Population, and to 1000 Deaths from all Causes; also the Number of Deaths of Infants under One Year from other groups of Diseases, and the proportions to 1000 Deaths from all Causes under One Year, and of Deaths to 1000 Population. HACKNEY DISTRICT. Total Deaths, 1885. Per milleage of Deaths to Total Deaths, 1885. Deaths per 1000 population. 1882 1883 1884 1885 1. Zymotic Disease 545 148 3.39 2.63 3.99 2.69 2. Pulmonary, other than Phthisis 756 206 3.96 3.31 2.93 3.69 3. Tubercular 604 137 2.59 2.63 2.05 2.39 4. Wasting Diseases Under 1 year. 256 70 0.98 1.19 1.06 1.23 5. Convulsive Diseases 171 47 0.65 0.78 0.71 0.81 3. Includes Phthisis, Scrofula, Rickets, Tabes Mesenterica, and deaths registered as being caused by Hydrocephalus in children more than 1 year old. 4. Includes Marasmus, Atrophy and Debility, want of Breast Milk, and Premature Birth. 5. Includes Infantile Hydrocephalus, Meningitis, Convulsions and Teething, under 1 year. The deaths from zymotic diseases, despite the large mortality from measles, were fewer in number than usual when 25 compared with the deaths from all causes, as they were 545 against 820 last year, and 148 against 222 per 1000 deaths from all causes. They amounted to 2.59 against 234 per 1000 population in all London, and 3.99 last year in this District. The mortality from pulmonary diseases other than consumption was greater than usual, as there were 756 deaths registered under this heading against 603 in 1884, and the mortality per 1000 population was 3.59 against 2.93 last year. Tubercular diseases caused rather less than the ordinary mortality, viz. 504 deaths, or 137 per 1000 deaths from all causes, and 2.39 per 1000 population against 2.05, 2.63 and 2.59 per 1000 during the three preceding years. Wasting and convulsive diseases in children under 1 year old, caused 256 and 171 deaths respectively and 70 and 47 deaths per 1000 deaths from all causes. This number, as regards the first named group of diseases was above the average, having been l.23 per 1000 population against 1.06, 1.19 and 0.98 in the three preceding years; and also as regards the second group, viz. 0.81 per 1000 population against 0.71, 0.78 and 0.65 in 1884, 1883 and 1882. As "wasting diseases" occur chiefly amongst children of the poor and in houses that receive especial sanitary supervision the high death rate from these causes is somewhat unsatisfactory, but is only what might have been expected, considering the increased number of poor and the density of population. The diseases included under this head are: Marasmas, atrophy, debility, want of breast milk, and premature birth. As I am often asked the length of time during which a person who is attacked with an infectious disease should 26 be prevented from mixing with healthy persons, I now give a list of these diseases and the time during which it is probable that the disease may be communicated to others:— Small-pox 8 weeks from appearance of rash. Modified do 5 weeks ditto Chicken-pox 18 days ditto Measles 4 weeks ditto German Measles 2 weeks ditto Scarlet Fever 7 weeks ditto Diphtheria 4 weeks from first illness Erysipelas (not from wounds)—5 weeks Typhoid Fever—4 weeks Mumps—3 weeks from date of swelling Some of these diseases, viz., small-pox and measles, are infectious before the rash comes out, and whooping cough before the "whoop" is heard, so that it is often very difficult to ascertain when the disease was caught. This is all the more difficult as the period of incubation, i.e., the time that occurs between the date of infection and the appearance of the rash, varies. In smallpox this is said to range between 8 and 20 days, the usual time being from 12 to 14 days, and we may fairly allow the same time for measles and whooping cough. The time during which a small-pox patient remains infectious varies somewhat in different cases, and, as shown above, whether or not the patient has been vaccinated or had a former attack, that is to say, has the disease in a "modified" form. At any rate infection has not ceased whilst there is any crust on the body, and I believe it still remains in the body as long as thin scales are continued to be found on the places where the pustules have been, and the same may be said of scarlet fever so far as the peeling of the skin is concerned. M ^4 TABLE IX. 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. 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 Annual Average of 10 Years, 1875-1884 Proportion of Deaths to 1000 Deaths in 10 Years, 1875-1884 Total Deaths in 1885 Proportion of Deaths to 1000 Deaths in 1885 Small-pox 2 92 179 86 10 69 225 13 19 210 90.5 27.2 86 23.2 Measles 61 15 91 31 81 21 149 43 117 55 66.4 19.8 168 45.6 Scarlet Fever 78 57 58 123 70 81 118 144 63 72 85.4 25.9 29 7.9 Diphtheria 21 23 18 23 19 14 1 51 43 39 25.2 7.5 47 12.8 Whooping Cough 113 126 43 135 110 141 70 182 56 157 113.3 34.1 85 23.4 Fevers. Typhus 1 Enteric 58 44 62 70 47 27 64 63 46 84 55.5 17.0 37 10.8 Simple continued 2 Diarrhœa 116 136 86 159 67 170 135 99 104 190 120.5 37.9 125 33.9 Totals 449 493 537 627 404 523 762 595 448 807 564.5 168.4 689 157.6 Totals—London 13,411 12,565 12,292 14,734 12,256 13,681 13,811 13,558 10,801 13,629 13,074 160.4 11,647 145.6 28 This table shows the great differences in the mortality in various years from the diseases mentioned. Thus, between 1875 and 1885 inclusive, the mortality from small-pox varied between 2 in 1875, 225 in 1881, and 210 in 1884. The number of deaths from measles also oscillated greatly, having been as low as 15 in 1876 and as high as 168 in 1885. The same remark applies, but in a less degree, to scarlet fever, which caused a mortality of 29 in 1885, and 144 in 1882; and also to diphtheria, which produced 51 deaths in 1882 and only 1 in 1881. Whooping cough and "fevers," chiefly typhoid, vary less in their mortality, as the smallest number registered from whooping cough in any one year, viz. 43, occurred in 1877, against a maximum of 182 in 1882; and a minimum from "fevers" of 27 in 1880, against a maximum of 84 in 1884. The largest number of deaths from these diseases in any one year occurred from diarrhoea, viz., 190 in 1884 against 67 in 1879, which was the smallest figure from this disease in the 11 years. The tendency to recur as an epidemic at regular intervals is very marked, thus small-pox was epidemic in 1877, 1881, and in 1884-5, so that it is not at all likely that it will recur to any extent before the autumn of 1887, or perhaps of 1888. Measles also to somewhat less extent recurs every 4 years, or nearly so, having been prevalent in 1877, 1881 and especially in 1885. Scarlet fever prevailed extensively in 1874, 1878 and 1881-2, so that it may be looked for as an epidemic in 1886-7, or at the latest in 1887-8. An unusual prevalence of diarrhoea depends on hot weather, so that it is scarcely safe to make any 29 forecast concerning it, except to remark that it is rare for this disease to cause an unusually large mortality for three consecutive years. TABLE X. The Deaths Registered at different Ages from all eauses during the Years 1876.85, the Deaths of Non.Residents in the Fever and Small.pox Hospitals being excluded, but of Inhabitants in Hospitals and other Public Institutions outside the District being included. AGE AT DEATH. 0 .1 1 .5 5 .15 15 .25 25 .35 35 .45 45 .55 55 .65 65 .75 75 .85 85 and upwards Totals 1885 897 658 174 165 213 238 260 314 403 298 72 3682 Per cents 24.3 17.8 4.7 4.2 6.7 6.4 7.6 8.5 10.9 8.0 1.9 100 Per cents. 1884 23.8 17.0 6.3 5.9 6.9 6.8 7.6 8.9 8.2 6.7 1.9 100 Ditto 1883 23.0 16.5 4.5 4.6 6.3 7.7 8.3 9.2 10.6 7.6 1.7 100 Ditto 1882 21.2 19.5 6.6 4.3 6.0 7.5 7.8 8.3 9.3 6.7 2.1 100 Ditto 1881 23.0 19.7 6.6 5.5 6.7 6.7 6.6 7.1 10.3 6.6 1.3 100 Ditto 1880 27.7 17.1 41 4.6 6.7 7.2 6.6 8.1 9.0 7.0 1.9 100 Ditto 1879 23.4 161 4.6 4.2 6.0 7.9 8.8 9.6 10.8 6.8 1.8 100 Ditto 1878 25.3 16.2 4.9 6.7 5.8 7.5 7.3 8.9 9.5 7.0 1.9 100 Ditto 1877 24.4 14.8 5.0 6.2 7.2 7.0 7.1 9.1 9.5 7.6 2.1 100 Ditto 1876.. 27.4 14.1 4.8 5.4 7.0 7.5 7.4 8.6 8.4 7.3 2.1 100 Per cents, of deaths 1876.84 24.4 16.8 5.2 5.2 6.4 7.2 7.7 8.7 9.5 7.0 1.9 100 Ditto 1866.76 24.3 15.7 5.1 5.3 7.1 7.3 7.4 8.0 9.8 7.8 2.2 100 Ditto 1856.65 21.0 16.4 6.1 5.1 6.9 7.2 7.3 8.9 10.9 8.0 2.2 104 I continue this table as heretofore, because it is useful in leading to a more careful consideration of the causes of death at certain ages, whenever any great departure from the ordinary percentages occur. It is evident, however, that the death rate amongst the inhabitants at any given age will depend on the number of those who are living at that age, as well as on the 30 prevalenoe of diseases which are most prone to attack and are most fatal to individuals at the particular age under consideration. Thus, diarrhoea, convulsions, bronchitis, debility and atrophy, are most fatal amongst children under 1 year old; measles, scarlet fever and whooping cough, and bronchitis between 1 and 5 years of age, so that an excessive prevalence of one or the other will cause an unusually large percentage of deaths at these ages. It is also evident that a high birth rate will be coincident with a large proportionate mortality at the ages of 0—1 and 1—5 years, irrespective of the prevalence of any particular disease, unless a very great change should occur in the social status of the population. The latter shows that the percentages of deaths under 1 year of age was about the average, viz., 24.3 per cent. of the whole number, against 24.4 for the 9 years 1876.84, and 243 for 1866-75. At the age period 1/5 the percentage was 17.8 against 16.8, and 15.7 and 16.4 in former periods; the high rate at this age having occurred in consequence of the prevalence of measles and whooping cough in 1885 as compared with former years. Between 5 and 65 years of age the mortality was less than usual, some ages having been 1 per oent. below the average, but between 65 and 85 the reverse obtained the mortality at the age period of 65—75, having been 1.4 per cent. in excess, and at 75-85 1 per above the average, arising most probably from the large proportion of the population living above 70 years of age. There were 31 deaths between 80 and 81 years of age, 28 between 81 and 82; 24 between 82 and 83; 27 between 83 and 84; 18 between 84 and 85; 15 between 85 and 86; 11 between 86 and 87; 8 between 87 and 88; 2 between 88 and 89; 10 between 89 and 90, making a total of 174 betweed 80 and 90 years of age. There were also 6 deaths between 90 and 91; 2 between 91 and 92; 6 between 92 and 93; 3 between 93 and 94; 3 between 94 and 95, and 1 between 97 and 98, making a total of 21 deaths at the great age of 90—98 years. 31 TABLE XI. Births in the Sub.Districts of Hackney, 1885—52 Weeks. Quarters. Stoke Newington Stamford Hill. West Hackney. Hackncy. South Hackney. Totals. First 209 112 333 756 353 1762 185 106 265 685 331 1572 Third 190 103 266 696 334 1589 232 103 314 674 339 1662 816 424 1177 2811 1357 6585 Per cent., 1885 12.4 6.4 17.9 42.7 20.6 100 „ „ 1884 12.0 66 19.0 41.3 21.1 100 „ „ 1883 11.9 5.4 20.0 41.2 21.5 100 „ „ 1881 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 In this and the following table are shown the number of births and deaths registered in the Sub.Districts of IIackney and Stoke Newington; the preceding tables having been compiled to show the sanitary condition of the District as a whole. Table XI. shows that there were registered during the first quarter 1,762 births, in the second 1,572, in the third 1,589, and in the fourth 1,662, making a total of 6,585 births in the year. Of these, 816 were registered in Stoke Newington, 424 in Stamford Hill, 1,177 in West Hackney, 2,811 in Hackney, and 1,357 in South Hackney. The percentages are 12 4 for Stoke Newington, 64 for Stamford Hill, 17.9 for West Hackney, 42m7 for Hackney, and 20.6 for South Hackney Sub.Districts. These show a slight excess for Stoke Newington 32 and Hackney, and, except 1884, for Stamford Hill, but a diminution in the other Sub-Districts. TABLE XII. Deaths in each Sub-District, 1881-85. Year. Stoke Newington Stamford Hill. West Hackney. Hackncy. South Haokuey. Totals. 1881 360 148 678 1728 700 3614 1882 379 175 625 1698 628 3505 1883 369 176 659 1646 695 3545 1884 361 172 645 1827 695 3700 *1885 424 196 621 1759 650 3650 It will be noticed that the total number of deaths do not correspond with those given in the other tables, which arises from the precise addresses of 32 residents of the District who died in Asylums outside London not being given in the ExtraMetropolitan Returns, so that these deaths cannot be assigned to any particular Sub-District of Hackney. It will be seen that the number of deaths belonging to Stoke Newington and Stamford Hill are in excess of any other year referred to in the table, whilst those in the other Sub-Districts are fewer in number. In West Hackney they were less than in any of these years, in Hackney smaller than in 1881 and 1884, and in South Hackney fewer than in 1882. I cannot give accurate percentages for these Sub-Districts, and therefore do not give any, as in the Hackney Sub-District the following deaths are registered, viz., in the Workhouse those of residents removed from all the Sub-Districts, many of whom were in the Workhouse before the last census; also the deaths in the City of London Union, which would have to be distributed, as well as a proportion of the population of these institutions, amongst the various SubDistricts in order to obtain accurate results. It would also be necessary to procure a census of the inhabitants in the SubDistricts, as the increase does not take place equally in all, 33 because in some the whole of the building ground was nearly covered at last census, whilst in others a large proportion of buildings have been erected, and there is still a good deal of building ground uncovered. It is probable that this number, 3,650, would give a nearer approach to exactness than that of 3,682, as I do not know the population belonging to Hackney in these asylums, but I preferred erring on the side of excess of deaths than otherwise. There have been 69 dead bodies removed to the Mortuary during the year, the majority by the Police, as the deaths chiefly resulted from drowning, accident, or suddenly in a public place. There was only one body received there when the death was caused by infectious disease, viz., from small-pox. In this case the coffin was filled with saw-dust nearly saturated with a strong solution of chloride of zinc, sorewed down, and placed in the air-tight receptacle lately made for such bodies. In a large proportion of the cases post-mortems were made, and as on one occasion the upper chamber was full, a body requiring a post-mortem was necessarily placed in the lower chamber, which was not fitted for that purpose, another postmortem table has been provided, which, as well as the air-tight case, can be moved to a new mortuary when built. TABLE XIII. Articles Disinfected for the Years 1880 to 1885. Years. Beda. Mattrasses. Palliasses. Bolsters. Pillows. Blankets. | Sheets. Quilts. Other Articles. Totals. Houses Disinfected. 1880 339 163 106 248 684 376 312 197 2269 4483 415 1881 761 232 46 649 1204 782 610 424 2084 6682 1046 1882 172 104 88 119 258 332 148 69 1022 2312 366 1883 227 104 82 167 423 337 184 117 1086 2727 346 1884 785 227 59 616 1441 1101 747 550 1265 6791 1169 1886 332 132 16 290 690 765 439 284 605 3663 603 34 As small-pox and scarlet fever were not so rife in 1885 as in 1884, the number of articles disinfected this year was less than in 1884, but greater than in any other year since 1881, having been 3,553. Of these 332 consisted of beds, 132 of mattrasses, 16 palliasses, 290 bolsters, 690 pillows, 765 blankets, 439 sheets, 284 quilts and 605 other articles. There were also 603 houses disinfected by the staff. The saving of the value of the articles disinfected is not the chief advantage gained by having a disinfecting apparatus, and working it by the Board's officers, as we receive a considerable amount of information respecting the prevalence of zymotio diseases, which we should not otherwise procure, through the desire of the middle class inhabitants to have their houses and bedding disinfected. The disinfection is so thorough that I cannot call to mind more than a case or two where the disease reappeared after the ordinary period of incubation had passed, except where there was satisfactory reason to believe that fresh infection from other sources than the bedding or houses had occurred. During the year 1,052 small bottles of carbolic acid and 4,086 small bags of disinfecting powder have been delivered to poor persons applying here for disinfectants. The name and address of every applicant and the reason for the application were entered in a book. In this way information has been obtained respecting the prevalence of infectious diseases and defects in house drains, with which we should otherwise have been unacquainted. The carbolic acid is chiefly used when diluted for soaking or washing infected clothiug; and the powder for drains, scrubbing rooms, &c. Large quantities of disinfectants have also been supplied to the Surveyor's Department for use when cleaning out street gullies, for disinfeoting the contents of street gullies, and cleansing urinals. There have been two outbreaks of zymotio diseases in two institutions in this district, the causes of which could not be ascertained. The first of these, viz., one of scarlet fever, occurred in the Girls' Refuge, near the Cambridge Heath Bridge, and lasted 35 for several weeks, although the patients were removed as soon as the disease was diagnosed, and the rooms and bedding freely disinfected, partly by the officers of this Board and partly by the officers of the Institution, under my direction. When I inspected the rooms and drainage arrangements I found everything satisfactory, and ascertained that the utmost care and all reasonable precautions were used for preventing the spreading of the disease. The endemic has long since subsided, as there has not been any case for several months past in this Institution. The other outbreak took place in the Convent, Hassett Road, and was one of typhoid fever, as many as 8 cases having occurred in the course of two months. The first three cases occurred within three days of one another, and two more on the thirteenth day after the first case, so that it was evident that there was some common cause for the outbreak. A very careful enquiry was made respecting the milk supply, which was extended to other customers who received milk from the same purveyor, and also respecting the dairy farm from which it came, but there was not any other known case of typhoid amongst those who used this milk and from whence it came. The milk was examined chemically and microscopically, also the tinned meat, and lard used for making pastry, but nothing wrong was discovered. The drains were in good order, but the trough forming the watercloset occasionally smelt, although it was automatically flushed twice a day. I advised this to be more carefully attended to, but do not think it originated the outbreak, and am therefore unable to assign the cause, which is certainly unsatisfactory, as I am not a believer in the spontaneous origin of typhoid fever. The filthy condition of the River Lea caused me much anxiety and considerable additional work, as I visited the river frequently, especially during the summer months, and tested the river water and the effluent from the Tottenham Sewage Works on many occasions. I carefully compared the condition of the river above and below the Tottenham Works, and found distinct 36 traces of ammonia and organic matter above the works, but not enough to be injurious, whilst opposite to the works and at all distances below, in our district, the water was most filthy. On comparing the water with sewage taken from one of our sewers by colour tests (nessler, nitrate of silver, &c.), I found that it contained as much ammonia and chlorine as a mixture of onethird sewage and two-thirds of distilled water. The Tottenham effluent differed but very slightly from sewage, so that it was evident that the treatment of the sewage at the works, except as regards solid matters, was of very little use. The flushing of the navigable river {i.e., the cut) was attended with very good results, and showed that much of the mischief arose from the river not being a running stream, and from the supply of water being intercepted higher up the river. As the River Lea Conservancy Board is not entitled to take more than 5½ million gallons per day of the water for navigation purposes—and frequently does not take that amount—whilst the water companies often took all the rest, it is evident that no sewage effluent should be allowed to be poured into the river, or rather cut, at Tottenham, at any rate during the warm weather. The New River Water Company took this year on an average about 18,000,000 gallons a day, and the East London about 35,000,000 gallons a day, making 53,000,000 against the 5½ million gallons taken by the Conservancy Board. It is therefore very evident, considering the large amount of evaporation going on and the limited supply, that a very large proportion of the water below the Tottenham Sewage outfall must consist of their effluent, and probably partly of untreated sewage, as I have on several occasions seen fæcal matter in the river. It must not be supposed that I mean to state that the Water Companies always take all the water except 5Ñ millions, as that is not the case, inasmuch as the East London Company does not usually take water during times of heavy floods, because the amount of suspended matter is then very large and would injuriously effect their reservoirs. 37 Tents, vans, sheds, or similar structures used for human habitation, which are in such a state as to be a nuisance or injurious to health, or which are overcrowded so as to be injurious to the health of the inmates, are now considered to be nuisances, if within the Metropolis, under the Nuisances Eemoval Acts. This alteration in the law was made by the Housing of the "Working Classes Act, which was passed in August, 1885. Under section 9, subsection 3, the Sanitary authority or the Sanitary Committee can authorise one of its officers to demand admission to these places between sis in the morning and nine at night, and any person obstructing him is liable to a penalty of forty shillings. He is entitled to demand admission whenever he has reasonable ground for supposing that there is a contravention of the provisions of the Act in any of these structures, or as regards cleanliness, overcrowding, &c., or that there is in any of these vans, tents, &c., any person suffering from a dangerous infectious disorder. If the occupier of any van, &c., should neglect to comply with notices served on him to abate the nuisances, he can be summoned for neglect in the same manner as any one else who neglects or refuses to comply with an ordinary notice under the Nuisances Removal or Sanitary Acts. The Act does not apply to the state of the ground or to noises arising out of the manner in which the business of the owners of the vans, &c., is carried on, and therefore will not assist in preventing annoyances arising therefrom. I visited several localities in the district on which vans, &c., were placed, and directed Mr. Sortwell to serve the necessary notices on the owners for the abatement of nuisances arising from offensive accumulations, &c., or to communicate with them by letter, and in most instances with good results. Except in a few instances the vans, &c., were not occupied, so that the occupiers could not be reached by the law, except when they caused nuisances such as could be dealt with under the Nuisances Removal Acts. In all such cases, when they occurred, the occupiers were served with the necessary notices and left the district. There is no 38 definition of the words " human habitation " in the Act, so that I suppose they apply only to such structures as are used for sleeping in, and therefore action cannot be taken in other instances. Clay Burning.—During the year clay has been burnt for ballast on several pieces of ground in the district, and has been a source of considerable annoyance to the adjacent inhabitants. There has been much difficulty in limiting the burning to the heap first fired, but in all cases success has attended the efforts to prevent a continuance of the nuisance. The course taken was the service of a notice to discontinue the burning, which was understood to mean that no additional matter should be placed on the heap; that already fired being allowed to burn out. This has generally been accepted by all parties as the best solution of the difficulty, and is probably as good terms as would have been procured if an injunction had been applied for and obtained, or other action taken under the Nuisances Removal Acts. There has also been a good deal of trouble caused by contractors depositing, on pieces of waste land, quantities of household and other refuse, collected not only in this but in other parishss. As there are so few available shoots, the utmost vigilanoe has to be adopted in preventing these deposits. At present a large amount is being shot on the Marshes, which, however, I look upon as likely to benefit the district, as it will assist in preventing the low lying land from being flooded. I think although complaints have been received concerning the deposits, that as the material has been levelled and in some instances sown with grass seed, there is not so great an objection to this as many persons think, although it is true that more care should have been used whilst the deposit was being made, in covering it immediately with an unobjectionable material. The road sweepings collected in our own roads are also chiefly shot in holes or on waste land in the district, and have required greater oversight even than the house refuse, as fish offal and other matters placed on the roads are sometimes 39 removed to the shoots. These deposits caused much work to the Sanitary Department, as the Inspectors have to visit the places frequently even when complaints are not made, and I have made several personal visits to almost every one of these localities, especially when they were near houses, as well as to heaps of burning ballast. As might have been expected in consequence of the long winter, the quantity of dust removed this year (March 25th, 1885, to March 25th, 1886,) has been larger than usual, 27,323 loads having been removed, against 24,836 loads in 1884-5. The cost has also increased in a larger ratio than the loads, as the Contract price per load for 1885-6, was 2/6 for the C Division, against 1/10 in 1884-5; 2/3 for the A Division against 1/9, and 2/- for the B Division against 1/10. The prices paid depend very much on the distance of the Division from which the dust is collected, to a shoot. The B Division adjoining the Marshes and other shoots, the sum paid per load is the smallest, but the low price was partly the result of a second tender, the first having been considered to be too high. The total cost for the removal of the dust and other house refuse was as follows, viz.:—£3053 2s. 0d. paid to the Contractors, £747 paid to the men employed by the Board at the rate of 15/- per week each, for assisting the Contractors in removing it from the houses to the carts, and £104 for the salary of the Dust Inspector, The Contractors are paid the prices named for each load of 60 cubic feet removed from the houses, and for the use of the carts, horses and implements, as well as for one man to each cart, who assists in the removal of the refuse to the cart, and who has sole charge of the cart, horse and implements. The driver and the Board's men are under the immediate control of the Dust Inspector, who sees that the carts go through every street in the District once a week, in accordance with the rota which I have laid down, and also that as many carts, &c., are provided under the contract as are required under my weekly orders. These orders are forwarded every week to 40 the Contractors, so that there is usually but little difficulty in getting the work well carried out. The chief difficulty arises from the shoots, as I will not sanction any which are likely to be injurious, so that each time a new contract is entered into, the greater is the difficulty experienced by the Contractors in procuring shoots. The number of requests to remove the dust was not large, viz., 1238, especially as it is the custom of many people to have the dust removed only after they have given notice here of their desire to have it done. The complaints of non-removal after a request to have it done, are very few, and every one was especially enquired into, and in most cases ascertained to have arisen from some misconception, such as a request to men who did not remove it from that street. The number of nuisances abated during the year was very large, viz., 10,651, including 608 houses which were disinfected, and exclusive of the accumulations of house refuse removed after special inspection of the poorer districts, and on complaint. There were as many as 786 choked or defective drains cleansed, repaired, or reconstructed; 249 choked watercloset pans released, and in some instances new pans provided; 89 yards drained and paved; 1226 premises on which bell traps were removed and yard gully traps or other suitable and efficient traps provided ; 629 premises in which sinks were disconnected from the drains, and 241 where the stack-pipes, the heads of which were placed near to windows, were cut off; making a total of 3255 instances in which the means of drainage were improved. In addition, the yard paving was relaid partially or entirely, in 913 premises; new dust-bins were provided or the old bins repaired in 861 premises. The number of iron bins or large pails provided amongst these was not so large as could be wished, because the owners of small property, as a rule, object to them. In addition, there were 2314 houses repaired, and the dirty rooms whitewashed or cleansed, and 8 were provided with additional means of ventilation. The number of premises in which a water-supply apparatus to the closets was provided, 41 amounted to 356, which is smaller than in 1884, as the number in the District without this means of cleanliness is every year becoming less ; but the apparatus previously provided required repair in as many as 861 houses, chiefly those of the poor. Indeed, many of the poor have not yet been educated up to the point of taking proper care in the use of flushing boxes, which are in many instances damaged almost as soon as put up. Another useful measure has been carried out rather extensively, namely, the provision of a means of drawing water direct from the main for household purposes, by a length of pipe fitted with a screw-down tap and connected with the main pipe supplying the cistern. I may say here, that I am not an advocate for removing water cisterns from the houses, as the occupiers are in that case occasionally without water. The number of houses inspected under the provisions of the Sanitary Act, 1866, (including the Regulations,) and the Nuisances Removal Acts, was 5824, and of houses inspected on complaint, 1136, which with 608 houses visited for disinfection, gives a total of 7568 houses visited during the year. The number of nuisances discovered on inspection and without complaint, it will be observed, was more than five times as many as those attended to on complaint. As many visits were paid to most of these before the nuisances were abated, the figures show that the inspectors were fully occupied. In addition to these, 99 cowsheds and 43 slaughter-houses were frequently visited; 210 greengrocers', fishmongers' and poulterers' yards were examined, many more than once, and 135 bakehouses inspeoted by Mr. Sortwell, in addition to attending to the complaints. There were also 106 houses measured under the Lodging-house Regulations, and the overcrowding (very slight) abated. Although the cow-sheds were in fair order, yet it was necessary to issue 45 notices, either for cleansing, repair of paving, chiefly of the yards, and repair of dung pits; also to oppose the renewal of the licenses to 3, because the necessary works were not done by the first licensing day. A list of cow-sheds and slaughterhouses licensed, will be found in the appendix. 42 As regards the removal of nuisances in houses, it was found necessary in several eases, in consequence of the extent of the dilapidations, to give notice for the shutting up of the premises under the Nuisances Removal Acts, in the event of the requisite works not being carried out. The owners of the following premises preferred shutting up or pulling down the houses to repairing them, viz.:—two cottages at High Hill Ferry, know as Saxon Nook and Alfred Hut; Nos. 38, 40, 42, 44, 46 and 48, Duncan Street, which were half pulled down; Nos. 1 and 2, Lawrence's Cottages, Sanford Lane; Nos. 1, 1a, 2, 3, 5 and 6, Wellington Street; 6 houses in Johns Place Well Street; and Nos. 157, 159, 161, 163, 165, 167, 169, 171, 173, 183 and 185, High Street, Homerton. In addition to these, I gave notice under the Artisans and Labourers Dwellings Acts, 1868, that three houses in High Street, Homerton, were in such a condition as to be unfit for human habitation. This report was referred to the Surveyor, who made his report to the Board, shewing how the premises might be made fit for human habitation. Part of the work had been done before the Surveyor reported, and the rest was speedily carried out in two houses after the Board had made the necessary order, and the other was closed. By the Housing of the Working Classes Act, passed on August 14th, 1885, it is enacted by section 4,— " That the owner of any premises who is required by an order " of a local authority made under the Artisans and Labourers " Dwellings Act, 1868, to execute any works or to demolish any " premises, shall cease to have the power to require the local " authority to purchase such premises." This section repeats ss. 3 and 4, of the 42nd and 43rd Vict., cap. 64, and leaves the Board in relation to the various Artisans Dwellings Acts, in the same position as before the passing of the last-named Act. These Acts are, in my opinion, to a certain extent, a premium to owners who allow their houses to become uninhabitable, and was therefore, not adopted by me for closing the other houses above-mentioned. 43 In addition to my other work, I have attended 20 Board Meetings, 28 Sanitary Committee Meetings, 7 View Committee Meetings, and 13 Special Committee Meetings, including those on the Dust Regulations, Lodging-house Regulations, the River Lea, &c. I have nothing to add respecting these Meetings, as the reports brought up by the Sanitary Committee and myself to meetings of the Board, have already made you acquainted with the results,—except to state that 1354 orders for the removal of nuisances were issued by the Committee during the year. The work done in connection with the River Lea, which occupied a large amount of my time, especially in the summer months, has already been referred to in another part of this report. I trust that the efforts made by the Board and the Committee, will lead not only to the purification of the Lea, but also of many other rivers which are most injuriously affected by the drainage carried into them. As large trade interests, as well as the facilities of drainage by local sanitary authorities are concerned in a general bill for the purification of rivers, the great time occupied hitherto in the effort to pass a satisfactory measure, cannot be any matter for surprise. Temperatures at Hackney, 1885. Highest. Lowest. Mean Temperature. Gain in Inches. January 51.8 22.6 36.1 1.8 February 57.6 27.8 43.8 2.6 March 60.8 26.2 40.3 1.8 April 72.6 29.4 47.6 2. May 7.4 31.8 49.9 2.3 June 84.6 40.4 59.0 1.6 July 91.8 47.6 61.7 0.5 August 79.0 43.2 50.5 0.7 September 76.4 32.8 55.2 4.44 October 60 4 32, 46.3 3.24 November 59.6 29, 43.4 3.07 December 51.8 24, 38.9 0.89 Total 2537 44 This table shows the highest and lowest temperatures, the mean temperature, and the rainfall for each month. They do not differ materially from those recorded at Greenwich, and I therefore adopt the Greenwich temperatures, rather than these, for comparison with former years. It will, however, be noticed that a very high temperature, viz., 91.8 degrees, was recorded in July, and a rather low temperature in January, viz., 22.6, giving the large range of 692 degrees in the year. The mean temperature of August, viz., 58.5, and the highest, viz., 79.0, were very low as compared with that of 1884, so that the mortality from diarrhoea in that month was comparatively small, 122 deaths from this cause having been registered, against 190 in 1884. The temperature in January, March and December, was generally low, especially in January, when it was only 36.1 against 440 in 1884, and 38.9 in December, against 414 in 1884. The mortality from inflammatory diseases of the lungs was high this year, viz., 756 against 603 in 1884, so that the balance of deaths due to the temperature was large in 1885, and yet the annual death rate was 0.6 per 1000 population below that of 1884, chiefly in consequence of the diminished mortality from small-pox, whooping cough, and scarlet fever. The number of deaths from measles was, however, very large, viz., 168 against 55 in 1884, but this unusual mortality was not only due to its prevalence, but also in part to the cold weather from the inflammatory affections of the lungs, to which the mortality of measles is attributable. There was very little sunshine in January, with a spell of cold between the 12th and 26th, and variable as regards temperature during the rest of the month. At Greenwich (from which alone the differences from the mean are given,) the temperature was — 139 deg. Fahr., as compared with the average for the 44 preceding years. In February, the temperature was + 4.3, having been in excess on almost every day of the month. In March, the opposite obtained, as the mean temperature was — 1.4, having been below the mean with the exception of the three or four days. In April, the 45 mean temperature was + 0.7, in May — 2.8, and in June + 0.6; snow fell on four days in April, on six days in May during the first ten days, when the temperature was always in deficit, and the rainfall in excess. In July, the weather was unusually warm on most days, but as a few days were unusually cold, the mean temperature was as + 0.3 Fahr. In August it was as much as 31 degrees below the average, and in September 1.5 in deficit; the rain in July and August was 3.10 inches below the average. October and the early part of November were cold, the temperature in October having been 4.0 degrees below the mean, whilst for November as a whole, it was + 0.7, the mean temperature from the 25th to December 4th, having been as much as 4.6 degrees in excess. From December 8th to 12th, inclusive, the cold was very unusual, as the mean temperature was minus 11.5 deg., 11.2 deg., 11.4 deg., 13.5 deg., and + 7.3 deg., respectively, the lowest temperature at Greenwich having been 233 deg., and at Hackney, 24.0, and the highest on these days but little above freezing point. I remain, Gentlemen, Yours obediently, JOHN W. TRIPE, M.D., Medical Officer of Health for the Hackney District. April 14 th, 1886. Ordered to be printed and circulated in the usual manner, WM. LA WE GANE, Chairman. April 14th, 1886, 46 Streets and other Places Inspected in 1885 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 Abbott street 21 82 25 121 20 2 .. .. .. .. Abney gardens .. .. .. .. .. .. .. .. .. .. Acton street ii 49 15 60 10 .. .. .. .. .. Ada street 40 160 64 275 26 .. .. .. .. .. Albert grove 3 15 3 17 3 .. .. .. .. .. Albert street 18 72 26 124 10 .. .. .. .. .. Aldham place 9 52 15 63 7 .. .. .. .. .. Amherst terrace 15 75 15 79 7 .. .. .. .. .. Anderson road 25 198 32 157 16 2 .. .. .. .. Andrews road 15 82 17 95 10 .. 12 .. .. .. Antwerp street 25 100 40 189 15 .. .. .. .. .. Arthur street 38 162 58 251 19 .. .. .. .. .. Ash grove 2 .. .. .. .. 2 .. .. .. .. Aspland grove 46 264 68 209 43 1 .. .. .. .. Assembly row 7 28 7 39 7 .. .. .. .. .. Austin building 8 20 8 25 2 .. .. .. .. .. Ballance road 1 .. .. .. 1 .. .. .. 1 .. Balcorne street 79 361 117 450 54 3 .. .. .. .. Ball's buildings 16 82 19 84 3 .. .. .. .. .. Barn street 21 76 23 119 19 .. .. .. .. .. Bartrip street 2 .. .. .. 2 1 .. .. .. .. Bath row 13 90 28 117 4 .. .. .. .. .. Baileys lane 9 34 11 62 5 1 .. .. 1 .. Bay street 32 146 46 201 13 1 1 .. .. .. Baxter's court .. .. .. .. .. .. .. .. .. .. Bentley road 17 75 29 123 17 .. .. .. .. .. Bentham road 2 •. , , ., 2 1 .. 2 .. .. Benn street, H.W 32 184 49 240 32 1 .. .. .. .. Berger road 47 231 60 312 32 .. .. .. .. .. Betteswortb terrace 4 28 7 33 4 .. .. .. .. .. Blackshaw place .. .. .. .. .. .. .. .. .. .. ..Blackstone road 43 280 104 415 26 .. 1 .. .. .. Blanchard street 11 77 22 115 6 .. .. .. .. .. Blanchard road 34 224 70 291 16 .. .. .. .. .. Bloomfield street 67 413 121 371 38 .. .. .. 1 .. Bohemia place 1 .. .. .. 1 1 .. .. .. .. Boleyn road 31 168 37 203 15 1 .. .. .. .. Boreham street 16 68 24 102 7 2 .. .. .. .. Bowling Green street 32 109 35 168 23 .. .. .. .. .. Bowling Green place 7 32 11 46 5 .. .. .. .. .. Bower road 24 132 30 155 18 1 .. .. .. .. Bradbury street 19 112 28 147 10 1 .. .. .. .. Bridge street 23 106 25 124 11 .. .. .. .. .. Brooksby's walk 56 316 72 311 24 4 .. .. .. .. Borwn's place 26 120 36 166 13 .. .. .. .. .. Brunswick street 51 224 108 313 37 3 .. .. .. .. Bushberry road, H. W. 1 6 2 11 1 1 .. .. .. .. Coach yard, S. N. 4 12 11 18 4 3 .. .. .. .. Carried forward 1006 6065 1617 6421 638 32 14 2 4 .. 47 Streets and other Places Inspected in 1885. 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 Brought forward 1006 6065 1517 6421 638 32 14 2 4 .. Cambridge cottages .. .. .. .. .. .. .. .. .. .. Caroline cottages 16 .. .. .. 16 .. .. .. .. .. Caroline place 13 62 15 73 3 .. .. .. .. .. Carolino street, Clapton .. .. .. .. .. .. .. .. .. .. Cassland road 4 24 6 28 4 1 3 .. .. .. Ciisterton street 1 .. .. .. 1 1 .. .. .. .. Castle street 28 148 63 224 16 1 .. .. .. .. Chalgrove road 90 454 119 685 63 13 .. .. .. .. Chapel court 6 10 6 19 0 .. .. .. .. .. Chapel road, S. II. 1 .. .. .. 1 1 .. .. .. .. Chapman road 11 63 12 50 11 .. .. .. .. .. Charles street 2 8 3 14 .. .. .. .. .. .. Chatswcrth road 144 1045 166 811 139 4 .. 1 1 .. Chippendale road 3 18 6 21 3 .. .. .. .. .. Church road, Homerton 6 26 8 43 4 3 .. .. .. .. Church road, W.H. .. .. .. .. .. .. .. .. .. .. Church terrace 12 48 20 93 5 1 .. .. .. .. Churchyard, Hackney 1 .. .. .. .. .. 1 .. .. .. Churchill road 3 18 6 22 2 3 .. .. .. .. Clarence road 1 6 2 11 1 1 .. .. .. .. Clevedon street 17 102 32 136 2 .. .. .. .. .. Clifden road 86 516 117 594 81 11 4.. .. .. .. College lane 9 36 14 63 2 1 .. .. .. .. College place 14 58 19 109 9 .. .. .. .. .. College street 60 214 61 270 42 1 3 .. .. .. Cooper sale road .. .. .. .. .. .. .. .. .. .. Conduit street and place 2 8 2 7 1 .. 1 .. .. .. Cottage place 11 20 11 30 4 .. .. .. .. .. Cowday street 16 90 29 117 14 .. .. .. .. .. Cross street, Homerton 11 48 14 57 8 1 .. .. .. .. Cross street, S.H. 19 92 31 134 15 4 .. .. .. .. Crozier terrace 64 308 95 601 40 2 .. .. .. .. Culford road 4 21 6 24 4 1 3 .. 1 Dalston lane .. .. .. .. .. .. .. .. .. .. Daintry street 18 84 18 99 18 .. .. .. .. .. Dagmar road 1 6 1 6 1 1 .. .. .. .. Davis' cottages 6 15 5 19 3 .. .. .. .. .. De Beauvoir road 2 8 2 13 2 2 .. 1 .. .. De Beauvoir square 2 16 2 16 2 1 2 .. .. .. Derby road 1 6 2 11 1 1 .. .. .. .. Digby road 86 404 113 538 74 4 .. .. .. .. Downham road 6 32 8 41 3 2 4 .. .. .. Dunn street 39 140 47 233 29 .. .. .. .. .. Duncan street 49 170 74 382 45 1 .. .. .. .. Duncan terrace 1 4 2 9 1 .. .. .. .. .. Carried forward 1869 9382 2660 11871 1313 94 35 4 6 .. 48 Streets and other Places Inspected in 1885 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 Brought forward 1869 9382 2660 11871 1313 94 35 4 6 .. Duncan square & road 81 326 112 571 61 6 2 .. .. .. Dunlace road 89 464 113 567 67 9 2 .. .. .. Durham grove 9 36 9 48 9 .. .. .. .. .. Dyssel street 20 120 35 175 16 .. .. .. .. .. Eaton place 56 247 88 332 29 3 .. .. 1 .. Edwards lane 23 113 33 105 11 .. .. .. .. .. Elderfield road 7 42 7 37 7 4 4 .. .. .. Elgin street 58 346 121 531 56 1 .. .. .. .. Eleanor road 3 .. .. .. 2 1 1 .. .. .. Elsdale road 1 .. .. .. 1 1 .. .. .. .. Essex Btreet 46 270 66 306 27 1 .. .. .. .. Exmouth place 21 81 29 104 16 .. .. .. .. .. Fairfield road 19 106 23 97 19 .. .. .. .. .. Fairey street 13 52 19 78 9 .. .. .. .. .. Falcon court and place 11 41 11 39 4 .. .. .. .. .. Felstead street 36 208 46 231 31 6 .. .. .. .. Fenn street 9 44 15 62 7 1 .. .. .. .. Fishers place 9 38 9 43 5 2 .. .. .. .. Florefield road 2 12 3 16 2 2 .. 1 .. .. Fords buildings 5 45 15 77 2 1 .. .. .. .. Frederick place, Hag.. 4 18 7 31 3 .. .. .. .. .. Fulham place .. .. .. .. .. .. .. .. .. .. Gainsboro' cottages 39 234 63 272 16 1 .. .. .. .. Gainsboro' road 29 194 46 203 27 1 .. .. .. .. Gainsboro' square .. .. .. .. .. .. .. .. .. .. George place, S. Hill 8 32 8 36 8 .. .. .. .. .. Gillett street 22 132 36 216 16 .. .. .. .. .. Gibsons buildings 1 20 5 37 1 .. 1 .. .. .. Glenarm road 75 .. .. .. 63 7 .. 1 .. .. Glynn road 16 .. .. .. 16 15 2 .. 1 .. Goring street 43 172 77 382 40 .. .. .. .. .. Green lanes 2 13 2 15 2 1 .. 2 .. .. Grove, Homerton 31 124 36 162 23 1 .. .. .. .. Grove lane, Hackney 1 4 1 6 1 .. .. .. 1 .. Grove lane, S. Hill 3 13 3 15 3 .. .. .. 1 .. Grove road, S. Hill 1 4 1 6 1 1 .. .. .. .. Grove passage and place, Hackney .. .. .. .. .. .. .. .. .. .. Haggerston road 32 161 48 226 21 .. .. .. .. .. Hamburg street .. .. .. .. .. .. .. .. .. .. Hartwell street 3 12 3 16 3 .. .. .. .. .. Hassett road, Homerton 4 .. .. .. 4 2 1 .. *8 .. Carried forward 2706 13106 3740 16963 1942 161 48 8 18 .. * Cases occurring in Convent. 49 Streets and other Places Inspected in 1885 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 Brought forward 2706 13106 3740 16963 1942 161 48 8 18 .. Havelock road 55 226 93 416 40 2 .. .. 1 .. Haywoods buildings 4 12 4 18 1 .. .. .. .. .. Hayes buildings 11 44 17 86 11 .. .. .. .. .. Hedgers grove 1 6 1 4 1 2 .. .. .. .. Helmsley street & place 28 112 40 176 9 1 .. .. .. .. Hertford road 1 .. .. .. 1 1 1 .. 1 .. Heslop place 8 39 9 44 4 .. .. .. .. .. *High hill ferry 2 .. .. .. 2 2 .. .. .. .. *High street, Homerton 26 106 29 146 26 4 .. .. .. .. High street, S. New 3 .. .. .. 3 3 2 .. .. .. Hill street 2 .. .. .. 2 2 .. .. .. .. Hindle street 34 158 63 231 25 .. .. .. .. .. Hockley street 23 92 23 122 16 .. 3 .. .. .. Holcroft road 29 174 61 190 10 .. .. .. .. .. Holmbrook street 65 258 99 404 47 6 .. .. 1 .. Holly street 2 12 2 27 2 2 .. .. .. .. Homer road 1 6 1 6 1 1 .. .. .. .. Homerton row 6 36 7 30 4 .. .. .. .. .. Homerton terrace .. .. .. .. .. .. .. .. .. .. Homfray street 28 168 42 243 24 1 .. .. .. .. Isabella road 10 75 13 68 2 .. .. .. .. .. Jacksons buildings .. .. .. .. .. .. .. .. .. .. Janes place 16 64 25 111 6 .. .. .. .. .. Jerusalem gardens 3 9 3 15 3 .. .. .. .. .. John street, Homerton 22 88 23 114 15 .. .. .. .. .. John street,Shacklewell 40 166 47 214 26 .. .. .. .. .. John street, S. New 1 .. .. .. 1 .. 1 .. .. .. Jolly Butcher's yard 4 16 4 19 3 Lamb lane 39 204 61 275 26 .. .. .. .. .. Landfield street 3 .. .. .. 2 2 .. 2 .. .. Lark row 1 .. .. .. 1 .. 1 .. .. .. Lauriston road 1 .. .. .. 1 1 .. .. .. .. Lawrence buildings 2 4 2 8 2 .. .. .. .. .. Lea Bridge road 3 .. .. .. 3 3 .. .. .. .. Lenthall road 2 .. .. .. 2 2 .. .. .. .. Lime grove 1 .. .. .. 1 4 .. .. .. .. London lane & terrace 1 .. .. .. 1 .. 1 .. .. .. Lockhurst street Priory 3 .. .. .. 3 3 .. .. .. .. Lordship road 1 .. .. .. 1 .. .. .. 1 .. McLaren street 4 .. .. .. 4 6 .. .. .. .. Mallard street 36 208 39 216 29 .. 1 .. .. .. Market row 4 16 6 31 1 •• .. .. .. .. Carried forward 3232 15405 4434 20176 2300 213 68 10 23 .. * Twice Inspected. 50 Streets and other Places Inspected in 1885. 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 Fever Brought forward 3232 1E405 4434 20176 2300 213 58 10 23 .. Mainwand street 4 22 4 16 3 1 .. .. .. .. Mandeville street 66 546 75 368 61 2 .. .. 3 .. Margaret street, S.H. 44 212 65 283 27 .. .. .. .. .. Margaret street 1 .. .. .. 1 1 .. .. .. .. Marian street 27 114 29 148 19 1 .. .. .. .. Marlow road 59 296 81 351 43 1 1 .. .. .. Mason's court and place 10 31 12 68 9 .. .. .. .. .. Matthias street 28 66 36 161 13 1 .. .. .. .. Mayfield road 124 720 161 811 114 1 2 1 1 .. Mead's place 23 64 26 105 19 .. .. .. .. .. Moadow street 12 62 17 47 7 .. .. .. .. .. Mehetable road 2 2 1 1 .. .. .. Middle street 5 20 8 43 5 .. .. .. .. .. Middleton road 19 114 26 114 6 .. .. .. .. .. Middlesex place & square .. .. .. .. .. .. .. .. .. .. Millington street 1 .. .. .. 1 .. 1 .. .. .. Morning lane 104 444 128 626 74 2 2 .. .. .. Montague road 68 272 68 346 60 4 .. .. .. .. Montague terrace& place 33 132 33 163 23 .. .. .. .. .. Myrtle street 24 160 30 137 20 .. 1 .. .. .. Nesbitt street 75 329 92 407 68 3 .. .. .. .. New street 9 63 22 96 7 .. 1 .. .. .. New Tyssen street 16 82 21 104 14 .. .. .. .. .. North street .. .. .. .. .. .. .. .. .. .. Northwold road 2 2 1 1 Nursery row and place 10 43 13 61 10 .. .. .. .. .. Orchard cottages 14 66 19 96 8 .. .. .. .. .. Orchard place 4 4 2 2 .. .. .. Osborn road 63 315 101 431 61 .. .. .. 1 .. Oswald road 6 .. .. .. 5 6 .. .. Ottaway street 2 .. .. .. 2 1 .. .. 1 .. Overberry street 4 •• •• •• 4 9 .. .. .. .. Palace road 71 284 114 498 56 1 .. .. .. .. Palatine road 3 18 3 17 3 .. .. 1 .. .. Paragon road .. .. .. .. .. .. .. .. .. .. Park place, Homerton .. .. .. .. .. .. .. .... .. .. Park street, S.N. 2 .. .. .. 2 ... . 1 1 .. .. Pear Tree place 2 6 2 7 2 Pedro street 54 306 69 332 45 12 5 .. .. .. Percy road, Well street 41 191 66 286 22 .. .. .. .. .. Plover street 1* 80 33 185 11 .. .. .. .. .. Carried forward 4279 20442 6787 26373 3113 262 75 13 31 .. 51 Streets and other Places Inspected in 1885 Number of Cases of Epidemic Diseases Name of Street or Koad Number of Houses Inspected Number of Rooms Number of Families Number of Inmates No. of houses in which nuiwances were found Small Pox Scarlatina Diphtheria Typhoid fever Typhus Brought forward 4279 20442 5787 26373 3113 262 75 13 31 .. Pemberton place .. .. .. .. .. .. .. .. .. .. Percy tcrrace 48 192 53 319 43 .. .. .. .. .. Pickles buildings 6 12 6 24 4 .. .. .. .. .. Pleasent places 4 16 6 29 2 .. .. .. .. .. Plough lane 6 29 11 41 4 1 .. .. .. .. Pond lane 1 .. .. .. 1 1 .. .. .. .. Prince Edward road 38 161 52 266 35 .. 1 .. .. .. Prouta road 3 .. .. .. 3 3 .. .. 1 .. Presburg street 1 .. .. .. 1 1 .. .. 1 .. Queen's court 7 14 7 35 3 .. .. .. 1 .. Railway crescent .. .. .. .. .. .. .. .. .. .. Red Lion lane .. .. .. .. .. .. .. .. .. .. Redwald road, Priory 6 .. .. .. 6 5 .. .. 2 .. Retreat place 3 .. .. .. 3 1 1 .. 1 .. Ridley road 4 12 4 15 4 .. .. 1 .. .. Rigby's buildings 3 6 3 10 2 .. .. .. .. .. Rochester place 6 13 6 19 2 .. .. .. .. .. Roseberry place 34 190 46 240 15 .. .. .. .. .. Rosina cottages 20 60 20 97 13 .. .. .. .. .. Rosina street 19 79 26 128 15 .. .. .. 1 .. Rossington street 1 •• .. •• 1 1 .. .. .. .. St. Johns place 14 37 14 59 10 .. .. .. .. .. St. Thomas cottages ,. .. ... .. .. .. .. .. .. .. Sanford lane 42 186 48 282 19 ... 5 .. .. .. Suxony cottages .. .. .. .. .. .. .. .. .. .. Sedgwick street 47 215 63 285 33 2 .. .. .. .. Sewdley street 3 12 3 9 3 .. .. .. .. .. Shacklewell row 36 144 45 291 21 2 .. .. .. .. Shepherd's place Shepherds lane .. 10 .. 57 .. 13 .. 62 .. 7 .. .. 1 .. .. .. Sheep lane 66 264 83 416 31 2 3 .. .. .. Silk Mill place and court .. .. .. .. .. .. .. .. .. .. Stamford hill 4 22 4 19 4 .. .. .. .. .. Stanboro' yard 2 6 2 7 1 .. .. .. .. .. Stannard road 10 .. .. .. 10 .. 2 .. .. .. Stelman street 1 .. .. ... 1 .. .. .. 1 .. Stockmar road 4 .. .. .. 4 3 .. .. 1 .. Stonebridge common 27 108 36 158 14 .. .. .. .. .. Sussex street 6 20 6 31 3 .. .. .. .. .. Suther street 1 .. . . .. 1 .. .. 1 .. .. Swiss cottages .. .. .. .. .. .. .. .. .. .. Carried forward 4761 22297 6344 29214 3432 284 88 15 40 .. 52 Streets and other Places Inspected in 1885 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 zmisances were found Small Pox Scarlatina Diphtheria Typhoid fever Typhus Brought forward 4761 22297 6344 29214 3432 284 88 15 40 .. Taylors buildings .. .. .. .. .. .. .. .. .. .. Templar road 6 .. .. .. 6 4 3 .. .. .. *Thomas street 19 61 21 105 11 3 .. .. .. .. Tottenham rd. & square 1 .. .. .. 1 1 .. .. .. .. Tranquil place 7 28 10 46 4 .. .. .. .. .. Trelawney road 1 .. .. .. 1 2 .. .. .. .. Triangle road 31 123 34 161 21 .. .. .. .. .. Tudor grove .. .. .. .. .. .. .. .. .. .. Tudor road 20 112 31 145 16 1 .. .. .. .. Tyrone court 4 10 5 21 4 .. .. .. .. .. Tyssen passage & place 18 72 29 107 12 3 .. .. .. .. Tysson street 26 94 33 149 17 2 .. .. .. .. Union street, W.H. 9 34 13 47 7 2 .. .. .. .. Urbane place 17 .. .. .. 2 .. 1 .. 1 .. Victoria grove 1 .. .. .. 1 .. .. 1 .. .. *Victoria road 36 202 60 241 34 2 .. .. .. .. Vyner street 1 .. .. .. 1 .. 1 .. .. .. Wallis road .. .. .. .. .. .. .. .. .. .. Warburton rd. & square 71 176 83 426 60 .. 1 .. .. .. Warburton street 6 24 11 67 5 .. .. .. .. .. Warwick villas 35 140 37 172 21 .. .. .. .. .. Watre lane 41 183 48 219 27 1 3 .. .. .. Wellington street 58 291 77 381 10 .. .. .. .. .. Well street 247 1372 289 1221 176 3 1 .. .. .. West street, Triangle 17 68 20 96 12 .. .. .. .. .. Western place .. .. .. .. .. .. .. .. .. .. Wetherell road 1 .. .. .. 1 .. .. .. .. .. Wharf road 13 60 25 117 6 .. .. .. .. .. White Hart court 6 12 6 20 2 .. .. .. .. .. White Post lane 1 .. .. .. 1 1 .. .. .. .. Whitmore road 2 .. .. .. 1 .. 1 .. 1 .. Wick road 9 .. .. .. 9 .. 1 .. 2 .. Williams cottages 1 .. .. .. 1 1 .. .. .. .. Wiliman grove .. .. .. .. .. .. .. .. .. .. Winchester place 4 20 6 31 4 .. .. .. .. .. *Windsor road 77 426 118 556 51 .. 3 .. .. .. Winslade road .. .. .. .. .. .. .. .. .. .. Woodland street 90 462 135 552 53 1 1 .. .. .. Woolpack place 14 56 14 71 8 .. .. .. .. .. York place 10 20 10 40 8 .. .. .. .. .. Carried forward 5661 26342 7459 34205 4026 317 104 16 49 .. *Twice Inspected. 53 SUPPLEMENTAL LIST OF STREETS IN WHICH MORE THAN TWO CASES OF SMALL-POX, &o., OCCURRED IN 1886. Name of Street or Road N umber of Houses Inspected Small-pox Scarlet Fever Diphtheria Typhoid Typhus Brought forward 5661 317 104 16 49 .. Abboteford terrace 1 1 .. .. .. .. Abershem road 1 .. .. 1 .. .. Albion road, Dalston 2 3 .. .. .. .. Alkham road 1 .. 1 .. .. .. Almack road 1 .. 1 .. .. .. Apreel street 3 1 3 .. .. .. April street 1 .. .. 1 .. .. Aspland grove 1 .. .. 1 .. .. Barratts grove 1 2 .. .. .. .. Bay ford street 1 .. .. 1 .. .. Benyon road 1 .. .. 2 .. .. Beecholme road 1 .. 3 .. .. .. Blurton road 2 3 2 .. .. .. Bouverie road 2 .. 1 .. .. .. Bodney road 1 1 .. .. .. .. Broadway, South Hackney 1 1 .. .. .. .. Brooke road 4 .. 2 1 .. .. Buckingham road 1 2 .. .. .. .. Burton crescent .. 1 .. .. .. .. Carlton road 2 2 .. .. .. .. Cazenove road 1 .. .. 3 .. .. Christie road 1 1 .. .. .. .. Church street, Stoke Newington 2 3 4 .. .. .. Clapton square 2 2 .. .. .. .. Clapton road 2 3 .. .. .. .. Colverstone crescent 2 3 .. .. .. .. Cross road, Downs 1 1 .. .. .. .. Dalston lane 4 7 1 .. .. .. Darnley road 1 .. 1 .. .. .. Devonshire road 1 .. 2 .. .. .. Dynevor road 1 1 .. .. .. .. Ellingfort road 1 .. 1 .. .. .. Evering road 2 .. 1 1 .. .. Enfield road 2 .. 2 .. .. .. Carried forward 5713 355 129 27 49 .. 54 SUPPLEMENTAL LIST OF STREETS, &c., 1885.—Continued. Street or Road Number of Houses Inspected Small-pox Scarlet Fever Diphtheria Typhoid Typhus Brought forward 513 355 129 27 49 .. Farleigh road 2 .. 2 .. .. .. Fortescue avenue 2 2 .. .. .. .. Frampton Park road 2 1 1 .. .. .. Forest road 1 1 .. .. .. .. Ferncliff road 1 .. .. .. 1 .. Foulden road 1 .. .. 1 .. .. German Hospital 1 2 4 .. .. .. Gilpin road 1 1 .. .. .. .. Greenwood road 1 2 .. .. .. .. Graham road 3 1 2 .. .. .. Groombridge road 1 .. 4 .. .. .. Gloucester road 1 .. .. 1 .. .. Harcombe road 2 1 .. 1 .. .. Hackney Union 1 4 1 .. 1 .. Hallidon street 2 3 .. .. .. .. Handly road 1 .. .. .. 2 .. Helmsley villas, London Fields 1 1 .. .. .. .. High street,Kingsland 1 1 .. .. .. .. Ivydene street 1 .. 1 .. .. .. Kenton road 2 2 .. .. .. .. Kenninghall road 1 .. 2 .. .. .. Kingsland road 4 4 1 .. 1 .. Kynaston avenue 1 2 .. .. .. .. Kyverdale road 1 .. 1 .. .. .. Kyverdale road .. .. .. .. .. .. Lnnsdowne road 1 1 .. .. .. .. Lavender grove 1 1 .. .. .. .. Loddiges road 1 3 .. .. .. .. Londesborough road 1 3 .. .. .. .. Lynscott road 1 1 .. .. .. .. Carried forward 5763 392 148 30 54 .. 55 SUPPLEMENTAL LIST OF STREETS, &c., 188Continued. Name of Street or road Number of Houses Inspected Small-pox Scarlet Fever Diphtheria Typhoid Typhus Broyght forward 5753 392 148 30 54 .. Mare street 6 4 1 1 .. .. Manor road, Stoke Newington 2 1 . . 2 .. .. Malvern road 1 .. 1 .. .. .. Median road 1 1 .. .. .. .. Middleton road 1 .. .. .. 1 .. Milton road 1 .. 1 .. .. .. Minson road 1 .. 1 .. .. .. Mortimer road 4 .. 7 2 .. .. Norfolk road 1 .. .. .. 1 .. Oakfield road 1 1 .. .. .. .. Oldfield road 1 .. .. .. 1 .. Olinda road 1 1 .. .. .. .. Osbaldeston road 1 1 .. .. .. .. Parkholme road 1 1 .. .. .. .. Powerscroft road 1 1 .. .. .. .. Poole road 2 1 1 .. .. .. Penshurst road 2 1 1 .. .. .. Pennoll road 1 .. l .. .. .. Quested buildings 1 1 .. .. .. .. Queen Elizabeth walk 2 .. 8 .. .. .. Queens road, Dalston 1 .. 3 .. .. .. Rendlesham road 1 .. 1 .. .. .. Richmond road 4 2 1 1 .. .. Rushmore road 6 6 2 •• 1 • • Sandringham road 2 1 .. 1 .. .. Seven Sisters road 4 1 3 .. .. .. Shakespeare road 1 1 .. .. .. .. Shellgroye road 1 1 .. .. .. .. Shore road 1 1 .. .. .. .. Shrubland grove 1 .. 5 .. .. .. Sidney road 1 5 .. .. .. .. Spurstowe road 1 1 .. .. .. .. Stoke Newington road 1 1 .. .. .. .. Shouthgate road 2 1 .. .. .. .. Sylvester road 2 1 1 .. .. .. St. Johns Church road 1 •• •• 1 .. .. Carried forward 5815 428 186 38 69 .. 56 SUPPLEMENTAL LIST OF STREETS, &c., 1885.—Cbntinuecl. Name of Street or Road Number of Houses Inspected Small -pox Scarlet Fever Diphtheria Typhoid Typhus Brought forward 5816 428 186 38 59 Tower street 1 •• 4 .. .. .. Ufton road 1 1 2 .. .. .. Urswick road 4 3 2 .. .. .. Victoria Park road 4 1 5 .. .. .. Walsingham road 1 1 .. .. 1 .. Winston road 1 .. .. 1 .. .. » Totals 5827 433 199 39 61 .. 57 TABLE OF DEATHS Of Inhabitants of the Hackney District between Jan. 1st. and Dec. 31st, 1885. 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. 66 to 75. 75 to 85. 85 and upward. Totals. Small pox. Vaccinated .. .. 2 8 7 6 2 .. .. .. .. 24 Unvaccinat'd 12 4 8 4 2 .. 2 .. .. .. .. 32 86 Vaccndoubtfl .. 2 10 3 7 4 3 .. 1 .. .. 30 Measles 22 133 12 1 .. .. .. .. .. .. .. 168 Scarlet Fever 3 17 9 .. .. .. .. .. .. .. .. 29 Typhus Fever .. .. 1 .. .. .. .. .. .. .. .. 1 Whooping Cough 33 51 1 .. .. .. .. .. .. .. .. 85 Diphtheria 1 29 16 .. 1 .. .. .. .. .. .. 47 Simple Fever .. 1 .. .. .. .. .. .. 1 .. .. 2 Enteric Fever 1 6 11 8 3 .. 2 4 2 .. 1 37 Other Miasmatic diseases .. .. .. .. .. .. .. .. .. .. .. .. Simple Cholera 2 .. .. .. .. .. .. .. .. 1 .. 3 Diarrhoea, Dysentery. 83 21 1 1 .. 2 .. 2 2 9 1 122 Ague,Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis, &c. 17 1 .. .. .. .. .. .. .. .. .. 18 Erysipelas 6 .. .. .. 2 1 1 4 2 i .. 17 Pyeemia, Pupereal Fever .. .. 1 3 8 3 .. .. 1 .. .. 16 631 Thrush, Vego Parasites 1 .. .. .. .. .. .. .. .. .. .. 1 11 Worms,Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 1 .. .. .. .. .. .. .. .. .. .. 1 Alcoholism .. .. .. .. 3 2 2 2 .. .. .. 9 Constitution ai Diseases. Rheumatio Fever .. .. 4 3 2 4 .. .. .. .. .. 13 Rheumatism .. .. .. 1 .. .. 2 .. 2 ] .. 6 Oout .. .. .. .. .. .. .. 2 3 l .. 6 Rickets .. 2 .. .. .. .. .. .. .. .. 2 Cancer .. 1 .. 1 10 .. 26 32 32 9 1 116 Tabes Mesenterica 41 16 5 2 .. .. .. .. .. .. .. 64 Tubercular Meningitis 26 34 3 2 .. .. 1 .. .. .. .. 66 Phthisis 6 7 6 40 80 68 58 20 10 3 .. 297 Scrofula, Tuberculosis 19 21 4 6 .. .. • • .. 1 .. .. 51 Purpura Haamoraga .. .. .. .. .. .. .. .. .. .. .. .. Anæmia, Leucocytha. .. 1 .. 1 .. .. .. .. 1 .. .. 3 Diabetes .. .. .. .. 1 1 6 4 1 .. .. 12 Other Constitutional Diseases 1 .. .. .. .. .. .. .. .. .. .. 1 637 Premature Birt 131 .. .. .. .. .. .. .. .. .. .. 131 Malformations 17 .. .. .. .. .. .. .. .. .. .. 17 297 Old Age .. .. .. .. .. .. .. 2 23 76 48 149 .. .. .. .. .. .. .. .. .. .. .. Carried forward.. 422 346 94 84 120 100 104 72 83 100 51 1576 1576 58 TABLE OF DEATHS .—Continued. TABLE OF DEATHS-Continued. AGES Under. 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 65 to 65. 65 to 75. 75 to 85. 85 and upward. Total. Brought forward.. 422 346 94 84 120 100 104 72 83 100 51 1576 1576 Nervous Diseases. Inflammation of Brain or Membranes 28 32 13 3 1 3 5 5 8 6 .. 104 Apoplexy, Hemiplegia 1 .. 3 4 9 9 18 40 51 31 6 172 Insanity, General Paralysis .. .. .. 1 2 6 4 4 12 15 .. 44 Epilepsy .. .. 3 3 3 3 3 3 2 .. .. 20 Convulsions 101 14 .. .. .. .. .. .. .. .. .. 115 Laryngismus Stridulus 11 10 .. .. .. .. .. .. .. .. .. 21 Diseases of Spinal Cord .. 2 1 2 3 2 1 2 .. 1 .. 14 Paraplegia .. .. 2 .. .. .. .. .. .. .. .. 2 OtherN ervous Diseases .. 2 2 1 2 3 1 2 1 2 .. 16 508 Diseases of Circulating Organs. Peri and Endo-Carditis .. 1 2 2 5 2 3 1 .. .. .. 16 Valvular Disease of Heart .. .. 2 2 4 1 3 .. 5 1 .. 18 OtherDiseases of Heart 1 1 7 14 9 20 22 38 58 25 2 137 Aneurism .. .. .. .. 1 3 1 .. .. .. .. 5 236 Respiratory Organs. Laryngitis .. 12 2 .. .. .. .. .. 2 .. .. 16 i Croun 4 30 5 .. .. .. .. .. .. .. .. 39 Asthma .. .. .. .. .. 1 3 3 7 2 .. 16 Bronchitis 102 80 9 1 .. 5 20 54 82 71 10 434 Pneumonia 33 63 8 6 14 17 12 20 23 6 .. 202 Pleurisy .. 5 1 3 6 6 4 10 2 .. .. 37 Other Respiratory Dis. .. .. .. 1 .. 5 2 2 2 .. .. 12 756 Diseases Digestive System. Dentition 16 16 .. .. .. .. .. .. .. .. .. 32 Quinsy, Sore Throat 3 2 2 .. .. .. .. .. 1 .. .. 8 Disease of Stomach 1 2 1 4 1 3 6 3 2 2 .. 26 „ of Bowels 1 1 .. .. .. .. .. 1 1 .. .. 4 Enteritis 10 3 .. 1 2 .. 1 .. 3 20 Obstruction of Intestines .. 1 1 2 .. 1 2 5 3 2 .. 17 Peritonitis 2 .. 2 10 4 1 2 2 .. 3 .. 26 Ascites .. .. .. .. .. .. .. .. .. 1 .. 1 Jaundice Liver 5 .. .. 2 2 8 12 12 17 10 .. 68 201 Diseases or Urinary System. Nephritis 1 1 1 2 1 .. 7 3 2 2 .. 20 Bright's Disease .. .. .. 3 5 5 12 14 17 4 .. 60 Other Kidney Diseases .. .. .. .. 1 4 3 3 1 .. .. 12 Bladder and Prostate .. .. .. .. .. 1 1 1 5 2 •• 10— 102 Carried forward.. 742 624 161 161 195 209 252 300 390 286 69 3379 3379 59 TABLE OF D E A T H S.-Continned. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 65 to 65. 65 to 75. 75 to 85. 85 and upward. Totals. Brought forward 742 624 161 151 195 209 252 300 390 286 69 3379 3379 Disease of Uterus .. .. .. .. .. .. 1 .. .. .. 1 2 Abortion, Flooding .. .. .. 1 7 10 .. .. .. .. .. 18 Pupereal Convulsions .. .. .. .. 2 2 1 .. .. .. .. 5 Ovarian Dropsy .. .. .. .. 1 1 1 3 2 1 .. 9 34 Bones and Joints, &c. Caries, Necrosis 1 .. 6 1 1 1 .. 1 1 .. .. 12 Arthritis, Ostitis .. 1 .. .. .. .. .. .. .. .. .. 1 Carbuncle, Phlegmon 1 .. .. .. .. .. .. .. .. .. .. 1 Other Skin Diseases 4 .. .. .. .. .. .. .. .. .. .. 4 18 vlolencb. Accidents & Violence 18 15 5 2 6 5 1 5 1 3 1 62 Homicide 2 .. 1 .. .. .. .. .. .. .. .. 3 Suicide .. .. .. .. 1 8 2 3 1 .. .. 15 80 Ill-defined Causes. Dropsy .. .. .. .. .. 1 .. .. 2 2 1 6 Debility and Atrophy 124 17 .. .. .. .. .. .. .. .. .. 141 Mortification 1 1 .. .. .. .. .. 1 4 6 .. 13 Tumour .. .. .. .. .. .. .. .. 1 .. .. 1 Abscess 3 .. 1 .. .. 1 2 .. .. .. .. 7 Hæmorrhage .. .. .. .. .. .. .. 1 1 .. .. 2 Sudden Deaths (doubtful) 1 .. .. .. .. .. .. .. .. .. .. 1 Causes not Specified .. .. .. .. .. .. .. .. .. .. .. .. 171 Totals 897 658 174 155 213 238 260 314 403 298 72 3682 3682 60 PREMISES INSPECTED DURING THE YEAR 1885. Number of Houses inspected under the Sanitary Act, 1866, and Nuisances Removal Acts 5824 „ „ Houses visited in which infectious diseases had appeared 608* „ „ Premises inspected from complaints received 1136 „ „ Cowsheds inspected—(premises) 65 —(sheds) 99 „ „ Slaughter-houses inspected 43 „ „ Greengrocers' yards inspected 147 „ „ Fishmongers' and Poulterers' yards inspected 63 „ „ Bake-houses inspected 135 „ „ Houses measured as well as inspected 106 „ „ Urinals inspected (twice) 91 „ „ Tripe and Gut Dressers removed 2 •There were 732 cases of various diseases in 608 premises, including 6 cases in Homerton Workhouse. NUMBER OF NUISANCES ABATED. IN THE FOLLOWING YEARS. In 1856 1567 In 1871 5180 1857 1789 1872 3099 1858 2515 1873 5406 1859 1224 1874 6110 1860 1267 1875 6262 1861 2481 1876 6445 1862 1235 1877 6257 1863 1996 1878 5912 1864 1410 1879 5468 1865 1512 1880 5720 1866 4260 1881 12055 1867 5811 1882 13753 1868 3923 1883 11054 1869 4354 1884 11837 1870 4240 1885 10651 61 Privy Cesspools emptied, filled up, and drained into the Sewer 5 Choked drains cleansed, repaired, or reconstructed 786 Number of Premises in whioh Choked Water-closet Pans were released 249 Number of Premises in which Yards were drained 89 Number of Premises in which new Traps were provided 1226 Number of Premises in which Sinks were disconnected from the drains 629 Number of Premises in which Stack Pipes were out off from drains 241 Total number of Nuisances from defeotive means of drainage abated - 3225 Number of Premises in which Yards were newly paved or the paving relaid 913 Number of Premises in which Dust Bins were provided, or old Dust Bins repaired 861 Number of Houses repaired, whitewashed, &o. 2314 Number of Houses in which the Ventilation has been improved 8 4096 7321 Number of Water-closets to which a supply of water has been given 356 Number of Houses supplied by Closet-cistern in which a Flushing-box was provided 84 Number of Houses supplied by butt only, and Cistern substituted 18 Number of Closets in which defective apparatus was repaired 861 Number of Screw-down Taps and lengths of Pipe provided to enable occupiers to draw water from the main of the house 263 Total number of Nuisances from defects in houses . 1582 Carried forward 8903 62 Brought forward 8903 Number of Houses disinfected 608 Number of cases of overcrowding abated 24 Number of Premises from which Pigs were removed 36 Number of Premises from which stable dung and other refuse were removed (excluding dust) 93 Number of filthy places cleansed 89 Number of other Nuisances removed (having no special heading) 898 1748 Total number of Nuisances abated in 1885 10651 Number of Accumulations of Dust specially removed 1238 „ „ Lodging Houses' Notices served 106 „ „ Notices for disinfecting premises 608 „ „ Preliminary Notices served 4816 „ „ Peremptory „ 851 Statutory „ „ 1354 Number of Letters sent out 1965 „ „ Persons summoned before a Magistrate 19 „ „ Copies of Summonses and Orders made out. . 114 „ „ Bodies deposited and taken to the Mortuary 69 „ „ Houses from which Bedding, &c., was removed to be Disinfected at the Board's apparatus 504 „ „ Articles Disinfected at the Board's apparatus „ „ Packets and Bottles of Disinfectants supplied 3553 to the Poor 5138 „ „ Fish condemned unfit for human food (pads) 37 * Many persons send requests here for removal of dust instead of placing the D cards in the window. All these, as well as complaints of non-removal, are included in the above. 63 LIST OF LICENSED COW-SHEDS IN THE HACKNEY DISTRICT. Name. Address. No. of Sheds Williams 6, Arthur Street, Hackney 1 Whitby, Mrs. 12, Bay Street, Dalston 2 Stevens Bridge Street, Homerton 1 James 46, Brooksby's Walk, Homerton 1 Jenkins 2, Buckingham Road 2 Britton 1, Chalgrove Road 1 Bansfield, R. C. Chapel Road 1 Harding & Co. 61, Church Road, Kingsland 1 Bailey, W. 72, Church Road, Homerton 1 Dalton, J. N. 1, Clifden Road 3 Richards 176, Culford Road 2 Frost Dalston Rise 2 Webb Devonshire Place 1 Abbott, C. 71, Digby Road 1 James, Mrs. 11, Downham Road 1 Jones 3, Elsdale Street f. Jones Enfield Road North 1 Motts 6, Florefield Road 1 Bowers 100, Frampton Park Road 1 Hughes 2, Gainsborough Road 2 Larter 1, Gloucester Road 2 Crane 17, Hertford Road 1 Rumball High Road, Clapton 4 Coxhall 41, High Street, Homerton 1 Jones, David 69, Holly Street 1 Cashford Jerusalem Square 4 Reynolds Landfield Road 2 Strong Lea Bridge 1 Dear Lea Bridge Road 1 64 Name. Address. No. of Sheds Wingrove London Lane 1 Stevens Marsh Farm, Temple Mills . 1 Low, M. W Manor Farm, Hackney Wick. 1 Warner 23, Mare Street 1 Bush Marsh Gate, Homerton 1 Low, E Marsh Hill, Homerton 1 Jones 2, Mayfield Road 1 Powell 14, Morning Lane 1 Stapleton, A. Brooklands, Stoke Newington 5 Matthews 1, Northwold Road, Clapton 1 Lewis 6, Palace Road, Hackney 1 Abbott 13, Paradise Place 1 Chandler 3, Park Place, Hackney 1 Horning Pond Lane, Hackney 4 Briggs, A. 65, Pritchard's Road 2 Camp 79, Shacklewell Lane 1 Clifton 33, Southgate Road 1 Sharp Spring Hill, Clapton 3 Webb Twemlow Terrace 1 Briggs, J. 180, Victoria Park Road 2 Dover 3, Warburton Road 1 Reynolds Water Lane 1 Brace 133, Well Street 1 Lillicrap (Oldacre and Haynes) 167, Well Street 2 Matthews Wellington Street 1 Fenton Wick Road 1 Evans 271, Wick Road 1 Roper 37, Wilton Road 1 Taylor 67, Downham Road 1 Snewin 3, Hill Street, Clapton 1 Bates, T. 46, Leswin Road 1 65 LIST OF LICENSED SLAUGHTER-HOUSES IN THE HACKNEY DISTRICT. Name. Address. Pattenden 235, Amherst Road Wildsmith Brookfield Road Raymond Cassland Road Teat 37, Church Road Woolven Clapton Road Abbott 16, Duncan Place Pope 3, Felix Place Sharman 90, Prampton Park Road Witherden 5, High Street, Homerton Snewin 3, Hill Street Fowler Hill Street Wragg 57, Holly Street Nixon 49, High Street, Kingsland Theobald 71, High Street, Kingsland Johnstone 323, Kingsland Road Scott 418, Kingsland Road Keyes 531, Kingsland Road Fish Lea Bridge Road Witherden Lower Clapton Tyler 80, Mare Street Churchill 142, Mare Street Hilton 177, Mare Street Gearey 266, Mare Street Shaw 296, Mare Street Jackson 312, Mare Street Capon Morning Lane Harold 119, Mortimer's Road Brock Plough Lane Dunford 200, Queen's Road Miall 211, Queen's Road 66 Name. Address. Murton 103, Rondlesham Road Browning 129, Tendlesham Road Nokes 53, Southgate Road Ebbells 94, Southgate Road Row 130, Stoke Newington Road May 220, Stoke Newington Road Stoneman 3, Terrace Road Hall Upper Clapton Tyler 92, Well Street Conway 113, Well Street Rolfe 169, Well Street Butcher 216, Well Street Parsons 241, Well Street Eaymond 51, Wilton Road