HAC10 Board of Works for the A Hackney District. REPORT on the SANITARY CONDITION of the HACKNEY DISTRICT, FOR THE YEAR, 1887, by JOHN W. TRIPE, M.D., Member of the Royal College of Physicians, Edin., &c.; Secretary and formerly President of the Meteorological Society; Vice-President of the Society of Medical Officers of Health; Corresponding Foreign Member of the Royal Society of Public Medicine of Belgium; Foreign Associated Member of the French Society of Hygiene, &c.; Medical Officer of Health and Public Analyst for the District. LONDON: A T. Roberts, Son & Co., Printers, 5, Hackney Road, E. 1888. INDEX. page Beds, number of, occupied in the Eastern (Homerton) Hospital 9 Birth and Death Rates, Annual 13 Births in the Sub-District of Hackney 31 Burial Ground, proposed new, Stoke Newington 39 Chemical Works and Offensive Businesses 39 Cow Sheds and Slaughter-houses 40 Death Rate 5 Deaths in each Sub-District, 1881-86 32 ,, Registered at different ages from all causes 29 ,, number of, at all ages 16 ,, Table of, including ages, Hackney District 60 ,, number of, from Zymotic Diseases 18 Diphtheria, cases of 25 Articles Disinfected, 1887 Disinfection „ „ 1882-87 ) 33 Dust Removal 44 Fairs 38 General Statistics, Sanitary 65 Meteorology 46 Mortuary, bodies deposited in 34 Nuisances abated, number of 63 ,, ,, statistics of 64 Population—Marriages, Births, and Deaths of 11 Premises Inspected 63 Refuse Shoots 37 Re-vaccination 25 River Lee 34 Sanitary Inspection 40 Scarlet Fever, cases of 21 ,, Mean Annual Mortality from 22 ,, Mortality, cases of, at different ages 23 ,, Houses Inspected in consequence of 7 Small-Pox, detail of cases of 56 ,, and Fever Patients, Regulations for Removal of (Metropolitan Asylums Board) 27 Streets and other Places Inspected 51 „ Supplemental List of 56 Typhoid or Enttric Fever, cases of 26 Water Supply 38 THIRTY-SECOND ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, BEING FOR THE Year 1887. To the Board of Works for the Hackney District. Gentlemen, It is with much satisfaction that I have to report for this year the lowest death-rate that has occurred since my. appointment in 1856, viz., 16.6 per 1000 inhabitants against 18 6 for all London. I have calculated the population to have been 226,000 in July 1st, 1887, which is a smaller number than the ordinary progressive rate for 1871-80 would have given. It is therefore most probable that I have not overestimated the population or under-calculated the death-rate, and that these figures are nearly accurate. As the number of the population can be ascertained accurately only once in ten years, I have checked off the estimated number by the assessments in the rate books of both Hackney and Stoke Newington (the latter kindly supplied to me by Mr. Webb), in 1881 and in 1887, and by the number of births. The former multiplied by the number of persons to an assessment in 1881 gives a higher number, whilst the births, after 6 allowing for the proportionate decrease in all London, give a lower number, and I have therefore taken the mean between these and that of the progressive rate of increase. As we have had an unusually large mortality from diarrhoea, and an epidemic of scarlet fever, this low death-rate is very satisfactory. The deaths from scarlet fever have been much below the average of the preceding ten years, as they were only 55 against the decennial mean of 83. This result has arisen chiefly from the extreme mildness of the disease, as more cases were reported to me this year than in 1886 or in 1882; the two last years when it was epidemic. In 1882, when I received reports of 287 infected houses, the number of deaths was 144, and 118 in 1881 ; whilst in 1886 there were 283 infected houses reported and 70 deaths, against 293 infected houses in 1887, and only 55 deaths. An examination of the death returns showed that there were comparatively few complications, such as kidney disease, in 1886 and 1887 as compared with former epidemics. The number of cases in a house amongst those who had not been previously attacked, so far as I could learn, was not less than in former epidemics, so that there did not appear to be any relation between the diminished mortality and the intensity of infectiveness. In my last report I discussed at some length the important question of the influence of the hospital in the spread of the disease in this district, and arrived at the conclusion that the evidence up to that time showed that, unlike smallpox, there was not such an aggregation of cases in the vicinity of the hospital as to lead to the belief that the disease was spread from it by aerial infection, and that, therefore if the hospital had exerted any injurious effect, it must have been by personal rather than by aerial infection. I have this year followed out the same plan of ascertaining the precise locality of each infected house, and showing it on a map, plotting down only one case for each house, with results somewhat intermadiate between those obtained by the discussion of the cases in the years 1832 and those of 1886. 7 TABLE I. Number and percentages of houses infected by Scarlet Fever, in different radii, the Hospital being taken as a centre, in 1882, 1886, and 1887. Radii. Number of houses infected. Percentages of houses infected to total cases. Mean No. of houses infected to total cases. Percent ages of houses in radii. 1882 1886 1887 1882 1886 1887 1882-6-7 1884 Quarter mile 18 44 39 6'3 15.5 13.3 11.7 6.1 Between ¼ & ½-mile 35 112 67 12.2 39.6 22.9 24.9 15.0 Totals within ½mile 53 156 106 18.5 55.l 36.2 36.6 21.1 Between ½ & 3/4-mile 36 35 35 — — — — — Between 3/4 & 1-mile 49 31 42 — — — — — Totals between ½ & 1 -mile 85 66 77 29.6 23.4 26.3 26.4 31.5 Outside one mile radius 149 61 110 51.9 21.5 37.5 37.0 47.4 Totals 287 283 293 100 100 100.0 100.0 100 A comparison between the number of houses in the different radii, and the cases during the years 1882, 1886, and 1887 taken altogether,the hospital being the centre,affords good ground for the conclusion that the hospital has been prejudicial in causing an increase of the disease in its vicinity. The reasons are, that although in 1882 there were only 6.3 per cent. of all the houses known to have been infected in the district, against 6.1 of total houses in the quarter-mile radius, yet in 1886 and 1887 there were 15.5 and 13.5 per cent. of infected houses amongst all the houses in which these cases occurred. That between the quarter and half-mile radii, which contain 15 per 8 cent. of all the houses in the district, 12.2 per cent. were infected in 1882, 39.6 per cent. in 1886, and 22.9 per cent. in 1887, making, with those in the quarter-mile radius, totals of 18.5, 55.1, and 36.2 respectively in the different years within the half-mile radius. The mean of the infected houses in the half-mile radius was 36.6 whilst the percentage of houses to all the houses was only 21.1 per cent. Between the half and onemile radii there were 31.5 per cent. of all the houses, whilst the percentages of infected houses were as follows : in 1882, 29.6 per cent. ; in 1886, 23.4 per cent.; and in 1887, 26.3 per cent., the mean number of infected houses being 26.4 per cent. amongst 31.5 per cent. of all the houses. Outside the mile radius there were 47.4 per cent. of all the houses in the district, whilst the percentages of infected houses were as follows : 51.9 per cent. in 1882 ; 21.5 per cent. in 1886 ; 37.5 per cent. in 1887, giving a mean of 37.0 per cent. houses infected in the 47.4 per cent. of all the houses in the district. If the density and the social status of the population, the means of isolation for infected cases, and the possession of wealth were the same all over the district, and returns of cases were furnished to me in equal proportions, these results would be conclusive against the hospital. The various parts of the district are, however, occupied by persons differing in all these respects, as a majority of those who reside within the quarter-mile radius are comparatively poor. It is therefore evident that the chances of the spreading of the disease are much greater here than elsewhere, except in other localities occupied by the poor, where in most instances local outbreaks have occurred. Again, as nearly all the cases are removed to the hospital from the houses of the poor, and I receive intimation of these removals, whilst I do not receive information of the existence of the disease in more than a small proportion of the houses of the more wealthy classes, the comparison and conclusions are open to grave objections. As regards small-pox the proportion of cases reported to total cases is much greater than for scarlet fever, as the former diseaes 9 excites greater aversion than the other, and is much more feared Besides, there are many more requests made for disinfection proportionally for small-pox than for scarlet fever. The streets and groups of houses in which scarlet fever prevailed outside the half-mile radius in each of the three epidemic years, were those occupied by the poorer classes, as at Hackney Wick; in the streets between the south end of the London Fields and the southern boundary of the Parish; in Blanchard Road and Street, &c.; and in the poorer streets of Shacklewell; and in the vicinity of Rossington Street. Within-the quartermile radius, the streets to the south and west of the hospital; and in the streets situated within the quarter and half-mile radii, those between Berger and Wick Roads, as well as Chalgrove Road were severely affected in 1886, but scarcely at all in 1882 and 1886. The figures also show that the disease was much more uniformly distributed over the district in 1887 than in 1882 and 1886. The large number of deaths in good class houses, compared with " cases " in these and smaller houses, shows that a considerable number of cases in the better class houses were not reported to me, and that therefore the comparison is by no means reliable, although it is the best I can make. The number of beds occupied at one time in the hospital in these years is shown in the following table. TABLE II. No. of Beds occupied in the Eastern (Homerton) Hospital in the Years 1882, 1886, 1887. 1882. No. of Beds occup'd 1886. No. of Beds occup'd 1887. No. of Beds occup'd September 29 172 October 8 190 October 6 306 October 13 193 „ 22 227 „ 24 401 „ 27 189 November 5 237 November 3 444 November 10 209 19 256 „ 17 426 25 177 December 2 253 December 3 399 December 8 145 „ 261 „17 380 10 The number of cases under treatment at one time in the Hospital was greater in 1886, and especially in 1887, than in 1882, and the number of houses infected in the two first-named years, viz.:—in 1886 and in 1887 was greater than in 1882 within both the quarter and half-mile radii, but the number of houses infected within these radii was about 30 per cent. fewer in 1887 than in 1886, although the number of cases treated in the Hospital was much larger in 1887 than in 1886. Of course it is possible that the outbreak in these streets in 1886 used up most of those who were liable to the disease, leaving but a comparatively small number capable of infection in 1887. It is evident, however, that the inquiry must be extended over a longer period in this and in other districts before a definite conclusion can be arrived at. It also shows that the cases should as far as possible be equally distributed over all the Metropolitan Asylums Board's Hospitals, instead of being concentrated to a great extent in one. A discussion of other points connected with the disease will be found further on. The number of cases removed from the districts and parishes in the north side of London to the various Asylums Board's Hospitals during the year 1887, varied very greatly, the largest numbers having been removed from Holborn, Islington, and Hackney. The numbers are as follows: from Holborn, 387; from Islington, 304; from Hackney, 289 from Shoreditch, 223 ; from Bethnal Green, 198 ; from Whitechapel, 149; from Poplar, 111 ; from Mile End Old Town, 105; and from the other parishes, less than 100 cases. There were 3 small-pox cases removed from Hackney, 5 from Poplar, 2 from St. Greorge's-in-the-East, and 1 from Bethnal Green. The other oases were of Scarlet or Enteric Fever. 11 TABLE III. Showing the Population, Marriages, Births, Deaths, and Density of Population per Acre for the Year 1887 and Ten Years preceding. Corrected Gross Numbers. The Year. Estimated Population Marriages Registered Births Corrected Number or Deaths. Density of Population per Acre. Total all Ages. Under One Year. Under Five Years. 1887 226,000 1466 6715 3751 912 1577 55.3 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 1885 210,600 1496 6585 3682 897 1555 53.5 1886 217,600 1466 6666 3693 954 1544 55.3 Means for the 10 years 1877—86. ) 190,238 1463 6346 3483 845 1451 48.3 *Registered in 53 weeks. 1871 1881. Population at Census 124,951 186,400 No. of Inhabited Houses at Census 19,347 27,503 No. of Persons on an average in each Inhabited House at do. 6.46 6.78 Total No. of Acres 3,935 3,935 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 Hacknev 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 nonresidents that have been registered in the District. 12 The population assigned to the District n Table III. has been calculated on the number of assessments in 1887 as compared with 1881, with oertain other compensations as previously mentioned. The death-rate has been calculated on a population estimated at 226,000, with 3,751 deaths, which latter, as mentioned in the footnote, has been arrived at by the help of the returns supplied to the Board, and obtained from Somerset House. These returns are of great value, otherwise the deaths in extraneous hospitals and institutions must have been calculated from the totals for all London, and therefore of doubtful value. The deaths include all registered from the 1st of Jan. to the 31st of December inclusive, but the births are for 52 weeks, and cannot be obtained otherwise than in weekly numbers. It will be noticed that the density of population is steadily increasing, having been only 40.7 persons to an acre in 1877 against 55.3 in 1887. Now, as increased density of population is an important factor in the death-rate, it is very satisfactory that the death-rate, as shown in Table IV., has been steadily diminishing since 1881, until it has reached the lowest point attained since my appointment in 1856, instead of having considerably increased, as might have been expected, with the increased density of population. Twenty years ago—i.e., in 1867 —the density of population was only 27.3 persons per acre, or less than half that existing at the present time, and the deathrate was 20.6 against 16.6 for 1887, a most astonishing difference, as there was not a larger proportion of deaths from zymotic diseases in 1867 than in 1887. The table also shows that the number of marriages is absolutely fewer than in 1877, and that the number of births has not increased in proportion to the population during these eleven years. 13 TABLE IV. Hackney District.—Showing the Annual Birth and Death Rates, and Death Rates of Children in a Thousand Deaths for the Year 1886, and ten Years preceeding. In Year. Birth Rate per 1000 of the Population. Birth Rate per 1000 of the Population. Corrected Death Kate 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. England Hackney Hackney London. Hackney London. Hackney Hackney 1887 31.3 29.7 16.6 19.6 136 159 243 420 1877 34.4 34.7 19.3 21.9 136 146 244 392 1878 34.0 35.6 20.2 23.5 144 164 226 480 1879 33.3 36.0 18.8 23.1 122 148 233 395 1880 32.7 35.1 18.3 22.2 142 158 273 477 1881 32.5 33.9 19.2 21.2 130 148 230 424 1882 32.2 32.9 17.9 21.4 119 162 219 414 1883 31.8 32.3 17.6 20.4 125 146 230 396 1884 32.1 30.8 18.0 20.3 124 168 238 408 1885 31.3 30.9 17.6 19.7 137 148 246 422 1886 31.3 30.4 17.0 19.9 143 159 258 418 Average of 10 years, 1877.86 | 32.6 33.3 18.4 21.4 132 165 240 423 MEANS. 1871—80 34.7 19.6 22.6 142 158 247 392 1861—70 33.8 20.4 24.4 143 162 — — 1851-60 31.8 19.1 23.8 128 155 — — The birth-rate in the District during the 10 years 1877-86 was 33.3 per 1,000 inhabitants, having been as high as 360 in 1879, and decreased gradually to 29.7 this year. It is somewhat singular that a similar decrease has obtained not only for London and all England, but also in France, where, indeed, it has been more marked still. The decrease in Hackney has been greater than in all England, as the highest in these 10 years in England was 34.4 in 1877, against 36.0 in Hackney in 1879, 14 and the lowest 31.3 against 30.4 in Hackney, or 3.1 decrease in all England, and 5.6 per 1,000 population in this district. The highest corrected death-rate in Hackney during the 11 years 1877-87 inclusive was in 1878, when it reached 20.2 per 1,000 population, and the lowest which occurred during the present year was 16.6, whilst the highest for all London was 23.5 in 1878 and the lowest 19.6 in 1887. The mean annual deathrates in the three decennial periods 1851-80 for this district were 19.1, 20.4, and 19.6, so that the present returns are very satisfactory. The death-rates under 1 year old per 1,000 registered births also indicate an improved sanitary condition of the district, as, although the inhabitants are generally speaking poorer than 20 years ago, and there is greater density of population, these deaths have proportionately decreased. Thus in 1861-70, there were 143 deaths during the first year of life in each 1,000 births, and 142 in 1871-80, against 132 in 1877-86, and 136 in 1887. The increase in the number of deaths in young children this year has been caused to a great extent by diarrhoea and inflammatory diseases of the lungs, which diseases, especially amongst the poorer classes, arise chiefly from a high summer temperature in the one case, and a low winter temperature in the other. The proportion of deaths in children under one year to total deaths was for the same reasons higher than for the 10 years 1877-86, having been 243 in 1887 against 240 in 1877-86 ; but under 5 years old, the difference, equally small, namely, 420 in 1887 to 423 in 1877-86 was in favour of this year. An analysis of the vital and mortal statistics of the sanitary districts of the metropolis, after complete distribution of the deaths occurring in public institutions during the year 1887 was published in the British Medical Journal for March 24, 1888. The death rate assigned to Hackney is lower than that given by me, as I am of opinion that the increase in the 15 number of inhabitants is not so great as it would have been if the annual rate of increase for the ten years, 1871—80 had continued until now. I calculated the number of our inhabitants on July 1st, 1888, to have been 226,000, whilst the number in this analysis is put down at 231,903. Besides this, my return is from January 1st, 1887, to December 31st, inclusive, whilst the other is almost necessarily for fifty-two weeks or for one day less. The annual death rate for Hackney in the analysis is given at 16.0, whilst in my report it is stated to be 16.6 per 1000 inhabitants. This is satisfactory as it corroborates my figures. The other districts having a low death rate are returned in this analysis as follows:— Paddington 15.9; Kensington 15.2; S. George's, Hanover Square 16.2; Hampstead 13.0; Hackney 16.0; Wandsworth 16.4; Camberwell 16.8; Plumstead 14.3. The high death rates are London City 23.0; S. Giles 26.1 ; Strand 23.4 ; Shoreditch 23.7; Whitechapel 23.3; S. George's, East 28.7; Stepney 25.3; S. Saviour's, Southwark 28.5 ; S. George's Southwark 27.0 ; and S. Olave, Southwark 26.6. These figures are all based on the assumption of the populations of each sanitary district having described the same curve as for 1871—80, and therefore cannot be checked, except perhaps by the medical officers of health for each district. At any rate, judging from the Hackney death rate, they are not far from the truth, and much nearer than any hitherto published for the whole metropolis, as it is only lately that the data for making these calculations have been available. The birth rate for the City of London is returned as the smallest in the metropolis, having been only 196 per 1,000 inhabitants; S. Martin's in the Fields having been 19.7; S. George's, Hanover Square 19.9; S. James', Westminster 20.6 ; Kensington 20.8 ; and Hackney 28.5. The districts and parishes having high birth rates are Whitechapel 38.0 ; Bethnal Green 38.3; S. Luke's 38.4; S. Olave, Southwark 38.3; S. George in the East 40.4 ; and Fulham as many as 48.9 per 1,000 inhabitants. The deaths of infants under 1 year old in 16 proportion to total births is a good criterion of the sanitary state of a locality, other conditions being fairly equal, and in this respect Hackney stands well, having proportionately fewer of these deaths than Kensington, Hammersmith, Fulham, Chelsea, Islington, Wandsworth, Camberwell and most other metropolitan sanitary districts. This is very satisfactory when the density and great mixture of our population as regards sooial status are taken into consideration. TABLE V. Showing the Number of Deaths at all Ages in 1887, 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. Deaths from these Diseases, 1887. Per milleage of Deaths to Total Deaths, 1887. Deaths per 1000 population. 1883 1884 1885 1886 1887 1. Zymotic Diseases 528 141 2.63 3.99 2.75 2.74 2.34 2. Pulmonary (excluding Phthisis) 774 206 3.31 2.93 3.59 3.18 3.42 3. Tubercular 428 114 2.63 2.05 2.39 2.39 1.90 4. Wasting Diseases Under 1 year. 323 81 1.19 1.06 1.23 1.47 1.43 6. Convulsive Diseases. 153 41 0.78 0.71 0.81 0.67 0. 69 Totals 2206 583 10.54 10.74 10.77 10.45 9.78 . Includes Phthisis, Scrofula, Rickets, Tabes Mesenterica, and deaths registered as being caused by Tubercular Meningitis in children more than 1 year old. Includes Marasmus or Tabes Mesenterica, Atrophy and Debility, want of Breast Milk, and Premature Birth, in children under 1 year. Includes Infantile Hydrocephalus, Meningitis, Convulsions and Teething, under 1 year. 17 The table shows that there were 2,206 deaths from these groups of diseases out of the 3,751 deaths from all causes, of which 528 were from zymotic diseases, 774 from inflammatory diseases of the lungs, 428 from tubercular affections ; 323 from wasting, and 153 from convulsive diseases of children under 1 year old. The number of deaths in each 1,000 population from all these causes varied but little during during the years 188387, the highest rate having been 10.77 in 1885 and the lowest 9.78 in 1887. The highest mortality from any group of diseases being 399 per 1,000 population from zymotic diseases diseases in 1884, whilst the lowest rate from these affections occurred this year, namely, 234. The highest rate from acute pulmonary diseases happened in 1885, when it was 3.59, and the next highest in 1887, when it reached 3.42 per 1,000 inhabitants. The deaths from tubercular diseases were unusually low this year, namely, 190 against 2 63 per 1,000 population in 1883, but the mortality from wasting diseases of infants under 1 year was rather high, so that probably some deaths which would ordinarily have been classed with tubercular affections were placed in this group. The mortality from convulsive diseases of infants was lower than usual, which is a satisfactory return, as these deaths are caused to a great extent by improper feeding in children having a constitutional tendency to these diseases. The deaths from pulmonary diseases (excluding phthisis, which is a constitutional affeotion), as might have been expected, have varied in different years to a greater extent than any other of these groups of diseases, owing to their relation to extremely cold weather. Since 1877 the annual death rates from these affections per 10,000 population have been as follows: 36.8,45.3, 37.9, 33.1, 29.3, 35.9, 31.8, and 34.2. It is not what may be called steady cold, so much as oscillations of very cold with comparatively warm weather, with more or less fog, that injuriously affects the lungs, as was well shown in 1887, when with a continuous depression of temperature, we had a rather low death rate in the early and late months of the year. 18 TABLE VI. Shouting the Number of Deaths from the principal Zymotic Diseases in the Hackney District during the 10 years, 1877 to 1886, and in the year 1887. Diseases. 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 Annual Average of 10 Years, 1877-1886 Proportion of Deaths to 1000 Deaths in 10 Years, 1877-1886 Total Deaths in 1887 Proportion of Deaths to 1000 Deaths in 1887 Small-pox 179 86 10 69 225 13 19 210 86 1 87.8 25.2 0 0 Measles 91 31 81 21 149 43 117 55 168 88 84.4 24.2 115 30.6 Scarlet Fever 58 123 70 81 118 144 63 72 29 70 82.8 23.8 55 15.2 Diptheria 18 23 19 14 1 51 43 39 47 46 301 8.6 35 9.3 Whooping Cough 43 135 110 141 70 182 56 157 85 123 110.8 31.8 136 36.3 Fevers. Typhus 62 70 47 27 64 63 46 84 — 56.0 16.1 - 12.6 Enteric 37 53 46 Simple continued. 2 4 1 Diarrhoea 86 159 67 170 135 99 104 190 125 200 133.5 38.3 137 36.5 Totals 537 627 404 523 762 595 448 807 589 585 585.4 168.0 525 140.4 Totals-London 12292 14734 12256 13681 13811 13558 10801 13629 13074 11121 12866 161.4 12684 154.3 NOTE.—Previously to 1885 all kinds of continued Fever were grouped together as " Fevers." 19 The almost entire absence of small-pox from this district during the two years 1886-87 is remarkable as only one death was recorded; 31 in 1886, and this death did not really belong to the district, as it occurred to a tramp who was taken ill the day he was admitted to the vagrant ward. The same number of deaths was recorded in 1857-58, but the population then was decidedly less than half what it is now, so that the comparison is in favour of the present time. The mortality from measles was much above the average of the last 10 years the deaths in 1887 having been 115 against 84 which was the mean of the preceding ten years. The deaths from scarlet fever as already mentioned were 55 against a mean of 83 for the years 1877-86, the highest number during these years having been 144 in 1882. The mortality from whooping cough was unusually large as 136 deaths were recorded this year against an average of 111 ; but it was not the largest mortality during the preceeding ten years, as there were as many as 182 deaths registered in 1882, and 157 in 1881. Enteric fever caused fewer deaths than usual as only 46 were registered from it against an average of 53 for 1877-86 84 in 1884,63 and 64 in 1882 and 1881; these figures, however, included a small number of deaths from other continued fevers. Diarrhoea also caused a mortality of about an average, viz.: 137 against 133 for each of the ten former years. The weather was unusually hot at times so that the very low annual mortality could scarcely have been expected, especially as 190 deaths from diarrhoea were registered in 1884, and 200 in 1886. The ratio of deaths from these diseases to the total number of deaths from all causes was 168 in the ten years 1877-86 against only 140 in 1887. This low proportion arose partly from the absolute number being below the average and partly from an unusually large mortality from inflammatory diseases of lungs. The ratios of deaths from these diseases in 1000 deaths from all causes were, during this year, as follows : from small-pox, none ; from measles, 30.6 ; from scarlet fever, 15.2 ; from diphtheria, 93; from whooping cough, 36 3; from enteric fever, 12.5 ; 20 and from diarrhœa, 36.5. These results are very satisfactory, especially as the number of deaths from these diseases was in excess in all London during 1887, having been 12,684 against 11,121 in 1886, and 154.3 per 1000 deaths from all causes, against 140.4 in the Hackney District. I now propose laying before you a report on each case of small-pox that has occurred in the district, and some important tables respecting scarlet fever, taken in part from the Fortyninth Report of the Registrar-General on Births and Deaths, and some important conclusions which he has arrived at from an examination of these and other tables, which I do not think it necessary to extract. Small-pox.—The details of the cases that have come to my knowledge during the year are as follows:—The first case was that of a female, aged five months,who was removed to the hospital on April 21st. I made careful enquiries of the mother, but could not obtain any information as to the source of infection. She said that the child had not been taken out since she was nine weeks old, when she was vaccinated ; that she herself had not been out of the neighbourhood during all this time, and had not had any visitors. No other case occurred in the house. The second case was that of a female, thirty years of age, who came into this district on April 27th, from Dewsbury, which place she left on the 26th. She was taken ill on May 5th, and was removed to the hospital on May 7th, the rash having appeared on that day. Before she went to Dewsbury she had been at Stockton-on-Tees from April 9th to the 22nd, in a house where there were four cases of modified small-pox, so that the period of incubation of the disease was at least twelve days. The third case occurred also in May, in the person of a married woman who came into this district from the Hackney Road, on April 28th. She sickened on the 9th of May, the rash appeared on the 13th, and she was removed on the 14th to the 21 hospital. No other cases occurred in these houses or in the neighbourhood. The fourth case was that of a commercial traveller, who had been travelling in Kent, who was attacked in Pembury Grove. He could not give any information as to the source of the infection ; he was moved to the hospital on May 30th. His child was afterwards attacked with modified smallpox, and removed to the hospital on the 18th June. The next case was that of a child aged five years, who was attacked with the disease on November 8th, and treated at homo. The source of infection could not be ascertained, there had not been any visitors to the house; the child had attended the Berger Road Board School, where, however, there was not any case amongst the children, so that the disease was not contracted at school. On the 17th another child in the same house, aged eight, was attacked, but the disease did not spread to any one else. Vaccination had been performed in all these cases, and all recovered. The Scarlet Fever cases in the district do not require any special mention beyond their number, and the care taken to disinfect the premises and the infected articles of clothing and bedding. It is almost certain that a very large number of cases were not reported to me, as it seems to be generally believed, firstly that disinfection is not so necessary as in small-pox ; and secondly, that it is better for persons to have the fever when young rather than when grown up, because it is then slighter, and less likely to prove fatal. A careful inquiry with all the means at present available, has been made by the Registrar-General of Births, Deaths, &c., on this subject, and a large number of cases collected, as shown in the following tables which have been taken with some additions from the Registrar-General's fortyninth report. The importance of the question, which could be adequately discussed only from data obtainable at the Registrar General's offices, must be my apology for the lengthy abstracts and tables. 22 TABLE VII. Mean Annual Mortality from Scarlet Fever per Million living at successive Age-Periods, 1859-85. Age. Annual Deaths per Million Living. Males. Females. Both Sexes. 0—1 1664 1384 1524 1—2 4170 3874 4022 2—3 4676 4491 4583 3—4 4481 4332 4408 4—5 3612 3556 3649 0-6 3681 3482 3546 5—10 1667 1613 1640 10—15 346 381 363 15—20 111 113 112 20—25 59 77 68 25—35 36 58 47 35 and upwards 13 15 14 The table shows that the mortality in each sex from scarlet fever rises to a maximum in the third year of life, and then slowly falls up to the fifth year, after which the fall is very rapid until the twenty-fifth year of life is reached, when the mortality becomes comparatively small. The table also shows that from birth until the tenth year of life the mortality amongst males from scarlet fever is greater than amongst females, the difference becoming less accentuated as the age increased up to five years, when the number of deaths became nearly equal. After ten years the mortality was greatest amongst females. During the ageperiod 0—5, 3,681 deaths from scarlet fever happened amongst 23 1,000,000 males against 3,482 deaths amongst the same number of females. These differenees led the Registrar-General to further enquire whether they were dependent on greater severity of the disease amongst males under five years, or if males are more subject to the disease than females. He therefore had the following table constructed from cases occurring in hospitals for ten years. TABLE VIII. Case Mortality at different Ages.—Deaths per 1,000 Cases of Scarlet Fever in Hospitals, 1874-85. Age. Males. Females. Both Sexes 0—1 395 442 419 1—2 384 316 365 2—3 255 226 210 3—4 184 174 179 4—5 130 112 121 0—5 241 217 229 5—10 106 97 101 10—15 56 53 54 15—20 40 34 37 20—25 39 32 35 25—35 75 43 59 35 and upwards 85 65 75 The Registrar-General in discussing this table pointed out the striking difference between the mortality of males and females, which shows how much greater the risk of death from an attack at every age period, except that of 0-1, is to the male than to the female sex. The death rate per 1000 attacks of the disease in males under five years was 241, and of females 217. 24 I may say that my investigations respecting scarlet fever, many years ago, led me to similar conclusions. The table also conclusive shows that the chance of death from an attack of scarlet fever diminishes from birth up to the end of the third year, then more slowly up to ten years of age, and afterwards with great rapidity up to 35 years of age. It will also be seen that whilst 229 children of both sexes died out of each 1000 oases under 5 years old, only 101 per 1000 cases died at the age period of 5-10 ; 54 between 10-15 ; 37 between 15-20 ; and 35 between 20-25 years of age ; after which the fatality of the disease increased up to 75 deaths per 1000 cases amongst persons who were 35 years old and above. The conclusions arrived at by the Registrar-General by a consideration of these and some other tables are as follows:— (1) The mortality from this disease is at its maximum in the third year of life, and after this diminishes with age, at first slowly, afterwards rapidly. (2) This diminution is due to three contributory causes: (a) the increased proportion in the population at each successive age period of persons protected by a previous attack; (ft) the diminution of liability to infection in successive age-periods of those who are as yet unprotected; (c) the diminishing risk in successive age-periods of an attack, should it occur, proving fatal. (3) The liability of the unprotected to infection is small in the first year of life, increases to a maximum in the fifth year, or soon after, and then becomes rapidly smaller and smaller with advance of years. (4) The chance that an attack will terminate fatally is highest in infancy, and diminishes rapidly with years to the end of the twenty-fifth year; after which an attack is again somewhat more dangerous. (5) The female sex throughout life, the first year possibly excepted, is more liable to scarlet fever than is the male sex. (6) But the attacks in males, though fewer, are more likely to terminate fatally. Now it is sometimes said that the separation from its family of a child who is attacked by scarlet fever is scarcely worth the trouble and expense it involves, seeing that the rest of the children, though they may escape on that special occasion, are almost certain to contract this very common disease at some future time, and may therefore as well, if not preferably, have it at once. The results, however, to which this statistical inquiry has led us, are completely 25 subversive of such a position. They show, independently of the plain fact that a very large proportion of persons go through life without ever contracting this disease; that the longer an attack is deferred the less likely it is to occur at all ; and not only so, but that, even supposing it to occur eventually, the less likely it is to end fatally. He-vaccination—During the last epidemic of small-pox, at my request, the public vaccinators were authorised to re-vaccinate at the expense of this Board children between 12 and 15 years of age, as I was strongly of opinion that the latter age, which was the lowest limit fixed by the Local Government Board for revaccination was too high for the public safety. An order has lately been issued by the Local Government Board modifying that of 1868, reducing the age at which re-vaccination can be performed und r ordinary circumstances, at the expense of the Poor Law Authority, to 12 years, and to 10 years when small-pox is prevalent, as it has been shewn by recent experience that the protective power of vaccination performed in infancy becomes much reduced at or soon after that age. The public vaccinator is not bound to re-vaccinate a person if he considered it unnecessary, or if he has not a sufficient supply of lymph for primary vaccination, so that the new order will not necessarily interfere with the vaccination of infants as it might otherwise have done. The term public vaccinator will also now apply to the medical officer of a workhouse, separate workhouse school, or workhouse infirmary, provided he performs vaccination in either of these institutions under contract. A further important provision is contained in the the order, viz. :—" That a public vaccinator to a workhouse may re-vaccinate children under his charge, at any ago, provided that he makes a record that in his opinion he considers the original vaccination to be at that time insufficient for the proper protection of the child." This order is to me very satisfactory, as it shows that the expenditure I advised the Board to incur in 1883 was necessary for and beneficial to the public health of this district. There were 47 cases of Diphtheria reported to me during 26 the year, but in comparatively few of the houses was thore any defect in the drainage arrangements. In several houses the sink-waste pipes were directly connected with the house drain, in two the drains themselves were defeotive. In one rather large house there were five cases but no deaths; the sink and bath waste pipes were directly connected with the house drain, and the smell was offensive with a strong current from the drain into the house. Typhoid or Enteric Fever —These names are used somewhat indiscriminately for one another, but it is certainly better to use the name "enteric fever." There were108 cases reported which occurred in 104 houses, and defects in the drainage arrangements, notably, sink-wastes connected directly with the drains were found in 24 houses. Two patients contracted the disease in Northampton, one coming from a house in which another case of the fever existed; a third patient was said to have been infected by drinking contaminated water; and another by either an abominable smell from sewage much decomposed, or from a little splashing against his (the patient's) mouth when he was engaged in removing the accumulation. In the other cases no assignable cause was mentioned, in answer to the enquiries, nor was any drainage defect found on or in the premises they occupied. Although there has not been any notification to me of an outbreak of infectious sore throat or of diphtheria from sewer gas poisoning, yet the occurrence is by no means rare. One very extensive outbreak was reported in a medical journal in which as many as 80 children were attacked, and the disease ran a severe but not a fatal course. The children's throats were covered inside with a leather-like membrane resembling that of diphtheria. It is described as being "extremely infectious, and undoubtedly arose from the poisonous effects of sewer gas." In another similar but less severe outbreak, the symptoms were similar to those in the one just mentioned, and "the disease, which resulted from 27 the escape of sewer gas into a lavatory and near a bedroom window, was decidedly communicable. This was shewn by the fact that when the first case was removed to a lodging for supervision, a little girl contracted the disease'' These cases show the importance of carefully examining the drains and inlets thereto, including the bath and sink-wastes, rain water pipes when connected with the drains, which is always done here in houses where diphtheria or repeated attacks of sore throat have occurred. Several of the last-mentioned cases occurred where defects in the drains or drainage arrangements were discovered on inspection. The regulations for the removal of patients by the Metropolitan Asylums Board issued during the present year are reprinted here, as they materially affect the health and comfort of persons requiring admission into the Asylums Board Hospitals. METROPOLITAN ASYLUMS BOARD. REGULATIONS FOR THE REMOVAL OF SMALLPOX AND FEVER PATIENTS. 1. Applications for the removal of patients to the Hospitals of the Board must be made as follows:— TO THE CHIEF OFFICES (Ambulance Department), on week days between 8 a.m. and 8 p.m. Care must be taken that applications made in the latter part of the day are despatched in time to reach the Offices before 8 p.m. TO THE AMBULANCE STATIONS (The Superintendents), every week day between 8 p.m. and 8 a.m., and all day on Sundays, Christmay Day, and Good Friday. The Ambulance Stations are situated as under:— Eastern Ambulance Station, Brooksby's Walk, nomerton, E. South -Eastern Ambuiance Station, New Cross Road (near Old Kent Road Railway Station), S.E. Western Ambulance Station, Seagrave Road, Fulham, S.W. 28 2. Every application must state the name, age, and full address of the patient, from what disease suffering, and in cases of fever the particular kind of fever; and also the name of the person making the application, and the Parish he represents. Applications which do not give these particulars will be referred back to the applicant for the required information to be furnished. 3. The Medical Certificate or Order for the admission of the patients must be handed to the Nurse in charge of the Ambulance. Should neither of these documents be handed to the Nurse, the patient will not be removed. 4. The Ambulance Nurses are to persuade patients on removal to leave all valuables, money, &c., and all outside clothing at home, to wear body-linen only, and to be wrapped in the blankets provided for the purpose. 5. At the time of the removal of a patient, the Ambulance Nurse is to leave with a relative or friend of the patient, or, in the absence of such a person, with a resident in the house from which the patient is taken, a notice stating the Hospital to which the patient is to be removed, and such notice is to have annexed to it a copy of the Regulations as to visiting, &c. She is also to place on the "Delivery Note" left with the patient at the Hospital, the name and address of the relative, friend, or resident above referred to. By Order, Chief Offices of the Board: W. F. JEBB, Norfolk House, Norfolk Street, Clerk. Strand, W.C. Postal Address: Norfolk House, Norfolk Street, Strand, W.C. Telegraphic Address: Asylums Board, London. Telphone Number: 2587. Note—The Regulations of previous dates are rescinded. 18th June, 1887. 29 TABLE IX. The, Deaths Registered at different Ages from all causes during the Years 1877-87, 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. YEARS. AGES 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. 1887 Totals 882 665 154 151 199 253 289 385 396 305 72 3751 Per cents 23.5 17.7 41 4.0 5.3 6.7 7.7 10.3 10.6 8.1 2.0 100 Per cents. 1886 25.8 16.0 4.4 4.7 5.5 6.8 7.2 9.0 10.5 7.9 2.2 100 Ditto 1885 24.3 18.8 4.7 4.2 5.7 6.4 7.6 8.5 10.9 8.0 1.9 100 Ditto 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 21 100 Ditto 1881 23.0 19.7 6.5 5.5 6.7 6.7 6.6 7.1 10.3 6.6 1.3 100 Ditto 1880 27.7 17.1 4.1 4.6 6.7 7.2 6.6 8.1 9.0 7.0 1.9 100 Ditto 1879 23.4 16.1 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 5.7 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 Per cents. of deaths 1876-85 24.4 16.9 5.2 5.1 6.4 7.2 7.5 8.6 9.7 7.1 1.9 100 Ditto 1866-75 24.3 15.7 5.1 5.3 7.1 7.3 7.4 8.0 9.8 7.8 2.2 100 Ditto 1856-65 21.0 16.4 6.1 5.1 6.9 7.2 7.3 8.9 10.9 8.0 2.2 100 The ages at death were as follows:—882 or 23.5 per cent. of all the deaths occurred in infants under 1 year old, which is below the average of the two last decennial periods, when the deaths at these ages were respectively 24.4 and 24.3 per cent. 30 of all the deaths. At the next age-period of 1/5 years, that is to say above 1 year and under 5 years, the mortality was somewhat in excess, having been 17.7 against 16.9 per cent. in 1876-85, and 15.7 in 1866-75. Between 5 and 15 years of age, as well as between 15-25, 25-35, and 35-45, the most active years of life, the proportion of deaths was less than in any of the decennial periods 1856-85, having been 4.1, 4.0, 5.3, and 6.7 per cent., making a total of 20.1 per cent. of the deaths at all ages, against 5.2, 5.1, 6.4, and 7.2, or a total of 23.9 per cent. in 1876-85, 24.8 per cent. in 1866-75, and of 25.3 in the 10 years 1856-65. This great and continuous diminution in our mortality at these ages, and especially at 15-45, is a very great gain, especially when taken in connection with the diminution in the annual death rate at all ages. It points to a great increase in the vitality of those who have been born since sanitary measures have been carried out, and induces us to hope for a further extension of longevity amongst those now growing up. Of course when a diminished death-rate occurs amongst the living who are under 45, a larger death-rate, when compared with deaths at all ages, must occur in those above that age, as there are a greater number of persons above 45 who are left to die: thus, in 1887 the number of deaths above 45 years of age reached 38.7 per cent. against 34.8 per cent in 1876-85, and 35.2 per cent. in 1866-75. In the Forty-ninth Annual Report of the Registrar General, to which I have already referred, it is stated that in 1886 the low death rates between 5 and 35 years of age, was very noticeable in all England, as he says that "the rate for each separate age-period, from 5 to 35 years of age, was the lowest on record." The fact that this low death rate has extended in Hackney to a later period in life, viz.: to 45 years of age, is very satisfactory. 31 TABLE X. Births in the Sub-Districts of Hackney, 1887—52 Weeks. Quarters. Stoke Newington Stamford Hill. West Hackney Hackney South Hackney Totals. First 207 122 251 719 358 1657 Second 202 121 282 721 344 1670 Third 192 120 303 639 365 1619 Fourth 206 140 333 751 339 1769 Total 807 503 1169 2830 1406 6715 Percent. 1887 12.0 7.5 17.4 42.2 20.9 100 „ ,, 1886 11.4 7.8 17.9 42.0 20.9 100 „ ,, 1885 12.4 6.4 17.9 42.7 20.6 100 „ „ 1884 12.0 6.6 19.0 41.3 21.1 100 ,, „ 1883 11.9 5.4 20.0 41.2 21.5 100 „ ,, 1882 12.2 5.4 19.6 40.6 22.2 100 „ ,, 1881 12.2 5.2 20.2 40.8 21.6 10 „ ,, 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 The births in the sub-districts point to an increase of population in Stoke Newington and Hackney, and in a slighter degree, in South Hackney, but not so as regards the other two sub-districts. Taking the returns of late years for all London, we may assume, however, that the decrease of population, if any, in the Stamford Hill and West Hackney registration sub-districts, has been but slight. The sub-registration districts do not, however, correspond with the wards or other divisions of the parish of Hackney, as the Stamford Hill sub-district includes Stamford Hill and Upper Clapton, the Hackney subdistrict includes Lower Clapton, Clapton Park, Dalston, Hackney proper, Hackney Wick, and nearly all Homerton, being therefore an enormous sub-district. The total number of births 32 registered in Stoke Newington was 807 against 706 last year; in Stamford Hill, 503 against 523; in West Hackney, 1169 against 1190; in Hackney, 2830 against 2803; and in South Hackney, 1406 against 1390; making a total of 6715 births in 1887 against 6661 in 1886. TABLE XI. Deaths in each Sub-District, 1881-86. Year. Stoke Newingt'n Stamford Hill. West Hackney. Hackney. South Hackney. 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 1886 374 250 652 1656 732 3670 1887 407 221 692 1710 721 3751 I have not attempted to calculate the percentages of deaths in the different sub-divisions, as there are difficulties, owing to the number of institutions in the Hackney sub-registration district, which includes the Hackney and City of London Workhouses and Infirmaries, the Small-pox and Fever Hospitals, and the German Hospital. I have restored as far as possible the deaths in the various hospitals and establishments within and outside the district to the various sub-districts; and distributed the deaths in these institutions over the various subdistricts, but there is a residuum consisting of inhabitants of Hackney who died without their proper addresses being known, and also of deaths from drowning and accidents of persons unknown, which I have been unable to distribute. I have thought it best therefore to give the whole numbers as altered. These show that the number of deaths as well as of births have increased in Stoke Newington and Hackney sub-districts as well 33 as in West Hackney, whilst they have slightly diminished in Stamford Hill and Sonth Hackney, pointing to similar conclusions as regards population to those arrived at from the births. Disinfection.—The number of articles disinfected during the year and also of houses disinfected were not so large ns when small-pox was prevalent, because, as before stated, wo do not have anything like so many applications for disinfection of houses in which scarlet fever has occurred from persons occupying the better class of houses, although the numbers differ but little from those of 1886. The number of beds removed to the Board's apparatus and disinfected were 110: of mattresses 64; of palliasses 16; of bolsters 79; of pillows 238; of blankets 185; of sheets 43; quilts 67; and other articles 230. There has not been any complaint during the year of damage by scorching, or loss of anything removed from the houses of the inhabitants to the disinfeoting chamber. TABLE XII. Articles Disinfected for the Years 1882 to 1887. Years Beds Mattresses Palliasses Bolsters Pillows Blankets Sheets Quilts Other Articles Totals Houses Disinfected 1882 172 104 88 119 258 332 148 69 1022 2312 366 1883 227 104 82 167 423 337 184 117 1086 2727 345 1884 785 227 69 616 1441 1101 747 550 1265 6791 1159 1885 332 132 10 290 690 765 439 284 605 3553 603 1886 96 50 15 74 195 299 50 55 206 1040 381 1887 110 64 16 79 238 185 43 67 230 1032 367 During the year one application was made for a certificate that a cab had been properly disinfected, which was rendered necessary by the cab having been used for the conveyance of a 34 patient to the fever hospital. In accordance with the cabman's request the cab was disinfected, and a certificate given free of expense. A large quantity of disinfectants has been given away to the poor during the year, but not to so great an extent as in former years, 1739 packets having been distributed against 2,948 in 1886, and 288 bottles (small size) of carbolic aoid. Eleven pads of stinking fish, chiefly of plaice, were destroyed as being unfit for human food. All of these were brought here by the purchasers and certificates given, to enable them to get their money back from the fish salesmen. Mortuary.—The total number of bodies removed to the mortuary during the year was 76, against the same number in 1886, and 69 in 1885. Inquestswereheldin a very large proportion of these cases, as most of the deaths were caused by suicide or accident. Twenty-three bodies were found in the river Lee, and the verdict in four was that of suicide. There were also three suicides on the railway or in a railway carriage, and seven dead bodies were removed because they were kept in the same room with the living. One body was brought to the mortuary when the death was caused by an infectious disease. This body was put into the air-tight receptacle, the coffin having been previously screwed down, and filled up with sawdust and carbolic powder. I have not had any complaint during the year as to the conditions of the mortuary, and whenever I visited it I found it clean, free from smell, and in good order. There are still many formalities to be gone through, including obtaining the sanction of the Enclosure Commissioners; advertising the exchange of ground with the Revd. Arthur Brooke'; and a lapse of three months after the advertisements have appeared before legal possession of the ground for the new mortuary can be obtained. Hirer Lee.—The water of the river was in fairly good condition up to the end of April, no complaints having been received, and the weekly samples of water were fairly clear for a navigable river, and without smell. The amount of free 35 ammonia never exceeded that contained in a mixture of one part of fresh Hackney sewage and 25 parts of distilled water, and often less Early in May an unfavourable change took place, although not very marked, as the amount of free ammonia equalled a mixture of one part of sewage with 15 of distilled water. Heavy rains however ocourred in the middle of the month, so that by the end of the month it was in a fair condition, and showed but little effects from the reception of the Tottenham effluent. By the middle of June the comparatively slight effect caused by the sewage being poured in had passed away, and up to the end of September, when the Tottenham effluent was again emptied into it, the river was in good condition, clear, without smell, and not containing more free ammonia than above the Tottenham inlet. At a meeting of the Board held in October I made the following Report, which was dated October 18th:— " Gentlemen, "In my last report I stated that during the month of September the water of the River Lee was unusually good, being fairly clear and without smell, even when kept for some days in the laboratory. The Tottenham effluent was, in accordance with the Act of Parliament, poured into the river on October 1st, and soon produced, as at the same period last year, a great change for the worse, as a sample of water taken on the 6th at Spring Hill Bridge was nothing like so clear as before, and was decidedly badsmelling. A sample of the effluent was therefore taken on the 7th, and was found free from smell, but was by no means clear, and became slightly offensive, by keeping, on the 8th, and much more so on the 10th and for some days afterwards. The water of the river became worse on the 8th, 9th, and 10th, when numerous fish were seen floating on the water. From that time the water has steadily improved, so that on the 13th it had but a very slight smell, which did not increase on keeping. On the 15th and 17th there was not any smell at the river side, although 36 the water was more opaque than before the Tottenham effluent entered it." The water having changed for the worse soon after the last report was written, I visited the river and had samples frequently taken of the water, and presented the following report to you for the fortnight ending October 29th: " Gentlemen, "I regret to have to report a decided chango for the worse in the water of the the river Lee since the date of my last report, arising from the very unsatisfactory condition of the effluent from the Tottenham Works, especially on the 21st, 22nd, and 27th of October. Having communicated with the Chairman of the Sanitary Committee, he advised me to write on the 22nd to the Tottenham authorities, and to the Lee Conservancy Board; and I have received answers to the effect that the Clerks to these Boards would lay my letters before their respective Boards. Mr. Corbie, the Clerk to the Lee Conservancy Board, also stated in his reply that he has written to the Tottenham Local Board of Health ' witli a view to the sewage being treated in a more satisfactory manner,' as the Conservators are not satisfied with the 6tate of affairs at Tottenham. On the 27th the river water contained double the quantify of ammonia to that on the 17th, and it was also not so clear and had an offensive smell." At a meeting of the Sanitary Committee in the early part of November, as the river, although in a better state, was not by any means in a satisfactory condition, the Committee directed that a copy of my reports be forwarded to the Clerk to the Tottenham Board of Health, soon after which the effluent improved in quality, and the river became in better slate, so that I was able at the first meeting of the Board, in December, to lay before you the following report, dated December 6thr:— 37 " Gentlemen, "I have to report that the River Lee is in a better state than it was at the time of my last report, the water being clearer, free from smell, and containing less free ammonia. The effluent has also improved, as it is somewhat clearer, less offensive, and contains less free ammonia. This improvement has followed the aotion of the Sanitary Committee in sending a copy of my reports to the Tottenham Local Board of Health, whose Clerk in reply has stated that by the advice of Mr. Henson, the patentee of the process adopted at their works, an additional quantity of chemicals has been lately used." lie/use Shoots.—Much trouble has been entailed on the Sanitary Department, including myself, by the shooting of refuse on several pieces of ground in various parts of the district. The largest shoot was that at Gainsborough Road, Hackney Wick, where, in order as far as possible to prevent the deposit of offal and other offensive matter, a man was appointed to look after the shoot and send away objectionable loads. He was paid by the owner of the ground, but acted under my supervision, as I visited the place once or twice a week, and an inspector daily. In spite of this supervision a nuisance was created, and the persons depositing were served with notices to cease shooting, which were obeyed. A letter was received from the Local Government Board on the subject, after action to stop the deposit had been taken, and, subsequently, a letter was received from the complainant, thanking the Sanitary Committee and myself for the means taken to stop the shooting. In another case a summons was taken out, and an order made by the magistrate to remove the offensive and injurious deposit; after which, although the shooting was not stopped, the matters deposited could not bo dealt with as a nuisance. There was another shoot on the Clapton Park Estate, consisting of a large hole from which gravel had been dug, and which was gradually 38 filled up with road sweepings and dry rubbish, and caused much annoyance partly inconsequence of the bole containing stagnant water which gave off an offensive smell. This also was filled up after considerable trouble. It is much to be regretted that owners of land can take out gravel, and fill up the hole thus made with rubbish, close to where the foundations of houses will be plaoed. This objectionable process not only creates a nuisance by the carting to and fro, and cutting up the roads, but is likely to cause injury to the health of the inhabitants who will occupy the houses hereafter, in consequence of foul gases being drawn from the heaps into the houses by the heat of the fire. Some years ago I gave evidence before a Committee of the House of Commons complaining of this practice, but without avail. Fairs.—Several miniature fairs have been opened in the district by gipsies and others taking possession of pieces of ground, either with or without the consent of the owners. On visiting them, I did not find much to complain of in a sanitary point of view, so that, although causing much annoyance to the neighbourhood, I could not require their removal in those cases when rent was paid for the use of the ground, and where water closets were provided. In two other instances, where rent was not paid, I communicated with the owner of the land, who had the vans and people removed immediately. As regards one piece of ground in Wick-road a notice was served on the owner to provide sufficient water-closet accommodation, and to keep the ground clean, both of which have been done. These places occupy much time, so that I should be glad if they could be suppressed. Water Supply.—In consequence of the continued drought during great part of the year, the water companies shut off the supply in the night nearly all over the district. On communicating with the Engineer of the East London Water Works Company I was assured that it was unavoidable in consequence of the enormous waste of water, especially at night, as it was a 39 custom amongst very many inhabitants to allow the water to run all night on to their lawns. Mr. Bryan assured me that even after it was shut off at night, the water delivered reached the enormous amount of 40 gallons per head of the total population. I also reoeived a few complaints of an offensive smell from the water, and on communicating the fact to Mr. Bryan, he ordered the mains of the locality to be scoured out, although it entailed a considerable waste of water. The cause of this was the growth of a weed in the mains, which occasionally takes place when the temperature of the water in them becomes high. When the plug was drawn from one of the mains I took the temperature, whioh I found to be as high as 68 deg. Fahr. so that the growth was not an out-of-the-way occurrence. Chemical Works and 0ffensive Businesses.—I reported some complaints received respecting offensive smells from Messrs. Me ssBerger's works at Water-lane, and that on enquiry I ascertained that they arose from a temporary break-down of the apparatus for destroying the effluvia. Also complaints were made to me respecting a manufactory of lacquer for brass work at Clapton Park, which has been discontinued in consequence of my visit, and the objection I made thereto. The fumes evolved were very irritating to the lungs. In additiom five gut dressers and driers have been compelled to remove from the district during the year. Proposed New Burial Ground in Stoke Newington.— In August a letter acoompanied by a plan was addressed to me by Dr. Hoffman, the Medical Inspector of Graveyards, enolosing an application from the solicitors of the St. Anne's Home, Manor Road, Stoke Newington, for newly establishing a burial ground there. The ground abutted on Abney Park Cemetery, was about 30 feet by 40, and was intended for the interment of 24 sisters, of whom there are 12 only in residence at any one time. It was proposed that there should be only one body buried in each grave, with at least 4 feet of earth over it to the level of the adjacent ground. I objected to the proposal, as in my 40 opinion it would be a private burial ground, and there would not necessarily be any one present at the interment besides the officials of the Home. Also that there might not be a sufficient sanitary supervision of the grave before it was filled in after an interment. That there were other obvious objeotions which I need not here mention, whilst there was no advantage to be gained, as a piece of ground could be bought in the Abney Park Cemetery and, by an arrangement with the Company, a doorway oould be made in the wall leading to the graves. To this Mr. Hoffman replied that if the matter were pressed by the solicitors he would not advise the necessary permission to be granted by the Home Secretary without previously holding a publio enquiry. I have not heard anything more on the subjet, so that it is probably dropped. Cow-theds and Slaughter-houses.—In company with the View Committee I visited all the cow-sheds and some of the slaughter-houses, and found them in a fairly good state, except Mr. Rumball's, of Upper Clapton, two of whose sheds were dirty at the time of more than one visit, and whose yard also generally contained rather large aooumulations of dung. The Committee decided to oppose the renewal of the license unless means were taken for keeping the sheds and yard clean, which were subsequently done, so that no complaint has been received, nor any undue accumulation found on inspection from that date. Applications were received for the renewal of licenses to cowsheds situated on 85 separate premises, when 22 sheds were found in a somewhat unsatisfactory state, as they required either cleansing, repairing the channels of the sheds, or paving of the yards. Applications were also made to the Metropolitan Board of Works for licenses to a proposed new cow-shed and a new slaughter-house. The Sanitary Committee viewed these premises, and reported thereon to the Metropolitan Board of Works. The applications were refused in both instances. Sanitary Inspection.—During the year there have been 41 5,213 houses inspected under the Sanitary Aot of 1866, a large proportion being houses occupied by two or more families. In addition to these there were 1,315 premises visited in consequence of oomplaints, many of which, however, were not inspeoted throughout, as the complaints referred in some instances to accumulations of offensive matter, defective means of drainage, defective water supply apparatus. There were also 367 premises visited in oonsequence of infectious diseases having ocourred therein, making a total of 7,099 inhabited houses visited during the year, or nearly one-fourth of the houses in the district. In addition there were 129 bakehouses inspected; 81 poulterers' yards; 134 greengrocers' yards; 43 slaughter-house; and 86 cow-sheds, making altogether 7,572 premises inspected. Nearly all these were visited at least three times, and a large proportion more frequently than this, so that a very large amount of work has been done by the sanitary staff during the year. The details of the nuisances removed are as follows:—A few cesspools, viz., 5, have been discovered and removed during the year. In all instances a search was made for them, in consequence of complaints of offensive smells in the houses, no other oause for the smell having been discovered on inspection. They were all emptied and filled up. The number of choked and defective drains which have been dealt with was larger than usual, as no less than 824 nuisances from this cause were abated during the year ; but the number of choked or broken closet pans attended to was smaller than usual, viz., 95, which shows that the poorer classes are getting more acoustomed to and have taken greater care of the water closets than in former years. The substitution of yard gulley for bell-traps has been actively carried out, as 1,066 bell-traps have been removed, chiefly from the betterclass houses. This number is not so large as for 1886, and will doubtless become smaller every year, as bell-traps are not allowed to be used for newly-built houses, and a considerable number of better-class houses are inspected every year There were also 727 waste-pipes from sinks and baths dis- 42 oonneoted from direot communication with the drains, chiefly in the same houses as those wherein the bell-traps were removed. Also 249 stack pipes were similarly treated in oases where the hopper heads were near to windows. The number of yards in which the paving was repaired, or relaid, reached 852, which was somewhat above the total for 1886 ; and for dust-bins repaired or new ones provided, 742, against 617 in 1886. The number of houses whitewashed and cleansed was 1,602, against 1,678, and means of ventilation improved, 31 against 10, making a total for improvements of this class of 3,227, against 3,120 in 1886. As might have been expected, the number of closets to which a supply of water was enforced diminished in 1887 to 178, against 205 in 1886, but of houses in which flushing boxes to the closets were newly provided was 104, being considerably more than in former years. The closets found with defective apparatus for flushing were far more numerous than in 1886, as for no less than 1,050 was it necessary to serve notioes for their repair. In a large proportion of oases the water in the supply pipes had been frozen in the winter, and been knooked up by the tenants, but not repaired by the owners; in comparatively few cases, however, the defects had been caused by violence. In 396 houses, where the supply of drinking water was obtained from a cistern supplying the closet, although the water was in the "main," a length of pipe with a tap was added so as to enable the consumers to obtain water direct from the main. Improvements in the water supply or water supply apparatus to houses amounted to the large number of 1731. Although scarlet fever was prevalent, the number of houses disinfeoted by the staff was not so numerous as in some former years, as in many cases disinfection was carried out under the direction of the medical attendant, who certified that it had been done to his satisfaction; but there were 367 houses disinfected by the officers of the Board. The total number of nuisanoes abated amounted to 9,698. In addition, 1,278 requests to remove aooumulations of dust were specially attended to, including 43 many respecting houses that had been shut up, but a large proportion were from houses where the occupants always write, and never put a "D" card in the window. These requests were attended to only on the regular day, otherwise the work could not be properly oarried out. The rota for the dustmen has been arranged so that the carts should go down every street at least once a week, and on a "D" card being shown in the window the dust is removed. There were a few complaints, all of which were trivial. In accordance with the provisions of the Sanitary Aot, 1866, including the Lodging House Regulations, 5,213 houses, chiefly ocoupied by the poor and containing two or more families, were, as before stated, thoroughly inspected, and as many as 3,620 were found to be wanting in some sanitary requirement, or were so dirty as to necessitate orders being served for whitewashing and cleansing. As only 1,315 complaints were reoeived, whioh included very many having no reference to the condition of the houses, it is evident that this regular and systematic inspection is of the greatest value in keeping these houses in a good sanitary state. The number of houses inspected in a similar manner in 1886 was 4653, against the 5,213 in 1887. The enquiries at and the examination of these houses extend to the number of families, of inmates, number of rooms; the state of houses as regards oleanliness and repair; of the yards, dust-bins, water supply and drainage arrangements, including a careful examination as to the disconnection of direot communications with the drains, of the sink waste and bath pipes, A similar enquiry is made as regards the houses in which infeotious diseases have appeared. A systematic inspection of the houses oocupied by others than the poor, to ascertain if any direot communication between the interior of the houses and the drains existed, as well as to see that the servants' water olosets were properly supplied with water, has been oarried on for years, as opportunity has ocourred without interfering with the other work. In many of these houses the drainage arrangements 44 were found to be defeotive as regards the points just mentioned. It has not been neoessary for me to report any premises under the provisions of the Artizans' Dwelling Aots, as with one exoeption all the owners of property complied with the notioes served on them for repairs of dilapidated houses; as regards the one exception I obtained a magistrate's order to close the house if the work were not done, and it was closed under his order. Dust, Removed.—Hitherto I have made my report in this matter for the financial year, from March 25th in one year to March 24th inclusive for the following year. As, however, the rest of my report is for a calendar year, I have made it up for the year 1886, so that my figures will not correspond with those contained in the financial statement presented to the Board in its accounts. During 1887 there were 30,088 loads of dust and house refuse removed, against 27,958 loads in 1886, of which 9,537 loads were removed in 1887 by Mr. Iszard, from the A Division, at 2s. 3d. per load; 10,529 loads by Mr. Potter, from the B Division, at 2s. por load, and 10,002 loads by Mr. Stevens, from the C Division, at 2s. 6d. per load, being the same sums per load as for 1886. The payments to the contractors in 1887 were £3,378 11s. 3d., and in 1886 £3,136 3s. 6d , to this must be added £716 11s. 6d., for wages to the men employed by the Board to assist in the removal, and in checking the loads removed, as well as £106 12s. to the dust inspector, making up a total expenditure of £1,201 14s. 9d. for the year. As far as I can ascertain, this is a smaller amount than for any other metropolitan district, considering the number and size of the loads removed. By the contraot the carts are to be of sufficient size to hold 60 cubic feet, the usual size being 54 cubic feet, and the Board has not to provide a shoot or shoots, as in some other districts or parishes, where as much as a Is. per load or its equivalent is paid by the Board or Vestry. To show the great increase in the cost of dust removal, partly owing 45 to higher contracts, and partly to increase of population, I may mention that five years ago, that is to say in 1882, the total cost was £2,860 10s. in this district, showing an increase in 1887 of £1,343 4s., of which the greater part was caused by the much greater number of loads removed. In the Poplar district, however, the increase of cost has been very much larger, as at a meeting of that Board, held in February last, it was stated that they paid in 1887 £2,000 a year more for the collection of tho dust, and £1,000 a year more for shoots, than in 1882. It is therefore evident that the system of dust collection in operation here is much more economical than that adopted in Poplar. The cost in Hackney for removal in 1887 was 2s. 9½d., and in 1882 2s. 7¼d. per load, so that the increased cost per load is not large. Tho tenders for the next three years are, however, higher than before, so that there will be an excess both in price aud quantity for tho future. Before concluding this part of my report, I desire to express my satisfaction with the manner in which all the officers in my department have performed their duties. I have attended 41 meetings of the Sanitary Committee and sub-Committee Meetings during the year, twenty being meetings either ordinary or special of the Committee; 6 of the View Committee; and 6 sub-Committee Meetings, chiefly in connection with the new dust contracts. I have also attended at the Presoott Street Sessions House, to oppose the renewal of a license to two cowsheds, as well as at tho Worship Street and Clerkenwell Police Courts to give evidence respecting nuisanoes. I also visited many places wherein nuisances existed, or infectious diseases had appeared. I have also to refer to one important Act, viz.: "The Margarine Act, 1887," which was passed this year, and came into operation on January 1st, 1888. Tho full title is "An Act for the better prevention of the Fraudulent Sale of Margarine." After giving a definition of butter, which is to bo made exclusively from milk or cream, with or without salt or other preservative, and with or without tho 46 addition of colouring matter, the Act sets out that Margarine shall mean all substances, whether oompound or otherwise, prepared in imitation of butter, and whether mixed with butter or not; and no such substanoe shall bo lawfully sold except under the name of Margarine, and under the condition set forth in the Act. Any one dealing in Margarine who is found guilty of an offence under the Act shall be liable to a penalty not exceeding £20 for the first offence, not exceeding £50 for the second offence, and not exceeding £100 for the third or each subsequent offence. Packages containing Margarine are to be branded or durably labelled "Margarine" in printed capital letters not less than one-and-a-half inches square, and when sold by retail, if in a package, it must be labelled as above mentioned; and if in a paper wrapper, the same shall have printed thereon the word "Margarine," in capital letters not less than a quarter of an inch square. There are other provisions which I need not set out, including power for any officer authorised to take samples under the Food and Drugs Act, 1875, to take samples of butter for analysis, adopting the forms required by that Act. In the early part of 1888 1 visited several shops, and the Food Inspector went to a very large number, and ascertained that the provisions of the Act as to marking and labelling have been well carried out. Tho price, however, at which it is 6old is high, viz.: either from 8d. to 1s. 2d., or more generally from l0d. to 1s. 2d.; but it is, in my opinion, much more wholesome than rankbutter, and contains a greater percentage of fat than butter, which often has a large quantity of butter milk mixed with it, owing to changes in which the rancidity chiefly depends. Meteorology.—The weather during the year has been somewhat unusual, and variable with less than the average rainfall. In the first half of January the temperature was unusually low, with frequent falls of snow, but after the 18th it rose, and there were some days of fine weather. The mean temperature for the month was 21 deg. below the average, and the rainfall was three quarters of an inch in depth. In 47 February, the mean temperature was nearly 2 deg. in exoess of that of January, but it was 1.3 deg. below the average. The air was generally cold and dry; the rainfall 105 inches below the average; and the barometer was unusually high. The first 3 weeks of March were very cold, with sharp frosts at night) the mean temperature being as much as 4 deg. below the average, although after the 21st the weather was milder. The sky was generally overcast in the morning with occasional dense fogs, but the death-rate both of Hackney and London generally was low for the time of year. The rainfall was again in defect to the extent of 0.16 inches, making a total of nearly 2 inches below the average for the quarter. April was cold and dry, the mean temperature was 3.4 deg. in defect, having been below the average all the month except from the 19th to the 23rd, with north-easterly winds and a fall of rain rather below the average. North-easterly winds prevailed in May, which was consequently cold, having been below the average with exception of five days. On the 1st the thermometer recorded a night temperature of 33 2 deg., on the 21st a temperature of 35.8 deg. was recorded with a mean of 43.1 or 11.9 deg. below the average, whilst the mean for the month was minus 2.7 deg., being the coldest May since 1845. A change for the better took place in Jane, when the mean temperature was 55.8 deg., or 2.l deg. in excess. In the middle of the month the weather was fine and warm, but after that somewhat cool. The rainfall in May was 0.36 inch in depth, aud in June, 0.74 inch below the average, making a total of 1.11 inches in defect for the quarter. In July the weather was unusually fine and warm, having been hotter than usual, especially at the commencement, with the exception of 3 days in the middle of the month. There was but little rain, the deficiency for the month being 1.22 inches, and there was a complete drought which lasted from June 4th to July 4th. The mean temperature for the month was 66.5 deg., or a daily excess of 4.8 deg. In August also, there was an unusual amount of fine, dry, sunshiny weather, but the temperature was 48 below the average during the middle of the month. The mean daily temperature was 62.5 deg., or 1.6 deg. in excess. The rainfall was about an average. On the 17th there was a severe thunder-storm, with a brilliaut display of lightning. September was cold and unsettled, but the rainfall continued to be deficient, viz.: to the extent of 0.21 inch, making a total of 1.44 inches less than usual for the quarter; and a total deficiency of rain for the nine months of 4.5 inches. The mean daily temperature was only 54.0 deg., or 3.1 deg in defect, presenting a great contrast to the weather in July and August. In the months of July and August there was a large number of deaths from diarrhoea, owing to the hot dry weather. October was generally fine, but unusually cold, the mean temperature for the month having been only 45.0 deg., or 5.0 below the average, and colder than any October since 1817. The rainfall was deficient to the extent of 1.76 inches; but in November, which was a cold month, it was in exoess to the extent of 1.44 inches. The air was dry in spite of the rain, as N.E. winds prevailed, and the mean temperature was 2.7 deg. in defect. December was fine but cold; the mean temperature having been 1.8 deg. below the average, and the rainfall 0.52 inch deficient, with S.W. and W. winds. The Greenwich returns, published by the Registrar General, show that the mean temperature was below the average in the first quarter of the year to the extent of 2.6 deg.; the second quarter of 1.2 deg.; and the fourth, of no less than 32 deg.; but the third had an excess of 0.8 deg., giving a mean for the year of 44.6 deg., or 14 deg. below the mean. The atmospheric pressure, as shewn by the 'barometer, was 0.070 inch in excess of the mean for the year, having been above the average in the first three quarters, and below it in the fourlh. Tho total rainfall at Greenwich for the year was only 1986 inches, having been no less than 5.36 inches below the average of the previous 72 years. It was deficient in each quarter, and especially in the first three months, taken as a whole. 49 Hackney Table of Temperature and Rainfall for 1887. Months. Absolute Temperature. Mean Temperature. Difference from mean of 46 years. Rainfall. Highest. Lowest. Totals. No.of Day Inches. January 52.2 17.2 36.6 —2.8 0.92 13 February 55.4 20.2 38.8 —0.8 0.31 6 March 57.8 24.0 37.6 —4.1 0.87 11 April 67.8 29.8 44.1 —2.0 1.16 9 May 72.0 33.2 49.8 —2.7 1.52 21 J uue 85.8 45.0 60.9 + 2.6 1.02 6 July 88.4 46.2 66.6 +4.3 1.22 11 August 88.6 45.4 62.6 +11 1.69 6 Sep.ember 69.2 36.0 54.0 —31 20.9 18 October 62.6 27.4 45.0 —5.0 1.07 10 November 65.6 21.4 40.8 —2.7 2.99 22 December 65.4 25.0 38.1 . —1.8 1.31 16 Total *16.17in 148 * The rain-gauge is placed od a wall, and therefore registers less than it would do on the ground, probably by 15 per cent., although it is well exposed. This table is oompiled as regards the highest and lowest temperatures, and the rainfall, from a record kept by me at my house. I have, however, extracted the mean temperatures, and tho differences therefrom from the Greenwich returns, as I have not a sufficiently long record for Hackney. The highest temperature recorded here was 88.6 deg., against 92.0 deg. at Greenwich, but both higher and lower temperatures are recorded at Greenwich than at Hackney, as there is less cloud and smoke there, and the country round about is much more open than here. The continued warmth of the summer is shewn by 50 the faot that on 17 days the thermometer indicated a temperature of above 80 deg., 8 of these days being in July. The lowest temperature recorded was 21.4 deg. in November, so that a range of 67.2 deg. occurred in the Richmond Road during the year. The table shows that in May the temperature fell to 33.2 deg., or within 1.2 deg. of the freezing point; in September to 36'0 deg., and that sharp frosts oocurred in January, February, March, April, October, November and December. As before stated, the mean temperature was below the average in nine and above it in three months of the year only. The rainfall was nearly five-a-half inches below that of 1886, and rain fell on 148 days only, against 187 days in 1886. I remain, Gentlemen, Yours obediently, JOHN W. TRIPE, M.D., Medical Officer of Health. April 11th, 1888. Ordered that this Report be received, printed and circulated in the usual manner, RICHARD MARTIN, Chairman. April 11 th, 1888. 51 Streets and other Places Inspected in 1887. Number of Cases of Epidemic Diseases. Name of Street or Road. Number of Houses Inspected. No. of Houses in which Nuisances where found. Small Pox. Scarlatina. Diphtheria. Typhoid Fever. Typhus. Abbott street 23 17 .. .. .. .. .. Abney gardens 26 3 .. .. .. .. .. Acton street 14 12 .. 1 .. .. .. Ada street 41 32 .. 2 .. .. .. Albert street 2 2 .. .. .. .. .. Aldham place 8 4 .. .. .. .. .. Amherst terrace 14 8 .. .. .. .. .. Andrews road 15 12 .. .. .. .. .. Antwerp street 26 23 .. 5 .. 1 .. Arthur street 36 30 .. 3 .. 4 .. Ash grove 52 37 .. .. .. 1 .. Balcorne street 67 35 .. .. .. .. .. Ball's buildings 14 7 .. .. .. .. .. Barn street 22 14 .. .. .. .. .. Bayford street 20 19 .. .. .. .. .. Blackshaw place 1 .. .. 3 .. .. .. Blackstone road 43 27 .. 2 .. .. .. Blanchard street 11 10 .. 1 .. .. .. Blanchard road 34 18 .. 1 .. .. .. Boleyn road 9 9 .. .. .. .. .. Boreham street 11 9 .. .. .. .. .. Bowling Green street 31 19 .. .. .. .. .. Bowling Green place 12 10 .. .. .. .. .. Bower road 22 6 .. .. .. .. .. Bradbury street 19 11 .. .. .. .. .. Bridge street 26 16 .. 1 .. .. .. Brunswick street 57 41 .. 1 .. .. .. Buckingham road 86 64 .. .. .. .. .. Cambridge terrace, S. N. Com. 8 4 .. .. .. .. .. Cassimer terrace 20 19 .. .. .. .. .. Casterton street 2 .. .. 3 .. .. .. Chapel court 6 3 .. .. .. .. .. Chapman road 15 12 .. .. .. .. .. Churchill road 62 45 .. 1 .. 1 .. College avenue 37 32 .. 4 .. 1 .. Clevedon street 17 7 .. .. .. .. .. College lane 1 1 .. 1 .. .. .. College street 8 8 .. 3 .. .. .. Cottage place 7 6 .. 2 .. .. .. Cotterill road 20 19 .. 1 .. .. .. Cowday street 12 9 .. 3 .. .. .. Cross street, Homerton 10 7 .. .. .. .. .. Cross street, 3. Hackney 17 8 .. .. .. .. .. Crozier terrace 2 .. .. 1 .. 2 .. Crescent cottages, C. Heath 1 .. .. 1 .. .. .. Daintry street 13 6 .. .. .. .. .. Darnley road 59 54 .. .. .. .. .. Carried forward 1057 735 - 40 1 11 - 52 Streets and other Places Inspected in 1887. Number of Cases of Epidemic Diseases. Name of Street or Road. Number of House Inspected. No. of Houses in which Nuisauces were found. Small Pox. Scarlatina. Diphtheria. Typhoid Fever. Typhus. Brought forward 1057 705 - 40 1 11 - Derby road 3 1 .. 3 .. 2 .. Devonshire road 67 53 .. .. .. .. .. Duncan square and road 61 52 .. 5 1 .. .. Dunlace road 5 .. .. 3 2 1 .. Durham grove 9 9 .. .. .. .. .. Durrington road 4 1 .. 9 .. .. .. Duncan street 48 34 .. .. .. 1 .. Eaton place 59 37 .. .. .. .. .. Edwards lane 1 .. .. 1 .. .. .. Elderfield road 4 .. .. 6 .. .. .. Elgin street 54 39 .. .. .. 1 .. Eleanor road 2 .. .. 2 .. .. .. Essex street 42 19 .. .. .. .. .. Ex mouth place 1 .. .. .. .. l .. Ellingfort road 41 34 .. 2 .. .. .. Fairey street 10 7 .. .. .. .. .. Falcon court and place 9 8 .. .. .. 1 .. Pel stead street 27 23 .. .. .. .. .. Fenn street 9 4 .. .. .. .. .. Fisher's place 9 7 .. .. .. 1 .. Florefield road 39 35 .. 2 .. 1 .. Frederick place, Hag 16 3 .. .. .. .. .. Fulham place 7 7 .. .. .. .. .. Gaiusboro’ road 73 17 .. .. .. .. .. Gainsboro' square 18 8 .. .. .. .. .. Gillett street 22 10 .. 1 .. 1 .. Glynn road 11 1 .. 14 1 2 .. Gomer terrace 9 6 .. .. .. .. .. Goring street 44 39 .. 1 .. 1 .. Green lanes 3 .. .. 7 .. .. .. Grove, The, Homer ton 2 .. .. 3 .. .. .. Grove lane, Hackney 15 14 .. .. .. .. .. Hamburg street 14 6 .. 1 .. .. .. Havelock road 68 33 .. 3 .. .. .. Haywoods buildings 4 4 .. .. .. .. .. Hayes buildings 15 10 .. .. .. .. .. Hayling road, S.N 29 24 .. .. .. .. .. Hertford road 14 13 .. 2 .. 4 .. Heslop place 8 5 .. .. .. .. .. High hill ferry 223 123 .. 1 .. .. .. High street, Homerton 2 .. .. l 2 .. .. Hockley street 27 16 .. 1 .. .. .. Holmbrook street 58 51 .. 5 .. .. .. Holly street 2 .. .. 2 .. .. .. Carried forward 2225 1488 - 115 7 28 - 53 Streets and other Places Inspected in 1887. Number of Cases of Epidemic Diseases. Name of Street or Road. Number of Houses Inspected. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Diphtheria. Tvphoid Fever. Typhus. Brought forward 2225 1488 - 116 7 28 .. Homer road 1 .. .. 1 .. 1 .. Homerton row 6 4 .. .. .. .. .. Homfray street 31 21 .. .. .. .. .. Isabella road 9 7 .. 1 .. .. .. Janes place 9 7 .. .. .. .. .. Jerusalem gardens and passage 1 .. .. 4 .. .. .. John street, Homerton 1 .. .. 1 .. .. .. Jolly butcher's yard 4 3 .. .. .. .. .. Kynaston avenue 6 3 .. .. .. .. .. Lauriston road 2 1 .. 1 6 .. .. Lea bridge 113 92 .. 2 1 .. .. Lea bridge road 18 16 .. 1 .. .. .. Lenthall road 3 .. .. 1 1 1 .. Lime grove 24 16 .. .. .. .. McLaren street 39 29 .. 4 l l .. Mallard street 39 19 .. .. .. .. .. Mandeville street 4 .. .. 10 .. .. .. Mare street 327 220 .. 1 .. .. .. Margaret street 43 39 .. 2 .. 1 .. Marian street 27 17 .. 1 .. 2 .. Marlow road 2 .. .. 2 .. .. .. Mason's court and place 10 1 .. .. .. .. .. Matthias street 29 26 .. .. .. .. .. Mead's place 26 24 .. .. .. .. .. Mead's cottages 3 1 .. .. .. .. .. Meadow street 12 5 .. .. .. .. .. Mehetable road 41 31 .. .. .. .. .. Middlesex place and square 8 2 .. 1 .. .. .. Millington street 2 1 . .. .. 1 .. Millard road 36 33 .. .. .. .. .. Montague road 65 47 .. 1 .. 1 .. Millfield road 23 21 .. .. .. .. .. Montague terrace and place 24 11 .. .. .. .. .. Median road 2 .. .. 4 2 .. .. Mount pleasant lane 12 9 .. .. .. .. .. Nesbit street 3 .. 2 .. l .. New street 11 6 .. .. .. .. .. North street 1 .. .. .. .. l Nursery row and place 8 6 .. .. .. .. .. Orchard cottages 12 6 .. .. .. .. .. Orchard place 1 .. .. 1 .. .. .. Carried forward 3263 2210 - 156 18 38 - 54 Streets and other Places Inspected in 1887. Number of Cases of Epidemic Diseases. Name of Street or Road. Number of Houses Inspected. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Diphtheria. Typhoid Fever. Typhus. Brought forward 3263 2210 - 156 18 38 - Osborn road 56 44 .. .. .. .. .. Oswald street 43 30 1 4 .. 1 .. Ottaway street 1 .. .. 1 .. .. .. Overberry street 104 89 .. 11 .. .. .. Palace road 60 41 .. .. .. 1 . Paragon road 76 72 .. .. .. 1 .. Park street, S.N. 1 .. .. .. 2 .. .. Pedro street 103 82 .. .. .. .. .. Plover street 29 4 .. 1 .. .. .. Prince Edward road 49 28 .. 1 .. 1 .. Pemberton place 8 6 .. .. .. .. .. Percy road 57 41 .. 1 .. .. .. Pickles buildings 6 4 .. .. .. .. .. Pleasant place 3 1 .. .. .. .. .. Pond lane 4 4 .. 3 .. 1 .. Prout road 60 54 .. 1 5 1 .. Presburg street 37 26 .. 2 .. 3 .. Providence cottages 4 4 .. .. .. .. .. Queen's court 5 4 .. .. .. .. .. Railway cottages 4 4 .. .. .. .. .. Railway crescent 30 21 .. .. .. .. .. Red Lion lane 6 3 .. .. .. .. .. Redwald road, Priory 36 32 .. .. .. .. .. Ridley road 49 43 .. 1 .. .. .. Rigby’s buildings 4 .. .. .. .. .. .. Rochester place 6 .. .. .. .. .. .. Rosina street 2 .. .. 2 .. .. .. Rushmore road 63 38 .. 4 .. 1 .. St. James's terrace, Clapton 7 7 .. .. .. .. .. St. John's cottages 15 10 .. .. .. .. .. St. John’s place 4 5 .. 1 .. .. .. St. Thomas's square 19 14 .. .. .. .. .. St. Thomas’s square 17 16 .. .. .. .. .. Sandford lane 35 17 .. 1 .. .. .. Salem place 7 3 .. .. .. .. .. Saxony cottages 13 11 .. .. .. .. .. Shacklewell row 35 16 .. .. .. .. .. Shepherd’s lane 13 10 .. 2 .. 1 .. Sheep lane 69 50 .. .. .. .. .. Shellgrove road 23 19 .. .. .. .. .. Sidworth street 18 18 .. .. .. .. .. Sussex street 10 7 .. .. .. .. .. Suther street 7 7 .. .. .. .. .. Swiss cottages 11 5 .. .. .. .. .. Carried forward 4460 3100 - 194 25 50 - 55 Streets and other Places Inspected in 1887. Number of Cases of Epidemic Diseases. Name of Street or Road. Number of Houses Inspected. No. of Houses in which Nuisances were found. Small Pox. Scarlatina. Diphtheria. Typhoid Fever. Typhus. Brought forward 4460 3100 - 194 25 60 - Templar road 84 70 .. 3 .. .. .. Thomas street 20 19 .. 1 .. .. .. Tottenham road and square 10 10 .. 2 1 .. .. Tower street, L.F 2 .. .. 2 1 .. .. Tranquil place 8 7 .. .. .. .. .. Triangle road 2 .. .. 2 .. .. .. Tudor grove 1 .. .. 2 .. .. .. Tyssen street 2 .. .. .. .. 2 .. Union road, S. H 1 .. .. 1 .. .. .. Union street, W. H 16 16 .. .. .. .. .. Urban place 17 16 .. 1 .. .. .. Victoria road 69 40 .. 11 .. .. .. Victoria grove 1 .. .. 3 .. .. .. Vyner street 1 .. .. 1 .. .. .. Warburton road and square 36 32 .. 4 .. .. .. Warwick villas 31 26 .. 2 .. .. .. Water lane 31 29 .. .. .. .. .. West street, Triangle 1 .. .. 2 .. .. .. Western place 14 11 .. .. .. .. .. Wetherell road 21 21 .. .. .. .. .. Wharf road 16 11 .. 1 .. 1 .. White Hart court 3 2 .. .. .. .. .. White Post lane 23 16 .. .. .. .. .. Wick lane 1 .. .. 1 .. .. .. Wick road 223 116 .. 2 1 1 .. William's cottages 4 5 .. .. .. .. .. Windsor road and terrace 89 60 .. 3 .. .. .. Winslade road 4 .. .. 5 .. .. .. Woodland street 2 .. .. 1 .. 1 .. Woolpack place 21 13 .. .. .. .. .. Totals 6213 3620 - 244 28 55 - 56 SUPPLEMENTAL LIST OF STREETS IN WHICH MORE THAN TWO CASES OF SMALL 1 OX, &c, OCCURRED IN 1887. Name of Street or Road. Number of Houses Inspected. Small-Pox. Scarlet Fever Diphtheria. Typhoid. Typhus. Brought Forward 5213 .. 244 28 66 .. Alkham Road, Stoke Newington 1 .. .. 1 .. .. Almack Road, Clapton 1 .. .. .. 1 .. Amhurst Road, Hackney 2 .. 1 1 .. .. Amhurst Park, Stamford Hill .. .. .. .. .. .. Annie Road, South Hackney .. .. .. .. .. .. Appleby Road 2 .. 2 .. .. .. Ardleigh Road 1 .. 1 .. .. .. Aspland Grove, Hackney 1 .. 2 .. .. .. Anderson Road 1 .. .. .. 1 .. April Street 1 .. .. 1 .. .. Bethune Road, Stoke Newington 3 .. 1 .. 2 .. Bodney Road, Hackney 1 .. 2 .. .. .. Brett Road 2 .. 3 .. .. .. Broadway, London Fields 4 .. 1 .. 5 .. Brook Road, Clapton 2 .. 3 .. .. .. Brougham Road, Stoke Newington 1 .. 1 .. .. .. Ballance Road 3 .. 3 .. .. .. Bath Row 1 .. 2 .. .. .. Bay Street 1 .. 1 .. .. .. Benn Street 2 .. .. .. 2 .. Berger Road 1 .. 1 .. .. .. Blinco Road 2 .. 3 .. .. .. Blurton Road 1 .. 1 .. .. .. Brooksby's Walk 1 .. 1 .. .. .. Bloomfield Street 2 1 2 .. .. .. Cazenove Road, Stamford Hill 1 .. 4 .. .. .. Chatham Place, Hackney 2 .. 1 .. 2 .. Chatsworth Road 2 .. 3 .. .. .. Church Road, Kingsland 1 .. 1 .. .. .. Church Street, Stoke Newington 1 . 1 .. .. .. Christie Road, South Hackney 1 .. 1 .. .. .. Clifton Grove 2 .. 1 .. 1 .. Clissold Road 1 .. 1 .. .. .. Clapton Common 1 .. 1 .. .. .. Cambridge Road 1 .. 1 .. .. .. Cassland Road 3 2 2 .. .. .. Chalgrove Road 1 .. 1 .. .. .. Chapel Road, Stamford Hill 1 .. .. 1 .. .. Church Road. Homerton 2 .. 2 .. .. .. Church Road, West Hackney 1 .. .. .. 1 .. Church Terrace 1 .. .. .. 1 .. Clarence Road 1 .. 1 .. .. .. Carried forward 5273 3 296 32 71 - 57 SUPPLEMENTAL LIST OF STREET3, &c., 1887-continued. Name of Street or Road. Number of Houses Inspected. Small-Pox. Scarlet Fever Diphtheria. Typhoid. Typhus. Brought forward 5273 8 296 32 71 - Clifden Road 3 .. 2 .. 1 .. Coopersale Road 2 .. 4 .. .. Culford Road 1 .. .. 1 .. .. Dagmar Road, South Hackney 2 .. 1 .. 1 .. Dalston Lane 4 .. 4 .. 2 .. Darenth Road 1 .. 3 .. .. .. Darville Road 1 .. 1 .. .. .. Dynevor Road 1 .. 1 .. .. .. Dyssel Street 1 .. 1 .. .. .. Evering Road 4 .. 1 3 1 .. Elsdale Street 1 .. 1 .. .. .. Fassett Road, Dalston 1 .. .. 1 .. Fairfield Road 1 .. 1 .. .. .. Fortesque Avenue 1 .. l .. .. .. Frampton Park Road 1 .. 2 .. .. .. Forest Road 4 1 4 .. 1 .. Fassett Square 3 .. 3 .. .. .. Flora Terrace, Stoke Newington 1 .. 1 .. .. .. Graham Road 5 .. 4 .. 2 .. Greenwood Road 1 .. 1 .. .. .. Gotha Street 1 .. 1 .. .. .. Gore Road 1 .. 1 .. .. .. Groombridge Road 2 .. 2 .. .. .. Gay hurst Road 1 .. 1 .. .. .. Gilpin Road 1 .. .. .. 1 .. Glaskin Street 1 2 .. .. .. Glenarm Road 2 .. 3 1 .. .. Grove Lane, Stamford Hill 1 .. .. .. 1 .. Hackney Union 1 .. 4 .. .. .. Hawkesley Road 1 .. .. 3 .. .. High Street Kingsland 2 .. .. .. 2 .. Harrowgate Road 1 .. 1 .. .. .. Heathland Road 1 .. 1 .. .. .. Hassett Road, Homerton 1 .. .. 1 .. .. Inver Road 1 .. l .. .. .. Carried forward 5330 4 349 42 84 - 58 SUPPLEMENTAL LIST OF STREETS, &o., 1887—continued. Name of Street or Road. Number of Houses Inspected. Small-Pox. Scarlet Fever Diphtheria. Typhoid. Typhus. Brought forward 5330 4 349 42 84 - Kenninghall Road 1 .. 1 .. .. .. King Edward's Road 1 .. 1 .. .. .. Kyverdale Road 1 .. 1 .. .. .. Lansdowne Road 5 .. 2 .. 3 .. Lawley Street 1 .. 2 .. .. .. Laura Place 1 .. 1 .. .. .. Lordship Park 2 .. 5 .. .. .. Leswin Road 1 .. 1 .. .. .. Linscott Road 1 .. 1 .. .. .. Lower Clapton Place 1 .. 1 .. .. .. Lamb Lane 1 .. .. .. 1 .. Landfield Street 1 .. .. .. l .. Lark Row 1 .. 1 .. .. .. London Lane and Terrace 1 .. .. .. 1 .. Lordship Road 1 .. .. 1 .. .. Loddiges Road 1 .. .. 1 .. .. Maury Road 1 .. 1 .. .. .. Mortimer Road 1 .. .. .. 1 .. Manor Place 1 .. .. .. l .. Montagne Road 1 .. .. .. 1 .. Massie Road 1 .. 5 .. .. .. Montagne Road, Dalston 1 .. 2 .. .. .. Middleton Road 1 .. 1 .. .. .. Mayola Road 1 .. 2 .. .. .. Norfolk Road 3 .. 4 1 .. .. Navarino Road 1 .. 1 .. .. .. Nightingale Road 1 .. 1 .. .. .. Nevil Road 2 .. 2 .. .. .. Narford Road 1 .. 2 .. .. .. Olinda Road 2 .. 5 .. .. .. Osbaldeston Road 1 .. 1 .. .. .. Oriel Road 1 .. 3 .. .. .. Painsthorpe Road 1 .. 2 .. .. .. Penshurst Road 2 .. 2 .. .. .. Parkholme Road 2 .. 4 .. .. .. Pembury Grove 2 2 1 .. .. .. Poole Road 1 .. .. .. 1 .. Carried forward 5379 6 405 45 94 - 59 SUPPLEMENTAL LIST OF STREETS, &o., 1887—continued. Name of Street or Road. Number of Houses Inspected. Small-Pox. Scarlet Fever Diphtheria. Typhoid. Typhus. Brought forward 5379 6 405 45 94 - Queen Elizabeth Walk 2 .. 2 .. .. .. Queen's Road 1 .. 1 .. .. .. Queen's Down Road 1 .. 1 .. .. .. Richmond Road 4 .. 3 1 1 .. Reedholm Street 1 .. 1 .. .. .. Rutland Road 1 .. 1 .. .. .. Rushmore Crescent 1 .. 4 .. .. .. Rockmead Road 1 .. 1 .. .. .. Springdale Road 2 .. 4 .. .. .. Stoke Newington Common 4 .. 9 .. .. .. Salisbury Road 1 .. 1 .. .. .. Smaller Road 1 .. 2 .. .. .. St. Mark's Square 1 .. 1 .. .. .. Southwold Road 1 .. 1 .. .. .. St. Andrew's Road 1 .. 1 .. .. .. Sydner Road 1 .. .. .. .. .. Sandringham Road 1 .. .. .. 1 .. Shore Road 1 .. .. .. 1 .. Shrubland Road 1 .. .. .. 1 .. Southgate Road 1 .. 1 .. .. .. Speldhurst Road 1 .. .. .. 1 .. Trederwin Road 1 .. .. .. 1 .. Temple Street 2 .. 1 .. 1 .. Trelawney Road 1 .. .. .. 1 .. Valentine Road 1 .. 1 .. .. .. Winston Road 1 .. .. .. 1 .. Woodberry Grove 1 .. .. .. 1 .. Well Street 2 .. 1 .. 1 .. Totals 5417 6 442 46 108 .. 60 TABLE OF DEATHS Of Inhabitants of the Hackney District between Jan. 1st. and Dec. 31st, 1887. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 36. 35 to 45. 46 to 65. 55 to 65. 65 to 75. 75 to 85. 85 and upwards Totals Smallpox. Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. Unvaccinated .. .. .. .. .. .. .. .. .. .. .. .. Vaccndoubtfl .. .. .. .. .. .. .. .. .. .. .. .. Measles 15 93 6 1 1 .. .. .. .. .. .. 115 Scarlet Fever 1 33 18 2 .. .. .. .. 1 .. .. 55 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 67 74 6 .. .. .. .. .. .. .. .. 136 Diphtheria . 22 12 1 .. .. .. .. .. .. .. 35 Simple Fever .. .. .. .. .. .. 1 .. .. .. .. 1 Enteric Fever .. 4 11 11 7 6 1 1 1 .. .. 41 Other Miasmatic Diseases .. .. .. .. .. .. .. .. .. .. .. .. Cholera and Diarrhoea 7 .. .. .. 1 .. .. .. .. .. .. 8 Diarrhoea, Dysentery. 98 25 .. .. 1 .. 1 1 6 4 1 137 Ague, Remittent Fever .. 2 .. .. .. .. .. .. .. .. .. 2 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis &c. 9 3 .. 2 .. .. .. .. .. .. .. 14 Erysipelas 6 .. 1 .. .. 2 3 1 4 4 4 21 Pyeemia, Puerperal Fever .. .. .. 4 1 3 1 1 .. .. .. 10 575 Thrush, Vege Parasites 3 3 .. .. .. .. .. .. .. .. .. 3 Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk. 2 .. .. .. .. .. .. .. .. .. 2 Alcoholism .. .. .. .. 2 7 2 3 1 .. .. 16 Constitutional Diseases. 20 Rheumatic Fever .. .. 2 2 3 2 1 .. 1 .. .. 11 Rheumatism .. .. .. .. .. 1 1 1 6 1 .. 9 Gout .. .. .. .. .. .. 3 5 4 1 1 14 Rickets 1 3 .. .. .. .. .. 1 .. .. .. 5 Cancer .. .. 2 3 6 24 31 43 33 11 2 154 Tabes Mesenterica 40 26 1 .. .. .. .. .. .. .. .. 66 Tubercular Meningitis 23 34 3 .. .. .. .. .. .. .. .. 60 Phthisis 4 12 6 44 89 87 61 35 16 2 .. 345 Scorfula,Tuberculosis 13 17 6 3 2 1 .. .. .. .. .. 41 Purpura Heemoraga 1 .. .. .. .. .. .. 1 .. .. .. 2 Anaemia, Leucocytha. 1 2 .. 2 .. .. 1 1 .. .. .. 7 Diabetes .. .. .. .. .. 1 4 5 3 1 .. 14 Other Constitutional Diseases .. .. .. .. .. .. 1 .. .. .. .. 1 729 Premature Birth 114 .. .. .. .. .. .. .. .. .. .. 114 Malformations 14 3 1 .. .. .. .. .. .. .. .. 18 Old Age .. .. .. .. .. .. .. 4 16 82 33 134 266 Carried forward 409 362 72 75 112 133 102 103 89 106 37 1690 1690 61 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 55 to 65 65 to 75 75 to 85 85 and upwards Totals. Brought forward 409 352 72 75 112 133 102 103 89 100 37 1590 1590 Nervous Diseases. Inflammation of Brain or Membranes 20 39 12 3 1 2 4 12 10 3 1 107 Apoplexy, Hemiplegia .. .. .. 1 2 7 16 37 55 37 7 162 Insanity, General Paralysis .. .. 1 1 6 5 3 8 14 9 .. 46 Epilepsy 1 1 2 4 3 2 1 2 .. 2 .. 18 Convulsions 95 20 .. .. .. .. .. .. .. .. .. 115 Laryngismu8Stridulus 11 8 .. .. .. .. .. .. .. .. .. 19 Diseases of Spinal Cord 3 1 1 2 1 2 3 1 3 .. .. 17 Paraplegia .. .. .. .. .. .. 1 .. .. .. .. 1 OtherNervousDiseases 3 .. .. 3 .. 2 3 2 1 1 .. 15 500 Diseases of Circulating Organs. Peri and Endo-Carditis .. 2 5 2 2 2 2 1 .. .. 1 17 Valvular Disease of Heart .. .. 2 4 5 2 6 11 4 1 .. 35 Other Diseases of Heart .. 2 9 8 12 15 29 44 54 30 2 205 Aneurism .. .. 2 .. 1 1 5 2 1 1 .. 13 270 Respiratory Organs. Laryngitis 1 8 .. 1 .. 1 .. .. .. .. .. 11 Croup 1 24 5 .. .. .. .. .. .. .. .. 30 Asthma .. .. .. .. .. .. 2 4 6 2 .. 14 Bronchitis 96 87 7 2 8 15 33 62 80 60 17 467 Pneumonia 47 58 7 11 8 18 21 18 21 11 2 222 Pleurisy 1 3 .. 1 2 5 2 4 1 2 1 22 Other Respiratory Dis. 2 .. .. .. 1 1 2 1 .. 1 .. 8 774 Diseases Digestive System. Dentition 15 18 .. .. .. .. .. .. .. .. .. 33 Quinsy, Sore Throat 4 1 1 .. .. .. .. .. 1 .. .. 7 Disease of Stomach 2 1 .. 1 2 .. .. 2 .. 1 .. 9 „of Bowels 2 1 1 .. .. .. .. 1 .. 1 .. 6 Enteritis 7 6 1 1 1 1 .. 2 1 2 .. 22 Obstruction of Intestines .. .. 2 2 1 2 6 3 4 4 1 25 Peritonitis .. 1 2 3 .. 1 3 1 4 .. .. 15 Spleen .. .. .. .. .. .. .. .. .. .. .. .. Jaundice,LiverDisease 2 2 .. 1 5 8 11 24 8 7 .. 68 185 Diseases of Urinary System. Kidney Disease 1 .. .. 1 2 .. 2 .. .. 6 Nephritis 1 3 1 1 3 .. 3 2 2 .. 16 Bright's Disease .. .. 1 1 1 4 12 11 8 5 .. 43 Other Kidney Disease. .. .. .. .. .. .. .. .. .. .. .. .. Bladder and Prostate .. .. .. .. .. 1 1 4 7 4 17 82 Carried forward 721 639 134 127 174 234 270 363 376 292 69 3401 3401 62 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. 55 to 65. | 65 to 75. 75 to 85. 85 and upwards. Totals. Brought forward 723 639 134 127 174 234 270 363 376 292 69 3401 3401 Disease of Uterus .. .. .. .. .. .. 1 1 .. .. .. 2 Abortion, Flooding .. .. .. 6 8 6 .. .. .. .. .. 20 Puerperal Convulsions .. .. .. .. 2 .. .. .. .. .. .. 2 Ovarian Dropsy .. .. .. 1 1 3 1 1 2 1 .. 10 34 Bones and Joints, &o. Caries, Necrosis 2 4 6 3 2 2 .. .. 1 .. .. 19 Arthritis, Ostitis .. .. .. .. 1 .. .. .. .. .. .. 1 Carbuncle, Phlegmon .. .. .. .. .. .. .. .. 1 .. .. 1 Other Skin Diseases 1 1 .. .. .. .. .. .. .. .. .. 1 22 Violence. Accidents andViolence 19 11 13 9 6 5 11 9 2 3 2 90 Homicide .. .. .. .. .. .. .. .. .. .. .. Suicide .. .. .. 2 3 .. 2 4 1 .. .. 12 102 Ill.defined Causes. Dropsy .. .. 1 1 .. .. .. 1 .. .. .. 3 Debility and Atrophy 131 10 .. .. .. .. .. .. .. .. .. 141 Mortification .. .. .. .. .. .. 1 2 10 6 1 20 Tumour .. .. .. .. .. .. .. 2 1 .. .. 3 Abscess 2 1 1 1 3 3 1 2 1 1 .. 16 Hemorrhage 4 .. .. .. .. .. 2 .. 1 2 .. 9 Sudden Deaths (doubtful) .. .. .. .. .. .. .. .. .. .. .. .. Causes not Specified .. .. .. .. .. .. .. .. .. .. .. .. 192 Totals 882 665 154 151 199 253 289 385 396 305 72 3751 3751 Per centage 23.5 17.7 4.1 4.0 5.3 6.7 7.7 10'3 10.6 81 2.0 63 PREMISES INSPECTED DURING THE YEAR 1887. Number of Houses inspected under the Sanitary Act, 1866, and Nuisances Removal Acts 5417 „ „ Houses visited in which infectious diseases had appeared 367* „ „ Premises inspected from complaints received 1315 „ „ Cowsheds inspected—(premises) 62 „ „ (sheds) 86 „ „ Slaughter-houses inspected 43 „ „ Greengrocers' yards inspected 134 „ „ Fishmongers' and Poulterers' yards inspected 81 „ „ Bake-houses inspected 129 „ „ Urinals inspected (twice) 78 „ „ Gut Dressers removed 5 • There were 602 cases of various diseases in the 367 premises. NUMBER OF NUISANCES ABATED IN THE FOLLOWING YEARS: In 1856 1567 In 1872 3099 1857 1789 1873 5406 1858 2515 1874 6110 1859 1224 1875 6262 1860 1267 1876 6445 1861 2481 1877 6257 1862 1235 1878 5912 1863 1996 1879 5468 1864 1410 1880 5720 1865 1512 1881 12055 1866 4260 1882 13753 1867 5811 1883 11054 1868 3923 1884 11837 1869 4354 1885 10651 1870 4240 1886 9047 1871 5180 1887 9698 64 Cesspools emptied and filled up 5 Choked drains oleansed, repaired or reconstructed 824 Number of Premises in which choked Water-closet Pans were released, or broken Pans removed 95 Number of Premises in which Yards were drained 76 Number of Premises in which new Traps were provided 1066 Number of Premises in which Sinks were disconnected from the drains 727 Number of Premises in which Stack Pipes were cut off from drains 249 Total number of Nuisances from defective means of drainage abated 3042 Number of Premises in which Yards were newly- paved or the paving relaid 852 Number of Premises in which Dust Bins were provided, or old Dust Bins repaired 742 Number of Houses repaired, whitewashed, &c. 1602 Number of Houses in which the Ventilation has been improved 31 3227 6269 Number of Water-closets to which a supply of water has been given 178 Number of Houses supplied by Closet-cistern in which a Flushing-box was provided 104 Number of Houses supplied by butt only, and Cistern substituted 3 Number of Closets in which defective apparatus was repaired1050 Number of Screw-down Taps and lengths of Pipe provided to enable occupiers to draw water from the main supply pipe of the house 396 Total number of Nuisances from defects in houses 1731 Carried forward 8000 65 Brought forward 8000 Number of Houses disinfected 367 Number of Cases of overcrowding abated 28 Number of Premises from which Pigs and other animals were removed 5 Number of Premises from which stable dung and other refuse were removed (excluding dust) 46 Number of filthy places cleansed 12 Number of other Nuisances removed (not included under other headings 1240 1698 Total number of Nuisances abated in 1887 9698 Number of Accumulations of Dust specially removed 1278* „ „ Preliminary Notices served 3882 Peremptory „ „ 1427 „ „ Statutory „ „ 572 Number of Letters sent out 1853 ,, ,, Persons summoned before a Magistrate 17 ' „ „ Copies of Summonses and Orders made out 57 „ „ Bodies deposited and taken to the Mortuary 76 „ „ Houses from whioh Bedding, &c., was removed to be disinfected at the Board's apparatus 354 Articles disinfected at the Board's apparatus 1032 Disinfectants supplied to the Poor 1739 pkts. 288 bots. Fish condemned unfit for human food (pads) 11 *Many persons send requests hero 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.