HAC 15 Board of Works for the Hackney District. REPORT on the SANITARY CONDITIO of the HACKNEY DISTRICT, FOR THE YEAH 1892, by J. KING WARRY, M.D. (LOND.), Dip/omate in Public Health; Licentiate of the Society of Apothecaries; Member of the Society of Medical Officers of Health; Fellow of the British Institute of Public Health; Associate of the College of State Medicine; Acting Medical Officer of Health and Public Analyst for the District. LONDON: A. T. Roberts, Son & Co., Printers, 5, Hacknev Road, N.E. 1893. INDEX. page. Action for Preventing Disease and for Abatement of Nuisances 18—28 Cholera 18 Choleraic Diarrhœa 19 Water Supply of Stoke Newington 20—21 Disinfecting Apparatus 22 River Lea 23 Analyses of Food and Drugs 37—38 Birth Rate 4 Cow Sheds, List of 40—41 Death Rate 5 Dusting Account 24 Estimated Population 3 Infant Mortality 6 Marriage Rate 4 Meteorology 16—17 Mortuary 26 Notifiable Diseases 7—10 Non-Notifiable Diseases 11—12 Prosecutions under P. H. Act 35 Prosecutions under Food and Drugs Act 39 Register of Sanitary Work 34 Senile Mortality 7 Specific Causes of Death 7—15 Sanitary Inspectors 27—33 Slaughter Houses, List of 42—43 Tables— Population, Area and Density in Sub-Districts of Hackney 4 Births in Sub-Districts 4 Deaths 5 Infant Mortality 6 Senile Mortality 7 Notifiable Diseases in Sub-Districts 9—10 Influenza 11 Heath Statistics 13—15 Dusting Account 25 Inquests 26 Suicides and Accidental Deaths 27 Districts or Vestries with population, houses, and number of Inspectors 29 Vital Statistics 3 Zymotic Diseases 7—11 Board of Works for the Hackney District. REPORT OF MEDICAL OFFICER. TOWN HALL, HACKNEY, November, 1893. Gentlemen,— I beg to present my report upon the Health of the District of Hackney for the year 1892. The general death rate is an improvement upon that of last year, but the Infantile mortality and Zymotic death-rate show a slight increase upon those of 1891. On the whole, Hackney continues to maintain its place as one of the healthiest districts of London. VITAL STATISTICS. Estimated Population.—The usual method of estimating the population of any district for any particular year during intercensal periods, is that adopted by the Registrar General. By this method it is assumed that the rate of growth of the population from the last census will be the same as that during the preceding decade. The population for the district of Hackney at the last census—viz., that of 1891—was found to be 229,531, an increase having taken place during the preceding ten years of 43,069. Applying this rate of increase to the population of Hackney, I estimate it to become 234,913 at the end of June, 1892. This shows an estimated total increase of 5,382 during the year. The natural increase, i.e., the excess of births over deaths, would equal 2,700. The density of the population of Hackney at the last census was found 4 to be .53 persons per acre. At the middle of the year 1892 I find the density had increased to 59.66 persons per acre. For comparative purposes I give below a table showing the estimated population, area, and density of the various registration sub-districts in Hackney. Table showing population, area, and density of Registration Sub-Districts in Hackney. Stoke Newington. Stamford Hill. West Hackney Hackney South Hackney Totals. Estimated Population 31,943 18,819 43,226 98,932 41,993 234,913 Area in square acres 638 613 467 1,749 470 3,937 Density=persons per acre 50.06 30.69 92.56 56.56 89.34 59.66 Births.—The total number of births which took place in Hackney during 1892 was 6,758, of which 3,382 were males and 3,376 were females. This is equal to a birth rate of 28.7 per 1,000 inhabitants, that of London being 30.9 per 1,000. Below is given a table showing the distribution of the births in the different sub-districts of Hackney, giving numbers and rates per 1,000 :— Births. No. of Births Registration District of Hackney. Registration Sub-District. All London. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. 6,758 755 429 1,214 3,032 1,328 131,535 Rate per 1000 28.7 23.6 22.7 28.0 30.6 31.6 30.9 Marriages.—The number of marriages solemnized in the District of Hackney during the year 1892 was 1,854, against the number 1,839 in 1891. The marriage rate for 1892 is, therefore, 15.7 per 1,000, against 17.4 per 1,000 for the total population of London. 5 Deaths. General Death Rate.—During the 52 weeks of the year 1892, 4,056 deaths were recorded in the District of Hackney. These consisted of 1,989 males and 2,067 females. These figures show a death rate of 17.2 per 1,000, against 17.8 for the year 1891. Deaths occurring in institutions in Hackney of persons resident in other districts are excluded from the above figures, but the deaths of Hackney residents in out-lying institutions are included. The following table shows the deaths distributed in the various Registration Sub-Districts :— Deaths in the Hackney Sub-Districts during the Year ending December 31st, 1892. Sub-Districts. Total No. of Deaths. No. of Persons who died in Hackney, lately residing out of the District. Deaths of Hackney Parishioners in outlying Institutions. Nett No. of Deaths. Males. females Males. Females Males Females Males. Females Hackney (proper) 1187 1249 279 243 64 58 908 1006 South Hackney 337 351 5 1 22 9 332 350 West Hackney 341 344 45 33 25 10 296 311 Stoke Newington 217 215 10 8 4 5 207 207 Stamford Hill 122 102 1 — 10 9 121 102 Totals 2,204 2,261 340 285 125 91 1,864 1,976 Total Deaths in Hackney (gross) 4,465 ,, ,, (nett) 3,840 No. of Deaths of Hackney Males. Females Total. Parishioners in outlying Institutions 125 91 216 No. of Deaths in Hackney (nett) 1,864 1,976 3,840 Total 4,056 6 It is seen from the above that the death-rate for the Hackney District for the year 1892 is lower than that for the preceding year, in spite of the enormous amount of infectious disease prevalent during the greater part of the year. Compared with the deathrate for all London—which was 20.7 per 1,000 in 1892—Hackney may be said to have a low death-rate. Infant Mortality.—Under this head is comprised the number of deaths recorded during the year under the age of one year, and is calculated as a rate per 1,000 of births during the same time. There were 912 deaths under 1 year in Hackney during the year 1892. Calculated as above, these would give a rate of 134.9 per 1,000 births; the infant mortality for the whole of London for the same year being 154.7 per 1,000. Thus the infant mortality of Hackney compares favourably with that for the whole of London. Below is given a table of the principal causes of deaths of infants, with the numbers in the four quarters of the year. Eleven principal causes of Infant Mortality. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. TOTALS. Measles 3 7 7 2 19 Scarlet Fever 1 0 1 2 4 Whooping Cough 29 9 1 2 41 Teething: 9 4 5 3 21 Diarrhœa 7 5 72 2 86 Convulsions 35 18 23 23 99 Lung Diseases 52 26 18 56 152 Tubercular Diseases 17 10 26 13 66 Atrophy and Debility 31 42 44 57 174 Premature Birth 30 28 26 25 109 Accidents & Violence 9 10 6 3 28 Total 223 159 229 188 799 Other Causes 37 17 35 24 113 Totals 260 176 264 212 Grand Total. 912 7 Senile Mortality.—Under this head are included all deaths of persons aged GO years and upwards, of which 1,071 took place in Hackney during the year. This is equal to a death rate of 4.5 per 1,000 living persons; that of London, at the same rate and for the same period, being 5.1. The influence of season on the death-rate is shown in the following table :— Table showing total Number of deaths (corrected) of persons 60 years of aye and upwards in the Hackney Sub-Districts during the Four Quarters of the Year ending December 31st, 1892. Quarters. Hackney. (proper) South Hackney. West Hackney. Stamford Hill. Stoke Newington Totals. First 230 61 73 25 59 448 Second 120 29 38 20 33 240 Third 76 16 21 10 24 147 Fourth 107 42 38 16 33 236 Totals 533 148 170 71 149 1071 SPECIFIC CAUSES OF DEATH. Class I. Specific Febrile or Zymotic Diseases.—This class of disease furnished 732 deaths out of the total number of deaths in Hackney for the year, and so gives a rate of 3.1 per 1,000 of the population, that for London being 3'6 per 1,000. Included in this class are the following infectious diseases. NOTIFIABLE DISEASES. Small-Pox.—During this year Small-Pox again made its appearance in the district of Hackney. The total number of cases reported was 26. Out of this number there was only one death. It may be remarked that this person had been vaccinated. Thus the death rate from this disease was 3.8 per cent of persons attacked. Scarlet Fever.—Hackney, in common with most of the London Sanitary districts suffered greatly from this disease in 1892. At the end of the month of March a sudden increase of cases took 8 ???ce and continued unabated for some weeks. This increase was mostly associated with the distribution of a particular milk supply, but a special report has already been made on this subject. Another and more marked increase took place in the month of September, and corresponded in point of time with the re-opening of the schools after the Summer vacation, and also with the breakdown in the hospital accommodation of the Metropolitan Asylums Board. How much each of these factors contributed to the spread of the disease it is difficult to say. The total number of cases reported to the Sanitary Authority was 1944, and amongst these 67 deaths were recorded, which is equal to a death rate of 3.4 per cent. of cases. This indicates a rather mild form of the disease. Diphtheria and Membranout Croup.—This disease has been very prevalent in Hackney during the year. There was a gradual rise in the number of cases from the beginning of the year, which rise attained its maximum in the month of May, and then declined until September, rising again in October rapidly, after which it fell. The total number of cases reported was 642, of these 134 died, giving a death rate of 20.8, which rate is a very high one. Enteric Fever.—This fever continued to increase from the month of May till its maximum in October and November, and then declined as the cold weather approached. The total number of cases reported was 185, and of these 24 were fatal, equalling a death rate of 12.9 per cent. Continued, Fever.—Under this name 10 cases of sickness were reported, one of which was fatal. Erysipelas.—344 cases of this disease were reported during the year. Of these 20 cases proved fatal, corresponding to a death rate of 5.8 per cent. Puerperal Fever.—23 cases of this grave disease were reported, 16 of which proved fatal; thus equalling a death rate of 69.5 per cent. of those attacked. 9 TABLE showing the number of Cases and Deaths from the Notifiable Infectious Diseases distributed in the various Registration Sub-districts of Hackney during the year 1892. DISTRICT. Smallpox Scarlet Fever Diphtheria Typhus Enteric Fever Continued Erysipelas Puerperal Fever Cholera Mem. Croup Cases. Deaths. Cases. Deaths. Caaes. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Hackney Sub-Districts. Hackney 9 1 923 39 314 82 68 10 5 1 169 10 11 10 — — 15 7 South Hackney 6 — 326 8 124 16 — — 43 3 2 — 92 1 3 2 — — 10 6 West Hackney 9 — 287 10 58 9 — — 29 5 1 — 37 1 3 1 — — 5 1 Stamford Hill — — 176 4 55 4 — — 14 4 — — 16 4 3 1 — — — — Stoke Newington 2 — 232 6 59 9 — — 31 2 2 — 30 4 3 2 — — 2 — 26 1 1914 67 610 120 — — 185 24 10 1 344 20 23 16 — — 32 14 10 TABLE showing the number of cases and deaths in Hackney from the notifiable Infectious Diseases distributed in each month of the year, 1892. Month. Smallpox. Scarlet Fever. Diphtheria. Typhus. Enteric Fever. Continued. Erysipelas. Puerperal Fever. Cholera. Mem. Croup. Totals. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. | Cases. Deaths. Cases. Deaths. Oases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. j Cases. Deaths. January .. .. 61 3 22 5 .. .. 4 1 .. .. 19 2 .. .. .. .. 3 1 109 12 February .. .. 33 1 30 7 .. .. 4 3 .. .. 15 .. .. .. .. .. 4 3 86 14 March 3 .. 57 2 56 11 .. .. 3 1 .. .. 16 2 2 1 .. .. 4 1 141 18 April 1 1 164 3 80 13 .. .. 3 1 .. .. 19 1 1 .. .. .. 2 .. 270 19 May 8 .. 160 5 84 14 .. .. 9 1 .. .. 30 1 1 1 .. .. 4 2 296 24 June 2 .. 153 6 35 19 .. .. 14 2 2 .. 18 1 1 1 .. .. 3 3 228 22 July 1 .. 155 5 44 6 .. .. 20 .. 2 .. 19 2 .. .. .. .. 1 1 242 14 August .. .. 142 3 50 8 .. .. 27 1 .. .. 20 1 2 1 .. .. 1 .. 242 14 September .. .. 280 2 42 6 . .. 21 5 4 .. 37 1 2 1 .. .. 4 2 390 17 October 1 .. 351 20 78 18 .. .. 31 5 .. .. 52 4 4 2 .. .. 2 .. 519 49 November 3 .. 224 9 51 9 .. .. 32 2 2 .. 56 2 6 5 .. .. 3 1 377 28 December 7 .. 164 8 38 14 .. .. 17 2 .. 1 43 3 4 4 .. .. 1 .. 274 32 26 1 1944 67 610 120 • • .. 185 24 10 1 344 20 23 16 .. .. 32 14 3174 263 11 NON-NOTIFIABLE DISEASES. Influenza.—Influenza was the cause of 119 deaths. Of these 88 occurred between the ages of 45 years and 85 years; also of the total number 112 fell in the first quarter of the year. Below is given a table showing the number of deaths in each month of the year.:— Deaths from Influenza in each month during the years 1891 and 1892. Year. Jan. Feb. Mar. Apr. May. June. July. Aug. Sep. Oct. Nov. Dec. 1891 0 0 0 2 86 39 6 3 2 1 1 1 1892 77 29 6 3 1 1 1 0 0 0 0 1 Diarrhœa.—This disease furnished 113 deaths during the year. These were distributed as below in the different quarters of the year. This table shows, in a very marked degree, the influence of season on the deaths from Diarrhoea. :— Deaths from Diarrhœa. First Quarter 8 Second Quarter 12 Third Quarter 88 Fourth Quarter 5 Of these 113 deaths, 86 occurred in children under one year, and 1O3 under 5 years. The remaining cases were fairly evenly distributed over the remaining age periods. The mortality rate is therefore 48 per 1,000 living persons against .60 per 1,000 for all Loudon. Measles.—In the course of the year under discussion, 97 deaths were recorded, yielding a mortality rate of .41 per 1,000 living persons. The rate for all London was .80 per 1,000. Whooping Cough.—'Ihese deaths numbered 115, which is equal to a mortality rate of .48 per 1,000 living persons, that for the whole of London being .58 per 1,000. 12 Glass II. Constitutional Diseases.—These diseases caused 699 deaths, the highest number being due to Cancer and Tubercular diseases. The mortality rate is 2.97 per 1,000, that of all London being 3.83 per 1,000. Class III. Developmental Diseases.—This class caused 336 deaths. Of these 109 were premature births. The rate for this class of disease is therefore 1.42 per 1,000, the London rate being 1.24 per 1,000. Class IV. Local Diseases.—Under this heading is classed Nervous diseases, those of the Circulating Organs, Respiratory Organs, Digestive System, &c. The deaths from this class numbered 1,865 and of these 818 were due to diseases of the respiratory organs. This total gives a death rate of 7.91 per 1,000, as against 1019 per 1,000 for all London. Class V. Violent Deaths.—These deaths numbered 119, which is equal to a mortality rate of .5 per 1,000, against .75 for London. Class VI. ILL-DEFINED AND NOT SPECIFIED CAUSES. To the total foregoing death rate must be added 288 deaths from ill-defined or not specified causes, giving a rate per 1,000 of 1.22, London giving a rate of .71 per 1,000. 13 TABLE OF DEATHS Of Inhabitants of the Hackney District between 1st. Jan. and 31st Dec., 1892 AGES Under 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 Smallpox. Vaccinated .. .. .. .. .. .. .. 1 .. .. .. 1 Unvaccinat'd .. .. .. .. .. .. .. .. .. .. .. .. Vaccn doubtfl .. .. .. .. .. .. .. .. .. .. .. .. Measles 19 70 8 .. .. .. .. .. .. .. .. 97 Scarlet Fever 4 45 14 2 2 .. .. .. .. .. .. 67 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 41 73 .. .. 1 .. .. .. .. .. .. 115 Diphtheria 9 73 48 3 .. .. 1 .. .. .. .. 134 Simple Fever .. .. .. 1 .. .. .. .. .. .. .. 1 Enteric Fever .. .. 4 6 9 4 1 .. .. .. .. 24 Other Miasmatic Diseases .. .. .. 1 .. .. .. .. .. .. .. 1 English Cholera 1 .. .. .. .. .. .. .. .. .. .. 1 Diarrhoea, Dysentery 86 17 .. 1 .. 2 2 1 2 1 1 113 Ague, Remittent Fever .. .. .. .. .. .. .. .. .. 1 .. 1 Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis, &c. 10 1 .. .. 1 1 .. .. .. .. .. 13 Erysipelas 6 2 1 .. .. 2 1 3 4 .. 1 20 Pyaemia 2 .. 1 1 1 2 1 4 1 .. .. 13 Puerperal Fever .. .. .. 4 8 4 .. .. .. .. .. 16 Thrush Vege Parasites 2 .. .. .. .. .. .. .. .. .. .. 2 Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism .. .. .. .. 3 3 4 1 .. .. .. 11 Influenza 5 3 2 5 6 9 12 27 29 20 1 119 185 284 78 24 31 27 22 37 36 22 3 749 Constitutional Diseases. Rheumatic Fever .. 2 .. 5 2 4 .. .. .. .. .. 13 Rheumatism .. .. 3 .. .. 2 1 1 2 .. .. 9 Gout .. .. .. .. .. .. 1 2 2 .. .. 5 Rickets 5 3 .. 1 .. .. .. .. .. .. .. 9 Cancer .. 2 5 .. 10 12 32 44 28 10 2 145 Tabes Mesenterica 31 11 2 .. .. .. .. .. .. .. .. 44 Tubercular Meningitis 22 37 11 4 1 1 .. 1 .. .. .. 77 Phthisis 2 9 14 57 75 91 52 17 10 1 .. 328 Scrofula,, Tuberculosis 11 11 6 3 2 1 1 3 .. .. .. 38 Purpura Hæmoraga .. 1 2 .. .. .. .. .. .. .. .. 3 Anæmia, Leucocytha .. .. .. 2 .. 1 1 1 .. .. .. 5 Diabetes .. .. 1 .. 2 2 4 2 4 3 1 19 Other Constitutional Diseases .. .. .. .. 1 .. 2 1 .. .. .. 4 71 76 44 72 93 114 94 72 46 14 3 69 Developmental Premature Birth 109 .. .. .. .. .. .. .. .. .. .. 109 Malformations 11 .. .. .. .. .. .. .. .. .. .. 11 Old Age .. .. .. .. .. .. 1 7 41 108 59 216 120 .. .. .. .. .. 1 7 41 108 59 336 14 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 Nervous Diseases. Inflammation of Brain or Membranes 14 18 8 5 3 4 6 10 10 2 .. 80 Apoplexy, Hemiplegia .. .. 1 .. 3 7 19 37 68 34 4 173 Insanity, General Paralysis .. .. 1 .. 3 9 12 12 18 10 2 67 Epilepsy .. 1 .. 4 1 2 .. 3 1 .. .. 12 Convulsions 99 37 2 .. .. .. .. 1 .. .. 1 140 Laryngismus Stridulus 6 2 1 .. .. .. .. .. .. .. .. 9 Diseases of Spinal cord 1 2 .. 3 1 2 2 2 5 1 .. 19 Paraplegia .. 1 .. .. .. .. .. 1 .. 2 .. 4 Other Nervous diseases •• .. .. .. 3 3 1 1 3 •• •• 11 120 61 13 12 14 27 40 6, 105 49 7 515 Diseases of Circulating Organs. Peri & Endo-Carditis .. 1 .. 1 .. 1 2 2 .. .. .. 7 Valvular Disease of Hear 1 .. 9 10 12 23 21 37 31 16 1 161 Other diseases of heart .. .. .. .. .. 2 4 2 2 4 1 15 Aneurism .. •• •• 1 1 1 4 .. .. 1 .. 8 1 1 9 12 13 27 31 41 33 21 2 191 Respiratory Organs. Laryngitis 2 10 1 .. .. 3 .. .. .. 1 .. 17 Croup .. 12 1 .. .. .. .. .. .. .. .. 13 Asthma .. .. 1 .. 2 2 3 2 1 .. .. 11 Bronchitis 107 80 1 1 6 14 26 56 89 61 13 454 Pneumonia 42 68 14 19 18 24 26 39 34 14 4 302 Pleurisy .. .. .. 2 1 3 1 1 2 .. .. 10 OtherRespiratoryDis. 1 2 .. .. .. 3 1 2 2 .. •• 11 152 172 18 22 27 49 57 100 128 76 17 818 Diseases Digestive System Dentition 21 14 .. .. .. .. .. .. .. .. .. 35 Quinsy, Sore Throat 1 1 .. .. .. .. .. .. .. 1 .. 3 Disease of Stomach. 4 3 .. 2 .. 3 4 .. 4 5 .. 26 ,, Bowels . .. .. .. .. .. .. .. 1 .. 1 .. 2 Enteritis 16 4 2 1 .. 3 .. 4 2 3 .. 35 Obstruction of Intes tines 1 .. .. .. 2 1 1 9 6 6 26 Peritonitis.. 1 3 3 7 3 1 3 3 3 .. .. 27 Spleen .. .. .. .. .. .. .. .. .. .. .. .. Jaundice, Liver Dis 5 .. .. 1 2 13 9 17 12 5 .. 64 49 25 5 11 7 21 17 34 27 21 1 218 15 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 Diseases of Urinary System. • Kidney Diseases .. 1 2 3 1 .. 3 4 7 2 .. 23 Nephritis .. 1 2 .. 2 1 2 1 2 3 .. 14 Bright's Disease .. 1 2 1 3 3 7 10 7 5 .. 39 OtherKidney Diseases .. .. .. .. .. .. 1 .. .. .. .. 1 Bladder and Prostate .. .. .. .. .. 4 .. 3 2 5 1 15 .. 3 6 4 6 8 13 18 18 15 1 92 Diseases of Uterus &c Disease of Uterus. .. .. .. .. 4 2 1 .. 1 1 .. 9 Abortion, Flooding .. .. .. .. 2 4 .. .. .. •• .. 6 Puerperal Convulsion .. .. .. .. .. 1 .. .. .. .. .. 1 Ovarian Dropsy .. .. .. .. 1 .. 2 1 .. .. .. 4 .. .. .. .. 7 7 3 1 1 1 •• 20 Bones and Joints, &c. Caries, Necrosis 1 .. 1 .. 2 .. .. 1 .. .. .. 5 Arthritis, Ostitis .. .. .. .. .. .. .. 2 .. 1 .. 3 Carbuncle, Phlegmon .. .. .. .. .. .. .. 1 1 .. .. 2 Other Skin Diseases .. 1 .. .. .. .. .. .. .. .. .. 1 1 1 1 .. 2 •• •• 4 1 1 .. 11 Violence. Accidents & Violence 28 11 8 6 9 7 9 5 7 1 1 92 Homicide .. .. .. .. .. 1 .. 1 .. .. .. 2 Suicide .. .. .. 3 5 7 4 4 2 •• •• 25 28 11 8 9 14 15 13 10 9 1 1 119 Ill-Defined Causes. Dropsy .. .. .. .. .. .. .. .. 1 2 .. 3 Debility and Atrophy 174 3 1 .. .. 2 1 .. .. .. .. 181 Mortification .. 1 .. .. .. .. 2 3 3 2 .. 11 Tumour .. 1 .. .. .. 1 .. 2 1 .. .. 5 Abscess 1 .. .. 1 .. .. 2 .. .. .. .. 4 Hæmorrhage 1 .. 1 1 2 2 3 .. .. 1 .. 11 SuddenDeaths (doubtful) 5 3 .. 4 4 6 7 13 14 9 3 68 Causes not Specified 4 .. .. .. .. .. .. .. 1 .. .. 5 185 8 2 6 6 11 15 18 20 14 3 288 Total 909 642 183 170 217 303 307 409 465 343 97 4056 16 METEOROLOGY. January.—The weather dry and very cold, the mean daily temperature being below the average until the 21st of the month, and for the remainder rather above the average, tbe mean for the month being 37.70. Rain or snow fell on 12 days of this month, the quantity being small, only .55 inches. February.—During the early part of the month the weather was dry and moderately warm, but later very cold, the temperature falling much below the average. Snow fell on several days, the average amount of rain and snow being equal to 1.76 inches. March.—This month was dry, with frost and bitter winds. The mean temperature was 38.4 and was below the average. The amount of rain was 1.11 inches. April.—The mean daily temperature was above the average during the first week, but below the average during the remainder, the mean for the last three weeks being 48.8. The rainfall was 1.13 inches. May.—The weather was changeable, the temperature being below the average during the first week, but above the average for the remainder of the month. The mean monthly temperature was 55.90. Rain fell on nine days, the total amount being l.49 inches. June.—Was variable, the temperature being above the average until the 11th, when a sudden cold set in, and the temperature continued below the average until the end of the month. The fall of rain was above the average, 2.41 inches being registered in 13 days. Thunder storms were frequent throughout the month. July.—Was cold and wet at the beginning, but dry towards the end of the month. The mean temperature and the rainfall were both below the average during nearly the whole of the month, the latter being only 1.54 inches. In the early part of the month the wind was S.W., and N.E. during the latter part. August.—The mean temperature was 63.5 being above the average during this month. The rainfall was also above the average, being 3.14 inches. The wind was mostly S.W. 17 September.—On the whole this month was dull and wet. The mean temperature of 58° was somewhat below the average for several years. Rain fell on 12 days, the total amounting to 2.35 inches. October.—The weather during this month was very cold, and the temperature below the average from October 1st, till October 27th, the mean daily deficiency amounting to 7°. Fogs were prevalent in London, and the rainfall was the highest during the year, 19 days being wet and 3.92 inches having fallen. November.—Milder weather prevailed during the first half of this month, the temperature being above the average, but the latter half was much colder, the mean daily temperature being 46.5° The amount of rainfall registered during the month was 2.67 inches. Fogs were prevalent. December.—Temperature was below the average for the last 52 years at the beginning of this month, but the second and third weeks were above the average daily temperature. This month was a comparatively dry one, rain falling on 10 days, and the amount measuring only 1.27 inches. 1892. Temperature. Bel. Humidity. Amnt. of Cloud. Rain. 9 a.m. Means. Extremes. Amnt. No. of Days. Min. Max. Range. Mean. Min. Max. o o o o o o o % In. January 37.5 33.4 41.9 8.5 37.7 24.1 52.2 87 9.7 .55 12 February 39.5 35.8 44.6 8.8 40.2 20.1 53.0 83 8.8 1.76 16 March 38.1 32.7 44.2 11.5 38.4 25.9 59.2 77 7. 9 1.11 10 April 47.6 39.1 58.4 19.3 48.8 30.2 72.4 68 7.1 1.13 10 May 57.1 47.3 64.6 173 55.9 35.5 811 63 9 2 1 49 9 June 59.0 51.2 66.6 15.4 58.9 40.4 30.1 68 7.9 2 .41 13 July 60.3 53.9 67.9 14.0 60.9 48.9 78.3 72 8.6 1.54 9 August 62.7 56.3 70.6 14.3 63.5 49.6 79.0 72 8.0 3.14 16 September 57.9 52.0 64.0 12.0 58.0 45.2 72.2 76 8.4 2.35 12 October 46.6 41.9 52.2 10.3 47.0 32.2 599 82 8.7 3.92 19 November 46.1 42.5 50.5 8.0 46.5 35.2 60.2 88 9.3 2.67 15 December 37.6 34.3 42.2 7.9 38.3 24.0 54.3 86 8.0 1.27 10 Year. 49.2 43.4 55.6 12.2 49.5 20.1 81.1 77 8.5 23.34 151 18 Action taken during year for Preventing the Spread of Infectious Diseases and for the Abatement of Nuisances. CHOLERA. During the summer of 1892 cholera spread rapidly over Europe, and attained a special virulence in certain ports on the western coast of the Continent. The disease being so near England, and the port of London being in daily communication with these ports, the Local Government Board—seeing the possibility of cholera being introduced by these means into London—sent a circular letter to the various sanitary authorities of the Metropolis, including Hackney, calling their attention to the danger of cholera being imported into London, and urging them to make preparations for the provision of hospital accommodation for cholera patients, to provide refuges for any persons who might be exposed to infection, for the lodgment of the families of infected persons while the houses were being disinfected and cleansed, and to provide free medical attendance and treatment during an epidemic. Knowing that the best preventive for the spread of such a disease as cholera is to secure all water supplies against being fouled in any way, and to have all dwellings put in a sound sanitary condition, I recommended the temporary employment of two extra Sanitary Inspectors. These Inspectors were employed upon house-to-house inspection; one at Hackney Wick, and the other in certain parts of Stoke Newington. In consequence of what was revealed by the inspections of the latter officer, I made a report to the Board, which was approved of and acted upon. ( Vide pp. 20). 1.—Hospital Accommodation.—Inquiries were made in the District as to the hospital accommodation available for cases of cholera should the necessity arise. This led to the result that about 100 beds in the different, institutions would be provided for Hackney patients, should such be required. 19 2,—Refuges.—A suitable house was found and negotiations opened for its temporary acquisition. 3.—Medical house-to-house Visitation and Treatment.—I suggested the present ward division of the District as being most suitable for this purpose, and that an equivalent number of the Poor Law Medical Practitioners should be engaged to undertake in the several wards the above visitation and treatment. Fortunately, the necessity for carrying these measures into execution did not arise. SUMMER OK CHOLERAIC DIARRHŒA. In consequence of the large number of deaths from this cause, I deemed it expedient to draw up certain preventive rules, and to recommend the circulation of copies of the same in the crowded parts of the District. Ten thousand copies were left at the houses in these parts, with the result that many serious nuisances were brought to the notice of the sanitary officials. The following is a copy of the rules drawn up :— BOARD OF WORKS FOR THE HACKNEY DISTRICT. RULES FOR THE PREVENTION OF CHOLERAIC OR SUMMER, DIARRHOEA. 1.—Offensive smells, or any defects in the water-closets or drainage of the house should be at once reported to the Sanitary Authority. 2.—House refuse must not be allowed to accumulate on the premises until it becomes a nuisance, but should be removed at frequent intervals. This will be done by the Board's dustmen, on placing in the window the printed '• D " supplied to each household. If possible all vegetable refuse to be burned, provided it can be done without creating a nuisance. Dustbins ought to be kept in thorough repair. 3.—Where there is constant dampness of the soil near the dwelling, or of its walls, it should be reported to the Sanitary Authority. 20 4.—Ventilation must be thoroughly attended to, and as much fresh air as possible allowed to circulate through the dwelling. 5.—(a) All food should be stored in well ventilated and lighted cupboards, away from any foul or offensive smells. Cupboards under stairs or in cellars should not be used for this purpose. (b) No tainted or stale food should be eaten. This especially applies to stale or unripe fruit, stale vegetables, fish or milk. All milk received on the premises should be boiled immediately. (c) Parents who artificially feed their infants on milk ought to see that it is quite fresh, and also give particular attention to the condition of the feeding bottles, cups, &c., used for this purpose. These should be scalded in every case before use. 6.—Cisterns supplying drinking water ought to be frequently cleaned out, and where such cisterns supply water closets, the fact should be reported to the Sanitary Authority at the Town Hall. 7.—Attention should be paid to the general health. If this is neglected there is far more likelihood of being attacked by the malady. J. KING WARRY, M.D., D.P.H., Acting Medical Officer of Health. August 8th, 1892. STOKE NEWINGTON AND WATER SUPPLY. In consequence of the inspections made in this part of Hackney, I submitted the subjoined report to the Board. REPORT. I beg further to draw the attention of the Board to the following facts with regard to the water supply of a certain district in Hackney. It is well-known that the greater part of Stoke Newington and some other neighbouring parts are supplied with drinking water by an intermittent service. This service of water requires a cistern in each house large enough to contain a day's supply of water for the whole household. During the last few months numerous inspections have been made in this district, and these inspections reveal the facts that many of the house-cisterns are placed in positions where the water is in great danger of contamination; also a very large proportion are connected directly with water-closets; and again, that many of the cisterns are only cleaned out at long intervals. I give below a table showing the proportion of these insanitary conditions in certain streets :— 21 Name of Street. Ayresorme Road. Painsthorpe Road. Sandbrook Road. Harcombe Road. Oldfield Road. Bull Alley. Chapel Place. Abney Gardens. Bowling Green Street. TOTAL. Total number of houses in the street 41 16 67 64 101 13 5 14 2 346 Number of houses where water cistern is placed under bed room floor 35 12 - - 15 - - - - 62 Number of houses where cistern is connected directly with w.c 23 14 49 31 42 10 5 14 4 192 Thus, out of a total of 346 houses, the drinking water of 254 is liable to contamination, either by reason of the position of the cistern, or by reason of the cistern being connected directly with the w.c. These streets are not selected ones. I believe the same proportion holds good throughout the whole of the district where the intermittent water supply is on. It is unnecessary to remark that this state of things is a very dangerous one to the district, and should Cholera be introduced at any time, such insanitary conditions would foster the growth and spread of the disease. While most of the work in the above mentioned streets is in progress to remedy the above state of things, it will require a long time with our present staff to put the whole district in a safe condition with respect to this matter. There is one way, however, in which the whole state of affairs in this particular district might be remedied within the space of two or three months. I allude to the putting on of a constant supply of water by the New River Company in place of the intermittent service. I. therefore, strongly recommend the Board of Works to represent to the London County Council the necessity, on sanitary grounds, of a constant water supply in the district supplied by the New River Company, and also to urge the Council to take the necessary steps to obtain it. I remain, Gentlemen. Yours obediently, J. KING WARRY, M.D., D.P.H.. Acting Medical Officer of Health for the District January 6th, 1893. 22 The Board after adopting the same, instructed its clerk to communicate with the London County Council, and represent the necessity on Sanitary grounds for a constant water supply for Stoke Newington. The London County Council replied, that as soon as possible notices would be served on the Water Company to supply a constant service of water in the district above mentioned. DISINFECTING APPARATUS. In the month of October last, having made an enquiry as to the efficiency of the present disinfecting apparatus—which is an oven disinfecting by dry heat alone—I found that the said apparatus did not effectually do the work of disinfection. The dry heat did not penetrate the articles exposed to its influence, and the temperature obtained was not equal in all parts of the oven; also, that I could not depend upon obtaining the desired temperature for disinfection from this apparatus. From experiments made, I found the disinfector to be most erratic in its behaviour, and quite worthless as a certain means of destroying the organisms of infectious diseases. I reported these facts to the Sanitary Committee, and recommended that a new steam disinfecting apparatus should be erected in place of the present dry heat apparatus. The Sanitary Committee appointed a Sub-Committee to enquire into the whole matter, and report thereon. Accordingly the Subcommittee reported to the Sanitary Committee as follows :— Town Hall, Hackney, N.E. 3rd November, 1892. REPORT OF THE SUB-COMMITTEE RE DISINFECTING APPARATUS. To the Sanitary Committee, Hackney Board of Works. Gentlemen, Your Sub-Committee have to report that they held a meeting on Saturday the 29th inst, for the purpose of considering your reference on this question. 23 Your Sub-Committee visited the disinfecting shed at Homerton Bridge, and made a thorough examination of the building, disinfector, and appliances in connection therewith, the disinfector being packed with clothing and bedding at the time. Your Sub-Committee are of opinion that the disinfecting apparatus and the building are thoroughly and dangerously inefficient for the requirements of the District, and they therefore recommend that immediate active measures be taken to remedy the same. (Signed) C. T. MATTHEW, Chairman. H. HULLAND. E. A. GIBSON. The Sanitary Committee, on receiving and considering this report of its Sub-Committee, resolved to recommend the Board of Works to purchase a Steam Disinfecting Apparatus, and to erect a more suitable building as a disinfecting station, in place of the present apparatus and shed. The Board of Works approved of and adopted the recommendations of its Sanitary Committee, and voted the necessary funds to carry out the work, also giving instructions that this work should be proceeded with. I am pleased to say that the apparatus has been ordered, and the building will soon be in course of erection. RIVER LEA. During the year 1892, I made repeated analyses of the water of this river. In each case the analysis showed that the water of the river was receiving from some source or sources, a great deal of pollution. I caused an inspection to be made of its banks, with a view of ascertaining the origin of these pollutions, and found that several houses on the Hackney Marshes drained into the stream. These drains have been cut off, but still no material difference has been made in the purity of the water. It appears however, that in addition, the River Lea receives in the Hackney District the effluents from two sewage farms, viz. :—Levton and 24 Walthamstow. I have made several chemical analyses of these effluents, and find that they approach very closely in point of pollution to that of raw sewage. Representations have been made to the London County Council and Lea Conservancy Boards, to provide some remedy for this state of things, as yet without avail. DUSTING ACCOUNT. During the year 48,012 loads of house refuse were removed by the Contractors from inhabited dwellings and disposed of upon their "shoots" (each of the above loads means 54 cubic feet), the Contractors receiving for their removal the sum of £8,763 7s. 1d. The cost of such removal varied, however, during the year, the average cost per load being 3s. 2¾d. during the first quarter of the year, but 3s. 9½d. per load during the remainder of the year, the average for the whole year being 3s. 8d. per load. This difference was due to a new contract entered into in April at a higher rate per load. But in addition to the above sum the Board expended £1,308 12s. 6d. in wages for their dustmen. This sum added to that paid to the Contractors brings the total to £10,971 19s. 7d., and the cost per load up to about 4s. 2¼d. At the last census— April, 1891—the number of inhabited houses in the District of Hackney was found to be 33,187. Without making any correction for an increase, and taking these figures to represent the number of inhabited houses in Hackney during last year, the average amount of dust removed from each house during the year was 1.4 loads, or 75.6 cubic feet, or 1.44 cubic feet per week. At 4s. 2¼d. per load it cost the Hackney Board of Works 5s. 10½d. to remove the refuse from each inhabited house for the year, or barely 1¾d. from each house per week. 25 Dusting Account—January to December, 1892. MONTH. "A" Division. "B" Division. "C" Division. Loads. Cost. Loads. Cost. Loads. Cost. £ s. d. £ s. d. £ s. d. January 1,532 226 12 2 1,324 215 3 0 1,238 216 13 0 February 1,580 233 14 2 1,260 204 15 0 1,336 233 16 0 March 1,525 225 11 6 1,260 204 15 0 1,270 222 5 0 April 1,446 250 0 9 1,212 257 11 0 1,202 225 7 6 May 1,628 281 10 2 1,302 276 13 6 1,432 268 10 0 June 1,716 296 14 6 1,360 289 0 0 1,392 243 12 0 July 1,267 219 1 9 1,052 223 11 0 1,168 204 8 0 August 1,246 215 9 1 1,116 237 3 0 1,104 193 4 0 September 1,411 243 19 9 1,302 276 13 6 1,212 212 2 0 October 1,299 224 12 4 1,242 263 18 6 1,120 196 0 0 November 1,517 262 6 4 1,286 273 5 6 1,248 234 0 0 December 1,703 294 9 7 1,374 291 19 6 1,330 249 7 6 Add 75 1 6* 17,870 2,974 2 1 15,090 3,014 18 6 15,052 2,774 6 0 + This was undercharged, afterwards recouped. 1892. DUSTMEN'S WAGES— £ s. d. Six Months ended 24th June 566 9 2 „ 30th December 742 3 4 £1,308 12 6 26 THE MORTUARY. The following tables give the number of bodies deposited in the mortuary and the post-mortems performed, together with the number of inquests held in the Coroner's Court during the year 1892.:— No. of bodies deposited in Mortuary 249 (a). To await inquests 240 (b). Upon request of relatives to await burial 9 No. of Post-mortems performed 35 INQUESTS. Verdicts. Sex. Male. Female. Natural causes 93 83 Accidental Death 19 10 Suicide 18 5 Murder .. 1 Open Verdict 6 5 Totals 136 104 27 TABLE showing Suicidal and Accidental Deaths in the Hackney District during the year ended 1892. SUICIDES. ACCIDENTAL DEATHS. Nature of Suicide. No. Nature or Accidental Death. No. Drowning 12 Suffocated in bed 21 Run over on the Railway 1 Concussion of brain 1 Hanging 5 Carbolic Acid Poisoning 1 Poison—Oxalic Acid 1 Jumping out of a train in motion 1 Do. Prussic Acid 1 Overdose of Chloral 1 Pistol Wound 3 Run over 2 Burns 2 Total 23 Total 29 THE PERMANENT STAFF OF SANITARY INSPECTORS. There is one subject which I think it my duty to bring before the Hackney district Board of Works for their serious consideration, and I think the present is the most fitting time for this— I refer to the permanent staff of Sanitary Inspectors. This staff is a quite inadequate one if the various duties placed by modern legislation upon the Sanitary Authority are to be carried out thoroughly, and to the extent contemplated and ordered by the different Sanitary Acts and Orders in force. The Board will, no doubt, require some proof that the staff of Inspectors is insufficient, consequently I shall proceed to lay before the members such facts as have led me to the conclusion that Hackney is not provided with sufficient Sanitary Inspectors. The evidence may be divided into two parts— 28 (a) Evidence derived by comparison of the Hackney staff, with certain other London districts. (b) Evidence derived from a consideration of the increased duties imposed by the various Acts and Orders upon the Local Authorities since the last increase in the number of permanent Inspectors. (A) In order to present this evidence in a fair and intelligible form, 1 have constructed a table showing the population, number of houses, inhabitants, and of permanent Sanitary Inspectors, together with the average number of houses and inhabitants per Inspector— (1st) For the whole of London, excluding Hackney. (2nd) For various other large London Districts, which I have selected as fair, representative types from the great divisions of North, South, East, West, and Central, respectively. I think it will be admitted, in the first place, that no one of the local bodies tabulated has erred on the side of extravagance in the number of permanent Sanitary Inspectors appointed for the District. The necessity for an increase in the permanent officials of local bodies is always closely scrutinized, and is never conceded until that necessity has been clearly established. Such being the case, how does Hackney compare with other districts of London? The best answer to this will be a careful examination of the annexed table. In this table the contrast between Hackney and the other London districts is very marked. Taking the whole of London, exclusive of Hackney, the number of Inspectors appointed is, roughly, in the proportion of one Inspector to about 3,000 houses, or to 23,000 inhabitants, but in Hackney the proportion is one Inspector 29 to over 6,000 houses, or about 46,000 inhabitants, i.e., if the whole of London—excluding Hackney—be taken as a standard, Hackney has not half its proper staff of Sanitary Inspectors. The number of Inspectors appointed at Hackney should be eleven to reach the above-mentioned standard. But the members of the Board of Works will be able to draw their own conclusions from a study of the table. DISTRICTS or VESTRIES. Population. No. of Houses. Inhabitants per House. No. of Sanitary Inspectors. No. of Inhabitants per Inspector. No. of Houses per Inspector. LONDON (excluding Hackney) 3,981,525 520,577 7.6 179 22,243 2,908 North. Marylebone 142,381 15,354 9.2 6 23,730 2,559 St. Pancras 234,437 24,611 9.5 8 29,304 3,076 Islington 319,433 38,259 8.3 14 22,816 2,732 Hampstead 68,425 9,528 7.1 4 17.106 2,382 Hackney 229,531 33,187 6.9 0 45,906 6,637 East. Shoreditch 124,009 13,932 8.9 4 31,001 3,483 Whitechapel 74,420 8,170 9.1 4 18,606 2,042 St. George-in-East 45,546 5,451 8.3 3 15,182 1,817 South. Battersea 150,458 20,930 7.1 7 21,494 2,990 Wandsworth 156,931 25,391 6.1 12 13,077 2,116 Jamberwell 235,312 33,991 6.9 14 16,808 2,427 Lewisham 92,647 15,898 5.8 6 15,441 2,649 Plumstead 88,539 14,545 6.0 3 29,513 4,848 | West. Kensington 166,321 22,002 7.5 6 27,720 3,667 Westminster 55,525 5,756 9.6 3 18,508 1,918 Central. St. Giles 39,778 4,068 9.7 5 7,955 813 Strand 25,107 2,154 11.6 2 12,553 1,077 Holborn 33,503 3,867 8.6 2 16,751 1,933 City of London 37,504 5,750 6.5 11 3,409 522 30 (B). In the Annual Report of the late Medical Officer of Health, Dr. Tripe, he stated, "There have been greatly increased duties placed on the Sanitary Staff by the Factory and Workshop Act, 1891, which have not been, and cannot be met by the present Inspectors, so that they must remain unattended to." The last permanent increase in the number of Sanitary Inspectors was made in the month of June, 1891. This increase brought the staff up to five permanent Inspectors, and it still remains at that number. Again; since the last increase made in the permanent staff of Sanitary Inspectors, legislation has placed further duties upon the local authorities. The following additional duties are imposed upon the Sanitary Authority by the passing of the Public Health Act of 1891.:— (1). Duty of enforcing abatement of Smoke nuisances. (This was previously performed by the police, of whom two were detailed in Hackney to give their whole time to the work). (2). The closing of underground rooms, formerly und< r the control of the District Surveyors. (3). Removal of dung or refuse, where owners are unable or unwilling to remove. (4). Inspection of newly-built houses, to see if water supply and fittings are proper and sufficient. (5). Under the head "Prevention of Infectious Diseases," the Sanitary Authority are obliged to disinfect and cleanse rooms previously occupied by any person or persons suffering from an infectious disease, should the master or owner decline to do so. (6). When Water Companies cut off the water from any dwelling, notice of this must be sent to the Local 31 Authority. The Authority then deals with this as a nuisance. (7). Enforcing the bye-laws of the London County Council. Sec. 1.—P. H. A. (London) 1893, includes this very important duty. "It shall be the duty of every Sanitary Authority to cause to be made from time to time inspection of their district, with a view to ascertain what nuisances exist calling for abatement under the powers of this Act, and to enforce the provisions of this Act for the purpose of abating the same, and otherwise to put in force the powers vested in them relating to public health and local government, so as to secure the proper sanitary condition of all premises within their district." I insert this section in full because, although it may have been included in previous Sanitary Acts, it has never been fully carried out in Hackney for want of a sufficient staff, and is practically to Hackney a new duty. Inland Revenue Act, 1891.—This imposes, upon the Medical Officer of Health, the fresh duty of granting certificates to persons owning houses let out in tenements, if the houses are in a satisfactory sanitary condition. Such certificates exempt the owners from Inhabited House Duty. Housing of the Working Classes Act, 1890.—This Act has placed many and increased duties upon the Local Sanitary Authority, but as no action has ever been taken in Hackney under its provisions, I have included it here amongst the new duties. Canal Boats Act.—Hitherto the number of Canal Boats which v;e have been able to inspect, has averaged about 100 during the year, but I have been informed by the Government Inspector, that he could not consider the Act properly enforced unless about 300 32 boats are inspected yearly. Of course this will add considerably to the work to be done by the Sanitary Authority. Factory and Workshops Act, 1891.—This Act, together with the recent circular relating to out-workers, has almost doubled the work of the Sanitary department, if carried out thoroughly. Enquiry has revealed the presence of something like 2,000 workshops and dwellings of out-workers, which under this Act and Order should be inspected to ascertain the presence or otherwise of any insanitary condition. With the present staff it is impossible that this can be attempted. Food and Drugs Acts and Margarine Acts.—If the Board of Works desire another 100 samples of Foods and Drugs to be analysed every year, the collection of these samples will take one half more time than that already consumed in the work. 1 do not pretend in the above list of increased duties to have exhausted them, but I have given I think sufficient to show that the amount of work to be done by the Sanitary Staff, has greatlyincreased during the last few years. Therefore from a comparison of our staff of permanent inspectors with those of other districts and vestries in London, and from a consideration of the increased duties imposed upon the Sanitary Authority since the last permanent increase, I am convinced, and I believe the Board will also be convinced, that Hackney is under-staffed in the matter of its Sanitary Inspectors. The question now naturally arises, how many Inspectors might be considered an adequate number for a district like Hackney ? In answering this question, I think it much preferable to estimate the number requisite on the total number of houses in Hackneyrather than on the population; for the Inspectors have to deal with dwellings rather than with individuals, although this remark is subject to the qualification that a dwelling with a large number of inmates requires more looking after than one with a few only. In the Northern Registration Districts of London, viz.: those bordering on Hackney, the permanent staff of Sanitary Inspectors 33 is in the proportion of one Inspector to from 2,382 to 3 076 inhabited houses. The latter is the proportion in St. Pancras. This is not an ideal standard, though it should be noted that St. Pancras has 9.2 inmates to each house, while Hackney has only 6.9, so if we adopted their proportion of one Inspector to about 3,000 houses, we should really be setting a higher and better example. In my opinion the District of Hackney should not have less than one Inspeotor to 3.000 houses, and this is a minimum which it may be necessary to alter in the future, should further duties added to the existing duties of the Sanitary Inspectors. I am sure the Board cannot hope to successfully fulfil its statutory obligations in regard to the public health with a smaller number than the above. I must remind the Members of the Board that by the Public Health Act (London) 1891, they may re-appoint their present Sanitary Inspectors under the Local Government Board, and so obtain half their salary from "the London County Council, out of the Exchequer Contribution Account, in accordance with Section twenty-four of the Local Government Act, 1888." By so doing the staff might be doubled without much additional local expense. I have ventured to bring this subject to the notice of the Hackney Board of Works, because of its importance and urgency, and also because in being silent I should have neglected an important duty. Connected with this subject is that of a redistribution and localisation of the duties of the Sanitary Inspectors. But this subject is so closely connected with that of the adequacy of the staff, that a consideration of the latter would necessarily be followed by that of the former. I remain, Gentlemen, Yours obediently, J. KING WARRY, M.D., D.P.H., Acting Medical officer of Health, and Public Analyst for the Hackney District. 34 REGISTER OF SANITARY WORK FOR THE YEAR 1892. Number of complaints received 2308 Inspections— Made on complaint 3077 House to house 2933 Houses after Infectious Diseases 2723 Houses re-inspected after Infectious Diseases 6807 Of Fishmongers' and Poulterers' yards 103 „ Cow houses (premises) 68 „ „ (sheds) 113 ,, Bakehouses 12 ,, Greengrocers' yards 95 ,, Urinals 63 ,, Canal Boats 76 Animals improperly kept 9 Letters sent out 5201 Statutory notices served 200 Copies of Summonses and Orders made out 294 Bodies received into the Mortuary 249 Houses from which bedding, etc. was removed to be disinfected by the Board's apparatus 1804 Articles disinfected by the Board's apparatus— Beds 1004 Mattrasses 347 Palliasses 8 Bolsters 753 Pillows 1818 35 Blankets 1604 Sheets 117 Counterpanes 5 Carpets, Rugs, etc. 43 Quilts 255 Other articles 836 6790 Rooms fumigated 1923 Disinfectants supplied to the poor (bottles) 1350 (bags) 3240 Inquests held 240 Post-mortems held 35 Intimation Notices served 3927 Peremptory or Final Notices served 421 Infectious Patients removed to Hospital 769 Cautionary Notices to Schools re Infectious Sickness 1927 Nuisances abated (miscellaneous) 4234 Accumulations of dust specially removed 1652 Condemned as unfit for human food—Fish 19 cwt. „ „ „ Fruit 5 „ „ „ „ Rabbits 32 „ Record of prosecutions under the Public Health (London) Act 1891, during the year 1892. Address. Complaint. Magistrate's Decision. 10, Stockmar road No water supply Order to close house as uninhabitable. 2, Lome Villas, Mandeville street Bell trap Withdrawn. 3, John street, Homerton Dirty and unwholesome rooms and defective arris gutters. Order to do the work within 14 days. 36 10, Stockmar road Refusal to comply with Magistrate's closing order. Order to pay fines incurred, £3 2s. Od. 9, Anderson road Bell trap, sink connected Order to do work within 7 days. 6, Durham grove Bell trap, sink connected Order to do work within 7 days. 5. Templar road Withdrawn, work done Union Wharf, Hertford road Offensive accumulations and deposit. Withdrawn, nuisance abated 38, Tottenham road Choked drains Work ordered to be done forthwith. 40, Tottenham road Choked drains Work ordered to be done forthwith. 156, Stamford hill No water supply Order to restore water within 7 days. Crown Wharf, Hertford road Accumulation of soft core Withdrawn, nuisance abated. Hertford Wharf, Hertford road Omega House, Barrett's grove Accumulation of refuse and burning. Underground room, damp house, no water supply, closet accommodation defective, gutters and stack pipes defective, rims defective. Dismissed, with £2 2s. Od. costs against the Board. Order to close underground room and fulfil other sanitary requirements within 21 days. £2 2s. costs. 156, Stamford hill Refusal to comply with order of Magistrate. Order made to close the house. 140, Winston road Foul, offensive and choked drains. Order to do the work within 3 days, fined Omega House, Barrett's grove Disobeying nuisance order £2 10s. and 2/- costs. Belgian House, Barrett's grove Underground room Order to close room, with £2 0s. 0d. costs. Omega House Non-compliance with Magistrates closing and nuisances orders. Panalties to be enforced, £24 12s. 0d. Belgian House 356, Green lanes Pan closets improperly trapped & flushed stack pipe defective and connected to drain water supply drawn from cistern supplying W.C. Order to do the work within 7 days. 2, 3,4, 5, 7 & 9, Windsor road Six houses; damp yard, paving defective, floors below ground-levelw.thout ventilation and dangerous, walls and ceilings dilapidated, house generally unfit for human habitation. Order to close the premises forthwith as uninhabitable. £1 6s. 0d. costs. 8, Southboro' road Closets without light or ventilation. Order to do the work within 7 days. 30, Charnock road No water supply Order to do the work within 7 days. 21, Lordship road Defective paving, etc. Withdrawn, work done. 26, Well street House damp Withdrawn, work done. 156, Stamford hill Occupying house without proper water supply. Ordered to pay fine and costs. £2 6s. 0d. 9, High road, Clapton House unfit for habitation, no W.C. accommodation Order to close house forthwith. 37 Table of Samples of Food and Drugs purchased, with number found Adulterated, during the year 1892. Samples. No. purchased. No. adulterated. Milk 111 15 Coffee 21 6 Butter 20 10 Cocoa 4 3 Pepper 8 — Mustard 8 - Chocolate 2 - Arrowroot 3 - Tea 1 - Brandy 1 - Whisky 8 - Rum 2 - Gin 6 - Ale 1 - Porter 1 - Precipitated Sulphur 1 - Cream. of Tartar 1 - Paregoric 1 1 Total 200 Total 35 Table of Adulterated Article, showing amount of Adulteration and result of legal proceedinga. No. of Sample. Article. Adulteration. Result of Legal Proceedings. Remarks. 2362 Milk 18% of added Water Fine 20/- & 12/6 costs 2364 Milk 24% „ 25/- „ 12/6 „ 2368 Coffee 30% of Chicory „ 20/- „ 12/6 „ 2370 Coffee .. 60% ,, 25/- „ 12/6 ,. 2376 Milk 10% of Water 10/-,, 12/6 „ 2379 Coffee 30% of Chicory „ 40/- „ 12/6 2385 Coffee 25% „ 20/- „ 12/6 „ 38 Adulterated Articles.—continued. No .of Sample. Article. Adulteration. Result of Legal Proceedings. Remarks. 2386 Milk 17% of Water Fine £10 & 12/6 costs From farmer's milk traced from Welwyn 2396 Milk 10% „ 20/- „ 12/6 „ 2402 Butter 69.8% of Foreign Fat 2/- „ 2403 Butter 39.9% „ „ 10/- „ 12/6 „ 2404 Coffee 25% of Chicory Dismissed as the pkt.was labelled mixture. 2420 Milk 16% of Water Dismissed. 2421 Milk 8% „ Dismissed. 2422 Milk 18% Fine £5 & 15/6 costs 2440 Butter 70% of Foreign Fat „ 20/-„ 12/6 „ 2441 Butter 80% „ 40/-,,12/6 „ 2445 Milk 7% of Water „ 10/- „ 12/6 „ 2457 Milk 11% „ „ 10/- „ 12/6 „ 2475 Butter 24% of Foreign Fat 2/- „ 2489 Milk 20% deprived of Fat Dismissed. Sold as separated milk. 2491 Milk 15% of added Water „ 20/- „ 12/6 „ 2494 Butter 30% of Foreign Fat „ 10/6 „ 2/- „ 2500 Milk 26% of Water „ 10/6 „ 2/- „ 2507 Cocoa 25% of ForeignStareh „ 10,6 „ 2/- „ 2509 Paregoric Contained no Opium Dismissed on point of law. 2516 Milk 11% of Water „ 12/6 „ 12/0 ., 2519 Butter 70% of Foreign Fat „ 10/ „ 12/6 „ 2521 Coffee 40% Chicory Dismissed with 21/-costs against Board. 2523 Cocoa 35% of ForeignStarch „ 10/6 „ 2/- „ 2524 Cocoa 23% „ „ „ 20/- „ 12/6 „ 2530 Milk 10% of Water „ 20/- „ 12/6 „ 2534 Butter 85% of Foreign Fat 12.6 „ 2535 Butter 96% „ „ 12/6 „ 2551 Butter 90% „ „ „ 10/6 „ 2/- „ 39 Summary of Reports of Food and Drugs Inspector of persons summone I during the year 1892, for offences under the Food and Drugs Act, 1875. and Margarine Act, Date. Name. Address. Description of Article. Extent of Adulteration. No. of Convictions (if any) Decision of Magistrate. 1892 20 Jan. Joseph Hume 113, Overbury Street, Clapton Milk 18% added water First Fined 20/- and 12/6 costs 20 Jan. E. Askew 16, Wick Road, Homerton Milk 24 % added water First Fined 25/- and 12/6 costs 2 Feb. James Warren 241, Amhurst Road Coffee 30 % chicory First Fined 20/- and 12/6 costs 20 Jan. Chas. Pearce 29, Rectory Road, Stoke Newington Coffee 60 % chicory First Fined 25/- and 12/6 costs 20 Jan. Richard Cutter 124, Clarence Road, Clapton Milk 10 % added water Firbt Fined 10/- and 12/6 costs 10 Feb. W. Sammon 120, Well Street, Hackney Coffee 30 % chicory First Fined 10/- and 12/6 costs 10 Feb. James Lee 51, Shacklewell Lane Coffee 25 % chicory First Fined 20/- and 12/6 costs 2 March Wm. Lyle Digswell Lodge, Welwyn, Herts Milk 17% added water. First Fined £10 and 12/6 costs 24 Feb. John Jones 97, Balls Pond Road Milk 10% added water First Fined 20/- and 12/6 costs 24 Feb. A. Smith 8, Tyssen Place, Dalston Milk Refusing to Serve Third Fined 40/- and 12/6 costs 23 March A. Staples 226, Well Street Butter 69.8% Margarine fat First 2/- costs 23 March H. Friedmann 25, Dalston Lane Butter 39.9% Margarino fat First Fined 10/- and 12/6 costs 23 March H. Coomber 15, Brooksby's Walk Coffee 24% chicory First Dismissed 23 March Farmer and Cleveland 68, High Street, Stoke Newington Milk 16% added water First 21 March M. Walker 4, St.Andrew'8 Pavement Stamford Hill Milk 8% added water First Dismissed 21 March Chas. Rose Windsor Farm Dairy, Seven Sisters Road Milk 15% added water First Fined £5 and 15/- costs 15 June J. Strong Lock House. Lea Bridge Milk Refusing to serve Third Fined £10 27 June Owen Austin 119, Wick Road Butter Not labelling package as Margarine First Fined 20/- and 12/6 costs 29 June Chas. Ashton 231, Well Street Butter Ditto ditto First Fined 40/- and 12/6 costs 8 July John Smith 253, Dalston Lane Milk 7% add d water First Fined 10/- and 12/6 costs 15 July James Cook 52, Matthias Road Milk 11% added water First Fined 10/- and 12/6 costs 18 Aug. Charles Cook 98, Well Street Butter 24% Margarine fat First Costs only 2/- 2 Sept. Frank Westley 6, Tottenham Square Milk Deprived of 20% fat First Dismissed 2 Sept. Henry Cheek 24, Downham Road Milk 15% added water First Fined 20/- and 12/6 costs 5 Oct. John Jones 19, Clarence Road Butter 30% Margarine fat First Fined 10/6 and '2/- costs 5 Oct. W. Speakman 153, High Street, Homerton Milk 25% added water First Fined 10/6 and 2/- costs 28 Oct. Wm. Talintyre 97, Rendlesham Road Cocoa 20% foreign starch First Fined 10/6 and 2/- costs 28 Oct. Arthur Bedalls 78, Chatsworth Road Paregoric No opium .. Dismissed on question of fact 28 Oct. Evan Jones 83, Well Street Milk 11% added water Second Fined 12/6 and 12/6 costs 18 Nov. Harcourt Husson 4, Clarence Terrace, Church Street, Stoke Newington Butter 70% foreign fat First Fined 10/- and 12/6 costs (Under Margarine Act) 23 Nov. Sidney Spouse 96, Green Lanes, N. Coffee 40% chicory Dismissed with £1 1s. costs against the Board 23 Nov. William Cooper 82, Kynaston Road Cocoa 35% foreign starch First Fined 10/6 and 2/- costs 25 Nov. Joseph Hume 113, Overbury Street Milk | 10% added water Second Fined 20/- and 12/6 costs 2 Dec. Robert Thornton 47, Kynaston Road Cocoa 32% foreign starch First Fined 20/- and 12/6 costs 16 Dec. William Phillips 88, New Windsor Road Butter 85% foreign fat First 12/6 costs 16 Dec. Edwin Hood 48, Mandeville Street Butter 95% foreign fat First 12/6 costs 13 Jan., 1893. Harriet Fitchett 125, Downham Road, N. Butter 90% foreign fat First 10/6 and2/costs 40 LIST OF LICENSED COW-SHEDS IN THE HACKNEY DISTRICT, OCTOBER, 1892. Name. Address. No. Of Sheds. Broadbridge, H. Areola Street 1 Jones, L. J. 3, Ardleigh Road, DeBeauvoir Town 1 Williams, W. 6, Arthur Street, Hackney 1 Parsons, F. Barn Street, Stoke Newington 1 Webb, S. H. 76a, Broadway, London Fields 1 Stevens, E. Bridge Street, Homerton 1 Parry, R. 46, Brooksby's Walk, Homerton 1 Jenkins, J. 2, Buckingham Road, Kingsland 2 West London Dairy Co. Chapel Road, Stamford Hill 1 French, T. 72, Church Road, Homerton 1 Lloyd, E. 84, Clifden Road, Clapton Park 3 Jenkins 67, Downham Road, Kingsland 1 James, Mrs. 11, Downham Road, Kingsland 1 Jones 3, Elsdale Street, Hackney 2 Coxall, T. Fenn Street, Homerton 1 Motts, E. 6, Florefield Road, Hackney 1 Larter, J. T. 1, Gloucester Road, South Hackney 2 Chapman 86, Green Lanes, Stoke Newington 1 Snewin, W. H. 3, Hill Street, Upper Clapton 1 Rumball, J. & J. High Road, Upper Clapton 4 Jones, J. 69, Holly Street, Dalston 1 Bates, T. 46a, Leswin Street, Hackney 1 Cashford, W. G. Jerusalem Square, Mare Street, Hackney 4 Carried forward 34 41 Name. Address. No. of Sheds. Brought forward 34 Reynolds, C. & E. Landfield Street, Hackney 2 Dear, A. S. Lea Bridge Road, Ivy Cottage 1 Wingrove, J. T. 4, London Lane, Hackney. 1 Stevens, W. E. Marsh Farm, Temple Mills 1 Low, W. Manor Farm, Hackney Wick 1 Warner, J. C. 23, Mare Street 1 Bush, J. Marsh Gate, Homerton 1 Low, E. Marsh Hill, Homerton 1 Jones, J. R. 2, Mayfield Road, Dalston 1 Webb 14, Morning Lane, Hackney 1 Chandler, J. 90, Morning Lane 1 Lewis, J. 6, Palace Road, Hackney 1 Briggs, A. 108, Pritchard's Road, Hackney 1 Harper, Sophia 257, Queen's Road, Dalston 1 Camp 79, Shacklewell Lane, Hackney 1 Tasker, J. Sigdon Road, Hackney 1 Clifton, F. 33, Southgate Road 1 Sharp, B. Spring Hill, Clapton 3 Stapleton, A. Stoke Newington Common 5 Briggs, J. 180, Victoria Park Road. 2 Dover, J. 3, Warburton Road, Hackney 1 Brace, E. A. 133, Well Street 1 Lillicrap, (Oldacre and Haynes) 167, Well Street 1 Evans, J. 271, Wick Road 2 Roper R. 37, Wilton Road 1 Total cow sheds 68 42 LIST OF LICENSED SLAUGHTER-HOUSES IN THE HACKNEY DISTRICT, OCT., 1892. Name. Address. Pattenden, H. E. 235, Amhurst Road Abbott, A. R. 42, Broadway, London Fields Raymond, J. 186, Cassland Road Teat, J. 37, Church Road Morey, G. 18, Church Street, Stoke Newington Jarrett, E. 97, Church Street, Stoke Newington Porter, E. 118, Church Street, Stoke Newington Sharman, J. 90, Frampton Park Road Paramor, S. 82, Green Lanes, Stoke Newington Davys, W. 108, Green Lanes, Stoke Newington Witherden, W. 5, High Street, Homerton Fowler, T. C. Hill Street Wragg, W. 57, Holly Street Nixon, E. 49, High Street, Kingsland Gooch, H. 71, High Street, Kingsland Johnstone, E. 323, Kingsland Road Scott, G. 418, Kingsland Road Moore, C. W. 531, Kingsland Road Fish, T. Lea Bridge Corner, Clapton Witherden, C. A. Lower Road, Clapton Tyler, A. 80, Mare Street Haff'ey, F. C. 142, Mare Street Hilton, J. 177, Mare Street Shepherd, J. 266, Mare Street Shaw, J. 296, Mare Street Jackson, J. 312, Mare Street 43 Name. Address. Capon, J. 32, Morning Lane Martin, A. 55, Nevill Road Scott, W. 200, Queen's Road, Dalston Hide, R. 211, Queen's Road, Dalston Stephenson 103, Rendlesham Road Hazel wood 77, Shacklewell Lane Nokes, G. 53, Southgate Road Ebbells, E. 94, Southgate Road Brampton 165, High Screet, Stoke Newington Row, R. 130, High Street, Stoke Newington May, A. 220, Stoke Newington Road Stoneman, P. 3, Terrace Road Clark, W. Upper Clapton Tyler, W. 92, Well Street Cranfield, R. 169, Well Street Butcher, F. 216, Well Street Prince, C. 241, Well Street Friday, R. 51, Wilton Road Wildsmith 258, Wick Road Browning West Side, London Fields