HAC 17 Board of Works for the Hackney District. REPORT on the SANITARY CONDITION of the HACKNEY DISTRICT. FOR THE YEAR 1894. by J. KING WARRY, M.D. (LOND.). Diplomate in Public Health; Licentiate of the Society of Apothecaries; Fellow of the Society of Medical Officers of Health; Fellow of the British Institute of Public Health; Member of the Sanitary Institute; Associate of the College of State Medicine; Medical Officer of Health for the District. LONDON: A. T. Roberts, Son & Co., Printers, 5, Hackney Road, N.E. 1895. INDEX. page Analyses of Food and Drugs 43 Birth Rate 5 Cow Sheds, List of 52 Customs and Inland Revenue Act 32 Death Rate 6 East London Water Co 36 Diphtheria (Special Report) 10 Districting of Inspectors 32 Dusting Account 39 Estimated Population 4 Enteric Fever (Special Report) 13 Housing of Working Classes Act 28 Infant Mortality 6 Marriage Rate 5 Meteorology 45 Mortuary 42 New River Water Co 38 Notifiable Diseases 7 Non-Notifiable Diseases 23 Prosecutions under Public Health Act 49 Prosecutions under Food and Drugs Act 43 Public Health Act (Lond) 30 Register of Sanitary Work 51 River Lea 34 Specific Causes of Death 7 Slaughter-Houses, List of 54 Tables— Population, Area and Density in Sub-Districts of Hackney 5 Births in Sub-Districts 5 Deaths 8 Infant Mortality 6 Population, Births, and New Cases of Infectious Sickness 20 Notifiable Diseases distributed in Months 22 Influenza 23 Death Statistics 25 Dusting Account 41 Inquests 42 Suicides and Accidental Deaths 42 Zymotic Diseases 7 The Parish of Hackney. MEDICAL OFFICERS REPORT For the Year 1894. SANITARY DEPARTMENT, Town Hall, Hackney, N.E. To the Members of the Hackney Vestry. Gentlemen, In presenting ray report on the health of Hackney for the year 1894, I have in the first place to explain that, owing to the separation of Stoke Newington from Hackney on the 25th of March of that year, I consider it necessary for statistical purposes to separate all figures relating to the former parish from those of the latter; so that whatever is stated respecting these parishes has reference in the case of Stoke Newington to the first quarter of the year only, but in that of Hackney to the whole year. 4 I am pleased to add that, judging from the general death-rate, the infantile death-rate, and the zymotic death-rate, all of which were lower than in 1893, the public health of Hackney showed a considerable improvement upon the previous year. The diminution in the number of cases of infectious disease points in the same direction. In spite of the increasing population and density, Hackney continues to hold its position amongst the most healthy districts of London. Population and Density.—I estimate the population of the parish of Hackney, up to the middle of the year 1894, to be 212,547; and that of Stoke Newington, 34,170; this is equal to an estimated increase of 6,078 persons for Hackney during the year, and of 1,413 persons for Stoke Newington. The natural increase, i.e. the increase of births over deaths, was for Hackney, for the year, 2,781; and for Stoke Newington 77, for the quarter beginning January 1st and ending March 25th. From the above estimates of population, I calculate the density for Hackney to be 64.4 per acre, and for Stoke Newington 53.5 per acre. The following table will set forth these facts:— 5 Table showing population, area and density of Registration Sub-Districts in Hackney. hackney. Stoke Newington. Stamford Hill. West Hackney Hackney South Hackney Totals for Hackney. Estimated Population 34,170 21,932 44,363 103,865 42,387 212,547 Area in square acres 638 613 467 1,749 470 3,299 Den8ity=persons per acre 53.5 35.7 95 59.3 90.1 64.4 Births.—During the year 1894 there were 5,938 births registered in the District of Hackney, of which 3,009 were males, and 2,929 females; the number for Stoke Newington for the quarter, January 1st to March 25th, being 178, these consisting of 97 males and 81 females. The former is equivalent to a birth-rate of 28.5 for Hackney, and the latter to a birth-rate of 20.8 for Stoke Newington. Compared with the year 1893, Hackney alone shows a decline of 51 births. The annual birth-rate for all London was 30.1 per 1000 of the population. Below is given a table showing number of births and rates per 1,000 in each Sub-District. BIRTHS. tion District of Hackney. Registration Sub-Districts. All London. Stoke Newington Stamford Hill. West Hackney. Hackney. South Hackney. No. of Births 5,938 178 397 1,177 2,987 1,377 130,553 Rate per 1000 285 20.8 18.10 2650 28.66 32.48 30.1 Marriages.—During the year 1590 marriages were solemnized in Hackney, and during the first quarter, 197 in Stoke Newington; producing a marriage-rate for Hackney of 13.2 per 1000 living persons. Deaths.—During the year 1894 there were 3,292 deaths in Hackney, 1,649 being males and 1,643 being females. The deaths for Stoke Newington, up to March 25th of the same year, were 101, of these, 45 were males and 56 females. B 6 After making the necessary corrections, excluding the deaths of persons belonging to other parishes, but dying in Hackney, and including the deaths of Hackney people dying in outside institutions, I find the recorded annual death-rate for Hackney was 15.48 per 1000, and the corrected death-rate, 16.26 per 1000; whilst the recorded annual death-rate for Stoke Newington for the first quarter was 11.82 per 1000. The rate for Hackney was much lower than that for the previous year, and is mostly due to a diminution of deaths under five years of age and at the higher ages. The annual rate for all London for 1894 was 17.8 per 1000. Infant Mortality.—The deaths registered under one year for Hackney, were 781; and for Stoke Newington, up to March 25th, 21. The annual infantile mortality for Hackney was, therefore, 128 per 1000 births; and for Stoke Newington, 107 per 1000 births. The Hackney infantile mortality rate was much lower than that of the previous year. The generally low temperature of the summer, and a decline in the infectious fevers, contributed largely to this result. The rate for all London for 1894 was 143 per 1000 births. Compared with this the Hackney rate indicates an improved sanitary condition. The table below gives the principal causes of deaths under one year, distributed in the four quarters of the year:— Eleven principal cavses of Infant Mortality. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. TOTALS. Measles 12 12 5 6 35 Scarlatina 1 0 0 1 2 Whooping Cough 12 5 7 1 25 Teething 2 3 9 4 18 Diarrhœa 3 5 45 5 58 Convulsions 26 17 21 22 86 Lung Diseases 42 26 22 43 133 Tubercular Diseases 12 17 18 6 53 Atrophy and Debility 48 28 39 29 144 Premature Birth 23 17 16 25 81 Accidents & Violence 7 6 6 12 31 Total 188 136 188 154 666 Other Causes 29 26 48 33 136 Totals 217 162 236 187 Grand Total. 802 7 SPECIFIC CAUSES OF DEATH. Class I. Specific Febrile or Zymotic Diseases.—The deaths from these causes during the year numbered 604 in Hackney, and eight in Stoke Newington. This is equal to a rate of 2.8 per 1000 for the former parish. The London rate for the same period was 2.64 per 1000. The rate for Hackney shows a considerable improvement upon that of 1893. In this class are included the following infectious diseases:— NOTIFIABLE DISEASES. Smallpox.—In Hackney 24 cases of this disease were notified, and one in Stoke Newington. None of these proved fatal. Compared with 1893, these figures show a decline of 37 notified cases. Scarlatina.—This disease was not so prevalent during 1894 as during the previous year. The total number of cases occurring in Hackney was 1,006; in Stoke Newington, 18 only. Of those notified, 56 died in Hackney, and one in Stoke Newington; the death-rate of the former being .26 per 1000 persons living in the district. The London rate was .22 per 1000. Diphtheria and Membranous Group.—There was also a great decline in the number of notifications of this disease during the year, 522 cases occurring in Hackney, and 15 in Stoke Newington. The deaths in Hackney numbered 124, and one in Stoke Newington; the mortality rate for the former place was, therefore, .58 per 1000 living persons. The London rate was .61 per 1000. As to the cause of so much diphtheria in London, and the conditions favourable to its spread, the Medical Officer to the London County Council has presented a preliminary statistical report, in which strong evidence is put forth to show that the aggregation of children in schools is a potent means in the spread of this disease at school ages. 8 9 Table A. TABLE OF DEATHS during the gear 1894 in the Hackney, District, classified according to Diseases, Ages, and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from all causes, at subjoined ages. Age under 5 or over 5. mortality from subjoined causes, distinguishing deaths of children under five years of age. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1 2 4 5 6 6 7 8 9 1 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Menibranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis. Pneumonia, and Pleurisy. , Heart Disease. Injuries. All Other Diseases. Total. (Columns for Population and Births are in Table B.) Typhus. Enteric or Typhoid. Continued Relapsing Puerperal (a) (b) (c) (d) (e) (d) (g) (h) (i) Hackney 1248 367 248 64 46 307 216 Under 5 .. 7 13 1 .. 2 .. .. .. .. 1 91 30 36 .. .. 8 119 4 18 285 615 5 upwds. .. 4 9 2 .. 12 .. •• 1 .. 3 5 2 1 4 .. 91 97 57 37 308 633 Workhouse 7 •• 1 .. •• 1 5 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 2 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 3 5 Infirmary 345 23 21 7 16 155 123 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. 4 .. .. .. 9 .. 3 28 44 5 upwds. .. .. 1 .. .. .. .. .. .. .. 1 .. •• 1 1 .. 55 29 36 8 169 301 City of London Union 4 1 •• .. .. 1 2 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 5 upwde. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. 1 3 M. A. Fever Hospital 64 7 25 20 6 6 •• Under 5 .. 10 15 1 .. .. .. .. .. .. .. 3 .. 1 .. .. .. .. .. .. 2 32 5 upwds .. 11 .. •• •• 9 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 2 32 German Hospital 18 .. 5 1 1 10 1 Under 5 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 3 .. 5 5 upwds .. .. .. .. .. l .. .. .. .. .. .. .. .. .. .. 2 .. 3 6 1 13 South Hackney 580 180 107 23 25 154 91 Under 5 .. 2 7 6 .. .. .. .. .. .. .. 43 13 14 .. .. 2 54 1 12 133 287 5 upwds .. .. 3 .. .. 4 .. .. 2 .. •• 2 1 1 4 .. 43 57 30 9 137 293 French Hospital 3 •• .. .. 1 1 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 2 3 Jewish Home and Hospital for Incurables 2 .. .. .. .. 1 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 2 West Hackney 493 122 65 18 17 157 114 Under 5 .. 1 12 .. .. .. 1 .. .. .. .. 12 14 7 .. .. .. 32 .. 10 98 187 5 upwds .. 1 5 .. .. 4 .. .. 1 .. 4 .. .. 2 2 .. 33 60 37 2 155 306 Metropolitan Free Hospital 28 3 5 2 2 13 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. .. 2 .. .. 2 8 5 upwde .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 2 4 4 8 20 Stamford Hill 223 59 26 4 19 66 49 Under 5 . . 1 2 .. .. .. .. .. .. .. .. 8 2 5 .. .. .. 19 .. 1 47 85 5 upwds .. .. 1 .. .. 1 .. .. 1 .. .. .. .. 1 .. •• 13 23 19 4 75 138 Stoke Newington 100 21 11 6 2 39 21 Under 5 .. .. .. 1 .. .. .. .. .. .. .. .. 2 .. .. .. .. 12 .. 1 16 32 5 npwds .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 10 12 8 .. 36 68 Invalid Asylum 1 .. .. .. .. .. 1 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Totals 3116 783 514 145 135 911 628 Under 5. .. .. 52 9 .. 2 1 .. .. .. 1 157 62 68 .. .. 10 49 5 49 612 1298 5 upwards .. 17 29 2 .. 31 .. .. 5 .. 8 8 4 6 11 .. 249 283 198 70 397 1818 The subjoined numbers have also to be taken into Account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 277 19 53 31 23 121 30 Under 5 1 11 21 .. .. .. .. .. .. .. 2 2 1 .. .. .. .. 6 1 2 25 72 5 upwds .. 8 11 .. .. 6 .. .. .. .. 1 .. .. 1 .. .. 19 10 15 15 119 205 Deaths occurring within the district among persons not belonging thereto 509 31 202 99 28 110 39 Under 5 .. 67 107 .. .. .. .. .. .. .. 1 11 .. 1 .. .. .. 10 .. 10 26 233 5 upwds .. 38 46 .. 1 19 .. .. .. .. 1 1 .. 1 .. .. 29 24 14 14 88 276 10 Amongst adults, infection may also be spread by their associating together in numbers, especially where the air space is somewhat stinted, as in workshops and factories. During the year an outburst of this kind took place in a workshop in Hackney, which illustrates some of the possible means of spread amongst workers, in addition to spread by actual contiguity. I give below the report, which I presented to the Vestry, as a result of my enquiries:— I beg to report the following circumstances connected with an outbreak of diphtheria, associated with sore throat disease, amongst the employes of a particular establishment in Hackney, and almost entirely confined to those employed in one particular workroom. On the fourth of June last I received a medical notification that L. J., of Preemont Street, was suffering from diphtheria. An inspection was immediately made of this patient's home, but no sanitary defect was found sufficient to account for her illness; and no information was afforded by her relatives at this time, as to its probable source. In fact, the friends, as is very common in these cases, considered the illness as one of simple sore throat; and were sceptical as to the infectious nature of the disease. Subsequent events, however, soon modified their views. A few days later, on the twelfth of June, I received an anonymous communication, stating that a large amount of diphtheria and sore throat disease existed amongst the work-girls of the establishment above indicated. On that information I visited the place in question, and ascertained the following facts:— (1.) Mr. X. (the proprietor) employs on his premises in dress and mantle making, on an average, forty-three adult females, all of these, with one exception, living off the premises; and in addition to these he employs one hundred and fifteen male and female shop assistants, ninety of whom lodge in the house. (2.) L. J., above mentioned, was one of the forty-three employed in this particular workroom; and at the date of my visit, in addition to L. J., thirteen other girls were away from business, suffering, it was stated, from sore throat; that amongst the shop assistants two employed on the first floor had recently had sore throats, and one also on the ground floor. On the following day the employes were all examined by the medical attendant, who found nine more of the work girls were suffering from inflamed throat or tonsils. These were all sent home until, under medical advice, they could safely return to work—the workroom in the meantime being closed for disinfection; and a thorough examination of the sanitary arrangements being made. The girls' workroom I found to be situated at the highest part of the building, cut off by a staircase from the rest of the establishment. It was well lighted and ventilated on the east and west sides. Its cubic capacity was over and above that required by the Factory and Workshops' Act, viz. 250 cubic feet per adult. A small part of the room was divided off by a glass partition to form a cutting room. For the purpose of communication with different parts of the establishment, four speaking tubes were provided in the workroom; one connected 11 with the ground floor shop, another with the mantle room on the first floor, and the remaining to two fitting rooms on the first floor. Attached to the workroom, but cut off by the staircase, was a lavatory; the accommodation and ventilation of which were ample. On testing the soil pipes here they were found to be sound; but a leakage was revealed in the basement of the building. The lavatory wastes were connected with the drain by the intervention of a D trap. The water for drinking and flushing the was was drawn from the same cistern without the intervention of a flushing-box. Cause of the outbreak.—As stated above, exclusive of L. J., the number of inflamed or sore throats amongst the work girls was twenty-two. Of these, four were subsequently notified as cases of diphtheria; and two others, when examined later on, presented all the throat appearances of a previous attack of diphtheria. As to the remainder, evidence is wanting that these were all diphtheritic in character, but during every prevalence of diphtheria, there is always a large number of cases of sore throat—their characters varying from those of simple sore-throat, up to those of an undoubted diphtheritic type. Such cases are all infectious, and are competent to give rise to wellmarked diphtheria in susceptible persons. So for the purposes of this report, the cases of diphtheria and sore throat must be taken together, in enquiring as to the source of infection. In the first place we naturally turn to see if any sanitary defect is present, competent to give rise to such a disease. As stated previously, a defect was found in the soil pipe, at its junction with the drain in the basement. If this were the cause, we should certainly expect those persons employed nearest and most exposed to this cause to be the most affected; but no one employed in the basement had sore throat: only one of the shop assistants on the ground floor had been ill, and only two on the first floor; therefore this, as a cause, must be dismissed. Another sanitary defect was the direct connection of the w.c.'s with the cisterns, which supplied the drinking water. But this arrangement existed all over the establishment. Not only were the work-girls (amongst whom was nearly the whole of the illness) supplied with this drinking water, but also all the shop assistants. If impure water were the cause, the employes in different parts of the establishment would have been equally effected. Moreover, the work-girls took less of this water than most of the shop assistants, for a large number of the latter lived in the establishment and took no other water; but, as we have seen, these were not appreciably affected. Lastly, some of the girls worst affected did not drink any of the water. The remaining and last sanitary defect was the existence of a D trap in the course of the lavatory waste pipe, cutting the pipe off from the housedrain. It would be more exact to say this arrangement was not "up to date" —for unless the water were frequently renewed, the seal might be broken or the soapy water stagnate, and so give rise to an evil odour; but at the time of my visit neither of these events had happened. Moreover, when we consider that, on an average, forty persons use these lavatory basins per diem, it would be a most unusual event for the trap to be either unsealed or the water offensive. 12 From a consideration of the course of this outbreak, I am led to believe that the disease was introduced by some one of the work-girls; that it was spread amongst them mainly by contact—by the use of the four speakingtubes and of the same towels in the lavatory. The following facts will, I think, establish this contention. The first case to be notified to me was that of L. J., on the fourth of June, who left her work on the second, feeling too ill to remain. The next notified were N.K. and R. J. on the thirteenth, the latter being sister to L.J. These three all worked together side by side at the same table in the small cutting room referred to above, and, with the forewoman, were the only persons working there. These girls were particularly well situated to contract an infection from one another should it be introduced. Outside the cuttingroom, and in the main work-room, were the speaking-tubes. Although these tubes were used at times by every one of the work-girls, they were mostly used by the three work-girls mentioned above—one reason being they were the nearest workers to the tubes, and being specially under the direction of the forewoman, messages would most conveniently be sent and received by them. Thus there were present all the necessary elements for the spread of diphtheritic infection. Sitting side by side during the early stages of the disease, N. K. and R. J., in all probability, caught the infection from L. J., and they also innocently contributed to the dissemination of the disease, in the manner described below. Supposing one, or all of these girls, suffering from diphtheria in its early stages, frequently pressed the mouthpieces of these speaking-tubes to their lips, these mouthpieces would be capable of conveying the disease to other healthy persons using them ; and this is, in my opinion, one means by which the disease was conveyed to other workers; another being the towels in the lavatory, which were used in common by the work-girls. In confirmation of the above view, I must refer to the earlier part of the report, in which I state that only one of the shop assistants on the ground floor suffered from sore throat. I learned, on inquiry, that it was the special duty of this assistant to answer the speaking-tube communicating with the affected workroom. Whether the tube had become infected throughout its whole length, and so conveyed the infection to this assistant, or whether her illness was a coincidence, I cannot be certain ; but I do think the incident significant, and confirmatory of the above views. I also mentioned two assistants employed on the first floor as suffering from sore throat. I was informed that these two had been accustomed, contrary to the rules of the establishment, to use the lavatory reserved for the work-girls, and had, at such times, called in to speak with different workgirls, thus exposing themselves to two sources of infection, viz. the infected lavatory towels and such of the workers suffering from the disease in a mild and unrecognized form. Conclusions.—(1.) I am of opinion that the disease was introduced into the workroom by one of the workers, and that the infection spread to the others in the manner above stated. (2.) There were certain sanitary 13 defects found on inspection, but these were not, in my opinion, adequate. to produce a specific disease like diphtheria. Note.—Both employer and employes have rendered me every assistance in arriving at my conclusions; the former immediately adopting any measures I suggested to prevent the spread of the disease, and the making good of the defects found. I remain, Gentlemen, yours obediently, J. KING WARRY, M.D., D.P.H., Acting Medical Officer of Health for Hackney. Enteric or Typhoid Fever.— The notification numbers of this disease also show a great decline upon those of 1893. There were 186 cases in Hackney and 39 deaths; the death-rate was consequently .13 per 1,000 living persons. The rate for all London equalled .15 per 1,000 living. In consequence of a complaint, made in June, 1894, that Typhoid Fever had been specially prevalent in a certain part of Hackney, during 1893, and a part of 1894, I presented the subjoined report to the Vestry. In accordance with the instructions of your Vestry, I beg to present the following report on a complaint made to tho London County Council with respect to a special incidence of Typhoid Fever, etc., in certain houses in Prince Edwards and Windsor Roads, Hackney Wick. Briefly, the complaint is as follows:—The writer in the first instance directs the attention of the London County Council to the sanitary condition of Prince Edward's Road, and makes the statement, that "between August and October, 1893, there were 17 cases of Typhoid Fever in 7 houses, besides cases of Scarlet Fever and Diphtheria," and that the number of these houses and the cases of fever occurring therein were Nos. 14 (five cases), 16 (one case), 18 (one case), 28 (one case), 68 (five cases); that "the local Sanitary Officer was communicated with by the District Matron of the East London Nursing Society in February last," but no action so far as the writer knows has been taken. That "the five first named houses stand back to back with some houses in Windsor Road, which some time since were condemned as being unfit for habitation. These houses are unoccupied but not pulled down." "The ground slopes away sharply from the land to Windsor Road consequently the back yards between the latter and Prince Edward's Road form a gulley where after heavy rain the water stands and interferes with the drainage." The writer further adds, "it is important something should be done, as there have been two cases of Typhoid this year at Nos. 9 and 12, Windsor Road, one of them having terminated fatally." C 12 From a consideration of the course of this outbreak, I am led to believe that the disease was introduced by some one of the work-girls ; that it was spread amongst them mainly by contact—by the use of the four speakingtubes and of the same towels in the lavatory. The following facts will, I think, establish this contention. The first case to be notified to me was that of L. J., on the fourth of June, who left her work on the second, feeling too ill to remain. The next notified were N. K. and R. J. on the thirteenth, the latter being sister to L. J. These three all worked together side by side at the same table in the small cutting room referred to above, and, with the forewoman, were the only persons working there. These girls were particularly well situated to contract an infection from one another should it be introduced. Outside the cuttingroom, and in the main work-room, were the speaking-tubes. Although these tubes were used at times by every one of the work-girls, they were mostly used by the three work-girls mentioned above—one reason being they were the nearest workers to the tubes, and being specially under the direction of the forewoman, messages would most conveniently be sent and received by them. Thus there were present all the necessary elements for the spread of diphtheritic infection. Sitting side by side during the early stages of the disease, N. K. and R. J., in all probability, caught the infection from L. J., and they also innocently contributed to the dissemination of the disease, in the manner described below. Supposing one, or all of these girls, suffering from diphtheria in its early stages, frequently pressed the mouthpieces of these speaking-tubes to their lips, these mouthpieces would be capable of conveying the disease to other healthy persons using them ; and this is, in my opinion, one means by which the disease was conveyed to other workers; another being the towels in the lavatory, which were used in common by the work-girls. In confirmation of the above view, I must refer to the earlier part of the report, in which I state that only one of the shop assistants on the ground floor suffered from sore throat. I learned, on inquiry, that it was the special duty of this assistant to answer the speaking-tube communicating with the affected workroom. Whether the tube had become infected throughout its whole length, and so conveyed the infection to this assistant, or whether her illness was a coincidence, I cannot be certain; but I do think the incident significant, and confirmatory of the above views. I also mentioned two assistants employed on the first floor as suffering from sore throat. I was informed that these two had been accustomed, contrary to the rules of the establishment, to use the lavatory reserved for the work-girls, and had, at such times, called in to speak with different workgirls, thus exposing themselves to two sources of infection, viz. the infected lavatory towels and such of the workers suffering from the disease in a mild and unrecognized form. Conclusions.—(1.) I am of opinion that the disease was introduced into the workroom by one of the workers, and that the infection spread to the others in the manner above stated. (2.) There were certain sanitary 13 defects found on inspection, but these were not, in my opinion, adequate. to produce a specific disease like diphtheria. Note.—Both employer and employes have rendered me every assistance in arriving at my conclusions; the former immediately adopting any measures I suggested to prevent the spread of the disease, and the making good of the defects found. I remain, Gentlemen, yours obediently, J. KING WARRY, M.D., D.P.H., Acting Medical Officer of Health for Hackney. Enteric or Typhoid Fever.—The notification numbers of this disease also show a great decline upon those of 1893. There were 186 cases in Hackney and 39 deaths; the death-rate was consequently .13 per 1,000 living persons. The rate for all London equalled .15 per 1,000 living. In consequence of a complaint, made in June, 1894, that Typhoid Fever had been specially prevalent in a certain part of Hackney, during 1893, and a part of 1894, I presented the subjoined report to the Vestry. In accordance with the instructions of your Vestry, I beg to present the following report on a complaint made to tho London County Council with respect to a special incidence of Typhoid Fever, etc., in certain houses in Prince Edwards and Windsor Roads, Hackney Wick. Briefly, the complaint is as follows:—The writer in the first instance directs the attention of the London County Council to the sanitary condition of Prince Edward's Road, and makes the statement, that "between August and October, 1893, there were 17 cases of Typhoid Fever in 7 houses, besides cases of Scarlet Fever and Diphtheria," and that the number of these houses and the cases of fever occurring therein were Nos. 14 (five cases), 16 (one case), 18 (one case), 28 (one case), 68 (five cases); that "the local Sanitary Officer was communicated with by the District Matron of the East London Nursing Society in February last," but no action so far as the writer knows has been taken. That "the five first named houses stand back to back with some houses in Windsor Road, which some time since were condemned as being unfit for habitation. These houses are unoccupied but not pulled down." "The ground slopes away sharply from the land to Windsor Road consequently the back yards between the latter and Prince Edward's Road form a gulley where after heavy rain the water stands and interferes with the drainage." The writer further adds, "it is important something should be done, as there have been two cases of Typhoid this year at Nos. 9 and 12, Windsor Road, one of them having terminated fatally." C 14 In the first place I must correct one or two mistakes in this letter. The total number of cases of Typhoid Fever notified to me, occurring in these houses during the time stated, was 13 not 17; also, only one case of Scarlet Fever occurred in these houses, and no case of Diphtheria. I give below a table of the whole cases of fever occurring in the above houses at Prince Edwards Road during the year 1893, and in certain houses of Windsor Road during 1894:— Particulars of Cases of Typhoid Fever at Hackney Wick—(Prince Edward's Road)—during the year 1893. Date of Notification. Address. Patient's Name. Age Date of Removal to Hospital. No. of Rooms occupied by family. No. in family. 5th Sept. 20 Prince Edward's Road Kate H. 16 5—9—93 3 7 5th ,, 14 „ „ „ Mary M. 14 .... 3 5 14 th ,, 68 ,, ,, ,, Annie S. 12 23—9—93 3 7 14th „ 22 „ „ „ Emily K. 4 14—9—93 3 9 15 th ,, 14 ,, ,, ,, Chas. M. 6½ 20—9—93 3 5 15th „ 14 ,, „ ,, Mrs. M. 38 .... 3 5 15th „ 14 ,, ,, ,, Hannah M. 12 20—9—93 3 5 15th , 70 „ „ „ George S. 20 Infirmary 5 6 22nd „ 28 ,, ,, ,, Philip H. 18 .... 5 5 22nd ,, 16 ,, ,, ,, Chas. J.M.H. 47 .... 6 4 3rd Oct. 68 ,, „ ,, Henry W.S. 32 21—10—93 3 6 20 th „ 68 ,, „ ,, Clara S. 6½ 21—10—93 3 6 21st ,, 68 „ ,, „ Chas. S. 4 22—10—93 3 6 Windsor Road, 1893. Date of Notification. Address. Patient's Name Age. Date of Removal to Hospital. No. of Rooms occupied by family. No. in family. 27thSept. 93 9 Windsor Road Ernest H. 17 26—9—93 to Lond. Hosp 1. 3 5 29th March 12 „ „ Chas. S. 11 28—3—94 5 5 11th April. 9 „ „ Annie M. 10 10—4—94 3 5 1st May 12 „ „ Eliza S. 7 .... 5 5 Site.—Hackney Wick, in which are included Prince Edward's and Windsor Roads, is built over what, a quarter of a century ago, was a continuation of the present Marsh land. The soil consisted then of a thin, though variable layer of brick earth and alluvium, overlying the London Clay. The brick earth was iu course of time excavated and used up in the manufacture of bricks, the excavations being ultimately filled in with rubbish—presumably containing a fair amount of house refuse—the whole area being raised to its present height with the same material. The level of the Marsh land, adjoining Hackney Wick, is about 14 feet above ordnance 15 datum; that of Hackney Wick varies from 16 feet above datum at Windsor and Prince Edward's Roads, to 20 feet above datum at Gainsborough Road, the former roads being thus about the lowest parts of the Wick district. Dwellings.—The houses in which the cases of Typhoid Fever occurred, concerning which I have been instructed to report, belong to two parallel terraces of cottages; those of Windsor Road facing east, and those of Prince Edward's Road facing west. The backs of these terraces are separated by a space of about 50 feet, the back additions about 25 feet. The dwellings themselves are all built on the same plan. They are four-roomed cottages— two rooms on the ground floor and two on the first floor—with a back addition, scullery and w.c., the last opening into the yard. The yards are partly paved, and each is provided with a stone-ware gully for surface drainage. Each w.c. is also supplied with a two-gallon flushing cistern, disconnected from the house water supply. Drainage.—On reference to the drainage plan for these streets, it will be seen that these houses are drained on the "combined system" in blocks. For instance, the drainage from Nos. 2 to 14 pass into a 9-inch drain laid through the back yards, with a fall towards the southern end of the road. Nos. 16 to 22 are drained in a similar manner, the outlet passing beneath No. 18 joining the sewer, at the front of the houses. Nos. 56 to 82 are combined similarly, the fall being southwards to the sewer in Victoria Road. The fall in this case is about 1 in 120. Nos. 1 to 16. Windsor Road, are drained on the same plan, the fall being about 1 in 113 towards Victoria Road, where the drain joins the Council's sewer direct. Closed Houses in Windsok Road.—With respect to the closed houses in Windsor Road referred to in the above letter, they are situated at the southern end of Windsor Road, and are numbered 2—9. The circumstances which led up to their closure are these:—In the first place it may be stated, that there was nothing in the build or surroundings of these houses different from the remaining houses in Windsor Road, except that being at the southern end of the road they were at a slightly lower level; and at times of heavy flood, should there be any impediment to the rainfall being carried away rapidly, were no doubt liable to flooding. In the latter part of the summer of 1892, an unusual fall of rain resulted in a surcharging of the London County Council's sewer in Windsor Road, the sewage bursting from the open gratings in the roadway and the street gullies, and completely flooding the ground floors of the above named houses. Immediately my attention was called to this condition of things—being caused by the overflow of the Council's sewer—I applied to the London County Council's Engineer to assist in having the sewage removed from these houses, and restoring things to their former state; but I was informed that no liability rested with the Council. Notices were then served on the owners to do the needful work; but as this was much delayed, I applied, under the instruction of the Sanitary Committee, to a Magistrate for Closing Orders under the Public Health (London) Act, 1891—the places being unfit for habitation. The orders were granted, and since that time the houses have been unoccupied. This flood apparently did not affect the houses in Prince Edward's Road, but on enquiry, I learn from the tenants, that some years back the ground floors and yards were flooded after heavy rain, the exact date varying with the memory of the individual—some of the tenants putting, the date of the flood four years, others two and a half years back. C 2 16 Typhoid Fever in Prince Edward's and Windsor Roads.—The first cases of Typhoid Fever notified from Prince Edward's Road were those of Kate H. from number 20, and Mary M. from number 14, both notifications being received on the 5th September. The former was removed to hospital, the latter was nursed at home. Both of these girls worked at different places and so far as could be ascertained the sources of contagion must have been different. The next cases were notified on the 14th September, viz., Annie S. from number 68, and Emily K. from number 22; the former was removed to hospital on the 23rd and the latter on the 14th September. The next cases notified were Charles M., Mrs. M. and Hannah M. from number 14, all of them being members of the same family, as Mary M. was nursed at home. The cause of these secondary cases were no doubt due to the nursing at home of Mary M.; for it was subsequently ascertained that Hannah slept in the same bed with Mary while she was ill, that Mrs. M. nursed Mary and attended to the rest of the family; and Charles had free access to the room, where Mary was lying ill. The next case to be notified was George S. from number 70. He was immediately removed to the infirmary. On the 22nd, Phillip H. of number 28, and Charles J. H. of number 16 were notified. These were both nursed at home under favourable conditions, and no further case occurred in these houses. On the 3rd October, Henry S. was notified, on the 20th October, Clara S., and on the 21st Charles S. from the same address. The last three cases were no doubt secondary cases contracted from Annie S., removed to hospital on the 23rd September. Annie was nursed at home more than a week before removal, Clara sleeping in the same bed with her, and Charles and the father having free access to the room occupied by Annie. In connection with the secondary cases of Typhoid Fever occurring at Nos. 14 and 68, Prince Edward's Pvoad, it may be remarked that although cases of Typhoid Fever might very well be nursed at home, where the nursing and isolation are good; yet if either of these requisites are wanting and the most scrupulous care is not taken in the immediate destruction of the excreta of the patient, the disease is very likely to be contracted by other members of the same family coming into contact with the patient. The above secondary cases were without doubt contracted in this way. With respect to the origin of the primary cases, the circumstances of each one were carefully enquired into as it was notified. Of these primary cases, only one attended any school; the others were either engaged at home or employed at different work places, and at these work places there was no special incidence of Typhoid Fever. Of the milk supply in one case, milk was never taken, and that for the other cases came from five different vendors. The water supplied to these dwellings came direct from mains of the East London Water Company, in common with the whole of the water supply to Prince Edward's and Windsor Roads. With respect to the sanitary condition of the houses occupied by the patients, an inspection was made after each notification had been received, and some defects were found. For instance, in five of the houses the walls and ceiling were found to be dirty, in three the yard paving was defective, in two the w.c. pans were foul, in two the w.c. pans were defective, and the flush bad. In two houses no defect was found. The usual notices were served and defects remedied. I cannot attribute the primary cases to any or either of these defects. 17 It may be that neighbourly inter-communication may account for some of these cases being contracted. For instance, Kate H. was removed to hospital on the 5th of September from number 20, and Emily K. from the next house on the 14th September. It is quite within the limits of probability, that the latter had been visiting the former during her illness. Again, Charles H., living at 16, is the landlord for 18, 20 and 22. He was frequently in and out of these houses, superintending himself, certain repairs. The same reasoning may apply to the cases from Nos. 68 and 70. With respect to the insinuation of the writer of the above letter, that the closed houses of Windsor Road had something to do with the origin of these cases, facts do not lend any support to this theory, for, firstly, the dwellings backing upon the worst of the closed houses were not affected with Typhoid Fever, and the only affected houses near them were Nos. 14 and 16; Nos. 20 and 22 not backing upon them, and 28 being some distance, and Nos. 68 and 60 being at a considerable distance from them. So far, a malevolent influence on the part of the closed houses on the inmates of neighbouring houses has not been substantiated. Again, as to the nature of the ground intervening between the backs of the Windsor Road houses and those of Prince Edward's Road, the writer states that this land slopes and forms a natural gulley, where water accumulates and interferes with the drainage. Undoubtedly the ground here is uneven and slopes towards Windsor Road, and after heavy rains, pools of water may be observed; but in the first place such pools of water as the above cannot possibly have anything to do with this outbreak of fever; even if causing dampness of the soil, they would only have a remote bearing on the outbreak; besides, inequalities occur at the back of the dwellings the whole of the length of Windsor and Prince Edward's Roads, yet the cases are mostly aggregated in five houses; finally an examination of the ground does not convince me the water remains long enough to have an evil influence on the inmates of the surrounding houses; for as stated above, each yard is provided with gullies to carry off surface water. The cases of Typhoid Fever, occurring this year in the Windsor Road, are instructive, and have a direct connection with those of last year in Prince Edward's Road. It will be remembered that Philip H., lodging at 28, Prince Edward's Road, was notified as suffering from Typhoid Fever, on the 22nd September; he was nursed at his lodgings by his sister, Mrs. O., a widow with two children, living at 9, Windsor Road. This sister appears to have attended to her brother at intervals during the day, and to her family the remainder of the day, sleeping with her children at 9, Windsor Road. In the same bouse with Mrs. O., a brother, Ernest H., was residing. On the 28th October, he was notified as suffering from Typhoid. From inquiry it came out that this patient had been in the habit of visiting his brother at 28, Prince Edward's Road, during his illness, and as being one of the family at 9, Windsor Road, was one of those whose food was probably prepared by Mrs. O. While it is clear to my mind that the virus of Typhoid Fever was transferred from Prince Edward's Road to Windsor Road, by relatives from the latter road visiting sick persons at the former, there is some difficulty in asserting positively that C. S., of 12, Windsor Road, the next case notified, contracted the disease directly from Ernest H., living at 9, Windsor Road, 18 because there is an interval of about three and a half months between the two cases ; but recent researches have demonstrated the possibility of the typhoid bacillus living months in suitable soil, so that the probability is that Ernest H. or Mrs. O. introduced the disease into 9, Windsor Road, where it remained latent during the winter months until the spring, when the next case was attacked. The next case notified was Charles S., of No. 2, Windsor Road, on the 29th March, 1894. This patient was a cousin of the last two patients, and there was a close daily intercourse between them. The next to be notified from the same disease was A. M., a daughter of the above-named Mrs. O., and cousin to the last patient. There is evidence that during the early stage of the disease the children were constantly together. This patient was removed to Hospital on the 11th April. The last to be taken ill was Ernest S., the notification arriving on the 1st May. This patient was sister to Charles S., notified on the 29th March, and both slept in the same room. She was also a cousin of A. M., notified on the 9th April, the two being constantly together. The association in the last three cases was so close as to leave no doubt in my own mind that the disease was transferred from one to the others by direct contagion. In estimating the value of the above evidence the habits of this class of people must be taken into consideration. It is quite usual for the excreta of Typhoid Fever patients nursed at home to be left an indefinite time in the sick-room : also those attending on the sick person do not recognize the absolute necessity for ablutions after each attendance on the patient. It has been no doubt the innocent neglect of these precautions which is responsible for most of the above cases. The remarks I have made as to the influence of the closed house in Windsor Road on the production of Typhoid Fever in Prince Edward's Road, apply also to the cases occurring this year in Windsor Road. Conclusions.—1. The origin of some of the first cases could not be found out at the time of notification or subsequently; but the secondary cases at 14 and 68, Prince Edward's Road, and 12 and 9, Windsor Road, as stated above, I believe to have been contracted from the first cases. 2. Whilst I do not consider the closed houses to be instrumental in the spread of Typhoid Fever, I think they ought either to be put in good condition or demolished. (Having been closed under the Public Health— London—Act, 1891, it is not possible to obtain a demolition order under that Act.) Note 1. Of course after the notification or recovery of each case, the rooms were fumigated, and the bedding was disinfected by dry heat we had not then the present steam apparatus. Note 2. The reason why some of the cases were not removed to hospital, was that the Asylum Board's Hospital accommodation was exhausted at this time, and cases could only be admitted as vacant beds arose. I remain, Gentlemen, Yours obediently, J. KING WARRY, M.D., D.P.H., June 22nd, 1894 Acting Medical Officer of Health for Hackney. 19 Continued Fever.—There were nine cases of this disease in Hackney and one death. Erysipelas.—There were 250 cases of Erysipelas in Hackney, and 11 in Stoke Newington. Of the former 12 died, but no deaths occurred amongst the latter. The mortality in Hackney equalled 05 per 1,000 living persons. Amongst the institutions, the Hackney Union Infirmary supplied 18 cases with one death. 20 21 Table B. TABLE of POPULATION, BIRTHS, and of NEW CASES of INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1894, in the Hackney Sanitary District; classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Population at all ages. Registered Births. Aged under 5 or over 5. New Cases or Sickness in each Locality, coming to the Knowledge of the Medical Officer of Health, Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Estimated to middle of 1894. 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 Smallpox. Scarlatina Diphtheria Membranous Croup. Fevers. Cholera Erysipelas Smallpox Scarlatina Diphtheria Membranous Croup. Fevers. Cholera] Erysipelas Typhus Enteric or Typhoid Continued Relapsing Puerperal Typhus Enteric or Typhoid Continued Relapsing Puerperal (a) (b) (c) (d) (e) Stoke Newington 30794 34170 178 Under 5 .. 1 3 1 .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 5 upwds. 1 17 10 1 .. .. .. .. .. .. 9 .. 7 2 1 .. .. .. .. .. .. .. Invalid Asylum 25 •• .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Northumberland House Pvte. Lunatic Asylum 117 .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stamford Hill 17759 21932 397 Under 5 .. 16 11 .. .. .. .. .. .. .. .. .. 5 4 .. .. .. .. .. .. .. .. 5 upwds. 4 56 33 .. • • 14 .. .. .. .. 16 2 28 10 .. .. 3 .. .. .. .. .. West Hackney 42590 44363 1177 Under 5 1 42 45 3 .. 1 .. .. .. .. 3 1 13 17 2 .. .. .. .. .. .. .. 5 upwds. 7 106 86 1 • • 27 3 .. 3 .. 40 4 53 26 1 .. 5 .. .. .. .. .. Metropolitan Hospital 112 .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. •• 1 .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. Hackney (H) 94091 103865 2987 Under 5 2 188 73 7 .. 4 .. .. .. .. 15 2 71 28 1 .. 1 .. .. .. .. .. 5 upwds. 10 354 163 5 .. 513 4 .. 7 .. 104 9 190 41 .. .. 36 .. .. .. .. .. Workhouse 1100 .. •• Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Hackney Union Infirmary 458 .. .. Under 5 .. 5 .. .. .. .. .. .. .. .. .. .. 5 .. .. .. .. .. .. .. .. .. 5 upwds. .. 17 1 .. .. .. .. .. .. .. 18 .. 17 .. .. .. .. .. .. .. .. .. M.A.B. Eastern District Hospital 410 .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. German Hospital 141 .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Salvation Army Maternity Home 42 .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Truant School 144 .. •• Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. South Hackney 41422 42387 1377 Under 5 .. 72 30 9 .. 3 .. .. .. .. 4 .. 18 10 .. .. 2 .. .. .. .. .. 5 upwds. .. 149 82 .. .. 43 .. 1 5 .. 51 .. 71 24 .. .. 19 .. .. .. .. .. Bethnal Green Overflow Workhouse 213 .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. King Edward Industrial School for Girls 124 .. •• Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . Totals 229542 246717 6116 Under 5 3 324 62 20 .. 8 .. .. .. .. 24 3 112 59 3 .. 3 .. .. .. .. .. 5 upwds. 22 700 375 8 .. 78 7 1 15 .. 239 15 367 103 2 .. 63 .. .. .. .. .. 22 Table showing the number of cases in Hackney of Notifiable Diseases distributed in each month of the year 1894. Month. Smallpox. Scarlet Fever. Diphtheria Typhus. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Relapsing Fever. Membranous Croup. Total. January 2 138 73 .. 17 1 34 1 .. 6 269 February 2 93 47 .. 19 1 22 4 .. 2 190 March 2 93 58 .. 14 1 25 .. .. 2 195 April 4 104 44 .. 7 .. 26 3 .. 3 191 May 13 85 34 .. 12 17 3 .. 4 168 June 100 29 .. 8 .. 14 1 .. 1 153 July 1 79 36 .. 3 .. 17 1 .. .. 137 August 1 75 42 .. 12 .. 16 .. 1 .. 147 September .. 76 35 .. 19 2 30 .. .. 1 163 October .. 75 52 .. 23 2 20 1 .. 2 175 November .. 61 42 .. 29 2 23 1 .. 6 164 December .. 45 48 .. 23 .. 19 .. .. 1 136 25 1024 537 .. 186 9 263 15 1 28 2088 23 NON-NOTIFIABLE DISEASES. Influenza.—There were 39 deaths in Hackney during the year, and four in Stoke Newington from this disease. The annual mortality for the former was .16 per 1,000 living persons. Deaths from Influenza in each month during the years 1891, 1892, 1898, 1894. 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 1893 3 4 11 10 4 4 3 1 1 1 7 37 1894 18 5 2 4 1 3 0 0 1 1 1 3 Diarrhœa.—From this cause 75 persons died in Hackney, but none in Stoke Newington. The Hackney rate was therefore .35 per 1,000. Of these 75 deaths, 58 occurred amongst children under one year, and 68 amongst children under five years old. The comparatively low temperature of the summer, in marked contrast to that of 1893, accounts for the decline in deaths from this cause. The death-rate for all London was .42 per 1,000. Table IV. Deaths from Diarrhœa— 1892. 1893. 1894. First Quarter 8 5 5 Second Quarter 12 29 6 Third Quarter 88 102 57 Fourth Quarter 5 9 7 Measles.—This disease supplied the highest number of deaths of any of the specific infectious diseases during the year; 166 being registered in Hackney, and one in Stoke Newington. The death-rate for the former equalled .77 per 1,000. The rate for London was 76 per 1,000. 24 Whooping Cough.—There were 67 deaths from this cause , 65 in Hackney, and 2 in Stoke Newington. The total shows a great decline upon the number for 1893. The rate for Hackney was .31, and for all London 48 per 1,000 persons living. Class II. Constitutional Diseases.—In this class of diseases 601 deaths occurred in Hackney, and 25 in Stoke Newington. Of these totals 405 deaths were due to tuberculous diseases, and 157 to cancer. The Hackney mortality rate was therefore 2.8 per 1,000. Class III. Developmental.—In Hackney 242 deaths occurred from these causes, equalling a death-rate of 1.1 per 1,000. There were 7 deaths in Stoke Newington. Class IV. Local Diseases.—These diseases caused 1,509 deaths in Hackney, and 46 in Stoke Newington, giving for the former place a mortality rate of 7.1 per 1,000 persons living. Class V. Violent Deaths.—Violence was responsible for 135 deaths in Hackney, and 1 in Stoke Newington, producing a death-rate of .63 per 1,000. Class VI. Ill-defined Cases.—Under this head 195 deaths were registered in Hackney, and 5 in Stoke Newington, giving to the former parish a rate of .91 per 1,000. 25 TABLE OF DEATHS Of Inhabitants of the Hackney District between 1st Jan. and 31st Dec., 1893. 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 Chicken Pox .. 1 .. .. .. .. .. .. .. .. .. 1 Membranous Croup 2 7 2 .. .. .. .. .. .. .. .. 11 Smallpox. Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. Unvaccinat'd .. .. .. .. .. .. .. .. .. .. .. .. Vaccndoubtfl .. 1 .. .. .. .. .. .. .. .. .. 1 Measles 35 124 8 .. .. .. .. .. .. .. .. 167 Scarlet Fever 2 30 21 3 .. 1 .. .. .. .. .. 57 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 25 38 4 .. .. .. .. .. .. .. .. 67 Diphtheria 6 06 37 3 .. 1 .. .. .. .. .. 113 Simple Fever 1 .. .. .. .. .. .. .. .. .. .. 1 Enteric Fever .. 2 9 7 11 7 2 .. 1 .. .. 39 Other Miasmatic Diseases .. .. .. .. .. .. .. .. .. .. .. .. English Cholera .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa, Dysentery 58 10 1 1 .. .. .. 1 2 2 .. 75 Ague,Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis, &c. 15 .. .. .. .. 1 .. .. .. .. .. 16 Erysipelas 1 2 .. 2 1 .. 2 .. 1 3 .. 12 Pyæmia .. 1 4 .. .. .. 1 2 .. .. .. 8 Puerperal Fever .. .. .. 2 1 2 .. .. .. .. .. 5 Thrush Vege Parasites 4 1 .. .. .. .. .. .. .. .. .. 5 Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk 1 .. .. .. .. .. .. .. .. .. .. 1 Alcoholism .. .. .. .. 2 2 2 2 .. .. .. 8 Influenza 2 5 2 4 3 5 1 8 4 5 .. 39 152 288 88 22 18 19 8 13 8 10 .. - 626 Constitutional Diseases. Rheumatic Fever .. .. 3 4 2 1 .. 1 .. .. .. 11 Rheumatism 1 1 2 4 .. .. .. 2 2 1 .. 16 Gout .. .. .. .. .. .. 1 .. 2 1 .. 4 Rickets 2 5 .. .. .. .. .. .. .. .. .. 7 Cancer .. .. .. 2 4 18 39 38 42 11 3 157 Tabes Mesenterica 23 9 2 .. .. 1 .. .. .. .. .. 35 Tubercular Meningitis 13 115 9 2 1 .. .. .. .. .. .. 40 Phthisis 5 5 7 48 67 62 51 19 11 2 1 278 Scrofula, Tuberculosis Purpura 12 16 7 3 7 .. 4 1 2 .. .. 52 Hæmorrhagica 1 .. .. .. .. .. 1 1 .. .. .. 3 Anæmia, Leucocytha 1 .. 1 4 .. 3 1 1 .. .. .. 11 Diabetes .. .. .. .. 1 .. 2 3 4 1 .. 11 Other Constitutional Diseases .. .. .. 1 1 .. .. .. .. .. .. 2 58 51 31 68 83 85 102 66 63 16 4 627 Developmental Premature Birth 81 .. .. .. .. .. .. .. .. .. .. 81 Malformations 14 .. .. .. .. .. .. .. .. .. .. 14 Old Age .. .. .. .. .. .. .. 1 31 80 42 154 95 .. .. .. .. .. .. 1 31 80 42 - 249 26 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 25 25 6 5 2 5 2 2 .. .. .. 72 .. Apoplexy, Hemiplegia .. .. .. .. 2 4 16 30 35 21 5 113 .. Insanity, General Paralysis .. .. .. .. .. 12 15 19 17 7 2 79 .. Epilepsy .. 1 1 7 1 4 1 .. 1 2 1 19 .. Convulsions 86 11 .. .. 1 .. .. .. .. .. .. 98 .. Laryngismus Stridulus 3 1 .. .. .. .. .. .. .. .. .. 4 .. Diseases of Spinal cord .. .. .. 1 .. .. .. 1 1 .. .. 3 .. Paraplegia .. .. .. .. .. 1 .. .. .. 1 .. 2 .. Other Nervous diseases 4 2 .. 3 3 5 11 12 10 2 .. 52 .. 118 40 7 16 9 31 45 64 64 33 8 - 435 Diseases of Circulating Organs. Peri & Endo-Carditis .. 1 4 .. 3 1 1 2 .. .. .. 12 Valvular Disease of Heart 4 .. 4 20 12 17 33 40 39 17 2 188 Other diseases of heart .. 1 .. .. .. 1 3 .. 6 4 .. 15 Aneurism .. .. .. .. .. 1 2 1 .. .. .. 4 4 2 8 20 15 20 39 43 45 21 2 - 219 Respiratory Organs. Laryngitis .. 7 2 .. .. .. .. .. .. .. .. 9 Croup 3 6 3 .. .. .. .. .. .. .. .. 12 Asthma .. .. .. 1 .. 1 9 9 9 .. .. 9 Bronchitis 64 38 .. 4 2 1 31 49 55 42 6 285 Pneumonia 66 88 8 4 15 15 15 21 16 8 1 257 Pleurisy .. .. .. .. .. 1 3 1 .. 1 .. 6 Other Respiratory Dis .. .. .. .. 1 1 .. .. .. .. .. 2 133 139 13 9 18 19 51 66 74 51 7 - 580 Diseases Digestive System. Dentition 18 12 .. .. .. .. .. .. .. .. .. 30 Quinsy, Sore Throat .. .. .. .. .. .. .. 1 .. .. .. 1 Disease of Stomach 2 .. .. 1 .. .. 2 5 .. .. 1 11 „ Bowels 2 1 .. .. .. .. 1 2 3 2 .. 11 Enteritis 26 5 3 .. 3 2 2 .. 2 1 .. 44 Obstruction of Intestines 4 .. 1 2 .. 1 1 .. 3 1 .. 13 Peritonitis 3 3 4 3 4 8 1 4 1 .. .. 31 Spleen .. .. .. .. .. .. .. .. .. .. .. 0 Jaundice, Liver Dis 2 .. .. .. 2 11 12 14 11 3 1 56 57 21 8 6 9 22 19 26 20 7 2 - 197 27 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 .. .. .. .. 2 .. 3 3 3 4 1 16 Nephritis .. .. 2 3 1 3 5 8 2 1 .. 25 Bright's Disease .. 1 2 .. 6 7 7 13 10 4 .. 50 Other Kidney Diseases .. .. .. .. .. .. 1 .. .. .. .. 1 Bladder and Prostate .. .. .. .. .. .. 1 4 2 2 .. 9 .. 1 4 3 9 10 17 28 17 11 1 - 101 Diseases of Uterus &c Disease of Uterus .. .. .. .. 4 1 .. 1 .. .. .. 6 .. Abortion, Flooding .. .. .. 1 1 1 .. .. .. .. .. 3 Puerperal Convulsion .. .. .. 1 1 .. .. .. .. .. .. 2 Ovarian Dropsy .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 2 6 2 .. 2 .. .. .. - 12 Bones and Joints, &c. Caries, Necrosis .. 2 1 2 2 .. .. .. .. .. .. 7 Arthritis, Ostitis .. .. .. .. .. .. .. 1 2 .. .. 3 Carbuncle, Phlegmon .. .. .. .. .. .. .. .. .. .. .. 0 Other Skin Diseases 1 .. .. .. .. .. .. .. .. .. .. 1 1 2 1 2 2 .. .. 1 2 .. .. - 11 Violence. Accidents & Violence 31 16 15 5 7 8 11 10 7 5 .. 115 Homicide 2 .. .. .. 1 .. .. .. .. .. .. 3 Suicide .. .. .. 3 4 3 3 2 3 .. .. 18 33 16 15 8 12 11 14 12 10 5 .. - 136 Ill-Defined Causes. Dropsy 1 .. 1 .. 1 .. .. .. .. .. .. 3 Debility and Atrophy 144 6 .. .. .. .. .. 1 3 .. 1 156 Mortification .. .. .. .. .. .. 1 1 2 7 1 13 Tumour .. .. .. .. .. .. 2 .. 1 .. .. 3 Abscess 3 .. .. .. .. .. .. .. .. .. .. 3 Hæmorrhage .. .. .. 1 1 1 .. 2 2 3 .. 10 Sudden Deaths (doubtful) 1 1 .. .. 1 .. 1 2 2 1 .. 9 Causes not Specified 1 .. .. .. .. .. .. 2 .. .. .. 3 151 7 1 1 3 1 4 8 10 12 2 - 200 Totals 802 567 176 158 183 220 299 330 344 246 68 3393 28 HOUSING OF THE WORKING CLASSES ACT, 1890. Jerusalem Gardens.—It was my duty in 1894, to make a representation to the Local Authority under Part II. of this Act. respecting a series of back to back houses called Jerusalem Gardens. These were situated on the eastern side of Mare Street, and were approached from there by a narrow passage opposite the Town Hall. For some years these cattages were a source of anxiety and trouble to the Sanitary Authority, frequently falling out of repair and presenting a dilapidated appearance. Back to back cottages have been proved to be a very unhealthy class of building, and with respect to minor ailments, Jerusalem Gardens undoubtedly sustained the bad reputation of its class: but to what extent the inmates suffered from living in this class of house it is almost impossible to state. Firstly, with the exception of a few families, the occupants of these cottages were frequently changing; secondly, the number of occupants were comparatively few; so that any mortality rates calculated from them would be misleading. Below is given a table showing the number of deaths during the last ten years in the cottages, and also the number of infectious cases notified there during the same time. Cases of infectious diseases reported during the 10 years 1885—1894, as occurring in Jerusalem Gardens. Year. Smallpox. Scarlet Fever. Diphtheria. Typhoid. Erysipelas. anous Croup. 1885 4 .. .. .. .. .. 1886 .. .. .. .. .. .. 1887 .. 4 .. .. .. .. 1888 .. .. .. .. .. .. 1889 .. .. .. .. .. .. 1890 .. 4 .. 1 .. .. 1891 .. .. 1 .. .. .. 1892 .. .. 1 .. .. .. 1893 .. .. 1 1 2 .. 1894 .. 1 2 3 1 1 4 9 5 5 3 1 29 Deaths in Jerusalem Gardens during the 10 years 1885—1894 inclusive. 1885—1 Smallpox, 1 Convulsions. 1886—None. 1887—1 Convulsions, Gastric Irritation. 1888—1 Whooping Cough, 1 Endo-Carditis, 1 Poisoning (Oil Jof Almonds), 1 Bronchitis. 1889—2 Broncho-Pneumonia, 1 Diarrhoea, 1 Acute Bronchitis, 1 Phthisis. 1890—1 Chronic Bronchitis and Congestion of Lungs, 1 Scarlet Fever, 1 Whooping Cough. 1891—1 Phthisis. 1892—1 Broncho-Pneumonia, 1 Meningitis, Convulsions. 1893—1 Choleraic Diarrhoea, 1 Bronchitis. 1894—1 Pertussis, 1 Diphtheria, 1 Dentition. On the 1st of August, 1894, I made a general inspection of these premises, with the Chairman of the Sanitary Committee, to whom I pointed out the defective and dilapidated character of the place, and the best method of dealing with such a condition of things. I suggested that this property could best be dealt with under Part II. of the Housing of the Working Classes Act, and that I should make a representation to the Sanitary Authority on their re-assembling after the summer recess. On the 20th of September, after a more detailed inspection of the premises, I presented a representation to the Sanitary Committee, of which the following is a summary. HOUSING OF THE WORKING CLASSES ACT, 1890. Town Hall, Hackney, N.E., September 28th, 1894. To the Hackney Vestry, being the Sanitary Authority for the Parish of Hackney. Gentlemen,—I beg to report to you, in pursuance of sec. 32 of the Housing of the Working Classes Act, 1890, that on the twentieth day of September I inspected the dwelling houses situate at, and known as, 1 to 11 Jerusalem Gardens (North), and 1 to 13 Jerusalem Gardens (South), within your parish. I found such dwelling houses to be in the state hereinafter set forth, which in my opinion is so injurious to health, that the said houses are unfit for human habitation. STATE OF DWELLING HOUSES. 1 to 11 Jerusalem Gardens (North), and 1 to 13 Jerusalem Gardens (South). Cottages built back to back; no through ventilation; walls damp; floor board rotten and laid upon the earth, and no through ventilation under floor; defective drainage (evidence of the presence of rats); eaves gutters defective; no sinks; walls dirty and dilapidated; no water to w.c., and in a foul condition; yard paving defective. 30 Your Committee took this representation into consideration, and resolved that the Clerk to the Vestry should serve notices, in accordance with the Act, upon the owner, to put the premises into habitable condition forthwith; failing which, that immediate steps be taken to obtain orders for closing, and, if necessary, demolishing the premises. The necessary notices were served by registered letter upon the agent to the property on the 21st of September. On the 27th of September summonses were applied for at the North London Police Court; and on the 5th of October the summonses were heard, and orders granted to close the twenty-four cottages as unfit for human habitation. On the 12th of October notices to quit the premises were served upon the tenants. Sufficient time was allowed the tenants to find suitable lodgings, and a few weeks after the cottages were vacated, and the owner began the work of demolition. At this time the site is cleared. PUBLIC HEALTH (LONDON) ACT, 1891. Under the provisions of the above Act nearly three thousand nuisances were abated during the year. Most of these were abated on a preliminary notice only, a statutory notice being required for a less number, and in a small number of instances legal proceedings were instituted as a last means. The number of summonses was 61, of which 14 were withdrawn, the necessary work having been done at the time of hearing. Magistrates' orders were obtained in the remaining 47 cases, with costs against the defendants. Infectious disease was not so prevalent in 1894 as in the previous year, yet 2,088 cases were certified by the Medical Practitioners of the districts. The houses in which these cases occurred were all inspected, and the nuisances found were abated. The number of rooms cleansed, articles disinfected and destroyed, is set out in the tables. Accommodation in accordance with Sec. 60 (4) was provided for the inmates of two houses, while their rooms were being disinfected. The rooms and articles cleansed and disinfected are set out in the tables. 31 Cowsheds.—The number of these is yearly diminishing. In 1894 the Inspectors inspected 68 sheds, and these were visited by the View Committee. In 14 of these sheds cows were not kept. Notices of intention to apply to the London County Council for yearly licence was received from 36 owners only, being a diminution of 10 on the previous year. These inspections revealed a few minor defects, but on the whole showed that the conditions under which cows are now kept in Hackney are fairly good. Smoke Nuisance.—The number of observations made by the Smoke Inspector during the year was 1,879. Intimation notices were served in 29 cases, statutory notices in nine instances, and legal proceedings instituted in one case only. The last failed, with costs against the Vestry, as the notice served by the Inspector was considered by the Magistrate faulty. The general result of the year's work is a diminution of the smoke nuisance, but much more requires to be done, and I believe better results might be obtained if Mr. Daly, the smoke inspector, was retained for this work only. Bake-houses.—During the year I made a personal inspection of the whole of the bake-houses of the district. The total number was 125. The general state of these bake-houses I considered very bad. Out of the 125 I found 42 structurally bad, being partly or wholly underground; in 44 drain inlets were found in the bake-house; soil-pipes were found passing through 8; 15 required more ventilation; and 36 required cleaning. Besides these, a large number of defects were present in connection with the dwelling-house to which the bake-house was attached. Notices to remedy these defects were served upon the owners, and were attended to. With respect to those bakehouses constructed underground, it is found that both lighting and ventilation are imperfect, and must necessarily be so in such ill-constructed work-places. The effect upon the health of the workers employed there is consequently bad. These defects also encourage a want of cleanliness, both of bake-house and person, with corresponding carelessness in the preparation of articles of 32 food. The remedy for these evils is to prohibit the construction of any more underground bake-houses, and to close permanently all those in existence as they cease to be occupied. Factory and Workshops Acts, 1878-1891.—The diminution of infectious disease permitted me to detail one of the Inspectors to inspect workshops during a short period of the year. The total number inspected was 72, and of these only 13 were found to be in a satisfactory condition; that is to say, about 18 per cent. only. Of the remainder 7 were overcrowded, 5 were without sufficient sanitary conveniences; in addition, 185 other nuisances existed on these premises. These figures show that this class of premises requires inspection as much as dwelling-houses. With the present increased staff this end will no doubt be attained. The above nuisances were all abated to the satisfaction of the local authority. CUSTOMS AND INLAND REVENUE ACT (1890). Applications were made to me'during the year 1894, by ten owners, to inspect 90 tenements under the provisions of the above Act, with a view to obtaining certificates that the tenements were in a good sanitary condition and provided sufficient accommodation for their inmates, and so obtaining a remission of the House Duty. On inspection I found 80 of these tenements in good sanitary condition, and certified accordingly; but the remaining eight were in so unsatisfactory a state that I refused to give certificates. INCREASE IN NUMBER OF SANITARY INSPECTORS AND THEIR DISTRICTING. In my annual report for the year 1892, I pointed out the necessity for an increase in the staff of Inspectors, and the need of appointing them to Districts, for all the duties for which Sanitary Inspectors are appointed. In my annual report for 1893 I again urged upon your Vestry the needs of the parish. I am pleased to state during 1894 the Vestry resolved to increase the number of their Inspectors, and to appoint each one to a District. 33 Accordingly on the 10th of October the following report was presented by the Sanitary Committee to your Vestry, and adopted. DISTRICTING OF SANITARY INSPECTORS. Your Committee have had before them your reference on the subject, and also the report of the Medical Officer of Health thereon, stating that the present Sanitary staff is insufficient for the carrying out of the provisions of recent Sanitary legislation, and having taken the matter into their serious consideration they have now to submit their report thereon. In assigning a District to each Inspector, your Committee recommend that one Inspector be appointed to each of the Wards in the parish, as approved by the London County Council, with the exception of Homerton (including Hackney Wick), which will require two Inspectors, as it contains over 6100 houses, and is therefore too large for one Inspector. The following table shows the proposed Districts. No. of Ward. Ward. No. of Rated Householders Minimum No. of Inspectors required 1 . Stamford Hill 4002 1 2 . West 4188 1 3 . Kingsland 3212 1 4 . Hackney 2615 1 5 . Mare Street 3935 1 6 . South 3691 1 7 . Clapton 3685 1 8 . Homerton (North) 3101 1 That is, the District north of Homerton Road and Marsh Hill and to the West of Church Road. Homerton (East) 3000 1 That is, the District East of above. 31429 9 The present staff consists of five permanent and two temporary Sanitary Inspectors, but as the vacancy caused by the resignation of Mr. C. Phillips has not yet been filled up, it will be necessary to appoint three Inspectors to make up the required number to nine, and to constitute each a permanent Inspector. In submitting these recommendations, your Committee beg to point out that the present salaries of the Sanitary Inspectors, including those temporarily engaged, amount to £750 per annum, or an average of £107 per Inspector. The whole of this sum is paid by the Hackney Vestry, but if the number of Inspectors be increased to nine, and the permanent Sanitary Inspectors reappointed under the Public Health (London) Act, 1891, sec. 108, 34 one half the salary of every such Sanitary Inspector will, subject to the approval of the Local Government Board, be paid by the London County Council out of the Exchequer contribution account, in accordance with sec. 24 of the Local Government Act, 1888 (51 and 52 Vic., s. 41), etc., the other half, viz.: £53 10s. per annum per Inspector, being paid by the Hackney Vestry. The total amount therefore to be paid by the Hackney Vestry for the nine Inspectors would then be £481 10s. per annum, showing a saving of £268 10s. Your Committee recommend that the necessary steps be taken for the appointment of three additional Sanitary Inspectors and the re-appointment of the present Inspectors in accordance with the Sanitary Officers' (London) Order, 1891. All of which your Committee respectfully submit. HENRY HULLAND, Chairman. EDWIN REYNOLDS E. WILMOT E. B. BISHOP J. R. BARLEY W. TAYLOR R. R1DGWAY R. FEESEY JOHN SHEEHAN THEOPHILUS NICHOLLS B. A. FORROW J. H. BRANSCOMBE M. WOOLLEY 10th October, 1894. In accordance with the Committee's recommendation, your Vestry, on the 14th of December, 1894, increased the staff of Inspectors to nine, the number required. RIVER LEA. In my report for the year 1893, I called the attention of the Vestry to the generally impure condition of the river Lea, as it passes through Hackney, which receives the effluents from the Leyton and Walthamstow sewage farms. The Walthamstow Local Board seemed to recognize the failure of their farm, by applying early in the year 1894 to the Local Government Board for a loan, for the purpose of extending the farm. An inquiry was held, but the loan was not granted. The effluent remains in the same, if not a worse, polluted state. The necessity for the purification of this river has become more urgent, owing to the action of the London County Council in constructing a bathing pool on the recreation ground of the Hackney 35 marsh, to be fed by the Lea water. The effluent from the abovenamed farm enters the river just above the point where the bathing pool is placed; so that when in use the latter will receive most of the effluent water. It is obvious that water, little removed from sewage, is not fit to be turned into a bathing pool. I am of opinion that it is the duty of the Lea Conservators to prevent this nuisance; but in the failure of this body to do their obvious duty, either the Local Authority, or the London County Council, or both, should press the Conservators to bring an action against the offending Local Boards to compel them either to produce a pure effluent, or to turn it into some other channel. Such proceedings would of course be taken under the following provisions of the Rivers Pollution Acts. Section III. Part 2 of the Rivers Pollution Prevention Act, 1876— III. Every person who causes to fall or flow, or knowingly permits to fall or flow, or to be carried into any stream, any solid or liquid sewage matter, shall (subject as in this Act mentioned) be deemed to have committed an offence against this Act. Where any sewage matter falls or flows or is carried into any stream along a channel used, constructed, or in process of construction, at the date of the passing of this Act for the purpose of conveying such sewage matter, the person causing or knowingly permitting the sewage matter so to fall or flow, or to be carried, shall not be deemed to have committed an offence against this Act if he shows to the satisfaction of the court having cognizance of the case, that he is using the best practicable and available means to render harmless the sewage matter so falling or flowing or carried into the stream. Section IX. Part 4. IX. The Conservancy Board constituted under the Lea Conservancy Act, 18G8, shall, within the area of their jurisdiction, have, to the exclusion of any other authority, the powers for enforcing the provisions of this Act which sanitary authorities have under this Act. The said Conservancy Board may also enforce the provisions of the Lea Conservancy Act, 1868, under the head or division, "Protection of Water," by application to the County Court having jurisdiction in the place in which any offence is committed against those provisions, and such Court may, by summary order, require any person to abstain from the commission of any such offence, and the provisions of this Act with respect to summary orders of county courts and appeal therefrom shall apply accordingly. 36 Section XX. (3) Definition. "Person" includes any body of persons, whether corporate or unincorporate. In considering the means of abating this nuisance, the suggestion contained in the report of Major Flower, Sanitary Engineer to the Lea Conservancy Board, dated November 3rd, 1893, is worth consideration. I quote it again— I repeat there will be occasional pollution from these large districts until there be a main intercepting sewer constructed to take away their sewage; and inasmuch as the London County Council has taken over the Hackney Marshes, I recommend this matter to their serious consideration. Tottenham might also be connected therewith, and the sewage thereof carried away by gravitation, and pumping be saved. The construction of such an intercepting sewer would effectually remove this danger to the bathing pool, and materially improve the quality of the Lea water. EAST LONDON WATER COMPANY AND CONSTANT SUPPLY. During the summer of 1894, complaints were received from the tenants of houses in Hackney, supplied with water by the East Loudon Company, that the supply was cut off at night, and only restored for a few hours during the day. This irregularity of the supply continued for some months, much correspondence taking place betweeu the Hackney Sanitary Authority and the Company; but all to no purpose, as the action of the Company was fully protected by their Water Acts. The following report, presented by the Sanitary Committee to the Vestry, gives a summary of the correspondence and results:— Shutting off Constant Watee Supply. Report of Sanitary Committee, on reference from the Vestry on letters from Local Government Board and East London Water Works Company, on the subject of shutting down the Company's mains at night, as follows: In consequence of complaints relative to the action of the East London Water Works Company in shutting off the Constant Water Supply at night, your Committee communicated with the Company, the Local Government 37 Board, and London County Council on the subject, calling attention to the serious results which would be likely to arise in consequence thereof. A reply was received from the Water Company, "and a report made to the Vestry on the subject on the 26th ult. In reply to a question under what authority they acted in shutting off the constant supply, the Company wrote, stating that the temporary cessation of the constant service is fully provided for under the Metropolis Water Act, 1871 (Sec. 15). Following upon this, the Local Government Board wrote, dated the 5th inst., stating that they had been in communication with the East London Water Works Company on the subject, which was receiving their attention. On the 10th inst., the Water Company forwarded copy of a report made by their Engineer dated 2nd inst., upon the causes necessitating the shutting off water at night in portions of the Company's District, to the effect that it is due to the drought last year having depleted to a very considerable extent, the springs ; and also that there is a great waste of water as even with the intermittent service, the Company is giving 249 gallons per tenement daily, an amount fully equal to the average of all the Metropolitan Companies. The report concludes by saying that this shows an ample supply has been, and is being distributed, and that if the tenants of property would turn off their taps when they had drawn off what they require, the full and constant service would be immediately reverted to. On the 9th inst. your Committee communicated with the Water Company, asking whether in the circumstances the Directors would reduce the number of hours the water is shut off, say from 10 p.m. to 4 a.m., instead of between the hours of 8 p.m. and 8 a.m., as at present, and that they would seriously consider the question of reverting to the constant service at the earliest possible opportunity. On the 10th inst. a reply was received stating that the request would be duly considered, at the same time adverting to the report of the Company's Engineer, and emphasizing the statement, that the present supply of water is more than ample for all reasonable domestic requirements, and that with the slightest care on the consumers' part the constant service could be reverted to at once, and further pointing out that if storage cisterns were fitted to the houses no real inconvenience would arise from the shutting down of the water for certain hours out of the twenty-four, which has now become an absolute necessity. Another communication was received from the Secretary to the Water Company, on the 15th inst. stating that after consulting with the Company's Chief Engineer, instructions had been given to delay shutting down the mains until from 10 p.m. to 4 a.m., as your Committee requested. The letter further stated that the Directors were seriously considering the whole question, and that they will order the resumption of the constant service at the earliest possible moment; at the same time asking the Local Authorities to aid them in every way in checking the waste of water, as they are pumping into the district at the present time twice the quantity of water that can by any possible means be fairly used. Your Committee do not think anything more can be done in the matter at present. Instructions have been given to the Sanitary Inspectors to 38 assist the Water Company as far as possible by warning the tenants of houses visited to see that the water is not wasted. All of which your Committee respectfully submit. HENRY HULLAND, Chairman 24th October, 1894. T. R. PITT EDWIN REYNOLDS E. WILMOT M. WOOLLEY E. B. BISHOP 3. H. BRANSCOMBE J. R. BARLEY JOHN SHEEHAN The following is the Section quoted and relied upon by the Water Company in defence of their action:— Sec. 15, Metropolis Water Act, 1871. "Notwithstanding anything in this Act, a company shall not be subject to any liability for not giving a constant supply, if the want of such supply arises from frost, unusual drought, or other unavoidable cause or accident." This failure of the Company to give a constant supply during a part of the year, when it is most essential, opens up the serious question whether the present is a proper and sufficient supply for such a district as Hackney. I think it will be agreed that a proper and sufficient supply is at least one which will be able to meet a drought of two years without restricting the supply to the consumer. This, the East London Water Company has failed to do. Moreover, the satisfactory working of our present system of drainage and sewerage is dependent upon an adequate and unstinted supply of water. NEW RIVER WATER COMPANY. CONSTANT SERVICE. In a report presented to the Vestry in 1892, I called the attention of the Board of Works to the fact that certain parts of Stoke Newington and West Hackney were supplied with water on an intermittent service by the above Company, and pointed out that owing to the position of many house cisterns, etc., the intermittent service was a dangerous one to the inhabitants of those districts. Representations were made at the time to the London County Council to apply to the New River Company for a constant service, but as yet the service has not been changed. Very recently, on a 39 further application, the information has been furnished that the supply will be changed within a short period. This is a very much-needed change, and I hope that before many months have passed the belief expressed by the London County Council will be an accomplished fact. DUSTING ACCOUNT. This account must be divided into two parts, first from the beginning of the year until March 25th, while Stoke Newington was still united with Hackney; and then from that date until the end o the year with Hackney alone. From January 1st to March 25th, 1894, there were 12,123 loads (each 54 cubic feet) of house refuse removed by the contractors from the District of Hackney, including Stoke Newington, at an average cost of 3s. 9½d. per load, and a total cost of £2,294 14s. 5d. The District at this time included Stoke Newington, but by the Plumstead and Hackney Act, from March 25th Stoke Newington became a separate parish. At the same time Hackney was divided into two Districts, Nortn and South, for the purpose of the removal of house refuse. Fresh contracts were also entered into by the Vestry, at the following prices :— s. d. North Division 3 9 per load South Division 5 3 per load. From March 26th to December 31st, 1894, 12,610 loads at 3s. 9d. per load were removed from the North Division, at a total cost of £2,206 15s. During the same period 16,985 loads were removed from the South Division at 5s. 3d. per load, and a total cost of £4,458 l1s. 3d. The average price per load for the two Divisions was 4s. 6d. per load, and the total cost for the nine months for the Parish of Hackney alone £6,665 6s. 3d. To this must be added £1,450 1s., the amount paid to the Vestry dustmen as wages. Thus for the year 1894 the price per load has increased 8½d. on the price for 1893. Every year the expense increases in a much greater ratio than the increase in population, and it behoves 40 the Vestry to make an effort to undertake the entire removal and destruction of the house refuse of the Parish. I say destruction, because it is impossible to find shoots to deposit this harmful material in the Parish of Hackney, and it is clearly inconsistent, if not morally wrong, for a Sanitary Authority constituted to do everything possible to remove and prevent the spread of disease, to deliberately send offensive refuse into a neighbouring District, where it may eventually do much harm. The remedy is clearly to destroy the material by fire, in the Parish where it is produced. During the year the Sanitary Committee resolved to put in operation the following bye-laws of the London County Council relating to the collection of house refuse. The first was adopted early in 1894, and the latter towards the end of the year. Bye-laws of London County Council. 5. Every person who shall convey any house, trade or street refuse across or along any footway, pavement or carriageway shall use a suitable receptacle, cart, carriage or other means of conveyance properly constructed so as to prevent the escape of the contents thereof, and in the case of offensive refuse so covered as to prevent any nuisance therefrom, and shall adopt such other precautions as may be necessary to prevent any such refuse from being slopped or spilled or from falling in the process of removal upon such footway, pavement or carriageway. If in the process of such removal any such refuse be slopped or spilled or fall upon such footway, pavement or carriageway, such person shall forthwith remove such refuse from the place whereon the same may have been slopped or spilled or may have fallen, and shall immediately thereafter thoroughly sweep or otherwise cleanse such place. 7. The Sanitary Authority shall cause to be removed not less frequently than once in every week the house refuse produced on all premises within their district. Sanitary Labour.—A total of £694 11s. 5d. was expended during the year on this work. This includes the fumigation of rooms, the stripping and cleansing of walls of rooms, and the disinfection of bedding, clothes and other articles, after exposure to infectious disease. 41 DUSTING ACCOUNT. January to December, 1894. MONTH. "A" Division. "B" Division. "C" Division. Totals. Loads. Cost. Loads. Cost. Loads. Cost. Loads. Cost. £ s. d. £ s. d. £ s. d. £ s. d. January 1,562 257 1 7 1,323 281 2 9 1,274 238 17 6 4,159 777 1 10 February 1,534 265 5 1 1,386 294 10 6 1,428 267 15 0 4,348 827 10 7 March 1,248 215 16 0 1,212 257 11 0 1,156 216 15 0 3,616 690 2 0 April north. south. totals. NEW CONTRACT FROM 25th MARCH, 1894. 1,692 292 12 0 2,124 557 11 0 3,796 850 3 0 May 1,410 246 15 0 1,972 517 13 0 3,382 764 8 0 June 1,422 248 17 0 1,840 483 0 0 3,262 731 17 0 July 1,328 232 8 0 1,916 502 19 0 3,244 735 7 0 August 1,244 217 14 0 1,667 437 11 9 2,911 655 5 9 September 1,214 212 9 0 1,676 439 19 0 2,890 652 8 0 October 1,296 226 16 0 1,750 459 7 6 3,046 686 3 6 November 1,398 244 13 0 1,844 484 1 0 3,243 728 14 0 December 1,626 284 11 0 2,196 576 9 0 3,822 861 0 0 12,630 2,206 15 0 16,985 4,458 11 3 29,596 666,5 6 3 4,344 738 2 8 16,561 3,039 19 3 20,843 5,181 18 9 41,719 8,960 0 8 Dustmen's Wages £1,450 1 0 Sanitary Labour 694 11 5 £2,144 12s. 5d. 42 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 1894:— Number of bodies deposited in Mortuary 277 (a). To await inquests 277 (b). Upon request of relatives, to await burial 0 Number of Post-mortems performed 102 INQUESTS. Verdicts. Sex. Male. Female. ] Natural causes 91 68 Accidental Death 40 32 Suicide 15 1 Murder 1 0 Open Verdict 24 5 Totals 171 106 Table showing Suicidal and Accidental Deaths in the Hackney District during the Year ended 1894. SUICIDES. ACCIDENTAL DEATHS. nature of suicide. No. nature of accidental death No. Poisoning 3 Suffocated in bed 22 Cut Throat 4 Fall 7 Shooting 5 Hœorrhage from cut lip 1 Drowning 1 Shock from burns 16 Injury to Brain 1 Gunshot wound 1 Fracture of Skull 1 Drowning 8 Hanging 1 Run over 7 Shock from scalds 6 Overdose of Chloroform 1 Fracture of Skull 1 „ Thigh 1 Injury to Spine 1 1 Total 16 Total 72 43 Table of Adulterated Articles, showing amount of Adulteration ana result of legal proceedings, 1894. No. of Sample. Article. Adulteration. Result of Legal Proceedings. Remarks. 2750 Milk 12% added water . Fined £3 & 12/6 costs 2769 Milk 43% cream abstractec „ 10/- „ 12/6 „ 2773 Margarine Exposed for sale un labelled and in plain wrapper „ 11- „ 12/6 „ 1/- paid to Crown 2783 Milk 8% added water „ 101 „ 12/6 „ 2786 Butter 65% added foreign fat „ 40/- „ 12 6 „ 2791 Butter 65% ,, „ „ 40/-,,12/6 „ 2792 Margarine Exposed for sale unlabelled and in plain wrapper „ 40/- „ 12/6 „ 40/- paid to Crown 2797 Milk 18% added water „ 5/- „ 12/6 „ 2802 Cocoa 30% added starch „ £3 „ 12/6 ,, 2 Milk 6% added water „ 1/- ,,12/6 „ 8 Coffee 40% added chicory „ 40/- „ 12/6 „ 21 Milk 5% added water „ 10/- „ 12/6 „ 26 Milk 25% deficient of fat „ 2/6 „ 12/6 „ 31 Coffee 60% added chicory ,, 30/- „ 12/6 ,, 34 Cocoa 45% added foreign starch „ 2/- „ 12/6 „ 40 Milk 5% added water „ 10/- ,,12/6 „ 42 Coffee 45% added chicory „ 30/- 44 Cocoa 35% added foreign starch „ 10/- 51 Milk 20% fat abstracted „ 30/- 54 Milk 15% „ „ 5/- 57 Milk 6% added water „ £6 15% fat abstracted 60 Margarine Exposed for sale unlabelled and in plain wrapper „ 20/- ,, 12/6 „ 20/- paid to Crown 44 No. of Sample. Article. Adulteration. Result of Legal Proceedings. Remarks. 63 Margarine Exposed for sale unlabelled and in plain wrapper 12/6 costs 86 Margarine Not labelled Fined 5/- & 2/- „ 5/- paid to 92 Milk 9% added water „ 10/- „ 12/6 „ Crown 93 Milk 8% „ „ 10/-,,12/6 „ 101 Milk 10% „ „ 1/- „ 12/6 „ 109 Milk 15% „ „ 30/- „ 12/6 „ 127 Milk 7% „ 12/6 „ 123 Milk 6% „ 12/6 „ 115 Margarine Unlabelled „ 5/- „ 12/6 „ 5/- paid to Crown 112 Margarine „ „ 5/- „ 12/6 „ 5/- paid to Crown 148 Margarine „ „ 20/-,,12/6 „ 20/- paid to Crown 149 Margarine Unlabelled and in plain wrapper „ 40/- ,,14/6 „ 40/- paid to Crown Table of samples of Food and Drugs, with member found adulterated during the year 1894. Samples. No. Purchased. No. Adulterated. Milk 107 17 Butter 16 2 Coffee 15 2 Margarine 11 10 Cocoa 13 3 Bread 2 Pepper 9 Mustard 7 Ginger 1 Gin 3 Whisky 6 Lard 2 Rum 3 Yeast 1 Olive Oil 1 Paregoric 1 Spirit of Nitre 1 Brandy 1 200 34 45 ROYAL METEOROLOGICAL SOCIETY. Abstract of Climatological Observations, Old Street, E.C. 1894. Temperature. Relative Humidity. Amount of Cloud. Rain. Means. Extremes. Amnt. No. of Days. 9 a.m. Min. Max. Range. Mean. Min. Max. ° ° ° ° ° ° ° % in. January 38.9 34.3 43.8 9.5 39.1 14.0 52.2 86 8.4 3.05 25 February 41.8 37.3 47.9 10.6 42.6 27.0 55.7 82 7.1 1.62 17 March 44.3 39.4 53.6 14.2 46.5 34.0 63.5 82 6.8 1.15 10 April 51.4 46.3 59.9 13.6 53.1 40.3 72.6 79 7.8 1.63 15 May 52.4 44.3 58.7 14.4 51.5 34.6 69.4 70 7.4 1.41 16 June 60.1 52.5 67.0 14.5 59.7 46.0 82.6 71 6.9 1.84 14 July 63.5 56.6 70.4 13.8 63.5 52.1 83.1 75 7.7 3.08 19 August 60.6 55.1 67.4 12.3 61.3 47.5 79.0 78 8.1 3.07 17 September 54.9 50.2 61.5 11.3 55.8 40.8 70.4 84 8.2 1.13 12 October 50.7 47.0 56.1 9.1 51.6 36.0 61.2 86 8.7 4.58 20 November 47.6 43.8 52.1 8.3 47.9 35.4 63.6 87 7.9 2.81 17 December 41.8 38.2 47.1 8.9 42.7 28.2 52.4 89 8.0 2.15 13 Year 50.7 45.4 57.1 11.7 51.3 14.0 83.1 81 7.8 27.52 195 January.—The weather was wet and cold until the 9th. From then until the end of the month it was warm, the temperature being above the average. The atmospheric pressure was above the average, the first half of the month the mean daily excess being 0.08 inches. From January 16th to the end of the month it was generally below its average, the mean daily deficiency being 0.16 inches. Rain fell on twenty-five days, the total amount being 3.05 inches. N.B.—I am indebted to the Secretary of the Royal Meteorological Society for the above abstract. 46 February.—The temperature was above the average until the 12th, below until the 24th, and above again until the end of the month. The atmospheric pressure was above the average until the 8th of the month, the mean daily excess being 0.26 inches below the average from the 9th to 12th, above from 13th to 22nd, and below again from 23rd to the end of the month. Rain fell on seventeen days of the month, the amount reaching to 1.62 inches. March.—The weather continued warm all this month, the temperature being above the average, the mean daily excess being 2°.4. The atmospheric pressure was above the average until the 5th, the mean daily excess being 0.10 inches; from the 6th until the 16th it was below its average, the mean daily deficiency being 0.46 inches ; and from March 17th to the end of the month the pressure was above its average, the mean daily excess being 0.24 inches. The rainfall amounted to 1.15 inches, this quantity falling on ten days. April.—The temperature of the air was above its average till April 18th, below from 19th to 22nd, and above again until 30th of the month. The atmospheric pressure was generally above its average until the 18th, and below its average the rest of the month. Rain fell on fifteen days during this month to the extent of 1.63 inches. May.—The weather was cold at the beginning of the month, warmer from the 14th to the 18th, the mean daily excess of temperature being 3°.8; the remainder of the month it was cold. The barometer pressure oscillated a great deal during this month, the variations ranging from 0.15 inches below to 0.14 inches above its average. Rain fell on sixteen days, the total quantity measuring 1.41 inches. June.—Until the 20th of the month the weather was cold, and the temperature below the average.; but from the 21st until the 30th the weather was much warmer, the temperature generally exceeding the average. The pressure was generally below its average up till the 12th of June, the mean daily deficiency being 0.17 inches, and for the remainder of the month it exceeded its average, the mean daily excess being 0.16 inches. Although rain fell only on fourteen days, the amount reached 1.84 inches. 47 July.—The weather was warm up till the 7th, cooler from the 8th to the 24th, and warm again to the 31st of the month. The atmospheric pressure was above the average until the 8th of the month, below from this date till the 23rd, and above the average to the 31st. As much as 3.08 inches of rain fell this month, the number of rainy days being nineteen. August.—The weather in this month was cold, dull and unsettled. The daily temperature was below its average from the 1st to the end of the month. The atmospheric pressure was generally below its average from the 1st of August to the 26th August, the mean daily deficiency being 0 07 inches. From the 27th to the end of the month it was above the average, the mean daily excess being 0.12 inches. The rainfall for this month was 3.47 inches, seventeen days being wet. September.—The weather this month was cold and dull, the mean daily temperature being below its average until the 18th, above its average from the 19th to the 25th, and below again until the end of the month. The atmospheric pressure was below its average from the 2nd to the 8th of the month, the daily deficiency being 0.05 inches. From the 9th to the 21st it was above, the mean excess being 0.21 inches, below again from 22nd to 26th, and above the average to the end of the month, the mean daily excess being 0.43 inches. Eain to the quantity of 1.13 inches fell during the month, the wet days being twelve. October.—The weather of this month was dull and cold with frequent rains, and the mean daily temperature of the air was frequently below the average until the 24th, when it became warmer, and continued so until the end of the month. The barometer pressure was above its average until the 17th of the month, the mean daily excess being 0.29 inches. From the 17th to the end of the month the pressure was below its average, the mean deficiency being 0.28 inches. Eain fell to the amount of 4.58 inches during this month. 48 November.—This month was dull and unsettled, with frequent rainfalls, and little sunshine. Up till the 20th of the month, the temperature was above the average, but below for the remainder of the month. The atmospheric pressure was generally below its average during the first half of the month; above its average for the remainder of the month. Rain fell on seventeen days, the total quantity equalling 2.81 inches. December.—This month was dull and mild, with frequent rains. At the beginning of the month the temperature was below the average, but from the 7th to the end of the month it was above the average. The pressure was generally above its average during the month, except from the 29th to 31st, when it was below. Rain fell on thirteen days, amounting in all to 2.15 inches 49 Record of Prosecutions under the Public Health (London) Act, 1891, during the year 1894. Address. Complaint. Magistrate's Decision. 41, Downham road, Kingsland Staircase unventilated Withdrawn, work done 5, West street, London Fields Non-compliance with Statutory notice Withdrawn, work done 7, Felstead street „ „ „ Withdrawn, costs paid 5, „ „ „ „ „ Withdrawn, costs paid 138, Millfields road „ „ „ Withdrawn, work done 7, 8, 9, 10,11 and 12, Montague terrace Choked and defective drains Withdrawn, work done 90, Dalston lane An occupied house without a proper water supply, and unfit for habitation Withdrawn, work done, house empty 1 to 7, Foulden mews Non-compliance with magistrate's order Fined 16/- each owner, and do the necessary work 3 to 17, Bentley road Defective drains outlet Order to do work within 14 days, and pay 18/- costs 19, Felstead street Insanitary condition of premises Closing order, and pay £2 2/- costs 218, Morning lane Defective drains, &c. Order to do work within 14 days, and pay £1 7/- costs 2, Woolpack place Premises dirty and dilapidated Closing order, and pay 10/costs 27, Benn street Defective drains, premises dirty and dilapidated Withdrawn, paid costs 3/- 89, Powerscroft road Defective drains outlet Order to do work within 14 days, and pay 10/6 costs 4, Montague road Insanitary condition Order, 14 days, and pay 8/costs 154, Stamford hill Insanitary condition Order, 28 days, and pay 8/costs 38 to 44, Cadogan terrace Drains defective, no dust bin, apparatus to closet defective Order to do work within 14 days, and pay £3 10/costs 1 to 11, Jerusalem Gardens Unfit for human habitation Order to close all the premises in 14 days, and pay £7 4/- costs 1 to 13, Jerusalem Gardens „ „ „ Albion Hall, Dalston Defective drains Order to do work within 14 days, and pay 6/- costs 23, McLaren street Uncovered dust carts Fined 5/-, and 2/- costs in each case 14, Morning lane „ „ „ 136, Lea Bridge road „ „ „ 14, Rose Cottage, Walthamstow „ „ „ Dung Wharf, Marsh hill Deposit of manure Fined 20/-, and 22/- costs 6, Springfield Defective drains Order to do work within 1 month, and pay 4/- costs ! 36, Horton road „ „ Order to do work within 14 days, and pay 4/- costs 50 Address. Complaint. Magistrates' Decision. 64, New Windsor road Defective drains Order to do work within 7 days, and pay 6/- costs 29, Crozier terrace „ „ Work done, and paid 20/- costs 86, Ballance road House dirty, roof defective Withdrawn 8, McLaren street Uncovered dust cart Fined 10/-, and 2/- costs each School Nook, Lea bridge „ „ „ Clapton pond Stagnant water, &c. Order to do work within 21 days, and pay 3/- costs 31, Crozier terrace House dirty Order to do work within 14 days, and pay 6/- costs 20, „ „ „ „ Order to do work within 14 days, and pay 6/- costs Articles destroyed after Infectious Disease, by request. Beds 21 Mattresses 7 Palliasses 7 Bolsters 2 Pillows 4 Carpets, etc. 3 Other Articles 11 Also few Articles of Clothing. 51 REGISTER OF SANITARY WORK FOB THE YEAR 1894. Number of complaints received 2,222 Inspections— Made on complaint 3,000 House to house 345 Houses, after Infectious Diseases 1,986 Total premises re-inspected 9,060 Fishmongers' and Poulterers' yards 4 Cow houses (premises) 48 „ (sheds) 68 Bakehouses 122 Greengrocers' yards 71 Urinals 26 Canal Boats 41 Animals improperly kept 20 *Letters, etc., sent out 7,362 Statutory Notices served 162 Copies of Summonses and Orders made out 497 Bodies received into the Mortuary 277 Houses from which bedding, etc., was removed to be disinfected by the Board's apparatus 846 Articles disinfected by the Board's apparatus— Beds 779 Mattresses 231 Palliasses 13 Bolsters 505 Pillows 1,481 Blankets 1,144 Sheets 67 Counterpanes 2 Carpets, Rugs, etc 3.11 Quilts 254 Other Articles 575 * This includes Committee Notices, Notices and Disinfection Certificates to Schools, and Notices to Owners. 52 Rooms fumigated 1,739 Houses cleansed after Infectious Diseases 536 Disinfectants supplied to the poor (bottles) 1,247 (bags) 6,648 Inquests held 277 Post Mortems held 7 Intimation Notices served 3,596 Peremptory or Final Notices served 729 Infectious Patients removed to Hospital 730 Cautionary Notices to Schools re Infectious Sickness 1,828 Certificates of Disinfection issued 1,492 Nuisances abated (miscellaneous) 2,921 Accumulations of Dust specially removed 936 Condemned as unfit for human food—Fish 17 cwt. ,, ,, ,, Fruit 3 tons ,, ,, ,, Other articles 5 cwt. I remain, Gentlemen, Yours obediently, J. KING WARRY, M.D., D.P.H., Medical Officer of Health for Hackney. LIST OF LICENSED COW-SHEDS in the Hackney District, October, 1894. Name. Address. No. of Sheds. Jones, L. J. 3, Ardleigh Road, De Beauvoir Town 1 Webb, S. H 76a, Broadway, London Fields 2 Stevens, W. E. Bridge Street, Homerton l Jones, J. 46, Brooksby's Walk, Homerton l Jenkins, J. 2, Buckingham Road, Kingsland 2 Thomas, M. 72, Church Road, Homerton l Lloyd, E. 84, Clifden Road, Clapton Park 2 Jenkins 67, Downham Road, Kingsland l James, Mrs. 11, Downham Road, Kingsland l Davies, Daniel 3, Elsdale Street, Hackney l Coxall, T Fenn Street, Homerton l 53 Name. Address. No. of Sheds. Motts, E. 6, Florefield Road, Hackney 1 Larter, George William, trading as J. T. Larter 1, Gloucester Road, South Hackney 2 Chapman 86, Green Lanes, Stoke Newington 1 Snewin, W. H. 3, Hill Street, Upper Clapton 1 Rumball, T. E. High Road, Upper Clapton 4 Bates, T. 46a, Leswin Street, Hackney 1 Cashford, W. G. Jerusalem Square, Mare Street, Hackney 4 Reynolds, Edwin Landfield Street, Hackney 1 Wingrove, J. T. 4, London Lane, Hackney 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 Lewis, J. 6, Palace Road, Hackney 1 Harper, Sophia 257, Queen's Road, Dalston 1 Camp, Thomas 79, Shackle well Lane, Hackney 1 Tasker, J. Sigdon Road, Hackney 1 Clifton, F. 33, Southgate Road 1 Welford, R. W Spring Hill, Clapton 2 Stapleton, A. Stoke Newington Common 5 Briggs, J. 180, Victoria Park Road 1 Johnson, John 3, Warburton Road, Hackney 1 Brace, E. A. 133, Well Street 1 Jackson. M. D. 167, Well Street 1 Jones, John 271, Wick Road 2 Roper, R. 37, Wilton Road 1 Total Cow Sheds 53 54 LIST OF LICENSED SLAUGHTER-HOUSES in the Hackney District, October, 1894. Name. Address. Friday, E. 235, Amhurst Road Raymond, J. 186, Cassland Road Teat, J. 37, Church Road Sharman, J. 90, Frampton Park Road Row, R. H 5, High Street, Homerton Wragg, Emma 57, Holly Street Stone, E. 49, High Street, Kingsland Gooch, H. 71, High Street, Kingsland Johnstone, E. 323, Kingsland Road Scott, G. 418, Kingsland Road Woollven, W. H High Road, Upper Clapton Stone, John 78, Stamford Hill Friday, Richard Dalston Lane Moore, C. W. 531, Kingsland Road Fish, T. Lee Bridge Corner, Clapton Witherden, C. A. Lower Road, Clapton Tyler, A 80, Mare Street Maples, Richard 142, Mare Street Beaver, W. P. 177, Mare Street Palmer, A. J. 266, Mare Street Shaw, J. 296, Mare Street Capon, J. 32, Morning Lane Martin, A. 55, Nevill Road Golding, Geo. 200, Queen's Road, Dalston Hide, M. S 211, Queen's Road, Dalston Stephenson, Jonathan 103, Rendlesham Road Nokes, G 53, Southgate Road 55 Name. Address. Ebbells, E. 94, Southgate Road Row, R. 130, High Street, Stoke Newington May, A. A. 220, Stoke Newington Road Stoneman, P. 3, Terrace Road Clark, Charles Upper Clapton Tyler, W. 92, Well Street Hill, George F. 169, Well Street Butcher, F. 216, Well Street Friday, R. 51, Wilton Road Wildsmith 258, Wick Road Browning, John. West Side, London Fields N.B.— Cow-sheds and Slaughter-houses are under the inspection of the London County Council, and are licensed by them subject to no objection being made by the Local Authority as regards the sanitary condition of the premises. Report of Medical Officer of Health received, and ordered to be printed and circulated in the usual manner. C. BUTTON, 12th June, 1895. Chairman of the Vestry.